Continuous medical education for re-licensing perception of dentists practicing in a Developing Country

Background: Continuing professional education [CPE] or continuous education [CE] is the means by which people maintain their knowledge and skills related to their profession. Mandatory continuing education is a major factor in relicensure that is being licensed to practice for a specific period with the license either getting renewed at the end of that period or forfeited. This study is designed to assess the awareness regarding importance of continuing professional education as a requirement for re-licensing among General Dental Practitioners and Specialists and to identify the role of governing bodies for endorsing re-licensure procedure on the basis of CME

Methods: Cross sectional study was conducted among 450 dentists practicing in Karachi [July 2013 to Dec 2013], divided in to two groups ;General Dental Practitioners [n=350]and Consultant Specialists[n=100]. Simple Random sampling technique was applied thorough lottery from available list of Dentists and Consultants. Data was collected through a self administered questionnaire. SPSS version 20 was used for analysis and Chi -square test to assess associations of categorical variables. P value less than 0.05 was considered as significant

Results: Majority participants n= 250 [55.6%] were aware about re -certification and re-licensing and n= 292 [64.9%]knew the difference between the two. Only n=153 [34%] were of the view that re -certification and re-licensing should be made mandatory in Pakistan

Conclusion: The awareness of CME and re-certification is high among our professionals

Histopathological patterns of oral squamous cell carcinoma

The objective of this study was to provide a baseline data on the pattern of oral squamous cell carcinoma in Karachi. The retrospective cross sectional study was conducted. The patients of oral squamous cell carcinoma were examined from January 2007- December 2010 at oral maxillofacial department, Darul Sehat Hospital Karachi. All retrievable case files were obtained and necessary data were extracted regarding age, gender, site and histological type. All cases were clinically examined and provisionally diagnosed. Biopsy was taken from the lesions and tissues were fixed in 10% buffered formalin and submitted to histopathologic department for histological confirmation. 62% of males and 38% females were diagnosed with squamous cell carcinoma. 30% were observed in age group of 41-50 years old. 45% of squamous cell carcinoma were on buccal mucosa. OSCC was most common of all oral malignancies of which most were in the older age group. Serious thought should be given to prevention and early detection

Benign migratory glossitis an unusual enigmatic lesion

Benign migratory glossitis is an asymptomatic inflammatory disorder of tongue of unknown etiology. This disease is characterized by depapillation, erythematous areas showing raised greyish or white circinate lines or bands with irregular pattern on the dorsal surface of the tongue. The objective in presenting these reports was to discuss the clinical presentation, associated causative factors and management strategies of benign migratory glossitis

Van Der Woude syndrome: a rare case in Pakistan

Congenital epithelial anomalies of the face [sinus of fistula or pits] are uncommon. Most of them involve the lower lip as a part of Van der Woude syndrome. This syndrome presents as a pair of pits in the lower lip vermilion in association with left lip and palate. The incidence is 0.001% of the general population. Additional clinical features include enamel hypoplasia, multiple congenitally missing teeth and abnormality of right limb as a birth defect. Management of the patients involves the collaboration of different specialists. An earlier management of these cases could improve self-esteem and quality of life of the patient. Very few cases of this condition have been reported worldwide. By reporting such new cases we wish to contribute to the understanding of the etiology and to the better knowledge of the details of this very rare condition

unusual presentation of [peripheral giant cell granuloma]

Peripheral giant cell granuloma is an uncommon lesion though not rare in the oral cavity. A case is reported where peripheral giant cell granuloma was associated with partially impacted mandibular canine. The presentation was interesting because the lesion was initially diagnosed as tuberculosis and the patient was treated with anti tuberculous drugs for nine months without any regression of the oral lesion. The case report emphasizes the importance of history, examination and investigation in diagnosis

Patient perception for dentist's attire and hygienic practices

To determine the patient's preferences for the attire, general behavior and hygienic practices of the dentists during treatment and its influence on patient-dentist relationship in Karachi, Pakistan. This cross sectional Study was conducted using a questionnaire comprising of eleven closed ended questions related to perception for attire, behavior and hygienic practices of the dentist during the treatment of the patients. The study was conducted between August to September, 2008. A total of 100 patients participated in the study; ages were between 16 years to 65 years. The questions were asked from the patients by the dental students of a medical college. Demographic data were obtained together with the details to know the perception of the patients visiting for their treatment to the dental surgeons in different hospitals and private clinics of various towns of Karachi. Some degree of privacy was attempted while administering the questionnaire. Male subjects were interviewed by the male students, while female participants were interviewed by the female students. The data was entered and analyzed through SPSS Version 13.0. Patients showed significant preferences towards dentists with formal dress code, covered hair, use of perfume, use of hand gestures only to explain important points, wearing white coat, identity badge, mask and eyewear. Nobody liked the dentist not using eyewear and mask. It was also observed that 63% of the patients were of the opinion to have their surgeons to adopt sterilization of the equipments before going for the dental procedures. With regards to the general outlook for male dentist; significant preference was observed for clean shave. Eighty eight percent of the patients showed their liking towards friendly expressions of the dentists to improve their confidence in seeking the treatment from them Patients prefer the dentists with professional image, formal attire and short hair. The use of white coat, identity badge, mask, protective eyewear, perfume, and appropriate hand gestures and most importantly the friendly expression of the dentist were highly favored by the patients. The educated patients required their surgeons to adopt sterilization of the equipments before going for the dental procedures. Less educated people were not aware of the importance of sterilization of instruments. A greater sense of awareness regarding sterilization needs to be created even in the less educated people to avoid serious infections like hepatitis

survey of hepatitis B infection awareness and prevalence of vaccinated dental students in teaching institutions of Karachi

The Hepatitis B virus [HBV] is an extremely infectious blood borne pathogen. There are estimated 350 million chronic carriers worldwide. 1 In comparison to other viruses, HBV differs mainly in its higher infectivity and preventability. Several published reports have raised concerns over the risk of medical students related to occupational blood exposures during the clinical medical training. 27, 29 It is important to emphasize that the training period in dentistry is associated with a greater frequency of exposure to blood borne pathogens than in medicine. 30 Such hazardous exposures are not infrequent among local health care workers. Further the training of undergraduates is also not well structured to prepare and prevent them from occupational exposures of infections. We conducted a survey to determine the awareness of hepatitis B virus infection and prevalence of vaccinated dental students in the teaching institutions of Karachi. A questionnaire survey was conducted about awareness, prevention, transmission of hepatitis B infection and vaccination against hepatitis B, from students of all five dental institutes in Karachi. Total of 590 students replied, with 243 [42%] students from pre-clinical and 347 [58%] from the clinical years. Frequency of vaccinated dental students was 86.16% in clinical whereas 74.89 among pre clinical students [p-value 0.01]. Knowledge of transmission and awareness was high amongst the clinical students as compared with pre-clinical [p-value 0.01]. Preclinical students were more aware about the prevention of HBV infection than clinical students [p-value 0.01]. A considerable proportion of students is not vaccinated against hepatitis B. In our sample clinical dental students had inadequate knowledge regarding prevention of HBV infection. Strategies need to be developed by the concerned authorities for prevention HBV infection in dental professional during their training and education

seven years audit of nerve injuries related to third molar extraction in hospital setting

To investigate incidence of nerve injuries after surgical removal of lower third molars in hospital setting. To assess the usage of different anesthetic modality and intravenous sedation for oral surgery. Total 1353 lower 3rd molars were removed in 687 patients during February 2000 to July 2007. Records of these patients were evaluated for neurological disturbance. Out of 687 patients one had permanent anesthesia of long buccal nerve [0.14%], five had temporary and one permanent anesthesia of inferior dental nerve [0.87%] and three had temporary and one permanent anesthesia of lingual nerve [0.58%]. There was no injury to mylohyoid nerve in our study sample. In our observation frequency of lingual nerve damage was consistent with reported literature. Injury of inferior dental nerve in our patients was found to be less than one percent. Local anesthesia and intravenous sedation is underused in oral surgery

Experience of operator in relation to administration of inferior alveolar nerve block

OBJECTIVE: The purpose of the study was to determine the effectiveness of inferior alveolar block in relation to the experience of the operator. PATIENTS and METHOD: It was a cross-sectional comparative study carried out in the Oral Surgery Department of Liaquat College of Medicine and Dentistry, Karachi, Pakistan. SUBJECTS: Sixty patients were included in this study of age range 14 - 70 years [38 male and 22 female]. Students administered local anesthesia on I I patients, house officers on 7 patients, demonstrators on 32 patients and on Assistant Professor 10 patients. Repetitions of anesthetic were observed in IS subjects. Anesthesia administered by an experienced operator is found to be more profound

Need of radiation protection in dentistry in Pakistan

Dental radiography is widely acknowledged to be one of the most important procedures for proper diagnoses and treatment. The number of examinations has increased remarkably in last 20 years all over the world. This vast growth in the use of dental X-rays has been accompanied by an increasing concern among both the public and health professionals on the hazards of diagnostic radiography in developed countries and strenuous efforts have been and are being, made to both quantity and limit these risks. The first formal recommendations for persons working with sources of radiation in the world were those developed by the British X-ray and Radiation Committee in 1921. After various reforms the rules and Regulations for the radiation protection has changed over the years. Various recommendations were given by the working party which are included in this publication. In Pakistan there is no system of ionising protection. To achieve the desired level of radiation protection in Pakistan it is essential that in every dental school, the content of the undergraduate course should ensure that students receives instructions, practical experience in taking, processing and interpretation of both intro-and extra-oral radiographs. Other suggestions are also been made

Unerupted deciduous central incisors

Whilst it is common for permanent central incisors not to erupt either because of local or systemic causes, it is rare fore deciduous incisors not to do so. We report a case where a 3 year old child presented with a non-eruption of the maxillary central deciduous incisors