Factors associated with patients' satisfaction of rubber dam use during root canal treatment

The use of rubber dam (RD) has been recommended in dental procedures including root canal treatment. The aim of the study was to identify factors that were associated with patients' satisfaction and acceptance of RD. Setting and Design: This was a cross-sectional study, conducted from January 2015 to December 2016 at Kuwait University School of Dentistry. Materials and Methods: A pretested questionnaire was used by a face-to-face interview of patients after taking informed consent. The study was approved by the Institutional Ethics Review Board. The providers/operators who applied RD were grouped into three categories: undergraduate final year (7th year) dental students; general dentists and postgraduate students; and specialists. Results: Mean age of the patients (n = 175) was 31.6 ± 13.0 years. About 55% had past experience, and 52% expressed a better experience during the current procedure compared with the previous one. A positive experience during the current procedure correlated significantly with the future intention of RD use (r = 0.244, P = 0.001). Time needed for RD application was short (4 min), irrespective of the operators. The duration of RD use during the procedure was significantly shorter among dental specialists compared with the other groups. Time for RD application was the only significant predictor for patient satisfaction, after controlling for other independent variables. Conclusion: Based on the positive influence of current RD use on the future intention, dentists should spend time needed to explain the importance, safety and effectiveness of RD use with their patients.

Prevalence of and Risk Factors for Lead Poisoning in Young Children in Bangladesh.

Lead poisoning is a major public-health problem in Bangladesh. A cross-sectional study was conducted to determine the extent of and risk factors for elevated blood lead levels (BLLs) in children in Bangladesh during September 2007–July 2009. The study included 919 children aged less than 16 years. The children were recruited from six urban locations in Dhaka and one rural area in Chirirbandar, Dinajpur. In total, 495 (54%) children had high BLLs (>10 μg/dL), with higher BLLs observed among children aged 5-9 years compared to children of other ages (p<0.001). The BLLs among children in urban Dhaka were significantly higher than those in rural areas (13.45±8.21 μg/dL vs 7.29±6.25 μg/dL, p<0.001). The high BLLs correlated with low body mass index (r=-0.23, p<0.001) and low haemoglobin status (r=-0.10, p=0.02). On bivariate analysis, proximity to industry (p<0.001), drinking-water from municipal supply or tubewell (p<0.001), brass or lead water-taps (p<0.001), use of melamine plate (p=0.001), and indigenous medicinal (kabiraji) treatments (p=0.004) significantly correlated with higher BLLs. Proximity to industry and the use of indigenous medicines remained significant predictors of high BLLs after controlling for the confounders. Several risk factors appropriate for future educational interventions to prevent exposure to lead poisoning were identified.

Intestinal enzymes during malnutrition & infection in rabbits.

BACKGROUND & OBJECTIVES: Malnutrition plays an important role in the intestinal absorption of nutrients. However, reports are not consistent whether intestinal enzymes are decreased in the presence of malnutrition. It is also not clear whether simultaneous presence of malnutrition and infection adds to the problem of malabsorption of nutrients. The aim of the present study was to determine intestinal functions in terms of concentrations of disaccharidase enzymes during diarrhoea and protein energy malnutrition. METHODS: Concentrations of three disaccharidase enzymes, namely maltase, sucrase and lactase were measured in nine energy-restricted and five control rabbits during diarrhoea induced by rabbit diarrhoeagenic Escherichia coli (RDEC-1). Malnutrition was achieved in the rabbit model by feeding the animals for 30 days with half the amount of food fed to well-nourished control rabbits. Both the energy-restricted and the control groups were challenged by RDEC-1. Diarrhoea occurred on day 1-7 after administration of the strain. After onset of diarrhoea, both groups of rabbits were sacrificed and their intestinal mucosa was examined to determine the concentration of lactase, maltase and sucrase. RESULTS: The energy-restricted animals and controls did not differ significantly for concentrations (units/mg proteins) of lactase (0.65 +/- 0.28 vs 0.56 +/- 0.17 ), maltase (6.20 +/- 2.70 vs 6.47 +/- 1.90) and sucrase (5.42 +/- 2.30 vs 5.13 +/- 1.40) measured during acute infectious diarrhoea. INTERPRETATION & CONCLUSION: The results suggested that the enzymatic functions of the intestinal brush border were not statistically different during diarrhoea among malnourished rabbits compared with their well-nourished counterparts.

Arsenic-related health problems among hospital patients in southern Bangladesh.

To assess the health effects of arsenic poisoning and to determine the relationship among duration and severity of skin lesions, exposure dose of arsenic, and nutritional status of people, 150 patients attending the Dermatology Outpatients Department of Sher-e-Bangla Medical College Hospital, Barisal, Bangladesh, were included in this cross-sectional study. The study was conducted during January-December 2000. Records of patients were collected prospectively using a pre-tested questionnaire, which included information on demography, sources of water for drinking and cooking, duration and amount of drinking-water obtained from shallow tubewells, clinical presentations, complications, and physical and laboratory findings. Water samples from tubewells currently being used by individual patients were examined. Nine percent of the patients were unaware that arsenic-contaminated water causes diseases. Due to lack of alternative water supplies, 25% of the subjects were still drinking water from contaminated tubewells. About 18% did not complain of any clinical symptoms, except that their skin lesions were ugly-looking, and 82% had moderate or severe skin lesions. Thirty-one percent of the water samples had arsenic concentrations 10-fold higher than the permissible limit of 0.05 mg/L in Bangladesh and 50-fold higher than the WHO guideline value of 0.01 mg/L. The mean arsenic concentration in water was significantly associated with the severity of disease. Body mass index correlated inversely (r = -0.298, p = 0.013) with the duration of disease after controlling for age. The findings suggest the need to enhance public awareness on negative health effects of arsenic poisoning in rural Bangladesh. From a public-health perspective, effective intervention strategies need to be developed to curb the exposure, strengthen rapid diagnostic facilities, establish effective treatment facilities in rural areas, and improve the nutritional status of people.

Urinary retinol excretion in children with acute watery diarrhoea.

Children with diarrhoea due to rotavirus infection excrete retinol in urine. This study aimed at demonstrating the extent and mechanism of urinary retinol excretion in children with acute watery diarrhoea caused by pathogens other than rotavirus. Thirty-two children, aged five months to five years, hospitalized with watery diarrhoea predominantly due to enterotoxigenic Escherichia coli in Bangladesh, were studied. Their serum retinol and retinol-binding protein (RBP) were low at admission and increased significantly after recovery from illness. The mean hospital stay of these patients was four days. Forty-seven percent of the children excreted retinol in urine on day 1, and about 38% continued excreting retinol on day 3. The estimated urinary retinol loss of 3.44 micromol for the illness episode represented more than 40% of liver retinol reserve (8.25 micromol) in malnourished children. A conservative estimate of the loss would represent at least 20% of the liver reserve in relatively better-nourished children. Kidney tubular dysfunctions of increased RBP excretion significantly predicted urinary retinol excretion in children with watery diarrhoea.