Association between oral health knowledge and practices of Saudi pregnant women in Dammam, Saudi Arabia

This study assessed the association between oral health knowledge and practices of pregnant Saudi women selected from visitors to a government hospital in Dammam, Saudi Arabia in 2014. Women answered questions on oral health knowledge during pregnancy and knowledge of infant oral health. Most women [> 70%] knew that dental caries in children can be prevented, that pregnancy affects oral health and that dental treatment during pregnancy can negatively affect infants. Most women [> 80%] performed oral hygiene procedures but only 18% regularly visited the dentist. In a regression analysis, oral health knowledge was not significantly associated with reported oral hygiene practices. Women who visited the dentist regularly were more likely to know how to prevent caries in children, and that dental treatment during pregnancy and infant health were associated

prevalence, causes, and relativity of dental anxiety in adult patients to irregular dental visits

To assess the frequency and causes of dental anxiety and their relation to irregular dental visits among adult dental patients. The Dental Anxiety Question [DAQ] included within a self-administered questionnaire was distributed to 1025 patients attending the Interns' Dental Clinics in the Department of Preventive Dental Sciences, College of Dentistry, University of Dammam, Dammam, Kingdom of Saudi Arabia from March 2012 to February 2013. A cross-sectional study design was used. The questionnaire consisted of 22 closed-ended questions divided into 4 sections; 1] demographics, 2] regularity of dental visits, and related causes, 3] DAQ, cancellation of dental appointments, history of previous trauma, dental anxiety provoking factors within dental environment and procedures, and 4] patients' status in dental clinics, preferences of dentists, and perceptions regarding dental anxiety. The prevalence of dental anxiety among the study sample was 27%. Anesthetic injection was the main factor of dental fear [88.2%], while dental surgical procedures [35.7%] and extractions [23%] were the most terrifying dental procedures. Lack of time [79.5%], cost [71.5%], far-situated dental services [62.2%], and fear [57.1%] were causes listed for irregular dental visits; while 31.3% had no specific reason. Irregular dental visits were not related to dental anxiety. Dental anxiety continues to be an obstacle despite the vast improvement in dentistry; and this raises an alert regarding personal and communication factors in the patient-dentist relationship. Factors such as equal distribution of dental services, time, and cost should also be addressed

Prevalence, severity, and secular trends of dental caries among various saudi populations: a literature review

The prevalence of dental caries is increasing across different nations around the globe. A review of the literature shows that dental caries is adversely affecting the oral health of children, adolescents, adults and elderly populations in Saudi Arabia. The objective of this review is to report the prevalence, severity, and progression of dental caries in different age groups of Saudi communities. Digital databases such as PubMed, Medline, Google scholar, and the Saudi Dental and Medical Journals were searched to retrieve the published articles and reports on dental caries in Saudi Arabia. Search strategy included key words such as "dental caries," dental decay, decayed missing filled teeth [dmft/DMFT], and oral health. Cross-sectional, retrospective and cohort studies [from 1982 to 2012] reporting the prevalence, incidence and severity of caries among children, adults and older individuals were included in the review. In children with primary dentition ages 3-7 years, the highest caries prevalence was almost 95% and maximum estimate of dmft was 7.34 during the last decade. Approximately, 91% was the highest caries prevalence and greatest DMFT value was 7.35 among the children/adolescents ages 12-19 years. The adults with a mean age between 30 and 45 years had maximum caries prevalence of 98% and DMFT of 14.53 while older individuals had greatest DMFT score of 24.3. Children, adults, and elderly populations demonstrate a higher prevalence and greater severity of caries, and secular trends also show a striking increase in dmft/DMFT and caries prevalence rates over the past few decades in Saudi Arabia

BRCA1 gene molecular alterations in Omani breast cancer patients

Breast cancer [BC] is the most common cancer reported in females in Oman and usually occurs at a relatively younger age, presents at an advanced stage and behaves aggressively. BC occurs in hereditary and sporadic forms. Although germ-line mutations in BRCA1 and BRCA2 genes are rare in sporadic cases compared with hereditary cases, molecular alterations, such as loss of heterozygosity, and CpG methylation, are common. In this study, we investigated the types of molecular alterations associated with hereditary and sporadic BRCA1-associated BC in Omani patients. We obtained clinical data and samples from 43 sporadic BC patients. The selection of cases was made based on the following criteria: aged

Insulin resistance causing post-transplant diabetes late after successful kidney-pancreas transplant: insights relevant to the pathogenesis of type 2 diabetes

New onset diabetes after transplant [NODAT] is common after solid organ transplantation and is associated with factors such as pre-transplant obesity and weight gain. We report an unusual case of severe insulin resistance [IR] leading to the development of NODAT four years after a technically successful simultaneous combined pancreaskidney transplant [SPKT] in a patient with long-standing Type 1 Diabetes [TIDM] complicated by end-stage diabetic nephropathy. Our subject became insulin-independent following his SPKT, but his significant weight gain following a short course of steroids for a biopsy-proven episode of mild pancreatic rejection at one year worsened his IR. His oral glucose tolerance at three years indicated preserved glucose tolerance but showed elevated c-peptide. Homeostasis Model Assessment [HOMA] indicated significant IR and a compensatory increase in beta-cell function. Symptomatic hyperglycemia requiring insulin developed at four years. Repeat metabolic testing confirmed glucose intolerance but demonstrated ongoing c-peptide production, albeit at lower levels. HOMA suggested ongoing IR but a loss of beta-cell function. Renal function had been excellent throughout. This genetically distinct pancreatic allograft maintained normal glucose tolerance in the face of marked insulin resistance for more than three years. Insulin resistance was sufficient to induce a progressive decline in insulin secretion leading to frank, though non-ketotic diabetes

Prevalence and risk factors for falls among the elderly in primary healthcare centers [PHC] in Qatar

Falling is the primary cause of accidental death in those aged 65 years and above. To determine the prevalence and risk factors for falls among the elderly in Qatar a cross-sectional study was made to 355 elderly persons attending 12 of the Primary Health Centers in Qatar. A questionnaire elicited socio-demographic data, and histories of falls in the previous 12 months, chronic disease, medication, and functional disabilities affecting daily life. One hundred and nineteen [34%] had fallen in the previous 12 months, half of it happened more than once, mostly inside the house, although most [87.6%] were still independent with little effect upon daily activities; women fell more than men; Qataris more than non-Qataris; there were significantly more falls in married and illiterate persons. Living alone was not a significant factor but those using walking aids and/or not exercising were at significant risk. Some chronic diseases were significant, others not, and some medications showed a significant relationship. Environmental risk factors did not appear to be significant. This study makes some recommendations to reduce the frequency of falls in elderly persons. An extensive bibliography is appended

Endometrial ablation in the women's Hospital, HMC, Doha, Qatar: a retrospective cohort

To study the outcome of various methods of endometrial ablation as a treatment of heavy vaginal bleeding, the records and post-operative histories were reviewed of 122 women with a mean age of 47 years who attended the Women's Hospital, Doha, Qatar, between January 2002 and December2005. Post-operative amenorrhea, oligomenorrhea, or a normal flow plus a satisfied patient were considered evidence of success; a need for further medical or surgical intervention was considered failure. Fifty-eight women [47.5%] had Thermachoice Balloon Ablation with a success rate of 83%; 37[30%] had Microwave Endometrial Ablation [MEA] with 71% success; and 27[22%] had Transcervical Resection of Endometrium [TCRE] with 74% success. Apart from the duration of the procedures there were no statistically significant differences in age, parity, pre-operative haemoglobin and platelets, presence of fibroids, pre-operative endometrial preparation by hormones, or final satisfaction level. It is concluded that Balloon Thermal Ablation, MEA and TCRE are equally effective for the treatment of abnormal vaginal bleeding

Psychiatric and socioenvironmental characteristics of Bahraini suicide cases

The characteristics of suicide victims have not been studied systematically in Arab countries. A questionnaire-guided interview of families of 29 Bahraini suicide cases from 1996 to 2005 was conducted in their homes by a social worker. Medical and psychiatric files were examined to complete the data. More suicide victims were male, young, single or divorced, unemployed and with a low education level compared with the general population. The majority of victims had chronic mental disorders, mainly schizophrenia, depression and substance abuse. The most notable environmental risks were reported to be family problems, family history of suicidal behaviour, and financial and relationship problems. The sociodemographic and clinical risk profile in Bahrain differs from other developed and developing countries

Epidemiology of genito-urinary tumors in Qatar

A retrospective review of genito-urinary tumors examined histopathologically in Qatar during the period 1998-2004 showed bladder cancer to be the most common followed by prostate, renal, testicular, renal pelvis and urethral tumours in order of decreasing prevalence. The apparent increasing annual prevalence of some tumors is discussed and the findings are compared with those reported from neighbouring countries and in literature from the West

Use of noninvasive positive pressure ventilation during pregnancy: case series

Mechanical ventilation is commonly required in critically ill pregnant patients, requiring ICU admission, with higher morbidity and mortality related to airway management. Alternatively, noninvasive positive pressure ventilation [NIPPV] is increasingly used to treat nonpregnant patients. Pregnancy has been a contraindication to its use. We would like to report a case series of successful use of NIPPV in pregnancy. NIPPV is increasingly used to treat hypoxemic respiratory failure. It has rarely been used during pregnancy. On the other hand, acute respiratory failure [ARF] remains a leading cause of ICU admission in obstetric patients. The use of NIPPV in managing ARF in pregnant patients was not investigated. We report the outcome of treatment with NIPPV of four sickle cell disease pregnant patients with ARF caused by acute chest syndrome. Median APACHE II score for the four cases was 27. Intubation was avoided in all cases. None had aspiration. Mean duration of NIPPV was 40 h with ICU discharge after a mean of 4 days

Body Mass Index [BMI] and neck circumference [NC] in diagnosing obstructive sleep apnea

Obstructive sleep apnea [OSA] is a common disorder for which obesity is a major risk factor. It has been suggested that the circumference of the neck [NC] is more predictive of OSA than general obesity assessed by the Body Mass Index [BMI]. In the National Tertiary Center for Sleep Study, Hamad Medical Corporation, Qatar, 187 patients were studied to evaluate the usefulness of NC and BMI in diagnosing OSA and in selecting patients for overnight polysomnography [PSG]. Eighty patients [42.8%], 69 males and 11 females with higher mean age, had evidence of significant OSA [RDI>15 events/h sleep]. OSA was found more in the non-Qatari [n=57, 55.3%] than the Qatari's [n=23, 27.4%]. NC mean levels were more in OSA group [42.51 +/- 3.12] than non OSA group [39.57 +/- 4.35] but, classifying obese as BMI = 30, there was no significant difference in the BMI of apneic and non-apneic groups. The study suggested that OSA is more common in males and NC correlates well in predicting OSA compared to generalized obesity/ BMI has no clinical relevance in diagnosing OSA

Noninvasive treatment of benign prostatic hyperplasia. Where do we stand in 2005

Noninvasive treatment of lower urinary tract symptoms [LUTS] due to benign prostatic hyperplasia [BPH] includes self-management and medical treatment. Self-management should be encouraged as an initial step for all men with uncomplicated LUTS/BPH. It consists of 3 elements, namely: education and reassurance, lifestyle modification of fluid intake and concurrent medical therapy and finally behavioral interventions including management of post-void dribbling and bladder retraining. If self-management fails, medical or surgical interventions are required. Further, research is required to define and test the effectiveness of self-management either as a primary intervention or to augment existing medical therapies. Benign prostatic hyperplasia patients in need of rapid onset of symptom relief and those with small prostates benefit from the use of alpha-blockers. Although 5-alpha-reductase inhibitors [5 ARIs] provide symptomatic benefits, the onsets of these are slower than those observed with the alpha-blockers. Amongst available therapies, only 5 ARIs have been shown to reduce the risk of acute urine retention [AUR] and BPH-related surgery compared to placebo. The Medical Therapy of Prostatic Symptoms [MTOPS] Study provides rational basis for combined alpha-blockers plus 5 ARIs in patients with a high index of disease progression [prostate volume >30 g and prostate-specific antigen >1.6 ng/ml]. Preliminary studies suggest that anticholinergics could be safe in LUTS/BPH and can help to alleviate irritative bladder symptoms due to overactive bladders commonly associated with BPH

Successful use of non-invasive pressure ventilation in a complicated flail chest

The current advanced trauma life support manual states that patients with significant hypoxia namely, SaO2 <90% on room air as a result of pulmonary contusion should be intubated and ventilated within the first hour of injury. Recently, several researchers have shown improved outcomes when patients with acute respiratory failure are managed with non-invasive positive pressure ventilation NIPPV. Trauma patients may also benefit from this therapy. We report a case of 15-year-old boy with isolated flail chest and pulmonary contusion, who was intubated in the emergency room, and was managed successfully with the NIPPV in the intensive care unit ICU despite, having had aspiration pneumonia early in the course of his stay. After initial stabilization, he failed a spontaneous breathing trial. Due to absence of contraindications to the use of NIPPV, the patient was extubated on day 7 from pressure support ventilation of 15 cmH2O and positive end expiratory pressure of 8 cmH2O to immediate NIPPV use. Three days later after a total of 50 hours of NIPPV use in the ICU the patient was successfully discharged home

Evaluation of once daily tobramycin versus the traditional three time daily for the treatment of acute pulmonary exacerbations in adult cystic fibrosis patients

Once daily tobramycin is convenient to use and achieves higher tissue levels that should kill Pseudomonas aeruginosa more rapidly. Small trials of OD compared with TDS aminoglycosides in CF patients have shown no difference in efficacy or toxicity. No one has looked in detail at the impact on sputum microbiology. In a prospective, randomized study at Papworth Hospital, UK, we compared OD with TDS tobramycin, each plus a second anti-pseudomonal, for the treatment of acute infective exacerbation in 15 adult cystic fibrosis patients colonized with Pseudomonas aeruginosa. Using the patients as their own control, the same individuals received the alternate treatment regime for the next exacerbation. We aimed to compare the clinical and bacteriological efficacy, toxicity, and the effects on susceptibility of the organism among patients in both treatment groups. Isolates were identified, and the Minimum Inhibitory Concentration [MIC] of the antibiotic in each patient was performed. Patients were assessed for clinical improvement, toxicity and the total viable count in their sputum on days 0, 7 and 14. In both treatment groups there was a significant clinical improvement, and toxicity did not occur in either group. There was no difference in clinical outcome, adverse events, or time to the next exacerbation. No difference was seen in the selection of antibiotic resistance. OD tobramycin appeared more effective in reducing the number of bacteria in the group overall at day 7 and in two individuals, at day 14