La gestion du patient irradié en prothèse amovible complète

La réhabilitation prothétique à l'aide de prothèse amovible chez un patient irradié présente quelques particularités. Car si le traitement en lui-même n'est pas très diff érent de celui effectué dans des conditions habituelles, la difficulté provient de la fragilité tissulaire, de la limitation de l'ouverture buccale, du risque d'ostéoradionécrose, de l'hyposialie et de la susceptibilité élevée aux infections mycosiques. Or la salive joue un rôle clé dans la tenue et le confort des prothèses amovibles. Elle a également un rôle de protection des surfaces orales. Une telle situation complique la réalisation prothétique et commande de prendre certaines précautions, particulièrement en prothèse amovible. Celle-ci se doit de rétablir les différentes fonctions orales, de restaurer l'esthétique et d'assurer un soutien psychologique du patient sans pour autant être à l'origine d'effets secondaires graves. Le but de notre travail est de montrer, à travers un cas clinique, les différentes particularités et précautions àprendre lors des différentes étapes de réalisation d'une prothèse amovible complète chez les patients édentés ayant subi une irradiation de la sphère oro-faciale

Trends in sociodemographic and drug abuse variables in patients with alcohol and drug use disorders in a Nigerian treatment facility

"BACKGROUND: Globally; patterns of the use of psychoactive substances have been changing. OBJECTIVE: To evaluate the trend in two five-year periods; 1992-1997 versus 2002 - 2007; of alcohol and substance use disorders and associated variables in patients admitted to a drug abuse treatment facility. METHODS: This was a comparative cross-sectional study involving all patients admitted into Drug Abuse Treatment; Education; and Research (DATER); Unit of the Neuropsychiatric Hospital; Aro; Nigeria within the study period. All subjects had a structured psychiatric interview; a physical examination; laboratory investigations and ""DATER"" Questionnaire protocols that elicited socio-demographic; drug and family variables. RESULTS: The patients in 2002-2007 versus those of 1992-1997 were younger (c2 13.29; p=0.01). More last borns were using drugs by 2002-2007 (c2 11.37; p=0.01). Cannabis was the most abused drug in 2002-2007 (53.5) as compared to cocaine (44) in 1992-1997 (c2 35.5; p"

Practical Regional Anaesthesia

Regional anaesthesia; from plexus blocks to skin infiltration; can be used to provide analgesia for most surgery. Cognisance must be taken of the following when choosing the dose of local anaesthetic agent : potency and toxicity of the drugs the site of injection the volume needed for the block the desired characteristics of the block (motor or sensory block) the patient's physiology

A comparison of Booked and Unbooked Patients with Ruptured Uterus in a Referral Hospital in the Niger Delta Region of Nigeria

Objective: To document differences in characteristics and outcome between booked and unbooked patients with ruptured uterus. Methods : A 10 year retrospective comparative analysis of booked and unbooked patients with ruptured uterus at the Baptist medical center; Eku; Delta State. Results: The overall incidence of ruptured uterus was 1 in 271 deliveries while the incidence among booked and unbooked patients was 1 in 556 and 1 in 140 respectively. There were a statistically significant difference in number of booked patients with formal education beyond the primary level compared with the unbooked patients (p =0.0206; 95CI 1.92-14.79). A higher proportion ofbooked patientswith ruptured uterus had history ofprevious uterinescar. All the three maternal deathsoccure in theunbooked patients. The overallcasefatality rate for ruptured uterus was 23or 1 in 4.3. Conclusion : Booked and unbooked patients with ruptured uterus have different characteristics and outcome. Subsequent studies on ruptured uterus should disaggregate their data according to the booking category of the patients. This will assist in making effective intervention plans that will impact both groups