Relationship between genuine and pseudohalitosis and social anxiety disorder.

Halitosis is described as offensive breath caused by various factors such as periodontal diseases, bacterial coating of tongue, systemic disorders and different types of foods. Pseudohalitosis is a situation that patients complain of oral malodor even though they do not have offensive odour. The purpose of this study was to compare the relationships between social anxiety estimations and both pseudohalitosis and genuine halitosis cases. Liebowitz Social Anxiety Scale (LSAS) and questionnaire regarding halitosis were applied to 100 participants. Halitosis was determined using organoleptic method, gas chromatography and portable sulphur monitor. anova test and 2-tailed Spearman's rank-order correlation coefficient were used to determine the differences and relations between groups. With reference to LSAS, 62% of participants had anxiety. Among these patients, 98% had genuine halitosis (P < 0·05). The mean measurements of VSC values were 248·65 ppm in halimeter, 298·02 ppm of H2 S, 95·33 ppm of CH3 SH and 47·00 ppm of (CH3 )2 S in gas chromatography. Halitosis was present in 90% of participants, and it was absent in 10% by organoleptic assessment. There was a significant correlation between organoleptic and halimeter measurements. Moreover, statistically significant relationship was detected between anxiety and halitosis. Genuine halitosis patients exhibit social anxiety, so it can be said that there is a causal relationship between halitosis and anxiety. Comparison of the results of objective measurements (sulphur monitor, gas chromatography, organoleptic method) was statistically significant; therefore, it can be said that these methods can be used in diagnosis of halitosis with high accuracy.

Comparison of the effect of naproxen, etodolac and diclofenac on postoperative sequels following third molar surgery: a randomised, double-blind, crossover study.

OBJECTIVE: To compare the three non-steroidal anti-inflammatory agents (NSAIDs) Diclofenac potassium, Etodolac and Naproxen sodium in relation to pain, swelling and trismus following impacted third molar surgery. STUDY DESIGN: The study was a randomized and a double-blinded study which included 42 healthy young individuals with impacted third molars and bone retention. Patients were randomly assigned to 3 groups (n: 14) to which Diclofenac potassium, Naproxen sodium and Etodolac were administered orally an hour before the operation. Impacted third molars were surgically extracted with local anaesthesia. Visual analog scales (VAS) were used to assess the pain in the 6th, 12th hours and on the 1st, 2nd, 3rd, 5th, and 7th days postoperatively. Swelling was evaluated using ultrasound (US) and mouth opening (trismus) was measured with a composing stick pre and post operatively on the 2nd and 7th days respectively. RESULTS: Regarding pain alleviation, Diclofenac potassium was better than Naproxen sodium and Naproxen sodium was better than Etodolac but these differences were not statistically significant. US measurements showed that the swelling on postoperative 2nd day was significantly lowest with Diclofenac potassium as compared to others (p= 0.027) while Naproxen sodium and Etodolac acted similarly (p=0.747). No difference was noted regarding trismus in any of the groups. CONCLUSION: NSAIDs (Diclofenac, Naproxen and Etodolac) are somehow similarly effective for controlling pain and trismus following extraction of mandibular third molars but Diclofenac potassium surpasses others in reduction of swelling.

Intermediate-term follow-up results of pulmonary balloon valvuloplasty in children.

Twenty-two patients (10 boys, 12 girls) with pulmonary valve stenosis whose mean age was 6.7 +/- 4.1 years (range 1 to 14 years) at time of the procedure underwent balloon dilatation angioplasty. All patients had isolated pulmonary valve stenosis with no associated cardiac anomalies, and their pulmonary valvular gradients were greater than 50 mmHg. Diagnostic catheterization and balloon valvuloplasty were performed during the same procedure. The mean peak systolic pressure gradient before balloon dilation of 95.8 +/- 29.5 mmHg (54-163 mmHg) was reduced to 30.2 +/- 15.8 mmHg (7-64 mmHg) after balloon dilation (p < 0.001). A linear relation was found between the predilation pressure gradient and the pressure gradient drop (r = 0,86; SE: 28.94) (y = 0.89x - 12.11). Following a successful valvuloplasty, the mean peak systolic pressure in the right ventricle decreased from 119.0 +/- 30.4 mmHg (71-184 mmHg) to 55.2 +/- 16.9 mmHg (29-97 mmHg) (p < 0.001). Continuous wave Doppler was used for follow-up. Pressure gradients were estimated in 14 patients between one and 29 months after the dilation 120 +/- 7.1 months). The mean follow-up gradient was 19.0 +/- 6.0 mmHg (11-32 mmHg). No important complication was noted in the immediate course or throughout the follow-up period, but four patients (28.6%) had minimal pulmonary insufficiency. In conclusion, these data confirm that balloon dilation in valvular pulmonary stenosis is safe and effective, and suggest that stenosis does not recur.

Acute rheumatic fever with three major criteria: polyarthritis, carditis and chorea. A case report.

An eight-year-old girl is presented with three major criteria of acute rheumatic fever: polyarthritis, carditis and chorea. The diagnosis was confirmed with a history of pharyngitis 15 days prior to admission and with the findings of positive acute phase reactants such as elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), elevated anti-streptolysin-O (ASO) titration, and clinical findings of polyarthritis, carditis and chorea. Patient responded well to salicylate and phenobarbital treatment. The rare association of these three major criteria in acute rheumatic fever is emphasized.

The coexistence of familial Mediterranean fever and polyarteritis nodosa; report of a case.

We describe a 14-year-old boy with a 5-year history of familial Mediterranean fever (FMF), treated with colchicine, who developed polyarteritis nodosa (PAN). He was admitted to our hospital with fever, general weakness, arthritis, and purpura. Five weeks after admission, hypertension was noted. Skin biopsy showed perivascular leukocyte infiltration in the epidermis. An aortography revealed multiple aneurysms of the renal, common hepatic, and intercostal arteries. He was treated with intravenous methylprednisolone, oral cyclophosphamide, and azathioprine. The known rare association of FMF and PAN is discussed.

Treatment of nocturnal enuresis: a placebo-controlled trial with piracetam, diphenylhydantoin and psychotherapy.

The study population consisted of 100 children with nocturnal enuresis (NE) aged between six and 14 years, who had been randomly selected amongst the enuretic outpatients at the Ankara S.S.K. Children's Hospital. A placebo-controlled evaluation of piracetam, diphenylhydantoin and psychotherapy was carried out. At the end of the eighth week of the study, it was discovered that the therapeutic effects observed in the patients administered piracetam did not differ from those given the placebo. Therefore, we recommend that psychotherapy in association with a placebo be the first step in the treatment of NE children.