Demographic Profile of Patients Undergoing Orthodontic Extractions- An Institution Based Cross Sectional Study

Background: Extraction in Orthodontics has always been a topic of debate and is one of the controversies in Orthodontics. There are numerous studies available regarding the frequency of Orthodontic extraction in clinics, but very less such institution borne studies have been reported. It is important to have demographic data on the prevalence of extraction. The present study was aimed to determine the epidemiological data regarding the prevalence of extraction in Orthodontic patients with respect to various demographic features.Material & Methods:This cross sectional study was done over a period of five months prospectively. Prevalence of Orthodontic extractions was obtained with regard to Gender, Age group, Education level. Various Orthodontic extraction patterns and overall extraction frequencies in relation to malocclusions was evaluated. Chi-square test was used to determine correlations between variables, Shaperio?Wilk W test and independent ‘t’ test was used for comparison between two groups.Results:Majority of the patients reporting for Orthodontic Extraction were females (65.1%).. Most of the patients belonged to ?19 age group, with higher secondary education level and belonging to urban area. The most commonly extracted tooth for Orthodontic treatment was premolar and the most common extraction pattern was all first premolars which was seen in Class I malocclusion. Females underwent more Orthodontic extractions.Conclusion:The data from this study is a dental tertiary institution borne data and reveals the frequency of Orthodontic patients indicated and reporting for extraction. The epidemiologic data from this study has given a comparison of extraction rates among gender, age, education level, residence and provides an insight about the most commonly extracted tooth and extraction pattern in orthodontic patients with various malocclusions. This study revealed a more trend towards all four premolar extraction. Prevalence of Orthodontic extraction was more among females (65.1%). The mean rate of extraction was found to be 4.14 with standard deviation of 1.04.

randomized comparison of ultrasound guided versus direct palpation method of radial artery cannulation techniques in adult patients undergoing open heart surgery

Background and Objective: The use of two dimensional ultrasound technique allows radial artery cannulation to take place under real time visualization and may increase the success rate of first time pass of the needle and reduce the complications of the invasive procedure compared to traditional palpation and trial method

We aimed to compare the success rate of radial arterial catheter insertion at first attempt and average time for successful first attempt by traditional palpation method with ultrasound guided technique in adult patients undergoing open heart surgery

Methodology: A randomized study was conducted at our hospital during a 12 months period from 1st January 2014 to 31st December 2014. After taking permission from hospital ethical committee, one hundred adult patients were enrolled in whom radial artery cannulation was required prior to open heart surgical procedures including CABG, valvular heart disease, atrial septal and ventricular septal defect repairs and total correction. Patients were divided in two equal groups. In Group I radial artery cannulation was performed by ultrasound guidance and in Group II it was done by palpation method; in both groups Seldinger technique was used

Demographic and medical data were recorded in both groups. Heart rate, and invasive blood pressure monitoring was done in the arm in which the catheter was going to be inserted. Alien test with the help of pulse oximeter was also performed in all patients for detecting adequacy of ulnar artery flow. Time to first successful cannulation and the number of attempts were noted

Computer software SPSS 19.0 was used for data statistical analysis, the Chi-square/Fisher's exact test used for the comparison of qualitative/categorical variable in between groups. Student's t-test used for comparison of quantitative / continuous variables in between groups

Results: Average time to first successful attempt was 72.4 +/- 23.0 sec vs. 94.6 +/- 13.7 sec in Group I and II respectively [p=0.001]. Average number of attempts at same radial artery was significantly less in ultrasound group [1.4 +/- 1.0] as compared to palpation group [2.0 +/- 0.7] [p=0.001]. Ultrasound group [Group 1] had successful insertion at the first attempt in 36 [72%] patients, as compared to 32 [64%] patients in [Group II], but the difference was statistically not significant [p = 0.391]

Conclusion: Average time for successful first attempt was significantly less for radial artery cannulation performed by two dimensional ultrasound guidance as compared to palpation method; however, it did not significantly increase the success rate of first time cannulation of radial artery

Endovascular treatment of a post catheterization pseudoaneurysm: a stitch in time saves nine

External iliac artery [EIA] pseudoaneurysms are a well-known complication after arterial catheterization procedures. Most develop as a result of high femoral puncture. Small asymptomatic pseudoaneurysms are usually of no consequence but large symptomatic pseudoaneurysm carries a significant risk of rupture with serious life-threatening consequences and needs to be treated. We report here a case of EIA pseudoaneurysm in a 60 year old male patient after a cardiac catheterization procedure. CT angiography demonstrated a large pseudoaneurysm arising from the EIA and compressing the urinary bladder. Patient complained of abdominal pain and felt dizzy and required transfusions due to rapidly developing anaemia secondary to blood loss. Conventional angiography revealed free extravasation of contrast from the EIA. Percutaneous intervention through femoral access was performed by deploying a covered stent which effectively sealed off the perforation site with no evidence of contrast extravasation

Psychological effects among internally displaced persons [IDPS] residing in two districts of Sindh

To identify the psychological effects of IDPs and to assess the psychological illnesses. Descriptive Cross Sectional study. This study was conducted at shelters surrounding the campus of Liaquat University of Medical and Health Sciences, Jamshoro and New Sabzi Mandi, Hyderabad after 1 month of the flood. During study 300 affected Internally Displaced Persons [IDPs] were examined for physical, social and psychological effects after one month of flood through structured interviews. We focused on the behavior and activities according to Diagnostic Statistical Manual of Mental Disorders IV [DSM-IV] to identify psychological effects. Beside that the history of diet manual in children, male and female gender was addressed. Out of 300 respondents, the mean age was 40 years. According to DSM IV, 134 [44%] participants met the criteria of depression. 30 [10%] IDPs reported aggression. 26 [9%] IDPs met the criteria of post traumatic stress disorder [PTSD], 110 [37%] IDPs reported lack of sleep. Geographically Pakistan faces frequent natural calamities. In recent past Pakistan has suffered a lot due to floods. There is need to focus on mental health of internally displaced persons which is most neglected aspect during and after flood and disasters. The government and nongovernment organizations should make implementing policy to take care of post health issues of IDPs

Chediak-higashi syndrome presenting in accelerated phase

Chediak-Higashi Syndrome [CHS] is a rare autosomal recessive disorder, characterized by silver hair, recurrent infections, partial oculo-cutaneous albinism, mild coagulation defect and progressive neuropathy. The characteristic feature of CHS is the presence of huge lysosomes and cytoplasmic inclusions within different body cells like the white blood cells. The disease has an early onset but usually presents in an accelerated phase. We present a case of a 2 years old boy with high grade fever, bilateral cervical lymphadenopathy, hepatosplenomegaly, abdominal distention of 28 days duration. He was diagnosed with Chediak-Higashi syndrome in accelerated phase on the basis of clinical presentation, morphological findings on peripheral blood film and bone marrow aspirate

Aetiological factors of chronic liverdisease in children

Background: Chronicity of liver disease is determined either by duration of liver disease or by evidence of either severe liver disease or physical stigmata of chronic liver disease. Chronic liver disease may be caused commonly by persistent viral infections, metabolic diseases, drugs, autoimmune hepatitis, or unknown factors. The objective of this study was to find out the aetiology of chronic liver disease [CLD] in children. Methodology: It was a descriptive, prospective study which used a structured proforma designed to collect data of cases of CLD from both indoor and outdoor Paediatrics units of Fauji Foundation Hospital, Rawalpindi, and Children Hospital, Pakistan Institute of Medical Sciences, Islamabad. All children under 12 years having either clinical or biochemical evidence of liver disease and/or elevated liver enzymes for more than 3 months were included in this study. Results: Sixty cases of CLD were enrolled from indoor and outdoor units from January 2010 to July 2011. Thirty-nine [65%] cases were male and 21 [35%] were female. Eleven children were less than 1 year, 18 were 1–5 years old and 31 were 5–12 years of age. Viral hepatitis was the most common cause found in 22 [36.7%] cases. Out of these 22 patients with viral aetiology 19 [31.66%] patients had Hepatitis C and 3 [5%] had Hepatitis B. Glycogen storage disease was seen in 8.3% cases, and biliary atresia and Wilson disease in 6.7% each. Other less commonly found cases were autoimmune hepatitis, TORCH infections, hepatoma and drug induced hepatitis [1.7% each]. Cause couldn't be established in 35% cases which remained idiopathic. Conclusion: Viral hepatitis is the leading cause of chronic liver disease in children, with the highest incidence of chronic Hepatitis C followed by metabolic disorders [glycogen storage disease and Wilson disease] and biliary atresia. Chronic viral hepatitis was most prevalent between 11 months to 12 years of age. Wilson disease was common in 3–7 years age group, and Biliary atresia in 4–7 months age group. Glycogen storage disease was prevalent between 5 months to 3 years. Keywords: Chronic liver disease, Chronic viral hepatitis, Wilson disease

impact of age and sex in the pattern of coronary artery disease

Coronary Artery Disease [CAD] is the primary cause of death in the world. Over the last three decades, invasive procedures such as coronary artery bypass grafting [CABG] and percutaneous coronary interventions [PCI] have resulted in significant improvements in survival and quality of life for patients. Besides traditional modifiable risk factors, it has been proved that some fixed, nonmodifiable factors contribute in the behaviour of coronary involvement. To see whether the age and sex as a coronary risk factor contribute this differential coronary involvement, we conducted this study. To determine the frequency of coronary artery disease [CAD] as it varies with age and gender. It is a descriptive study carried out at NICVD Karachi. All the subjects were adults with previous history of ischemic heart disease and recommended coronary angiography based on history and non-invasive tests. There were 79.6% male patients and the mean age was 52 years [ranged from 28 to 85 year]. In 80% of patient femoral artery access was used for performing the procedure. Right coronary artery was found dominant in 73% angiograms. Left anterior descending artery was the most frequently involved artery[73.6%] among major coronary arteries and obtuse marginal was most frequently involved [20.4%] branche artery. Ramus intermedius was found diseased in 4.2%.The frequency of involvement of Left Main artery and distal segments of major coronary arteries was increased with advancing age but there was no significant association between age and sex and involvement of other coronary arteries. In conclusion males have a higher recorded rate of coronary angiography and single vessel disease is the most common finding. Females and ages above 80 and below 40 had low incidence of angiographic events

Congenital giant aneurysm of the left atrial appendage: diagnosis and management

Left atrial [LA] aneurysm is a rare congenital abnormality [1] and associated with life-threatening complications. We report the natural history of Left atrial aneurysm which was complicated by supraventricular tachycardia [SVT] and stroke in early childhood and her condition deteriorate rapidly after development of progressive mitral regurgitation [MR] and heart failure and expired despite successful surgery

Our purpose of this case report is to give the natural history of LA aneurysm and review it along its current literature, surgical strategy, and patient outcome. In literature there is a very limited description of such cases and their management

Vaccination against hepatitis B among doctors at a teaching hospital in Lahore

Hepatitis B is still a major cause of morbidity and mortality, but the disease is preventable, specially through awareness of its spread, screening and vaccination. Setting: Study was done at Sir Ganga Ram Hospital/Fatima Jinnah Medical College to examine the vaccination status against Hepatitis B among the doctors from the Departments of Medicine, Surgery, Gynae and Pathology. Material and In this descriptive study, a total of 110 doctors participated. It took into account different aspects like their vaccination status, status of the booster dose, whether they checked their immunologic status before or after vaccination and reason for not being vaccinated. A total of 71.8% of doctors working in the institution were vaccinated. The results showed that the status was better in the female doctors. A total of 81.5% consultants got themselves vaccinated followed by 74.3% house officers and only 63.6% medical officers who were probably most involved with the patients. Regarding the post-vaccination status 87.5% consultants, 7.1% medical officers and none i.e. 0% house officer had their post vaccine antibody titre checked. Among the house officers 66.6% received their booster dose [where applicable] followed by consultants and medical officers. Lack of awareness was mentioned as the biggest reason for not being vaccinated. Awareness through health education regarding Hepatitis B and bringing down the cost through other methods of vaccination is important in this country where the disease is very common

Studies on normal and abnormal excretion patterns of uric acid in Bahawalpur

Uric acid concentration in serum and urine of 296 persons of Bahawalpur city is reported. Although the general pattern corresponds to the studies in other regions of the world but the range of uric acid concentration in male and female serum and uric acid is slightly higher. Correspondingly the incidence of uricemia is also high in the region with some cases of gout. Statistically, the serum urate level were more compact and had smaller coefficient of variance. Only persons with serum urate level above 125mg/100ml showed signs and symptoms of gout