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A new approach for better anterior esthetic using platelet-rich fibrin as sole graft material combined with ovate design dental bridge

Buzayan MM, Mahdey HM, Ning CJ

J Indian Prosthodont Soc, 2020 04 07;20(2):219-223.
PMID: 32655228 DOI: 10.4103/jips.jips_264_19

Alveolar ridge deficiency is considered a major esthetic limitation, especially in the maxillary anterior region. Several approaches have been developed to enhance and increase the soft-tissue volume. Among those approaches are connective tissue grafts, platelet-rich fibrin (PRF) membrane and implying the guided bone regeneration concept. The PRF grafting technique was employed in this clinical case to improve and enhance the anterior esthetic without the need for the bone graft and augmentation. This article describes the use of PRF as a sole grafting material for both socket and soft-tissue augmentation for a 23-year-old male, who had an accident 8 years ago while he was playing a basketball, which caused his upper front teeth to be intruded and discolored. The upper left central tooth suffered a major external root resorption; hence, it was extracted. PRF was prepared and packed in and extruded out of the socket. This was combined with ovate design provisional bridge. Ten days, 1 month, 3 months, and 6 months postoperative review showed a significantly well-progressed healing. According to the encouraging result obtained in this clinical case in regard to tissue healing and esthetic, the PRF can be a potential sole graft material for small anterior deficient areas. This may reduce the need of bone augmentation and graft in such selected cases.
Systematic review of cardiovascular magnetic resonance imaging T1 and T2 mapping in patients with Takotsubo syndrome

Humayra S, Yahya N, Ning CJ, Mir IA, Mohamed AL, Manan HA

Heliyon, 2024 May 15;10(9):e29755.
PMID: 38707280 DOI: 10.1016/j.heliyon.2024.e29755

BACKGROUND: Current imaging advancements quantify the use of cardiovascular magnetic resonance (CMR) derived T1 and T2 tissue characterization as robust indicators for cardiomyopathies, but limited literature exists on its clinical application in Takotsubo syndrome (TTS). This systematic review evaluated the T1 and T2 parametric mapping to delineate the current diagnostic and prognostic CMR imaging outcomes in TTS.
METHODS: A comprehensive literature search until October 2023 was performed on ScienceDirect, PubMed, Web of Science, and Cochrane Library by two independent reviewers adhering to the PRISMA framework. The Newcastle-Ottawa Scale (NOS) was used to evaluate the methodological quality of studies.
RESULTS: Out of 198 results, 8 studies were included in this qualitative synthesis, accounting for a total population of 399 subjects (TTS = 201, controls = 175, acute myocarditis = 14, and acute regional myocardial oedema without infarction = 9). Approximately 50.4 % were TTS patients aged between 61 and 73 years, whereof, females (n = 181, 90.0 %) and apical variants (n = 180, 89.6 %) were significantly higher, and emotional stressor (n = 42; 20.9 %) was more prevalent than physical (n = 27; 13.4 %). The NOS identified 62.5 % of studies as moderate and 37.5 % as high quality. Parametric tissue mapping revealed significantly prolonged T1 and T2 relaxation times at 1.5T and 3T respectively in TTS (1053-1164 msec, 1292-1438 msec; and 56-67 msec, 60-90 msec) with higher extracellular volume (ECV) fraction (29-36 %), compared to healthy subjects (944-1211 msec, 1189-1251 msec; and 46-54 msec, 32-68 msec; 23-29 %) and myocarditis (1058 msec, 60 msec). Other significant myocardial abnormalities included increased left ventricular (LV) end-systolic and diastolic volume and reduced global longitudinal strain. Overall, myocardial oedema, altered LV mass and strain, and worse LV systolic function, with higher native T1, T2, and ECV values were consistent.
CONCLUSIONS: Future research with substantially larger clinical trials is vital to explore the CMR imaging findings in diverse TTS patient cohorts and correlate the T1 and T2 mapping outcomes with demographic/clinical covariates. CMR is a valuable imaging tool for TTS diagnosis and prognostication. T1 and T2 parametric mapping facilitates the quantification of oedema, inflammation, and myocardial injury in Takotsubo.
The performance of ultrasound and upper gastrointestinal study in diagnosing malrotation in children, with or without volvulus

Mohamed Burhan MS, Hamid HA, Zaki FM, Ning CJ, Zainal IA, Ros IAC, et al.

Emerg Radiol, 2024 Apr;31(2):151-165.
PMID: 38289574 DOI: 10.1007/s10140-024-02201-9

BACKGROUND: Rapid diagnosis is crucial for pediatric patients with midgut volvulus and malrotation to prevent serious complications. While the upper gastrointestinal study (UGIS) is the traditional method, the use of ultrasound (US) is gaining prominence.
OBJECTIVES: To assess the diagnostic sensitivity and specificity of US compared to UGIS for malrotation and midgut volvulus.
METHODS: A cross-sectional study was performed on 68 pediatric patients who underwent US and/or UGIS before surgery for suspected midgut volvulus or malrotation in Kuala Lumpur (PPUKM and HTA), referencing surgical outcomes as the gold standard.
RESULTS: US demonstrated a higher specificity (100%) than UGIS (83%) for diagnosing malrotation, with a slightly lower sensitivity (97% vs. 100%). For midgut volvulus, US surpassed UGIS in sensitivity (92.9% vs. 66.7%) while maintaining comparable specificity. The SMA/SMV criteria showed better sensitivity (91.1%) than the D3 assessment (78.9%) on US, though both had high specificity.
CONCLUSION: US is equivalent to UGIS for identifying malrotation and is more sensitive for detecting midgut volvulus, supporting its use as a primary diagnostic tool. The study advocates for combined US and UGIS when either yields inconclusive results, optimizing diagnostic precision for these conditions.

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