A Comparison of Endodontic Treatment Factors, Operator Difficulties, and Perceived Oral Health–related Quality of Life between Elderly and Young Patients

Introduction The purpose of this study was to compare endodontic treatment factors, treatment difficulties, and oral health–related quality of life (OHRQOL) between elderly and young patients. Methods A total of 150 adults, 75 elderly (≥65 years) and 75 young patients (18–64 years), were recruited. Operators enumerated difficulties associated with communication, diagnosis, rubber dam application, access cavity preparation, canal localization, working length determination, instrumentation, and obturation after root canal treatment. The number of treatment visits, maxillary first molars with a second mesiobuccal canal, and the technical quality of the root filling were registered. Patients filled out questionnaires on pain, attendance of regular dental visits, esthetics, and masticatory function and the Oral Health Impact Profile-14. Results Significantly more elderly had necrotic pulp (P < .001) and needed root canal treatment on teeth with full-coverage crown/bridge abutment (P < .001). It was significantly difficult to perform access cavity preparation and localize root canals on the elderly and on teeth with a full-coverage crown/bridge abutment. In regression analysis, the elderly presented with difficulties only during canal localization (P < .05). Second mesiobuccal canals were obturated in 43.5% of the young patients and 23.1% of the elderly patients. There were no significant differences in the number of treatment visits or the technical quality of root filling between the 2 groups. There were no significant differences in pain sensation, esthetics, masticatory function, or regular dental visits between the 2 groups. Elderly patients reported a significantly better OHRQOL (P < .05). Patients experiencing pain, patients needing treatment on anteriors/premolars, and females reported a significantly poorer OHRQOL (P < .05). Conclusions The elderly presented with treatment difficulty during canal localization and had better OHRQOL compared with young patients.publishedVersio

Skateboards: Are they really perilous? A retrospective study from a district hospital

<p>Abstract</p> <p>Background</p> <p>Skateboarding has been a popular sport among teenagers even with its attendant associated risks. The literature is packed with articles regarding the perils of skateboards. Is the skateboard as dangerous as has been portrayed?</p> <p>Methods</p> <p>This was a retrospective study conducted over a 5 year period. All skateboard related injuries seen in the Orthopaedic unit were identified and data collated on patient demographics, mechanism & location of injury, annual incidence, type of injury, treatment needed including hospitalisation.</p> <p>Results</p> <p>We encountered 50 patients with skateboard related injuries. Most patients were males and under the age of 15. The annual incidence has remained low at about 10. The upper limb was predominantly involved with most injuries being fractures. Most injuries occurred during summer. The commonest treatment modality was plaster immobilisation. The distal radius was the commonest bone to be fractured. There were no head & neck injuries, open fractures or injuries requiring surgical intervention.</p> <p>Conclusion</p> <p>Despite its negative image among the medical fraternity, the skateboard does not appear to be a dangerous sport with a low incidence and injuries encountered being not severe. Skateboarding should be restricted to supervised skateboard parks and skateboarders should wear protective gear. These measures would reduce the number of skateboarders injured in motor vehicle collisions, reduce the personal injuries among skateboarders, and reduce the number of pedestrians injured in collisions with skateboarders.</p

Impact of Case Difficulty, Endodontic Mishaps, and Instrumentation Method on Endodontic Treatment Outcome and Quality of Life: A Four-Year Follow-up Study

Introduction: Root canal treatment (RCT) is often considered a difficult procedure for both the patient and treatment provider. The American Association of Endodontists case difficulty assessment form categorizes cases as minimal, moderate, and high difficulty level. We recently showed that endodontic mishaps occur frequently during treatment of teeth in high difficulty category. The aims were to investigate the clinical and radiographic outcome at least 4 years after RCT and to evaluate patients’ perceived oral health-related quality of life (OHRQoL). Methods: Two hundred thirty-four patients (257 endodontically treated teeth) who were previously included in a quality assurance study were offered a recall appointment at the Department of Clinical Dentistry, University of Bergen, Norway. Patients were given a thorough clinical, radiographic examination and asked to fill out the Oral Health Impact Profile-14 questionnaire. Results: A total of 149 patients (160 teeth) attended the 4-year (range, 4–6 years) recall appointment. An unchanged or lower Periapical Index (PAI) score at recall visit was registered on 153 teeth (95.6%) (P < .001). Radiographic success rate (PAI score ≤ 2) was 87.5%, and clinical success (absence of clinical signs and symptoms) was 88.8%. Both radiographic and clinical success was observed in 78.8% of teeth. Teeth in high difficulty category, instrumented with engine-driven files, and molars presented with significantly more clinical signs and symptoms but not high PAI score (PAI score ≥ 3) (P < .05). Endodontic mishaps such as overinstrumentation and overfill with gutta-percha resulted in significantly high PAI score (P < .05). Patients with no clinical signs and symptoms after RCT and elderly had a significantly better OHRQoL (P < .05). Conclusions: Presence of clinical signs and symptoms rather than PAI score affected patients’ OHRQoL.publishedVersio

Bilateral spontaneous non-traumatic rupture of the Achilles tendon: a case report

<p>Abstract</p> <p>Introduction</p> <p>We present an interesting case of spontaneous non-traumatic bilateral rupture of the Achilles tendons, which is a rare condition. Delayed or missed diagnosis of Achilles tendon ruptures by primary treating physicians is relatively common.</p> <p>Case report</p> <p>A 78-year-old Caucasian woman presented with spontaneous non-traumatic bilateral rupture of the Achilles tendons. Her symptoms started two days after she took ciprofloxacin 500 mg twice daily for a urinary tract infection and prednisolone 30 mg once daily for chronic obstructive airway disease.</p> <p>Conclusion</p> <p>This case report aims to increase the awareness of this rare condition, which should be borne in mind with regard to patients who are on steroid therapy and are concurrently started on fluoroquinolones.</p

Performance of BFRP and GFRP Hollow Circular Steel columns subjected to axial compression loads

Recent research has been focused on rehabilitation and strengthening of deteriorated steel structures and bridges using Fiber Reinforced Polymer (FRP) materials. This paper deals with the behavior of FRP confinement of hollow steel sections subjected to axial compression loads. The load carrying capacity and buckling failure patterns of hallow steel sections strengthened by different FRP were studied experimentally. Numbers of circular hallow steel sections of same diameter with different L/D ratio test specimens were fabricated. Three different L/D ratio test specimens were used as control specimens. The different number of layers in FRP such as basalt (BFRP) and glass (GFRP) fabrics in different orientations has been fabricated. The effects of strengthened elements were observed under axial compression load. The load vz slenderness ratio, stress strain relationship, the ultimate load vz orientation and number of ply wrapping by different FRP were deeply analyzed and are plotted, tabulated and discussed. Besides local and overall buckling modes, failure patterns and rupturing of fiber of strengthened and non strengthened specimens were also observed. It is concluded that BFRP fabric wrapped by double layers in the circumferential direction elements withstand more axial compressive load than other strengthened and non strengthened elements

Non union of scaphoid fracture in a cricketer – possibility of a stress fracture: a case report

Scaphoid stress fractures are rare and can be a cause of wrist pain in sportspersons. All the cases reported in the literature have been sportspersons. Missing a scaphoid stress fracture could lead to non-union of the scaphoid and early degenerative arthritis of the radio-carpal joint. This can cause chronic wrist pain and can reduce the career span of a sportsperson. We report a case of non union of a scaphoid fracture in a cricketer possibly secondary to a stress fracture

Influence of dental education on adoption and integration of technological aids in the delivery of endodontic care by dental practitioners: a survey

Objective To investigate adoption and integration of technological aids during endodontic treatment and where dental practitioners (DPs) learnt to use this technology. Materials and methods An electronic questionnaire was distributed to all 459 dentists who graduated from University of Bergen between 2008 and 2018. The respondents were divided into two cohorts, older graduates (2008–2013) and newer graduates(2014–2018). Results A total of 314(68.4%) DPs answered the questionnaire. Magnification in the form of dental operating microscopes (DOM) and dental loupes was used by 180 (59.6%), electronic apex locators (EAL) by 271(89.7%) and motor-driven files by 281 (93.4%) DPs. The most frequent response, as to where they learnt to use them was: during undergraduate dental (UG) education. Significantly more newer graduates (90.7%) performed instrumentation based on what they learnt during UG education (p < .001). Older graduates based their instrumentation method equally on what they learnt during UG education (51.9%) and continuing dental education(42.6%). Rubber dam was used during all treatment procedures by 93% of the DPs. Conclusions UG education is a communication channel with long-lasting importance for adoption and integration of technology by DPs. Exposure to innovations (awareness) during UG education is adequate for integration of technology. Continuing dental education is as valuable as UG education for adoption of technology for older graduates.publishedVersio

Anaphylactic reaction associated with Ranitidine in a patient with acute pancreatitis: a case report

Ranitidine is a widely used drug and is known to be well tolerated. This case report illustrates a severe anaphylactic reaction after a single intravenous dose of 50 mgs of ranitidine and highlights this unusual but life threatening adverse reaction

Mechanical characteristics of three staples commonly used in foot surgery

<p>Abstract</p> <p>Background</p> <p>Bone staples are an accepted method of fixation in foot surgery. They reduce operating time and trauma in surgical procedures. A variety of memory staples are available but their properties compared to standard staples are not known. We carried out a study comparing two popular types of memory staples and a standard stainless steel staple.</p> <p>Methods</p> <p>Standardized bone models of metatarsals made from Tufnol tubes were osteotomized and stabilised using one of three types of bone staples, two types of memory staple (Memory staple and heat-activated Memoclip) or a standard stainless steel staple (Richards). Constructs were loaded in bending and torsion on a material testing machine. The moment and torque to achieve 10 degree of bending or torsion and permanent angulation of the osteotomized bones were assessed.</p> <p>Results</p> <p>The Richards staple was found to provide a four times larger resistance to bending and torsion than the two memory staples. However, it was permanently deformed after bending. The Memory and Memoclip staples were equal in their stiffness. In addition, angulation of bones fixed with the Memoclip was elastic, preventing any permanent deformation.</p> <p>Conclusion</p> <p>The Richards staple was stiffer, although the permanent deformation of this staple is a disadvantage. Memoclip staples exhibit lower but adequate stiffnesss when compared to the standard Richards staple and are not permanently deformed after bending. The Memoclip staples were easier to handle. The results will enable surgeons to determine the optimal staple for foot and ankle procedures.</p

Isolated radial head dislocation, a rare and easily missed injury in the presence of major distracting injuries: a case report

High velocity accidents can lead to major injuries – long bone fractures, abdominal trauma, pelvic fractures and chest injuries. These injuries can act as distracting factors during the initial assessment of a polytrauma patient and innocuous but significant smaller injuries can be missed. We present a rare case of isolated anterolateral radial head dislocation in a polytrauma patient