Changes in oral-health related quality of life, oral hygiene status and body growth in children with special health care needs following oral rehabilitation under general anaesthesia

Aim: To assess changes in oral health related quality of life, oral hygiene status and body growth in children with special health care needs following dental treatment under general anaesthesia. Methodology: Twenty children with special health care needs undergoing dental treatment undergoing general anaesthesia at the Unit of Pediatric Dentistry and those with Special needs, Faculty of Dentistry, Cairo University were selected in this study. For each patient oral hygiene status (assessed by Plaque index), weight, height and body mass index were assessed at baseline and at 3,6 and 9 months. OHRQoL was assessed using the early childhood oral health impact scale (ECOHIS) at baseline as well as 3, 6 and 9 months intervals. Results: At follow up, there was a slight increase in body weight in 100% of patients, 87.5% in height, 25% in body mass index that their percentile curve had been changed while in 75% of cases remain the same percentile curve but higher BMI. The overall Early Childhood Oral health impact scale scores decreased significantly (P < 0.001) demonstrating large effect sizes, at baseline score was significantly higher than at 3, 6 and 9 months respectively.&nbsp

Deterioration and conservation of an archaeological Byzantine lead sarcophagus from Jerash, Jordan

The research looks at a Byzantine sarcophagus made of lead, found in Jerash (Gerasa), Jordan, kept in the warehouse of the Jerash Museum under No.1824. The sarcophagus was exposed to unsuitable storage conditions that caused severe damage. Examination by optical stereomicroscope and scanning electron microscope revealed that the sarcophagus suffered from various deterioration phenomena, for example, the presence of corrosion layers, folds and various cracks. The analysis of the sarcophagus by the EDX unit attached to a scanning electron microscope and x-ray fluorescence, showed that it contained 98% lead, in addition to a very small percentage of other elements such as iron, aluminum, sodium, silicon, and carbon. Analysis by X-ray diffraction revealed that the sarcophagus also contained minerals, which included Graphite (C), Lead (Pb), Litharge (PbO), Cerussite PbCO3, Hydrocerussite 2PbCO3.Pb (OH)2. The treatment, restoration, and maintenance stages of the lead sarcophagus were then carried out and were followed by mechanical and chemical cleaning and straightening of the deformed areas. The missing parts were also integrated, and the four sides of the sarcophagus were assembled using plexiglass as a support material. Treatment with a benzotriazole solution in ethanol with a concentration of 5%, and with Paraloid B72, also with a concentration of 5% were carried out (coating). The sarcophagus cover was also completely repaired. After completion of the treatment, restoration, and conservation processes of the sarcophagus, a transparent glass cabinet of 1 cm thick was designed for its display inside the Jerash Museum in an environment with a relative humidity of 25-30% and temperature of 20-22 °C.La ricerca prende in esame un sarcofago bizantino in piombo, rinvenuto a Jerash (Gerasa), in Giordania, conservato nel magazzino del Museo di Jerash con il n. 1824. Il sarcofago è stato esposto a condizioni di conservazione non idonee che hanno causato gravi danni. L’esame allo stereomicroscopio ottico e al microscopio elettronico a scansione ha rivelato che il sarcofago soffriva di vari fenomeni di deterioramento, ad esempio erano presenti strati di corrosione, pieghe e crepe varie. L’analisi del sarcofago da parte dell’unità EDX collegata a un microscopio elettronico a scansione e fluorescenza a raggi X, ha mostrato che conteneva il 98% di piombo, oltre a una piccolissima percentuale di altri elementi come ferro, alluminio, sodio, silicio e carbonio. L’analisi mediante diffrazione di raggi X ha rivelato che il sarcofago conteneva anche minerali, che includevano grafite (C), piombo (Pb), litargio (PbO), cerussite PbCO3, idrocerussite 2PbCO3.Pb (OH)2. Sono state quindi eseguite le fasi di restauro e manutenzione del sarcofago in piombo, seguite da pulitura meccanica e chimica e raddrizzatura delle zone deformate. Sono state integrate anche le parti mancanti e i quattro lati del sarcofago sono stati assemblati utilizzando il plexiglass come materiale di supporto. Sono stati effettuati trattamenti con una soluzione di benzotriazolo in etanolo alla concentrazione del 5%, e con Paraloid B72, anch’esso alla concentrazione del 5% (coating). Anche la copertura del sarcofago è stata completamente restaurata. Al termine degli interventi di restauro e conservazione del sarcofago, è stata progettata una teca in vetro trasparente dello spessore di 1 cm per la sua esposizione, all’interno del Museo di Jerash, in un ambiente con umidità relativa del 25-30% e temperatura di 20-22 °C

Characteristics and in-hospital outcomes of patients with acute coronary syndromes and heart failure in the United Arab Emirates

<p>Abstract</p> <p>Background</p> <p>Heart failure (HF) is a serious complication of acute coronary syndromes (ACS), and is associated with high in-hospital mortality and poor long-term survival. The aims of this study were to describe the clinical characteristics, management and in-hospital outcomes of coronary syndrome (ACS) patients with HF in the United Arab Emirates.</p> <p>Findings</p> <p>The study was selected from the Gulf Registry of Acute Coronary Events (Gulf RACE), a prospective multi-national, multicenter registry of patients hospitalized with ACS in six Middle East countries. The present analysis was focused on participants admitted to various hospitals in the UAE with a diagnosis of ACS in 2007 and were analyzed in terms of HF (Killip class II/III and IV) on admission. Of 1691 patients (mean age: 52.6 ± 11.7 years; 210 Females, 1481 Males) with ACS, 356 (21%) had an admission diagnosis of HF (Killip class II/III and IV). HF patients were less frequently males (19.2% vs. 34.3%; P <it><</it> 0.001). HF was more frequently associated with hypertension (64.3% vs. 43.9%; P < 0.001), hyperlipidemia (49.4% vs. 31.8%; P < 0.001) and diabetes mellitus (DM) (51.1% vs. 36.2%; P < 0.001). HF was significantly associated with in-hospital mortality (OR = 11.821; 95% CI: 5.385-25.948; P < 0.001). In multivariate logistic regression, age, hyperlipidemia, heart rate and DM were associated with higher in-hospital HF.</p> <p>Conclusions</p> <p>HF is observed in about 1 in 5 patients with ACS in the UAE and is associated with a significant increase in in-hospital mortality and other adverse outcomes.</p

A case report of anti-NMDA receptor encephalitis in a young Egyptian female patient presenting with hyperreligiosity

Abstract Anti-n-methyl-d-aspartate receptor (NMDAR) encephalitis is a form of autoimmune encephalitis that remains under-recognized due to the variability of the initial symptoms and can be misdiagnosed as viral encephalitis or other pathogens. This syndrome has been predominantly described in young females including personality changes, autonomic dysfunctions, and neurologic decompensation. About half of the cases have tumors, most commonly teratomas of the ovaries; another established trigger is herpes viral encephalitis, while the cause in other cases is unclear. In case of clinical suspicion, electroencephalogram and brain magnetic resonance imaging are useful, but lumbar puncture for cerebrospinal fluid analysis is used to confirm the diagnosis. Treatment for this disease includes immunosuppression, plasmapheresis, and tumor resection when indicated. In this case report, we present a case that presented with hyperreligiosity and proved to have autoimmune encephalitis. The main purpose of our case is to increase awareness regarding immune-mediated encephalitis, especially the anti-NMDAR encephalitis

Characteristics, Management, and In-Hospital Outcomes of Diabetic Patients with Acute Coronary Syndrome in the United Arab Emirates

We describe the baseline characteristics, management, and in-hospital outcomes of patients in the United Arab Emirates (UAE) with DM admitted with an acute coronary syndrome (ACS) and assess the influence of DM on in-hospital mortality. Data was analyzed from 1697 patients admitted to various hospitals in the UAE with a diagnosis of ACS in 2007 as part of the 1st Gulf RACE (Registry of Acute Coronary Events). Of 1697 patients enrolled, 668 (39.4%) were diabetics. Compared to patients without DM, diabetic patients were more likely to have a past history of coronary artery disease (49.1% versus 30.1%, P<0.001), hypertension (67.2% versus 36%, P<0.001), and prior revascularization (21% versus 11.4%, P<0.001). They experienced more in-hospital recurrent ischemia (8.5% versus 5.1%; P=0.004) and heart failure (20% versus 10%; P<0.001). The mortality rate was 2.7% for diabetics and 1.6% for nondiabetics (P=0.105). After age adjustment, in-hospital mortality increased by 3.5% per year of age (P=0.016). This mortality was significantly higher in females than in males (P=0.04). ACS patients with DM have different clinical characteristics and appear to have poorer outcomes

Lower effectiveness of divalproex versus valproic acid in a prospective, quasi-experimental clinical trial involving 9,260 psychiatric admissions

OBJECTIVE: The authors examined clinical differences between divalproex sodium and generic immediate-release valproic acid. METHOD: This 6-year prospective, quasi-experimental clinical trial compared the effectiveness and tolerability of divalproex and valproic acid. The dependent variables were length of hospital stay, rehospitalization rate, and adverse drug reactions in 9,260 psychiatric admissions. RESULTS: Inpatients who initially received divalproex sodium had a 32.7% longer hospital stay and 3.8% higher readmission rate than did patients who initially received valproic acid. Initial treatment with divalproex prolonged length of stay by 30.3% in patients treated with divalproex and valproic acid during different admissions. After other variables were controlled by multiway analysis of variance, the hospital stay of patients who continued the initial medication was 15.2% longer (2.0 days) for divalproex than valproic acid. Switching medications was more common for valproic acid, partly because of study design. Medication intolerance occurred in approximately 6.4% more patients taking valproic acid than divalproex. However, switching from valproic acid to divalproex did not significantly prolong length of stay, over that for continuous divalproex, or increase the rehospitalization rate. CONCLUSIONS: Lower peak valproate concentrations with divalproex sodium may have enhanced tolerability but may also explain the lower effectiveness. Extended-release divalproex could lower effectiveness further and require higher doses. Thus, inpatients are better served by beginning with generic valproic acid and by changing to delayed-release divalproex only if intolerance occurs. This would save up to one-third of inpatient costs and two-thirds of a billion dollars yearly in medication costs

Outcomes in Newly Diagnosed Atrial Fibrillation and History of Acute Coronary Syndromes: Insights from GARFIELD-AF

BACKGROUND: Many patients with atrial fibrillation have concomitant coronary artery disease with or without acute coronary syndromes and are in need of additional antithrombotic therapy. There are few data on the long-term clinical outcome of atrial fibrillation patients with a history of acute coronary syndrome. This is a 2-year study of atrial fibrillation patients with or without a history of acute coronary syndromes