Physiology and Anatomy

Objective: Biotene mouthwash is an antimicrobial agent used in prevention of periodontal disease, xerostomia and halitosis. it seems that no study has been conducted to evaluate its effect on prevention of alveolar osteitis(AO) .So the purpose of the study is to evaluate effective of biotene mouthwash on prevention of alveolar osteitis after extraction of permanent mandibular teeth and to investigate association of risk factors of AO with incidence of AO. Methods and materials: This randomized double blind clinical trial was conducted in oral and maxillofacial surgery department of Tabriz dental faculty. In case group (n=192), the patients received Biotene mouthwash and used it, three times a day for one week. Control group (n=197) received 0.09% sterile saline solution and used it similar to case group. The patients with the symptoms of AO were recalled for the diagnosis of alveolar osetitis on the third postoperative day. Results: In the experimental group 6 ( 3.1%) of AO incidence was found. While in the control group, 17 (8.6%) of AO was observed. The reduction in the incidence of AO in case group was statistically significant in comparison with control group p=0.03, p<0.05 for fisher`s exact test (Chi-square test). smoking was a variables that has significant relation to increased rate of AO. p=0.235, p<0.05. Conclusion: It was concluded that the use of Biotene mouthwash can be effective in reducing the incidence of dry socket after extraction of mandibular teeth. Smoking was significantly associated with the increased incidence of alveolar osteitis.

Bone is essentially a heterogeneous system consisting of water, mineral and collagen which determine the physical properties of bone composite material. The decrease in bone weight was dose dependent after treatment with all the two salts of metal i.e. NiNO3 and NiSO4. Bone provides essential framework and rigidity to the body. The toxic substances affect the development of bone by impairing the availability of essential nutrients resulting in abnormal bone development and toxicity. The impact of nickel toxicity on bone of mice has been studied histochemically (under light and electron microscope) by using two nickel salts . Histopathologically, the necrosis to layers of decalcified bone i.e. periosteum, matrix and endosteum was observed with all two salts. The bone forming cells, lamellae and Haversian canals were also affected. The cortical width of bone section decreased as the dose of salts increased. These changes were also observed on samples of powdered dried bone of all groups with SEM. These changes were dose dependent and of the same order as mentioned above. The toxicity of nickel salts was in the order of NiSO4 > NiNO3 .

The objective of this work was to provide an iconographic and narrative review of the normal and pathological aspects of the hippocampus of the elderly subject in imaging. Know how to perform a routine 1.5 Tesla MRI hippocampal study. Recognize the main hippocampal anomalies during degenerative, infectious, vascular, inflammatory, tumor, toxic and metabolic Take home message: interest of MRI in the study of the tonsil-hippocampal regions. Know the basics of the Anatomy of the Hippocampus and the Limbic System. Recognize the main hippocampal anomalies, during degenerative, infectious, vascular, inflammatory, tumor, toxic and metabolic summary The hippocampus is a small brain structure, internal temporal, playing a primary role in the mechanisms of memory. Magnetic resonance imaging (MRI) is the imaging modality of choice for the analysis of this structure. At the elderly, dementias represent the majority of causes of hippocampal abnormalities, especially atrophic, but other specific pathologies constitute differential diagnoses to be known in this population.

Intradural disc herniation (IDH) is a rarely reported cause of radicular pain. Preoperative imaging can be useful for diagnosis, but differentiation of intra-dural tumors from large disc hernias is difficult and intraoperative findings are required for definitive diagnosis. We present here a case of IDH, which was depicted by high-resolution MRI. It is very representative of the difficulty to make the diagnosis and illustrates the added value of high-resolution MRI when an atypical disc herniation is suspected.

Breast cancer is the most common cancer in women worldwide. In Morocco, it is a real public health issue. It is responsible for lymphatic, bone, pulmonary, hepatic and cerebral metastases; gastrointestinal metastases remain however rare (0.3%) . Gastric linitis plastica is the most frequent form of gastrointestinal metastasis. The diagnosis of gastric linitis plastic is based mainly on endoscopy and histology.Immunohistochemistry plays a fundamental role in differentiating primary from secondary gastric cancer.Therapeutic modalities usually include palliative chemotherapy and hormonal therapy. A 27 years old female patient, admitted to the hospital because of developing progressive distension of the abdomen associated with abdominal pain, asthenia, anorexia and weight loss, she denied having haematemesis or jaundice. On examination, the patient appeared pale, cachectic with significant loss of body fat and muscle but she was haemodynamically stable and afebrile. His abdomen was soft, but tender. No masses or organomegaly were palpated. On percussion, a shifting dullness was observed, which suggested ascites. Normal bowel sounds were present. at chest examination a right breast mass was noted.Initial investigations showed a hypoalbuminemia (14g/l), a low hemoglobin (9 g/dl), CT scan showed diffuse thickening of the gastric wall and a large peritoneal effusion , indurated right-sided breast mass (estimated at 2 cm) was noted on breast radiological investigations. This examination was followed by upper endoscopy, which showed thickened, erythematous and rigid gastric mucosa extending from the gastric fundus to the distal body with poor distensibility. Pathologic evaluation of breast mass biopsy revealed infiltrating ductal carcinoma that tests positive for the human epithelial growth factor receptor 2 (HER2) on immunohistochemical studies. Gastric biopsies showed an adenocarcinoma with the presence of signet ring cell type . Immunohistochemistry excluded gastrointestinal origin. There was a strong immunoreactivity for estrogen and progesterone receptors, cytokeratin (CK7) and HER2. Histological exam concluded for metastatic breast cancer with gastric linitis plastica. After Multidisciplinary team meeting, it was decided to combine chemotherapy with hormone therapy. The patient died before the treatment was started.

Left ventricular (LV) aneurysm or pseudoaneurysm are most often secondary to myocardial infarction. They predispose to heart failure, rhythm disorders and thrombus formation. Their diagnosis can be difficult, requiring a high performance imaging. The purpose of our study is to demonstrate the important role of cardiac MRI in the study of the left ventricular aneurysms. We performed a retrospective study, which collected 68 patients referred for cardiac MRI, between 2007 and 2021, and for whom the final diagnosis of left ventricular aneurysms or pseudoaneurysms was retained. We evaluated the incidence of this pathology, the underlying heart disease, the myocardial morphology, perfusion and viability, as well as those of aneurysms with search for thrombus. The mean age was 64.4 years, with a male predominance. Cardiac MRI was performed mostly to search for myocardial viability (61.8 %). The underlying heart disease was exclusively ischemic heart disease. In 58.8% of the cases, the diagnosis was that of a true aneurysm without thrombus and in 38.2% of cases with thrombus. LV pseudoaneurysm was present in only 2 patients. These aneurysms were mainly located apically (84.8%). Perfusion defect perfusion was noted in the necrotic coronary territories, with the presence of viability in 11.8% of cases. The mean of the LV end-diastolic diameter was at 66.3+/- 8.2 mm (i.e. 39 mm/m2) and the mean volumes were at 264.1± 101.5 ml (155.3 ml/m2). The mean LV ejection fraction was at 29.8 ±10%. Thus, cardiac MRI is the "gold standard" in post-infarction studies for an exhaustive study, not only for the diagnosis of LV aneurysms, but also on the complete myocardial study.

We report the case of a 49-year-old patient admitted to our emergency department at the Kintambo Reference General Hospital for spontaneous rupture of the spleen. At the admission of the patient, we found a pallor of the conjunctiva, the abdomen was distended, slightly contracted with splenomegaly on palpation. The biological assessment was normal. Abdominal ultrasound showed splenomegaly of homogeneous echostructure and peritoneal effusion in the form of a dense hypoechoic plaque. Abdominal CT revealed heterogeneous splenomegaly complicated by spontaneous rupture of the spleen with capsular hematoma and peritoneal effusion of average abundance. Splenectomywasrecommended in our patient.

Ureterosigmoidostomy has been widely used as a surgical urinary diversion technique. However, it can be the cause of many infectious, metabolic, or tumoral complications. We report a case of a patient who developed a rectosigmoid carcinoma at the site of a previous ureterosigmoidostomy after a long latent period.

The Bezold-Jarisch reflex is a cardioinhibitory reflex characterized by a triad of signs (bradycardia, hypotension, and apnea) and involved in some cases of vasovagal syncope. Its physiopathology is still largely unknown. We report two cases of young patients presenting with vasovagal syncope and whose autonomic system investigation showed a profile highly suggestive of Bezold-Jarisch reflex. 

Benign tracheoesophageal fistula is a rare clinical entity and a rare complication of prolonged intubation and tracheostomy, we report the case of 20-year-old woman with a tracheoesophageal fistula secondary to mechanical ventilation. Ventilation difficulties and the recurrent lung infections were the mean symptoms, Early diagnosis was confirmed by bronchoscopy then the patient underwent a surgical repair of the fistula and interposition of a muscle flap. Acquired nonmalignant tracheoesophageal fistula is a preventable disease but this complication can still occur. The surgical treatment remains the best option.