Eradication Of Endodontic Infection By Instrumentation Role Of Nursing In The Management

There are a number of various working processes that are involved in endodontic therapy. These procedures include the isolation of the operating field, access to the pulp chamber, cleaning and shaping stages, and finally, the necessity for a three-dimensional filling of the canals. During each stage, a set of instruments that are either single-use or sterilizable is required. Nursing has a very essential part in the management of endodontic infection eradication because they will be the first line of defense in recognizing the symptoms being experienced by the patient. When it comes to reusable tools, it is essential to pay attention to the removal of material that has been deposited on the blades, which is not easy to remove manually. This review demonstrated that the use of single-use or first-use instruments necessitates the implementation of procedures associated with presterilization or sterilization

Overview On Surgical Management Of Overactive Bladder

Overactive bladder syndrome is a persistent and incapacitating disorder that has profound medical, psychological, and social implications, greatly impacting the wellbeing of countless individuals globally. A significant number of individuals experience urine urgency, which can be extremely bothersome. The primary indicator of overactive bladder (OAB) is a sense of urgency, often accompanied by increased urine frequency and nocturia. After ruling out other medical conditions with similar symptoms, the initial approach to managing OAB is providing guidance on fluid consumption and bladder training. If needed, antimuscarinic medicines may be added as a supplement. If patients have significant distress from OAB symptoms even after maximizing medicinal treatment, they may choose to undergo invasive procedures. There is currently a limited understanding of the hierarchical structure of central nervous system control. However, the use of functional imaging is starting to reveal the difficulties that need to be addressed in this area. Current research is exploring the use of botulinum neurotoxin-A injection, oral β3-adrenergic agonists, and innovative methods for nerve stimulation as potential therapies. The inherent subjectivity of urine urgency, the absence of animal models, and the complex pathophysiology of overactive bladder (OAB) pose substantial obstacles to achieving effective clinical therapy

The Importance of Preventive Medicine in Family Practice: A Review of Current Guidelines and Recommendations

Prevention is seen as a critical topic in family practice. Primordial prevention, primary prevention, secondary prevention, tertiary prevention, and quaternary prevention are all part of this strategy to disease prevention. To avoid the formation and development of risk factors, primary prevention focuses on addressing the fundamental causes and social determinants of disease. Primary prevention is the practice of preventing illnesses before they arise via the use of treatments such as immunizations and health education. Secondary prevention focuses on illness identification and intervention as early as possible to avoid disease development. Tertiary prevention addresses illness outcomes by restoring health and offering rehabilitation. Finally, quaternary prevention seeks to safeguard patients against needless medical treatments and the harm caused by over-medicating. Risks frequently rise in tandem with frailty and comorbidities. In contrast, advantages frequently drop as life expectancy increases. Preventive management strategies should consider the patient's viewpoint and be mutually agreed upon. Healthcare providers must prioritize the deployment of preventive care services, even when clinical treatments are required, in order to overcome preventive care hurdles. Healthcare practitioners may play a critical role in illness prevention and contribute to family well-being by investing in preventive care and executing these measures

The World Federation of ADHD International Consensus Statement:208 Evidence-based conclusions about the disorder

Background: Misconceptions about ADHD stigmatize affected people, reduce credibility of providers, and prevent/delay treatment. To challenge misconceptions, we curated findings with strong evidence base. Methods: We reviewed studies with more than 2000 participants or meta-analyses from five or more studies or 2000 or more participants. We excluded meta-analyses that did not assess publication bias, except for meta-analyses of prevalence. For network meta-analyses we required comparison adjusted funnel plots. We excluded treatment studies with waiting-list or treatment as usual controls. From this literature, we extracted evidence-based assertions about the disorder. Results: We generated 208 empirically supported statements about ADHD. The status of the included statements as empirically supported is approved by 80 authors from 27 countries and 6 continents. The contents of the manuscript are endorsed by 366 people who have read this document and agree with its contents. Conclusions: Many findings in ADHD are supported by meta-analysis. These allow for firm statements about the nature, course, outcome causes, and treatments for disorders that are useful for reducing misconceptions and stigma.</p

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10&nbsp;years; 78.2% included were male with a median age of 37&nbsp;years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Dimensional stability of 3D-printed edentulous and fully dentate hollowed maxillary models over periods of time

Abstract Background Dental casts made utilising digital workflow are becoming more common because to their speed and cost savings. However, studies on their dimensional accuracy over time with diverse designs are missing. Objective The aim of this in vitro study was to assess the dimensional stability of 3D-printed edentulous and fully dentate hollowed maxillary models with 50-micrometer resolution over 1 day, 14 days, and 28 days using surface matching software. Methods Scanned edentulous and fully dentate maxillary typodont models were used as references. The models were scanned by a desktop lab scanner of 15-micrometer accuracy (D900, 3Shape). Then, the files were used in designing software (Meshmixer, Autodesk) to create hollowed maxillary casts. Fifteen edentulous and 15 fully dentate (total of 30) models were printed using a DLP lab printer (Cara print 4.0, Kulzer). The 3D-printed models were scanned using the same desktop lab scanner of 15-micrometer accuracy at intervals of baseline days, 1 day, 14 days, and 28 days to assess the effect of aging (n = 120). The dimensional changes were quantified and compared using the root mean square (RMS) method, expressed in micrometres (µm). The study employed repeated measures analysis of variance (ANOVA) to assess and compare the root mean square (RMS) values across the variables. The data was analysed using SPSS (26, Chicago, Illinois, USA). Results The RMS of the edentulous models rapidly increased from a mean value of 0.257 at the beginning of the study to 0.384 after twenty-eight days. However, the mean RMS values for the dentate models did not change much over the four intervals. It varied only from 0.355 to 0.347. The mean values for edentulous patients increased from 0.014 to 0.029 during the period from baseline to twenty-eight days. However, the mean average values decreased for the dentate models from 0.033 to 0.014 during this period. By utilizing ANOVA, mean RMS values increased insignificantly till one day but significantly to fourteen and twenty-eight days. Dentate model mean values differed insignificantly across four intervals. Repeated measures ANOVA for combined and separated data showed no significant differences across edentulous, dentate, and total models over times. Conclusion The study revealed changes in the dimensions of 3D-printed edentulous models over a span of 3 and 4 weeks. Caution should be applied when using 3D-printed dental master models for constructing definitive prostheses on edentulous models over a period of 3 to 4 weeks

The Association between Cardiorespiratory Fitness and Reported Physical Activity with Sleep Quality in Apparently Healthy Adults: A Cross-Sectional Study

Background: Recently, poor cardiorespiratory fitness (CRF) has been postulated as an adverse health outcome related to poor sleep quality. However, studies investigating the relationship between CRF and a subjective sleep quality index are scarce. Thus, the current study aimed to investigate the association between CRF and the Pittsburgh Sleep Quality Index (PSQI) in apparently healthy people. The secondary aim was to investigate the association between reported physical activity (PA) and PSQI. Methods: Thirty-three healthy male participants volunteered to participate. CRF (VO2PEAK) was measured via cardiopulmonary exercise testing on a treadmill. A short form of the International Physical Activity Questionnaire (IPAQ) was used to measure PA, and PSQI was used for the sleep quality index. Results: There was no correlation between CRF and PSQI total score or any component of the PSQI. There was a significant inverse correlation between IPAQ and PSQI total score (r = −0.36, p = 0.04). Categorical data analysis of the two questionnaires revealed that 42.4% of the participants who reported low physical activity also had poor sleep quality. Conclusions: The current study showed no association between CRF and the subjective sleep quality index but demonstrated a moderate inverse association between reported PA and subjective sleep quality index. The findings suggest that the more reported PA, the better the overall sleep quality

Knowledge about emergency management of orofacial injuries among school teachers at Alkharj Saudi Arabia

Background: Children suffer from orofacial injuries during sport activities in schools. School teacher's knowledge about managing emergency during orofacial injuries will help in treatment prognosis. Aim: To assess and compare school teacher's knowledge about management of orofacial injuries at alkharj Saudi Arabia. Materials and Methods: Cross-sectional study was planned among school teacher working in various schools at alkharj. Questionnaire consisted of Demographic details such as age and year of experience and knowledge-related questions about management of orofacial injuries. Questionnaire was distributed and collected on the same day. Results: All participants were aware that sport activities results in injuries to head, orofacial structures, or teeth. 15.6% participants have undergone training. 84.4% of study participants have told they don't know to manage avulsed tooth. 92.8% of study participants are interested to get training on orofacial injury management. Conclusion: Knowledge of school teachers about management of orofacial injury is insufficient. Teachers are primary level of contact in schools during sports injuries, measures should be taken to improve their knowledge about orofacial injuries

Association of Oral and General Health with Nutritional Status of Older Adults Attending Two Medical Centers in Riyadh, Saudi Arabia: A Cross-Sectional Study

Malnutrition could profoundly affect older adults’ oral health and quality of life, whereas oral health might, in turn, impact dietary intake and nutritional status. The present study aimed to investigate the association between general and oral health and nutritional status among older adults attending nutrition clinics at two main medical centers in Riyadh, Saudi Arabia. A cross-section study was carried out among adult patients (≥60 years) who attended a geriatric clinic or nutrition clinic at King Khalid University Hospital or King Abdulaziz Medical City, Riyadh. A validated clinician’s Mini Nutritional Assessment Short-Form (MNA-SF), Oral Health Impact Profile-5 (OHIP-5), and 36-Item Short Form Survey (SF-36) were collected from each participant. A total of 261 participants with a mean age of 72.14 (±8.97) years were recruited. Diabetes (71%) and hypertension (80%) were present in the majority of patients. The overall MNA-SF score was (10 ± 3). Based on the categorization of the MNA-SF score, 65.9% were classified as malnourished or at risk of malnutrition. Participants with OHIP-5 scores higher than the median (>5) were more likely to be malnourished than those with scores at or lower than 5 (p < 0). The adjusted odd ratio for the MNA-SF score categories indicated that for a one-unit increase in the total SF-36 score, the odds of the malnourished category are 0.94 times less than the risk of malnutrition and normal nutritional status, with OR 0.97 (95% CI 0.94–0.95). Malnutrition or being at risk of malnutrition is likely associated with poor general and oral health. Healthcare providers need to incorporate dietitians into care plans to promote the nutritional health of older adults

Application of 32 factorial design for loratadine-loaded nanosponge in topical gel formulation: comprehensive in-vitro and ex vivo evaluations

Loratadine (LoR) is a highly lipophilic and practically insoluble in water, hence having a low oral bioavailability. As it is formulated as topical gel, it competitively binds with the receptors, thus reducing the side-effects. The objective of this study was to prepare LoR loaded nanosponge (LoR-NS) in gel for topical delivery. Nine different formulations of emulsion were prepared by solvent evaporation method with polyvinyl alcohol (PVA), ethyl cellulose (EC), and dichloromethane (DCM). Based on 32 Full Factorial Design (FFD), optimization was carried out by varying the concentration of LOR:EC ratio and stirring rate. The preparations were subjected for the evaluation of particle size (PS), in vitro release, zeta potential (ZP) and entrapment efficiency (EE). The results revealed that the NS dispersion was nanosized with sustained release profiles and significant PS. The optimised formulation was formulated and incorporated into carbopol 934P hydrogel. The formulation was then examined to surface morphological characterizations using scanning electron microscopy (SEM) which depicted spherical NS. Stability studies, undertaken for 2 months at 40 ± 2 °C/75 ± 5% RH, concluded to the stability of the formulation. The formulation did not cause skin irritation. Therefore, the prepared NS hydrogel proved to be a promising applicant for LoR as a novel drug delivery system (NDDS) for safe, sustained and controlled topical application