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Purpose: To evaluate the clinical outcomes of preloaded toric intraocular lens (IOLs) implantation in eyes undergoing phacoemulsification. Methods: This prospective study included 51 eyes of 51 patients with visually significant cataracts and corneal astigmatism ranging between 0.75 and 5.50 D. All patients underwent phacoemulsification with SupraPhob toric intraocular lens implantation under topical anesthesia. The main outcome measures were uncorrected distance visual acuity (UDVA), residual refractive cylinder, spherical equivalent, and IOL stability at 3 months follow?up. Results: At 3 months, 49% (25/51) of patients had UDVA equal to or better than 20/25 with 100% of eyes achieving better than 20/40. Mean logMAR UDVA improved from 1.02 ± 0.39, preoperatively to 0.11 ± 0.10 at 3 months follow?up (P < 0.001, Wilcoxon signed?rank test). The mean refractive cylinder improved from ? 1.56 ± 1.25 D preoperatively to ? 0.12 ± 0.31 D at 3 months follow?up (P < 0.001) while the mean spherical equivalent value changed from ? 1.93 ± 3.71D preoperatively to ? 0.16 ± 0.27D (P = 0.0013). The mean root mean square value for higher order aberrations was 0.30 ± 0.18 ?m while the average contrast sensitivity value (Pelli?Robson chart) was 1.56 ± 0.10 log unit, at the final follow?up. The mean IOL rotation at 3 weeks was 1.7 ± 1.61 degrees, which did not change significantly at 3 months (P = 0.988) follow?up. There were no intraoperative or postoperative complications. Conclusion: SupraPhob toric IOL implantation is an effective method for addressing preexisting corneal astigmatism in eyes undergoing phacoemulsification with good rotational stability
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Background: AS-OCT is a noncontact imaging device that provides the detailed structure of the anterior part of the eyes. The Objectives In this review, the author will discuss the clinical applications of AS-OCT in the scleral contact lens fittings.Material & Methods:Pre-Scleral lens fit and post fit ASOCT done on 30 patients to assess the normal fitting and compare it with the slit lamp evaluation.Results:ASOCT gives a Quantitative measurement of the fit.Conclusions:ASOCT comes out as a helpful tool for beginners particularly for a good assessment of a contact lens fit. The author also presents some interesting cases demonstrated via AS-OCT.
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Background: The Ocular Prosthesis device is very important toprovide the best possible functional & cosmetic results. It is important to have a firm understanding of management of the anophthalmic socket & when to make appropriate referrals to the Ophtahlmic Surgeon. The Objectives In this review, the author will discuss about one of the component of Ocular Prosthesis ie. Orbital implants.Material & Methods:The patients who requires ocular prosthesis are selected as per the need & requirement, also on the basis of types of available implants.Results:One should follow the components& scenario for optimal outcome.Conclusions:An eye care professional should be aware of the entire structure & all the recent development involved in it. They also have to be empathetic and have a creative oulook in management of such conditions by using all the available resources.
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Abstract Introduction: Tracheostomy is commonly performed surgical procedure in ENT practice. Postoperative care is the most important aspect for achieving good patient outcomes. Unavailability of standard guidelines on tracheostomy management and inadequate training can make this basic practice complex. The nursing staff and doctors play a very important role in bedside management, both in the ward and in the intensive care unit (ICU) setup. Therefore, it is crucial that all healthcare providers directly involved in providing postoperative care to such patients can do this efficiently. Objectives: The objective of this study is to assess the knowledge regarding identification and management of tracheostomy-related emergencies and early complications among healthcare professionals so as to improve practice and further standardization. Methods: Cross-sectional observational study included two hundred and fifty-four doctors and nurses from four large tertiary care hospitals. The questions used were simple and straightforward regarding tracheostomy suctioning, cuff care, cuff management, tube blockage, and feeding management in patients with tracheostomy. Results: Based on evidence from our study, knowledge level regarding tracheostomy care ranges from 48% to 52% with knowledge scores above 50% being considered satisfactory. Significant gaps in knowledge exist in various aspects of tracheostomy care and management among healthcare professionals. Conclusion: Our findings demonstrated an adequate knowledge level among health care professionals ranging from 48% to 52% with knowledge scores above 50% being considered satisfactory and revealed that gaps in knowledge still exist in various aspects of tracheostomy care and management.
HIGHLIGHTS Healthcare workers should be well versed in identifying tracheostomy management, its complications and responding accordingly. Doctors and nurses (131 =52%) possessed good knowledge about various aspects of tracheostomy care and management. The poorest scores were regarding cuff pressure (38.9%), suction pressure (39.4%) and first response in tube blockade (31.1%). Higher scores were found in age group 26 to 30 years (54.2%) and those having 1-3 years of clinical experience (41.2%). No statistically significant assoiation of knowledge regarding tracheostomy care was apparent with age, gender or years of practice.
Resumo Introdução: A traqueostomia é um procedimento cirúrgico comumente feito na prática otorrinolaringológica. O cuidado pós-operatório é o aspecto mais importante para alcançar bons resultados para o paciente. A indisponibilidade de diretrizes padrão para o manejo da traqueostomia e o treinamento inadequado podem tornar complexa essa prática básica. A equipe de enfermagem e os médicos desempenham um papel muito importante no manejo à beira do leito, tanto na enfermaria quanto na unidade de terapia intensiva (UTI). Portanto, é crucial que todos os profissionais de saúde diretamente envolvidos na prestação de cuidados pós-operatórios a esses pacientes possam fazer isso de forma eficiente. Objetivo: Avaliar o conhecimento sobre a identificação e manejo de emergências relacionadas à traqueostomia e complicações precoces entre os profissionais de saúde, a fim de melhorar a prática e sua padronização. Método: Estudo observacional transversal que incluiu 254 médicos e enfermeiras de quatro grandes hospitais terciários. As perguntas foram simples e diretas em relação à aspiração da traqueostomia, cuidados com o cuff, manejo do cuff, obstrução da cânula e manejo da alimentação em pacientes traqueostomizados. Resultado: Com base nas evidências de nosso estudo, o nível de conhecimento sobre os cuidados com a traqueostomia varia de 48% a 52%, com escores de conhecimento acima de 50% considerados satisfatórios. Existem lacunas significativas no conhecimento em vários aspectos dos cuidados e manejo da traqueostomia entre os profissionais de saúde. Conclusão: Nossos achados demonstraram um nível de conhecimento adequado entre os profissionais de saúde, variação de 48% a 52%, com escores de conhecimento acima de 50% considerados satisfatórios e revelaram que ainda existem lacunas no conhecimento em vários aspectos do tratamento e manejo do paciente traqueostomizado.
DESTAQUES Profissionais de saúde devem estar bem familiarizados com a identificac¸ão do manejo da traqueostomia, suas complicac¸ões e como agir de acordo com a necessidade. Médicos e enfermeiras (131 = 52%) possuíam bons conhecimentos sobre vários aspectos dos cuidados e manejo da traqueostomia. Os piores escores foram em relac¸ão à pressão adequada do cuff (38,9%), à pressão de aspirac¸ão adequada (39,4%) e primeiros socorros em caso de obstruc¸ão da cânula (31,1%). Os melhores escores foram encontrados no grupo 26 a 30 anos (54,2%) e aqueles com experiência clínica de 1-3 anos (41,2%). Não houve associac¸ão estatisticamente significante entre o conhecimento sobre os cuidados com a traqueostomia, idade e gênero e os anos de prática de médicos e enfermeiras.
Subject(s)
Tracheostomy/adverse effects , Intensive Care Units , Cross-Sectional Studies , Health Personnel , Delivery of Health CareABSTRACT
We describe a modified technique of intraoperative optical coherence tomography (iOCT)?guided removal of post?laser?assisted in situ keratomileusis (LASIK) epithelial ingrowth with interface ethyl alcohol and mitomycin C application to prevent a recurrence. Epithelial ingrowth was visualized as hyperreflective deposits in the interface on iOCT, and the location and extent were noted at the beginning of the procedure. A simple dimple?down maneuver was performed to help identify the circumference of the LASIK flap. iOCT helped to delineate the flap edge and ensure dissection in the correct plane with complete removal of epithelial cell nests. Real?time visualization of the interface helped in on?table decision making regarding the extent of lifting the flap to encompass the entire region of hyperreflective epithelial ingrowth, as well as the need for additional interventions to ensure complete flap apposition at the end of surgery. All patients gained an uncorrected visual acuity of 20/20–20/25 with no recurrence
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Objective@#: There are different types of cerebral vascular malformations. Pial arteriovenous fistulas (PAVFs) and dural arteriovenous fistulas (DAVFs) are two entities; they consist of one or more arterial connections to a single venous outlet without a true intervening nidus. The high turbulent flow of PAVFs and aggressive DAVFs with cortical venous reflux can result in venous outflow varix and aneurysmal dilatation. They pose a significant challenge to transvenous embolization (TVE), stereotactic radiosurgery, and surgical treatment. We aim to share our centers’ experience with the transarterial embolization (TAE) for arteriovenous fistulas (AVFs) with large venous pouches and to report the outcome. @*Methods@#: The authors’ two institutions’ databases were retrospectively reviewed from February 2017 to February 2021. All patients with intracranial high flow PAVFs and aggressive DAVFs with venous outlet ectasia and large venous varix and were treated by TAE were included. @*Results@#: Fifteen patients harboring 11 DAVFs and four PAVFs met our inclusion criteria. All patients underwent TAE in 17 sessions. Complete angiographic obliteration was achieved after 14 sessions in 12 patients (80%). Four patients (25%) had residual after one TAE session. Technical failure was documented in one patient (6.7%). Fourteen patients (93.3%) had favorable functional outcome (modified Rankin score 0–2). @*Conclusions@#: TAE for high flow or aggressive intracranial AVFs is a safe and considerable treatment option, especially for those associated with large venous pouches that are challenging and relatively high-risk for TVE.
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Background@#and Purpose Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year. @*Methods@#We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020). @*Results@#There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P<0.0001) and 2020 (41.4%; 95% CI, 37.0 to 46.0; P<0.0001). A COVID-19 diagnosis was present in 7.6% (132/1,738) of CVT hospitalizations. CVT was present in 0.04% (103/292,080) of COVID-19 hospitalizations. During the first pandemic year, CVT mortality was higher in patients who were COVID positive compared to COVID negative patients (8/53 [15.0%] vs. 41/910 [4.5%], P=0.004). There was an increase in CVT mortality during the first 5 months of pandemic years 2020 and 2021 compared to the first 5 months of the pre-pandemic year 2019 (2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03). In the first 5 months of 2021, there were 26 cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), resulting in six deaths. @*Conclusions@#During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year. COVID-19 diagnosis was associated with higher CVT in-hospital mortality. During the first 5 months of 2021, there was an increase in CVT hospitalization volume and increase in CVT-related mortality, partially attributable to VITT.
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This study assessed the potential of termite gut inhabiting bacteria towards bioconversion of cellulosic waste into biofuel. Total seven bacterial isolates from the gut of Heterotermes indicola were isolated. Among all the isolates, HI-1 produced the largest zone upon primary screening. Untreated paper had more cellulose content (73.03%) than acid (0.5%) treated paper that was used as a lignocellulosic substrate for saccharification. Among all the isolates tested, glucose yield (1.08mg/mL) was high for HI-1 isolate. Several factors were considered for optimizing augmented glucose yield (8.57mg/mL) and growth (8.07×108cfu/mL), such as temperature 37°C, pH 4.5, 5% (w/v) substrate concentration, 6 % bacterial inoculum size, agitation 150 rpm with PEG 0.25 % and Ca2+ ions 0.002 g/L. Overall 8-fold increase in glucose yield was achieved. Enzyme activity of HI-1 showed higher endoglucanase 0.29 ± 0.01 (U/mL/min) and exoglucanase 0.15±0.01 (U/mL/min) activity under optimum conditions, mentioned above. temperature 37°C, pH 4.5, substrate concentration 5%, inoculum size 6%, surfactants PEG 0.01%, ions Ca2+(0.002g/L) and agitation (120 rpm). Simultaneous saccharification and fermentation (SSF) of hydrolyzed office paper yielded 5.43mg/mL bioethanol. According to 16S rRNA sequence homology, the bacterial isolate H1 was identified as Alcaligenes faecalis. Bioethanol production from office paper untreated waste proved an effective strategy. Bacteria having natural tendency towards cellulosic waste consumption are promising for bioconversion of cellulosic waste to valuable products.
Subject(s)
Isoptera/microbiology , Alcaligenes faecalis , BioethanolABSTRACT
@#Adolescence stage is filled with enormous changes and challenges. At this stage, adolescents are not mentally mature so they failed to adjust to the changes of their life and are at greater risk of developing smoking habit. Many psychosocial factors contribute to adolescents’ smoking, among them family role is prominent. So, the present correlational study aimed to highlight the familial predictors of smoking in adolescents. It was hypothesized that parenting styles, lack of parent-child communication, less parental monitoring, parents and sibling smoking would be related to adolescents smoking. Data was collected from 150 adolescents (smokers: 70, non-smokers: 80) throughconvenient sampling technique. Parental bonding instrument and parental monitoring questionnaire were used. Binary Logistic regression revealed less Parental care and father’s monitoring, lack of mother-child communication and siblings’ smoking as significant predictors of smoking. The study implications are discussed with its application in health, social and counseling psychology.
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Background: Adolescent is a stage of development tangent, like a bridge of childhood and adulthood. It is the healthiest age group of our society which is almost 20% of our total population. World health organization (WHO) defines adolescents are in the 10-19 year in age group. One of the major physiological changes that take place in adolescent girls is the onset of menarche, which is often associated with problems of irregular menstruation, excessive bleeding and dysmenorrhea.Methods: This cross-sectional observational study was carried out in 668 female adolescent aged 10-19 years irrespective of their marital status visiting the OPD of obstetrics and gynecology department of BSMMU. All data was analyzed using SPSS program version 22.0.Results: Results were expressed in frequencies or percentages. Of the 668 adolescent girls, 418 (62.6%) had different type of menstrual disorder. Of these 418 cases about 127 (30.38%) of them were a case of puberty menorrhagia, 109 (26.07%) cases were oligomenorrhoea and 91 (21.77%) were amenorrhea. Other presentations were pre-vaginal discharge, vulval itching, lower abdominal pain, dysuria, feeling lump in lower abdomen, mastalgia, feeling lump in the breast, discharge from breast, acne, hirsutism.Conclusions: This study shows more than half of adolescent girls are having menstrual disorder. Adolescent gynecology needs increased awareness and greater attention to improve the quality of their life. Setting up a separate adolescent clinic is necessary for efficient management of adolescent problem.
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Abstract Background: Postoperative nausea and vomiting is the second most common complaint in the postoperative period after pain. The incidence of postoperative nausea and vomiting was 60-80% in middle ear surgeries in the absence of antiemetic prophylaxis. Because of this high incidence of postoperative nausea and vomiting, we aimed to assess the effect of palonosetron-dexamethasone and ondansetron-dexamethasone combination for the prevention of postoperative nausea and vomiting in patients of middle ear surgery. Methods: Sixty-four patients, scheduled for middle ear surgery, were randomized into two groups to receive the palonosetron-dexamethasone and ondansetron-dexamethasone combination intravenously before induction of anesthesia. Anesthesia technique was standardized in all patients. Postoperatively, the incidences and severity of nausea and vomiting, the requirement of rescue antiemetic, side effects and patient satisfaction score were recorded. Results: Demographics were similar in the study groups. The incidence difference of nausea was statistically significant between groups O and P at a time interval of 2-6 hours only (p = 0.026). The incidence and severity of vomiting were not statistically significant between groups O and P during the whole study period. The overall incidence of postoperative nausea and vomiting (0-24 hours postoperatively) was 37.5% in group O and 9.4% in group P (p = 0.016). Absolute risk reduction with palonosetron-dexamethasone was 28%, the relative risk reduction was 75%, and the number-needed-to-treat was 4. The patient's satisfaction score was higher in group P than group O (p = 0.016). The frequency of rescue medication was more common in group O than in group P patients (p = 0.026). Conclusion: The combination of palonosetron-dexamethasone is superior to ondansetron-dexamethasone for the prevention of postoperative nausea and vomiting after middle ear surgeries.
Resumo Justificativa: Náusea e vômito no pós-operatório é a segunda queixa pós-operatória mais frequente após a dor. Sem profilaxia antiemética, a incidência de náusea e vômito no pós-operatório foi de 60−80% após cirurgia do ouvido médio. Dada a alta incidência relatada de náusea e vômito no pós-operatório, nosso objetivo foi avaliar o efeito da combinação de palonosetrona-dexametasona e ondansetrona-dexametasona na prevenção de náusea e vômito no pós-operatório em pacientes submetidos a cirurgia do ouvido médio. Método: Sessenta e quatro pacientes programados para cirurgia de ouvido médio foram aleatoriamente divididos em dois grupos. Um recebeu a combinação de palonosetrona-dexametasona (grupo P) e o outro ondansetrona-dexametasona (grupo O) por via intravenosa antes da indução anestésica. A técnica anestésica foi padronizada em todos os pacientes. No pós-operatório, foram registradas incidência e gravidade das náuseas e vômitos, necessidade de antiemético de resgate, efeitos colaterais e índice de satisfação dos pacientes. Resultados: As características demográficas foram semelhantes nos grupos estudados. A diferença na incidência de náusea foi estatisticamente significante entre os grupos O e P apenas no intervalo de tempo entre 2 e 6 horas (p = 0,026). A incidência e gravidade de vômito não foram estatisticamente significantes entre os grupos O e P durante todo o período do estudo. A incidência geral de náusea e vômito no pós-operatório (0−24 horas de pós-operatório) foi de 37,5% no grupo O e de 9,4% no grupo P (p = 0,016). A combinação palonosetrona-dexametasona associou-se com redução do risco absoluto de 28%, redução do risco relativo de 75%, e o número necessário para tratar foi 4. O escore de satisfação do paciente foi maior no grupo P (p = 0,016). A frequência da medicação de resgate foi mais comum no grupo O (p = 0,026). Conclusão: A combinação de palonosetrona-dexametasona é superior à ondansetrona-dexametasona na prevenção da náusea e vômito no pós-operatório após cirurgia de ouvido médio.
Subject(s)
Humans , Male , Female , Adult , Young Adult , Dexamethasone/administration & dosage , Ondansetron/administration & dosage , Postoperative Nausea and Vomiting/prevention & control , Palonosetron/administration & dosage , Double-Blind Method , Incidence , Prospective Studies , Patient Satisfaction , Postoperative Nausea and Vomiting/epidemiology , Drug Therapy, Combination , Ear, Middle/surgery , Middle Aged , Antiemetics/administration & dosageABSTRACT
The leiomyoma is a benign smooth-muscle neoplasm commonly found in the female genital tract, gastrointestinal tract, or skin. Leiomyomas of the oral cavity are unusual. Oral leiomyomas are uncommon due to the paucity of the smooth muscle in the mouth (except in blood vessels) and thus the involvement of jaw bones is extremely rare. Leiomyomas have been classified as solid angiomyoma, angioleiomyoma (vascular leiomyoma), and epithelioid variants. Angioleiomyomas are benign mesenchymal tumors derived from smooth muscle, which rarely occur in the oral cavity. Malignant transformation probably does not occur but careful histopathologic examination is still necessary to differentiate these benign lesions from their malignant counterparts due to different prognosis. Although uncommon in the maxilla and mandible, they should be included in the differential diagnosis of radiolucent lesions of jaw bones. An extensive search of literature was carried out on the Medline-PubMed and Google Scholar database using the keywords such as leiomyoma, angioleiomyoma, jaw bones, maxilla, mandible, intra-osseous to thoroughly search and collect all the reported cases of intraosseous leiomyoma (but our search was not limited to these terms only). To the best of our knowledge, only 23 cases of intraosseous leiomyomas have been reported so far in the jaw bones, among which only 8 belonged to angioleiomyomas. Herein, we report the 9th case of intraosseous angioleiomyoma, one of the variants of leiomyoma and overall 24th intraosseous leiomyoma in a 6-year-old female child, together with conventional histopathologic and immunohistochemical findings
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Introduction: Diabetic foot ulcer is a major disablingcomplication of Diabetes Mellitus and often precedes lowerextremity amputation. This study aims to evaluate the level ofHbA1c and lipid profile in patients with diabetic foot ulcer asT2DM patients areprone to diabetic dyslipidemia,which puts them at risk ofdeveloping macrovascular and microvascular diseases.Material and methods: The study was accomplished at atertiary care hospital in Jammu & Kashmir. One hundred tensubjects with T2DM were enrolled for the present study, thisincluded 55 subjects with DFU and 55 subjects without DFU.The HbA1c and lipid profile of the subjects were measuredwith standard methods.Results: In our study HbA1c level was found higher indiabetic patients with diabetic foot ulcer when compared withpatients without. Also lipid profile was found deranged indiabetic foot ulcer patients in comparison to control group. Itwas found that approximately 78% DFU have HbA1c levels˃7%. Unlike the DFU-patients, 79% of patients without DFUhave HbA1c level controlled.Conclusion: As diabetic foot ulcer is a major disablingcomplication of Diabetes Mellitus and often precedes lowerextremity amputation, we conclude that HbA1c level shouldbe maintained in normal range and regulating it is imperativefor avoiding T2DM complications.
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Objectives:To compare orthodontic pain and its Influence on quality of patient’s life as perceived by them with that assessed by their orthodontic care providers.Materials and Methods:It was crosses sectional study involving 75 patients attending the orthodontic clinic and14 orthodontic care providers from September to October 2010. Patients aged 16 and older, receiving fixed orthodontic treatments were included. Patients and orthodontists scored painduring different orthodontic procedures using a qualitative pain intensity scale which graded pain for different orthodontic procedures. Oral health related quality of life (OHRQoL) was assessed by means of a 4-point likert scale to measure the influence of orthodontic treatment related pain on different aspects of life.Results:For change of consistency of diet (p=0.02) statistically significant difference was observed between mean ranks of patients and orthodontists. For pain during record taking, higher mean ranks were reported for patients aged between 20-30 years (p = 0.01) whereas for pain after separator placement, patients aged above 30 had higher mean ranks (p = 0.05).Conclusions:Orthodontists can accurately estimate the degree of pain their patients’ experience. Significant proportions of patients experience substantial degrees pain during the visits, subsequent to orthodontic visits and pain due to fixed orthodontic appliance therapy transiently affects patients’ OHRQoL
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The trends in the acceptability of contraceptives is globally shifting from permanent sterilisation to long acting reversible contraceptive (LARC). With the increasing use of IUCD, the knowledge of its common and rare complications has become pertinent. One of them is cervical perforation in which strings are mostly visible and hence it can be easily missed. Here we present a rare case of cervical perforation which was timely detected before it could have caused more damage. A patient complaining of IUCD associated pain should undergo thorough examination and a probability of perforation should be kept in differential diagnosis despite string visibility. A clinician has to be more vigilant about this rare complication to prevent damage to cervix and avoid unwanted pregnancy.
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Submandibular gland is the most common site of stone formation among all the salivary glands, owing to its long duct, mucus rich saliva and antigravity flow. Swelling and pain on eating is its most common presentation. Most salivary stones are made up of calcium phosphates, and only a few contain pure organic material. Surgical removal is required, and the route of surgery is planned according to the site and size of the stone.METHODSWe conducted a cross sectional study on 25 consecutive patients with a clinical diagnosis of submandibular sialolithiasis. Thorough history taking and clinical examination was followed by ultrasound scan to confirm the diagnosis and establish the site and size of the stone. Stone procured after removal was analysed chemically in the biochemistry laboratory.RESULTSOut of 25 patients, calculi in 11 cases were found in the intraglandular part of the submandibular gland and in 14 cases in the intraductal part of the gland. Out of the 14 cases with stone in the intraductal part, in 4 cases the stone was removed with the help of sialagogues and milking due to the very small size of the stone; whereas, in 10 cases the stone was removed intraorally with marsupialisation of the duct under local anaesthesia. In 11 cases the gland had to be removed along with the stone. As per the biochemical analysis, calcium and phosphate stones were the commonest in our study followed by oxalate calculi. Obtained results showed that the studied salivary stones had almost 10% association with nephrolithiasis. The salivary pH was acidic in 10 cases and alkaline in 15 cases.CONCLUSIONSCharacteristic history, thorough clinical examination and ultrasonic examination help us in the diagnosis of sialolithiasis. The site and size of the calculus is the deciding factor for the surgical plan. Biochemically stones are invariably composed of calcium and phosphates. Simultaneous occurrence of sialoliths and renal calculi was purely by chance or as a comorbidity needs to be studied more in a larger study group.
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Introduction:Resistin, (Retn) a pro -inflammatory cytokine, accumulates at the site of inflammation.It is found to be elevated in chronic inflammation. The aim of this present study is to evaluate the levels of salivary resistin in healthy individuals and in patients with Oral pre-malignant lesion.Materials and Methods: This case control study comprises of total 90 patients which includes 45 healthy controls and 45 cases diagnosed with oral pre-malignant lesions. Salivary levels of resistin and clinical parameters were evaluated in all of them. Socio -demographic data (age, gender and residence) was collected from all participants through a questionnaire. In addition, we also recorded the total duration of tobacco usage (in years), daily frequency, and intra-oral examination and oral hygiene practices. This was followed by evaluation of clinical parameters of oral premalignant lesions and investigation of salivary levels of resistin through ELISA Results: Thesaliva of all the patients showed presence of resistin. On analyzing the samples present study shows no significant difference and variation in the salivary levels of resistin in healthy and OPML patients.Conclusion: With the results of this study, it can be concluded that there is no significant difference in the salivary levels of resistin in healthy individuals and individuals diagnosed with oral pre-malignant lesion
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Background: Oral squamous cell carcinoma is prevalent in South Asian countries with rising cases of its incidence and mortality. Despite advancements in treatment, survival and recurrence rates are poor. Immunotherapy is a novel therapeutic modality in immunooncology. Immune checkpoint proteins are under investigation for clinical implications amongst which Programmed Death Ligand-1 has shown valuable results in certain malignancies. Aims: To determine the immunohistochemical expression of Programmed Death Ligand-1(PD-L1) in oral squamous cell carcinoma and to find an association of Programmed Death Ligand-1 with stage and clinicopathological parameters of oral squamous cell carcinoma.Study Design:Cross-sectional study.Place and Duration of Study:Ziauddin Medical University, Karachi, 1 Year duration during 2018-2019.Methods: A total number of140 biopsy confirmed cases of oral squamous cell carcinoma were recruited in the study. Immunohistochemical expression of Programmed Death Ligand-1 was evaluated and associated with the clinicopathological parameters of oral squamous cell carcinoma (OSCC). The data was statistically analyzed through Descriptive statistics and Chi square test by using SPSS v.20.Results: Out of 140 participants, 74% were males (n=103) and 26% were females (n=37). Programmed Death Ligand-1 positivity was observed in 62.1% of cases (n=87). The Mean age of the participants was 48.91 ± 11.7 years. The most common site of cancer involvement was buccal mucosa and majority of participants were habitual of consuming chewable products i.e. Pan, Gutka and betel nut (89; 64%). Stage III and IV tumours comprised a major portion of cases in our study.(52; 37%), (56; 40%).A statistically significant p-value was noted for the association of Programmed Death Ligand-1 with stage II and IV tumours. (P-values: 0.029, 0.001)The association of Programmed Death Ligand-1 with other variables such as age, gender, ethnicity, sites or habits was not statistically significant.Conclusion:This study concludes that the statistical significance of Programmed Death Ligand-1 expression with tumour stage is suggestive of worsening prognosis and might have detrimental effects as tumour progresses in advanced stage. Programmed Death Ligand-1 positivity in patients having oral squamous cell carcinoma could be useful in future research in the light of cancer immunotherapy which has shown success in oncology.
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Aims: The aim of this study is to determine association between lymph node metastasis and various clinico-pathological parameters in order to predict their future prognosis of cancer patients.Study Design:Cross sectional study design.Place and Duration of Study:Ziauddin Hospital, North Nazimabad campus, Karachi.Methodology:November 2018 to September 2019.Results:The present study enrolled 140 OSCC patients visiting ZiauddinUniversity of which 30 (21.4%) were females and 110 (78.6%) were male patients. The mean age of patients was 46.99 ± 12.26. The buccal mucosa was the most common site observed 93 (66.4%). The mean size of tumour was 4.05 ± 2.261 mm, mean thickness was 1.70 ±1.32 mm. It was found that lymph node metastasis was not present in 66 (47.1%) of OSCC cases, 22 (15.7%) cases were found N1, 9(6.4%) N2a, 27(19.3%) N2b, 3 (2.1%) and 13(9.3%) N3 Significant association was found between age and lymph node metastasis: (P0.02); however, gender showed no significant association. (P0.149).Thickness of tumor, site of tumor, peri-neural invasion, lympho-vascular invasion and bone penetration showed significant association with lymph node metastasis with (P0.040, 0.021, 0.016, 0.00 and 0.001) respectively.Conclusion:Our study showed significant association of lymph node involvement with tumour staging, tumour thickness, lymphovascular involvement,perineuralinvasion and bone penetration. Our suggestion is to incorporate these clinic-pathological variables while determining the treatment and prognosis of Oral squamous cell Carcinoma(OSCC). Given the very high incidence and prevalence of Oral Cancer in our country and the region further multi-centered researches should be carried out and with larger sample sizes. Early diagnosis and restrictions on smokeless tobacco products can limit the occurrence and progression of OSCC.
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Background: Occupational injuries/diseases are considered as leading problems for workers, especially in less developed countries. Based on International Standard Classification of Occupation (ISCO-08) four broad skill levels are defined. Employment has been established as a fundamental determinant of health and review of occupation/all cause mortality has been carried to observe the impact of occupation skill on cause of death.Methods: A retrograde study conducted on mortality data of State Life Insurance Corporation of Pakistan. Randomly 500 death cases were collected during study period between 2006 to 2018.The death claim instrument were proposal forms and death claim register. The data about occupation and cause of death was inserted on spread sheet of excel and finally analyzed through SPSS for occupation skill and cause of death.Results: Almost equal proportion of data found in skill-1 (14%) and skill-4 (12.6%) while maximum contribution found in skill level-2 (49.40%) followed by skill-3 (24%).The maximum percentages of mortality seen cause wise as CVS (49.39% skill-2), cancer (17.46% skill-4), road side accident (14.28% skill-1), multiple causes (6.67% skill-3), liver disorder (5.71% skill-1), CNS (3.17% skill-4), kidney disorder (5.71% skill-1), GIT (6.35% skill-4), respiration (3.17% skill-4), un-natural (2.02% skill-2), idiopathic (2.85% skill-1), endocrine (1.58% skill-4), body temperature (1.42% skill-1), poisoning (0.83% skill 3), electric shock (2.85% skill-1), sepsis (1.58% skill-4), obstetric (0.83% skill-3) and burn (1.42% skill-1) while lowest found as CVS(46.67% skill-3), cancer (7.14% skill-1), road accident (7.93% skill-4), multiple causes (2.85% skill-1), liver (1.58% skill-4), GIT (2.02% skill-2), respiration (1.61% skill-2) and idiopathic (0.40% skill-2). Many causes in skill-1 and skill-4 found no mortality.Conclusions: Mortality due to cardiovascular diseases found highest in all skills while lower frequency of death seen in other systematic disorders. Mostly highest and lowest mortality percentages found either in skill-1 or skill-4 whereas comparatively higher percentages have steadily been maintained in skill-2 and skill-3