ABSTRACT
Cerebral palsy (CP) is a developmental and physical disorder with different degrees of severity. Since CP manifests itself in early childhood, numerous research studies have concentrated on children with CP. Patients with CP encounter different severity of motor impairments attributed to the damage or disturbance to the fetal or infant developing brain, which begins in early childhood and persists through adulthood. Patients with CP are more prone to mortality compared to the general population. This systematic review and meta-analysis aimed to assess the risk factors that predict and influence mortality in patients with CP. Systematic search for studies assessing the risk factors for mortality in CP patients that were conducted from 2000 to 2023 in Google Scholar, PubMed, and Cochrane Library was performed. R-One Group Proportion was used for statistical analysis and Newcastle-Ottawa Quality Assessment Scale (NOS) for quality appraisal. Of the 1791 total database searches, nine studies were included. Based on the NOS tool for quality appraisal, seven studies were of moderate quality, and two studies were rated as of high quality. The risk factors included pneumonia and other respiratory infections, neurological disorders, circulatory diseases, gastrointestinal infections, and accidents. Pneumonia (OR = 0.40, 95% CI = 0.31 - 0.51), neurological disorders (OR = 0.11, 95% CI = 0.08 - 0.16), respiratory infections (OR = 0.36, 95% CI = 0.31 - 0.51), cardiovascular and circulatory diseases (OR = 0.11, 95% CI = 0.04 - 0.27), gastrointestinal and metabolic causes (OR = 0.12, 95% CI = 0.06 - 0.22), and accidents (OR = 0.05, 95% CI = 0.04 - 0.07) were the risk factors assessed. It was concluded that multiple factors predict the risk of mortality in patients with CP. Pneumonia and other respiratory infections are associated with a high risk of mortality. Cardiovascular and circulatory diseases, gastrointestinal and metabolic disorders, and accidents are strongly linked to mortality in CP patients.
ABSTRACT
BACKGROUND: Unhealthy lifestyle behaviors are the main reason for the worldwide epidemic of chronic diseases. Changes in lifestyle, such as physical activity, healthy diet, and non-smoking, require preventive strategies at the national and individual levels. Clinical counseling is one of these strategies which helps patients to be motivated and enhance their self-management. The present study aimed to improve clinical counseling practice at the National Guard Primary Health Care Center, Jeddah, Saudi Arabia. Objective:To assess the quality of counseling from the patient's perspective in the primary care center of the National Guard (specialized polyclinic center) using a modified counseling quality instrument (CQI). Subjects and methods: In a cross-sectional study and through a convenient sampling technique from the patients visiting the National Guard Primary Health Care Center (specialized polyclinic center), 358 patients completed a self-administered questionnaire regarding their experiences of clinical counseling. The Kruskal-Wallis test was used to record the statistically significant differences between the ordinal variable of participants' quality scores and their demographic characteristics. RESULTS: The mean age of participants was 35± 8 years, ranging between 22 to 69 years. Most of the participating patients were women (63%). Slightly more than half the patients obtained clinical counseling during their appointments, and physicians at the clinic gave 57% of these clinical counseling sessions. The patients were generally satisfied with the counseling. They rated the counseling sessions as good in terms of content, the process of counseling, the way of interaction, and the degree of goal-oriented discussion. In addition to receiving counseling from physicians, older participants and those with postgraduate education were found to significantly positively affect patient perceptions of counseling quality. CONCLUSION: This study found that half of the participants did not get clinical counseling during their visits, indicating no standardization in clinical counseling services for all patients. Although patients were generally satisfied with the counseling session provided to them, time constraint was the highest dissatisfaction item among two-thirds of the patients in the present study.
ABSTRACT
BACKGROUND: Implant-supported prosthetic rehabilitation of a severely atrophic posterior mandibular alveolar ridge is a real challenge. Implant placement in such situations is very difficult and implies the risk of inferior alveolar nerve (IAN) damage. PURPOSE: The purpose of this study is to evaluate the incidence of neurosensory disturbance and the cumulative survival of dental implants placed after the IAN transposition (IANT) procedures followed by dental implants placement. MATERIALS AND METHODS: Twenty International Team for Implantology implants were placed in eight patients following unilateral IANT. In two patients, nerve transposition was performed bilaterally, and hence, a total of 10 IAN transposition surgeries were performed. Neurosensory dysfunction was objectively evaluated by using light touch test (LT), pain test (PT), and 2-point discrimination test (2-DT). In addition, patients were asked to answer a short questionnaire to investigate the individual feeling of discomfort and advantages related to this surgical technique. The mean follow-up periods were 47.1 months (range 12-78 months). RESULTS: Neurosensory disturbance (i.e., disturbance registered by the LT, PT, and 2-DT tests) was experienced in 2 of 10 cases. The cumulative implant survival was 100%. However, at the time of data analysis (12-79 months after surgery), all patients indicated that they would go through the surgery again. CONCLUSION: IANT can permit the placement of implants with adequate length and good initial stabilization as used in routine sites, with the same favorable prognosis. All patients felt that they had received benefits from their new prostheses in terms of improved comfort, chewing efficiency, and esthetics.
