Oral candidal colonization in cleft patients as a function of age, gender, surgery, type of cleft, and oral health.

PURPOSE: To assess the colonization rate of oral Candida species and the influence of age, gender, oral health status, number of surgeries, and type of cleft. PATIENTS AND METHODS: A prospective study of 60 patients with cleft and 60 control subjects was carried out at the Cleft Centre at King Abdullah University Hospital and the Maxillofacial Unit at Jordan University of Science and Technology between October 2007 and June 2008. Oral health was assessed using the Gingival, Plaque, and Decayed, Missing, and Filled (DMFT/dmft) indexes using World Health Organization criteria. A culture swab was obtained from the tongue and buccal and palatal mucosae. Candida albicans and other Candida species were identified using the germ tube test and the automated biochemical test panel VITEK. RESULTS: The colonization rate of Candida in patients with cleft (63.3%) was significantly higher than in healthy control subjects (18.3%). The colonization rate of Candida and the distribution of C albicans varied with age but were not significantly associated with gender in patients with cleft and healthy controls. The candidal colonization rate was highest in patients with cleft who had at least 3 surgeries (78.2%) and in patients with bilateral clefts (77.7%). Patients with cleft had a significantly poorer health status than healthy controls; however, this was not influenced by the type of the cleft or the number of surgeries. CONCLUSION: Patients with cleft had a significantly higher rate of oral candidal colonization compared with control subjects, which varied with age, type of cleft, and the number of surgical interventions. Oral health status was significantly poorer in patients with cleft.

Women's health custom made: building on the 40 days postpartum for Arab women.

The 40-day postpartum period is characterised in the Middle East and elsewhere by an observance of seclusion, congratulatory visiting, the reciprocal exchange of gifts and money, and a special diet. Based on primary data from in-depth interviews among the Negev Bedouin in Israel, health enhancing practices are reviewed. The data are a subset from a larger study carried out in this setting. Often postnatal checkups, family planning counselling, and immunization services may not be routinely available or used. It is argued that these health services could be provided at the end of the 40-day period for mother and child, as in a pilot study in Tunisia some years ago. Health service provision would thus build on the health enhancing practices of the 40-day period.

Efficacy of nuclear scintigraphy in the diagnosis and management of sinusitis.

OBJECTIVE: The purpose of this study was to determine whether or not nuclear scintigraphy is useful in the diagnosis and management of chronic sinusitis. The ideal isotope(s) and drawbacks of the different isotopes in different clinical situations are reviewed and discussed. DESIGN: A retrospective review of patients undergoing nuclear medicine studies to aid in the diagnosis and management of sinus disease was carried out. METHOD: Ideal candidates were chosen from both previously operated and unoperated patients whose computed tomography (CT) scan findings could not differentiate benign mucosal thickening from active inflammation. Nuclear scintigraphy scans using indium (In-111), gallium (Ga-67), and technetium (Tch-99m) were used to differentiate acute infection from chronic inflammation involving bone (osteitis) and/or mucosa. This information was then used to guide the management of their condition. Nuclear scintigraphy results were compared to findings on CT scan and during surgery. RESULTS: In-111 was found to be the best isotope for identifying pus or acute disease in the sinuses whereas Ga-67 was very good for identifying both chronic mucosal disease as well as acute disease. Tch-99m was very sensitive for identifying bony remodelling and was therefore not found to be useful if the patient had undergone previous sinus surgery. CONCLUSION: Although not to be considered, in our view, a first-line diagnostic test, nuclear scintigraphy, is useful in cases where CT results are nondifferentiating.