Effect of standard versus patient-targeted in-patient education on patients' anxiety about self-care after discharge from cardiovascular surgery clinics

We compared standard and patient-targeted in-patient education in terms of their effect on patients' anxiety. One hundred and ninety-eight patients who were hospitalised for coronary artery bypass surgery were given standard education (group 1) or individualised education (group 2) on the management of their healthcare after discharge. Patients in group 2 were assessed on the patient learning needs scale and were given education according to their individual needs. The level of anxiety was measured by the state-trait anxiety inventory. Anxiety scores were significantly lower in group 2 than group 1 after education (p < 0.001). While state anxiety did not change after education in group 1 (p = 0272), it decreased significantly in group 2 (p < 0.001). For cardiovascular surgery patients, patient-targeted in-patient education was more effective than standard education in decreasing anxiety levels, therefore the content of the education should be individualised according to the patient's particular needs

The effectiveness of the ketogenic diet in drug-resistant childhood epilepsy

2nd International Behcet Uz Children's Congress -- MAR 04-07, 2020 -- Izmir, TURKEYBackground. We aimed to investigate the effectiveness of ketogenic diet (KD) in children with various types of refractory epilepsy. Methods. A total of 91 children (49 females) aged 3 to 193 months (median, 52 months) with drug resistant epilepsy who received KD treatment for at least 12 months were enrolled in the study. Seizure frequency, adherence to diet, reason for discontinuation of KD, and adverse effects were recorded. Response was defined as >= 50% improvement in seizure frequency compared to baseline. We also searched for influences of different variables on the outcome. Results. Intent-to-treat analysis revealed an improvement in seizure frequency for >= 50% in 73.6%, 80.2%, 75.8%, 73.6%, and 70.3% of patients at month-1,-3,-6,-9, and month-12, respectively. Overall, 32 (35.2%) patients remained seizure-free at month-12. There was no significant differences between responders and non responders in terms of age at onset of epilepsy, age at onset of KD, gender, or etiology. Mild hyperlipidemia was associated with a higher response rate. At the last follow-up (median: 20 months), 38 (41.8%) patients were still maintained on KD. While 15.4% of patients completed the diet with a success in seizure control, remainder discontinued KD due to lack of efficacy (23.1%), non-adharence to diet (11%), intercurrent infection (4.4%), adverse effects (3.3%), and death (1.1%). Conclusion. Ketogenic diet treatment appears to be effective in about two-thirds of children with various types of drug-resistant epilepsy, including one-third remaining seizure free. Mild hyperlipidemia seems to be associated with a higher response rate. Discontinuation of KD is mostly due to lack of efficacy or nonadherence, and rarely side effects

Cone-beam computed tomography evaluation of impacted and transmigrated mandibular canines: a retrospective study.

Objectives The purpose of this study is to evaluate CBCT images of impacted mandibular canines in detail and to discuss implications for diagnosis and treatment. Methods CBCT images of dental patients applied between December 2015 and December 2017 were evaluated retrospectively.&nbsp;2591 CBCT images, including mandible in their feld of view, were determined and evaluated regarding the presence of mandibular canine impaction. 66 impacted mandibular canines of 58 patients were analyzed in detail regarding their location, morphology, associated pathologies, and their relationship with the neighboring anatomic structures, the role of these factors on transmigration, as well as treatments applied. The Pearson Chi square test was used between the groups. Results Transmigration was observed in 53% of impacted mandibular canines. Teeth with transmigration were localized horizontally, below the apex of adjacent teeth frequently, and had no contact with mandibular cortical bone mostly. 62% of mandibular canines were in contact/proximity with the incisive mandibular canal. The most applied treatment for transmigrated teeth was surgical removal, followed by radiographic monitoring, but orthodontic traction was not preferred in any case. For non-transmigrated teeth, the most applied treatment options were surgical removal, orthodontic traction, and radiographic monitoring, respectively. Autotransplantation was not preferred in any case of impacted teeth. Vertical position of the crown tip (p&lt;0.05) and the presence of deciduous mandibular canines and their resorption showed signifcant relation to transmigration (p&lt;0.05). Conclusion Transmigration is common among impacted mandibular canines. Resorption of adjacent teeth roots was one of the possible complications of impaction and likely contact/proximity of incisive mandibular canal with impacted mandibular canines, which may pose difculties in surgical treatment, can be better detected by CBCT.</p

A Cornelia De Lange Syndrome Patient with Cleft Palate: A Case Report with Intraoral and Extraoral Findings

Objective: This case report presents the clinical and genetic findings in a one-week-old male patient with Cornelia de Lange Syndrome (CdLS) and unilateral cleft palate with a review of literature which includes case reports with cleft lip and palate. Case Presentation: The patient exhibited characteristic facial dysmorphism, including a low-set hairline, long and bushy unibrow, inclined nose with anteverted nostrils, long philtrum, thin lips, and micrognathia. Upper limb malformations, genitourinary anomalies, and hirsutism were also present. The patient underwent comprehensive follow-up for five months, during which an alginate impression was taken to aid intraoral feeding, and a plaster model was prepared for the construction of an obturator, an essential component of the cleft palate management plan. The treatment plan involved multidisciplinary collaboration, including pre-surgical orthodontic preparation, evaluation of dental anomalies, surgical intervention with an oral and maxillofacial surgeon, post-operative care, and monitoring. Post-surgical orthodontic treatment and speech therapy were planned for later stages, followed by fine-tuning and a retention plan for long-term stability. Conclusion: CdLS is a complex genetic disorder characterized by various physical abnormalities. This case report demonstrated the management of a one-week-old male patient with CdLS and unilateral cleft palate through a comprehensive multidisciplinary approach. Early intervention, personalized treatment plans, and long-term follow-up are crucial for addressing dental and maxillofacial complications associated with cleft palate in CdLS patients. Collaborative efforts among specialists yield optimal outcomes, improving the quality of life for individuals with CdLS and cleft palate. Keywords: cornelia de lange, cleft palate, cleft li