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Hypertensive crises is still a major public health problem, causing end organ damage like myocardial infarction, stroke, and renal failure. Labetalol and nitroglycerine are among the two most commonly used medicine to control the blood pressure, but there is no head to head comparison between these two medicines. This was a prospective randomized non-blinded study which included 50 patients of hypertensive crises, out which 25 patients received intravenous labetalol and 25 patients received intravenous nitroglycerine. We found that labetalol controlled the blood pressure more rapidly in comparison to nitroglycerine, without causing any extra side effect
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Background& objectives : Intertrochanteric fractures of hip are relatively one of the common fractures and it is imposing a huge burden on patients in terms of medical expenses and morbidity .A sliding hip screw (DHS) and trochanteric nail (TN) both are described for fixation of these fractures. The discussion about the selection of ideal implant is controversial in terms of outcomes in various studies. Methods: Ninety patients with intertrochanteric fracture were treated in our hospital from Jan 2009 to Dec 2011. All AO 31-A1 patients who were between 40-80 years old were included to compare Dynamic hip screw and Trochanteric nail in the management of intertrochanteric fractures by analyzing operative time, duration of hospital stay, complications, time taken to union and post operative mobility. 63 patients were enrolled in DHS group and 27 were enrolled in intertrochanteric nail group.Results: Patients treated with DHS had shorter operative time ,less radiological exposure ,easy reduction and fewer intraoperative and postoperative complications .Implant failure and non union was noted in one out of twenty seven patients treated with trochanteric nail group.Interpretation & Conclusions : The analysis of our study supports the use of DHS rather than trochanteric nail for the treatment of stable intertrochanteric fractures in elderly patients.
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Objective: To evaluate and compare the denture satisfaction tendencies for and between the completely and partially edentulous patients, with different prosthodontic treatment modalities. Methodology: The study was conducted to include twenty eight patients that were fit to the criteria of the research, asked to answer some questions, reflect their satisfaction with the newly received dentures, which were delivered to patients according to their conditions and needs (complete removable denture, conventional metal frame RPD, RPD with flexible esthetic clasps and RPD with attachments). Results:The data collected from these patients was grouped and the questionnaires values were calculated to estimate the most satisfied group, which was seen with the group who received RPD with flexible esthetic clasps. But the significant difference analysed by Mann-Whitney Test, was focused on the satisfaction of prostheses’ appearance, that was clearly revealed for the patients who received RPD with resilient attachments; followed by the group who received complete dentures and RPD with esthetic flexible clasp (at the same level), supported by the family and friends positive opinions. Also the same group that received RPD with attachments achieved optimum level in prosthesis’ satisfaction for retention. Conclusion:The results of this research directed the attention to the recent treatment modalities in fabrication of dentures, like using flexible esthetic clasps and attachments; the patients that received RPD with flexible esthetic clasps appeared to be more satisfied with their prostheses, mostly this was related to the comfortability, esthetic and retention traits, followed with group that received RPD with attachments that showed significant differences in esthetic and retention scores than other groups. While the complete denture wearers were the less satisfied group, related obviously to the difficulty to gain the retention in relation to the partial once, as well as the uncomfortable feelings.
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Abstract: Background:Elders in retirement (old age) homes are mainly those who have been abandoned by their family and have one or more physical or mental disabilities. It is a major challenge for the dental professional to plan oral health strategy for this group of patients. Methodology:This cross‑sectional study was conducted using a survey proforma. Information regarding their experience with the new denture, 1 month, 3 months and 6 months after denture insertion was gathered. Statistical analysis of the data was done using the Chi‑square test withP < 0.05 considered significant. Results:One hundred and eighty‑three residents out of a total of 400 residents in 3 retirement (old age) homes were denture wearers. Among them, 101 (55.2%) were females and 82 (44.8%) were males. Dental prosthesis whether worn regularly, discomfort, retention, cleansing of denture during a period of 1month, 3 months and 6 months was found to be significant satisfaction with the prosthesis, denture adhesives used, food accumulation during a period of 1month, 3 months and 6 months was found to be non significant.Conclusion:The emotional characteristics of the patient must be taken into consideration during the entire procedure. We must understand that the success and failure of the prosthesis depends mainly on the patient’s confidence in the dentist rather than the quality of the prosthesis.
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Abstracts: The loss of an eye has a far-reaching impact on an individual’s psychology and an immediate replacement is necessary to promote the physical and psychological healing of the patient and to improve his/her social acceptance. The loss of an eye is an emotional and psychological set back to the patient. Acceptable cosmetic results usually can be obtained with a facial prosthesis. Maxillofacial prostheses which restore and replace missing organ, aim to improve the patient’s aesthetics, restore and maintain health of the remaining structures and consequently provide physical and psychological well-being. Enucleation of the eye is therefore normally followed by fabrication of an ocular prosthesis to improve esthetics. This case report describes prosthetic rehabilitation of a 75 year old male patient having a right ocular defect. The resultant prosthesis was structurally durable and aesthetically acceptable with satisfactory retention. The importance of meticulous treatment planning to tackle the challenges faced in fabricating an ocular prosthesis is explained with the relevant literature.
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The purpose of the study was to evaluate the outcome of open tibial shaft fiactures [Gustilo IIWB] with A0 External Fixator and to document complications. Perspective study. This study was conducted at DHQ teaching Hospital, Gujranwala and at Fazil Memorial Hospital, Gujranwala from November 2010 to November 2012. 50 patients with open tibial shaft fractures were treated with AO External Fixator. Open fractures were classified according to Gustilo Anderson Criteria and wounds with EIA and IIIB were selected. Outcome was determined by the rate of union, while nonunion, pin tract infection, pin loosening and osteomylitis were recorded as complications. The follow up period was 08 months. Out of fifty cases of open tibial shaft fractures, 38 [76%] were men and 12 [24%] were Ladies. Mean age was 35.2 [8-67], 22 [44%] had Gustilo IIIB wound while 28 [56%] had Gustilo IIIA injuries. Pin tract infection and pin loosening rate were 12% and 16% respectively. Nonunion was seen in 10% of the cases. In 41 [82%] of the cases fracture united and average union time was about 26.5 weeks. No case of osteomylitis seen. External Fixator is simple and effective treatment for open tibial fractures
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Humans , Male , Female , Fractures, Open , External Fixators , Patient Outcome AssessmentABSTRACT
Abstract: Patient autonomy has a critical role in making decisions in medical practice and it is accepted by international conventions on health care and various national medical codes. However, pertaining to terminally ill patients, this right becomes very problematic in regards to end of life decisions. Utilitarian ethicists motivated by materialistic worldview and individualism have made patient autonomy based arguments for the permissibility of active euthanasia. An appraisal of pro-euthanasia arguments that include the best interest, golden rule, and autonomy is made in this paper. The best interest and golden rule arguments are based on subjective moral judgment thus failing the universalization test. The argument from autonomy is unconvincing because of the confounded autonomy of the terminally ill patients.
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ABSTRACT: This study attempts an exposition of different perceptions of obligation to medical treatment that have emerged from the Islamic theological understanding and how they contribute to diversity of options and flexibility in clinical practice. Particularly, an attempt is made to formulate an Islamic perspective on ordinary and extraordinary means of medical treatment. This distinction is of practical significance in clinical practice, and its right understanding is also important to public funded healthcare authorities, guardians of the patients, health and life insurance institutions, and employers who provide health care coverage to their employees. Not only these parties, but also lawyers and justice administration functionaries such as public prosecutors and judges are in need of understanding this distinction to deal with relevant litigations. The distinction could be made regarding terminally ill patients and non-terminally ill patients separately. The essential factors that matter in making the distinction between ordinary and extraordinary means of treatment are: (1) patient capacity (2) expert advice, and (3) nature of medication. Regarding terminally ill patients, medical treatment can become extraordinary because of (1) patient capacity and (2) nature of medication. In both these case the deciding condition applies: the expert advice taken from a group of physicians. In regards to non- terminally ill patients, extraordinary medical treatment includes three cases: (1) treatment that is known to be useless and futile, (2) treatment that endangers the life or cause more harm than what it removes, and (3) useful treatment, but the patient is unable to bear the cost.
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ABSTRACT: Pain medication is one of the responses to the mercy argument that utilitarian ethicists use for justifying active euthanasia on the grounds of prevention of cruelty and appeal to beneficence. The researcher reinforces the significance of pain medication in meeting this challenge and considers it the most preferred response among various other responses. It is because of its realism and effectiveness. In exploring the mechanism and considerations related to pain medication, the researcher briefly touches the Catholic ethical position on the issue, a position that cannot be ignored in the development of contemporary bioethics. The researcher particularly deliberates on the contemporary Islamic discourse on the issue; by furthering the debate in line with the Islamic legal maxims and general guidance from the primary sources of Islamic law and ethics. The resolution on the issue is sought by synthesizing the views and legal maxims (al-Qawaid al-Fiqhiyyah) on the issue, which in conclusion provide justification for pain medication by considerably regarding pain as “necessity” and “pressing need”. However, such resolution allows pain medication to the limit and proportion that removes the pain and prohibits overdosing the patient with medication that may directly cause the death.
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Background: Anatomy professors world over are lamenting about medical students' lack of interest in dissections and its diminishing utilisation in medical studies. The objective of our study was to find out the reasons why some of the Pakistani medical students were avoiding dissections. Method: We conducted this study in 5 medical colleges of Pakistan from Dec 2010Oct 2011. Questionnaires were prepared and administered to more than 500 Pakistani medical students, at least 6 months after their first cadaver dissecting session. Mostly 1 st and 2 nd year medical students participated in this study. Result: Around 43% students have actually performed dissections in some form, whereas around 57% had never touched the cadaver. Further evaluation of these results revealed that out of 57% of students, 45% avoided dissection due to bad smell of formaldehyde, 37% due to moral/ethical grounds, 22% due to low motivation and respect of human body, 19.4% due to anxiety, 18.6% due to religious reason, 16% due to fear, asthma and emotional reaction, 9.4% due to toxic chemical, 8.6% due to laziness and 7% due to nightmares. Conclusion: In spite of availability of required number of cadavers in all 5 medical colleges and a clear realisation amongst the students that dissecting cadaver is an effective way of learning anatomy; majority of students were not very keen and had therefore not performed dissection even once. Keywords: Anatomy, dissection, cadaver, questionnaire, medical student, formaldehyde