Efficient searching strategies in pubmed

Literature search is a fundamentally important problem in research but become harder as the literature grows at a faster speed and broader scope. PubMed is a free Web literature search service developed and maintained by the National Center for Biotechnology Information [NCBI]. It is as part of NCBI's Entrez retrieval system that provides access to a diverse set of 38 databases. PubMed currently includes citations and abstracts from over 5000 life science journals for biomedical articles dated back to 1948, therefore it serves as the primary tool for electronically searching and retrieving biomedical literature. Although PubMed provides a broad, up-to-date and efficient search interface, it has become more and more challenging for its users to quickly identify information relevant to their individual needs, owing mainly to the ever-growing biomedical literature. In present article several tools for efficient search are discussed, like Boolean operators ["AND", "OR", "NOT"], filters, search field tags, use of MeSH terms, wildcard [" * "] and search with key words. Aims: The purpose of this article is to assist general readers in the development of the basic skills required to use PubMed

Molar-like incisors: a rare case of multiple anomalies of the developing dentition

A rare case of a 9-year-old child is presented. The child was brought to the dental department of Children Hospital of Pakistan Institute of Medical Sciences, Islamabad in 2005, with severe toothache. His painful tooth was a mobile left lower central incisor which was cavitated, abnormal in shape and bigger in size. His other erupted teeth were also of abnormal shape [lowers anterior teeth resembled molars and upper anteriors resembled premolars], hypocalcified and cavitated. The mobile tooth was extracted under local anaesthesia. The extracted tooth had a hollow crown without any root. The panoramic radiograph of the patient showed generalized macrodontia, abnormal shaped teeth with almost no roots in both primary and permanent dentition. There were missing primary and permanent anterior teeth in both jaws possibly resulting in impaction and ectopic position of the other teeth. Due to uncooperative behaviour of the patient's father investigations of any systemic involvement could not be performed. It is believed that no similar case has been previously reported in literature

Enamel defects frequency in deciduous teeth

Developmental defects of the enamel are the result of alterations during amelogenesis due to hereditary, systemic or environmental factors. The present study was done to determine the frequency of developmental defects of enamel in primary teeth at Children Hospital PIMS, Islamabad from February 2011 to January 2012. The study was cross sectional and sample comprised of 300 children, which included 182 [60.7%] males and 118 [39.3%] females. The mean age of the studied population was 3.63 +/- 1.05 years. Enamel defects were present in 115 [38.3%] children. Out of 182 males 69 [37.9%] males and out of 118 females,46 [38.9%] females had enamel defect; thus frequency of enamel defect was not significantly different between the two genders [p=0.852]. The mean age of the children with enamel defect was 3.74 +/- 1.00 and mean age of children without enamel defect was 3.55 +/- 1.06 years respectively. This difference was not statistically significant [p=0.124]. Frequency of enamel defect was significantly higher among families with higher income categories [p=0.020].Out of 300 children, 185 [61.7%] had normal enamel, 5 [1%] had only demarcated opacity, 9 [3%] had only diffuse opacity, 80 [26.7%] had only hypoplasia, 3 [1%] had demarcatead diffuse opacity, 3 [1%] had demarcated opacity with hypoplasia, 13 [4.3%] had diffuse opacity with hypoplasia and 2 [0.7%] had all three defects. Present study concluded that more than one third of the children had developmental defects of enamel in primary teeth and most frequent lesion was enamel hypoplasia

Protocol for dental treatment before bone marrow transplantation [BMT] in paediatric patients

Bone marrow transplant [BMT] provides a chance to life for the patients with end-stage diseases like leukaemia, aplastic anaemia etc. The success of the transplantation procedure depends on the immune reactivity of the recipient patient, which may trigger the rejection. The aim of the present study was, to find out dental treatment needs in patients before BMT in Children's Hospital, Pakistan Institute of Medical Sciences [PIMS, Shaheed Zulfiqar Ali Bhutto Medical University] Islamabad, and also to make the dentists aware of the special needs of BMT patients, the specific medication and the necessity of an effective dental treatment. It was retrospective study done on 44 children who required BMT and were referred from oncology department of Children's hospital. Data of patients were taken from the hospital records. The age of patients ranged from 01-12 years with mean of 4.69 +/- 2.5 years. Out of total 44 patients, 12 were females and 32 were males. The difference in ratio between male and female patients is statistically significant [P<0.01]. Patients were divided into 2 groups of 1-5 years and 6-12 years. The difference in ratio of males to females in age group of 1-5 years is also significant [P<0.01]. Patients who required dental treatment before Bone Marrow Transplant were 29 [65.5%], while 15[34%] patients did not require any dental treatment. This difference is highly significant [P<0.05]. More dental treatment was required in age group of 1-5 years old children as compared to group of 6-12 years old. Total 101 teeth were restored, 13 teeth were extracted and 19 fissure sealants were placed. None of the patient showed dental infection after bone marrow transplant, therefore the protocol of the pre-BMT dental treatment was helpful in minimizing infection during immune-suppression period of post bone marrow transplantation

Comparison of role stressors, job satisfaction and turnover intensions of dentists working in public and private sectors

The main purpose of present study was to determine the difference in level of role stressors [Role Conflict and Role Overload] and their effect on Turnover Intention or Job Satisfaction of dentists. The study also explored the impact of role stressors with reference to demographic factors of age, sex and experience level. The current research was consisting of two parts, a pilot study and then main study. In pilot study a sample of 50 respondents were taken to pre-test and establish instruments' psychometric properties in local socio-cultural context. Main study was carried out on 100 faculty dentists' working in public/private teaching institutes. Dentists with minimum of one year job experience were selected by using Convenience Sampling technique. This was analytical, cross sectional and correlation study. A specially designed questionnaire used in present study was based on General Health Questionnaire [GHQ], Role Stressors Inventory, Turnover Intentions and Job Satisfaction instruments. Multiple regression analysis was computed to examine the relationship between role stressors and outcomes. T-test and ANOVA analyses were used to examine the difference on the basis of gender and experience level respectively. In the present study 40% of the sample ware males and 60% females. Females were more stressed than male dentists. More workload and conflict was found among dentists working in public/government dental teaching institutes as compared to private dental teaching institutes but on the other hand turnover intentions were more in dentists who were working in private dental teaching institutes. The knowledge of how to manage stress at work may be beneficial to better manage job related attitudes and behaviors. Health sector reforms should emphasize management of the stressors by means of better organizational and job design

Pattern of root canals in maxillary second premolars

Lack of knowledge of root form, internal morphology and critical interpretation of radiographs will undoubtedly lead to an error in obturation of root canals. The aim and objective of this study was to clinically and radiographicaly determine the frequency of single and more canals in maxillary second premolars and to compare the clinical and demographic features by taking periapical radiography at two different angles among a sample of local population and also to investigate the gender variations. Patients were recruited from regular pool of patients presenting to Dental department of PIMS, Islamabad, for root canal therapy on maxillary second premolars, during six month study period. Hundred male and female patients were selected according to the inclusion and exclusion criteria. Periapical radiographs through PT were taken at different angulations and visualized. Endodontic files were inserted into the canals through an access opening and a confirmatory radiograph was taken to confirm the numbers of root canals. The preoperative radiographs were correlated with the clinically assessed radiographs. Among the hundred patients [n=57] 57% were males and [n=43] 43% were females. Clinically assessed radiographs showed that 65% had single root canals and 35% had multiple canals. There was no significant difference between characteristics of patients with maxillary second premolars presenting with single canal or multiple canals

Dental caries status in 6-9 years old children

The purpose of this study was to determine the dental caries status in six to nine years [6-9 years] old children. Total [n=543] patients with dental caries between 6-9 years were selected from dental OPD of Children's Hospital, PIMS, Islamabad. Names, ages, sex, addresses and caries status of each patient was recorded in separate questionnaires. Intra oral examinations were performed with mirror, probe and good light. X-rays were not taken to diagnose the caries. Among total n=543 patients, the female were 244 [45%] and male were 299 [55%]. The dmft was 7.45, 6.52, 5.74 and 5.33 for aged six, seven, eight and nine respectively. The frequency of caries was higher in age group of eight. The DMFT was 0.39 for each child. In present study the frequency of caries was found to be higher than reported by Almoudi in Saudi children and reported by Kerala in India

Risk factors for dental caries in Pakistani children

The present study was carried out to determine any possible association of caries with oral hygiene and food habits. This was prospective descriptive study. Total [n= 543] patients with dental caries between 6-9 years were selected from dental OPD of Children's Hospital, PIMS, Islamabad. Questions regarding brushing habits and food habits were asked by interviewing the accompanied adults and caries status of teeth after intra oral examination were recorded in questionnaire. X-ray was not taken to diagnose the caries. The frequency of caries was higher in age group of eight and nine. Children who ate candies daily had statistically [p<0.05] high caries. Negative correlation was found between mother's education, father's education and caries- Significantly high frequency of caries [P<0.05] was found in children who ate bread in their breakfast with sugar sweetened tea and patients used fluoride containing toothpaste had less caries. Surprisingly, in comparison of food habits between male and female subjects no significant difference was found

Comparison of radiographic and electronic working length in anterior teeth

The aim of this study was to compare the endodontic working length of anterior teeth by electronic apex locator and conventional radiographic method to determine the accuracy and reliability of latest generation electronic apex locator [Sybron Endo]. The study was carried out in the dental department of Pakistan Institute of Medical Sciences, Islamabad from April 2004 to January 2005. The use of electronic devices to determine working length has gained increasing popularity in the recent years particularly after introduction of latest generation of apex locators. An in vivo study was conducted on 30 permanent single rooted anterior teeth that were indicated for root canal treatment. First the working length was taken by electronic apex locator followed by conventional radiographic [Ingle's method]. After recording both measurements, the difference between the two results were compared to evaluate the diagnostic efficacy and ability of an electronic apex locator for accurate determination of working length. In 23 among 30 root canals, [76.6%] electronic measurement coincided with the radiographic measurements. In 4 cases [13.3%] it was short of radiographic measurements by 0.5mm. Both these results were considered acceptable however, in the remaining 3 cases the results were considered unacceptable, as in 2 cases [6.67%] it was more than radiographic measurement by 0.5mm and in 1 case electronic measurement was more than radiographic by 1.5mm. It has been concluded from the present study that the electronic apex locator is an effective device with an accuracy of more than 90%; hence it can be used as adjunct to conventional radiography but cannot replace it

Dentinogenesis imperfecta- a case report

A young 18-year old female patient reported to PIMS with pain in left upper first molar. Intra oral examination revealed infected, grossly carious left upper first molar and marked attrition of her all teeth. The colour of her teeth was also not normal, and opalescent She did not mention any complaint regarding tooth color or gradual reduction on height of her teeth. Extra oral and physical examination revealed no abnormality. Radiographic examination showed bulbous crowns, obliterated pulp chamber and canals. She had three brothers and two sisters. Her one sister and two brothers were also suffering from same dental problem. Except for her youngest brother, all others were wearing full dentures. Only one sister and one brother were normal. Her father had three brothers and three sisters. Out of the seven, three brothers [including her father] and all three sisters had the same disease. She also mentioned that the grandmother [paternal] of her father was also suffering from same problem

Dental management of patients suffering from [Lowe syndrome]

Lowe syndrome [LS] is an x-linked recessive disorder of unknown etiology resulting in ocular, cerebral and renal disorder. It is X linked recessive disorder, caused by a defective gene on Chromosome number Xq 26. Males are more affected than females. Clinical features are bilateral congenital cataract [100%], Glaucoma, Infantile hypotonia, gross motor developmental delay, reduced or absent deep tendon reflexes, muscle wasting, moderate to severe mental retardation, frequent high pitched scream seizures, growth failure, Rickets, Joint hyper mobility and renal manifestations. Prognosis is poor for normal life style. There are developmental delays, visual problems and progressive mental retardation. The patient dies in the first decade of complication of Fanconi syndrome if treatment is not provided. Lifespan can be extended with supportive therapy. A case of LS with dental management, although not ideal is presented. Mentally retarded patients needs regular dental visits to reduce avoidable dental pain

Management of papillon lefevre syndrome

It is a rare, autosomal recessive disorder occurring between the first and fifth years of life and is characterized by palmoplantar keratoderma and periodontitis followed by the premature shedding of both primary and permanent teeth. The teeth are affected in the order of their eruption, exhibiting inflammation of the periodontal tissue, bleeding of the gums, pocket formation, loosening of teeth, and finally spontaneous exfoliation without showing definite signs of root resoption by about age five. After an edentulous interval, the same process begins shortly after the second dentition. PLS [Papillon Lefevre Syndrome] is transmitted as an autosomal recessive trait. In addition, some patients manifest excessive sweating, the growth of fine body hair and the development of dirty colored skin on the affected parts. Genetic analysis of several affected families suggests that the disorder may result from mutations of a gene that regulates production of an enzyme known as cathespin C. A case of PLS is presented along with management of this condition. The result was satisfactory with limited resources. The patient was satisfied with improved esthetic, speech and chewing abilities

Conclusion: Any young patient who exhibits palmar hyperkeratosis should be examined carefully for periodontal breakdown