Background and objective: Bone sialoprotein is a mineralized tissue-specific protein expressed in differentiated osteoblasts that appear to function in the initial mineralization of bone. The aim of this study was to investigate the effect of local bone sialoprotein on increasing the rate of anchorage during orthodontic tooth movement.
Methods: This study used 14 dogs wearing orthodontic appliance for 40 days. They were divided equally into two groups; experimental group that injected with 0.1 µg /10µL sialoprotein around the anchoring tooth in three different time intervals, while the other control group received normal saline injection. Different clinical measurements including loss of anchorage, space closure, rotation, tipping and extrusion were done on the stone casts of each dog before and after tooth retraction.
Results: Clinical measurements revealed a highly significant difference between experimental and control group regarding loss of anchorage and space closure. The sialoprotein injected group showed less loss of anchorage than control group and the space closure was higher in experimental group than in the control group.
Conclusion: This study showed that the local injection of sialoiprotein reduced movement of the anchoring tooth during orthodontic treatment and provided higher stability for the anchoring tooth.
1. Geron S, Shpack N, Kandos S, Davidovitch M, Vardimon AD. Anchorage loss-a multifactorial response. Angle Orthod 2003; 73:730-7.
2. Esenlik E, Naziroğlu M, Açikalin C , Övey IS. Vitamin E supplementation modulates gingival crevicular fluid lipid peroxidation and antioxidant levels in patients with orthodontic tooth movement. Cell Biochem Funct 2012; 30:376-81.
3. Bartzela T, Türp JC, Motschall E, Maltha JC. Medication effects on the rate of orthodontic tooth movement: a systematic literature review. Am J Orthod Dentofacial Orthop 2009; 135: 16-26.
4. Ong CKL, Joseph BK, Waters MJ, Symons AL. Growth hormone receptor and IGF-I receptor immunoreactivity during orthodontic tooth movement in the prednisolone-treated rat. Angle Orthod 2001; 71:486-93.
5. Kim JY, Kim BI, Jue SS, Park JH , Shin JW. Localization of osteopontin and osterix in periodontal tissue during orthodontic tooth movement in rats. Angle Orthod 2012; 82:107-14.
6. Gameiro GH, Pereira-Neto JS, Magnani MB, Nouer DF. The influence of drugs and systemic factors on orthodontic tooth movement. J Clin Orthod 2007; 41:73-8.
7. Kohno S, Kaku M, Kawata T, Fujita T, Tsutsui K , Ohtani J, et al. Neutralizing effects of an anti-vascular endothelial growth factor antibody on tooth movement. Angle Orthod 2005; 75: 797-804.
8. Liu L, Igarashi K, Haruyama N, Saeki S, Shinoda H, Mitani H. Effects of local administration of clodoronate on orthodontic tooth movement and root resorption in rats. Eur J Orthod 2004; 26:469-73.
9. Saddi KRGC, Alves GD, Paulino TP, Ciancaglini P, Alves JB. Epidermal growth factor in liposomes may enhance osteoclast recruitment during tooth movement in rats. Angle Orthod 2008; 78:604-9.
10. Chaplet M, Detry C, Deroanne C, Fisher LW, Castronovo V, Bellahcene A. Zoledronic acid up-regulates bone sialoprotein expression in osteoblastic cells through Rho GTPases inhibition. Biochem J 2004; 384:591-8.
11. Wang S, Sasaki Y, Ogata Y. Calcium hydroxide regulates bone sialoprotein gene transcription in human osteoblast-like saos 2 cells. J Oral Sci 2011; 53:77-86.
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13. Zhang L, Hou X, Lu S, Rao H, Hou J, Luo R, et al. Predictive significance of bone sialoprotein and osteopontin for bone metastases in resected Chinese non-small-cell lung cancer patients: a large cohort retrospective study. Lung Cancer 2010; 67:114-9.
14. Goldberg HA, Baht G, Gordon J, Pitelka V, Chen H, Holdsworth D, et al. Bone Repair Mediated by Bone Sialoprotein. Eur Cell Mater 2008; 16:47.
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16. Malaval L, Wade-Gueye NM, Boudiffa M, Fei J, Zirngibl R, Chen F, et al. Bone sialoprotein plays a functional role in bone formation and osteoclastogenesis. J Exp Med 2008; 205:1145-53.
17. Hilbig H, Kirsten M, Rupietta R, Graf HL, Thalhammer S, Strasser S, et al. Implant surface coatings with sialoprotein, collagen, and fibronectin and their effects on cells derived from human maxillary bone. Eur J Med Res 2007; 12:6-12.
18. Madan MS, Liu ZJ, Gu GM, King GJ. Effect of human relaxin on orthodontic tooth movement and periodontal ligament in rats. Am J Orthod Dentofacial Orthop 2007; 131:8e1-10.
19. Gonzales C, Hotokezaka H, Karadeniz EI, Miyazaki T, Kobayashi E. Effects of fluoride intake on orthodontic tooth movement and orthodontically induced root resorption. Am J Orthod Dentofacial Orthop 2011; 139:196-205.
20. Hashimoto F, Kobayashi Y, Mataki S, Kobayashi K, Kato Y, Sakai H. Administration of osteocalcin accelerates orthodontic tooth movement induced by closed coil spring in rats. Eur J orthod 2001; 23:535-45.
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22. Soma S, Matsumoto S, Higuchi Y, Takano-Yamamoto T, Yamashita K , Kurisu K, et al. Local and chronic application PTH accelerates tooth movement in rarts. J Dent Res 2000; 79:1717-24.
23. Seifi M, Eslami B , Saffar AS. The effect of prostaglandin E2 and calcium gluconate on orthodontic tooth movement and root resorption in rats. Eur J Orthod 2003; 25:199-204.
24. Curtin P, McHugh KP, Zhou H, Flückiger R, Goldhaber P , Oppenheim FG, et al. Modulation of Bone Resorption by Phosphorylation State of Bone Sialoprotein. J Biochem 2009; 48:6876-86.
25. Tye CE, Rattray KR, Warner KJ, Gordon JA, Sodek J, Hunter GK, et al. Delineation of the hydroxyapatite nucleating domains of bone sialoprotein. J Biol Chem 2003; 278:7949-55.
26. Wang D, Christensen K, Chawla K, Xiao G, Krebsbach PH , Franceschi RT. Isolation and characterization of MC3T3- E1 preosteoblast subclones with distinct in vitro and in vivo differentiation/mineralization potential. J Bone Miner Res 1999; 14:893-903.
27. Valverde P, Tu Q, Chen J. BSP and RANKL induce osteoclastogenesis and bone resorption synergistically. J Bone Miner Res 2005; 20: 1669-79.
28. Razzouk S, Brunn JC, Qin C, Tye CE, Goldberg HA, Butler WT. Osteopontin posttranslational modifications, possibly phosphorylation, are required for in vitro bone resorption but not osteoclast adhesion. Bone 2002; 30:40-7.
29. Chen JK, Shapiro HS, Wrana JL, Reimers S, Heersche JN , Sodek J. Localization of bone sialoprotein (BSP) expression to sites of mineralized tissue formation in fetal rat tissues by in situ hybridization. Matrix 1991; 11:133-43.
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31. Yang L, Li Z, Li X, Wang Z, Wang S, Sasaki Y, et al. Butyric acid stimulates bone sialoiprotien gene transcription. J Oral Sci 2010; 52:231-7.
32. Sasaki Y, Wang S, Ogata Y. Transcriptional regulation of bone sialoprotein gene by CO2 laser irradiation. J Oral Sci 2011; 53:51-9.
33. O'Toole GC, Salih E, Gallagher C, FitzPatrick D, O'Higgins N, O'Rourke SK. Bone sialoprotein-coated femoral implants are osteoinductive but mechanically compromised. J Orthop Res 2004; 22(3):641-6.
34. Graf HL, Stoeva S, Armbruster FP, Neuhaus J, Hilbig H. Effect of bone sialoprotein and collagen coating on cell attachment to TICER and pure titanium implant surfaces. Int J Oral Maxillofac Surg 2008; 37(7):634-40.
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Background and objective: Deltopectoral flap is a two staged flap requiring skin graft of the donor site. This study was conducted to evaluate the possibility of primary closure of the deltopectoral flap-donor site without skin grafting.
Methods: The operations were conducted at Rizgari Teaching Hospital in the center of Erbil City, Kurdistan Region of Iraq. From January 2009 to December 2012, 14 deltopectoral flaps for reconstruction of oral/facial cancer ablative defects were done. Data on the age, gender, tumor site, and postoperative complications related to primarily closed deltopectoral flap-donor site (fistula, dehiscence, or hematoma leading to impairment of wound healing) and postoperative hospital stay were recorded.
Results: Of the 14 head-and-neck tumours, 10 were squamous cell carcinomas and four were ameloblastomas. Eleven of the patients were males and only three were females. The mean age (±SD) of the patients was 59±13 years. There was no evidence of partial or complete loss of the flap in any of the patients studied. There was no case of breakdown of the primarily closed donor site. The only registered complication was slight localized dehiscence at the most proximal and distal part of the primarily sutured flap donor site in one patient.
Conclusion: Primary closure of deltopectoral flap donor site is possible with minimal complication that overcomes the problem of skin grafting. Minimal wound breakdown in younger patients had been noted and left to heal by secondary intention.
1. Miloro M. Peterson’s Principals of Oral and Maxillofacial Surgery, 2nd ed. London: BC Decker; 2004.
2.Timmons MJ, Davies DM. Complications of radial forearm flap donor sites. Br J Plast Surg 1986; 39:176-8.
3. Ducic Y, Smith JE. The Cervicodeltopectoral Flap for Single-Stage Resurfacing of Anterolateral Defects of the Face and Neck. Arch Facial Plast Surg 2003; 5:197-201.
4. McGregor IA, Jackson IT. The extended role of the deltopectoral flap. Br J Plast Surg1970; 23:173-5.
5. Bakamjian VY, Long M, Rigg B. Experience with the medially based deltopectoral flap in reconstructive surgery of the head and neck. Br J Plast Surg 1971; 24:174-83.
6. Daniel RK, Cunningham DM, Taylor GI. The deltopectoral flap: an anatomical and hemodynamic approach. Plast Reconst Surg 1975; 55:275-80.
7. Jackson I, Lang W. Secondary esophagoplasty after pharyngo-laryngectomy using a modified deltopectoral flap. Plast Reconst Surg 1971; 48:155-9.
8. Neligan PC, Gullane PJ, Vesely M, Murray D. The internal mammary perforator flap: new variation on an old theme. Plast Reconst Surg 2007; 11(3): 891-3.
9. Balakrishnan C, Narasimhan K, Gursel T, Jackson O, Schaffner A. Closure of orocutanous fistula using a pedicled expanded deltopectoral flap. Can J Plast Surg 2008; 16(3):178-80.
Background and objective: Tissue expanders are useful adjuvant in reconstruction after burn. The technique provides tissue of similar texture and color to the defect to be covered and has the added advantage of minimal donor site morbidity. The study aimed to assess the outcome and complications of using tissue expansion for head and neck postburn reconstruction.
Methods: Thirty patients with head and neck burn scar, treated with thirty eight tissue expanders, were included in this prospective study at the Plastic Surgery Department in Rizgari Teaching Hospital in Erbil from April 2009 to November 2012, with the mean age of 14 years. Statistical package for social sciences (SPSS version 18) was used for data entry and analysis.
Results: The commonest use of tissue expander was for treating postburn scar alopecia (18 patients, 60%), followed by postburn cheek scar (six patients 20%). The scar size ranged from 4x10cm to 16x24cm. Complete burn scar excision was possible in 80% of cases with single or multiple sessions of expansion. Early exposure of the expander followed by infection occurred in three cases (10%), which led to interruption of the expansion and expander removal. Satisfactory results were achieved after reconstruction in 90% of cases.
Conclusion: Tissue expansion, if carefully planned and conducted, is one of the treatments of choice for post-burn reconstruction of the head and neck, allowing an expanded flap suitable for versatile coverage.
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3. Argenta L, Marks M. Principles of tissue expansion. Stephen J. Mathes. Plastic surgery. 2nd edition. Philadelphia: Saunders-Elsevier; 2006. P. 539-66.
4. Argenta L,Watanabe M, Grabb W. The use of tissue expansion in head and neck reconstruction. Ann Plast Surg 1983; 11:31.
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6. Bauer B. Tissue expansion.In: Beasley RW, Aston S, Bartlatt S, Gurtner G, Spear S. Grabb and Smith`s plastic surgery. 6th edition. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins; 2007.
7. Foustanos A, Zavrides H. Reconstruction of facial burn sequelae utilizing tissue expanders with embodiment injection site: case report. Acta 2006; 48:5-8.
8. Motamed S, Niazi F, Atarian S, Motamed A. Post-burn head and neck reconstruction using tissue expanders. BURNS 2008; 34:878-84
9. Hudson D, Lazarus D, Silfen R. The use of tissue expansion in pediatric plastic surgery.Ann Plast Surg 2000; 45(6):589-94.
10. Lasheen E, Saad K, Raslan M. External tissue expansion in head and neck reconstruction. J Plast Reconstr Aesthet Surg 2009; 62(8):251-4.
11. Bozkurt A, Gregor A, Dey D, Vogeler F. Retrospective analysis of tissue expansion in reconstructive burn surgery: Evaluation of complication rates. BURNS 2008; 34:1113-8.
12. Saleh Y. Scalp reconstruction using tissue expander. Egypt J Plast Reconstr Surg 2004; 28:71-5.
13. Hafezi F, Naghibzadeh B, Pegahmer M. Use of overinflated tissue expanders in the surgical repair of head and neck scars. JPRAS 2008; 20:1-8.
14. Tavares M, Belerique M, Franco D, Porchat A, Franco T. Tissue expansion in burn sequelae repair. BURNS 2007; 33:246-51.
15. Hromadka M, Deschamps J, Sawan K, Elamm C. Delayed development of toxic shock syndrome following abdominal tissue expansion in a pediatric reconstruction patient: case report. Ann Plast Surg 2010; 64(2):254-7.
16. Kotb M, Soliman M. Guidelines to Minimize the Complications of Tissue Expansion. Egypt J Plast Reconstr Surg 2007; 31(1):79-82.
Background and objective: Herpes simplex virus type 2 linked to the genital tract infection may produce significant acute or chronic cervicitis. Identification of the virus is important due to its association with genital tract disease and sexual transmission. The virus establishes lifelong latency with periodic reactivation. Therefore, it causes significant physical and psychological morbidity. The aim of this study was to assess and compare cytological examination with serological test in the diagnosis of genital herpes simplex virus type 2.
Methods: This study included 104 women. Pap smear was collected from 24 healthy women as a control group (group A), 40 patients with severe cervicitis on cytological examination (group B) and 40 patients with atypical cervicitis (group C). Blood sample was obtained from the patients and the control group and tested for Herpes simplex virus type 2 specific serology. The ages of the studied groups ranged from 21-53 years. They were referred to the Maternity Teaching Hospital and private laboratories in Erbil city, Kurdistan region, Iraq during the period from December 2011 to December 2012.
Results: Herpes simplex virus type 2 IgG antibodies were found in 10 sera from patients with nonspecific cervicitis (group-B) and only in three patients with atypical cervicitis (group-C). No positive serological test was identified in the control group. All Pap smear results showed features suggestive of cervicitis but without viral cytopathic herpetic changes.
Conclusion: The serological test was superior to cytology for the diagnosis of Herpes simplex virus type 2 infection in women presented with cervicitis with no clinically apparent genital ulcer or blisters.
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8. Money D, Steben M. Infectious Diseases Committee, Society of Obstetricians and Gynecologists of Canada. Guidelines for the management of herpes simplex virus in pregnancy. J ObstetGynaecol Can 2008; 30(6):514-26.
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15.Munday PE, Vuddamalay J, Slomka MJ, Brown DW. Role of type specific herpes simplex virus serology in the diagnosis and management of genital herpes. Sex Transm Infect 1998; 74(3):175-8.
16. Haverkos H, Rohrer M, Pickworth W. The cause of invasive cervical cancer could be multifactorial. Biomed Pharmacother 2000; 54(1):54-9.
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18. Paulo M, Borges AB, Duarte G, Quintana SM, Montes MB, Toloi MR. The environmental cofactors in carcinogenesis in high risk HPV/HIV-positive women. Braz J Infect Dis 2007; 11(2):189-95.
19. Tran-Thanh D, Provencher D, Koushik A, Duarte-Franco E, Kessous A, Drouin P, et al. Herpes simplex virus type II is not a cofactor to human papillomavirus in cancer of the uterine cervix. Am J Obstet Gynecol 2003; 188(1):129-34.
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Background and objective: Acne vulgaris is a common skin disorder. Combination therapy with topical retinoid and antibiotic is recognized as an effective treatment of acne vulgaris. The aim of this study was to compare the efficacy and tolerability of topical clindamycin solution as a monotherapy with the combination gel of clindamycin/adapalene for the treatment of mild to moderate acne of the face.
Methods: This comparative therapeutic trial was conducted at the out patient department of Dermatology and Venereology at Rizgari Teaching Hospital in Erbil City from November 2008. Hundred patients with mild to moderate acne of the face were enrolled in the study and were divided in to two groups; group I (n=50); apply clindamycin phosphate solution 1%, and group II (n=50); apply a combination gel of clindamycin1% /adapalene 0.1%; once daily at night for 12 weeks.
Results: Of 100 patients, 89 patients completed their treatment as per protocol, 45 patients in group I, and 44 patients in group II. At the end of the 12 weeks; the mean percent reductions of noninflammatory, inflammatory, and total lesion count were greater in group II than in group I. A significantly greater reduction of total (P = 0.008), and noninflammatory lesions (P = 0.002) were seen in group II than in group I. Both treatments were well tolerated, and few side effects were reported.
Conclusion: This study demonstrates that the combination of topical clindamycin and adapalene is more effective than clindamycin solution alone, and provides faster benefit in treatment of mild to moderate acne.
1. Simpson NB, Cunliffe WJ . Disorders of the Sebaceous glands. In: Burns T, Breathnach S, Cox N, Griffiths C editors. Rook's Textbook of Dermatology; 7th edition. Oxford: Black well scientific Publication; 2004. 43:15-42.
2. Kubba R, Bajaj AK, Thappa DM, Sharma R, Vedamurthy M, Dhar S, et al . Acne in india: Guidelines for management: Pathogenesis of acne. Indian J Dermatol Venereol Leprol 2009a; 75(1):S5-9.
3. The Evaluator's Global Severity Score (proposed at the Division of Dermatology Advisory Committee [DODAC] meeting of November 4 and 5, 2002).
4. Zaenglein AL, Graber EM, Thiboutot DM, Strauss JS.AcneVulgaris and Acneiform Eruptions. In: Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ editors. Fitzpatrick's Dermatology in General Medicine; 7th edition. New York: McGraw-Hill; 2008.P.690-703.
5. Piskin S, Uzunali E . A review of the use of adapalene for thetreatment of acne vulgaris. PubMed Central: Ther Clin Risk Manag 2007; 3(4):621-4.
6. Habif T.P.Acne, Rosacea, and Related Disorder. In: Clinical Dermatology; 4th Edition. Philadelphia: Mosby; 2004. P.162-94.
7. Bowman S, Gold M, Nasir A, Vamvakias G .Comparison of clindamycin/benzoyl peroxide, tretinoin plus clindamycin, and the combination of clindamycin/benzoyl peroxide and tretinoin plus clindamycin in the treatment of acne vulgaris: a randomized, blinded study. J Drugs Dermatol 2005;4(5):611-8.
8. Dos SK, Barbhuiya JN, Jana S, Dey SK. Comparative evaluation of clindamycin phosphate 1% and clindamycin phosphate1% with nicotinamide gel 4% in the treatment of acne vulgaris. Indian J Dermatol Venereol Leprol 2003; 69: 8-9.
9. Jain GK, Ahmed FJ. Adapalene pretreatment increases follicular penetration of clindamycin: In vitro and in vivo studies. Indian J Dermatol Venereol Leprol 2007; 73: 326-9.
10. Wolf JE, Kaplan D, Kraus SJ, Loven KH, Rist T, Swinyer LJ, et al. Efficacy and tolerability of combined topical treatment of acne vulgaris with adapalene and clindamycin: a multicenter, randomized, investigator-blinded study. J Am Acad Dermatol 2003; 49:S211-7.
11. Zhang JZ, Li LF, Tu YT, Zheng J. A successful maintenance approach in inflammatory acne with adapalene gel 0.1% after an initial treatment in combination with clindamycin topical solution 1% or after mono-therapy with clindamycin topical solution 1%. J Dermatolog Treat 2004; 15(6): 372-8.
12. Nilfroushzadeh MA, Siadat AH, Baradaran EH, Moradi S. Clindamycin lotion alone versus combination lotion of clindamycin Phosphate plus tretinoin versus combination lotion of clindamycin phosphate plus salicylic acid in the topical treatment of mild to moderate acne vulgaris: A randomized control trial. Indian J DermatolVenereol Leprol 2009; 75: 279-82.
Background and objective: Diabetes mellitus is a disorder that is often associated with cardiovascular diseases and underlying lipid abnormalities. The aim of this study was to calculate the serum level of LDL indirectly, using different equations in type 2 diabetes patients in an attempt to focus on the variation of estimating level which reflected on the decision to prescribe lipid lowering agents.
Methods: A total of 70 patients with type 2 diabetes using oral hypoglycemic agents alone and/or once- or twice-daily insulin, their non-HDL atherogenic lipoprotein in reference to atherogenic index were conducted in Martyr Layla Qasm Center for Diabetes Mellitus in Erbil, Iraq, during the period from June, 2011 to January, 2013.
Results: Age of type 2 diabetes patients ranged from 29 to 82 years with a mean age of 56.6 years with duration of disease ranged between 1.2-39 years. Results revealed that the mean fasting serum glucose and glycosylated hemoglobin were 181.9 mg/dl and 8.428%, respectively. The mean value of serum triglycerides was 171.5 mg/dl which is higher than the cut-off normal value of 150 mg/dl. Results showed significant correlation between atherogenic index and calculated atherogenic lipoprotein and significant correlation between atherogenic index and waist circumference as an indicator of central obesity.
Conclusion: The mean body mass index value indicated that the patients were obese and the mean value of waist circumference did not reach the cut-off level of central obesity. The mean value of atherogenic index indicated that the patients were at increased risk of cardiovascular events. Estimation of LDL value from the direct measurement of lipid profile in type 2 diabetes with high serum triglyceride level is not a reliable method.
Keywords: type 2 diabetes, atherogenic index.
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10. Ito K, Yoshida H, Yanai H, Kurosawa H, Sato R, Mannita D, et al. Relevance of intermediate-density lipoprotein cholesterol to Framingham risk score of coronary heart disease in middle-aged men with increased non-HDL cholesterol Int J Cardiol 2013; 168(4):3853-8.
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Background and objective: Herbal medicine is a traditional or folk medicine practice based on the use of plants’ seeds, berries, roots, leaves, barks, flowers and plant extracts for medicinal purposes. This survey highlights the traditional phytotherapy practices by traditional healers of Erbil-Kurdistan region in the treatment of various disorders.
Methods: An ethnobotanical survey was undertaken to collect information from traditional healers on the use of medicinal plants in Erbil-Kurdistan region. The indigenous knowledge of local traditional healers and the native plants used for medicinal purposes were collected through questionnaire and personal interviews.
Results: The investigation revealed that the traditional healers were not professionally authorized and 32 plants belonging to 23 families were used to treat various diseases in traditional medicine. The plants reported have been identified and presented in a table with the vernacular names, useful parts, dosage preparations and medicinal uses.
Conclusion: Many recorded species of plants are used in Erbil- Kurdistan region in traditional medicine but lack phyto-therapeutic evidence. Most indigenous plants remain to be studied which may yield many exciting data for further investigation.
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Background and objective: Fasting during the Ramadan month is a religious duty and it is obligatory for all healthy adult Muslims. The aim of this study was to investigate the effects of fasting during Ramadan in different times and place on body weight, blood sugar, serum lipids and blood pressure.
Methods: Fifty three healthy adult fasting volunteers were included in the study. Peripheral venous blood samples were taken three days before Ramadan, at the end of the first week, and at the end of the fourth week of fasting. The last blood sample was taken one week after the end of Ramadan. Serum total cholesterol, HDL and LDL, triglycerides and glucose were measured. Vital signs and body mass index were taken by one of the researchers.
Results: Thirty three (62.3%) volunteers were males, 93.4% were below 40 years of age. Weight changed significantly during Ramadan. Mean systolic blood pressure decreased by 11 mmHg while diastolic blood pressure decreased by 9 mmHg (P <0.001). Fasting blood sugar decreased by 14.96 mg/dl (P <0.001). Plasma lipids; cholesterol decreased by 19.3 mg/dl (P <0.027), LDL by 23 mg/dl (P <0.001), triglyceride by 44 mg/dl (P <0.003) but the HDL increased by 5.4 mg/dl (P <0.002) during Ramadan fasting. Before Ramadan, 19% of participants had abnormal serum cholesterol and 37% had abnormal LDL level, while after Ramadan all had normal lipid levels (P <0.001). The proportion of participants with abnormal HDL decreased from 94% before Ramadan to 50% after Ramadan (P <0.001).
Conclusion: Ramadan affects the body physiology and lowers the weight, serum lipids, blood pressure and blood glucose levels.
1. Azizi F. Research in Islamic fasting and health. Ann Saudi Med 2002; 122:186-91.
2. Akanji AO, Mojiminiyi OA, Abdella N. Beneficial changes in serum apo A-1 and its ratio to apo B and HDL in stable hyper-lipidaemic subjects after Ramadan fasting in Kuwait. Euro J Clin Nutr 2000; 54:508-13.
3. Yucel A, Degirmanci B, Acar M, Albayrak R, Haktanir A. The effect of fasting month of Ramadan of the abdominal fat distribution. Tohoku J Exp Med 2004; 204(3):179-87.
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6. Sarraf-Zadegan N, Atashi M, Naderi GA, Baghai AM, Asgary S, Fatehifar M. The effect of fasting in Ramadan on values and interrelations between biochemical, coagulation and hematological factors. Ann Saudi Med 2000; 20:5-6.
7. Mansi K. Study the effect of Ramadan fasting on the serum glucose and lipid profile among healthy Jordanian students. A J App Sci 2007; 4(8):565-9.
8. Ziaee V, Razaei M, Ahmadinejad Z, Shaikh H, Yousefi R, YarmohammadiL, et al. The changes of metabolic profile and weight during Ramadan fasting Singapore Med J 2006; 47(5):409.
9. Temizhan A, Donderici O, Ouz D, Demirbas B. Is there any effect of Ramadan fasting on acute coronary heart disease events? Int J Cardiol 1999; 70:149-53.
Background and objective: Infiltration anesthesia for the posterior region of the mandible has been routinely avoided because of its questionable effectiveness related to the dense cortical bone of the mandible. The aim of this study was to evaluate the effectiveness of infiltration anesthetic technique on mandibular posterior non-vital teeth.
Methods: Forty four patients aged between 13and 73 years who attended the Department of Oral and Maxillofacial Surgery in the College of Dentistry, Hawler Medical University for extraction of posterior non vital tooth were included in this study. For the infiltration anesthetic technique, patient’s approval was taken. The patients were equally divided into two groups. Group (1) received 0.6 ml out of 1.8 ml of 2% lidocaine with 1:80000 adrenaline injection bucally and the same amount infiltration lingually opposite the intended tooth. Group (2) received 1.5 ml out of 1.8 ml of 2% lidocaine with 1:80000 and the remaining 0.3 ml was injected for long buccal nerve anesthesia.
Results: In group (1), 68.2% had no pain during extraction, showed statistically highly significant difference (P = 009). Gender showed no significant difference. In group (2), 100 % of the patients had no pain during extraction.
Conclusion: Infiltration anesthesia for non-vital mandibular molars is effective as a substitute for inferior alveolar block technique.
1. Oulis CJ, Vadiakas GP, VasilopoulouA. The effectiveness of mandibular infiltration compared to mandibular block anesthesia in treating primary molars in children. Pediatr Dent J 1996; 18:301-5.
2. Heller AA, Shankland WE. Alternative to the inferior alveolar nerve block anesthesia when placing mandibular dental implants posterior to the mental foramen. J Oral Implantol 2001; 27:127-33.
3. Talesh KT, Solahaye-Kahnamouii S .Application of Crestal Anesthesia for Treatment of Class I Caries in Posterior Mandibular Teeth. J Dent Res 2011; 5:17-22.
4. Oulis CJ, Vadiaka GP, Vasilopoulou A. The effectiveness of mandibular infiltration compared to mandibular block anesthesia in treating primary molars in children. J Pediatr Dent 1996; 18:301-5.
5. Champan PJ. Postoperative pain control for outpatient oral surgery. J Endod 2003; 28:89-91.
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8. Etoz1 OA, Erl N, Demirbas AE. Issupraperiosteal infiltration anesthesia safe enough to prevent inferior alveolar nerve during posterior mandibular implant surgery. Med Oral Patol Oral Cir Bucal 2011; 16:386-9.
9. Madeira MC, Percinoto C, das Graças M, Silva M. Clinical significance of supplementary innervation of the lower incisor teeth: a dissection study of the mylohyoid nerve. OralSurg Oral Med Oral Pathol 1998; 46:608-14.
10. Pogrel MA, Smith R, Ahani R. Innervation of the mandibular incisors by the mental nerve. J Oral MaxillofacSurg 1997; 55:961-3.
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Background and objective: The term hemangioma refers to the common tumor of infancy that exhibits rapid postnatal growth and slow regression during childhood. Hemangioma has a perinatal incidence of 1%-3% and affecting 10% of infants by one year of age. The aim of this study was to evaluate treatment outcomes following various managements of hemangiomas.
Methods: One hundred four patients were included in this prospective study. Based on clinical management, each patient was assigned to different treatment groups: steroid, surgical, and combined therapy. Treatment outcomes were evaluated based on improvement in size and color, by a blinded panel of three raters including two doctors and one patient or patient’s parents. Finally, comparison of outcomes between groups was analyzed statistically. A p value ≤ 0.05 was considered statistically significant.
Results: The results revealed that there was reduction in size and improvement in color following intervention in each group. Comparison of treatment outcomes between treatment groups revealed statistically significant difference among the groups regarding improvement in color (P <0.01) and reduction in size of hemangioma (P <0.01), and surgical treatment was better (among 31 patients, 17 got moderate improvement and 11 excellent improvement) compared with steroid therapy (among 36 patients, 19 got moderate improvement, and 3 excellent improvement).
Conclusion: A favorable outcome can be achieved following appropriate intervention during all stages of development of hemangiomas.
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5. Tollefson M, Frieden J. Early growth of infantile hemangiomas: what parents’ photographs tell us. J Pediatrics 2012; 130:314-20.
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10. Aaron Fay, John Nguyen, Milton Waner. Conceptual Approach to the Management of Infantile Hemangiomas. J Pediatr 2010; 157(6):881-8.
11. Eivazi B, Cremer H, Mangold C, Teymoortash A, Wiegand S, Werner J. Hemangiomas of the nasal tip: An approach to a therapeutic challenge. Int J Pediatr Otorhinolaryngol 2011; 75:368-75.
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13. Enjolras O, Gelbert F. Superficial hemangiomas: associations and management. Pediatr Dermatol 1997; 14:173-9.
14. Achauer M, Chang J, Vander M. Management of hemangioma of infancy: review of 245 patients. Plast Reconstr Surg 1997; 99:1301-8.
15. Mcheika N, Renauld V, Duportb G, Vergnesc P, Levarda G. Surgical treatment of haemangioma in infants. Br J Plast Surg 2005; 58:1067-72.
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17. Pope E, Krafchik R, Macarthur C. Oral versus high-dose pulse corticosteroids for problematic infantile hemangiomas: a randomized, controlled trial. J Pediatrics 2007; 119:1239-47.
18. Bennett L, Fleischer B, Chamlin L, Frieden J. Oral corticosteroid use is effective for cutaneous hemangiomas. An evidence based evaluation. Arch Dermatol 2001; 137:1208-13.
19. Demiri C, Pelissies P, Genin T, Tsakoniatis N, Martin D, Baudet J. Treatment of facial haemangiomas: the present status of surgery. Br J Plast Surg 2001; 54:665-74.
20. Kane J, Morris S, Jackson T, Woods E. Significant hemangiomas and vascular malformations of the head and neck: clinical management and treatment outcomes. Ann Plast Surg1995; 35:133-43.
21. Frieden J, Eichenfield F, Esterly B, Geronemus R, Mallory B. American Academy of Dermatology guidelines of care for hemangiomas of infancy. J Am Acad Dermatol 1997; 37:631-7
Background and objective: It is well known that oral candidiasis increase in many situations, like obesity, debility, leukemia, viral infection, use of certain drugs in addition to diabetes mellitus. The aim of this study was to estimate the prevalence of Candida albicans in the oral cavity of diabetic and non-diabetic subjects and to identify factors predisposing to colonization in the diabetic patient. The variables evaluated include absolute white blood cell counts and differentials, glycosylated hemoglobin levels, serum glucose, blood urea, serum creatinine and duration of diabetes.
Methods: One hundred subjects of type II diabetes mellitus and one hundred non-diabetic subjects (control) were studied for isolation of Candida albicans from oral cavity. Further investigations for diabetic group were done regarding serum glucose, HbA1c, and total and differential white blood cell counts.
Results: This study showed 56 (56%) out of 100 diabetic subjects and 30 (30%) out of 100 in non-diabetic subjects were found to carry Candida in their oral cavity. In the diabetic group, no relationship was found to total or differential white blood cell count, recent use of antibiotics, serum glucose and HbA1c values. A significant relationship was found in diabetic patients who had chronic renal disease.
Conclusion: Colonization of Candida albicans in the oral cavity was found to be higher in diabetic subjects than in non-diabetic. However, glycaemic control in diabetes, total and differential white blood cells were found to bear no relation with carriage of Candida in the oral cavity.
Keywords: Candida albicans, type II diabetes mellitus, white blood cells.
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Background and objective: Accuracy of working length determination is important in successful endodontic treatment. The aim of this study was to clinically compare working length determination in dry and wet canals with radiography and i- Root apex locater and in cases of presence or absence of peri apical lesion (An in vivo study).
Methods: This study was conducted in the Department of Endodontic in the College of Dentistry at Hawler Medical University, Erbil, Iraq. A total number of 45 single rooted teeth with single canals have been evaluated. An access cavity was then prepared and the pulp was extriped with barbed broach. Initial electronic measurements have been done under a wet condition; the root canals were rinsed with normal saline and then dried with paper points. i-Root TM apex locator had been used to estimate the working length. Each measurement was repeated three times and the mean value was calculated and computed. Then the K- file was selected for each tooth according to the size of each canal and peri apical radiograph had been taken to measure the length for each canal and compared with recorded length by apex locater. Statistically analysis included the used of paired sample t-test. A P value of ≤0.05 was considered statistically significant.
Results: There was no significant difference between working length determination by radiography and i-Root TM electronic apex locator in dry and wet canals and in case of presence or absence of peri apical lesion.
Conclusion: This study did not show any difference between radiography, i-Root TM and direct visualization in working length determination.
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3. Assunção DF, Albuquerque D, Ferreira D. The Ability of two apex locators to locate the apical foramen: An In Vitro Study. J Endod 2006; 32:6.
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7. Gordon MP, Chandler NP. Electronic apex locators. Int Endod J 2004; 37:425-37.
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13. Fouad AF, Reid LC. Effect of using electronic apex locators on selected endodontic treatment parameters. J Endod 2000; 26:364-7.
14. ElAyouti A, Weiger R, Lost C. The ability of root ZX apex locator to reduce the frequency of overestimated radiographic working length. J Endod 2002; 28:116-9.
15. Hoer D, Attin T. The accuracy of electronic working length determination. Int Endod J 2004; 37:125-31.
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Background and objective: Many bacterial isolates show an increased antimicrobial resistance due to biofilm production. Repeated exposure to sub lethal concentrations of antimicrobial agents certainly contributes to the resistance as compared to planktonic bacteria. The aim of this study was to test whether the bacterial phenotypes of P. aeruginosa can be changed during exposures to the concentrations at sub lethal doses of chlorhexidine.
Methods: Sheep blood agar plates were used for evaluation of haemolysin assay for isolates of P. aeroginusa. A 96-flat bottom well microtiter plates were used for determination of MIC of antibiotic and biofilm formation.
Results: All tested isolates were able to lyse RBCs after exposure to sub-MIC of chlorhexidine. Effectiveness of sub-lethal doses of chlorhexidine on biofilm formations varied depending on the contact time. In general, long contact time exhibited increasing biofilm than short time. No significant difference in biofilm was detected among contact times: day I, day II and day III (P = 0.132, P = 0.139 and P = 0.125, respectively). The most effective sub-MIC of CHX was against azithromycin, since the resistance increased significantly (P = 0.008).
Conclusion: Surviving P. aeruginosa to low concentration of chlorhexidine can exhibit stronger biofilm and increased resistance to antibiotics.
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