Computer-based oral hygiene instruction versus verbal method in fixed orthodontic patients

Fixed orthodontic appliances in the oral cavity make tooth cleaning procedures more complicated

Objectives: This study aimed to compare the efficacy of computerized oral hygiene instruction with verbal technique among fixed orthodontic patients referred to the evening clinic of Orthodontics of Shiraz Dental School

Materials and Methods: A single-blind study was performed in Orthodontic Department of Shiraz, Islamic Republic of Iran, from January to May 2015 following the demonstrated exclusion and inclusion criteria. The sample size was considered 60 patients with 30 subjects in each group. Bleeding on probing and plaque indices and dental knowledge were assessed in the subjects to determine pre-intervention status. A questionnaire was designed for dental knowledge evaluation. The patients were randomly assigned into the computerized and verbal groups. Three weeks after the oral hygiene instruction, indices of bleeding on probing and plaque index and the dental knowledge were evaluated to investigate post-intervention outcome. The two groups were compared by chi-square and student t tests. The pre- and post-intervention scores in each group were compared using paired t-test

Results: In the computerized group, the mean score for plaque index and bleeding on probing index was significantly decreased while dental health knowledge was significantly increased after oral hygiene instruction, in contrast to the verbal group

Conclusions: Within the limitations of the current study, computerized oral hygiene instruction is proposed to be more effective in providing optimal oral health status compared to the conventional method in fixed orthodontic patients

Open lung biopsy with local anesthesia

Open lung biopsy may be required in the patients with parenchymal lung disease who do not have a clearly defined diagnosis. There is no doubt thoracotomy with general anesthesia is preferable to local anesthesia; but it is associated with high risks in the severally ill patients. The aim of this study is to review our experience and compare the efficacy and complications of using local anesthesia versus general anesthesia for open lung biopsies in high risk patients. From January 2002 to September 2004, Twenty five patients [18 males, 7 females] underwent open lung biopsy using minithoracotomy in the Baqiyatallah hospital in Tehran. 14 [56%] of them had open lung biopsy using general anesthesia [GA] and 11 [44%] selected for this procedure with local anesthesia [LA], all of LA group were excluded from GA because of their poor condition. we reviewed effectiveness of LA for minithoracotomy and also compared the safety, accuracy and various complications of this procedure between the two methods of anesthesia. The mean age in the first [GA] group was 42.5 [ +/- 14.7] years and in the second [LA] group was 49.6 [ +/- 12.2] years [NS]. The average length of hospital stay, postoperative air leak, and the diagnostic accuracy was not significantly different between the two groups. There was one operative-related mortality in the second group [NS]. In selected patients with diffuse lung disease or peripheral lesions Local anesthesia is an acceptable substitute to general anesthesia for minithoracotomy to obtain adequate lung tissue for accurate diagnosis

Value of fine needle aspiration in diagnosis of palpable breast masses

Fine needle aspiration [FNA] as a cytological method for the evaluation of breast masses was first performed in 1930, and of present is used as a routine method for the evaluation of breast masses. Aspiration via fine needle as a diagnostic tool is easy, accessible and relatively non - invasive. The purpose of this study was to determine the diagnostic value of this method and its comparison with open biopsy in determining the nature of breast masses. This prospective study included 62 females with palpable breast masses who were candidates for breast biopsy. Mean age was 43.7 +/- 14.3 years [16-68 years]. All patients had palpable breast masses and underwent FNA prior to conventional open breast biopsy Excised tissues and FNA samples were studied by a pathologist who was blinded to the patient's name and her medical history. According to histopathological exam, there were 40 [64.5%] benign and 22 [35.5%] malignant. Incidence of malignancy was higher in the larger masses. When FNA reports were compared with final histopathology reports, there was one false negative and one false positive report. Positive predictive value [PPV] and negative predictive value [NPV] were 95.5% and 96.7% respectively. This study demonstrates that FNA is safe and accurate diagnostic procedure in evaluation and diagnosis of breast masses. We recommend it to be used as the initial diagnostic test for all palpable breast masses. To avoid any misdiagnosis, open biopsy should be performed when needle aspiration is negative or the masses are clinically suspicious for malignancy

Result and complication of vertical banded gastroplasty in morbid obesity

Vertical Banded Gastroplasty [VBG] is a method to reduce the stomach volume, which causes weight loss through lowering amount of consuming solid foods. This operation consists of implanting a small pouch in the proximal of the stomach and a tight exit area. This study was made to evaluate the efficacy and complication of VBG in the treatment of morbid obesity. The present practical study is prospective clinical experience without control group who was carried out between year 1376 and 1381. Of total 30 patients; 21 [70%] females and 9 [30%] male who underwent [VBG] in Baqiyatallah hospital. The averages of age was 32.87 +/- 8.12 years, height 168.66 cm, weight 130.70 +/- 19.33 Kg and BMI 45.53 +/- 10.15 kg/m[2]. The indication of surgery was BMI >40 or BMI = 35-40 with co-morbid illness. Seventy percent of patients complained from a symptom due to excess weight and co-morbid illness [diabetes, high blood pressure, cardio-pulmonary problems]. Duration of hospitalization in the patients in the groups without early complication was 9.7 days and the average follow up was 24 months [range 2-72 months]. Weight loss in the first month after surgery was 11.03 +/- 2.48 and after first year was 41.38 +/- 10.93. The average decrease in BMI at the end of study was 10.45 kg/m[2]. 66.7 percent of the patients did not show any post-operative complication. One of the patients had pulmonary emboli [3.3 percent], one wound infection [3.3 percent], one GI bleeding [3.3 percent] and 2 patients had peritonitis [6.6 percent]. Regarding delay complication, there was one case of intestine obstruction [3.3 percent] and 6 cases of incisional hernia [20 percent]. One of the patients died due to hypovolumic shock [3.3 percent]. This study showed that amount of loss of weight following a VBG operation was significant and also, it was found that amount of loss of weight in male was significantly more than female [P=0.020]. Among the excess weight associated disease, it was only respiratory problems, which had a significant relationship with post surgery complication [P=0.026]. In the meantime, three was no significant relationship between age, weight, sex and BMI with regard to postoperative complication