Oral Health Status and Treatment Needs for Children with Special Needs: A Cross-Sectional Study

Abstract Objective: To determine the oral health status along with the treatment need among Arabian children with special health care needs. Material and Methods: Fifty-seven special health care needs children aged 17 or younger, studying at RAK-RCD were recruited for the study. In addition to demographic data, the subjects were screened for the type of disability, oral health status, dental caries, occlusion abnormalities, and type of treatment required. Dental caries was recorded according to the WHO oral health survey criteria and methods. Oral hygiene status was recorded as good, fair, or poor according to the Simplified Oral Hygiene Index (S-OHI). Occlusion anomalies were categorized using Angle's classification of occlusion Results: Fifty-four subjects aged 3-17year old, comprising 70.4% males and 29.6% females participated in the study. There were 7 (13%) subjects in the 3-5 years age group, 23 (42.6%) in the 6-10 years age group, and 24 (44.4%) in the 11-17 years age group. Twenty-two (26%) subjects had Down Syndrome (DS), 14 (25.9%) Mental Disability, 9 (16.7%) Autism, 5 (9.3%) deafness and hearing loss and 4 (7.4%) multiple disabilities. Forty-six (85.2%) had dental caries with a mean dmft/DMFT score of (5.67± 4.69). Only eight (14.8%) were caries-free. Thirty-five (64.8%) had good oral hygiene, 25.9% fair oral hygiene and 9.3% poor oral hygiene, with statically insignificant differences across gender (p=0.43), age groups (p=0.11). Nevertheless, there was a significant difference between oral hygiene and the types of disabilities (p=0.0004). Up to 41% of the subjects required oral prophylaxis, 89% restorations, 13% extractions, 20% orthodontic treatment, and 11% dental prosthesis Conclusion: There was a high prevalence of dental caries and periodontal diseases among the subjects. The study highly recommends the education of the children's parents and caregivers on the need for diet modification, meticulous oral hygiene, and regular dental visits. Furthermore, there is a great deal of oral health program the RAK Rehabilitation Center for Disabled need to achieve.

Emergency Management of Traumatic Dental Injuries: Knowledge of Dubai School Nurses

Abstract Objective: To assess the knowledge of school nurses in Dubai, United Arab Emirates, about the emergency management of Traumatic Dental Injuries (TDIs) at schools. Material and Methods: A cross-sectional questionnaire survey was conducted amongst 68 school nurses (SN) prior to inviting them to an educational workshop on the emergency management of TDIs. The educational workshop covered all the topics in the questionnaire and provided basic necessary information to the SN regarding the emergency management of TDIs. Descriptive statistics were used to describe the characteristics of the sample; the Kolmogorov-Smirnov test was used to test normality for the score of knowledge and Mann-Whitney U test to correlate score of knowledge with different demographical variables (p<0.05) Results: An overall lack of knowledge about the emergency management of TDIs was observed. The overall average for the score of knowledge for all the participants was 10.75 out of a total of 16 correct answers. Female participants had significantly higher scores of knowledge compared to males (p=0.02). None of the other demographic variables were significantly associated with the score of knowledge Conclusion: More training programs are essential for school nurses to improve their knowledge and awareness for better future handling of traumatic dental injuries.

Dental caries experience, oral health status and treatment needs of dental patients with autism

OBJECTIVES: Autism is a lifelong neurodevelopmental disorder. The aims of this study were to investigate whether children with autism have higher caries prevalence, higher periodontal problems, or more treatment needs than children of a control group of non-autistic patients, and to provide baseline data to enable comparison and future planning of dental services to autistic children. MATERIAL AND METHODS: 61 patients with autism aged 6-16 years (45 males and 16 females) attending Dubai and Sharjah Autism Centers were selected for the study. The control group consisted of 61 non-autistic patients chosen from relatives or friends of autistic patients in an attempt to have matched age, sex and socioeconomic status. Each patient received a complete oral and periodontal examination, assessment of caries prevalence, and caries severity. Other conditions assessed were dental plaque, gingivitis, restorations and treatment needs. Chi-square and Fisher's exact test of significance were used to compare groups. RESULTS: The autism group had a male-to-female ratio of 2.8:1. Compared to controls, children with autism had significantly higher decayed, missing or filled teeth than unaffected patients and significantly needed more restorative dental treatment. The restorative index (RI) and Met Need Index (MNI) for the autistic children were 0.02 and 0.3, respectively. The majority of the autistic children either having poor 59.0 percent (36/61) or fair 37.8 percent (23/61) oral hygiene compared with healthy control subjects. Likewise, 97.0 percent (59/61) of the autistic children had gingivitis. CONCLUSIONS: Children with autism exhibited a higher caries prevalence, poor oral hygiene and extensive unmet needs for dental treatment than non-autistic healthy control group. Thus oral health program that emphasizes prevention should be considered of particular importance for children and young people with autism.

Imported Malaria in United Arab Emirates: Evaluation of a New DNA Extraction Technique Using Nested PCR

Local malaria transmission in the United Arab Emirates (UAE) came to an end in 1997. Nevertheless, UAE has been subjected to substantial importation of malaria cases from abroad, concerning both UAE nationals and immigrants from malarious countries with a total number of 2,119 cases in 2007. To evaluate a new DNA extraction technique using nested PCR, blood samples were collected from 132 individuals who presented to Infectious Diseases Department in Rashid Hospital, Dubai, and Central Department of Malaria Control with fever and persistent headache. Giemsa-stained blood films and ELISA test for malaria antibodies were carried out for detection of Plasmodium infection. Plasmodium infections were identified with the genus-specific primer set and species differentiation using nested PCR. A rapid procedure for diagnosis of malaria infections directly from dried blood spots using for the first time DNA extract from FTA Elute cards was evaluated in contrast to extraction techniques using FTA classic cards and rapid boiling technique. Our new simple technique for DNA extraction using FTA Elute cards was very sensitive giving a sensitivity of 100% compared to 94% using FTA classic cards and 62% in the rapid boiling technique. No complex preparation of blood samples was required prior to the amplification. The production cost of DNA isolation in our PCR assay was much less in comparable to that of other DNA extraction protocols. The nested PCR detected plasmodial infection and could differentiate P. falciparum from P. vivax, and also detected the mixed infection.

Imported Malaria in United Arab Emirates: Evaluation of a New DNA Extraction Technique Using Nested PCR

Local malaria transmission in the United Arab Emirates (UAE) came to an end in 1997. Nevertheless, UAE has been subjected to substantial importation of malaria cases from abroad, concerning both UAE nationals and immigrants from malarious countries with a total number of 2,119 cases in 2007. To evaluate a new DNA extraction technique using nested PCR, blood samples were collected from 132 individuals who presented to Infectious Diseases Department in Rashid Hospital, Dubai, and Central Department of Malaria Control with fever and persistent headache. Giemsa-stained blood films and ELISA test for malaria antibodies were carried out for detection of Plasmodium infection. Plasmodium infections were identified with the genus-specific primer set and species differentiation using nested PCR. A rapid procedure for diagnosis of malaria infections directly from dried blood spots using for the first time DNA extract from FTA Elute cards was evaluated in contrast to extraction techniques using FTA classic cards and rapid boiling technique. Our new simple technique for DNA extraction using FTA Elute cards was very sensitive giving a sensitivity of 100% compared to 94% using FTA classic cards and 62% in the rapid boiling technique. No complex preparation of blood samples was required prior to the amplification. The production cost of DNA isolation in our PCR assay was much less in comparable to that of other DNA extraction protocols. The nested PCR detected plasmodial infection and could differentiate P. falciparum from P. vivax, and also detected the mixed infection.

Ocular dirofilariasis in Dubai, UAE.

A rare occurrence of ocular subconjunctival dirofilariasis in a 53-year-old healthy Indian male working in Dubai, UAE presenting with an acute red eye is reported. Surgical excision under topical anesthesia was carried out uneventfully in the outpatient clinic. The live worm removed from the subconjunctival space was identified as Dirofilaria repens on the basis of microscopic examination and histopathology. Surgical excision of subconjunctival dirofilariasis is safe in an outpatient setting and curative precluding the need for further systemic antihelminthics.

Assessment of obesity, lifestyle, and reproductive health needs of female citizens of Al Ain, United Arab Emirates.

This study was conducted to determine the reproductive and lifestyle characteristics in a representative sample (n = 535) of women in Al Ain, United Arab Emirates, to guide the development of health programmes for this population with rising affluence. A cross-sectional survey was carried out using the stratified two-stage sampling technique. Although most women were young, were pre-menopausal, did not smoke, reported good health status, and 84% (95% confidence interval [CI] 81-87%) reported being sufficiently active to meet expert recommendations, the prevalence of obesity (defined by body mass index > or = 30) was very high (35%; 95% CI 31-39%) and many (28%; 95% CI 24-32%) reported having a chronic disease. The prevalence of obesity was associated positively with age and negatively with education (p < 0.001 for both). Postmenopausal women had significantly more chronic diseases, reported poor health more often, were less physically active (p < 0.001 for all), and had a higher percentage of body fat (p = 0.002) compared to premenopausal women. Health services should emphasize the prevention and treatment of obesity and improving the general health status of postmenopausal women.

Prevalence of Helicobacter pylori infection among low socio-economic workers.

Epidemiological studies have shown that the prevalence of Helicobacter pylori infection in a community and occupational health are closely related to lifestyle and socio-economic status. There is little information on H. pylori profile in industrial workers in the literature. The aim of this study was to investigate the prevalence rate of H. pylori profiles among low socio-economic workers in the United Arab Emirates (UAE). This study was undertaken by determining IgG H. pylori antibody profiles among industrial exposed and referent workers, sera. Presence of anti-H. pylori antibodies in the frozen stored sera was determined by ELISA. Also, data on dietary and lifestyle were obtained. The result was considered positive if IgG anti-H. pylori antibody titers was > 300. People with seropositive levels of IgG antibodies to H. pylori were assumed to be infected with H. pylori. Most of the industrial workers lived in less modern accommodation, were less educated, ate their vegetable products unwashed and did not have drinking water facilities, when compared to referents. H. pylori serology by IgG was positive in 167 industrial workers (78.4%) and 137 in referent workers (64.3%) respectively, (p < 0.002). The sensitivity and specificity of the IgG serology assay were 94.5%, and 97.2% respectively. There was statistically significant difference between the exposed industrial and non-exposed control groups in respect of their H. pylori profiles.

Epidemiology and outcome of "early-onset" vs "late-onset" necrotizing enterocolitis.

OBJECTIVE: We hypothesized that among neonates with necrotizing enterocolitis (NEC), important epidemiologic and outcome differences exist between those with early-onset vs. those with late-onset NEC. METHODS: We reviewed all records of neonates cared for in the King Fahad University Hospital during the past ten years who had the diagnosis of NEC. We separated cases into two groups depending on age at diagnosis. Specifically, we termed "early-onset" those cases diagnosed during the first seven days of life, and "late-onset" those diagnosed thereafter. We compared, in the two groups, gestational age, clinical signs at onset, laboratory data, surgical findings, complications, and mortality. RESULTS: From 1989 to 1999, 37 cases of stage IIa (or higher) NEC were diagnosed; 25 "early-onset" and 12 "late-onset". Neonates with "early-onset" NEC were more mature (35.4 +/- 2.5 weeks gestation) than those with "late-onset" (27.7 +/- 2.8 weeks, P=0.0001), were more likely to have feedings begun in the first 48 hours of life (P = 0.0002), and more likely to have feeding increments of >25 ml/kg/day (P=0.03). Neonates with "late-onset" NEC were more likely to present with vomiting (P=0.003) and apnea (P=0.001), and were more likely to have ileal rather than colonic necrotic lesions, short bowel syndrome, and mortality (P=0.03). CONCLUSION: During the past 10 years at the King Fahad University Hospital, cases of early- and late-onset NEC have had distinct epidemiologic and outcome features. Recognizing these differences may be useful in prognostication and counseling.

The prevalence of Toxoplasma gondii specific IgG and IgM antibodies in blood donors in Al Ain, United Arab Emirates indicates a potential risk to recipients.

The results of a prospective cross-sectional study on the anti-toxoplasma IgG and IgM specific antibody profile among blood donors in Al Ain United Arab Emirates are presented. The overall infection rate was 34%. Based on IgM specific antibody positive rate, acute toxoplasmosis was evident among 3% of the blood donors studied. The theoretical implications of these findings are discussed.

Respiratory syncytial virus infection among hospitalized young children with acute lower respiratory illnesses in Al Ain, UAE.

To establish the frequency and clinical pattern of Respiratory Syncytial virus (RSV) infection in the region, children under 3 years of age admitted for acute lower respiratory illness during two winter seasons of the years 1993-94 and 1994-95 were studied prospectively. Seventy two cases were diagnosed to have RSV infection among the 252 studied, representing 28.57% of these patients. The overall infection rate was 32.1% and 36.5% respectively for the two studied winter seasons. Among these children, 90% were under 12 months of age. A clinical diagnosis of sepsis and respiratory distress was entertained in five RSV positive cases and they were < 1 month of age. The clinical pattern of RSV infection included bronchiolitis in 58.3% of cases, bronchopneumonia (19.4%) and pneumonia (11.1%). RSV activity was detected throughout the year with predominance during cooler months with an associated relative humidity (RH) between 50-60%. These results indicate that RSV plays a significant etiologic role among ALRI in hospitalized infants and young children in the Oasis region of the UAE. Factors such as RH, environmental temperature and lifestyle probably play an additional role in our region for the maintenance and dissemination of infection around the year.