Long term sexual outcomes of Mayer Rokitansky Küster Hauser Syndrome patients after Uncu-modified Davydov procedure.

Background: Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome has an incidence of 1 in 4000. The absence of the vagina and uterus results in sexual dysfunction and infertility. The first-line treatment is vaginal dilatation. There exists a number of second-line surgical options including the Uncu-modified Davydov procedure. Objective: To determine the complication rate, anatomical outcomes, and long-term sexual outcomes of MRKH syndrome patients after Uncu-modified Davydov procedure. Materials and Methods: Patients with MRKH syndrome who underwent paramesonephric remnant-supported laparoscopic double-layer peritoneal pull-down vaginoplasty (aka Uncu-modified Davydov procedure) between January 2008 and December 2021. The procedure involves laparoscopic circular dissection of the pelvic peritoneum followed by pulling down, through the opened vaginal orifice, and suturing the vaginal cuff with the support of uterine remnants. The long-term complication rate, anatomical outcomes, and sexual function outcomes (as measured by Female Sexual Function Index (FSFI)) were ascertained. Main outcome measures: Main Outcome Measures: The long-term complication rate, anatomical outcomes and FSFI survey results. Results: A total of 50 patients with MRKH syndrome underwent the Uncu-modified Davydov procedure between Jan 2008- Dec 2021. There were four perioperative complications: three bladder injuries (6%) and one rectal serosa injury (2%). Four long-term postoperative complications were identified: one vesicovaginal fistula (2%), one recto-vaginal fistula (2%), and two vaginal stenoses (4%). All patients were physically examined at least one year after surgery. The mean vaginal length was 8.4 + 1.9 cm. The mean FSFI score was 31.5 + 3.9 (minimum score of 24, maximum score of 36). Conclusion: Conclusion: The Uncu-modified Davydov procedure has been demonstrated to be a safe and effective treatment option with high female sexual function index scores for patients with MRKH syndrome. What is new?: The long-term complication rate, anatomical and sexual outcomes of Uncu-modified laparoscopic peritoneal pull-down vaginoplasty were reported in this study. The results indicated that the surgical approach could be used in selective MRKH patients who failed first-line self-dilatation therapy.

ATHEROGENIC INDICES IN THE ASSESSMENT OF CARDIOVASCULAR DISEASE RISK IN CHILDREN WITH OBESITY AND SUBCLINICAL HYPOTHYROIDISM.

BACKGROUND: The frequency of subclinical hypothyroidism (SH) in patients with obesity is increased compared with the normal population. However, data on the risk of cardiovascular disease (CVD) in patients with SH are still scarce. Lipid parameters are strong predictors of early CVD. We aimed to investigate the role of lipid indices in predicting CVD risk compared to conventional lipid components. METHODS: A total of 220 euthyroid obese children (EU) and 90 obese children with SH were included in the study. All data were collected from hospital files. Lipid indices were evaluated. Atherogenic index of plasma (AIP), cardiac risk ratio (CRR) and atherogenic coefficient (AC) were calculated. AIP>0.24, CRR>5 ve AC>3 were considered as cardiovascular risk criteria. RESULTS: The presence of SH increased the risk of higher AIP and the risk of CRR, compared to euthyroid obese children. CONCLUSION: Subclinical hypothyroidism in obese children may cause dislipidemia carrying a high cardiovascular disease risk.

Investigation of mineral content of root canal dentin after the application of various antibiotic paste using energy-dispersive X-ray detector.

The purpose of this study was to evaluate mineral content of root canal dentin after treatment with different antibiotic pastes including the mixture of metronidazole, ciprofloxacin, doxycycline, cefaclor, amoxicillin, or minocycline. Fifty extracted maxillary canine teeth were randomly divided into five groups (n = 10 teeth for each group). Root canals were prepared Reciproc rotary files. Canals were irrigated using 5 ml 5% NaOCl and 1 ml 15% EDTA. Each tooth in all groups were longitudinally splitted into two pieces as a control and experimental samples. Each experimental group received following antibiotic paste; double antibiotic paste (DAP) and triple antibiotic paste with doxycycline (TAPd), TAP with cefaclor (TAPc), TAP with amoxicillin (TAPa), and TAP with minocycline (TAPm) for 21 days. The Ca, P, Mg, Ca, and K levels, and the Ca/P ratio was analyzed by a scanning electron microscope (SEM) equipped using a Bruker energy-dispersive X-Ray (EDX) detector. Data were analyzed with independent samples t-test, one-way anova, and Duncan tests. Ca and Ca/P ratio showed a statistically significant increase TAP with amoxicillin and cefaclor (p < .05). DAP, TAPd, and TAPm did not change the mineral levels (p > .05). TAPa and TAPc with increased the Ca level and Ca/P ratio of the root canal dentin which consequently positively influences the revascularization process.

Clinical evaluation of specific oral and salivary findings of coeliac disease in eastern Turkish paediatric patients.

AIM: The aim of this study was to evaluate enamel defects (EDs), recurrent aphthous stomatitis (RAS) and salivary findings in Eastern Turkish children with coeliac disease (CD), and to compare the results with healthy children. STUDY DESIGN: 70 children (35 CD patients and 35 healthy patients) aged between 5 to 15 years were included in this study. Intraoral examination was performed; saliva specimens were collected for analysis. Oral health conditions, tooth brushing frequency, saliva pH level, flow rate and buffering capacity were recorded. Kruskal-Wallis test was used for comparison of DMFT and dft index. Chi-squared test was used for the data of oral health status. The significance level was set at p = 0.05. RESULTS: EDs were seen in 54.3% (19 patients) of the CD patients and more frequently than the controls (p < 0.05). Regarding RAS, 31.4% (11 patients) of the CD patients and none of control group had aphthous ulcers (p < 0.05). Salivary flow rate and buffering capacity were lower in CD patients (p < 0.05). CONCLUSION: The oral examination could be a significant contribution to the detection of CD. Especially paediatric dentists can play an important role in the early diagnosis and may help paediatricians about CD.

Clinical Evaluation of Restorative Materials in Primary Teeth Class II Lesions.

OBJECTIVE: The aim of this study was to evaluate clinical success of primary teeth class II lesions restored with different restorative materials [Hybrid Composite Resin (HCR), Resin Modified Glass Ionomer Cement (RMGIC), compomer, and Giomer Composite Resin (GCR)] followed up for 24 months. STUDY DESIGN: This study was carried out on 146 primary molars of 41 children in the age range of 5-7 years. The class II lesions in primary molars of a patient were restored using different restorative materials. Restorations were evaluated according to FDI-criteria and their survival rates were determined. Data were analysed with Pearson chi-square, Kaplan-Meier and Wilcoxon (Breslow) tests (α = 0.05). RESULTS: The failure rates of restorative materials were as follows: compomer 33.3%, RMGIC 28.1%, HCR 22.5% and GCR 21.1%. CONCLUSIONS: While the functional failure was the most important factor in restorative material failure, RMGIC was the most successful material in terms of biological evaluation criterion and GCR had the longest survival rate.

Finite element analysis of different restorative materials in primary teeth restorations.

AIM: The purpose of this finite element analysis (FEA) study is to evaluate and compare the stress distributions at the primary molars and restorative materials according to the material used. MATERIALS AND METHODS: A total of 12 3D models of Class II cavities in primary molars plus one control model were analysed. Study design: Three-dimensional FEA was used to compare stress distribution on enamel, dentin and restoration surfaces of cavities. STATISTICS: Stresses occurring under occlusal forces were compared with the von Mises criterion. RESULTS: The highest von Mises stress values at the enamel and restoration of restored tooth 84 were computed. On the basis of these results, all materials were ranked on enamel stress as: flowable composite resin (FCR)> compomer > resin modified glass ionomer cement (RMGIC) > giomer composite resin (GCR) > hybrid composite resin (HCR) > amalgam. Moreover, ranking of materials on restoration stress was FCR < compomer < RMGIC < GCR < amalgam < HCR. CONCLUSION: A restorative material with appropriate elasticity module, able to balance stress concentrations, should be used to increase the survival rate of both the hard tissue of the tooth and the restoration material.

Effects of obstructive jaundice and external biliary diversion on bacterial translocation in rats.

OBJECTIVE: To find out the rate of translocation of bacteria to visceral organs in obstructive jaundice, and whether the absence of bile within the intestine or the presence of obstructive jaundice itself promotes bacterial translocation. DESIGN: Prospective, controlled experimental animal study. SETTING: University hospital, Turkey. SUBJECTS: 40 Inbred albino rats weighing 160-220 g. INTERVENTIONS: Three groups of rats were studied: sham operated controls (n = 15), ligation of the common bile duct (CBD) (n = 15), and CBD-ligation and proximal external biliary division through a Silastic catheter (n = 10). Specimens of distal small bowel mesenteric lymph nodes (MLN), liver, spleen, and lung were obtained on the 10th postoperative day, and quantitative bacteriological analysis done. Caecal aerobic microflora were also measured for qualitative and quantitative comparisons. RESULTS: The translocation of bacteria to MLN, liver, and spleen, but not to the lungs, was slightly but not significantly increased by ligation of the CBD. Ligation of the CBD with simultaneous external biliary diversion caused increase translocation to all organs examined (with the increases to the MLN (p = 0.012), liver (p = 0.009), and spleen (p = 0.028) being significant). There was no difference in the raised bacterial counts in MLN and visceral organs after ligation of the CBD or biliary diversion. The pattern of caecal microflora did not change in any group. CONCLUSIONS: These findings suggest that the absence of bile from the gut may promote bacterial translocation to visceral organs.