Occurrence of some oral potentially pathogenic microorganisms and their associated risk factors

Background: The human mouth harbors one of the most diverse microbiomes in the human body. Multiple factors might affect the composition of oral flora, such as oral hygienic practices. Disturbance in the composition of the oral flora might lead to local as well as systemic diseases

Objective[s]: To estimate the occurrence of some oral potentially pathogenic microorganisms and their associated risk factors, as well as their association with dental caries

Methods: Saliva samples were collected from 130 participants affiliated to the High Institute of Public Health [HIPH] including university teaching staff/ postgraduate students, administrative employees and workers. A questionnaire sheet was completed for everyone. It included demographic data, clinical data as well as oral hygienic practices. The DMFT index was recorded as an index for oral caries. All 130 saliva samples were examined for the presence of Enterobacteriaceae, Streptococcus mutans [S. mutans] and Candida spp. Demographic data, dental hygiene practices, dental complaints as well as the DMFT index were all studied in relation to the studied microbial agents

Results: The most prevalent microorganism among participants was S. mutans [64.6% of isolates] followed by Candida spp [20.8%] then Enterobacteriaceae spp [10%]. Isolates of Enterobacteriaceae spp were distributed as follows: Citrobacter koseri [4.6%], followed by Klebsiella pneumoniae [3.8%], then Klebsiella oxytoca. S. mutans was the only microorganism that was significantly affected by the type of snacks taken between meals [p=0.001]. Among those who had sugary snacks between meals, S. mutans was isolated in 81.3% of them. Candida spp was present in 27.3% of married participants, and this finding was statistically significant. The intake of drinks between meals was also significantly associated with positive Candida cultures [31.1% of participants who took drinks in between meals had positive Candida cultures]. Enterobacteriaceae were significantly less frequently isolated among participants with secondary and university education [5% and 6.5% respectively] compared to uneducated and primarily educated participants [13% and 40% respectively]. None of the studied microorganisms were associated with any specific dental hygienic practice, or specific dental symptoms and signs. The only organism isolated that was significantly associated with DMFT index was S. mutans [p = 0.001]. None of the microorganisms were found to be significantly associated with the presence of any of the other two microorganisms

Conclusion: S. mutans was the most prevalent microorganism among participants and was significantly associated with higher DMFT index. The presence of potentially pathogenic oral microorganisms was influenced mainly by the educational status as well as dietary habits [the intake of sugars and drinks between meals] rather than specific oral hygienic practices

Laparoscopic suture gastropexy for chronic gastric volvulus

Gastric volvulus is a rare condition, however it may result in serious complications. It occurs mainly as a result of congenital laxity of the stomach's attachments and might be accompanied by a diaphragmatic hernia. A patient may have acute or chronic disease. We present 6 patients of chronic gastric volvulus who were managed with laparoscopic suture gastropexy. We managed 6 patients with chronic gastric volvulus during the past 4 years. All of them had primary and organoaxial type of volvulus. All of them were proved by barium meal study and underwent elective surgery in the form of laparoscopic posterior suture gastropexy. All patients recovered well from surgery. The postoperative pain was minimal with early ambulation. The average hospital stay was 3 days. There was neither morbidity nor mortality. Follow up with barium meal studies gave good results in all cases. Diagnosis of chronic gastric volvulus needs a high index of suspicion. This is because of its rarity and its similarity with other more common diseases as cholelithiasis and peptic ulcer. Confirmation of diagnosis requires barium meal study. It could be managed either by open surgery, by laparoscopic/ endoscopic approach or by laparoscopic approach alone. Laparoscopic suture gastropexy gives good results. Eventhough worldwide experience in laparoscopic surgery for gastric volvulus is limited, the results are encouraging. Laparoscopic management seems to be safe and feasible

Significance of thoracolumbar spinal canal dimensions in prediction of neurologic injury in patients with burst fractures

The relation between the spinal canal dimensions and its association with neurologic sequelae after cervical spine injuries has been established. A similar relation at the thoracolumbar spine is debated in the literature. The aim of this work is to determine the relation between the spinal canal dimensions and their association with neurologic sequale after thoracolumbar burst fractures. In a prospective study between January 1999 and December 2001, 48 patients with thoracolumbar burst fractures [T11-L2] 22 with neurologic deficit and 26 without neurologic deficit were included in our study. There were 30 males and 18 females, their age ranged from 18 to 62 years with a mean age of 37 years. Computed tomographic [CT] scans were done for all the patients to evaluate the pattern of the fracture and to measure the sagittal, the transverse diameters and the surface areas of the spinal canal at the level of injury, as well as one level above and one level below the fracture level. The type of neurological deficit in all patients was scored on the scale of Frankel et al 1969. All the patients with burst fractures of the thoracolumbar junction, with and without neurologic deficit, were compared in sagittal diameter, transverse diameter, sagittal-to-transverse diameter ratio and cross sectional area [CSA]. Statistical analysis was performed using Student s t-test. We found that the ratio of sagittal-to-transverse diameter at the level of injury was significantly smaller in patients with neurological deficit than those without a neurologic deficit. The mean transverse diameter at the level of injury was significantly larger in patients with neurological deficit than in the neurologically intact patients. The surface area of the canal at the level of the injury was significantly smaller in patients with neurological deficit than in those without a deficit. There was no significant statistical relation between spinal canal measurements above and below the level of injury with the neurologic deficit. We concluded that. There were no anatomic factors at the thoracolumbar junction that predisposed to neurologic injury after burst fracture, however the shape and the size of the canal after injury were predictive of neurologic deficit