ABSTRACT
The objective of the study was to determine level of dental anxiety related to dental procedures in dental students and comparing the dental anxiety between male and female undergraduate dental students of Rawal Dental College. This cross-sectional study was conducted at Rawal Dental College, Islamabad, Pakistan during October 2016. A validated Corah Dental Anxiety Scale [DAS] questionnaire were distributed among dental students in first, second, third and fourth year students present at the day of study. There were four questions with five options in this scale that assess level of anxiety. Total score ranged from 4-20. This was total of all points of scale items. The score 8 or below 8 showed no anxiety, 9-12 showed moderate level of anxiety, 13-14 showed high level of anxiety and 15-20 showed severe level of anxiety. Chi-Square Test used to determine level of anxiety and Mean Anxiety Score between male and female students. Mean and Standard Deviation of gender was calculated by independent T test and that of Academic classes of dental students were calculated by one-way ANOVA. Results showed female students presented with higher mean anxiety score as compared to male students. The difference was statistically insignificant [P-value = 0.10]. Dental anxiety reduced from first year to final year. Female students had more high to severe level of anxiety as compared to male students. Mean and standard deviation of Mean anxiety score was calculated i.e. 9.11 +/-3.15
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Hepatitis B is a virus of great concern for healthcare providers, with an increasing prevalence in Pakistan. Dentists are blamed for this as negligence in infection control procedures [improper instru-ment sterilization, reuse] has led to this surge. The study was aimed to collect information regarding knowledge, attitude as well as practices about Hepatitis B infection by 200 house officers in dental colleges of Rawalpindi and Islamabad.A KAP survey was done in Dec 2017 with pretested questionnaire having queries regarding knowl-edge, attitude and protective measures to prevent transmission of Hepatitis B. SPSS 16.0 software was utilized for data analysis. There were 136 [68%] female participants and 64 [32%] males were participants with mean age of 23.6+1.2 .The results showed that the dental professionals were quite aware of Hepatitis B and its transmission [62.5%].92.5% responded that without proper infection control measures one can acquire it. They were well informed about Hepatitis B vaccination [89.5%], precautions and droplet isolation procedures. However, continuous educational programs on isolation precautions and infection control measures can reduce the chances of cross infection
ABSTRACT
To compare the frequency of E. faecalis in the saliva and root canals of teeth associated with apical periodontitis due to endodontic treatment failure in the same patient. Cross-sectional comparative study. Samples were collected from Operative Dentistry Department, AFID, while Iaboratory processing was done at AFIP, Rawalpindi. Study duration was one year. Fifty patients, both males and females with failed endodontic treatment were selected. Saliva and root canal samples were collected from each patient, inoculated on MacKonkey agar plate and incubated at 35-37[degree]C for 48 hrs. E. faecalis colonies were identified by colony morphology, gramstain, catalase, bile asculin test, arabinose fermentation and growth in 6% NaCl nutrient broth. The frequency of E. faecalis in saliva was 34% and in root canal it was 58%. Frequency between the presence of E. faecalis in root canals and saliva was found to be statistically different [p = 0.001]. The presence of E. faecalis in root canal was not associated with their presence in saliva
Subject(s)
Humans , Male , Female , Saliva/microbiology , Dental Pulp Cavity/microbiology , Treatment Failure , Periapical Periodontitis , Endodontics , Cross-Sectional StudiesABSTRACT
The purpose of this article was to report the successful nonsurgical endodontic management of mandibular first premolar with unusual anatomy and hypercementosis that was not reported elsewhere before and the challenges that were faced while determining the apical stop and preparation of apical part of the canal. A 25-year old Saudi male patient reported to referral hospital, with chief complaint of continuous pain in lower right quadrant for 2-3 days. His medical history was non-contributing. Clinical examination revealed a carious lesion on the mandibular right first premolar. The pain was of acute in nature but was not tender on percussion . Interestingly unique pattern of the canal system was found on periapical radiographs which resembled configuration ofVertucci type V and hypercementosis at the apex of the tooth. In this case while performing the endodontic treatment two very important challenges were faced. The first one was to determine the working length as the apices of tooth were hindered by hypercementosis and other one was to prepare the apical part of canal adequately without file separation that was obstructed by hypercementosis. Determination of working length was challenged as there was no definitive apex found on the digital radiographs and also variable readings were found with the apex locator, therefore the image was magnified and contrast with different color scheme with the help of digital imaging software [Vatech] in order to determine the radiographic apical preparation stop. Following the working length determination, the root canals were prepared with a crown down technique and the great resistance were noticed in apical part of canal due to hypercementosis, therefore the apical preparation was finished at proptaper finishing file [F 1] and obturated with lateral condensation. This case describes a mandibular premolar with an unusual anatomy and pathology. Coronally the single canal is divided into two canals in mid-root that terminate into separate apical foramens, but presence of excessive cementum at apex of root hindered the apex on radiographs, thus apical termination point of endodontic instrumentation was difficult to evaluate and also the apical part of canal was hard to prepare, owing to hyper cementation
ABSTRACT
Background: Needle stick injuries remains potential source of transmission of infections
Objective: To determine the prevalence of needle stick injuries among doctors and nurses working in Sheikh Zayed Hospital Rahim Yar Khan
Methodology: This cross sectional study was conducted from 1[st] June to 31[st] December 2014. All the nurses and medical officers who were listed in the medical superintendent office of the Sheikh Zayed Hospital Rahim Yar Khan were included in the study. A structured, self administered questionnaire was designed to describe the occurrence of needle-stick injuries among respondents. The questionnaire sought information about socio-demographic characteristics such as age, sex, marital status and years of experience. The questionnaire also included information about the frequency of being stuck by a needle or a sharp instrument while at work during the last six months. A yes/no response were used to assess whether the doctor/nurse reported the injury. The participants were asked about the reasons of needle stick injuries and how they managed the incident. Data analysis was performed using SPSS, version 17. The chi-square test was used to assess the association between duration of service and needle stick injuries
Results: Total of 308 health care workers [HCWs] participated in this study which included 173 medical officers and 135 nurses. About half of the medical officers were in the age category of 30 to 39 years while half of the nurses in 20 to 29 years of age. Among these HCWs 27.8% medical officers and 25.2% nurses had above 10 years of work experience. Needle stick injury was reported by 22.54% doctors and 37.78% nurses in the past six months and it was found significantly higher among nurses as compared to doctors [p=0.001]. Among perceived reasons of needle stick injuries the most frequently reported reason was workload [48.7% doctors, 56.9% nurses] followed by Recapping of needle [30,8% doctors, 21.6% nurses], hurriedness [12.8% doctors, 13.7% nurses] and non-cooperation of patient [7.7% doctors, 7.8% nurses]. After needle stick injury only 38.5% doctors and 25.5% nurses washed it with disinfectant. Duration of service was significantly associated with needle stick injury among doctors [p=0.000] and nurses [p=0.000]
Conclusion: In summary, we conclude that the frequency of Needle stick injury among Health Care Workers is high and duration of service was significantly associated with needle stilck injuries
ABSTRACT
The maternal and infant mortality in Pakistan is still high. The use of safe and important methods of contraception allows men and women to decide the number and spacing of their pregnancies and to improve the uptake and continuation of use of family planning services through improving the quality of family planning services. objectives of this study is to assess the quality of family planning services, asses information provided by providers to clients, asses client knowledge and satisfaction with services provided preferred choice and current method of contraception used by client. A cross sectional study was conducted from May to July 2014 in Family Planning Department of PIMS hospital, Islamabad by using consecutive sampling technique for data collection. Data was analyzed by using SPSS version 16. The information about each element of quality of care is present as a list of 25 indicators of quality of care each indicator specifies a percentage, mean or SD. Among 100 clients with 0.05 margin of error and 95% Confidence level [Z alpha/2]. Majority of the clients were satisfied with the services of the facility. [40.27%] of the clients would like to have next child after >5 years while the mean age of the youngest child was 11.77 months with Standard deviation SD of 9.850. Majority of the clients [57%] choose Intra Uterine Contraceptive Device [IUCD] after consultation and 62.50% want to change their method. Non-availability of IEC material on FP was another problem. Rate of discontinuation is higher among women who have not been adequately counseled about side effects. It is concluded from this research study that the information provided to the clients were inadequate, this might be due to provider's improper training and poor interpersonal communication and technical skills
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Comparative study of formocresol and calcium hydroxide pulpotomy procedure has a particular importance in this part of the subcontinent where low socioeconomic status is debilitating and does not allow many persons to undergo an expensive therapy like Mineral Trioxide Aggregate therapy, laser therapy and electro cauterization modality of pulpotomy. The purpose of this study was to compare the efficacy of two different vital pulp therapy techniques both clinically and radiographically in cariously exposed primary molars, utilizing calcium hydroxide and formocresol as the material for pulpotomy. It was a Quasi-experimental study. The sampling technique was a non-randomized convenience sampling. The study was conducted and completed in one year 28, Military Dental Centre, La-hore. The study was carried out using clinical and radiological criteria of follow up for evaluating the success of the two techniques by selecting 60 subjects, all Pakistanis. The sample comprised of subjects within 4 to 6 years age bracket selected alternatively according to gender. Formocresol and Calcium hydroxide pulpotomy was performed after amputation and proper hemostasis of the coronal pulp chamber and the selected patients were divided into two groups. The patients selected for formocresol pulpotomy were placed in Group F and the patients for calcium hydroxide pulpotomy were placed in Group C. Follow up of the cases were performed at 03 months, 06 months and 01 year period and the results in terms of success and failure were recorded in the stipulated data form and analyzed by SPSS version 17 for Windows. Sixty cariously exposed primary molars required vital pulp therapy. Thirty primary molars [50%] in Group F and thirty primary molars [50%] in Group C. 27 teeth [90%] treated with formocresol and 17 teeth [56.7%] with calcium hydroxide were classed as clinically and radiographically successful at the end of one year. The results showed a significant difference in the efficacy of the two groups [p= 0.004]. It was concluded that there was a significant difference in the efficacy of the two medicaments projecting higher rate of success with formocresol as compared to calcium hydroxide both clinically and radiographically
Subject(s)
Humans , Male , Female , Calcium Hydroxide/pharmacology , Formocresols/pharmacology , Dental Pulp/drug effects , Dental Pulp Cavity , Root Resorption/etiologyABSTRACT
To compare the frequency of E.faecalis in the saliva and root canals of teeth associated with apical periodontitis due to endodontic treatment failure. Cross-sectional comparative. Samples were collected from Operative Dentistry department, AFID, while laboratory processing was done at AFIP, Rawalpindi. Duration of this study was one year. Fifty patients, both males and females with failed endodontic treatment were selected. Saliva and root canal samples were collected from each patient, inoculated on MacKonkey agar plate and incubated at 35-37°C for 48 hours. E.faecalis colonies were identified by colony morphology, Gram stain, catalase, bile asculin test, arabinose fermentation and growth in 6% NaCl nutrient broth. The frequency of E. faecalis in saliva was 34% and 58% in root canal samples. Frequency of the presence of E.faecalis in root canals and saliva was found to be statistically different [p=0.000]. The presence of E.faecalis in root canal was not associated with their presence in saliva
ABSTRACT
A 65-year-old male presented with a 3-year history of orbital symptoms. An imaging-based diagnosis of fibrous dysplasia involving the skull base was made at another institution. CT showed a diffuse sinonasal mass and ground-glass appearance of the bones of the anterior skull base with bony defects and mucocele formation. MRI demonstrated an accompanying intracranial and orbital rind of soft tissue mass along the hyperostotic bones. FDG-PET showed corresponding intense hypermetabolism. Small cysts were observed at the tumor-brain interface. Biopsy revealed esthesioneuroblastoma with bone infiltration that is compatible with the hyperostotic variant of esthesioneuroblastoma. There are a few cases of hyperostotic esthesioneuroblastoma reported in the literature.
Subject(s)
Aged , Humans , Male , Fatal Outcome , Fibrous Dysplasia of Bone/diagnosis , Hyperostosis/diagnosis , Magnetic Resonance Imaging , Neuroblastoma/diagnosis , Positron-Emission Tomography , Skull Neoplasms/diagnosis , Tomography, X-Ray ComputedABSTRACT
The occupational dust leads to various respiratory diseases. It is a major health problem among factory workers and is under reported in everyday scene of medical practice. To assess the frequency of occupation related lung diseases among study population. To seek association of socio-demographic characteristics with occurrence of lung diseases among study population. Descriptive cross sectional study. This study was conducted in the Zeal Pak Cement factory, site area, Hyderabad for a period of one year. Data was collected by filling a questionnaire; subjects were selected by convenience sampling. Frequencies were computed, chi-square test was applied to see any statistical analysis of various categorical variables. Among 100 subjects examined, the frequency of respiratory diseases was found among 83% workers. 70% subjects belonged to labour class who were closely exposed to occupational dusts. 58% of the subjects were earning < rs:4000 /month; however no association of socio-economic status was seen with occurrence of respiratory diseases [p=0.06]. 63% workers belonged to age group 31-40 years. Chronic bronchitis was the most commonly presenting respiratory disease i.e. 37%, while cor pulmonale reported in 4% of the workers. Silicosis along with tuberculosis was reported among workers of age group 40-50 [p=0.01]. The high frequency of occupation dust related respiratory diseases warrants further research in order to design preventive strategies against them
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The aim of the study was to determine the most common causes of root canal failure in patients who reported to the operative department of AFID [Armed forces institute of dentistry] for retreatment. This was a cross sectional study carried out at the operative department of ARID Rawalpindi from January 2011 to December 2012. Among 200 patients included in the study, 112 [56%] were male and 88[44%] were female with mean age of 31.24 years [SD +/- 10.1]. In the present study the most common cause of root canal failure was found to be underfilled [42%] followed by poor lateral condensation [22%] and unfilled / untreated [20%], overfilled [6%], fractured instruments [4%] and inadequate coronal restorations [3%]. The patients presented with different symptoms The most common symptom being the tenderness [74%] followed by pain [20%], swelling [15%], loss of restoration [13%], sinus formation [6%], mobility [4%], fractured crown [4%] and split tooth [1%]
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This cross sectional study was conducted at Pak Field Hospital Level 3 Darfur Sudan from Jan 2011 till May 2012 to find out the reasons for extractions of teeth in UNAMID troops. 1500 patients, from various countries were interviewed and examined. Percentage of six common reasons [caries and its sequel, periodontal problems, impactions, prosthetic, orthodontic and other causes] were calculated by SPSS version 16, as whole, separate for male, female and for individual countries. Results showed that Overall 41.2% of the teeth were extracted due to advanced dental caries whereas 34.8% due to periodontal disease, 12.04% due to impactions, 4.4% for prosthetic purposes, 4.3% for orthodontic and 3.2% for other reasons. Advanced caries was the primary cause for extractions in male while impactions and orthodontic causes were the main reasons. Highest numbers of teeth were extracted due to advanced caries in patients from Nigeria [43.5%] and due to periodontal reason from patientsof Bangladesh [37.1%] and Nepal [37%]
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To determine the prevalence and cause of self-medication among dental patients, a cross sectional study was conducted on 335 patients of AFID Rawalpindi. Patients were interviewed on basis of questionnaire highlighting age, gender, income and educational qualification, history of past practice of self-medication, substances used and causes of it. Frequency tables were generated and statistical relationship between the variables was analyzed by SPSS version 16. 31.34% of the respondents claimed to be involved in self medication. 48% respondents used self-prescribed antibiotic and analgesics, 22% used clove oil, tobacco or tablet aspirin in tooth cavity, 17% had got their treatment by roadside unqualified dentists and 13% consulted faith healer to relieve tooth pain. 33% felt that their complaints were minor enough to consult dentist, 53% were short of time to visit hospital [ and were prompted by family members to self medicate, 10% were afraid of dental treatments while only 4% claimed that these were cheaper options for them. Self-medication practices were common in participants of this study. Government should enforce relevant legislation which limits the practice of road side local tooth healers and restricts the sales of drugs without prescription
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The present study was undertaken to compare the efficacy of manual and powered toothbrushes in 70 patients between 19 and 44 years of age who reported with mild gingivitis to AFID. Patients were randomly divided into two groups of 35 each. Group A patients were selected for electronic powered tooth brushes, while group B patients were selected for manual brushes. At baseline, after one and 3 months, plaque was rated using Silness-Loe plaque index. Data were statistically analyzed using SPSS version 12. Both brushes significantly reduced the plaque accumulation, though to different degrees. A lower plaque score [score 0 and 1] was obtained at three months in 88.5% patients using powered brushing and in 77.1% patients using manual brushing. Powered brushing showed lower plaque score in 11.4% more patients than the manual brushing after three months of follow up
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To compare impact of ibuprofen and acetaminophen premedication on the efficacy of inferior alveolar nerve block in irreversible pulpitis. Randomized controlled trial. Operative Department, AFID Rawalpindi from 18 September 2007 to 17 September 2008. Three hundred and sixty patients with irreversible pulpitis were divided into two groups. At base line patients pain was recorded. Ibuprofen was given to patients in group A and acetaminophen to group B patients. Patients were given drugs in tablet form. After 30 minutes cold test with ethyl chloride was done and patient pain was recorded on visual analogue scale. Inferior alveolar nerve block was administered. Forty five minutes from base line cold test was performed and pain was recorded. Access to the endodontic cavity with round bur in high speed handpiece was made and patient response was noted. Inferior alveolar nerve block was successful if patient had no pain to cold test at 45 minutes and on access to cavity preparation. Data was analyzed by SPSS version 12. There was no statistically significant difference between ibuprofen and acetaminophen on success rate of inferior alveolar nerve block in patient with irreversible pulpitis. Ibuprofen and acetaminophen premedication has similar efficacy on success of inferior alveolar nerve block in patients with irreversible pulpitis.
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Plexiform Neurofibroma appeared at the age of 5 years, with little pain and itching at the site. Increase in size and weight of Plexifom was gradual with age. In this case the Plexiform developed on lower right arm. All over the body, the patient also showed other signs of NFl, Caf-au-lait spots [CLSs] and sessile neurofibroma. Freckles were seen in the arm pits and over the stomach skin. The Lisch nodules were also present in the eyes of the subject. Pedigree of the patient confirms that the case is familial one where his mother had NFl but no Plexiform. Biopsy confirms that neurofibromatosis tumors were benign
Subject(s)
Humans , Male , Neurofibromatoses , Cafe-au-Lait Spots , Arm/pathology , BiopsyABSTRACT
Serum total sialic acid is a marker of acute phase response. Elevated levels have also been associated with several risk factors for diabetic vascular disease. The objective of the study was to find out a relationship between sialic acid and metabolic variables in type 2 diabetic patients with and without microvascular complications. This study included 200 subjects of whom 50 were of diabetes mellitus with nephropathy, 50 patients of type 2 diabetes mellitus with retinopathy, 50 patients of type 2 diabetes without any complication and 50 healthy individuals without diabetes mellitus [control subjects]. The subjects aged 15 - 60 years were selected for study. Fasting venous blood samples were taken from all the 200 subjects. Simultaneously urine sample were also collected from each of them. All blood samples were analysed for fasting and postprandial glucose, total cholesterol, triglyceride [TG], low density lipoprotein [LDL], high density lipoprotein [HDL], creatinine, HbAIc on fully automated analyser. Serum and urine sialic acid along with microalbumin levels were also estimated. Serum total sialic acid concentrations were significantly higher among all diabetic subjects with or without complications compared to control subjects. In diabetic patients there was a significantly increasing trend of serum and urinary sialic acid with severity f nephropathy [p < 0.001] and with the degree of urinary albumin excretion [p < 0.001]. Elevated serum sialic acid concentrations were also associated with severel risk factors. The main finding of this study is that elevated serum and urinary sialic acid and microalbumin concentration were strongly related to the presence of microvascular complications like diabetic nephropathy and retinopathy and cardiovascular risk factors in type 2 diabetic patients
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Diabetes Complications , Diabetic Angiopathies , Diabetes Mellitus , Diabetes Mellitus, Type 2 , Diabetic Retinopathy , Diabetic NephropathiesABSTRACT
To study the effect of morphine on in vitro production of testicular T from un-stimulated or LH stimulated Leydig cells. Experimental study. Biological and Biomedical Sciences Department, Aga Khan University Karachi. De-capsulated testes from two rats were subjected to enzymatic dispersion for each experiment. Cells were pre-incubated in the incubation medium to remove endogenous Testosterone Thereafter, 80K cells were used for each treatment in 2001 of suspension. Incubation medium contained either no treatment [control] or different concentrations of morphine [5x10-5 -10-9 M]. Leydig cells were also incubated with different doses of LH [16-500 ?IU] and morphine. Naloxone, an opioid receptor antagonist [10-6 M], was used to determine if morphine induced effects on the Leydig cells could be reversed. Incubations were carried out for three hours in a shaking water bath at 340C. Reaction was stopped by placing the tubes in a water bath at 600C, and thereafter the tubes were transferred to a tray containing ice before freezing. Testosterone was measured directly in the incubation medium by radioimmunoassay. Morphine reduced Testosterone production from Leydig cells at all concentrations tested [p<0.01]. There was a dose dependent response to LH stimulation by the Leydig cells and testosterone levels were significantly different from control [p<0.01] and incubation with morphine in the presence of LH significantly reduced T levels [p<0.01]. Inhibition of opioid receptors with naloxone significantly attenuated morphine induced inhibition of T [p<0.01]. These in vitro results show that the morphine inhibits T secretion directly at the testis level