Methods for caries detection: an overview

It is critical to detect caries as early as possible to reverse/halt the carious process or to restore the tooth in a most conservative manner. The conventional caries detection methods may fail to detect early carious lesions. Therefore, efforts have been underway to develop more sophisticated caries detection systems. Various caries detection systems are discussed in this review. The evidence supporting new systems is currently limited. This brief review describes available technology and research supporting its use. Each system have its own indications and benefits. It can be recommended that the systems such as Laser Fluorescence, Quantitative Light-Induced Fluorescence [QLF] and Digital Image fiberOptic Trans-illumination [DiFOTI] do facilitate earlier detection of enamel caries

comparison of outcome of diagnosed versus undiagnosed breech at term in labour

To assess the proportion of undiagnosed breech presentation in labour and to compare their mode of delivery and outcome with those diagnosed prior to onset of labour. This comparative study was conducted in the department of Obstetrics and Gynaecology unit I, at Holy Family Hospital Rawalpindi. January 2001 to June2002. Low risk singleton breech presentation, 50 diagnosed and 50 undiagnosed cases in labour were selected to compare their mode of delivery and outcome. All high risk cases with breech presentation associated with complications or major congenital abnormalities were excluded. Outcome measures were assessed in form of Apgar score, birth injuries and neonatal deaths. Maternal morbidity was also assessed in term of infectious morbidity and duration of hospital stay 70% cases were selected for elective caesarean section in diagnosed group and 10%in the undiagnosed group. 54% of babies delivered by caesarean section weighed more than 3.5kg. There was no difference in perinatal morbidity and mortality. Maternal morbidity, and duration of hospital stay increased considerably in diagnosed group. Significant number of breech presentations remain undiagnosed because of lack of antenatal care and are more likely to deliver vaginally without any significant difference in neonatal mortality and morbidity. Caesarean section of selected cases of breech presentations is associated with increased maternal morbidity in both groups without corresponding improvement in neonatal outcome

Cervical ripening. A double blind controlled trial of PGE2 pessary

OBJECTIVE: To determine the efficacy of PGE2 pessary in the cervical ripening and to study its effect on other parameters of labour and delivery. DESIGN: Prospective study. SETTING: Maternity Unit II Nishtar Hospital Multan. SUBJECT: A randomized double blind trail of PGE2 pessary was carried out in patients admitted for induction of labour. MEASUREMENT AND RESULT: We looked at the change in Bishop scoring, induction delivery interval, mode of delivery and fetal outcome. Fifty% of the patients who received prostin E2 pessary went into labour before planned amniotomy while only five% of the patients receiving placebo did so. No significant difference was found in mode of delivery and incidence of fetal distress between the two groups. The shortened induction delivery interval following pre treatment with PGE2 [3 mg] pessary