Mini-implants, mega solutions: a review

Dental implants have evolved as a standard treatment option for the replacement of missing teeth. Though this treatment modality provides a high level of patient satisfaction and success, it cannot be performed in all cases. Implant use is also restricted when the quality and quantity of bone at the edentulous site is limited, in addition to medically impaired patients. Among the conditions are remaining ridges with reduced interdental spacing, atrophic edentulous maxillary and mandibular ridges, and narrow ridges such as the mandibular incisor and maxillary lateral incisor area. A proper augmentation method for the placement of a regular diameter implant (3.75 to 7 mm) can improve the height and width of bone at such sites. However, bone augmentation and bone grafting procedures are rarely undertaken due to financial constraints, the risk of subjecting the patient to additional surgical procedures, the added time factor, or the guarded prognosis of the grafted site. In such cases, mini-implants are the choice of treatment. Mini-implants have the potential to be a viable alternative to standard-diameter implants in some circumstances. Benefits of mini-implants can be gained by replacing a single missing tooth, or preferably they must be used in multiples to retain fixed dental prostheses and might serve as an inexpensive, and efficient solution for retaining overdentures in selected cases

Detection of Multidrug-Resistant Acinetobacter baumannii among Gram-Negative Bacteria Isolated from Clinical Samples

Acinetobacter baumannii is an aerobic, Gram -negative cocco-bacilli, non-fermentative, non-motile, and non-fastidious organism belonging to the genus Acinetobacter. The A. baumannii has emerged as a worldwide nosocomial pathogen causing about 80%25 of nosocomial infections comprising ventilator-acquired pneumonia, bacteremia, meningitis, urinary tract infections, skin and soft tissues infections associated with high mortality rate of approximately 63.3%25. Although literature shows sufficient information about the drug resistant A. baumannii, there has been inadequate reports on the antibiotic resistance level of this bacterium in the study area. The aim of this research was to detect Multidrug-resistant A. baumannii isolates among Gram-negative bacteria isolated from Federal Teaching Hospital, Gombe, Nigeria. A total of 1008 clinical samples were collected and cultured on MacConkey agar and Blood agar plates at 37o C for 18-24 hours. Following the incubation period, discrete colonies obtained were subjected to Gram staining. The Gram-negative isolates were identified based on conventional biochemical tests with further use of VITEK 2 COMPACT (BioMérieux, France) for confirmation of A. baumannii amongst the Gram-negative organisms. The results obtained showed that 263 Gram-negative organisms were isolated. A. baumannii accounted for 8.5%25 prevalence. Most of the A. baumannii isolated were from the male patients (75%25) within the age range of 33-48 years. Antibiotic susceptibility test using Kirby Bauer method in accordance with CLSI guidelines was done on 20 A. baumannii isolates. The isolates were more sensitive to levofloxacin (60%25), followed by Gentamicin (55%25), then Ciprofloxacin and Tetracycline (50%25) respectively. High level of resistance to Ceftriaxone (80%25), Cefepime (75%25), Ceftazidime (65%25), Piperacillin-Tazobactam (55%25), Ampicillin%252FSulbactam (60%25), Tigecycline (60%25), Meropenem (55%25) and Amikacin (60%25). This study revealed that 15 (75%25) of the A. baumannii were found to be multidrug-resistant. Therefore, antibiotic stewardship is necessary to combat further dissemination of this organism

Control of superluminal transit through a heterogeneous medium

We consider pulse propagation through a two component composite medium (metal inclusions in a dielectric host) with or without cavity mirrors. We show that a very thin slab of such a medium, under conditions of localized plasmon resonance, can lead to significant superluminality with detectable levels of transmitted pulse. A cavity containing the heterogeneous medium is shown to lead to subluminal-to-superluminal transmission depending on the volume fraction of the metal inclusions. The predictions of phase time calculations are verified by explicit calculations of the transmitted pulse shapes. We also demonstrate the independence of the phase time on system width and the volume fraction under specific conditions.Comment: 21 Pages,5 Figures (Published in Journal of Modern Optics

Antibiogram of Pseudomonas species: an important tool to combat antibiotic resistance for patient safety in Gombe, Nigeria

Background: Pseudomonas species are responsible for different healthcare-associated infections and are inherently resistant to many commonly used antibiotics. Hospital antibiograms are either absent or not regularly available in most healthcare facilities in Nigeria. The objective of this study is to present the antibiogram of Pseudomonas isolates in Federal Teaching Hospital Gombe (FTHG) in order to guide antibiotic prescription for better patient safety in the hospital.Methodology: The is a hospital-based cross-sectional study. A total of 4309 bacterial isolates were recovered from aerobic cultures of routine clinical specimens including urine, sputum, blood, swabs, aspirates, biopsies, seminal fluids and cerebrospinal fluids at the Medical Microbiology laboratory of the hospital between January and December 2019. Pseudomonas species were identified by colony morphology, Gram-reaction and conventional biochemical tests. Antibiotic susceptibility testing was performed on each Pseudomonas isolate using the modified Kirby-Bauer disk diffusion method on Mueller-Hinton agar and results interpreted according to the guideline of the Clinical and Laboratory Standards Institute (CLSI). Data were analysed using the Statistical Package for Social Sciences (SPSSTM) software version 23.0.Results: Of the total 4309 bacterial isolates, 436 (10.1%) Pseudomonas species were identified, with majority (49.8%) from urine specimens. Antibiotic susceptibility test results revealed average susceptibility rates of 73.8%, 70.1%, 66.2%, 59.5%, and 34.3% to ciprofloxacin, gentamicin, levofloxacin ceftazidime, and carbenicillin respectively. These rates fluctuate only slightly for each of the antibiotic during the 12 months period of survey.Conclusion: Pseudomonas species were most sensitive to ciprofloxacin and gentamicin among the first line antibiotics in FTHG in 2019. Regular updates and presentation of hospital antibiogram especially for intrinsically resistant bacteria such as Pseudomonas involved in healthcare associated infections, is an important tool in combating antimicrobial resistance and ensuring patient safety. Keywords: antibiogram, Pseudomonas, antimicrobial resistance, antimicrobial stewardship, patient safet

Epilepsy in rural South African children prevalence, associated disability and management

Objective. To determine the prevalence of epilepsy and its associated disabilities in rural South African children aged 2 - 9 years.Setting. Eight villages in the district of Bushbuckridge, Northern Province, South Africa_Design. A two-phase design was used_ The first phase involved screening children on a house-to-house baSis by interviewing mothers or caregivers using an internationally validated questionnaire for detecting childhood disability in developing countries. The second phase consisted of a paediatric/ neurodevelopmental assessment of the children who screened positive.Results. A total of 6692 children were screened; 722 (10.8%) had a paediatric evaluation and 49 (0.73%) had epilepsy. The· lifetime and active prevalences of epilepsy in these children were 7.3/1 000 and 6.7/1 000 respectively. Associated developmental disability was recorded in 35 affected children (71.4%), including 8 (16.3%) in whom this was moderate to severe. More than a half of the children with epilepsy (57.1%) did not receive anticonvulsant medication.Conclusion. The prevalence of epilepsy in the rural childhood population investigated is higher than that recorded in most similar studies from sub-Saharan Africa, and the poor utilisation of 'appropriate anticonvulsant treatment is cause for concern. This study highlights the paucity of relevant information on the epidemiology of epilepsy in South Africa and that the system available for its management, especially in rural areas, appears to have functional deficiencies. Appropriate research is needed to identify the problems in service delivery and to enable the planning and implementation of an appropriate primary health care-based system for the diagnosis and management of epilepsy in children