Dental Illness Research Articles

Awareness of Oral Health in Diabetic Patients in Saudi Arabia

Diabetes mellitus (DM) consists of a clinically heterogenous array of metabolic conditions hallmarked by hyperglycemia caused by defective insulin secretion, action, or both. DM can cause various oral complications such as salivary gland dysfunction, infections including candidiasis, delayed wound healing, increased caries susceptibility, gingival and periodontal diseases, lichen planus and burning mouth disorders. Inadequate oral public health awareness of the connection between diabetes and oro-dental health issues has been noted in many studies from across the globe. Based on the current literature, it is evident that oral health is not prioritized by the majority of diabetic patients in Saudi Arabia. Saudi diabetic patients with lesser education demonstrate lower awareness levels about oral health issues in general. Similarly, more older patients have been seen to possess less oral health awareness relative to their younger counterparts. Further, they have been found to be less compliant towards meeting dental appointment targets and adopting recommended oral hygiene practices as compared to other populations studied in the Western nations. Also, non-professional advice has been noted as the dominant outlet of dental health information in case of most Saudi patients with diabetes. It is vital to reinforce the need for routinely visits to dentists for education on oral health when patients visit their diabetic clinic. Organization of structured patient education programs targeting all age groups and different types of diabetes is necessary to improve oral health awareness. It is also vital that individuals are provided with the latest recommendations on methods to practice oral health related self-care techniques in order to minimize the risk of periodontal destruction and tooth loss, thereby reducing the burden of dental illnesses on the Saudi health infrastructure.

Plaque Removal Efficacy of Dental floss Compare to Water Jet Following Single Use

Background: Dental plaque (biofilm) is a well-known contributor to the onset and progression of many dental illnesses. Plaque is a natural biofilm that develops on oral surfaces and contains a wide variety of organisms. As a result, it is critical to control plaque formation, particularly in the young population, by implementing effective preventive strategies. Objective: To assess and compare plaque removal efficacy of water flosser and string floss in patients. Study design: Randomized controlled trial Place and Duration of study: Department of Periodontology, Sardar Begum Dental College, Gandhara University from 1st March 2019 to 31st May 2019. Methodology: Seventy patients were enrolled. Patients were randomly allocated to one of two groups, group A (using dental floss) as the control group and group B (using waterpik) as the intervention group, using the lottery technique. Patients were randomly allocated to one of two groups, group A (control group), using dental floss and group B (intervention group), using waterpik utilizing the lottery technique. All participants were taught correct brushing technique utilizing the Modified Bass technique and manufacturer's instructions for using waterpik as well as normal flossing instructions for using Dental floss. Results: The mean age presentation was 34.23±6.78 years. The females were 42 (60%) males were 28 (40%). The mean percentage showed that those using water flosser with tooth brushing had low plaque score than using string floss with tooth brushing. The independent t test showed that water flosser is significantly more effective (p=0.001) in plaque reduction than conventional string floss. Conclusion: A water flosser coupled with hand brushing is more effective in eliminating plaque than string floss. Plaque removal was 20-30% higher in the group that used a water flosser. Key words: Efficacy, Dental floss, Water jet

A Review on medicinal plants in dentistry

The dental afflictions are indubitably the most important global infectious diseases affecting both children and adults. The most significant dental illness is dental caries and periodontal pathologies. The major reason of oral health troubles is more inhabitants with pathogenic bacteria and for this reason, conservative treatment can often be in efficient because of bacterial resistance or may have unpleasant side effects.For that reason, studies in the field have focused on finding new therapeutic alternatives.The use of natural medicines for dental care is an ancient cross-cultural practice that persists in the majority of cultures today.Over the past decade, interest in drugs derived from medicinal plants has markedly increased. This study was designed at a literature review focusing on studies investigating herbal drugs and their therapeutic application, mechanism of action, side effects, toxicities and probable drug interactions. A small number of studies were established to hold their rational employ in dentistry. Because there is a rising employ of phytotherapeutic agents in dentistry, additional studies are required to evaluate their safety and efficacy for clinical use.
 Keywords: Herbal medicine, Oral health, Dentistry, Caries, Infections

QUESTIONNAIRE FOR THE PATIENT'S HEALTH IN THE DENTAL ANAMNESIS

Purpose: The study aims to test the knowledge of a selected group of parents of child patients regarding the diagnosis, the health status of the children, and the choice of a medical institution in the Varna region. Material and methods: Respondents answered questions about knowledge concerning: general health, a change in general health, child's admission to hospital and whether it was ill during the last three years, whether a doctor is treating the patient for a general medical or systemic disease, pain that has occurred at the moment, and how parents choose a medical institution with modern dental services and others. For data analysis, we applied a test and mathematical model of SPSS v. 20. Results: Nine children (22.50%) of the surveyed participants are currently complaining of pain caused by a dental problem. Parents report two children with past dental illnesses. The main source of information about the services offered by the University Medical and Dental Center in the city of Varna is relatives and acquaintances who have used the center's services (40.00%), followed by the information published on the Internet (30.00%). Conclusions: The study improves the parents’ knowledge, the choice of clinical and paraclinical methods in the anamnesis, diagnosis, methods and quality of treatment in childhood. The obtained results are also applied in the future planning of new clinical and treatment goals.

Validity of Screening for Pre-Diabetes and Type2 DM in Patients Presenting with Oral Symptoms

Introduction: Type 2 DM is a major health problem in the present world with its high micro andmacrovascular complications leading to increased mortality and morbidity. Our diagnosed T2DMrepresents the tip of the iceberg, where the hidden part places a vital challenge to the health caresystem. Objectives: Various risk factors are identified to screen the population for diabetes which isstill an incomplete list hence we aimed to identify the dental illness as a potent risk factor to screenT2DM and Prediabetes. Methodology: This is an observational study in which 92 patients attendingto dental clinic except for traumatic problems were screened for T2DM with random blood sugar andHbA1c. Results: In our study we observed 22.8% pre-diabetic and 8.8% with newly diagnosedT2DM among the study population. Chronic periodontitis was accounting for more than 60% of thesubjects presenting dental illness. Conclusion: In our study we conclude that dental illness to beaccounted as a potent risk factor for T2DM/Pre-Diabetes.

Выбор лечебных материалов в качестве корневого наполнителя среди биоактивных силеров (обзор литературы)

According to WHO (2012), Russian and foreign researchers data, prevalence rate of dental diseases among children reaches 75–95 %, among adults – 100 %, and in age groups above 35 years old, dental and mouth cavity problems become the primary concern. Despite intensification of the sanitation process in clinical dentistry, many researchers note the tendency of decrease in national dental health. Dealing with such an important medical-social goal as radical decrease of dental illnesses is in the area of complex approach not only to realization of sanitation-prophylaxis measures, but also in using novel ideas in dental services. The problems of legal regulations and administrative management of dental clinics in new economic conditions are key priority areas for the modern Russian medical industry. Rapid development of medical services market, improvement medical insurance services, providing more freedom for medical organizations in implementation of its activities marked the significance of search for more effective mechanisms of dental clinics work organization, focused on dental services improvement. High quality medical care should provide financial-economy and medical-social efficacy of healthcare development programs, determined to improve population quality and duration of life. Herewith, currently there are no unified criteria to determine medical care quality in Russia and abroad. The expediency to perform independent medical expertise of performed dental services is beyond dispute. Objectification of final treatment result evaluation is possible only when the patient medical condition data is available, determination of causal relationships between medical personnel actions and their consequences for the health of a citizen.

Knowledge and Awareness on Oral Hygiene and Its Relation with Chronic Disease Among Chennai Population

Oral cleanliness is the act of keeping one's mouth spotless and liberated from infection and different issues (for example awful breath) by standard brushing of the teeth (dental cleanliness) and cleaning between the teeth. It was significant that oral cleanliness has been done all the time to empower avoidance of dental illness and terrible breath. Oral health had consistently stayed a disregarded substance. The sampling method was convenience sampling. The dependent variables were knowledge, attitude and oral hygiene practices. The present study involved a questionnaire-based observational cross-sectional type of study of 100 participants. The questionnaire was distributed among 100 students. Of 100 participants, 51.8% of the participants are female while 48.2% of the participants are male. 50.9% of the participants cleans teeth once a day whereas 43.9% participants cleans teeth twice a day. Oral hygiene is important for overall health. To maintain good oral hygiene, we should clean our mouth properly and regularly. In the present study the awareness on oral hygiene and its relations with chronic disease was assessed, most of the participants are aware of the good oral hygiene.

The dental anomaly: how and why dental caries and periodontitis are phenomenologically atypical

BackgroundDespite their shared origins, medicine and dentistry are not always two sides of the same coin. There is a long history in medical philosophy of defining disease and various medical models have come into existence. Hitherto, little philosophical and phenomenological work has been done considering dental caries and periodontitis as examples of disease and illness.MethodsA philosophical methodology is employed to explore how we might define dental caries and periodontitis using classical medical models of disease – the naturalistic and normativist. We identify shared threads and highlight how the features of these highly prevalent dental diseases prevent them fitting in either definition. The article describes phenomenology and the current thought around the phenomenology of illness, exploring how and why these dental illnesses might integrate into a phenomenological model.ResultsWe discover that there are some features particular to dental caries and periodontitis: ubiquity, preventability and hyper-monitorablility. Understanding the differences that these dental diseases have compared to many other classically studied diseases leads us to ethical questions concerning how we might manage those who have symptoms and seek treatment. As dental caries and periodontitis are common, preventable and hyper-monitorable, it is suggested that these features affect the phenomenology of these illnesses. For example, if we experience dental illness when we have consciously made decisions that have led to it, do we experience them differently to those rarer illnesses that we cannot expect? Other diseases share these features are discussed.ConclusionsThis paper highlights the central differences between the classical philosophical notion of disease in medicine and the dental examples of caries and periodontitis. It suggests that a philosophical method of conceptualising medical illness - phenomenology - should not be applied to these dental illnesses without thought. A phenomenological analysis of any dental illness is yet to be done and this paper highlights why a separate strand of phenomenology should be explored, instead of employing those that are extant. The article concludes with suggestions for further research into the nascent field of the phenomenology of dental illness and aims to act as a springboard to expose the dental sphere to this philosophical method of analysis.

Description on the Quality of Life among Elderly Affected by Dental and Oral Health in Jagir Health Centre Surabaya

Macroscopically, teeth experience changes in shape and color along with increasing age. In Indonesia around 24% of elderly people aged 65 years or older experience tooth loss. This condition was a threat to quality living elderly in living everyday life. Taking this into consideration, this study is intended to investigate the factors such as education level, frequency of brushing teeth, frequency of dental visit and illnesses (hypertension, diabetes mellitus and coronary heart disease) affected the caries severity and the quality of life among the elderly of Puskesmas Jagir. The findings from this study proved that lack of awareness of maintained a healthy oral health and lack of awareness of the side-effects of medication taken to the oral health as well as low interest in visiting dental clinics are three of the major problems that deteriorate the oral health of the elderlies since the DMF-T scores (> 13) for these factors were high. Thus, the elderly need to acquire the necessary knowledge by attending counselling classes and visiting the dentist in order to apply this knowledge for a better quality of life.

MAIN PROPERTIES OF ABRASIVE DENTISTRY MATERIALS UTILIZED IN POLISHING OF REMOVABLE DENTURE BASES

The requirements to the quality of dental prostheses are currently very high. All dental prostheses need thorough final finishing through filing and polishing in order to obtain smooth, polished, shiny and esthetic surface. In addition to comfort and aesthetics this guarantees high hygienic quality of dental prostheses and extends their operational characteristics. Smooth and even surface of plastic or thermoplastic prostheses can more efficiently resist aging and decay caused by the change of temperature and bacterial flora activity which typically occur in the mouth cavity.
 Modern orthopedic dentistry utilizes various abrasive materials for filing and polishing of removable dentures made from different materials. Filing is the method of removing roughness and unevenness from the surface of dentures. Polishing is the final process of finishing aimed at obtaining smooth, shiny surface of dentures. It has been proved that rough and badly polished surface of dentures can cause significant patient’s discomfort and complicate hygiene of the mouth cavity. Together with the aggressive environment of the mouth cavity, such surfaces can lead to dental plague and tartar deposit, which, correspondingly, leads to bad smell, stomatitis and other dental and general illnesses. It has been proved that high quality finishing of the surface of removable dentures contributes to the improvement of their sustainability, durability and aesthetic characteristics. Well-polished surface of removable dentures more efficiently resists the processes of destruction, such as aging and decay, caused by the change of temperature and bacterial flora activity.
 The analysis of bibliography has shown that the process of polishing and the quality of the surface under work depend on a number of factors. The most significant role belongs to the size of abrasive particles, the pressure of abrasive on material and its thermal conductivity, the speed at which abrasive particles move along the surface. Grains of the size 0,15-0,75 mm are used most often. It has been specified that coarse polishing can utilize grains of bigger size reaching 1,5-2 mm. It has been proved that the pressure of abrasive should be light in order to prevent the damage of dentures or instruments. Moreover, excess pressure can cause overheating of an instrument or the surface of dentures being polished. It has also been demonstrated that even short-term high temperature exposure can result in polymer deformation which reduces sustainability and durability of removable dentures. It is known that overheating can be avoided on condition of following the basic rules of polishing.
 Orthopedic dentistry utilizes pumice, silicate or aluminum oxide, silicone dioxide as abrasive filler. The particular interest presents the study of the efficiency of zirconium silicate as an abrasive component of polishing paste for finishing of thermoplastic polymer bases and providing full gloss of the surface. Stearin, paraffin, wax, petrolatum are used as the components of surfactants, as they demonstrate low surface tension and facilitate spreading the paste on the polished surface.
 There is not a wide range of locally produced polishing pastes utilized in dentistry. They leave traces, microscratchings; do not allow obtaining even, smooth shiny surface of dentures with thermoplastic polymer basis. Finishing of removable dentures requires a lot of time and expenses from professionals.

Comparative Study of Oral Hygiene Among Urban and Urban Slum Dwellers of Ahmedabad

Aims and Objectives: To compare the oral hygiene practices and study the proportion of dental problems among urban and urban slum areas.
 Methodology: An observational, cross sectional study was carried out in 150 people in urban and urban slum areas. The study duration was four months (June 2015 to September 2015). The data was collected in a pre-designed proforma. The knowledge of the community was considered with regards to oral hygiene and harmful effects of bad food habits and tobacco consumption. The oral problems and hygiene was assessed by using mouth mirror and probe. The data was analyzed using SPSS version 24.0 Software.
 Results: Out of the total data collected, 75 of the data entries were obtained from urban area and urban slum area each. The age wise distribution was done as well in both the areas. Among them, most common age group was 20-45 years (50.7% in urban while 48.0% in urban slum) followed by 10-19 years, 46-60 years, 1-9 years and 60and above age group. The common symptoms observed like broken teeth (28%), gingivitis (13.30%), caries (21.10%) etc. were more in urban as compared to urban slum areas. Most common brushing practice was using paste (90%) followed by powder (10%) and salt (1%). More number of people in urban area (28%) consumes carbonated drinks as compared to urban slum (6.7%) (P value = 0.001). The proportion of sensitive teeth was more in urban (36%) as compared to urban slum (26.7%) (P value = 0.126). Most of the people in urban as well as urban slum area (97.3%) change their brush within 15 days-3 months.
 Conclusion: The proportion of gingivitis, dental illness, grinding teeth, sensitive teeth are more commonly seen in urban areas as compared to that of the urban slums. However, the proportion of bleeding gums, awareness regarding dental problems, frequency of brushing teeth and pattern of brushing were almost similar in both of the areas.

Popular initiatives in 2014–2016 call for the introduction of mandatory dental care insurance in Switzerland: The contrasting positions at stake

Switzerland’s mandatory health insurance system provides coverage for a standard benefits package for all residents. However, adult dental care is covered only in case of accidents and inevitable dental illnesses, while routine dental care is almost completely financed out-of-pocket. In general, unmet health needs in Switzerland are low, but unmet dental needs are significant, when compared with other countries in Europe. Recent popular initiatives in Switzerland have aimed to introduce a mandatory insurance model for dental care through a mandatory contribution of 1% of gross salaries toward dental care insurance. In three cantons, the proposals have collected the required number of signatures and a public referendum is expected to be held in 2017/2018. If implemented, the insurance system is expected to have a significant impact on the dental profession, dental care demand, and the provision of dental services. The contrasting positions of stakeholders for and against the reform reflect a rare situation in which dental care policy issues are being widely discussed at all levels. However, such a discussion is of crucial relevance not only for Switzerland, but also for the whole of Europe, which has significant levels of unmet needs for dental care, especially among vulnerable and deprived individuals, and new solutions to expand dental care coverage are required.

Assessment of abuse of self-medication for oral and dental problems among 21–60 years aged populace residing in the rural areas of Belgaum Taluk, Karnataka, India: A questionnaire study

Background: The practice of self-medication has been recognized since ages. There has been enough literature available regarding it being there for medical illnesses; however, there is a dearth of information about it for dental causes. Hence, this study was designed to determine the abuse of self-medication for dental illnesses and the reasons for resorting to it. Materials and Methods: This study was conducted in 10 taluks of Belgaum district. Totally, 230 consenting respondents were selected by random sampling from 10 villages and interviewed with the aid of 18-point, closed-ended question-based, semi-structured questionnaire. Results: Odontalgia was the most common reason for which people resorted to self-medication (57.69%). 70% of the respondents did not have the knowledge about the dose, duration, side effects, and interactions of drugs they had used. Paracetamol was the most commonly used drug for self-medication. Conclusion: Analgesics were the most common drugs abused for self-medication. Adequate health education of the populace was found mandatory to make people aware of the use and misuse of drugs, especially analgesics, and regarding the potential adverse effects they can show, especially when used repeatedly, or on a chronic basis. Furthermore, dental health-care services were supposed to be made readily available and affordable so that self-medication among rural patients could be reduced to the barest minimum.

An unusual case of life-threatening airway compromise complicating a neck dissection

Sir, The potential complications associated with neck dissection classically include damage to important neurovascular structures within the dissection parameters. However, there are no documented cases within the literature that describe severe delayed airway compromise as a result of unilateral or bilateral neck swelling in the perioperative period. A degree of post-operative swelling is to be expected, but delayed airway compromise requiring intubation and intensive care unit support following neck dissection is uncommon. We report an unusual case of severe unilateral neck swelling developing secondary to an elective neck dissection together with a discussion of current diagnostic and management strategies. A 64-year-old male underwent a left modified radical neck dissection (levels I–V) following previous excision of a 2.4 mm Breslow thickness melanoma on the left shoulder and subsequent cytology-confirmed metastatic lymphadenopathy in the left posterior triangle. Pre-operative intravenous augmentin was administered, and three drains were placed at the conclusion of surgery. Following an uncomplicated recovery, all drains were removed and the patient was discharged 6 days later. He subsequently presented 48 h post-discharge with rapid onset swelling of the left side of the neck. A CT scan suggested a collection in the submandibular region causing moderate airway compromise and midline airway shift (Figs. 1a, b and 2a, b). Re-exploration of the neck dissection identified marked swelling of the anterior belly of the digastric and myoglossus muscles, but no collections or haematoma. Microbiology swabs of the neck sent from theatre confirmed the presence of Staphylococcus aureus in the wound. Intravenous tazocin and clindamycin were commenced, and the patient returned to intensive care intubated. The patient was extubated after 36 h following clinical improvement and discharged the following day with no further episodes of neck swelling or long-term sequelae. Ludwig’s angina was the initial diagnosis in this patient, but given that the infection was unilateral, it did not fit the classical diagnostic criteria of bilateral neck swelling. Ludwig’s angina is a life-threatening cellulitis, usually originating in the submandibular space. This condition typically occurs secondary to odontogenic infections [1], with the most common pathogens identified as Streptococcus viridans, S. aureus and Staphylococcus epidermidis, and group B streptococcus [1, 2]. Other recognised causes include parapharangeal abscesses, mandibular fractures, oral piercings, submandibular gland sialadenitis and oral malignancy [1]. Those suffering from dental caries and systemic illnesses such as diabetes mellitus, malnutrition, alcoholism and immunosuppression are also at risk [2, 3]. Ludwig’s angina often begins as a mild infection which rapidly progresses to bilateral swelling of the neck and floor of the mouth with associated trismus, tongue elevation, and stridor, ultimately leading to airway compromise and asphyxia [1–4]. The presence of cellulitis helps to differentiate this condition from others such as haematoma [5]. Without treatment, Ludwig’s angina carries a high mortality of 50 %, although this figure is markedly reduced to 10 % by antibiotics and supportive treatment [1, 2, 6, 7]. * Philip Rubin Philip.Rubin@cddft.nhs.uk

Oral hygiene and oral flora evaluation in psychiatric patients in nursing homes in Turkey.

The World Health Organization has stated that psychiatric patients are a group of people who have oral and dental illnesses. The aims of this study were to document the oral hygiene of individuals with chronic psychiatric illness, to determine the extraoral and intraoral findings, to detect the dominant microorganisms in oral flora, and to inform clinicians of these findings. The study included 100 patients (69 men and 31 women) with different psychiatric illnesses living in a nursing home. They were 19-96 years old (median, 48 years). The participants completed a questionnaire about patients' oral health. They underwent extraoral and intraoral examinations. Two swab samples were obtained from the oral mucosa of these patients. Gram preparations were analyzed for leukocytes, bacteria, and yeast. Chi-square test and z-test were used. All patients (100%) had the necessary equipment for oral hygiene; however, many (43%) patients had poor oral hygiene. There was a high prevalence of xerostomia (56%) and fissured tongue (61.4%) (among other tongue anomalies). The most commonly isolated microorganisms were coagulase-negative Staphylococcus0 (35.9%), Streptococcus spp. (30.3%), nondiphtheroid Bacilli (16.9%), Staphylococcus aureus (2.3%), Candida spp. (11.8%), and Gram-negative Bacilli (2.8%). The oral hygiene of most patients was insufficient. The presence of Gram-negative Bacilli growth in the oral flora can be explained by poor hand hygiene. These findings suggest that it is useful to educate individuals about oral hygiene and hand hygiene and to inform the staff and families about this issue.

Prevalence of psychiatric co-morbidity among patients attending dental OPD and the role of consultation-liaison psychiatry in dental practice in a tertiary care general hospital.

Background:Psychiatric co-morbidities are frequent among patients attending dental OPD, some of which go unrecognized and hence untreated.Aims:The present study has been carried out to detect the psychiatric co-morbidities among dental patients and determine the scope of consultation-liaison (C-L) psychiatry in a rural teaching hospital regarding comprehensive management of the patients.Settings and Design:This cross-sectional, descriptive type study was conducted in a multi-speciality tertiary care teaching hospital in the northern part of West Bengal, India.Materials and Methods:One hundred patients attending the dental OPD were randomly included in the study and every patient was consecutively referred to psychiatry department for assessment, during the period from 1st November 2013 to 30th April 2014. All referred patients were clinically examined and psychiatric co-morbidity was assessed by the help of General Health Questionnaire (GHQ)-28 and Mental Status Examination.Statistical analysis used:The data were subjected to statistical package for social sciences (SPSS), version 16, and statistically analyzed using Cross tab and Chi test. P <0.05 was considered to be statistically significant.Results:The commonest dental illness was dental caries (22%). More than two-third of the patients had psychiatric co-morbidity according to GHQ-28 total score. Sixty-eight patients were diagnosed to have mental disorder on mental status examination. Somatoform disorder (25%) was the commonest type of mental disorder, followed by mixed anxiety and depression (14%).Conclusions:This study has pointed the need for psychological examination of patients visiting dental specialty with unexplained physical symptoms. Such patients can be identified and treated, provided a psychiatric consultation service exists.

Development and Validation of RP-HPLC and Ultraviolet Spectrophotometric Methods of Analysis for the Quantitative Determination of Chlorhexidine Gluconate and Benzydamine Hydrochloride in Pharmaceutical Dosage Forms

High performance liquid chromatographic and 1st derivative spectrophotometric methods for simultaneous determination of chlorhexidine gluconate (CG) and benzydamine hydrochloride (BH) in gargle and spray preparations used for the treatment of dental illnesses, mouth and faucet infections and providing oral hygiene were developed and validated. CG and BH responses were respectively measured at 271 nm and 324 nm in 1st derivative spectrophotometry. In HPLC; the analysis of CG and BH together with internal standard hydrochlorothiazide (HCT) were performed using an analytical column of Nucleosil 100-5 C18 (5 μm, 250 × 4,6 mm i.d.). Substances were eluted by a mobile phase consisting of 40 mM triethylamine containing phosphate buffer (10 mM, pH 3.0) and acetonitrile (65:35, v/v) at a flow rate of 1 mL min-1. UV detector was set to 230 nm. Under these chromatographic conditions, retention times of HCT, CG and BH were 3.44, 5.42 and 8.58 min, respectively. Developed methods were validated for the parameters of stability, linearity, sensitivity, accuracy, precision, specificity, ruggedness and robustness given in current ICH Guideline. Linearity ranges for two substances were 1-60 μg mL-1 in HPLC and 1-50 μg mL-1 in 1st derivative spectrophotometry. Developed methods were accurate, precise, specific, sensitive, rugged and robust due to the outcome from validation study results. These methods were applied to the binary mixture preparations of CG and BH (gargle and spray) and their reliability for the analysis of these preparations are presented. Keywords: Benzydamine hydrochloride, Chlorhexidine gluconate, Gargle, HPLC, 1st Derivative spectrophotometry, Spray, Validation, Spray preparations, ICH Guideline, LOD, LOQ

Uninsured Adults Presenting to US Emergency Departments

Emergency departments (EDs) are experiencing increased patient volumes and serve as a source of care of last resort for uninsured patients. Common assumptions about the effect of uninsured patients on the ED often drive policy solutions. To compare common unsupported statements about uninsured patients presenting to the ED with the best available evidence on the topic. OVID search of MEDLINE and MEDLINE in-process citations from 1950 through September 19, 2008, using the terms (Emergency Medical Services OR Emergency Service, Hospital OR emergency department.mp OR emergency medicine.mp OR Emergency Medicine) AND (uninsured.mp OR medically uninsured OR uncompensated care OR indigent.mp OR uncompensated care.mp OR medical indigency). Of 526 articles identified, 127 (24%) met inclusion/exclusion criteria. Articles were included if they focused on the medical and surgical care of adult (aged 18 to <65 years) uninsured patients in emergency settings. Excluded articles involved pediatric or geriatric populations, psychiatric and dental illnesses, and non-patient care issues. Statements about uninsured patients presenting for emergency care that appeared without citation or that were not based on data provided in the articles were identified using a qualitative descriptive approach based in grounded theory. Each assumption was then addressed separately in searches for supporting data in national data sets, administrative data, and peer-reviewed literature. Among the 127 identified articles, 53 had at least 1 assumption about uninsured ED patients, with a mean of 3 assumptions per article. Common assumptions supported by the evidence include assumptions that increasing numbers of uninsured patients present to the ED and that uninsured patients lack access to primary care. Available data support the statement that care in the ED is more expensive than office-based care when appropriate, but this is true for all ED users, insured and uninsured. Available data do not support assumptions that uninsured patients are a primary cause of ED overcrowding, present with less acute conditions than insured patients, or seek ED care primarily for convenience. Some common assumptions regarding uninsured patients and their use of the ED are not well supported by current data.

Persepsi Sakit Gigi dan Pola Berobat, Susenas 2001

The National Socio-Economic Survey (NSES) 2001 collected data on the perceived dental illness, disturbance and its duration in dental treatment by health services, and in modern and traditional self-medication. The NSES data was analyzed to study the community perception towards dental illness and motivation for dental care. The prevalence of dental illness was 1.2 per 100 respondents in the last one-month period prior to the survey, showing no significant difference when compared to NSES 1998 or 1.3 per 100 respondents. The perceived dental illness was most prevalent among the 35-39 year old subjects, at 1.8 per 100 respondents. Among those with dental illness, 67 percent of the cases had disturbed daily acitivity with an average duration of 4 days. Among those with dental illness, 69percent of the cases ever had modern or traditional self-medication to overcome the symptoms. However, 36 percent of those with dental illness had further treatment by the health services, showing an increased coverage of health service treatments in 2001 compared to 1998 (13 percent of dental cases). Among these only 67 percent of the treatments were performed by dentists.

Conditions of detention and the deterioration of juveniles’ health: An evidence of ill‐treatment in Rio de Janeiro

This paper demonstrates that the health of juveniles in deprivation of liberty in Rio de Janeiro, Brazil, deteriorates while in detention and that conditions of detention are the major catalyst for offenders’ declining health status. The environment is conducive to the propagation and contamination of health‐related problems such as skin, respiratory, dental, and ear illness and viruses and parasitic infections. The paper concludes that at the moment, both inmates and the environment are disease carriers, deteriorating juveniles’ health status.