Research Confirms Effectiveness of Oral Health Preventive Practices

Lack of insurance or funds for dental services, lack of access to dental offices, fear of dentists, and avoidance of dental offices during COVID can lead to oral health problems in older adults. Brushing, flossing, and drinking fluoridated water can protect teeth when dentists are unavailable. Limiting intake frequency of carbohydrates and chewing sugarfree gum after eating add protection. A recent systematic review and meta-analysis confirmed the effectiveness of sugarfree gum in reducing caries, in children and adults who chewed sugarfree gum compared with those who did not chew. Chewing sugarfree gum significantly reduced caries increment, with a prevented fraction of 28 percent, roughly equivalent to the prevented fractions for fluoride toothpastes and supplements. A follow-up systematic review provides further evidence that chewing sugarfree gum reduces the numbers of Streptococcus mutans in the oral cavity. Finally, chewing sugarfree gum could alleviate symptoms of xerostomia and may reduce caries.

Creative Arts Interventions in Addressing Depression in Older Adults: A Systematic Review

Depression experienced by older adults is proving an increasing global health burden, with rates as high as 27% in the USA. This is likely to increase in coming years as the number and proportion of older adults in the global population rises. Therefore, it is imperative that the effectiveness of approaches to the prevention and treatment of depression are understood. Creative arts interventions, including art, dance movement, drama, and music, are utilized internationally to reduce depressive symptoms in older adults and promote wellbeing. This includes interventions led by trained arts therapists as well as other health and arts professionals. This presentation will include a report of findings from a recent systematic review of the outcomes of four creative arts modalities (art, dance movement, drama, and music) with particular attention paid to processes of change documented in each modality.

Concept of Busoore Labaniya (Acne Vulgaris) and its Management In Light of Unani System of Medicine

Acne vulgaris is extremely common dermatological disorder, affecting more than 85% of adolescents and young adults. In western societies, acne vulgaris is a nearly universal skin disease afflicting 79% to 95% of the adolescent population. A recent systematic review of the epidemiology of acne across the world noted acne prevalence estimates ranging from just over 20% to over 95%. The greatest burden of acne globally is between the first and third decade of life and almost certainly causes embarrassment, stigma, shame, guilt, and low self-esteem, which are likely to cause psychosocial problems. It is characterized by both inflammatory (papules, pustules and nodules) and non-inflammatory comedones (open and closed) lesions. In Unani system of medicine, acne vulgaris is termed as busoore labaniya that are whitish eruptions on the nose and face that represent milk droplets or frozen ghee (Roghan zard) due to Ma’dah sadidiyah or pus like morbid matter that is directed towards the skin for expulsion along with ghaleez bukharat. There are mentioned numerous single and compound formulations having Mujaffif and Muhallil properties for the management of Busoore Labaniya. The principle of treatment is aimed to removal of morbid matter, which is the actual culprit for the genesis of pathology leading to development of busoore labaniya. So there is need to explore the Unani concept of dermatoses. Present review paper is an attempt to highlight the possible management and preventive measures of acne vulgaris through Unani medicine. Keywords: Busoore labaniya, Acne vulgaris, Unani system of medicine, Mujaffif and Muhallil.

EP.TU.637To Resect or Not to Resect? Incidental Meckel’s Diverticulum at Colon Cancer Resection

Case An 85-year-old man underwent elective resection for a large proximal transverse colon tumour. At the time of this open extended right hemicolectomy, a Meckel’s diverticulum was identified in the ileum, but not resected considering the age and character of the diverticulum. However, on the sixth post-operative day, he developed small bowel obstructive symptoms which required a reoperation. It was found that the cause of obstruction was identified as a long pedunculated Meckel’s diverticulum wrapped 15 centimetres proximal to the anastomosis. Considering the general condition of the patient and co-morbidities, resection of the Meckel’s diverticulum and loop ileostomy was performed. The patient has now recovered and is being followed up in the community awaiting stoma reversal. Background Occurring in 2% of the population, Meckel’s diverticulum is the most common congenital gastrointestinal malformation. Complications of a Meckel’s diverticulum include obstruction, haemorrhage, perforation, diverticulitis and intussusception. Most complications manifest in childhood and are less likely to occur in adults. The indication for resection of incidental Meckel’s diverticula in an adults is still debated amongst surgeons. Discussion and Conclusion This case demonstrates an unfortunate scenario of a post-operative complication from an abnormality detected at the time of the index surgery. A recent systematic review has shown that evidence in literature remains controversial for resection in asymptomatic Meckel’s Diverticulum. There are even scoring systems to facilitate decisions in such situations. This case offers an interesting perspective where morbidity may have been reduced if resection was undertaken.

Use of Non-steroidal Anti-inflammatory Drugs in Treatment of COVID-19: Safe, Safe, and …. Lifesaving?

A recent systematic review and meta-analysis published at Drug Safety has confirmed the safety of NSAIDs in treatment of COVID-19. The author is discussing another potential of efficacy that might reveal lifesaving as NSAIDs might prevent or reverse the evolution of the aggressive hyperinflammatory responses associated with COVID-19.

The Deleterious Effects of COVID-19 in the Peripartum Period: A Case Report

While the Coronavirus Disease 2019 (COVID-19) pandemic continues to wreak havoc across the nation and the globe as one of the most significant global health crises of our time, recent attention has been turned to the effects of COVID-19 on pregnancy and the puerperium. Although most cases have been asymptomatic, for some patients, the disease may be accompanied by serious complications such as pneumonia, acute respiratory distress, multi organ failure, and death. Several case studies have noted that patients with co-morbidities are at a significant risk of these complications. In a recent systematic review and meta-analysis, authors conclude that cardiovascular disease was associated with increased composite poor outcome in patients with COVID-19. The following case report highlights the multi-system complications and severity of symptoms that can take place after childbirth in a patient with co-morbid obstetric and prenatal conditions and an initially asymptomatic COVID-19 infection.

Complications following replantation of primary teeth: a case report

Introduction: the avulsion of primary teeth is a disturbing and unexpected event. Description: this report describes the clinical case of a three-year-old child who suffered an avulsion and replantation of the primary upper central incisors at the site of the injury. The guardians sought treatment for the child at the Federal University of Minas Gerais after the replantation. Four months later, the child suffered a new trauma and the replanted teeth presented advanced mobility, root resorption and fistula. The clinical conduct was extraction and rehabilitation with a fixed esthetic maintainer. Discussion: the literature describes two treatment options for avulsion of primary incisors: replantation and non-replantation. According to a recent systematic review, the difficulty in obtaining a consensus regarding the best clinical conduct is due, in part, to the scarcity of publications that present not only follow-ups with clinical success, but also with failures. The outcomes of replantation can be influenced by several factors. The time elapsed between replantation and splinting, and the new episode of trauma, negatively influenced the prognosis in the present case, leading to failure. Replantation of primary incisors is not yet evidence-based treatment. Therefore, this option must be chosen with caution and in ideal situations. It requires constant clinical and radiographic monitoring for evaluation of outcomes.

Patient-centered outcomes used in pediatric focused manual therapies research studies: a secondary data analysis of a systematic review

Background Patient-reported outcome measurements (PROM) are instruments that seek a patient’s health or functional status. Inclusion of standardized PROMs in research studies and clinical practice provides a more comprehensive understanding of an intervention from the patient’s viewpoint. This secondary analysis identified PROM usage and appropriateness of references for property measurements from clinical trials included in a recent systematic review of pediatric manual therapy. Methods All included manuscripts within a recent systematic review had two authors extract PROM and associated property measurement data, including the property measurements supporting citations. Inclusion criteria for the articles were published clinical trials (observational or experimental) of pediatric children receiving manual therapy (any profession) for any condition between 2001-March 2018. For each PROM’s associated property measurement, two authors used the COSMIN study design checklist to appraise the quality of the cited study to evaluate the property measurement. Results Of the 50 manuscripts included in the systematic review, 20 manuscripts reported the use of 52 PROMs. Of the 52 PROMs assessed, 31 did not make a statement about the instrument’s property measurement, 7 PROMs had property measurements stated but not referenced, 4 PROMs stated that the property measurement information was unknown, and 10 had property measurement data with reference(s). These 10 PROMs with referenced property measurements were from 7 unique PROMs: constipation assessment scale, satisfaction visual analog scale (VAS), crying time diary, sleep diary, fear avoidance belief questionnaire (FABQ), pain VAS, and autism treatment evaluation checklist. The assessment of the referenced property measurements found that several property measurement’s dimensions had not been assessed and those that had were evaluated were done so with poor or fair standards. Conclusions This secondary analysis finds that clinical studies of pediatric manual therapy lack consistent use of PROMs with high quality property measurements. Further research to establish and implement PROMs to be used in future research studies and in clinical settings should become a priority for professions using manual therapy in children.

The effect of an integrated reading and anxiety intervention for poor readers with anxiety

A recent systematic review has reported that poor reading is reliably associated with anxiety. However, we currently lack evidence-based intervention for children who have both poor reading and anxiety (PRAX). In this study, we tested a new PRAX intervention in 8- to 12-year-old children using a double-baseline intervention case series design. Analyses of both group and individual data revealed that 12 weeks of PRAX intervention significantly improved children’s reading and spelling accuracy, and significantly reduced both anxiety disorders and symptoms. These results support PRAX intervention as a treatment for comorbid reading and anxiety problems in children and pave the way to a randomised controlled trial.

Use of a search summary table to improve systematic review search methods, results, and efficiency

Background: Systematic reviews are comprehensive, robust, inclusive, transparent, and reproducible when bringing together the evidence to answer a research question. Various guidelines provide recommendations on the expertise required to conduct a systematic review, where and how to search for literature, and what should be reported in the published review. However, the finer details of the search results are not typically reported to allow the search methods or search efficiency to be evaluated.Case Presentation: This case study presents a search summary table, containing the details of which databases were searched, which supplementary search methods were used, and where the included articles were found. It was developed and published alongside a recent systematic review. This simple format can be used in future systematic reviews to improve search results reporting.Conclusions: Publishing a search summary table in all systematic reviews would add to the growing evidence base about information retrieval, which would help in determining which databases to search for which type of review (in terms of either topic or scope), what supplementary search methods are most effective, what type of literature is being included, and where it is found. It would also provide evidence for future searching and search methods research.