Correlation of inter canine width with vertical facial morphology in patients seeking orthodontic treatment

It is generally accepted that an important relationship exists between the arch width and vertical facial morphology. The size and form of the dental arches can have considerable implications on or-thodontic diagnosis and treatment planning. The objective of this study was to determine relationship between inter canine width and vertical facial morphology in a sample of patients seeking orthodontic treatment. This cross sectional comparative study was conducted at out patients department of Orthodontics, KRL Hospital, Islamabad from 11-03-2010 to 11-09-2010. 100 subjects were included in the study. 100 lateral cephalometric radiographs and dental casts were obtained, and traced. On lateral cephalograph, SN-MP angle was measured. On dental casts inter-canine widths were measured. When comparison was made between Inter-canine width with SN-MP angle, the p-value for all the results was significant with a p value <0.05. It was concluded from this study that there is a statistically significant relationship between inter canine widths and vertical facial morphology

GBS and AFP [acute flaccid paralysis] system in AJK

Main objective of the study is to highlight the major cause of AFP and% of GBS represents the AFP during the study period. Retrospective analytical study. This study was conducted in AJK, for the duration of three years from January 2011 to December 2013. Retrospective analysis of AFP cases reported during 2011-2013. Primarily the AFP cases investigated through history and clinical examination. Principal cause of AFP [Acute flaccid Paralysis] cases were investigated through specific tests like serum electrolytes, CSF [cerebrospinal fluid], electromyogram and viral culture from stool sample to exclude poliovirus. All the cases reported from AJK and taken on the line list labeling as GBS were included in the study during 2011-2013. Three years data analysis shows more than 50% GBS cases presenting AFP and the numbers are increasing every year. Most of the GBS and even AFP belong to 6-59 months age group. More than 55% GBS cases recover completely and this proportion increased from 2011-2013. Data analysis revealed GBS is a major cause of AFP in AJK and needs not to be overlooked to keep poliovirus transmission ceased here. AFP surveillance system is huge resource and this is a high time to study all the causes responsible for acute flaccid paralysis to strengthen polio eradication efforts and to develop understanding for prevention and control, to avoid acute flaccid paralysis related morbidity and mortality amongst children in Pakistan

Evaluation of AFP surveillance sensitivity in AJK

Main objective of the study is to analyse sensitivity of the surveillance system, required to keep poliovirus circulation ceased in AJK. Retrospective analysis of AFP cases reported during the study period. This study included all the AFP cases reported during the study period in AJK from Jan. 2011 to Dec. 2013. Historical data is used to analyse AFP surveillance for detecting poliovirus infection in children age <15 years in the study area based on few assumptions that all the results are negative and adequate information were available to make ultimate diagnosis of each AFP case reported in the area during study period. Surveillance sensitivity analysed using AFP surveillance criteria recommended by WHO and variable used in AFP surveillance system. Surveillance sensitivity is analysed based on two indicators "non polio AFP rate" and stool adequacy. Sensitivity level analysed in AFP cases aged 6-59 months for >/= 7 OPV doses including routine and SIAs revealed 6/10 districts have high sensitivity. Long absence of Polio virus in the area, creeping up of boredom among health human resource, Clinician's failure to notify all AFP cases resulting in down going Surveillance sensitivity

Diabetics and their diseases, what do they know? Assessing knowledge level among diabetic patients

Limb loss is one of the most devastating complications of Diabetes mellitus. Prevention is possible only with a well educated patient. We set out to assess patient education by physicians and foot care awareness in patients attending our DHQ Hospital. Descriptive study. This study was carried out at the DHQ Hospital, Mirpur, Azad Kashmir from 01.12.2012 to 30.03.2013. This was a descriptive study involving 311 patients attending DHQ Hospital, Mirpur, Azad Kashmir. The patients were chosen by convenience sampling. The patients could be either type 1 or type 2 diabetics. A total of 18 multiple-choice questions were used. Patients less than 40 years were excluded from the study. 314 patients were enrolled in the study. 37.62% of patients were aged 40 to 50 years. Females comprised 52.41% of the patients. 49.52% of patients were illiterate. About a third of patients [31.51%] visited their doctor weekly or fortnightly. A size-able number of patients [39.55%] had never or rarely been guided about life style changes by their doctors. 68.17% of patients had never or rarely been guided about diabetic complications. Only 23.15% patients were aware about foot care. Pearson Chi-Square values were highly significant P<0.0001 for education and foot care awareness. Patient education by physicians is almost non-existent in Pakistan and needs to be improved. Improving literacy will improve patient foot care awareness

Assessment of psychosocial impact of dental aesthetics and self perceived orthodontic treatment need in young adults

The aim of this study was to assess the psychosocial impact of dental aesthetics using the 'Psychosocial Impact of Dental Aesthetics Questionnaire' [PIDAQ] and self-rated Aesthetic Component [AC] of the Index of Orthodontic Treatment Need [IOTN], and individual attitude to own teeth and general appearance. The cross sectional study was conducted among the students of Margalla Institute of Health Sciences [MIHS], Rawalpindi with age ranging from 18-25 years. Students were asked to complete a 'Psychosocial Impact of Dental Aesthetic Questionnaire' [PIDAQ]. Total of five variables 'Dental self-confidence, Social impact, psychosocial impact, Aesthetic concern and Patients Beliefs were evaluated by series of questions, and Dental Aesthetics was assessed by using of IOTN Aesthetic Component. The Kruskal-Wallis test was applied to determine differences between the mean scores for all the subject groups [1 to 4+]. Chi square test was performed for patient beliefs. All the five variables showed significant correlation with perceived severity of malocclusion with p-value of less than 0.01. The association between self-rated IOTN-AC grading and psychosocial well-being was established, signifying that the self-perceived aesthetics may be a significant factor in defining treatment need as the degree of malocclusion itself

effect of vertical skeletal pattern in the buccal corridor area show during posed smile

Emergence of soft tissue paradigm in clinical orthodontics has made smile analysis and designing key elements in treatment planning. Smile is an integral constituent of the facial attractiveness of a person. Various factors influence smile. The smile frame work is influenced by gingival display during smiling, incisors display and the buccal corridor space. Buccal corridor area show according to many influences smile immensely. Lateral cephalograms were taken with patient's Frankfort Horizontal plane parallel to the floor, unstrained lips and teeth in centric occlusion. Radiographs were traced. Ratio between lower anterior facial heights to total anterior facial heights were recorded on the patient's data form to establish the vertical skeletal relationship of the patients. This ratio was correlated with the increased or decreased buccal corridor show during posed smile by applying the Pearson correlation coefficient. Data was analyzed on statistical package for social sciences [SPSS version 10]. Descriptive statistics were used. Mean +/- S.D was calculated for age [in years], vertical skeletal pattern value and the buccal corridor area of subjects. The range of ratio of lower anterior facial height to total anterior facial height [in degrees] was 48[degree sign] to 67[degree sign] with a mean of 56.357[degree sign] and standard deviation of 3.59[degree sign]. The relationship of ratio of lower anterior facial height to total anterior facial height [in degrees] with buccal corridor area show [mm] was significant [P-value < 0.05]. The results show that as ratio of lower anterior facial height to total anterior facial height [in degrees] increases the mean buccal corridor area show decreases. Factors effecting buccal corridor area show must be kept in mind since it has an influence in the outcome of treatment. It is paramount to do so since most patients assess the outcome of their treatment by the attractiveness of their smile

Social barriers towards orthodontic treatment need

In the recent past, though number of patients requiring orthodontic treatment has significantly increased but at the same time parents / patients have certain social constraints such as age, gender bias, poor socio-economic status, nature of job, importance of orthodontic treatment need, treatment time, number of dental surgery visits, associated pain and discomfort, aesthetics during treatment, extraction need and orthognathic surgery need, which refrain parents / patients from undergoing orthodontic treatment and at times considerable counseling is needed. Aim of this study was to find out the common barriers towards orthodontic treatment. A total of 250 physically and mentally healthy participants' age 18-45 years were included in this study. These patients filled a consent form and a valid questionnaire identifying barriers towards orthodontic treatment. SPSS 17.0 was used for statistical evaluation. It was inferred from the results that in third world countries like Pakistan specially in private setup medical / dental institutions, major constrains towards orthodontic treatment were poor socioeconomic status, nature of job not allowing repeated visits / long duration, long duration in case of females due to marriage age, extraction need and orthognatic surgery need

Effect of inter-premolar width on buccal corridor area show during posed smile

Orthodontic diagnosis and treatment planning is in a period of remarkable change, away from a previous focus on dental occlusion and hard tissue relationship and towards a greater emphasis on soft tissue adaptation and proportions. The re-emergence of the soft tissue paradigm in clinical orthodontics has made smile analysis and designing, key elements in treatment planning. Hence the purpose of this study was to establish the correlation between one of the many variables effecting smile; the inter-premolar width with the buccal corridor area show of a patient during posed smile. 147 dental casts and frontal photographs were obtained and measured for the inter-premolar width and buccal corridor area show. SPSS version 10 was used to calculate mean and SD for age [in years], inter-premolar width and the inter-commissure width of subjects. Frequencies and percentages were calculated for gender. Pearson correlation coefficient was determined for the inter-premolar width with the buccal corridor area show. r value was determined between -1.0 and +1.0The p value for inter-premolar width and buccal corridor area show during posed smile was < 0.05 being significant. It was concluded from the study that there is a statistically significant relationship between inter-premolar width and the buccal corridor area show during posed smile

Correlation of overjet, ANB and wits appraisal for assessment of sagittal skeletal relationship

The purpose of this study was to determine the sagittal skeletal relationship through overjet and its reliability in determining skeletal relationship by correlating it with ANB angle and Wits appraisal in Angle's class I, class II division I and class III malocclusion groups in a tertiary care hospital sample. On clinical examination overjet was measured with the teeth in centric occlusion. Lateral cephalograph was taken to measure the ANB angle and Wits appraisal. The correlational analysis of overjet with ANB angle in the three malocclusion classes showed, that there was a weak correlation of overjet with ANB angle in class III group with "r" value of 0.444 whereas P value showed statistical significance [P-value < 0.05]. The correlation of ANB angle in the other two malocclusion classes was weak as well as statistically insignificant i.e in class I [r = 0.106, P-value > 0.05] and in class II division I [r = -0.187, P-value > 0.05]. The correlation between overjet and Wits appraisal in class III was strong and statistically significant with the "r" value of 0.605 and P-value < 0.05. The results of correlational analysis showed that there was a weak correlation between overjet and Wits appraisal in class I and class II division I [r = 0.317 and 0.398 respectively], whereas class I correlation was statistically insignificant [P-value > 0.05] and class II division I was significant [P-value < 0.05]. This study concluded that overjet is a good predictor for sagittal skeletal relationship only in class III malocclusion

correlation between lower incisor crowding and arch length discrepancy [ALD]

The estimation of tooth size arch length [TSALD] is an important part of treatment planning in orthodontics. This procedure involves considerable time and efforts on the part of a busy clinician. The purpose of this study was to device a new method of predicting the tooth size arch length discrepancy of dental arches at chair without thorough and cumbersome procedure of measuring all teeth from mesial of the first molar to mesial of the contra lateral. Lower incisors were chosen as a standard to assess arch length discrepancy. The study was carried out on 100 patient's casts comprising of 43 males and 57 females. Mean age of patients was 21 years. All sample selected had a permanent set of dentition with a class one molar relation and incisor crowding. The correlation between lower incisor crowding and arch length discrepancy was calculated. The results indicated that there was a moderate correlation between TSALD in lower arch. The correlation coefficient was calculated as 0.673. There was no correlation between lower incisor crowding and upper arch length discrepancy shown by a value of 0.264. Further, chi square test was applied to find an association between the two values [LIC and lower ALD] which showed a p value of 0.00, indicative of strong association. The study suggests that there is a correlation LIC and ALD which further necessitates research in this area to quantify the correlation

cephalometric measurement of "L1-apo distance" in a Pakistani sample

Knowledge of the normal dentofacial patterns of various ethnic groups is important for clinical and research purposes. The objective of this study was to measure the norm for the "L1-APo distance" in a hospital based Pakistani sample. The obtained data was also compared with the already existing White American mean of the "L1-APo distance". It was a descriptive cross sectional study which was carried out in KRL Hospital; Islamabad.100 lateral cephalometric radiographs [50 females and 50 males] were obtained and traced for the above mentioned measurement. The database was developed in SPSS 10.0 for windows. Results showed that subjects in the present sample have more labial inclination of the lower incisors over the basal bone as compared to the White Americans. [p value .00] And the females of the sample have slightly more labial inclination as compared to the males although this difference is not significant. [p value .083]

Patient perception regarding impact of orthodontic treatment

The objective of this study was to assess the orthodontic treatment need and outcome expectations among patients and to assess whether their expectations were realistic or unrealistic. A total of 200 physically and mentally healthy participants age 12-30 years were included in this study. These patients filled a consent form and valid questionnaire measure of orthodontic treatment need and outcome expectations. SPSS 17.0 was used for statistical evaluation. It was concluded that Patients perception regarding orthodontic treatment need varies from no treatment [4%] need to strong treatment need [18.5%]. Majority of the patients [60%] however felt significant treatment is needed. 56.6% patients themselves were concerned about their self being and felt that orthodontic treatment would improve their dento-facial concerns while 49.5% patients felt treatment need necessary but pressures from society was additional reason. 3% surly have unachievable aesthetic expectations from treatment. Out of 31.5% patients who wanted sufficiently good treatment at the end of treatment 10% were unattainable. 7%patients had unrealistic expectations, 33%patients had realistic expectations but were demanding while 60% patients had realistic expectations from treatment

Periodontal status of patients seeking orthodontic treatment at the orthodontics department, de,montmorency college of dentistry, Lahore

The aim of the present study was to determine the periodontal status of patients seeking orthodontic treatment. One hundred patients with an age range of 12-25 years and having a full complement of permanent dentition, reporting to the orthodontics department were selected. Patients having major medical problems, history of having antibiotics, orthodontic treatment and smoking were excluded

Community Periodontal Index was used to assess the periodontal status of these patients. From these 100 patients, Data was analyzed by using SPSS [Version 8.0] in personal computer. Results showed that gingival bleeding was the main presentation of the patients who reported to the orthodontics department to seek treatment, followed by calculus

Outcome of surgery of congenital heart disease at AFIC/NIHD, Rawalpindi, Pakistan in year 2000

Surgery of congenital heart disease is palliative as well as curative and outcome of this surgery depends upon nature and gravity of lesion, facilities of operation theatre, expertise of surgeons, anesthetists and paramedical staff, postoperative intensive care, prediction and timely management of post operative complications. A non randomized, non experimental study was carried out to analyze the postoperative complications of congenital cardiac surgeries at AFIC/NIHD Rawalpindi. All children up to 12 years of age undergoing operative procedures of their congenital cardiac lesions in year 2000 were followed up for complications. There were total 202 surgeries up to 12 years of age in year 2000. Overall mortality rate was 10.3%, being maximum of total correction [25%] and minimum for ASD closure and pulmonary volvotomy [0%]. Mortalities of other surgeries were; B-T shunt 16%, mitral valve replacement 16%, PA banding 14%,VSD closure 11.3% and PDA ligation 2.2%. Regarding etiology of these mortalities RV failure complicated by fluid retention and deranged hemodynamics for total correction, shunt block for B-T shunt, respiratory infection superimposed by compromised heart for PA banding and aspiration pneumonia for PDA ligation. Out of these mortalities about 75% were due to surgeries of registrar surgeons. This rate may be reduced by more experience and formulating structured training. Thorough evaluation revealed that scrupulous preoperative assesment by echocardiography, screening tests for sepsis, surgery in expert hands, meticulous cardiac anesthetic care, prediction and urgent treatment of post operative complications, intensive postoperative, management and regular follow-up with clinical and echocardiographic evaluation can reduce the incidence of mortality and morbidity from these operations

ASD with skeletal deformities: a case of holt oram syndrome

Congenital heart diseases are often associated with skeletal deformities. When the later involves the upper limbs, the diagnosis of Holt Oram syndrome is made. We had this patient who was late to present and had already developed severe pulmonary hypertension

Post-operative pain relief by stadol using patient controlled analgesia [PCA] Comparison with pethidine

Patient controlled analgesia [PCA] is a useful technique of administering analgesic drugs as far as haemodynamic stability and conscious level is concerned. Stadol group had lower pain scorings and decrease in heart rate five minutes after all the top up doses,. Pain relief with pethidine was irregular and there was persistent increase in heart rate five minutes following 2nd 3rd and 4th dose. High pain scores for 4-5 hours post-operatively suggest either the patients were prepared to tolerate the pain and demand analgesia only with severe pain or the patient did not understand the scale for measuring pain because of their education level and social status which were not evaluated in this study. It seems as if visual analogue scale has its limitations