Chronic periodontitis, a silent hazardous disease

Chronic periodontitis is a common disease, which occurs as an outcome of tooth supporting tissue's inflammation [periodontal ligament and gums], initiated by the exposure of the periodontium to dental plaque. By the action of various toxic products liberated from pathogenic plaque bacteria there is periodontal destruction, as well as hosts inflammatory responses elicited against plaque bacteria and their products. Inflammatory processes can be considered as the most essential functional part of pathophysiology of atherosclerosis resulting in cardiovascular disease [CVD]. Elevated levels of C -reactive Protein [CRP] have been associated with CVD and regarded as indeperident determinant of atherosclerosis. This study has been carried out to assess the possible relationship between chronic peri-odontitis and CVD determinants. This cross sectional study involved a total of 100 subjects including 50 chronic periodontitis patients and 50 healthy controls between the ages of 35 - 40 years. The patients were obtained from de-Montmorency College of Dentistry, Lahore. A detailed personal history, past medical and dental history was taken. Patients of chronic periodontitis were selected using Community Periodontal Index of Treatment Needs [CPITN], according to inclusion and exclusion criteria. Blood sample were drawn and CRP was measured by using standard enzyme linked immunosorbent assay [EL1SA] method. These parameters were compared in chronic periodontitis patients with age and gender matched healthy controls, to observe the significance of difference. The results of this study showed that serum CRP which was a strong independent risk jnarker of CVD is statistically significantly elevated in chronic periodontitis patients as compared with age and gender matched healthy controls. The correlation between serum CRP and severity of chronic periodontitis was also highly significant. The results of this study suggest that elevated CRP in chronic periodontitis patients may predispose them to the development of early atherosclerosis. Because of the significant association of elevated inflammatory mediators with CVD, their determination may help to improve the prediction and prevention of CVD in chronic periodontitis patients as well as these results is expected to bring awareness in people about oral hygiene

Effective learning through multiple choice questions against short essay type of assessment in medical physiology students of Lahore

The present study was carried out to evaluate the advantages of Multiple Choice Questions [MCQ] against short Essay type [SEQ]. longitudinal study. This study was conducted Rashid Latif Medical College, Lahore from December 2011 to March 2013. A total of 200 second year students were involved in the study and their scores in SEQ and MCQ papers were analyzed. Out of them 100 students were girls and 100 were boys. The students were informed that they are going to be accessed via three SEQ examinations and three MCQ examinations and then a survey and viva was conducted. Gender differences in performances were also studied. The result of this study shows that those students who were kept on MCQ type of assessment emerges to be weak students at the end of the session as compared to others who were assessed by SEQs. The SEQ type of assessment was established as a better method of assessment to strengthen student's learning process and helped students to exert and retain more knowledge

Functioning uterus with absent cervix, short vagina and transverse septum

A 25-year-old married lady with primary amenorrhea, infertility, lower abdominal pain and dyspareunia underwent vaginoplasty, total abdominal hysterectomy with right adnexal clearance for congenital absent cervix, vaginal septum with functioning uterus and right sided endometrioma. Mould was kept in vagina for 2 weeks followed by intermittent vaginal dilatation for one week. Couple was advised normal coital function and intermittent vaginal dilatation at home. Patient was followed regularly in OPD for 4 months and there was no complaint regarding sexual life

Pregnancy with macroprolactinoma

A macroprolactinoma recurred in a 25-year-old lady, who had initially presented with inability to conceive, secondary amenorrhea, galactorrhea and persistent headache. She was diagnosed as a patient of pituitary macroadenoma of 1.7 cm with elevated serum prolactin level. She was given Bromocriptine, which normalized her menstruation as well as the prolactin level followed by conception during treatment. Pregnancy remained uneventful till 27 weeks when she developed severe headache and total loss of vision from left eye and partial from right eye at 27 weeks. MRI showed enlargement of macroadenoma upto 2.5 cm with compression on optic chiasma. Transsphenoidal adenectomy was performed. After surgery visual field defect improved but plasma prolactin level remained elevated. She delivered vaginally at 39 weeks. Later, treatment with Bromocriptine [15 mg/day] failed to keep prolactin level normal and Lisuride hydrogen [0.8 mg/day] reduced the prolactin levels

Comparison of misoprostol and PGF2alpha for second trimester termination of pregnancy

Aims: To compare the effectiveness of vaginally administered misoprostol with extra-amniotic prostaglandin F2alpha [PGF2alpha] injection for termination of pregnancy

Study Design: Interventional study

Setting: This study was conducted in gynae unit III Nishter hospital Multan over period f 15 months

Material and Methods: Patients admitted to labour ward with pregnancy of less than 20 weeks of gestation requiring termination of pregnancy due to fetal and maternal causes were included in this study. A detailed history was taken followed by clinical examination especially the cervical scoring was done. Sixty patients were randomly assigned to receive either tablet misoprostol [cytotec] intravaginally or extra-amniotic injection of prostaglandin F2a Induction-expulsion interval, need for evacuation and the incidence of side effects were analyzed for both groups

Results: Successful termination was achieved in 98% patients with misoprostol and 94% with PGF2a Induction expulsion interval was < 12 hrs in 80% patients in misoprostol group and 60% in PGF2a group [P value < 0.000]. Evacuation rate was 23.3% with PGF2a and 10% with misoprostol group. The incidence of prostaglandin-associated pyrexia, vomiting and diarrhea were significantly increased in the PGF2alpha group [p<0.05]

Conclusion: In this study, vaginal misoprostol has been found to be more effective and associated with a shorter induction to expulsion interval, fewer ERPOC for incomplete evacuation and less side effects when compared with extra-amniotic PGF2alpha. In view of its effectiveness, as shown in this study, vaginally administered misoprostol has the potential to provide a better option for medical abortion in many parts of the world