Objectives
To investigate the influence of micro-osteoperforation (MOP) on rate of orthodontic tooth movement and pain perception with fixed appliances.
Design
2 arm parallel randomized controlled trial with an allocation ratio of 1:1.
Setting
The outpatient department of a dental college.
Participants
105 patients were screened, out of which 60 met the inclusion criteria and consented to participate; consisting of 33 females and 27 males requiring en-masse retraction following first premolar extractions.
Methods
The experimental group consisted of patients bonded with a fixed appliance (Gemini 3M) who received MOP distal to canines throughout the period of retraction every 28 days. These were compared with a control group treated with identical brackets without MOP and were assessed for rate of tooth movement (canine retraction) and pain perception using a Visual Analogue Scale (VAS) of 10 mm.
Results
Prior to commencement, all baseline parameters were matched between the two groups (p>0.05). A statistically significant increase in rate of tooth movement in the MOP group (p<0.05).
Conclusion
MOP appears to enhance the rate of tooth movement with no differences in pain perception.
Introduction
In Ghana, men who have sex with men (MSM) are estimated to be 11 times more likely to be living with HIV than the general population. Stigmas at the intersection of HIV, same‐sex and gender non‐conformity are potential key drivers behind this outsized HIV disease burden. Healthcare workers (HCWs) are essential to HIV prevention, care and treatment and can also be sources of stigma for people living with HIV and MSM. This article describes the process and results of adapting an evidence‐based HIV stigma‐reduction HCW training curriculum to address HIV, same‐sex and gender non‐conformity stigma among HCWs in the Greater Accra and Ashanti regions, Ghana.
Methods
Six steps were implemented from March 2020 to September 2021: formative research (in‐depth interviews with stigma‐reduction trainers [n = 8] and MSM living with HIV [n = 10], and focus group discussions with HCWs [n = 8] and MSM [n = 8]); rapid data analysis to inform a first‐draft adapted curriculum; a stakeholder adaptation workshop; triangulation of adaptation with HCW baseline survey data (N = 200) and deeper analysis of formative data; iterative discussions with partner organizations for further refinement; external expert review; and final adaptation with the teams of HCWs and MSM being trained to deliver the curriculum.
Results
Key themes emerging under four immediately actionable drivers of health facility intersectional stigma (awareness, fear, attitudes and facility environment) informed the adaptation of the HIV training curriculum. Based on the findings, existing curriculum exercises were placed in one of four categories: (1) Expand—existing exercises that needed modifications to incorporate deeper MSM and gender non‐conformity stigma content; (2) Generate—new exercises to fill gaps; (3) Maintain—exercises to keep with no modifications; and (4) Eliminate—exercises that could be dropped given training time constraints. New exercises were developed to address gender norms, the belief that being MSM is a mental illness and stigmatizing attitudes towards MSM.
Conclusions
Getting to the “heart of stigma” requires understanding and responding to both HIV and other intersecting stigma targeting sexual and gender diversity. Findings from this study can inform health facility stigma reduction programming not only for MSM, but also for other populations affected by HIV‐related and intersectional stigma in Ghana and beyond.
Chronic suppurative otitis media is a disease with worldwide prevalence having potentially serious long term effects. It is a disease well known for its recurrence and persistence despite treatment. A study on culture and sensitivity of aural discharge collected from 40 cases of bilateral chronic suppurative otitis media was done to compare the bacteriological profile of either ear. Pseudomonas aeruginosa was the major organism isolated in both ears and was sensitive to Amikacin and newer drugs like Gatifloxacin. It was concluded that the infecting organisms in case of bilateral chronic suppurative otitis media are remarkably similar. If adequate treatment is instituted early, it can go a long way in reducing the prevalence of this socially embarrassing disease.
A number of physiological changes occur during pregnancy and amongst them, audiological and nasal changes are quite significant. These are mainly due to the changing levels of sex hormones and return to normal once the pregnancy is over. This study was conducted to document these changes. Forty (pregnant 40 and non-pregnant 40) consenting subjects in age group of 20-35 years were assigned to test and control groups. They underwent complete ENT and Obstetric examination. In test group Pure Tone Audiometry was performed in all trimesters of pregnancy and within 3 months of delivery. The subjects in the control group underwent pure tone audiometry only once. The nasal patency was measured by Gertner's plate method. Results from each trimester and postpartum period were compared. A highly significant difference in pure tone thresholds was observed at frequencies ranging from 125 to 1000 Hz (P < 0.001). However frequencies higher than 1000 Hz demonstrated no significant correlation. Nasal patency as measured by mean area of vapour condensation in all trimesters and control groups was highly significant (P < 0.001). The results of this study confirm that these changes occur in the first trimester and gradually improve during the subsequent trimesters returning to normal in post partum period. However number of pregnancies bear no relationship with these changes.
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