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Sociodemographic and Clinical Profile of Suicide Attempts in Adults: Case of a Moroccan Hospital
Get PDFObjective: Over the past decade, and despite the increasing awareness of suicide attempts among adults in Morocco, there was no complete system of statistics. As a result, the socio-demographic profile of reported adult suicide attempts varied in some studies. The purpose of this study was to provide the socio-demographic and clinical profile of suicide attempts in adults in a Moroccan hospital.Methods: A retrospective study of a descriptive type carried out in Psychiatric University Hospital Arrazi-Salé during one and a half year (January 2016 to April 2017). The information was collected using a pre-established questionnaire based on medical records. The data entry and statistical evaluation were performed by the SPSS software (20.0).Results: A total of 62 patients were recruited, 32 women and 30 men who met the eligibility criteria. The profile of the suicidal attempters who must be kept in the hospital to prevent a suicidal recidivism is a young adult between the ages of 25 and 40, male, with psychiatric disorder: mood disorder, schizophrenia, anxiety disorder, borderline personality disorder, histrionic or psychopathic personality, alcohol or other psychoactive substance dependence, familial and emotional connectedness, material deprivation with previous suicide attempt that demonstrates the possibility of acting out because as we known that the risk of recidivism increases with the number of previous attempts.Conclusion: The development of repeated epidemiological surveys makes it possible to better understand the prevalence of suicide attempts in Morocco and to implement suicide prevention programs
Non-Invasive Ventilation in Infants Attending a Tertiary Care Center: A Retrospective Review
Get PDFBronchiolitis was found to be the greatest worldwide cause of infant hospitalization presenting with symptoms of cough, wheezes, difficulty in breathing, decreased feeding, and apneas. It is estimated that 1-3% of hospitalized infants will require treatment in an intensive care unit especially when risk factors are present. This study analyzes the use of Non-invasive ventilation (NIV) in severe bronchiolitis and its role in reducing the rate of ventilator associated pneumonia (VAP), and the duration of oxygen requirement. Data were collected retrospectively through PHENIX; hospital electronic system for infants less than one year old. Shortness of breath, cough, apnea, cyanosis, N-CPAP immediate or later after few hours, mechanical ventilation (MV), length of hospital stay, and survival status were the outcome variables. Mann-Whitney U test was performed via SPSS version 25.0.Fifty-five infants with bronchiolitis were admitted with forty-nine episodes receiving NIV or MV. A total of thirty-seven infants were treated with NIV while 15 infants were treated with MV. Fever was the major indication for initiating NIV among infants followed by cough, apnea, and shortness of breath. Insignificant evidence was reported between baseline respiratory parameters and infants receiving NIV and MV. Changes in respiratory variables in the first four hours showed significant increase for infants receiving NIV than those receiving MV. Infants receiving NIV had significantly fewer days in NIV and PICU, but insignificant fewer days in hospital stay. The experience for using NIV in infants admitted for bronchiolitis recommends that NIV might be adjunct to mechanical ventilation. This strategy was related with a lower rate of pneumonia and a shorter duration of oxygen therapy
Palatal-root Resection in Endodontic–Periodontal Combined Lesions - A Case Report
Get PDFEndodontic-periodontal combined lesion is a clinical dilemma because establishing a differential diagnosis and predicting a prognosis are difficult. A correct diagnosis is sometimes difficult; an accurate knowledge of the etiologic factors is essential for adequate choice of treatment. The management of endodontic-periodontal combined lesion demands both endodontic and periodontal therapy. Root resection therapy is one treatment option for preserving multirooted tooth with furcation involvement. This case report reviews root resective therapy and the concomitant endodontic management as a treatment option for an endo-periodontal lesion in periodontitis patients in maxillary molar. The role of root resection and treatment strategy are also discussed based on a review of the endodontic and periodontal literature
Clinical Guideline for Diagnosis and Treatment of Dens Invaginatus
Get PDFThe invaginated tooth, also called dens invaginatus or dens in dente, is a rare anomaly affecting human dentition, resulting from invagination of enamel organ into the dental papilla.Maxillary lateral incisors are the most commonly affected teeth. The accentuated pit within the DI accumulates debris causing prompt initiation and progression of dental caries with subsequent involvement of the pulp, resulting in periapical pathology. Invagination depth varies from a slight enlargement of the cingulum to an extended invagination into the apex. This anatomic variation means a true clinical challenge because of its complex anatomy. Early diagnosis is then essential to avoid any periodontal complications.This study aims to review: etiopathogenics, classification, elements of the diagnosis and provides guidelines for the management of dens invaginatus cases in clinic that provide hope for teeth that could not be saved before.
The Photodynamic Treatment of Oral Lichen Planus: A Literature Review
Get PDFLichen planus (LP) is a chronic, relapsing, non-infectious inflammatory disease affecting the skin and mucous membranes. The exact origin of oral lichen planus (OLP) is not well known. Complete spontaneous healing is rare. The treatment of oral OLP is palliative; there is no curative treatment so far which is a therapeutic challenge for practitioners. The goals of treatment are the control of pain, signs, and symptoms. Local corticosteroids remain the first-line treatment. In case of failure of drug therapy, other treatments can be considered such as photodynamic therapy (PDT). Material and methods: Our work was carried out using the PubMed, ScienceDirect, and EBSCO search engines to explore the literature on the efficacy of PDT in the treatment of lichen planus. Conclusion: PDT appears to have some effect in the treatment of OLP in adult patients. However, further randomized controlled trials with a long follow-up period, standardized PDT parameters, and comparison of PDT efficacy with steroid therapy are warranted to obtain strong conclusions in this regard
The Oral surgery in and after the COVID-19 period from the consultation to the operating room
No full textSevere acute respiratory syndrome (SARS) caused by the SARS-CoV-2 virus was first reported in Wuhan, China, in December 2019 has rapidly spread worldwide at an unprecedented rate and has profound health and socioeconomic effects directly affecting all fields. From the onset of the pandemic, the authors realized the impending impact on the dental field. Dental professionals are uniquely exposed to environments with high levels of infection risk from aerosols and oral fluids. Dental treatment has become a challenge during the epidemic. However, the light of optimism has faded with the onset of vaccination.
The purpose of this article is to provide guidance to dental surgeons on how to adapt their current practice during and after the COVID-19 pandemic with respect to consultation activity, surgical activity, and drug prescribing in oral surgery. Thus, an electronic search was performed from PubMed (MEDLINE), Scopus, Cochrane, Google Scholar and Sciencedirect databases. 35 articles were identified of which 24 were selected to compose this article. Within the limitations of this literature review, the presence of the virus is inevitable in oral surgery practice. Dentists must continue to provide care to their patients while monitoring the evolution of Covid-19
The Balance between Oral Health Needs and Supply Induced Demand in Welsh Dental Services
No full textIntroduction: Reducing social inequality along with oral health inequality in Wales is a policy objective. In this ecological study the relationships between deprivation, dental workforce and oral health are explored. Method: Twenty two Unitary Authorities (UAs) serving the population of Wales were studied. The number of dentists were obtained from NHS Business Services as well as the 2019 population figures from StatsWales. As data for whole time equivalent General Dental Practitioner (GDP) workforce were not available, GDP sites were used. The condition of teeth at the age 12 years was used as a measure of oral health from the most recent epidemiological survey available. The relationship between oral health and workforce was established using the Welsh Index of Multiple Deprivation (WIMD).Results: Associations were observed between dental sites and population as well as between oral health and deprivation. A new composite variable called the University of South Wales Dental Index (USWDI) was introduced by combining the number of dentists with their corresponding WIMD of the most deprived 10% of the population. Using regression modelling the USWDI demonstrated its superiority in using either the number of dentists or the WIMD most deprived 10% alone to predict decayed, missing and filled teeth (DMFT).Conclusion: Workforce levels have increased and there has been a corresponding improvement in oral health over two decades. At the same time deprived subgroups continue to experience relatively higher levels of disease. A proportion of the general dental services delivered in Wales has continued to be based on the principle of supply induced demand for care rather than oral health need. Improving oral health in a diverse population like Wales cannot be achieved by increasing dental workforce alone. It is necessary to account for levels of deprivation. USWDI as a predictor of DMFT could be a useful tool to monitor the macro delivery of oral health care for the future in Wales
Contribution to the Assessment of the Quality of the Pre-Analytical Phase of Medical Biology Tests at the Ibn Sina University Hospital in Rabat
Get PDFThe study of the nonconformities (NC) literatures in medical biology report that between 60-85% of laboratory errors are produced during the pre-analytical phase, which are often external and escapes the biologist's control. The objective of our study was to identify the factors at the origin of non-conformities during this phase at the University Hospital of Rabat. A mixed analytical descriptive study realized between August 2019 and August 2020 based on a non-compliance form, a self-questionnaire, an observation grid, focus groups and semi-structured interviews. We also set up the Deming wheel PDCA as well as the work tools (BRAINSTORMIN, 5M, ISHIKAWA). Our results show that 22 % of the prescriptions of biologic tests are drafted by nurses and not doctors this in the absence of an updated list of biological exams. The samples are taken at 88,1% by unqualified personnel and 95 % without any guide or manual. For the traceability aspect, the name of the sampler is never placed on the sheet of examination, age, sex of the patient; time and nature of the sample are often not mentioned in the label vials of samples. Transportation is made by pneumatic cylinder system and sometimes by unqualified staff in absence of procedures for packaging and transportation equipment without traceability. The reception of samples is carried out by untrained staff on the error management of the pre-analytical phase. They result at first from a major defect of coordination between the laboratory and the services, then by the lack of continuing education and the weak competence of the staff involved in this process and finally compounded by the lack of manual sampling, procedures for packaging, transport, reception and triage
Effect of Accelerating Aging on Retention and the Release Period of Clips in a Bar Retained Maxillary Implant Overdenture
Get PDFObjectives: This study was made to detect the effect of accelerating aging on retention and measuring the release period of clips in a 2 and 3 bar retained maxillary implant overdenture. Materials and Methods: Four implants were placed in two maxillary edentulous epoxy models. One model had two bar attachments with two clips overdenture while the other model had three bar attachments with three clips in the overdenture. Retention and release period of the clips were checked before applying insertion removal cycles. Retention was measured using a universal testing machine after 540 cycles (6 months) and 1080 cycles (1 year) of insertion removal on a chewing simulator.Results and Conclusions: There was a significant difference in retention and release period between two bars and three bars implant retained maxillary overdentures. A significant difference was also seen in each group after accelerated aging. Therefore, the three bar implant retained overdenture had higher retention values than two bar. Retention loss occurred in both groups after the insertion removal cycles. Release period value was lower in two bar overdenture than three bar overdenture
The Combination of Anti-Thymocyte Globulin and Basiliximab for Haploidentical Hematopoietic Stem Cell Transplantation
Get PDFObjectives: Identical hematopoietic stem cell transplantation (haplo-HSCT) is associated with a higher risk of graft rejection when compared to matched sibling donor transplantations. Methods: The study included 34 patients who were treated with a novel regimen combining basiliximab, Anti-thymocyte globulin (ATG) and conventional immunosuppressive in the recipients of haplo-HSCT. Results: The cumulative incidence of grade II–IV and grade III–IV aGVHD was 38.2% and 11.8%, while the rates of limited and extensive cGVHD were 17.6% and 23.5%, respectively. Laboratory evidence of CMV and EBV reactivation were found in 9 patients (26.5%) and 6 patients (18.8%), respectively. The relapse rate of haplo-HSCT was 14.7% at 1 year; and 1-year OS and DFS were achieved in 58.8% and 55.9% of the patients, respectively. Conclusions: The results suggested that basiliximab combined with low-dose ATG could be a promising treatment strategy in haplo-HSCT