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The colony-forming unit (CFU)/mL of tested microorganisms continuously decreased with increased NAg concentration. In the eluted component test, no significant differences were noted in the 3rd, 15th, and 30th days between the different concentrations of Nag-containing composite resin disks and control samples. According to the disk-diffusion agar test, there was no growth inhibition zone for the composite resin disks containing 1% and 2% concentrations of Nag. However, the growth inhibition zone was seen with a 5% concentration, with a diameter of 9.5±0.71 mm for S. mutans, 8.5±0.71 mm for S. sanguis, and 8±1.41 for L. acidophilus. Conclusion. The incorporation of NAg into composite resins has antibacterial effects, possibly preventing dental caries around fixed orthodontic retainers.Background. Contamination of dentin surface is one of the common problems in restorative dentistry. The aim was to investigate the effects of different surface contaminators on the dentin shear bond strength (SBS) of universal adhesive system (UAS) applied in etch-and-rinse (ER) and self-etch (SE) strategies. Methods. One hundred forty-four maxillary anterior sound human teeth were divided into six groups based on the types of surface contaminators no surface contaminator (control) and experimental groups contaminated with blood, saliva, aluminium chloride (ALC), ferric sulphate (FS), and caries disclosing agent (CDA). Then, each group was further subdivided into two, based on the application strategy of UAS (ER and SE). After applying the adhesive according to the manufacturer's instructions, and bonding cylindrical composite samples, the SBS was measured. The data were analysed using two-way ANOVA, Tukey's HSD test and t test (P less then 0.05). Results. The SBS in all contaminated groups, except for CDA, was significantly lower in both ER and SE strategies compared to control group (P less then 0.05). A comparison between the application strategies revealed that ER and SE were only significantly different in the FS contaminated group (P less then 0.05). Conclusion. All tested contaminators, except CDA, significantly decreased SBS of UAS in both ER and SE strategies.Background. This study aimed to evaluate the effects of repeated sterilization cycles on the surface alterations of various nickel-titanium instruments, including ProTaper Next (PTN), TF Adaptive (TFA), HyFlex CM (HCM), and 2Shape (2S). Methods. Twenty-four new NiTi files of four different alloys were selected. The instruments in each group were divided into two equal groups, as follows control and sterilization. The first group was chosen as the control without applying any sterilization procedure, while in group 2, five cycles of sterilization procedures were applied. The surface topographies were evaluated using scanning electron microscope (SEM) and atomic force microscope (AFM). The root mean square (RMS) and maximum height (MH) values and three-dimensional images were recorded. The data were analyzed with the Shapiro-Wilk test, one-way ANOVA, and post hoc Tukey tests. The statistical significance level was set at P ≤ 0.05. Results. Before the experiment, HCM demonstrated the highest RMS value, and 2S showed the lowest. After the procedures, the RMS and MH values deteriorated on the surface of PTX, TFA, and 2S (P 0.05). Conclusion. The initial irregularity on the surface did not affect the rate of alteration. The HCM files demonstrated superior surface properties after several cycles of sterilization. The PTN, TFA, and 2S presented similar surface responses after five cycles of autoclave sterilization.This paper opens the themed issue (a monograph) "Aberrant cytogenetic and reproductive patterns in the evolution of Paraneoptera", prepared by a Russian-Bulgarian research team on the basis of long-term collaborative studies. In this first part of the issue, we provide the basic introductory information, describe the material involved and the methods applied, and give terminology and nomenclature of used taxonomic names.Chest radiograph is one of the most commonly employed imaging modalities in primary care. It may be done for symptomatic patients or routine health screening. Hence, it is important for a primary care physician to be able to interpret chest radiograph systematically in relation to patient's clinical history. Here, we would like to illustrate a case of abnormal chest radiograph detected during health screening.Endogenous endophthalmitis accounts for approximately 5 - 10% of all endophthalmitis cases. We report a case of a middle-aged gentleman with underlying uncontrolled diabetes mellitus who presented with fever and generalised body weakness for one week. He was diagnosed with invasive Klebsiella syndrome based on blood culture with presence of bilateral pleural effusion, liver abscess, renal impairment and sphenoidal sinusitis. The patient developed sudden bilateral painless reduced vision on day two of admission. Ocular examination revealed bilateral severe anterior chamber reaction and severe vitritis that obscured the view of the fundus. Ocular B-scan ultrasonography showed multiple loculations in the posterior segment in both eyes. There was soft tissue density with calcification in the left sphenoid sinus on computed tomography of the orbit. He was treated for bilateral endogenous endophthalmitis with multiple intravitreal antibiotic injections, but showed no improvement. Functional endoscopic sinus surgery was performed and revealed that the left sphenoid sinus was filled with fungal balls. Following drainage of sphenoidal pus, there was resolution of vitritis and fundus examination showed features of underlying fungal infection with a "string of pearls" present along the vascular arcade of both eyes. The patient was diagnosed with bilateral endogenous endophthalmitis secondary to invasive Klebsiella syndrome with coexisting fungal endophthalmitis secondary to sphenoid mycetoma. In addition to repeated intravitreal antibiotic injections, he was also treated with systemic and topical antifungal therapy. At three months post treatment, the infection resolved and his vision improved from counting fingers to 6/36 bilaterally. Key messages A middle-aged gentleman presented with bilateral endogenous endophthalmitis secondary to invasive Klebsiella syndrome with coexisting fungal endophthalmitis secondary to sphenoid mycetoma. A high index of suspicion is required for early diagnosis of fungal endophthalmitis.Atrial septal defect (ASD) is a congenital heart disease often encountered in the adult population, as it is frequently asymptomatic in childhood. In untreated patients with ASD, some may go on to develop complications such as atrial arrythmias, pulmonary hypertension and Eisenmenger syndrome. Pulmonary hypertension is seen in 6 - 35% of this group of untreated patients in adulthood as a result of left-to-right shunting. Symptoms of pulmonary hypertension include progressive dyspnoea, ascites and syncope. Here, we would like to illustrate a case of ASD presenting with recurrent syncopal attack.Fingertip infections are commonly diagnosed in primary care. There is a serious condition, acrometastases, that is often mistaken for these infections. Acrometastases are defined as metastases located distal to the elbow or knee. We present a case of a malignant phyllodes tumour with acrometastases to the distal phalanx of the left middle finger that was misdiagnosed as a fingertip infection on 2 separate occasions, highlighting the need for vigilance regarding acrometastases.Biliary ascariasis is a rare disease in a non-endemic area. However, it is one of the possible etiological factors for retarded growth as well as malnutrition in children. It may cause intestinal obstruction, appendicitis, biliary obstruction, liver abscess, hepatolithiasis, and pancreatitis in adults. Herein, we report a patient with ascending cholangitis secondary to biliary ascariasis who was successfully managed with Endoscopic Retrograde Cholangio Pancreaticography.Retained rectal foreign body, with its associated social stigma, is a medical condition that is infrequently reported in Malaysia. We report the surgical management of five cases of retained foreign objects in the rectum seen over a one-year period. There were three young and two elderly male patients. One of the elderly patients presented with altered bowel habits and an abdominal mass that mimicked a symptomatic colonic tumor. All patients had an abdominal radiograph which clinched the diagnosis of a retained foreign rectal body. Successfully retrieved objects included two bottles, one bidet device, and two sex toys. Open surgery for retrieval of the impacted rectal foreign body was required in one patient. All underwent successful retrievals without any adverse postoperative complications. In our case series, retained rectal foreign bodies were observed only in the male gender. The age presentation was bimodal, with age groups in the twenties and sixties. The treatment options used for the retrieval of these impacted foreign bodies included transanal extraction or explorative laparotomy. Proximal migration and delayed presentation are possible indications for the latter approach.

A diagnosis of ankylosing spondylitis (AS) is challenging and often delayed despite patients being symptomatic. Low back pain is the most common initial symptom, appearing in the second and third decades of life. Acute anterior uveitis (AAU) occurs much later in the course of the disease, often when the destruction of the spine is already debilitating.

Here, we report three cases of AS that were diagnosed after the patients developed AAU. Methods A case series illustrated AAU leading to the diagnosis of AS years after the initial episode of low back pain. A comparison of the clinical presentation, diagnosis, and outcomes was also illustrated.

We report three cases of acute anterior uveitis (AAU)-associated AS diagnosed only after many visits to the primary health care provider with the complaint of chronic low back pain. https://www.selleckchem.com/CDK.html All three patients had irreversible radiological changes upon diagnosis of AS. The AAU resolved with topical steroids, and one patient developed cataract.

A high index of suspicion of AS in a young adult with chronic back pain before the development of AAU may prevent further functional loss and provide a better prognosis. Diagnosis of AS following AAU is not only associated with dependency but also may rob the vision of a young adult.

A high index of suspicion of AS in a young adult with chronic back pain before the development of AAU may prevent further functional loss and provide a better prognosis. Diagnosis of AS following AAU is not only associated with dependency but also may rob the vision of a young adult.Melkersson-Rosenthal Syndrome (also termed "Miescher-Melkersson-Rosenthal Syndrome") or (MRS), is a rare neurocutaneous disorder characterized by the clinical triad of recurring facial nerve paralysis, swelling of one or both lips and fissural tongue. We report a patient with Melkersson-Rosenthal Syndrome initially referred to Dermatology Department as angioedema. The diagnosis and treatment procedures were presented with special emphasis to the clinical features of this rare condition.

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