relationship between oral self-care and oral hygiene among diabetic patients in Ajman, United Arab Emirates

Objectives: The study looks into the relation of oral hygiene measures implemented by the diabetes patients and the presence of debris, calculus and gingivitis

Materials and methods: The study was conducted among 404 diabetic patients. All patients were confirmed diabetics for which they were being treated. After a written consent and completing a demographic questionnaire, an oral examination was done by the doctors to record the oral Hygiene status [the presence of debris, calculus and gingivitis] via the criteria of the gingival index by [Loe H.], for the gingival inflammation. The criteria used to score the oral debris and calculus indexes by [Green and Vermillion]

Results: the majority of diabetic patient [86.0%] was with oral hygiene problems. 49.2% were using the brushing as the self-oral hygiene measure, 29%were using all methods. Only 29.2% of all the patients were free from gingivitis, debris and calculus. Supra gingival calculus, alone or along with gingivitis and debris was the less frequent finding. Whereas the debris was the highest frequent finding

Conclusion: As oral health is integral with general health, diabetes exaggerates the response of the periodontal tissues to the presence of debris and calculus. Good oral hygiene behavior, including brushing, flossing and using mouthwash, is important self-care measures and apart from regular dental office visits and motivation for this group of patients. It should be done in proper technique and adequate frequency

Assessment of commercial specific IgE assays for detection of allergens in allergic patients

Allergy is a serious health problem throughout the world, affecting people of all ages. Allergic diseases such as asthma, rhinitis and atopic dermatitis are becoming epidemic in all countries. The cost of investigating these diseases is increasing and becoming very expensive. There are many ways to explore allergenic antibodies to assess the presence and the amount of specific IgE. These are: Skin test [Prick], Specific IgE [ELISA], RAST Sp. IgE and Elimination Challenge methods. Skin test produces pain, local or anaphylactic reaction and patient discomfort. Other procedures are expensive to the patient. So, a modified procedure, based on the same principle of previous tests, was studied in Allergy and Immunology laboratory of Ain Shams University. The procedure has suitable cost for all patients; it is very simple, accurate, cheap and does not produce any problems for patients. It depends on ELISA technique and measures the quantitative amount of the following different allergens: Food and Drug allergens such as, Milk, Eggs, Banana, Maize, Fish, Chocolate, Wheat, Nuts, Strawberry, Shrimps, Spices and Aspirin as a drug allergen. Inhalants, as House dust, Mite, Mixed Pollens, Mixed Moulds, Hay dust, Wool, Latex and Cat Hair. The results of this test for 150 allergic patients were compared with those of national specific IgE kits [ELISA], Sp.IgE [RAST], Skin test and elimination challenge test. Statistical results of sensitivity showed respectively: 88.9%, 89.6%, 91.2%, 71.4%, 93.1%. As regards specificity, the results were 93.1%, 94.7%, 95.3%, 65.5%, 91.6%, respectively. These results conclude that the test is in line with all other standard tests. It can also be noted that it is not only the cheapest and most commercial technique using the immediately available, locally prepared reagents, plates and other requirements found in any standard laboratory, but, additionally, probably it can be unique in using foods, drug and inhalants allergens at the same time. Now, it is applied successfully in Allergy and Immunology unit in Ain Shams university hospitals in Egypt. The test has also been recently introduced at the Center for Advanced Bio Medical Research and Innovation [CABRI] at the Gulf Medical University, Ajman, UAE, using a commercial system from Phadia. About two hundred different IgE levels against specific antigens are tested using the Immunocap 100. The allergen of interest, covalently linked to the Immunocap is incubated with the serum being tested. The unbound IgE is washed away and the bound specific IgE is detected using a fluorescent reader. The concentration is calculated using a calibration curve

Empty sella syndrome

An Empty Sella occurs due to herniation of the arachnoid throughan incompetent diaphragma sellae. Over time, cerebrospinal fluid [CSF] pulsations may enlarge the sella and compress the gland against the floor of the sella. Empty Sella Syndrome is a considered a less common entity and is usually asymptomatic and an incidental finding. However, it can be a manifestation of increased intracranial pressure and can be occasionally severe. Compression of the pituitary gland may affect function, or traction on the optic chiasm and nerves may cause visual symptoms. An empty sella may be classified as primary when this occurs in persons who have not received pituitary radiation or pituitary surgery, while an empty sella discovered following such procedures is classified as secondary empty sella. We had a 41 year old patient who came to us with symptoms of headache and left sided hemi-sensory disturbance. An evaluation revealed multiple comorbid illnesses with MRI showing features of Empty Sella

possible role of chronic intestinal candidiasis in the genesis of intractable allergic diseases

A role of disturbed intestinal normal flora, such as Chronic Intestinal Candidiasis [C.I.C.] syndrome, in the genesis of intractable allergic diseases, through changing in the intestinal mucosal barrier was suggested. In this study, we have assessed the C.I.C. in the patients with intractable allergies to elucidate the potential involvement of this syndrome in the genesis of these diseases and to find out a relation between the serum level of candida IgG, IgM and IgA with the disease intractability [serum total IgE] through an intestinal functional impairment in these patients. The serum levels of candida IgG, IgM, IgA were assessed in 20 patients with C.I.C. and intractable allergic diseases as well as in 20 healthy volunteers and their levels were correlated to the laboratory parameter of disease intractability referring to an intestinal functional impairment in these patients. When compared with the control group, the patients showed a significantly higher concentration [< 0.0001] of only serum candida IgG. A statistically significant positive correlation was found between this higher concentration and disease intractability while a negative insignificant correlation was found between serum candida IgM and negative significant correlation between serum candida IgA and disease intractability in these patients. The results of intestinal biopsies showed variable lesions but there was absence of candida hyphae or intestinal invasion. The results of this study suggest that disturbed intestinal normal flora produced by C.I.C. may play important role in the genesis of intractable allergic diseases. Measurement of serum candida IgG reflects the disease intractability in these patients even without increasing frequency of acute intestinal candida infection [IgM] or invasion [IgA]. In addition, inhibition of C.I.C. either by drugs or diet adjustment may improve the clinical manifestations or decrease the progress of these diseases. However, further studies are needed to elucidate the exact role of C.I.C. in relation to other factors involved in the pathogenesis of intractable allergic diseases by affecting the intestinal mucosal barrier

Partial lobar collapse of lung in young adult: a case report

Atelectasis describes loss of lung volume due to collapse of lung tissue. It can be classified according to pathophysiologic mechanism [e.g. -Obstructive and Non obstructive], amount of lung involved [e.g.-lobar, segmental and subsegmental] or location [i.e. specific lobe or segment location]. Obstructive atelectasis [i.e. resorptive] is a consequence of blockage of an air-way[1]. We hereby present a young man who came to outpatient clinic with history of chest pain and dyspnea. He was subsequently found to have partial collapse of left upper lobe of lung. Bronchoscopy showed mucus plug closing anterior and posterior segment of left upper lobe. The patient responded significantly following removal of mucus plug both clinically and radiologically

Specific IgE against staphylococcal enterotoxin [superantigens] in allergic rhinitis: an independent risk factor for severe bronchial asthma

The study aimed to investigate whether IgE to Staphylococcus aureus enterotoxins might be relevant to disease severity in adult asthmatic patients. Specific IgE antibody concentrations in serum against enterotoxins, grass pollen [GP], and house dust mite [HDM] allergens and total IgE levels were measured in 69 adult control subjects, 152 patients with non-severe asthma, and 166 patients with severe asthma. Severe asthma was defined as inadequately controlled disease despite high-dose inhaled corticosteroids plus at least 2 other controller therapies, including oral steroids. Statistical analysis demonstrated Enterotoxin IgE positivity which was significantly greater in patients with severe asthma [59.67%] than in healthy control subjects [13% P< .001]. Twenty-one percent of patients with severe asthma showing positive enterotoxin IgE were considered non atopic. Also statistical analyses demonstrated significantly increased risks for enterotoxin IgE-positive subjects to have severe asthma [95%] versus enterotoxin IgE-negative subjects. The presence of GP or house dust IgE antibodies was not associated with either significantly increased risk for asthma or severity. Oral steroid use and hospitalizations were significantly increased in patients with positive enterotoxin IgE and non-atopic asthma. GP IgE was associated with a higher FEV1 percent predicted value and enterotoxin IgE was associated with a lower FEV1 percent predicted value. Staphylococcal enterotoxin IgE antibodies, but not IgE against inhalant allergens, are risk factors for asthma severity. We hypothesize that the presence of enterotoxin IgE in serum indicates the involvement of Staphylococcal superantigens in the pathophysiology of patients with severe bronchial asthma

Evaluation of carcinoantigen 19-9 as a new biomarker in different types of carcinoma

The present study was conducted to evaluate serum CA 19-9 as a new biomaker for the early detection of different types of cancer. Serum CA 19-9 level was estimated for 30 patients with pancreatic carcinoma, 26 patients with hepatic carcinoma and 15 healthy controls. Results obtained showed that serum CA 19-9 levels were significantly higher in the pancreatic carcinoma patients [167.6 +/- 14.3] than both patients with hepatic carcinoma [58.6 +/- 4.8] and healthy controls [8.3 +/- 1.2]. Also, it was revealed that CA 19-9 levels were significantly higher in the hepatic carcinoma patients then the healthy controls. Sensitivity of CA 19-9 was estimated in each group. It was 96.6, 73.1 and 0.0% in the pancreatic, hepatic and healthy individuals. Therefore, it may be suggested that CA 19-9 is valuable and good aid in the detection of such types of cancer