Challenges of Autism Spectrum Disorders Families Towards Oral Health Care in Kingdom of Saudi Arabia

Abstract Objective: To assess the knowledge, attitudes, and practice regarding oral health care among parents of autistic children and also the challenges faced by them in providing dental care for their Autism Spectrum Disorders (ASD) children's in four regions of Kingdom of Saudi Arabia. Material and Methods: In total, 263 parents of autistic children participated in this cross-sectional study who were enrolled from 4 major regions of Kingdom of Saudi Arabia. A self-administered questionnaire formulated in simple Arabic was distributed to parents of children diagnosed with autism or any form of ASD. The questionnaires consisted of demographic questions and also to assess their knowledge on oral health, child's oral hygiene practices and visits to their dentist, oral hygiene, experience and challenges in waiting room area before the dental treatment, acceptance of treatment or rejection, accessibility to find non-dental centers either government or private for treatment and their recommendations. Results: All the parents brushed their child's teeth using a toothbrush and fluoridated toothpaste. A total of 29.7% of the parents informed that their child never brushes teeth. A total of 41.4% of the parents visit the dental clinic when the child complains about dental problems and 54% find difficulty in locating appropriate dental clinic to deal with their ASD children. Most parents reported taking their child to a private office (38.8%). Only 3.8% of parents reported that their children had seizures during dental procedures. Conclusion: The knowledge toward oral health was found to be inadequate among the majority of the parents. Parents of ASD children need to be educated about the consequences of oral health neglect and the importance of regular check-ups.

Lipid nanoparticles [SLNs and NLCs]: wide range of application from cosmetics to cancer chemotherapy

The present review compiles the applications of lipid nanoparticles mainly solid lipid nanoparticles [SLN] and nanostructured lipid carriers [NLC] for the delivery of pharmaceutical actives. The attempts to overcome the low solubility and bioavailability of some drugs by their incorporation into lipid nanocarriers have been summarized. A special focus of this review is on different routes of administration of SLNs and NLCs which begins from oral route especially for administration of anticancers, parentral route for drug targeting, pulmonary and topical route for administration of antimicrobial, anti-proliferative and anti inflammatory agents, ophthalmic application to finally cosmetic application of lipid nanocarriers

Is the airtraq laryngoscope superior to macintosh laryngoscope using armord endotracheal tube in head and neck surgery?

The control of the airway is a fundamental aim for the anaesthiologast during routine anaesthesia. The incidence of difficult tracheal intubation has been estimated at 3-18%. This incidence may be more in head and neck Surgery. Our study conducted on 30 patients divided randomly in two groups each of 15 patients. Fifteen patients intubated by Macintosh laryngoscope and 15 by Airtraq laryngoscope. We found that success rate in Airtraq laryngoscope was 100% in comparisons to Macintosh laryngoscope which was 81.8%. We found also the intubation time was reduced significantly with use the Airtraq laryngoscope. The intubation was done in the first attempts in all patients in Airtaq group without need to optimizing maneuvers in comparison to Macintosh laryngoscope which need optimizing maneuvers and also use intubating aids like Bougie. Nearly no complication in Airtraq group like oral mucosal laceration, oxygen alteration and heamodynamic changes. We found that the Airtraq laryngoscope provides superior intubating condition without need intubating aids and less or no complications

Randomized clinical study of cryotherapy, loop electrosurgical excision and electrocautery for treatment of squamous lesions of the cervix

Objective: to compare cryotherapy, loop electrosurgical excision and electrocautery for treatment of squamous lesions of the cervix

Patients and method: Women at least 18 years old with biopsy- proven SIL, between June 2003 and December 2004. 72 patients underwent loop excision, 64 patients in the electrocuatery group and 60 patients in the cryotherapy group

Setting: Early cancer detection units of El-Minia University Hospital and Ain Shams Maternity Hospital

Intervention: Cryotherapy, loop Electrosurgical excision procedure [LEEP] and Electrocautery were done

Main outcome measures: Complication [as infections, bleeding, cervical stenosis, pain, visibility of the transformation zone and discharge] and efficacy [rate of recurrence and persistence of the lesions] of the three treatment modalities

Results: there were no statistically significant difference in complications, rate of persistence or recurrence. Risk of persistent or recurrent lesions were higher among patients with large and high grade lesions

Conclusions: the data support a high success rate with the three modalities. No differences in the complication or failure rates were detected

Comparative study of diffferent combination of total intravenous anesthesia in different-surgical procedures

Total intravenous anesthesia [TIVA] is a natural extension of balanced anesthesia. Propofol is considered to be the most suitable anesthetic drug for use in TIVA because of its pharmacokinetic properties suitable for this technique. Remifentanyl is the best analgesic component, remifentanyl has an ester linkage in its molecular structure, it has a very short duration of action because of rapid breakdown of the ester linkage by nonspecific plasma and tissue esterases. 30 patients aged between 20-40 years old undergoing surgical-procedures were included in this study. All patients premedicated with oral diazepam [0.2 mg/kg], 90 minutes preoperative patients were divided into three groups propofol fentanyl [P/F], propofol/ remifentanyl [P/R], and ketamine midazolam[K/M] group. We used these drugs in each group for induction and maintenance of anesthesia and we compared the three groups regarding: Hemodynamic changes, hormonal and metabolic changes, recovery pattern, side effect.-The result of this study showed that, remifentanyl in[P/R] group caused hemodynamic stability better than that of the other two groups. There is decrease in plasma cortisol level which was statistically significant during surgery and post operatively [P>0.05] in all patients in [P/R] group. While in [P/F] and [K/M] groups there was significant increase. All patients in the three group showed increase in blood sugar and B-endorphin levels during operation and in recovery room which was statistically significant only for B-endorphin in [K/M] group. There was no significant difference between [P/F] group and [P/R] group for the dose requirement of propofol. The small doses of fentanyl and ketarnin used in this study are not enough to suppress the hormonal and metabolic changes caused by stress response to surgary. Patients in [P/R] group showed shorter recovery period than in the other two group. We can concluded from this study that remifentanyl used with propofol was effective as the primary opioid in TiVA and provided better intra-operative hemodynamic stability during stressliall surgical events than that achieved with the recommended dose of fentanyl

Effect of amlodipine, fosinopril and atenolol on glucose metabolism and microalbuminuria in STZ diabetic rats

This study compares the effect of a calcium channel blocker [amlodipine], an ACE inhibitor [fosinopril] and a B 1-blocker [atenolol] on blood glucose level, plasma insulin level, insulin sensitivity and 24 hours urinary albumin excretion in groups of rats made diabetic by a single intraperitoneal injection of streptozotocin [STZ] [60 mg/kg]. Five groups of rats were used in this work. The first group [control non-diabetic rats] was normoglycemic with blood glucose level 116.8 +/- 9.4 mg/dl and 24 hour[H] urinary albumin 8.2 +/- 1.2 mg/24 H urine. The other four groups were made diabetic by a single dose of STZ. The second group [control non-treated diabetic rats] exhibited hyperglycemia 8 weeks after induction of diabetes with blood glucose level 354 +/- 32.6 mg/dl, plasma insulin level 10.1 +/- 0.8 mIU/ml and 24 H urinary albumin 42.6 +/- 3.2 mg/24 H wine. Results of this study revealed that amlodipine oral administration in a dose of 5 mg/kg for 8 weeks in the third group of STZ diabetic rats induced a significant reduction of blood glucose level [234 +/- 18.6 versus 354 +/- 32.6 in control diabetic rats, P< 0.05] and plasma insulin level [8.2 +/- 06 mIU/ml versus 10.1 +/- 0.8 mIU/ml in control diabetic rats, P<0.05]. Amlodipine also caused significant reduction in 24 H urinary albumin [18.2 +/- 1.2 mg versus 42.6 +/- 3.2 mg in control diabetic rats, P<0.05] and significant improvement in sensitivity to intraperitoneal bolus dose of insulin where it caused a significant reduction in blood glucose level at 0.5 H,1 H and 6 H after insulin compared to control diabetic rats, P<0.05. The results of this study also revealed that administration of fosinopril in a dose of 5 mg/kg/day oral to the fourth group of STZ diabetic rats for 8 weeks induced a significant reduction in blood glucose level plasma insulin level, and 24 H urinary albumin excretion compared to control non-treated diabetic rats. Fosinopril, also produced a significant improvement in insulin sensitivity at 0.5 H, 1 H and 6 H after insulin injection compared to control non-treated diabetic rats. In contrast, atenolol given orally in a dose of 10 mg/kg/day for 8 weeks to fifth group of diabetic rats did not induce a significant change in blood glucose level, plasma insulin level and 24 H urinary Albumin and even reduced insulin sensitivity compared to control non-treated diabetic rats. It could be concluded from these results that both amlodipine and fosinopril are better antihypertensives than atenolol in diabetic patients as they improved glucose tolerance and albuminuria in STZ diabetic rats

role of autonomic innervation of the adrenal gland on the expression of corticosterone diurnal rhythm

Several lines of evidence indicate that alterations in sympathetic input to the adrenal gland may represent one of the routes by which adrenal responsiveness to circulating adrenocortico-trophic hormone [ACTH] is modulated. This study is designed to evaluate the role of autonomic innervation of the adrenal gland on the expression of corticosterone diurnal rhythm. This work was done on forty [40] rats divided into 3 groups. Group I is resting control group. Group II is divided into 2 subgroups. Subgroup II a was injected with dexamethasone while subgroup II b treated with dexamethasone and ACTH. Group III is splanchnicotomy group. Plasma corticosterone level was measured in blood samples from all groups at AM and PM. In dexarnethasone-treated rats, dexarnethasone reduced PM level of corticosterone without significant change in AM corticosterone level when exogenous ACTH was given to dexamethasone treated rats, corticosterone response was found to be without significant AM/PM difference. In splanchnic nerve transection group, splanchnicotomy resulted in a non significant change in AM corticosterone level, while PM corticosterone level reduced significantly. This result indicates that splanchnic neural input to adrenal gland facilitates resting PM corticosterone secretion

Hepatitis B virus seromarkers among Egyptian pesticide applicators

It is evident that HBV infection is quite prevalent in Egypt and is a public health problem. This study was conducted on a group of pesticide applicators from different Egyptian governorates: 159 Subjects from upper Egypt [South]. 152 Subjects from lower Egypt [North], and 87 Subjects as control. Hepatitis B seromarkers [HBsAg, anti-HBc and anti-HBs] were detected by using ELISA technique, besides doing some liver function tests [SGOt, SGPT and S. Cholinesterase]. Abdominal ultrasonography was done for 246 subjects to evaluate thickness of portal tracts [hepatic schistosomiasis] and the other echo pattern of the liver. The frequency of carriers [HBsAg] was 7.4%; immune [antiHBs and anti-HBc] was 51%, remote post exposure [anti-HBs] was 13.8%. and window phase [anti-HBc] was 7.7%.Results showed that both the carrier infection rates increased with age between 20-39 years, however, the rates decreased with ages >40 years. The carrier rate among bilharzial liver cases [57.89%] was higher than in non-bilharzial liver cases [12.11%]. On the other hand, the infection rate was higher in non-bilharzial liver cases [54.64%] than in bilharzial liver cases. The percent of coarse liver pattern [by ECHO] among carriers [10.53%] was higher than that for the non-infected subjects [2.27%]. This denotes the pathological effect of hepatitis B virus on the liver

Effect of some high risk pregnancy factors on fetal biophysical profile score, Apgar score, blood gases and birth weight

The effect of some high risk pregnancy factors on fetus and newborn were examined in 100 high risk pregnant mothers and 20 normal controls during the 3rd trimester and at birth. The fetal biophysical profile score, Apgar score, PH and blood gases of high risk pregnancy group showed a significant lower values compared to the normal group. These data demonstrated the usefulness of fetal biophysical profile score in predicting the neonatal condition, specially in high risk pregnancy and that its value in fetal evaluation equals that of Apgar score, blood gases and PH in neonatal evaluation