Nigerian Journal of Clinical Practice

The effects of resected gastric volume on postoperative weight loss and waist‑to‑hip ratio after Sleeve Gastrectomy; A prospective study

I Ertuğrul, YE Altuntaş, C Kayaalp, A Başkent, S Ertuğrul, HF Küçük — Wed, 30 Apr 2025 00:00:00 +0000

Background: This prospective study was carried out to evaluate the effects of resected gastric volume (RGV) on postoperative weight loss and waist-to-hip ratio (WHR) in patients with morbid obesity after laparoscopic Sleeve Gastrectomy (LSG). Material and Method: LSG procedure was performed for a total of 107 patients. Gastric specimen measurements were taken for all patients. Patients’ body mass index (BMI), WHR, and percentage of excessive weight loss were recorded and evaluated postoperatively at the 1st, 6th, and 12th months. Patients were divided into three groups based on RGV: Group 1 with RGV lower than 800 ml, Group 2 with RGV between 800 and 1100 cc, and Group 3 with RGV higher than 1100 cc. These three groups were comparatively evaluated. Results: No statistically significant difference was found between RGV and weight loss or reduction in WHR. There were statistically significant differences in the distribution of ASA scores between patient groups (P<0.05). The maximum inflated volume of the great curvature of the stomach and calibration tube mean values were significantly higher in Group 3 (P<0.05). The operation time was significantly lower in Group 3 (P<0.05). There was no significant difference between the groups in any of the other demographic and clinical values (P>0.05). Conclusion: No statistically significant difference was found between groups in the present study in terms of weight loss, WHR, and RGV. It is thought that the remaining stomach volume might be more important than the resected stomach volume since weight loss is likely attributed to the reduction in gastric volume.

Comparative study of preprocedure and real‑time ultrasound‑guided combined spinal epidural anesthesia in obese patients

R Anand, GK Ram, A Kumar, M Kumar, A Aman, B Naskar — Wed, 30 Apr 2025 00:00:00 +0000

Background: It is a great challenge to perform regional anesthesia in obese patients. In general, combined spinal epidural (CSE) anesthesia is performed blindly using the surface landmark of the midline approach. Obesity masks the surface landmark and makes the procedure difficult. Aim: This study aimed to compare the efficacy and ease of the real‑time ultrasound (USG)‑guided CSE (RUC) and preprocedure USG-guided CSE (PUC) approach in obese patients. Settings and Design: This prospective randomized intervention study was conducted at a tertiary care center. Methods: Eighty patients with the American Society of Anaesthesiologists Grade II and III and a body mass index >30 kg.m⁻ ² were included in the study, and randomly, they were assigned into two groups: PUC and RUC groups. The main focus of the study was on the initial effort to position an epidural catheter and administer a subarachnoid block effectively. The secondary outcomes included the number of attempts, the number of passes made, the time needed to identify the epidural space (measured in seconds), and the time it took to place the epidural catheter (measured in seconds) successfully. Results: Out of 80 patients, 77 patients were randomly allocated between two groups for the final analysis. The PUC group received 39, and the RUC group received 38 patients. The median number of attempts was 4 [interquartile range (IQR) 2–4] and 2 (IQR 1–2), respectively, in the PUC and RUC groups (P < 0.001). Compared to the PUC group, the RUC group showed a statistically significant reduction in the median number of passes, the time taken for space identification, and the time required for successful epidural catheter placement. Conclusions: In the comparison between the PUC and RUC groups, the PUC group demonstrated significantly longer durations for space identification, required more attempts, had a greater number of passes, and exhibited a prolonged time for successful epidural catheter placement.

Cardiovascular changes due to antipsychotic agents among first episode patients with schizophrenia

TO Iyidobi, TC Iyidobi, AC Ndukuba, KU Amadi, PC Odinka, RC Muomah, S Ghasi — Wed, 30 Apr 2025 00:00:00 +0000

Background: Antipsychotic medications increase cardiovascular diseases beyond schizophrenia. This effect is worsened by the kind of antipsychotics used. Aim: To determine the cardiovascular changes due to antipsychotics in schizophrenic patients in tertiary hospitals in Enugu State, Nigeria. Materials and Methods: This was a prospective analytical study of 64 schizophrenic in-patients screened using Mini International Neuropsychiatric Interview (MINI). Data were collected with a designed questionnaire and proforma of cardiovascular indices assessed at baseline, 1 and 3 months visits. (test of significance was set at 0.05). Results: The mean age of participants was 32.41 ± 7.33 years. Three-quarter, 78.1% of the participants were on atypical antipsychotics. There are significant increase in mean differences of Blood Pressure and Electrocardiogram changes from baseline to 3 months following initiation of antipsychotics; SBP (117.96 ± 8.00 to 129.31 ± 13.54, F = 34.03, P < 0.001), QRS duration (105.14 ± 34.40 to 111.87 ± 37.24, F = 21.7. P < 0.001) and PR interval (155.84 ± 24.27 to 165.85 ± 27.71, F = 74.25, P < 0.001). The differences in type of antipsychotics (typical > atypical) had a greater significant effect on the mean SBP (T – test = 2.27, P = 0.02) and mean P-wave axis (T – test = 2.60, P = 0.01). Conclusion: Antipsychotics increased cardiovascular indices post baseline. The typical antipsychotics significantly increased the SBP and P-wave axis of ECG compared to the atypical antipsychotics. Atypical antipsychotics and regular cardiovascular indices monitoring is advocated.

The importance of monocyte‑to‑high density lipoprotein‑cholesterol ratio in predicting severity of coronary artery disease in acute coronary syndrome

C Kaynak, E Ozmen, M Aslan — Wed, 30 Apr 2025 00:00:00 +0000

Background: Evaluating the association between coronary artery disease (CAD) severity and new inflammatory markers in acute coronary syndrome (ACS) is critical for managing the therapy procedure as well. Aim: The primary goal of this study was to investigate the association between the monocyte-to-high density lipoprotein‑cholesterol ratio (MHR), a novel inflammation marker, and the severity of CAD in patients with ACS. Methods: The study was performed on ACS patients who were hospitalized for coronary angiography (CAG) in the coronary intensive care unit and was conducted with a retrospective design. The study comprised 344 patients (mean age 60.49 ± 12.23 years) with ACS who had CAG and laboratory testing. There were 212 patients with mild CAD according to the Synergy between percutaneous coronary intervention (PCI) with Taxus and Cardiac Surgery (SYNTAX) score (SYNTAX score ≤22) and 132 patients with severe CAD (SYNTAX score >22). The association between SYNTAX score, MHR, uric acid, the neutrophil-to-lymphocyte ratio (NLR), and other markers were assessed. All analyses were performed using SPSS 26.0. Results: A modestly linear association was observed between MHR and SYNTAX score (r = 0.522, P < 0.001). Multivariate logistic regression analysis found male gender, high uric acid, high MHR, and NLR as possible individual predictors of SYNTAX score >22 in ACS. The receiver operating characteristic (ROC) analysis revealed that MHR 15.64 (AUC = 0.794; P < 0.001) could predict SYNTAX score >22 with higher sensitivity (81.8%) and specificity (78.3%). Conclusions: The higher MHR independently predicts the severity of CAD in ACS. It may be a better parameter than the higher NLR and uric acid levels to predict CAD severity in ACS patients.

Evaluation of anthropometric measurement results and the relationship between individual identity and geographic belonging through artificial neural networks from a mental health perspective

Ş Öztuna, C Işık, NA Altınöz — Wed, 30 Apr 2025 00:00:00 +0000

Background: Identity verification and geographical belonging are significant issues with mental health implications, particularly in forensic contexts. Anthropometric measurements offer potential insights into these relationships. Aim: This study aims to evaluate the significance of anthropometric measurement results and the relationship between an individual’s identity and their geographical belonging through artificial neural networks from a mental health perspective. Methods: Study Population: The study population consisted of female individuals who visited or were brought to the forensic medicine outpatient clinic of a public hospital located in the center of Balıkesir Province between June 2023 and October 2023. Sample: The sample consisted of 100 voluntary female participants who agreed to take part in the study. The participants’ geographical origins were inquired, and anthropometric measurements were conducted. Measurement results were recorded in an artificial neural network program using participant code names and evaluated using the Matlab program. Results: It was found that lip prints, fingerprints, and the angle of the mandible contained varying amounts of usable data in both the training and testing phases. The system developed by the researchers achieved a high success rate with an R-value of 1 during the training process and 0.97 during the testing process. Conclusion: In future research addressing identity verification as a social issue from a mental health perspective, solutions may involve improving the performance of this system by utilizing different artificial neural network models, learning algorithms, and activation functions.

Psychological effects of earthquake on health professionals: Investigation of post‑traumatic stress disorder and related factors

S Deniz, F İnceoğlu, M Koca — Wed, 30 Apr 2025 00:00:00 +0000

Background: Earthquake is characterized as an event that can cause trauma. Earthquake Post-Traumatic Stress Disorder is expressed as a disorder that basically causes intense anxiety in the individual and seriously impairs the functioning of the individual when the individual witnesses events such as death or serious injury. Aim: This study was conducted to determine the prevalence of posttraumatic stress disorder among health professionals after the earthquake. Methods: The study was conducted on healthcare workers working at Malatya Training and Research Hospital after the February 2023 earthquakes. In the analyses conducted with SEM, the sample size is required to be 200 or more. Accordingly, 379 participants were recruited for the study. Results: The overall mean score of the Post-Traumatic Stress Disorder Scale was calculated as 44.48, and the mean score of the Impact of Events Scale was calculated as 49.76. Re-experiencing scores had statistically significant effects on hyper arousal (β₁ = 0.808; P = 0.001), negative changes (β₁ = 0.651; P = 0.001), and avoidance (β₁ = 0.767; P = 0.001) scores. Avoidance scores had a statistically significant effect only on the negative changes score (β₁ = 0.149; P = 0.001). Conclusion: As a result of the research, the prevalence of long-term PTSD among healthcare workers living in the earthquake zone was determined as 46.7%. This result revealed that the effects of PTSD were widely seen even approximately 1.5 years after the earthquake disaster. It has been found that the recollection of events due to sudden trauma experienced by individuals affects post‑traumatic stress disorder.

Cross‑cultural adaptation and validation of the Turkish version of the Tonsil and Adenoid Health Status Instrument

Y Gündoğdu, AC Yumuşakhuylu, O Asya, J Mamadli, Ç Oysu — Wed, 30 Apr 2025 00:00:00 +0000

Background: Tonsil and Adenoid Health Status Instrument (TAHSI) is a powerful, validated, and disease specific assessment tool for adenotonsillectomy. Adenotonsillectomy rates show geographic variation. In addition, healthcare utilization and patient behaviors are very different among countries. Therefore, validation and cross cultural adaptation of TAHSI is required. Aim: This paper aimed to validate the cross cultural adapted version of the TAHSI. Methods: This single center prospective study included 129 patients who had undergone adenotonsillectomy or tonsillectomy and 98 healthy children in a single institution between January 2018 and June 2022. Results: T TAHSI and all eight subscales’ total scores were higher in the patient group compared to the healthy group. In addition, the difference in T TAHSI scores before and after surgery was significant. After surgical intervention, a substantial decrease in the T TAHSI score was observed. Conclusion: T TAHSI is a dependable and thoroughly validated tool, adapted for use across various cultures. It serves as a powerful tool for medical professionals, particularly for assessing the outcomes of surgical procedures in adenotonsillar disease. T TAHSI is instrumental in determining the success of surgical treatments. Additionally, elevated scores on this tool should signal to clinicians the potential need for surgical intervention.

Urinary stone disease in Southeast Nigeria: Current trends in prevalence and distribution

OM Mbadiwe, AC Onuh, SK Anyimba, OC Amu, II Nnabugwu — Wed, 30 Apr 2025 00:00:00 +0000

Background: The prevalence of urolithiasis is increasing globally with higher rates noted in the Western world. This rising trend has also been reported in Asia and Africa. The rise in Africa has been attributed to global climate change and growing socioeconomic status. However, epidemiological studies on urolithiasis are limited in our setting. Aim: The aim of this study was to determine the prevalence of urolithiasis and generate data in this regard. Methods: This was a retrospective study carried out between January 2015 and March 2024. The medical records of patients who had abdominopelvic computerized tomography (CT) scans for either urological or nonurological conditions were retrieved for this study. The age, gender, presenting symptom, anatomic site, and dimension of the identified stone were recorded. Analysis was done using the Statistical Package for Social Sciences (SPSS) version 26. Results: The records of 2478 subjects were retrieved for this study. A total number of 356 subjects had urolithiasis, which gave a prevalence of 14.4%. The mean age of the subjects was 50.0 ± 15.0 years. The number of male subjects was 207 (58.1%) while that of female subjects was 149 (41.9%) with a male to female ratio of 1.4:1. The most common symptom the subjects experienced was flank pain (42.4%), while the most common location of the stone was in the right kidney (46%). Conclusion: The prevalence of urinary stone disease in our environment is rising. This could pose both health and economic challenges.

The effects of adding G-CSF to the induction therapy of patients with AML being treated with the 7+3 protocol: A retrospective comparative study

A Eser, O Kara — Wed, 30 Apr 2025 00:00:00 +0000

Background: Although some new treatment protocols have been developed, 7+3 chemotherapy is still the most widely used treatment for acute myeloid leukemia (AML) induction therapy. Granulocyte colony-stimulating factor (G-CSF) is a widely used treatment modality for myelosuppression after chemotherapy as it accelerates myeloid healing and reduces the incidence and severity of fever and infections. Most current guidelines recommend primary G-CSF prophylaxis in solid cancer patients with a risk of ≥20% febrile neutropenia. However, the use of G-CSF in the induction treatment of AML is controversial as it increases the proliferation of leukemic blasts in vitro. Aim: This study was to investigate the effects of G-CSF use in AML induction therapy on survival. Methods: The study group included 36 patients over the age of 18 with bone marrow blast rate >20% who were diagnosed with AML [M₀ -M₅ according to FAB (French-American-British) classification] using diagnostic tests, such as flow cytometry and bone marrow biopsy between 2016 and 2020. Eighteen of these patients were from a center that employed prophylactic G-CSF during induction therapy, and the remaining 18 patients were from another center that did not employ prophylactic G-CSF during induction therapy. The characteristics of the patients were reviewed retrospectively from their files. The induction therapy used was 7+3 (7-day cytarabine +3-day idarubicin) chemotherapy regimen. Results: Although not reaching statistically significant levels, the use of G-CSF in AML induction therapy was found to provide both OS and PFS advantages. In addition, patients who used G-SF had statistically significantly fewer intensive care unit (ICU) stays than those who did not use it. Conclusion: Although the use of G-CSF in induction therapy of AML patients did not significantly increase survival rates, it caused a statistically significant decrease in the need for intensive care. However, larger-scale studies with longer follow-up periods are needed to confirm the results of this study.

Comparison of obese and nonobese children and adolescents regarding trabeculation and cortex of the mandibular jaw bone

KT Temur, G Magat, AS Onsüren, S Ozcan — Wed, 30 Apr 2025 00:00:00 +0000

Background: Considering the frequency of dental visits among obese individuals, understanding the effects of obesity on bone is crucial for orthodontic and surgical planning. Aim: This study aimed to evaluate potential alterations in mandibular jaw bone trabeculation and cortical bone in obese children and adolescents through fractal analysis (FA) and radiomorphometric indices. Settings and Design: This retrospective case-control study reviewed data from pediatric dental patients treated at a university faculty. Methods: Dental panoramic radiographs of obese (34) and nonobese (39) children and adolescents were evaluated through FA, mandibular cortical width (MCW), panoramic mandibular index (PMI), and mandibular cortical index. Statistical Analysis: Mann–Whitney U and Chi-square test were used for comparisons. P < 0.05 was accepted for the significance value. Results: When the measurements of both the case and control groups were evaluated, it was determined that the PMI measurements on both the right and left sides were lower in the obese group compared to the healthy group (P < .0001). When the relationship of age with measurements of the entire sample was evaluated, MCW values on both the right and left sides were lower in children under 12 years of age compared to those over 12 years of age (P < 000.1). Conclusions: Obesity in children and adolescents may lead to a decline in mandibular cortical thickness. Clinicians should consider the potential effects of obesity on the mandibular bone in the treatment planning of obese children and adolescents presenting to dental clinics for orthodontic treatment and surgical procedures.

Gastrografin® use and its benefits in small bowel obstruction – A single‑center retrospective study

N Arslani — Wed, 30 Apr 2025 00:00:00 +0000

Background: Gastrografin® (GG) is a water‑soluble contrast agent. Besides its role in diagnosing small bowel obstruction (SBO), its effectiveness in treating adhesive small bowel obstruction (ASBO) has been suggested. Aim: A retrospective study was performed at our institution to observe whether patients receiving GG benefited from the intervention compared to patients receiving standard treatment of SBO. Methods: Administration of GG was the surgeon’s decision, as was the decision for operative treatment. No treatment protocols were used at the department regarding GG use. The observed variables were length of hospital stay (LoHS), operative rate, and mortality rate. Results: Results of our study confirmed a substantial diagnostic value of GG challenge; passage of GG to the large bowel indicates successful conservative treatment of SBO. We observed that patients receiving GG (GG+) at our department did not have a significantly lower LoHS or mortality rate than those not receiving GG (GG-). However, GG+ did have a lower mean LoHS and a lower mean mortality rate than GG- group. The GG+ group displayed a significantly lower operative rate. Based on the design of our study, this cannot be attributed to the therapeutic effect of GG but rather to the selective treatment of patients. Conclusion: The GG challenge is a solid diagnostic tool, indicating a successful resolution of SBO if the passage of the contrast to the large bowel can be demonstrated. Although our study results point towards its positive effect, we cannot confirm the therapeutic function of GG due to probable treatment bias in severely affected patients.

Synopsis and pregnancy outcome of decompensated heart failure in pregnancy at a Tertiary Health Care Centre in South‑Eastern Nigeria: A retrospective study

Wed, 30 Apr 2025 00:00:00 +0000

Background: Heart failure during pregnancy is rare, potentially serious, and complicates approximately 1% of all pregnancies. However, there is a global dearth of data on heart failure in pregnancy, and no data from southeastern Nigeria. Aim: To determine the prevalence, clinical profile, and outcomes of pregnancy in women presenting with heart failure during pregnancy at the University of Nigeria, Enugu. Methods: A hospital-based, retrospective study covering 9 years between 2013 and 2021, using data from the medical records of patients seen at the cardiology and obstetrics/gynecology units. Information on the clinical profile, echocardiographic reports, and pregnancy outcomes were obtained and analyzed. Results: Of 9749 new pregnant women, 26 (0.3%) had heart failure during pregnancy, with a prevalence rate of 0.3% and a mean age of 33.27 years. Among 26 women, peripartum cardiomyopathy (46%) was the most common cause of heart failure. The most common presenting symptoms were breathlessness (84.62%), bilateral leg swelling (69.24%), and paroxysmal nocturnal dyspnoea (65.39%). The majority presented with New York Heart Association classes III (57.7%) and IV (26.9%). The most affected age group and mode of delivery were 31–40 years (82%) and cesarean section (50%), respectively. Pregnancy outcomes showed high maternal (11.5%) and fetal/neonatal (15.4%) mortality rates. There was a significant association between the etiology and severity of heart failure (P = 0.009), and the trimester of pregnancy at presentation (P = 0.009). Conclusion: heart failure in pregnancy is associated with high maternal and fetal mortality. The most common cause of heart failure in South Eastern Nigeria was peripartum cardiomyopathy.

Clinical utility of large next‑generation sequencing panel across diverse tumour types: A single‑center retrospective analysis

HP Chen, ZY Guo, LM Zhang, S Sun, JX Huang, M Sha, HH Sheng, H Yu — Wed, 30 Apr 2025 00:00:00 +0000

Background: In complex real-world clinical practice, the application of advanced technologies, such as next-generation sequencing (NGS), is crucial for achieving the most reasonable and relatively effective therapy for cancer patients at each stage of treatment. Aim: This study aimed to retrospectively analyze the clinical utility of a large NGS panel in the management of solid tumors within a clinical practice setting. Method: A comprehensive NGS panel was used to detect diagnostic, prognostic, and therapeutic biomarkers in solid tumors on a commercially available platform. NGS assay was performed on 431 specimens from 416 patients. Results: At least 1 actionable variant was in 89.1% of all specimens. The most frequently altered gene was TP53, followed by EGFR, KRAS, PIKC3A, and RB1. In 55.7% of cases, at least 1 therapeutically targetable variant was identified, including 25.3% of cases harboring variants for which a targeted therapy was available for the disease and 26.0% of cases harboring variants for which a targeted therapy was available for other diseases. The median tumor mutational burden (TMB) was 10.3 mutations/ Mb. Microsatellite instability (MSI) was available for 352 patients, and only 6 cases were MSI-high. The patients receiving targeted therapy and/or immune checkpoint inhibitors survived significantly longer than those receiving chemotherapy and/ or radiotherapy (P = 0.001). Conclusion: Our results demonstrate the significant clinical utility of comprehensive genomic profiling in the routine clinical testing of patients with solid tumors.

The role of the BUN/albumin ratio in predicting poor clinical outcomes in patients with acute pancreatitis

Z Biyik, M Biyik, YC Yavuz, L Altintepe, MK Korez, A Cizmecioglu — Wed, 30 Apr 2025 00:00:00 +0000

Background: The blood urea nitrogen (BUN) to albumin ratio (BAR) has emerged as a potential prognostic marker in various pathological states. Aim: This study aims to elucidate the utility of BAR in predicting the incidence of acute kidney injury (AKI) and severe acute pancreatitis (SAP) in patients diagnosed with acute pancreatitis (AP). Methods: This retrospective analysis included 210 patients diagnosed with AP and monitored at a tertiary university hospital. Patients were classified into three categories based on the severity of pancreatitis: mild AP, moderately severe AP, and severe AP. Results: BAR levels increased significantly with the progression of disease severity (P < 0.001). Median BAR values were 3.3 for mild AP, 3.9 for moderately severe AP, and 11.6 for severe AP. In multivariate regression analysis, BAR was identified as an independent prognostic factor for both severe AP (odds ratio [OR] =1.341, 95% confidence interval [CI]: 1.016– 1.612, P = 0.002) and AKI (OR = 1.382, 95% CI: 1.138–1.679, P = 0.001). Receiver operating characteristic (ROC) analysis indicated that a BAR threshold exceeding 5.192 predicted severe AP with a sensitivity (Sn) of 71.4% and specificity (Sp) of 82.5% (area under the curve [AUC] =0.849, P < 0.001). Additionally, a BAR threshold greater than 4.505 was found to predict AKI with a Sn of 63.2% and Sp of 86.6% (AUC = 0.782, P < 0.001). Conclusion: BAR, assessed at hospital admission, demonstrates considerable promise as a readily accessible biomarker for predicting the severity of AP and the development of AKI.

Histomorphometric analysis of the human umbilical cord and its vessels in pregnant women with anemia: A case‑control study

Wed, 30 Apr 2025 00:00:00 +0000

Background: Anemia during pregnancy is a significant public health concern as it is associated with adverse maternal and fetal consequences. Aim: To assess the histomorphometric changes in the umbilical cord as an indicator of maternal physiological dysfunction and to evaluate the impact of maternal anemia on fetal development. Methods: A case-control study was conducted to explore the histomorphometric changes in UC and its vessels in women with anemia in Central Sudan. The following parameters were studied using the ImageJ software: vessel area (VA), wall area (WA), lumen area (LA), mean wall thickness boundary (MWTB), mean wall thickness skeleton (MWTS), and external diameter skeleton (EDS). Results: UCs were studied in 73 women with anemia and 102 women without anemia. Only one woman had severe anemia (hemoglobin level, <7 g/dl). Maternal age, parity, and gestational age showed no significant differences between women with and without anemia. However, the median (interquartile range) birth weight was significantly lower in women with anemia than in those without anemia [3.29 (2.91‒3.58) g vs 3.42 (3.09‒3.77) g, P = 0.043]. None of the investigated variables (VVA, WA, LA), MWTB, MWTS, and EDS) did not differ between women with and without anemia. No significant correlations were found between maternal hemoglobin levels and UC parameters. Conclusion: The current study showed no difference in UC parameters between women with and without anemia. The nonsevere form of anemia may explain the results of this study. Therefore, further research is required in this regard. Data Access Statement: The data supporting the findings of this study are available from the corresponding author upon reasonable request. Due to ethical and privacy concerns, some data may be restricted in accordance with institutional and regulatory guidelines.

Parents’ gender preferences for dentists in different procedures for themselves and their children

GB Senirkentli, DS Uyar, Y Turan, BM Özgül, RE Tirali, E Çakmak — Wed, 30 Apr 2025 00:00:00 +0000

Background: Patient preferences, especially physician gender, may vary with different types of treatment decisions. While past research has explored gender preferences in health care providers, there is a gap regarding dentists. Aim: This study aims to fill this gap by investigating whether parents have gender preferences for their own and their children’s dentists and the reasons behind those preferences. Understanding these preferences can improve treatment success and patient‒ dentist relationships. Methods: This study included 292 parents who attended the Department of Paediatric Dentistry at Baskent University between 2019 and 2020. A questionnaire was given to the parents of the patients with their consent. The demographic data of the patients and parents were also examined. Results: A total of 292 parents who agreed to participate were included in the study. The majority of parents stated that they do not have a preference for the gender of the dentist for different treatments or procedures, whether for themselves or their children. Conclusion: Most of the surveyed parents did not have strong preferences for the gender of their dentists for dental procedures, but there were subtle variations in their responses. Further research into the reasons behind these preferences could improve the parent‒dentist relationship, creating a better environment for the child.

Evaluation of salivary opiorphin levels in acute pericoronitis related pain

SY Ertem, MS Ozdogan — Wed, 30 Apr 2025 00:00:00 +0000

Background: Opiorphin is a peptide that can exhibit varying concentrations in saliva in relation to pain and may serve as a potential pain biomarker. Aim: This study aimed to evaluate pain-related changes in salivary opiorphin levels in patients with acute pericoronitis. Materials and Methods: A total of 40 saliva samples were analyzed by taking two different samples from 20 patients. Non-stimulated saliva samples were collected using uncovered cotton rolls from the same patients during tooth extraction, when acute pain was present due to acute pericoronitis, and again 1 week post-extraction, after the pain had subsided. Patients’ pain levels were assessed before treatment and at a 7-day follow-up visit using a visual analog scale just before saliva sampling. Opiorphin levels in the presence and absence of pain were measured using a human opiorphin ELISA kit (Hangzhou Eastbiopharm Co., Ltd., Hangzhou, China). Statistical analyses were conducted using International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) Statistics Version 25 (IBM SPSS, Chicago, IL). The opiorphin levels in samples taken from saliva before and after tooth extraction were evaluated using Analysis of Variance (ANOVA). Results: Mean salivary opiorphin levels were found to differ significantly between the presence of pain due to acute pericoronitis and the pain-free period following treatment. Salivary opiorphin concentration was significantly higher before treatment (17.38 ng/ml ± 5.83 ng/ml) compared to after treatment (13.54 ng/ml ± 5.37 ng/ml). The findings of this study suggest that pain due to acute pericoronitis causes a statistically significant increase in salivary opiorphin levels (P = 0.026). Saliva samples from healthy patients with acute pericoronitis were collected at the same time of day to minimize environmental variables. The age and gender of the participants did not affect opiorphin levels before or after treatment. Conclusion: The findings of this study suggest that salivary opiorphin levels increase in the presence of pain associated with acute pericoronitis. Future studies with larger sample sizes conducted across different populations may further contribute to understanding opiorphin as a potential pain mediator.

Analysis of injuries caused by electric scooters admitted to the emergency department: A prospective observational study

TC Ozturk, M Ekşioğlu, YE Sağmal — Wed, 30 Apr 2025 00:00:00 +0000

Objective: This study aims to investigate and analyze the patterns, types, and epidemiology of E-scooter-related injuries presenting to the emergency department as well as to determine possible factors that may affect the severity of injury. Methods: This is a prospective observational study conducted in an inner-city tertiary education and research hospital with 290,000 annual emergency admissions in tax in Istanbul, Turkiye. The study period was defined as 01.02.2022–01.02.2023. Patients presenting to the emergency department with an electrical scooter injury were included in the study. Results: A total of 137 electrical scooter cases were included in the study. Our results revealed a male predominance (73.7%), with the highest incidence observed in the 17–25 age group. Most accidents involved the electrical scooter rider (92.7%), occurring predominantly as falls (75.2%) and commonly on main roads (70.8%). Accidents were more prevalent during weekdays and between 07:00 and 18:00, aligning with commuting hours. In terms of severity, 83.9% were classified as minor (ISS < 9), 9.5% as moderate (ISS = 9–15), 2.9% as severe (ISS = 16–25), and 3.6% as critical (ISS > 25). Traumatic brain injuries were observed in 12 patients. 4.4% had concussion, and 4.4% intracranial hemorrhage. One of the patients with subarachnoid hemorrhage died in an intensive care unit. Conclusion: Although minor injuries are more common, the fact that we have a deceased case and patients with potentially fatal traumatic brain injuries suggests accidents involving electrical scooters should be carefully examined and preventive measures and regulations should be implemented by the governments.

Inflammatory and analgesic profiles in intervertebral disc herniation: Variability with respect to neurological deficit

B Morkoç, O Aktan, HS Solak, E Bodur, J Karakaya, B Kaymak, S Bilgin — Wed, 30 Apr 2025 00:00:00 +0000

Background: Disc herniation is both a mechanical and biochemical process in which contact between intervertebral discs and spinal nerves causes compression, chemical irritation, inflammation, and pain. The inflammatory process is known to vary depending on pain duration, herniation type, and pain severity, but the relationship with neurological deficits remains unknown. Aim: This study aimed to compare individuals with lumbar disc herniation with and without neurological deficits (WND/WOND) and healthy individuals in terms of serum levels of tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6), interleukin 4 (IL-4), interleukin 1 beta (IL-1β), beta-endorphin, anandamide, and 2-arachidonoylglycerol (2-AG). Methods: The study included 37 lumbar disc herniation patients WND (22 female, 15 male), 37 patients WOND (22 female, 15 male), and 35 healthy individuals (18 female, 17 male). TNF-α, IL-6, IL-4, IL-1β, beta-endorphin, anandamide, and 2-AG serum levels were analyzed using commercial enzyme-linked immunosorbent assay kits. Results: There was no difference in TNF‑α levels between the WOND, WND, and control groups (P = 0.383). The WOND and WND groups showed significantly higher expression of IL-1β (P < 0.001) and IL-4 (P = 0.034, P < 0.001) when compared with healthy controls. IL-6 expression was lower in the WND group than in the control group (P < 0.001). Beta-endorphin, anandamide, and 2-AG levels did not differ significantly between the WOND, WND, and control groups (P = 0.888, P = 0.247, P = 0.433, respectively). Conclusion: This study is the first to demonstrate the effect of the presence of a neurological deficit on serum biomarker levels in patients with lumbar disc herniation. Even in the presence of neurological deficit, decreased levels of proinflammatory cytokines and increased levels of anti‑inflammatory cytokines indicated regression of the disc herniation. These results suggest the need to establish new and improved treatment protocols to target the inflammatory process in individuals with lumbar disc herniation.

Evaluation of physicians’ knowledge levels concerning healthy lifestyle behaviors

O Taydas, MT Egici, I Gonenc — Wed, 30 Apr 2025 00:00:00 +0000

Background: The term “healthy lifestyle behaviors” (HLBs) refers to a way of living that lowers the risk of being seriously ill or dying early. Aim: To assess physicians’ behaviors concerning healthy lifestyle behaviors. Materials and Methods: The cross-sectional study was conducted in the form of a face-to-face survey with physicians actively working at a training and research hospital. Using the simple random sampling method, the minimum number of physicians to be included in the study was calculated as 236. A survey form comprising three parts was used to collect data: a participant information form, the Periodic Health Examinations and Screening Tests Behavior Questionnaire, and the Health‑Promoting Lifestyle Profile (HPLP). The lowest obtainable score on the HPLP scale is 52, while the highest score is 208. Results: The mean age of the physicians participating in the study was 30.14 ± 4.81 years. Of the participants, 62.7% (n = 165) were women. The mean score of the study participants was 128.03 ± 19.4. The mean scores on the dimensions of the HPLP were 20.71 ± 4.12 for nutrition, 17.99 ± 4.77 for physical activity, 19.28 ± 3.75 for stress management, 25.19 ± 4.01 for interpersonal relations, 21.08 ± 4.26 for health responsibility, and 23.77 ± 4.49 for spiritual growth. Conclusions: Physicians who participated in the study had a low HPLP score, despite the expectation that they should be more sensitive and serve as role models in adopting healthy living since they provide related recommendations to their patients.

Serum and saliva biomolecules in periodontitis patients with and without alzheimer’s disease

D Öztürk, I Midi, M Alaylıoğlu, EN Tuncer, D Gezen-Ak, E Dursun, B Doğan — Wed, 30 Apr 2025 00:00:00 +0000

Background: Alzheimer’s disease (AD) and periodontitis are linked to a systemic pro‑inflammatory state, potentially influencing the progression of one another. Aims: This study aims to evaluate serum and salivary IL-10, IL-18, and resistin levels between periodontitis patients with and without AD. Materials and Methods: Forty-three periodontitis patients with AD (mild or moderate), 40 without AD were included in the study. To determine the cognitive status Mini-Mental State-Examination (MMSE) test was used. Samples of blood and saliva were collected a day after measurement of periodontal parameters. ELISA method was used to analyze IL-10, IL-18, and resistin levels both in serum and saliva samples. Results: No difference was detected regarding clinical periodontal parameters across both groups (P > 0.05). The periodontitis patients with AD had elevated serum IL-18 levels compared to those without AD (P < 0.05). In the AD group, salivary resistin levels were higher in severe periodontitis patients than in moderate ones (P < 0.01). Furthermore, MMSE score was correlated negatively with serum levels of IL-18 (P < 0.05), and salivary levels of resistin positively with gingival index, bleeding on probing, and probing depth (P < 0.05). Conclusion: This study confirms the possible role of serum IL‑18 in the inflammatory process of AD. Additionally, the present relationship between salivary resistin levels and the severity of periodontitis in AD patients needs further investigation to fully understand the implications.

Comparison of catastrophic health expenditure among health‑insured and noninsured diabetic patients in Kaduna State, North West Nigeria

ZS Babandi, MA Darma, MB Jibril, AT Aliyu, S Shehu, A Lawal, AA Aliyu — Wed, 30 Apr 2025 00:00:00 +0000

Background: Diabetes imposes significant economic burdens on individuals and households through higher out‑of‑pocket payment. Access to affordable care is critical to reducing mortality and associated suffering. Aim: To assess and compare catastrophic health expenditure (CHE) and factors associated with CHE among health-insured and noninsured diabetic patients in Kaduna State, Nigeria. Materials and Methods: A comparative cross-sectional study was conducted using a multistage sampling technique to select 500 respondents. Using an interviewer-administered questionnaire, information was collected on sociodemographic characteristics, income, cost of care, and CHE. Results: The mean age of the respondents was 50.0 ± 1.3 years and 53.7 ± 14.6 years for the health-insured and non-insured groups, respectively. About 42% and 68% of the health-insured and insured patients incurred CHE, respectively (P = 0.001). The intensity of CHE was 18.3% and 26.2% for the health-insured and noninsured diabetic patients, respectively (P = 0.43). Religion (AOR: 1.98; CI: 4.21–6.6; P = 0.048), occupation (AOR: 0.13; CI: 0.042–0.421; P = 0.001), and duration of diabetes (AOR: 2.1; CI: 1.021–8.223; P = 0.045) were found to be associated with CHE. Conclusion: The study found a significant difference in the incidence of CHE between the two groups, although the difference in intensity of CHE was not significant. It is recommended that the Federal and State Governments ensure health insurance coverage and other social safety nets for nonformal sector diabetic patients to protect them from CHE.