ABSTRACT
Pit and fissures are the most common affected sites of caries occurance in newly erupted first permanent molars, however effectiveness of sealants are questionable in these teeth, due to difficulties in moisture control. The purpose of this study was to evaluate and compare the impact of two different categories of dentin bonding agents on sealant performance. 56 pairs of sealants [122 teeth] were placed bilaterally and randomly on the occlusal surface of both upper and lower first molars with either dentin bonding agent. With no preparation of the surface, Adper prompt or Excite both were applied as one layer and cured before sealant placement. Caries assessment was performed according to the CCC method [Color, Coverage, Caries] introduced by Deery et al. [2001] at 6-month intervals for 12 months. Partially or totally lost sealants were replaced at each recall visit. Data were analyzed using the Wilcoxon test. Total etch and Excite were significantly superior in both retention and caries prevention [P=0.0001]. Excite showed a significantly greater retention in the mandible than maxilla [P=0.027], whilst Adpaer prompt showed no difference between the jaws.. Among the teeth whose sealants were lost, progression of caries was greater in the Adper Prompt group. According to findings of this study, application of total-etch and bond is preferred to self-etch adhesives before sealant application in newly erupted first permanent molars
ABSTRACT
To compare the efficacy of classic treatment for ocular toxoplasmosis [pyrimethamine, sulfadiazine and prednisolone] with a regimen consisting of trimethoprim/sulfamethoxazole [TMP/SMX] [co-trimoxazole] plus prednisolone. In a prospective randomized single-blind clinical trial, 59 patients with active ocular toxoplasmosis were randomly assigned to two treatment groups: 29 were treated with pyrimethamine/sulfadiazine and 30 patients received TMP/SMX. Treatment consisted of six weeks of treatment with antibiotics plus steroids. Anti-toxoplasmosis antibodies [IgM and IgG] were measured using ELISA. Outcome measures included changes in retinochoroidal lesion size after six weeks of treatment, visual acuity before and after intervention, adverse drug reactions during follow up and rate of recurrence. Active toxoplasmosis retinochoroiditis resolved in all patients over six weeks of treatment with no significant difference in mean reduction in retinochoroidal lesion size between the two treatment groups [61% reduction in the classic treatment group and 59% in the TMP/SMX group, P=0.75]. Similarly no significant difference was found in visual acuity after treatment between the two groups [mean visual acuity after treatment was 0.12 LogMAR [20/25] in classic treatment group and 0.09 LogMAR [20/25] in TMP/SMX group, P=0.56]. Adverse events were similar in both groups with one patient in each suffering from any significant drug side effects, The overall recurrence rate after 14 months of follow up was 6.7% with no significant difference between the treatment groups [P = 0.48]. Drug efficacy in terms of reduction in retinal lesion size and improvement in visual acuity was similar between a regimen of TMP/SMX and the classic treatment of ocular toxoplasmosis with pyrimetbamine and sulfadiazine. Therapy with TMP/SMX appears to be an acceptable alternative for the treatment of ocular toxoplasmosis
Subject(s)
Humans , Male , Female , Trimethoprim, Sulfamethoxazole Drug Combination , Sulfadiazine , Prednisolone , Prospective Studies , Single-Blind Method , Randomized Controlled Trials as TopicABSTRACT
To determine the type and outcome of surgery for retinal detachment resulting from macular hole in highly myopic eyes. This retrospective analysis was performed on the medical records of highly myopic patients who underwent surgery for retinal detachment [RD] resulting from macular hole at Labbafinejad Hospital, Tehran-Iran from 1992 to 2001. Variables included age, gender number and type of operations, visual acuity before and after the procedures and surgical success rate. Overall, 28 eyes of 27 patients [26 female and one male] with mean age of 59.8 +/- 11 years were included. Main follow-up was 17.3 [range 3-72] months. Mean axial length was 29 +/- 2.74mm [range: 24 to 35mm] and mean degree of myopia was -16.4 +/- 3.1 D [range -10 to -22 D]. Posterior staphyloma was present in 20 eyes [71%]. Seven eyes had undergone failed scleral buckling as the primary procedure prior to referral. lntravitreal SF[6] injection was the primary procedure in 12 eyes with localized detachments; the retina became attached in 5 [41.6%] of these eyes, however redetachment occurred in 7 [584%] eyes. Overall, 23 eyes [including 7 failed scleral buckling cases, 7 redetachments following SF[6] injection and 9 cases of primary surgery] underwent vitrectomy with use of high viscosity silicone oil. No major complications occurred during the operations. Overall, final anatomical success was 92.9% and visual improvement occurred in 85.7% of the eyes. In highly myopic eyes with RD due to macular hole, less invasive procedures such as SF[6] injection seem to be appropriate for eyes with localized detachment. In cases of total or subtotal RD and posterior staphyloma, pars plana vitrectomy and silicone oil tamponade seem to be the preferred procedure