Causes of tooth extraction amongst diabetic patients seen in a dental hospital in Peshawar

The aim of the study was to evaluate the causes of common conditions leading to tooth extraction, male/female ratio in diabetic patients. This was a retrospective cohort study. Data were collected from previous records between January 2011 to July 2015 from the Department of Oral and Maxillofacial Surgery, Sardar Begum Dental College, Peshawar. Among 2,103 total diabetic patients presented to the department, 1,618 diabetic patients have their complete record for tooth extractions. The primary reasons for exodontia specified in the records were Caries, Periodontitis, others. Others include those patients who have extractions either due to preprosthetic purpose, trauma or fracture or any other reason other than caries and periodontitis. The data was analysed through SPSS 22. The mean age presentation was 47.50 +/- 19.82 years and the age range 25-70 years. There were 1,618 extractions carried out in 2,103 subjects [76.94%]. The female diabetic patients predominate n=983 [60.75%] the male patients n=635 [39.25%]. Caries was the dominant cause of tooth extraction in both subjects n= 1042 [64.40%] followed by periodontitis n= 416 [25.71%] and others n=160 [9.90%]. Caries is the dominant cause of extraction in diabetic patients and female diabetic patients predominate male diabetic patients in terms of tooth extraction

Frequency of complete heart block after surgical closure of perimembranous ventricular septal defect

Objective: to find the frequency of complete heart block [CHB] in patients undergoing surgical perimembranous Ventricular septal defect [VSD] closure

Methodology: this was a Descriptive cross sectional study performed in Cardiovascular Department Lady Reading Hospital Peshawar. Data was collected from 28 January 2013 to 28 July 2013 with sample size of 103.Sampling technique was non probability consecutive. All patients with perimembranous ventricular septal defect, aged 5 years to 25 years with any gender were included in the study

Results:-mean age was 12.63 years +/- 6.63. Patients were divided in four categories according to their age. Over all complete heart block in the perimembranous ventricular septal defect after surgical closure was 10[9.71%]. Age wise distribution of complete heart block shows that majority of the complete heart block 6[12.8%] were found in age less than or equal to 10 years

Conclusion:-VSD closure is less often associated with CHB but there should be arrangements for pace maker to timely pace the patient in case of any emergency

Patterns of minor salivary gland tumors in Khyber Pahktunkhwa

Present study was carried out to determine the pattern of minor salivary gland tumors, diagnosed at City Medical Laboratory, Peshawar [Pakistan]. The study was conducted at Sardar Begum Dental College using the Anatomical pathology records of City Medical Laboratory, Peshawar from January 2003 to December 2012 and were analyzed by Statistical Program for Social Sciences version 16. A total of 78 cases were diagnosed as minor salivary gland tumors. Out of these 47 were benign and 31 malignant. The male to female ratio for both benign and malignant tumors was 1:1.7. The mean age was 40.39 years. The most common benign tumor was Pleomorphic adenoma [89.3%] and malignant was Adenoid cystic carcinoma [87.09%]. The hard palate was the most common affected site [57.4% in benign and 32.2% in malignant tumors]. The present study showed a different pattern of occurrence of malignant minor salivary gland tumors among the population of Khyber Pahktunkhwa as compared with the European and American population

Condylar fractures in children - a study

The purpose of the study was to highlight the etiology, age, gender and site distribution, treatment options available and complications occurring as a result of condylar fractures in growing children. This retrospective study was carried out on a total of 57 patients from Jan 2008 to Oct 2009 at the department of oral and maxillofacial surgery, Khyber College of Dentistry, Peshawar, Khyber Pakhthunkhwa province of Pakistan. Fifty seven patients were recruited in this study. The male to female ratio was 1.6:1. Fall was the most common cause of condylar fractures i.e., [73.7%]. The peak incidence of condylar fracture was high among 6-10 years age group i.e. 26 [45.6%]. Forty one patients [71.9%] had unilateral condylar fractures and [28.1%] had bilateral. Maxillomandibular fixation [MMF] was performed in 28 patients [49.2%] to correct occlusal disturbance, minor deviations and to reduce the pain associated with it, while occlusion was disregarded in 29 patients [50.8%] but were put on close follow up. Overall 41 patients [71.9%] were treated successfully with conservative treatment approach but 16 patients [28.1%] have reported after 1-2 years with complications of temporomandibular joint [TMJ] Ankylosis. Among these 10 patients [62.5%] had unilateral TMJ Ankylosis. Gap arthroplasty with disc interpositioning was performed in patients with established complication of temporomandibular joint ankylosis

Treatment of oroantral fistula - a study

The aim of this study was to evaluate and analyze the occurrence, characteristics and treatment outcome of oroantral fistula in 29 patients from Sept 2004 to Nov 2009. These patients were examined both clinically and radio-logically for oroantral fistula. Data regarding the age, gender, cause and site of fistula and treatment outcome was evaluated and reviewed. The age range was 18-60 years with high frequency occurring in 31-40 years. Male outnumbered female. The common cause of OAF was extraction of teeth [n=25, 86.5%] followed by cysts [n=2, 6.7%]. The most common involved tooth in the causation of OAF was upper first molar [n=13, 52%]. Surgical technique used to close the fistula was buccal advancement flap. Recurrence of fistula occurred in 2 patients [6.7%] and were re-operated using the palatal flap. The merits and demerits of the procedure are discussed

Maxillofacial and associated fractures of the skeleton - a study

The purpose of the present study was to evaluate the incidence of associated skeleton fractures with maxillofacial fractures and to list age gender and bone involved with poly trauma patients. The study is first of its kind in the region and will help to develop a better poly trauma management team. A Descriptive study was carried out in Oral and Maxillofacial Surgery Department of Khyber College of Dentistry, Peshawar, Pakistan for a period of one year i.e., from 20[th] June 2009 to 19[th] June 2010. All the patients presenting with maxillofacial injures and associated fractures of the skeleton were included in this study. Age, gender distribution, aetiology, associated injuries and treatment modalities undertaken in these patients were recorded. A total of 505 patients reported to oral and maxillofacial surgery unit of Khyber College of Dentistry, Peshawar, and amongst them 54 [10.6%] had associated fractures of the rest of the skeleton of the body. The most commonly involved bone was mandible [67%] followed by zygomatic complex fratures i.e. 15% in these patients. 50% of the fractures resulted because of Road Traffic Accidents. Upper limb fractures were the most common bone fractures associated with maxillofacial trauma i.e., 53.25% of the cases

Retaining or extracting a tooth in the line of mandibular fracture - a study

The purpose of the study was to compare the treatment outcome of extractions and nonextractions of teeth in the lines of mandibular fractures and to determine the most common complications. A Quasi-experimental study was undertaken in the Department of Oral and Maxillofacial surgery, Khyber college of Dentistry Peshawar from January 2007 to January 2008. A total of 100 patients having tooth in the line of mandibular fracture were recruited in the study. The patients were divided into two groups of 50 patients each. In Group A the tooth was retained in the line of fracture, and while in Group B the tooth was extracted. Each patient was evaluated for postoperative results and the differences between them assessed. Statistical analysis included chi-square test. Results were considered significant if p d" 0.05. Majority of the patients were young adults. The most common site was parasymphysis while the most commonly involved teeth in the fracture line were incisors. The major operative morbidity proved to be infection followed by malunion and maloclusion. Both groups were not different in relation to postoperative infection [P= 0.461], malocclusion [P= 0.5577], malunion [P= 0.5577] delayed union and non-union. There was no significant difference in the outcome between the extraction and non-extraction of a tooth in the line of fracture

Cancrum oris - a descriptive case series on 13 patients

To evaluate the age, gender, site distribution and associated systemic debelitating conditions [if any] of the patients with Cancrum Oris. A. descriptive retrospective study was undertaken in the Oral and Maxillofacial Surgery unit of Khyber College of Dentistry from January 2005 to January 2010. Information regarding the variables of the study i.e., age, gender, site distribution and associated systemic debilitating conditions, was collected from the ward charts during the study period. A. total of 13 patients reported to the unit during the study period, 8 males and 5 females with male to female ratio of 1.6:1. The age range of the patient was from 9 to 70years with the mean age of 37.69 SD + 22.65. The first and the third decade of life was the most common age group affected with Cancrum Oris i.e., 23.07% each, with another peak in the sixth decade of life i.e., 23.07%. bilateral anterior maxilla was affected in 30.76% cases. Uncontrolled diabetes was the common associated systemic debilitating condition i.e., 72%. All of the patients were from low socio-economic class. Cancrum oris is a disease of low-socioeconomic group. In our series of patients the most common associated debilitating systemic condition was diabetes melitis with a bimodal age distribution

frequency of caries in school going children of Peshawar

To determine the frequency of dental caries, the gender distribution, the most commonly involved deciduous and permanent tooth in dental caries and to evaluate tooth brushing habits in school going children of Peshawar. This descriptive study consisted of 1000 children aged between 6 to 14years old. The information was gathered by taking a detailed history and clinical examination of the students and noted in a structured questionnaire. Brief biodata and oral hygiene levels were recorded in descriptive form while the carious teeth were recorded in tabulated form. Data was analysed using SPSS 10. Out of a 1000 students, 642 [64.2%] had caries. The caries distribution was more in boys [54%] as compared to girls [46%], with male to female ratio 1:0.85. The highest prevalence of caries was found in 12 year old children [77%]. Highest numbers of caries were found in first molar in both primary [262] and permanent dentition [188]. Thirty eight percent children claimed to have brushed their teeth once daily and 11.5% did not brush their teeth at all. Our study showed that there is a lack of awareness of oral hygiene and its importance has not been emphasised enough to the school going children

Pattern of zygomatic bone fractures and treatment modalities: a study

This study was designed to determine the pattern of zygomatic bone fracture, etiology and treatment options. The term pattern in this study was used for the sites/processes of zygomatic bone fracture. The variables evaluated were age, gender, sites of fracture and treatment options. A total of 81 patients with zygomatic bone fracture were treated in Oral and Maxillofacial Surgery unit, Khyber College of Dentistry, Peshawar for a period of one year from July 2007 to June 2008. Majority of patients were young males in 3rd and 4th decade. Male to female ratio was 12.5:1. Road traffic accidents [76.5%] were the most common and interpersonal violence 2.5% as the least common etiology of zygomatic bone fracture. In 28.4% patients, zygomatic bone was fractured at single site while in 71.6% it was fractured at more than one. Fracture at zygomatic buttress and infraorbital rim [27.2%] in combination was most common finding. Twenty three percent patients did not require treatment, 32.1% zygomatic bone fractures were reduced indirectly and 44.4% were reduced directly by open reduction and internal fixation

Association of aetiology, presentation and post-operative complications of post-traumatic peripheral artery pseudoaneurysm

To describe post traumatic pseudoaneurysms and its association to causes, presentation and conventional surgical treatment modalities. This Descriptive study carried out in the Department of Cardiovascular Surgery, Lady Reading Hospital, Peshawar from January 2003 to December 2007. Patients with associated arteriovenous fistula were excluded from this study. All the demographics including age, sex, type of injury, site, associated complications operative details, pen operative morbidity and mortality were prospectively recorded in a data base. The total number of patients was seventy five. All the patients underwent conventional surgical procedures. Reverse saphenous graft was received by 34%, 24% had end to end anastomosis, 12% had interposition synthetic graft, 8% had rent repair while 21.33% had primary ligation of the involved artery. There was no pen operative mortality. Six patients had post operative complication in the form of graft, thrombosis and or infection. Three patients had amputation, two in lower limb and one in the upper limb. Majority of them were male 90.66%. Age ranged from 7 years to 75 years. Most of the patients [77.3%] were in second to fourth decade of life. The most common cause of injury was gunshot wound [56%] followed by stab wounds [13.33%] and road traffic accidents [12%]. Few cases of bomb blast [6.66%], Post cardiac catheterization [4%], glass injury [4%] and intravenous drug abusers [2.66%] were also reported. The commonest site of injury was fern oral artery [37.33%].In this study majority of patients were male with gunshot wound as commonest cause. Reverse saphenous vein graft was treatment of choice. Infection and thrombosis were the commonest postoperative complications

Features and management of mono-ostotic fibrous dysplasia of the jaws - a study

The study was carried out on a total of 13 biopsy confirmed fibrous dysplasia patients reported to Oral and Maxillofacial surgery Unit of Khyber College of Dentistry, Peshawar over a period of 3 years i.e., from January 2004 to December 2005. The aim of the study was to evaluate the clinical and radiographic features and management of the patients with mono-ostotic fibrous dysplasia of the jaw bones. The age range of the patients suffering from mono-ostotic fibrous dysplasia was from 10 to 35 years with the mean age of years 19.78 years SD + 7.53. There were more females [62%] as compared to males [38%], with male to female ratio of 1:1.6. The maxillary bone [69%] was more frequently affected than the mandibular [31%]. While the condition has affected most of the patients in their second decade of life i.e. 53.85%. Swelling has been the most common presenting complaint [76.9%]. All the cases were treated with surgical shaving or re-contouring. Two cases of recurrent fibrous dysplasia were also reported within the study period

Surgical management of intestinal tuberculosis

To study the outcome of various surgical procedures performed for intestinal tuberculosis. This Study was carried out from July 2004 to June 2005 at Lady Reading Hospital, Peshawar on 30 operated patients of intestinal tuberculosis provisionally diagnosed on history, physical examination and x-ray findings. Emergency patients had a short work up including routine hamatological, biochemical and chest radiography while those admitted electively, had an ESR and upper gastrointestinal barium studies in addition to routine investigations. Final diagnosis was made after histopathology. Different operative procedures were performed according to the available facilities and preoperative condition of the patient. Study included 10 males and 20 females, ranging in age from 15-60 years with mean of 23.5 years. Twenty Seven patients [90%] were operated in emergency and 3 patients [10%] as elective cases. In 19 cases [63%],. ileum was involved while combined ileum and jejunum in 6 cases [20%]. Twenty patients [66%] had strictures in small gut. The most commonly performed procedures were resection and end to end anastamosis in the form of segmental resection [11 cases], stricturoplasty in 7 cases and loop ileostomy [5 cases]. Wound infection was the main post-operative complication [7 cases]. The average hospital stay was 10 days. Mortality was 10% [3 cases]. Resection of the diseased segment is the standard procedure to relieve obstruction but in the presence of multiple strictures and limited bowel length, stricturoplasty is a better alternative