Diagnosis of hypertension on the basis of four temperament theory of avicenna in al-qanoonft al-tibb

According to WHO in Pakistan above about 150,000 people suffer from cardiac diseases, in 2002 and hypertension is top of the list. Developing country like Pakistan faces sever social, economical and psychological burden as shown in Table 1. Human get affected by its psychology, diet and environment which become source of his health or disease. The Canon of Medicine [Arabic: Al-Qanun fi al-Tibb] is an encyclopedia of medicine in five books compiled by Ibn Sina [Avicenna] and completed in 1025. It presents a clear and organized summary of all the medical knowledge of the time. The Canon of Medicine is based upon the Four Humors of Hippocratic medicine, but refined in various ways. There are four major groups of causes which are responsible in hypertension increase in dryness, hotness, moistness and coldness. When we apply the laws of nature to inhibit the cause like nature do we can hypertension and get cure. Nature always treat the dryness [Autumn/Spring] with hotness [summer], hotness with moistness [Rain], moistness with coldness [winter] and coldness with dryness in the form of seasons. There are specific character of each temperament. In present study patients [n=40] randomly selected in Outpatient Department of Shifa-ul-Mulk Memorial Hospital at Hamdard University, Karachi, Pakistan. These patient according to their temperaments classified according to their temprament. The most common temperament in hypertensive patients was atrabilious [Dry] followed by phlegmatic [Cold and Moist]?

Construction faults associated with complete dentures made by clinical students

Objective: The objective of this study was to evaluate the construction faults associated with complete dentures made by clinical students

Study Design: Descriptive / cross-sectional study

Place and Duration of Study: This study was conducted at Prosthodontics; Department Institute of Dentistry; Liaquat University of Medical and Health Sciences Jamshoro from May 2015 to October 2015

Materials and Methods: Total 197 complete denture wearer's patients were recruited in this study. Faults associated with vertical dimension, centric relation, denture base thickness, finishing and polishing were examined and noted in proforma. Data was analyzed by SPSS version 17.0

Results: Out of 197 patients male and female patients were 56.3% and 43.7% respectively. Vertical dimension was found to be high in 82% patients and centric relation was noted 81% as right and 19% as wrong. According to thickness of denture base plate, 80% were thick and 5% were thin denture base. According to finishing and polishing of dentures, 55% dentures were seen with satisfactory results

Conclusion: It is concluded that the most common faults in construction of complete dentures were high vertical dimension, thick denture base plates and finishing and polishing

Prevalence and susceptibility pattern of methicillin resistant staphylococcus aureus [MRSA]

To determine the prevalence and susceptibility pattern of MRSA isolated at a single tertiary care hospital at Rawalpindi and to compare MRSA susceptibility pattern with MSSA [Methicillin sensitive Staphylococcus aureus]. Descriptive cross sectional data based study. The study was conducted at department of microbiology, Pakistan Railways Hospital Rawalpindi, from January 2012 to March 2014. Culture reports data were retrospectively collected from microbiology laboratory. The antibiotic susceptibility patterns of all staphylococcal strains were determined by modified Kirby Bauer antibiotic sensitivity method. The data was analyzed on the basis of antimicrobial susceptibility pattern, location of the patient [OPD, ward patients] and specimen type [wound swab, pus, HVS and effusions]. A total of 167 isolates were used in the study. Among these isolates 55 [33%] were MRSA and 112 [67%] were MSSA. The majority of S.aureus isolates were obtained from patients with skin and soft tissue infections. All [100%] strains of MRSA isolated during study period were found to be sensitive to Vancomycin, and linezolid and 95% to Teicoplanin, as well as they showed higher susceptibility against chloramphenicol [88%],Fusidic acid [70%] and Rifampin [48%] while MSSA showed higher susceptibility to Gentamicin [92%],Erythromycin [86%] and Ciprofloxacin [71%] as compared to MRSA. This study showed a high prevalence of MRSA in this tertiary care hospital of Rawalpindi. Present study conclusively shows that Vancomycin, Linezolid and Teicoplanin remain the first choice of treatment for MRSA infections. Still alternative antibiotics like chloramphenicol, Fusidic acid, and Rifampin are available to maintain and reserve the efficacy of Vancomycin, Teicoplanin and Linezolid in treating life threatening illnesses

Dental caries among the patients visiting out patient department of liaquat medical uinversity Hospital, Hyderabad - Sindh

The objective of this study was to find out the prevalence of dental caries and DMFT score among the patients visiting out-patient department ofLiaquat Medical University Hospital. This was cross sectional study conducted at the Liaquat Medical University Hospital. The minimum sample size calculated was 278. Oral examination was carried out using mouth mirror and a blunt ball-ended probe on the dental chair using artificial light. The results showed that there were 57.2% male and 42.8% female. The prevalence of dental caries was 60.4%.The mean DMFT score was 2.10 with Standard Deviation 2.11. 59.5% caries was present in male and 40.5% caries was present in female, the male patients were more affected than female showed insignificant results. Male and female patients had mean DMFT score 1.26 with a Standard Deviation [SD] 0.449 and 1.39 with a Standard Deviation [SD] 0.493 respectively. It was concluded that the prevalence of dental caries and DMFT score is higher in the selected study population so for prevention and control of dental caries continuing dental health education programs should be emphasized for general population as a whole

Plaque score and gingival health status among 6-12 years old children in hyderabad division

The objective of this study was to evaluate the plaque score and gingival health status among 6-12 years old school children. This cross sectional study was done from 15th July to 10th August 2014 among the students of Matiari [Rural Area] and Hirabad Hyderabad [Urban Area]. Schools were selected on convenient basis. Age ranged from six to twelve years and only boys were included in the study. All clinical dental examinations were conducted in schools with mouth mirror and explorer in the day light. Plaque index and gingival index developed by Loe and Silness were used for each student to record the plaque score and gingival condition. The plaque disclosing tablet [Eviplac Pastilhas; Biodinamicas TM], was used to identify the plaque score. All the students were asked about routine oral hygiene procedures. Data were analyzed in statistical package for social sciences [SPSS] version 16. Quantitative variables are presented in percentages. Mean and standard deviations were computed for qualitative variables. Chi-square test and independent sample t-test were applied to see the significant association. Total one hundred seventy six school children were included in this study; ninety six were from rural area and eighty from urban area. The mean age was 15.85 +/- 7.773. The gingivitis was seen in 80.7% students. Gingivitis was more in the rural children than from urban areas which was statistically not significant. The mean plaque score was 39.63 +/- 19.15 in present study. The independent sample T-test analysis revealed no significant difference between rural and urban students. Gum bleeding was more common in rural school students which is statistically significant. It is concluded that there was a higher gingival inflammation in present study population. Urban students had good gingival condition and low mean plaque score than rural students. Mild type of gingivitis was more common in rural students

Dissection of ascending aorta after aortic valve replacement and reduction Aortoplasty

A case of Debakey type-II [Stanford type-A] dissecting aortic aneurysm, after aortic valve replacement and reduction aortoplasty, is reported. The patient was 35 years male who was diagnosed of severe aortic regurgitation along with aortic root dilatation of 7 cm. He underwent aortic valve replacement with 27-A St Jude's mechanical aortic valve along with reduction aortoplasty. Nine months later, he was admitted to our hospital with complaint of severe sudden anterior chest pain. Computed tomography with aortic enhancement showed dilatation and dissection of ascending aorta. Successful operation of aortic root replacement with composite graft was performed and patient was discharged without any postoperative complication. The aortic diameter at the time of aortic valve replacement is an independent risk factor for the late aortic dissection

Orthodontic treatment needs among population visiting the liaquat university of medical and health sciences hospital

This study was to determine the orthodontic treatment need in local population visiting the Liaquat University of Medical and Health Sciences Hospital by using index of orthodontic treatment need. Descriptive cross sectional study. This study was conducted on patients visiting to Dental outpatient department [OPD] of Liaquat University of Medical and Health Sciences Hospital, Jamshoro from September 2012 to October 2013. Informed written consent was taken from 150 patients' satisfying the inclusion criteria,history and clinical examination was done on patients by using index of orthodontic treatment need. SPSS version 19 was used to analyze the data and frequency was determined for categorical variables. Mean and standard deviation was computed for numerical variables. According to Dental Health Component [DHC] treatment need 36.7%, 34.7%, 24.7% and 4.0% found to have orthodontic treatment need from no little treatment to very great treatment respectively and according to Aesthetic Component [AC] treatment need 49.3%, 44.0% and 6.7% found to have orthodontic treatment need from no little treatment to great treatment need. It was concluded that the patients of this locality found to have increased need for orthodontic treatment

Assessment of efficacy of different home prophylactic plaque control methods in orthodontic patients

OBJECTIVE: The objective of the study is to determine the efficacy of different home prophylactic plaque control methods in patients undergoing orthodontic treatment

MATERIAL AND METHODS: A cross sectional study was conducted at the Department of Orthodontics, Liaquat University of Medical and Health Sciences, Jamshoro and private orthodontic clinics in Hyderabad

The patients fulfilling the inclusion criteria were asked to chew the plaque disclosing tablet [EviplacPastilhas], swish it for 30 seconds, then asked to spit out and asked to wash once with drinking water, plaque score was calculated by using Turesky Modification of Quigley Hein plaque index. Selected patients were given a self-administered questionnaire regarding mechanical means of plaque control

RESULTS: In this study 42% were male and 58% females. The mean age was 19.1 + 2.47 years

The mean plaque score was 4.29+ 1.58 in this study. 62.9% patients were using regular tooth brush and 34.3% were using orthodontic tooth brush. 18.8%, 6.9%, and 3.7% patients were using inter-dental brush, tooth picks and dental floss respectively

The analysis of variance [ANOVA] test revealed no significant differences in different type of brush

CONCLUSION: It is concluded that majority of orthodontic patients were cleaning their teeth either with orthodontic brush or regular tooth brush and very few patients were using interdental aids to control plaque. Both regular and orthodontic brushes were effective in controlling plaque with is statistically insignificant difference

Evaluation of pain after administration of local anesthesia with and without medication [midazolam] in irreversible pulpitis in a sample of Sindh

The objective was to evaluate pain experience of the patient after administration of local anesthesia in symptomatic irreversible pulpitis with and without pre-medication Patients were diagnosed after taking medical and dental history, clinical examination, thermal tests and by taking radio-graphs. One hundred patients formed the study group. They were divided into two groups of fifty each, Group-A patients were given oral medication [Midazolan, Dormicum 7.5mg] and inferior dental nerve Block, while Group-B patients were given only Inferior Alveolar Nerve [IAN] Block [1.8 ml cartridge-1:100000 epinephrine] of Xylestesin-S [ESPE-Germany] without any pre-medication. Pre-operative pain of patients of both groups was recorded on Visual Analogue Scale [VAS] i.e: 0= no pain, 10 = most severe pain. [VAS 0>10] Group-A patients were given anesthesia 45 minutes after pre medication while Group-B, patients were treated routinely after administrating inferior dental nerve Block block. In group A [40% showed no pain, 44% mild pain, 12% moderate pain and 4% suffered severe pain n=50] while in group B [20% showed no pain, 50% mild pain, 20% moderate pain and 10% suffered from severe pain after the procedure was done. It was concluded that the patients who had received sedation, prior to anesthesia showed better results

Oral Hygiene Habits Among 6-12 Year Religious School Students

Objective: To assess the knowledge, attitude and practices for oral hygiene habits among 6-12 years religious school students Study Design: Cross sectional study. Place and Duration of Stud: This study was carried out at the Department of Community Dentistry, LUMHS, l Jamshoro from 15 July to 10 August 2014. Materials and Methods: Cross sectional research was conducted among the religious students of Madarsa Jamia Ghousia Taheria Matiari [Rural Area] and Mumtaz ul Madaris Hirabad Hyderabad [Urban Area]. Madrasas were selected on convenient bases. Religious students between age group 6-12 year male only were included in the study. All the students were asked the questions from self-administered questionnaire and were ticked the answers. Data were analyzed in statistical package for social sciences [SPSS] version 16. Results: Majority of religious students from rural and urban areas were cleaning their teeth once a day. 36% from rural and 28% from urban areas reported for miswak [chewing stick] followed by tooth brush and tooth powder, no one was using dental floss. 59% reported for occasionally usage of miswak at the time of ablution [wadoo]. Only 10% religious students were rinsing their mouth after meal. 65% religious students were complaining of bad smell. Conclusion: it is concluded that oral health knowledge, attitude and practices [KAP] among study participants were poor and needs to be improved

Impact of chewing Khat on the mode of delivery of Yemeni pregnant women

Khat chewing is common among Yemeni women, even during pregnancy where it may affect the wellbeing during pregnancy and during delivery of these pregnant women. This study was conducted to determine the impact of Khat chewing on the mode of delivery of pregnant Yemeni women. This is a prospective study for 60 regular Khat chewing pregnant women and 120 non-Khat chewing pregnant women, selected from those attended with singleton pregnancy in their first or second trimester from the ANC unit of AL-Gamhouri Teaching Hospital in Taiz [Republic of Yemen]. Khat chewer pregnant women, when compared with the control, showed statistically significant risk of 6.06 times to deliver at gestational age earlier than 37 weeks and insignificant risk of 2.27 times to deliver after 42 weeks. They showed a statistically significant risk of 2.65 times to deliver by cesarean section [CS] and insignificant risk of 4.86 times for instrumental delivery. This study concluded that Khat chewing is associated with higher rate of cesarean and instrumental deliveries that may affect maternal and fetal wellbeing

Risk factors in spreading odontogenic infection

Spreading odontogenic infection is the extension of infection from its original site and can create potential life threatening situations. There are several risk factor reported for spreading odontogenic infection in literature including systemic health, virulence of organism and anatomical site. Apart from these factors odentogenic infection also observed in normal individuals. The objective of this study is to identify Risk factors in spreading odontogenic infection. Descriptive Case Series Study. This study was conducted in Department of Oral and Maxillofacial Surgery, Institute of Dentistry, LUMHS from January 2011 to February 2012. A descriptive case series study on 60 patients of spreading odontogenic infection was conducted. Male female ratio was 2.3:1, 2[nd] and 3[rd] decade was common presentation. The most frequent clinical findings were pain, swelling, trimus. The Buccal space was the most frequent location for a single space infection [53.3%], followed by Submandibular space [35%], Canine space [5%]. Three patients presented with multi space involvement [6.6%]. The most common involved tooth was mandibular third molar 26 [43.3%].The most common cause of the infection was periapical infection followed by pericronitis. 83.3% patient were healthy patients with no co morbid, only 16.7% patients were with co morbid like DM, hypertension and pregnancy. There was also no difference for mean WBC count. This study shows that lower molars were the most common involved teeth and buccal space was frequent space to be involved. The site of infection is important risk factors. We observed Odentognic infection in common in healthy individual than non-healthy individuals

Prevention of alveolar osteitis in surgical removal of lower third molar

The purpose of this study was to evaluate and compare the efficacy of chlorhexidine [CHX] and amoxicillin plus clavulanic acid combination with control and Chlorhexidine CHX rinse alone for prevention of alveolar ostitis following the extraction of mandibular third molar. This clinical double blind randomized control trial was carried out in the Department of Oral and Maxillofacial Surgery at Liaquat University Hospital, Hyderabad for a period of two years from February 2008 to December 2009. A total of 214 patients were included in the study using non- probability purposive sampling technique. Informed consent was taken for participation in study and all treatment options, risks, benefits and complications were discussed before any intervention. The study was approved by university ethical review committee. All the patients were randomly divided into three groups by using random number table. After written informed consent extraction of 3[rd] mandibular molar was performed. Group 1 rinsed with 15 ml of 0.2% Chlorhexidine solution for 30 seconds twice daily for seven days. Group 2 patients in addition to 0.2% Chlorhexidine solution were prescribed Augmentin [amoxicillin trihydrate 500 mg plus, clavulanic acid [125 mg]] twice daily for 7 days. The patients of Group 3 used normal saline solution [0.09% NaCl]. Patients were scheduled on third and seventh day postoperatively for postoperative follow-up and were evaluated for the presence or absence of alveolar osteitis. The diagnosis of alveolar osteitis was made on the basis of collaborative clinical and subjective findings. The results of this study showed significant reduction in the incidence of alveolar osteitis in patients who received 0.2% CHX rinse in combination with oral amoxicillin and clavulanic acid

Crown fractures: frequency and associated causative factors among school children in district Khairpur-Sindh

In dentistry, crown fracture [CF] is a constant source of concern, hence in order to recommend suitable preventive measures it is essential to recognize its etiological factors beside its frequency and characteristics. The purpose of this study is to identify causative factors and treatment needs of Crown Fracture among school going children. This study was conducted from October 2010 to December 2010 to record the cause of dental trauma in relation to age and gender of school going children in rural areas of Sind province. The population in this study was 9-18 years old attending primary and higher secondary school students studying in 9 public and 4 private schools in district Khairpur. Crown Fracture ranging from normal crown to fractured crown involving pulp was observed. Root fracture was not recorded as no radiographs were taken, trauma reasons were asked and treatment taken or not was recorded. SPSS version 16 was used to analyze the available qualitative variables for results. Chi square test was used for testing the statistical differences between cause of crown fractures in relation to gender and age. Most common cause of coronal trauma was recorded as fall followed by road traffic accident, assault and sports related injury 51.3%, 15.7%, 13.1% and 6.5% respectively. Risk factors of CF almost identical as cited in dental literature by majority of authors

assessment of maxillofacial gunshot injuries and emergency management

Firearm injuries constitute a major challenging problem in maxillofacial surgery, causing major deformities of human body, and financial Burden to our society. Violent crimes are the major cause. Unemployed youth and socioeconomic deprivations are factors which contribute towards violence. There are few important steps in management of head and neck gunshot injuries, obtaining an airway, control hemorrhage, recognizing additional injuries and finally definitive repair facial deformities. The objective of this study was to report the causes, and patterns of maxillofacial gunshot injuries. A retrospective assessment of patients treated for gunshot injuries at Mayo hospital Lahore from May 2007 to July 2009 and February 2010 to January 2011 at Liaquat University Hospital Hyderabad was conducted, and data was collected with special emphasis on the patient's demographics, mode of injury, initial airway management, and bone injuries The sample consisted of 120 patients. [78.3%] males, in third and fourth decade of age were the most common group, violent crime [62.5%] was the predominant cause, and mandible [58.3%] was the most common site of injury. From this Available information provided in this study, is concluded that violent crime was major cause of facial gunshot injuries. Male gender and young adults were the most commonly victimized patients

Evaluation of laboratory request forms for culture and sensitivity testing of pus specimen

To evaluate the awareness among health care professionals about the importance of various components of request form through their form completion behavior in a teaching hospital at Rawalpindi. Retrospective study. All lab request forms accompanying pus specimen for culture and sensitivity received in the laboratory of Islamic International Medical College Trust Pakistan Railways Hospital during the calendar year of 2010 were analyzed. A total of 525 Laboratory [Lab] Request forms for pus culture and sensitivity were received. These were analyzed for completion of all the provided information spaces. The results were entered in Microsoft access sheet and analyzed. Most of the specimens [55%] originated from Department of Gynecology and Obstetrics, followed by Departments of Surgery 23%, Orthopedics 11%, Pediatrics 2%, Medicine 1%, ICU and ER 1%, ENT 1%. Department was not mentioned in 6% forms. Most of these forms were signed by Post Graduate Trainees [44%], followed by Medical officers 18%, Consultants 11%, House Officers 9%, Ward Representatives 8%, Registrars 4% and signed without designation 1%. Five percent forms were received unsigned. In the Patient Identification part of the form Father / husband's name was written only in 38%. Patient's ward, bed number, age, gender and Registration No. were missing from 5.7%, 30.7%, 15.2%, 10.5% and 14% respectively. Although clinical notes were given in 90.3% but diagnosis was stated in 26.5% and history of antibiotic therapy only in 2,3% forms. Important information like site of pus collection and type of wound were missing from 20.4% and 27.6% of the forms. The type of test required was stated in 81% whereas the date was missing from vast majority [81.7%] of forms. The study indicates lack of awareness about the importance of components of Lab Request form among Health Professionals. Serious omissions are made even in patient identification information. The frequently neglected important parameters included history of antibiotic therapy, date of sample collection, and site of pus. The study highlights the need for attention to teaching and training laying emphasis on this issue and conducting CME lectures for both graduate and postgraduate levels

Qualitative analysis of sputum specimens submitted for acit fast bacilli [AFB] microscopy to a teaching hospital at Rawalpindi

To find out the quality of sputum specimens submitted for AFB microscopy, to categorize these specimens on the basis of their quality and to compare the frequency of AFB positive smears in each category of these specimens. Five hundred and seventy convenient sputum samples from patients referred for AFB microscopy of sputum were examine after Ziehi Neelsen staining. Based on Heinman and Radano's criteria for sputum, all the sputa under study were divided into sputum and non-sputum categories. The non-sputum category was sub-divided into saliva and mixed samples based on the ratio of pus cells and epithelial cells. All the smears for qualitative categorization and for AFB were examined by the qualified microbiologist. The frequency of AFB positive smears in each category was calculated. Out of 570 specimens submitted, only 110 [19%] were found to be sputum specimens, while 324 [57%] were saliva and 136 [24%] were declared as mixed. The frequency of AFB positive smears was the highest in samples categorized as sputum, 23.6% [26 out of 110] followed by mixed samples 7.35% [10 out of 136], and saliva 0.31% [1 out of 324]. The overall frequency of AFB positive smears was 6.49% [37 out of 570]. Quality of sputum specimen plays a major role in the detection of AFB from the sputum smears. As evident from this study, the frequency of AFB positive smears in the sputum was found to be much higher as compared to saliva and mixed samples

Peroperative transesophageal echocardiography: clinical benefit during cardiac surgery

To evaluate the benefit of peroperative Transesophageal echocardiography [TEE] during cardiac surgery. An observational analytic study. This study was carried out in the department of Cardiac Surgery Civil Hospital, Dow Medical College Karachi and Dow University of Health Sciences, from April 2001 to May 2007. In 385 patients undergoing cardiac surgery, preoperative transesophageal echocardiography was performed according to ASA guidelines. Category I in which TEE considered useful, and category 11 are those where TEE is potentially useful but indications are less clear. All TEE examination was reviewed by cardiologist and anesthesiologist. For each patient. the diagnostic decision making and patient care was assessed using three criteria 1] Change in medical therapy; 2] Change in surgical procedure; 3] Confirmation of suspected diagnosis. TEE had greater utility in category I than in category 11 indications 17/70 [25%] versus 57/315 [18%] respectively. The nature of the clinical benefit was as follows: modification of medical therapy in 23/74[31.08%], modification of planned surgical intervention in 49/74[66.2%]. confirmation of a diagnosis in 2/74 [2.70%]. The benefit on therapy was [23.3%] in valvular replacement. [12.6%] in coronary artery bypass surgery and [5%] in congenital heart disease and intracardiac tumors. present study validate the usefulness of the ASA practice guidelines, demonstrating a greater benefit of TEE on clinical management for category I indications than for category II. The TEE was more useful in diagnostic decision making in valvular replacement rather than other procedures

Fluoroscopy guided instillation therapy in chyluria using combination of povidone iodine with contrast agent: is a single instillation sufficient?

PURPOSE: To evaluate the safety and efficacy of a single instillation in a combination of povidone iodine with contrast agent under fluoroscopy guidance for the treatment of chyluria. MATERIALS AND METHODS: From December 1999 to July 2006 a total of 40 patients with chyluria were treated by renal pelvic instillation therapy (RPIS). The sclerosing solution was prepared using povidone iodine with contrast agent diluted with sterile water in a ratio of 1:1:3. It was instilled on the side having chylous efflux using a bulb tip ureteric catheter. Unilateral instillation was done in 26 cases, 10 on the right side and 16 on left. Fourteen patients had bilateral chylous efflux and RPIS was performed on both sides in the same session. Fluoroscopy was used to evaluate the complete filling of the pelvic calyceal system. The sclerosing solution was kept in the system for 5 minutes and the ureteric catheter was then withdrawn. RESULTS: Immediate clearance was observed in 39 patients. Recurrence occurred in five patients. They were treated again using the same procedure with satisfactory results. The longest follow-up was five years and the shortest five months. CONCLUSION: RPIS of chyluria using a single instillation a combination of povidone iodine with contrast agent is safe and effective. Use of fluoroscopy helps to determine the exact amount of sclerosing solution required to completely fill the system and therefore overfilling is avoided. Moreover, the complications, which arise due to pyelointerstitial backflow, are prevented.