Evaluation of the chemopreventive effects of Ankaferd Bloodstopper in 7,12-dimethylbenz[a]anthracene-induced oral epithelial dysplasia.

OBJECTIVES: Ankaferd BloodStopper® (ABS) is an herbal extract which has been used historically as a hemostatic agent in traditional Turkish medicine. ABS comprises of standardized mixture of herbs Thymus vulgaris, Glycyrrhiza glabra, Vitis vinifera, Alpinia officinarum, and Urtica dioica. In addition to its hemostatic effects, the herb ABS contains some other biological effects including antioxidant and antitumoral properties. The aim of this study is to investigate the chemopreventive effects of ABS in 7,12-dimethylbenz[a]anthracene (DMBA)-induced oral epithelial dysplasia. MATERIALS AND METHODS: A total of 40 Sprague Dawley rats were randomly divided into four groups. Group 1 animals received DMBA alone, and group 2 animals received both DMBA and Ankaferd. Group 3 animals received ABS alone while group 4 animals served as control group and received only liquid paraffine. All animals were sacrificed, and tissue samples were analyzed histologically at the end of the experimental period (14 weeks). RESULTS: Histological studies have shown that the buccal pouches of animals treated with DMBA alone revealed severe dysplasia while only mild or no dysplasia were noticed in DMBA + ABS group. Ankaferd were administered to animals and control group showed no dysplasia or other oral lesions. CONCLUSION: The results suggest that Ankaferd Bloodstopper® has chemopreventive effect against DMBA-induced oral epithelial dysplasia. CLINICAL RELEVANCE: Ankaferd Bloodstopper® could be used as a supportive treatment option of cancer in oral and maxillofacial surgery since it possesses chemopreventive effect.

The Evaluation Acute Traumatic Stress Level in Close Relatives of Stroke Patients.

OBJECTIVE: Stroke is the second most common cause of death and the leading cause of adult disability. Both stroke patients and their family can therefore experience increased traumatic stress level. METHODS: The participants are close relatives of patients (n=65) who had a first time stroke (CRPWS) hospitalized. A control group (CG) (n=61), who had no history of chronic illness in their family and had at least one traumatic life event experience. The National Institutes of Health Stroke Scale, Modified Rankin Scale, Personal Information Form, Life Events Checklist, Traumatic Stress Symptom Scale, and Multidimensional Scale of Perceived Social Support, were used in the study. RESULTS: We found no significant association between NIHSS and MRS of patients and traumatic stress level of the family member. The traumatic stress level was significantly higher in the CRPWS group than in the CG group. Traumatic stress level was higher in women than men and was not associated with perceived social support in the CRPWS group. CONCLUSION: The traumatic stress level of the relatives was not associated with the clinical features of the stroke patients. In the early phase, after the diagnosis of stroke, psychological support may be important to prevent CRPWS from PTSD.

Topical application of olive oil macerate of Momordica charantia L. promotes healing of excisional and incisional wounds in rat buccal mucosa.

OBJECTIVE: In Turkish folk medicine Momordica charantia L. is used for wound healing. The aim of the present study is to investigate this folkloric knowledge and confirm the plant's potential effect on buccal mucosa wound in the rat. DESIGN: Wound healing activity of olive oil macerate of Momordica charantia L. was investigated in linear incision and circular excision wound models created in the buccal mucosa of the rat. The tissues were histopathologically evaluated, moreover, hydroxyproline contents of the tissues were determined. The anti-inflammatory activity was also assessed by using Whittle method with some modifications. RESULTS: Olive oil macerate of M. charantia showed significant wound healing activity both in incision (45.1%) and excision (89.8%) wound models and demonstrated anti-inflammatory activity with the inhibition value of 31.3% at the dose of 100mg/kg. CONCLUSION: The experimental data revealed that M. charantia showed significant wound healing and anti-inflammatory effect.

Biochemical and biomechanical assessment of effects of L-carnitine on oral mucosal wounds.

OBJECTIVES: The present study aimed to investigate the oral mucosal wound healing potential of L-carnitine in a rat model. MATERIALS AND METHODS: Twenty-four Wistar-albino rats were divided into 4 groups: control group (group I), L-carnitine groups (100 and 200 mg/kg/day, intraperitoneally) (groups II and III), and vitamin E group (100 mg/kg/day, intraperitoneally) (group IV). A 1.5-cm linear incision was created on the buccal mucosa of each rat and was left to heal by secondary intention. On the tenth day, rats were anesthetized and sacrificed. The tensile strength of wound was measured with a tensiometer. Hydroxyproline (HYP) and malondialdehyde (MDA) levels in wound were assayed by spectrophotometry. Results were statistically analyzed using a one-way ANOVA analysis (p ≤ 0.001). RESULTS: In the analysis of tissue samples, there was a statistically significant decrease in MDA levels in group II (p < 0.01) and group IV (p < 0.001). Wound tension strength that was seen in groups II (57.88 %) and IV (48.71 %) was better than group III (33.39 %). Hydroxyproline levels in group II (46.98 ± 1.37) was higher than groups III (29.40 ± 1.64) and IV (38.83 ± 1.41). CONCLUSION: Although there was a tendency toward faster healing in the groups receiving L-carnitine, it may have a dose-related positive effect for wound healing. CLINICAL RELEVANCE: With the advantages of having positive effects on wound healing, being a natural substance in the body, being easy to procure, and having a practical usage, L-carnitine may be clinically feasible for human oral mucosal wounds.

Effectiveness of a multidimensional approach for prevention of ventilator-associated pneumonia in 11 adult intensive care units from 10 cities of Turkey: findings of the International Nosocomial Infection Control Consortium (INICC).

PURPOSE: To evaluate the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional approach on the reduction of ventilator-associated pneumonia (VAP) in adult patients hospitalized in 11 intensive care units (ICUs), from 10 hospitals, members of the INICC, in 10 cities of Turkey. METHODS: A prospective active before-after surveillance study was conducted to determine the effect of the INICC multidimensional approach in the VAP rate. The study was divided into two phases. In phase 1, active prospective surveillance of VAP was conducted using the definitions of the Centers for Disease Control and Prevention National Health Safety Network, and the INICC methods. In phase 2, we implemented the multidimensional approach for VAP. The INICC multidimensional approach included the following measures: (1) bundle of infection control interventions, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback of VAP rates, and (6) performance feedback of infection control practices. We compared the rates of VAP obtained in each phase. A time series analysis was performed to assess the impact of our approach. RESULTS: In phase 1, we recorded 2,376 mechanical ventilator (MV)-days, and in phase 2, after implementing the multidimensional approach, we recorded 28,181 MV-days. The rate of VAP was 31.14 per 1,000 MV-days during phase 1, and 16.82 per 1,000 MV-days during phase 2, amounting to a 46 % VAP rate reduction (RR, 0.54; 95 % CI, 0.42-0.7; P value, 0.0001.) CONCLUSIONS: The INICC multidimensional approach was associated with a significant reduction in the VAP rate in these adult ICUs of Turkey.

Florid cemento-osseous dysplasia: Report of a case documented with clinical, radiographic, biochemical and histological findings.

Florid cemento-osseous dysplasia (FCOD) has been described as a condition that characteristically affects the jaws of middle-aged black women. This condition has also been classified as gigantiform cementoma, chronic sclerosing osteomyelitis, sclerosing osteitis, multiple estenosis and sclerotic cemental masses. It usually exhibits as multiple radiopaque cementum-like masses distributed throughout the jaws. Radiographically, FCOD appears as dense, lobulated masses, often symmetrically located in various regions of the jaws. Computed tomography, because of its ability to give axial, sagittal, and frontal views, is useful in the evaluation of these lesions. This article reports the case of a 45-year-old white man who was diagnosed with FCOD on the basis of clinical, radiographic, biochemical and histological findings. It is of major importance to realize that all dentists have a unique opportunity as well as ethical obligation to assist in the struggle against wrong dental treatments that might save patients dental health. This case report illustrates the point that periapical radiolucencies may represent benign fibro-osseous lesions that may be overlooked or result in unnecessary endodontic treatment. Key words:Florid cemento-osseous dysplasia, florid osseous dysplasia, fibro-osseous lesions.

Impact of a multidimensional infection control strategy on catheter-associated urinary tract infection rates in the adult intensive care units of 15 developing countries: findings of the International Nosocomial Infection Control Consortium (INICC).

PURPOSE: We aimed to evaluate the impact of a multidimensional infection control strategy for the reduction of the incidence of catheter-associated urinary tract infection (CAUTI) in patients hospitalized in adult intensive care units (AICUs) of hospitals which are members of the International Nosocomial Infection Control Consortium (INICC), from 40 cities of 15 developing countries: Argentina, Brazil, China, Colombia, Costa Rica, Cuba, India, Lebanon, Macedonia, Mexico, Morocco, Panama, Peru, Philippines, and Turkey. METHODS: We conducted a prospective before-after surveillance study of CAUTI rates on 56,429 patients hospitalized in 57 AICUs, during 360,667 bed-days. The study was divided into the baseline period (Phase 1) and the intervention period (Phase 2). In Phase 1, active surveillance was performed. In Phase 2, we implemented a multidimensional infection control approach that included: (1) a bundle of preventive measures, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback of CAUTI rates, and (6) feedback of performance. The rates of CAUTI obtained in Phase 1 were compared with the rates obtained in Phase 2, after interventions were implemented. RESULTS: We recorded 253,122 urinary catheter (UC)-days: 30,390 in Phase 1 and 222,732 in Phase 2. In Phase 1, before the intervention, the CAUTI rate was 7.86 per 1,000 UC-days, and in Phase 2, after intervention, the rate of CAUTI decreased to 4.95 per 1,000 UC-days [relative risk (RR) 0.63 (95% confidence interval [CI] 0.55-0.72)], showing a 37% rate reduction. CONCLUSIONS: Our study showed that the implementation of a multidimensional infection control strategy is associated with a significant reduction in the CAUTI rate in AICUs from developing countries.

Caries detection with DIAGNOdent and ultrasound.

OBJECTIVE: The objective of this study was to evaluate the repeatability of 2 nondestructive caries detection methods, ultrasound (ULS) and DIAGNOdent, for the detection of approximal caries lesions, and to evaluate 2 tips provided for the DIAGNOdent. STUDY DESIGN: White/brown-spot lesions (n = 42) were captured by a digital camera, and measured by test methods and confocal laser scanning microscope (CLSM). Intra- and inter-observer reliability, accuracy, and Cohen's kappa and Spearman's rho statistics were used. RESULTS: At DIAGNOdent, intra-observer agreements were 78.5%, 66.7% for A tip and 59.5%, 47.6% for B for 2 examiners, respectively. Accuracy of both tips was 50% for the first examiner; 45.3% for A and 47.6% for the B tip for the second examiner. All ULS measurements were accurate, reliable, and positively and significantly correlated between examiners. CONCLUSION: The A tip of the DIAGNOdent was found to be better than the B tip for the detection of enamel caries. All DIAGNOdent and ULS measurements were positive and significantly correlated for both examiners. Both methods demonstrated high repeatability and accuracy.

Childhood craniofacial Burkitt's lymphoma presenting as maxillary swelling: report of a case and review of literature.

Burkitt's lymphoma (BL) is an undifferentiated malignant lymphoma comprising of uniformly primitive lymphoreticular cells. The tumor was seen originally in patients in Africa. African type BL usually occurs in the jaws of young children. In American cases, abdominal involvement predominates. Strong evidence implicats Epstein-Barr virus in the development of BL. BL is found most commonly in childhood, with a peak incidence in African cases at 5 to 8 years old and in American cases at 10 to 12 years old. The disease shows a preference for males in a 2:1 to 4:1 ratio. BL is the most rapidly growing neoplasm requiring immediate diagnosis and treatment; however, it is extremely sensitive to chemotherapy. In this report, a case of BL that was initially misdiagnosed as an acute dental abscess is presented and the role of the dentist in the diagnosis and treatment of these patients is emphasized.

Comparison of two different viscosupplements in knee osteoarthritis -- a pilot study.

A pilot study was designed to investigate the efficacy of two different hyaluronic acid preparations combined to physical therapy in patients with knee osteoarthritis in terms of reduction in pain and disability and muscle strengthening. Thirty-seven patients with symptomatic osteoarthritis of the knees were randomly assigned into three groups. First group received a lower molecular weight hyaluronic acid plus physical therapy, second group received a higher molecular weight hyaluronic acid plus physical therapy, and the third group received physical therapy alone. The isokinetic knee muscle strengths and index of severity for osteoarthritis of the knee scores were evaluated at baseline, at the end of treatment (3 weeks) and at 3 months of follow up. At both short-term (3 weeks) and long-term (3 months) evaluations, index of severity for osteoarthritis of the knee scores were reduced in all three groups, while there was no significant muscle strengthening.

Functional outcome in stroke patients with atrial fibrillation.

OBJECTIVES: To identify the prevalence of atrial fibrillation (AF) in a sample of stroke patients and to evaluate the impact of AF on patient clinical characteristics and functional outcome. DESIGN: A retrospective case-comparison study. SETTING: University-affiliated rehabilitation centers. PARTICIPANTS: One hundred ninety-six of 231 consecutive stroke patients admitted to inpatient rehabilitation units were evaluated during the rehabilitation period. MAIN OUTCOME MEASURES: Characteristics of cerebral lesions, patient demographic features, disease duration, length of hospital stay (LOS), risk factors for stroke, and functional status at admission and at discharge were assessed and compared in patients with and without AF. Functional Independence Measure (FIM) and Adapted Patient Evaluation Conference System (APECS) were used to evaluate functional status. RESULTS: AF was diagnosed in 41 (20.1%) patients. Patients who had AF were more likely to have ischemic cerebral lesions. There were no significant differences between the AF and non-AF groups with regard to mean age, LOS, and disease duration. Ischemic and valvular heart disease were more common in patients with AF. Based on FIM and APECS scores, both initial and discharge disability were more severe in patients with AF. In a multivariate model, AF was a negative prognostic factor for functional outcome in stroke patients. CONCLUSION: AF is not only associated with increased risk of stroke, but also with markedly greater disability in stroke patients. Factors such as size and type of cerebral lesions, stroke severity, comorbid conditions, and impact of AF on systemic and cerebral circulation can influence stroke recovery.