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Endo-Periodontal Lesion in a Patient with Diabetes: A Case Report
No full textEndodontic infection is more prevalent in patients with diabetes. This has been reported in a number of histological and microbial studies. Nevertheless, clinical aspects of this relationship remain poorly documented. The present case report illustrates an acute endo-periodontal lesion with a purulent exudate in a 39-year-old female patient with type I diabetes and highlights successful management of endodontic and periodontal infection in a patient with uncontrolled diabetes
Music, Arts and Cognitive Behavioural Therapy to Treat Sleep Disorders
Get PDFInsomnia is a global burden. Cognitive-behavioural therapy models for treating pathological sleeplessness have significant effect sizes, hence the common recommendation of CBT-I. Akin to this approach, the present article presents a novel model which relates to the broader spectrum of sleep disorders and involves music-and arts specific health benefits such as (i) vocal rituals as soothing sleep cues and means to make irritating cognitions fade, (ii) control of sleepiness and inappropriate daytime naps through music-based martial arts techniques, (iii) voice-and movement-based relaxation and psychosomatic re-balancing, as well as profound music immersion and music-induced altered states of consciousness, (iv) arts-based psychotherapy to cope with pathological factors, such as nightmare objects and (v) psychoeducation to understand the benefits of the arts for healthy sleep. Cultural features of sleep habits, differences between face-to face and online practices, individualized arts-based CBT, and the multidimensional healing power of the arts are discussed and encourage further research to optimize personalized and standardized arts-based cognitive behavioural therapy in sleep medicine and public health
Using the Diffusion-of-Innovation Theory to Examine Factors Influencing the Implementation of an Electronic Medical Record in Obstetrics
Get PDFObjectives: The objectives of the present study were to assess the perceptions of physicians and midwives using an Obstetric Electronic Medical Record (EMR) software and apply the diffusion-of-innovation theory to examine the factors that users perceive as influencing the implementation of EMRs.Patients and methods: Type of study: This is a mixed study after implementing an EMR. Study location: Dakar, Senegal. Methodology: We designed an online questionnaire sent to all users of the software. The questionnaire included three parts: a section collecting the sociodemographic and professional characteristics of the participants; a section about the usage of the software, the impact on the organization, the advantages, and limits; the last section where the users reported their degree of satisfaction and the extent to which they would be willing to recommend the software based upon their experience. The questionnaire was completely anonymized and accessible to physicians wishing to take the survey. Consent was first requested from the participants.Results: Of the 60 physicians approached, 51 (85%) agreed to participate in this study. Of them, 62.7% were women, and the average age and experience were 32.3 years and 22.1 months, respectively. Overall, the software was perceived as simple, intuitive, and designed for an obstetrician. However, some physicians reported several drawbacks, including the time needed to type in the information, especially when they were on duty with a heavy workload, lack of sufficient computers, and some bugs. More than half of the participants agree that being young is not necessary to use the software optimally. However, an ideal user should be open-minded and cope with change. On a 0–10-scale, participants stated that they were satisfied with the software, that it positively impacted their department's organization, and that they would recommend the software, with all medians above 8.Conclusion: Identifying the determinants of adopting the EMR is crucial for its successful implementation and dissemination. User responses will help fine-tune implementation strategies to promote better integration of this technology into medical practices beyond our facility
Evaluation of the Respect of the Root Canal Trajectory by Rotary Niti Instruments (Protaper®Universal): A Retrospective Radiographic Study
Get PDFIntroduction: Root canal shaping is the critical step in endodontic therapy. Perioperative errors, such as false canal stripping, may occur during this step. The endodontic instrumentation based on stainless steel is often the cause of these errors because of the rigidity of the alloy on which it is manufactured. Unlike the endodontic NiTi instrumentation, this allowed better respect of the root canal path, thanks to the flexibility of the NiTi alloy. Materials and Methods: This study aimed to assess the respect of the root canal path by the rotary NITI instruments of the ProTaper® Universal system. This is a retrospective radiological study of 241 canals whose shaping was performed by the rotary ProTaper® Universal system in the Department of Conservative Dentistry & Endodontics at the Dental Treatment and Consultation Center (CCTD), CHIS, Rabat. Results: We noted the occurrence of preoperative incidents at various percentages. The incidence rates were as follows: the ledge with an incidence rate of 3.3%, the false canal with 2.1%, and the stripping with 5.4%; however, zipping had an incidence rate of 1.7%. We also determined a relationship between stripping and a tight preoperative root canal angle. Conclusion: All results suggest the reproducibility of the rotating ProTaper® Universal system
A Retrospective Study of Microbial Profile of Head Injury and Stroke Patients Admitted in EMCH, Savar, Dhaka, Bangladesh
Get PDFIntroduction: Many head injury patients have reduced consciousness, are prone to aspiration of oral secretions, and likely develop pneumonia. Respiratory tract infection (RTI), especially pneumonia, is a very common disease in neurosurgical intensive care units (NSICU).Objective: This study evaluates the microbial profile of head injury and stroke patients admitted to Enam Medical College & Hospital (EMCH), Savar, Dhaka, Bangladesh.Methods: It was a retrospective study conducted at EMCH, Savar, Bangladesh, from 2017 to 2021. A total of 46 patients admitted with a head injury and stroke were enrolled in this study. Data were collected using a structured questionnaire containing all the variables of interest. Data were processed and analyzed with the help of the computer program SPSS for Windows version 25.Results: This study sample consisted of 84.8% males and 15.2% females. The mean age was 42.54 ± 18.09 years. Pathogens found in culture samples were tracheal aspirate C/S (54.3%), urine C/S (26.1%), catheter tip C/S (13%), and the tip of the ET tube C/S (4.3%). The main attributed pathogens were Staphylococcus aureus (47.8%), Klebsiella spp. (37%), E. coli (32.6%), Streptococcus (2.2%), Acinetobacter spp. (2.2%), and Pseudomonas spp. (2.2%).Conclusion: This study shows that Staphylococcus aureus, Klebsiella spp., and E. coli are the most common isolated pathogens. Therefore, detailed microbial profiles and antibiotic susceptibility testing are necessary for the prevention of pathogens and effective treatment
Interception of a Reverse Incisor Occlusion in Mixed Dentition
Get PDFIntroduction: This case report describes an orthodontic interception of a mixed dentition reverse incisor bite in a 12-year-old boy at the time of consultation. Case report: After a careful clinical examination supported by routine radiological examinations, a skeletal Class III diagnosis was made, and an orthodontic interception was decided to restore the inverted incisor joint and orofacial functions disrupted by the malocclusion. After 20 months of interceptive treatment consisting of a joint jump and Class III intermaxillary traction, we found satisfactory overhang and coverage, allowing us to monitor the placement of the definitive canines with an improvement in the skin profile and smile. Conclusion: This simple gesture made it possible to put the mandible back in a position restoring normal incisal coverage and contributing to good orofacial muscle maturation, which is closely linked to the restoration of various occlusal functions
The Evolution of Third Molars in Orthodontics: What about Anterior Dental Crowding? — A Systematic Review
Get PDFBackground: Third molar influence on anterior crowding is controversial. However, it is assumed that it plays a significant role in compromising dental arch space. Aim: This study reviews the literature to clarify the role of third molars in anterior crowding and relapse after orthodontic treatment using a systematic review.Materials and Methods: A systematic search was conducted based on an electronic search of several databases (PubMed, ScienceDirect, and Cochrane Library) covering publications from 2010 to January 2022. The search was performed using the PICOS framework, limited to the following keywords in English and French: «wisdom tooth» OR « third molar » AND «anterior teeth crowding».Results: Based on the keywords used, 549 bibliographical references were initially identified. After removing duplicate references and studies, the number of articles was reduced to 315. A review of titles and abstracts resulted in the selection of 23 articles. After reading the complete text, six articles were included in this systematic review.Conclusion: No relationship between the incisors crowding and the presence of third molars was identified. Therefore, the indication for prophylactic removal of third molars to avoid incisor crowding is not justified
Diagnostic Procedures and Prosthetic Management of Cemento-Osseous Dysplasia: A Case Report
Get PDFCement-osseous dysplasia is an uncommon benign fibro-osseous lesion of the maxillae in which cementum tissue replaces the normal architecture of the bone. It is usually asymptomatic, and its discovery is incidental at a routine radiological examination. Treatment is necessary if an infection develops due to exposure to the lesion in the oral cavity. In these severe cases, pain, cortical blowing, and facial deformity may be present. Thus, patients with cemento-osseous dysplasia have prosthetic bearing surfaces unfavorable for prosthetic rehabilitation. The management of cemento-osseous dysplasia requires a careful clinical examination to make a correct diagnosis and develop the appropriate treatment plan. The practitioner must inform the patient of the limitations of prosthetic rehabilitation. The objective of this article is to review, through a case report, the clinical, histological, and radiological characteristics and possible complications of this lesion and to highlight its impact on the prosthetic bearing surfaces and the problems inherent in prosthetic rehabilitation
Outcomes of Repair of Anterior Penile Hypospadias by Snodgrass Technique: A Study of 50 Cases
Get PDFIntroduction: Hypospadias is a developmental anomaly characterized by a urethral meatus that opens onto the ventral surface of the penis proximal to the end of the glans. Hypospadias occurs in 1 in 125 live male births. Classically, three abnormalities are found in the hypospadias penis: (1) an ectopic opening of the urethral meatus at the ventral surface; (2) a ventral curvature of the penis (chordee); (3) a hooded foreskin on the dorsum of the penis with a lack of skin on the ventral due to a V-shaped defect referred to as urethral delta. There are anterior (65%), middle (15%), and posterior penile hypospadias (20%). Objective: The objective of surgical repair of hypospadias is to provide complete straightening of the penis, placing the meatus at the tip of the glans, forming a symmetrical conical-shaped glans, and constructing a neo-urethra uniform in caliver and acceptable skin coverage. Materials and Methods: This is a cross-sectional, descriptive, observational study conducted in the Department of Pediatric Surgery, Dhaka Medical College & Hospital, Dhaka, Bangladesh, from 1 January 2009 to 30 June 2010. The total number of cases is 50. Patients having anterior penile hypospadias were selected by simple random sampling. The mean age of the patients was 5.22 years (2 to 10 years). Surgical correction was done using the Snodgrass technique. The mean operative time was 90 minutes and the postoperative hospital stay was 10 days. Results: Satisfactory results were obtained in 35 (70%) patients, and only 14 (28%) had urethrocutaneous fistula, wound infection was developed in 5 (10%) patients, and two (4%) patients had meatal stenosis. The outcome was evaluated based on urethrocutaneous fistula, meatal stenosis, and cosmesis. Of 50 patients, 35 (70%) had no urethrocutaneous fistula and the results were cosmetically acceptable. Conclusion: Early detection and correction are essential to minimize the complications and lessen the psychological trauma of the patient. Therefore, a thorough examination of the neonates following delivery in different maternal and child care clinics is mandatory. Early and timely measures also give the best cosmetic and functional results. Thus, we should put all our efforts into achieving this goal
H-type Rectourethral Fistula with Anal Stenosis in a Male Patient: A Case Report with Literature Review
Get PDFBackground: H-type rectourethral fistula is a rare variant of anorectal malformation that affects male neonates. It is usually associated with anal stenosis but with a normal anal position and shape, so it is difficult to be diagnosed early after birth. We present this case to evaluate the functional outcome of this rare anomaly in a male patient and compare it with other reported cases with different ages at diagnosis.Case Presentation: A nine-month-old infant presented with recurrent attacks of urinary tract infection and failure to thrive. After proper evaluation, the diagnosis of an H-type rectourethral fistula with anal stenosis was confirmed, and a diverting double-barreled colostomy was performed as an initial procedure. Posterior sagittal anorectoplasty with ligation and division of fistula was successfully done, followed by colostomy closure. Now the patient is five years old and is continent for urine and stool.Conclusions: The diagnosis of H-type rectourethral fistula with anal stenosis is challenging to physicians, and a high index of suspicion is required to reach the diagnosis as the anal opening had a normal shape and location. If this condition is diagnosed and treated early, these patients will have an excellent functional prognosis, as the muscle complex and anal sphincter are well developed