Patterns and frequency of dental caries in primary teeth

Primary teeth play an important role in mastication, speech and occlusion of permanent dentition. Due to high prevalence of dental caries in primary teeth, it is essential to educate parents about prevention and management of dental caries of children. The objective of this study was to determine the pattern and prevalence of caries in primary teeth among children reporting to Khyber College of Dentistry, Peshawar. Total 900 children having age 4 to 7 years were includes in this study. Dental caries was assessed using sterilized mouth mirror and dental probe under dental chair light in primary teeth. The collected data were analysed in SPSS version 16.0. Percentages and frequencies were calculated for examined and affected teeth. Z-test was applied for statistical difference among girls and boys. P<0.05 was considered significant. Out of total of 900 children, 478[53.11%] affected by caries. The posterior teeth had greater prevalence of caries. In anterior teeth, central incisors[10%] followed by lateral incisors[8.09%] were affected by dental caries. Canine[3%] were least affected. In posterior teeth, second molars were affected more than first molars by caries. Girls were having less caries than boys.[p<0.05]

Work-related musculoskeletal disorders among dental practitioners in Khyber Pakhtunkhwa

The aim of this study was to determine the prevalence of musculoskeletal disorders among the dental professionals of the public and private sectors of Khyber Pakhtunkhwa. A standard questionnaire was circulated among 137 practicing dentists, including questions regarding age, gender, body mass index, clinical experience, posture during work, exercise and musculoskeletal disorders complaint. The data were analyzed using SPSS 17.0. The male to female ratio was 2.6:1. Majority of the dentists were in the age range of 25-34 years [51.1%]. Most of the dentists had a clinical experience of more than 10 years [48.2%], were working 5-6 hours daily and were practicing sitting dentistry [47.4%] and indirect vision [51.1%]. Musculoskeletal disorders were reported by 46.7% of the participants. The most common complaint was lower backache [57.8%] followed by neck ache [37.5%] and shoulder ache [29.6%]. There was a significant relationship between musculoskeletal disorders and the clinical experience of the dentist and the posture used. It was concluded that there was a high prevalence of musculoskeletal disorders in the area of study

Incidence of fourth canal in mandibular first molars - a study

The aim of this study was to assess the incidence of three and four root canals in mandibular first molars in our population. One hundred and fifty patients were recruited in this study. The data were obtained on specially designed proforma. The teeth were examined clinically and radiographically. Sixty three females and 87 males participated in this study. The age ranged from 15 to 63 years. 40% of lower first molars had four canals [two mesial and two distal] while remaining had three canals [two mesial and one distal]. The incidence of four canals in permanent mandibular first molars was relatively high in this study group

Radiological feature of hepatic cirrhosis hepatitis "c" in Pakistan our experience at department of radiology, services institute of medical sciences

Objects: to evaluate the accuracy of liver fibrosis stage by utilizing the techniques of advanced ultrasound performance in patients with chronic liver disease with Hepatitis C

Material and Method: this cross-sectional study was prospectively designed by including 101 consecutive patients with a diagnosis of chronic liver disease including liver cirrhosis between January and December 2010. The ultrasound score was determined from both hepatic lobes and the average scoring was calculated for liver edge, liver surface and liver parenchymal texture. A score of O was given when no abnormality was observed; score 1 for mild abnormality; score of 2 for moderate abnormality; and a score of 3 for severe abnormality. Scoring was given for a blunted edge and severe irregular surface or a highly coarse texture only when these characteristics were clearly confirmed by the low frequency probe

Results: out of 101 subjects, 63.4 % were male and 36.6 % were female with age range of.23-70 years [mean age 50.73 years SD+/- 10]. 17.8 % subjects were between age group 20-40 years, 67 .3 % between age group 41- 60 years and 14.9 % between 61 years and above. Mean duration of illness was 2.86 years [minimum 1 year and maximum 15 years]. Mean liver size was 12.261 with SD+ 2.7145. Mean portal vein size was 1.662 SD+ 2.3247. Mean spleen size was 71.71 SD+ 32.226. 62.4 % had splenomegaly, 66.3 % had ascites, 56.4 % had bruising and bleeding, 62.4% had varices. 20.8 % had sharp edge 48.5 % had mildly blunted edge and 30.7 % had blunt edge, '11.9% had smooth edge. 33.7% had mildly irregular edge, 39.6 % had irregular edge and 14.9 % had highly irregular edge. Regarding liver parenchymal structure 13.9 % had fine, 22.8 % had mildly coarse, 48.5 had coarse and 14.9 % had highly coarse liver parenchymal. structure.15.8 % of subjects had mild fibrosis [score 0-2], 55.4 % had moderate fibrosis [score 3-5], 28.7 % had severe fibrosis [score 6-8]

Conclusion: US scoring system is clinically useful for differentiating patients with minimal or no fibrosis from those with mild to severe fibrosis. This is also useful for prognostic information and determining the optimal therapeutic options during the follow-up of chronic liver disease

in vivo study to evaluate the efficacy of electronic apex locators in the determination of working length

The aim of this study was to determine whether the performance of electronic apex locators can equal or outdo the radiographic technique and establish itself as a standard baseline entity for the determination of working length. One hundred and seventy five canals of 84 patients were included in this study at the Department of Operative Dentistry, Khyber College of Dentistry for the preparation phase of root canal treatment. The canals were dried and the Joypex 5 apex locator was used to record the working length. The patients were sent for aperiapical radiograph and radiographic working length was calculated. Both values were recorded on specially designed proforma; the difference was noted and subjected to statistical analysis using a Paired-samples T test with a critical p-value of<0.05. Out of 175 canals measured, the radiographic working length coincided with the electronic working length in 101 [60.0%] cases. In 31 cases [17.7%], the electronic working length was short by 0.5mm and in 24 cases [13.7%,] the electronic working length was over by 0.5mm. In 7 cases [4%,] the electronic working length was short by 1mm and over by 1mm in 4 cases [2.3%]. In 2 cases each, the apex locator underestimated the working length by 2 and 3mm [1.1% each]. Overall, the difference between the working lengths measured by the two methods was statistically insignificant [p=0.294]. The difference between the two working lengths obtained was not significant [b=0.294,]. The apex locator was able to locate the apical foramen to within +/- 0.5mm in 91. 1% of the cases. However its solo application for determining working length is discouraged and must be used in tandem with conventional radiography

Effect of prophylactic amoxicillin on endodontic flare-up in teeth with asymptomatic, necrotic pulps and periradicular pathosis

The objective of this study was to compare the effect of prophylactic amoxicillin used and placebo in preventing endodontic flare-up in teeth with asymptomatic necrotic pulp and periradicular pathosis undergoing root canal treatment. The Quasi experimental study on 125 patients formed the study groups which was conducted at the Department of Operative Dentistry of Khyber College of Dentistry, Peshawar over a period of 10 months [10-09-2009 to 15-8-2010]. Patients were randomly divided in to two groups; experimental and control groups by selecting convenient sampling. Internationally recommended doses of prophylactic amoxicillin were given to patients in experimental group and placebo in control group one hour before the start of endodontic treatment. On the first visit complete biomechanical preparation was accomplished. Access cavity was sealed with zinc oxide eugenol. Five patients [4%] developed flare-up in experimental and six [4.80%] in control groups. The results demonstrated that 11/125 or 8.80% patients had developed flare-up. Data analysis revealed no significant differences between flare-up and non- flare- up patients for age, sex and tooth location. Prophylactic amoxicillin did not decrease frequency of the occurrence of flareup significantly [P = .33]. Experimental and control groups measured by flare-up index showed almost similar results

role of factors contributing to oral and dental health status

The objective of the present study was to find various reasons or factors which contribute to poor oral and dental health. This study was carried out in three months from Sept to Nov 2009. One hundred and thirty five subjects were included in this study by convenience sampling method. A proforma was made to record the information. One hundred and five subjects [77.8%] were educated while 22.2% were uneducated. The participants belonged to good, satisfactory and poor socioeconomic classes [12.6%, 51.9% and 35.6% respectively. Negligence was the main reason for poor oral and dental health [44.4%] followed by unawareness [26%]. Education and socioeconomic condition had no significant effect on the oral and dental health [P-value 0.713 and 0.061 respectively]

Success of dental amalgam as a retrograde filling material - a comparative observational study

The objective of the present study was to evaluate the efficiency of dental amalgam as retrograde filling material compared to gutta-percha. A prospective and comparative observational study was carried out on 30 patients at Khyber College of Dentistry, Peshawar from October 2004 to October 2009 with or without retrograde amalgam filling and the success was determined at the end of the year both radio-graphically and clinically. The radio graphic success rate was 86.6% and the clinical success rate was 73.3% where amalgam was used as retrograde filling material

Causes of endodontic treatment failure - a study

The aim of this study was to determine different causes of endodontic treatment failure in patients who approached the Department of Operative Dentistry, Khyber College of Dentistry, Peshawar, for re-treatment. This study was carried out from December 2009 to February 2010 and included seventy five patients of both genders with different post endodontic treatment complaints. Clinical and radio-graphic examination was used to confirm treatment failure. The most common clinical symptoms were tenderness, tenderness and pain, or swelling [72%, 29.3% and 22.7% respectively]. The common causes of endodontic treatment failure were poorly filled [40%], under filled [34.7%] and no root canal filling [17.3%]. Root canal failure due to overfilling was 5.3%. Most of these failed cases were either treated by internees [House officers] in the teaching institutes [34.7%] or general dental practitioners [57.3%]

Association of aetiology, presentation and post-operative complications of post-traumatic peripheral artery pseudoaneurysm

To describe post traumatic pseudoaneurysms and its association to causes, presentation and conventional surgical treatment modalities. This Descriptive study carried out in the Department of Cardiovascular Surgery, Lady Reading Hospital, Peshawar from January 2003 to December 2007. Patients with associated arteriovenous fistula were excluded from this study. All the demographics including age, sex, type of injury, site, associated complications operative details, pen operative morbidity and mortality were prospectively recorded in a data base. The total number of patients was seventy five. All the patients underwent conventional surgical procedures. Reverse saphenous graft was received by 34%, 24% had end to end anastomosis, 12% had interposition synthetic graft, 8% had rent repair while 21.33% had primary ligation of the involved artery. There was no pen operative mortality. Six patients had post operative complication in the form of graft, thrombosis and or infection. Three patients had amputation, two in lower limb and one in the upper limb. Majority of them were male 90.66%. Age ranged from 7 years to 75 years. Most of the patients [77.3%] were in second to fourth decade of life. The most common cause of injury was gunshot wound [56%] followed by stab wounds [13.33%] and road traffic accidents [12%]. Few cases of bomb blast [6.66%], Post cardiac catheterization [4%], glass injury [4%] and intravenous drug abusers [2.66%] were also reported. The commonest site of injury was fern oral artery [37.33%].In this study majority of patients were male with gunshot wound as commonest cause. Reverse saphenous vein graft was treatment of choice. Infection and thrombosis were the commonest postoperative complications

Surgical technique for retroperitoneoscopic nephrectomy: a case report

A case of right non-functioning kidney secondary to chronic pyelonephritis is presented. The successful management through retroperitoneoscopic nephrectomy is described, emphasising the technique of this minimally invasive therapeutic option

Should we say good bye to closed mitral commissurotomy in our setup

To study the short-term results of closed mitral commissurotomy in patients with rheumatic mitral stenosis. Material and This study was conducted at the department of cardiovascular surgery, Lady Reading Hospital, Peshawar from January 2003 to December 2003. Data was collected on a preformed proforma. Mitral valve characteristics were evaluated according to the scoring system devised by Wilkins and Associates. All those patients who had severe mitral stenosis and echo score of < 12, raised pulmonary hypertension or patients with atrial fibrillation were included in this study. Patients having echo score > 12, left atrial and left atrial appendage clot, moderate mitral regurgitation were excluded from the study. After operation patients were followed up for six months for haemodynamic stability. During this time period, 76 patients with rheumatic mitral stenosis underwent closed mitral commissurotomy. Total patients were 76 [male 18, female 58] with age range of 10 to 60 years. Pre-op 2 2 mitral valve area ranged from 0.6 to 01 cm a mean of 0.74 + 0.13 cm. Mean mitral valve gradient was 19.7 + 6.3 mm Hg. Pulmonary artery systolic pressure ranged from 35-110 mmHg. Five patients had associated severe tricuspid regurgitation. Twenty patients had controlled atrial fibrillation. At two weeks follow-up in the out patients department after closed mitral commissurotomy the mean mitral valve 2 gradient was 9.4 + 4.2 mmHg and mitral valve area was 1.6 +/- 0.7 cm. One patient developed severe mitral regurgitation and one had left hemperesis. Pulmonary artery systolic pressure assessed by Doppler, dropped to a mean of 40 mmHg. There was no death. At six months follow-up the improved haemodynamics were maintained. Cost of the whole procedure was less than the cost of the percutaneous transmitral commissurotomy catheter alone. Closed Mitral Commissurotomy is a safe procedure. It is cost effective in developing countries with limited health budget, closed mitral commissurotomy still has a role to play

Devega's tricuspid valve annuloplasty: Still a good alternative in our setup

To assess the durability of Devega's repair of tricuspid valve in severe tricuspid regurgitation [TR]. From January 2002 to December 2003. 22 Devega's surgical repairs of tricuspid valve in severe TR were done either with mitral valve replacement or with Atrial Septal Defect [Secundum Type] repair. Clinical data was retrieved from hospital records and analyzed post-operatively on the basis of NYHA status and echocardiographic findings at the interval of 6, 12 and 24 weeks. The durability of Devega's repair was assessed. Out of 22 Devega's repair, over 80% of the patients having severe TR+3 reverted to no TR and about 20% patients had mild TR postoperatively at the interval of 6 months and the repair was intact on echocardiography. Devega's repair of tricuspid valve in severe TR is a safe and economical procedure in our setup

Abdominal aortic aneurysm surgery - local experience

The aim of this study was to evaluate the outcome of AAA referred to our unit by general surgeons/physicians.This study was conducted from Jan 1996 to Dec 2001. 25 AAA were referred. Age range 18-75 years [mean 54 years] male 19, female 6. Eight out of 25 patients presented with dissecting leaking AAA while 16 presented with non-specific symptoms. Diagnoses were made only by doppler ultrasound. Out of 8 leaking AAA 2 patients were not operated because of low pressure and no response to resuscitative measures. Six patients underwent surgery but we lost 4 out of which 1 had table death, 2 patients died on 3rd and 5th post operation day because of Acute MI, 4th patient died on 4th post operative day because of graft thrombosis. Two patients survived the operation and went home on the 10th post operation day. Out of the non-dissected group of AAA all the patients survived surgery and discharged home on the average 10th post operation day. Non-specific abdominal pains radiating to back especially in the elderly should be thoroughly investigated keeping in mind the AAA and they may be referred to the respective center for proper management