Caries experience in children with molar-incisor hypomineralisation in Fujairah, United Arab Emirates and its association with hypomineralised teeth number.

BACKGROUND: Molar-incisor hypomineralisation (MIH) has been found associated with an increase in dental caries. Studies utilising the recent MIH diagnosis and calibration criteria recommended by the EAPD in 2021 are very scarce. Additionally, the available data in literature about the relationship between the hypomineralised teeth number (HTN) and caries come from only one study. PURPOSE: To assess the relationship between MIH and caries experience among children in the city of Fujairah, UAE, utilising the recent criteria recommended by the European Academy of Paediatric Dentistry (EAPD) in 2021, and to assess the relationship between the number of teeth affected with MIH, and dental caries. METHODS: One hundred and sixty-two children were included in this cross-sectional study, aged 7-9 years old. Children were examined for MIH according to Ghanim et al. (Eur Arch Paediatr Dent 16:235-246, 2015. 10.1007/s40368-015-0178-8) criteria and Ghanim et al. (Eur Arch Paediatr Dent 18:225-242. 10.1007/s40368-017-0293-92017) training manual. Caries experience was assessed with decayed, missing, filled (dmft, DMFT) scoring system. RESULTS: dmft mean was 6.56 (SD ± 3.78) and DMFT mean was 0.91 (SD ± 1.23). Children with MIH had significantly higher dmft (p = 0.003) scores. Children with higher HTN had significantly higher dmft (p = 0.008) scores. CONCLUSION: Children in Fujairah have extremely high caries scores. Children with MIH have more decayed, missing and filled teeth. Hypomineralised teeth number was positively associated with caries experience.

Prevalence and severity of Molar-Incisor Hypomineralisation in children in Fujairah, United Arab Emirates.

AIM: This study aims to find the prevalence of MIH in children in the city of Fujairah, United Arab Emirates, utilising the current standardised guidelines for diagnosis and calibration. BACKGROUND: Molar-Incisor Hypomineralization (MIH) prevalence in paediatric patients has been widely studied. However, most of the available studies have utilised criteria that did not offer consistent diagnostic and calibration tools, which resulted in incomparable results. METHODS: Cross-sectional study. One hundred sixty-two school children aged 7-9 years in the city of Fujairah, UAE have been randomly selected and orally examined for the presence of MIH lesions. This was conducted following Ghanim et al. [2015] guidelines and after calibrating examiners following Ghanim et al. [2017] training manual. CONCLUSION: MIH prevalence was high in the city of Fujairah, UAE. More studies utilising the standardised criteria are required for valid comparisons. Further research on the aetiology of MIH is also needed.

A randomised prospective trial of trans-septal suturing using a novel device versus nasal packing for septoplasty.

BACKGROUND: Nasal packing or trans-septal sutures are used to prevent postoperative complications in septoplasty. Trans-septal suturing is not commonly used, since it takes time and is technically difficult with the available devices following septoplasty. METHODS: This study included 64 patients who underwent septoplasty. Following septoplasty, the patients were divided into two groups: group 1 had trans-septal sutures placed using a novel device and group 2 had the nose packed with a tampon. The duration of surgery, postoperative symptoms and complications were compared. RESULTS: All of the postoperative symptoms were significantly less in the group with trans-septal sutures. The mean duration of surgery was 34.9 minutes in the nasal packing group and 37.8 minutes in the trans-septal suture group, and the difference was significant (p = 0.026). No postoperative bleeding, submucoperichondrial haematomas, infections or abscesses occurred in any of the patients, whilst nasal perforation was observed in one patient in each group. Two (5.4%) patients in group 1 and one (3.7%) patient in group 2 had postoperative adhesions. CONCLUSIONS: We have developed a simple, inexpensive device for performing trans-septal suturing that is easy to use in the nasal cavity. We conclude that the use of continuous septal suturing with our device is an easy modification of the standard procedure, with only a small increase in operating time.

Towards sustainable delivery of health services in Afghanistan: options for the future.

Disruption caused by decades of war and civil strife in Afghanistan has led many international and national nongovernmental organizations (NGOs) to assume responsibility for the delivery of health services through contracts with donor agencies. Recently the Afghan Government has pursued the policy of contracting for a basic package of health services (BPHS) supported by funds from three major donors-the World Bank, the United States Agency for International Development (USAID) and the European Commission. With the gradual strengthening of the public health ministry, options for the future include pursuing the contracting option or increasing public provision of health services. Should contracting with NGOs be pursued, a clear strategy is required that includes developing accreditation instruments, better contracting mechanisms and a system for monitoring and evaluating the entire process. Should the government opt for an increasing role, problems to be solved include securing the transition to public provision, optining guarantees that appropriate financing will be provided and reconfiguration of the public health delivery system. Large-scale contracting with the private for-profit sector cannot be recommended at this stage, although this option could be explored via subcontracting by larger NGOs or small-scale trial contracts initiated by the public health ministry. Irrespective of the option chosen, an important challenge remaining is the recalcitrant problem of high out-of-pocket payments. Sustainable delivery of health services in Afghanistan can only be achieved with a clear national strategy in which all stakeholders have roles to play in the financing, regulation and delivery of services.

Health and development.

In this paper, the relationship between health and development is discussed. The impact of development on health and the importance of health to development are illustrated. The challenges to achieving health and development are outlined and the role of the World Health Organization in promoting these two objectives and their interrelationship is reviewed.

Targeting the cell wall of Mycobacterium tuberculosis: structure and mechanism of L,D-transpeptidase 2.

With multidrug-resistant cases of tuberculosis increasing globally, better antibiotic drugs and novel drug targets are becoming an urgent need. Traditional ß-lactam antibiotics that inhibit D,D-transpeptidases are not effective against mycobacteria, in part because mycobacteria rely mostly on L,D-transpeptidases for biosynthesis and maintenance of their peptidoglycan layer. This reliance plays a major role in drug resistance and persistence of Mycobacterium tuberculosis (Mtb) infections. The crystal structure at 1.7 Å resolution of the Mtb L,D-transpeptidase Ldt(Mt2) containing a bound peptidoglycan fragment, reported here, provides information about catalytic site organization as well as substrate recognition by the enzyme. Based on our structural, kinetic, and calorimetric data, we propose a catalytic mechanism for Ldt(Mt2) in which both acyl-acceptor and acyl-donor substrates reach the catalytic site from the same, rather than different, entrances. Together, this information provides vital insights to facilitate development of drugs targeting this validated yet unexploited enzyme.

Towards sustainable delivery of health services in Afghanistan: options for the future.

Disruption caused by decades of war and civil strife in Afghanistan has led many international and national nongovernmental organizations (NGOs) to assume responsibility for the delivery of health services through contracts with donor agencies. Recently the Afghan Government has pursued the policy of contracting for a basic package of health services (BPHS) supported by funds from three major donors - the World Bank, the United States Agency for International Development (USAID) and the European Commission. With the gradual strengthening of the public health ministry, options for the future include pursuing the contracting option or increasing public provision of health services. Should contracting with NGOs be pursued, a clear strategy is required that includes developing accreditation instruments, better contracting mechanisms and a system for monitoring and evaluating the entire process. Should the government opt for an increasing role, problems to be solved include securing the transition to public provision, obtaining guarantees that appropriate financing will be provided and reconfiguration of the public health delivery system. Large-scale contracting with the private for-profit sector cannot be recommended at this stage, although this option could be explored via subcontracting by larger NGOs or small-scale trial contracts initiated by the public health ministry. Irrespective of the option chosen, an important challenge remaining is the recalcitrant problem of high out-of-pocket payments. Sustainable delivery of health services in Afghanistan can only be achieved with a clear national strategy in which all stakeholders have roles to play in the financing, regulation and delivery of services.

Health and development

In this paper, the relationship between health and development is discussed. The impact of development on health and the importance of health to development are illustrated. The challenges to achieving health and development are outlined and the role of the World Health Organization in promoting these two objectives and their interrelationship is reviewed