February 2017

Oral habits are learned patterns of muscle contraction and have a very complex nature. They areassociated with anger, hunger, sleep, tooth eruption and fear. Some children even display oral habits for release of mental tension. Such habits are the most frequent cause of these malformations mostly seen in the early childhood and mixed dentition stages. Other than the forces created by the oral habits there are many forces that are acting on the structures of the oral cavity.Oral habits, if persist beyond certain developmental age, can pose great harm to the developing teeth, occlusion, and surrounding oral tissues. In the formative years, almost all children engage in some non-nutritive sucking habits. Clinicians, by proper differential diagnosis and thorough understanding of natural growth and developmental processes, should take a decision for intervening. Parental awareness about the adverse oral habits is also another factor which needs to be looked into, negligence of the parents can become a cause to the dentofacial anomalies in the children. This article was aimed to give an insight into different oral habits and their management as a guide to parents and dentists.

Introduction: Postoperative delirium is a complication that frequently occurs in post-operative patients, both in cardiac and non-cardiac surgery, with the most affected being the elderly. Diagnostic criteria for delirium or cognitive impairment are documented in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). The incidence reported on this entity varies between 25-80%, and its diagnosis will depend on its definitions, forms of presentation, type of surgery and time of its evaluation in the postoperative period. Considering that society is being demographically transformed by the increase of older adults in our population, the need to maintain the functionality and the cognitive state after the anesthetic-surgical procedure of this vulnerable age group has become more important. The incidence reported on this entity varies between 25-80%, and its diagnosis will depend on its definitions, forms of presentation, type of surgery and time of its evaluation in the postoperative period. Considering that society is being demographically transformed by the increase of older adults in our population, the need to maintain the functionality and the cognitive state after the anesthetic-surgical procedure of this vulnerable age group has become more important. Based on what has been reported in the medical literature of the specialty, a close association of postoperative cognitive deterioration has been demonstrated with the administration of anesthetic agents, among other risk factors. Objectives: It is to define if, through changes revealed through neuromonitoring with Near Infrared Spectroscopy (NIRS), factors that could be associated with the presentation of cognitive impairment in elderly patients undergoing a major surgical procedure can be detected early. Postoperative cognitive delirium is understood as: - condition characterized by alterations in memory, concentration, language comprehension and social integration, which in the short, medium or long term is reflected in the functional capacity of patients. Material and Methods: A sample of 60 patients older than 70 years, undergoing elective major surgery, who underwent NIRS neuromonitoring, were evaluated and the cognitive function was evaluated through the Montreal Cognitive Evaluation (MoCA) in the postoperative period. Measures of central tendency, distribution and dispersion were determined (Smirnov-Kolmogorov test). Frequencies and percentages were calculated, Whitney Mann's U-test / chi squared, Mommy Ratio with 95% CI. The Stata version 13 program was used. Statistical significance was taken with a p value of less than 0.05, with a 95% confidence interval. Results: Of the total sample obtained, 53.3% were women and 46.7% were men. The median age was 71 years. In relation to the service: General Surgery (30%), Orthopedics (28.3%) and Cardiology (20%). The type of anesthesia most frequently used was general anesthesia balanced 66.7%, followed by regional anesthesia (18.3%), and general intravenous anesthesia 15%. The surgical time had a median of 90 minutes, mean pulse oximetry saturation (SpO2) was 95%; In the NIRS, 68.3% had adequate cerebral saturation levels, that is, above 90% or no more than 20% of variation in their baseline. The 33.3% of the sample showed some type of postoperative cognitive delirium, through the evaluation of MoCA. There were no statistically significant differences in sex distribution, age and type of anesthesia between groups with and without cognitive deficit. Conclusions: In recent years there has been a special interest in the investigation of postoperative delirium, since there is currently no specific and sensitive assessment scale, applicable to the patient undergoing an anesthetic-surgical procedure, given the characteristics that a patient (Type of surgery, anesthetic time, hemodynamic changes, transperative cerebral hypoperfusion, perioperative haemorrhage, drugs used, to mention a few), such as the various risk factors that identify them.

Introduction: The disorders that alter the function vestibular are a major public health problema, both clinical as economic perspective. Objective: To identify vestibular disorders in patients with postural instability at The Naval High Specialty Hospital. Material and Methods: A cross-sectional, non-randomized, descriptive and ambispective study was conducted, as well as a systematic review and analysis of the clinical records of each evaluated patient at the Otorhinolaryngology service, reported with postural instability symptom (dizziness, vertigo, latero-pulsion , Postural instability) as the main reason for medical care. The SPSS 19.0 statistical package for Windows was used for the data analysis. 2 x 2 factorial design to estimate prevalence. The bivariate analysis was performed with the χ2 test, considering a p≤0.05. Student's t, Mann-Whitney U, and Kruskal-Wallis tests were used as well. A p≤0.05 was considered significant. Results: A total of 1077 files reviewed, 374 patients with different peripheral vestibular disorders were obtained. Of the total sample (n = 374), 71.7% (268) are of the female gender and 28.3% (106) are male. The mean age +/- standard deviation is 55.7 +/- 16.4 years, with an age range of 18-95 years. The prevalence of benign paroxysmal postural vertigo (BPPV) is 84.0%, endolymphatic hydrops with 11.5%, posttraumatic vertigo 4.5%, vestibular neuronitis 2.4% and 5.6% with Menieré's disease, perilymphatic fistula, otosyphilis and upper semicircular canal dehiscence did not reach the 1%. Conclusions: The prevalence of vestibular disorders is similar to that reported at literature, benign paroxysmal postural vertigo the most frequent. Consequently, and differing from the literature, the endolymphatic hydrops is the second most prevalent vestibular pathology, followed by Menieré's disease and, in lower frequency the vestibular neuritis, contrasting widely with it reported in the literature. Therefore, it is essential not only to carry out extension studies but also a complete clinical evaluation in order to establish a specific diagnosis of the vestibular disorders that affect our population that is suffering postural instability.

Young people are often considered to be the group that does not care and apathetic toward politics, but their voices are important for the development of democracy. Therefore, efforts should be made to encourage them to participate in an election that has become a symbol of democracy. Social media is able to change the view as well as encouraging young people to become more actively involved as citizens, including participating in the elections. This research aims to study the effects of exposure to social media content on the university students' knowledge of elections. The method used is survey research and Jakarta Governor Election Campaign 2012 became a research context.The findings in this study are political information and menus available in social media that allow users to interact directly with the candidates, have a relationship with knowledge of elections and encourage interest among young voters in elections.

Background: Mortality from hemorrhage in renal failure and liver, chronic units critical is 40% and the deleterious effects related to transfusion are high, the decision to transfuse should be selected, methods of interpretation of coagulation go global test methods like tromboelastograma, however what is most effective for guiding a better decision making? Method: A study was conducted in patients with bleeding in the Naval General Hospital of high specialty of the city of Mexico with diagnostic Insufiencia hepatic or Renal chronic who were randomized into two arms, one global test of coagulation and the other the tromboelastograma, for both hemoglobin goal was more than 7 grams/dl and venous saturation greater than 65%, during resuscitation was assessed the occurrence of lung injury and circulatory overload transfusion as well as presence of thrombosis-associated. Results: 31 patients who met the screening criteria were included where TEG® when compared with global testing showed reduction of transfusion in the treatment of hemorrhage (1. 71± 1.2 vs 3.41 ± 3.04, P: 0.04) without complications (p < 0.05) Conclusion: TEG® is effective to reduce the use of procedures and thereby reduce complications and mortality.

OBJETIVE: Determinate the family burden in the caregiver of the patient with diabetic foot in the Naval Specialty Hospital of Veracruz. METHODS: The caregiver of a patient with a diabetic foot was observed attending to the wound clinic, monthly period of June to October 2016. The Self-Applied Family Load Scale-Questionnaire was applied to him, through three sections, the objective load, the level of attribution and the subjective load with a reliability of 0.85 No-random sampling and probabilistic sample. It was analyze with absolute and relatives frequencies, by confidence intervals and tendency measures, and probabilistic pack SPSS v22.0. RESULTS: 70 interviews were made, observing an average of 160 days of evolution since the beginning of the injury, female relatives caregiver of the patient response were 69%, children of the patient 60%; according to Wagner classification a deep ulcer was found in 46%. Caregiver average age of 48 ± 14 years old, 54% housewife, 50% with elementary or lower schooling. Attribution level showed 1.10 (IC 95% 0.98-1.23) correspond it to possible relation, objective load 0.69 (IC 95% 0.59-0.79) range 0-2. CONCLUSION: In family burned was observed a possible relation in the attribution level of the caregiver of patient with diabetic foot.

Hereditary spherocytosis (HS) is a heterogeneous group of hemolytic anemia caused by deficiency or dysfunction of red blood cell (RBC) cytoskeletal proteins. It is a common disorder located mostly in Caucasian population; most affected individuals have mild or only moderate hemolysis. In a few rare cases, the measurement of RBC membrane proteins is required to clarify the nature of the membrane disorder in absence of the family history. Patients with HS are at more risk of developing gallstones, whose prevention represents a major impetus for splenectomy in such patients. The main purpose of the study is to perform a mini review on the formation of gallstones in patients with hereditary spherocytosis. Hence, regular ultrasound and other diagnostic examinations are recommended for timely detection of any presence of gallstones in patients with HS.

This study presents the importance of studying E-Government services in Jordan. This study attempts to examine the acceptance possibility of E-Government and the major factors impacting the application of E-Government in the context of Jordan citizens. A quantitative approach survey of 266 citizens was used in this study. The modified acceptance framework grounded on the Unified Theory of Acceptance and Use of Technology (UTAUT) model is employed for ascertaining the factors affecting the citizens’ intent to employ E-Government. The statistical analysis outcomes indicate the citizens’ high acceptance level towards E-Government.

The plant was investigated for possible toxicity (both acute and subacute toxicity) in wistar rats. Twenty five female rats were divided into five groups of five rats each. The first group was orally dosed with 2000 mg/kg body weight of the extract for acute toxicity testing. The remaining four groups were used for subacute testing and were dosed as follows; group A received orally administered distilled water, group B received 50mg/kg, and groups C and D received 100 and 200 mg/kg respectively of the extract orally. All animals survived the acute and subacute toxicity testing but histopathological changes were seen in the liver, kidney, spleen, and lungs of all the treatment groups. Haematological and biochemical parameters were also altered in all treated groups. This experiment suggests that the leaves of Guiera senegalensis do have toxic effects despite its wide use in African traditional medicine.