Awareness and practice of contraception among female students at the Institute of Management and Technology (IMT), Enugu.

A study of the knowledge, attitudes to and practice of contraception among the female students at the Institute of Management and Technology (IMT), Enugu, was carried out, involving 266 female students out of a total female student population of 1,510. The mean age of the population sample was 19.1 years and 254 (95%) were single. Ninety-six percent were aware of the availability of contraceptives. Knowledge relating to the practice of contraception was superficial since as many as 61% of the objectors believed that contraception subsequently led to infertility. One hundred and thirty (49%) of the studied population had used one form of contraception or another sometime in their lives. Seventy-six percent had not used any contraception for initial intercourse. The rhythm method followed by the barrier method were the most popular forms of contraception. Practice of contraception by the studied population was inconsistent as 21% of the students eventually had an unwanted pregnancy and 18% had an induced abortion. Health education is strongly recommended to our women folk in order to reduce the high incidence of unwanted pregnancy and its associated medical and social complications.     

Caries-based treatment need assessment by clinical dental nurses in Anguilla, British West Indies

OBJECTIVE: To determine the ability of dental nurses in Anguilla to assess treatment need following training in WHO criteria. PARTICIPANTS: Sixty-six randomly selected schoolchildren aged 6, 9, 12, 14, 15 and 17 years. DESIGN: Point prevalence study involving three different groups of schoolchildren [n = 20 (C0), 23 (D1), 23 (D2)] and four plaster casts comprising 52 extracted teeth (T0). MAIN OUTCOME MEASURES: Tooth- and person-based inter and intra-examiner agreement. METHOD: The only three government dental nurses in Anguilla were trained and calibrated by a benchmark dentist in June 2000 using WHO criteria. Tooth-based Treatment Need and person-based Treatment Urgency were assessed during 466 evaluations involving 1,733 teeth. Examiner agreement levels were compared during two calibration exercises (T0, C0) and two duplicate examinations (D1 and D2). The treatment components were classified as preventive (diet modification, prophylaxis, OHI, sealants); restorative (restorations, pulp care and crowns); and rehabilitative (tooth removal). RESULTS: All scores presented are Kappa scores. Substantial agreement was obtained at T0 (0.614-0.764), and almost perfect agreement at C0(0.832-0.872), D1(0.917-0.954) and D2(0.966-0.977). Almost perfect reliability occurred at C0(0.963-0.991) and D1(0.971-0.992) while perfect reliability was attained by all examiners at D2(1.0). Substantial and almost perfect agreement was obtained for all treatment modalities irrespective of caries prevalence and severity. Agreement levels increased as the survey progressed. Perfect agreement was obtained for all categories of treatment urgency. CONCLUSIONS: Dental nurses in Anguilla can validly and reliably assess treatment need provided training is adequate, of realistic duration and they are involved in all aspects of the exercise.     

In vitro detection and quantification of enamel and root caries using infrared photothermal radiometry and modulated luminescence

Artificially created demineralized and remineralized carious lesions on the root and enamel of human teeth were examined by photothermal radiometry (PTR) and modulated luminescence (LUM). Fourteen extracted human teeth were used and a lesion was created on a 1 mmx4 mm rectangular window, spanning root to enamel, using a lactic acid-based acidified gel to demineralize the tooth surface. The lesion was then exposed to a remineralization solution. Each sample was examined with PTR/LUM on the root and enamel before and after treatment at times from 1 to 10 (5 on root) days of demineralization and 2 to 10 days of remineralization. Ten-day (5 on root) demineralized samples were remineralized. After completing all the experiments, transverse microradiography (TMR) analysis was performed to compare and correlate the PTR/LUM signals to the depth of lesions and mineral losses. The PTR and LUM amplitudes and phases showed gradual and consistent changes with treatment time. In this study, TMR showed good correlation coefficients with PTR and LUM. It was also found that the length of the treatment time did not correlate very well to any technique, PTR/LUM or TMR, which implies a significant degree of inhomogeneity of the demireralization and remineralization rates in each and every tooth.     

The importance of very early decompressive craniectomy as a prevention to avoid the sudden increase of intracranial pressure in children with severe traumatic brain swelling (retrospective case series)

Purpose  

The purpose of the retrospective case series of eight consecutive patients is to call our attention to the optimal timing of decompressive craniectomy (DC) in children.     

Contributions of Working Memory and Inhibition to Cognitive Flexibility in Nigerian Adolescents

ABSTRACT

This study used a novel approach that combined the latency and accuracy scores to examine the relative involvement of inhibition and working memory in two measures of cognitive flexibility – mixing cost and switch cost in 110 Nigerian adolescents. Results showed that inhibition was significantly associated with switch cost. On the other hand, working memory was negatively associated with mixing cost. These findings support the assumption that cognitive flexibility skills are dependent on inputs from inhibition and working memory processes. Inhibition is involved in the deactivation of irrelevant stimuli during switching trials while working memory is essential to maintain the current rule in sets that require no shifting.     

The effectiveness of an NaF rinse containing fTCP on eroded enamel remineralization

Objective

The authors investigated the effectiveness of a functionalized tricalcium phosphate (fTCP) combined with a low fluoride level in a mouthrinse to reharden eroded enamel lesions.

Methods

Ninety enamel slabs attached in pairs to removable appliances were randomly assigned to three treatment groups (n?=?30/group): (T1) NaF rinse (225 ppm F?+?40 ppm fTCP), (T2) NaF rinse (225 ppm F; ACT^®), and (T3) no mouthrinse (saliva). While wearing the in situ appliance for 14 days, subjects brushed their teeth with 1100 ppm F toothpaste (Crest©) for 2 min, rinsed with 15 ml of water for 10s, and then rinsed with 15 ml of their assigned treatment mouthrinse. Treatment efficacy was evaluated using surface microhardness (SMH) and transverse microradiography (TMR). Intra- and intergroup comparisons (α?=?0.05) were performed using the t-test and ANOVA followed by the Tukey test (HSD).

Results

With SMH, intragroup comparison (t-test) indicated significant rehardening of the eroded lesion with exposure to T1 (p?<?0.001) and T2 (p?<?0.01) but not with T3 However, with TMR, remineralization was only significant (p?=?0.01) with T1, but not with T2 and T3. In the intergroup comparison with percentage change in SMH, T1 was significantly different from T3 (p?<?0.01; Tukey HSD) but not from T2, and T2 was significantly different from T3. Intergroup comparison based on percentage mineral gain showed that T2 (p?=?0.02) and T3 (p?=?0.01) differed significantly from fTCP, but not between each other.

Conclusion

Addition of low level fluoride to functionalized β-tricalcium phosphate promoted rehardening of eroded enamel lesions.

     

Azadirachta indica extract–artesunic acid combination produces an increased cure rate of Plasmodium berghei-infected mice

Context: Available artemisinin-combination therapies (ACTs) are expensive. Various traditional herbal remedies for malaria involve plants, proven scientifically to have antiplasmodial effects, e.g., Azadirachta indica A. Juss. (Meliaceae).

Objective: Combination of an artemisinin-based compound and a medicinal herb extract will provide an indigenous alternative/herb-based ACT.

Materials and methods: The in vivo schizontocidal activity of the crude aqueous extract of 100, 500, and 1000?mg/kg of A. indica fresh leaves (NCE) and 6, 15, and 20?mg/kg of artesunic acid were determined, alone and in combination, while keeping the dose of artesunic acid constant at 15?mg/kg, using the Peter’s 4-day suppressive test and Swiss albino mice. The ED₅₀ was calculated from the dose-response relationships. Percentage survival and cure were also determined.

Results: The average yield of two extractions of NCE was 8.33?±?1.67%. Combination of 1000?mg/kg of NCE and 15?mg/kg of artesunic acid, produced a significant reduction of parasitemia (96.87%), compared to 20?mg/kg of artesunic acid alone (68.14%). The combination had an ED₅₀ of 0.58?mg/kg while that of artesunic acid alone was 8.814?mg/kg. The combinations of NCE with artesunic acid produced a cure, although the artesunic acid did not produce a cure in 30?d.

Discussion: NCE increased the activity of artesunic acid in terms of reduction in parasitemia, and increased survival time and cure rate.

Conclusion: The combination of an artemisinin and aqueous extract of neem leaf is possible, providing a potentiated reduction of parasitemia, and increased cure rate.     

Examiner training and reliability in two randomized clinical trials of adult dental caries

Objectives: This report describes the training of dental examiners participating in two dental caries clinical trials and reports the inter‐ and intra‐examiner reliability scores from the initial standardization sessions. Methods: Study examiners were trained to use a modified International Caries Detection and Assessment System II system to detect the visual signs of non‐cavitated and cavitated dental caries in adult subjects. Dental caries was classified as no caries (S), non‐cavitated caries (D1), enamel caries (D2), and dentine caries (D3). Three standardization sessions involving 60 subjects and 3,604 tooth surface calls were used to calculate several measures of examiner reliability. Results: The prevalence of dental caries observed in the standardization sessions ranged from 1.4 percent to 13.5 percent of the coronal tooth surfaces examined. Overall agreement between pairs of examiners ranged from 0.88 to 0.99. An intra‐class coefficient threshold of 0.60 was surpassed for all but one examiner. Inter‐examiner unweighted kappa values were low (0.23‐0.35), but weighted kappas and the ratio of observed to maximum kappas were more encouraging (0.42‐0.83). The highest kappa values occurred for the S/D1 versus D2/D3 two‐level classification of dental caries, for which seven of the eight examiners achieved observed to maximum kappa values over 0.90. Intra‐examiner reliability was notably higher than inter‐examiner reliability for all measures and dental caries classifications employed. Conclusion: The methods and results for the initial examiner training and standardization sessions for two large clinical trials are reported. Recommendations for others planning examiner training and standardization sessions are offered.     

Current erosion indices--flawed or valid? Summary

The problem of erosive tooth wear appears increasingly to be encountered by clinicians and researchers. An adequate way of defining and recording erosive tooth wear is essential in order to assess the extent of this clinical phenomenon, both on an individual level and in the population, and for the adequate provision of preventive and therapeutic measures. Well-established erosion indices have been used in most of these studies, although in many cases modifications have been made to suit the different research aims. This use of different indices is one reason why it still cannot be claimed that there is enough current knowledge on this clinical phenomenon. This article summarises the proceedings of a workshop to discuss the topic of dental erosion indices. The result of the workshop is the proposal for a new scoring system (Basic Erosive Wear Examination, BEWE) designed for use both within the research field and for dental clinicians, with the aims of standardising assessment of erosion for international comparisons, raising awareness and providing guidelines for treatment of erosive tooth wear in dental practice.