Introduction: Tooth enamel is a tissue that undergoes a high mineralization process but is susceptible to acidic foods and drinks. Calcium and phosphate are the main components of tooth enamel. Isotonic drinks are soft drinks that people like because they can replace body fluids when dehydrated, but these drinks are high in acid content, which accelerates tooth enamel decay. Material and methods. Laboratory experimental study (in vitro), a sample of 16 maxillary first premolars were divided into two groups. All teeth are separated by crowns and roots. In group one, the isotonic solution measured calcium levels with a wavelength of 420 nm, and in the second group of isotonic solutions, the phosphate level was measured at a wavelength of 590 nm. Furthermore, the teeth were immersed in 20 ml of isotonic drink for 60 seconds, then the levels of dissolved calcium and phosphate were measured again with a UV-vis spectrophotometer. Results. There was a significant difference in the increase in the solubility of calcium and phosphate in tooth enamel before and after immersed in isotonic drink P=0.012 (P<0.05) Conclusion. Isotonic drink affects the solubility of calcium and phosphate in tooth enamel.

Objective : Study the advantages and pitfalls of both 0.15 mg/kg and 0.2 mg/kg of Cisatracurium for Intubation. Background: The patients coming to a Tertiary Care Hospital during period 2018-2019 for surgery under General Anaesthesia, who met the Inclusion Criteria were studied in a hundred patients. After giving all components of balanced general anaesthesia, patients randomised into 2 groups either 0.15 mg/kg or 0.2mg/kg of Cisatracurium as a muscle relaxant and Intubation was done at 3 minutes. Measurements and Results: Heart rate, Blood pressure, Systolic, Diastolic, Mean, SpO2, ETCO2, TOF monitoring at the adductor pollicis, and BIS were monitored for 7 minutes and Intubating conditions in both the groups were evaluated, and scored according to the Steyn’s Modification of Helbo-Hansen Scoring system. In haemodynamic changes in Group A [0.15 mg/kg] Heart rate and Blood pressure showed an increasing trend before coming down to baseline by 7 minutes. In Group B [0.2mg/kg] the trend was decreasing from baseline after a minor increase in heart rate at 2 minutes and Mean Blood pressure was lower at all intervals when compared to baseline. Regarding Intubation In Group A maximum number of participants were having good score (56%) followed by poor (30%) and excellent (14%) whereas in Group B excellent score was maximum (62%) followed by good (32%) and poor (6%). With respect to Train of four stimulation Group B showed decreased response to neuromuscular stimulation from 3 minutes onwards compared to Group A. Bispectral index monitoring, in both groups, showed a decreasing trend at every time interval. Conclusion: Cisatracurium is a potent non-depolarising neuromuscular blocking agent and tracheal intubation can be accomplished with good to excellent intubating conditions according to Steyn’s Modification of Helbo-Hansen Scoring System at 3 minutes following 0.15 mg/kg and 0.2 mg/kg of Cisatracurium. From the study of 100 patients in 2 groups, we found that Cisatracurium in a dose of 3ED95 (0.15mg/kg) has haemodynamic stability in view of Heart rate and Blood Pressure. Cisatracurium at a dose of 0.2mg/kg was more haemodynamically stable than Cisatracurium at 0.15 mg/kg during intubation. Article Details How to Cite Kiran Chheda, Vyankatesh Munje, & Alka Halbe. (2023). Comparison of Two Doses of Cisatracurium (0.15mg/Kg and 0.2mg/Kg) in a Single Centre, Prospective, Comparative, Parallel Group of Patients Undergoing General Anesthesia with Endotracheal Intubation by Studying Ease of Intubation. International Journal Of Medical Science And Clinical Research Studies, 3(02), 160–166. https://doi.org/10.47191/ijmscrs/v3-i2-02

Peptic ulcer disease (PUD) is predicted to affect between 0.1 and 0.3 percent of the population each year. PUD develops at a rate of roughly 1% per year in Helicobacter pylori (H. pylori) infected persons, which is 6 to 10 times higher than in uninfected people. The prevalence of PUD increases with age in both duodenal and stomach ulcers. Two factors contribute to peptic ulcer disease: H. pylori infection and the use of nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs have also been related to an increased risk of complications from peptic ulcer disease, such as gastrointestinal bleeding, perforation, and gastric outlet obstruction.

Patients with metastatic melanoma occasionally develop de novo hypopigmentation, pathologically indistinguishable from Suttons nevus and common vitiligo, respectively. The case of a 68-year-old female with vitiligo of 2 years of evolution is documented, presenting a left inguinal mass and a para-aortic lymph node conglomerate. In the left inguinal region, a ganglion with thickened cortex and liquid content was identified. The laboratory results report hemoglobin of 8.30 g/dL, leukocytes 19.12 u/L, albumin 2.2 mg/dl, DHL 1222 Ul/L, alpha-fetoprotein 2 ng/ml, Ca-125 14.30 U/ml, Ca-19.9 8.60 U/ml and carcinoembryonic antigen of 2.14 ng/ml. Upon inspection, hypochromic, bilateral, and symmetrical lesions can be seen on the back of the hands, wrists, scalp, facial region, and neck. Biopsy showing malignant metastatic melanoma is performed. Starting management with Pembrolizumab 1 mg/kg every 21 days. Currently in follow-up and adjuvant treatment. Melanoma is the most aggressive form of skin cancer. The association of malignant melanoma with de novo hypopigmentation has been found, synchronously or following the diagnosis of the tumor. In recent years, it has led to the development of monoclonal antibodies. However, its diagnosis has implications for life prognosis due to high mortality.

Background: In recent years, the incidence of gastroesophageal reflux disease (GERD) seems to occur in the population of Saudi Arabia more than in Western countries and Eastern Asia. Such a higher risk of prevalence also reported by university students may be the result of their changing lifestyle factors. Aim: The aim of the present study is therefore to determine the prevalence of GERD in Al-Baha university students and determine the risk factors, complications, and relieving strategies. Methods: A cross-sectional design was carried out among 566 participants in the Al-Baha region. A close-ended questionnaire was used which was comprised of sociodemographic factors and information about risk factors, symptoms, relieving factors, and complications. It was used to collect data from the participants and their responses were analysed using a statistical package for social sciences (SPSS) whereby frequency analysis was conducted for each research variable. Results: Out of 566 participants, only 144 students with GERD from Al-Baha university those who completed the questionnaire. There was a higher percentage of female (54.95%) respondents than males (45.05%). The data analysis revealed that overall symptom prevalence was high among students (25.44%) and the common symptoms were esophageal refluxes and heart burn. Common risk factors were smoking, alcohol, and stress. Besides, participants reported positive behaviors of relieving factors against GERD. In addition, there were significantly fewer complications reported by the participants. Conclusion: Overall, the students at the university of Al-Baha have a high prevalence of GERD and therefore retain a higher potential for acceptability of the program to reduce the increasing prevalence of GERD.

One of the most common diseases in tropical countries is Hansens disease. Mainly presents as Tuberculoid and lepromatous leprosy apart from its sub classification. Neuritic Hansens disease is one of the commonly seen cases by the neurologists. It can present as mononeuritic form or mononeuritis multiplex with or without dermatologic manifestations. Among the peripheral nerves involved most common are greater auricular, ulnar,superficial radial,Median, common peroneal and posterior tibial. Its very rare to involve supra orbital nerve.Here we present a case of Supra orbital neuralgia with thickened nerve associated with erythematous hypoaesthetic patch with raised margins.Tapping over the supra orbital nerve produces severe shock like pain .This patient was not willing for Biopsy and hence basing on clinical diagnosis MDT was started and the patient showed remarkable improvement in 1 month.

Preservation of nipple sensitivity after breast reduction is an important goal to achieve. However, most breast reduction techniques focus more on breast aesthetics and nipple areolar complex vascularity, ignoring nipple sensitivity particularly nipple erogenous sensation. In fact, the nipple nervous system includes a tactile sensation system and an erogenous sensation system, the latter being less described and commonly overlooked by plastic surgeons performing breast reductions. The erogenous sensation is supplied by the IVth, Vth and VIth intercostal nerves who run laterally on the surface along the muscular aponeurosis. The total posterior pedicle breast reduction technique described by Richard Moufarrege in 1982 consists of dissecting the skin away from the breast tissue offering free access to all breast quadrants. This technique is known for its robust blood supply to the nipple areolar complex, for its preservation of the breastfeeding function and for its low rate of long term complications such as pseudoptosis. In this article, we also demonstrate that the Moufarrege Total Posterior Pedicle preserves the nipple erogenous sensation among women undergoing breast reduction using this technique.

Pelvic floor dysfunction is one of the most pressing issues in the health and quality of life of women. Pelvic prolapse occurs in 30-50% of women who have given birth. And although this pathology is not life-threatening, it significantly complicates a womans normal life. Genital prolapse (GP) occurs due to lack of pelvic floor support function. It should be noted that the structures of the pelvic diaphragm are under the influence of dynamic load, resulting in easy rupture of ligaments. However, today it is known that not only mechanical damage is the cause of pelvic organ failure. Many studies have shown that in women with prolapse, the concentration of collagen is reduced or its defective forms are detected, due, in particular, to metabolic disorders and the ratio of ionized forms of magnesium and calcium in the direction of the latter. The article presents modern literature data on the peculiarities of pregnancy and childbirth of women with genital prolapse. An example is a clinical case of a pregnant woman with this complication. A clinical case with grade III GP and manadgment using obstetric perforated pessary, magnesium and progesterone and proved the possibility of vaginal delivery in this pathology.

Dental fluorosis is a condition caused by chronic ingestion of excess fluoride during tooth enamel formation. This induces subsurface porosities to varying extents depending on the severity of fluorosis. Such patients consult dentist mainly for aesthetic reasons. Selection of an appropriate treatment plan for such cases depends on the severity of the condition. Laminate veneers is a conservative method of restoring the appearance of discoloured, pitted teeth, and teeth with diastemas that provide extremely good aesthetic results. They are considered as the treatment of choice for moderate to severe cases of dental fluorosis given the optimum aesthetics, wear resistance, biocompatibility, and long-term results of these veneers.

Spiegels hernias are uncommon anomalies in the Spiegels aponeurosis, which runs between the rectus muscle and the semilunar line. They are most commonly found in the "Spigels hernia belt" between the navel and the interspinal line (a horizontal line connecting the anterosuperior iliac spines). We recommend open repair for individuals who arrive with an acute Spiegels hernia, especially if there is a risk of high-grade blockage, strangulation, intra-abdominal infection, and/or the necessity for bowel resection. Furthermore, open repair may be required due to the surgeons lack of expertise with and/or experience with laparoscopic methods, or when laparoscopy is contraindicated due to an inability to tolerate pneumoperitoneum or securely access the peritoneal cavity. Sutures or mesh can be used to repair an open Spiegels hernia. Given the risk of recurrence, we only do suture repair in cases of contamination when mesh implantation is contraindicated and may enhance morbidity.

The liver is the most usually damaged organ following blunt trauma, which can occur as a result of blunt, thoracic, or abdominal trauma. Penetrating liver damage is accompanied with potentially fatal lesions of key neighboring tissues (e.g., vena cava, aorta). (The size and depth of the liver hematoma and/or laceration as discovered on computed tomography (CT) or at the time of surgery are used to classify liver damage (I through VI). Injury severity correlates with greater morbidity and death. Exploratory laparotomy for trauma involves of first controlling bleeding using abdominal tamponade in all four quadrants, then inspecting the intra-abdominal organs and, if necessary, exploring the retroperitoneum. Before treating gastrointestinal damage, active bleeding is addressed.

Background: One of the frequent ocular disorders affecting people in their middle and advanced years of age is pterygium. It is a benign, proliferative disorder of the conjunctiva and subconjunctival tissue that has the potential to impair vision. Clinical examination can quickly diagnose and stage it. Sunlight exposure is believed to be the most significant element in the development of pterygium. Dry eyes, smoking, prolonged outdoor activity, low socioeconomic position, and high altitudes are additional risk factors. If it grows onto the corneas centre, a major problem is the obliteration of the visual axis. Another reason for impaired vision is the development of irregular astigmatism brought on by flattening of the cornea in the horizontal meridian.

Background : Knowledge of food and nutrition is one of the factors that influence nutritional status, so formal and non-formal nutrition education is needed. Efforts to increase knowledge and attitudes regarding balanced nutrition are through the process of nutrition education. Nutrition education carried out must be in accordance with the conditions in Islamic boarding schools which limit students from using electronic media, one of which is by using pocket book media. Purpose : Knowing the effect of nutrition education using pocket books on balanced nutrition guidelines on vegetable and fruit consumption, iron consumption and the BMI index in teenage students at Islamic boarding schools. Method : This research is community nutrition research. This type of quasy experimental research with a research design pretest – posttest control group design. The sample consisted of 20 samples from the treatment group and 20 samples from the control group. The data collected are sample identity, knowledge and attitudes. Statistical analysis using testWilcoxon andMann whitney. Results : The average score of vegetable and fruit consumption practices for the two groups has increased. In the treatment group, the increase before and after the intervention was 59.00 ± 28.19. The control group also experienced an increase between before and after being given the intervention of 26.70 ± 24.0168.30. As for iron consumption in the treatment group, there was an average increase in the difference in Fe consumption before and after the intervention was 1.27 ± 1.24. The control group also experienced an increase in the average difference in Fe consumption between before and after being given the intervention of 0.96 ± 1.79 Nutrition education using pocket books on balanced nutrition guidelines had an effect on vegetable and fruit consumption and iron consumption withp value = 0,001 (p < 0,05). Conclusion : Nutrition education using pocket book media on balanced nutrition guidelines has an effect on consumption of vegetables and fruit, consumption of iron in teenage students at Islamic boarding schools.

Background: During the coronavirus disease 2019 (COVID-19) pandemic, the utilization of face masks was made mandatory as a protective tool. However, prolonged use of face masks increases the risk of dry eye, which affects peoples visual-based activities. The Al-Baha area is a high-altitude area located in the west of the Kingdom of Saudi Arabia in the Hejaz region. As a result, residents of this region are more likely to suffer from dry eyes because of the extreme environmental conditions. Subsequently, the aim of this study is to determine the prevalence of mask-associated dry eye (MADE) and its associated risk factors among the general population of the Al-Baha area, Saudi Arabia. Materials and Methods: This is a cross-sectional study conducted using an anonymous online questionnaire composed of 56 questions. Data were collected from 480 participants in the Al-Baha area. Results: The prevalence of MADE among the general population of Al-Baha, Saudi Arabia, was 39.2%, which is higher than the global prevalence. The risk factors for MADE include exposure to dry weather, wind, blepharitis, and ectropion. Moreover, it was determined that females were more likely to develop MADE than males; likewise, people in the age group of 16 to 25 were more likely to have MADE. Conclusion: The study shows that the prevalence of MADE in Al-Baha is comparatively higher than the worldwide prevalence, which is best explained by this area being at a high altitude. Based on the studys findings, some recommendations to guard against MADE are made to patients, the general public, and ophthalmologists.

Systemic lupus erythematosus (SLE) is an entity that promotes the formation of autoantibodies that trigger immune complexes that damage various organs of the body. Worldwide, SLE has a prevalence of 13-7000 per 100,000 people and leads to a high mortality from cardiovascular diseases, as well as the risk of developing lupus nephritis (LN) in 60% of cases. We present the case of a 41-year-old patient with a history of recently diagnosed arterial hypertension and bronchial hyperreactivity of 20 years of evolution, admitted for 1 month of evolution with asthenia, myalgia, arthralgia and fever she identifies malar erythematous dermatosis and systolic murmur in a pulmonary focus.

Background: Thyroid nodule is one of the most common endocrine system diseases in the world with the increasing number of incidences every year. A thyroid nodule is commonly detected by ultrasonography (USG), in which ultrasonography is the main modality of non-invasive thyroid nodule examination that is accessible, and inexpensive. Aim: The present study aims to improve the clinical practice and management of thyroid lesion by establishing correlations between TIRADS classification ultrasonography (USG) with cytopathological findings in thyroid nodule patients. Methods: Research method that is used is anobservational analytics with cross-sectional approach. The sample of this research is taken by a consecutive sampling method from medical records of thyroid nodule patients in Wahidin Sudirohusodo Hospital year 2021. Statistic test that is used in this research is spearman test. Data analyzes uses SPSS 27.0. software.

Background: Thyroid nodule is one of the most common endocrine system diseases in the world with the increasing number of incidences every year. A thyroid nodule is commonly detected by ultrasonography (USG), in which ultrasonography is the main modality of non-invasive thyroid nodule examination that is accessible, and inexpensive. Aim: The present study aims to improve the clinical practice and management of thyroid lesion by establishing correlations between TIRADS classification ultrasonography (USG) with cytopathological findings in thyroid nodule patients. Methods: Research method that is used is anobservational analytics with cross-sectional approach. The sample of this research is taken by a consecutive sampling method from medical records of thyroid nodule patients in Wahidin Sudirohusodo Hospital year 2021. Statistic test that is used in this research is spearman test. Data analyzes uses SPSS 27.0. software.

We report a case of Adrenoleukodystrophy ABCD1 gene variant presenting with segmental optic atrophy in a 34-year-old male. The patient presented to our Neuro-Ophthalmology clinic with complaints of defective vision in both eyes, mild headache and gait disturbances. Ocular examination showed best corrected visual acuity of 6/24 in both eyes and fundus examination revealed temporal pallor of optic disc. Systemic examination revealed spastic paraparesis. Neuroimaging was advised which revealed well defined confluent symmetric bilateral T2/FLAIR hyperintense areas in parietal-occipital deep white matter and in the splenium of the corpus callosum, acoustic and optic radiations bilaterally. Genetic testing was positive for ABCD1 c.1966T>C (p.Ser656Pro) gene variant. X-linked adrenoleukodystrophy (X-ALD) is a rare neurodegenerative disease characterized by genetic mutation of the ABCD1 gene, primarily affecting males. Our patient presented with defective vision and walking problem due to Adrenoleukodystrophy ABCD1 gene variant. Ocular symptoms often occur after the systemic abnormalities are noted.

Extracorporeal shock wave lithotripsy (ESWLs) results can be enhanced by the application of specific technological concepts and the selection of advantageous instances. This studys goal is to analyze the mechanisms of action of ESWL., indications and contraindications, success predictors, and consequences. ESWLs & "calculi" were used as topics in a search between Jan. 1984 and Oct. 2013 in the Pubmed® database. Only human-conducted studies with a sufficient level of evidence, including clinical trials or reviews/meta-analyses, were considered for inclusion. To optimize the seek for the ESWL results, many technical factors, including the kind of ESWLs apparatus, the intensity & frequency of the impulses, the connecting of patients to the device, the position of the stones, as well as the type of anesthesia, should be taken into consideration. Other patient-related variables, such as the density & size of the stone, skin-to-stone distance, anatomy of the excretory system, and renal anomalies, are also significant. The insertion of a routine double J stent before the procedure is not typically advised, nor is antibiotic prophylaxis required. For stones larger than 10 mm, alpha-blockers, in particular, tamsulosin, are helpful. Following ESWL, minor problems are possible but often respond favorably to therapeutic therapy. It is unclear how ESWL affects those with diabetes or hypertension.

Introduction: Scarring happens after trauma, injury or surgery to any tissue or organ in the body. Disturbing perceptions like pain, itchiness or tenderness from one perspective, and functional limitations in the form of contractures on the other, are ramification of problematic scars. In addition, scar esthetics can also have a negative influence on psychosocial factors. Various treatment options described in the literature include chemical, physical, and surgical methods. The purpose of physical scar treatment is primarily focused on preventing inappropriate healing of the skin Methods: This literature review was compiled using information from numerous web databases, including NCBI, Google Scholar, Science Direct, and Pubmed. Data were analyzed. Results: Good wound management is to reduce the incidence of scar tissue in the wound. Embryonic scarless wound healing is a form of wound healing in the embryo and results in scarless wounds. Many in vivo studies have been carried out on several experimental animals, and the molecules that play a role are examined. Molecules that play a role in scarless and scarring wound healing are TGF-ß 1, 2, and 3. TGF-ß 1 and 2 play a role in the formation of scar tissue, while TGF-ß3 plays a role in tissue regeneration. There is a hypothesis that TGF-ß3 injected into the tissue will help wound healing and increase tissue regeneration so that scarless wound healing occurs. Conclusion:. Molecules that play a role in scarless and scarring wound healing are TGF-ß 1, 2, and 3. TGF-ß 1 and 2 play a role in the formation of scar tissue, while TGF-ß3 plays a role in tissue regeneration. Scarless and scarring wound healing is not only based on the molecules that play a role but healing time and injured tissue also have an effect on wound formation. scarring and scarless wound healing can also occur in the same individual and the same individual tissue

Breastfeeding has been shown to provide considerable benefits to newborn and maternal health. The World Health Organization recommends exclusive breastfeeding of babies up to six months of age. It is well known that breast reduction techniques that preserve the column of subareolar breast tissue have a greater likelihood of successful postoperative breastfeeding. The best representative of these techniques is the Total Posterior Pedicle breast reduction which was described by Richard Moufarrege since 1982. It consists of dissecting the skin away from the breast tissue offering free access to all breast quadrants. This technique is known for its robust blood supply to the nipple areolar complex, the preservation of the nipple areolar complex sensation, and for its low rate of long-term complications such as pseudoptosis. In this article, we demonstrate that the Moufarrege Total Posterior Pedicle preserves breastfeeding function in women undergoing breast reduction using this technique.

Burditts lymphoma (BL) is a subtype of non-Hodgkins lymphoma considered one of the fastest-growing tumors. Due to its rarity in the adult patient, as well as its high aggressiveness, it is important to know how to diagnose it in time to improve the patients prognosis and provide timely treatment. The aim of this paper is to present the clinical case of a young adult patient with Burkitts lymphoma.

Fibrolamellar hepatocellular carcinoma is a primary hepatic malignancy, primarily affecting adolescents and young adults without underlying liver disease. We present the case of a 22-year-old male farmer who presents burning pain in the epigastrium with an intensity of 2/10 on the VAS scale, on palpation with the presence of a tumor in the right hypochondrium with ultrasound of the liver and bile ducts with evidence of liver mass in the segment VIII, in addition to exploratory laparoscopy with the discovery of multiple implants in 70% of the liver surface. In the histopathological analysis with morphological findings compatible with fibrolamellar carcinoma. In the laboratory with AST 356 UI/L, ALT 205 UI/L, GGT 930 U/L, LDH 343 UI/L AF 638 UI/L, for which treatment was started with atezolizumab 1200 mg and bevacizumab 1000 mg. Continuing to follow up. Fibrolamellar hepatocellular carcinoma is a variant of hepatocellular carcinoma, which usually presents with non-specific symptoms. The imaging approach is fundamental in the diagnosis, being the anatomopathological confirmation. Despite being low frequency tumors, they should be suspected in all young patients with a palpable mass in the liver.

Background Vitamin D deficiency is considered as a major public health problem all over the world. Vitamin D acts as a hormone with multi-functions. The main source of vitamin D is solar UV radiation, which converts 7-dehydrocholesterol to pro-vitamin D which is modified to vitamin D given normal skin temperature. Vitamin D deficiency is a common disorder presents in all ages and in both genders. Vitamin D plays an important role in modulating the immune response to infections and reduction inflammatory response. Vitamin D deficiency has a genetic predisposition. There is a correlation between low 25-hydroxyvitamin D levels and dyslipidemia, so correction of vitamin D deficiency is important for treating disturbance in lipid profile. Repletion of 25-hydroxy vitamin D levels raised serum calcium level and decrease parathyroid hormone levels.