Notes

Twice Benefit: A clear case of Concurrent Alcohol Use and also Genetic Hemochromatosis Leading to Avascular Necrosis with the Femur.
To evaluate effect of dental caries experience and untreated dental decay on Oral Health-Related Quality of Life (OHRQoL) in working adults.

The clinical records of 160 patients were reviewed. Dental health indicators were derived from individual tooth- and surface-level data allowing for calculating the number of decayed surfaces (D), number of decayed missed filled surfaces (DMFS), and significant caries (SiC) indices. A questionnaire was administered to verify demographic factors and OHRQoL. The questionnaire was administered via face-to-face interview, for patients in the hospital; or via telephone interview, for those who could not complete it during their hospital visit. Models were developed using multivariable linear regression to predict total OHIP-14 scores and examine the simultaneous association of independent and outcome variables. The model was adjusted for age, gender, and nationality..

Physical limitation and psychological discomfort were the most frequent impacted domains, affecting 17.s with severe dental caries report poorer OHRQoL. Clinicians should be aware of impacts that dental decay may have on OHRQoL, including physical, psychological concerns, and pain.
To evaluate the influence of blood contamination on the bond strength and apatite forming ability of Biodentine used as root-end filling material.

Eighty (n=80) extracted single-rooted, sound human maxillary anterior teeth were prepared and obturated. Then, the roots were resected, retrograde cavities were prepared and Biodentine was inserted as the root-end filling material. Teeth were then randomly divided into 2 equal groups (n=40) according to the setting environment of Biodentine i.e., group A where setting took place in human blood and group B where setting took place in deionized water (control group). Teeth were incubated at 37 °C for 45min to ensure complete setting. Root discs with the filling material in their core were prepared. Push-out bond strength test was performed using a universal testing machine and failure mode was examined. Both groups were aged in HBSS for 30days. Apatite nucleation was evaluated at one-day, 7-days, and 30-days interval using SEM for morphological analysis and EDX for elemental analysis. Calculation of the Ca/P ratios was performed in addition to XRD for crystal phase analysis.

Blood contamination (group A) resulted in significant reduction of bond strength values. It also affected the amount of apatite deposition on the material surface and interfacial spaces with higher Ca/P ratios than that of the normal stoichiometric hydroxyapatite.

Blood contamination during setting of Biodentine had a detrimental effect on the bond strength and reduced the nucleation of apatite in comparison to non-contaminated group.
Blood contamination during setting of Biodentine had a detrimental effect on the bond strength and reduced the nucleation of apatite in comparison to non-contaminated group.Impalement injury is said to occur when a blunt force causes a long object to penetrate a body part resulting in retention of the object in situ. We report two unusual cases of impalement from rural India one, chest impalement by a hunting spear and the other, an extremity impalement by a rotatory tiller blade. Thoracic impalement injuries are very rare, and there is only one other published report of chest impalement by a spear (trident) in the modern era. There are only two published reports of extremity impalement by a rotatory tiller blade. We also describe the difficulties encountered in their management. Patient-1 sustained accidental impalement to the right hemithorax by a spear used for hunting wild boars, leaving a meter long shaft protruding from his body. This necessitated his transfer to the hospital on the cargo bay of a pickup truck and also precluded complete radiological investigations before surgery. In addition, the reversed barbed tip of the spear made the extraction difficult. Patient-2 sustained impalement through the right knee by a rotatory tiller blade which bound him to the machine. The blade had to be disconnected from the shank assembly of the tiller to extricate him. Due to the proximity of the blade to the popliteal vessels, vascular control was necessary before extraction. Both the patients took several hours to reach the hospital as the accident occurred in remote rural areas. However, both had a successful outcome after surgical removal of the impaled object by a multidisciplinary involvement. We also have reviewed the published literature and given our suggestions for the management of these unusual and difficult injuries.A 73-year-old male suddenly felt chest pain and nausea in his home. The fire department requested the dispatch of a physician-staffed helicopter. When the medical staff of the helicopter checked him, his 12-lead electrocardiogram showed ST elevation at the II, III, and aVF leads. After being fitted with pads for monitoring and defibrillation, he was transferred to the helicopter. Before landing at the base hospital a few minutes later, his electrocardiogram suddenly demonstrated ventricular fibrillation (VF). The patient received an electric shock. 5-(N-Ethyl-N-isopropyl)-Amiloride When the helicopter landed on the base hospital, he still showed VF. After being directly transferred to the catheter room, he received advanced cardiac life support with percutaneous cardiopulmonary support. A trans-arterial coronary angiogram revealed total occlusion of the right coronary artery. After recanalization of the occluded artery, he regained spontaneous circulation. He received intensive care, including targeted temperature management, and he regained consciousness and achieved social rehabilitation. We herein report the first case of VF safely treated with an electric shock during air evacuation by a rotary-wing aircraft in the English literature. Preparations in advance are necessary to perform electric shock safely during a flight aboard rotary-wing aircraft.
Previously acknowledged as "bedside ultrasound", point-of-care ultrasound (PoCUS) is gaining great recognition nowadays and more physicians are using it to effectively diagnose and adequately manage patients. To measure previous, present and potential adoption of PoCUS and barriers to its use in Canada, Woo et al established the questionnaire "Evaluation Tool for Ultrasound skills Development and Education" (ETUDE) in 2007. This questionnaire sorted respondents into innovators, early adopters, majority, and nonadopters.

In this article, we attempt to evaluate the prevalence of PoCUS and the barriers to its adoption in Lebanese EDs, using the ETUDE.

The same questionnaire was again utilized in Lebanon to assess the extent of PoCUS adoption. Our target population is emergency physicians (EPs). To achieve a high response rate, hospitals all over Lebanon were contacted to obtain contact details of their EPs. Questionnaires with daily reminders were sent on daily basis.

The response rate was higher in our population (78.
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