Silver diamine fluoride for managing carious lesions: A literature review

Though the prevalence and the severity of dental caries is decreased in past few years, still children from low socioeconomical status in many industrialized or developing countries are still suffering from ill-effects of dental caries. The antimicrobial effect of silver compounds has been proven by the 100-year-old application of silver compounds. Silver diamine fluoride (SDF) has been used to arrest dental caries during 1970s in Japan, but it was not exposed much to other parts of the world. Today in many countries a 38% (44,800 ppm fluoride) SDF solution is commonly used to arrest caries and also to reduce hypersensitivity in primary and permanent teeth. Application of SDF to arrest dental caries is non-invasive procedure and is quick and simple to use. Reports of available studies showed that there is no severe pulpal damage after SDF application. However, it has some drawbacks like black discoloration of the carious teeth and an unpleasant metallic taste. But, low cost of SDF and its simplicity in application suggest that it is an appropriate agent for use in community dental health programme. Thus, SDF appears to meet the criteria of both the WHO Millennium Goals and the US Institute of Medicine’s criteria for 21st century medical care, that is, it is a safe, effective, efficient, and equitable caries preventive agent.

1056Maternal dyslipidaemia is associated with shorter gestational length in a UK cohort of 7440 pregnancies

Background Mechanisms for human labour are unknown because of difficulties in human pregnancy experimentation, limiting our ability to prevent preterm birth. Maternal metabolism is potentially involved. This study aimed to explore associations of multiple maternal metabolic traits with gestational age at delivery (GA). Methods Women with singleton pregnancies recruited to the Born in Bradford cohort study were included. A total of 157 maternal blood metabolites sampled between 26-28 weeks were measured using high-throughput NMR metabolomics. Associations between each metabolite and GA was modelled using linear (GA continuous) and logistic (GA binary) regressions; adjusted for age, BMI, ethnicity, socioeconomical status, alcohol, smoking, parity, pre-existing and gestational diabetes and hypertension, pre-eclampsia, and labour onset. Results The complete case sample included 7440 pregnancies (12308 eligible; 4540 had missing data). 1SD increases in large and very large HDLs were associated with longer mean GAs of 0.5-1 day, including 1SD increased HDL mean diameter associated with +0.5 day mean GA (95%CI:0.2to0.8;p=9.1E-4). 1SD increases in VLDLs and LDLs were associated with shorter mean GAs of 0.5-1 day, including 1SD increase in large VLDL associated with -0.7 days difference in GA (95%CI:-1.021to-0.465;p=2.299E-07). Conclusions Our findings suggest for the first time that maternal dyslipidaemia is related to differences in GA even after adjusting for multiple key confounders. Further studies are needed to clarify whether lipoprotein metabolism is causally involved in human labour. Key messages Human labour may involve pathways related to lipoprotein metabolism.

Neurodevelopmental status in children with congenital hypothyroidism at the children’s hospital and the institute of the child health Multan.

Objectives: To determine the neurodevelopmental status in children with congenital hypothyroidism. Study Design: Cross Sectional Study. Setting: Department of Pediatric Endocrine and Developmental Pediatrics Outpatient at The Children’s Hospital and The Institute of the Child Health (CHICH) Multan. Period: January to December 2019. Material & Methods: A total of 119 children, 1-5years of age having congenital hypothyroidism were included. Their socioeconomical status, age at which the diagnosis was made, duration of thyroxine intake was noted. Development in domains of personal-social, fine motor-adaptive, language and gross motor skills was assessed by using The Denver developmental screening test (DDST). Developmental quotient of each domain was measured and less than 70% was considered significant delayed. SPSS-20 was used for statistical analysis. Results: Out of 119 patients, 47.8% were male, 61.3% were among the age group of 1-3 years and the mean age was 1.40 ± 0.489 years. Forty-five percent (45.4%) belonged to low and 47.1% to middle socioeconomical status. Only 46.2% children started taking thyroxine within 2 months of life. Significant delay in personal-social domain was detected in 73.9% (n=88) children while 80.7% (n=96), 80.7% (n=96) and 86.6% (n=103) patients had significant developmental delay in fine motor-adaptive, language and gross motor skills respectively. Developmental delay was significantly low in children started on thyroxine therapy within 2-months of age (p-value ≤ 0.05 for all domains of development. Conclusion: Children with congenital hypothyroidism suffer from delayed development, so these patients must be referred for developmental therapy along with medical therapy.

Sex difference in incidence of gastric cancer: an international comparative study based on the Global Burden of Disease Study 2017

ObjectivesTo investigate sex difference in global gastric cancer incidence by year, age and socioeconomical status.DesignAn international comparative study.SettingWe obtained the global and national sex-specific incidence of gastric caner by year and age from the Global Burden of Disease Study 2017. The human development index (HDI) in 2017 as an indicator of national socioeconomical status was extracted from the Human Development Report.Main outcome measuresSex-specific incidence of gastric cancer was compared by year and age at the global level. Linear regression analyses were performed to explore socioeconomic-associated sex difference in gastric cancer incidence.ResultsDespite declining incidence of global gastric cancer in both sexes between 1990 and 2017, relative sex difference showed an increasing trend, with male to female ratios of age-standardised incidence rates (ASRs) rising from 1.86 to 2.20. Sex difference was almost negligible under 45 years of age and relative difference maximised in the age range of 65–69 years with male to female ratios of ASRs being 2.74. Both absolute sex difference (standardised β=0.256, p<0.001) and relative difference (standardised β=0.387, p<0.001) in ASRs were positively associated with HDI.ConclusionsThis study revealed that decreasing incidence of global gastric cancer was accompanied by widening sex difference in the past few decades. Men always had higher incidence than women. Greater sex difference was found in older age and in more developed countries. These findings highlight the importance of making sex-sensitive health policy to cope with the global gastric cancer burden.

GAMBARAN KECENDERUNGAN DEPRESI KELUARGA PASIEN SKIZOFRENIA BERDASARKAN KARAKTERISTIK DEMOGRAFI DAN PSIKOSOSIAL

Depression is a serious mental health problem. Prevalence is estimated 5-10% per year. The presence of a schizophrenic family member is a known stressor which can cause chronic stress. Chronic stress are oftenly associated with depression. The goal of this study is to establish the depression likelihood of schizophrenia patient’s family based on demographic and psychosocial characteristics at Sambang Lihum Hospital, South Kalimantan. This study is a descriptive study, and the samples are obtained through non probability samplingand purposive sampling. Questionnaires are used to collect general data of schizophrenia patient’s family, Beck Deperession Inventory-II (BDI-II) dan Holmes and Rahe Life Stress Inventory (HRLSI).The results of this study shows the rate of depression based on severity, which are 54% normal, 22% mild, 19% moderate and 5% severe. Normal or depression-negative dominates the distribution in the 46-55 age range (early geriatrics) at 64%, lives in the city at 55,55%, male at 55,31%, high school education at 81,81%, socioeconomical status based on full-time occupation at 100%, and income > minimum wage at 63,33%, unmarried at 69,23%, first-degree relative at 59,25%, and mild stressful life events at 80,76%. Keywords: depression likelihood, schizophrenia patient’s family, demography, psychosocial stress Abstrak: Depresi merupakan masalah kesehatan yang cukup serius. Prevalensi depresi di dunia diperkirakan 5-10% per tahun. Memiliki anggota keluarga yang menderita skizofrenia merupakan suatu stressor yang mengakibatkan stres yang bersifat kronik. Peristiwa kehidupan yang berlangsung lama atau stres kronik lebih banyak dihubungkan dengan depresi. Tujuan penelitian ini adalah untuk mengetahui gambaran kecenderungan depresi keluarga pasien skizofrenia berdasarkan karakteristik demografi dan psikososial di RSJ Sambang Lihum Kalimantan Selatan. Metode penelitian yang digunakan adalah studi deskriptif. Pengambilansampeldilakukandengan metode non probability sampling melalui purposive sampling.Jumlah sampel adalah 100 responden. Instrumen yang digunakan berupa kuesioner yang memuat biodata umum keluarga pasien skizofrenia, Beck Deperession Inventory-II (BDI-II) dan Holmes and Rahe Life Stress Inventory (HRLSI). Hasil penelitian didapatkan kategori normal (tidak depresi) 54%, derajat depresi ringan 22%, derajat depresi sedang 19%dan derajat depresi berat 5%. Tidak depresi (normal) mendominasi distribusi pada usia 46-55 tahun (masa lansia awal) sebesar 64%, tempat tinggal di daerah kota sebesar 55,55%, jenis kelamin laki-laki sebesar 55,31%, tingkat pendidikan SMA sebesar 81,81%, status sosioekonomi berdasarkan aktivitas ekonomi bekerja penuh waktu sebesar 100% dan berdasarkan pendapatan >UMP sebesar 63,33%, status pernikahan tidak menikah sebesar 69,23%, status dalam keluarga saudara kandung sebesar 59,25%, peristiwa hidup stressful stres ringan sebesar 80,76%. Kata-kata kunci: kecenderungan depresi, keluarga pasien skizofrenia, demografi, stress psikososial

DEPRESSION

Infertility is very stressful event and is proven to associate with depression,anxiety, sexual dysfunction loneliness, sadness and impaired couple’s relationship. Objectives:To determine the frequency of depression in infertile females and to determine the various riskfactors associated with infertility and depression. Study Design: Prospective cross sectionalstudy. Setting: Department of Obstetrics and Gynecology of Ziauddin University Karachi. Period:January to June 2014. Methodology: Infertile women were interviewed and the diagnosis andseverity of depression was assessed together with the effects of different predicators such asage, duration of infertility, employment educational and socioeconomical status using PHQ-9 scale scoring. Results: This study showed that 199 (58%) of the infertile women sufferedfrom depression. There was a statistically significant association with socio economical statuswhile no significant association was detected with age of women, duration of infertility andeducational status. Conclusion: We found a high prevalence of depression among infertilewomen. Depression was more among women belonging to higher socioeconomic class.

EXPERIENCES AND VIEWS OF PREGNANT WOMEN ON SMOKING

Backround: Worldwide, approximately 1 billion people, from which 200-250 million are women, smoke. Based on the Estonian Medical Birth Register data, in 2010, 7,5% of pregnant women were smokers, and in 2012, 7% of pregnant women were smoking during their pregnancy. Thus, smoking rates among pregnant women fell only 0,5%. The objective of the research was to find out the views of pregnant women who were smoking during pregnancy of the effect of smoking on the health of them and their babies, and experiences in quitting smoking, changing indicators, e.g. smoking and socioeconomical status (initial exposure to smoking, employment, long-term partnerships etc.) in 2009-2013.Methods: This research is a phenomenological study, which was being carried out from October 2009 until January 2013. Data collection methods were semi-structured interviews with 45 pregnant women smoking during their pregnancy and being registered for antenatal care in three health care institutions of Republic of Estonia. An inductive approach for qualitative analysis was used.Results: Most women smoking during pregnancy started smoking in their teens, their parents smoked, they were under 30 years old housewives or unemployed. On an average of 11-20 cigarettes were consumed each day, the pregnancy of the research group did not influence frequency and tobacco intake. The participants in the research group reported that tobacco consumption helped them relax, gave them a chance to spend time in a good company, and it was not regarded as a bad habit but a social addiction, being caused by availability of tobacco products. Although most of them had an opinion about harmful effects of smoking, e.g. a cough, asthma and rapid fatigue, on the health of them and less on their expected babies, they continued smoking.Conclusions: The smoking and socioeconomical status of women smoking during pregnancy in 2009-2013 has not changed, health awareness of them is low and has not improved. Support groups with close relatives are needed to motivate cessation. In the first place, prevention needs a good example, purposeful cooperation, which starts in daily life context – at homes, in educational institutions and in the community. Limiting the availability of tobacco products, postponing and preventing an initial exposure to smoking are thought to be of great importance. The results of the research will be introduced in health care institutions and they can be used in the health promotion process.