Job Satisfaction of U.A.E. Dental Practitioners.

OBJECTIVE: The study aims to analyze job satisfaction among registered clinical dentists in the United Arab Emirates (UAE), and also to explore satisfaction with different work environmental factors and relate them to overall job satisfaction. MATERIALS AND METHODS: A survey modified from the American Dental Association version of job satisfaction published in 2013 to 2014, was given to 197 licensed dentists in Dubai and Sharjah cities in the UAE. The questionnaire included four main sections, in addition to the demographic factors questions. All questions were answered using the 5-point Likert scale. The only exception was the comfortability in the working environment which was answered using a 3-point Likert scale. STATISTICAL ANALYSIS: Categorical data were presented as frequencies and percentages, and data were analyzed using means and standard deviations. Regression analysis was performed with overall job satisfaction as the dependent variable and seven aspects of satisfaction with work and individual characteristics as the independent variables. An α level of 0.05 was used for tests of statistical significance. RESULTS: The overall job satisfaction of dentists working in the UAE is high compared with other countries. Highest satisfaction was related to the relationship with patients, colleagues, and staff. On the other hand, the least satisfaction was linked to the opportunity for part-time work and benefits package. There were no significant differences between male and female participants regarding all work-related factors apart from autonomy. However, private sector dentists had a higher level of satisfaction compared with the public sector in many work-related factors. CONCLUSION: There are various dimensions that collectively influence the level of overall job satisfaction. Difference existing between the levels of job satisfaction among private and public sector dentists and between male and female dentists need to be addressed to increase the level of job satisfaction among UAE dentists and thus improve all dental care system.

Neck irradiation: a risk factor for occlusive carotid artery disease.

OBJECTIVES: to determine whether irradiation is an independent risk factor for carotid atherosclerosis, and propose guidelines for patient follow-up. DESIGN: a retrospective case control study. MATERIALS AND METHODS: two groups of patients with severe carotid artery stenosis (>70%) were compared: 30 post-neck irradiation patients, and a control group of 100 patients with no history of neck irradiation. Disease location and severity were assessed by duplex. The relationship between atherosclerotic risk factors, time since irradiation and carotid artery disease was examined. RESULTS: the average age of study group patients was 67 years (43-86) compared to 69 years (46-89) in the control group. The average interval from irradiation to diagnosis was 14 years (3-53) (median 12.5 years). The study group suffered less from diabetes, ischaemic heart disease, and peripheral vascular disease ( p<0.02). There were no significant differences among risk factors with respect to age, gender, smoking, hypertension, and hypercholesterolemia. Post-neck irradiation patients had a significantly higher prevalence of bilateral disease (p=0.02), and a higher rate of common carotid artery lesions (p<0.002). CONCLUSIONS: neck irradiation should be considered a risk factor for occlusive carotid artery disease. Preoperative angiographic study should be considered, due to frequent involvement of the common carotid artery.

Carotid endarterectomy in awake patients with contralateral carotid artery occlusion.

OBJECTIVES: Patients with severe stenosis of an internal carotid artery with contralateral occlusion (ICO) are at an increased risk for stroke, and therefore surgical treatment is usually recommended. Carotid endarterectomy (CEA) under regional anesthesia enables constant monitoring of neurologic status and selective shunting in cases of clinically evident cerebral ischemia. In this study, we assess the selective use of shunts based solely on changes in neurological status in awake patients with ICO undergoing CEA as well as their complication rates. METHODS: During 1996-1998, we studied intraoperative findings and results of CEA under regional anesthesia with clinical monitoring of neurological status in two groups: (1) patients with stenosis (> 70% by NASCET) and contralateral occlusion (n = 50) and (2) patients with stenosis and no contralateral occlusion (n = 94). RESULTS: Shunt insertion was required in 42% of group 1, and 6% in group 2. All of the patients in group 1 requiring shunts had stump pressures < 50 torr. The average stump pressure of group 1(40 torr) was significantly lower than that of group 2 (75 torr), and was also lower than that of patients with severe contralateral stenosis (35 patients, 76 torr). Perioperative stroke rates were identical in both groups (2.1%). CONCLUSION: Since ICO patients are at a high risk for brain ischemia during ICA clamping, they require shunt insertion frequently. Patients with no contralateral occlusion require shunting at a much lower rate - even in the presence of severe contralateral stenosis. Regional anesthesia allows for early detection of brain ischemia and therefore, the perioperative results in both groups are similar.

Duplex scanning and CT angiography in the diagnosis of carotid artery occlusion: a prospective study.

OBJECTIVES: Differentiating total occlusion from tight stenosis of the internal carotid artery is crucial with regard to treatment and prognosis. At our institution, the diagnosis of carotid stenosis is based on duplex scanning. In cases of occlusion, duplex is not reliable, and angiography is performed, thereby increasing morbidity. We tried to determine whether a combination of duplex scanning and CT angiography (CTA) can replace angiography in the diagnosis of carotid occlusion. DESIGN: Prospective study. MATERIALS AND METHODS: From 1995 to 1997, 148 patients were diagnosed as having carotid occlusion by duplex scanning. CTA was performed on all patients. Forty-four patients underwent angiography and 10 patients were surgically explored. Both procedures were considered "gold standard" for the diagnosis of occlusion. RESULTS: Arteries found to be occluded by both CTA and duplex scan were confirmed as occluded by angiography or operation in 95% of the cases (42/44). Arteries found to be occluded by duplex but patent by CTA were confirmed as patent in 100% of cases (10/10). CTA has a significantly higher positive predicting value for diagnosing occlusion than duplex scan (95% vs. 77%, p value < 0.01). CONCLUSIONS: Combination of duplex scanning and CTA is safe and accurate in the diagnosis of carotid occlusion and can replace angiography in most cases, thereby reducing morbidity.

Use of EEG spectral edge as index of equipotency in a comparison of propofol and isoflurane for maintenance of general anaesthesia.

Propofol and isoflurane were compared for haemodynamic stability and recovery time as main anaesthetic agents for maintenance in a total of 43 ASA I and II patients in uncomplicated operations lasting at least 30 min. The premedication (oral diazepam), induction (thiopentone-fentanyl-suxamethonium) and maintenance protocol (N2O-O2 2:1 litre min-1, fentanyl and vecuronium in incremental doses) were identical for all patients. In one group of 20 patients, propofol was used in continuous intravenous (i.v.) infusion (starting dose 3 mg kg-1 h-1), while in the second group of 23 patients, isoflurane was administered in a starting concentration of 1%. To improve the equipotency of the two agents in all cases the dose of the main anaesthetic was titrated to keep the EEG 90% spectral edge frequency (SEF-recorded by processed EEG monitor) between 8 and 12 Hz. Mean blood pressure (BP) and heart rate (HR) deviations of +/- 20% from the baseline were recorded. The incidence of mean blood pressure deviations/case in the propofol group was less than half of those occurring in the isoflurane group (0.45 vs. 0.96 P = 0.04). The mean duration of blood pressure deviation from baseline value was 5.5 min in the propofol group vs. 16.8 min in the isoflurane group (P = 0.01). The recovery intervals were significantly shorter in the propofol group (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)