Skeletal class II has always been a challenge in orthodontics and often needs assistance of surgical orthodontics in nongrowing patients when it presents with severe discrepancy. Difficulty increases more when vertical dysplasia is also associated with sagittal discrepancy. The advent of mini implants in orthodontics has broadened the spectrum of camouflage treatment. This case report presents a 16-year-old nongrowing girl with severe class II because of retrognathic mandible, and anterior dentoalveolar protrusion sagittally and vertically resulted in severe overjet of 13 mm and excessive display of incisors and gums. Both maxillary central incisors were trimmed by dental practitioner few years back to reduce visibility. Treatment involved use of micro implant for retraction and intrusion of anterior maxillary dentoalveolar segment while lower incisors were proclined to obtain normal overjet, and overbite and pleasing soft tissue profile. Smile esthetics was further improved with composite restoration of incisal edges of both central incisors.
Melioidosis is caused by the gram-negative bacillus, Burkholderia pseudomallei. It is endemic in tropical Australia and in Southeast Asian countries. The overall mortality from this infection remains extremely high despite recent advancement in its treatment. This review discuss about clinical manifestations, diagnosis and management of melioidosis.
BACKGROUND: In primary health care centres, upper respiratory tract infections (URTIs) in children are commonly encountered by physicians. Viruses cause most URTIs, but parents' attitudes often represent an important reason for antibiotic abuse, which leads to the development and spread of antimicrobial resistance. The goal of this study was to examine parents' knowledge, attitudes, and practices (KAP) about antibiotic use for children with URTIs in Palestine.
METHODS: A cross-sectional study was performed in primary health care centres in Nablus city from 1 June to 31 October 2012. A questionnaire was developed and administered to determine parents' KAP regarding antibiotic use for their children with URTIs.
RESULTS: Three hundred and eighty-five parents completed the questionnaire. A total of 79.7% of the parents were attentive to the truth that antibiotic misuse is responsible for bacterial resistance. Only 18.9% of parents thought that antibiotics did not have any harmful side effects. Fifty nine per cent of parents did not agree that URTIs are mostly viral in origin and are self-limited. Almost 73% of parents choose antibiotics as a treatment for URTIs, while earache (68%) and fever (64%) were the most common reasons for which parents expected antibiotics. However, more than 38% of the parents never asked the paediatrician to prescribe antibiotics, and only 6% congratulated their paediatricians for not prescribing antibiotics.
CONCLUSIONS: Although there is a trusted relationship between parents and paediatricians, Palestinian parents have insufficient knowledge related to antibiotic use for URTIs in children, which results in inappropriate attitudes and practices. Educational interventions for both parents and physicians will reduce unnecessary antibiotic use and resistance.