Searsrogers6843
This study aims to evaluate the impact of the COVID-19 pandemic on orthodontic appointments, and the concerns and anxiety levels of orthodontic patients in Iran.
An anonymous 40-question questionnaire was sent online to the patients of private orthodontic clinics in 2 cities of Birjand, and Mashhad, capitals of Eastern provinces of Iran. Orthodontic patients of Mashhad dental school received the questionnaire as well. Descriptive statistics were reported, and the association between gender, oral health literacy (OHL), and adherence to orthodontic appointments and attendance, along with data on feeling, concern, and level of anxiety regarding quarantine/coronavirus pandemic were evaluated using the chi-square analysis.
Three hundred twenty-four patients, with a mean age of 32.43 years, answered the questionnaire. Fifty-seven percent of participants said that they only left home for their daily requirements. Seventy-two percent of the participants reported feeling calm about the COVID-19 pandemic and its consequences. DL-Buthionine-Sulfoximine order Most of the patients (74%) said that they would attend their orthodontic appointment in case of urgency, and 41% of patients declared that their greatest concern was the probability of a delay in completion of treatment. Forty-five percent of patients had adequate OHL. There was a significant association between OHL and willingness to attend orthodontic treatment, concerns regarding the impact of the pandemic on orthodontic treatment, and the frequency of daily teeth brushing.
Women respected the quarantine more than men. Patients with higher OHL were more willing to attend their appointments, but only in case of an emergency, due to the outbreak of COVID-19. Women were more concerned and had better oral hygiene behaviors.
Women respected the quarantine more than men. Patients with higher OHL were more willing to attend their appointments, but only in case of an emergency, due to the outbreak of COVID-19. Women were more concerned and had better oral hygiene behaviors.
To evaluate the views and anxiety levels of orthodontic patients during the first clinical appointment after the coronavirus disease 2019 (COVID-19) lockdown.
Data were collected using a questionnaire that was administered to patients aged over 14 years who resumed their scheduled orthodontic treatment at Adıyaman University, Faculty of Dentistry, Department of Orthodontics during the normalization period after the COVID-19 lockdown. Anxiety levels of the participants were assessed using the State-Trait Anxiety Inventory (STAI).
The study included 241 participants, comprising 177 (73.4%) women and 64 (26.5%) men with a mean age of 17.73 ± 3.27 years. Anxiety levels were significantly higher in women (State-trait index-State anxiety [STAI-S] 39.26 ± 9.81, State-trait index-Trait anxiety [STAI-T] 43.53 ± 9.16) than in men (STAI-S 34.32 ± 10.12, STAI-T 38.5 ± 7.87) (P < .01). No significant relationship was found between the presence of chronic diseases and anxiety levels (P > .05), while a positive correlation was found between age and trait anxiety (P = .041). Of all patients, 79.7% were positive about rescheduling their clinical appointment. Participants with higher anxiety levels indicated that they considered dental clinics as risky environments for the spread of COVID-19 infection (P < .01) and thus wanted to resume their treatment once the pandemic had ended (P < .05).
The results indicate that patients receiving fixed orthodontic treatment were anxious in the clinic.
The results indicate that patients receiving fixed orthodontic treatment were anxious in the clinic.
To evaluate displacements and stress distributions in finite element models (FEMs) of the craniofacial complex of 13-yearold male patient with complete unilateral cleft palate (UCP), a 15-year-old female patient with complete bilateral cleft palate (BCP), and a 15-year-old female patient with isolated cleft palate (ICP), which may respond differently to expansive forces.
The FEMs were based on computed tomography scans of patients with UCP, BCP, and ICP who needed maxillary expansion. Von Mises stress distribution after 0.2 mm of expansion and displacements after 5 mm of expansion were investigated.
The highest amount of stress was observed in the ICP model. Surprisingly, no stress was noted around the nose in the BCP model. The amount of dentoalveolar expansion decreased from anterior to posterior on the cleft side of the UCP, BCP, and ICP models. In contrast, on the non-cleft side of the UCP model, the maximum dentoalveolar expansion occurred at the molar area, decreasing toward the anterior parts. Anatomical structures expressed posterior displacement in the UCP model. In the ICP model, structures close to midline showed anterior displacement, while structures in the lateral parts showed posterior displacement. In contrast with the other 2 models, the structures in the BCP model showed anterior displacement. Vertically, all the anatomic structures in the BCP model showed inferior displacement, while in the ICP and UCP models, only the structures close to the midline showed inferior displacement.
Maxillary expansion caused different patterns of stress distribution and displacement in different types of clefts. Clinicians should consider the type of the cleft, and may expect differing patterns of widening following maxillary expansion.
Maxillary expansion caused different patterns of stress distribution and displacement in different types of clefts. Clinicians should consider the type of the cleft, and may expect differing patterns of widening following maxillary expansion.Nasogastric tubes are being used in clinical anaesthesia settings on a daily basis. Although rare, knotting could occur during insertion or removal. Here, we report a knotted nasogastric tube which stocked in patient's nasopharynx that was removed by using a pediatric bougie. Clinicians must be aware of potential knotting of nasogastric tube. Pediatric bougie could be utile if knotted tube gets stocked in nasopharynx.
Fire in the operating theater is a potential source of important morbidity for the patient. Laser surgery of the head and neck district presents a particularly high risk of fire due to the presence of all three elements of the 'fire triad,' necessary to cause combustive or explosive events an oxidiser, a fuel, and a heat source. The aim of the present study is to emphasise the need of new prevention tools and greater adherence to the recommendations available in the literature.
The sudden occurrence of combustion within the airway of an infant undergoing laryngeal laser surgery was presented along with his management.
An infant underwent CO2 laser surgery for the treatment of the laryngeal stenosis. Unfortunately, the endoscopic procedure was complicated by a fire of the tracheal tube. The tube was immediately removed, the saline was flushed down the trachea and the ventilation was maintained through a face mask. Subsequently, a fiberoscopy was performed and showed a vocal cord burn.
Since operating room fires are still an underreported occurrence, we believe that this present work might raise awareness about this potential complication and give useful suggestions for the management of airway fires in paediatric anaesthesia.
Since operating room fires are still an underreported occurrence, we believe that this present work might raise awareness about this potential complication and give useful suggestions for the management of airway fires in paediatric anaesthesia.Computed tomography (CT) may be used to determine the reversible causes of in-hospital cardiac arrest (IHCA), while the automated chest compression devices (ACCDs) might be helpful to maintain sufficient circulation in x-ray environment during CT. We describe a case, where ACCD was used for continuous cardiopulmonary resuscitation during the CT procedure in an 82-year-old patient with IHCA of unknown cause. Artifact-free CT helped to identify the retroperitoneal hemorrhage as a cause of IHCA, which could not be identified using bedside diagnostics. This observation suggests ACCDs as a helpful adjunct for cardiopulmonary resuscitation in patients undergoing CT diagnostics of IHCA.Descending necrotising mediastinitis is a terrible disease, usually a complication of an inflammatory process of the pharynx, pathology of the mandibular or submandibular space. The development of mediastinitis in a patient after haemithyroidectomy under general anaesthesia with tracheal intubation due to esophagus injury is a very rare condition. Our patient's early post-operative period was complicated by severe pain behind the sternum not associated with acute coronary syndrome. On the second post-operative day, our suspicions of mediastinitis were not definitively supported by diagnostic tests. On the fourth post-operative day, the patient experienced septic shock, necessitating emergent repeated oesophagogastroduodenoscopy, which located the injury of oesophagus. Emergent torachotomy for mediastinitis, gastrostomy and mediastinal drainage was conducted on the fourth post-operative day. Despite aggressive surgical and critical care management, the patient died 3 days after. Death was caused by mediastinitis complicated by severe sepsis and multiple organ failure. On autopsy, the damage to the posterior wall of the oesophagus occurred as a result of penetrating trauma to cervical and thoracic spine osteophytes during hemithyroidectomy. The pathology section revealed that acute angle osteophytes located at the cervical level injured the oesophagus when the pressure was applied in removing part of the thyroid gland with malignant neoplasia.
Both the Supreme Laryngeal Mask Airway (SLMA) and the I-gel (I-gel) are supraglottic airway devices (SADs) commonly used for airway management in paediatric patients. This study aims to compare the efficacy in terms of insertion and ventilation profiles of size 2 SLMA and the I-gel in anaesthetised paediatric patients.
100 children were prospectively allocated to two groups depending upon the device inserted as SLMA (n = 50) and I-gel (n = 50). The primary outcomes were studied in terms of ease of insertion, haemodynamic changes, ventilation parameters, leak pressure and incidences of complications during general anaesthesia.
There were no failed attempts in the insertion of the airways in either group. The SLMA was more easily inserted in the majority of cases compared to the I-gel group. The number of attempts for insertion and the time taken for insertion were comparable in the I-gel and the SLMA group (13.8462.38 vs. 14.0261.7) (P .57, .66). Securing an effective airway took <30 seconds in both ttients. Also, it provides higher OSP during anaesthesia and is better tolerated during emergence, with minimal risk of injury to the oropharynx.
Prediction of post-extubation stridor (PES) after thyroid surgeries has been challenging, and many criteria such as preoperative clinical parameters and intraoperative cuff leak test (CLT) have been used with variable results. The application of laryngeal ultrasound in predicting PES is a relatively new and non-invasive technique. Measurement of the air column width difference (ACWD) by laryngeal ultrasonography can predict PES. This study aimed to evaluate the efficacy of laryngeal ultrasound in the prediction of PES in patients after thyroidectomy and compare it with that of the CLT.
A total of 200 patients who had undergone total thyroidectomy under general anaesthesia in a tertiary healthcare hospital were enrolled in the study. At the end of the surgery, air column widths (ACWs) were measured during endotracheal cuff inflation and deflation using laryngeal ultrasound in patients with spontaneous breathing. ACWD was measured and compared with that of the CLT at the time of extubation to predict PES.
A total of 12 (6%) patients developed PES.
