Acute necrotic hemorrhagic leukoencephalitis related to COVID-19: a report of 2 cases

Acute necrotic hemorrhagic leukoencephalitis (ANHLE) is a subform of acute disseminating leukoencephalitis which is a post viral or vaccination uncommon disease with poor prognosis. Radiological findings include multiple or diffuse lesions involving the white matter and sparing the cortex with or without rim enhancement. In addition to areas of hemorrhages with possible involvement of basal ganglia and thalami. We describe the imaging findings for 2 cases of ANHLE; a 59-years-old male and a 47-years-old female. Both of them were tested positive of SARS-COVID2 with presentation of consciousness loss and respiratory failure. CT and MRI brain show global white matter changes associated with acute hemorrhagic necrosis, although uncommon, are compatible with postviral acute necrotic hemorrhagic leukoencephalitis with end point of death for the first patient and coma for the second patient.

Approaches used to care for carious primary molars among pediatric dentists and general dental practitioners in Saudi Arabia

Background

The aim of this cross sectional study was (1) to identify and compare the approaches which are used to care for carious primary molars between pediatric dentists (PDs) and general dental practitioners (GDPs) in Saudi Arabia and (2) to evaluate the knowledge level of the most appropriate treatment decisions for both groups with regard to caries in primary molars and its relation with demographic variables.

Material and Methods

A random sample of 600 GDPs and all registered PDs (n = 100) in the Saudi dental society in 2016 were emailed a two part questionnaire; the first part included questions about demographic data and the second part investigated knowledge of the participants of the most appropriate treatment decision in four hypothetical case scenarios in which the severity of caries in a single primary first molar differed. Data were analyzed using chi square and ordinal logistic regression statistical tests. The significance was set at 0.05.

Results

The average knowledge score was 1.28 for GDPs and 1.80 for PDs. There were significant differences between both groups on their choice of the most appropriate treatment option in three out of four scenarios. Two factors significantly improved the participants’ knowledge; age and qualification (P<0.050.05). PDs were more interventionists, ready to perform pulpotomy and extraction in the absence of equally appropriate treatment options.

Conclusions

GDPs and PDs in Saudi Arabia had different treatment approaches of different carious conditions affecting primary molars. PDs had moderate but significantly better knowledge of the most appropriate treatment option than GDPs.

Key words:Dental caries, general dental practitioners, pediatric dentists, primary molars, treatment approaches.