RESUMO
BACKGROUND: The best way to handle an emergency is to be prepared in advance. The purpose of this study was to assess the availability of medical emergency drugs at dental offices and to determine the level of knowledge and preparedness of dentists to manage medical emergencies at their dental offices. MATERIALS AND METHODS: A descriptive cross-sectional study was conducted from January to June 2014 with 250 dental graduates to determine their knowledge and ability in the management of medical emergencies and assess availability of emergency drugs and equipments in dental offices in the Ahmedabad and Udaipur areas of India. The questionnaire consisted of mainly objective questions, requiring a simple yes or no reply. Mann-Whitney test was used for the analysis. A 95% confidence level was used and a P value of less than or equal to 0.05 was considered statistically significant. RESULTS: The results of our study showed that almost all the surveyed dentists (98%) enquired about medical history, but only 12% obtained filled health history proforma from patients regarding the above. Only 38.4% participants recorded the vital signs of patients before commencing any treatment. Also, 7.6% reported about having attended any workshops on emergency training or management programs. Emergency kits were available with only 24% participants and the available kits were assessed for the availability of emergency drugs. Also, 34% were confident about giving intramuscular injection and only 6.6% were sure about giving intravenous injections. The P value was found to be highly statistically significant. CONCLUSION: The results of our study reflect an alarming situation about the capability of dentists to deal with such conditions.
RESUMO
Obesity has been associated with osteoarthritis and increased morbidity and mortality. Most joint arthroplasty patients have a high body mass index (BMI). Some surgeons are reluctant to operate on obese patients due to technical difficulties and the anticipated higher complication rate. The purpose of this prospective study was to determine whether obesity is associated with longer operative times. We attended 100 consecutive primary total joint arthroplasties. Patients were divided into four groups depending on their BMI: the normal group (BMI: 18 to 24.9 kg/m2), the overweight group (BMI: 25 to 29.9 kg/m2), the obese group (BMI: 30 to 39.9 kg/m2), and the morbidly obese group (BMI ≥ 40 kg/m2). Anesthesia type and time, duration of surgery, time needed for scrubbing, draping, and transferring the patient to the operating table were all documented. The mean operative time for total hip arthroplasty (THA) was significantly increased in morbidly obese patients (R2 = 0.197, p = 0.003). The mean scrubbing time for total knee arthroplasty varied with BMI (p = 0.028). Time to administer spinal anesthesia was significantly increased in morbidly obese patients (R2 = 0.1466, p = 0.018). Morbid obesity is associated with a significant increase in the time needed to administer spinal anesthesia and the overall time needed to perform a THA.
