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

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

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