in-vitro effect of two different concentrations of sodium hypochlorite on dentine hardness

To investigate the effect of two different concentrations of irrigant solutions of sodium hypochlorite [NaOCl] 2.25% and 5.25%, on dentine hardness. Forty-eight extracted anterior and posterior teeth were decoronated and the roots were endodontically cleaned and shaped. Each root was sectioned into cervical, middle and apical sections of 3mm thickness and mounted in an acrylic resin disc-shape mould. After polishing the coronal surface of each section, microhardness was measured using a Wallace microhardness indentation tester at four locations 1mm away from the root canal lumen. Specimens were allocated into two groups and then irrigated with either 5.25% or 2.25% sodium hypochlorite for one hour and microhardness was measured again. A statistically significant decrease [p0.05] difference in the decrease of dentine hardness between the 5.25% and the 2.25% concentrations for the root as whole and in every root section. Irrigation with 2.25% or 5.25% sodium hypochlorite significantly decreased root dentine microhardness

Physician behaviour for antimicrobial prescribingfor pediatric upper respiratory tract infections=asurvey in general practice in Kuwait

Upper respiratory tract infections [URTIS] are among the most frequent reasons for physician office visits in paediatrics .Despite their predominant viral aetiology ,URTIS continue to be treated with antimicrobials . we explored general practitioners '[GPs] prescribing behavior for antimicrobials in children [<12years] with URTIs in Kuwait, using the guidelines from the Center for Disease Control and prevention [CDC] as a reference . A cross -sectional study was conducted on 92 consenting GPs from the 109 contacted and pediatricians in Kuwait [Governmental and private clinics] ,between January to June 2009 . Using a pilot -tested questionnaire,GPs identified the 5 most frequent URTIs they see in office and reported on their antimicrobial prescribing practices for these URTIs . The 5 most frequent URTIs presenting in children in general practice, are the common cold pharyngitis ,tonsillitis ,sinusitis and acute otitis media [AOM] in rank order .GPs prescribe at least 25 different antibiotics for these URTIs with significant associations for amoxicillin ,co-amoxiclav, cefaclor,cefuroxime ,erythromycin ,clarithromycin [p<0.001] Amoxicillin alone or with clavulanate was the most frequently prescribed antibiotic for all URTIs . prescribing variations from the CDC recommendations were observed for all URTIs except for AOM[50%],the most common condition for antibiotics . severity [95.7%] and duration of illness [82.5%] influenced doctors 'prescribing infections [70%].physicians do not request laboratory investigations primarily because they are unnecessary [86%] and the waiting time for results is too long [51%]. Antibiotics are over prescribed for paediatric URTIs in Kuwait and amoxicillin with co-amoxiclav were preferentially prscribed . Except for AOM, GPs' prescribing varied from the CDC guidelines for drug and duration .physicians recognize antibiotics are overused and consider parents expecting antibiotics and a concern for secondary bacterial infections are prescribing pressures . Guidelines to manage URTIs, ongoing surveillance programs for antibiotic resistance ,public health education on non-antibiotic strategies ,and postgraduate education for rational pharmacotherapy in general practice would decrease inappropriate antibiotic use in URTIs

Measuring parents'satisfaction with pediatric in -hospital care

Measurement of parent satisfaction has the potential to be an important component in evaluating service adequacy because parents usually are [a] responsible for obtaining health services for their children, [b] key to the success of treatment through their participation, [c] the best source of information about the effects of caring for a child with health problems, and [d] the primary caregivers after service completion. Research consistently shown that the most important factor contributing to satisfaction in the healthcare context has been interpersonal relationship between staff and consumers. Technical aspects of care, although an important determinant of clinical outcomes, have not been found to account for significant variance in consumer satisfaction. Focusing on interpersonal interactions of staff, therefore, served as the common denominator when developing items for the parent satisfaction questionnaire described in this thesis. So, the purpose of that study is twofold. First, to attempt to develop an Arabic language questionnaire for assessing parent satisfaction with inpatient care in pediatric hospitals, taking into account that item pool selection should incorporate the importance of the communication skills of the physicians. Second, to elicit parents' assessments of care in the particular setting of Children's hospital and possibly identify the contributing factors to their dissatisfaction

Combined percutaneous cystolithotripsy and transurethral prostatectomy for treatment of large bladder calculi with benign prostatic hypertrophy

Between May 1998 and August 2001, 40 patients were included in this study and divided into two groups. Group I comprised 20 cases presented by large bladder calculi associated with obstructive benign prostatic hypertrophy [BPH] treated with combined percutaneous pneumatic cystolithotripsy [PCCL] using lithoclast and transurethral resection of the prostate [TURP]. Group II consisted of 20 patients with obstructive BPH with no bladder calculi treated with TURP alone. A laparoscope port 10 mm [Endopath, dilating tip trocar, Ethicon Endosurgery, Inc., USA] was used for bladder puncture. The results of group I were compared with those of group II. All the 20 patients with bladder calculi were having single large calculus more than 40 mm in its longest diameter as measured by ultrasound and abdominal X-ray. Patients discovered to have prostate cancer and also those with small or multiple bladder calculi or with indwelling catheter were excluded from the study. Indications for TURP were determined by AUA symptom score, uroflowmetry, the amount of post-voiding residual urine and by cystoscopy. Prophylactic antibiotics were given to all cases. It was concluded that PCCL, using pneumatic lithoclast combined with TURP, appears to be an effective, safe, minimally invasive and economical treatment method for patients with large bladder calculi and BPH

Minimally invasive techniques in management of benign lower ureteral structure

Seventy patients [55 males and 15 females] with benign lower ureteric strictures were included in this study. Six patients had bilateral stricture. The strictures were due to inflammatory process [40 patients], ureteroscopy [12 patients], ureterolithotomy [7 patients], hysterectomy [6 patients] and ovarian cystectomy [5 patients]. Two groups were studied. On failure in one technique, the patient was shifted to another one. In group I, 33 ureteral strictures were treated with balloon dilatation. In group II, the strictures were treated with endoureterotomies. The strictures of group II were subdivided into three subgroups according to the method of endoureterotomy whether cold knife [n = 28], uretero-resectoscope [n = 30, 21 patients of them had failed balloon dilatation] or Acucise cutting balloon [n = 10, 2 of them had failed endoureterotomy by cold knife and 5 patients had failed endoureterotomy by uretero- resectoscope]. Double-J stent 7 F was left for 6-9 weeks in all cases. A postoperative follow up was done in all cases by repeating ultrasound and excretory urography after three months and once every six months, thereafter. The results showed that the overall success rate of balloon dilatation was 36.4%. Only 12 of 33 ureters were patent during the follow up. The success rates of cold knife, electrocautery and Acucisendoureterotomy were 57.1%, 83.3% and 90%, respectively