Clinical Evaluation of Pit and Fissure Sealants Placed by Undergraduate Dental Students in 5-15 Years-old Children in Iraq

Abstract Objective: To clinically evaluate the retention and marginal discoloration of pit and fissure sealants applied to primary and permanent teeth. Material and Methods: The study population encompassed of 5-15 years-old children. After consenting, a light-curing sealant was applied to etched pits and fissures of occlusal surfaces of selected sound teeth. The retention rate and marginal discoloration were assessed, 3 months after application of the sealants based on the criteria proposed by Simonsen's criteria (total retention: score 0, partial loss: score 1, and total loss: score 2). Each tooth was considered as an independent sample during analysis. Results: The achieved sample size was 43 children aged 5-15 years (mean age=10.0 years). Therefore, data of 100 teeth from 43 children were used for the final analysis. The percentage of completely retained sealants (59%) was higher than the percentage of partially retained sealants (23%) and completely missing sealants (18%) after 3 months follow up. Out of 100 sealed teeth, 60% were either had marginal discoloration or completely missing. Using the Mann-Whitney test, there was a statistically significant difference (p<0.05) between primary and permanent teeth in terms of retention. However, there was no statistical difference (p>0.05) between upper and lower teeth in terms of retention. Conclusion: The success rate of fissure sealants after 3 months follow-up was satisfactory.

Low prevalence of nodules in rheumatoid arthritis patients in Kuwait: a description and a comparison of patients from the Kuwait registry for rheumatic diseases

Objectives: To describe the prevalence of rheumatoid nodules [RN] in patients with rheumatoid arthritis [RA] and to compare their features with those of patients without RN

Subjects and Methods: Adult RA patients [n = 952] in the Kuwait Registry for Rheumatic Diseases from February 2013 to December 2015 were evaluated for RN. Demographic and serological features and disease activity and severity were obtained from the registry

Results: Of the 952 RA patients, 22 [2.3%] had RN and 930 [97.7%] did not. Age, sex, disease duration, smoking, and family history of an autoimmune rheumatic disease were similar. Obesity was more prevalent in the RN group, i.e. 11 [50%] vs. 326 [35.1%], p = 0.016. There was no difference in rheumatoid factor [RF] or anti-cyclic citrullinated peptide antibody positivity. Patients with RN had more sicca symptoms, i.e. 8 [36.4%] vs. 152 [16.3%], p = 0.025, a higher mean score on the visual analogue scale pain [3 +/- 2.9 vs. 2 +/- 2.7, p < 0.001], more tender joints [6.4 +/- 8.8 vs. 4.2 +/- 7.2, p = 0.001], a higher patient global assessment of disease activity [3.3 +/- 2.7 vs. 2.3 +/- 2.7, p < 0.001], and more deformities, i.e. 3 [13.6%] vs. 74 [8%], p = 0.034. The mean health assessment questionnaire score in RN patients was 1.1 versus 0.9 in patients without RN [p = 0.08]. Patients with RN had a low disease activity [means: disease activity score [DAS-28], 3.02; clinical disease activity index, 7.7; and simple disease activity index, 10.4], similar to the other group. While the rates of methotrexate treatment were comparable, biologic therapy was administered more in patients with RN [i.e. 15 [68.2%] vs. 478 [51.4%], p < 0.001]

Conclusion: In Kuwait, the prevalence of RN is low among RA patients. Patients with and without RN are similar in terms of demographics and serologic features, except for more obesity. However, patients with RN have more sicca symptoms, joint deformities, and painful and tender joints. Disease activity scores are low with more frequent biologic therapy

Does the implant design influence the outcome after total Knee Arthroplasty?

Objective: To compare the outcome of the two different TKA implant designs used at SMC and to derive an estimate for the cost-effectiveness of using different implants

Design: A Retrospective Study

Setting: Department of Orthopedics, Salmaniya Medical Complex, Bahrain

Method: Two hundred ninety-eight patients who had TKA from January 2011 to June 2014 at SMC were reviewed. Patients with different implant designs were compared for pain severity, the range of motion [ROM], walking distance and satisfaction

Result: There were no significant statistical differences in pain severity, ROM, walking distance or patient's satisfaction between the two implant designs used at SMC

Conclusion: Selection of the implant design from the known manufacturers should be based on appropriate criteria

Assessment of biochemical and antioxidative status in patients suffering from dengue fever / 华中科技大学学报（医学）（英德文版）

A multi-centred study was designed to collect dengue epidemiologic data from government and registered private hospitals/clinics and maintained archive of frozen specimens in bio-bank to be used for future dengue epidemic control program, and assess the epidemiology of dengue fever (DF) by evaluating biochemical and oxidative status of patients. ELISA IgM antibodies test was done to confirm DF. From August 2010 to December 2011, 101 confirmed blood samples of DF patients referred to pathology lab of Jinnah Hospital Lahore were subjected to the epidemiologic assessment by evaluating the biochemical and physiological indices and alterations of circulating antioxidants. Clinical features of DF patients and effect of fever on blood components and serum proteins of liver were recorded. The hospital stay in DF, dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS) showed significant difference. Significant increases in serum alanine amino transferase (ALT) (P=0.000), aspartate amino transferase (AST) (P=0.000), alkaline phosphatase (ALP) (P=0.000), malondialdehyde (MDA) along with significant decreases in total protein (TP) (P=0.000), reduced glutathione (GSH) (P=0.000), superoxide dismutase (SOD), catalase (CAT) (P=0.000), and sialic acid contents (P=0.016) were observed. A positive correlation existed between bound sialic acid levels, liver enzymes and circulating antioxidants (r=0.656, P=0.016). In the present study, alterations of circulating antioxidants in DF suggest that DF might be a metabolic response to an acute, self-limiting tropical viral infection, and a consequence of the viral inflammatory process.

Assessment of biochemical and antioxidative status in patients suffering from dengue fever / 华中科技大学学报（医学）（英德文版）

A multi-centred study was designed to collect dengue epidemiologic data from government and registered private hospitals/clinics and maintained archive of frozen specimens in bio-bank to be used for future dengue epidemic control program, and assess the epidemiology of dengue fever (DF) by evaluating biochemical and oxidative status of patients. ELISA IgM antibodies test was done to confirm DF. From August 2010 to December 2011, 101 confirmed blood samples of DF patients referred to pathology lab of Jinnah Hospital Lahore were subjected to the epidemiologic assessment by evaluating the biochemical and physiological indices and alterations of circulating antioxidants. Clinical features of DF patients and effect of fever on blood components and serum proteins of liver were recorded. The hospital stay in DF, dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS) showed significant difference. Significant increases in serum alanine amino transferase (ALT) (P=0.000), aspartate amino transferase (AST) (P=0.000), alkaline phosphatase (ALP) (P=0.000), malondialdehyde (MDA) along with significant decreases in total protein (TP) (P=0.000), reduced glutathione (GSH) (P=0.000), superoxide dismutase (SOD), catalase (CAT) (P=0.000), and sialic acid contents (P=0.016) were observed. A positive correlation existed between bound sialic acid levels, liver enzymes and circulating antioxidants (r=0.656, P=0.016). In the present study, alterations of circulating antioxidants in DF suggest that DF might be a metabolic response to an acute, self-limiting tropical viral infection, and a consequence of the viral inflammatory process.

Clinical experience in treatment of liver hydatid disease

To determine the efficiency of using medical therapy [albendazole, mebendazole] in treatment of hydatid liver disease. This study was conducted in Basrah general hospital, Baserah, Iraq during the period of 1989 to 2007. Two hundred and forty eight patients with hydatid liver disease were included in this study, of whom 163 were females and 85 were males. Open surgical treatment was done for 146 patients while 102 patients were treated medically with antihelmintic drugs. Mebendazole [40-50 mg/kg/day] was used for 700 patients, while albendazole [10-15 mg/kg/day] was used in the treatment for 32 patients. The course of medical treatment was continued for 6-12 months. Open surgical treatment were indicated in: patients with too large hydatid liver cyst, superficially located hydatid cyst that may rupture spontaneously or traumatically, infected hydatid cyst, hydatid cyst with billiary tree communication, and hydatid liver cyst with pressure effect on vital structures. While medical treatment with albendazole and mebendazole was used for patients with multiple small hydatid cysts, deeply seated hydatid cyst in liver parenchyma, and patients with high risk for anesthesia and major surgical procedure. These antihelmintic drugs devitalize the protoscoleces and germinal layer of hydatid cyst andlower intracystic pressure [[dead cysts]], and so it will decrease the chance of recurrence locally or peritoneally. Out of those medically treated [[102]] patients, 38 patients got complete cure after one year coarse of medical treatment and 42 patients underwent operation for different causes after 3-6 months period. While the remaining 22 patients were lost to follow up. Medical treatment with mebendazoleand albendazole is beneficial in getting complete cure in certain cases. If surgery needed after medical treatment, there will be a decrease in chance of recurrence peritoneally and locally in the liver because of inactivation and devitalization [[death]] of hydatid liver cyst[s]

Osteoid osteoma of the fifth metatarsal bone

A twelve-year-old male with 6-week history of atraumatic pain in the lateral aspect of his right forefoot not responding to conservative treatment were seen in the orthopedic clinic. The pain was worse at night and relieved with non-steroidal anti-inflammatory drugs. Plain radiographs and MRI revealed features of osteoid osteoma of the right fifth metatarsal bone. The osteoid osteoma was removed by curettage, which gave the patient a complete relief of his presenting symptoms. This case demonstrates the rare anatomic position of osteoid osteoma

Organophosphorus insecticide poisoning: management in surgical intensive care unit

To evaluate the outcome of patients with organophosphorus poisoning. Descriptive [non-interventional] study. Surgical Intensive Care Unit, Civil Hospital Karachi, from January 1996 to December 2002. Medical records of all the patients with organophosphorus poisoning, admitted during the study period, were reviewed. Their clinical features, complications, management and survival were noted. Out of 52 patients, admitted to surgical intensive care unit during the study period, 92.31% survived and were discharged to medical wards. Major cause of mortality [7.69%] was acute respiratory distress syndrome. The common cause of mortality in organophosphorus poisoning is aspiration pneumonia leading to acute respiratory distress syndrome that is preventable by securing the airway early in emergency room

Wandering Spleen

Wandering spleen is a rare clinical entity, characterized by splenic hypermobility that results from elongation or maldevelopment of its suspensary ligaments. The wandering spleen is in constant danger of torsion and infarction. This condition poses a great diagnostic challenge due oto lack of awareness and paucity of symptoms. Among adults, it usually occurs in females of childbearing age, the children below ten years of age are other sufferers. The clinical presentation may be acute or chronic, such as asymptomatic abdominal mass, an acute abdomen, or, most commonly, a mass associated with vague abdominal symptoms. Computed tomography and duplex ultrasonography are best diagnostic modalities. The traditional conservative approach carries high risk of infarction leading to splenectomy and postsplenectomy sepsis. Splenopexy is the treatment of choice for all noninfarcted wandering spleens. Splenectomy should only be performed when there is no evidence of splenic blood flow after detorsion of the spleen. The present study, reviews the presentation, course, diagnostic modalities and management options of wandering spleen

Burn-out syndrome-synonym: [Al-Ofool] syndrome Work-related stress in health workers and others

Burn-out syndrome is a stress event faced by different workers. Health professional and especially those in mental health field are vulnerable. Current thinking about causes, course and clinical features are discussed together with sound stragies for treatment and management in the light of presentation are tackled. The role played by health worker himself is given more importance in health promotion, well being and fair of patients and their happiness. Alternative term was suggested to replace the so called "burn-out" which describe closely the stressful situation and avoid the connotation, of ominous label of "burn-out" which implies a non-return to pre-state condition "Al-Ofool" syndrome

scoliometer in screening school children for scoliosis

The scoliometer was evaluated prospeetively in screening 36 school children, of which 18 were scoliotic and 18 normal. They had visible back asymmetry measurable by the Angle of Trunk Inclination [ATI] by the scoliometer. The ATI was 5°-20°, mean 9.916 for scoliotics and 8.555 for normal children. The scoliotic curve was revealed and its Cobb angle measured by radiography. Statistical analysis showed no significant relationship between ATI of scoliotic and normal children [t=1.216; P >/= 0.05], nor between ATI and the Cobb angle in scoliotic children [t=0.822; P >/= 0.05]. The correlation coefficient was r=0.3351; P >/= 0.05]

Heroin at Panjgur

Average age of heroin addicts seen in a day at Panjgur was 21.6 years, duration of habit within eight months, smoked in group of four persons and each consumed 1/2 g daily in two sessions. The dependence was discovered by the medical officer in most of the patients who approached the rural health centre for the treatment of chest infection or malaria. The prevalence of heroin addiction was calculated on the basis of patients seen at the RHC during the last eight months. Very conservative estimate puts the figure at an alarming high level of 13.6% in the age group 10 - 39 years of the male population