Risk factors for dysmenorrhea among young adult female university students

Objectives. The aim of this study was to investigate associated risk factors for dysmenorrhea in a sample of Serbian university students. Methods. A case-control study was conducted among undergraduate students (n = 288) attending lectures during 2014/2015 academic year at the Faculty of Medical Sciences, University of Kragujevac. Results. The only significant associations were between dysmenorrhea and age at menarche (OR adjusted = 0.74; 95% CI 0.58-0.95; p = 0.017), family history of dysmenorrhea (OR adjusted = 3.39; 95% CI 1.74-6.63; p = 0.000), duration of menstrual flow (OR adjusted = 1.52; 95% CI 1.16-1.99; p = 0.002) and smoking at least one cigarette a day (OR adjusted = 5.09; 95% CI 1.83-14.15; p = 0.002). The factors associated with dysmenorrhea were not interacting with each other. Conclusion. Our results suggest that earlier age at menarche, longer duration of menstrual flow, prior family history of dysmenorrhea and smoking at least one cigarette a day are important risk factors associated with dysmenorrhea. Smoking cessation should be strongly encouraged.

Bijela krvna slika u različitim stadijima kroničnog parodontitisa

Periodontal disease is considered to be an inflammatory disorder that is related to the accumulation of oral microbial biofilm and the host response to this accumulation. The host reaction to gingival microorganisms is characterized in part by increase in the polymorphonuclear leukocyte counts, which is one of the most important steps in host defense. Exaggerated leukocytes and neutrophils of host response are a very important component in the pathogenesis of periodontal disease. The purpose of this study was to investigate the relationship between white blood cell count and periodontal disease in subjects with moderate and severe periodontitis and in control subjects with healthy periodontal tissues. Leukocytes for the present study were obtained from peripheral venous blood of 50 patients with moderate periodontitis, 50 patients with severe periodontitis and 25 healthy subjects. The clinical parameters of periodontitis including plaque index, bleeding on probing and gingival index were determined in all study subjects. In both moderate and severe periodontitis, the results indicated a significantly higher count of neutrophils (p<0.001), as well as of both lymphocytes and total leukocytes (p<0.05). The values of clinical parameters (plaque index, gingival index and bleeding on probing) also showed significant between-group differences (p<0.005 and p<0.001, respectively). It is possible that there is a significant relationship between total leukocyte count, neutrophil count and different forms of periodontal disease.Parodontna bolest je upalni poremećaj koji je povezan s akumulacijom oralnog mikrobnog biofilma i odgovorom domaćina na tu akumulaciju. Reakciju domaćina na gingivne mikroorganizme karakterizira donekle i povećanje broja polimorfonuklearnih leukocita, koji je jedan od najvažnijih koraka u odgovoru domaćina. Povećanje leukocita i neutrofila u okviru odgovora domaćina je veoma važna komponenta u patogenezi parodontne bolesti. Cilj ovoga istraživanja bio je ispitati vezu između broja bijelih krvnih zrnaca i parodontne bolesti kod ispitanika s blagom i uznapredovalom parodontopatijom i kontrolnih ispitanika sa zdravim parodontnim tkivom. Uzorak krvi za ispitivanje broja leukocita u ovom se istraživanju uzimao iz periferne venske krvi 50 ispitanika s umjerenom, 50 ispitanika s uznapredovalom parodontopatijom i 25 kontrolnih ispitanika. Klinički parametri parodontopatije, tj. plak indeks, indeks krvarenja i gingivni indeks određivali su se kod svih ispitanika. Kod obje skupine s parodontopatijom rezultati su pokazali značajno povećan broj neutrofila (p<0,001). Rezultati su također pokazali kako postoji značajnost između limfocita i ukupnog broja leukocita (p<0,05) među skupinama. Vrijednosti kliničkih parametara (plak indeks, gingivni indeks i indeks krvarenja) pokazale su značajnu razliku (p<0,005, p<0,001) među skupinama. U zaključku, moguće je da postoji značajna veza između ukupnog broja leukocita, broja neutrofila i različitih oblika parodontne bolesti

Association between chronic periodontitis and serum lipid levels

Background/Aim. Periodontitis is a local inflammatory process mediating destruction of periodontal tissues triggered by bacterial insult. However, this disease is also characterized by systemic inflammatory host responses that may contrbute, in part, to the recently reported increased risk for systemic diseases, including an altered lipid metabolism. On the other hand, many people in the world are affected by hyperlipidemia, which is a known risk faktor for atherosclerosis. The aim of this study was to determine the relationship between periodontal disease and blood lipid levels. Methods. A total of 50 patients with periodontitis included in this study had no documented history of recent acute coronary events. The healthy, non-periodontal subjects (comparison group) comprised 25 subjects. All the patients were periodontology examined and completed a medical history. Dental plaque index, probing depth, gingival index bleeding on probing and clinical attechment levels were recorded. Blood samples were taken on admission for measurements of serum total cholesterol, triglycerides, hight density lipoprotein cholesterol (HDL-cholesterol), and low density lipoprotein cholesterol (LDL-cholesterol). Results. The obtained results showed that mean levels of cholesterol (6.09 ± 1.61 mmol/L), triglycerdes (2.19+1.67mmol/l) and LDL cholesterol (4.09 ± 1.40 mmol/L) in individuals with periodontitis were higer, and levels od HDL (1.43 ± 0.51 mmol/L) was lower than those of individuals without periodontitis (4.86 ± 1.37; 1.14 ± 0.71; 3.18 ± 0.64; 1.53 ± 0.32 mmol/L, respectively). Conclusion. This study confirms a significant relationship between periodontal disease, regardless its intensity, and blood lipid levels in the studied population. The results imply that periodontitis may be a risk factor and may contribute to the pathogenesis of atherosclerosis and cardiovascular diseases (CVD). However, future prospective randomized studies have to determine whether periodontal disease is a risk factor for the occurrence of CVD

Terapijska učinkovitost klindamicin gela kao dodatak bazičnoj terapiji kronične parodontopatije

Clindamycin, a lincosamide antibiotic, has been under-recognized as an antimicrobial agent for use in dentistry. The aim of the present work was to evaluate clinical efficacy of 2% clindamycin gel in addition to the basic mechanical periodontal therapy. At baseline, scaling and root planing (SRP) was performed at all 50 subjects (control group and test group). Clindamycin gel was applied after SRP only in the test group. Clinical measurements including periodontal pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP) and plaque index (PI) were done at baseline, and at 3 and 6 months after treatment. Compared to baseline, the PPD and CAL values significantly decreased in the test group (p<0.05) and were statistically lower (p<0.05) compared to control group. PPD reduction of 2.42 mm was obtained in the test group and could be generally considered as clinically significant. A PPD reduction greater than 2 mm indicated that clindamycin gel could be used efficiently as an adjunct to SRP. Also, between-group difference in BOP and PI scores was statistically significant 6 months after treatment. In conclusion, the application of clindamycin gel in combination with SRP enhanced the efficacy of non surgical periodontal therapy in reducing pocket depth and improving attachment levels in chronic periodontitis subjects and had additional benefits over mechanical therapy alone.Klindamicin, linkozamidni antibiotik, je u širokoj upotrebi u stomatologiji. Cilj ovoga rada je bio procijeniti kliničku učinkovitost 2% klindamicin gela kao dodatne terapije bazičnoj terapiji kronične parodontopatije. Bazična terapija provedena je u svih 50 pacijenata (kontrolna skupina i ispitna skupina). Klindamicin gel je primijenjen nakon bazične terapije parodontopatije samo u ispitnoj skupini. Praćeni su sljedeći klinički parametri: dubina parodontalnog džepa (DPDZ), razina pripojnog epitela (NPE), indeks krvarenja (Ikr), plak indeks (PI). Mjerenje indeksa provedeno je prilikom prve terapije te tri i šest mjeseci nakon tretmana. DPDZ i NPE vrijednosti su bile značajno smanjene u ispitnoj skupini (p<0,05) i bile su statističke niže u odnosu na kontrolnu skupinu (p<0,05). Smanjenje dubine parodontalnog džepa za 2,42 mm zabilježeno je u ispitnoj skupini i može se smatrati klinički značajnim. Ovo smanjenje pokazuje da klindamicin gel ima terapijski učinak kao dodatak bazičnoj terapiji u liječenju kronične parodontopatije. Također je evidentirana statistička razlika između skupina u Ikr i PI šest mjeseci nakon terapije. Zaključuje se da primjena klindamicin gela u kombinaciji s bazičnom terapijom parodontopatije povećava učinkovitost nekirurške terapije

IDENTIFICATION OF FACTORS INFLUENCING BIRTH WEIGHT, LENGTH, AND HEAD CIRCUMFERENCE

Newborn size at birth is an important indicator of fetal health, neonatal health, infant survival and childhood morbidity. The aim of our study was to assess and identify factors that significantly influence birth weight, length, and head circumference by performing a post hoc analysis of the data collected during the retrospective-prospective observational cohort study which was conducted at the Clinic for Gynecology and Obstetrics at the University Clinical Centre Kragujevac, Serbia. The influence of potential factors on birth weight, length, and head circumference was evaluated by multiple linear regression analysis. The study included 320 pregnant women and 332 newborns. Four factors had a significant negative effect on birth weight: smoking, twin pregnancy, use of methyldopa and corticosteroids during pregnancy. Smoking, twin pregnancy and corticosteroid use also had a significant negative effect on birth length. Negative effect on fetal head circumference at birth had smoking, use of corticosteroids and antibiotics during pregnancy. Maternal height and gestational age at birth showed a positive influence on fetal anthropometric measurements. Clinicians should pay attention to pregnant women with lower body height, twin pregnancy, who smoke and use corticosteroids, methyldopa and antibiotics

Periodontal medicine: The emergence of a new branch in periodontology

Introduction: Periodontal medicine is the emergence of a new branch of periodontology. Periodontal medicine is a term used for different purposes in different parts of the world. In certain countries, it relates to the study of the dynamic relationship between periodontal diseases and systemic conditions, such as cardiovascular and cerebrovascular disease, preterm delivery low-birth-weight babies, diabetes mellitus, osteoporosis, and disorders of the respiratory tract. Such studies investigate the peripheral impacts of periodontal inflammation on systemic health. In other countries, 'periodontal medicine' is a term used to describe the periodontal (and gingival) manifestations of medical conditions. This includes their investigation, diagnosis and therapeutic management and how management of the oral condition integrates with the patient's medical management as part of a holistic approach within defined care pathways. Conclusion: The text is a comprehensive analysis of research on periodontal disease and its link to systemic conditions. The periodontal treatment may be important in terms of preventing a patient's overall health. Periodontologists emphasize that infections in the mouth can cause health problems in other parts of the body

Anthropometric parameters and aesthetics in the making of fixed prosthodontic restaurations: Part 2

Introduction: The role of aesthetic dentistry in the field of fixed dental prosthetics is to redesign the smile, which means not only the treatment on the teeth, but also the treatment of the surrounding soft tissues. Successful therapy can be achieved by establishing the harmony between the static (teeth, gingiva) and dynamic factors (lips, cheeks, mimic muscles) at rest and when performing various functions of the orofacial system. The aim: of the study was to analyze the parameters of the oral soft tissues (gingival health, gingival height, gingival zeniths, lip line and symmetry and balance of the dentition) that affect the aesthetics of fixed prosthodontic restorations. Literature data and clinical experience were used. Conclusion: Adherence to the described parameters is of great importance in the development of aesthetic and functional fixed prosthetic restoration

Morphological characteristics of the lip grooves in citizens of the Republic of North Macedonia determined by Cheiloscopy

Introduction: Cheiloscopy is defined as the study of the sulci labiorum, known as "lip prints". Aim of the study: The aim of this study was to determine the morphological characteristics of the lip grooves in the three dominant nationalities in the Republic of North Macedonia (Macedonians, Albanians, Roma) and to compare the obtained results with the morphological characteristics of the lip grooves in three other populations from different geographical regions. Material and methods: In this research, we included 150 examinees aged 25-50 years and divided them into three groups: Macedonians (50), Albanians (50) and Roma (50). The lip prints were taken using microscopic slides and detected using the dactyloscopic powder and brush method. We used the Suzuki and Tsuchihashi classification to typify the lip prints. Results: The most common type of lip grooves in the population of the Republic of North Macedonia was the type II grooves. There was no significant difference in the presence of different types of lip grooves in the four quadrants between males and females, nor between Macedonians, Albanians and Roma. The comparative analysis showed that populations from different geographical areas had different anthropological and morphological characteristics of the lip grooves. Conclusion: Type II lip grooves are the most common in the population of the Republic of North Macedonia and there is no statistically significant difference between the prevalence of different types of lip grooves in the three nationalities in this study. Considering the large number of factors that can affect the quality of the lip print, we recommend that a swab should always be taken before collecting the lip print in order to attempt to extract DNA material from the found trace

Drug-drug interactions in patients with acute coronary syndrome across phases of treatment

Uvod: Akutni koronarni sindrom (AKS) predstavlja značajan uzrok morbiditeta i mortaliteta širom sveta. Ciljevi ove studije bili su otkrivanje faze lečenja u kojoj su bolesnici sa AKS izloženi najvećem broju potencijalnih interakcija između lekova, kao i utvrđivanje najčešćih potencijalnih interakcija i faktora koji utiču na njihov broj u tri faze lečenja: od prvog kontakta sa zdravstvenom službom do koronarografije (1. faza), od koronarografije do poslednjeg dana hospitalizacije (2. faza) i na otpustu iz bolnice (3. faza). Materijal i metod: Istraživanje je dizajnirano kao opservaciona retrospektivna kohortna klinička studija koja je sprovedena na Klinici za kardiologiju, Kliničkog centra u Kragujevcu. Baze Medscape®, Epocrates® i Micromedex® su korišćene za otkrivanje potencijalnih interakcija između lekova. Rezultati: U studiju je uključeno 245 bolesnika. Ukupan broj potencijalnih interakcija bio je najveći u 2. fazi lečenja prema svim bazama, ali je statistički značajna razlika između sve tri faze pokazana samo za potencijalne interakcije po Medscape® bazi. U 1. fazi lečenja, nezavisno od kategorije ozbiljnosti i korišćene baze, najčešća potencijalna interakcija bila je između aspirina i heparina, u 2. fazi između aspirina i enoksaparina, a u 3. fazi između aspirina i bisoprolola. U barem jednoj fazi lečenja starost, >6 sati od pojave simptoma do prijema, dužina hospitalizacije, primarna perkutana koronarna intervencija, hronična opstruktivna bolest pluća, ranije prisutne aritmije, hiperlipidemija, hipertenzija, gojaznost, sistolni krvni pritisak na prijemu, TIMI rizik skor na prijemu, ALT, CRP, LDL, broj propisanih lekova i različite farmakološke grupe lekova su povećavali rizik za pojavu većeg broja potencijalnih interakcija, dok su koronarografija posle 24 sata hospitalizacije, mehanička ventilacija, astma, cerebrovaskularne bolesti, demencija i podatak o alergiji na lekove u medicinskoj dokumentaciji delovali protektivno. Efekat pola, tipa AKS-a, Charlson-ovog indeksa komorbiditeta, delirijuma, srčane insuficijencije, dijabetesa, aPTT-a i broja lekara koji su bolesniku propisivali lekove zavisio je od faze lečenja i kategorije ozbiljnosti potencijalnih interakcija između lekova. Zaključak: Lekari bi trebalo da obrate posebnu pažnju na mogućnost pojave potencijalnih interakcija između lekova kod bolesnika sa AKS kod kojih su prisutni faktori koji mogu povećati njihov broj.Introduction: Acute coronary syndrome (ACS) is an important cause of morbidity and mortality worldwide. The objectives of this study were to reveal the treatment phase in which ACS patients were exposed to the highest number of potential drug-drug interactions (pDDIs), as well as to determine the most common pDDIs and risk factors for pDDIs in three phases of ACS treatment: from the point of first medical contact to the coronary angiography (1st phase), after coronary angiography to the last day of hospitalization (2nd phase) and at discharge from hospital (3rd phase). Material and method: A retrospective observational cohort clinical study was conducted at the Clinic for Cardiology of the Clinical Centre Kragujevac, a public tertiary care hospital in Kragujevac, Serbia. Medscape®, Epocrates® and Micromedex® were used to detect pDDIs. Results: This study included 245 ACS patients. According to all three interaction checkers total number of pDDIs was highest in 2nd phase, but a statistically significant difference between all three phases was shown only for pDDIs detected by Medscape®. The most common pDDIs across phases of treatment regardless of the severity category and interaction checker were aspirin + heparin (1st phase), aspirin + enoxaparin (2nd phase) and aspirin + bisoprolol (3rd phase). In at least one treatment phase age, >6 hours from the beginning of the symptoms to admission, longer hospitalization, primary percutaneous coronary intervention, chronic obstructive pulmonary disease, prior arrhythmias, hyperlipidemia, hypertension, obesity, systolic blood pressure at admission, TIMI risk score at admission, ALT, CRP, LDL, number of prescribed drugs and various pharmacological classes increased risk of pDDIs, while coronary angiography after 24 hours of hospitalization, mechanical ventilation, asthma, cerebrovascular diseases, dementia and drug allergy protected against them. Effects of gender, type of ACS, Charlson Comorbidity Index, delirium, heart failure, diabetes, aPTT and number of prescribers depended on the phase of treatment and pDDI severity. Conclusion: In conclusion, physicians should be vigilant to the possibility of pDDIs in patients harbouring factors which may increase their rate

Drug-drug interactions in patients with acute coronary syndrome across phases of treatment

Uvod: Akutni koronarni sindrom (AKS) predstavlja značajan uzrok morbiditeta i mortaliteta širom sveta. Ciljevi ove studije bili su otkrivanje faze lečenja u kojoj su bolesnici sa AKS izloženi najvećem broju potencijalnih interakcija između lekova, kao i utvrđivanje najčešćih potencijalnih interakcija i faktora koji utiču na njihov broj u tri faze lečenja: od prvog kontakta sa zdravstvenom službom do koronarografije (1. faza), od koronarografije do poslednjeg dana hospitalizacije (2. faza) i na otpustu iz bolnice (3. faza). Materijal i metod: Istraživanje je dizajnirano kao opservaciona retrospektivna kohortna klinička studija koja je sprovedena na Klinici za kardiologiju, Kliničkog centra u Kragujevcu. Baze Medscape®, Epocrates® i Micromedex® su korišćene za otkrivanje potencijalnih interakcija između lekova. Rezultati: U studiju je uključeno 245 bolesnika. Ukupan broj potencijalnih interakcija bio je najveći u 2. fazi lečenja prema svim bazama, ali je statistički značajna razlika između sve tri faze pokazana samo za potencijalne interakcije po Medscape® bazi. U 1. fazi lečenja, nezavisno od kategorije ozbiljnosti i korišćene baze, najčešća potencijalna interakcija bila je između aspirina i heparina, u 2. fazi između aspirina i enoksaparina, a u 3. fazi između aspirina i bisoprolola. U barem jednoj fazi lečenja starost, >6 sati od pojave simptoma do prijema, dužina hospitalizacije, primarna perkutana koronarna intervencija, hronična opstruktivna bolest pluća, ranije prisutne aritmije, hiperlipidemija, hipertenzija, gojaznost, sistolni krvni pritisak na prijemu, TIMI rizik skor na prijemu, ALT, CRP, LDL, broj propisanih lekova i različite farmakološke grupe lekova su povećavali rizik za pojavu većeg broja potencijalnih interakcija, dok su koronarografija posle 24 sata hospitalizacije, mehanička ventilacija, astma, cerebrovaskularne bolesti, demencija i podatak o alergiji na lekove u medicinskoj dokumentaciji delovali protektivno. Efekat pola, tipa AKS-a, Charlson-ovog indeksa komorbiditeta, delirijuma, srčane insuficijencije, dijabetesa, aPTT-a i broja lekara koji su bolesniku propisivali lekove zavisio je od faze lečenja i kategorije ozbiljnosti potencijalnih interakcija između lekova. Zaključak: Lekari bi trebalo da obrate posebnu pažnju na mogućnost pojave potencijalnih interakcija između lekova kod bolesnika sa AKS kod kojih su prisutni faktori koji mogu povećati njihov broj.Introduction: Acute coronary syndrome (ACS) is an important cause of morbidity and mortality worldwide. The objectives of this study were to reveal the treatment phase in which ACS patients were exposed to the highest number of potential drug-drug interactions (pDDIs), as well as to determine the most common pDDIs and risk factors for pDDIs in three phases of ACS treatment: from the point of first medical contact to the coronary angiography (1st phase), after coronary angiography to the last day of hospitalization (2nd phase) and at discharge from hospital (3rd phase). Material and method: A retrospective observational cohort clinical study was conducted at the Clinic for Cardiology of the Clinical Centre Kragujevac, a public tertiary care hospital in Kragujevac, Serbia. Medscape®, Epocrates® and Micromedex® were used to detect pDDIs. Results: This study included 245 ACS patients. According to all three interaction checkers total number of pDDIs was highest in 2nd phase, but a statistically significant difference between all three phases was shown only for pDDIs detected by Medscape®. The most common pDDIs across phases of treatment regardless of the severity category and interaction checker were aspirin + heparin (1st phase), aspirin + enoxaparin (2nd phase) and aspirin + bisoprolol (3rd phase). In at least one treatment phase age, >6 hours from the beginning of the symptoms to admission, longer hospitalization, primary percutaneous coronary intervention, chronic obstructive pulmonary disease, prior arrhythmias, hyperlipidemia, hypertension, obesity, systolic blood pressure at admission, TIMI risk score at admission, ALT, CRP, LDL, number of prescribed drugs and various pharmacological classes increased risk of pDDIs, while coronary angiography after 24 hours of hospitalization, mechanical ventilation, asthma, cerebrovascular diseases, dementia and drug allergy protected against them. Effects of gender, type of ACS, Charlson Comorbidity Index, delirium, heart failure, diabetes, aPTT and number of prescribers depended on the phase of treatment and pDDI severity. Conclusion: In conclusion, physicians should be vigilant to the possibility of pDDIs in patients harbouring factors which may increase their rate