Comparison of the infra-red absorption peaks of untreated and silane treated glass fibers through fourier transform infra-red spectroscopy

Fiber reinforced composites [FRCs] have a wide range of applicability in almost all fields of science. Recently, glass fibers have gained popularity in the field of dentistry owing to their excellent capability of bonding with PMMA denture base after silane treatment, biocompatibility, and esthetics. However, dental grade glass fibers are not only expensive, but they are also not readily available everywhere. This study was aimed at evaluating the quality of coating of saline coupling agent that formed on industrial glass fibers, after they were treated with Trimethoxysilylpropyl methacrylate silane, and to assess the feasibility of using silane treated industrial glass fibers for dental usage, due to their low cost and abundant availability. This was done by comparing the infra-red [IR] absorption peaks of both types of woven E-glass fibers commercial [StickNET, Stick Tech, Finland and Industrial [Iqbal Sons, Karachi], by using Fourier Transform Infra-red [FTIR] spectroscopy. The results indicated the presence of a polymerized layer of the silane coupling agent on both the commercial and industrial GFs. The absorption peaks on both types of glass fibers were identical, demonstrating that industrial glass fibers could be effectively used in replacement of commercial glass fibers, for the reinforcement of PMMA dentures

Comparison of Anti BPH capsule [herbal] and Terazosin HCl in the treatment of benign prostate hyperplasia

Benign prostatic hyperplasia [BPH] is a disease of senile age, usually occurring> 60 years of age. BPH is a disease that involves cell proliferation of the prostate. Pathological hyperplasia affects the elements of the glandular and connective tissue of the prostate. This study is designed to scrutinize the efficacy and tolerability of herbal drug Anti BPH capsule for the management of benign prostate hyperplasia [BPH], in this study we select the 100 patients in which 50 received the Anti BPH capsule and 50 received the Terazosin HCl. We use the American Urological Association BPH Symptom Score Index Questionnaire to measure the quality of life of the patients. We compare the before treatment and after treatment results for each symptom. We record the following symptoms, incomplete emptying of bladder, Frequency, Intermittency, Urgency, Weak stream, Straining, Nocturia and weight of prostate gland by USG. We compare the both drug by using paired sample t-test. The level of significance of incomplete emptying of bladder before treatment and after treatment is 0.013 in test group and 0.032 in control group. Similarly the level of significance of Frequency before treatment and after treatment in test groups in, intermittency, Urgency, Weak stream, staining, Nocturia and mean weight of prostate gland are 0.007, 0.015, 0.044, 0.012, 0.017, 0.004 and 0.020; where as in control group afford as 0.031, 0.044, 0.044, 0.032, 0.024, 0.009 and 0.035 respectively. The herbal drug Anti BPH capsule is more effective in the treatment of BPH than Allopathic medicine Terazosin HCl

safety and efficacy of percutaneous trigger finger release under local anaesthesia

Objective:To determine the safety and efficacy of trigger finger and thumb released percutaneously with an 18 gauge needle under local anaesthesia

Materials and Methods: This descriptive case series study was conducted at Orthopaedic and Traumatology Unit "A" Medical Teaching Institution[MTI] Lady Reading Hospital [LRH] Peshawar Pakistan from April 2014 to December 2015.All patients of trigger finger or thumb of either gender fulfilling the inclusion criteria were percutaneously released under local anaesthesia with the tip of an 18-gauge hypodermic needle.Post operative assessment of these patients was done weekly for a month and then monthly for 6 months. Clinical results were evaluated in terms of pain, activity level and patient satisfaction after 6 months at follow up and rated as excellent, good and poor

Results:Thirty two fingers in twenty five patients with mean age 38.28 years +/- 11SD [range 18 to 62 years] were included in the study. Post operatively excellent results were achieved in 90.9%[20/22] patients and good in 9%[2/22] patients at six months follow up. There were only 3[9.3%] failed releases requiring conversion to open release. There was no recurrence of trigger finger and no digital nerve nor tendon injuries reported

Conclusion:Percutaneous trigger finger release under local anaesthesia is a safe and highly effective method for releasing trigger fingers. We recommend it as a treatment of choice for established trigger finger or thumb

Frequency and antimicrobial susceptibility pattern of methicillin resistant staphylococcus aureus in open fractures

Objective: to determine the frequency and antibiotic sensitivity of methicillin resistant staphylococcus aureus [MRSA] in open fractures

Study design: descriptive case series

Place and Duration of study: Orthopaedics and Traumatology Unit A Lady Reading Hospital Peshawar, from January 2014 to June 2016

Methodology: patients of both gender and all ages fulfilling the inclusion criteria were included in this study. Swabs were taken from wounds with Levine's technique and sent to the hospital laboratory immediately where standard methodology was adopted for culture and sensitivity of the pathogens in all cases and results were reported as per Clinical and Laboratory Standards Institute [CLSI] guidelines. All MRSA positive cases were isolated within 24 hours and the standard MRSA protocol implemented immediately

Result: a total of 200 open fractures were sampled over a period of two and a half years. Positive cultures of MRSA were obtained in 47[23.5%] patients. The mean age of the patient was 24 year [range 18 year to 52 year]. Males were 43[81.4%] while females 4[8.5%] in number. Open tibial fractures were highest [n=21, 44.6%] in number followed by femur [n=12, 25.5%]. Majority [n=15, 31%] of the fractures were Type IIIA. All of the isolated MRSA cultures were 100% sensitive to vancomycin, linezolid, teicoplanin, chloramphenicol and tigecycline while resistance was observed for ciprofloxacin, levofloxacin, clarithromycin, and erythromycin

Conclusion: methicillin resistant staphylococcus aureus infection in open fracture wound is not uncommon. The isolated pathogen showed a variable pattern of sensitivity and resistance to the antibiotics tested

Clinical efficacy and safety of herbal medicine Dermidoc in the management of atopic dermatitis versus allopathic medicine PolymixinB-bacitrin ointment

Atopic dermatitis [AD] commonly identified as eczema. AD is an inflammatory, long-lasting, highly pruritic reverting disease of the skin. AD is classified by disease of outer skin layer barrier function. AD is progress with Immunoglobulin E facilitated sensitization to food and environmental allergens. One study stated that more than 59.6% of teen-agers with AD are at high risk of develop asthma or rhinitis. Interaction between genes and environment increase the prevalence of AD. AD have three standard stages: infantile, childhood, and adulthood. AD sign and symptoms diverge extensively. AD can be present that simply affect the hand to where a patient presents with erythroderma. AD present with erythematous papules, extremely pruritic with serous exudate. Lichenified plaques and papules are symptoms of long lasting AD. Due to outer skin layer barrier dysfunction bacterial and viral infection risk is increased in AD patients. This study was directed on 100 patients in which 50 are PolymixinB-bacitrin group and 50 are Dermidoc group. Patients were selected after seeing inclusion and exclusion criteria and taking written informed consent. Dermidoc group expressively amended skin symptoms associated with AD comparing to the PolymixinB-bacitrin group. The Dermidoc cream is effective and well tolerated. The results were analysis using paired sample t-test. The p value is <0.05. Test group [Dermidoc] were significantly more effective than PolymixinB-bacitrin group

Bioglass, a new trend towards clinical bone tissue engineering

[It is submitted that the list of the published articles available on the Pubmed database were extracted using the key words [Osteogenesis and Bioglass] on 3rd April, 2015 followed by extraction of the full text articles from different sources and then thorough review of all the articles was done in 4 months' time period [from April to July 2015] to reproduce this manuscript. Authros]. Bioglass also called a bioactive glass has an inherent osteogenic potential, thus, provide new strategies to regenerate diseased or lost bone with minimum exposure to multiple materials. This article covers the systematic review of all the research done on bioglass and osteogenesis since 2007 till present on PubMed based on the eligibility criteria. The main objectives of the study were to evaluate the latest trend of bioglass research, to determine its osteogenic potential and to comprehend its possible clinical applications. Increasing trend is observed towards the in vivo research of bioglass for its osteogenic potential and effective clinical applications. In the field of dentistry, the use of bioglass is identified in quick healing and regeneration of intrabony defects especially the periodointium with a potential application in periodontology and maxillofacial surgery. Bioglass is a more potent and cheap alternative to bone implantation and transplantation with minimum side effects and efficient replacement with body's own new regenerated tissue

Current trends in delivery of agents via dental restorations

Agents of choice may be introduced in to the mouth via dental restorations, but this concept is only in embryonic stages and needs to be explored, modified, controlled and gauged to make it useful. This study aims at indicating the common therapeutic agents that are being delivered via dental restorations, modern restorative materials successfully delivering agents, and methods of agent incorporation; elaborating the potential for future use of such systems. Relevant publications from the last fifty years were included by searching 'dental restorations', and 'drug delivery systems' via [Mesh terminology]. Specific exclusion and inclusion criteria were set. It was found that the arena of drug delivery via dental restorations seems to be restricted to fluoride, the most commonly delivered agent via restorations. Glass ionomer cements including resin modified GICs; composites including compomers, and nanocomposites; and to some extent amalgam are the materials being researched upon. Although most research surrounds systems that rely upon recharge, modern microcapsules have been designed that can be used to incorporate the agent into the restoration. There is a dearth of work been done on the factors affecting the delivery of agents. So far, the dicalcium phosphate anhydrous [DCPA] incorporated nanocomposite is the most promising fluoride-delivering restorative material with a competent blend of fluoride releasing and mechanical properties. DCPA-incorporated nanocomposite and ion impregnable microcapsules are new horizons for drug delivery using dental restorations

Outcome of dynamic compression plating in fracture shaft of humerus

Background: Fracture shaft of humerus is a common orthopedic problem and represents roughly 3% of all fractures, usually managed non-operatively. The usual operative modalities used for fixation of humerus fractures are the kuntscher nails, dynamic compression plate [DCP], external fixator and intramedullary nail [IMN]. Plating of fracture shaft of humerus is the more common surgical treatment option. There is a higher rate of excellent and good results and tendency for earlier union with the plating of fracture shaft of humerus

Methods: This study was conducted at Orthopedic Department of Allied and DHQ Hospital Faisalabad from November 2011 to November 2012. All patients with fracture shaft of humerus were included and treated with dynamic compression plating

Results: 91 patients with mean age of 37.24 including 70 [76.9%] males and 21 [23.1%] females falling in inclusion criteria were operated by same orthopaedic surgeons team with same implant i.e. DCP. At 1ST postoperative day, 87 patients [95.60%] had no neurological deficit while 4 patients [4.40%] had neurological deficit. At 12th postoperative day only 9 patients [9.9%] had superficial wound infection while 82 patients [90.1%] have no wound infection

Conclusion: Humeral shaft fracture is one of the commonest fractures among the working community and elderly. Fixation of fracture with Dynamic Compression Plate is the treatment of choice. Postoperative radial nerve injury is an important complication and few patients in this study developed neurological deficit

Supracondylar humeral fracture in children: management by percutaneous lateral-entry pin fixation

This case series was conducted at the Department of Orthopaedics and Traumatology, Lady Reading Hospital Peshawar, from January 2007 to June 2008 to assess the outcome of two percutaneous lateral-entry pins in the operative management of supracondylar humeral fractures. The study included management of Type II and III displaced supracondylar humeral fractures according to Wilkins's modification of Gartland's classification system in 193 patients. The fractures were fixed with two percutaneous lateral-entry pins. Seventy-two children had Type II fracture and One Hundred and Sixty-five children presented with Type III fracture according to Wilkins's modification of Gartland's classification system. A comparison of perioperative and final radiographs showed no loss of reduction of any fracture. There was no hyperextension, loss of motion, cubitus varus, iatrogenic nerve palsies and no patient required additional surgery. Six patients had pin tract infection. Follow up rate was 81.5% Results were evaluated by Flynn's Criteria, 93.3% Excellent/good results were obtained. In this case-series, the use of lateral-entry pins was found to give excellent/very good results. It is an effective treatment option for unstable supracondylar fractures of humerus in children. This method provides the greatest skeletal stability and prevents neurovascular complications in children, as in other techniques, hence giving excellent results

Malignant fibrous histiocytoma of hand - a case report

Malignant Fibrous Histiocytoma [MFH] is one of the most common soft-tissue sarcoma of late adult life. The common sites of involvement include the extremities especially the lower extremities, retro peritoneum and head and neck. Hand is an uncommon site of presentation. These tumors follow an aggressive course and recur unless widely excised. We present a case of an 18-year old female with MFH of second metacarpal of left hand

Comparison of enoxaparin and dalteparin with unfractionated heparin in the treatment of non-st elevated acute coronary syndrome

Background: The term non-ST elevated Acute Coronary Syndrome [ACS] encompasses unstable Angina [USA] and non-ST segment elevated Myocardial Infarction [NSTEMI], both of which may end up in death or a fatal/non-fatal Myocardial Infarction [MI]. Unfractionated heparin [UFH] has been shown to reduce death and MI in patients with USA and NSTEMI. Of late, there has been a great interest in the role of low molecular weight heparins [LMWHs] in the two conditions and they have been found to be at least as effective as or even more effective than UFH. Methods: A total of 90 patients who presented to CCU of Khyber Teaching Hospital, Peshawar with USA or NSTEMI, from June 2008 to June 2009, were enrolled into the study. An equal number of patients were randomly assigned to one of the three arms for 5 days each: Group A received enoxaparin, group B received dalteparin and group C received UFH. The primary end points of the study were all cause mortality, STEMI, refractory USA, recurrent USA or a major bleed. The secondary end point was minor bleeding. Results: At the end of the study, there were 2 deaths each in the dalteparin and UFH group, whereas no such event was recorded in the enoxaparin group. Two patients had STEMI in the UFH group but none in the other two groups. Conclusion: LMWHs are far more superior to unfractionated heparin. Keywords: Acute Coronary Syndrome, Coronary Artery Disease, Atherosclerosis, Unstable Angina, Myocardial Infarction, Unfractionated Heparin, low-molecular weight heparin

Pattern of coronary artery disease with no risk factors under age 35 years

Coronary artery disease [CAD] is no more deemed to be an ailment of the 4[th] or 5[th] decade; rather an earlier age incidence is not infrequently encountered in our population. However, there are a few data regarding CAD in young adults, and much about its underlying pathology still remains undetermined. The objective of this study was to delineate the coronary arterial disease pattern in adults under the age of 35 years, but having no known coronary risk factors. This prospective study was conducted at the Cardiology Departments of all 3 public sector tertiary care hospitals in Peshawar from Jun 2008 to Dec 2009. After having excluded the traditional risk factors for CAD, patients under the age of 35 years with objective evidence of CAD were subjected to percutaneous coronary angiography. Out of a total of 104 patients, 85 [81.73%] patients were men, and 19 [18.27%] were women. The mean age of the whole group was 32.66 +/- 3.237 [22-35] years. Significant CAD [>50% diameter narrowing of at least one major coronary artery] was found in 87 [83.7%] patients while 17 [16.3%] patients had non-atherosclerotic coronary artery disease, including 12 [11.53%] patients having normal coronary arteries, 1 [1%] patient had anomalous origin of right coronary artery [RCA], 1 [1%] patient had coronary arteritis, 2 [1.92%] patients had coronary artery ectasia, and 1 [1%] patient had a myocardial bridge over left anterior descending artery [LAD]. Among the patients with significant CAD, the prevalence rate of one, two and three vessel disease was 54 [51.9%], 22 [21.2%] and 11 [10.6%] respectively. Almost 50% of the lesions occurred in LAD followed by 25% in RCA and 20% in circumflex, while only one patient [1%] had isolated significant CAD of left main coronary artery. Osteal segments were involved in 10%, proximal in 61%, mid in 21% and distal segments in 7% of the lesions. In the younger age group, CAD is mostly a disease of men, single vessel CAD predominates with LAD involvement mostly, predominant osteal to proximal segment involvement of vessels, and a much higher incidence of normal coronaries and non-obstructive CAD is met with

Comparison of effect of locally available brands of clopidogrel on platelet aggregation in patients with coronary artery disease

Anticoagulant effect of clopidogrel is of utmost importance in coronary artery disease, especially in prevention of coronary stent thrombosis. Recently, many new local brands of clopidogrel have been launched, with unknown efficacy. This study was conducted with the aim to compare two locally prepared clopidogrel brands, in terms of the effect of a loading dose of 600 mg on inhibition of platelet aggregation in patients with coronary artery disease. This was a double blind randomised study. Sample population consisting of 35 patients, were admitted at Lady Reading Hospital, Peshawar, for the management of coronary artery disease. Baseline platelet aggregation of all these patients was measured. These patients were divided in two groups randomly. Group-A consisting of 18 patients was given brand 'A' clopidogrel 600 mg, while Group-B consisting of 17 patients was give brand 'B' of clopidogrel 600 mg. The platelet aggregation of both groups was then measured at baseline, and at 2, 4, and 6 hours after taking the loading dose of 600 mg. Platelet aggregation time at baseline in Group-A was 2.61 +/- 2.28 sec. and in Group-B it was 2.24 +/- 1.52 sec. [p=0.57]. After 2 hours of clopidogrel administration in Group-A the platelet aggregation time was 1.44 +/- 1.58 sec. and in Group-B it was 1.53 +/- 1.107 sec. [p=0.85]. Platelet aggregation time after 4 hours in Group-A was 0.28 +/- 0.57 sec. and in Group-B 1.06 +/- 1.03 sec. [p=0.009], and after 6 hours it was 0.00 +/- 0.00 sec. in Group-A and in Group-B it was 0.59 +/- 0.71 sec. [p=0.001]. The two brands of clopidogrel had a significant difference in their effect on inhibition of platelet aggregation. Different brands of clopidogrel may not be equally effective

Arthroscopy: a reliable diagnostic tool in lesions of knee joint

To evaluate the accuracy of clinical diagnosis in lesions of knee joint and to compare it with arthroscopy diagnosis. This comparative study was conducted in the department of Orthopedics Hayatabad Medical Complex, PGMI Peshawar. Duration of study was from July 2000 to, June 2002. Patients with symptoms of knee pain, clicking, locking and instability were admitted and proper history and clinical examination was done to reach a clinical diagnosis. This was followed by arthroscopy. The clinical and arthroscopy findings were compared. The total number of patients was 64. There were 52 males and 12 females with male female ratio of 4: 1. The age ranged from 18 to 50 years with mean age of 35 year. Right side was involved in 24 and left side in 40 patients. The results of the study showed that the accuracy of clinical diagnosis was 65.6%. On arthroscopy, medial or lateral menisci injury was found in 18[28.1%], cruciate ligament injury in 14[21.9%] and osteoarthrosis in 6[9.37%] No major complication was observed in the study. Arthroscopy is a valuable method of diagnosis in knee joint lesions

Kartagener's syndrome

Lower respiratory tract infections are a common problem in our society. In recurrent lower respiratory tract infections the cause may be either general impairment of immune mechanism, abnormalities of mucus or abnormalities of cilia. We report a case where the patient was having recurrent lower and upper respiratory tract infections and had situs inversus totalis. The present case i.e. Kartagener's syndrome is an inherited disorder transmitted in autosomal recessive manner with variable penetrance. Although there is no specific treatment for this condition, failure to recognize the condition may subject the patient to unnecessary repeated admissions and investigations and inappropriate treatment

Conservative treatment of congenital talipes equino varus [clubfoot]

The Congenital Talipes Equino Varus is the most common disorder of congenital deformities of foot. Material and This study was conducted know the of conservative treatment of the condition. A total of one hundred and ten patients with 165 Feet having Congenital Talipes Equino Varus deformities were registered for study from July 1998 to June 2000 at Hayatabad Medical Complex Peshawar. All the patients with congenital clubfoot deformity were included in the study and those having deformity secondary to poliomyelitis, cerebral palsy, meningomyelocoele and arthogryposis multiplex congenital were excluded from the study. Ninety-six patients with 144 clubfeet completed their followup of two years. The average age of patients was 19 days, ranging from 01 day to 12 weeks. The deformity was classified according to Harrold and Walker's classification. All the patients were treated non-operatively using Kite and Lovell technique. The were assessed by using Turco's assessment method. 81.24% excellentgood were achieved at two years of follow-up. Conservative Treatment is the best option of treatment for Congenital Talipes Equino Varus [clubfoot], which starts at an early age. It prevents future deformity in children and lessens the burden over the society