Predictors of Routine Dental Check-up Among Male Adolescents in Saudi Arabia

Cilj: Željela se procijeniti povezanost socijalno-ekonomskih čimbenika i samopercipiranih oralnih stanja s rutinskim stomatološkim pregledima među mladićima u pubertetu. Metode: Ovo presječno istraživanje provedeno je na mladićima (od 10. do 12. razreda) iz javnih škola u različitim gradovima u istočnoj pokrajini Saudijske Arabije. Za odabir sudionika primijenjeno je višestupanjsko randomizirano uzorkovanje. Za prikupljanje podataka korišten je pilotirani upitnik preveden na arapski jezik. Rezultat: Bilo je uključeno 586 učenika prosječne dobi 16,86 ± 0,87 godina. Prevalencija rutinskih posjeta stomatologu tijekom prethodne godine iznosila je 18,9 %. Kod polovine cjelokupnog uzorka zabilježeni su karijes (50,5 %) i osjetljivost zuba (50 %) praćena bolovima (42,2 %). Bivarijantna analiza otkrila je da su djeca s karijesima (ILO 0,4, 95 % CI 0,26, 0,61), zuboboljom (OR 0,63, 95 % CI 0,41, 0,97) i zadahom (IL 0,41, 95 % CI 0,23, 0,71) rjeđe odlazila na rutinske stomatološke preglede od onih bez navedenih stanja. Konačni model multivarijantne logističke regresije pokazao je da su karijes (OR 0,42, 95 % CI 0,27, 0,66) i zadah (OR 0,45, 95 % CI 0,25, 0,78) statistički značajno povezani s rjeđim posjetima doktoru dentalne medicine radi redovitih pregleda. Nije uočen znatan utjecaj socijalno-ekonomskih čimbenika na rutinske odlaske stomatologu. Zaključci: Mali broj mladića odlazio je na rutinske stomatološke preglede. Djeca s karijesom i neugodnim zadahom rjeđe su to činila. Treba povećati svijest o važnosti redovitih stomatoloških pregleda kako bi se kod školske djece smanjila prevalencija oralnih bolesti.Objective: To evaluate the association of socioeconomic factors and self-perceived oral conditions with routine dental check-up among male adolescents. Methods: This cross-sectional study was conducted on male children (grade 10-12) from public schools in different cities of the Eastern province of Saudi Arabia. A multistage random sampling was used for the recruitment of study participants. A piloted questionnaire translated into the Arabic language was used for data collection. Results: There were 586 students with mean age 16.86±0.87 years. The prevalence of routine dental visit within last year was 18.9%. Half of the entire sample had dental cavities (50.5%) and tooth sensitivity (50%) followed by dental pain (42.2%). Bivariate analyses found that the children with dental cavities (OR 0.4, 95% CI 0.26, 0.61), dental pain (OR 0.63, 95% CI 0.41, 0.97), and malodor (OR 0.41, 95% CI 0.23, 0.71) had significantly lower odds of routine dental visits than those without these conditions. The final model of multivariable logistic regression showed that dental cavities (OR 0.42, 95% CI 0.27, 0.66) and malodor (OR 0.45, 95% CI 0.25, 0.78) were significantly associated with lower likelihood of visiting dental office for a regular dental check-up. No significant influence of socioeconomic factors on routine dental attendance was observed. Conclusions: A small proportion of children performed routine dental visits. The children with dental cavities and malodor were less likely to perform routine dental visits. The awareness about the importance of regular dental check-up should be raised to reduce the burden of oral diseases in schoolchildren

Global Prevalence of Tobacco Use in Adolescents and Its Adverse Oral Health Consequences

BACKGROUND: Smoking is associated with various systemic conditions and contributes to a huge financial burden to economies around the world. AIM: The study aimed to evaluate global data about the prevalence of tobacco use among male and female adolescents and to discuss smoking-related oral complications. METHODS: The prevalence data of tobacco use among adolescents (13-15 years) was retrieved from the World Health Organization (Global Health Observatory). The World Bank’s statistics about gross national income (GNI) per capita were used to categorise low-income, lower-middle-income, upper-middle-income, and high-income countries. PubMed, Web of Science, Scopus, and Embase databases were searched to gather updated evidence about the adverse consequences of smoking on oral health among adolescents. RESULTS: The prevalence of tobacco use was 19.33%, and there were 23.29% of male and 15.35% female smoker adolescents in 133 countries (p < 0.001). The highest prevalence of tobacco use in male (24.76%) and female (19.4) adolescents was found in high-income countries. Significantly higher proportions of male adolescents were smokers than female counterparts in low-income, lower-middle-income, and upper-middle-income (p < 0.001). However, there were no statistically significant differences in tobacco use between male and female adolescents in high-income countries. Low-income countries had the lowest prevalence (14.95%) of tobacco use, while high-income countries had the highest prevalence estimates (22.08). Gingivitis (72.8%), gingival bleeding (51.2%), oral malodor or halitosis (39.6%) is common oral conditions among smoker adolescents. Smoking habit is significantly associated with dental caries, periodontal disease, hairy tongue, smoking-related melanosis, and hyperkeratosis among adolescents. CONCLUSION: There was a high prevalence of tobacco use among male and female adolescents around the globe. Available evidence suggests a strong association between smoking and compromised oral health among adolescents. Globally, measures should be taken to prevent and control the menace of tobacco use to reduce systemic and oral complications

Prognostic Factors for Decompressive Hemicraniectomy in Severe Traumatic Brain Injury Patients with Traumatic Mass Lesions: A Prospective Experience from a Developing Country

Objective:  To evaluate the prognostic factors affecting functional clinical outcomes in severe traumatic brain injury patients with traumatic mass lesions undergoing decompressive hemicraniectomy (DHC). Materials and Methods:  A prospective cohort of 85 patients of severe traumatic brain injury patients with traumatic mass lesions underwent a unilateral decompressive hemicraniectomy. Functional outcomes were assessed using the Glasgow Outcome Score at 28 days, 3 months, and 6 months. Bivariate analysis (chi-squared) was used to identify parameters that resulted in poor outcomes and multiple regression was used to identify independent factors predicting poor outcomes. Results:  85 patients were recruited. Functional outcomes were dichotomised as favourable (Glasgow Outcome Score of 4 – 5) and poor (Glasgow Outcome Score 1-3) and evaluated at 28 days, 3 and 6 months. A total of 59 patients expired (69.4%). Bivariate analysis revealed GCS 3 – 5 at presentation (P = 0.002), midline shift greater than 7.5mm (P < 0.001), the volume of the mass lesion more than 40ml (P = 0.006) resulted in a poor outcome. Age dichotomised to less than or more than 50 years bordered statistical significance (P = 0.063). Only GCS at presentation and midline shift were independent factors that predicted poor outcomes when controlling for covariates.  Conclusion:  Decompressive hemicraniectomy can be a lifesaving intervention in managing severe traumatic brain injury patients with traumatic mass lesions. However, its use needs to be employed judiciously.&nbsp

Optimization of physico-chemical factors for augmenting biomass production of baby hamster kidney cells (Bhk-21) in roller bottle

Abstract Physical (seeding density, incubation period, incubation temperature and rolling speed) and chemical (amount of cell culture growth medium and fetal calf serum) factors were optimized for enhancing biomass production of Baby Hamster Kidney cell

Oral health-related interdisciplinary practices among healthcare professionals in Saudi Arabia: Does integrated care exist?

Background There is a bidirectional relation between oral and general health, therefore collaboration between healthcare providers is needed. This study investigated current interdisciplinary practices (IDP) and the associated factors among healthcare professionals in Saudi Arabia. Methods A cross-sectional study was conducted in the Eastern Saudi Arabia recruiting four groups of health professionals (nurses, physicians, pediatricians and Ear-Nose and Throat (ENT) specialists). A validated, self-administered questionnaire was distributed online and shared through social media platforms. The questionnaire explored predisposing factors (demographics) and facilitating factors (knowledge, attitudes, attendance of oral health training and source of knowledge) associated with IDP. Results A total of 1398 health professionals were recruited. Participants showed fair oral health knowledge (7.1 ± 2.1) and attitudes (22.2 ± 3). Three-fourths (74.6%) reported always providing oral health education (OHE) to their patients, more than half (59.6%) reported always conducting an oral health screening (OHS), two-thirds (66.7%) reported responding to patients’ questions about oral health or conditions and 58.7% reported referring patients to dentists. Pediatricians and physicians had greater odds of IDP compared to other health professionals. Source of oral health knowledge (Ministry of Health (MOH) and formal education) was significantly associated with increased odds of IDP. Participants with good oral health knowledge had greater odds of responding to patients’ oral health question as well as have more referral practices. Conclusion The results reveal a discrepancy between participants' IDP, knowledge, and attitudes. Incorporating dental component to medical curricula, continuous education and training programs targeting health professionals through Ministry of Health should be considered.publishedVersio

The burden of Diabetes, Its Oral Complications and Their Prevention and Management

BACKGROUND: Diabetes mellitus (DM), chronic disease, is a public health problem that affects 8.5% adult population worldwide. The number of adults with DM has risen sharply from 108 million in 1980 to 422 million in 2014. In 2012, 1.5 million individuals died because of DM and an additional 2.2 million deaths occurred because of high blood glucose level resulting in cardiovascular and other systemic diseases. DM brings huge economic loss to patients, their families, and healthcare systems. Globally, the cost of DM was US$1•31 trillion in 2015.AIM: This review article utilised the prevalence data of diabetes mellitus from the World Health Organization and International Diabetes Federation to provide a comprehensive picture of the disease in different parts of the world.METHODS: Electronic databases such as Google Scholar, Medline via PubMed, Scopus, and Web of Science were used to search the literature. The library resources of Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia were used to retrieve studies on the topics of the present review.RESULTS: Systemic complications of DM include heart attack, kidney disease, limb loss, blindness, and peripheral nerve damage. More than 90% of diabetic patients were found to have oral manifestations. It is known that DM severely damages oral tissues causing periodontal disease, tooth loss, xerostomia, caries, burning mouth disorder, taste and salivary gland dysfunction, delayed wound healing, lichen planus, geographic tongue, and candidiasis. The evidence is mounting about a strong bidirectional relationship between DM and periodontal disease. Unfortunately, many diabetic patients are unaware of the association between DM and oral health, and only a small percentage of them visit the dentist for routine dental check-ups. Changes in lifestyles (control of blood glucose levels and self-care practices), regular dental check-ups with emphasis on periodontal assessment, and reinforcement of oral health instructions can effectively prevent oral complications of DM. Scaling and root planning are effective in improving glycemic control among diabetic patients.CONCLUSION: Dental professionals should be part of the multidisciplinary team that helps individuals with diabetes

Biochar: An emerging recipe for designing sustainable horticulture under climate change scenarios

The interest in sustainable horticulture has recently increased, given anthropogenic climate change. The increasing global population will exacerbate the climate change situation induced by human activities. This will elevate global food demands and the vulnerability of horticultural systems, with severe concerns related to natural resource availability and usage. Sustainable horticulture involves adopting eco-friendly strategies to boost yields while maintaining environmental conservation. Biochar (BC), a carbon-rich material, is widely used in farming to improve soil physical and chemical properties and as an organic substitute for peat in growing media. BC amendments to soil or growing media improve seedling growth, increase photosynthetic pigments, and enhances photosynthesis, thus improving crop productivity. Soil BC incorporation improves abiotic and biotic stress tolerance, which are significant constraints in horticulture. BC application also improves disease control to an acceptable level or enhance plant resistance to pathogens. Moreover, BC amendments in contaminated soil decrease the uptake of potentially hazardous metals, thus minimizing their harmful effects on humans. This review summarizes the most recent knowledge related to BC use in sustainable horticulture. This includes the effect of BC on enhancing horticultural crop production and inducing resistance to major abiotic and biotic stresses. It also discuss major gaps and future directions for exploiting BC technology

Oral health-related interdisciplinary practices among healthcare professionals in Saudi Arabia: Does integrated care exist?

Background: There is a bidirectional relation between oral and general health, therefore collaboration between healthcare providers is needed. This study investigated current interdisciplinary practices (IDP) and the associated factors among healthcare professionals in Saudi Arabia.Methods: A cross-sectional study was conducted in the Eastern Saudi Arabia recruiting four groups of health professionals (nurses, physicians, pediatricians and Ear-Nose and Throat (ENT) specialists). A validated, self-administered questionnaire was distributed online and shared through social media platforms. The questionnaire explored predisposing factors (demographics) and facilitating factors (knowledge, attitudes, attendance of oral health training and source of knowledge) associated with IDP.Results: A total of 1398 health professionals were recruited. Participants showed fair oral health knowledge (7.1 ± 2.1) and attitudes (22.2 ± 3). Three-fourths (74.6%) reported always providing oral health education (OHE) to their patients, more than half (59.6%) reported always conducting an oral health screening (OHS), two-thirds (66.7%) reported responding to patients' questions about oral health or conditions and 58.7% reported referring patients to dentists. Pediatricians and physicians had greater odds of IDP compared to other health professionals. Source of oral health knowledge (Ministry of Health (MOH) and formal education) was significantly associated with increased odds of IDP. Participants with good oral health knowledge had greater odds of responding to patients' oral health question as well as have more referral practices.Conclusion: The results reveal a discrepancy between participants' IDP, knowledge, and attitudes. Incorporating dental component to medical curricula, continuous education and training programs targeting health professionals through Ministry of Health should be considered.</p

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication