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

First line management of adult diabetic ketoacidosis patients

BackgroundiDiabetic Ketoacidosis [DKA] is a hyperglycemic crisis that can occur in patients with both type 1 and 2 diabetes mellitus. It is a medical emergency with a significant morbidity and mortality. It is however a potentially reversible condition in case an emergency and immediate medical attention, prompt recognition, diagnosis and treatment were provided

Aim of the Study: was to leverage the current research data in order to construct a treatment guideline for diabetic ketoacidosis in the emergency department

Methods:A literature search was carried out on MEDLINE [including MEDLINE in-process], CINAHL,Embase and the Cochrane Library. Databases using [diabetic ketoacidosis] as a MeSH heading and as textword. High yield journals were also hand searched

Findings: The initial treatment phase aims to restore circulating volume, reduce blood glucose levels, to correct any electrolyte imbalances and to reduce ketone levels which in turn corrects the acidosis. Evidence also showed that there is no need for insulin bolus prior to starting an insulin drip in the treatment of diabetic ketoacidosis. Also, using beta-hydroxybutyrate at presentation can expedite diagnosis and therefore treatment. Implementing treatment guidelines into the emergency department may help expedite diagnosis and treatment

Conclusion: Prompt first line management of DKA is the most critical stage to profoundly reduce morbidity and mortality rates of this potentially fatal crisis. It's therefore crucial to follow the evidence-based guidelines and DKA protocol in the emergency department to expedite diagnosis, guide treatment, and improve continuity of care between the emergency department and the ICU as well as improving the clinical outcomes of patients with DKA. Initially, this will improve outcomes by decreasing the delay until treatment is initiated andprovide a continuum of treatment between the emergency department and the intensive care unit

Furthermore, the healthcare providersmust ensure that they have the ability to provide support and education to people at risk of developing DKA and those that have had an episode of DKA by spreading awareness and education to help reduce both the initial occurrence and recurrence of this often preventable life-threatening condition

Oral Health; extent of awareness among patients visiting Islamic International Dental Hospital

It has been now established beyond doubt that dental diseases are the most common cause of human suffering. It is due to the impact of these diseases and human suffering that World Health Organization has included Oral Health as one of the indicators for health of individual. The National Oral Health survey clearly indicates that oral diseases burden the people of Pakistan and there is lack of perception of needs or absence of tooth ache that causes a delay in seeking dental treatment. The survey also shows that preventive services are rare and there is lack of oral health education, preventive practices and lack of dental health promotional programs in Pakistan. There is no study at national level to reflect the extent of awareness regarding oral health in population. The present study was conducted with the objective of evaluating the extent of knowledge regarding oral health among patients visiting Islamic International Dental Hospital [IIDH]. 200 patients visiting IIDH were randomly selected in this cross sectional study that was conducted from May to July 2013. Out of these 80 were male and 120 were female. The age range of patients was from 15 to 60 years. None of the patient had any psychological or motor dysfunction which could inhibit the perception and performance of oral hygiene measures. All the patients were educated and ensured of anonymity. A multiple choice questionnaire was designed and distributed among participants. The questionnaire included 13 questions with different responses and predetermined answers. The data thus collected was compiled, analyzed using SPSS version 17 and interpreted. In order to summarize the awareness level, responses were scored from 0-13 based on the number of correct responses. The extent of awareness was graded on a three scale parameter which was poor, fair and good. Results were expressed in terms of percentage. The results showed that only 4% of the patients scored good while 43%% and 53% scored fair and poor awareness respectively. The study concluded that the level of awareness regarding oral health is limited among patients visiting IIDH

Periodontal tissue destruction. Extent of periodontal tissue destruction in patients visiting IIDH

Periodontal diseases are the most common inflammatory diseases affecting the oral tissues. This study was conducted to determine the extent of destruction of periodontal tissues in patients visiting Islamic International Dental Hospital [IIDH] and also to compare different variables e.g. age, brushing, plaque, calculus, recession, BOP, systemic diseases etc with periodontal destruction. Cross sectional study. Department of Periodontology Islamic international Dental Hospital, Islamabad. November 2011 to December 2011. 80 patients 52 males and 28 females were randomly selected. A questionnaire was designed and two house officers were calibrated and trained in filling the questionnaire and examining the patient in department of Periodontology of Islamic International Dental Hospital. The results show that 25% of the patients were healthy with no loss of supporting structures. 30% of the patients had early periodontal destruction, 28% of patients had moderate periodontitis and 17% were having advanced periodontal destruction. Periodontal destruction was more in males as compared to females and periodontal destruction increased with increasing age. It may be concluded from the study that prevalence of periodontitis increases with advancement of age

Effect of orthodontic treatment on periodontal health

This study was undertaken to assess the effects of orthodontic treatment on the periodontal health of young patients. 50 patients were randomly selected irrespective of sex from the orthodontic department of Islamic International Dental Hospital, Islamabad. Periodontal examination was performed before, after six months and after 18 months of treatment. CPITN [community periodontal index for treatment need] was used to assess the periodontal health of indexed teeth. SPSS version 17 and Chi Square test was used to analyze and compare the data. The results showed that patients undergoing orthodontic treatment do show the signs of periodontal disease. Comparison of patients of pre ortho and intra ortho revealed a p value of 0.02 while p value of patients during and after orthodontic treatment suggested a strong relationship between progress of periodontal disease during orthodontic treatment. P value of 0.456 of pre and post ortho patients suggested that there is no direct relationship between the two. The knowledge, attitude and practice on gingival health among orthodontic patients were poor

Management of gingival pigmentation: an experience at islamic international dental hospital, Islamabad

This study was undertaken to evaluate the difference between two surgical techniques; gingivectomy incision and epithelial denudation forthe management of melanin pigmented gingiva. Quasi experimental study. Islamic International Dental College, Islamabad. Twelve patients with healthy periodontium and complaining of black pigmented gingival with 20- 30 years of age, who reported at Islamic International Dental Hospital, Islamabad were selected. Six of them were treated with gingivectomy incision and other six were treated with epithelial denudation. The results were quite promising indicating that patients undergoing epithelial denudation showed healing more rapidly with little post operative complaints as compared to patients undergoing gingivectomy. Although both techniques can be used for treatment of pigmented gingiva but epithelial denudation is better than gingivectomy in terms of less post operative pain and sensitivity and early healing of the lesion