Incidence and Clinical Pattern of Mixed Connective Tissue Disease in Sudanese Patients at Omdurman Military Hospital: Hospital-Based Study.

BACKGROUND: Mixed connective tissue disease (MCTD) is a rare autoimmune disease, characterized by the production of specific autoantibody anti-RNP, which presents with varied overlapping symptoms of different connective tissue disorders. The aim of this study is to identify the frequency and patterns of MCTD. METHODS: This is a descriptive cross-sectional hospital-based study conducted at the rheumatology clinic at Omdurman Military Hospital between February 2019 and July 2019. The study included 30 patients and data were collected using a designated questionnaire. RESULTS: The study showed that the majority of patients (96.7%) were females and only 3.3% was male. About 30% of the patients aged between 30 and 39 years were the most affected. As a first diagnosis, 10% of the patients had a MCTD fulfilling the Alarcon-Segovia criteria. The remaining 90% of the patients were diagnosed with other diseases before evolving into MCTD. The most common clinical presentation was arthralgia in 100% of the patients, 90% were symmetrically followed by myositis in 70% of the patients, arthritis in 63.3% of the patients, puffy fingers in 63.3% of the patients, and hand swelling in 60% as major musculoskeletal symptoms. Regarding the initial results in immunological profile, the most common positive autoantibodies among the patients were anti-RNP titer in 96.7% of the patients, ANA in 90%, anti-Sm in 50%, RF in 50%, anti-Ds DNA in 46.7%, and anti-Ro in 43.3%. CONCLUSION: This study showed that MCTD is more common in females, only 10% of patients presented with a fulfilling criteria of the disease at diagnosis, and the rest of the patients presented with other rheumatologic diseases before evolving into MCTD.

A Comparative Study of the Microleakage of Resilon/Epiphany and Gutta-Percha/AH-Plus Obturating Systems.

INTRODUCTION: The aim of the present study was to investigate and compare the apical sealing ability of Resilon/Epiphany-filled root canals with those that were obturated with gutta-percha/AH-Plus endodontic sealer. MATERIALS AND METHODS: A total of 60 extracted human single-rooted teeth were selected; 25 teeth for each test group and five for each control group. After conducting conventional endodontic treatment, the teeth were immersed in physiologic saline solution for thirty days, and subsequently sealed and stored in methylene blue dye solution for seven days. The teeth were sectioned to evaluate the linear apical leakage using a stereoscopic microscope. The data were statistically analyzed by non-parametric Kruskal-Wallis and Mann-Whitney U tests. RESULTS: The results showed significant differences between the two groups of endodontic sealers (P<0.001). CONCLUSION: Within the limitation of the present in vitro study, Resilon/Epiphany sealer had better apical sealing ability than gutta-percha/AH-Plus sealer.

An in vitro comparison of root canal system prepared with either hand or rotary instruments.

INTRODUCTION: The aim of the present study was to compare hand stainless steel K-files and Nickel-Titanium Profile 0.04 taper 29 series rotary instruments for their efficiency, procedural errors and time consumed in preparation of root canal system. MATERIALS AND METHODS: A total of 46 maxillary and mandibular first premolars extracted for orthodontic purposes were collected (two contralateral teeth from each individual). The samples were divided into two groups of 34 canals each. Teeth in the first group were prepared with stainless steel hand K-files while the second groups were prepared with profile 0.04 taper series 29 rotary files. Preparation period was recorded for both groups. Impression material was introduced into the prepared canals so that the replica of prepared canals was achieved. These were assessed under stereomicroscope to assess the efficiency in preparing canals in respect to canal smoothness, ability of impression material to flow and quality of taper.Statistical analyses were performed using t-test, Chi-square and Fishers exact tests. RESULTS: RESULTS showed significantly shorter preparation time for Profile than K-file. 8.8% of the canals prepared with K-files showed canal blockage, while all canals prepared with Profile remained patent. Alterations in working length working distance appeared in 23.5% of canals prepared with K-file and 11.7% in canals prepared with Profile. Failed instruments in K-files were significantly higher, mostly deformation (P<0.001). Profiles failed instruments were in the form of fracture and no deformation was detected. Both systems showed unsatisfactory walls smoothness and flow. CONCLUSION: Within the limitation of this study it was concluded that Profile 0.04 taper series 29 rotary systems prepare canals more rapidly, and have lower incidences of fracture and blockages, and only limited loss of working length. Canal preparation with K-file was time consuming and showed higher incidence of deformed instruments; overall, rotary instruments seem to offer greater advantages.

HCV-related morbidity in a rural community of Egypt.

The origin of the hepatitis C virus (HCV) epidemic in Egypt has been attributed to intravenous schistosomiasis treatment in rural areas in the 1960s to 70s. The objective of this study was to estimate the HCV-related morbidity in a rural area where mass schistosomiasis treatment campaigns took place 20-40 years before. The study sample included 2,425 village residents aged 18-65 years recruited through home-based visits. Overall, HCV antibody prevalence was 448/2,425 = 18.5% (95% CI = 16.9-20.1%), reaching 45% in males over 40 years, and 30% in females over 50 years. Of those with HCV antibodies, 284/448 (63.4%, 95% CI = 58.7-67.9%) had chronic HCV infection, among which 107/266 (40.2%, 95% CI = 34.3-46.4%) had elevated alanine aminotransferase (ALT). As part of pre-treatment screening, 26 consenting patients had a liver biopsy: 13 (50.0%) had a treatment indication. Thus, of all patients with HCV antibodies, 13 (2.9%) were eligible for treatment and willing to be treated. The relatively low level of morbidity observed in this study is discussed in view of co-factors of HCV infection progression, such as young age at infection, absence of alcohol intake, the prevalence of Schistosoma mansoni infection, and the prevalence of chronic hepatitis B.

Visualizing central effects of S-adenosyl-L-methionine (SAMe), a natural molecule with antidepressant properties, by pharmaco-EEG mapping.

In a double-blind, placebo-controlled, cross-over study, the central effects of the natural molecule S-adenosyl-L-methionine (SAMe), or ademetionine (ADE), used in low doses as a nutraceutical and in higher doses as a pharmaceutical, were investigated by means of EEG mapping and psychometry. Ten young, normal healthy volunteers of both sexes, with a mean age of 25.2+3.9 yr received, in random order, infusions of 800 mg ADE in 250 ml of isotonic solution, and placebo consisting of 250 ml of isotonic solution administered over 30 min for 7 d, with a wash-out period of 3 wk in between. EEG recordings and psychometric tests were carried out 0, 1, 3 and 6 h after drug administration on days 1 and 7. While there were no significant changes in psychometric findings, multivariate analyses of the EEG results based on MANOVA/Hotelling T 2 tests demonstrated significant encephalotropic effects of ADE compared to placebo. ADE-induced changes were characterized by a decrease in total power, an increase in absolute delta power and a decrease in absolute alpha and beta power, further by an increase in relative delta and beta power and a decrease in relative alpha power, a slowing of the delta/theta centroid, an acceleration of the alpha centroid as well as a slowing of the centroid of the total power spectrum. These changes are typical of classical antidepressants of the thymoleptic type such as imipramine and amitriptyline. Time-efficacy calculations demonstrated a significant central effect of ADE in the first hour after the first infusion, declining slowly until the third hour and thereafter steeply until the sixth hour; a further significant effect was after 1 wk of daily infusions and in the third hour after one superimposed infusion on day 7 of subacute treatment. Our pharmaco-EEG findings suggest both inhibitory and excitatory drug effects at the neurophysiological level, underlying the antidepressant properties well-documented in clinical trials.