Category Archives: Number

Pier Abutment: Bridge the gap with Non rigid connector – A clinical case report

Vineet Sharma, Kamal Kumar Meena, Balwant Singh Gurjar, Ramawatar Nagar

Department of Prosthodontics and crown & bridge, RUHS College of Dental Sciences, Jaipur, India

DOI: 10.2478/amma-2022-0008

Pier abutment is defined as a freestanding abutment with edentulous space on both sides. This case report described the rehabilitation of a patient who presented to the department with the primary complaint of missing teeth and difficulty in mastication. Intraoral examination revealed missing right maxillary canine and the second premolar, with the lone standing first premolar acting as a pier abutment. To reduce the stress transferred to the abutment and prosthetic assembly, a non-rigid (Tenon-mortise) connector was used in the case, with a keyway (mortise) distal to the pier abutment and a key (Tenon) mesial to the distal pontic.

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Chest wall secondary chondrosarcoma caused by malignant degeneration of an enchondroma: case report and literature review

Corina Florica Ioniță1, Ioana Iulia Cojocaru2, Adriana Gomotîrceanu1, Bogdan Andrei Suciu3, Doina Milutin2, Anca Alexandra Molnar2, Vlad Neag2, Ioana Hălmaciu3

1. Topmed Medical Center, Târgu Mureș, Romania
2. Emergency County Hospital, Targu Mures, Romania
3. Department of Anatomy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania

DOI: 10.2478/amma-2022-0006

Introduction: Enchondromas are benign tumors originating in the cartilaginous tissue of the hyaline gristle, rarely located in the chest wall. They sometimes undergo a sarcomatous transformation, becoming secondary chondrosarcomas.
Case presentation: We present the case of a 53-year-old patient who, following a chest computed tomography scan performed after a thoracic trauma, was diagnosed with an osteolytic tumor at the chondrocostal junction of rib 4. Surgery was performed, with partial straight resection of ribs 3–5. Histopathological examination of the resection piece identified the existence of a chest wall chondrosarcoma on the background of malignant degeneration of an enchondromatosis lesion. The postoperative evolution was favorable, and the patient was discharged on the eighth postoperative day.
Conclusion: In patients with even asymptomatic chest wall enchondromas, periodic clinical evaluation of these lesions is required, given their risk of malignant degeneration.

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Rehabilitation of maxillary arch with attachment-retained reinforced single complete denture

Oana Cella Andrei1, Daniela-Ioana Tărlungeanu1, Ruxandra Mărgărit2, Gabriela Ciavoi3, Adriana Bisoc1

1. Department of Removable Prosthodontics, UMF Carol Davila Bucuresti
2. Department Of Restorative Odontotherapy, UMF Carol Davila Bucuresti
3. Department Of Dental Medicine, University of Oradea

DOI: 10.2478/amma-2022-0003

Introduction: Fracture of maxillary complete denture is a common problem for dentists and denture wearers, occurring especially when it is opposing mandibular natural teeth or fixed and implant-sustained restorations; to prevent it, various methods and materials are available.
Case presentation: This case is of a patient losing his old maxillary removable partial denture due to the mobility of the frontal abutments. Considering the age of the patient and the status of the mandibular arch, completely restored and having a mix of natural teeth, fixed and implant-sustained restorations, the functional and esthetic rehabilitation of the maxillary arch, and also the long-term resistance of the denture, are a serious prosthetic challenge. An association between ball attachments, metal-casted reinforcement and masking agents for both are described, underlying their role in the treatment’s succes.
Conclusion: The age and health status of the patient and the situation of the mandibular arch imposed the construction of a functional, strong and stable maxillary denture; the technique described in this article offers a good functional and esthetical result and benefits the patient, even if the implant-prosthetic therapy is not available.

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The influence of transport condition and processing time on plasma ammonia results

Karina-Alexandra Cojocaru1, Oana Roxana Oprea2,3, Minodora Dobreanu2,3

1. Municipal Emergency Hospital Roman, Romania
2. Emergency Clinical County Hospital of Targu-Mures, Romania
3. Laboratory Medicine Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania

DOI: 10.2478/amma-2022-0005

Objective: Ammonia is extremely unstable in blood specimens and has special requirements during transport, processing and storage. The aim of our study was to determine the stability of ammonia in EDTA K3 blood samples and to establish a protocol for sample handling.
Methods: In this study, 36 healthy subjects and 47 inpatients diagnosed with type 2 diabetes mellitus were enrolled. Two peripheral blood samples were collected from healthy volunteers (Sample A1 and A2) and one peripheral blood sample was collected from the inpatients diagnosed with type 2 diabetes mellitus (Sample B). Sample A1 and B were transported in ice bath within 15 minutes of blood collection, centrifuged immediately and processed. The sample was re-centrifuged after 15 minutes and a second ammonia result was obtained. Sample A2 was transported at room temperature and stored between 2 and 4 hours, centrifuged and plasma ammonia measurement was performed. The sample was re-spun after 15 minutes and a fourth ammonia result was obtained.
Results: In our study, in healthy group the difference between sample A2 and set point value (on ice, 15 minutes) is 25.08 µg/dl, showing an increase of 55.29%. After another 15 minutes, an increase of 82.02% was observed compared with the standard value. In diabetes mellitus group, after 30 minutes of blood collection, an increase of 11% over the set point value was observed.
Conclusions: The blood specimen should be transported on ice to the laboratory and analyzed within 15 minutes of blood collection due to plasma ammonia spontaneously increase.

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Unified protocols for transdiagnostic treatment versus the Beckian’s approach of cognitive behavioral therapy for medical students with emotional disorders

Cosmin O. Popa1, Peter Olah2, Cristiana Cojocaru3, Zsolt Jakab3, Dana V. Ghiga4, Alina Schenk3

1. Department of Ethics and Social-Sciences, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
2. Department of Medical Informatics and Biostatistics, Faculty of Medicine, University of Medicine and Pharmacy of Tirgu Mures, Romania
3. The Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
4. Department of Research methodology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania

DOI: 10.2478/amma-2022-0002

Background: Emotional disorders are highly prevalent among medical students, impacting their academic performance and general quality of life. It was shown that cognitive-behavioral and emotion regulation strategies are efficient for reducing anxiety and depressive symptoms in young people.
Objective: This study aims to compare the efficiency of standard individual Cognitive-Behavioral Therapy (CBT) to a group intervention based on the Unified Protocol for Transdiagnostic Treatment (UPTT) of emotional disorders in two groups of medical students with similar baseline characteristics.
Method: The sample of this research was composed of 64 medical students in total, of which 34 were included in the CBT group (Mage= 19.5 years, SD= 0.96) and 30 were included in the UPTT group (Mage= 19.4 years, SD= 0.93). The level of irrational beliefs and emotional distress were measured before and after the interventions, which were carried out by certificated psychotherapists.
Results: Statistically significant differences were observed between pre-test and post-test in both groups. The level of irrational beliefs dropped after the CBT (M=62.91, SD=21.30, p<0.05) and the UPTT intervention (M=67.33, SD=34.89, p<0.05), respectively. Similarly, the profile of emotional distress changed after the CBT (M=77.62, SD=16.97, p<0.05) and the UPTT intervention (M=68.77, SD=20.06, p<0.01).
Conclusion: Psychological interventions relying on cognitive-behavioral approaches, including standard, individual psychotherapy and a group intervention designed according to a transdiagnostic protocol, are suitable methods for reducing emotional disorders among medical students.

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Risk Assessment of Failures in Generic Drug Development and Approval Procedure under Competitive Generic Drug Therapy and Patent Challenge Exclusivities Provided by the United States Food and Drug Administration

M Vivek Reddy1, GNK Ganesh1, B Babu2, Ramesh Jagadeesan3, Praharsh Kumar MR4

1. Department of Regulatory Affairs, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Ooty, Nilgiris, Tamil Nadu-643001, India.
2. Department of Pharmaceutical Analysis, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Ooty, Nilgiris, Tamil Nadu-643001, India.
3. Department of Analytical and Product development. Recipharm Pharmaservices, Bangalore, Karnataka-560002, India.
4. Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Ooty, Nilgiris, Tamil Nadu-643001, India.

DOI: 10.2478/amma-2022-0004

Objective: The United States Food and Drug Administration implemented two exclusivity programs Competitive generic therapy and Patent Challenge exclusivity to develop generic drugs, which provide a 180-day monopoly market for first generic applicants in the United States of America. The aim of the present study is to find the root cause of failures in developing and filing the first generic drugs under these exclusivities and to compare both the exclusivities to find the merits and demerits.
Methods: We used descriptive statistics for data analysis of both the exclusivities and Risk assessment was conducted on 14 industries to find the root cause of failures in every stage of the approval procedure by FMECA (Failure mode, Effects and Criticality Analysis).
Results: We found 44% of rejections in competitive generic therapy drugs and 30% of rejections in patent challenge exclusivity drugs. The risk analysis conducted on failures found that, in drug selection, 6% of failures are occurred due to rare diseases. In drug development, 9% of failures are occurred due to formulation failures. In pre-approval, 10% of failures are occurred due to secondary patents. In post-approval, 6% of failures are occurred due to product changes after approval.
Conclusion: We hope this study can give an idea for small and medium companies in developing countries for the early development of generic drugs for life-threatening diseases.

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Maturogenesis of an immature necrotic tooth with an extensive perirapical lesion using platelet rich fibrin

Bhaswati Chakraborty1, Ashwin Rao2

1. Department of Dentistry, Calcutta National Medical College and Hospital, West Bengal University of Health Sciences, Kolkata, West Bengal, India
2. Department of Paediatric and Preventive Dentistry, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India

DOI: 10.2478/amma-2022-0001

Introduction: Earlier, treatment of immature necrotic tooth focussed only on surgical endodontic management and apexification procedures. Regenerative endodontic therapies have called for a paradigm shift in management of such cases. Prognosis becomes challenging though at times due to chronicity of infection, inadequate disinfection of canal space and cytotoxic nature of irrigants used hindering the survival of the apical stem cells.
Case presentation: This report highlights the management of a long-standing case of an immature necrotic tooth with an extensive periapical lesion in a 12 year old male patient. The protocol of regenerative endodontic procedure using platelet rich fibrin (PRF) was followed. Follow up visits at 1week, 3months and 12 months revealed a successful clinical and radiological outcome leading to progressive maturogenesis of the tooth.
Conclusion: The case report favours the possibility of stem cells of apical papilla being viable even in chronic periapical lesions. Hence conservative approach involving regenerative endodontic therapies should always be sought for as first line of treatment in such cases.

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Ulnar-basilic arteriovenous fistula with multilocular gigantic aneurysmal dilatation: a case report

Emil-Marian Arbănași1, Eliza Russu1,2, Adrian Vasile Mureșan1,2, Eliza-Mihaela Arbănași3, Reka Kaller1

1. Clinic of Vascular Surgery, Emergency County Hospital, Târgu-Mureș, Romania
2. First Department of Surgery, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
3. Faculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania

DOI: 10.2478/amma-2021-0035

Introduction: Arteriovenous fistula dysfunction has been associated with a range of problems such as thrombosis, stenosis, dilatation, and infection.
Case presentation: We present the case of a 64-year-old patient with chronic kidney disease on hemodialysis and with aneurysmal dilatation of the ulnar-basilic arteriovenous fistula, having an increased risk of rupture. A temporary dialysis catheter is placed in the left femoral vein, an aneurysmal basilic vein is ligated at the anastomosis, aneurysmal dilatation is emptied by compression, and a right radiocephalic arteriovenous fistula is performed. The patient undergoes hemodialysis on the second day and subsequently three times a week for six weeks until the new arteriovenous fistula develops. He returns for aneurysmal sac resection.
Conclusion: The purpose of this paper is the presentation and management of a 15-year-old ulnar-basilic arteriovenous fistula with multilocular aneurysmal development and an imminent rupture.

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