The New Nation - Internet Edition

Dental emergencies

Md. Al-Amin Bhuiyan

Many types of emergencies may have to be faced by the dentist during dental procedures. Dentist must know how to recognize & manage medical emergencies - they may be rare. Their professional skill & equipment should enable them occasionally to save patient's lives. In that case patients should be quickly transferred to the hospital, but city traffic & the load on ambulance services are so heavy that the delay can be considerable. Under such circumstances, measures taken by the dentist may be critical. Dentists are also required to ensure that all members of their staff are able to provide practical assistance in these circumstances.

# Sudden loss of consciousness -

1. Fainting, due to hypotension, cerebral ischaemia, anxiety, pain, injections, fatigue, long term starvation etc.

2. acute hypoglycaemia mainly affects the diabetes patients

3. Syncope

4. Anaphylactic shock

5. cardiac arrest

6. stroke

7. myocardial infarction

8. Circulatory collapse secondary to corticosteroid therapy.

# Acute chest pain

1. Angina

2. myocardial infarction

# Difficulty in breathing

1. Asthma

2. Anaphylactic shock

# Convulsions

1. Epilepsy

2. Any cause of loss of consciousness

# Other emergencies

1. Haemorrhage- i) After tooth extraction ii) Minor oral surgery

2. Profuse bleeding due to bleeding disorders

3. Avulsed tooth

4. Extruded or intruded tooth

5. Fracture, i) Fracture of tooth ii) Fracture of jaw

6. Injuries to the soft tissues of the mouth

7. Drug reactions & interactions

8. Major maxillofacial injuries, due to accident.

# How often should you visit the dentist:

If possible, you should visit your dentist every six months for a preventive checkup. Infants should visit the dentist at about 12 months of age.

# Top six tips for managing dental emergencies: As we all know accidents can and do happen. Having a dental emergency can be very painful and scary. These tips will tell you what to do if you are ever faced with a dental emergency. If you or someone you know has a dental emergency, don't be panic. These tips will tell you what to do in case of a dental emergency.

Tips-1: Toothaches- Never take any pain killers including aspirin on the gum because it can burn the gum tissues. Clean your mouth by rinsing thoroughly with warm water, gently floss around the tooth to remove any food particles. If your tooth continues to hurt, you should contact with your dentist as soon as possible. A toothache can result from several dental problems. Regular dental checkups will help to prevent toothache.

Tips-2: Broken tooth- if your tooth breaks you should immediately contact with your dentist. You should also clean your mouth by rinsing thoroughly with warm water. Apply a cold compress to that area to minimize any swelling.

Tips-3: Possible broken jaw- when any accident occurs, if you think that your jaw might be broken, apply a cold compress to that area to minimize any swelling. You should immediately contact with your dentist or go to the emergency room of a nearby hospital.

Tips-4: Knocked out tooth- if your tooth has been knocked out, rinse the tooth very gently to make sure it is clean, do not scrub the tooth or remove any tissue that is attached to it.

Be sure to place a towel or wash cloth in the sink so that it does not go down the drain. If you can, gently place the tooth back into the socket.

If this is not possible, place the tooth in a small container or cup of milk. You will need to take the tooth with you & get to your dentist immediately.

Tips-5: Bitten tongue or lip- if you have bitten your tongue or lip, gently wipe the area clean with a cloth.

Apply a cold compress to the area to minimize any swelling. If the bleeding will not stop, you should go to the emergency room of a nearby hospital.

Tips-6: Something caught between your teeth- Gently insert a piece of dental floss or a dental thread (waxed)- be very care not to cut the gum tissue. If you are unable to remove the object, contact your dentist. Never use any sharp object to try & remove something that is stuck in between your teeth.

The myths on HIV/AIDS

S.M Shahrear Akhlaque

People like to believe in Myths although myths are not true. In fact, those who are in verdict power, they always attempt to broaden many kinds of humors or myths for legitimate their supremacy. Hence, myth is a very strong tools for developed country to edict over the under developed countries. However around the world, there are great numbers of different myths about HIV/AIDS. Here are some of the most common ones:

'Sex with a virgin can cure HIV'. . This myth is common in some parts of Africa, and it is totally untrue. The myth has resulted in many rapes of young girls and children by HIV+ men, who often infect their victims. Rape won't cure anything and is a serious crime all around the world.

'You would have to drink a bucket of infected saliva to become infected yourself' . . .This is a typical myth. HIV is found in saliva, but in quantities too small to infect someone. If you drink a bucket of saliva from an HIV positive person, you won't become infected. There has been only one recorded case of HIV transmission via kissing, out of all the many millions of kisses. In this case, both partners had extremely badly bleeding gums.

'It only happens to gay men / black people / young people, etc'. . This myth is false. Most people who become infected with HIV didn't think it would happen to them, and were wrong.

'HIV can pass through latex'. . Some people have been spreading rumors that the virus is so small that it can pass through 'holes' in latex used to make condoms. This is untrue. The fact is that latex blocks HIV, as well as sperm - preventing pregnancy, too.

According to the recent research by various AIDS Research Institute we came to know that, The AIDS prevalence in Bangladesh is still under 1% in general. But the reality is low stratum of AIDS in the country today, does not guarantee low prevalence tomorrow. Because all the risk factors which give birth to explosive HIV/AIDS epidemics are present in Bangladesh vigorously. For example high level of unprotected sex, needle sharing among IDUs and high level of syphilis are found in the country. Even the outbreak of HIV in neighboring countries (India/Thailand) and steady rise of STDs in the country make Bangladesh a high-risk zone of HIV/AIDS. Further more cross border mobility and international employment is a great threat resulting in the rapid spread of HIV/AIDS.

Worldwide, internal and external migration and trafficking is another enormous dilemma to HIV/AIDS. Trafficking is strong link with HIV epidemic, typically trafficking victims are used in commercial sex industry in other geo-political area. They were forced to sexual accomplish with multiple partners in daily footing. The 'Rainbow Nari O Shishu Kallyan Foundation' and 'SHARP Samaj Kallayan Shangstha' jointly survey at Maymensing Brothel in Bangladesh. This study point out that, more than 25% sex workers were entered this profession entwined through instigation of traffickers.

In this article, I endeavor to prove the above circumstances as myth but the fact is that, if all concerning groups do not take part in their standard roll timely, then somehow the myths can become true within dumpy time. Hence, my suggestion in favor of preventing HIV/AIDS from the country as below: Government ministries and departments (health, education, social welfare, labour, justice) must provide necessary education and reserve peoples rights. An affordable, reachable, accessible, strong system must be made available to individual/ groups. So they can demand their rights.

Policy maker are responsible for developing public health policies that are based on human rights. Such policies not only focus on the rights of people living with HIV/AIDS, but also on the broader range of human rights that influence peoples vulnerability of the epidemic.

Private and public companies should provide their employees with the knowledge, skill and resources to protect themselves from HIV/AIDS. This require effective programmes (education, counseling, treatment for sexuality transmitted infection (STIs), condom demonstration or distribution) and policies (clear guideline to illness. testing) based on technical expertise that target all levels of the company to ensure a sustained, flexible, sensitive and non discriminatory response to HIV/AIDS.

NGO should provide HIV/ AIDS education and foyer others in government, the private sector, media and religious organization to provide HIV education. In addition, NGO should demonstrate successful strategies for overcoming the cultural, social and political obstacles among parents, teachers, government officials, religious leaders and media to provide accurate information about HIV/AIDS for all people, including women, children.

Media, religious leaders and politicians need to allow and encourage free access to up to date and adequate information about HIV/AIDS and sexuality.

Teachers and health professionals need to ensure that, children and adults have the necessary knowledge and skills to shield themselves from HIV infection.

All levels of parents must protect the health of their children. Protect them from abuse, neglect and exploitation and provide them necessary education that they need to protect themselves from HIV/AIDS.

Medicine at our doorsteps: Tarmuj (Water melon)

-Jamayet Ali

Tarmuj (Water melon) is one of the most popular and familiar fruits in our country. But it is not our native fruit. It is reported to have originated in the Kalahari desert of South Africa from where it has been migrated to other countries of the world. Besides Bangladesh, it grows well in Turkey, USA, Japan, Egypt, Italy, Brazil, Greece, Syria, Mexico, Spain, Thailand, Argentina, India and Iraq. In our country Tarmuj is mainly grown in the districts of Mymensingh, Tangail, Faridpur, Chittagong, Chittagong Hilltracts, Noakhali, Comilla, Sylhet etc. Being drought resistant it is grown in hot and dry regions. But it can also be grown on wide variety of soils ranging from high sandy-loams to clayey loams. However, it thrives best on deep rich wel1-drained sandy loams. As a result, it is often cultivated on moist sandy river-beds during the dry season. It can also be grown on garden, gravelly and acidic soils. The land is prepared by ploughing 2-3 times and planking. It is then laid out into 2-4 metre wide beds with 60 cm wide furrows between them. In river beds under each hill, manure is added and then covered with 58cm of loose soil before planting the seed. The crop requires weekly irrigation till the fruits have set. Excessive irrigation may result in fruit cracking. In river beds it requires less number of irrigation. In remote areas where irrigation facilities are scarce and in undulating terrain, earthen pitchers can be provided for irrigating the vines.

Botanical name ofTarmuj is Citrullus vulgaris. Every part of Tarmuj is useful but it is valued mainly for the sweet spongy; juicy pulp. The pulp is eaten fresh especially during the hot summer months for its cooling effect. It is also made into a refreshing squash. The pulp cut into cubes or balls is added to fruit salad to enhance its taste and appearance. The size of the fruit and colour of the rind do not always indicate the maturity of the fruit with the flat palm; a mature fruit emits a mutffed sound. The juicy pulp has been successfully canned and bottled and sold in USA and other European countries as a dietetic drink. It contains a high content of potassium which imparts to it diuretic properties. It is thus useful for treating patients with kidney ailments. It is also useful in blending food products having high natural acidity such as plum, apple paste etc. Combinations containing upto 61-80 percent of water melon juice / pulp with orange, grapes and pineapple are acceptable.

Food scientists after analysis have shown that Tarmuj is rich in food values. Edible 100 gms. of T arm uj contain: mineral matter, 0.3; fibre, 0.2; energy, 16k cal; protein, 0.2; fat, 0.2; carbohydrate, 3.3g/100g; oxalic acid, 11; calcium, 11; magnesium, 13; sodium, 27.3; potassium, 160; copper, 0.05; sulphur, 42; chlorine, 21; thiamine, 0.02; riboflavin, 0.04; vitamin C, 1; niacin, 0.1 and iron, 7.9mg/lOOg. The green and red portions of the fruit can be separated and processed separately. The red portion is made into a squash or syrup while the green portion is made into pickles and preserves. The pulp does not lend itself to easy preservation. When preserved in pure form with or without the addition of acid, it losses its palatability (Food Processes and Analyses, Mohammad Yunus, BARC, Dhaka; Wealth of India, Raw Materials, Vol. III, 606)

Seed of tarmuj is rich in oil and unsaturated acids. The oil has a pleasant odour and taste and can be used directly as a cooking oil. The fatty acid composition of the seed oil apparent absence of any harmful constituents makes it an excellent edible oil. Besides, it can be used as an illuminant as a lubricating oil for surface coating material, and in the manufacture of soap. The defatted seed meal is exceptionally high in protein. It contains 66.2% protein (Lysine being the limiting amino acid) which is more than in soybean, peanut or sunflower seed meals. The very high content of oil in the whole seeds and of protein in the defatted meal could make commercial cultivation of these seeds for edible oil and protein a lucrative business. Comparisons of the content of seed meal with FAO/WHO recommended protein and amino acid requirements of human subjects, indicates that this meal will by itself adequately supplement the high carbohydrate-low protein diets of people in the tropics.

Medicinal Properties: Tarmuj is also familiar for its medicinal properties. As it contains a high content of potassium, it imparts to it diuretic properties. It is thus useful for treating patients with kidney ailments. It is also useful in blending food products having high natural acidity such as plum puree or apple paste. Improper storage of pulp leads to contamination. The contaminated pulp makes an excellent substratum for growth of intestinal parasite bacteria. They can multiply rapidly in such juice and develop toxicity, as such the pulp is strongly suspected to be associated with outbreak of food poisoning. The seeds on separation from the pulp are dried in the sun. They are often substituted peanuts in parts of Africa. Salted and cooked, they are eaten as appetizer.

The carnels are roasted and ground and added to sauces and soups to enrich their flavour and consistency. The kernels are low in carbohydrate content. So they are suitable as food for diabeties. The leaves are considered as a febrifuge in the Philippines. The fruit juice is a cooling drink prescribed in strangury and urinary complaints. The fruit rind is dried and incinerated and applied to sores. The pericarp is given in diarrhoea. The seeds are cooling and demulcent, purgative and diuretic. They are used in the treatment of cancer (Wealth of India, Raw Materials, Vol.-III, Ca-Ci)

Medicine: The unripe fruit is sweet; cooling, fattening, strengthening, aphrodisiac, astringent to the bowels; indigestible; cures jaundice. The ripe fruit is sweet; cures "kapha" and "Vata"; causes biliousness. The seed is sweet, fattening, aphrodisiac. The leaves are bitter, haematinic (Ayurveda). The fruit is tasteless when unripe, sweet when ripe; cooling, expectorant, diuretic, stomachic; purifies the blood; allays thirst; cures biliousness; good for sore eyes. The seeds are tonic to the brain (Yunani)

The seeds are used as a cooling medicine. In Bombay, they are also considered diuretic and strengthening. The Vytians prescribe the juice of the fruit to quench thirst, and also as an antiseptic in typhus fever (Ainslie). The fruit is used as a purgative in Sind.

The juice of the pulp is given in Guiana as a cooling enema. An emulsion of the seeds is made into a poultice with the pounded leaves and applied hot in cases of intestinal inflammation. The fruit pulp was formally used in the Western Province of the Cape Colony as a cathartic in dropsy and other complaints (Indian Medicinal Plants, K.R. Kirtikar & B.D. Basu, Vol.-II, 1149-50).

Medicinal values: The seeds are used as a cooling medicine. Dr. Dymoc says that they are in great demand and kept decorticated and ready for use. In Bombay they are considered cooling, diuretic and strengthening. Ainslie remarks that the Vytians prescribe the juice of the fruit to quench thirst, and also as an antiseptic in typhus fever, in which cases he himself administered it with good results. Special Opinius: " Cooling as well as a diuretic (Assistant Surgeon Anund Chunder Mukerji, Noakhally) (Dictionary of the Economic Products Of India, Watt, Vol.- 11, 332)

Properties and uses: Fruit pulp and juice are cooling, refreshing and laxative. Seeds possess diuretic property. Fruit is useful in the treatment of urinary affections, hepatic congestion and intestinal catarrh. seeds possess demulcent, diuretic, vermifuge, nutritive, aphrodisiac and anthelmintic properties. They paralyse tape worm and round worm incats. Citrullin and arginine are thought to in crease urea production in the liver, thus increasing the flow of urine. The ripe fruit pulp is nutritious, cooling and refreshing and is eaten as a delicious fruit all over the world to relieve thirst (Medicinal Plants of Bangladesh, Second Edition, Abdul Ghani, 116).