Benign migratory glossitis - A neglected oral health issue in pakistan

Objective: To investigate the frequency of benign migratory glossitis [BMG] and its association with medical conditions

Materials and Methods: This descriptive cross-sectional and multicenter study was carried out in Karachi and Hyderabad city.A total of 2022 dental patients of 10-80 years of age were included. After taking verbal informed consent, clinical examinations and proforma was filled chair side. Descriptive and comparative analysis were done using SPSS version 23 and Chi-square test was the choice of analysis to test the significance of the undertaken objectives

Results: Frequency of BMG was found to be 33[1.6%]. Higher predilection was seen in females 21[1.03%] as compared to males 12 [0.59%]. 10[5.8%] cases were found in 51-60 years of age group followed by 9 cases in 31-40 years. The most common affected site was dorsal surface of the tongue 29 [87.88%]. Cross tabulation of BMG with medical condition revealed presence of BMG in 3hypertensives and 1 diabetes mellitus patient. Remaining 29 cases were not suffering from any medical condition.The association of BMG with fissured tongue was also investigated and found statistically significant in 11[33.3%] cases with a p-value [P<0.001]

Conclusion: Frequency of BMG was found to be 1.6%. Majority of cases of BMG did not have any association with medical conditions. Fissured tongue was found in statistically significant number of BMG cases

Problem based learning as a novel mode of information transfer for faculty development in Pakistan: a phenomenological study

To explore faculty experiences about 'problem based learning1 used as a faculty development approach in understanding and applying the core concepts and issues in health professions education through their views and opinions. It was a qualitative phenomenological study. The study was conducted at Islamic International Medical College, Rawalpindi, Pakistan. Data was collected in 2006, 2010 and 2013 respectively with three batches of M. Phil basic medical sciences students and data analysis done in 2013. Hence, total duration of study is three and half years. The selected study subjects were 16 faculty members [medical and dental] from three batches of M.Phil basic medical sciences course who participated in a Post Graduate Certificate Course in Medical Education. In this study, semi structured interviews were conducted and interview notes were taken, in order to explore the faculty experiences about the 'problem based learning1 used as a mode of information transfer and faculty development approach. The data verbatim transcribed through interview notes, coded and thematic analysis was done manually. Results were in the form of description of faculty1 lived experiences with the PBL. Findings indicated that faculty perceived problem based learning1 as a very useful learning tool. This study indicated that a well-constructed PBL case scenario, based on common and real teaching problems in medical education can have a substantial effect on enhancing the performance of faculty/medical teacher's performance that helps in better 'learning transfer1 of teaching skill

Evaluation of anesthetic efficacy of 4% articaine as buccal infiltration vs 2% lidocaine as IANB in the mandibular 1st molar with irreversible pulpitis

The purpose of this prospective, randomized, study was to compare the anesthetic efficacy of 4% articaine with 1:100,000 epinephrine and 2% lidocaine with 1:200,000 epinephrine for buccal infiltration and inferior alveolar nerve block respectively in patients experiencing irreversible pulpitis in permanent mandibular first molars. Sixty emergency patients diagnosed with irreversible pulpitis of a mandibular first molar ran-domly divided into two groups. Thirty patients received buccal infiltration of 1.7 ml of 4% articaine with 1:100,000 epinephrine and thirty patients received standard inferior alveolar nerve block with 1.8 ml of 2% lidocaine with 1:200,000 epinephrine. Endodontic access was begun 10 minutes after solution deposition, success [anesthetic efficacy] was defined as none or mild pain [Visual Analogue Scale recordings] on endodontic access preparation or pulp extirpation. Twenty-two patients out of 30 did not experience pain with 4% articaine [success = 52.4%] and 20 out of 30 patients did not experience pain in 2% lignocaine group [success = 47.6%]. There was no statistically significant difference between the articaine formulation as buccal infiltration and lidocaine formulation as IANB with regard to anesthetic success [p value =0.220]. Even though buccal infiltration of 4% articaine and IANB of 2% lidocaine were equally effective, buccal infiltration can be considered a viable substitute in IANB for anesthetizing mandibular first molar with irreversible pulpitis

Financial wellness awareness: a step closer to achieve millennium development goals for Pakistan

To explore financial wellness [FW] awareness amongst public and private sector medical college students of Karachi. A cross sectional questionnaire based survey was conducted on medical students from 3 public and 5 private sector medical colleges of Karachi from February 2011 to December 2011. All ethnic groups having age range of 18-23 years were included. A questionnaire tailored from wellness wheel evaluated the responses of FW on a four point Likert's scale ranging from 0-3[never, sometimes, mostly, and always]. Factor analysis explored common FW factors among both public and private sector medical college [MC] students. Private MC Students were better in terms of making short and long terms financial goals compared to students in public sector. The students of public MC were more focused to make and restricting to given budgets [p=0.05]. The FW element of keeping savings in bank account was responded more by private MC candidates [P < 0.0001] but was spent thrift as well [P < 0.0001]. Factor analysis revealed two factors; 'Financial Security Wellness' which was better in Private MC Students [p=0.001] and 'Care towards Expenses Wellness" in which results were not significant. Both groups of medical college students lacked FW awareness element in terms of caring towards financial expenses. The awareness of importance of financial security was practiced better by private MC students in terms of making short and long term financial goals and keeping savings in bank accounts. They were however deficient in the knowledge of making and restricting themselves to budgets

Extraction of wisdom teeth under general anesthesia- a study

The objective of the study is to highlight the indications, surgical procedure and complications of 3rd molar removal under General Anesthesia among patients reporting to Khyber College of Dentistry Peshawar. Impacted teeth are teeth that fail to erupt into their proper functional position in the dental arch. These often need extraction due to reasons like pericoronitis, caries of 3rd or 2nd molar, periodontal pocket on distal aspect of 2nd molar, cysts, tumors and pain of unexplained origin. This Retrospective descriptive study was carried out in Department of Oral and Maxillofacial Surgery at Khyber college of Dentistry Peshawar during the period from July 2007 to October 2012 on 121 patients from whom 484 teeth were extracted under general anesthesia. All patients included in the study were advised panoramic X-ray study and Pederson scale was used to find out difficulty of extraction. Out of 121 patients, 71 were male and 50 female with the male to female ratio of1.42:1. The age range of the patient was from 19 years to 41 years. Majority of the wisdom teeth were extracted in the third decade of life. Among males, out of a total of 282 mandibular third molars, 70 teeth were most difficult, 40 moderate while 32 belonged to mildly difficult category. Among female patients, 46 were mildly difficult. Complication rate in current study was 4.5% [22 patients]. These included lingual and ID nerve paresthesia, tuberosity fracture and dry socket. Extraction of all four third molars is a safe procedure to be carried out under general anesthesia and has a low rate of complication

Bird's eye on LMC dental graduates academic contributory role to enhance undergraduate dental education and vision for pakistan: a commentary

Dental education, like Medical education in our country, should now be shifted towards student centered, be Evidence cum Competence based and incorporate room for Faculty Development to meet International trends. This special GJC dentistry commentary is dedicated to the academic contributions of our entire respected LMC dentistry faculty from a lecturer to the level of professor, who taught and trained us to play vital academic role, from the year 1963 till 2013. This commentary is contribution to share our academic role for the promotion of our dynamic skill oriented Oral Health Profession in Pakistan

Spectrum of mandibular fractures presented at abbasi Shaheed Hospital, Karachi

Careless high speed driving and increasing violent attacks in the Karachi had increased the burden of maxillofacial trauma proportionally. The objectives of the study were to: Enlist the various causes of Mandibular fractures in patients coming to the Department of Oral and Maxillofacial Surgery, Abbasi Shaheed Hospital and to describe the various sites of Mandibular fracture. The descriptive, cross sectional study on the patients fulfilling the inclusion criteria. They were asked for the parameters which includes age, gender, etiology of fracture, and site of fracture using a questionnaire. Statistical analysis of continuous and categorical variables was conducted using SPSS version 16.00. Male preponderance with male: female ratio of 2.4: 1, 71.1% males and 28.9% females, mean age of the patient was 28.2 years 12.7. The most common cause of injury was recorded as Road traffic accident [RTA] 65.6% and the most common site of fracture was Parasymphysis [24.1%]. This study clearly demonstrates the most common cause of Mandibular fractures was RTA and the most common site was the Parasymphysis in our population

Prevalence of dry socket related to gender and site

The aim of this study was to assess the prevalence of dry socket in association with gender, site and age. This study includes hundred consecutive patients with dry socket coming to the OPD at Oral Surgery Department, Khyber College of Dentistry, Peshawar. A comprehensive proforma was formu-lated and filled for comparison of gender, age and site in relation to dry socket. The results of this comparative study were analyzed through chi-square test. Females were 2.37 times more prone to dry socket as compared to males. Whereas, dry socket was found 2.94 times more common in mandibular extractions as compared to maxillary. It was less common in young age group [18%] as compared to older patients [67%]

En bloc resection of huge cemento-ossifying fibroma of mandible: avoiding lower lip split incision

Cemento-ossifying Fibroma [COF] is an osteogenic benign neoplasm affecting the jaws and other craniofacial bones. It commonly presents as a progressively slow growing pathology, which can sometimes attain an enormous size, causing facial deformity. A case of a huge cemento-ossifying fibroma, appearing as a mandibular dumbbell tumour in a male patient is documented, which caused massive bone destruction and deformity. It was surgically removed by performing en bloc resection of mandible avoiding the splitting of lower lip incision technique, thereby maintaining his normal facial appearance

Oral hygiene KAP assessment and DMFT scoring among children aged 11-12 years in an urban school of Karachi

To assess the oral hygiene knowledge, attitude and practices among school children and evaluate their DMFT [Decayed/Missing/Filled Teeth] scores. Cross-sectional study. A private school of Karachi from March to April 2008. Convenient sample comprising 300 students of grade 6 within the age group of 11-12 years was selected. A knowledge, attitude and practices survey questionnaire based on quantitative indicators was filled by the students. Clinical examination was done for DMFT. Data analysis was done by using SPSS version 11. Associations were assessed using chi-square test and a p-value of < 0.001 was considered significant. There were 160 males and 140 females in the target group. The mean DMFT was found to be 1.27. The children had satisfactory knowledge of oral health's effect on general health and the problems associated with poor dental hygiene. However, 50.3% children did not have positive attitude towards importance of a dentist's role in maintaining their dental health. Only a few students [11.3%] had familiarity with dental floss. A statistically significant association was found between frequency of brushing and children's knowledge of the problems related to irregular tooth brushing [p < 0.001]. The attitude of school children towards dental health and dental service utilization is determined by certain social and cultural factors. The mean DMFT of 1.27 showed that there must have been some poor oral practices that are contributing towards a higher mean

Maxillary adenomatoid odontogenic tumour - an uncommon oral pathology, reported locally

Background: Adenomatoid odontogenic tumor [AOT] is relatively an uncommon oral tumour, which accounts for about 3-7% of all odontogenic tumors as reported in the literature, but local reporting in Pakistan is insignificant. AOT is a benign [hamartomatous], noninvasive odontogenic tumour with slow and sustained growth. This report describes the surgical therapy, clinical course and morphological characteristics of an AOT, which developed in the maxilla of 22 years old female patient, initially diagnosed as a Gobulomaxillary Cyst, based on the clinical and radiological features. No local recurrence has been observed so far, as it was successfully completely removed under local anaesthesia

Role of general health care providers in referring patients with odontogenic infection

To highlight the role of general health care providers in referring patients with odontogenic infection. This study was carried out at two teaching Dental Colleges simultaneously, the departments of Oral and Maxillofacial Surgery Hamdard University Dental Hospital, and Fatima Jinna 1 Dental College Hospital Karachi. A total of 108 cases were managed for clinically diagnosed fascial space infect from March 2004 to August 2006. From the total of 108, 76 patients were managed at Hamdard University w as 32 patients were managed at Fatima Jinnah Dental College Hospital respectively. The referral inform, I was extracted from the referral letter and patient interview [history and examination]. In cases where referral lettrs were not present the referral source was recorded as "self referral". The mean age of the sample was recorded as 26.7 years with minimum age .1d maximum age 63 years. In all, 64.8% patients were male and 35.2% patients were females with M:F ratio of 1.8:1. The referred cases accounted for 59.3% excluding the self referred cases. Most referrals were recorded from medi and surgical specialists [25%], followed by general medical practitioners [24.1%], and general dental practitioners [10.2%]. Self referrals accounted for 40.7% of the sample. Oro-facial infections occur in sites that lend themselves to early detection by most health-care providers and, to a certain extent also, by self-examination. These study findings raise the concern that lack of patient awareness and its associated inappropriate clinical management should be aimed at formulating referral guidelines for the GDP and the GMP to provide guidance for a detailed clinical examination of the oro-facial region, and to decide the need for urgent referral to the specialist Especially if severe fascial space infection is anticipated particularly in patients having compromised host defenses associated with poor oral health

Direct pulp capping: degree of bleeding is a strong candidate as prognosis index, in-vivo study

The study was carried out to document the clinical prognosis of direct pulp capping and analyzing the clinical effects of degree of bleeding on prognosis. Sixty asymptomatic permanent carious molar teeth revealing accidental pulp exposures during removal of deep dentinal caries were selected. This study was done from April 2003 till September 2004. All the teeth were capped with dentine adhesives [total-etch system]. The cavities were restored with composite resins. The patients were examined through six months. The patients with severe pain or facial swelling or teeth which exhibited peri -apical lesions were considered failure. From the total 60 Molar teeth selected, 51 cases were found successful at the last day of the study, while 09 cases failed during the course of the study. The number of successful cases found with significant statistical p-value <0.05. Cases were divided into three categories according to the degree of bleeding from exposed pulp. Table 1. The cases with less bleeding tendency [+] exhibited significant success rate of 97% than cases with profuse bleeding [++, +++] 84% and 33% respectively