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Purpose: To determine the pattern of refractive error among commercial drivers in north India. Methods: Descriptive study with convenient sampling conducted among commercial drivers of north India. Results: A total of 213 (75.8%) heavy?vehicle and 68 (24.2%) light?vehicle drivers were screened for eye diseases. Refractive error for distance was reported in 44 (15.7%; 95% CI: 11.6–20.4) drivers. Hyperopia was reported in 23 (8.2%; 95% CI: 5.2–12) drivers, followed by myopia in 15 (5.3%; 95% CI: 3–8.6) drivers and astigmatism in six (2.1%; 95% CI: 0.7–4.5) drivers. Presbyopia was reported in 157 (55.8%) drivers. Dry eye was reported in 70 (24.9%), stereo deficiency in 77 (27.4%), and color vision deficiency in 11 (3.9%) drivers. Three drivers were diagnosed with cataract, and two were referred for retina evaluation. Conclusion: Hyperopia in both eyes was the most common refractive error. Dry eye disease and color vision deficiency were also reported. Most of the drivers were not using spectacles for refractive error correction. Due to their mobile nature, drivers with cataract and retina diseases did not turn up for follow?up.
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Background: Cellulitis is an inflammation of the skin and subcutaneous tissues, usually resulting from microbial invasion. It may occur as a result of tissue injury. The mainstay of treatment includes antibiotic therapy based on the susceptibility and severity of infection. The aim of the study is to evaluate various antibiotics used in the treatment of cellulitis at a tertiary care hospital.Methods: Participants were patients referred by Dermatologists, General surgeons with acute and complicated cellulitis. Demographic data, Clinical and biochemical data were analyzed at admission. Then the time taken for improvement of symptoms and length of stay were analyzed.Results: A total of 58 patients were included in the study of which 38(65.5%) patients were male and 20(34.4%) patients were female. Patients having comorbid conditions were found to be having higher length of stay (mean±SD-13.7±3.6 days), severity of infection and antibiotic therapy. Patients with diabetes(mean±SD-16.8±4days) have higher length of stay and slow wound healing. Patients with left leg cellulitis 32(55%) were higher than the right leg cellulitis 17(29%). The reason behind this remains undetermined, which highlights scope for future research in this region.Conclusions: Management of patients was done with mono or dual/combination antibiotic therapy or surgical treatment was done based on clinical response. According to our study patients with co-morbidities especially Diabetes have slow prognosis of cellulitis as they required longer length of stay in a hospital and prolonged treatment. Rational clinical decision on the use of various antibiotics shall be implemented based on evidence-based methods such as iv-to-po shift, regular evaluation of clinical response and stepping down to a narrow-spectrum to reduce the length of stay which can improve the paradigm and the positive clinical response for the management of cellulitis.
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The hard tissue erbium lasers have the capability to prepare enamel, dentin, caries, cementum and bone in addition to cutting soft tissue.The present study is aimed at evaluating the tensile bond strength a self etching restorative system, on superficial and deep dentin, after cutting the tooth with bur or Er:YAG laser. Methods: Sixty sound extracted human premolars were used in the study. These teeth were then randomly divided into two groups of thirty teeth each. Group 1- Bur cut, cut using diamond cutting disc and Group 2- Laser cut, cut using Er:YAG laser calibrated with 200mJ/10HZ/2.0W under 4ml/min water spray. These were then divided into two more subgroups of fifteen teeth as superficial and deep dentin sub groups. Specimens were coated with bonding agent followed by a microhybrid resin composite (SUREFILL,DENTSPLY). The specimens were then debonded in tension by mounting it on a universal testing machine (Instron Type 4204 Co.USA) and specimen SEM analysis of surfaces was done. Results: Bur cut superficial dentin showed maximum tensile bond strength (22.86 MPa) while bur cut deep dentin showed the least tensile bond strength (15.8MPa),Laser cut superficial dentin and deep dentin showed almost similar bond strength -19.18 MPa and 19.94MPa respectively. Conclusion: The superficial dentin produced better bond strength and results than deep dentin. Surface treatment by Er:YAG laser hampered the adhesion of self etching adhesive systems in both superficial and deep dentin.
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Restoration of the endodontically treated teeth is complicated by the fact that much or all of the coronal tooth structure has been destroyed by caries, previous restorations and the endodontic access preparation. Post-andcore has been most commonly used when insufficient dentin remains. Methods: Fourty translucent glass fiber post (Tenax fiber Trans Coltene Whaledent) of diameter 1.3 mm and 40 extracted premolars were used. Post were divided into 4 groups of 10 each depending on the pre –treatment of post surface.In Group 1: Multilink N primer A & B was applied on post surface and root dentin for 15 sec, (Control group), group 2 : Monobond S primer was applied for 60 sec, followed by multilink N primer A & B, Group 3: Immersion in 30% H2O2 for 5min, rinsing and application of Monobond S Primer (silane) and multilink N primer A & B and Group 4: application of 25% polyacrylic acid for 5 sec, rinsing, silane and multilink N primer A & B dual cure adhesive. The specimens were then sectioned horizontally into 1- mm-thick post-dentin sections. The post space (9mm) were divided into 3 halves: the coronal, middle and the apical third.The push out bond strength (MPa) were measured using a universal testing machine at a crosshead speed of 0.5mm/sec.Failure mode of each debonded specimen were analyzed using a stereomicroscope. Maximum failure mode were adhesive failure between post and resin cement. Results: The bond strength values were higher in group 3 and group 4 compared to group 2 and group 1. Conclusion: The pre-treatment of fiber post increases bond strength between fiber post and root dentin.
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Microleakage is considered to be an important factor influencing the longevity of dental restorations. Bulk Fill composites possess specific characteristics, including more desirable flowability to attain consistent adaptation to the cavity preparation. Elasticity and low polymerization shrinkage in bulk fills minimizes microleakage, postoperative sensitivity, and secondary caries. Improved depth of curing of at least 4 mm eliminates the need for layering. The purpose of this study is to evaluate and compare the microleakage in two Bulk Fill composites - SonicFill (Kerr corp. USA) and TetricEvo Ceram Bulk Fill (IvoclarVivadent) using stereomicroscope. Methods: 40 caries/cracks free extracted human maxillary premolars were used. A class 1 cavity measuring 3mm by 3mm by 2mm was prepared in all the teeth and then teeth were divided into 2 groups of 20 each, Group I: SonicFill Bulk Fill composite and Group II: TetricEvo Ceram Bulk Fill composite. All specimens have been thermocycled for one thousand cycles (5/55ºC, 30 seconds) in Eppendorf Master Cycler gradient (Eppendorf AG, Hamburg, Germany). All samples were immersed in 2% methylene blue dye for 24 hours. Teeth were sectioned mesio-distally and observed under a stereomicroscope and dye leakage scored. Results: The mean microleakage of SonicFill(KERR) was 1.75 and of TetricEvoCeram (IVOCLAR) was 2.55.The mean microleakage was higher in Teric EvoCeram than in Sonic fill and the difference was statistically significant. Conclusion: Within the limitations of this study, it may be concluded that Sonic Bulk Fill composite shows lesser microleakage than Tetric EvoCeram.
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The purpose of this study was to identify and compare the antibiotic prescription trends in the management of endodontic infections between general and specialist dental practitioners in the region of Delhi & NCR. Methods: 300 questionnaires were distributed amongst dentists practicing in the region of Delhi, Ghaziabad & Gurgaon. Each questionnaire had 20 questions. Out of 300, only 247 were returned or deemed useful. The data was analyzed using descriptive statistics and chi-square test of significance. Results: 83 % of general dental practitioners (GDP) and 69.6% specialist dental practitioners (SDP) prescribe antibiotics for routine endodontic treatment. For patients with no history of drug allergy, the most commonly prescribed antibiotic was amoxicillin and clavulanic acid. In patients with uncertain diagnosis, 15.1% of GDP prescribe antibiotics compared with 13.9% of SDP. In the case of intraoral swelling 91.8% of general dental practitioners chose to prescribe antibiotics compared with 87.3% of specialist dental practitioners (SDP), in the scenario of retreatment, general dental practitioners (54.2%) prescribed antibiotics similar to specialist dental practitioners (53.8%). The average number of days of antibiotic prescription was 5 days. Visits from medical representatives affected the choice of drug prescribed by 35%. Conclusion: Dentists tend to overprescribe medication during routine endodontic treatment. GDP overprescribe antibiotics significantly more than SDP for the same.
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Safa(alopecia areata) means loss of hairs where ordinarily hair would be found. Safa(AA) is a type of non scaringalopecia that affects males and females equally and occurs in both children and adults. About 2% of the patients are affected and come to outpatient department for care. It is characterized by reversible hair loss most commonly involving the scalp although other parts of head, including eyelashes and beard may also be affected. A patient 16 years old was given Unani medicine for 45 days as local application on lateral aspects of eyebrows twice daily for thirty days and once for later 15 days.New hairs were seen on affected areas after one month, after 45 days normal hairs were seen on affected sites.It can be concluded that Unani medicine is effective in treating alopecia.
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Background: Musculoskeletal disorders due to occupation occur over a period of time because of repeated work load. Dentist due to their working posture while treating patients are prone to low back pain. Dental professionals spend most of their work days in static, awkward positions. Study was done to find the same. Aim: To study the prevalence of risk factors for low back pain in dentists and to find the possible correlation of these factors with working posture. Methods: The prospective study was done on 65 patients with females being predominant 53.84%, males 46.15 % with mean age being 26.5 years. Dentists were evaluated with the self-administered Nordic musculoskeletal evaluation chart, postural discomfort chart, and a self-prepared questionnaire. Results: Data was analysed and showed 45 (69%) subjects presented with lower back pain. The commonest site of pain was predominated by lower back 48.8%, followed by involvement of more than one area which constituted 24.4%, cervical 15.5% and upper back 11.11%. 93.3 % of subjects showed a mild to moderate level of severity and only 6.6% of subjects showed severe LBP. No correlation between working experience and working hours with low back pain was found. Conclusion: Our study reveals that dentists are at high risk for having lower back pain due to their working posture while treating the patients. To minimize the risk of work-related musculoskeletal disorders s among dentists, work postures need to be improved.
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Background: To evaluate the antimicrobial effect of non-thermal atmospheric plasma on mutans biofilms. Materials: A 100 µl culture of Streptococcus mutans poured into two 120 well flat base microtiter plates, allowed to adhere and incubated overnight using brain heart infusion (BHI). These 120 wells were grouped into four groups, group A-helium treated, group B-plasma treated, group C- chlorohexidine treated and group D-control group (untreated group) with a group size of 30 wells per group. Triphenyl tetrazolium chloride (TTC) essay & Colony Forming Units (CFU) counting was done to check the viability & survival of streptococcus mutans biofilms. Results: The results showed that there was a significant difference in the mean optical density (OD) among the four groups (p<0.001). Post-hoc analysis revealed that untreated samples and Helium had significantly higher mean OD than plasma and chlorhexidine groups. A similar result was also seen using the survival essay by CFU counting. Conclusion: Plasma utilizes the air from the atmosphere, thus rendering plasma a better reach in the oral cavity. This property of plasma can be efficiently used to neutralize Streptococcus mutans biofilms in the oral cavity.
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Background: Misuse of topical corticosteroids is a widespread among young people in India, especially women. The inadvertent use of topical corticosteroids for various common dermatological conditions is associated with significant adverse effects Aim: To assess the steroid abuse for various common dermatological conditions and its adverse effects. Materials & Methods: Sixty patients who attended OPD dermatology were taken in to study. A detailed clinical history with regard to age, gender, education status, duration and frequency of use of topical steroids, type and formulation of the drug (lotion, cream, ointment), cause for using the drug and the source of the drug (by dermatologist, doctor- physician/Ayurvedic/homeopathic, over the counter (OTC) were taken. Results: Majority of patients were between the age group of 15-30 years and females were in predominance. The common indications were facial pigmentation, dermatophytosis and acne. The source of drug were mostly from pharmacist, friends and family members. Most commonly used steroid were betamethasone valerate, clobetasol propionate and mometasone furoate. The common side effects observed were acneiform eruptions, tinea incognito, and erythema with telangiectasia, cutaneous atrophy and striae. Conclusion: Topical steroids should be used cautiously and judiciously. Awareness should be given regarding the indications and its consequences. Avoidance of self-medication by over the counter purchase should be stressed upon. While treating children extreme care should be given regarding the selection of potency of topical steroids.
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Background: Acne vulgaris affects about 85% of adolescents, often extending into adulthood. Though considered to be merely a cosmetic problem, it is associated with considerable psychological impairment, such patients are prone to low self-esteem, low self-confidence and social dysfunction which may lead to anxiety, depression, obsessive compulsiveness and sometimes suicidal ideation. AIM: This study was aimed to assess the impact of acne and its sequelae on the quality of life. Methods: The current cross sectional study was conducted in Patients diagnosed as acne vulgaris attending OPD of HIMSR in department of dermatology for a period of 6 months. Patients aged 15 years and above were included in our study. A detailed history was taken after obtaining consent from all the participants of study. Dermatology life quality index (DLQI) was administered on patients to determine the impact of acne vulgaris on their quality of life (QOL). Results: This study included 200 patients with females being more in number 130 (65%) as compared to male patients which were 70 in number (35%). The mean age was 20.49 with majority of patients being in 15-20 years of age group. Mean DLQI score was 8.22, statistically influenced by the age of the patient, duration and grade of acne, acne scar, and post acne hyperpigmentation. Conclusions: This study showed significant impairment of quality of life in acne patients. Counseling along with early treatment of acne vulgaris both are important as to reduce disease-related psychosocial sequelae and enhancing the efficacy of treatment.
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Background: Melasma a common skin pigmentary disorder poses a great challenge to clinicians due to unsatisfactory results and high recurrence rate. Many treatment modalities have been tried by clinicians without significant improvement in the lesion. Methods: This cross sectional study was done on 90 patients including both male and female and were diagnosed with moderate to severe melasma. TA 250 mg (thyrodin) bid for six months was prescribed along with topical sunscreen. Digital photography was performed at the first visit and at subsequent visits. The effects of treatment were evaluated by two dermatologists independently. Results were assed clinically and photographically. Result: 90 patients with moderate to severe melasma were enrolled in the study. The average age was 36 years. 44patients (48.8%) had good improvement, 25 patients (27.7%) had excellent improvement and 17 patients (18.8%) had fair improvement and 4 patients (4.4%) had no improvement. Three patients complained about gastric upset. None of the patients had serious systemic side effects, only few had oligomenorrhoea, palpitation. Patient’s satisfaction was similarly noted. Conclusion: oral administration of TA is effective and safe treatment for melasma.
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Background: Cleaning and shaping the root canal is an important phase in endodontic therapy. A prepared root canal should have a shape that flares from apical to coronal regions, maintaining the apical foramen and not changing the original canal curvature. Aim: To compare canal transportation, canal centring ability and remaining dentin thickness, in curved root canals using Twisted Files, PathFiles-ProTaper System, RaCe files, WaveOne reciprocating files and hand NiTi K-files with Cone Beam Computed Tomography. Materials and methods: 125 canals with completely formed apices and angle of curvatures ranging from 10 degrees to 60 degrees were used. The teeth were divided in five experimental groups of 25 each. Instrumentation was performed in Group I with Twisted files, Group II with PathFile-ProTaper, Group III with Hand NiTi files, Group IV with RaCe files and Group V with WaveOne reciprocating files. CBCT images were obtained before and after instrumentation with Kodak CS9300 equipment Neerja Sharma, Shafia Sarfi, Avdesh Sharma, Mandeep S Grewal. Evaluation of canal preparation with rotary and hand Niti files in curved root canals using Cone Beam Computed Tomography: An In Vitro Study. IAIM, 2017; 4(7): 45-55. Page 46 (CS3D Imaging Software 3.1.9). The amount of canal transportation, centering ability and remaining dentin thickness was calculated at nine levels. Results were analysed using ANOVA test and Post-hoc Bonferroni Multiple Comparison test. Results: Statistically significant difference was noted among the groups at the middle and apical third level with WaveOne files showing the least and hand NiTi files showing the highest transportation. The mean centering ratio was statistically highest with WaveOne and smallest with hand NiTi files at the middle third level. At the apical level (p < 0.05) the mean remaining dentin thickness was highest with WaveOne and smallest with PathFile-ProTaper. Conclusion: WaveOne and Twisted files were similar in terms of canal transportation, centring ability and remaining dentin thickness. Hand NiTi files and Pathfile-ProTaper systems produced maximum amount of canal aberrations.
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Background: It won’t be wrong to admit that composite resins are currently the back bone of aesthetic and conservative dentistry. However a major drawback of composite resins is that their setting reaction involves formation of polymer chains leading to polymerization shrinkage. Aim: To compare microleakage in silorane composite using oblique, vertical and horizontal layering techniques to microleakage of nanofilled composite using oblique, vertical and horizontal layering techniques. Materials and methods: 120 extracted maxillary premolar teeth were assigned to 2 groups based on the material used Group A nanocomposite and Group B-silorane and each group was divided further into 3 subgroups depending on incremental technique used for restoration into horizontal, oblique and vertical (sub groups A1, A2, A3, B1, B2 and B3). A Class 1 cavity measuring 3mm3mm2mm was prepared in all the teeth. In group A teeth Clearfil TMSE Bond (Kurary Medical inc. Okayama, Japan) was applied. Group A teeth were filled with FiltekTM Z350 XT (nanocomposite) (3M ESPE, St Paul, USA) using horizontal (A1), oblique (A2) and vertical (A3) incremental layering technique and each Shafia Sarfi, Neerja Sharma, Ekta Garg, Dildeep Bali. Comparing microleakage in Silorane based composite and nanofilled composite using different layering techniques in class I restorations: An in vitro study. IAIM, 2017; 4(7): 23-32. Page 24 increment was cured for 30 seconds. In Group B teeth P90 system adhesive was applied and teeth were filled with FiltekTM P90 silorane (3M ESPE, St. Paul, USA) using horizontal (B1), oblique (B2) and vertical (B3) incremental layering technique. Specimens were thermocycled for 1000 cycles (5/55ºC, 30 seconds) and immersed in 2% methylene blue dye for 24 hours. Following immersion teeth were sectioned and observed under a stereomicroscope. Results were analysed using KruskalWallis test followed by Mann Whitney U test. Results: Siloranes showed significantaly less microleakage than nanofilled composites. The difference between the horizontal group, oblique group and the vertical group was found to be statistically non-significant (P value >0.05) but mean microleakage was more in vertical group compared to oblique and horizontal group. Conclusion: Within the limitations of this study, we found that Siloranes exhibit significantly less microleakage as compared to nanofilled composites irrespective of the layering technique used.
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Abstract: Coumarin and coumarin-3-acetic acid derivatives were synthesized by reacting phenols with malic acid, ethyl acetoacetate and ethyl acetylsuccinate in appropriate reaction conditions. All synthesized compounds were subjected to test for their antimicrobial activities against variety of gram positive [Bacillus subtilis, Staphylococcus aureus] and gram negative bacterial stains [Shigella sonnei, Escherichia coli] by agar dilution method. Several of them exhibited appreciable good antibacterial activity against the different strains of gram positive and gram negative bacteria. These findings suggest a great potential of these compounds for screening and use as antibacterial agents for further studies with a battery of bacteria
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Worry about risk for breast cancer and pain are associated with mammography use. Both have been found to be a barrier to mammography use by women. To examine the anxiety and pain associated with mammography use in a sample of women stratified according to breast cancer risk. This prospective observational study. Department of Obstetric and Gynecology, Benazir Bhutto Hospital. August 2011 to June 2012. Patients and Women awaiting screening mammography in the reception area were asked to complete a questionnaire containing demographics for calculation of breast cancer risk and the Likert scale for anxiety before the procedure and VAS for assessment of pain after the procedure. Our study included 100 women undergoing screening mammography with an average age of 53.9 +/- 8.8 years. 15% were classified "higher risk" by the Gail model. The average anxiety level was 4.03 +/- 1.3 on Likert scale and average pain during the procedure was 3.3 +/- 2.18 on VAS. Significant differences [p<0.05] were found between average and higher risk groups. The population of women in this sample appears to have a level of breast cancer worry and procedure related pain that is proportional with their risk for developing breast cancer
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Coronary artery disease occurs with the interact ion between environmental influences and genetic factors. Genetic susceptibility may be caused by mutations and polymorphisms in a variety of genes mainly involved in blood coagulation, metabolism of lipids, homocysteine and or iron. The most common form of genetic hyperhomocysteinemia results from the production of a thermolabile variant of methylene tetrahydrofolate reductase [MTHFR] with reduced enzymatic activity. This study was performed on ninety individuals selected with normal serum glucose, kidney, liver, and thyroid function test and lipid profile. They classified into: Group I: 27 apparently healthy persons as control group. Group II: 3 apparently healthy persons with elevated homocysteine level. Group III: 27 CAD patients with normal coronary angiography. Group IV: 33 CAD patients with abnormal coronary angiography. The following specific investigations were done for all the studied persons:- Serum homocysteine [Hcy], serum folic acid [FA] and MTHFR genotyping by PCR-RFLP
Results: In group III three patients had elevated Hey [11.1%]. There was significant elevation of Hey level in group IV compared to group I [P<0. 05].however there were insignificance differences in mean value of folic acid of the studied groups compared to each other. As regard the relation between the MTHFR polymorphisam and hey and FA levels, in group I there was significant elevation of serum Hey level in carriers of CT genotype compared to carriers of CC genotype [P<0.05]. Homocysteine level was highly elevated in patients had TT genotype in group III and group IV when compared to CC and CT genotypes and this was statistically highly significant [<0.000] in group IV, but insignificant elevation in group III Folic acid level was not differing between patients had TT genotype when compared to CC and CT genotype in all studied groups and that was statistically insignificant. When we study the severity of CAD in group IV there was insignificant elevation of serum Hey level in group of one vessel affection compared to group of two vessel and multi vessel affection, there was Significant elevation of serum Hey level in group of >/= 90% stenosis compared to group of >50-75% stenosis and 75-90% stenosis. However there was insignificant difference in serum FA between the groups compared to each other. Homozygous TT was detected in group of one vessel affection and with >90% stenosis. Carriers of TT genotypes in group of one vessel affection and in>/= 90% stenosis had highly significant elevation [P<0.000] of serum homocysteine compared to CC and CT genotypes in the same group
Conclusion: Our findings support that homozygous MTHFR TT genotype is a genetic risk factor for CAD
Subject(s)
Tetrahydrofolates/genetics , Polymorphism, Genetic , GenotypeABSTRACT
Objectives:-The breast cancer has great impact on physiological and psychological health of patients. This study was designed to investigate the psychological and physical effects of breast cancer. Patients and methods:-One hundred (100) patients were included in the study sample. All the patients were evaluated with the help of a questionnaire which developed with the help of psychologists. Results:-The results showed that the patient had high distress level at the time of diagnosis and during treatment.80% of patients reported that they do not get enough support by their husbands. Results also showed that treatment of breast cancer severely affects the fertility and no pregnancy was recorded during the treatment of breast cancer. Conclusions:-The results of the present study showed that the patients involved in CA breast undergo several psychological & physiological changes. During the treatment patient’s psychological treatment is must to boost the self esteem & to courage the patient to fight against the disease.
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To find the frequency of iatrogenic VVF in patients admitted for repair of VVF in Lady Willingdon Hospital, Lahore. An observational study. Lady Willingdon Hospital, Lahore, from January 2007 to December 2008. All cases of VVF treated at the centre during the study period were included in the study. The patients were admitted and evaluated through detailed history, physical examination, relevant investigations and evaluation under general anaesthesia [EUA]. Iatrogenic VVF was defined as the one following gynaecological procedure. Repair was done through abdominal or vaginal route based on the findings of EUA. Results of repair were noted and analyzed using SPSS version 12. Iatrogenic cases of VVF made more than half of the total cases [54%] while 46% were due to obstructed labour. Women under the age of 40 years, made up 77% of the total cases. The success rate for repair of VVF was 87%. This study shows that iatrogenic injuries in women under 40 years of age form a major share in the etiology of VVF requiring a check on the experience of surgeons doing the gynaecological and obstetrical surgeries in a developing country
Subject(s)
Humans , Female , Iatrogenic Disease , Labor, Obstetric , Prevalence , Cesarean Section/adverse effects , Hysterectomy/adverse effectsABSTRACT
This study aimed to determine the knowledge and attitudes towards homeopathy among general practitioner and specialist physicians in Sari. Our results indicate Sari physicians had not sufficient knowledge about homeopathy; but they liked collaboration with homeopaths for treatment of their patients and have courses for homeopathy education