Bleeding Gums Research Articles

Dengue Fever in Pregnant Women with a Favorable Outcome

Dengue fever is a viral infectious disease, it manifests itself from mild to severe severity, in some cases to fatal outcomes. The number of cases of dengue fever has been increasing in recent years. The results of many studies have also shown adverse effects on pregnant infected women. This article describes the clinical course of Dengue fever in pregnant women, which occurred in moderate severity and without complications. Dengue fever in a pregnant woman manifested itself in the form of complaints of pain in the epigastric region, bleeding gums and petechial hemorrhages within 1 day. She had a high fever for 5 days before going to the hospital. Upon admission, her body temperature was 37 °C, blood pressure was 110/80 mmHg, pulse rate was 80 beats per minute, respiratory rate was 20 beats per minute. She had mild dehydration, normal breathing and heartbeat. The height of the bottom corresponds to the gestation period of 31 weeks, and the fetal heart rate was 144 beats per minute. Petechiae measuring at least 1-2 m in diameter were found around her face, forearms and both basal areas. In a laboratory study, the results showed changes in the number of platelets in the form of thrombocytopenia, leukocytopenia and in the biochemical analysis of blood by increasing the concentration of C-reactive protein and the detection of antibodies in serum during serological analysis. Although many studies have shown that Dengue during pregnancy increases the risk of preeclampsia, hemorrhagic dengue fever (HLD), fetal distress, premature birth, cesarean section and maternal mortality and intrauterine development delay and stillbirth consequences. This clinical case concludes with favorable outcomes. But the physiological effects of dengue fever during pregnancy (for both mother and child), depending on the trimester, as well as research and treatment methods require further study, especially in the region of endemic zones and India.

Effects of Toothpaste Containing 2% Zinc Citrate on Gingival Health and Three Related Bacteria-A Randomized Double-Blind Study.

Gingivitis is the initial stage of periodontitis, one of the most common oral diseases and the primary cause of tooth loss. This study aims to evaluate the effect of toothpaste containing 2% zinc citrate on gingival health and the abundance of three bacteria related to gingivitis and periodontitis. Eleven volunteers with the same oral health status were randomly assigned to the treatment (n = 5) and control (n = 6) groups. The control group used fluoride toothpaste, while the treatment group used fluoride toothpaste supplemented with 2% zinc citrate for 3 months. The plaque index, gingival index, and bleeding index were measured at baseline (0 day), 3 weeks, and 3 months. Dental plaque from four areas of the mouth (FDI criteria) was collected at the same timepoints. A total of 132 dental plaque samples were analyzed using quantitative PCR (qPCR) to monitor the abundance of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Tannerella forsythia. Toothpaste containing 2% zinc citrate significantly lowered the gingival index and reduced gum bleeding but did not affect the plaque index. It also reduced the total abundance of the three bacteria related to gingivitis and periodontitis in dental plaque over a long-term period. Toothpaste with 2% zinc citrate persistently improves gingival health and reduces the presence of gingivitis-associated bacteria in dental plaque. Chinese Clinical Trial Registry (Clinical trial registration no.: ChiCTR1900020592) (09/01/2019).

PENGETAHUAN DAN PERILAKU TENTANG PEMELIHARAAN KESEHATAN GIGI MULUT

Dental problems are a problem that is very prone to be obtained for children especially during their growth period. Oral health maintenance must be carried out early on at elementary school age considering that oral and dental diseases are ranked in the top ten most common diseases and are spread in various regions. Based on the phenomenon obtained at MI Ma'arif NU Karang Turi, there are 3 students who often experience oral health problems such as mouth ulcers, cavities and bleeding gums. Meanwhile, the other 2 students did not experience oral health problems which could result in disrupted activities and learning at school. The purpose of this study was to determine the level of knowledge and behavior about oral health maintenance in fifth grade students of MI Ma'arif NU Karang Turi. The instrument in this study was a knowledge and behavior level questionnaire. This research method uses quantitative research design. The sample in this study were 35 students. The sampling technique in this study used total sampling. The results of the description of the level of knowledge and behavior show that as many as 18 respondents with a percentage (51.4%) have a good level of knowledge. While as many as 19 with a percentage of respondents (54.3%) had poor behavior. Recommendations that can be given in this study are to make a consistent schedule or routine, for example after finishing dinner, then brush your teeth before bed.

A study of CPITN score in Periodontics Clinic Patients, RSGM Airlangga University, 2022

Background: Approximately 90% of the global population suffers from periodontal disesase, characterizes by bleeding gums, pain, and bad breath. The impact of this disease is diverse, ranging from tooth loss, disruption of aesthetics and confidence, to influencing individual nutritional status. The disease can be caused by damage of the periodontal tissues. Therefore, the Community Periodontal Index of Treatment Needs (CPITN) is highly essential for assessing the extend of issues in periodontal tissues, including evaluating oral and dental health problems in patients. This assessment can aid in the treatment and prevention of periodontal disease. Material and Methods: This research is a descriptive study. The population consists of all patients who visited the periodontology clinic at the Faculty of Dentistry, Airlangga University, in the year 2022. The sample was taken using a total sampling technique, involving secondary data obtained from the periodontal status cards of patients, specifically focusing on the examination data related to the condition of periodontal tissues based on the Community Periodontal Index of Treatment Needs (CPITN). Conclusion: The CPITN scores vary between gender and age groups of the patients. Therefore, bivariate research is needed to analyze the relationship of these parameters with the CPITN scores of periodontology patients.

Oral health related cardiovascular disease risk factors: a cross-sectional study

Abstract Background Hypertension, cardiovascular disorders, and hypercholesterolemia represent significant public health concerns. This research presentation examines the impact of various oral health indicators, such as bleeding gums, untreated dental decay, loose teeth, and missing teeth, on these conditions within Hungary. Materials and methods This study utilized data from 5,603 individuals participating in the 2019 Hungarian European Health Interview Survey. Predictor variables were chosen using elastic net regularization and k-fold cross-validation to enhance the performance of weighted logistic regression models. Sensitivity analysis underpinned the robustness of the results. Results Significant associations emerged between deteriorating oral health and the prevalence of various cardiovascular conditions. An increased likelihood of hypertension was observed in individuals with multiple tooth removals, showing an odds ratio (OR) of 1.67 with a 95% confidence interval (CI) of [1.01-2.77]. The use of dental prosthetics presented an OR of 1.45 [1.20-1.75]. Additionally, presence of gum bleeding corresponded to elevated odds for both cardiovascular disease (OR = 1.69 [1.30-2.21]) and hypercholesterolemia (OR = 1.40 [1.09-1.81]). Conclusions enhancing oral health could potentially mitigate chronic cardiac conditions, highlighting the importance of integrating dental care in comprehensive disease management strategies. Key messages • Poor oral health is linked to higher hypertension and heart disease odds. • Dental care is crucial in cardiac disease prevention and management.

Clinical and laboratory evaluation of the effectiveness of children's toothpastes containing 1000 ppm fluoride

Relevance. This article presents the findings from studies evaluating the effectiveness of toothpastes containing 1000 ppm fluoride in clinical settings. The data demonstrates the cumulative benefits of these toothpastes on oral hygiene, the reduction of inflammatory oral manifestations, and their anticaries effects.Purpose. To assess the effectiveness of fluoride-containing toothpastes through laboratory tests and clinical trials.Materials and methods. The study evaluated the effectiveness of toothpastes containing 1000 ppm fluoride using the following parameters: Greene-Vermillion hygiene index, periodontal indices (PMA and SBI), enamel mineralization and resistance, presence and number of carious lesions at the white spot stage, enamel hypersensitivity, and antimicrobial activity against Streptococcus spp.Results. The analysis of hygiene indices demonstrated that the tested toothpastes were highly effective in cleaning, with a positive cumulative effect on participants' oral hygiene. The use of these toothpastes significantly reduced inflammatory manifestations, decreased gum bleeding, and improved periodontal tissue health. A reduction in the number of participants with early-stage carious lesions, as well as a decrease in the overall number of lesions, was observed. The toothpastes also enhanced enamel resistance to acid exposure, contributing to their anticaries benefits. Enamel hypersensitivity was reduced, and a dose-dependent antibacterial effect against Streptococcus mutans, Streptococcus gordonii, and Streptococcus sobrinus was observed.Conclusion. Toothpastes containing 1000 ppm fluoride demonstrated strong cleaning and refreshing effects, along with a positive cumulative impact on oral hygiene and a significant reduction in inflammation. Their anticaries benefits were confirmed, and they also reduced enamel hypersensitivity. The tested toothpastes were well-tolerated, with no reports of allergic reactions or irritation.

Use of polyphyte oil in the treatment of chronic gingivitis in orthodontic patients

The study presents the results of research on the treatment of chronic catarrhal gingivitis in patients undergoing long-term orthodontic treatment with fixed appliances. A domestic product based on plant components, a four-component polyphyte oil «Fitoleum® Oil for Gums and Teeth», was used for treatment. The study involved 36 patients diagnosed with chronic catarrhal gingivitis who had been undergoing orthodontic treatment with bracket systems for six to eighteen months. All patients were divided into two groups: the main group (20 persons), using the four-component polyphyte oil, and the control group (16 persons), receiving standard treatment.The therapeutic effect was assessed based on the absence of complaints of itching and discomfort in the gums, as well as indicators of the sulcus bleeding index (SBI) according to Mühlemann and the degree of inflammation using the papillary-marginal-alveolar index (PMA). Measurements were taken on the first, third, and fifth days of the study. The results showed a positive dynamic in clinical and index indicators on the fifth day of using the four-component polyphyte oil «Fitoleum® Oil for Gums and Teeth» in all patients of the main group.Thus, the use of this oil demonstrated high effectiveness in treating chronic catarrhal gingivitis that developed during orthodontic treatment with bracket systems. The advantages of using the four-component polyphyte oil include reducing inflammatory processes, decreasing the level of gum bleeding, and improving the overall condition of the oral mucosa. The obtained results confirm that this method can be recommended for widespread use in clinical practice for patients undergoing orthodontic treatment.

Periodontal treatment needs in children and adolescents with inflammatory bowel disease.

Increased incidence of periodontal disease is described in adult patients with inflammatory bowel disease (IBD), implicating similarities in gut immunopathogenesis and periodontitis. Evaluation of periodontal status and treatment needs of children with IBD in remission, according to disease phenotype, sex, age, and oral hygiene status, and compare them to age-matched healthy population of a dental practice. Fifty-five children with IBD (mean age 12.27±3.67 years) and 55 matched healthy controls of a dental practice (mean age 12.21±3.96 years) were assessed with the simplified gingival index (GI-S) and the plaque control record (PCR) index and the community periodontal index of treatment needs (CPITNs). A dental questionnaire on therapy, oral hygiene, gum bleeding, and dental attendance was completed by participants. Children with IBD in remission had higher gingival inflammation and periodontal treatment needs compared to controls. In patients with IBD, the CPITN was higher in older compared to younger children (59.37% vs. 47.83%) and in boys compared to girls (65% vs. 46.67%). Among controls, CPITN was also higher in older children (21.88% vs. 4.34%) and in boys (16% vs. 13.33%). Older children and boys with IBD have more periodontal treatment needs, compared to controls, despite similar oral hygiene.

Crimean-Congo hemorrhagic fever in Herat province of Afghanistan, 2007-2021

Crimean-Congo hemorrhagic fever (CCHF) is a geographically widespread tick-borne hemorrhagic diseasecaused by the Crimean-Congo hemorrhagic fever virus (CCHFV). In Afghanistan, the first case of CCHF wasdetected in Takhar province in 1998, after which no additional cases were reported for ten years. The aim ofthis study is to report the analyses of the clinical and epidemiological features of confirmed CCHF cases thatwere recorded in Herat province between 2007 and 2021. This prospective case series study was conducted atHerat Regional Hospital between January 2007 and December 2021. Demographic and clinical data werecollected for each patient; all patients were hospitalized. Biochemical and hematological laboratoryexamination, and the detection of CCHV IgM and viral RNA was performed for all patients. Statistical analyseswere performed in IBM SPSS Statistics (version 26). A total of 252 confirmed CCHF cases including 160(63.5%) males and 91 (36.5%) females, with a mean age of 33.37±14.1 years were included in the study. Themajority of patients were in 11-50 age category, 32.9% were housewife, 38.4% were farmers, shephard, andbutchers. The most prevalent clinical presentations were fever (100%), headache (98.8%), body pain (96.4%),Ecchymosis (48.0%), epistaxis (44.8%) and gum bleeding (33.3%). The majority of cases occurred betweenApril and October. The case fatality rate of CCHF in this study was 2.8%. Considering the significant social,economic and health burden CCHF places on the community, enhanced public health measures are necessaryto control CCHF in Herat province and neighboring regions.

Oral health status and factors associated with oral health of primary school children in Gulu district, northern Uganda

BackgroundGlobally, oral diseases remain a major public health problem. However, there is limited information about the oral health status and factors associated with oral disease among children in Uganda. The aim of this study was to examine the oral health status and factors associated with oral health of primary school children in urban and rural areas of the Gulu district of northern Uganda.MethodsA comparative cross-sectional study was conducted among 356 school children aged 11–13 years attending six schools located in urban and rural areas. The children received a clinical oral examination and participated in a questionnaire survey that collected information on sociodemographic and oral health knowledge, attitude, and practices. All data were entered and analysed using IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp statistical software. Logistic regression analyses examined factors associated with dental caries and gingival bleeding.ResultsOf the 356 children (11–13 years) included, the mean age was 12.2 years, 140 (39.3%) were male and 176 (49.4%) were from urban areas. The proportion of school children with dental caries was 33.6% (n = 119), with the mean decayed, missing due to caries, and filled teeth (DMFT) index of 0.81 (25th percentile = 0; 75th percentile = 1.00). There was no significant difference in caries prevalence between rural and urban children (31.6% versus 35.6%, p = 0.33). Of the children involved in the study, 141(39.8%) had gum bleeding. The mean oral knowledge score was 2.85 ± 1.53 (range, 0–7), while the mean attitude, hygiene practice, frequency of sweets consumption, and oral health related impact scores were 4.25 ± 1.23 (range, 1–6), 5.40 ± 1.81 (range, 0–9), 25.66 ± 4.29 (range 9–54) and 2.1 ± 1.65 (range, 0–6), respectively. Using logistic regression analyses, as oral health knowledge score increased the odds of not having dental caries increased (aOR = 1.19, 95% CI 1.02–1.39).ConclusionThe prevalence of dental caries and gum bleeding of primary school children in Gulu district is high. Children lacked knowledge on causes of oral disease, and behaviour towards oral disease prevention. In addition, oral health knowledge scores were significantly associated with dental caries. Oral health education programs in schools should emphasise providing skills-based education.

Unusual presentations in systemic lupus erythematosus with concurrent IgA nephropathy lesion: a rare case report from Eastern Nepal

Introduction: Systemic lupus erythematosus (SLE) is an autoimmune disease involving multiple organs. While lupus nephritis (LN) is seen in SLE, concurrent IgA nephropathy lesion is rare. Uncommon manifestations like cutaneous ulcers and orbital involvement present diagnostic challenges, and this case from Nepal emphasizes careful diagnostic approach in such cases. Case presentation: A 42-year-old female presented with bilateral lower limb swelling, gum bleeding, and epistaxis. Initial evaluation revealed pancytopenia and suspected renal involvement. Renal biopsy showed IgA nephropathy lesions, but clinical and laboratory findings favored lupus nephritis. Treatment with immunosuppressive agents was initiated. Despite therapy, the patient developed cutaneous ulcers and orbital cellulitis. Decreasing anti-ds DNA levels were noted during the course of treatment. Discussion: The diagnosis of lupus nephritis in the presence of IgA nephropathy lesions emphasizes the complexity of SLE diagnosis. Treatment with immunosuppressive agents targeting the underlying autoimmune process, yet the development of cutaneous ulcers and orbital cellulitis highlights the importance of timely intervention in managing SLE complications. In resource-limited settings, clinicians should initiate interventions based on clinical and lab findings while awaiting detailed biopsy results. Conclusion: This case highlights diagnostic challenges in SLE and emphasizes the necessity for careful monitoring and timely intervention in managing complications. The interplay between SLE and IgA Nephropathy (IgAN) suggests that SLE may trigger or exacerbate it, complicating disease management. Further exploration is needed to enhance the understanding and management of complex autoimmune disorders like SLE.

Identification of a homozygous variant in ABCG5 by panel sequencing in a Pakistani family with sitosterolemia: Genotype-phenotype correlation and management considerations

Sitosterolemia is a rare autosomal recessive disorder characterized by impaired excretion of plant sterols, leading to their accumulation in tissues and organs. We identified a hitherto unreported homozygous variant, in ATP-binding cassette sub-family G member 5 (ABCG5) (NM_022436.3) c.274A>G p.(Lys92Glu), segregating in two affected sibs (Sit1C and Sit1F) of a consanguineous Pakistani family, during genetic workup for hereditary hemolytic anemia. Both patients had anemia, history of gum bleed and easy bruising. Peripheral film revealed stomatocytes and macrothrombocytopenia. Plasma sitosterol level was found to be significantly high (27.7 mg/dL and 25.1 mg/dL for Sit1C and F respectively), confirming diagnosis of sitosterolemia in both patients. Treatment with Ezetimibe, a sterol absorption inhibitor, resulted in significant decrease in sitosterol as well as LDL-cholesterol, in these patients. This study confirms the potential of panel sequencing as a diagnostic tool for sitosterolemia. Definitive diagnosis has significant clinical implications for genetic counseling and management strategies, such as dietary modifications and successful management with Ezetimibe.

Relationship Between Pre-Diabetes and Gum Disease

Background: Pre-diabetes is a condition characterized by elevated blood glucose levels that are not yet high enough to be classified as diabetes. This intermediary stage increases the risk of progression to type 2 diabetes and is associated with various complications, including periodontal disease. Understanding the relationship between pre-diabetes and periodontal health is critical for developing effective prevention and management strategies.Objective: To explore the relationship between pre-diabetes and gum disease, evaluating the prevalence and types of periodontal complications in pre-diabetic patients.Methods: A retrospective analysis was conducted on clinical records of 150 patients diagnosed with pre-diabetes from 2018 to 2022. Data were collected on periodontal conditions, including gingivitis, periodontitis, bleeding gums, and tooth loss. Statistical analyses, including chi-square tests and logistic regression, were performed using SPSS version 25 to evaluate the association between periodontal complications and demographic factors.Results: Gingivitis was present in 12% of patients, periodontitis in 15%, bleeding gums in 8%, and tooth loss in 5%. Significant associations were found between periodontal complications, older age, and longer duration of pre-diabetes (p < 0.05).Conclusion: Pre-diabetic patients exhibited a high prevalence of periodontal complications, highlighting the need for early periodontal assessment and management to prevent disease progression

Anti-Inflammatory Activity and Wound Healing Ability of Coconut Oil Mouthwash on Gingival Fibroblast Cell In Vitro

Coconut oil-pulling therapy is used for maintaining oral health. The procedure has benefits for the prevention of oral disease, including dental caries, oral malodor, bleeding gums. However, virgin coconut oil (VCO) has unsatisfying oily taste. Therefore, coconut oil mouthwash (CoMW) was recently developed. This in vitro study aimed to evaluate the anti-inflammatory activity of coconut oil mouthwash consisting of 60% v/v virgin coconut oil (VCO), 30% v/v propylene glycol (PG), and 10% v/v distilled water on human gingival fibroblast (HGF) cells compared with the activity on murine macrophage (Raw 264.7) cells. The cytotoxicity of CoMW, 0.12% chlorhexidine gluconate (CHX), VCO, and PG was assessed. IC50 concentration of CoMW, CHX, and PG were 1:8 (v/v), 1:32 (v/v), and 1:16 (v/v), respectively. All tested concentrations of VCO had no impact on cell viability. Their anti-inflammatory effects of each IC50 concentration were further studied. Notably, the IC50 concentration of CHX also significantly inhibited nitric oxide production in lipopolysaccharide (LPS)- activated Raw 264.7 cells. Moreover, the IC50 concentrations of CoMW, VCO, PG, and CHX could suppress the interleukin-1 beta (IL-1β), interleukin-6 (IL-6) and cyclooxygenase-2 (COX-2) gene expressions in LPS-activated HGF cells, while also enhancing the cell migration of HGF cells as likely to the effect observed with the IC50 concentration of CHX. Wound healing ability of CoMW was also demonstrated after testing with a scratch assay. These findings indicated promising potential for coconut oil mouthwash as an effective agent in reducing inflammation and facilitating wound healing.

Assessment of oral health status amongst postal employees of Bhubaneswar city: A cross-sectional study.

Upholding good dental health has wider effects on productivity and performance at work in addition to being crucial for individual well-being. Because it can affect both their personal well-being and productivity at work, post office workers' oral health is therefore a critical issue of concern. Hence, evaluating Bhubaneswar city post office workers' dental health is the study's aim. With the aid of the WHO 2013 oral health assessment form, a cross-sectional study involving 171 regular post office workers was undertaken. Using the Chi-square test and an ANOVA for pertinent variables, the data were analysed using SPSS statistical software version 27.0. Potential confounding variables were adjusted using multiple logistic regression analysis. The survey included a total of 171 post office personnel, of which 76.6% were men and 23.4% were women. The participants' periodontal health revealed that 67.7% had deep periodontal pockets, 18.7% had shallow ones, and 95.3% had bleeding gums. The mean DMFT of the study participants was 4.10 ± 3.149. Among post office workers, tobacco use and oral health conditions represent a crucial junction of variables that call for caution and preventative action.

A Survey of Lithuanian Pregnant Women's Knowledge about Periodontal Disease, Its Prevalence and Possible Influence on Pregnancy Outcomes.

Background: This study aimed to subjectively assess the changes in the oral health status of pregnant women, to find out their attitudes and knowledge about possible changes in the oral cavity that occurred during pregnancy, and their influence on the outcomes of pregnancy. Methods: 112 pregnant women who visited the Republican Siauliai Hospital during their pregnancy participated in the study. An anonymous self-administered questionnaire was used to conduct the research, surveying their demographic characteristics, oral health changes and habits during pregnancy, and awareness of possible negative pregnancy outcomes. Results: The study involved 112 pregnant women, with 35 in the first trimester, 28 in the second, and 48 in the third trimester. The findings revealed that pregnant women do not take sufficient care of their oral health: more than half of the respondents did not visit an oral care specialist during pregnancy; 22.3% of women reported brushing their teeth only once a day or less; and 35.7% did not clean interdental surfaces at all. Statistically, significantly more urban women believed there is a relationship between maternal oral health and adverse pregnancy outcomes than women living in rural areas (p = 0.013). While significant oral health changes were not observed in the first trimester, more women in the second and third trimesters reported issues such as bleeding gums, swelling, plaque accumulation, tartar, and caries (p < 0.001). Conclusions: The attitude of women towards oral health during pregnancy and their understanding of the possible risks for unfavorable pregnancy outcomes are insufficient. Notably, oral health issues become more prominent in the second and third trimesters, necessitating appropriate oral care to reduce the incidence of oral and dental diseases during pregnancy. This underscores the importance of educational and preventive public health policies focused on oral care for pregnant women, aimed at increasing awareness and promoting practices that safeguard both maternal and fetal health.

Clinical, Demographic, And Haematological Profile of Haemophilia Patients at Sir Sunder Lal Hospital Varanasi With CoE Haemoglobinopathies And Day Care Centre

Introduction: Hemophilia is a recessive coagulation and bleeding disorder that is X-linked and inheritable. The Factor VIII (F8) and Factor IX (F9) genes are involved in hemophilia A and B, two hereditary diseases. The process of hemostasis is hampered by spontaneous or post-traumatic bleeding, which also increases the risk of hemophilia. Aim: The purpose of our study is to evaluate the hematological, clinical, and demographic traits of individuals with hemophilia A and B. Results: A total of 646 hemophilia patients were examined during the study period. the majority of hemophilia A patient 544 (84.21%) and hemophilia B102 (16.01%). Based on severity, severe 342 (52.94%), Moderate 247 (38.24%), and Mild (8.82%) had been diagnosed Most common age group was &lt;1 -58 years. The bulk of the study population had a mean age of (Mean ±SD=18.45±13.00) and a median of 17. Maximum number of patients at the ages of 21 and 30 years (21.05%) and a median of 25. The most common age of spontaneous bleeding across all patients was 17 and there was no discernible difference between those with moderate and severe symptoms of bleeding. Hemarthrosis infection (target joint) was most prevalent (79.10%), then prolonged bleeding after cut/ trauma (62.38%). Hemarthrosis knee joint was the joint that was infected (target joint) the most common (79.10%), followed by joint bleeding (46.75%) Severe disease affected the knee joint more frequently than moderate disease. Conclusion: The present research revealed differences in the incidence and nature of bleeding on its own in hemophilia patients. Gum bleeding and posttraumatic bleeding in a child who is otherwise healthy should alert the doctor to consider hemophilia onset is &lt;1 year. On the other hand, 61.3% of patients had hemophilia when they received their initial diagnosis. The median number of bouts of

Development of a clinical prediction score for Ebola virus disease screening at triage centers in the Democratic Republic of the Congo.

The 2018-2020 Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo (DRC) was the largest since the disease's discovery in 1976. Rapid identification and isolation of EVD patients are crucial during triage. This study aimed to develop a clinical prediction score for EVD using clinical and epidemiological predictors. We conducted a retrospective cross-sectional study using surveillance data from EVD outbreak, collected during routine clinical care at the Ebola Transit Center (ETC) in Beni, DRC, from 2018 to 2020. The Spiegelhalter and Knill-Jones method was used for score development, including potential predictors with an adjusted likelihood ratio above 2 or below 0.50. Validation was performed using a dataset previously published in PLOSOne by Tshomba et al. Among 3725 patients screened, 3698 fulfilled the inclusion criteria, with 571 (15.4%) testing positive for EVD via RT-PCR Test. Seven predictive factors were identified: asthenia, sore throat, conjunctivitis, bleeding gums, hematemesis, contact with a sick person, and contact with a traditional healer. The prediction score achieved an Area under the receiver operating characteristic (AUROC) of 0.764, with 81.4% sensitivity and 53.6% specificity at a -1 cutoff. External validation demonstrated an AUROC of 0.766, with 80.8% sensitivity and 41.4% specificity at the -1 cutoff. Our study developed a screening tool to assess the risk of suspected patients developing EVD and being admitted to ETUs for RT-PCR testing and treatment. External validation results affirmed the model's reliability and generalizability in similar settings, suggesting its potential integration into clinical practice. Given the severity and urgency of EVD as well as the risk nosocomial EVD transmission, it is essential to continuously update these models with real-time data on symptoms, disease progression, patient outcomes and validated RDT during EVD outbreaks. This approach will enhance model accuracy, enabling more precise risk assessments and more effective outbreak management.

The Relationship Between Tooth Brushing Methods and Gum Bleeding Among the Elderly at Posyandu Lansia in Surabaya

The elderly experience a decline in immune function, making them susceptible to dental and oral diseases, one of which is gum bleeding. Improper tooth brushing techniques can cause gum bleeding because brushing in the wrong direction can make the gums bleed easily and leave food residues uncleaned. Problem: The high percentage of gum bleeding during tooth brushing in the elderly at the Posyandu Lansia Kampung Mustika Baru Ngagel Surabaya in 2024. On average, the elderly have poor tooth brushing techniques. Objective: To analyze the relationship between tooth brushing methods and gum bleeding in the elderly at the Posyandu Lansia Kampung Mustika Baru Ngagel Surabaya in 2024. Research Method: This research is an analytical cross-sectional study. Sampling was done using purposive sampling with a sample of 36 elderly individuals. The data collection instruments used were observation sheets to measure tooth brushing methods and examination sheets to identify gum bleeding. The analysis technique used was the Chi-square test. Research Results: On average, the elderly's tooth brushing methods, after observation, were categorized as poor. There is a significant relationship between tooth brushing methods and gum bleeding in the elderly at the Posyandu Lansia Kampung Mustika Baru Ngagel Surabaya, with an asymp.sig (α) value of 0.000 (p &lt; 0.05). Conclusion: The better the elderly brush their teeth, the less likely they are to experience gum bleeding, thereby reducing the risk of gum bleeding

Autism Severity, Adverse Childhood Experiences, and Oral Health: A Comparative Study of Adolescents in the United States.

Dental health significantly influences overall child physical well-being, academic success, and psychosocial development. This paper explores the intersection of a range of Autism Spectrum Disorder (ASD) functionality, multiple types of Adverse Childhood Experiences (ACEs), and dental health in adolescents. The purpose is to investigate the independent and interactive effects of ASD severity and ACEs on dental outcomes. Data from the 2018 and 2019 National Surveys of Children's Health were analyzed, focusing on 28,263 adolescents (ages 11-17). Logistic regressions assessed associations between ASD severity (mild, moderate, severe), cumulative number of ACEs, and dental outcomes (teeth condition, cavities or bleeding gums, check-ups, cleanings). Covariates included demographic and socioeconomic factors. Controlling for covariates, severe autism independently increased the odds of poor teeth (odds ratio = 6.17), cavities or bleeding gums (OR = 3.76), no previous year check-up(OR = 2.94), and no previous year cleaning (OR = 4.20). Higher ACE scores also independently increased the odds of all dental outcomes. Interactions revealed a cumulative effect of multiple ACEs on poor dental outcomes only for adolescents with severe levels of autism. This study illuminates the heightened vulnerability of adolescents with severe autism and a history of ACEs, emphasizing the need for targeted interventions. Multidisciplinary strategies integrating dental care and mental health support within tailored interventions are crucial for improving dental health and access for older youth with low functioning autism. While these findings provide valuable insights, the cross-sectional design and reliance on parental reports necessitate cautious interpretation.