ABSTRACT
Objectives: This is a field survey aimed to assess the status of the present dental and oral health services at Gezira Locality. The facilities included were those in urban and rural areas including Wad Medani Dental Hospital; Wad Medani Military Hospital; El Gadaiea Health Centre and Marinjan Health Centre. Material and methods: The study tools were direct pre-coded questionnaires; and a checklist. The procedure involved dental clinics to estimate the dental health services by assessing status of personnel; equipment and materials. A checklist was used to assess the personnel; equipment and instruments. Results: Thirty study sites in the rural area were chosen from five study councils which included Alhosh; Wad Alnaeem; Alhag Abdalla; Almadina Arab and Hantoub. They comprise 418 towns; villages and camps; of these only 118 with health services. In these there are only 4 dental units; three of them were incomplete; all of them were operated by dental assistants; while the only complete unit was operated by a medical assistant. This result revealed absolute lack of dental services in rural areas. The present units are old and most of them were not functioning. This was the reason that most of ruralpopulation seeks oral health services for periodontal diseases and dental caries in Wad Medani health institutions. Most of the patients irrespective of their residence; preferred treatment at private dental clinics because they expect better care due to good facilities. The results also revealed a poor level of oral health services reflected by the presence of a high level of decayed and missing component of DMFT. Conclusion: It is concluded that there is poor provision of dental services in both quantity and quality at Gezira Locality. It recommended that the dental services in Gezira Locality have to be restructured to improve their quantity; quality and efficiency
Subject(s)
Dental Health Surveys , Health Services , Oral HealthABSTRACT
The purpose of this study was to determine if immune mechanisms in GAD positive patients' contribute to the pathogenesis of a specific sub-type of Type 2 diabetes. GAD positive (n=8) and GAD negative (n=8) subjects diagnosed with Type 2 diabetes were matched for age, gender, body mass index, duration of diabetes and glycaemic control. All subjects underwent an insulin-modified frequently sampled intravenous glucose tolerance test to measure insulin sensitivity and insulin secretory function with minimal model analysis. In addition, BRIN-BD11 clonal beta-cells were supplemented with patients' sera to determine basal and alanine-stimulated insulin secretion and terminal complement complex (TCC) formation. Both groups were severely insulin resistant (0.56+/-0.17 vs. 0.99+/-0.3310(-4)min(-1)/(microUml(-1)) for GADneg and GADpos, respectively) but the GAD negative subjects had a higher basal (87+/-11 vs. 58+/-14pmoll(-1), p<0.05) and glucose-stimulated insulin secretion (DeltaAUCins 0.96+/-0.12 vs. 0.60+/-0.12pmol/(l(-1)min), p<0.05). In vivo measures of insulin secretion were negatively correlated with TCC formation, independent of antibody status. In conclusion, GAD positive subjects initially diagnosed with Type 2 diabetes are unable to compensate for insulin resistance due to more pronounced beta-cell impairment. TCC formation may be partly responsible for the insulin secretory dysfunction associated with this specific sub-type of Type 2 diabetes.
