Orthodontic treatment needs and association between malocclusion and oral hygiene behaviors

The objective of the study was to determine orthodontic treatment needs and investigate the relationship between malocclusion and oral hygiene behaviors and oral problems among male Saudi schoolchildren in Dammam. This cross-sectional study involved male intermediate schoolchildren [age 12-16 years] from public schools of Dammam, Saudi Arabia. A sample of 376 children was selected using multistage random sampling. The orthodontic treatment needs were assessed using dental aesthetic index [DAI]. The World Health Organization [WHO] questionnaire was used to collect data about oral hygiene habits and problems. The prevalence of malocclusion was 19.7%. Thirty four [9%] children had DAI scores [26-30], and had definite malocclusion that required elective treatment. Twenty two [5.9%] children had severe malocclusion [ DAI scores 31-35], and treatment was highly desirable. DAI score of >/= 36 was found in 18 [4.8%] children with severe or handicapping malocclusion that required mandatory orthodontic treatment. A higher proportion of children [85.1%] with malocclusion cleaned their teeth daily in comparison with children without malocclusion [76.8%]. A significantly [p = 0.023] higher proportion of students with malocclusion [60.8%] was dissatisfied with their dental appearance than those with normal occlusion [46%]. In conclusion, a high prevalence of malocclusion was observed among male schoolchildren in Dammam. The study found no statistically significant relationship between malocclusion and oral hygiene behaviors

Extraction and isolation of important bioactive compounds from the fruit of Physalis ixocarpa

The current study investigates pharmaceutically important bioactive compounds in the fruits of Physalis ixocarpa. Two different extractions methods were used to study its effect on percent extract yield, recovery of bioactive compounds and antioxidant activity of the extracts. The data indicated that Soxhlet extraction had high efficiency of recovery than maceration method for extracting compounds; percent extract yield and antioxidant activity of the extracts. In maceration, the percent extract yield was found to be in order of water >methanol >ethyl acetate whereas in Soxhlet extraction, it was in order of methanol >water >ethyl acetate. Ethyl acetate extract produced by Soxhlet extraction showed strong antioxidant activity of 59.7% [250ppm] as compared to other extracts. Analysis of ethyl acetate extract showed the presence of Triglyceride. GC-MS study of triglyceride revealed the presence of trilinoleinic acid [9,12Octadecdienoic acid], tripalmitin [hexadecanoic acid] and trioleinic acid [9-Octa decenoic acid]. Four impure and three pure compounds were isolated from crude methanol extract of the fruit. The structure of pure compounds were identified by NMR and characterized as sugar, glucose and fructose

Pattern of facial gunshot and blast injuries amongst law enforcing forces

Objective: To assesses the pattern of maxillofacial gunshot and blast injuries amongst law enforcing forces personnel

Study Design: Descriptive Study

Place and Duration of Study: Combined Military Hospital Lahore from Jan 2010 to Dec 2010

Materials and Methods: This prospective study evaluated 52 patients from Jan 2010 to Dec 2010 at Combined Military Hospital [CMH], Kohat Pakistan. All patients in this study were males as fighting corps of law enforcing forces comprises only male soldiers and officers. Patients aged from 18 to 50 years with mean age 29.12 years +/- 8.56 years

They were assessed for presence of gunshot and ballistic injuries by clinical examination and evaluation of necessary radiographic investigations

Results: Nineteen patients out of total 52 patients had no other injury which accounts for about 36.9%. In maxillofacial area upper third of face was most frequent site to receive gunshot and ballistic injuries as 10 patients received injuries to upper face which measures about 19.2%. Along with maxillofacial area upper limbs were most common site affected as 14 patients received injuries to upper limbs which is 26.9% of all patients

Conclusion: Gunshot wounds present a great challenge to oral and maxillofacial surgeons and a multidimensional team approach is required to rehabilitate the victims of gunshot injuries

Triple assessment in the diagnosis of carcinoma breast: mammography along with clinical symptomatology

To determine the clinical symptoms and marnrnographic findings in patients of carcinoma breast. Validation study. Armed Forces Institute of Radiology and Imaging Rawalpindi, from January 2011 to Dec 2011. Women of > 30 years of age including premenopausal and postmenopausal with positive findings on histopathology were included in the study. Pregnant women, breast-feeding women, women younger than 30 years old [in whom only sonography was performed] were excluded from the study. Total 57 female patients were included in the study through non-probability consecutive sampling. Mean age of the patients was 52.8 years [SD = 10.3]. Age range of the patients was between 32-72 years. Maximum patients were in the age group of 40 - 50 years. A total of 42.1% patients reported with complaint of lump and mastalgia while 29.8% with lump alone. As far as mammographic findings are concerned speculated mass with axillary lymphadenopathy was the major finding. Histopathological results showed that most common malignant mass was invasive ductal carcinoma [89.5%]. Mammography is the mainstay for evaluation of breast cancer but only patients with the complaints of lump and mastalgia should be evaluated through mammography to avoid unnecessary evaluation

Acute appending: diagnostic algorithm using routine ultrasonography and optional computed tomography

Objective: to access the algorithm in diagnosis of acute appendicitis, using routine ultrasonography and optional computed tomography [CT]

Material and Methods: it was prospective study of 128 patients presenting in emergency department with complaint of pain right lower quadrant of abdomen. After clinical evaluation and lab investigations, ultrasonography abdomen was done for all patients. If provisional diagnosis was made on these bases, treatment was started. If ultrasonography findings were negative or inconclusive, CT was done with intravenous contrast. The final diagnosis was made by ultrasonography/CT report, operative findings, histopathology report of the removed specimen and outcome of the treatment

Results: after completion of initial clinical workup and ultrasonography, we were able to make provisional diagnosis in 90 patients. Ultrasonography showed inflamed appendix in 76 patients, alternate diagnosis in 14 patients and in 38 patients report was normal or inconclusive. CT was done in these 38 patients. CT scan showed inflamed appendix in 15 patients and alternative diagnosis in 4 patients. In 19 patients CT report was normal. 91 patients were operated for open appendectomy. In 85 patients, inflamed appendix was proved on histopathology and in 6 patients, appendix was normal. Accuracy of clinical diagnosis alone was 81 %, with Ultrasonography was 85%, with CT was 97% and accuracy of whole diagnostic pathway was 95%

Conclusion: in suspected case of acute appendicitis, diagnosis algorithm using routine ultrasonography and optional CT yields high diagnostic accuracy. Patients with normal ultrasonography and CT findings can be safely observed

Comparison of awareness about nephrology and kidney diseases amongst doctors in institutes with and without nephrology departments

To compare the awareness about nephrology and kidney diseases in medical officers and postgraduate trainee doctors working in institutes with and without nephrology departments. This cross sectional study was conducted at Nephrology Department, Shalamar Hospital Lahore from 1[st] Jan to 31[st] Mar 2013. Doctors working on medical floor with more than one year experience after house job were included in the study. Each doctor was given questionnaire comprising of 28 questions. Two hundred and eleven doctors fulfilling the criteria were included in the study. Most of the doctors were male 150[71.1%]. Knowledge had strong correlation with practice [p= 0.001]. Knowledge regarding nephrology and chronic kidney disease [CKD] was found significantly different among doctors of different hospitals [[F=36.09, p=0.000]. Practice regarding nephrology and chronic kidney disease [CKD] was found significantly different [F= 7.222, p=0.000]] among doctors of different hospitals of Lahore. Doctors working in the Shaikh Zayed Hospital [SZH], Lahore were having maximum score in the components of the knowledge and practice than other hospitals. Awareness of the Medical Officers and postgraduate doctors is poor regarding nephrology and kidney diseases. Doctors working in institutes with established nephrology services have better knowledge than other units. Working experience of doctors improve the practice significantly

Management of obstructive sleep apnea and facial asymmetry by distraction osteogenesis of mandible

Micrognathia and obstructive sleep apnea syndrome [OSAS] are problems subsequent to temporomandibular joint ankylosis [TMJa] in growing patients. For patients with micrognathia and OSAS secondary to TMJa, it is important to restore proper mandibular form and posterior facial height, achieve occlusal stability and satisfactory mouth opening. We report a 2-year follow-up of a patient with Micronesia and OSAS secondary to unilateral TMJ ankylosis of the right side. The patient had an operation of TMJa before she reported to us but mouth opening was limited. The treatment involved vertical ramus osteotomy, coronoidectomy and external distraction osteogenesis of her mandible. After the treatment of micrognathia oropharyngeal airway space was increased, patient was followed up for 2 years and the results remain uneventful

Choroidal metastasis from renal cell carcinoma presenting with cataract

We report a case of rare involvement of the eye with choroidal metastasis from renal cell carcinoma presenting 08 years after the primary tumor was removed. The patient initially presented with cataract most probably induced by the tumor. After cataract extraction, tumor was detected when it induced vitreous involvement and retinal detachment. Enucleation was performed and an extraocular mass was also excised. Histopathology confirmed the diagnosis of metastasis from renal cell carcinoma in the ocular tumor, extraocular mass and the vitreous

Neurofibromatosis type II: a rare neurocutaneous syndrome

Neurocutaneous syndromes are heterogeneous group of disorders with abnormalities of central as well as peripheral nervous system. Neurofibromatosis type II [NF-II] is an autosomal dominant neurocutaneous syndrome rarely diagnosed in pediatric population. Diagnosis is based on clinical history and radioimmaging. We present a 14 years old boy with headache and decreased hearing, who turned to be a case of neurofibromatosis type II

Diagnostic role of EEG in children having unprovoked seizures, experience at the neurophysiology department, The children's hospital, Lahore

Although advances in imaging technology offer ever-increasing diagnostic accuracy, the electroencephalogram [EEG] retains its importance and is the cornerstone for the diagnosis and treatment of epilepsy. A cross-sectional descriptive study was conducted at Neurophysiology Department of The Children's Hospital, Lahore. Our aims were to find out the different types of epilepsies diagnosed on EEG in children referred for interictal EEG with recent clinical diagnosis of epilepsy. Out of 645 children referred for EEG after seizures, 415 [64%] were males and 230 [36%] were females, 21% had their first seizure before one year of age, 54% of them were between the ages of 1-5 years and 46% of them were more than 5 years of age. We found normal interictal EEGs in 54% whereas 46% children had abnormal EEGs. So in addition to supporting the diagnosis of epilepsy, EEG has significant potential to classify epileptic seizures

Tranverse myelitis: Unusual site of involvement

Transverse myelitis is defined as an acute inflammation of spinal cord leading to abrupt onset of weakness of lower limb. In majority of cases, mid thoracic spine is involved. We present a ten year old girl whose cervical spinal cord was involved which is rare. MRI of spine is the investigation of choice

Myotonia congenita in a brother and sister

Myotonia congenita is a rare channelopathy and carries a good prognosis. Two cases of young siblings are presented detected with difficulty in gait and motor activities. Both had typical hypertrophied body musculature. EMG was diagnostic

Comparison of optical urethrotomy with perineal urethroplasty in the management of traumatic blind posterior urethral stricture

To assess the efficacy, safety and complication of optical urethrotomy in traumatic blind posterior urethral stricture, and compare results with perineal urethroplasty. A prospective study of 40 cases of blind traumatic urethral stricture was conducted at the department of urology, Services Hospital Lahore from Feb: 1997 to March 1999. Majority of the patients [32] were in the 2nd to 4th decade of life. Most cases [30] belonged to the urban areas and the common site was membraneous urethra. Road traffic accident [36] and fall from height [3] were the commonest causes of stricture development. Twenty cases were treated with optical urethrotomy and 20 by urethroplasty. Although results of perineal urethroplasty were good [77.5%] as compared to optical urethrotomy [68.5%] but statistically no significant difference observed between two groups [P=0.257]. The difference between morbidity, mean peak flow rate and mean residual urine was also insignificant. There was significant difference between two groups in terms of operative time, mean hospital stay and blood transfusion. It is recommended that optical urethrotomy may be used as a alternative procedure to urethroplasty in patients with blind traumatic posterior urethral strictures

Quality control procedures to avoid repeat films in diagnostic radiology department

This study was conducted to assess the repeat film rate and major causes of artefacts, which are major sources of unnecessary patient irradiation in a radiology department. In this study a total number of 2542 x-ray examination were carried out in a period of six months. Out of this, 81 patients were re-examined due to unacceptable results. To avoid repeat film and unnecessary patient irradiation, aggressive quality control program must be instituted in radiology departments. This includes equipment procurement and maintenance, proper reception, procurement and maintenance, proper reception, preparation and registration of patients, expertise of radiographers and efficient processing procedures. Repeat rate estimation on quarterly basis is an important requirement of quality control program