Impact of vitamin d on development of early childhood caries

Objective: To compare the levels of vitamin D in children with early childhood caries and children with healthy sound dentition

Study Design: Cross sectional study

Place and Duration of study: The study was conducted at Islamic International Medical College from September 2015 to March 2016

Material and Methods: Eighty children, between 2-8 years of age, were recruited after fulfilling a questionnaire from their parents or care giver. The sample population was divided into two groups. Group 1 consisted of children suffering from dental caries and was comprised of 60 patients. Group 2 consisted of children with sound healthy teeth and was comprised of 20 children. Questions assessing children s socioeconomic background, dietary habits particularly frequency of sweet and milk intake, outdoor activity and dental hygiene related behavior were included. The diagnosis of childhood caries was based on oral health diagnostic criteria defined by World Health Organization [WHO] Overall total caries score [decayed missing filled teeth index] was obtained

Levels of 25-hydroxyvitamin D [25[OH] D] was measured from serum samples of the children participating in this study using enzyme linked immunosorbent assay [ELISA]. Correlation analysis was done with Pearson correlation and t-test was applied

Results: Results have established association of Vitamin D levels in children with early childhood caries. Pearson correlation and t-test have revealed that total decayed, missing, filled primary teeth [dmft] caries score was also associated with 25[OH] D concentrations less than 30ng/ml, decreased oral hygiene, lower monthly income, increased sugar consumption, decreased milk intake and decrease outdoor activities. This cross-sectional study showed that carries and lower serum vitamin D are closely related with each other

Conclusion: Data from this cross-sectional study showed that dental caries and lower serum vitamin D were closely related. Improving children's vitamin D status may be an additional preventive consideration to lower the risk for caries

Risk factors for preterm births in lady reading hospital, Peshawar

To determine the various maternal and neonatal risk factors of preterm birth. A descriptive case series was conducted from 1st January 2010 to 3Jxt December 2010. In this study all cases, a live Pre term birth [PTB] [29 - <37 weeks] by vaginal delivery or caesarean section and their mothers were included. A total of 205 [04.04%] neonates were identified as premature neonates. Majority [29.3%] were in the age range of 2 days with mean age of 1.5073 +/- 1.2627 days. Out of 205, 51.7% were male and 48.3% were female. Maternal age of 21-35 years was recorded in majority 79.51% with mean age of 28.10 +/- 5.8982 years. Majority of mothers [96.1%] were illiterate, 76.6% belonged to rural areas, 76.1% belonged to poor class, 35.1% were multiparas. A history of Premature rupture of membrane [PROM] was found in 61% cases, history of burning micturition 4.9%, physical injuries 0.5%, polyhydramnios 14.14%, previous low birth weight baby 41.5%, threaten abortion 27.8%, antepartum hemorrhage 36.1%, previous perinatal loss 31.2%, previous premature birth 30.2%, maternal pyrexia 14.1%, previous twins 6.3% and placenta previa 4.4%. Frequency of prematurity was 04.04%. Among the various risk factors maternal age, illiteracy, rural residence, poverty, joint family setup, history of PROM, previous low birth weight babies, history of antepartum hemorrhage, multiparity, previous perinatal loss, previous premature babies, threaten abortion, were the prominent risk factors found in majority of cases

Prevalence of rhesus type and abo incompatibility in jaundiced neonates

To determine the prevalence of Rh and ABO incompatibility in jaundiced neonates. This hospital based descriptive study was conducted in Pediatrics Unit, Lady Reading Hospital Peshawar. A total of 200 neonates with clinically diagnosed jaundice were included in the study. Out of 200 neonates 70% were male and 30%female. Majority of neonates 99.5% age was ranged from 0-10 days while only 0.5% neonate was 13 days. Out of 200 neonates, the frequency of ABO-incompatibility and Rh-incompatibility in jaundiced neonates in this study was 22.5% and 12.5% respectively. Out of the remaining 65.5% cases physiological jaundice was diagnosed in 40.5% neonates, prematurity in 15% neonates and G6PD in 9.5% neonates. Among 22.5% cases of ABO incompatibility there were 16.5% males and 6% females. Majority 15% presented on 1[st] day of life, followed by 3% on 2[nd] and 3[rd] day of life respectively, 1% on 4[th] day, 0.5% on 5[th] day of life. Out of 200 neonates presented with jaundice, prevalence of ABO-incompatibility was found to be 22.5% followed by Rh-incompatibility 12.5%

Our experience of anesthetic management for separation of craniopagus conjoined twins

We describe the anesthetic/airway management for surgical operations in conjoined twins [Craniopagus] in Children Hospital, PIMS, Islamabad, in January 2011. The anesthetic technique and associated problems are summarized

Bone transport in segmental defect in femur and tibia using Naseer Awaits fixator

To evaluate the Ilizarov method of segment transport with a locally made linear Naseer Awais fixator. Design: Prospective study comprising Twenty cases. Setting: Department of Orthopaedics Allama Iqbal Medical College, Lahore [Pakistan]. Subjects: 19 male and one female reporting for segmental defects in femur and tibia both with and without infection. The locally made fixator proved reliable. The process of segment transport was completed in 16 cases, 4 had complications putting an end to the process. Consolidation of the segment was delayed as compared to studies by the pioneers in this field. Problems of pin tract infection, early consolidation improper docking, spindling of the regenerate segment and poor quality regenerate formation were encountered. Ilizarov method of segment transport has a sound biological basis. It is independent of the type of fixator. It requires great deal of time and effort on the part of the surgeon and the patients. The patients should be psychologically prepared and the whole course and mechanics of the procedure should be thoroughly explained to them

Leg lengthening with ilizarov method using locally devised, economical Naseer Awis fixator

Lengthening of short lower limbs using Naseer Awais [N.A] fixator. Design: Prospective study comprising 10 cases. Setting: Department of orthopaedics Allama Iqbal Medical College, Lahore. Subjects: Six male and four female patients reporting shortening of femur of tibia due to various causes. The lengthening was achieved in all cases. The consolidation and maturation of newly formed segment was delayed as compared with the pioneer studies. Pin tract infection, osteotomy site infection, bending of schaz screws and contractures were experienced. Ilizarov method is a dependable procedure of leg lengthening. It is independent of the type of fixator. Locally devised Naseer Awais [N.A.] Fixator is a useful economical device for lengthening

percutaneous kirschner wire fixation of Colles fracture

A prospective evaluation of closed reduction, percutaneous K wire fixation and external immobilization for Colles fractures in 45 patients is presented. The patients selected had unilateral fracture, were free from systemic bone disease and had no history of injury to the wrist in the past. Fractures were reduced by closed method under image intensifier, fixed with two K wires [1.6 mm diameter] and protected with a dorsal slab from metacarpophalangeal joints to proximal forearm. Pins and slabs were removed after six weeks and patients encouraged to resume normal activity. The patients were followed up for six months to one year at an interval of three months. 39 patients were available at one year for subjective and objective assessment. The clinical results in 30 patients were excellent, good in six patients and satisfactory in three patients. The results of this series demonstrate that simple percutaneous fixation with two wires can successfully maintain reduction in most displaced Colles fractures with a very low incidence of complications and unsatisfactory results and can be recommended as a procedure of choice for Colles' fracture

Experience with cutaneous, muscular and myocutaneous flaps in orthopedic problems

An evaluation of 44 patients of soft tissue defects mostly due to extensive musculo-skeletal trauma needing coverage by cutaneous or myocutaneous flaps is presented in this article. It also includes ten cases of non traumatic soft tissue defects needing flap treatment. The indications included: 1. Post-traumatic soft tissue defects. 2. Non traumatic chronic osteomyelitis without soft tissue defects. 3. Congenital soft tissue and skin problems like constrictions and contractures. 4. Soft tissue defects created by excision of tumours in limb salvage surgery. Skin flaps were mostly done where defects were small, infection mild and in all cases of congenital problems. Muscle flaps were used in larger soft tissue defects, in Grade III open fractures, cases of chronic osteomyelitis and soft tissue defects in tumour surgery. Most of the muscle flaps were in the region of tibia fibula and foot. Skin flaps showed 80% and muscular flaps showed 90% success rate. The overall rate of control of infection was 85%. There were two complete and two partial failures in muscle flaps. There were three complete and four partial failures in cutaneous flaps. We recommend the use of cutaneous flaps for relatively smaller and infection free defects and muscular or musculocutancous flaps where the soft tissue defects are bigger and there is greater degree/risk of infection like grade III B open fractures