International Medical Journal

Abstract : One of the main reasons for patients to seek orthodontic treatment is esthetic or cosmetic causes. The midline is an essential reference for all esthetic deviations. So, knowledge of the midline will result in an improved understanding of facial and dental esthetics invariably. However, there is numerous methods for determine facial midline, the present study had been established to find the relationship between the facial midline and dental midline in two different methods and compare the results of the two methods. The objective of the present study were to assess the prevalence of facial and maxillary dental midline coincidence and non-coincidence by frontal digital photograph and clinical dental floss examination, assess the distribution of midline coincidence and non-coincidence regarding gender and side, and compare between the result of frontal digital photograph and dental floss examination regarding coincidence and non-coincidence. The sample consist of 110 Iraqi adults (60 females, 50 males) aged 18-25 years. Clinical examination by a digital photograph and dental floss were performed for each individual to determine facial midline. Frontal full-face digital photographs of the subjects (in smile) were made under standardized conditions using a digital mobile camera. Imaging software was used to mark the dental midline and to digitally constructing an Esthetic frame, which was used to mark the facial midline. Also, the facial midline determined clinically by stretching a dental floss from the nation to pogonion passing over the midline of the philtrum to see the correlation with dental midline which represents the vertical line through the tip of the incisal embrasure between the two maxillary central incisors. The results of the present study showed that the non-coincidence of facial and maxillary dental midline results contribute the highest percentage (60%), (51.81%) by photographic analysis and dental floss examination respectively. Maxillary dental midline shift to the right side in the majority of the sample (65.15%), (61.40%) by photographic analysis and dental floss examination respectively. For males and females, the facial midline non-coincidence with maxillary dental midline and shift to the right side in the majority of the sample by both methods. There is no significant difference between the results of photographic analysis and dental floss examination. Facial midline not a coincidence with the maxillary dental midline in the majority of the sample by both methods frontal photograph and dental floss assessment. For male and female, the facial midline non-coincidence with maxillary dental midline and shift to the right side in the majority of the sample by both methods, and there is no significant difference between the frontal photograph and dental floss methods.
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Abstract : Muscular imbalance plays one of the key factors for impaired relationships between the muscles which prone to the tightness that loses extensibility, and those prone to inhibit loses its normal strength thereby leads to weakness. Individuals with unilateral neck pain exhibit significantly less low trapezius strength on the side of neck pain when compared to the contralateral side. There is a strong association between lower trapezius muscle weakness and neck pain. Hence this study was aimed to compare the effectiveness of lower Trapezius strengthening with isometric neck exercises over lower Trapezius strengthening in relieving pain and reducing disability in patients with chronic neck pain. A comparative study was done for 30 patients with recurrent chronic neck pain were chosen using convenient sampling method from Isari Mission Hospital, Thalambur were picked based on inclusion criteria and Exclusion Criteria They were then divided into two groups Group A – experimental group and Group B – control group and followed up for 2 weeks. The pre-test and post-test values were assessed for the Numeric Rating Scale (NRS), Neck Disability Index (NDI) and Manual Muscle Testing (MMT – MRC). The paired t-test revealed that there was a significant decrease in pain among group A (lower trapezius strengthening with isometric neck exercises) than group B in patients with chronic neck pain. The conclusion of the study is that there was the effectiveness of lower trapezius strengthening with isometric neck exercises in Group A than in Group B in relieving pain and reducing disability in patients with chronic neck pain.
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Abstract : Proprioception decreases with aging is in part because of changes in muscle spindle function, muscle spindle is one important aspect affecting the strength and movement of the shoulder joint. There is a definitive clinical importance depicting the relationship between shoulder and pathology, stating the mechanoreceptors involving in this mechanism is concerned with a proprioceptive feedback loop when there is a loss of proprioceptive impulses reaching the central nervous system, there is no signal to the capsule and ligaments of the shoulder joint and then improper function and vice versa leading to a vicious cycle. Hence this study aims to know the Effects of Proprioceptive Training in Reducing Pain and Improving Range of Motion in Patients with Periarthritis Shoulder. An experimental study was done for 30 peri arthritis shoulder patients were picked using a convenient sampling method from Isari Mission Hospital, Thalambur were chosen based on inclusion criteria and Exclusion Criteria. The subjects were given proprioceptive exercises training and followed up for 4 weeks. The pre-test and post-test values were assessed for Shoulder Pain and Disability index scale and passive joint ROM for shoulder abduction. The paired t-test revealed that there was a significant increase in the Shoulder Pain and Disability index scale and passive joint ROM for shoulder abduction. The conclusion of the study is that the proprioceptive exercises were an effective form of treatment associated with periarthritis of the shoulder in patients.
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Abstract : Obstructive sleep apnea (OSA) is a common chronic disorder with increased morbidity and mortality. Asymptomatic LV diastolic dysfunction is also a common condition with many interrelated risk factors. To investigate the prevalence of diastolic dysfunction among obstructive sleep apnea patients and the impact of its severity on diastolic dysfunction grade. Fifty patients with obstructive sleep apnea confirmed by Home Sleep Apnea Testing (HSAT). The diastolic function of the left ventricle determined by Doppler echocardiography. Baseline characteristics, the severity of obstructive sleep apnea, and diastolic dysfunction severity are compared. The median age is 45 years. Most patients (n = 37, 74%) were male. Thirty-six (72%) patients were hypertensive. The Mean Body Mass Index (BMI)was 29 kg/m2. Fifteen patients (30%) were current smokers. The mean apnea-hypopnea index (AHI) was 33±12 events/hour and most patients had severe OSA, with AHI>30 events/hour (n = 26, 52%). Diastolic dysfunction prevalence is 72% (n=36 patients). Only hypertension is significantly associated with diastolic dysfunction (p-value 0.004) with no significant association with age, gender, diabetes mellitus, Body Mass Index (BMI) and smoking status. Diastolic dysfunction grade has a significant association with the AHI, OSA severity and minimum SpO2 (p-values 0.000, 0.028 and 0.000, respectively). Diastolic dysfunction is prevalent in OSA patients with many related risk factors. Hypertension significantly associated with diastolic dysfunction and Diastolic dysfunction grade has a significant association with the apnea-hypopnea index (AHI), OSA severity and minimum SpO2.
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Abstract : To compare the clinical efficacy of microvascular decompression surgery (MVD) and gamma knife radiosurgery (GKR) as a treatment for patients with primary trigeminal neuralgia (TN) and evaluate outcome regarding pain relief, recurrence, and complications with both modalities of treatment. A randomized prospective study conducted in The Neurosciences Hospital, Baghdad, Iraq. Eighty-four patients with TN from January 2016 to January 2018, 45 patients had GKR while 39 patients treated with MVD. The pain evaluated pre- and post-operatively using Barrow Neurological Institute Pain Intensity scale (BNIPI), visual analog scale (VAS) and Brief Pain Inventory Facial (BPI-Facial) scoring systems. In the GKR procedure, the trigeminal root entry zone targeted with a radiation dose of 80 Gy. MVD was performed using the retro sigmoid approach. The follow-up period was two years. Both groups showed a considerable decrease in BNIPI scores and VAS scores in the postoperative two years follow-up compared with the preoperative scores with a P-value <0.01. However, the pain relief rate was significantly higher in the MVD group (92.3%) compared to that of GKR groups (73.3%) with a P-value of 0.02. Postoperative VAS scores of the MVD group were remarkably lower as compared with those treated with GKR during the same postoperative time. (P=0.01). GKR and MVD offered safe and efficient treatment options. MVD remains the standard surgical method of treatment for patients with TN with better pain relief rate, lesser pain recurrence rate and faster response than GKR.
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