RESUMEN
INTRODUCTION: To describe the relationship and impact of age group, gender and skin complexion on the prevalence and clinical distribution of oral mucosal alterations of developmental origin (OMA-DO) among school children aged 5-13 years. METHODS: A randomized representative national survey of Jordanian school children including all Country geographic areas was performed. Cut-off age that significantly correlated with presence and distribution of OMA-DO was identified (ROC curve). Skin complexion was classified into light/fair, intermediate/tan, dark/brown based on skin complexion index. Chi square test with P value≤0.05 was used for significance of correlations. RESULTS: Two thousand two hundred and fifty one children were clinically examined. The average age that significantly correlated with prevalence and distribution of OMA-DO was 9.9 years. Female gender was significantly correlated with four OMA-DO: leukoedema (L), linea Alba (LA), Fordyce's granules (FG), commissural lip pits (CLP) and wider distribution of racial pigmentations (RP) (P<0.05, χ2 test). Older age group (9.9-13 years) was significantly correlated with 7 OMA-DO: L, LA, FG, frenal tag, CLP, mandibular and maxillary tori (MT) as well as wider clinical distribution of RP, FG, L (P<0.05 χ2 test). Dark skin complexion significantly correlated with 5 OMA-DO: L, LA, FG, RP, MT and wider clinical distribution of RP (P<0.02, χ2 test). CONCLUSIONS: Increased prevalence and wider clinical distribution of OMA-DO are significantly associated with older age group of 9.9-13 years, female gender, and dark skin complexion. Oral health care provides are encouraged to be familiar with these correlations. This knowledge is expected to improve OMA-DO diagnosis and clinical management. Continuous education programs in this field are recommended.
Asunto(s)
Sistemas de Distribución en Hospital , Enfermedades de la Boca , Adolescente , Anciano , Distribución de Chi-Cuadrado , Niño , Preescolar , Femenino , Humanos , Mucosa Bucal , PrevalenciaRESUMEN
INTRODUCTION: Following the introduction of haemostatic agents, new opportunities are available when facing problematic bleeding. We report the first case of traumatic postpartum hemorrhage successfully controlled with a fibrin sealant. CASE PRESENTATION: 26-year nulliparous patient had a rotational forceps delivery and developed multiple vaginal lacerations. Haemostasis could not be achieved after suturing, vaginal packing and IV tranaxemic acid. She lost approx. 3,500 ml blood and received 4 U transfusion. Tisseel was used as a thin layer on vaginal wall and bleeding settled. She had good recovery and perineum healed well. CONCLUSION: Tisseel consists of a two-component fibrin biomatrix to stop diffuse bleeding. When the tissues are very oedematous, it can be difficult to insert sutures. We tried this innovative option with very effective results. The absence of long-term complications is reassuring and we recommend its use in similarly extreme situations.