Association of COVID-19-imposed lockdown and online searches for toothache in Iran.

BACKGROUND: Novel coronavirus disease-2019 (COVID-19) has impacted populations in many ways worldwide, including access to oral health services. This study aims to assess the association between lockdown due to COVID-19 and online searches for toothache in Iran using Google Trends (GT). METHODS: We investigated GT online searches for toothache within the past five years. The time frame for data gathering was considered as the initiation and end dates of the national lockdown in Iran. We performed one-way ANOVA statistical test to compare relative search volumes (RSVs) between the year 2020 and 2016-2019 for the whole country. Then we investigated the possible association of RSVs in provinces with dentists' density, prevalence of current daily smokers, Human Development Index (HDI), Internet access, and fluoride concentration in water using linear regression. RESULTS: When comparing 2020 with the previous four years, there was a rise of 2020 RSVs versus all previous years combined and each year (P < 0.001 for all of them). In the linear model for the year 2020, HDI (B = - 3.29, 95% CI: (- 5.80, - 0.78), P = 0.012) had a strong negative relationship with provincial RSVs. HDI mostly had strong positive relationship with provincial RSVs in prior years. Fluoride concentration (B = - 0.13, 95% CI: (- 0.24, - 0.03), P = 0.017) and dentists' density (B = - 0.04, 95% CI: (- 0.25, 0.17), P = 0.669) were also negatively associated with RSVs in 2020. These associations were mostly negative in the previous years as well. Internet access (B = 0.36, 95% CI: (- 0.38, 1.09), P = 0.325) and prevalence of daily smokers (B = 0.33, 95% CI: (0.13, 0.53), P = 0.002) were positively associated with RSVs. CONCLUSION: The RSVs for toothache in 2020 have increased due to COVID-19-imposed lockdown compared with the same period in the past four years. This increase was related to socioeconomic factors.

Prevention of Biliary Leakage after Removal of T-tube in Immunocompromised Patients.

Biliary leakage after T-tube removal is an important complication which can be lethal especially in patients who received immunosuppressant agents. The purpose of the study is to determine a method which can evaluate the completion of tract formation in high-risk patients. Participants include 46 patients who were candidates for open cholecystectomy and common bile duct (CBD) exploration and T-tube insertion. Twelve of patients received corticosteroids and were divided into two groups. In the first group, T-tube was removed conventionally, but in the other group, we performed a "fistulography" 1 month postoperative to evaluate maturity of tract between CBD and the skin. Biliary peritonitis was seen in half of patients who are managed conventionally, but no complication was detected in patients who underwent fistulography. Fistulography is suggested to be done before T-Tube removal in immunocompromised patients in order to detect tract formation, which is effective in reduction of postremoval complications.