Frequency of undiagnosed hypertension in patients presenting with stroke

Objective: To determine the frequency of undiagnosed hypertension [HTN] in patients presenting with stroke

Study Design: Descriptive cross sectional study

Place and Duration of Study: Department of medicine, Combined Military Hospital [CMH] Kohat from June 2011 to June 2012

Material and Methods: A total of 190 patients with stroke were included in the study with non-probability, consecutive sampling. Written informed consent and demographics of patients were obtained and permission of the hospital ethical committee was taken. Detailed past history was obtained especially focusing on whether a known hypertensive patient or using any antihypertensive medication. All the patients were subjected to detailed physical examination. Blood pressure [BP] was measured by using standard mercury sphygmomanometer on two different occasions 10 minutes apart and the patient was labeled as hypertensive if both readings showed equal to or more than 140/90mmHg of blood pressure

Results: The mean age of patients was 46.31 +/- 15.30years. There were 126 [66.3%] males and 64 [33.7%] females. The mean systolic BP of patients was 125.59 +/- 19.97mmHg while diastolic BP was 86.32 +/- 12.62 mmHg. In this study, there were 64 [33.7%] cases who had undiagnosed HTN before stroke. The difference was insignificant among different age groups and both genders [p-value>0.05]

Conclusion: The frequency of undiagnosed HTN is high in patients presenting with stroke which calls for a proper screening program to diagnose and treat HTN at early stage to prevent such deadly complications

Some unfavorable intraoral features in edentulous patients reporting for complete denture treatment at the prosthodontics department of a teaching dental hospital

Introduction and Objectives: To gain an insight into the prognosis of complete denture treatment, the dental practitioner must be familiar with the anatomical and physiological condition of edentulous mouth of each individual patient. This study reports frequencies of some common unfavorable intra-oral features in edentulous patients reporting for complete denture [CD] treatment at the Prosthodontics Department, Khyber College of Dentistry [KCD] Peshawar [Pakistan]

Methodology: This was a descriptive, cross sectional study conducted during the period from February 2011 to February 2013.Using pre-structured data collection sheet, information of some unfavorable intraoral features of edentulism was recorded from patients seeking consultation for complete denture therapy in both jaws for the first time. History, clinical and radiographic examinations were the method for assessing the unfavorable intraoral features including mandibular bone height, maxillary residual ridge morphology, pattern of muscle attachment and maxillo-mandibular relationship

Results: Mean age was 61.8 +/- 9 years with male to female ratio of 1.27. Patients easy-to-treat with conventional CDs were 43 [27%] as compared to 116 [73%] who were difficult-to-treat. The frequencies of unfavorable features including mandibular bone height, maxillary residual ridge morphology, pattern of muscle attachment and maxillo-mandibular relationship were 60 [37.7%], 40 [25%], 54 [34%] and 55 [34.6%] respectively. Females had significantly reduced mandibular bone height

Conclusion: The high frequency of unfavorable intraoral features suggests screening of edentulous patients for knowing their levels of treatment complexity with conventional complete dentures

Determining the oral surgery confidence and factors influencing non compliance with pre-prosthetic surgery

The objective of this study is to determine the factors responsible for noncompliance in pursuing preprosthetic surgery and baseline oral surgery confidence amongst patients reporting to Khyber College of Dentistry, Peshawar. This cross sectional analytical study was carried out at the Department of Prosthodontics at Khyber College of Dentistry, Peshawar. Informed consent was taken from the patients participating in the study. A custom made proforma was made to note demographic variables for comparison with the Litt's Oral Surgery Confidence Questionaire [OSCQ], the type of preprosthetic surgery required and factors influencing noncompliance with the said procedure namely increased treatment duration, local and systemic morbidity, associated expenses, failure of surgery and myths heard or believed. Scoring of the OSCQ was done from 0-9 on 11 items and total score calculated. T-test was used to determine significance of gender and level of education with OSCQ score [p-value <0.05]. One way ANOVA was utilized to determine significance of age and required procedure with OSCQ score [p-value <0.05]. 105 patients comprised the study sample with a M:F ratio of 1:1.05. The mean age of the sample was 58.06 +/- 11.22 years. Illiterate patients accounted for 82.9%. Alveoloplasty was the most commonly prescribed procedure [56.2%]. Local and systemic morbidity was the most common factor leading to noncompliance in undergoing preprosthetic surgery [29.5%]. The mean OSCQ score was 46.61 +/- 11.91. Gender and level of education were found to have a significant relationship with OSCQ scores [[p-value <0.05] whereas age and procedure required did not show the same with OSCQ scores [p-value >0.05]. Illiteracy was the predominant educational state amongst the sample and alveoloplasty was the most commonly prescribed procedure alone and also in combination with other procedures. Moderate confidence level was noted in undergoing oral preprosthetic surgery. Gender and educational levels showed a significant relationship with OSCQ scores and these are the areas that should be focussed on to improve compliance in pursuing pre-prosthetic surgery which in turn can improve satisfaction with the use of complete dentures

Factors influencing the type of prosthetic restoration for partially dentate adults

In developed countries, patients' factors and esthetic concerns have predominantly influenced prosthodontic treatments. The objective of this investigation was to see if such factors in local partially dentate patients influenced the clinicians' decision regarding the prostheses planned. This was a descriptive study carried out in Khyber College of Dentistry, Peshawar from March to October 2007. Using a structured data collection-sheet, patient's data including gender, age, socio-economic status, educational level, oral-hygiene status, main concern of patients for consultation and the number, location and type of saddles in the jaws were all recorded. The type of prosthodontic service planned for each patient was also recorded. One investigator collected the required data from each of the 206 partially dentate patients by the method of direct interviewing. Acrylic removable dental prostheses [RDPs] were more frequently provided than fixed dental prostheses [FDPs]. No precision-retained or implant-supported prosthesis were planned. Irrespective of the type of prosthesis, the restoration of chewing function was the major concern of patients for consultation. Age, socioeconomic status, educational level and type of saddle in the maxilla influenced patients' treatment with RDPs. In comparison, better socioeconomic status and educational level were the reasons in case of planned FDPs. The reason for the planned FDPs in the maxilla was esthetics as compared to improvement in chewing function in case of the mandible. Acrylic RDPs were the most frequently planned prostheses. Patients; socioeconomic status and educational level and the type and location of saddle influenced the type of prosthesis planned for patients