The Effect of Brand, Thickness, and Abutment Substrate on the Masking Ability of Monolithic Zirconia Cera The goal of the present study was to determine the minimum thickness of monolithic zirconia required to achieve an acceptable masking ability and to examine how brand, thickness, and abutment substrate influenced that masking ability (∆E). Seventy-two A2-shade monolithic zirconia disc specimens in various thicknesses (1.0, 1.5, and 2.0 mm) were fabricated using three brands: Nacera® Pearl 1, DD cubeX2 and XTCERA TT. A spectrophotometer was used to determine the CIELab values of the specimens, which were placed on a D4-shade resin composite and white acrylic (control) substrates. The ∆E was calculated and compared with the acceptable (AT = 5.5) and perceptible (PT = 2.6) tolerance thresholds. Further investigation was conducted on 72-disc specimens from the monolithic zirconia brand with the best masking ability on D3-shade resin composite and semi-precious alloy. Using two-way ANOVA, the interaction of thickness, brand, and abutment substrate on ∆E was investigated. Nacera® Pearl 1 at 1.5 mm thickness was sufficient to achieve AT on a D4-shade resin composite substrate, whereas 2.0 mm of DD cubeX2 and XTCERA TT were required. Nacera® Pearl 1 further testing on two other substrates requires thicknesses of 1.5 mm and 1.0 mm, respectively. Only the Nacera® Pearl 1 group achieved PT on D3- and D4-shade resin composite (2.0 mm) and semi-precious alloy substrates (1.5 mm). Brand, thickness, and abutment substrate influenced the ∆E (p < 0.001). To achieve an acceptable masking ability, the minimum thickness of monolithic zirconia tested on D3- and D4-shade resin composite and semi-precious alloy should be around 1.5 mm to 2.0 mm.

Throughout history, a proportion of men appear to correlate penis size and dimensions directly with physical fitness and sexual prowess. Foreign materials, such as paraffin oil, paraffin balm, mineral oils, and silicone, have been used to promise an improvement in penile shaft contour and dimensions. These materials are injected directly into the penis; inducing granuloma formation to achieve increased penis length and girth. However, the result is a severely disfigured and swollen penis, which cannot achieve erection. Local complications of penile lipogranuloma include infection, ulceration, local migration, and cavernosal invasion; leading to functional impairment. Meanwhile, systemic complications include foreign body embolization, organ infarct, and death. Penile lipogranuloma is best treated surgically. Granulomatous skin needs to be completely excised; wound closure with a scrotal skin flap, Cecil’s inlay operation and split thickness skin graft commonly used options. Our case series has shown that penile lipogranuloma, induced by subcutaneous foreign body injections into the penile shaft, and its subsequent adverse outcomes to patients and their partners.

Febrile neutropenia is a common and potentially fatal problem encountered in cancer patients undergoing chemotherapy. We carried out an observational study to evaluate the possible risk factors of developing fever amongst neutropenic children with an underlying malignancy. We also looked at the microbiological profile of causative pathogens in patients with febrile neutropenia. During a study period of 1 year, a total of 90 neutropenic episodes were recorded amongst 57 patients who were on treatment and follow-up during the study period. Multivariate analysis showed that factors such as chemotherapy status, underlying disease, existing central venous catheters, presenting white blood cell counts at chemotherapy, use of steroid therapy or hospitalisation at the onset of neutropenia, were not significant risk factors for developing fever during neutropenic episodes. Although the presence of a central venous catheter was associated with a higher risk of developing fever, it did not reach statistical significance (p=0.11). Of the 90 neutropenic episodes, 59 (65.6%) developed fever and 25 of these had positive blood cultures. The causative organisms include gram-negative bacteria (64%), gram positive bacteria (16%) and fungus (20%). Of the gram-negative organisms, Klebsiella spp. predominated (28%) with the extended spectrum beta-lactamase producing strain forming the majority (16%). Amongst those with fungaemia, Candida spp. and Candida tropicalis formed the majority (8% each) of the isolates.
Fever ; Neutropenia ; Malignant Neoplasms ; Chemotherapy-Oncologic Procedure ; majority