Surgical uncovering and orthodontic positioning of unerupted maxillary right canine and left central incisor

Excluding all third molars, the most common impaction is of maxillary canine. Palatal impaction [80%] is much more common than labial impaction [20%]. Impaction of maxillary central incisor does not occur frequently. We report an 11-year girl with clinical and radiological features of impacted maxillary canine and maxillary left central incisor. At the age of five years, she had a fell victim to history of trauma of maxillary central incisor with premature exfoliation. Radiograph showed labial impaction of right canine and left central incisor in maxilla

Diabetes mellitus; significance of HBA1c determination in patients

This study was done to find HbA1c levels in diabetes mellitus [DM] patients presenting at Bolan Medical Complex Hospital Quetta and observe the effects of antihyperglycemic treatment and physical exercise on HbA1c level. A cross sectional comparative study. One hundred [100] patients were selected from Bolan Medical complex Hospital Quetta. Patients were divided in three groups. Group A included the patients who were on antihyperglycemic drugs, following dietary restrictions and doing physical exercises. Group B included patients who were on antihyperglycemic drugs following dietary restrictions but not doing physical exercises. Group C included the patients who were not using any antihyperglycemic drug, not following dietary restriction and not doing any physical exercise. HbA1c of all patients was determined, data was analyzed using SPSS. Anova was applied. HbA1c of group A was higher than group B and group C. HbA1c of group B was higher than group C. HbA1c is a valuable test for monitoring glucose control over extended period of time and plays role in taking measures to avoid diabetes mellitus complications, therefore it should be tested regularly

Comparison of sodium hypochlorite and mixture of tetracyline citric acid and detergent as irrigating material in endodontics

The main objectives of root canal therapy are cleaning, shaping and obturating the canal system in three dimensions and preventing reinfection. So the irrigation is important part of a root canal treatment as it allows for cleaning beyond the reach of root canal instruments. Inadequate irrigation or instrumentation without irrigation increases the accumulation of debris on the cutting surfaces of instruments as well as debris and smear layer on root canal walls. In this review article, comparison of MTAD [mixture of tetracycline citric acid and detergent] and sodium hypochlorite [NaOCl] as irrigating material in endodontics is made

Awareness of diabetic patients regarding their oral hygiene

The study was conducted at Diabetic Clinic ofLiaquat University Hospital Hyderabad from July 2013 to December 2013, with the sample size of 200 patients who fulfilled the inclusion criteria. Data were collected through a self-designed questionnaire through an interview by the investigator. 79.5% patients did not know what type of diabetes they were suffering from 94% of the patients were well aware of the systemic complications of diabetes mellitus whereas 31.5% had no idea that being a diabetic they need to take extra care of their oral hygiene. Around 52% of the patients brushed their teeth once a day and 34% brushed twice a day.69% of the participants did not take any extra measures for maintaining their oral hygiene. Gingivitis was thought to be the most common oral manifestation occurring in the oral cavity of a diabetic patient was the reply of 49.2% of the patients. This study concludes that although diabetic patients seem to have a good knowledge and awareness about systemic complications related to the disease, the accurate awareness about oral hygiene, how to properly maintain it and diabetic related oral manifestations was deficient and there was considerable room for improvement

Battery operated and manual tooth brush; comparison for dental plaque removal

Background: Dental plaque may cause oral problems that may include dental caries, periodontal problems, and halitosis. Motivation, awareness and manual dexterity have much effect on tooth brushing. The advantages related with manual and battery operated tooth brushing have been reported different in the literature

Objective: To compare the manual and battery operated tooth brush for plaque removal efficiency

Study Design: Randomized control trial

Setting: The Dental OPD of Department of Community Dentistry, Liaquat University of Medical and Health Sciences, Jamshoro

Period: November 2011 to June 2013

Methods: Total 100 patients of both genders, aged ?18 years were included. Patients were equally divided into manual and battery operated brush groups. The presence of plaque was checked and plaque index was recorded. Wilcoxon sign pair test was applied to compare pre and post plaque score for manual and battery operated tooth brush. Independent sample t test was applied to compare percent reduction of plaque score between groups. The significance level of P-value was up to 0.05

Results: In manual brush group, 27 were male and 23 were female. Mean age was 25.65 +/- 5.87 years. In battery operated brush group, 32 were male, 18 were female. Mean age was 29.92 +/- 10.37 years. Before manual brushing mean plaque score was 1.88 +/- 0.65 while after brushing it was reduced to 1.11 +/- 0.43. Percent reduction was 40.96%, p=0.0005. Mean plaque score was 1.35 +/- 0.37 and 0.69 +/- 0.29 before and after brushing respectively in battery operated brushing. Percent reduction was 48.9%, p=0.0005. Battery operated brushing was significantly more effective than manual [p=0.023]

Conclusion: Battery operated tooth brush was significantly more effective than manual toothbrush. It removes significantly more supragingival plaque than manual tooth brush

Electronic apex locator versus conventional radiograph; determination of working length: a prospective in-vivo study

For successful endodontic outcome, accurate working length has to be determined. Even with improved systems of working length [WL] measurement, different readings may be recorded in different electrolytes present in the canal

Methodology: total 90 patients were selected for this prospective in vivo study resented at Department of Operative Dentistry, Liaquat University of Medical and Health Sciences, Jamshoro, during 6 months i.e. from 1[st] Sep 2014 to 28[th] Feb 2015, with single rooted permanent mandibular first premolars with matured apices. After extirpated pulp tissue a file was inserted in the canal and WL was obtained by radiograph as well as by electronic apex locator [EAL]. The measurements determined by both methods were compared by applying paired sample t-test. SPSS 18 was used for data analysis

Results: among 90 subjects 37 were males. Mean +/- SD WL obtained radiographically was 19.8 +/- 1.03-m whereas mean +/- SD WL obtained electronically was 18.9 +/- 1.05 mm. Mean difference between measurements of both methods was 0.87-mm, which was statistically significant [P <0.05]

Conclusion: the electronic apex locator was better than the radiograph in determining working length of root canal at statistically significant level

Serum lipid profile; significance of risk factors regarding offsprings of premature coronary heart disease patients

This study was conducted to determine serum lipid profile in children of premature coronary heart disease patients and compare results between children having parents with one, two or three risk factors. A cross sectional comparative study. Ninety seven [97] subjects having parents with one risk factor, sixty three [63] subjects having parents with two risk factors and sixty five [65] subjects having parents with three risk factors were selected from Punjab Institute of Cardiology Lahore. Fifty [50] age and sex matched subjects of parents without a history of coronary heart disease were also selected. The serum total cholesterol, serum triglycerides, serum low density lipoprotein cholesterol and serum high density lipoprotein cholesterol was performed and results were compared. Offsprings of parents having more number of risk factors had statistically significantly high total cholesterol and low density lipoprotein cholesterol as compared with offsprings of parents having one risk factor. Triglycerides and high density lipoprotein cholesterol of offsprings of parents having one, two, three or more than three risk factors were comparable. Offsprings of parents having premature coronary heart disease [CHD] had abnormal lipid levels as compared with control group. Coronary heart disease risk factors are significant regarding abnormal lipid levels. Offsprings of premature CHD patients are prone to develop CHD as compared to normal control group. Genetic predisposition seems to be important in development of CHD

Maternal risk factors in preterm neonates

To study the frequency of maternal risk factors in preterm birth. Descriptive - Cross sectional study. This study was carried at Hamdard University Hospital, Karachi from January 2013 to December 2013. All preterm neonates were examined at Hamdard University Hospital. Mothers who delivered neonates before 37 weeks of gestation and their suspected maternal risk factors contributing to preterm labor were registered on a pre-designed proforma. Keeping prevalence of 14.9%[1], bound of error 5%, confidence interval 95%, the calculated sample size is 195. There was Non-probability consecutive sampling. Mothers who delivered live born babies in Hamdard hospital Karachi before 37 weeks of gestation. Babies were born after 37 weeks of gestation and still birth. During the study period, 195 mothers who delivered preterm neonates were included. Out of 195 patients, anemia was found as most common risk factor for preterm delivery in 50.8% mothers, followed by history of previous abortion and premature rupture of membrane with 23.0% and 13.8% respectively. History of previous preterm delivery, pre-eclampsia and antepartum hemorrhage were the least reported risk factors at 4.1% each in our study. Prematurity is still a major problem in Pakistan. Early detection of the most common maternal risk factors as: nutritional status of women [BMI], previous abortions, previous preterm births will reduce the prematurity rate, medical cost and suffering of the parents

Coronary heart disease; to find correlation among total cholesterol, triglycerides, high density lipoprotein cholesterol, low density lipoprotein cholesterol in offsprings of parents having coronary heart disease

This study was done to find any correlation among total cholesterol, triglycerides, low density lipoprotein cholesterol and high density lipoprotein cholesterol estimated in serum of offsprings of coronary heart disease patients. A cross sectional comparative study. Two hundred and fifty [250] subjects having parents with coronary heart disease were selected from Punjab Institute of Cardiology Lahore. The serum total cholesterol, triglycerides, low density lipoprotein cholesterol, and high density lipoprotein cholesterol were estimated. Coefficient of variation was calculated to find whether observations in one series vary correspondingly with observations in another series. Highly significant positive correlation was found between total cholesterol and triglycerides, and, total cholesterol and low density lipoprotein cholesterol. Highly significant negative correlation was found between low density lipoprotein cholesterol and high density lipoprotein cholesterol. Correlation between TG and LDL-c was also significant. Serum total cholesterol, triglycerides, low density lipoprotein cholesterol and high density lipoprotein cholesterol have strong association with one and other. For prediction, prevention and management of coronary heart disease it is important to estimate and observe the correlation among these parameters

Body mass index [BMI] of international medical student in OJHA Campus Karachi, Pakistan

Measuring body mass index [BMI] by calculating height and weight gives significant information on the health and nutritional status of individuals. Wide range of factors including blood pressure level, heart disease, asthma, headache, backache, joint pain, anesthesia risks, menstrual abnormalities and insulin resistance is associated with increase in BMI. [1] To measure height and weight for Body Mass Index calculation. [2] To compare national data of Body Mass Index. Cross sectional study. This study was conducted at the Department of Community Medicine, Dow International Medical College [DIMC], Dow university of Health sciences OJHA campus Karachi from April 2012 to April 2013. The sample of the study was 112 medical student selected through random sampling method from DIMC. BMI trend of American student [10.90%] and Pakistani Local student is slightly different were under weight in local Pakistani student [20.65%]. While over weight were more in American student [over weight 29.64%]. Majority of local and International students are fall in Normal range [55.35%]. It was interesting that obesity in American students [3.70%] and local born students [3.44%] was almost same. The study concludes that BMI of International student who were born in Pakistani migrant family have different trend. How ever over all majority of students both local and international fall in normal BMI range

Patients leaving against medical advice: an inpatient psychiatric hospital-based study

To determine the frequency of patients leaving against medical advice [LAMA] in an inpatient psychiatric facility in Rawalpindi, Pakistan. Descriptive cross-sectional study. Institute of Psychiatry, Benazir Bhutto Hospital, Rawalpindi, from August 2010 to February 2011. Patients who got admitted during study period irrespective of duration of illness and mode of admission were recruited through non-probability consecutive sampling and followed till discharge to determine their mode of leaving hospital. A thirteen-item proforma was developed and information was obtained on demographic, socioeconomic, patient related and disease related variables. Descriptive statistics were calculated on SPSS 14. The total number [n] of participants was 246. Among the participants, 96 [39%] left against medical advice [LAMA] whereas 150 [61%] left on regular discharge on physician's advice. Frequency of patients who left against medical advice was found to be more in males [63.5%], younger age groups [21 - 30 years], lesser educated [more than half were under matric] and with the ICD-10 diagnosis of substance abuse [23.9%]. About half of patients who LAMA had a prior history of psychiatric illness and a significant number [37.5%] had a history of previous psychiatric admission. Leaving against medical advice is a frequent problem in psychiatric inpatients and is a matter of great concern for the treating doctors

Morbidity pattern and health education for school age children in Karachi

To screen morbidities among school age children, to assess health education need to prevent these diseases and to compare morbidities with national and international patterns Cross Sectional Epidemiological Study This study was conducted at DIMC, DUHS, Karachi during February and March 2012. This study was conducted of school children of Karachi. Sample size; 125 children from 6 primary, kg and nursery classes data was collected on pre -designed and pre- tested proforma Total 22 morbidities were identified on clinical examination and anthropometry methods common morbidities were max in ear, scabies, lice infestation, alopecia, anemia, and underweight, DNS, Rhinorrhea, 21.5% children had no morbidity while 28.8% needed primary health care/ first aid or simple treatment or referral while 71% needed health education, hygiene or nutrition supplements. Morbidities are same as reported from Pakistan and Indian studies published Journals and books and all morbidities were preventable School age children are suffering from common preventable diseases they need primary health care education hygiene and nutrition supplement to improve their health Medical Universities NGOs and Education and Health Department can manage by health camps or by formal school health services programme

Gingivitis and dental caries status among the school going children of Jamshoro city

The purpose of the study is to assess the gingivitis and dental caries status among school going children of Jamshoro city. Descriptive Study This study was conducted at the out patients department of Liaquat University Hospital Jamshoro during the year Jan 2010 to Oct 2011 A descriptive study was conducted among 700 school going children. The general information and the information regarding oral hygiene practice and dental visits were obtained. The gingivitis of the subjects was assessed by using Loe and Silness Gingival Index. The dental caries status was assessed by using International Caries Detection and Assessment System. Out of 700 school children, n=270 [38.57%] were boys and reaiming n=430 [61.42%] were girls, the age distribution was done in three groups and in group one total children were n=101 [14.42%], in group two n=187 [26.71%] and in group three n=432 [58.85%] children, Gingival Index according to Loe and Silness in grade zero were n=322 [46.00%] children, grade one n=165 [23.57%] children, grade two n=143 [20.42%] children and in grade three n=70 [7%] children, Dental Caries Status of school children in relation with age group was in age group one n=199 [28.42%] children, in age group two n=175 [25%] children and in age group three n=115 [16.42%] children. The results of this study indicate that there is a moderate prevalence of gingivitis and dental caries among school going children of Jamshoro city. We the dental care providers, oral hygienist, parents and teachers trying to motivate the school going childrens for to improving the oral health of the oral cavity so that they can prevent themselves from common problems of the oral cavity

Frequency of compliance with antidepressants using antidepressant compliance questionnaire

To find out the frequency of compliance of patients using anti-depressants prescribed at out-patient department. Descriptive cross sectional study. This study was conducted in the out-patient department of Institute of Psychiatry, Benazir Bhutto Hospital, Rawalpindi from September 10,2010 till May 10,2011. One hundred and sixteen patients aged 18 years and above, presenting with moderate depressive illness, able to understand and speak Urdu, taking treatment for at least 4 weeks and belonging to both genders were recruited from out-patient department using consecutive [non-probability] sampling technique. Patients having severe depressive illness with psychotic features and severe agitation were excluded. Antidepressant Compliance Questionnaire was translated and validated through a pilot study and then the Urdu translation was orally administered to each participant for the assessment of compliance with antidepressant medication. Among the participants 74.1% were compliant and 25.9% were non-compliant with anti-depressant medications. This study found a high degree of patient compliance with anti-depressants. The results would help in early recognition of non-compliant patients, so that necessary changes could be made in the treatment plan to ensure better compliance

Are tremors in old age, really senile? a hospital based study

To study the frequency and severity of tremors in otherwise healthy elderly adults at Sind Government Hospital Liaqatabad, Karachi. This cross-sectional study, was conducted at the Sindh government hospital, Liaquatabad, Karachi from October, 2007-2009. Five hundred otherwise healthy adults of both genders of more than 60 years were selected. After thorough clinical examination, classification and the severity of tremors were assessed by tasks given to the patients by principal investigator which he designed himself. All variables were put in proper register. Data entry and analysis was performed by single researcher on SPSS 16 for biostatistics. The inclusion criteria were adults of more than 60 years of either gender with no history of any systematic or neurological illness and presently not on drugs. The exclusion criteria were disputed age groups and those who cannot sign or write their names because they cannot be assessed by tasks. The mean age was 68.75 years +/- 6.74 with male female ratio of 1.95:1. Out of 500 subjects 84 [16.8%] showed no tremors, 307 [64.4%] had mild tremors only evident on special movements i.e. enhanced physiological tremors [physiological senile tremors] and 109 [21.8%] had moderate to severe tremors evident on movements i.e. kinetic, essential tremors [pathological senile tremors], with family history of 50.45%. Tremors in old age are not part of life. Most of them had enhanced physiological tremors while few were of essential type with strong family history. If these are detected, they should be evaluated and classified and can be managed to make elderly population more useful to their family and the society

Patient satisfaction with electroconvulsive therapy in a tertiary care hospital

To determine the frequency of satisfied patients with ECTs in a public sector tertiary care hospital. Cross-sectional, descriptive study. The study was carried out in the in-patient department of Institute of Psychiatry, Benazir Bhutto Hospital, Rawalpindi, a tertiary care public sector hospital, from October 2010 to June 2011. A consecutive sample of 163 inpatients of both genders, excluding acutely disturbed patients was recruited. Proforma regarding the socio-demographic details was filled by the participants. ECT satisfaction Questionnaire was orally administered in Urdu to each participant for the assessment of their satisfaction with ECT. Data was analyzed using SPSS 10.0. Using the ECT satisfaction Questionnaire, 62.6% patients were satisfied while 37.4% were dissatisfied with ECT. Majority of patient was satisfied with Electroconvulsive therapy. However there is a need to explore specific reasons for satisfaction/dissatisfaction with this treatment modality in order to improve the delivery of this treatment in accordance with the patients' expectations for better treatment adherence and improved outcomes

Benign lesions in abdominal hysterectomies in women presenting with menorrhagia

Menorrhagia is a common and debilitating problem. It is one of the major causes leading to hysterectomy in women all over the world. Menorrhagia is most commonly associated with benign pathologies like uterine fibroids, adenomyosis and pelvic infection. Rarely it is secondary to malignant pathology like endometrial carcinoma. Hysterectomy specimens form a major component of histopathological work in Pathology laboratories. The present study was undertaken in Pathology department, Allama Iqbal Medical College, Lahore to find out the morphology and frequency of different benign histopathological lesions in total abdominal hysterectomy specimens in patients presenting with menorrhagia. A descriptive case series study of one hundred total abdominal hysterectomies of patients presenting with menorrhagia carried out. Patients' data and detailed gross examination of specimens were recorded on a proforma. Representative sections were taken for microscopic examination and findings were recorded. The ages of the patients ranged from 30- 59 years with maximum number [73%] of cases in 40 - 49 years age group. Macroscopically fibroids were seen in 69% cases in myometrium. Microscopic examination of cervix revealed features of chronic cystic cervicitis in 100% cases. Endometrial histology showed disordered proliferation [41%] followed by hyperplasia [25%] as the commonest finding. Myometrium revealed foci of adenomyosis in 49% cases. The commonest neoplastic lesion was leiomyoma [69%]. In patients with menorrhagia the commonest neoplastic lesion was leiomyoma [69%], and commonest histopathological cervical lesion as chronic cervicitis [100%]. Endometrial hyperplasia was the most common lesion [41%] on endometrial histology. Myometrium revealed foci of adenomyosis in 49% cases

Welding associated ocular injuries

To determine the types of eye injuries during welding and to suggest measures for its prevention. This study was carried out at CMH Sialkot from October 2005 to March 2007. An observational study was conducted at [18 months]. Welders included in this study were from military setups i.e. Electrical and Mechanical Engineering [EME] workshops, battalion workshops, Military Engineering Services [MES] and civil workshops. They attended eye OPD for their ocular injuries, sustained during welding and grinding. Their knowledge of welding induced ocular injuries and level of safety measures awareness was assessed. Patients were thoroughly examined with special emphasis on anterior segment. Orbital x-ray and B-scan ultrasound were carried out where intraocular foreign body [IOFB] was suspected. Total 110 patients were studied during a period of 18 months. The commonest ocular injury that we encountered was metallic foreign body followed by photokeratitis and conjunctivitis. Majority workers were between 25 and 35 years of age. Their knowledge of safety measures was satisfactory but few were aware of ocular hazards of welding. Eye injuries due to welding are preventable. Workers performing welding tasks or working nearby welders must be trained, to reco gnize the potential hazards of welding and in proper use of safety equipments to prevent ocular damage

Coronary heart disease; lipid abnormalities as predictor in offspring of premature coronary heart disease patients

This study was conducted to perform serum lipid profile in off springs of premature coronary heart disease [CHD] patients and age and sex matched normal controls and compare the results of two groups. A cross sectional study. 250 off springs of diagnosed premature CHD patients were selected from Punjab institute of cardiology, Lahore and Services hospital, Lahore. 50 age and sex matched normal controls were selected from different areas of Lahore. Serum total cholesterol [TC], serum triglycerides [TG] serum low density lipoprotein-cholesterol [LDC-c] and serum high density lipoprotein cholesterol [HDL-c] was performed. Serum TC, TG, LDL-c of off springs of premature CHD patients was increased as compared with normal controls. Serum HDL-c of all the subjects of off springs of premature CHD patients was decreased as compared with normal controls. Off springs of premature CHD patients are more prone to develop lipid abnormalities as compared with normal controls

Neural tube defects; prevalence in population of Rahim Yar Khan

To know the frequency of NTD among total births in teaching Hospital Rahim Yar Khan and to know the possible causes of neural tube defects in area of Rahim Yar Khan. Prospective study. Department of Obstetrics and Gynaecology Sheikh Zayed Medical College/Hospital Rahim Yar Khan. One year from November 2006 to October 2007. All pregnant mothers were registered in the study but only those were selected who were diagnosed during pregnancy or after delivery as a case on NTD. Out of 6701 live births, a total of 52 cases were diagnosed at NTD. The information was collected by taking history along with ultrasound findings and biochemical tests. The incidence came out is 2-8/1000 live births. The maternal mean age was 28.9 years and more common in primigravida i.e. 33% and 30% were grand multigravida. 75.3% of women belonged to low income group, and were not taking proper balanced diet. 80% lived in Joint family and 96.2% females were house wives. 96% cases of NTD were detected by ultrasound at mean gestation of 21.66 wks. The most common NTD was anencephaly found in 67% of cases, spina bifida 29% and encephalocele was found only in 4% of cases. The male; female ratio was 2:3. 74% of women had Hb level less than 10 mg/dl and in 20 women the type of anaemia was macrocytic-hypochromic. Low socio-economic status, poverty and poor dietary habits may be factors for higher incidence of neural tube defects. Our study provides new data for the health care providers to improve health facilities and their utilization and iron and folic acid supplementation targeted to all women of child bearing age to prevent neural tube defects