Predictive Value of Neutrophil-to-Lymphocyte Ratio for Differentiating Organic Dyspepsia from Functional Dyspepsia

ABSTRACT Objective: Dyspepsia, one of the most commonly seen symptoms, can be due to organic dyspepsia (OD) or functional dyspepsia (FD). The aim of this study is to evaluate neutrophil-tolymphocyte ratio (NLR) for the predictability of OD due to peptic ulcer disease (PUD) and gastric cancer (GC). Methods: We investigated retrospectively the patients with dyspepsia who underwent endos-copy. The study included 119 patients with OD (41 patients with biopsy-proven GC and 78 patients with PUD) and 100 patients with FD diagnosed. Results: The NLR among the patients with GC and PUD was significantly higher than FD subject (p < 0.001 each). The NLR in patients with GC was also significantly higher than that in patients with PUD (p < 0.005). When OD was compared with FD, NLR and white blood cell were statistically significantly higher (p < 0.001 and p < 0.05 respectively). The best predictive cut-off value of NLR was 1.72 with a specificity of 63% and a sensitivity of 66% for OD, on receiver-operating characteristic curve analysis. Conclusion: Neutrophil-to-lymphocyte ratio was higher in patients with OD compared with those with FD, and even higher in patients with GC. Our findings suggest that NLR should be calculated in patients with dyspepsia and patients with high levels of NLR should undergo endoscopy.

Remodelling of Humeral Fracture in a Child with Osteopetrosis Tarda following Conservative Management -A 7-year Follow-up: A Case Report

@#Osteopetrosis (OP) is a rare hereditary sclerosing bone dysplasia characterised by generalised hard and brittle bone secondary to defective osteoclastic function. Osteopetrotic bone is brittle, thus these subjects are prone to frequent fractures, particularly of the long bones. Due to defective osteoclastic function, remodeling is also defective in OP. This report is a case of humeral fracture in a 9 years old girl who was followed seven years. The fracture had remodeled totally similar to healthy bone at the final follow-up. Conservative treatment should be kept in mind in the management of fractures in children with OP, and fractures within acceptable angulations and/or translations should be treated conservatively without hesitation.

Recurrence rate of odontogenic keratocyst treated by enucleation and peripheral ostectomy: Retrospective case series with up to 12 years of follow-up

BACKGROUND: Odontogenic keratocysts have been reported with high recurrence rates in the literature so various treatment modalities from simple enucleation to resection have been performed to achieve the cure. The purpose of this retrospective study was to investigate the recurrence rate of odontogenic keratocysts (OKCs) treated by enucleation and peripheral ostectomy. MATERIAL AND METHODS: An electronic search of the database of the Hacettepe University, Faculty of Medicine, Department of Pathology, was undertaken to identify patients histologically diagnosed with OKCs treated at Department of Oral and Maxillofacial Surgery between 2001 and 2015. RESULTS: In total, 81 patients were studied. The mean age at the time of diagnosis was 42 years, and the male:female ratio was 1:0.7. OKCs were located primarily in the posterior mandibular region (41%). Twenty-seven patients were re-examined to determine the recurrence rate. The mean follow-up period was 5 years (range, 1-12 years). The recurrence rate was 14.8%. The relationship between location of the lesion and recurrence was not statistically significant (p= 0.559). There was also no statistically significant relation between the recurrence rate and treatment option of teeth involved in the lesion (p= 0.579). CONCLUSIONS: The authors conclude that treatment of OKCs by enucleation with peripheral ostectomy is associated with minimal morbidity and is preferred over other aggressive treatment modalities. Meticulous radiographic examination and careful surgical resection may decrease the recurrence rate of OKCs

Effect of sumac extract on serum oxidative status, RANKL/OPG system and alveolar bone loss in experimental periodontitis in rats

Objectives Sumac (Rhus coriaria L.) is widely used spice which has several properties such as antioxidant, anti-inflammatory and antimicrobial. The purpose of this animal study was to evaluate the effects of sumac extract on levels of receptor activator of nuclear factor-kappa B ligand (RANKL), osteoprotegerin (OPG) expression, serum oxidative status, and alveolar bone loss in experimental periodontitis. Material and Methods Twenty-four Wistar rats were separated into three groups: non-ligated (NL, n=8), ligature only (LO, n=8), and ligature and treated with sumac extract (S, n=8) (20 mg/kg per day for 11 days). A 4/0 silk suture was placed around the mandibular right first molars subgingivally; after 11 days, the rats were sacrificed, and alveolar bone loss was histometrically measured. The detection of RANKL and OPG were immunohistochemically performed. Levels of serum total antioxidant status (TAS)/total oxidant status (TOS), and oxidative stress index (OSI) were also analyzed. Results Alveolar bone loss was significantly greater in the LO group compared to the S and NL groups (p<0.05). The number of inflammatory cell infiltrate (ICI) and osteoclasts in the LO group was significantly higher than that of the NL and S groups (p<0.05). The number of osteoblasts in the LO and S groups was significantly higher than that of the NL group (p<0.05). There were significantly more RANKL-positive cells in the LO group than in the S and NL groups (p<0.05). OPG-positive cells were higher in S group than in LO and NL groups (p<0.05). TOS and OSI levels were significantly reduced in S group compared to LO group (P<0.05) and TAS levels were similar in S and NL group (p>0.05). Conclusions The present study showed that systemic administration of sumac extract may reduce alveolar bone loss by affecting RANKL/OPG balance, TOS and OSI levels in periodontal disease in rats. .

Litiasis prostática: cálculos silentes / Prostatic calculi: silent stones

Introducción y objetivos: En la práctica urológica se encuentran con frecuencia cálculos prostáticos durante la resección transuretral de la próstata. Nuestro objetivo era demostrar las propiedades físicas y químicas de los cálculos prostáticos, así como determinar la posible relación entre la inflamación de la próstata y los cálculos prostáticos. Métodos: Se incluyó en el estudio a pacientes consecutivos (excluidos los sujetos con PSA≥4ng/ml y urolitiasis) sometidos a resección transuretral de la próstata (RTUP) en quienes se observaron cálculos prostáticos. Se analizó la composición química de los cálculos prostáticos obtenidos de cada paciente durante la RTUP, que se observaron también al microscopio electrónico (MEB) para determinar su estructura y morfología superficial. El uroanatomopatólogo valoró las muestras para emitir el diagnóstico definitivo y determinar la existencia y el grado de la inflamación. Resultados: Se incluyó en el estudio a cinco pacientes. Se obtuvieron de cada paciente al menos tres (de 3–8) muestras de cálculos (con un diámetro de 1–5mm). Los cálculos tenían una composición mixta de fosfato cálcico y carbonato cálcico. En la MEB se observó que los cálculos tenían una superficie lobular formada por pequeñas esferas. El examen histopatológico de las muestras de RTUP reveló hiperplasia prostática benigna acompañada de inflamación entre leve e intensa. Conclusiones: Los cálculos prostáticos son cálculos de calcio precipitados concéntricamente situados dentro de los conductillos prostáticos con una morfología granular arracimada. Estos cálculos prostáticos parecen ir acompañados de inflamación histopatológica (AU)

Introduction and Objectives: Prostate stones are frequently encountered during transurethral resection of the prostate in urology practice. We aimed to demonstrate the physical and chemical properties of prostate stones. We also aimed to determine possible relationship between inflammation of prostate gland and prostate stones. Methods: The consecutive patients (excluding subjects with PSA≥4ng/ml and urolithiasis), who underwent TURP operation and who were observed to have prostatic calculi during TURP, were included in the study. The prostatic stones obtained from each patient during TURP were analysed for chemical composition and observed under electron microscopy (SEM) for structure and surface morphology. The pathological specimens were assessed by the uropathologist for the final diagnosis and existence and degree of inflammation. Results: Five patients were included in the study. From each patient at least three (range 3–8) samples of stones (diameter varying from 1mm up to 5mm) were obtained. The stones were made of mixed composition of calcium phosphate and calcium carbonate. The stones were found to have lobular surface made up of small spheres under SEM. Histopathological examination of the TURP specimens revealed being prostatic hyperplasia accompanied with inflammation of mild to severe degree. Conclusions: Prostatic stones are concentrically precipitated calcium stones within the prostatic ductuli with granular grape like morphology. Histopathological inflammation seems to be associated with these prostatic calculi (AU)