Dr Rahul VC Tiwari - Oral & Maxillofacial Surgery - SIBAR Institute of Dental Sciences, Gunutr, Andhra Pradesh.Oral surgery in liver transplant candidates: a retrospective study on delayed bleeding and other complications
Dr Rahul VC Tiwari - Oral & Maxillofacial Surgery - SIBAR Institute of Dental Sciences, Gunutr, Andhra Pradesh.
Oral surgery in liver transplant candidates: a retrospective study on delayed bleeding
and other complications
Dr Rahul Tiwari OMFS SIBAR Institute of Dental Sciences, Guntur, Andhra Pradesh. Influence of tooth sectioning technique and various risk factors
in reducing the IAN injury following surgical removal
of an impacted mandibular third molar
Objectives: To evaluate the clinical outcomes and complications following total laryngectomy in a South-East Asian Population.
Design: 10-year retrospective review of cases of total laryngectomy or laryngo-pharygectomy.
Main outcome measures: 5-year overall survival (OS) and disease-free survival (DFS).
Results: 61 patients of which 55 (90%) had laryngeal SCC while 6 (10%) had hypopharyngeal SCC. Overall median survival was 85 months. 5-year OS and DFS for laryngeal SCC were 65% and 47% respectively while 5-year OS and DFS for hypopharyngeal SCC were both 33%. Most common cause of death was due to advanced cancer secondary to disease recurrence.
Bo Abrahamsen's presentation from Osteoporosis 2016: Surgically treated osteonecrosis and osteomyelitis of the jaw and oral cavity in patients highly adherent to alendronate treatment.
Find out more at: https://nos.org.uk/conference
Nurse led chest drain clinic: a study of change from national health system i...Abdulsalam Taha
Abstract:
Background and Objective: There are many nurse-led clinics now in UK, like Chest-Pain, Endoscopy and Bronchiectasis Clinics. Herein, we present the project of Nurse-led Chest Drain Clinic in Guy’s and St Thomas, s Hospital/ London. The aim is to analyze this change project.
Methods: A project of change was designed to set an outpatient clinic run by specialist clinical nurses for patients discharged home with an ambulatory chest drain system in situ. The project is observed and analyzed via interviews with the responsible nurses.
Results: The clinic was established in 2005, run by two Nurse Case Managers, 60 patients were seen in 2007 and the clinic remained well attended. Patients were happy to spend less time in hospital as they could stay safely with their families.
Conclusions: A safe at home management of long-term chest drains was provided by this nurse-led clinic.
Key Words: chest, drainage, nurse-led clinic.
Publication Date: Dec 2013
Publication Name: Middle East Journal of Nursing
view on www.me-jn.com
Dr Rahul Tiwari OMFS SIBAR Institute of Dental Sciences, Guntur, Andhra Pradesh. Influence of tooth sectioning technique and various risk factors
in reducing the IAN injury following surgical removal
of an impacted mandibular third molar
Objectives: To evaluate the clinical outcomes and complications following total laryngectomy in a South-East Asian Population.
Design: 10-year retrospective review of cases of total laryngectomy or laryngo-pharygectomy.
Main outcome measures: 5-year overall survival (OS) and disease-free survival (DFS).
Results: 61 patients of which 55 (90%) had laryngeal SCC while 6 (10%) had hypopharyngeal SCC. Overall median survival was 85 months. 5-year OS and DFS for laryngeal SCC were 65% and 47% respectively while 5-year OS and DFS for hypopharyngeal SCC were both 33%. Most common cause of death was due to advanced cancer secondary to disease recurrence.
Bo Abrahamsen's presentation from Osteoporosis 2016: Surgically treated osteonecrosis and osteomyelitis of the jaw and oral cavity in patients highly adherent to alendronate treatment.
Find out more at: https://nos.org.uk/conference
Nurse led chest drain clinic: a study of change from national health system i...Abdulsalam Taha
Abstract:
Background and Objective: There are many nurse-led clinics now in UK, like Chest-Pain, Endoscopy and Bronchiectasis Clinics. Herein, we present the project of Nurse-led Chest Drain Clinic in Guy’s and St Thomas, s Hospital/ London. The aim is to analyze this change project.
Methods: A project of change was designed to set an outpatient clinic run by specialist clinical nurses for patients discharged home with an ambulatory chest drain system in situ. The project is observed and analyzed via interviews with the responsible nurses.
Results: The clinic was established in 2005, run by two Nurse Case Managers, 60 patients were seen in 2007 and the clinic remained well attended. Patients were happy to spend less time in hospital as they could stay safely with their families.
Conclusions: A safe at home management of long-term chest drains was provided by this nurse-led clinic.
Key Words: chest, drainage, nurse-led clinic.
Publication Date: Dec 2013
Publication Name: Middle East Journal of Nursing
view on www.me-jn.com
Dr Rahul Tiwari OMFS SIBAR Institute of Dental Sciences, Guntur, Andhra Pradesh. MANAGEMENT OF SADDLE NOSE DEFORMITY USING DERMAL FAT AND COSTAL CARTILAGE “SANDWICH” GRAFT - A Problem-Oriented Approach and Anthropometrical Evaluation.
Dr Rahul Tiwari OMFS SIBAR Institute of Dental Sciences, Guntur, Andhra Pradesh. A comparison of bone resorption over time. An analysis of the free scapular, iliaccrest and fibular microvascular flaps in mandibular reconstruction
Dr Rahul VC Tiwari - Novel Transoral Approach to the Posterolateral Maxilla and Infratemporal Region - 10th jc - DEPARTMENT OF ORAL AND MAXILLOFACIAL SURGERY - SIBAR INSTITUTE OF DENTAL SCIENCES, GUNTUR
Dr Rahul VC Tiwari - Oral & Maxillofacial Surgery - SIBAR Institute of Dental Sciences, Gunutr, Andhra Pradesh. Relationship between fracture of mandibular condyle and absence of unerupted mandibular third molar—a retrospective study
5th publication -Dr Rahul VC Tiwari - Department of ral and Maxillofacial Surgery, SIBAR Institute of Dental Sciences, Takkellapadu,Guntur, Andhra Pradesh - 522509.
The study had two specific goals: 1) Determine the impact of a simulated reduced dose rendering on the detection of skeletal fractures in children, and 2) Evaluate the effect of enhanced skeletal processing on the same detection task. The methodology and results of this study were on display at RSNA 2015. Read the blog at http://www.carestream.com/blog/2016/04/12/carestream-pediatric-fracture-detection-study-and-potential-dose-reduction/#more-7700 or visit www.carestream.com/medical
Minor Oral Surgical Procedures -Stoma 2014, lecture by dr arun georgeArun1g
Lectures on Various minor Oral Surgical procedures , delivered by Dr Arun George MDS during minor oral Surgical workshop conducted at Mar Baselios Dental College, Kerala, India for more information regarding the procedures mail to -
drarun1g@gmail.com
Dr Rahul Tiwari OMFS SIBAR Institute of Dental Sciences, Guntur, Andhra Pradesh. MANAGEMENT OF SADDLE NOSE DEFORMITY USING DERMAL FAT AND COSTAL CARTILAGE “SANDWICH” GRAFT - A Problem-Oriented Approach and Anthropometrical Evaluation.
Dr Rahul Tiwari OMFS SIBAR Institute of Dental Sciences, Guntur, Andhra Pradesh. A comparison of bone resorption over time. An analysis of the free scapular, iliaccrest and fibular microvascular flaps in mandibular reconstruction
Dr Rahul VC Tiwari - Novel Transoral Approach to the Posterolateral Maxilla and Infratemporal Region - 10th jc - DEPARTMENT OF ORAL AND MAXILLOFACIAL SURGERY - SIBAR INSTITUTE OF DENTAL SCIENCES, GUNTUR
Dr Rahul VC Tiwari - Oral & Maxillofacial Surgery - SIBAR Institute of Dental Sciences, Gunutr, Andhra Pradesh. Relationship between fracture of mandibular condyle and absence of unerupted mandibular third molar—a retrospective study
5th publication -Dr Rahul VC Tiwari - Department of ral and Maxillofacial Surgery, SIBAR Institute of Dental Sciences, Takkellapadu,Guntur, Andhra Pradesh - 522509.
The study had two specific goals: 1) Determine the impact of a simulated reduced dose rendering on the detection of skeletal fractures in children, and 2) Evaluate the effect of enhanced skeletal processing on the same detection task. The methodology and results of this study were on display at RSNA 2015. Read the blog at http://www.carestream.com/blog/2016/04/12/carestream-pediatric-fracture-detection-study-and-potential-dose-reduction/#more-7700 or visit www.carestream.com/medical
Minor Oral Surgical Procedures -Stoma 2014, lecture by dr arun georgeArun1g
Lectures on Various minor Oral Surgical procedures , delivered by Dr Arun George MDS during minor oral Surgical workshop conducted at Mar Baselios Dental College, Kerala, India for more information regarding the procedures mail to -
drarun1g@gmail.com
Minor Oral Surgical Procedures -Stoma 2014, lecture by dr arun george
Similar to Dr Rahul VC Tiwari - Oral & Maxillofacial Surgery - SIBAR Institute of Dental Sciences, Gunutr, Andhra Pradesh.Oral surgery in liver transplant candidates: a retrospective study on delayed bleeding and other complications
Epidemiology./Biostatistics class on lung cancer screening including description of lung cancer, natural history and treatment, lung cancer statistics, lung cancer risk factors, NLST results, NLST follow-on, criteria for a good screening test, USPSTF and CMS lung cancer screening guidelines, and challenges to screening
The Public Presentation does not include any confidential information or findings from this Team Masters Project with BioMarin Pharmaceutical.
BioMarin and KGI titled our project as:
"Recurrent bleeding in patients with mechanical flow devices: an environmental study."
Jonathan G Stine, Puja M Shah, Scott L Cornella, Sean R Rudnic.docxpriestmanmable
Jonathan G Stine, Puja M Shah, Scott L Cornella, Sean R Rudnick, Marwan S Ghabril, George J Stukenborg,
Patrick G Northup
Jonathan G Stine, Sean R Rudnick, Patrick G Northup,
Division of Gastroenterology and Hepatology, University of
Virginia, Charlottesville, VA 22908, United States
Puja M Shah, Department of Surgery, University of Virginia,
Charlottesville, VA 22908, United States
Scott L Cornella, Department of Medicine, University of
Virginia, Charlottesville, VA 22908, United States
Marwan S Ghabril, Division of Gastroenterology and Hepatology,
Indiana University, Indianapolis, IN 46202, United States
George J Stukenborg, Department of Public Health Science,
University of Virginia, Charlottesville, VA 22908, United States
Author contributions: Stine JG and Shah PM contributed equally
to this work; Stine JG, Shah PM, Ghabril MS, Stukenborg GJ
and Northup PG designed research; Stine JG, Shah PM, Cornella
SL and Rudnick SR performed research; Stine JG and Shah PM
analyzed data; Stine JG, Shah PM, Cornella SL, Rudnick SR,
Ghabril MS, Stukenborg GJ and Northup PG wrote the paper.
Supported by (In part) grant funding from the National
Institutes of Health (Grant 5T32DK007769-15); and NIH-
Surgical Oncology grant (T32 CA163177).
Conflict-of-interest statement: We have no conflicts of interest
to report.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was
selected by an in-house editor and fully peer-reviewed by external
reviewers. It is distributed in accordance with the Creative
Commons Attribution Non Commercial (CC BY-NC 4.0) license,
which permits others to distribute, remix, adapt, build upon this
work non-commercially, and license their derivative works on
different terms, provided the original work is properly cited and
the use is non-commercial. See: http://creativecommons.org/
licenses/by-nc/4.0/
Correspondence to: Jonathan G Stine, MD, MSc, Division
of Gastroenterology and Hepatology, University of Virginia, JPA
and Lee Street, MSB 2145, PO Box 800708, Charlottesville, VA
22908, United States. [email protected]
Telephone: +1-434-9242959
Fax: +1-434-2447529
Received: September 18, 2015
Peer-review started: September 19, 2015
First decision: October 21, 2015
Revised: November 2, 2015
Accepted: November 10, 2015
Article in press: November 11, 2015
Published online: November 28, 2015
Abstract
AIM: To determine the clinical impact of portal vein
thrombosis in terms of both mortality and hepatic
decompensations (variceal hemorrhage, ascites, por-
tosystemic encephalopathy) in adult patients with
cirrhosis.
METHODS: We identified original articles reported
through February 2015 in MEDLINE, Scopus, Science
Citation Index, AMED, the Cochrane Library, and
relevant examples available in the grey literature. Two
independent reviewers screened all citations for inclu-
sion criteria and extracted summary data. Random
effects odds rati ...
Officially endorsed by the European Hypertension Society, the 1st Gulf Hypertension Conference is the NEW addition in the Arab Health Congress 2015. The aim of the conference is to provide the most updated clinical and scientific data in the field of hypertension (HTN).
Over two-action packed days most aspects of hypertension management will be discussed. A group of highly specialised physicians will gather to present and discuss the latest recommendations, guidelines and debates in the field. The conference will elaborate on the extent of the disease and its impact in the region.
It will provide physicians, as well as regional health agencies, with recent advancements in the field as well as improving hypertension management, ultimately reflecting in the delivery of better patient care and outcomes.
Key topics
Epidemiology of HTN
Updates on antihypertensive medications
Renal denervation and baroreceptor stimulation therapies in treating hypertension
Chronic kidney disease and diabetic nephropathy updates
Hypertension in pregnancy and transplant populations
30th Annual New Treatments in Chronic Liver Disease
March 20-22, 2015
Estancia La Jolla Hotel, La Jolla, California
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60.Srinivasan S, Velusamy G, Munshi MAI, Radhakrishnan K, Tiwari RVC. Comparative Study of Antifungal Efficacy of Various Endodontic Irrigants with and without Clotrimazole in Extracted Teeth Inoculated with Candida albicans. J Contemp Dent Pract. 2020 Dec 1;21(12):1325-1330. PubMed PMID: 33893253.
Mathew P, Kattimani VS, Tiwari RV, Iqbal MS, Tabassum A, Syed KG. New Classification System for Cleft Alveolus: A Computed Tomography-based Appraisal. J Contemp Dent Pract. 2020 Aug 1;21(8):942-948. PubMed PMID: 33568619
Sahu S, Patley A, Kharsan V, Madan RS, Manjula V, Tiwari RVC. Comparative evaluation of efficacy and latency of twin mix vs 2% lignocaine HCL with 1:80000 epinephrine in surgical removal of impacted mandibular third molar. J Family Med Prim Care. 2020 Feb;9(2):904-908. doi: 10.4103/jfmpc.jfmpc_998_19. eCollection 2020 Feb. PubMed PMID: 32318443; PubMed Central PMCID: PMC7113948.
65.Izna, Sasank Kuntamukkula VK, Khanna SS, Salokhe O, Chandra Tiwari RV, Tiwari H. Knowledge and Apprehension of Dental Health Professionals Pertaining to COVID in Southern India: A Questionnaire Study. J Pharm Bioallied Sci. 2021 Jun;13(Suppl 1):S448-S451. doi: 10.4103/jpbs.JPBS_551_20. Epub 2021 Jun 5. PubMed PMID: 34447131; PubMed Central PMCID: PMC8375944.
Vohra P, Belkhode V, Nimonkar S, Potdar S, Bhanot R, Izna, Tiwari RVC. Evaluation and diagnostic usefulness of saliva for detection of HIV antibodies: A cross-sectional study. J Family Med Prim Care. 2020 May;9(5):2437-2441. doi: 10.4103/jfmpc.jfmpc_138_20. eCollection 2020 May. PubMed PMID: 32754516; PubMed Central PMCID: PMC7380795
Mittal S, Hussain SA, Tiwari RVC, Poovathingal AB, Priya BP, Bhanot R, Tiwari H. Extensive pelvic and abdominal lymphadenopathy with hepatosplenomegaly treated with radiotherapy-A case report. J Family Med Prim Care. 2020 Feb;9(2):1215-1218. doi: 10.4103/jfmpc.jfmpc_1125_19. eCollection 2020 Feb. PubMed PMID: 32318498; PubMed Central PMCID: PMC7113973.
36.Kesharwani P, Hussain SA, Sharma N, Karpathak S, Bhanot R, Kothari S, Tiwari RVC. Massive radicular cyst involving multiple teeth in pediatric mandible- A case report. J Family Med Prim Care. 2020 Feb;9(2):1253-1256. doi: 10.4103/jfmpc.jfmpc_1059_19. eCollection 2020 Feb. PubMed PMID: 32318508; PubMed Central PMCID: PMC7113959.
More from CLOVE Dental OMNI Hospitals Andhra Hospital (20)
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
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neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Novas diretrizes da OMS para os cuidados perinatais de mais qualidade
Dr Rahul VC Tiwari - Oral & Maxillofacial Surgery - SIBAR Institute of Dental Sciences, Gunutr, Andhra Pradesh.Oral surgery in liver transplant candidates: a retrospective study on delayed bleeding and other complications
2. Oral surgery in liver transplant candidates:
a retrospective study on delayed bleeding
and other complications
2
10/25/2016 8:31:03 AM
3. About the Journal
Journal Name: Oral Surgery, Oral Medicine,
Oral Pathology and Oral Radiology
Periodicity of journal: Monthly
• Editor in Chief: R Bryan Bell
• Publisher’s name: Thomas Reuters Ltd.
• ISSN NO Print : 0265 -539X
310/25/2016 8:31:03 AM
4. About the Journal contd..
• Impact factor:
• Peer review:
• Indexation:
0.732
Yes
Pubmed, Google scholar, EBSCO
410/25/2016 8:31:03 AM
5. • Date of publication: 1st May 2016
• Volume: 121
• Issue: 5
• Type of article: Research Article
• Page numbers: 490-495
• Received: 25 August 2015
• Accepted: 24 January 2016
About the Article
510/25/2016 8:31:03 AM
9 months
6. About the Article contd..
• Author names :
• Institutional Attachments :
• Designations :
• Keywords :
Jaana helenius hietala
& its associates
Helinski, finland
Not Mentioned
Dental infections,
Heamorrhage,
Tooth extraction,
Liver cirrhosis
610/25/2016 8:31:03 AM
7. • Study design : Mentioned.
• Common terms : Common terms were used.
Title :
Oral surgery in liver transplant candidates: a
retrospective study on delayed bleeding and other
complications
710/25/2016 8:31:03 AM
11. 11
Guggenheimer et al 2003, Helenius heitala j et al 2013
Pre-transplant dental treatment is a prerequisite in many liver transplantation
pt.to prevent post-transplant infectious complications, such as bacteremia
and sepsis, which could be fatal in immunocompromised patients.
Helenius heitala j et al 2012, ward BB et al 2006
In particular, patients with chronic liver disease (CLD) have shown poor oral
health with a high prevalence of dental infections in pre-LT dental
evaluations. Patients with CLD also run a high risk of bleeding after oral
surgery, due to CLD-associated coagulopathy
Perdigao JP et al 2012, Stanca CM et al 2010
previous studies were limited by small cohorts (9 to 90 patients), and those
patients often had well-compensated CLD
Valerian 2007, Hong CH 2012
Earlier studies that specifically studied LT candidates, that is, patients with
advanced or end-stage liver disease, included only 23 to 36 patients.
10/25/2016 8:31:03 AM
REVIEWOFLITERATURE
12. Objectives:
Untreated dental infections pose a threat for immunocompromised
liver transplant (LT) recipients.
Therefore, pretransplant dental evaluations are recommended.
However, risk of bleeding should be considered among patients with
end-stage liver disease and prophylactic blood transfusions may be
used to prevent bleeding.
We retrospectively studied the incidence of and risk factors for oral
surgery-related bleeding in candidates for LT and hypothesized that
complications may occur despite pre- and peri-operative hemostatic
actions.
1210/25/2016 8:31:03 AM
14. Study design:
One hundred thirty four patients who had tooth extractions
by oral and maxillofacial surgeons pre-LT
were studied.
The primary endpoint was bleeding between 24 h and 2
weeks post-extraction. Bleeding risk was analyzed by the
pre-operative platelet (PLT) count and INR.
Invasiveness of procedures, severity of liver disease, PLT,
INR, prophylactic transfusions of PLT, fresh frozen plasma,
and tranexamic acid (TA) were included in uni- and
multivariate logistic regression analysis to further assess
risk.
1410/25/2016 8:31:03 AM
15. Sampling technique:
Study design:
Setting Locations:
Relevant dates Periods
of recruitment:
Statistical analysis:
Statistical test:
Not mentioned
Retrospective study
Helsinki, Finland
2000-2006 (toto of 306- dental
evaluation 263 in that 134) = -129?
SPSS.ver.17
Chi-square,
Mann-Whitney test
Univariate logistic regression
Multivariable logistic regression
Materials and Methods
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17. Results
Twelve patients exhibited minor bleeding; four
despite PLT>100x109/L and INR<1.5.
Increased bleeding associated with INR and
prophylactic transfusions by univariate analysis;
by multivariate analyses, prophylactic TA and PLT
remained significant.
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23. Observed Limitations
23
• Retrospective
• Only INR & Platelets were considered
• Results partly confirm the hypothesis
• No other complications are mentioned
• Only males
• No reason for age groups
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25. Conclusion is meaningful and is based on aim of the
study.i.e risk of bleeding is difficult to predict in
patients with cirrhosis but, on the other hand,
frequency of delayed bleeding is in general low.
Acknowledgement were not mentioned.
Recommendation were not mentioned.
Finally, results suggest that use of prophylactic blood
coagulation factors requires individual assessment.
CRITICAL APPRAISAL OF CONCLUSION
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26. Suggested Title:
26
Delayed bleeding in tooth extraction males
among 45-51 year old with liver transplant in
Helniski : A Restrospective study.
OR
Retrospective study of delayed bleeding after
tooth extraction in 45-50 year old age group
who underwent liver transplant in helinski.
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27. 23 references in total.
References accessed were : 14
References are in HARVARD .
Number of articles reflecting the study: 09
Reference before 2006: 10
Reference after 2006: 13
Introduction: 8 were cited
Materials and methods: NONE
Discussion: 15 were cited
CRITICAL APPRAISAL OF REFERENCES
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28. Statement of clinical relevance
INR and platelet count do not reliably predict bleeding after
tooth extractions in liver transplant candidates due to
rebalanced hemostasis.
Lisman T et al. 2010 . Rebalanced hemostasis in patients with liver
diseases: evidence and clinical consequences.
Hence, routine prophylactic replacement therapy may be
ineffective.
Alternatively, local hemostatic measures and close post-
operative follow-up by a skilled clinician are recommended.
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