Knowledge about composite restorations repair vs replacement- a survey among a subpopulation of saudi dental students / Conhecimento sobre reparo e substituição de restaurações de resina - uma pesquisa entre uma subpopulação de estudantes sauditas de odontologia

Objective: The purpose of this study was to evaluate the knowledge among dental students at King Khalid University, Jazan University, and Najran University in the kingdom of Saudi Arabia about when to repair or replace defective direct composite restoration. Materials and Methods: A questionnaire-based survey was formulated, pursuing the information about management (repair/replacement) of defective composite restorations and distributed among 200 dental students of three universities in the southern region of the kingdom of Saudi Arabia. The data were collected with the help of an online questionnaire. Data entry and the analysis were done using the statistical software package SPSS version 20.0. It was presented using descriptive statistics in the form of frequencies and percentages for qualitative variables, and range means and standard deviations for age, quantitative variable. Analytic statistics were done using Chi-Square tests (χ2) to test the significant difference between categorical variables. The level of significance, the p-value was 0.01(p<0.01). Results: The decision to choose between composite repair or replacement was influenced by whether this topic was taught to them at various undergraduate levels during Bachelor of Dental Surgery. The reason associated with the decision to repair defective composite restorations, 76% reported as cost-effective followed by Increased longevity (71%), the permanent filling (70%), patient's preference for repair (65%), and least time consuming (50%). 67% participants preferred significantly (p<0.001) repair due to secondary caries in the previously restored tooth with composite, followed by the small surface defect in a composite restoration (65%), risk of pulpal damage significantly (p<0.001) in a defective composite restoration (62.5%) and more invasive and destructive treatment option (35%). More than half of respondents 123 (61.5%) reported that they were not taught about composite repair during the Bachelor of Dental Surgery. Conclusion: It is suggested with the help of our study that didactic and clinical training components regarding composite repair should be seriously included in the teaching curriculum of dental institutions as it is in the best interest of the patient. Dental students should be provided with clinical training on this topic so that they can follow proper decision-making protocols available during repair or replacement of defective resin composite restorations. Other researches in the future can be carried out for refining the guidelines and techniques utilized for composite repair. (AU)

Objetivo: O objetivo deste estudo foi avaliar o conhecimento entre estudantes de odontologia da King Khalid University, Jazan University e Najran University, no reino da Arábia Saudita, sobre quando reparar ou substituir restaurações de resina composta direta defeituosas. Material e Métodos: Foi formulada uma pesquisa baseada em questionário, buscando informações sobre o manejo (reparo / substituição) de restaurações de resina composta e distribuída entre 200 estudantes de odontologia de três universidades da região sul do reino da Arábia Saudita. Os dados foram coletados com o auxílio de um questionário online. A entrada e análise dos dados foram feitas com o software estatístico SPSS versão 20.0. Foi apresentado por meio de estatística descritiva na forma de frequências e percentuais para as variáveis qualitativas, e amplitude de médias e desvios-padrão para a idade, variável quantitativa. A estatística analítica foi feita usando testes de qui-quadrado (χ2) para testar a diferença significativa entre as variáveis categóricas. Ao nível de significância, o valor de p foi de 0,01 (p <0,01). Resultados: A decisão de escolher entre o reparo ou substituição do compósito foi influenciada pelo fato de este tópico ter sido ensinado a eles em vários níveis de graduação durante o Bacharelado em Odontologia. O motivo associado à decisão de reparar restaurações de resina composta defeituosas, 76% relataram como custo-benefício seguido por maior longevidade (71%), restauração definitva (70%), preferência do paciente para reparo (65%) e menos demorado ( 50%). Sessenta e sete por cento dos participantes preferiram o reparo significativamente (p <0,001) devido a cárie secundária no dente previamente restaurado com resina composta, seguido pelo pequeno defeito de superfície em uma restauração composta (65%), risco de dano pulpar significativamente (p <0,001) em um restauração de resina composta com defeito (62,5%) e opção de tratamento mais invasiva e destrutiva (35%). Mais da metade dos entrevistados, 123 (61,5%) relataram que não foram ensinados sobre reparo de resina composta durante o Bacharelado em Odonotlogia. Conclusão: É sugerido com a ajuda de nosso estudo que os componentes do treinamento didático e clínico sobre reparo de resina composta devem ser seriamente incluídos no currículo de ensino de instituições odontológicas, pois é do interesse do paciente. Os estudantes de odontologia devem receber treinamento clínico sobre este tópico para que possam seguir os protocolos de tomada de decisão adequados disponíveis durante o reparo ou substituição de restaurações de resina composta com defeito. Outras pesquisas no futuro podem ser realizadas para refinar as diretrizes e técnicas utilizadas para reparo de resina (AU)

Efficacy of combination of fluoxetine and cognitive behavioral therapy and fluoxetine alone for the treatment of obsessive compulsive disorder

A number of pharmacological approaches as well as psychological interventions are effective in the treatment of obsessive-compulsive disorder [OCD]. The present study was conducted to see the relative efficacy of treatment approaches. 30 diagnosed cases of OCD were taken and divided into two groups. Each group consisted of 15 patients. Group A [N=15] received Capsule Fluoxetine and Group B [N=15] received Capsule Fluoxetine and CBT [13 weekly sessions]. Twenty six participants completed the study [13 in each group]. Dhaka University Obsessive-compulsive Scale [DUOCS] was used to measure the symptom severity. Symptom scores were measured at weeks 1, 5, 9 and 13. After 13 weeks, analysis of the data was done and the means of initial DUOCS score and 13th week score were compared. In both the groups the mean score changes were highly significant [p=0.000]. Intra group analysis revealed that both the treatment approaches were highly efficacious. Inter-group analysis revealed that the response in combination group was significantly higher starting from 9th week, continuing up to 13th week. Mean symptom reduction and mean percentage reduction of symptoms were also higher in the case of combination group

Simple technique of uterine compression sutures for prevention of primary postpartum hemorrhage during caesarian section

To report our clinical experience of the effect of applying simple technique of uterine compression sutures to prevent primary postpartum hemorrhage in atonic uterus developed during caesarian section. The use of simple uterine compression sutures in atonic uterus during caesarian section was reviewed within the period of January 2006 to March 2008 in a tertiary obstetric unit in three Medical College. It is a descriptive observational study. In atony uterus, first to treat fundal compression, used Intravenous or Intramuscular uterotonic drugs followed by per-rectal use of misoprostol and observed 10-15 minutes and then applied simple technique of uterine compression sutures. Age of patients ranged from 15-40 years. 49 patients were primiparae and 54 patients were multiparae. Indications for caesarian section were previous caesarian section 21 [20%], large baby head to disproportion 23 [22%], obstructed labour and prolonged labour 29 [28%], twin pregnancy 16 [15.5%], polyhydromnios 4 [3.8%], abruptio placenta 4 [3.2%], placenta preavia accreta 7 [6.5%], All cases were maintained with post-operative 10 units oxytocin for 8 hours. Two patients needed one unit blood transfusion after surgery. No post-operative excessive bleeding was observed. There was no alteration of uterine involution and lochial discharge. In followed up cases subsequent pregnancy were 12 [11.6%]. Extreme degree of uterine compression may leads to uterine anatomic damage. Simple compression technique is surgically easy, with life saving potential, offers relative safety, time saving and can be managed by trainee doctors after some experience

Bangladesh HIV/AIDS communication challenges and strategies.

Bangladesh is in a precarious position in relation to the HIV/AIDS epidemic. Rates are currently low compared to the rest of the South Asian region, and the disease is relatively confined to small, high-risk populations--mainly injection drug users (IDUs) and commercial sex workers. Yet if steps are not taken quickly to keep the epidemic in check, it could easily spread to the general population as it has in other countries nearby. This would both increase the negative impact of HIV/AIDS and make it much harder to target for containment. It is therefore imperative that healthy behavior be promoted among IDUs and sex users, not only for their own health, but for the health of the country. Prevention will be the key to halting the spread of HIV infection through the implementation of communication and education programs aimed to change high-risk behavior. However, the disparate number of HIV/AIDS prevention programs independently operating in Bangladesh combined with the difficulty in adequately targeting this unique population of IDUs and sex workers establishes a complex situation where attaining behavior change is extremely difficult. This paper proposes adoption of the FOMENT model to design a health communication campaign targeting the high-risk populations in Bangladesh.

Laparoscopic management of atypical presentation of ectopic pregnancy

Analysis of management in 22 ectopic pregnancies clinically presented as an atypical form. Twenty two patients with suspected ectopic pregnancy were successfully managed laparoscopically during three years period at Victory Nursing and infertility management centre, Khulna, Bangladesh. All patients had dull ache pain in lower abdomen or any one of the iliac fossa. All cases were hemodynamically stable and ambulatory. Ultrasonography findings were complex Heterogeneous mass without any free fluid in 8 cases, definitive gestational sac in 6, and sac like structure in 8 cases. Urinary beta"hCG was positive in 40.9% and negative in 59% cases. Pre-operative diagnoses were chronic ectopic pregnancy in 11, ruptured corpus luteum in six and chocolate cyst in five cases. Operating diagnosis were chronic ectopic pregnancy 14, unruptured tubal and cornual pregnancy 5, ovarian ectopic in three cases. Surgical procedures were salpingostomy, salpingectomy, salpingo-ophrectomy, partial ovarian resection and only sac removal with peritoneal toileting. Operating time was 30"120 minutes. The average post- operative stay was 24"48 hours without any complications. Unruptured early ectopic may present with minimal symptomotology. Hence in all women of child bearing age the provisional diagnosis of ectopic pregnancy may be kept in mind while examining and investigating a patient