Factors associated with the technical quality of root canal fillings performed by undergraduate dental students in a Malaysian Dental School

Aim: A retrospective clinical audit was carried out on records of endodontic treatment performed by dental undergraduates. The audit was performed to evaluate the technical quality of root canal fillings performed by dental undergraduates and determine the associated factors. Methods: 140 records of patients who had received root canal treatment by dental undergraduates were evaluated through periapical radiographs by two examiners (κ =0.74). The root canal fillings had their quality evaluated according to extent, condensation and presence of procedural mishap. Possible factors associated with technical quality such as tooth type, canal curvature, student level and quality of record keeping were evaluated. Data were statistically analyzed using chi-square test (p<0.05). Results: Among the 140 root-filled teeth, acceptable extent, condensation and no-mishap were observed in 72.1%, 66.4% and 77.9% cases respectively. Overall, the technical quality of 68 (48.6%) root-filled teeth was considered acceptable. Overall, non-acceptable root canal fillings were significantly more likely to be observed in molars (69.2%), moderately and severely curved canals (71.4%) and junior students (61.5%). There was no association between acceptable root canal fillings and quality of record keeping. Conclusions: The technical quality of root canal fillings was acceptable in 48.6% cases and it was associated with tooth type, degree of canal curvature and student seniority.

Effect of bleaching agents containing fluoride or calcium on enamel microhardness, roughness and permeability

Aim: To evaluate the effect of different in-office bleaching agents on the permeability, roughness and surface microhardness of human enamel. Methods: For evaluation of roughness and microhardness, 40 hemi-faces of 20 premolars were subjected to initial roughness (Ra parameter) and microhardness (VHN) measurements. Thirty-two premolar’s crowns were used for permeability test. Then, all specimens were randomly divided into four groups: C - without bleaching (control), HP35 - bleaching with 35% hydrogen peroxide (HP), HPF38 - 38% HP+fluoride, HPC35 - 35% HP+calcium. Final roughness (FR) and microhardness (FM) measurements were evaluated. For permeability, the 32 crowns were immersed in 1% sodium hypochlorite (20 min) and silver nitrate solutions (2 h) and subjected to developing solution under fluorescent light (16 h). Three sections from the crowns were analyzed in light microscope (100x) to evaluate the scores of permeability: Score 0 - no tracer agent penetration; Score 1 - less than half the thickness of enamel penetration; Score 2 - tracer agent reaching half the enamel thickness; Score 3 - entire enamel depth penetration, without reaching dentin and Score 4 - tracer agent reaching dentin. For roughness and microhardness evaluation were used one-way ANOVA and Dunnet post-test for independent samples, and t test for paired samples. For permeability, the data were analyzed by Kruskal Wallis and Dunn tests. Results: A significantly higher permeability and surface roughness were observed in groups HP35, HPF38 and HPC35 compared to the C group, as well as decreased microhardness (p<0.05). Conclusions: All bleaching agents increased permeability and surface roughness, and decreased microhardness of human enamel; thus, the addition of fluoride or calcium was not beneficial.

Self-reported vaccination in the elderly : SABE Bogotá study, Colombia

Objectives: To determine the frequency of vaccination in older adults within the city of Bogotá and to estimate the association with sociodemographic and health factors. Methods: This is a secondary data analysis from the SABE-Bogotá Study, a cross-sectional population-based study that included a total of 2,000 persons aged 60 years. Weighted percentages for self-reported vaccination [influenza, pneumococcal, tetanus] were determined. The association between vaccination and covariates was evaluate by logistic regression models. Results: A total of 73.0% of respondents received influenza, 57.8% pneumococcal and 47.6% tetanus vaccine. Factors independently associated with vaccination included: 1- age (65-74 years had higher odds of receiving vaccinations, compared to 60-64 years; 2- socioeconomic status (SES) (higher SES had lower odds of having influenza and pneumococcal vaccines, compared to those with lower SES); 3- health insurance (those with contributive or subsidized health insurance had higher odds (between 3 and 5 times higher) of having vaccinations, compared to those with no insurance); 4- older adults with better functional status (greater Lawton scores) had increased odds for all vaccinations; 5- older adults with higher comorbidity had increased odds for influenza and pneumococcal vaccinations. Conclusion: Vaccination campaigns should be strengthened to increase vaccination coverage, especially in the group more reticent to vaccination or vulnerable to reach it such as the disable elder.

Factors influencing the recommendation of the Human Papillomavirus vaccine by South African doctors working in a tertiary hospital.

Background: In South Africa, HPV vaccination programme has been incorporated recently in the school health system. Since doctors are the most trusted people regarding health issues in general, their knowledge and attitudes regarding HPV infections and vaccination are very important for HPV vaccine program nationally. Objective: The objective of this study was to investigate factors contributing to recommendation of HPV vaccines to the patients. Methods: This was a quantitative cross-sectional study conducted among 320 doctors, using a self-administered anonymous questionnaire. Results: All the doctors were aware of HPV and knew that HPV is transmitted sexually. Their overall level of knowledge regarding HPV infections and HPV vaccine was poor. But the majority intended to prescribe the vaccine to their patients. It was found that doctors who knew that HPV 6 and 11 are responsible for >90% of anogenital warts, their patients would comply with the counselling regarding HPV vaccination, and received sufficient information about HPV vaccination were 5.68, 4.91 and 4.46 times respectively more likely to recommend HPV vaccination to their patients, compared to their counterparts (p<0.05). Conclusion: There was a knowledge gap regarding HPV infection and HPV vaccine among the doctors.

Prevalence and associated factors of TB/HIV co-infection among HIV Infected patients in Amhara region, Ethiopia.

Background: Tuberculosis is one of the world’s most common causes of death in the era of Human immunodeficiency virus. The purpose of this study was to determine the prevalence and associated factors of TB/HIV co-infection. Methods: Hospital based retrospective studies were conducted among adult HIV-positive patients. Logistic regression method and Chi square test were applied. Results: A total of 571 HIV positive study participants were enrolled. Of these, 158 (27.7%) were found to have pulmonary tuberculosis. Lower baseline CD4 count<200cell/μl, patients who drunk alcohol, patients who were ambulatory at the initiation of ART, patients whose marital status was single were significant predictors for increased risk of tuberculosis in PLWHIV (P <0.05). Non smoker patients, patients in WHO clinical stage I, patients in WHO clinical stage II and ownership of the house had significant protective benefit against risk of TB (P <0.05). Conclusion: The prevalence of TB/HIV co-infection in adults on ART in our study was moderately high. Having advanced clinical status and presence of risk factors were found to be the predicting factors for co-infection. The health office should open TB/HIV co-infection units in the hospitals and health workers should be cautious when a patient has an advanced disease.

Antitumor effect and mechanism of action of polysaccharides extracted from Polygonum perfoliatum L whole plant in human lung carcinoma A549 cell line

Purpose: To optimize the extraction conditions of polysaccharides from Polygonum perfoliatum L. (PSDP) and to evaluate their anti-tumor activities on A549 cell line. Methods: Extraction of PSDP was optimized using Box-Behnken design (BBD). Three factors of response surface methodology (RSM) including extraction time, ratio of water to raw material and number of extractions were employed to optimize the yield of PSDP. The cytotoxic effect of PSDP on human lung carcinoma A549 cell line was evaluated in vivo, while its effects on expressions of caspase3, caspase-9, Bcl-2 and Bax were determined by western blot assay. Result: BBD was significant and applicable to PSDP extraction. Based on the contour plots, response surface plots and variance analysis, it predicted that the optimum conditions for PSDP extraction were: 1.58 h (extraction time); 30.18 mL/g (ratio of water to raw material); and 2.02 (number of extractions). PSDP had significant inhibitory effect on the growth of A549 cells in a concentration- and timedependent manner (p < 0.05). After treatment with PSDP, caspase-3, caspase-9 and Bax were significantly up-regulated (p < 0.05), whereas Bcl-2 was down-regulated, all concentration-dependently. Conclusion: RSM analysis is an appropriate method to optimize PSDP extraction. The results also indicate that PSDP has significant anti-tumor effect against A549 cells, most likely via inducing mitochondria-mediated apoptosis.