Conjunctival vessel morphology in patients with type 2 diabetes mellitus: findings of a case-control study

OBJECTIVE

Diabetic retinopathy is a serious complication of diabetes mellitus that may lead to vision loss. Retinal problems are more likely to occur as the illness advances. Micro- and macro-vascular angiopathy is both linked to diabetes mellitus. Examining the impact of diabetes on blood vessels is one approach to understanding the disease's outward symptoms. The purpose of this research is to evaluate the morphology and breadth of conjunctival vessels in people with type 2 diabetes mellitus and to establish a correlation between these alterations and clinical retinal changes.

PATIENTS AND METHODS

A case-control study was conducted in the Department of Ophthalmology, KIMS, Koppal, Karnataka. The study included diabetic patients who voluntarily participated and were assessed at the Ophthalmology Outpatient Department (OPD). The general and ophthalmic history was taken for both cases and control. The best corrected visual acuity was estimated. Each subject, including cases and controls, had a general and ophthalmic history recorded. The anterior segment was evaluated with a slit lamp. After completing the clinical examination, the subjects underwent a conjunctival vessel imaging study using the slit lamp. The imaging included the study of conjunctival vessel morphology using ImageNet.

RESULTS

Both the test and control groups are comparable in terms of age and gender. The severity of diabetic retinopathy was shown to correlate with the conjunctival width range. Mild diabetic retinopathy is characterized by a conjunctival width of 30-34 microns (mean: 34.9), moderate diabetic retinopathy by 35-39 microns (mean: 37.3), severe diabetic retinopathy by 40-44 microns (mean: 42.4), and proliferative diabetic retinopathy by 50-54 microns (mean: 45.6).

CONCLUSIONS

Diabetes mellitus patients have larger conjunctival arteries as the disease becomes more severe. Dilated and tortuous conjunctival arteries are visible indicators that correlate with worsening diabetic retinopathy. This could be used for screening to ensure timely referral.

The effect of bleaching on surface roughness and gloss of different CAD/CAM ceramic and hybrid ceramic materials

OBJECTIVE

To assess the effect of bleaching on surface roughness and gloss of different CAD/CAM ceramic materials.

METHODS

The ceramic materials included IPS e.max CAD (lithium disilicate), VITA ENAMIC (polymer infiltrated ceramic), and Celtra Duo CAD (zirconia reinforced lithium silicate). Samples of each material were randomly divided into four groups (n = 10); a control group immersed in distilled water, the second and third groups were treated with 20% carbamide peroxide (20% CP) and 35% carbamide peroxide (35% CP) bleaching agents for 4 h/day and 60 min/day respectively for 7 days. The fourth group was treated with 40% hydrogen peroxide (40% HP) applied twice, each turn for 20 min. After treatment, the surface roughness (using 3D non-contact profilometry) and surface gloss were assessed followed by imaging with a scanning electron microscope. The data were analyzed using multiple linear regression and Kruskal-Wallis one-way ANOVA tests (α = 0.05).

RESULTS

The surface roughness (p = 0.157) and gloss (p = 0.073) of IPS e.max CAD were not significantly affected by the different bleaching treatments. Similarly, no significant effect on surface roughness (p = 0.162) and gloss (p = 0.965) were shown for Celtra Duo CAD. On the other hand, VITA ENAMIC was significantly affected when treated with 20% CP and 35% CP showing increased roughness (p = 0.001) and gloss (p = 0.008).

CONCLUSIONS

Home bleaching treatments (20% CP and 35% CP) significantly affected the surface roughness and gloss of VITA ENAMIC while IPS e.max CAD and Celtra Duo CAD were not affected by the different bleaching treatments.

A comparative analysis of periapical status by using cone beam computed tomography and periapical radiography

OBJECTIVE

The aim of this study was to compare the periapical status of different teeth by using the Periapical (Pa) and the cone beam computed tomography (CBCT) radiographs.

PATIENTS AND METHODS

Pa and CBCT radiographs were obtained from the patients who required Endodontic treatment. The absence and presence of periapical lesions were investigated using both Pa and CBCT radiographs. Periodontal conditions other than periapical lesions were also observed by using both radiographs and recorded. Cohen's Kappa analysis was performed to observe the inter-rater and intra-rater reliability. Descriptive statistics including frequency and percentages of presence and absence of periapical lesions were analyzed. Independent t-test was conducted to compare the Pa and CBCT for the detection of periapical lesions. Chi-square test was used to investigate the distribution of gender and periapical lesions by both radiographs.

RESULTS

A total of 204 teeth from 72 patients (29 female and 43 male) were assessed via CBCT and Pa radiographs. Inter-observer and intra-observer reliability showed the absolute level of agreement. T-test showed there is significant difference between Pa and CBCT radiographs regarding detecting periapical lesions. Chi-square test showed no significant differences between the gender and apical pathosis.

CONCLUSIONS

CBCT is more reliable to detect periapical lesions compared to the Pa radiographs.

Impact of COVID-19 pandemic on quality of partner relationship and sexual activity among COVID positive males: a cross sectional study

OBJECTIVE

Our aim was to assess sexual activity, partner relationships among males who had been infected with COVID-19, to study the impact of COVID-19 infection on partner relationship and to find out the association between partner and sexual relationship during lockdown.

MATERIALS AND METHODS

A cross sectional study was conducted in Saudi Arabia through social media platforms via online questionnaire between December 1, 2020 and January 31, 2021 among 871 participants after a pilot study among 20 participants of which 497 were included in the study. Statistical analysis was conducted using SPSS version 20.0 (IBM Inc., Armonk, NY, USA). Responses were presented as frequencies and percentages and the association was studied using Chi squared test/Fisher's exact test. The value of p ≤ .05 was considered significant.

RESULTS

Out of the total study participants, nearly 85% of them belonged to the age range of 18 to 39 years, more than half of the participants were married. In the six months prior to the study being conducted, 268 respondents (53.9%) did not have sexual relationships. Respondents with positive COVID-19 infection reported that their partner lived with them in the same house during home isolation and was also found to be significantly associated with having intact sexual relationships in the last six months of the lockdown period (p-value < .001). Moreover, respondents who reported having good relationships with their partners during the pandemic were found to be significantly associated with having intact sexual relationships during the pandemic lockdown (p-value < .001).

CONCLUSIONS

Among the COVID-19-positive respondents, sexual activity and partner relationships were largely found to be intact during the pandemic lockdown period.

Comparison of adhesion formation and tensile strength after three laparoscopic herniorrhaphy techniques

Several techniques for laparoscopic inguinal herniorrhaphy have been described in the literature: laparoscopic extraperitoneal mesh repair (EXTRA), transabdominal preperitoneal mesh repair (TAPP), and intraperitoneal onlay mesh repair (IPOM). To evaluate the incidence of adhesion formation and the tensile properties of these techniques, young male pigs underwent mesh placement using the above techniques. The animals had follow-up for 6 weeks, and no trocar site adhesions were observed. No intraperitoneal adhesions resulted in the group that underwent EXTRA technique. One case of filmy omental adhesions was observed with the TAPP technique, and two cases of adhesions were associated with the IPOM technique, one minimal and one case of dense adhesions to the bladder. The tensile strength of mesh incorporation into abdominal fascia was compared for the three techniques and measured using a tensiometer. The IPOM technique resulted in the weakest tensile strength of 0.53 +/- 0.01 kg (mean +/- SEM), whereas both the EXTRA and TAPP were comparable and significantly stronger (p < 0.05), with tensiometric values of 0.69 +/- 0.03 and 0.60 +/- 0.02 kg, respectively. We concluded that IPOM, although technically the easiest procedure to perform, is associated with the highest risk of adhesion formation and the lowest tensile strength. In comparison, the EXTRA and the TAPP techniques had the advantages of better tissue incorporation and tensile strength. Adhesion formation was not observed with the EXTRA technique, in which the peritoneum was not violated, and was uncommon and minimal with the TAPP technique.