An Assessment on the Clinical Performance of Non-carious Cervical Restorationsasclepiuspdfs
Cervical restorations were known as the least durable type of restoration. Therefore, it is important for clinician to identify the contributing factors that may lead to failure of the restorations. Objective: The purpose of this study was to compare the clinical performance in terms of type of restorative materials and the influence of clinical handling technique of non-carious cervical restorations. Materials and Methods: This cross-sectional study was carried out to patients with restorations on non-carious cervical lesions (NCCLs) at Universiti Sains Islam Malaysia dental clinic. The clinical performance of the restorations was evaluated using the ratings of the United States Public Health Service criteria and analyzed using the Pearson Chi-square.
Gingival prosthesis: an efficient solution to severe gingival recessions in a...Premier Publishers
Clinical attachment loss in periodontal disease may lead to gingival recessions, elongation of the crowns, black triangles and unaesthetic appearance of maxillary anterior. For these problems surgical procedures may not have acceptable results in case of severe gingival recessions. Thus, non-surgical methods, like gingival prostheses/veneers, should be considered as an alternative treatment approach in such cases. It is an easy constructed and practical device to optimize the esthetic and functional outcome after the control of periodontal disease. This case report of young female patient illustrates treatment for an advanced tissue loss in a maxillary anterior area using a removable gingival prosthesis/veneers. This treatment modality offered a good optional solution and optimum esthetic patient satisfaction with a 2-year follow-up.
Objective: The aim of the present study was to make an evaluation of inter-canine width before and after the stage of levelling and alignment in the mandible using three different orthodontic arch wires. Subjects and methods: Thirty orthodontic patients both males and females were selected and treated by the same researcher. The patients were randomly divided equally into three groups according to the type of wire that was used, so Group A, B and C will be used. Group A, this group included 10 patients treated with (CNA) wire. Group B, this group included 10 patients treated with (Cu NITI) wire. Group C, this group included 10 patients treated with (NITI) wire. Results: The results showed that inter-canine width showed no significance after the finishing of the leveling and alignment stage.
An Assessment on the Clinical Performance of Non-carious Cervical Restorationsasclepiuspdfs
Cervical restorations were known as the least durable type of restoration. Therefore, it is important for clinician to identify the contributing factors that may lead to failure of the restorations. Objective: The purpose of this study was to compare the clinical performance in terms of type of restorative materials and the influence of clinical handling technique of non-carious cervical restorations. Materials and Methods: This cross-sectional study was carried out to patients with restorations on non-carious cervical lesions (NCCLs) at Universiti Sains Islam Malaysia dental clinic. The clinical performance of the restorations was evaluated using the ratings of the United States Public Health Service criteria and analyzed using the Pearson Chi-square.
Gingival prosthesis: an efficient solution to severe gingival recessions in a...Premier Publishers
Clinical attachment loss in periodontal disease may lead to gingival recessions, elongation of the crowns, black triangles and unaesthetic appearance of maxillary anterior. For these problems surgical procedures may not have acceptable results in case of severe gingival recessions. Thus, non-surgical methods, like gingival prostheses/veneers, should be considered as an alternative treatment approach in such cases. It is an easy constructed and practical device to optimize the esthetic and functional outcome after the control of periodontal disease. This case report of young female patient illustrates treatment for an advanced tissue loss in a maxillary anterior area using a removable gingival prosthesis/veneers. This treatment modality offered a good optional solution and optimum esthetic patient satisfaction with a 2-year follow-up.
Objective: The aim of the present study was to make an evaluation of inter-canine width before and after the stage of levelling and alignment in the mandible using three different orthodontic arch wires. Subjects and methods: Thirty orthodontic patients both males and females were selected and treated by the same researcher. The patients were randomly divided equally into three groups according to the type of wire that was used, so Group A, B and C will be used. Group A, this group included 10 patients treated with (CNA) wire. Group B, this group included 10 patients treated with (Cu NITI) wire. Group C, this group included 10 patients treated with (NITI) wire. Results: The results showed that inter-canine width showed no significance after the finishing of the leveling and alignment stage.
Long term clinical and bacterial effetcx of xylitol on paitnets with fixed or...EdwardHAngle
Background: The objective of this study was to evaluate long-term clinical and bacterial effects of using 6 g of
xylitol per day for 3 months on patients with full fixed orthodontic appliances.
Methods: The study was a pilot clinical trial that included 41 subjects who were undergoing orthodontic
treatment. The subjects were randomly divided into three groups. Group A received xylitol chewing gum, group B
received xylitol dissolvable chewable tablets, and Group C served as the control group and did not receive xylitol
gums or tablets. Clinical examination and the collection of plaque and saliva samples were carried out at baseline
and 3, 6, and 12 months. All three groups were given oral hygiene instruction and were put on a 6-month cleaning
and topical fluoride schedule. Plaque scores and bacterial counts were used to evaluate the effectiveness of the
different approaches at reducing the caries risk.
Results: Xylitol groups did not experience any more reduction in plaque score, plaque MS counts, or salivary MS
counts than the control group nor did they have lower values at any of the time points. Chewing gum did not
significantly increase the incidence of debonded brackets over the other groups.
Conclusions: Xylitol does not have a clinical or bacterial benefit in patients with fixed orthodontic appliances. Oral
hygiene instructions and 6-month topical fluoride application were effective at reducing plaque scores and bacterial
counts in patients with full fixed appliances regardless of whether or not xylitol was used.
Healing of Periapical Bone Lesion After Periradicular Surgery And Graft Place...QUESTJOURNAL
Objectives: 1.To clinically evaluate the healing process following periapical surgery with Chitra granules 2.To radiographically evaluate healing, following periapical surgery with Chitra granules. 3.To compare the bone healing in the study group, clinically and radiographically following the modalities of treatment, with that of the control group (without graft). Materials: 1.Chitra hydroxyapatite granules. 2. Gutta-percha — for root canal obturation by lateral condensation. 3. High Copper amalgam used as retrofilling materials. To evaluate healing after periapical surgery using Chitra granules, 22 patients were selected from out patient section of Department of Conservative Dentistry and Endodontics, Govt. Dental College, Kozhikode,based on clinical and radiographical evaluation. The study group consisted of 13 males and 9 females. All were of the age group 15-35 years. After selection they were randomly divided into two groups A and B. In group A the Chitra granule were placed in the bony defect and in group B the defect were left as such after surgery. Results: Clinical parameters showed better early symptom free condition in group A compared to group B. But data found statistically insignificant (t-7.27,df-1.8, P >0.05). Radiographical evaluation data analysis showed statistically significant difference among group A and group B. Conclusion: Biocompatible Chitra granule not only obliterates the cavity but act as a scaffold for bone growth and prevent scar tissue formation.It is osteoconductive. In comparison to the conventional periapical surgery, the placement of Chitra granules facilitates bone regeneration more easily. The material is found to be very cost effective, easily available, easy to manipulate and involves least complication to both clinicians and patients.
This journal club presents a case of prosthetic
rehabilitation of an amputated thumb. It emphasizes that
prosthetic replacement is a better option for aesthetic and
psychological improvement, particularly in cases where the
victim is unwilling to undergo complicated surgical procedures for reconstruction of thumb or where functioning
of thumb cannot be restored even by multiple surgeries. In
the present case, a 20 years old female patient, with
missing thumb of her right hand was rehabilitated aesthetically by a non-invasive and cost effective prosthetic
procedure by using heat temperature vulcanizing silicone
material. The prosthesis (the thumb) was attached using
medical adhesives. On 3 months recall appointment, no
complications were observed. The prosthesis was in good
shape and required no further intervention. The prosthetic
thumb lacks the sensation of a normal or reconstructed
thumb, although it does not require the multiple procedures
of surgical reconstruction and the accompanying loss of
time for rehabilitation and healing
EXPERIMENTAL SUBSTANTIATION OF THE CHOICE OF THE RESTORATION METHOD IN THE CE...IAEME Publication
The etiology of abfraction defects is still in dispute. The etiology of these affections
is not fully established. An important factor in the success of the treatment of
abfraction defects of teeth by aesthetic restoration is the optimal choice of filling
materials. It is impossible to improve the efficiency and quality of dental care without
materials science. The aim of the study was to determine the strength of the
restoration with uniaxial compression of the tooth before and after thermal cycling.
The object of the study was 20 removed teeth with abfraction defects. The teeth were
divided into two groups depending on the type of restoration. Half of the teeth were
subjected to uniaxial loading in each group, the second half was subjected to thermal
cycling before loading. Samples with indirect restorations showed greater strength
both before and after thermal cycling.
Efficiency of Donning and Doffing Medical Examination GlovesCSCJournals
Quickly donning and doffing medical gloves is of vital importance for high-pressure environments. The efficiency of glove donning, however, is sometimes hindered because of moisture on the hand. A variety of commercial glove coatings exist that are said to enable a smoother donning process, however, no previous studies have examined the differences in time taken to don or doff gloves manufactured using different materials and coatings. The aim of this new study was to compare the efficiency of donning and doffing different glove types. 14 participants were timed on their efficiency to don and doff chlorinated latex and nitrile gloves, as well as polymer coated latex and nitrile gloves. All glove types were studied in both dry and wet hand conditions, leading to a total of 8 different glove condition combinations. The results indicate that polymer coated latex gloves are desirable when a quick glove change is required as there was no statistically significant difference between the average time taken to don these gloves in dry and wet hand conditions. Higher incidences of sticking were found among the wet hands, particularly in the polymer coated nitrile, which took the longest to don. However, little differences were found between all glove types, suggesting that neither the material itself, nor the internal coating, have an effect on the overall donning process when hands are dry. Discrepancies in best fit size were also noticed between the recommended sizes based on anthropometric measurements and the participants preferred glove size.
Micro-computed tomographic assessment of dentinal microcrack formation in str...DR.AJAY BABU GUTTI M.D.S
Micro-computed tomographic assessment of
dentinal microcrack formation in straight and
curved root canals in extracted teeth prepared
with hand, rotary and reciprocating instruments IEJ 2021
IMMEDIATE LOADING WITH MINI DENTAL IMPLANTS IN THE FULLY EDENTULOUS MANDIBLEAbu-Hussein Muhamad
Mini dental implants (MDI) have become increasingly popular in the past decade and have been approved for many long-term uses in dentistry. There are many advantages of the use of mini dental implants from both a practitioner and patient perspective. For the general dentist starting out in implant dentistry, their placement can be more challenging than conventional implants. It requires a different skill set, but one which can be learned with proper guidance and practice.In the study are presented clinical cases with mini implants with spherical joints for retention of removable overimplant mandibular dentures.
Key words: mini dental implants, immediate loading implants Prosthetics, overdenture
Dr.Sachdeva's Dental Institute is a Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Call us regarding Denta treatment:-
Dr. Rajat Sachdeva
+919818894041,01142464041
drrajatsachdeva@gmail.com
Follow us here:-
• Google+ link: https://goo.gl/vqAmvr
• Facebook link: https://goo.gl/tui98A
• Youtube link: https://goo.gl/mk7jfm
• Linkedin link: https://goo.gl/PrPgpB
• Slideshare link : http://goo.gl/0HY6ep
• Twitter Page : https://goo.gl/tohkcI
• Instagram page : https://goo.gl/OOGVig
Learn more:-
• www.sachdevadentalcare.com
• www.dentalclinicindelhi.com
• www.dentalimplantindia.co.in
• www.dentalcoursesdelhi.com
• www.facialaestheticsdelhi.com
Long term clinical and bacterial effetcx of xylitol on paitnets with fixed or...EdwardHAngle
Background: The objective of this study was to evaluate long-term clinical and bacterial effects of using 6 g of
xylitol per day for 3 months on patients with full fixed orthodontic appliances.
Methods: The study was a pilot clinical trial that included 41 subjects who were undergoing orthodontic
treatment. The subjects were randomly divided into three groups. Group A received xylitol chewing gum, group B
received xylitol dissolvable chewable tablets, and Group C served as the control group and did not receive xylitol
gums or tablets. Clinical examination and the collection of plaque and saliva samples were carried out at baseline
and 3, 6, and 12 months. All three groups were given oral hygiene instruction and were put on a 6-month cleaning
and topical fluoride schedule. Plaque scores and bacterial counts were used to evaluate the effectiveness of the
different approaches at reducing the caries risk.
Results: Xylitol groups did not experience any more reduction in plaque score, plaque MS counts, or salivary MS
counts than the control group nor did they have lower values at any of the time points. Chewing gum did not
significantly increase the incidence of debonded brackets over the other groups.
Conclusions: Xylitol does not have a clinical or bacterial benefit in patients with fixed orthodontic appliances. Oral
hygiene instructions and 6-month topical fluoride application were effective at reducing plaque scores and bacterial
counts in patients with full fixed appliances regardless of whether or not xylitol was used.
Healing of Periapical Bone Lesion After Periradicular Surgery And Graft Place...QUESTJOURNAL
Objectives: 1.To clinically evaluate the healing process following periapical surgery with Chitra granules 2.To radiographically evaluate healing, following periapical surgery with Chitra granules. 3.To compare the bone healing in the study group, clinically and radiographically following the modalities of treatment, with that of the control group (without graft). Materials: 1.Chitra hydroxyapatite granules. 2. Gutta-percha — for root canal obturation by lateral condensation. 3. High Copper amalgam used as retrofilling materials. To evaluate healing after periapical surgery using Chitra granules, 22 patients were selected from out patient section of Department of Conservative Dentistry and Endodontics, Govt. Dental College, Kozhikode,based on clinical and radiographical evaluation. The study group consisted of 13 males and 9 females. All were of the age group 15-35 years. After selection they were randomly divided into two groups A and B. In group A the Chitra granule were placed in the bony defect and in group B the defect were left as such after surgery. Results: Clinical parameters showed better early symptom free condition in group A compared to group B. But data found statistically insignificant (t-7.27,df-1.8, P >0.05). Radiographical evaluation data analysis showed statistically significant difference among group A and group B. Conclusion: Biocompatible Chitra granule not only obliterates the cavity but act as a scaffold for bone growth and prevent scar tissue formation.It is osteoconductive. In comparison to the conventional periapical surgery, the placement of Chitra granules facilitates bone regeneration more easily. The material is found to be very cost effective, easily available, easy to manipulate and involves least complication to both clinicians and patients.
This journal club presents a case of prosthetic
rehabilitation of an amputated thumb. It emphasizes that
prosthetic replacement is a better option for aesthetic and
psychological improvement, particularly in cases where the
victim is unwilling to undergo complicated surgical procedures for reconstruction of thumb or where functioning
of thumb cannot be restored even by multiple surgeries. In
the present case, a 20 years old female patient, with
missing thumb of her right hand was rehabilitated aesthetically by a non-invasive and cost effective prosthetic
procedure by using heat temperature vulcanizing silicone
material. The prosthesis (the thumb) was attached using
medical adhesives. On 3 months recall appointment, no
complications were observed. The prosthesis was in good
shape and required no further intervention. The prosthetic
thumb lacks the sensation of a normal or reconstructed
thumb, although it does not require the multiple procedures
of surgical reconstruction and the accompanying loss of
time for rehabilitation and healing
EXPERIMENTAL SUBSTANTIATION OF THE CHOICE OF THE RESTORATION METHOD IN THE CE...IAEME Publication
The etiology of abfraction defects is still in dispute. The etiology of these affections
is not fully established. An important factor in the success of the treatment of
abfraction defects of teeth by aesthetic restoration is the optimal choice of filling
materials. It is impossible to improve the efficiency and quality of dental care without
materials science. The aim of the study was to determine the strength of the
restoration with uniaxial compression of the tooth before and after thermal cycling.
The object of the study was 20 removed teeth with abfraction defects. The teeth were
divided into two groups depending on the type of restoration. Half of the teeth were
subjected to uniaxial loading in each group, the second half was subjected to thermal
cycling before loading. Samples with indirect restorations showed greater strength
both before and after thermal cycling.
Efficiency of Donning and Doffing Medical Examination GlovesCSCJournals
Quickly donning and doffing medical gloves is of vital importance for high-pressure environments. The efficiency of glove donning, however, is sometimes hindered because of moisture on the hand. A variety of commercial glove coatings exist that are said to enable a smoother donning process, however, no previous studies have examined the differences in time taken to don or doff gloves manufactured using different materials and coatings. The aim of this new study was to compare the efficiency of donning and doffing different glove types. 14 participants were timed on their efficiency to don and doff chlorinated latex and nitrile gloves, as well as polymer coated latex and nitrile gloves. All glove types were studied in both dry and wet hand conditions, leading to a total of 8 different glove condition combinations. The results indicate that polymer coated latex gloves are desirable when a quick glove change is required as there was no statistically significant difference between the average time taken to don these gloves in dry and wet hand conditions. Higher incidences of sticking were found among the wet hands, particularly in the polymer coated nitrile, which took the longest to don. However, little differences were found between all glove types, suggesting that neither the material itself, nor the internal coating, have an effect on the overall donning process when hands are dry. Discrepancies in best fit size were also noticed between the recommended sizes based on anthropometric measurements and the participants preferred glove size.
Micro-computed tomographic assessment of dentinal microcrack formation in str...DR.AJAY BABU GUTTI M.D.S
Micro-computed tomographic assessment of
dentinal microcrack formation in straight and
curved root canals in extracted teeth prepared
with hand, rotary and reciprocating instruments IEJ 2021
IMMEDIATE LOADING WITH MINI DENTAL IMPLANTS IN THE FULLY EDENTULOUS MANDIBLEAbu-Hussein Muhamad
Mini dental implants (MDI) have become increasingly popular in the past decade and have been approved for many long-term uses in dentistry. There are many advantages of the use of mini dental implants from both a practitioner and patient perspective. For the general dentist starting out in implant dentistry, their placement can be more challenging than conventional implants. It requires a different skill set, but one which can be learned with proper guidance and practice.In the study are presented clinical cases with mini implants with spherical joints for retention of removable overimplant mandibular dentures.
Key words: mini dental implants, immediate loading implants Prosthetics, overdenture
Dr.Sachdeva's Dental Institute is a Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Call us regarding Denta treatment:-
Dr. Rajat Sachdeva
+919818894041,01142464041
drrajatsachdeva@gmail.com
Follow us here:-
• Google+ link: https://goo.gl/vqAmvr
• Facebook link: https://goo.gl/tui98A
• Youtube link: https://goo.gl/mk7jfm
• Linkedin link: https://goo.gl/PrPgpB
• Slideshare link : http://goo.gl/0HY6ep
• Twitter Page : https://goo.gl/tohkcI
• Instagram page : https://goo.gl/OOGVig
Learn more:-
• www.sachdevadentalcare.com
• www.dentalclinicindelhi.com
• www.dentalimplantindia.co.in
• www.dentalcoursesdelhi.com
• www.facialaestheticsdelhi.com
Atrophied Edentulous Mandible with Implant-Supported Overdenture; A 10-year f...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Atrophied Edentulous Mandible with Implant-Supported Overdenture; A 10-year f...Abu-Hussein Muhamad
Abstract: Severe atrophy of the inferior alveolar process and underlying basal bone often results in problems with a lower denture. These problems include insufficient retention of the lower denture, intolerance to loading by the mucosa, pain, difficulties with eating and speech, loss of soft-tissue support, and altered facial appearance. These problems are a challenge for the prosthodontist and surgeon. In this case report, patient with resorbed edentulous mandible was successfully rehabilitated using two dental implants placed in the interforaminal region with ball abutments opposing conventional maxillary complete denture. Key Words: dental implants; dental prosthesis, implant-supported; resorption,
RCT on Base tie in laparoscopic appendecomy (Journal Club).pptxadnanhabib31
This is ppt made on a study based on Randomised controlled trial on the tie of appendix base in laparoscopic appendectomy by hem-o-lok,endoloop or stapler.This study showed that hem-o-lok clips are better and cheaper as compared to others.
Medical science, particularly in Orthopaedics has progressed
and seen tremendous revolutionary changes over
the last few decades. Starting from an era of no surgery,
it has refined to minimally invasive surgeries and keyhole
surgeries in almost all sub specialties of Orthopaedics.
A review on the concept of Atraumatic Restorative Treatment
it focuses on the definition, concept. indications, contraindications, history and functionality of this treatment
Journal Club Presentation on Overlay Removable Partial DentureNeerajaMenon4
Overlay removable partial dentures (ORPDs), a subset of overdentures, are often referred to as an RPD that has part of their components covering the occlusal surface of the abutment teeth to restore them into a functional occlusion
EWMA 2014 - EP473 CLINICAL FEATURES OF DIABETIC FOOT ULCERS WITH HIGH LEVELS ...EWMA
García Álvarez Yolanda, Lázaro Martínez José Luis, García Morales Esther, Sanz Corbalán Irene, Aragón Sánchez Francisco Javier,
Álvaro Afonso Francisco Javier, Molines Barroso Raúl, Chana Valero Pedro
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
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5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
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.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
The hemodynamic and autonomic determinants of elevated blood pressure in obes...
EWMA 2014 - EP495 TOTAL CONTACT CASTING – A SOUTH AFRICAN APPROACH TOWARDS OFFLOADING THE DIABETIC FOOT
1. TOTAL CONTACT CASTING –
A SOUTH AFRICAN APPROACH TOWARDS
OFFLOADING THE DIABETIC FOOT
LIEZL NAUDE
WOUND MANAGEMENT SPECIALIST AT ADVANCED LOWER LIMB & WOUND MANAGEMENT CENTRE, PRETORIA, SOUTH AFRICA
HOWARD ALEXANDER
PODIATRIST AT ALEXANDER & FARREL PODIATRY EDENVALE, SOUTH AFRICA
INTRODUCTION
• Foot ulcerations are the most common complications associated with
the patient living with diabetes worldwide and South Africa is no
different.
• SeveralTotal Contact Casting (TCC) methods are available worldwide,
most well-known the description of application of aTCC with plaster
bandage as described in Levin and O’Neal’sThe Diabetic Foot 7th
edition.
• TCC undisputedly regarded as gold standard off-loading method to
most rapidly heal neuropathic plantar foot ulcers.
• Most common reason for not usingTCC:“fear of failure” by health
professionals feeling uncertain about application.
• The introduction of a fibreglass cast system allows for a much lighter
and sturdier cast as well as better patient compliance.
2. STUDY AIM & METHOD
To adapt the current existingTCC systems available to fit the
South African Environment.
Total of fifty (n = 50)TCC’s were applied at the two (2)
centres.
Patient Inclusion criteria:
Neuropathic ulcers in need of off-loading by reduction of plantar pressures
whilst walking.
Charcot foot in order to stabilize the structural deformity with or without
plantar ulceration.
Several existingTCC methods were evaluated such as:
• Removable Cast Walker
• Plaster Bandage
• Fibre glass cast
Two fibreglass systems were evaluated and described for the
purpose of this study
EWMA 2014 EP495 2
System A
o Fibreglass hard cast x 1
o Fibreglass soft cast x2
o Stockinet x 2
o Microfoam
o Woolpadding
o Cast Shoe
System B
o Fibreglass hard cast x 1
o Fibreglass soft cast x2
o Stockinette x 1
o Water resistant Stockinette x 1
o Felt padding
o Woolpadding
o Cast Shoe
ATTRIBUTES EVALUATED IN ORDER
TO ENHANCE PATIENT
COMPLIANCE:
Cast weight (light weight fibreglass
material)
Durability (Strong and re-usable)
Removability (easy re-application)
Aeration (good evaporation due to
materials used)
Wash-ability & Hygiene
Total Plantar surface contact
Protection and prevention of skin
abrasions and additional pressure points
Open toe box (for easy inspection of toes
also allowing aeration)
3. CASE EXAMPLES
Neuropathic Diabetic Foot Ulcer (DFU) 2nd & 3rd Metatarsal Head
Day 0 Day 12
Patient with a history of trauma due to shear ad friction. Patient has severe peripheral neuropathy and
had to drive a delivery truck overnight for 12 hours continuously resulting in blistering with subsequent
bleeding and tissue breakdown. Photographs shows results after 12 days in a TCC removable fiberglass
cast.
EWMA 2014 EP495
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Charcot Foot with Mid foot DFU
Day 0 Day 0 Charcot foot
Day 5 Day 8 Structural stabilisation of Charcot foot
Charcot foot with mid foot
DFU
Patient with a history of Charcot with
subsequent foot deformity and pressure
points resulting in ulceration. Problem
started 2 years ago, patient developed
blood blister after he was supplied with
faulty innersoles in August 2012 and was
referred to Orthopaedic surgeon. On the
14th of November 2012 the Orthopaedic
surgeon stabilized the Charcot foot in
theatre with instrumentation. In May 2013
patient developed new blood blister which
was again debrided in theatre 25 June
2013. Current ulceration not healing and
still draining with subsequent incidences of
bleeding due to pressure. Wound care was
started together with BSN Fiberglass TCC
on the 3rd of October 2013. Complete
closure as well as stabilization of the
Charcot midfoot defect was achieved within
8 days.
4. RESULTS
System A & B both were effective in reducing plantar pressures while walking by 84% to 92%.
Both systems demonstrate efficacy in stabilising Charcot foot.
Both systems demonstrate a cohort mean wound closure time of 36 days during this study.
Both systems reduced lower limb oedema due to the soft fibre glass cast.
Both systems improved patient mobility.
Both systems improved patient quality of life.
Both systems reduced overall wound care costs.
Both systems prevented further amputation.
System B provides better aeration than System A, the Removable Cast Walker and Plaster
cast.
System B enables better hygiene as a removable, washable cast.
Improved patient’s adherence were seen with System B due to the aeration and hygiene
associated with the cast.
EWMA 2014 EP495
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COMPARISON BETWEEN SYSTEM A AND SYSTEM B
Attribute System A System B
CastWeight (light weight fibre glass) Yes Yes
Durability (strong and re-usable) Yes Yes
Removability (easy re-application Yes Yes
Aeration (good vaporation) Better than plaster cast or
removable walker
Improved aeration due to water
resistant inner lining
Wash-ability & Hygiene Cast not washable due to inner
lining with stockinet, if washed it
takes a very long time to dry
Washable water resistant inner
lining which allows for quick
drying whilst doing wound care
Total plantar surface contact Yes Yes
Protection & prevention of skin abrasions and
additional pressure points
Yes Yes
Open toe box (for easy inspection of toes and
also allowing aeration)
Yes Yes
COMPARISON
*System A – 3M casting material System B – BSN casting material
5. CONCLUSION
The study showed that through small adjustments
better patient adherence can be achieved especially in
the warm South African climate.
System B demonstrated an improved patient
adherence due to the wash ability and aeration of the
cast material
It is recommended that more skills training
workshops are needed in order to guide health
professionals and change perceptions in incorporating
TCC as the gold standard in all practices working
with patients with diabetic foot ulcers.
Howard Alexander
www.fixmyfeet.biz
howardal@mweb.co.za
Liezl Naude
www.eloquent.co.za
Liezl@eloquent.co.za
EWMA 2014 EP495
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