design

Background: There is paucity in studies reporting long-term results following anterior cruciate ligament (ACL) rupture. A UK national ligament registry (NLR) designed to collect demographic, clinical and outcome data on patients undergoing ACL reconstruction was launched in 2013. There was therefore an emergent question on the role of such registry as an additional source of evidence. Study aims: A framework analysis aimed to provide a basis for the evaluation of outcomes following ACL management and formulate a structure of the evidence, which can be derived from the registry. Methods: A systematic approach was adopted to select relevant studies. Qualitative thematic and meta-narrative analyses were conducted. Level-1 registry data were recorded for all primary ACL reconstruction procedures from January to June 2016. Registry data content and validity were evaluated. Results: Seven studies were suitable for analyses yet none defined the pattern of meniscal injury following initial treatment. When reported the incidence varied markedly between 23% and 80%. There was evidence of collection of at least one principal outcome measure in at least 85% of participants across all studies. Thematic analysis identified four key domains of outcome measures (1) intervention selection, (2) Knee stability evaluation, (3) Patient reported outcomes, (4) Radiographic evaluation and risk of secondary osteoarthritis. Graft choice, rate of meniscal and chondral injuries and cumulative risk of revision surgery had incomplete and inconsistent reports. Comparison of demographic and clinical data with the first registry report demonstrated: predominately younger patient population; older female patients at time of intervention; and higher incidence of meniscal tears. Conclusions: Registry data driven quality and research improvement open a new paradigm in ACL reconstruction evidence base and future practice. Early observations have consolidated the importance of associated meniscal injuries in the management of ACL rupture. Further work is needed to improve registry data completeness, accuracy and validity. A proposed data migration process using available technologies can help harmonise data collection without the added burden on clinical services.

Background: With the development of sports science and badminton equipment, the roles of badminton shoes, such as to alter lower - extremity biomechanical parameters, prevent sports injuries and enhance performance, were confirmed by a mass of studies. Methods: In this study, a serial of methods including literature review, visualization analysis, mathematical statistics, are used to describe the progresses of the badminton shoes relate to exercise in some training aspects, which can be searched by CNKI and SCOPUS databases. Results: Among the exiting research, most mainly focused on evaluation and design of badminton shoes, sports injuries and performance, some have tested and verified the roles mechanism of badminton shoes. However, there are still some disadvantages to can’t ignore, such as the quantities of studies the designed level and the mechanism exploration. Conclusions: To sum up, the roles of the badminton shoes in sports training still need to be explored and confirmed.

Background: Epidemiological studies report that females experience greater rates of concussion when compared with males. Biomechanical factors may result in greater post-impact head velocities and accelerations for a given force for females when compared with males. Purpose: To quantify the magnitude, frequency, duration and distribution of impacts to the head and body in rugby league match activities for females versus males. Design: Prospective descriptive epidemiological study. Methods: 21 female and 35 male amateur rugby league players wore wireless impact measuring devices (X2Biosystems; xPatch) behind their right ear over the mastoid process during match participation across a single season. All impact data were collected and downloaded for further analysis. Results: Male amateur rugby league players experienced more head impacts than female amateur rugby league players (470 ±208 vs. 184 ±18; t(12)=-3.7; p=0.0028; d=1.94) per-match over the duration of the study. Male amateur rugby league players recorded a higher median resultant Peak Linear Acceleration (PLA(g)) (15.4 vs. 14.6 g; F(824,834)=51.6; p<0.0001; t(1658)=-3.3; p=0.0012; d=0.10) but a lower median resultant Peak Rotational Acceleration (PRA(rad/s2) (2,802.3 vs. 2,886.3 rad/s2; F(831,827)=3.1; p<0.0001; t(1658)=5.7; p<0.0001; d=0.13) when compared with female amateur rugby league players Conclusion: Females recorded lower median values for PLA(g) and Head Impact Telemetry severity profile (HITSP) for all positional groups but had a higher PRA(rad/s2) for Hit-up Forwards (HUF) and Outside Backs (OSB’s) when compared with male HUF and OSB’s. Females also recorded more impacts to the side of the head (48% vs. 42%) and had a higher 95th percentile resultant PRA(rad/s2) (12,015 vs. 9,523 rad/s2) to the top of the head when compared with male rugby league players.

Patellofemoral pain syndrome is common among athletes who participate in jumping, running and pivoting sports. The aim of this study was to compare selected lower limb biomechanical variables between University of Ibadan students (athletes) with and without patellofemoral pain syndrome. The research design for this study was a case control survey and a purposive sampling technique was used to recruit participants. Two hundred and twenty two (191(85.8%) males and 31 (14.2%) females) sportsmen participated in this study. The participants’ age was between 20-29 years. Fourty sportsmen tested positive to Clarke’s test while 27 sportsmen tested positive to Eccentric step test. Measurements of static quadriceps angle, hamstring tightness and navicular height were taken for all participants. Data were analyzed using descriptive statistics of mean, standard deviation, percentages and inferential statistics of Independent ‘t’ test. The mean lower limb biomechanical variables of participants with patellofemoral pain syndrome were 13.18 ± 2.37°, 106.46 ± 16.11° and 1.21 ± 0.61 cm while those without were 13.65 ± 2.46°, 128.95 ± 25.36° and 1.03 ± 0.58 cm for static quadriceps angle, hamstring tightness and navicular height respectively. There was no significant difference (p > 0.05) in selected lower limb biomechanical variables between participants with and without patellofemoral pain syndrome. In conclusion there was no significant difference in static quadriceps angle, hamstring tightness and ankle pronation between participants with and without patellofemoral pain syndrome. It was recommended that PFPS development is probably multifactorial with other functional disorders of the lower extremity apart from the selected variables.

The present study examined the effect of the European-Based ‘Alive and Kicking’ exercise program on the health-related physical fitness of individuals with (Experimental Group: EG) and without (Control Group: CG) (Intellectual Disability: ID). The Self-Determination Theory: SDT, guided both the 6-month preparatory phase and the 9-month exercise program, which was conducted in five separate European countries (Cyprus, France, Greece, Portugal and Spain). The total sample (n = 200, 54% males and 46% females) comprised of 168 individuals with ID (age: 26.54 years, + 7.78) and 32 individuals without ID (age: 25.81 years, + 8.73) respectively. The statistical analyses revealed that the ID group’s performance (EG) improved significantly in a range of health-related physical fitness variables (sit & reach, pushups, sit ups, long jump, ½ mile walk/ run). In turn, the participants from the CG improved mainly in muscular endurance (sit ups and pushups). The results are discussed in accordance with SDT and the dairies kept from the staff involved (coaches and psychologists) during the 9–month intervention. The present findings, although subjective to certain limitations, are encouraging, given the large-scale, real-world nature of the research design, and provide evidence supporting the integration of theoretical strategies enhancing motivation into traditional coaching programs for individuals with ID.

Identifying concussion and initiating removal from play is challenging for even the most diligent youth sports organizations. Empowering parents to implement removal from play protocols and sideline testing may be the most practical plan at community levels to protect young athletes. We developed paradigms for community-based youth sports teams that incorporated both standard concussion protocols and research investigations. The research studies were designed to determine how sideline tests of vision, cognition and balance augment the capacity for parents and other responsible adults to identify youth athletes with concussion in ice hockey, football, lacrosse and cheerleading. Research-based sideline tests were performed at pre-season baseline sessions and during the season at the time of injury or as soon as symptoms were recognized by trained volunteer parent team testers. The combination of standard concussion protocols and research studies were performed for 510 athletes, aged 5-17 years, over 2.5 years through 5 athletic seasons. To implement the protocols and studies, approximately 80 student volunteers and parents were educated and trained on early concussion recognition and on baseline and sideline test administration. Over 80% of parent-identified head injuries were physician-confirmed concussions. Of the sideline tests performed, over two-thirds were administered within 24 hours of injury; the rest were performed within an average of 2.6 days post-injury since some athletes had delayed development of symptoms. Removal from play guidelines and standard concussion evaluation protocols were maintained in the context of the sideline testing research investigations. Based on this observational study, parents of youth athletes can be successfully empowered to perform rapid sideline tests in the context of existing concussion protocols. Implementation of objective testing may improve concussion identification and shift the culture of advocacy and responsibility towards parent groups to promote safety of young athletes. Ongoing investigations will further examine the impact of these programs on concussion management in youth sports.

Introduction: The high morbidity and mortality by hypertensive cardiopathy demand the construction and validation of tools to stratify the risk of developing this condition. Objective: To design and validate an index, based on risk factors, that permits to predict the development of hypertensive cardiopathy in patients with a diagnosis of essential arterial hypertension. Methods: A prospective cohort study was done in hypertensive patients assisted at the specialized arterial hypertension physicians’ office of the “Carlos Manuel de Céspedes” Specialty Policlinic attached to the General University Hospital, Bayamo Municipality, Granma Province, Cuba from January 1st, 2010 to December 31, 2016. Internal and external validity and the internal consistency of the index were determined. Results: The index sensitivity was of 97, 20 (IC: 93, 93-94.09) and specificity of 65, 38 (IC: 76, 25-76, 20). Both the index discriminative capacity (area under the ROC curve= 0,944; interval of confidence: 0.932-0.956; p<0.0005) and calibration (p=0.751) were adequate. Conclusions: The present study proposes an index to predict the risk of developing hypertensive cardiopathy, with adequate discriminative capacity and calibration (external validity). The index can be used as a tool of clinical and epidemiological surveillance since it permits to identify subjects with greater probability of developing the condition and to stratify the risk.

Background: Acute Coronary Syndrome describes a spectrum of disease ranging from unstable angina through non-ST-Elevation Myocardial Infarction (NSTEMI) to ST-Elevation Myocardial Infarction (STEMI). Early death in NSTEMI is usually due to an arrhythmia. Patients should be admitted immediately to hospital, preferably to a cardiac care unit because there is a significant risk of death. Objective: To compare the diagnostic accuracy of TIMI versus GRACE for prediction of death in patients presenting with Acute Non-ST elevation Myocardial Infarction. Material & Methods: This present cross sectional study was conducted at Department of Cardiology, CPEIC, Multan. All patients assessed according to given scores in the two scoring system i.e. TIMI risk score and GRACE score. Then patients were labeled as high or low risk for death. Data was collected by using pre-designed proforma. 2x2 tables were generated to measure the sensitivity, specificity, positive predictive value, negative Predictive value and diagnostic accuracy of TMI Risk score and GRACE Score for prediction of death in NSTEMI patients. Results: In our study the mean age of the patients was 55.73±9.78 years. The male to female ratio of the patients was 1.6:1. The diabetes as risk factor was found in 145(39%) patients, smoking as risk factor was found in 53(14.2%) patients and hypertension as risk factor was found in 174(46.8%) patients. the sensitivity of TIMI risk was 97.7% with specificity of 92.93% and the diagnostic accuracy was 95.16%, similarly the sensitivity of GRACE risk was 100% with specificity of 95.96% and the diagnostic accuracy was 97.85%. Conclusion: Our study results concluded that both the TIMI risk and GRACE risk are good predictor of death in patients presenting with Acute Non-ST elevation Myocardial Infarction with higher sensitivity and diagnostic accuracy. However the GRACE risk showed more accurate results as compared to TIMI risk.

Introduction: Implementation of prevention strategies for patients with coronary artery disease (CAD) is essential, but many fall short of reaching their goals. Patients often perceive themselves as healthy and are less motivated to change lifestyle. To obtain better results patients need repeated information, preferably with motivational and person-centered approaches. Aims: To investigate whether health care providers inform CAD patients about risk factors and lifestyle changes at a percutaneous coronary intervention unit. Also to investigate whether the information given at discharge included secondary prevention management and if motivational and person-centered approaches were used. Methods: This is a descriptive, observational study that includes both a qualitative and quantitative design. Physicians and nurses working at a percutaneous coronary intervention (PCI) unit and physicians at a coronary care unit (CCU) participated. A staff nurse observed and noted what information the patients received at the PCI unit. At the CCU, observations regarding secondary prevention strategies during the discharge counselling were performed. Results: There were 50 observations made at the PCI unit. The information mainly consisted of tobacco consumption, physical activity and diet. During the 31 discharge counselling sessions the diagnosis, interventional procedure and medical treatment were frequently included. Most patients received little or no person-centered or motivational counselling. Conclusion: Nearly all patients at the PCI unit received information about the consequence of tobacco consumption, and more than half about the beneficial effects of physical activity. In contrast, the counselling at discharge need to focus more on behavioral changes and a motivational and person-centered approach.

Chronic heart failure has been extensively characterized as a disorder arising from a complex interaction between impaired ventricular performance and neurohormonal activation. Since beta adrenoceptor blocking agents are currently considered an integral component of therapy for the management of patients with severe chronic heart failure; several well designed clinical trials have been conducted to determine the morbidity and mortality benefits of these agents these studies, however did not yield the same results in terms of morbidity and mortality benefits. Currently only Bisoprolol, Carvedilol and sustained release metoprolol succinate have clinically proven and convincing morbidity and mortality benefits the current list of approved medicines of the National Health Insurance Scheme (NHIS) of the republic of Ghana does not provide coverage for these lifesaving therapeutic agents. The objective of this review was to collate the relevant scientific evidence that will convince the authorities at the National Health Insurance Authority (NHIA) of the Republic of Ghana to include at least one of the evidence based beta adrenoceptor blocking agents in the list of approved medicines. A thorough search on the internet was conducted using Google scholar to obtain only the clinically relevant studies associated with the benefits of beta adrenoceptor blocking agents in patients with chronic heart failure published in the English language. The phrases beta adrenoceptor blocking agents and chronic heart failure were used as search engines. The search engine yielded several studies that met the predefined inclusion criteria. However, only the Cardiac Insufficiency BIsoprolol Studies (CIBIS-I and CIBIS-II), Carvedilol Prospective Randomized Cumulative Survival Study (COPERNICUS) and Metoprolol CR/XL Randomized Intervention Trial (MERIF-HF) because of the clinical relevance of their findings Beta adrenoceptor blocking agents such as atenolol and propranolol have been used in the management of patients with chronic heart failure. However, their efficacy and optimal dose in reducing mortality have not been scientifically established not all beta adrenoceptor blocking agents scientifically studied provide the same degree of clinically meaningful and convincing morbidity and mortality benefits in patients with chronic heart failure.

Gestational diabetes mellitus is becoming a very common medical disorder associated with pregnancy especially so in the Middle East and more so in Saudi Arabia, thus putting the women and fetuses at an increased risk of maternal and neonatal morbidity and mortality. Screening for Gestational diabetes mellitus was recommended because of its asymptomatic nature and good proportion of patients with no classic risk factors. We recommended universal screening because of the beneficial effect of screening, diagnosis and subsequent treatment. The most recent study done in Security Forces Hospital showed a significant decrease in morbidity and mortality with application of the new values of screening, in spite of the increase of incidence of Gestational diabetes mellitus from 14.5 % in 2005 study, to 23.9 % in the recent study in 2015. Objectives: To highlight and determine the best screening method values of FBS and 2hrspp used to diagnose gestational diabetes mellitus. Maternal & neonatal out come and associated risks for patients who had Gestational diabetes mellitus, where scrutinized. The study was done in the period from June 1st 2013-31 of May 2014. Design: Retrospective cohort study. Setting: Tertiary centre (Security Forces hospital _Riyadh_Saudi Arabia). Patients: Out of 6849 patients who had their delivery in Security Forces Hospital between June 2013 and May 2014 (one year), 6340 patients (92.5 %) were screened for gestational diabetes mellitus, and out of these 1516 patients (23.9 %) were labeled as Gestational diabetes mellitus after exclusion of cases of IDDM and NIDDM. Main outcome measured: The purpose of this study is to advise on using new values for diagnosis of gestational diabetes and to assess the outcome of pregnancy after new values are implemented in security forces hospital for diagnosis. The outcome included ages of mothers, parities, number of abortions, associated medical disorders, and estimated blood loss. Control methods were also reviewed, gestational age of induction of labor. Associated intrapartum complications as well as fetal outcome were also reviewed. The weight of babies, congenital abnormalities, admission to neonatal intensive care unit were also studied. The different values used , and percentages of diagnosed values of last 3 studies done in Security Forces Hospital in comparison to the most recent study with new values(2014-2015) as shown in table 11. Results: The incidence of gestational diabetes mellitus increased from 14.5 % in the year 2003 - 2004 to reach 23.9 % in 2014, in the same institute (Security Forces Hospital), where the study was done using different values. In our study in Security Forces Hospital we recorded a significant decrease in morbidity and mortality on applying the new values. A significant reduction in the number of expired babies of mothers who were diagnosed as gestational diabetes with new values with a decrease from 5.6 % in previous years studied to reach 1.5 % in 2014, reflecting the effective control and the good catch for the new values. Conclusion: Universal screening, with whatever values to blood sugar used, is a better method screening than the selective one: Using 75 gram of Oral Glucose Tolerance Test proved to be cost effective, easily accessible, and with good pickup rate of up to 93 % of patients in Security Forces Hospital. Recommendations: To continue using the new values that will be universally implemented, with long term follow-up of mothers and newborn.

Objectives: To check if there is any significant difference in the immediate outcome of pregnancy with diabetes using the new values of FBS & 2hrs post prandial with 75g OGTT for 1 year (from 1st June 2013-31st May 2014) in comparison to the previous data done in the same institute with other values and with international figures. The data in our study included fetal, maternal morbidities, intra partum and postnatal outcomes, in order to help, if possible, on deciding the best values to use for screening for gestational diabetes mellitus. Furthermore, to know the new percentages of gestational diabetes mellitus in SFH by utilizing the new values of Blood Sugar readings. Design: Retrospective cohort study Setting: Security Forces Hospital-Riyadh-Saudi Arabia Patients: Done (from 1st June 2013 – 31st May 2014), on patients who had attended Security Forces Hospital, Riyadh, Saudi Arabia. This chosen year’s data was compared with data collected in the three previous years using different figures. Main Outcome measured: Average age of mother, maternal aspects of parity, history of GDM, number of abortions``````````````````````````````, estimated blood loss in labor, associated medical disorder, complications of previous pregnancies, methods of control of GDM, gestational age for IOL and associated intrapartum complications. Immediate neonatal outcome in cases of GDM, comparison of birth weights of babies & any specific congenital abnormalities and delayed causes of admission to NICU in the 4 years studied were also reviewed. Results: The percentage of diagnosed cases of gestational diabetes mellitus (GDM) after screening was 24 % as compared with 14.5% in previous study of 2003-2004 & with the number of screened patients amounting to 93% out of the total number of deliveries between 2013-2014 (in both years universal method of screening was used). The multidisciplinary set up of our GDM specialized clinic which was composed of dieticians, diabetic educators, endocrinologists and obstetric physicians operating together, helped to reduced the use of insulin in combination with diet to only 24% in comparison to 76% of patient using diet and exercise alone. The study showed a mean age of 33years and weight of 77kg. It was also noted that 16% of the patients diagnosed with GDM were multiparous averaging 1-5 deliveries. Almost 62% of patient didn’t give any history of GDM and no history of previous medical diseases. The majority of the patient with GDM delivered without complications during labor, with 30% having vaginal lacerations & 73% of patient had an estimated blood loss of less than 500cc. NICU admissions secondary to hyperbilirubinaemia averaged almost 17% in comparison to previous studies and only one baby expired in a GDM patient. Our study revealed a good fetal and maternal out come with less delivery complications and less incidence of postpartum hemorrhage (5.7%). Conclusion: It is concluded that Universal Screening of Pregnant women whether with previously used glucose value or new ones for gestational diabetes mellitus is a better option, which has proven to improve both maternal and fetal outcomes. The 75 OGTT test is a cost effective test and with both easy accessibility and good screening pick up number (92.5%) of the patients in Security Forces Hospital, Riyadh. Recommendation: We recommend annual follow up for patients, both the mother and the baby after postpartum, to prevent the development of type 2 diabetes.

Objectives: To highlight and determine the maternal and neonatal outcome and associated risks for patients who have undergone their 6th and more caesarean sections. Design: Case control study. Setting: Tertiary Centre (Security Forces Hospital – Riyadh – Saudi Arabia). Patients: 80 patients selected to study group who have undergone their sixth and more caesarean sections in Security Forces Hospital. Between June 2006 and May 2010. This group was compared to 80 patients who have undergone their third to fifth caesarean sections during the same time period and immediately following the studied case. Main outcome measured: Age and parity of women in study and the control group were correlated with the number of previous caesarean sections. Intra operative and post-operative maternal complications including presence and grade of adhesions, intra partum and postpartum hemorrhage, use of measurement and methods (both medical and surgical) to control bleeding such as Bakry balloon, Internal iliac artery ligation, etc., were highlighted. Bowel injury, blood transfusion, admission to surgical intensive care, incidence of placenta previa and accreta, post-operative complications like paralytic ileus, wound infection were also noted. Further, neonatal outcome including birth weight, Apgar score, and need for neonatal intensive care unit admission were reviewed. Results: Patients in the study group had higher incidence of extensive adhesions (41.25%) compared to (12.25%) in the control group. Bowel injury was (2.5%) in study group with none in the control group. The incidence of placenta previa was (8.75%) in the study group as compared to (2.5%) in the control group, with placenta accreta complicating (28.57%) of placenta previa seen only in the study group. Blood transfusion was higher in the study group (20%) as compared to (5%) in the control group. Neonatal admission to NICU was higher in the study group (27.5%) in comparison to the control group (12.5%). Also birth weight was lower in the study group. Conclusion: The more the number of caesarean sections, the more the maternal and neonatal morbidity. Patients should have proper counselling during antenatal follow up about the risks of repeated caesarean sections, and offered bilateral tubal ligation after the third or fourth caesarean sections.

Worldwide, Canine Distemper Virus (CDV) infection is a highly prevalent disease with high morbidity and mortality. CDV causes a multisystemic disease in a wide range of hosts including 9 families of mammals among them some primates, cetaceans and numerous carnivores. It presents a high tropism for lymphoid, neurological and epithelial tissue, leading to an infection of almost all systems, so the clinical signs observed are very varied. The diagnosis is made based on the clinical presentation of the disease, which considers a variety of signs and must be confirmed by a laboratory diagnostic method. The molecular technique called Reverse Transcription Polymerase Chain Reaction (RT-PCR) has been used to characterize viral strains based on the basis of genetic differences on the hemagglutinin (H) gene of CDV has allowed the identification of 14 circulating lineages in the world. Two lineages, namely the America-1 and the Europe-1/South America-1 have been described in Chile. The goal of this work was to implement a multiplex RT-PCR protocol, which was built on the in silico design of primers based on the H gene nucleotide sequences stored in the Genbank® database. This method was capable of detecting the previously described two circulating genetic lineages of CDV in a differential way providing a supporting diagnostic tool for epidemiological studies in the country. These results suggest that the primers described here are extremely selective for the above-mentioned lineages. In addition, our initial screening indicated that most analyzed clinical samples corresponded to the America-1 lineage, stressing the need for a continuous surveillance in order to properly address the prevalence of both lineages in Chile.

Anoikis resistance (AR) is a favorable attribute exhibited by cancer cells for metastasis. Carcinoma associated Fibroblasts (CAFs) plays a crucial role in AR in various cancers. It was proved in array of studies in different cancers that there was definite interrelationship between CAFs and AR. But its role in OSCC is ambiguous. It is the need of the time to reveal the correlation of CAF and oral squamous cell carcinoma (OSCC) in relation with anoikis. Molecular pathways which affects the AR via CAFs in various cancers has been highlighted in this communication. Divulging the importance of CAF in cancer will aid in designing customized novel chemoprevention therapy and thus will help in enhancing the prognosis of patient in OSCC.

Objective: The aim of the study was to determine the compliance to infection control of various dental laboratories in Durban. Study design: This was a qualitative survey. Setting: Dental laboratories in Durban area, South Africa. Subject: Registered laboratory technicians. Study methodology: Convenient random sampling method was used. Results: There was poor compliance to infection control procedures by most dental laboratories. Majority, 66.67%, of the dental laboratories relied on dental clinics for disinfection of dental impressions; therefore, they did not disinfect the impressions. On the other hand, only 33.33% carried out disinfection of dental impressions on their own. A high number (53.3%) of the respondents had disinfection areas within their dental laboratories, 6.7% had no disinfection areas while 40% depended upon dental clinics for all disinfections. About 60% of the dental technicians had valid vaccinations against Hepatitis B Virus while 40% had no vaccination against HBV. Conclusion: The results of this study indicated that there was substantial nonconformity to infection control measure in all dental laboratories. There should be comprehensive inspection of dental laboratories prior to licensing and thereafter by the South African Dental Technician Council’s inspectors to ensure that all dental laboratories comply with the various infection control measures.

The rehabilitation of partially or completely edentulous patients with implant supported prostheses has been widely used, achieving high success rates. However, many studies consider the presence of bruxism as a contraindication for this treatment modality. The purpose of this study was to review the literature and identify risk factors in implant supported rehabilitation planning in subjects with bruxism. The rehabilitation of bruxers using implant supported prostheses, using implants with adequate length and diameter, as well as proper positioning, seems to be a reliable treatment with reduced risks of failure. Bruxism control through the use of a night guard by rigid occlusal stabilization appliance, relieved in the region of implants, is highly indicated. Although it is clear that implant supported rehabilitation of patients with bruxism requires adequate planning and follow-up, well-designed randomized controlled trials are needed to provide reliable evidence on the long-term success of this treatment modality.

Objective: To describe pathological fi ndings on pre-treatment dental panoramic tomograms of edentulous jaws taken before complete denture treatment. Design: Descriptive cross-sectional study. Setting: Prosthetic division, Department of Conservative and Prosthetic Dentistry. School of Dental Sciences, University of Nairobi. Results: Data was obtained from clinical records and OPGs of 163 edentulous patients seen at the prosthetic clinic between 2010 and 2016 for complete denture therapy. From history and examination alone, clinicians reported significant findings on 50.3% of records, while 43.6% had no such findings. Ten (10) (6.1%) records were unclear. Examination of OPGs revealed 79.1% of the films had no pathological findings while in 20.9% had. Most of the findings (70.0%) were retained roots, 6% were radio-lucencies, 12% were other radio-opacities, 9% were impacted teeth while 3% had both retained root and radio-opacity. Most pathologies (64%) were located in the posterior region of jaws while the other findings were evenly distributed in the anterior and posterior regions of the jaws. There was no predilection of pathological findings to any other factor other than gender. In 83.4% records, queries on clinical notes coincided with significant findings on OPGs; while 16.6% were either unclear or did not coincide. Most (71%) OPG findings led to modification of treatment plan. Conclusion: Pathological findings are common on pre-treatment OPGs. It may be good practice to take an OPG for edentulous patients prior to complete denture therapy where such services are available, to prevent complications from intra-bony pathologies. However, Most of the findings are either detectable by clinical exam or may not be of major consequence to the health of patients. Complete denture may be done without OPGs for new and old denture wearers where the service is not available.

Background: Post abortion family planning (PAFP) is the initiation and use of family planning methods immediately after, and within 48 hours of an abortion, before fertility returns. In most women fertility returns on average about two weeks after an abortion; however, ovulation can occur as early as 11 days post-abortion. Objective: To assess utilization of post abortal contraceptive use and associated factors among women who came for abortion service at Debre Berhan Referral Hospital, Debre Berhan, Ethiopia March 2019. Methodology: Institutional based cross sectional study design was conducted using hospital data obtained from Gynecology ward in Debre Berhan Referral Hospital, Debre Berhan, Ethiopia, from March 1 -10, 2019. A systematic random sampling technique was used from the abortion register log book. Data was cleaned manually, coded and entered into Epi-data version 3.1 then exported to and analyzed by SPSS version 21 software. Multivariate analysis with AOR, 95% CI and p-value< 0.05 were used to identify variables which have significant association. Result: The finding of the current study showed that among 371 study subjects 170(45.8%) utilized post abortal family planning. There was a significant association between utility of post abortal family planning and post abortion family planning counseling [AOR: 19.245, 95% CI: (10.199, 36.313), p-value= 0.001] and women who were primiparous had 5 times more likely to utilize post abortal family planning as compared to the women who were nullyparous [AOR: 5.314, 95%CI (1.089, 24.210), p value=0.001]. Conclusion and Recommendation: From a total of 371 study subjects 45.8% have utilize contraceptive after abortion service received. This study also showed that parity and counseling’s of family planning were statistically significant associated with utilization of post abortal family planning. We recommend Debre Berhan hospital to scale up activities on post abortal care to increase the number of clients who post abortal family planning.

Despite evidence on major interventions on the uptake and scale up of interventions meant to promote maternal health care services, little is known about adequate use of such program in urban Ghana among reproductive aged women. This study examined the determinants of women’s Satisfaction on antenatal care use in selected health facilities in the Kwabre East Municipality of Ghana. Using facility-based cross-sectional survey design, a three-stage sampling technique was conducted to sample 220 women attending postnatal care at selected public health facilities. Open-ended questionnaires were used to obtain data from respondents. Descriptive statistics and inferential statistics including binary logit regression model were used to analyze the data with the help of SPSS and STATA software. Logit analytical framework was computed to determine equations of variance. The association between antenatal care use and women’s satisfaction was determined and assessed using Pearson’s χ2 (2) test indicating 1% was run. Most women (92.7%) had at least four ANC visits during their entire pregnancy. The results indicate standard deviation of 7 with 81% regular ANC visits and 19% irregular. Most women (55%) received care by one caregiver, followed by women (35%) who received care by two caregivers and women (10%) who were cared for by three caregivers. The regression results showed varying utilization levels of 10%, 5% & 1% ANC satisfaction. System induced factors aimed at promoting maternal care use satisfaction are suggested.