A New Technique for Surgical Treatment of Vaginal Agenesis Using Combined Abdominal-Perineal Approach

Optimum therapeutic approach in vaginal agenesis has always been an area of extensive controversies. Although surgical management gained priority due to the evolution of techniques, there is currently no consensus in the literature regarding the best type of surgical approach. The most commonly preferred surgical procedure among gynecologists is McIndoe operation which involves the creation of a space between bladder and rectum, insertion of a mold covered with split-thickness skin graft into that neovaginal space, and use of postoperative vaginal dilation to avoid stenosis. However, many modifications have been introduced in time in an attempt to increase the success rates. In this paper, we describe two cases with vaginal agenesis with functioning uterus who were subjected to surgery by combined abdominal-perineal approach. The surgical technique also included the use of a specially designed vaginal mold made up of polymethyl methacrylate and use of Hyalobarrier gel which is an adhesion-preventing agent

Effects of Different Anti-Epileptic Drug Groups and Brushing on the Color Stability of Restorative Materials Used in Pedodontics: An In Vitro Evaluation

Objectives: This study will evaluate the effects of anti-epileptic drugs and brushing used in children on the color change of three restorative materials by creating an in vitro study model. Methods: Forty samples of polyacid-modified composite resin (compomer), glass ionomer cement (GIC), and composite resin (CR) were prepared. Samples were split into four groups (n = 10) and soaked in three anti-epileptic drugs (Tegretol, Depakine, Keppra) and distilled water. For each group (n = 5), two subgroups (brushing and non-brushing) were created. Discolorations [CIEDE2000 (ΔE00)] were determined initially and on days 7 and 14. The data were analyzed with a four-factor repeated measures ANOVA analysis, and a post hoc analysis Bonferroni test was used. Results: After the second week, the highest ΔE00 value was seen in the non-brushed compomer material in the Tegretol drug group (8.59 ± 0.43). In contrast, the lowest value was seen in GIC filling material-brushing-Depakine drug (3.45 ± 2.14). ΔE00 values in the brushing groups were statistically significantly lower than those in the no brushing groups (p < 0.05). Conclusions: It has been determined that the color stability of aesthetic restorative dental materials used in pediatric dentistry is affected by antiepileptic drugs. In addition, it has been determined that tooth brushing positively affects the color stability of restorative materials. Therefore, pediatric dentists should advise their patients and their relatives about this issue and take precautions

Effect of brimonidine tartrate 0.15% on scotopic pupil size and upper eyelid position: controlled trial

Background To evaluate the effect of brimonidine tartrate 0.15% ophthalmic solution on pupil size under scotopic condition and upper eyelid position. Methods This study comprised 72 eyes of 36 healthy subjects. A single drop of brimonidine tartrate 0.15% ophthalmic solution was instilled in the right eye and artificial tear was instilled in the left eye. Pupil size was measured using an infra-red pupillometer under scotopic condition before and at 30 min, 2, 4, 6, 8 and 10 h after instillation. Measurement of margin reflex distance 1 (MRD1) was performed using a millimetre ruler before and after at 10 min after instillation. Results The mean age of the subjects was 32.19 +/- 11.43 years (range 10-52 years), 17 were female and 19 were male. Before brimonidine instillation, the mean pupil size was 6.09 +/- 1.03 mm in the brimonidine eyes and 6.06 +/- 1.04 mm in the control eyes. There was a significant decrease in mean pupil size at 30 min (4.45 +/- 1.04), 2 h (4.49 +/- 1.06), 4 h (4.59 +/- 1.06), 6 h (4.89 +/- 1.06) and 8 h (5.38 +/- 1.02) after instillation compared to before in brimonidine eyes (p < 0.001 for all). There was a significant miosis continued for at least 6 h (5.95 +/- 1.03) in control eyes (p < 0.001). There was no significant change in MRD1, before and after instillation both in brimonidine and control eyes. Conclusions Brimonidine tartrate 0.15% had a significant miosis under scotopic condition for at least 8 h after instillation and had a significant miosis on the untreated eye for at least 6 h

DIGOXIN TOXICITY IN THERAPEUTIC SERUM LEVELS

Aim:The purpose of this study, to evaluate digoxin toxicity and risk factors leading to digoxin toxicity in patients with therapeutic digoxin levels.Material and Methods: We studied ninety–five patients with digoxin level was above of the 1.4 ng/mL and below of the 2.0 ng/mL at admission. They were divided into two groups, drug toxicity or nontoxicity, on the basis of both clinical symptoms and electrocardiography recording. The clinical and laboratory data were compared between these groups.Results: When overall patients’ digoxin usage indications were evaluated, it was revealed that 56 patients (58.9%) had been received digoxin only for heart failure, 32 patients (33.6%) only for atrial fibrillation and 20 patients (21%) received digoxin for both conditions. The exact reason for digoxin usage could not be determined in 17 patients (17.9%). When patients were evaluated, no differences in age, gender, medical history other than coronary artery disease and laboratory findings were observed between toxic and nontoxic patients. The medical history of coronary artery disease in toxic patients was significantly higher than in nontoxic patients (p: 0.008). In these variable, no differences were observed except atrial fibrillation (p&lt;0.001), between toxic and nontoxic patients.Conclusion: In this study, the exact reasons for digoxin use could not be determined in 17 (17.9%) patients. In appropriate usage of digoxin could be increased risk of adverse outcomes and education program may reduce in appropriate use. Clinicians should be aware that signs of toxicity may occur at levels below of the 2.0 ng/mL, and such toxicity is more likely in the presence of atrial fibrillation or coronary artery disease.Keywords: Digoxin, toxicity, intoxication, serum digoxin level

Clinicopathologic and survival analyses of synchronous primary endometrial and epithelial ovarian cancers

AimThe aim of the study was to describe clinicopathologic characteristics, survival outcomes and the factors associated with recurrence in patients diagnosed with synchronous primary endometrial and epithelial ovarian cancers