Effects of maintaining apical patency on post-operative pain in molars with necrotic pulp and apical periodontitis

Objective: To determine the effect of maintaining apical patency on post-operative pain in molars with necrotic pulp and apical periodontitis

Place of Study: This RCT was conducted in dental section of Faisalabad Medical University, Faisalabad

Period: 14 months from Setember-2016 to November-2017

Methods: Patients having molar teeth with necrotic pulp along with apical periodontitis were included for analysis. We included 200 teeth in this study. In group one [n=100], AP was maintained while in group two [n=100] AP was not maintained. Post-op pain was noted at 12 hours, 24 hours, 2nd day to 7th day after surgery daily. VAS pain score with value from 0 to 10 was used to calculate pain score. Data analysis was done using SPSS software [v21]. After checking normality of data using Shapiro–Wilk test, independent sample t-test was used to determine significant difference in mean pain scores between the group

Results: There was female sex predominance in both groups; 57% in AP group and 59% in non-AP group. Regarding type of teeth mandibular molar were in higher number; 66% in AP group and 67% in non-AP group. There was significant difference in VAS pain scores upto 4th day after surgery after that pain score was no statistically different between the AP and non-AP group

Conclusion: Maintaining apical patency is associated with significantly less post-operative pain severity score in molars with necrotic pulp and apical periodontitis

Intervention program for nursing staff regarding approach to a patient with spider phobia and/or bite

Spider bites are uncommon medical events, since there are limited number of spiders worldwide with fangs strong enough to pierce human skin, and most spiders bite humans only as a final defense when being crushed between skin and another object. Thus, most lesions attributed to spider bites are caused by some other etiology. The spiders that can cause medically significant bites include widow and false widow spiders [worldwide], recluse spiders [mostly North and South America], Australian funnel web spiders [eastern coastal Australia] and Phoneutria spiders [Brazil]. Acute spider bites most commonly result in a solitary papule, pustule, or wheal. Systemic symptoms can accompany envenomation of widow; funnel web, and Phoneutria spiders, and less often, those of recluse spiders

Barriers for Parental Failure in Bringing their Children to the Dental Clinic—A Questionnaire-based Study in Indian Population

Clinical dentistry has been taking strides towards improving the oral health and delivering quality dental treatment. But there are certain barriers which inhibits the utilization of these services. Among them is the parental attitude towards dental care. Since children depend on their parents. There is a group of children who do not show up for their dental treatments or check- ups due to parental failure. This study was done to enumerate the main problems and barriers explaining the reasons regarding parental failure for bringing their children to the dental clinic. A questionnaire was distributed among 200 parents and the possible reasons were evaluated. Certain barriers such as lack of knowledge of parents regarding the importance of oral health, treatment cost, treatment time, missing school, daily work load, fear from dental treatment and multiple visits were identified as potential barriers.

Evaluation of leptin, interleukin-1 beta and tumor necrosis factor alpha in serum of malaria patients as prognostic markers of treatment outcome

Objective: To analyze serum leptin levels in patients with malaria falciparum and compare them with healthy controls and correlate with development and outcome of malaria infection. Methods: Sixty cases of malaria falciparum were included in this study as patients. Thirty healthy individuals of comparable age, racial and body mass index were taken as controls. All patients were diagnosed by clinical picture and the presence of malaria parasites in blood film. Estimation of liver function test, kidney function test, complete blood count, fasting blood sugar, fasting serum insulin, pro-inflammatory cytokine tumor necrosis factor alpha (TNFα) and interleukin 1 (IL1), estimation of morning serum leptin and calculation of body mass index (kg/m

Evaluation of leptin, interleukin-1 beta and tumor necrosis factor alpha in serum of malaria patients as prognostic markers of treatment outcome

<p><b>OBJECTIVE</b>To analyze serum leptin levels in patients with malaria falciparum and compare them with healthy controls and correlate with development and outcome of malaria infection.</p><p><b>METHODS</b>Sixty cases of malaria falciparum were included in this study as patients. Thirty healthy individuals of comparable age, racial and body mass index were taken as controls. All patients were diagnosed by clinical picture and the presence of malaria parasites in blood film. Estimation of liver function test, kidney function test, complete blood count, fasting blood sugar, fasting serum insulin, pro-inflammatory cytokine tumor necrosis factor alpha (TNFα) and interleukin 1 (IL1), estimation of morning serum leptin and calculation of body mass index (kg/m(2)) were done in both groups on the day of admission, on discharge and 7 d after discharge.</p><p><b>RESULTS</b>At admission, leptin levels were significantly higher in patients group than in control while fasting serum insulin levels were not significantly different between the two groups. There were significant increases as regard to TNFα and IL1 in malaria patients. Significant differences were observed between the control and the patient group for leptin, TNFα and IL1 at the time of admission and discharge. After discharge for 7 d, a significant decline in serum leptin levels, TNFα and IL1 in the patients group was observed as compared with time of admission and time of discharge, a positive correlation between serum leptin levels and TNFα and IL1.</p><p><b>CONCLUSIONS</b>Leptin hormone level might play an important role in development and outcome of malaria infection.</p>

Anti diabetic effects of cinnamon extract in albino rats with effects on the serum insulin levels

To determine the changes in the serum insulin levels in alloxan induced diabetic albino rats in comparison with oral hypoglycemic drugs. An experimental study. This study was conducted at Al Tibri Medical College Karachi during December 2012 to December 2013. The present study was conducted on 60 Albino rats which were group from A to F consisting of 10 rats in each group. These groups were further divided into two sub groups which were treated with low dose and high dose of the cinnamon and oral hypoglycemic drugs. The results showed that there is significant reduction in serum insulin level in the alloxan treated group animals which was improved in group C animals treated with low dose of cinnamon extract in alloxan induced diabetic rats. Also animals in group D and group E treated with tolbutamide and acarbose respectively showed higher increase in serum insulin level as compared with cinnamon extract treated groups, however when cinnamon extract was used in combination with tolbutamide or acarbose it showed synergetic effects. Tolbutamide and Acarbose treated groups showed better anti diabetic effect by increasing the serum insulin level in comparison with cinnamon extract treated groups when used individually. This effect was enhanced when cinnamon extract was used in combination with either tolbutamide or acarbose

Primary vaginal hydrocele; different surgical procedures: a comparative study

A hydrocele is a fluid - filled sac surrounding a testis that results in the swelling of scrotum. They can develop due to inflammation or injury within the scrotum. This study aimed to evaluate the efficacy and adaptation of different surgical procedures in the repair of hydrocele.Comparative, Retrospective study .The study was conducted at Fauji Foundation Hospital Karachi, Al-Tibri Medical College, Karachi and Civil Hospital Karachi from January, 2000 to December, 2013. Patients with primary vaginal hydrocele registered during the period of thirteen years in the out patient department of surgery were selected. A total of 300 patients were assessed clinically, diagnostically and radiologically about the status of hydrocele before the surgical procedures and anesthetic opinion. The different surgical technique were carried out in different group of patients asJaboulay's technique in 70 patients, Lord's procedure in 70 patients, Aspiration and Sclerotherapy in 05 patients, Window operation technique in 05 patients and the Hydrocelectomy by supra pubic procedure were carried out in 150 patients out of total 300 registered patients. The data collected and analyzed statistically in SPSS version 19.00. The different procedures have been adopted surgically in patients with primary vaginal hydrocele. The results showed that among the different operative techniques adopted, the best procedure regarding hydrocelectomy is the supra pubic approach line of treatment. It showed better result and recovery with very minimum complications and side effects as compared to other surgical procedure. The data thus concluded that hydrocelectomy done via supra pubic approach in number of patients proved to be the best procedure because of having very little complications

Assessment of Cedrus deodara root oil on the histopathological changes in the gastrointestinal tissues in rats

The present study was designed to investigate the effect of Cedrus deodara root oil on the histopathology of different gastrointestinal organs of Wistar rats. This oil was used traditionally as an anti-ulcer agent in the Indus Unic System and extracted from the plant root by destructive distillation method. A total of 90 rats were taken and divided into groups A, B and C, each comprising of 30 animals. The animals of group B and C were given 0.5 ml/kg and 2.5 ml/kg of C. deodara oil respectively while group A served as control and administered vehicle only. The treatment was given to the animals ones only for 24 hours. All animals were sacrificed and the organs like esophagus, stomach and ileum were taken out. Tissue processing and staining procedure was then carried out for any pathological changes in the animal tissues during microscopic examination. The results indicated that Cedurs deodara root oil at both doses 0.5ml/ kg and 2.5 ml/kg exhibited some adverse effects such as erosion of epithelium, edema on sub-mucosal and mucosal layers, congestion of blood vessels as well as presence of inflammatory cells on esophagus, stomach and ileum were seen. Moreover shortening of villi was also seen at both doses. A study conducted on mammalian toxicity previously on rats revealed that the C. deodara root oil used is not very toxic and comes under least toxic group as standardized by toxicologists. Based on the results obtained it was concluded that C. deodara root oil produced some adverse changes in the tissues of GIT when given at 0.5 ml/kg and 2.5 ml/kg doses but the effects were not lethal therapeutically at this dose LC[50] 16.5 ml/kg. The plant oil showed some toxicity and needs further detailed studies to assess its potential toxicity and therapeutic status before using this material as drug

Determination of pesticide residues hexachlorocyclohexane, cyclodiene, diphenylaliphate and their metabolites in the breast milk of women from Karachi- Pakistan

The aim of this study was to determine the presence of pesticide residues hexachloro-cyclohexane, cyclodiene, diphenylaliphate and their metabolites in the milk of women from different regions of Karachi, Sindh-Pakistan. An experimental study. This study was conducted in the department of Zoology, University of Karachi from April 2009 to April 2011. A total of 30 human breast milk samples were collected from the Gynae wards of Karachi hospitals. A breast pump was used to collect 5 ml milk sample from each women. The sample was taken in the sterilized and labeled vials. The collected samples were then stored at -20°C for analysis. All the samples were analyzed for the presence of pesticide residues. Samples of milk were prepared accordingly and the purified samples injected into the Shimadzu GC-ECD apparatus. The peaks of the samples were compared by the retention time of the standard peaks. The chromatogram obtained indicated the quantity of pesticide residues. The standard chromatogram of organochlorine pesticides and their isomers were prepared and analyzed on GC-ECD. The standard chromatograms were then matched with the chromatogram of milk samples. The isomers like alpha, beta, gamma and delta were detected as major residues of HCH. The cyclodiene compounds such as aldrin and alpha- endosulfan were detected as common compounds. DDT was found in 43% of milk samples. The percentage of cyclodiene residues was higher than HCH and diphenylaliphate. A significant bioconcentration of organochlorine residues was found in the breast milk. Total DDT concentrations were found higher than total HCH levels. It is thus concluded that this bioconcentration of pesticide residues clearly indicates that the mother contains a heavy amounts of such toxic chemicals

Clinical presentation and evaluation of histopathological patterns of hospital-based frequency of thyroidectomic biopsies

The aim of this study is to evaluate the clinical presentation of different histophathological pattern of hospital-based surgical thyroidectomic specimens. Multicentre, Prospective Study. This study was conducted at the department of Pathology, Isra University Hyderabad; Liaquat University of Medical and Health Sciences, Jamshoro; Memon Hospital, Hyderabad and Al-Tibri Medical College and Hospital, Isra University Karachi Campus from July 2009 to December 2011. In the present 358 thyroidectomic specimens were collected from four different hospitals of Sindh. Specimen of thyroid tissue was taken after the end of thyroidectomy. The tissues were fixed in buffered neutral formalin and after processing embedded in paraffin to form tissue blocks. A 5 micro m thick sections were cut by microtome and the sections were then stained with Hematoxylin and Eosin [H and E] strain. Special stain like PAS were also used for confiring specific diagnosis. The histopathalogical examination was then carried out for any morphological changes. The results showed that hospital-based frequency of throidectomy specimens was found to be 4.1%, indicating that the thyroid diseases are common in plain areas of Sindh. Multinodular goiter was the most common histopathological pattern in 202 cases and usually presents as asymptomatic lump in the neck. Thyroid neoplasms were found to be the second most common disease in 94 cases specially in the follicular adenoma and papillary carcinoma. The mean +/- SD age of the patients in 358 thyroidectomy specimen was 32.65 +/- 10.66 years. The persons having age ranges between 10 to 70 years were considered. The youngest patient included in our study was 10 years old female with colloid adenoma. The female to male ratio was 2.5:1. Thyroid diseases are common in plain areas. Multinodular goiter is the most prevalent thyroid disease. Follicular adenoma and papillary carcinoma are the most frequent thyroid neoplasms. It is therefore concluded that multinodular goiter and thyroid neoplasm are the most common pattern in thyroid diseases in these ares

Lichtenstein repair; A community based teaching hospital experience

To describe our experience of Lichtenstein repair in a community based teaching hospital. This prospective study included patients presenting to the surgical outpatient department of Fatima Hospital for elective hernia repair over a 2 year period. Sixty four patients underwent hernia repair. All were males. Most common [67%] were indirect inguinal hernias. Fifty-seven percent had no symptoms. Chronic constipation was present in 22% and cough in 11% patients. Eighty six percent of the patients had no co-morbidities and 84% patients belonged to ASA class I. Eighty seven percent procedures were performed under spinal anesthesia. Mean operating time was 57 +/- 18 minutes with no operative complications. Four patients had scrotal hematoma and 3 had seromas, while one patient each had wound infection, spinal headache and urinary retention. None of the patients required surgical intervention or mesh removal. Average cost per patient was 3204 +/- 510 rupees. Our outcomes of Lichtenstein repair were comparable with the international and local literature. Further reductions in costs can be achieved by performing the procedure under local rather regional anesthesia

Scanning Electron Microscopy studies on Wohlfahrtia nuba [myiasis producing fly] larvae

Using SEM techniques, micromorphological features of the three larval instars of Wohlfahrtia nuba were studied, revealing their anterior ends, anterior spiracles, and posterior ends and posterior spiracles. We illustrated some important differences especially in shape and size of the mouth hooks, size, number and shape of the leaf-like structures surrounding the mouth vestibule and the blunt broad branches of the lower end of the frontal sclerites. Also, this work illustrates the process of first larval moulting, which occurs through a longitudinal line starting from the anterior end of the larva till reaching its posterior end. Characteristic morphological differences were illustrated between the three larval instars as well. Thus it seems that it is of much importance to use SEM in the study of the larval stages of myiasis-producing flies and not only in the third stage

Cost review of basic surgeries at Fatima hospital

Fatima Teaching Hospital provides basic surgical and medical facilities for rural population of Karachi. The hospital, being a project of the Baqai Foundation, provides these facilities at reduce costs. This article summarizes the costs of three basic procedures offered at Fatima Hospital. The hospital performed a total of 99 hernia repairs, 34 cholecystectomies and 24 hemorrhoidectomies over a 12 month period. The total cost paid by the patients for each, uncomplicated procedure, was 3390/-, 4010/- and 1600/- respectively. The contributions made by the Baqai foundation amount to be Rs 1000/- per patient per day. The overall contributions made by the Baqai Foundation over 1 year period for the three procedures was 297000/-, 170000/- and 87000/- respectively. Baqai Foundation is making significant contributions towards provision of basic medical and surgical facilities to the poor people of rural Karachi, at a much subsidized and affordable rates

Effects of Jurak extract on the locomotor activity and brain acetylcholinesterase level in mice

The aim of the study was to examine the effects of jurak [a mixture of tobacco and fruits] extract on locomotory behaviour and brain acetylcholinesterase [AChE] activity in male albino mice. Adult, Swiss-Webster mice of same age and weight were injected subcutaneously with 2.5 or 15 mg jurak extract/kg body weight in aliquots of 0.1 ml normal saline. The locomotor indices comprising the number of squares crossed squats, durations of locomotion and immobility were observed at 15, 30, 60 and 120 min intervals post-injection [PI]. The mice were also allowed to cling to a wire and the time taken to fall down [clinging time] was used as an indication of myorelaxation. The AChE level was estimated in the brain tissue at 30 and 120 min PI. A significant suppressive effect of jurak extract was observed on all tested locomotory indices. The brain AChE activity was significantly elevated at lower doses whereas at the high dose of 15 mg/kg it reverted to normal level. The results indicated a low correlation between the behavioural indices and the brain AChE activity following injection of jurak extract, stressing the need to consider factors like the form of nicotine administered, use of nicotine antagonists and to assay the nicotine concentrations in the tissue of the site controlling behavioural responses