Abstract: Medical emergency when occurs in a dental environment should be handled efficiently and effectively in order to sustain life until medical help arrives. This study aimed to asses knowledge amongst dental practitioners about the possible risks of a medical emergency to improve patient care.
A questionnaire based study was conducted in the dental teaching hospitals of Punjab, India in 2016. The questionnaire comprised of three sections to assess dentist’s perception and knowledge on the commonly faced medical emergencies along with dentist’s confidence in performing Basic Life Support (BLS). 220 questionnaires were distributed out of which 198 were returned. The study sample included 128 female and 70 male dentists with a minimum clinical experience of one year.
The results showed 71.7% received a formal BLS training while 28.3% had not received any training. Moreover, the mean medical emergency score obtained was 5.28 out of a maximum of 10. 55.2% of the dental practitioners felt confident in performing Cardio Pulmonary Resuscitation (CPR), out of which, 80.5 % had the correct knowledge of performing a CPR according to this study.
The most significant finding was almost half of the dentists lack the knowledge and necessary training. Hence, in order to improve quality of patient care annual BLS courses should be made mandatory.

Abstract: Gestational diabetes is a serious health problem. Applying tele-nursing in healthcare is increasingly prioritized to reduce maternal mortality, morbidity and improve newborns’ survival especially in remote areas. Aim of the study: To examine the effect of tele-nursing services on healthy lifestyle and self-efficacy among gestational diabetes women. Design A quasi - experimental design was adopted. Setting: The study was conducted at the Maternal and Child Health Center in the Fayoum University Hospital. Sample: One hundred and one mothers with gestational diabetes were enrolled in the study and randomly divided into study and control groups. Tools: Four tools were used for data collection: I) A structured interviewing questionnaire, II) Health promotion lifestyle profile scale, III) Self-efficacy of health behaviors, and IV) Women satisfaction Likert scale. Results: There were statically significant differences between both groups regarding the health promotion lifestyle profile as well as self efficacy scores at 32 and 37 weeks of gestation. The mean level of fasting blood glucose was significantly lower in the study group than the control group at 37 weeks of gestation (p<0.05). Meanwhile the mean level of postprandial blood glucose was significantly lower than the control group at 32 and 37 weeks of gestation (p<0.05). As well as, the mothers who received the telephone support achieved increased numbers of attendances to the antenatal center for follow up. In addition, the satisfaction level was high among the mothers who received the telephone support than those in the control group. Conclusion: The findings of this study demonstrated that tele-nursing support could significantly enhance the health promotion lifestyle profile and self efficacy scores, as well as maintain blood glucose levels among mothers with gestational diabetes and also increase the adherence to antenatal visits.

Abstract: Self mutilating habits also known as masochistic/ sadomasochistic habits are those in which the patient enjoys deliberately damaging themselves. The common traumatic lesions in the oral cavity may be chemical, thermal, physical in nature. The physical one is more severe , widespread and can involve the deeper tissues thus tends to be more resistant to conventional forms of treatment .This paper presents a case of impalement injury to the soft palate in a 4 year old boy and its management.

Abstract: To determine the status and problems related to menstrual cycle in the Bengali college students and to evaluate its effect on their daily routine.
Methods: A cross-sectional survey of 875 students conducted by questionnaire at 4 different general degree colleges in West Bengal. Questions related to menstruation, elucidated variation in menstrual patterns like length of cycle, duration of bleeding period, history of dysmenorrhea and its severity, PMS and absenteeism from college/classes.
Results and conclusion: The mean+/- SD age of the students was 19.1+/-1.99 years, the mean age of menarche was 12.07±0.89 years. A total of 76% (665 out of 875) students suffering from dysmenorrhea and 85.1% (745 out of 875) students have premenstrual symptoms. Dysmenorrhea was mild (grade 1) in 24.91% (249 out of 875), moderate (grade 2) in 43.31% (431 out of 875) of students and severe (grade 3) in 16.91% of students (195 out of 875). 54.63% students with dysmenorrhea reported that they limit their daily activities and 28.11% reported college absenteeism during menstruation. Prevalence of premenstrual symptoms were: somatic complaints such as abdominal bloating( 42% ), peripheral edema (7.07% ), lumbago (74% ), headache (34% ), general fatigue(82% ), vomiting(13.98% ), and psychological disorders such as irritability (65% ), depression (45% ), nervousness (15% ), mood swings (32% ). Positive correlation had found between dysmenorrhea and obesity, duration of bleeding, amount of blood flow and positive family history. Presence of dysmenorrhea is high in the subjects who did not participated in regular exercise (87.5%).

Abstract: The Medical data accessibility using cloud computing provides the patients and doctor to access the Health record using Electronic Health Record (EHR)system .83% of health care organizations using cloud services,9.3% plan to adopt cloud .In the proposed system, the cloud based application provides the privacy for both patients as well as doctors through secure sharing of information using private cloud. Electronic Health Record facilitates providing the information among authorized physicians and patients in various geographic areas providing more timely access to life saving in formation and reduces the need for duplicate testing. The evaluation of the medical data shows that ability to analyse and track information and avoids the sniffing across the network by providing encryption and decryption techniques using Advanced Encryption Standard algorithm. The potential of using cloud computing in delivering 21st century healthcare offers many exciting possibilities for professional, organization working in this field. Furthermore, there are also valid concerns relating to the security, governance of the integration issues and the ability of cloud computing to cope with business process change.

Abstract: Creation of a functioning arterio venous access accounts for a majority of the inpatient admission in nephrology blocks. Elderly women, diabetics and patients with recent or past history of smoking pose a significant hurdle in creating a successful fistula especially contributing for a large majority of failed fistulas.
Materials and methods: A prospective study was carried out to evaluate the association of smoking on failed fistulas in patients of end stage renal disease on 60 consecutive patients of end stage renal disease with failed primary vascular access between 14 to 70 years of age over a period of 2 years. Details such as history of diabetes, hypertension, and use of tobacco in any form, prior vascular access surgery and patency of the access are collected. Results: On multivariate logistic regression analysis using SPSS 15 software, we found that tobacco abuse is associated with failed arterio venous fistula (p value= 0.023).However, partial thrombosis of a failing Arterio venous access, uncorrected, is invariably associated with non-functioning of AV fistula (p value < 0.001)
Discussion: Ozdemira et al have concluded that when fistula location was excluded from the analysis, smoking (RR = 4.140, P < .01) was an   independent risk factors for thrombosis. Wetzig et al have also confirmed that there was a significantly higher incidence of early and late fistula failure in those patients who were cigarette smokers. 
Conclusion: Smoking or tobacco abuse is adversely associated with outcome in management of failed fistulas.

Abstract: The ultimate goal in periodontal therapy is creation of an environment that is conducive to maintaining patient’s dentition in health, comfort, and function. The shift in therapeutic concepts from resection to regeneration has significantly impacted the practice of periodontology in the last two decades. The objective of this review article is to provide an overview of various bone graft materials intended for periodontal reconstructive therapy.

Abstract:  Thrombo-embolic phenomena are a major cause of morbidity and mortality in the western countries(5) . The same is not true in Zambia for some reason we do not see that many patients with this problem. It could be that we actually do not diagnose these cases (4).
Common and serious disorders in which Thrombo-embolic mechanisms participate include: pulmonary embolism, myocardial infarction, cerebral infarction, and infarction of abdominal viscera, which conditions though seen are not common in our setting (5). 
Thrombo embolic phenomena usually occur either on the venous side or on the arterial side. It is rare to have it on both the venous and arterial side at the same time.
We present the case of an eighteen year old female patient who presented with  symptoms and physical findings of concurrent venous and arterial thrombo embolic phenomena.

Abstract: The development of neonatal infection in intensive care unit is associated with an increase in morbidity, mortality and cost. Therefore, the aim of this study was to examine the effect of instructional program on Nurses Compliance with Universal Precautions of Infection Control in Neonatal Intensive Care Units. This study was conducted in the Neonatal Intensive Care Units (NICU) at El Menoufia University Hospital and El-Gamia sharaia in Shebien El kom city, Egypt. A quasi-experimental design was used. A convenient sample of all registered nurses who were working in the above mentioned settings were selected (60 nurses). Two tools were used for data collection; a structured interview questionnaire sheet and an observational checklist. The findings of this study revealed that nurses who attend an educational program their knowledge and practice regarding compliance with universal precautions of infection control were improved in posttest than in pretest. In conclusion, implementation of educational program for nurses improved their knowledge and practice toward compliance with universal precautions of infection control in neonatal intensive care unit. It is recommended that nurses needed continuous in-service education and training programs about infection control and should be conducted on a regular basis to improve their knowledge and practice. Also, written standard universal precautions guidelines for infection control should be available in NICU and should be updated periodically to suite the new trends.

Abstract: Pregnancy represents a time of rapid change in maternal physiology and nutritional requirements. Dietary recommendations during pregnancyshould have a particular focus on micronutrients (vitamins, minerals) to support growth and development of the fetus .The aim of the current study was to assess the effect of nursing intervention on the beliefs and practices of pregnant women regarding vitamins and minerals intake. The Design of this study was quasi-experimental. The target population comprised all pregnant women who have files for follow up at MCH center. Sample size was 100 pregnant women fulfilling the inclusion criteria. Tools of this study included sociodemographic data, questionnaire about beliefs and practices of pregnant women regarding vitamins & minerals intake and a schedule of 24-hour recall dietary assessment for pregnant women. The results revealed thatthere were a statistically significant difference between vitamins and minerals intake during pregnancy and pregnancy outcomes after nursing interventions. It is concluded that the nursing interventions, improved beliefs of pregnant women and corrected practices toward vitamins and minerals intake. It is recommended thatfurther research on wider scale are needed to explore beliefs and practices, increase awareness about vitamins and minerals intake during pregnancy and study their effect on pregnancy outcomes.

Abstract: The combination of axillary radiation therapy and axillary surgery substantially increases the risk of arm edema in breast cancer patients. This may be caused by disruption of lymphatic pathways which produces fibrosis. Among the many treatment techniques suggested for arm edema, intermittent pneumatic compression (IPC) has been recommended at low pressures as single or multi-chamber pumps as part of the multimodal program. To study the effect of addition of IPC pumps in the rehabilitation of arm edema, this study was devised as a comparative study. Females who developed arm edema within a year of breast cancer surgery were included and compared for effects of multi – modal program with or without IPC pump use. Assessments were made using circumferential measurements. 

Abstract: In Zambia, Sigmoid Volvulus is one of the most common presentation and yet those of Gastric Volvulus are rare condition in the country but they do occur. Gastric Volvulus is a rare clinical entity too.  It is defined as an abnormal rotation of the stomach of more than 180°, creating a closed-loop obstruction that can result in incarceration and strangulation. The many cases of chronic Gastric Volvulus are not diagnosed; the incidence and prevalence of Volvulus are unknown. Males and females are equally affected. About 10-20% of cases occur in children, usually before the age of 1 year, but our youngest patient we have   reported was as young as 16 years of age. Gastric Volvulus in    children; is often secondary to congenital diaphragmatic defects.  It is generally believed that the condition is uncommon in adults younger than 50 years but our findings   have presented a very different presentation. Here is presented the few cases we have seen in the Chingola mine hospitals and the Ndola central hospital over a period of fifteen years spread on the two hospitals from June 2000 to the end of June 2015. Over 15 years only seven patients came into our care. They were all females and no males at all. The youngest was 16 years old and the oldest was 45 years old.The major presenting complaints was of upper abdominal pain and it was for a long time; the periods running over years.

Abstract: Background: Breastfeeding is an extremely time-sensitive relation¬ship. Experiences with breastfeeding in the first hours and days of life significantly influence an infant’s later feeding.
The study aimed to explore the effect of baby-friendly hospital initiative breast feeding program on maternity nurses, mothers and infant outcomes.
Subjects &methods a quasi-experimental design was used. The study was conducted at obstetric departments at Shebin – Elkom teaching hospital, Menoufia university hospital and Banha university hospital. A simple random sample of two hundred mothers and 50 maternity nurses were involved in the study. 5 tools were used to collect data.
Results: There was statistically significant difference between case and control group regarding mothers' knowledge, attitude regarding breast feeding and practice of sex steps of baby friendly hospital initiative intervention. A significant improvement was observed in nurses' implementation of baby-friendly hospital initiative breast feeding intervention immediately after program implementation.
Conclusion:  Significant improvement in maternity nurses, implementation of ten steps of baby – friendly hospital initiative intervention after program implementation. Significant improvement in mothers' implementation of six steps of baby – friendly hospital initiative intervention after program implementation.
Recommendations: Maternity units should be encouraged to undertake significant strategic and practical changes required to achieve baby friendly hospital initiative standard status.

Abstract: The larynx is a rare site of involvement by amyloidosis. We report one case of laryngeal amyloidosis. The patients was 50 years old female with history of persistent hoarseness of voice. Fibreoptic laryngoscopy used for diagnosis of benign laryngael mass. Microlaryngeal Excision of the mass was done. Histopathological examination confirmed the diagnosis of amyloidosis. Appropriate follow up is an important part of the long term management of the disease.

Abstract: Tuberculosis (TB) major cause of illness and death worldwide, particularly in low and middle income countries. The aim of this study was to determine the effect of health education to improve knowledge and practices towards TB patients and their families (care givers). Design: A quasi experimental design was utilized in this study. Setting: The study was conducted at Chest Hospital (El-Mamore) and Kom El-Shoaafa hospital both in Alexandria. Sample: 100 patients, attending the settings during the period of the study, (from beginning of May to the end of October 2013) beside 100 from their family care givers. Tools: A structured interviewing questionnaire, it contains 3 parts: a) Sociodemographic data,  b) Environmental assessment sheet,  c) Knowledge of patients and their families about TB, d) Assessing practice toward TB as observed the patient and family caregivers. Results of this study elaborated that the patients and their family caregivers had lack of knowledge and practices about tuberculosis pre program implementation; The study showed also remarkable improvement in knowledge and practices of patients and their family caregiver. Post implementation of the health education program. The study concluded that the health education program had been succeeded in improving knowledge and practices of patients and their family caregivers about tuberculosis post program implementation. The study recommended that implementation of health education about preventive measures, infection control are importance of complying to treatment.

Abstract: Background: Medication errors represent the largest single cause of errors in the hospital setting. The Institute of Medicine reports 44,000 to 98,000 people die in hospitals annually as a result of medical errors that could have been prevented. Hospital medication error rates can be as high as 1.9 per patient per day. It is estimated that 95% of medication errors are not reported because staff fear punishment. So the study aimed to: Assess perception of barriers to medication administration error reporting among nursing students. Design:  A descriptive, across-sectional was used for this study. Tools: One tool used in data collection. Medication administration errors questionnaire; It  composed of four parts; first part included demographic data, second part consisted questions regarding medication errors and an estimate of the number of nursing students made and reported  medication errors , third part consisted barriers to reporting medication error and last part consisted of causes of medication error. Subjects and Setting: A 247 nursing students enrolled at faculty of nursing, in Menoufia Governorate, Egypt. Results: Number of error done by bachelor was higher than internship student; number of error reported by internship was higher than bachelor student. Fear barrier was the major barrier followed by administrative barrier. Bachelor students more agree with "physician’s writing on the doctor’s order form is difficult to read and internship students more agree with” Nurses are tired and exhausted Conclusion: the study concluded medication administration errors high occurrences among nursing students and often underreported. Recommendation: Nursing student’s instructors must demonstrate positive responses to nursing students for reporting medication errors.

Abstract: Menstruation is a natural process, it is linked with several misconceptions and practices, which sometimes result into adverse health outcomes.  Hygiene-related practices of women during menstruation are of considerable importance. The aim of this study is to assess female students’ knowledge and attitude regarding menstruation, observe general wellbeing of female student and investigating the relationship between current knowledge of female students about menstruation and menstrual hygienic practices. A descriptive research design was utilized to fulfill the aims of the study. The sample consist of 200 nursing student at El-Nasr Insurance Health Hospital in Helwan City. The researcher met the students through studying day in break time to illustrate the nature of study and gather data. The result revealed that the majority of nursing students has a poor knowledge and attitude of menstruation hygiene. So this study recommends to spot attention on  reproductive system hygienic care as a part of fixed curriculum in infection control.