Evaluation of the efficacy of DIAGNOdent Laser in Comparison with Clinical Observation Technique in Occlusal Caries Diagnosis

Background and Aim: Considering the high prevalence of dental caries, early detection of occlusal caries, which is difficult is very important. The aim of this study was to evaluate the efficacy of two methods of clinical observation and DIAGNOdent laser in the diagnosis of occlusal caries. Materials and Methods: In this experimental study, 75 qualified molar teeth were evaluated for occlusal caries by clinical observation and DIAGNOdent laser techniques. Then, after caries removal (as gold standard), the depths of cavities were measured with a probe. Finally, data analysis was performed using SPSS 21 software and kappa test. Efficiency, agreement and correlation between the mentioned methods were determined. Results: The efficacy of occlusal caries detection is significant in both clinical observation and DIAGNOdent methods compared to the gold standard (For both: P = 0). According to evaluation of agreement with gold standard, Kappa value was 0.59 for clinical observation and 0.29 for DIAGNOdent laser. Evaluation of the correlation between the two methods, the r value for clinical observation and gold standard was 0.7 and for laser and gold standard was 0.54. Conclusion: The significant relationship between both clinical observation and DIAGNOdent laser with gold standard showed occurrence of diagnostic error in both methods. However, clinical observation is a more effective way to evaluate early occlusal caries in comparison to DIAGNOdent. Clinical observation and the gold standard also have a direct and relatively strong relationshi

A 5-year experience on perinatal outcome of placenta accreta spectrum disorder managed by cesarean hysterectomy in southern Iranian women

Abstract Background We aimed to investigate the risk factors of placenta accreta spectrum (PAS) disorder, management options and maternal and neonatal outcomes of these pregnancies in a resource-limited clinical setting. Methods All women diagnosed with placenta accreta, increta, and percreta who underwent peripartum hysterectomy using a multidisciplinary approach in a tertiary center in Shiraz, southern Iran between January 2015 until October 2019 were included in this retrospective cohort study. Maternal variables, such as estimated blood loss, transfusion requirements and ICU admission, as well as neonatal variables such as, Apgar score, NICU admission and birthweight, were among the primary outcomes of this study. Results A total number of 198 pregnancies underwent peripartum hysterectomy due to PAS during the study period, of whom163 pregnancies had antenatal diagnosis of PAS. The mean gestational age at the time of diagnosis was 26 weeks, the mean intra-operative blood loss was 2446 ml, and an average of 2 packs of red blood cells were transfused intra-operatively. Fifteen percent of women had surgical complications with bladder injuries being the most common complication. Furthermore, 113 neonates of PAS group were admitted to NICU due to prematurity of which 15 (7.6%) died in neonatal period. Conclusion Our findings showed that PAS pregnancies managed in a resource-limited setting in Southern Iran have both maternal and neonatal outcomes comparable to those in developed countries, which is hypothesized to be due to high rate of antenatal diagnosis (86.3%) and multidisciplinary approach used for the management of pregnancies with PAS