Tele-Screening, Triaging of Dental Patients, and Reopening of Dental Services During SAR-CoV2 Pandemic

Background: The nature of dental profession requires a dentist to be in a close proximity to the patient’s mouth to perform various operative treatments including procedures such as generating aerosols. As such, dentistry is considered as one of the riskiest profession for the cross-transmission of SARS-CoV2. Although the prevalence and incidence of SARS-CoV2 continue to increase worldwide; the dental services and treatment of non-emergency cases have resumed in many countries including Sudan. Moreover, the use of smartphone technology in communication with patients can play an important role in controlling the spread of SARS-CoV2. Therefore, the aim of this short review was to draw a summary on using smartphone technology for telescreening dental patients prior to their visit to the clinics and to set guidelines and rules for dental treatment during SARS-CoV2 pandemic. Methods:  For the purpose of this study, telescreening is referred as a virtual contact between patients and healthcare personnel used to provide health services during the highly contiguous SARS-CoV2 pandemic. Using a smartphone, dental patients can be screened and questioned about their medical history and particularly for SARS-CoV2 (for symptoms such as fever, headache, coughing, breath shortness, loss of smell or taste). They should also be asked about their travel history to epidemic area, visiting hospital or coming in contact with a confirmed SARS-CoV2 patient during the last 14 days. On arrival to a dental clinic, the patient's temperature should be measured, instruction for wearing masks, hand hygiene, and keeping distances from others inside the waiting zone. Conclusion: Telescreening and triaging will minimize the time of patients’ exposure to dental clinic environments, hence decreasing the risk of getting SARS-CoV2 infection for both patients and dental healthcare workers.  Keywords: COVID-19, dentistry, procedure generating aerosols, smartphone, social distance, surgical masks

Wilson’s Disease and Autoimmune Hepatitis Coexistence: A Cause of Diagnostic Delay

This case report describes a 27-year-old housewife who presented with a progressive and insidious onset of abdominal distension, loss of appetite, and fatigue which started 3 months before her presentation. The physical assessment showed moderate ascites and small liver size, and no other peripheral evidence of chronic liver disease was observed. A diagnosis of liver cirrhosis and was confirmed by investigations and imaging, where ascites responded well to therapy with diuretics. Investigations for the cause of cirrhosis was established through the diagnosis of autoimmune hepatitis, and she was started on steroids and azathioprine with partial improvement in liver biochemistry. She presented 8 months later with neuropsychiatric symptoms in the form of slurred speech and difficulty walking. Accordingly, Wilson’s disease was suspected to be the cause and further investigations confirmed this. A chelating agent, D penicillamine, was added to her immunosuppressive treatment. Nine months later she showed slow improvement in her neurological symptoms and was referred for assessment for liver transplantation. Wilson’s disease, although rare, should be suspected in patients with decompensated liver disease. The dominance of clinical and epidemiological features of autoimmune hepatitis as a common causative pathology for chronic liver disease in young and middle-aged ladies may hide the presence of other serious different pathologies such as Wilson’s disease

Lesión híbrida formada por un complejo odontoma y quiste dentígero: hallazgos radiográficos e histomorfológicos. Un informe del caso.

Undergraduate dental student’s eligibility and ability to treat difficult endodontic cases is a new area open for debate. A fifth year undergraduate dental student managed to perform a successful root canal treatment (RCT) on a 42 year old male patient diagnosed as a rare case of mandibular first molar with five root canals. As an educational case report, in a country like Sudan, close supervision and clinical training of undergraduate students in treating difficult endodontic cases is recommended.La elegibilidad y la capacidad de los estudiantes de odontología de pregrado para tratar casos de endodoncia difíciles es una nueva área abierta a debate. Un estudiante de pregrado de odontología de quinto año logró realizar un tratamiento exitoso del conducto radicular (ECA) en un paciente masculino de 42 años diagnosticado como un caso raro de primer molar mandibular con cinco conductos radiculares. Como un informe de caso educativo, en un país como Sudán, se recomienda una estrecha supervisión y capacitación clínica de estudiantes universitarios en el tratamiento de casos de endodoncia difíciles