Clinical and endoscopic evaluation of haemetemesis

A study was undertaken at the Medical Intensive Care Unit of the Jinnah Postgraduate Medical Centre [JPMC], Karachi to assess the efficacy of oesophago-gastroduodenoscopy in 650 patients presenting with upper gastrointestinal bleeding. Clinical examination supplemented by endoscopic evaluation was helpful in identifying a cause in 91 percent of cases. Oesophageal varices, peptic ulcers and superficial mucosal lesions were the leading causes of haemetemesis occurring in 41 percent, 26 percent and 20 percent of cases respectively. Clinical diagnosis is very erratic and most of the cases presenting with upper gastrointestinal bleeding must be subjected to oesophago-gastroduedenoscopy

Factors influencing selection and arrangement of teeth in prosthetics

The artificial teeth are set up in the denture to satisfy the aesthetics and function of edentuluts patients. Artistic skill as well as a sound knowledge of oral and para-oral structures is pre-requisite for proper placement of teeth. In this article different factors for good denture construction have been discussed. Size shape and colour of the artificial teeth are important. Guidelines can be taken from the face from jaw size and the colour of the patient. Old denture, one or more remaining natural teeth and the patient's consent are also importnat. The anterior teeth must fulfill aesthetic and phonetic requirements while posterior teeth must be able to chew different foods efficiently. The muscular structure, bony pattern and relationship of the ridges also play a part in stable and functional denture construction