Category Archives: Original Research

Testosterone deficiency is associated with clinically relevant depression symptoms

Liliana Vartolomei1, Sabin Octavian Tătaru1, Andrei Cotruș2, Camelia Stanciu2, Anca Ileana Sin3

1. IOSUD, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
2. Department of Psychology, Dimitrie Cantemir University, Targu Mures, Romania
3. Department of Cell and Molecular Biology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania

DOI: 10.2478/amma-2023-0008

Objective: To investigate the association between testosterone deficiency and depressive and/or anxiety symptoms.
Methods: A cross-sectional study was conducted at the urology outpatient clinic from Ludus County Hospital. A set of validated questionnaires ((International Prostate Symptoms Score (IPSS), Depression Anxiety and Stress Scale (DASS-21), Zung Self-rating Depression Scale (Zung SDS)) were self-administrated. Inclusion criteria: age > 40 years. Exclusion criteria: any relevant psychiatric, cardiovascular, or cancer comorbidity. Statistical analyzes were performed using the statistical software Statistical Package for Social Sciences (SPSS, version 23, Chicago, IL, USA).
Results: From the total of 55 participants included in the study, 23 (41.8%) had testosterone deficiency. Most were from the 60-69 years decade, 23 participants (41.8%), and the mean age was 59.3 (SD 9.03) years. Eleven (20%) patients had depressive symptoms according to the depression subscale, of these, 7 had mild symptoms and 4 according to Zung SDS. Testosterone deficiency was associated with an increased DASS-21 global score, p=0.021, and depression score, p=0.047.
Conclusions: Patients with testosterone deficiency are presenting symptoms of depression. Therefore, these patients need a multi-disciplinary approach that should include a psychological evaluation before making a further management decision.

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Comparison of two different file systems on postoperative pain after root canal instrumentation: A randomized controlled trial

Saad Shahnawaz1, Nabiya Shahroz2, Muhammad Ahmed Zafar1, Shahroz Sajjad3, Mehwish Pasha4, Arfa Sabir Hussain1

1. Operative and Endodontic Department Islamic International Dental Hospital, Islamabad, Pakistan
2. Operative and Endodontic Department Shifa international hospital, Islamabad, Pakistan
3. Operative and Endodontic Department Armed Forces Institute of Dentistry, Islamabad, Pakistan
4. Dental materials Department, Shifa international hospital, Islamabad, Pakistan

DOI: 10.2478/amma-2023-0006

Introduction: In this study post instrumentation pain is evaluated between rotary hyflex CM files and conventional k-files at different time intervals.
Methodology: fifty patients were equally assigned into two groups and instrumented using hyflex cm or conventional files. VAS for pain was noted before the start of a root canal and after the procedure at 12, 24, and 48 hours.
Results: There was no significant difference at 12, 24, and 48 hours with P values being 0.127, 0.867, and 0.846 respectively.
Conclusion: There is no significant difference in causing post-instrumentation pain between hyflex CM and conventional files at different time intervals. However, when accessing preop pain of the conventional file group, it had more pain mean score compared to hyflex group. According to this study, Conventional files may be able to slightly decrease the chances of post-instrumentation pain more than hyflex CM instrumentation.

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Evaluation of effects on hepatocellular carcinoma cell line of Cocos nucifera: In vitro study

Zeynep Tasdan1, Gülçin Alp Avci2, Emre Avci3

1. Department of Molecular Biology and Genetics, University of Hitit, Corum, Türkiye
2. Department of Basic Medical Sciences, University of Health Sciences, Ankara, Türkiye
3. Department of Biochemistry, University of Health Sciences, Ankara, Türkiye

DOI: 10.2478/amma-2023-0004

Objective: Cancer is one of the most important diseases today. The use of chemical drugs, surgical operations, and transplants is very common in its treatment. In addition to these treatment methods, studies include the effects of natural and plant-derived substances. Various substances are used in these studies, which are called phytotherapy. The antioxidant activity and cytotoxic effects of Cocos nucifera on hepatocellular carcinoma HepG-2 and the mouse fibroblast L929 cell line were investigated in this study.
Methods: In this study, in vitro cytotoxic effects of C. nucifera at different concentrations (7.81-500 mg/ml) were investigated on the L929 Mouse Fibroblast cell line and HepG-2 Hepatocellular Carcinoma cell line. In addition to these studies, their antioxidant capacity was evaluated via spectrophotometric methods. In this work, different concentrations of C. nucifera were examined.
Results: According to the results, C. nucifera had a cytotoxic effect in HepG-2 and ensured the proliferative effect of cells in the L929 cell line. Among C. nucifera extracts according to total antioxidant capacity results, C. nucifera extract was found to be the richest in antioxidants with 2.79 mmol/L, while the material with the lowest antioxidant capacity was determined to be C. nucifera milk. DPPH free radical scavenging activity results show the opposite.
Conclusion: In line with the data we obtained, it is thought that C. nucifera can be used in liver cancer studies, and its antioxidant effect may play an important role in balancing against oxidative stress. Simultaneously, the data show that the exposure time and concentrations of the active substance are related to the cytotoxic effect. However, it may be considered that the use of C. nucifera water, extract, and milk in cancer patients may be supported by more comprehensive clinical studies.

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A study of the impact of solid cast removable dentures with silver electroplating on the condition of patients

Andriy Nikonov1, Valeriia Krynychko1, Nataliia Bobrovska1, Nataliia Breslavets1, Olha Smirnova2, Zahar Muhin3

1. Department of Dentistry, Faculty of Medicine, V. N. Karazin Kharkiv National University, Kharkiv, Ukraine
2. National Technical University “Kharkiv Polytechnic Institute”, Kharkiv, Ukraine
3. Department of Pediatric Dentistry and Orthodontics, Faculty of Surgery, Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine

DOI: 10.2478/amma-2023-0002

Objectives: The aim of our study was to determine the effectiveness and biocompatibility of the use of solid clasp dentures with silver plating in the restoration of partial defects of the dentition.
Methods: The study involved 23 patients with partial secondary adontia after oral rehabilitation. At the first stage, before the start of treatment and after a month of using a clasp prosthesis, patients underwent studies of blood biochemical parameters, Schiller-Pisarev’s test and Papillary-marginal-alveolar index. At the second stage of the research, silver electroplating was applied to the metal parts of the clasp prosthesis and after a month of use, its effect on oral hygiene and blood biochemical parameters was assessed.
Results: After installation of the removable prosthesis with solid structures, the PMA index after the use of silver-plated clasp prosthesis decreased to medium severity, which is explained by positive impact on the inflammatory process in the gums. We can see the stability of biochemical parameters of blood in patients with solid removable prostheses can serve as a justification for the administration of silver electroplating for prophylactic and therapeutic purposes.
Conclusions: The effectiveness of the use of silver plating in the treatment of partial defects of the dentition eliminates the clinical manifestations of the pathological condition and prevents possible complications in the oral cavity.

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Hereditary hemochromatosis: Retrospective study on clinical data from Emergency County Hospital Mures

Victor Sigmirean

Emergency County Hospital Mures, Targu Mures, Romania

DOI: 10.2478/amma-2022-0031

Objective: Hereditary hemochromatosis, or primary hemochromatosis, is a recessive genetic liver disorder caused by iron accumulation in tissues. This study evaluates patients with hereditary hemochromatosis to determine correlations between clinical and laboratory data.
Methods: The data analyzed in this study was gathered from the discharge records from 2019 to 2021 of the Gastroenterology Department of the Mures Country Emergency Clinical Hospital. 15 patients with hemochromatosis were sampled during the studied period.
Results: Hepatic cirrhosis is present in 67% of the studied group of patients, 40% of patients presented hypertension and 20% of patients showed diabetes mellitus and portal hypertension. Positive correlations were obtained between serum iron and alkaline phosphatase (r=0.8536), between serum iron and lactate dehydrogenase (r=0.7381), and between serum iron and urea (r = 0.79). Positive, strong correlation between ferritin and serum iron (r=0.7719), GOT (r=0.778) and GPT (r=0.6108). total bilirubin and direct bilirubin (r = 0.85), between total bilirubin and GOT (r = 0.68) and GPT (r = 0.82).
Conclusions: Excess iron stored is influencing organ function trough reactive oxygen species, the hepatic signs being a main participant in the clinical presentation, while serum iron cause damage to other tissues such as myocardium, pancreas and kidneys. Treatment for hemochromatosis includes phlebotomies, and iron chelation with Deferoxamine.

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The effect of postprandial in vivo and experimental in vitro hyperlipidemia on human peripheral blood monocytes

Ion Bogdan Manescu1, Mariuca Manescu1, Elena Cristina Preda2, Doina Ramona Manu1, Minodora Dobreanu1,3

1. George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
2. County Emergency Clinical Hospital of Targu Mureș, Romania
3. Center for Advanced Medical and Pharmaceutical Research, Targu-Mures, Romania

DOI: 10.2478/amma-2022-0026

Objective: In this study, we aimed to investigate the effect of transient postprandial in vivo and prolonged experimental in vitro hyperlipidemia on human peripheral blood monocytes.
Methods: Peripheral blood was collected from seven healthy subjects after an overnight fast and three hours after a standardized high-fat meal. Both fasting and postprandial samples were stained for surface markers CD14/CD11b and intracellular lipids using BODIPY493/503. Postprandial samples only were used for isolation of peripheral blood mononuclear cells that were further incubated overnight with postprandial hyperlipidemic autologous plasma, then stained as described above. All samples were analyzed on a FACSAria III flow cytometer.
Results: Flow cytometric analysis revealed two monocyte populations (CD14+): CD14low and CD14high. In fasting, these populations show similar morphology (FSC/SSC), but different expressions of CD14, CD11b, and BODIPY493/503. At three hours postprandially, a moment of maximum hyperlipidemia, neither population suffered significant changes. After the 24-hour incubation, cell activation was observed in both populations: similar fold change increase in SSC, increase in FSC for CD14high cells only, similar foldchange increase in CD14, slightly higher foldchange increase in CD11b for CD14low monocytes, and significantly higher foldchange increase in lipid content for CD14high monocytes. CD14high monocytes appear to undergo a more intense activation than CD14low monocytes.
Conclusions: We conclude that all monocytes react after prolonged in vitro exposure to plasma lipids, each subset having its own activation pattern. All monocyte types may play a role in inflammation and the development of plaques. Monocyte assays are a valuable tool for the investigation of atherosclerosis at the cellular level.

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Artificial intelligence based model for establishing the histopathological diagnostic of the cutaneous basal cell carcinoma

Andrei Calin Dragomir1, Iuliu Gabriel Cocuz1, Ovidiu Simion Cotoi2, Leonard Azamfirei3

1. George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
2. Department of Pathophysiology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
3. Department of Anesthesia and Intensive Care, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania

DOI: 10.2478/amma-2022-0020

Introduction: Artificial intelligence (AI), a component of computer science, has the ability to process the multitude of medical data existing in the medical system around the world. The goal of our study is to build an AI model, based on Machine Learning, capable of assisting pathologists around the world in the diagnosis of the basal cell carcinoma of the skin.
Material and Method: Our study is represented by the development of a Mask-RCNN (Mask Region-based Convolutional Neural Network) model, for the detection of cells with typical basal cell carcinoma tumoral changes. A number of 258 digitized histological images were used. The images emerged from Hematoxylin&Eosin stained pathology slides, diagnosed with cutaneous basal cell carcinoma between January 2018 and December 2021, at the Pathology Service of the Mureș County Clinical Hospital.
Results: All the used images have the unique resolution of 2560×1920 pixels. For the learning process, we divided these images into two datasets: the learning dataset, representing 80% of the total images; and the test dataset, representing 20% of the total images. The AI ​​model was trained using 1000 epochs with a learning rate of 0.00025 and only one classification category: basal cell carcinoma.
Conclusions: The AI model successfully identified in 85% of the cases the areas with pathological changes present in the input images.

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An evaluation of concordance between linear measurements obtained from conventional, digital and reconstructed three-dimensional printed orthodontic models: an in vitro study

Shravan Shetty1, Srikant Natarajan2, Supriya Nambiar1, Prithvi Shetty3, Kavery Chengappa4, Mukul Shetty5

1. Department of Orthodontics and Dentofacial Orthopaedics, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
2. Department of Oral Pathology and Microbiology, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
3. Department of Public Health Dentistry, A.J.Institute of Dental Sciences, N.H.17, Kuntikana, Mangalore, Karnataka, India
4. Department of Public Health Dentistry, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
5. Department of Orthodontics and Dentofacial Orthopedics, A B Shetty Memorial Institute of Dental Sciences; NITTE Deemed to be University, Mangalore, Karnataka, India

DOI: 10.2478/amma-2022-0028

Objective: To evaluate the potential use of digital and reconstructed three-dimensional printed models as an alternative to conventional plaster models by assessing the accuracy of their linear measurements.
Methodology: Pre-treatment plaster models of 45 patients were selected from the archives of the Department of Orthodontics. Each physical plaster model was scanned and digitized using a three-dimensional (3D) laser surface scanning system (inEOS X5, Dentsply Sirona, Bensheim, Germany). The scanned STL files were later used to reconstruct models by 3D printing using Figure4® standalone 3D printer (3D systems, Rock Hill, South Carolina). Measurements of teeth 11 and 16, the transverse width of the upper jaw between the first molars (MM – intermolar width) and canines (CC – intercanine width) were done manually using a digital vernier caliper (Mitutoyo, Kawasaki, Japan), and the CAD Assistant software (Open cascade, Guyancourt, France). Intra examiner data, Intraobserver variability, and measurement accuracy were evaluated using Intraclass Correlation Coefficient (ICC) analysis was done using SPSS 20.0.
Results: The intraclass correlation coefficients were >0.8 indicating high reproducibility and reliability. Significant differences were found between the physical and the digital models but to a small proportion which were deemed not clinically relevant.
Conclusion: Both the digital models and reconstructed three-dimensional printed models using Figure4® technology were clinically permissible in terms of accuracy and reproducibility. The digital storage, transmission, and treatment planning in an environmentally friendly manner should promote digital over conventional records.

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Clear or White? A RT-PCR plate comparison for SARS-CoV-2 diagnosis

Elena Cristina Preda1, Valeriu Moldovan1, Oana Roxana Oprea2

1. County Emergency Clinical Hospital, Târgu Mureș, Romania
2. George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania

DOI: 10.2478/amma-2022-0024

Objective: During the COVID-19 pandemic, laboratories have used various extraction and amplification kits, associated with different auxiliary materials. This study aims to investigate how different types of plates may affect RT-PCR performance.
Methods: Data on the positive controls (PCs) of RT-PCR runs for SARS-CoV-2 detection between December 2020 and April 2022 was collected retrospectively in the Molecular biology department of the County Emergency Clinical Hospital of Târgu Mureș’s clinical laboratory. The materials used consisted in MOLgen SARS-CoV-2 (Adaltis) and EliGene COVID19 CONFIRM 500 R amplification kits, 96-well full-skirted white and clear plates, and clear films. Microsoft Excel was used for the database and it included information about Cycle threshold (Ct) and maximum fluorescence. Statistical analysis, performed in MedCalc, consisted of Grubbs test, Kolmogorov–Smirnov Test, F test, T student test, and Mann-Whitney test to compare central tendencies. The significance threshold was set at p<0.05.
Results: The Ct comparison for MOLgen kit white plates vs clear plates: FAM channel- U=1052.5, Z=2.07, p=0.038, medians for white plates and clear plates were 22.80 and 23.25, respectively; ROX channel- U=784, Z=3.21, p=0.001, medians 21.93 and 21.43, respectively; Cy5 channel- U=1028.5, Z=1.95, p=0.518, medians 22.12, 21.75, respectively. For EliGene kit: U=848.5, Z=3.27, p=0.001, medians 28.26 (white plates) and 28.0 (clear plates). Comparison of the maximum fluorescence reached on both kits with white and clear plates computed p values <0.0001.
Conclusions: Between white and clear plates there are statistically significant differences considering Ct values and maximum read fluorescence, but with no impact on test outcome.

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Nutrition in pregnancy – impact on anaemia in pregnant women

Oana Liliana Atomei1, Paula Paraschiva Monor1,2, Bogdan Aurelian Stana3,4, Monica Tarcea5

1. Faculty of Medicine and Biological Sciences, „Ștefan cel Mare” University of Suceava, Romania
2. Emergency County Hospital „Sfântul Ioan cel Nou” Suceava, Romania
3. Physiology Department, Faculty of Medicine, „Gr. T. Popa” University of Medicine and Pharmacy, Iași, Romania
4. 2nd Pediatrics Clinic – Emergency Clinical Hospital for Children „St. Maria”, Iași Romania
5. Department of Community Nutrition and Food Safety, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania

DOI: 10.2478/amma-2022-0016

Aim: Most pregnant women can achieve their caloric and nutritional needs by careful food choices during pregnancy, but there are fairly common situations when pregnant women develop anaemia, which needs to be managed properly to avoid maternal-foetal complications. The main objective of the study was to identify the nutritional factors favoring the occurrence of iron deficiency anaemia in pregnant women.
Methods: Data collection for the cross-sectional study was carried out using a questionnaire that provided information on nutrition and risk factors during pregnancy in a group of patients from Suceava. The questionnaire was given to pregnant women admitted to the Emergency County Hospital „Sfântul Ioan cel Nou” Suceava, Romania, between March and May 2017.
Results: The anaemia occured in 46.3% of pregnant women. Although 22.2% of pregnant women received oral iron supplementation, effects on anaemia correction were not observed (p=0.02). We found that weight status did not influence anaemic status (p=0.51), and the presence of anaemia in pregnancy was independent of risk factors for pregnancy (smoking, p=0.05; alcohol consumption, p=0.66), iron absorption inhibitors in the diet (coffee, p=0.33; tea, p=0.53), water intake (p=0.52) or night eating (p=0.27).
Conclusions: The results of dietary survey showed no direct link between the prevalence of anaemia and nutritional factors. Lower pre-pregnancy BMI was not associated with higher risk of iron deficiency anaemia, and daily iron supplementation during pregnancy did not meet the needs to counteract the anaemic syndrome. Nutrition education is particularly important for the prophylaxis of iron deficiency anaemia in pregnant women.

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