Factors affecting defaulting from DOTS therapy under the national programme of tuberculosis control in Alexandria, Egypt

This unmatched case-control study aimed to identify factors affecting default from therapy under the national programme of TB control in Alexandria, Egypt. Record reviews and structured interviews were made with 57defaulters and 187 randomly selected controls. Univariate analysis showed 13 out of 54 factors investigated were significantly associated with defaulting and/ after stepwise logistic regression, 5 factors remained in the model: younger age [adjusted OR= 0.16], rural area of residence [OR= 12.9], long waiting times [OR=5.81], poor physician-patient communication [OR= 3.06] and fear of information leakage [OR =3.62]. Reasons cited by defaulters included long distance to the clinic, unsuitable clinic times and long waiting times. The main factors associated with defaulting from the national programme of TB control In Alexandria, Egypt were service-related factors, which are amenable to Improvement

Laparoscopic cholecystectomy with selective pre-operative endoscopic cholangiography and sphincterotomy, a safe combination

One hundred and twenty four patients with symptomatic gall bladder stones underwent elective laparoscopic cholecystectomy over a period of three years. They have been successfully and safely performed without operative cholangiography for one hundred and twenty one patients [97.6%]. Pre-operative endoscopic retrograde cholangiogram was performed for fourteen patients suspected to have choledocholithiasis on clinical grounds. Ten of them were found to have common bile duct stones. Endoscopic sphincterotomy was done for these ten patients and all stones were cleared. For one month follow up after discharge, no complications were seen and none has come back with late complications thereafter. Laparoscopic cholecystectomy with endoscopic retrograde cholangiogram and sphincterotomy was safe and effective with good cosmotic result and fast recovery. There was no need to perform operative chorangiogrom and exploration of common bile duct

Preliminary investigation into the effect of a new technique for ultrasonic packing of composite resin

The use of composite resin has been increasingly growing during the last decade. The clinical performance and the properties of the material are greatly influenced by the technique used for packing the material in the prepared cavity. Eighty samples, divided into four equal groups of 20 teeth each, were prepared in Heliotest teflon split die using Durafil composite. Group A samples were packed under constant load of 250 gm. for 10, 20 and 30 seconds. Groups B,C and D were packed under the same constant load but with the application of the ultrasonic energy for 10, 20 and 30 seconds. The tested specimens were evaluated, by two operators separately, for the quality of the line and point angles, number and size of the voids using an Environmental Scanning Electron Microscope [ESEM]. Results revealed superiority of the ultrasonic energy packing over the conventional pressure packing technique regarding all the parameters of the evaluation. A filler free layer [FFL] was observed at the side of ultrasonic energy application and resulted in a matrix rich layer on the surface of the samples. These findings were attributed to the increase in the flow of the composite material due to the acoustic energy applied and though increasing the adaptation of the material and decreasing the number and size of the voids in the originally viscous composite. Further investigations into the effects of ultrasonic packing on physical properties of composite restorative materials are needed

SEM study of glass ionomer cement surface: to ETCH or not to ETCH?

Fifteen specimens of Ketac-Cem GIC were packed in Heliotest teflon split die. They were divided into three equal groups of five teeth each where they were either left untreated [control] or etched using 37% phosphoric acid. The etched samples were either etched after 15 min. or 24 hours from the start of the mix then the GIC surfaces were washed using air water spray for 30" and dried using oil free compressed air. SEM photomicrograph were taken to study the microstructure and the surface roughness of the GIC samples. The micro graphs revealed increased roughness of the samples etched after 24 hours followed by that of the untreated control surface then the 15 min. etched surface of the GIC samples. The GIC surface may be either left unetched to avoid the future deterioration of the surface or to postpone the etching treatment for at least 24 hours to allow the GIC to set undisturbed to avoid the damaging effects of premature etching of the matrix on the GIC surface

Study of fatigue on composite core constructed around different types of posts

Three different designs of dowels prepared of stainless steel of the same size and dimensions [0.4 cm in diameter] with a flat circular head of diameter of 0.9 cm. The first design being smooth, the second having a vent passing from one side to the other, and the third of the threaded type. We used in this study a conventional chemically cured composite, and it was applied around the retentive area of each post to give the shape of a cylinder [1 cm length] by the help of special copper matrix. Cores were subjected to fatigue test using a device with half kg load at 50 cm height. The number of strokes required to fracture the composite core around each post was recorded. It was found that the composite core around the smooth posts showed maximal fatigue limit