Variability in the therapeutic response of metformin treatment in patients with type 2 diabetes mellitus

Objective: To assess the glycemic response of metformin in patients with Type-2 Diabetes Mellitus [T2DM] as well as to see its association with reductions in BMI and GIT intolerance

Methods: This Quasi, Experimental study was conducted at Jinnah-Allama Iqbal Institute of Diabetes and Endocrinology [JAIDE] Jinnah Hospital, Lahore from 1st March 2016 to 30th September 2016. Newly diagnosed T2DM patients were given metformin for duration of three months and later on they were categorized into Responders and Non-Responders on the basis of HbA1c [A1C] reductions, which were estimated by Hemoglobin [A1C] analyzer [TD4611A TAIDoc Tech. Taiwan] through photometry. Similarly, baseline BMI and BMI after three months therapy with metformin was also recorded

Results: Among total of 200 patients, 40.5% of the patients were classified as Non-Responders whereas; 59.5% of the patients as Responders. The baseline BMI [26.09 kg/m2] was also decreased significantly after metformin therapy [25.40 kg/m2]. It was found that metformin reduced the A1C in all the patients. However, the glycemic control was much better in patients with higher baseline A1C [1.13% ± 0.08] as compared to lower baseline levels [0.61% ± 0.07]. Regarding GIT intolerance, 140 patients lacked the symptoms, out of which 60.7% were responders and 39.3% were non-responders

Conclusions: Metformin lead to improvement in glycemic control in 59.5% of newly diagnosed T2DM patients after taking metformin for three months but in 40.5% it did not which may be because of combined effects of various gene polymorphisms and their interaction with non-genetic factors. Metformin reduced the BMI in all the patients; however, BMI lowering activity of metformin was same regardless of its effect on HbA1C. Moreover, the signs and symptoms of GIT intolerance did not differ between the two groups

Comparison between extra oral and intraoral surgical procedures for the management of mandibular angle fractures

Objective: To evaluate and compare the treatment outcomes of isolated mandibular angle fractures managed by open reduction and internal fixation using intra oral and extra oral approaches. Study Design: Randomized control trial. Place and duration of Study: Department of oral and maxillofacial surgery, Liaquat University Hospital Hyderabad, from May 2011 to Nov 2011

Patients and Methods: The patients who presented with isolated mandibular fracture were selected according to inclusion criteria. The diagnosis was made by standard history, clinical examination and radiographic investigations. The patients were randomly divided into two groups, A and B. Group A patients were managed by extra oral approach and group B patients were managed using intra oral approach. The patients were prescribed antibiotics for one week and follow up was carried for four weeks. Nerve damage, limited mouth opening, infection, mal-occlusion, hypertrophic scar and aesthetic dissatisfaction were immediate and late post operative complications observed and documented

Results: Road traffic accident [RTA] was the main etiologic factor [66.66%]. Marginal mandibular nerve damage was noted in 20% cases treated with extra oral approach [group A]. Post operative esthetic dissatisfaction was present in 60% patients [group A] as compared to 6.66% of the patients [group B]. The rate of mouth opening compromise and mal-occlusion were also higher in the patients treated with extra oral approach compared with intra oral approach, although statistically not significant

Conclusion: The intra oral approach for mandibular angle fracture management is an effective and comparatively better technique as compare to the extra oral approach

Evaluation of 99mTc-sulfadiazine as Bacillus microorganisms infection imaging agent using animal model

Bacterial infection is one of the vital sources of morbidity and mortality. The development of single photon emission computed tomography [SPECT] radiotracer agents using antibiotics, for targeting in-vivo bacteria, helps in antibiotic dose calibration, targeted infection therapy and reduction in mortality rate. The aim of this study was to appraised [99m]Tc-labeling sulfadiazine as a radiopharmaceutical for bacillus infections imaging. Radiolabeling of sulfadiazine with technetium-99m was carried out by subsequent addition of 1.5 mL aqueous solution of sulfadiazine [1mg/mL], 120Mug stannous tartrate, gentistic acid as stabilizing agent and 185 MBq normal saline solution of 99mTcO4 -1 [pertechnetate] at pH = 5. The reaction mixture was incubated for 40 min at room temperature with light stirring. The quality control analysis [ITLC-SG and paper chromatography analysis] revealed 98% labeling yield. Biodistribution and scintigraphic study was carried using bacillus bacterial infection induced New Zealand white rabbits. Due to the ease of [99m]Tc-sulfadiazine conjugation method, high labeling efficiency, shelf stability [>95% up to 6h], blood serum stability [90% up to 6h] and high uptake in the infected muscle [T/NT =2.21 at 1h], [99m]Tc-SDZ could be used as radiopharmaceutical of choice for further pre-clinical and clinical studies

Etiology, patterns and treatment modalities for mandibular fractures

Objective: The objective of current study was to evaluate the etiology, patterns of presentation, frequency and different treatment modalities for mandibular fractures in patients treated at Lahore Medical and Dental College/Ghurki Trust Teaching Hospital [LMDC/GTTH]

Methodology: This descriptive – cross sectional study was conducted at Lahore Medical and Dental College, Lahore/Ghurki Trust Teaching Hospital [LMDC/GTTH] from March 2015 to September 2017. The current study included one hundred and twelve [112] patients who were indentified having mandibular fractures. Data were collected regarding patient's age, gender, etiology, site of fracture, patterns and treatment modalities and analyzed using SPSS version 20

Results: The patients' ages were between 3 to 55 years [24.87+/-10.867, mean/SD]. The majority of fractures occurred amongst 21-30 years of age group having female to male ratio of 1:5.6. Road traffic accident [RTA] was the most frequent etiological factor for mandibular fractures in 89 [79.47%] of patients, followed by assaults 11[09.82%] and fall 07 [06.25%]. A total of 189 fractures were recorded in 112 patients giving a mean of 1.7 fractures per patient. Out of 189 fractures, the parasymphysis was the most prominent site of mandibular fractures[43.39%], followed by condyle [22.75%] and angle [15.87%]. The treatment modality of open reduction and internal fixation [ORIF/ORIF with IMF] was performed in 88[78.57%] of patients while closed reduction and indirect fixation [IMF with eyelet wiring/arch bar elastics and splint fixation] was done in 24 [21.43%] of patients

Conclusion: As evidenced by the present study, road traffic accidents are the most common cause of mandibular fractures in young adults, mostly due to violation of traffic rules. These findings highlight the need to reinforce legislation for prevention of such injuries both in children and adults

Radiolabeling of benzylpenicillin with lutetium-177: quality control and biodistribution study to develop theranostic infection imaging agent

Benzylpenicillin acts through binding with beta-lactamase enzyme and inhibiting the bacterial cell wall biosynthesis. Therefore, the radiolabeling of benzylpenicillin with lutetium-177 is expected to serve as a theranostic agent for deep-seated bacterial infections. The radiolabeling of benzylpenicillin resulted tilde 93% radiochemical yield at optimized reaction conditions. Radiochemical purity analysis was tested with the help of Whatman No. 2 paper and instant thin layer chromatography. Biodistribution study with healthy New Zeeland white rabbit revealed moderate accumulation in different organs. Kidneys are the major organs, showed not more than 4.57+/-0.89% injected dose per gram organ [ID/gm organ] at 1 h time point and 3.48+/-1.11% ID/gm organ at 6 h time point. The accumulation of tracer agent in liver was found in the range of 7.42+/-2.42% to 9.09+/-2.76 ID/gm organ. The glomerular filtration rate studies revealed rapid clearance - omitting the chance of nephrotoxicity. The radiolabeling yield, biodistribution and glomerular filtration rate results revealed [177]Lu-benzylpencillin could be a potential candidate to diagnose the deep-seated bacterial infection

Seroprevalence of Toxoplasma gondii Infection in Wild Boars, Wild Rabbits, and Wild Chickens in Hubei Province, China

Toxoplasma gondii causes serious infection worldwide in humans and animals. In this study, the seroepidemiology of toxoplasmosis was investigated in wild boars (Sus scrofa) (n=377), wild rabbits (cape hare, Lapus capensis) (n=331), and wild chickens (red junglefwol, Gallus gallus) (n=571) in 4 forested and country sided area of Hubei province of China. For this, blood samples were collected and tested by indirect hemagglutination test (IHA). The seroprevalence was found to be 7.2%, 5.1%, and 12.6% in wild boars, rabbits, and chickens, respectively, with significant differences among these species. The prevalence of T. gondii infection in male and female wild boars was found to be 7.9% and 6.5% (P<0.01), in male and female rabbits was 5.6% and 4.9% (P<0.01), and in male and female chickens was 17.1% and 7.7% (P<0.01), respectively, with significant differences between 2 genders of chickens (P<0.01). The findings of this study may help in planning of the prevention measures against T. gondii infection in wild animals in this area.

Pharmacological screening of Hypericum androsaemum extracts for antioxidant, anti-lipid peroxidation, antiglycation and cytotoxicity activity

Oxidative stress and glycation processes have a combined effect on diabetes related complications. Crude plant extracts and plant derived compounds possessing both antiglycation and antioxidant activities have a high therapeutic potential for treating these complications. Antioxidant, antiglycation, anti-lipid per oxidation and cytotoxic activities of crude methanol extract and solvent fractions of Hypericum androsaemum L. [Hypericaceae] were evaluated and correlated with total content of phenolics and flavonoids. Significant radical scavenging activity was observed for the methanol extract against 2,2-diphenyl-1-picrylhydrazyl [DPPH] free radical used as a basis for antioxidant activity with IC50 value of 92.70 +/- 2.85 micro gmL-1 [96.20 +/- 2.34% inhibition at 500 micro gmL-1]. In case of anion scavenging activity the results were not very significant [33.20 +/- 1.22% inhibition at 500 micro gmL-1]. Anti-lipid per oxidation activity was highest for n-hexane fraction [67.83 +/- 1.33% inhibition at 500 micro gmL-1] while the ethyl acetate fraction had the highest antiglycation activity [62.77 +/- 2.54% inhibition at 500 micro gmL-1]. Statistically significant correlation was determined for antioxidant and antiglycation activity and phenolic and flavonoid contents. In cytotoxicity assay all the extracts had IC50 values >30 microg mL-1 as compared to the standard cycloheximide [IC50 value 0.084 +/- 0.1 micro gmL-1]. The polar extracts of H. androsaemum can be a good source of non-toxic compounds with antioxidant, anti-lipid per oxidation and antiglycation activities

Prevalence, Associated Risk Factors, and Phylogenetic Analysis of Toxocara vitulorum Infection in Yaks on the Qinghai Tibetan Plateau, China

Toxocara vitulorum has been rarely reported in yaks at high altitudes and remote areas of Sichuan Province of Tibetan Plateau of China. The current study was designed to investigate the prevalence, associated risk factors, and phylogenetic characteristics of T. vitulorum in yak calves on the Qinghai Tibetan plateau. Fecal samples were collected from 891 yak calves and were examined for the presence of T. vitulorum eggs by the McMaster technique. A multivariable logistic regression model was employed to explore variables potentially associated with exposure to T. vitulorum infection. T. vitulorum specimens were collected from the feces of yaks in Hongyuan of Sichuan Province, China. DNA was extracted from ascaris. After PCR amplification, the sequencing of ND1 gene was carried out and phylogenetic analyses was performed by MEGA 6.0 software. The results showed that 64 (20.1%; 95% CI 15.8–24.9%), 75 (17.2; 13.8–21.1), 29 (40.9; 29.3–53.2), and 5 (7.6; 2.5–16.8) yak calves were detected out to excrete T. vitulorum eggs in yak calve feces in Qinghai, Tibet, Sichuan, and Gansu, respectively. The present study revealed that high infection and mortality by T. vitulorum is wildly spread on the Qinghai Tibetan plateau, China by fecal examination. Geographical origin, ages, and fecal consistencies are the risk factors associated with T. vitulorum prevalence by logistic regression analysis. Molecular detection and phylogenetic analysis of ND1 gene of T. vitulorum indicated that T. vitulorum in the yak calves on the Qinghai Tibetan plateau are homologous to preveiously studies reported.

Is laparoscopic cholecystectomy a safe treatment option in empyema of gall bladder?

To find out the effectiveness and safety of laparoscopic cholecystectomy for treatment of empyema gallbladder. Quasi-experimental study. PNS Shifa Karachi and CMH Lahore, Pakistan from January 2010 to August 2013. Out of 493 patients who underwent laparoscopic cholecystectomy [LC] by a single consultant surgeon during the study period, 40 patients who had empyema gall bladder on laparoscopic findings were included in the study. All patients with diagnosis of acute cholecystitis [n=117] who had no pus present in gall bladder and patients with diagnosis of biliary colic or chronic cholelithiasis [n=336] were excluded from the study. Forty patients were diagnosed to have empyema gall bladder. LC was successfully completed in 39 patients [97.5%]. In one patient [2.5%] the procedure was converted to open cholecystectomy [OC] due to finding of cholecystoduodenal fistula on laparoscopy. Mean operating time was up to 58.62 +/- 26.33 minutes. Postoperative complications occurred in 3 [7.5%] of the operated patients. Mean duration of hospital stay was 1.7 +/- 2.09 days. One patient with co-morbidity of diabetes mellitus died of septicemia resulting in a mortality rate of 2.5%.In laparoscopy for empyema gallbladder the complications are related to the advanced disease process and not to the approach. In skilled hands, laparoscopic cholecystectomy can be performed successfully in patients with diagnosis of empyema gallbladder

Nature of oral biopsies; Liaquat university hospital hyperabad

Biopsy is the removal of a tissue sample from a living body with the objective of providing the pathologist with a representative, viable specimen for histopathologic interpretation and diagnosis. Objectives: To find out frequency and nature of oral biopsies reported at liaquat university hospital Hyderabad. Design: Descriptive/Cross sectional. Period: 1st February 2012 to 31st January 2014 Setting: Oral and Maxillofacial Surgery Department, Liaquat University Hospital Hyderabad. Material and Methods: A total of 180 patients were reported at OPD and Oral and Maxillofacial Surgery ward of Liaquat University Hospital for oral incisional, excisional and punch biopsy purpose. Study design was descriptive/cross sectional study. All patients were treated both under general anesthesia as well as local anesthesiaandsedation. All the biopsies were sent to histopathology department for confirmation of diagnosis. Results:119 patients [66.1%] were males and 61 patients [33.8%] were females with age range from 10-80 years. Malignancy was diagnosed in 80 patients [44.4%] while odontogenic cysts were diagnosed as second common category with 38 patients [21.1%]. Conclusions: Squamous cell carcinoma was diagnosed as the most common malignant lesion which is rising danger to the society specially as the age advances.

Various fractions of Hypericum x moserianum and Hypericum ericoides possess antiglycation, anti-lipid peroxidation, antioxidative activities and non-toxic effects in vitro

In the present study, two species Hypericum x moserianum and Hypericum ericoides which belong to genus Hypericum were evaluated for their potential antiglycation, antioxidant, anti lipid peroxidation and cytotoxic activities. These species are widely used in folk medicine and to the best of our knowledge there were no previous reports regarding antioxidant, anti-glycation and cytotoxicity studies of these species. Among the crude methanol extracts and fractions of both the species, the ethyl acetate fraction of H. x moserianum exhibited promising antioxidant activity against 1, 1-diphenyl-2-picrylhydrazyl [DPPH] with IC50 129.084+/-1.215µg/ml, followed by methanol extract [IC50=232.083+/-1.215µg/ml] and aqueous fraction [IC50=266.962+/-2.213µg/ml]. The ethyl acetate fraction of Hericoides exhibited IC50 value of 295.088+/-2.320µg/ml. In antiglycation assay, the ethyl acetate fraction of H.x moserianum showed 52.096% inhibition at 500µg/ml. For lipid peroxidation assay, the dichloromethane, aqueous and n-hexane fractions of H. x moserianum showed 67.241, 66.147 and 64.213% inhibition respectively, while aqueous fraction of H. ericoides exhibited 67.404% inhibition at 500µg/ml. In cytotoxicity assay, all fractions of both the species were found to be non-toxic on mouse fibroblast 3T3 cells with IC50 value greater than 30µg/ml as compared to cycloheximide with IC50 value 0.073+/-0.1µg/ml used as a st and ard. It was concluded from the study that among the two species, crude methanolic and ethyl acetate fractions were more active regarding the antioxidant, anti-glycation activities while dichloromethane, aqueous and n-hexane fractions possessed anti-lipid peroxidation activity

Learning styles of medical students and their demographic characteristics

Background: Learning styles are different ways of collecting information. Every individual has a different learning style which can be measured by using different inventories

Objective: To determine the learning styles of the third year medical students in Sheikh Zayed Medical College Rahim Yar Khan and to find association of learning styles with the demographic characteristics

Material and Methods: This cross sectional study was conducted at Sheikh Zayed Medical College Rahim Yar Khan during May 2013 and target population was 3[rd] year medical students including all the medical students of third year MBBS to analyse learning styles. The instrument used was the "Kolb Learning Style Inventory" which divides the individuals in to four different types of learning styles. The results were tabulated and were analysed by using SPSS version 17

Results: Analysis of learning styles inventory showed that among third year medical students, the dominant learning style was convergent learning style as 42 out of 122 [34.4%] students' opted for it. The second, third and fourth preferred learning styles were accommodative 33 [27%], assimilative 25[20.5%] and divergent 24[19.7%] respectively

Conclusion: The dominant learning style was convergent among 3[rd] year medical students and there was significant association of learning styles with demographic characteristics

Evaluation of serum triglyceride and cholesterol in subclinical Hypothyroidism

This study was aimed to evaluate the effects of subclinical hypothyroidism on lipid profile with special reference to total cholesterol and triglyceride levels. Analytic study. This study was carried out at the Punjab Institute of Nuclear Medicine [PINUM], Faisalabad and IMBB, university of Lahore from January 2011 to September 2011. [Eight months] 100 female patients of age ranges from 20-50 years having subclinical hypothyroidism [SCH] and 20 euthyroidsubject of same age and sex [control] were included in this study. Serum FT[4], FT[3], TSH, total cholesterol and triglyceride of subclinical hypothyroid patients and control group were determined. In subclinical hypothyroid patients total cholesterol were significantly increased as compared to euthyroid group. Serum TSH and total cholesterol showed positive correlation. Serum triglyceride did not significantly increased in SCH. The total cholesterol level elevated in SCH. This increases the risk of atherosclerotic coronary artery disease [CAD] in subclinical hypothyroid patients

Efficacy of mitomycin C in reducing recurrence of anterior urethral stricture after internal optical urethrotomy

PURPOSE: To determine the efficacy of mitomycin C in reducing the recurrence of anterior urethral stricture after internal optical urethrotomy (IOU). MATERIALS AND METHODS: This was a randomized controlled trial conducted in the Department of Urology at the Institute of Kidney Diseases Peshawar from March 2011 to December 2013. A total of 151 patients who completed the study were divided into two groups by the lottery method. Group A (cases) comprised 78 patients in whom mitomycin C 0.1% was injected submucosally in the stricture after conventional IOU. Group B (controls) comprised 73 patients in whom IOU only was performed. Self-clean intermittent catheterization was not offered in either group. All patients were regularly followed up for 18 months. Recurrence was diagnosed by use of retrograde urethrogram in all patients and flexible urethroscopy in selected cases. Data were collected on a structured pro forma sheet and were analyzed by SPSS. RESULTS: The mean age of the patients in group A was 37.31+/-10.1 years and that in group B was 40.1+/-11.4 years. Recurrence of urethral stricture was recorded in 11 patients (14.1%) in group A and in 27 patients (36.9%) in group B (p=0.002). The mitomycin group also showed a delay in recurrence compared with the control group (p=0.002). CONCLUSIONS: Recurrence of urethral stricture is high after optical urethrotomy. Mitomycin C was found to be highly effective in preventing the recurrence of urethral stricture after IOU.

Scleredema of Buschke: a case report

Scleredema of Buschke or scleredema adultorum is a rare sclerotic disorder. It has been reported as an unusual skin complication in diabetic patients with a long history of poor metabolic control. This disease is usually localized in the proximal parts of the trunk including nape of neck, back and shoulder areas. Consequently, the range of movement of the affected areas could be altered. Histologic examination of a skin biopsy shows deposits of collagen and aminoglycans in the dermis. The pathophysiology of scleredema of Buschke and its relationship with diabetes are not clearly identified. Few therapeutic options are proposed without satisfying results. We report an unusual case of a 45-year-old woman with a long history of poorly controlled diabetes type 1 who presented with indurated edema of the trunk. The presumptive diagnosis of scleredema adultorum was confirmed by the presence of typical histological findings and after eliminating other diagnosis of edema.

Serum ferritin level in thalassemic patients of 10-15 years and its relationship with thyroid function tests

To determine the prevalence of hypothyroidism and to evaluate any possible correlation between serum ferritin level and thyroid function tests in transfusion dependent beta-thalassemic patients. An observational and correlation study. This study was conducted at DHQ hospital, Hilal-e-Ahmar hospital and Ali Zaib Foundation hospital Faisalabad from 15[th] of May 2011 to 15[th] of Jan 2012. A total number of 90 thalassemia major patients, of 10-15 years of age, were included in this study. Serum levels of thyroxine, tri-iodothyronine, thyroid stimulating hormone were determined and correlated with serum ferritin level. Five milliliters of blood was drawn from each subject and thyroid profile [T[3], T[4] and TSH] and serum ferritin were determined. Pearson correlation coefficient test was applied to determine any correlation between serum ferritin level and other parameters. There was a weak negative correlation of Serum Ferritin with both Triiodothyronine and Thyroxine, but both correlations were statistically insignificant [p-value= 0.294 and 0.189 respectively]. Serum Ferritin had a weak positive, but insignificant correlation with TSH. Hypothyroidism was detected in 15 patients [16.67%]. Out of these 8 [8.89%] were having subclinical hypothyroidism, 5 [5.56%] mild hypothyroidism, 1 [1.11%] overt hypothyroidism and 1[1.11%] patient having secondary hypothyroidism. High prevalence of hypothyroidism warrants regular screening of thyroid functions in thalassemic patients irrespective of their serum ferritin levels

Needle stick injuries among dental students, house officers and paradental staff working at Liaquat Medical University Hospital, Hyderabad

The objectives of the study were to find out the risks of needle stick injury and to identify who sustained such injuries and under what circumstances and what actions were taken to minimize the risks of needle stick injuries among dental students, house officers and para dental staff working at Liaquat Medical University Hospital. It was carried out from Aug 2011 to Sept 2012. Information was obtained through Questionare. Study design was descriptive. 513 students, house officers andparaden-tal staff participated in this study. House officers 23[4%] were male and 57 [11%] were female. Male students were 102 [20%] and female were 223[44%]. Among Paradental staff male were 92[18%] and female 16 [3%], and they suffered 79[10%] injuries. Self inflicted injuries were 455 [58%] and through other persons 315 [41%]. Department-wise injuries were Operativel 140 [18%], Prosthodontic 25[3%]. Orthodontic 28 [3%]. periodontology. 27[3%], Oral Maxillofacial Surgery 97[12%]. Through block anesthesia 428 [55%] and through infiltration needle 345 [44%]. Students were at high risk

Diabetes mellitus prediction; Serum lipids, ALT and fasting blood glucose: using serum lipids and ALT

The rapid change in lifestyles and dietary has led to a pandemic of diabetes mellitus. The diagnosis of diabetes mellitus sometimes requires 2 hr OGTT sampling. Recent evidence has shown that there are lipid related abnormalities associated with diabetes mellitus, so a consideration comes in fortheir utilization as a marker to support diabetes mellitus. [1] To correlate serum total cholesterol, triglycerides and ALT with fasting blood glucose [2]. To predict diagnosis of diabetes mellitus using above serum markers. Cross-sectional analysis, descriptive study. This study was carried out between Mar-2010 to Jan-2011 at the department of pathology, PNS RAHAT in collaboration with PNS SHIFA. A total of 251 subjects were screened for presence of glucose dysregulation. Based upon the results of fasting blood glucose, subjects were grouped as having normal glucose tolerance [NGT], impaired fasting glucose [IFG], and newly diagnosed diabetes mellitus [NDDM]. A comparison of lipids including triglycerides, total cholesterol and alanine aminotransferase [ALT] were made in the above groups to measure the differences between the above mentioned three groups. ALT, triglyceride and total cholesterol were correlated with results of fasting blood glucose through pearson's correlation. Later the performance of different cut-offs of triglycerides, total cholesterol and two mathematical models [[Factor-l=FBG [mmol/L] + triglycerides [mmol/L]] and [Factor-ll=FBG [mmol/L] + triglycerides [mmol/L] + total cholesterol [mmol/L]]] were evaluated for detecting diabetes mellitus against the gold standard 2 hr OGTT in 71 subjects. The results of triglycerides, total cholesterol and serum ALT between the three groups were as: [[Triglycerides: NGT =1.91, IFG =2, 10, NDDM= 2.75, p=0.003] [total cholesterol: NGT=5.03, IFG=5.19, NDDM=5.74, p=0.056] [ALT:NGT=28.47, IFG=27.95, NDDM=25.78, p=0.846]]. Most correlation was found between serum triglycerides and fasting blood glucose [r2=0.235, p<0.001]; while serum total cholesterol and ALT showed lesser correlations [[total cholesterol:r2= 0.172, P=0.007], [ALT:r2= 0.010, p= 0.877]]. While triglycerides demonstrated superiority in terms of sensitivity to total cholesterol for detection of diabetes mellitus, the factors incorporating lipids and glucose had the highest overall diagnostic efficiency. Triglycerides and total cholesterol levels rise from normoglycemic individuals to subjects having impaired fasting glucose and newly diagnosed diabetics. The inclusion of triglycerides and total cholesterol for diagnosis of diabetes mellitus improves the chances of for detection of diabetes mellitus

Complications associated with different treatment modalities of mandibular fracture

The aim of this study was to compare the complications of various techniques used to treat mandible fractures. This clinical study was carried out on 150 patients of mandibular fracture at Liaquat University of Medical and Health Sciences Hospital Jamshoro, Sindh from May 2004 to April 2006. Inclusion criteria were patients having single mandibular fracture, were medically fit for surgery, and had sufficient dentition were selected for maxillomandibular fixation. Patients with bone pathology, immnocompromised, comminuted and infected fracture were excluded. They were distributed in three groups and were treated with three standard techniques. Miniplates, MMF [maxillomandibular fixation] and Miniplates + MMF for 15 days. Age ranged from 12-60 years, mean age was 26.5 years. There were 135[90%] males and 15[100%] females. Most common site was parasymphysis [489%]. Post operative complications were recorded as infection, malocclusion, delayed union, nonunion, nerve damage and TMJ Dysfunction. 21 complications were encountered in 21 patients among all three groups. In MMF group number of complications were 11 [22%]. In Plating group were 8[16%]. In plating + MMF group were 2[4%]. The use of miniplate secured with four 2.0mm wide and 7.0mm long monocortical screws and maxillomandibular fixation for two weeks has proven to be the most effective treatment modality for mandible fracture

Wisdom tooth removal: are we following any guidelines in Pakistan

The surgical removal of third molar/ wisdom teeth remains the frequently performed surgical procedure at most Oral and Maxillofacial units. The objective of the study was to assess the level of understanding among general dental practitioners regarding third molar/wisdom tooth, its indication for removal and complication. Cross-Sectional study. This study was conducted at the Department of Oral and Maxillofacial Surgery LUM and HS, Jamshoro from February to April 2013. A self administered questionnaire comprising of 12 questions was distributed among the 50 general dental practitioners of Hyderabad city. The results of the study shows that level of understanding among general dental practitioners regarding wisdom tooth and its complication was not up to the level expected and majority thinks a guideline is necessary to remove the wisdom tooth. Our outcome and emphasis would be that PMDC should introduce a guideline and those dentist involved in surgical dentistry should be asked to attend short courses to improve their level of understanding regarding wisdom teeth removal and how to avoid its complications