Knowledge, behaviours and beliefs of parents regarding the oral health of their children.

AIM: The purpose of this study was to assess the Saudi parent's knowledge, behaviours, and beliefs regarding the oral health of their children. MATERIALS AND METHODS: Parents answered a questionnaire, which included questions about parental knowledge, behaviours, and beliefs regarding dental caries development, baby bottle use, and how to care for children's oral health as well as the reasons for their children's first visit to the dentist and other questions. RESULTS: There was a statistically significant difference in the mean scores of knowledge of participants, across all age groups. Age, number of children, and education level were statistically significantly related to the mean scores of behaviours. Beliefs scores of participants indicated statistically significant difference in relation to the education level, monthly family income, and use of smart phone. CONCLUSION: There is discrepancy between parental knowledge, behaviours, and beliefs regarding oral health of their children and there is association of these variables with their sociodemographic status.

Comparison of Saudi child versus parent-report of child tooth-brushing practices.

OBJECTIVE: This cross-sectional study compared Saudi children's tooth-brushing practices as reported by children and parents and then matched the agreement of reports. MATERIALS AND METHODS: A sample of 100 Saudi parents and their children of ages 8-12 years participated in this cross-sectional investigation. A self-administered structured questionnaire regarding the current tooth-brushing practice and habits at home was filled by the child. The same questionnaire was filled independently by parents. RESULTS: Mothers were more likely to teach children about tooth-brushing and fathers were minimally helping children during tooth-brushing. Mothers were the first to teach the children and approximately 33% of the children started brushing their teeth by age 5. Children and parents reported that children clean their teeth using a tooth-brush (73.74% and 76.77%), miswak (5.05% and 5.05%), or both (21.21% and 18.18%), respectively. CONCLUSIONS: There was some agreement between reported tooth-brushing practice of children and their parents. It is important to question both the child and parent regarding oral hygiene practice and compare their answers to get more broad knowledge about their practices. Approximately, one-third of the children started brushing their teeth by age 5, which differs from recommended oral hygiene practices.

Evaluation of tablet PC as a tool for teaching tooth brushing to children.

AIM: This study evaluated the effect of a single time tooth brushing instruction using video on a tablet PC (Apple iPad) compared to operator presentation using jaw model for plaque removal. METHODS: This cross-sectional study included a convenience sample of 100 children divided into two groups. For Group 1 brushing was demonstrated to the child by the operator with the use of a jaw model. This demonstration was videotaped for subsequent use in Group 2 using a tablet PC (Apple iPad). Plaque index was recorded before and after demonstration of the assigned method of teaching tooth brushing. RESULTS: The results showed a significant difference using the two methods. The difference between the mean plaque index values with the jaw model and tablet PC at baseline and after tooth brushing represented 17.27% (50% improvement) and 11.56% (34% improvement) respectively. Boys showed a 18.3%. higher improvement in tooth brushing compared to girls. Seventy-five percent of the children reported using tablet computers in their daily life. CONCLUSION Teaching children by using a jaw model was more effective in improving plaque index score than using video on tablet PC by 16%. Both methods of tooth brushing teaching were fully accepted by all children.

The effect of cavity disinfectants on microleakage of composite restorations in primary teeth.

AIM: The purpose of this study was to determine the effect of different cavity disinfectants on microleakage of Class V resin- based composite restorations in primary teeth. MATERIALS AND METHODS: Standard non-beveled Class V cavities were prepared on 50 human primary anterior teeth with the incisal and cervical margin placed on the enamel. The crowns were randomly divided into 6 groups. Four experimental groups of 10 teeth each, in which cavities were disinfected using the following solutions: 1) S. persica extract (Ethanol 1 mg/ml); 2) 1.3% sodium hypochlorite (NaOCl); 3) 0.2% chlorhexidine gluconate (CHX), and 4) No solution applied. Two control groups; 5 teeth each; 5) Negative control: filled cavity and entirely coated with nail varnish and 6) positive control: empty cavity and without nail varnish coating. Each cavity in groups 1-5 were filled with Filtek Z350 XT Universal Restorative (3M Espe, St. Paul, USA). All specimens were thermocycled for 500 cycles (5°C/55°C) and prepared for microleakage evaluation using a 2% methylene blue. RESULTS: For the experimental groups; there was no significant difference in dye penetration between the incisal and cervical walls in all groups (P=0.176). However comparing microleakage by location/walls showed a significant difference in dye penetration between the incisal walls (P=0.014) and cervical walls (P=.045). CONCLUSIONS: None of the disinfectant solutions in the experimental groups were able to prevent dye penetration. In comparison to chlorhexidine gluconate and sodium hypochlorite; application of S. persica did not increase microleakage and was not detrimental to enamel and dentin adhesion using the restorative technique and materials used in this study.

Effect of Honey and Green Tea Solutions on Streptococcus mutans.

OBJECTIVES: The aim of this cross-sectional in vivo study was to assess the effect of green tea and honey solutions on the level of salivary Streptococcus mutans. STUDY DESIGN: A convenient sample of 30 Saudi boys aged 7-10 years were randomly assigned into 2 groups of 15 each. Saliva sample was collected for analysis of level of S. mutans before rinsing. Commercial honey and green tea were prepared for use and each child was asked to rinse for two minutes using 10 mL of the prepared honey or green tea solutions according to their group. Saliva samples were collected again after rinsing. The collected saliva samples were prepared and colony forming unit (CFU) of S. mutans per mL of saliva was calculated. RESULTS: The mean number of S. mutans before and after rinsing with honey and green tea solutions were 2.28* 10(8)(2.622*10(8)), 5.64 *10(7)(1.03*10(8)), 1.17*10(9)(2.012*10(9)) and 2.59*10(8) (3.668*10(8)) respectively. A statistically significant reduction in the average number of S. mutans at baseline and post intervention in the children who were assigned to the honey (P=0.001) and green tea (P=0.001) groups was found. CONCLUSIONS: A single time mouth rinsing with honey and green tea solutions for two minutes effectively reduced the number of salivary S. mutans of 7-10 years old boys.

The impact of recent advances in laboratory astrophysics on our understanding of the cosmos.

An emerging theme in modern astrophysics is the connection between astronomical observations and the underlying physical phenomena that drive our cosmos. Both the mechanisms responsible for the observed astrophysical phenomena and the tools used to probe such phenomena-the radiation and particle spectra we observe-have their roots in atomic, molecular, condensed matter, plasma, nuclear and particle physics. Chemistry is implicitly included in both molecular and condensed matter physics. This connection is the theme of the present report, which provides a broad, though non-exhaustive, overview of progress in our understanding of the cosmos resulting from recent theoretical and experimental advances in what is commonly called laboratory astrophysics. This work, carried out by a diverse community of laboratory astrophysicists, is increasingly important as astrophysics transitions into an era of precise measurement and high fidelity modeling.

S1(1A1)<--S0(1A1) transition of benzo[g,h,i]perylene in supersonic jets and rare gas matrices.

The study of the S1(1A1)<--S0(1A1) transition of benzo[g,h,i]perylene (BghiP, C22H12) in supersonic jets and solid rare gas matrices is reported. In the jet-cooled spectrum, the origin band position is located at 25,027.1+/-0.2 cm-1, the assignment being supported by the analysis of vibrational shifts and rotational band contours. Except for the origin band, which is weak, all bands are attributed to the fundamental excitation of nontotally symmetric b1 vibrational modes of S1. The intensity pattern is interpreted as a consequence of the weak oscillator strength of the electronic transition combined with intensity-borrowing through vibronic interaction between the S1(1A1) and S2(1B1) states. The spectra of the S1(1A1)<--S0(1A1) and S2(1B1)<--S0(1A1) transitions have also been measured for BghiP in solid neon and argon matrices. The comparison of the redshifts determined for either transition reveals that the polarizability of BghiP is larger in its S2 than in its S1 state. Bandwidths of 2.7 cm-1 measured in supersonic jets, which provide conditions relevant for astrophysics, are similar to those of most diffuse interstellar bands. The electronic transitions of BghiP are found to lie outside the ranges covered by present databases. From the comparison between experimental spectra and theoretical computations, it is concluded that the accuracy of empirical and ab initio approaches in predicting electronic energies is still not sufficient to identify astrophysically interesting candidates for spectroscopic laboratory studies.

Numerical investigation of the discharge characteristics of the pulsed discharge nozzle.

The characteristics of the plasma generated by a pulsed discharge slit nozzle (PDN) are investigated. The PDN source is designed to produce and cool molecular ions creating an astrophysically relevant environment in the laboratory. A discharge model is applied to this system to provide a qualitative as well as a quantitative picture of the plasma. We find that the plasma's properties and behavior are characteristic of those of a glow discharge. We model the electron density and energy, as well as the argon ion and metastable atom number density. The results reveal a high abundance of metastable argon atoms in the expansion region, which is more than one order of magnitude higher than the abundance of electrons and ions. These findings confirm experimental observations, which concluded that large molecular ions are dominantly formed through Penning ionization of the neutral molecular precursors seeded in the supersonic expansion of argon gas. The simulations presented here will help optimize the yield of formation of molecular ions and radicals in the PDN source; they will also provide key physical insight into the characteristics of interstellar molecules and ions analogs in laboratory experiments.

Validation of the spectrophotometric determination of omeprazole and pantoprazole sodium via their metal chelates.

Spectrophotometric procedures for the determination of two irriversible proton pump inhibitors, omeprazole (OMZ) and pantoprazole (PNZ) sodium have been developed, the procedures are based on the formation of 2:1 chelates of both drugs with different metal ions. Pantoprazole sodium is quantified by a stability-indicating procedure through chelation with iron (III) in aqueous-ethanol medium to form an orange chelate picked at 455 nm. The procedure retains its accuracy in presence of up to 70% of its degradate, sulfenic acid prepared by degrading the pure drug in borate buffer of pH 8 at 37 degrees C for 5 days. The colored chelates of OMZ in ethanol are determined spectrophotometrically at 411, 339 and 523 nm using iron (III), chromium (III) and cobalt (II), respectively. Regression analysis of Beer's plots showed good correlation in the concentration range of 15-95, 10-60 and 15-150 microml(-1) of pure OMZ using iron (III), chromium (III) and cobalt (II), respectively, and in the range of 30-300 microg ml(-1) of PNZ sodium using iron (III). The limits of detection are 0.22-3.65 microml(-1) while limits of quantitation range between 0.74 and 12.17 microg ml(-1). The optimum assay conditions are investigated and the recovery of the cited drugs from their dosage forms ranges from 97.2 to 100.3%. Good values of precision are obtained, intraday R.S.D. are 0.93-1.75% and the inter day R.S.D. are 0.51-3.29%.

Marginal seal of sealant and compomer materials with and without enameloplasty.

OBJECTIVES: This in vitro study evaluated the quality of marginal seal and fissure penetration of a resin-sealant (Concise) and a compomer restorative material (F2000) with and without enameloplasty. SAMPLE AND DESIGN: Thirty extracted sound human permanent third molar teeth were divided into six groups of five and used in this in vitro study. METHODS: Occlusal surfaces of the teeth in different groups were either left intact or prepared using a #582 S diamond bur. Teeth were then restored with Concise and F2000 restorative materials using combinations of different surface treatments. Teeth were prepared for microleakage, then immersed in 5% methylene blue for 4 h, and subsequently sectioned into four bucco-lingual sections. Sections (20 per group) were examined using a stereomicroscope. The following parameters were evaluated: marginal leakage, marginal gap, voids and filling defects, as well as enamel fissure penetration. RESULTS: Kruskal-Wallis one-way ANOVA showed statistically significant differences between the groups for marginal leakage (P < 0.0001), marginal gap (P < 0.001), and enamel fissure penetration (P < 0.001). No statistically significant differences between the groups for voids and filling defects were detected. Non-parametric Tukey's multiple range test showed that microleakage of sealant with acid etch and tooth preparation and compomer with acid etch, bonding agent and tooth preparation were statistically significantly less than that of compomer with bonding agent and no tooth preparation (P < 0.0001) and compomer with bonding agent and tooth preparation (P < 0.01). CONCLUSIONS: Microleakage is similar when sealant with acid etching, and compomer with acid etching and bonding agent, are used with and without enameloplasty. Marginal gap is more evident in the compomer group with bonding agent and without enameloplasty. Enamel fissure penetration is better when enameloplasty and acid etching are used.

Pneumonectomy for non-small cell lung cancer: predictors of operative mortality and survival.

OBJECTIVE: The purpose of this study was to identify predictors of operative mortality and survival following pneumonectomy for non-small cell lung cancer (NSCLC). METHODS: All 206 patients having a pneumonectomy for NSCLC between 1991 and 1997 in our unit were prospectively studied. There were 162 males (79%) and 44 females (21%) with a mean age (+/- standard deviation) of 61+/-7.7 years (range 34-81 years). Squamous cell (75%) and adenocarcinoma (17.0%) were the predominant histological types. The possible impact of 29 parameters on operative mortality and survival was tested with univariate and multivariate analysis. The mean follow-up was 2.3+/-1.2 years, ranging between 0 and 6.8 years, and it was complete. RESULTS: Operative mortality was 6.8% (14 deaths). On multiple logistic regression older age (P=0.04) and the development post-operatively of bronchopleural fistula (BPF) (P=0.01) were independent predictors of operative mortality. The overall, Kaplan-Meier, 1-, 3- and 5-year survival (+/- standard error from the mean), inclusive of operative mortality, was 68+/-3.3, 42+/-4.1 and 35+/-4.5%. On Cox proportional hazards regression adenocarcinoma (P=0.006), the development of BPF (P=0.003), older age (P=0.03) and higher pathological stage (P=0.02) were independent adverse predictors of survival. CONCLUSION: Pneumonectomy for NSCLC carries a considerable, but acceptable, operative mortality and provides an important survival benefit. This study suggests that older age and BPF are major determinants of an unfavourable in-hospital outcome; older age, BPF, adenocarcinoma cell type and higher pathological stage significantly reduce the probability of a long-term survival.

Shear bond strength of six restorative materials.

The purpose of this study was to determine and compare the shear bond strength of a conventional glass-ionomer cement, a resin modified glass-ionomer, a composite resin and three compomer restorative materials. Dentin of the occlusal surfaces from sixty extracted human permanent molars were prepared for shear bond strength testing. The specimens were randomly divided into six groups of 10 each. Dentinal surfaces were treated according to the instructions of manufacturers for each material. Each restorative material was placed inside nylon cylinders 2 mm high with an internal diameter of 3 mm, which were placed perpendicular to dentin surfaces. Shear bond strengths were determined using an Universal Testing Machine at crosshead speed of 0.5 mm/min in a compression mode. Conventional glass-ionomer, Ketac-Molar aplicap showed the lowest mean shear bond strength 3.77+/-1.76 (X +/- SD MPa) and the composite resin, Heliomolar showed the highest mean shear bond strength 16.54+/-1.65 while the mean bond strength of Fuji II LC was 9.55+/-1.06. The shear bond strengths of compomer restorative materials were 12.83+/-1.42, 10.64+/-1.42 and 11.19+/-1.19 for Compoglass, Hytac and Dyract respectively. ANOVA revealed statistically significant differences in the mean shear bond strengths of all groups (P<0.001). No statistically significant difference was found between the three compomer materials (P>0.5). Ketac-Molar and composite resin showed statistically significant difference (P<0.0005). The mode of fracture varied between materials. It is concluded that the compomer restorative materials show higher shear bond strength than conventional glass-ionomer and resin modified glass-ionomer, but less than composite resin. The fracture mode is not related to the shear bond strengths values.

Airway fire during tracheostomy: prevention strategies for surgeons and anaesthetists.

Airway fires are an uncommon but real and devastating complication of tracheostomy. One such fire in a 31-year-old man is described. Surgical fires are discussed, and 15 reported cases of tracheostomy fire are reviewed. A tracheostomy protocol, adopted by our department and designed to avoid this life-threatening complication, is described. Surgeons and anaesthetists involved in tracheostomy must understand the fire hazard and how to avoid it.

Surgical treatment of para-oesophageal hiatal hernia.

The development of laparoscopic antireflux surgery has stimulated interest in laparoscopic para-oesophageal hiatal hernia repair. This review of our practice over 10 years using a standard transthoracic technique was undertaken to establish the safety and effectiveness of the open technique to allow comparison. Sixty patients with para-oesophageal hiatal hernia were operated on between 1989 and 1999. There were 38 women and 22 men with a median age of 69.5 years. There were 47 elective and 13 emergency presentations. Operation consisted of a left thoracotomy, hernia reduction and crural repair. An antireflux procedure was added in selected patients. There were no deaths among the elective cases and one among the emergency cases. Median follow-up time was 19 months. There was one recurrence (1.5%). Seven patients (12%) required a single oesophagoscopy and dilatation up to 2 years postoperatively but have been asymptomatic since. Two patients (3%) developed symptomatic reflux which has been well controlled on proton-pump inhibitors. Transthoracic para-oesophageal hernia repair can be safely performed with minimal recurrence.

A tailored surgical approach for gastro-oesophageal reflux disease: the Nottingham experience.

OBJECTIVE: The objective was to assess the results which can be achieved by tailoring the anti-reflux procedure to the anatomical and functional situation of the patient with gastro-oesophageal reflux disease (GORD). PATIENTS AND METHODS: Two hundred and seventy six patients undergoing a primary tailored anti-reflux procedure between 1986 and 1996 were evaluated. An anti-reflux procedure was selected on the basis of the anatomical and functional findings assessed by means of barium video, endoscopy, manometry and prolonged pH monitoring. The operations performed were Nissen fundoplication (77), total fundoplication gastroplasty (TFG; 140) and Belsey Mark IV (BMIV; 59). The unit policy is for life-long follow-up. The symptoms at review were assessed and graded according to previously published criteria (Orringer MB, Skinner DB, Besley HR. Long-term results of the mark IV operation for hiatal hernia and analyses of recurrences and their treatment. J Thorac Cardiovasc Surg 1972;63:25-31). Patients with recurrent symptoms were fully re-investigated. RESULTS: Mean hospital stay was 8.2 days (5-32 days). There was one hospital death (0.36%). Mean follow-up was 6.7 years (range, 2.2-13.1 years). Overall excellent or good results were achieved in 247 (89.5%) patients (92.2% in Nissen, 90.7% in TFG and 83.1% in BMIV group, P=0.1). In patients without oesophagitis (n=72), the success rate was 93.1%, while for patients with grade IV oesophagitis (n=89) this was 87.6% (P=0.2). Kaplan-Meier freedom from recurrent or new, operation-induced, symptoms at 10 years was 88.1% (89.5% in Nissen, 87.4% in TFG and 73.8% in BMIV groups, P=0.08). CONCLUSIONS: These data suggest that where the appropriate anti-reflux procedure is selected, surgery can achieve satisfactory mid- and long-term success rates across the spectrum of GORD. When oesophageal shortening is evident, or merely suspected, we favour a TFG. In the presence of impaired motility and no evidence of oesophageal shortening, a BMIV is the preferred approach. The Nissen procedure is used for uncomplicated cases.

An atypical presentation of spontaneous pneumomediastinum.

Spontaneous pneumomediastinum is a rare condition and a most uncommon complication of sporting activity. We describe a case of spontaneous pneumomediastinum in a 17-year-old boy while playing football with no history of blunt trauma to the chest. The patient presented with symptoms and signs suggestive of an oesophageal perforation. The importance of correct investigations and subsequent management are discussed.

Comparison of long-term results of total fundoplication gastroplasty and Belsey Mark IV antireflux operations in relation to the severity of oesophagitis.

OBJECTIVE: Belsey Mark IV (BM IV) and total fundoplication gastroplasty (TFG) were the standard anti-reflux operations in two consecutive periods in Nottingham City Hospital Thoracic Surgery Unit. The aim of this study was to compare the long-term results obtained by these two procedures emphasizing their relation to the severity of the oesophageal mucosal damage. METHODS: Ninety patients (50 females and 40 males with a mean age of 57 years) who had a BM IV operation between 1976 and 1983 and 86 patients (46 females and 40 males, with a mean age of 56.5 years) undergoing a TFG procedure between 1983 and 1986 were evaluated. All patients were assessed preoperatively by means of clinical history, barium meal and endoscopy. In addition, 72 of the patients having a TFG had prolonged pH monitoring and manometric studies. The unit policy is for life-long follow-up. The symptoms at review were assessed and graded according to the criteria published by Orringer et al. (Orringer MB, Skinner DB, Belsey RHR. Long-term results of the Mark IV operation for hiatal hernia and analyses of recurrences and their treatment. J Thorac Cardiovasc Surg 1972;63:25-33). RESULTS: In the BM IV group there was one post-operative death (1.1%). The median follow-up was 11 years (range 3-18 years). Overall good results were achieved in 64 patients (71.9%). In patients without oesophagitis (n = 24) the success rate was 91.7% while for grades I (n = 17), II-III (n = 36) and IV (n = 12) oesophagitis this was 76.5, 66.7 and 41.7%, respectively (P = 0.01). The actuarial success rate at 10 through to 18 years was 71.0%. In the TFG group there was no postoperative death. The median follow-up was 10 years (range 2-14 years). Overall good results were achieved in 78 patients (90.7%). In the absence of oesophagitis (n = 10) the success rate was 90.0% and for grades I (n = 12), II-III (n = 26) and IV (n = 38) oesophagitis this was 91.6, 92.3 and 89.4%, respectively. The actuarial success rate at 10 through to 14 years was 90.3%. The differences in the overall success rate (P = 0.002), the success rates forgrades II-III (P = 0.02) and IV (P = 0.001) oesophagitis and the long-term actuarial success rates (P = 0.001) were significant. CONCLUSION: These data provide evidence on the superiority of the TFG against the BM IV in achieving long-term relief of reflux symptoms in the presence of severe oesophagitis. We believe that failure of BM IV in this setting is due to obvious or subtle oesophageal shortening.

Jet-discharge cavity ring-down spectroscopy of ionized polycyclic aromatic hydrocarbons: progress in testing the PAH hypothesis for the diffuse interstellar band problem.

Naphthalene cations (C10H+8) were produced in a slit jet coupled with an electronic discharge, and cavity ring down was used to obtain its absorption spectrum in the region 645-680 nm. Two of the strongest C10H+8 bands previously characterized by matrix isolation spectroscopy were found, both with a fractional blue shift of about 0.5%. This is the first gas-phase electronic absorption spectrum of an ionized polycyclic aromatic hydrocarbon (PAH). This work opens the way for a direct comparison of laboratory PAH spectra with the diffuse interstellar bands (DIB), the origin of which still constitutes an open problem in astrophysics.

Polycyclic aromatic hydrocarbons and the diffuse interstellar bands: a survey.

We discuss the proposal relating the origin of some of the diffuse interstellar bands (DIBs) to neutral and ionized polycyclic aromatic hydrocarbons (PAHs) present in interstellar clouds. Laboratory spectra of several PAHs, isolated at low temperature in inert gas matrices, are compared with the spectra of five reddened early-type stars selected from an extensive set of astronomical spectra. From this comparison, it is concluded that PAH ions are good candidates to explain some of the DIBS. Unambiguous assignments are difficult, however, because of the shift in wavelengths and the band broadening induced in the laboratory spectra by the solid matrix. This situation is illustrated by a comparison with the gas-phase spectra made available recently for two PAH ions. Definitive band assignments and, ultimately, the test of the proposal that PAH ions carry some of the DIBs must await the availability of a larger set of gas-phase measurements in the laboratory. The present assessment offers a guideline for future laboratory experiments by allowing the preselection of promising PAH molecules to be studied in jet expansions.