Background: Despite significant advances in cleft lip and palate (CLP) care, the often quoted "rule of 10 s" has not been objectively investigated concerning its practicality since its inception, especially, in low-resourced country like Ghana. Aim of the Study: This was to evaluate the unilateral cleft lip weight, haemoglobin and surgical repair outcome by considering the "Rule of 10's". Materials and Methods: A retrospective study of all consecutive patients who presented with unilateral cleft lip and were operated on during the period 2011 to 2015. The information retrieved from the patient's records included the following at the time of surgery: Age (weeks), weight (pounds), hemoglobin level (g/dl), type of cleft and surgical outcome. Results: A total of 120 patients were seen during the study period (2011 to 2015) that had unilateral cleft lip. Female to male ratio was 3:2. (74) 62% had in addition, cleft palate (UCLp) and (46) 38% were only unilateral cleft lip without a palate (UCLo). Unilateral cleft lip was also divided into complete(UCLc) and incomplete unilateral cleft lip(UCLi). Out of the total number 120 patients seen during the study period, (80) 67% had complete unilateral cleft lip while (40) 33% had incomplete unilateral cleft lip. At week 10, the average weight were 11.2, 8.5, 8.2, 11.8 pounds for the various types of cleft at the time of surgery of the lip (UCLo, UCLp, UCLc and UCLi respectively). ≥10 weeks, the level of Haemoglobin at the time of surgery were 10.5, 8.6, 8.6 and 10.8 gm/dl (UCLo, UCLp, UCLc and UCLi respectively. Most of the patients, 28.4% with an associated cleft palate had their unilateral cleft repairs done by week 15. Conclusion: Children with unilateral cleft lip with an associated palate and unilateral complete cleft lip turned to have lower haemoglobin and weight at week ten after birth compared to unilateral incomplete cleft lip without cleft palate patients. This means that, the rule of 10s is still applicable in our centre especially for those with incomplete unilateral cleft lip without an associated cleft palate. There were more post-operative wound infections in children who had unilateral cleft lip with an associated cleft palate.
Background Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact are the four oral health-related quality of life (OHRQoL) dimensions (4D) or areas in which oral disorders impact pediatric patients. Using their dentists' assessment, the study aimed to evaluate whether pediatric dental patients' oral health concerns fit into the 4D of the Oral Health-Related Quality of Life (OHRQoL) construct. Methods Dentists who treat children from 32 countries and all WHO regions were selected from a web-based survey of 1580 international dentists. Dentists were asked if their pediatric patients with current or future oral health concerns fit into the 4D of the Oral Health-Related Quality of Life (OHRQoL) construct. Proportions of all pediatric patients’ oral health problems and prevention needs were computed. Findings Data from 101 dentists treating children only and 523 dentists treating children and adults were included. For 90% of pediatric patients, their current oral health problems fit well in the four OHRQoL dimensions. For 91% of oral health problems they intended to prevent in the future were related to these dimensions as well. Both numbers increased to at least 96% when experts analyzed dentists´ explanations of why some oral health problems would not fit these four categories. Conclusions The study revealed the four fundamental components of dental patients, i.e., the four OHRQoL dimensions (Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact) are also applicable for pediatric patients, regardless of whether they have current or future oral health concerns, and should be considered when measuring OHRQoL in the pediatric dental patient population.
Background: Every human being of adult years and sound mind has a right to determine what shall be done with his/her own body. Patient autonomy and the practice of informed patient consent are now pivotal in medical practice. Aim: To assess patient's knowledge of Patients' Rights Charter and whether patients receive adequate information to enable them make an informed consent to a particular treatment. Methodology: Patients who were undergoing elective surgery from selected surgical departments of Komfo Anokye teaching hospital in Kumasi were randomly selected and assisted to answer structured questionnaire without the knowledge of their doctors. The study period was in June to December (2014). Descriptive analysis was done using SPSS (II) of the results. Results: 84.7% (144) had no idea about the Patients' Rights Charter of the Ghana Health Service. 75% (128) did not know or had not heard of informed patient consent. Of those who knew of the charter, 85% (37) had ever stayed in a developed country. 60% (102) did not know of their diagnosis. 79% (134) said the doctor only asked them to either sign or thumb print the consent document without giving them treatment options or possible complications. Conclusion: Most of respondents undergoing various surgical procedures at the Komfo Anokye Teaching Hospital were not aware of the existence of the Patients' Rights Charter of the Ghana Health Service. Again, practitioners did not provide sufficient information to patients for them to make an informed decision about their health. A. A. Oti et al.
Background: Aesthetics is a primary consideration for patients seeking dental treatment. The size and shape of the maxillary anterior teeth have significant effects not only on the dental aesthetics, but also on the complete facial aesthetics of a person. To satisfy this expressed need, the "Golden Proportion" is a numerical value that is used as a rule in achieving dental aesthetics. In the last two decades, several studies have questioned the application of this rule in dentistry. Aim: The aim of this study is to evaluate the presence of "The Golden Proportion in the maxillary anterior teeth widths of clients visiting the Komfo Anokye Teaching Hospital's (KATH) Oral Health Directorate, Kumasi". Materials and methods: A total of 100 dentulous subjects comprised of 50 males and 50 females, with ages ranging between 18 and 37 years were chosen using convenience sampling. Their dental casts were evaluated for apparent width by digital calliper. Results: The results of the study were expressed in relation to gender and tooth laterality. The results revealed that the golden proportion existed in 14% and 20% for the left and right respectively between the central incisor and the lateral incisor for males, 12% and 16% respectively for the left and right sides of females, 8% and 20% for the left and right sides respectively for males between the lateral incisor and canine and 16% and 20% for the left and right respectively for females. Conclusion: Comparison of our results with the established golden value shows differences between 1.618 and from the range that was acquired from this study. The results suggest that the rule of the golden proportion should not be strictly applied when restoring anterior teeth of patients in the dental clinic.
Background: Religious, cultural beliefs and demographical differences can have a huge impact in shaping people's reactions and attitudes toward cleft children. Myths and folk beliefs frequently accompany the birth of a child with deformities especially in Africa. Objective: Evaluate cleft mothers with cleft children attending a multidisciplinary cleft clinic at Komfo Anokye Teaching Hospital about their experiences on aetiology, expectation, family reaction and treatment of cleft lip and palate. Methodology: The study design was a cross-sectional study which involved consecutive mothers of cleft lip and palate children reporting to Komfo Anokye Teaching Hospital (KATH) Cleft clinic by using a structured questionnaire. The study period was from January to June 2013. Results: The highest recorded response (47.50%) from mothers was that their nuclear families had been supportive. The least recorded nuclear family reaction was indifferent to child's condition (3.70%). 47.50% of mothers reported their extended family members had been supportive whereas the least recorded reaction of extended family members (1.25%) was avoidant behaviour. 52 Mothers (65%) answered that they are not mocked by members of the society whereas 28 (35%) answered they were mocked. Conclusion: The above study demonstrates that mother's educational background was low. Some mothers still believe CL/P is caused by evil spirit even though they are in the minority. Most mothers were hopeful that their babies will have a normal life after surgery. There was high level of family support for cleft families.
Objectives To compare the frequency of patients’ oral health problems and prevention needs among Slovenian and international dentists with the aim to validate the four oral health-related quality of life (OHRQoL) dimensions across six clinical dental fields in all World Health Organization (WHO) regions. Methods An anonymous electronic survey in the English language was designed using Qualtrics software. A probability sampling for Slovenia and a convenience sampling strategy for dentist recruitment was applied for 31 countries. Dentists engaged in six dental fields were asked to categorize their patients’ oral health problems and prevention needs into the four OHRQoL dimensions (Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact). Proportions of patients’ problems and prevention needs were calculated together with the significance of Slovenian and international dentists’ differences based on dental fields and WHO regions. Results Dentists (n=1,580) from 32 countries completed the survey. There were 223 Slovenian dentists (females: 68%) with a mean age (SD) of 41 (10.6) years and 1,358 international dentists (females: 51%) with a mean age (SD) of 38 (10.4). Pain-related problems and prevention needs were the most prevalent among all six dental fields reported by dentists; Slovenian (37%) and 31 countries (45%). According to Cohen, differences between Slovenia, the broader European Region, and 31 countries were considered non-significant (<0.1). Conclusion According to the dentists’ responses, the frequency of patients’ oral health problems and prevention needs are proportionate between Slovenia and 31 countries, regionally and globally. The four OHRQoL dimensions can be considered universal across all dental fields.
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