Immediate Implant Loading in Osteoporotic Patients: Mini Review

Immediate Loading in implant treatment has gained trust and confidence among implantologists. Hence, immediate loading needs careful criteria to be considered during treatment planning. Adell, et al. [1] advocated that implant micro movement caused by functional force around the bone-implant interface during healing may lead to fibrous tissue formation rather than bone [1]. Occlusal scheme is another key factor that predicts the success rate in immediate loading. Balshi & Wolfinger [2] claimed that most of failures in their immediate loaded implant patients were due to bruxism [2]. Surgical technique is another factor. Gentle surgery, absence of heat generation and operator experience play a marvellous role in raising the success rate. It has been elucidated that a temperature over 47 °C for a minute might yield heat necrosis in the bone [3,4]. Success rate effect ranged between negative factor to positive one in relation to the placement of immediate loading in fresh extraction sites and healed ones. Chaushu, et al. [5] claimed a negative effect if implants were loaded immediately in fresh extractions sites [5]. Whereas, Jo, et al. [6] claimed a higher success rate when implants loaded immediately in fresh extraction sites [6]. Operators’ skills play a significant factor in enhancing implant treatment success. Clinicians who placed more than 50 implants will reduce the failure rate by 50% when compared with inexperienced ones [7]. Implant design plays a relevant role for yielding primary stability [8]. MalÓ, et al. [9] found no difference in success rate after 1 year between implants inserted with insertion torque ≥ 30 Ncm compared to implants inserted with torque < 30 Ncm [9]. Immediate implant loading for completely mandibular edentulous arches gained favorable clinical achievements in the long term [10]. Khan, et al. [11] claimed that platelet rich fibrin has a role in preventing bone loss during the surgical to prosthetic phase [11]. Bone diseases affect on implant osseointegration. Osteoporosis is an example; it is characterized by a decrease in bone mass, and considered a major public health concern [12]. Many authors [13-15] have advocated that mutilation of osseointegration might occur around implants in osteoporotic animal specimens. Degidi & Pittelli [16] advocated that it is possible to immediately load dental implants in an osteoporotic patient [16]. Osteoporosis is not a contraindication for implant therapy [17]. Oteoporotic patients received dental show acceptable outcomes [18]

Dry Socket: Frequency, Clinical Picture, and Risk Factors in a Palestinian Dental Teaching Center

Aims: The objectives of this study were to find out the frequency, clinical picture, and risk factors of dry socket at the Dental Teaching Center of Al-Quds University in Palestine. Methods and Materials: Two previously used questionnaires were accomplished in this study over a one year period. The first questionnaire was completed for every patient who had one or more permanent teeth extracted in the Dental Surgery Clinic. The other one was completed for every patient suffered a postoperative pain and was diagnosed with dry socket. Results: There were 1305 dental extractions performed in 805 patients. The overall frequency of dry socket was 3.2%. The incidence of dry socket following non-surgical extractions was 1.7% while it was 15% following surgical extractions (P< 0.005). The incidence of dry socket was significantly higher in smokers (12%) than in non-smokers (4%) (P < 0.005), however, there is a strong association between the amount of smoking and the incidence of dry socket (P < 0.002). The incidence of dry socket was significantly higher in the single extraction cases (13%) than in the multiple extraction cases (5%) (P = 0.005). Age, sex, medical history, extraction site, amount of local anesthesia and experience of operator play no role in the occurrence of dry socket. Conclusion: Smoking, surgical trauma and single extractions are considered predisposing factors in the occurrence of dry socket. On the other hand, factors like: age, sex, medical history, extraction site, amount of anesthesia, and operator experience have no effect on the observation of dry socket

Pregnant & Lactating Mothers’ Attitudes and Practice of the Ten Steps to Successful Breastfeeding at King Fahd Hospital of University (KFHU) – Khobar, Saudi Arabia: Appraisal of Baby Friendly Hospital Initiatives

Background: World Health organization (WHO) and the United Nations Children’s Fund (UNICEF) have been recommended the application of the Ten Steps to Successful Breastfeeding of the Baby-Friendly Hospital Initiative (BFHI) in order to promote &amp; support breastfeeding. The aim of this study was to assess pregnant and lactating mothers' attitudes and practice of ten steps to successful breastfeeding at KFHU. Methods: Data was collected using interview questionnaire sheet from pregnant ladies in the third trimester (N=73) and lactating mothers (N=84) who are delivered and have infants from 6 hours up to 6 months of life at KFHU. Results: more than two thirds of the sample has secondary or university education. Majority of mothers breastfed their previous children but 36.9% of them discontinued breastfeeding before 6 months. Health education addressing breastfeeding was given only for 16.6% of the total sample. Mothers agree to feed their babies on demand (74.5%), day and night (82.8%), to continue breastfeeding up to 2 years (75.8%), while 47.8% were agree to exclusive breastfeeding up to 6 months.Conclusion: Although there was a clear agreement about the steps to successful breastfeeding among pregnant &amp; lactating mothers, the actual practice of these steps are obviously incongruent with BFHI criteria for accreditation. Recommendation: health education, training and support for all pregnant and lactating mothers are crucial elements to promote breastfeeding, as well as the hospital policy taking into consideration to turn the BFHI into practice for the purpose of accreditation. Keywords: Breastfeeding, attitudes, practice, Baby Friendly Hospital Initiative

The Relationship between Implant Size and Success Rate in Computer Guided Implant Surgery

Guided implant surgery gained acceptance and credit in implant dentistry. The aim of this study is to find out and evaluate the relationship between implant size and success rate following computed tomography scan guided implant surgery. Sixty-four (36 females, 28 males) completely and partially edentulous patients aged between 42 and 65 years old were participated and fulfilled the inclusion criteria of the study. Two hundred and seventeen dental implants (length: 10, 11.5, and 13 mm; Diameter: 3.3, 3.75, and 4.2 mm) were placed using computed tomography scan guided implant surgery, 117 implants were placed in the maxilla, while 100 implants were placed in the mandible. The implants were evaluated for clinical parameters at 2, 4, and 12 weeks intervals after installation. The overall success rate was 95.4%. Clinical stability of the implant size (Diameter 3.3 mm, Length 10 mm) was the least as compared to other dimensions (P ≤ 0.05). Medium and large size implants (Diameter 3.75 and 4.2 mm, Length 11.5 and 13 mm) were the highest success rate in implant surgery. Implants width (diameter 3.3 mm) and length (10 mm) are best avoided in guided computed tomography surgery as compared with other implant sizes especially in atrophic bony areas. Computer-guided implant surgery remains exciting. Watchful planning and precise stability of the surgical guide are mandatory for successful protocol. Further investigations should be performed to assess such technique among dental patients from satisfactory point of view. Intensive cooperation between dentists and software engineering discipline should be aimed to maximize the success of such technique.The authors would like to thank Dr Haitham Al-Alami and Prof. Mahmoud Al-Omiri for their kind contribution in this study

Prediction Heart Attack using Artificial Neural Networks (ANN)

Abstract Heart Attack is the Cardiovascular Disease (CVD) which causes the most deaths among CVDs. We collected a dataset from Kaggle website. In this paper, we propose an ANN model for the predicting whether a patient has a heart attack or not that. The dataset set consists of 9 features with 1000 samples. We split the dataset into training, validation, and testing. After training and validating the proposed model, we tested it with testing dataset. The proposed model reached an accuracy of 98.01% on the Heart Disease Dataset

Relationship between Impacts of Complete Denture Treatment on Daily Living, Satisfaction and Personality Profiles

Objectives: To investigate the association between satisfaction with conventional complete denture prostheses (CDs), impacts of CDs on daily living and personality profiles. Materials and methods: Fifty-six patients (28 males and 28 females; mean age 53.79 ± 7.762 years) with fitted upper and lower removable CDs were recruited for this study. Clinical success of CDs was assessed according to specific clinical criteria. The dental impact on daily living questionnaire (DIDL) was used to measure satisfaction with CDs and their impacts on daily living. NEO five factor inventory (NEO - FFI) was used to measure patients’ personality profiles. Pearson correlation test and regression models were used to analyze the collected data. Results: Females were more satisfied with appearance and less satisfied with eating and scored higher on neuroticism, and lower on extraversion and openness personality domains (p < 0.05). Older patients were more satisfied with appearance and less satisfied with oral comfort and general performance (p < 0.05). Neuroticism, extraversion, openness and agreeableness personality profiles could predict and had significant relationship with CDs impacts on daily living and satisfaction with CDs. Conclusion: Psychological profiles (e.g. neuroticism, extraversion, openness and agreeableness) might play a role and explain CDs impacts on daily living and patients’ satisfaction with their oral status and CD treatment, therefore, might be used to predict satisfactory outcomes of CD treatment. In this regard, technical aspects of CDs are less essential when the prosthesis is clinically successful. Clinical significance: Psychological factors may play a role and also provide valuable information for the prediction of satisfactory outcomes of complete denture treatmen

Management of Burns in Gaza-Strip A Multi-center Clinical Audit

A combined prospective and retrospective study was conducted in the ERs of Al-Shifa, Nasser Medical Complex and European Gaza hospitals. Two structured questionnaires were used to collect the management of burn according to the Palestinian management protocol. This study found that from the 147 cases that came to the ER, 37.6% underwent ABCDE approach and 87.8% (n=129/147) received sterile dressings. Background: Burns is a global public health problem and appropriate intervention will decrease morbidity and mortality. This study aimed to evaluate the management of burns in the emergency room (ER), burns units and intensive care units (ICU) of the Gaza-Strip. Objectives: To evaluate the management of burns in the ER, burns unit and ICU in terms of following ABCDE approach, using sterile dressings, giving fluid resuscitation, antibiotics, ranitidine and undergoing physiotherapy. Methods: A prospective study evaluated the management of patients presenting with burns injuries to the ER between the period 22nd July to 20 August 2018, and retrospectively, management of patients was evaluated, who were admitted to the burns units and to ICU between 1st January 2017 and 30th July 2018 at Al-Shifa Hospital and Nasser Medical Complex. The Palestinian management protocol was used for evaluation. A total of 428 patients were identified to have burns injuries during the study period. Of these, 142 were excluded, 108 due to missing files and 34 files had poor documentation (no documentation of medication or assessments). Included were 147 patients admitted to ER, 122 on the burns unit and 17 on the ICU. Results: In the ER, 57.1% (n=84/147) of patients were male, with a mean age of 15.4±14.1. Of the 147 cases, 17.7% (n=26/147) were major burns, which included more than 10% total body surface area burned (TBSA). Of these, 37.6% underwent ABCDE approach and 87.8% (n=129/147) received sterile dressings. From the 122 patients admitted to the burns unit, 59.8% (n=73) were male with a mean age of 11.4±14.6 years. From these, 47.5% (n=58/122) underwent fluid resuscitation, 97.5% (n=119/122) received antibiotics, 17.2% (n=21/122) received ranitidine and 56.6% (n=69/122) underwent physiotherapy. Out of the 17 patients admitted to ICU, 76.5% (n=13/17) were male, with a mean age of 19.2±12.8 years. All of these patients received prophylactic antibiotics, 58.8% (n=10/17) had endotracheal intubation, 5.9% (n=1/17) underwent central venous pressure measurement (CVP), 23.5% (n=4/17) had ABG tested and 88.2% (n=15/17) kidney function tests (KFT), and 64.7% (n=11/17) received ranitidine. No patient had a chest X-Ray (CXR) or carbon monoxide (CO) level done. From the ICU patients, 17.6% (n=3/17) benefitted from physiotherapy, and 35.3% (n=6/17) Conclusion: The findings of this study demonstrate poor adherence to guidelines in some points, such as patients presenting with major burns, who should all benefit from the ABCDE approach, but less than 40% of patients actually did and antibiotics, which should only be prescribed when indicated, were given to nearly all patients admitted to the burns unit or ICU. Efforts are required to improve staff practices with burn injuries

Therapeutic Properties of Vanadium Complexes

Vanadium is a hard, silver-grey transition metal found in at least 60 minerals and fossil fuel deposits. Its oxide and other vanadium salts are toxic to humans, but the toxic effects depend on the vanadium form, dose, exposure duration, and route of intoxication. Vanadium is used by some life forms as an active center in enzymes, such as the vanadium bromoperoxidase of ocean algae and nitrogenases of bacteria. The structure and biochemistry of vanadate resemble those of phosphate, hence vanadate can be regarded as a phosphate competitor in a variety of biochemical enzymes such as kinases and phosphatases. In this review, we describe the biochemical pathways regulated by vanadium compounds and their potential therapeutic benefits for a range of disorders including type 2 diabetes, cancer, cardiovascular disease, and microbial pathology

Effect of Tadalafil on Penile Duplex parameters in Erectile Dysfunction Patients

Background: Tadalafil is a PDE-5 (phosphodiesterase inhibitor) inhibitor that supports endogenous nitric oxide's vasodilatory actions and aids in erection maintenance. The penile duplex has proven to be very useful for imaging superficial structures and for determining the reasons of erectile dysfunction (ED). Objectives: To assess the effect of daily oral tadalafil 5mg for 3 months on penile duplex parameters in erectile dysfunction patients. Patients and Methods: A case control study involved 30 Egyptian patients ED. Appropriate clinical history and penile duplex examination before and after treatment with daily oral tadalafil mg for 3 months were performed. Results: The mean age of the patients was 53.17 ± 7.8 years. We founded that there was significant (p < 0.001) improvement in the level of erection after treatment. The rate of erection E1 and E2 was decreased from 53.3% to 3.3%. Likewise, the rate of E3-E5 was increased from 46.7% to 96.7%. Moreover, the mean duration of erection was elongated from 24.7 ± 5.3 to become 37.4 ± 3.8 and this was statistically significant (p < 0.001). Also, the mean peak systolic volume (PSV) was significantly (p = 0.001) increased after treatment (38.4 ± 9.1 cm/s) compared with the pre-treatment levels (23.9 ± 6.1 cm/s). Unlikely, the mean end diastolic volume (EDV) was insignificantly (p = 0.340) lower in post-treatment (2.25 ± 0.5 mL) compared with pre-treatment levels (2.97 ± 0.4 mL). Likely, the mean resistant index (RI) showed insignificant difference (p = 0.965) after treatment (0.9 ± 0.02) compared with before treatment (0.9 ± 0.08). For penile artery diameter, there was significant (p = 0.009) increase in the diameter after treatment (0.9 ± 0.1 mm) compared with before treatment (0.8 ± 0.1 mm). Conclusion: Oral daily tadalafil 5mg for 3 months is considered an effective treatment for ED according to penile duplex parameters

First molecular analysis of rabies virus in Qatar and clinical cases imported into Qatar, a case report

Identifying the origin of the rabies virus (RABV) infection may have significant implications for control measures. Here, we identified the source of a RABV infection of two Nepalese migrants in Qatar by comparing their RABV genomes with RABV genomes isolated from the brains of a RABV infected camel and fox from Qatar