Complications Associated with Local Anesthesia in Oral and Maxillofacial Surgery

One of the important attempts in clinical oral surgery practice is to maintain safe and effective local anesthesia. Dental procedures are frequently performed under local anesthesia; thus, drug-related complications are often encountered. It is mandatory to have a preoperative evaluation of the patient and choosing the proper local anesthetic agent. Various complications including hypersensitivity, allergy, overdosage, toxicity, hematoma, trismus, paresthesia, or neuralgia can be observed during practice. Therefore, the practitioner should be aware of the possible complications and management methods. The aim of this chapter is to review the preoperative and postoperative complications associated with the local anesthetic in oral and maxillofacial surgery practice. The prevention of measures and treatment of the complications is also emphasized

Evaluation of the importance of immunological profile for pemphigus vulgaris in the light of necessity to modify compensation theory

According to the “desmoglein compensation theory,” anti-Dsg1 and anti-Dsg3 profiles are crucial for the clinical outcome of pemphigus vulgaris. However, recent studies have highlighted several cases with an incompatibility between the antibody profile and clinical manifestation. Data of 37 patients who had been diagnosed pemphigus vulgaris in our Department between January 2014-June 2016 were retrieved from our clinical database. Patients with ABSIS skin involvement scores, oral mucosa extent and severity scores, anti-Dsg1 and Dsg3 antibody profile were included in this retrospective study. Patients with discordance between clinical manifestations and immunological profile were considered as atypical clinical phenotype. Patients with missing data were excluded. In all 37 patients, Dsg1 and Dsg3 antibody titers at the baseline did not correlate with the concurrent ABSIS scores. At follow up, we detected statistically significant correlations between anti Dsg-1 profile and ABSIS skin involvement scores (p=0.006; r=0.588) and between anti-Dsg3 and ABSIS mucosal extent and severity scores (p=0.058; r=0.431). After treatment, the reduction of Dsg-1 antibody titers was statistically significant in remittent patients (p=0.027). We did not detect statistically significant reduction of Dsg-3 antibodies. Four subjects had incompatible antibody profile and clinical activity. Discordance between phenotype-antibody profile and clinical activity-Dsg titers support the idea that non-Dsg antigens may also be the target for pemphigus autoimmunity. </p

A Novel Deep Learning Technique for Morphology Preserved Fetal ECG Extraction from Mother ECG using 1D-CycleGAN

Monitoring the electrical pulse of fetal heart through a non-invasive fetal electrocardiogram (fECG) can easily detect abnormalities in the developing heart to significantly reduce the infant mortality rate and post-natal complications. Due to the overlapping of maternal and fetal R-peaks, the low amplitude of the fECG, systematic and ambient noises, typical signal extraction methods, such as adaptive filters, independent component analysis, empirical mode decomposition, etc., are unable to produce satisfactory fECG. While some techniques can produce accurate QRS waves, they often ignore other important aspects of the ECG. Our approach, which is based on 1D CycleGAN, can reconstruct the fECG signal from the mECG signal while maintaining the morphology due to extensive preprocessing and appropriate framework. The performance of our solution was evaluated by combining two available datasets from Physionet, "Abdominal and Direct Fetal ECG Database" and "Fetal electrocardiograms, direct and abdominal with reference heartbeat annotations", where it achieved an average PCC and Spectral-Correlation score of 88.4% and 89.4%, respectively. It detects the fQRS of the signal with accuracy, precision, recall and F1 score of 92.6%, 97.6%, 94.8% and 96.4%, respectively. It can also accurately produce the estimation of fetal heart rate and R-R interval with an error of 0.25% and 0.27%, respectively. The main contribution of our work is that, unlike similar studies, it can retain the morphology of the ECG signal with high fidelity. The accuracy of our solution for fetal heart rate and R-R interval length is comparable to existing state-of-the-art techniques. This makes it a highly effective tool for early diagnosis of fetal heart diseases and regular health checkups of the fetus.Comment: 24 pages, 11 figure

Generalized livedo reticularis like eruption induced Generalized livedo reticularis like eruption induced by trimethoprim/sulfamethoxazole: A case report with by trimethoprim/sulfamethoxazole: A case report with concomitant myelosuppression

Livedo reticularis is a reticular discoloration of the skin because of the vascular anatomy of the skin. The condition most commonly affects the legs. Drug induced livedo reticularis which is an acknowledged side effect of amantadine, tends to be widespread, asymptomatic, benign rash. There are also reports of livedoid eruption induced with drugs including dapsone, imatinibe, gefitinibe. We describe a case of livedo reticularis like eruption and haemotological toxicity with trimetophrim-sulfamethoxazole. The purpose of this report is to remind clinicians of this rare, benign side effect of the common prescribed medication

Pustular Activation Of Plaque Psoriasis Induced After Hepatitis B Vaccination

Pustular psoriasis is a rare variant of psoriasis characterized by recurrent pustule formation on the erythematous base. Pustular exacerbation in plaque psoriasis can be triggered by systemic steroid use and its abrupt cessation, drugs such as salicylate, iodine, lithium, hydroxychloroquine, interferon-alpha, infections, pregnancy, and hypocalcemia. As far as is known, the pustular exacerbation in plaque psoriasis after hepatitis B vaccination has not been previously defined in the literature, and this is the first case report as a new trigger agent.WoSScopu

Cadmium removal using potato peels as adsorbent: kinetic studies

In this study, untreated waste potato peels were used as adsorbents for treatment and cadmium removal mechanisms were investigated. Maximum removal efficiency was 76% at an initial concentration of 100 mg L-1 of Cd(II) at pH 5.8 in an aqueous solutions at room temperature; 7.61 mg of cadmium was removed per gram of adsorbent. However, as the initial concentration increased, the removal efficiency decreased. Under optimum conditions, two parameters equilibrium isotherms (Langmuir, Freundlich, Temkin etc.) were applied. The Freundlich isotherm has the highest correlation (99.9%) in isotherms. Isothermal adsorption capacity (K-F) has 19.94 mg g(-1) and heterogeneity factor (1/n) 1.0 were determined. In adsorption, it was found that both the boundary layer diffusion and the intra-particle diffusion steps were effective, and the determination of the adsorption rate showed that the Type I pseudo-second-order equation had a high correlation (99%) at all concentrations

A rare case of trigeminal trophic syndrome with an extensive scalp, forehead, and upper eyelid ulceration in a patient with undiagnosed Alzheimer disease

Background: Trigeminal Trophic Syndrome (TTS) is a rare presentation of facial ulceration, which is characterized by the triad of anesthesia, paraesthesia, and damage of trigeminal sensory branches.Main observations: We report a unique case of TTS as an extensive forehead and scalp ulceration in a patient with undiagnosed Alzheimer disease.Conclusions: Treatment options for trigeminal trophic syndrome are limited and disappointing especially in older patients with dementia. Family education and behavioral modification therapies may be well tolerated option in this population

Data analysis of 287 patients present with erythema nodosum: A closer look at associations

Background: Erythema nodosum (EN) is the most common clinical variant of panniculitis. It may occur in association with a wide variety of causative stimuli. The aim of our study is to describe the possible etiologic factors associated with EN and compare them with the series previously reported in the literature. Materials and Method: This is a retrospective chart review of 287 patients who have presented to our clinic with tender erythematous nodular lesions and finally diagnosed as eythema nodosum between January 2010 and December 2015. Results: Our retrospective study included 239 females and 48 males (sex ratio, 5:1). Of the 287 EN patients, etiologic factor has been determined in 123 (42.85%) of the participants and this group was categorized as secondary EN. In secondary EN group the leading etiologic factor was infections (n=68, 23.69%). Other etiologic factors were Behcet’s Disease (n=18, 6.27%), connective tissue disease (n=8, 2.78%), tuberculosis (n=6, 2.09%) sarcoidosis (n= 5, %1.74), drugs (n=6, 2.09%), granulomatous mastitis (n=2, 0.69%), IBD (n=2,0.69%), malignancy (n=1, 0.34%) and food supplement (n=1, 0.34%). Conclusion: Our data confirm that viral and bacterial infections are the leading causative factors of EN, followed by Behcet’s Disease, pregnancy and connective tissue disease (CTD). These conditions should be investigated as part of systemic search

A rare case of trigeminal trophic syndrome with an extensive scalp, forehead, and upper eyelid ulceration in a patient with undiagnosed Alzheimer disease

Background: Trigeminal Trophic Syndrome (TTS) is a rare presentation of facial ulceration, which is characterized by the triad of anesthesia, paraesthesia, and damage of trigeminal sensory branches.Main observations: We report a unique case of TTS as an extensive forehead and scalp ulceration in a patient with undiagnosed Alzheimer disease.Conclusions: Treatment options for trigeminal trophic syndrome are limited and disappointing especially in older patients with dementia. Family education and behavioral modification therapies may be well tolerated option in this population

Basic Theory for Differential Equations with Unified Reimann-Liouville and Hadamard Type Fractional Derivatives

In this paper, we extend the definition of the fractional integral and derivative introduced in [Appl. Math. Comput. 218 (2011)] by Katugampola, which exhibits nice properties only for numbers whose real parts lie in [0,1]. We prove some interesting properties of the fractional integrals and derivatives. Based on these properties, the following concepts for the new type fractional differential equations are explored: Existence and uniqueness of solutions; Solutions of autonomous fractional differential equations; Dependence on the initial conditions; Green’s function; Variation of parameters formula