level of patient satisfaction in emergency departments of public sector tertiary care hospitals, faisalabad

Introduction: The patient satisfaction is a feeling which affects the patient's experience in the hospitals. The services which they are provided with in the emergency departments also known as ED, need to be assessed on certain parameters in order to recognize the standard of the provided health care services in the emergency, and the meticulous assessment of the areas which require improvement

Objective: To determine the outcome of patients who were satisfied by the emergency services provided at the public sector tertiary care hospitals of Faisalabad to evaluate the parameters from which the patients turned out to be unsatisfied, in order to improve the quality of care

Study Design: This is a descriptive cross-sectional study

Setting: It was carried out in the Emergency departments of tertiary care hospitals in Public sectors, Faisalabad

Duration of study: The study was carried out within time frame of three [03] months [March to May 2017]

Sample Size: A real time survey was conducted on approximately 4000 patients

Data collection procedure: The patients visiting the ED in tertiary care hospitals were interviewed regarding their experience, their time of arrival, the medical personnel who received them and their satisfaction level with the provided treatment and care

Results: The most consistently observed finding associated with higher levels of satisfaction, was the patient-oriented care provided by doctors, nurses and paramedic staff. Doctors and nurses who spent more time with the patient, had better communication skills, showed more empathy and treated the patients within 5 minutes of arrival in the emergency resulted in more patient satisfaction. On the basis of these characteristics, the calculated number of satisfied patients turned out to be 75%. However, 25% of the patients responded that they would not prefer emergency departments of public sector tertiary care hospitals of Faisalabad for future visits

Conclusion: The evaluation of patient satisfaction level provided a precise estimation of the health care services in the Emergency departments which were up to the mark and which required improvement in order to serve the patients well in future

Viability of costochondral graft in temporomandibular joint ankylosis

Temporomandibular joint [TMJ] ankylosis is a very distressing structural condition that causes severe facial disfigurement leading to pathopsychological stress. Impairment of speech, difficulty with mastication, rampant caries, poor oral hygiene, disturbances of facial growth and severely compromised airway are the leading consequences of TMJ ankylosis. Surgical intervention is the widely accepted treatment modality of TMJ ankylosis. Current study was performed on 30 patients for three years [2009-2012] department of Oral and Maxillofacial Surgery, Children Hospital and Department of Nuclear Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore and costochondral graft was used to treat mandibular ankylosis. 21 [70%] patients were males and were divided into age groups of 2-5, 6-12 and 13-18 years. Regarding the side of mandible involved in male patients, unilateral ankylosis was found in 15[50%] and bilateral ankylosis were found in 6[20%] patients. Similarly in female patients, unilateral ankylosis was found in 7[23%] and bilateral ankylosis was seen in 2[7%] patients. Regarding post-operative monitoring of graft, bone scintigraphy was performed one week after the surgery and then after 12 weeks and 16 weeks to assess the viability and uptake of costochondral graft. Tc.99m MDP bone scan was performed in supine position with intravenous administration of 370MBq one week after the placement of graft. Results showed that out of 30 patients, CCG graft was viable in 28[93%] while it was non-viable in 2[7%] patients

Prevalence and severity of temporomandibular disorders [TMD] in undergraduate medical students using Fonseca's questionnaire

Objective was to assess the prevalence and severity of TMD in undergraduate medical students. It was a cross sectional descriptive study based on Fonseca's Questionnaire. It was conducted in four medical disciplines [Dentistry, Medicine, Pharmacy and Physical therapy] of The University of Faisalabad. All study participants were full time students and were females. Self-reported questionnaire was distributed among students and they were given detailed explanation to fill it. After collection of forms, scoring was done according to given standard method and data was entered in SPSS and statistical test of Chi-squared was applied. One hundred and thirty seven [137] students were enrolled and completed questionnaire of the study. 11[7.9%] students were observed with No TMD, 62[44.3%] with mild TMD, 62[44.3%] with moderate TMD and 5[3.6%] students with severe TMD [Fig 1]. Difference among age groups was significant [p?0.047] for three questions [Q2, Q, 5, Q10] There was no statistically significant difference regarding prevalence of TMD among all four disciplines of students. Regarding severity of TMD, it was observed that MBBS students were more in category of severe TMD as compared to other disciplines. It was concluded that the mean level of stress and TMD is almost equivalent in different disciplines of professional education with a variation in its level of severity which is 2 times more in MBBS students as compared to other students. There was no significant difference regarding prevalence of TMD in four groups of study

Etiology of mandibular condylar fractures; a study from tertiary care hospital of Lahore

It is a cross sectional study conducted in a tertiary care hospital. Patients of condylar fracture reporting to oral and maxillofacial trauma center were evaluated radiographically [OPG, PA view and Lateral Oblique View] as well as clinically to record the etiology of mandibular condylar fractures. A total of 70 patients of 3 to 45 years of age were included in this study. The frequency of condylar fractures was higher in male of all age groups except for 11-20 years where females comprised of 55.5% of the cases. Among males, the highest frequency of fractures occurred in the third decade of life. Regarding the etiology of mandible condylar fractures, falls [45.71%] and RTA [40%] were found to be the most predominant causative factors, followed by industrial and occupational accidents [6%], Sports injuries [6%] and assault injuries [3%]. Falls were the etiologic factor in most of the cases which explains the association of falls with the mechanism of condylar injury. Road traffic accidents were the second common cause. Type 2 fractures which are low neck fractures with displacement were seen to be the most frequent

Bidirectional relationship between chronic kidney disease and periodontal disease

Non communicable diseases [NCDs] affect the life of an individual in terms of mortality, morbidity and financial crises. Main NCDs are diabetes mellitus [DM], cardiovascular diseases [CVD], pulmonary diseases, osteoporosis and chronic kidney diseases [CKD]. About 40% of the total deaths can be controlled by eliminating the risk factors for NCDs. Periodontitis have recently been labeled as an important potential risk factor for NCDs. CKD affect the oral health status of patients by inducing gingival hyperplasia, xerostomia, calcification of root canals and delayed eruption of teeth. Periodontitis increases systemic inflammatory burden leading to worsening of CKD which in turn has been has been found to negatively affect CKD of patients on hemodialysis therapy by altering their serum albumin and C-reactive protein levels. As hypoalbuminemia leads to increased mortality in CKD patients, it needs to be avoided by reducing systemic inflammatory burden in patients receiving HD therapy. Treating periodontal disease could be one factor that might decrease the systemic inflammatory burden and thereby improve quality of life of these patients. Data from descriptive, cross sectional and longitudinal studies published between 2000 and 2012 were included. Data searches based on human studies only. The key words, periodontitis, chronic kidney disease and hemodialysis, on MEDLINE, approximately 120 studies were identified. 35 of them were relevant to all three keywords. Most of them were cross sectional studies and total 7 clinical trials were identified regarding checking of serum levels after periodontal therapy with variable results. Patients with CKD have higher prevalence of periodontal disease while non-surgical periodontal therapy has been indicated to decrease the systemic inflammatory burden in patients with CKD specially those undergoing HD therapy

Mixed dentition space analysis: a review

During mixed dentition period discrepancy between spaces available and required in the arch is predicted so that teeth can erupt freely with good alignment. Mixed dentition space analysis is done for this purpose in which size ofunerupted canine andpremolars is predicted. Accurate prediction is very important regarding correct orthodontic diagnosis and treatment planning. Prediction equation and or tables based on size of already erupted permanent teeth are the most widely used methods. Tooth size varies in different racial and ethnic groups and among genders so prediction equation and tables specific to each population for both male and female must be made. Mandibular incisors; combination ofmandibular incisors and mandibular 1[st] molars; and mandibular incisors and maxillary 1[st] molars have been used worldwide. Recent studies have reported that mandibular incisors are not the best predictors and sum ofmandibular incisors and maxillary 1[st] molars are even more accurate predictor for the estimation of size of unerupted teeth. In Pakistani population combination of mandibular incisors and maxillary 1[st] molar have not been employed so study must be conducted to estimate which combination of group of teeth is more accurate for the estimation of size of unerupted canine and premolars in local population