ABSTRACT
Introduction: During instrumentation smear layer formationoccurs on dentinal wall and for a successful root canal itsremoval is necessary. Aim of the study was to compare effectof 17% EDTA, MTAD & 18%Etidronic acid (HEBP) + 5%NaOCl, irrigating solutions on smear layer removal andpenetrability of AH Plus sealer into dentinal tubules usingscanning electron microscopy (SEM).Material and methods: Sixty single rooted mandibularpremolars, were divided into three groups (n=20).Group -I17% EDTA, Group -II MTAD, Group -III 18%Etidronic acid+5% NaOCl. The final rinse was done by 5ml of solution for2 minutes. Ten samples from each group were evaluated atmiddle and apical thirds for smear layer removal using SEM.Remaining ten samples of each group were obturated withgutta-percha & AH PLUS sealer and evaluated at 5mm abovefrom the root apex for sealer penetration using SEM.Results: At middle 3rd no difference in smear layer removalwas seen between Group –I and Group -II For apical 3rdGroup- II showed better smear layer removal than Group–I and Group- III. Thus both in middle and apical thirdsMTAD showed better smear layer removal. For mean sealerpenetration Group -II showed a highest depth of sealerpenetration i.e, 231.37±18.12µm followed by Group -I154.95±22.53µm and Group –III 125.99±17.39µmConclusion: MTAD is effective in smear layer removal fromboth middle and apical thirds. Maximum depth of sealerpenetration was seen in MTAD group followed by EDTAgroup and least in Etidronic acid group
ABSTRACT
Objective: To determine effectiveness and safety of echocardiography guided bed side Balloon Atrial Septostomy [BAS] in dextro transposition of great Arteries [dTGA] with intact ventricular septum [IVS] at a public sector tertiary care hospital Karachi, Pakistan
Methods: This case series include 40 patients with echocardiographic findings of dTGA with IVS and restricted PFO [
Results: Median age was 16 days, Majority of them [n=23, 58%] were severely cyanosed with SpO[2] of 41.4 +/- 3.4% and underwent emergency BAS and remaining underwent elective procedure. An increase in SpO[2]% from 46.0 +/- 6% to 81.0 +/- 3.0% [p=<0.001] and ASD size from 1.4 +/- 2.8mm to 5.45 +/- 0.4mm was observed [p=<0.001]. No complication was observed in most of cases [n=28, 70%]. Mean hospital stay was 3.4 +/- 1 days. Success rate was 97.5% however, one neonate died due to neonatal sepsis
Conclusion: Our study provides sufficient evidence that bed side balloon atrial septostomy is a safer technique, save a lot of time and resources which were required otherwise in transporting these patients to catheterization laboratory
ABSTRACT
Objective: The aim of this study was to determine the duration of hospital stay in different types of infantile burn
Methods: This retrospective study was conducted at the plastic surgery, burn unit of Patel hospital during the period of 7 years from January 2007 to December 2013. Children ageing one year or less at the time of admission with any type of burn were included in the study and those above one year were excluded. The patients medical records were obtained from medical record department. SPSS 21 version was used for statistical analysis. Data description is given by percentage. Standard deviation and central tendency [medians and means] were taken as measures of variability. For comparison Chi square test was used. P value less than 0.05 was taken as statistically significant
Results: Total 789 paediatric burn patients were admitted in Patel Hospital during January 2007 to December 2013, in which 106 were infants. Infants having scald burn were 83 [78.3%], fire burn 21 [19.8%] and chemical burn 2 [1.9%]. Male to female ratio was 1.5:1. Out of these 106 infants, 74 [70%] were hospitalized for 1 - 10 days, 18 [16.9%] were hospitalized for 11 - 20 days, 6 [5.6%] and 8 [7.5%] infants were hospitalized for 21 - 30 days and more than 30 days respectively. Most of the infants with different types of burn injuries remained under treatment between 1 - 10 days. Infants with scald, fire and chemical burn were 59 [71.1%], 14 [66.7%], and 1 [50%] respectively and remained under treatment at hospital between 1 - 10 days. It was observed that duration of stay was prolonged for infants with fire burn as compared to those with scald burn, if total body surface area [TBSA] was more than 10%. Infants with both second and third degree of fire burn [66.6%] had length of stay more than 20 days as compared to [27.3%] of scald burn. The length of stay was affected mostly in those infants who had secondary wound infections. Out of 106 infants, 28 [26.4%] had growth of organisms in wound cultures. In 106 infants, 95 [89.6%] were discharged, 2 [1.9%] left against medical advice [LAMA] and 9[8.5%] expired. Among these 6 [66.6%] of them expired due to scald burn and 3 [33.3%] expired due to fire burn. Most of the infants 5 [55.5%] expired within 5 days due to more than 40% of their TBSA involved and having third degree burn
Conclusion: We have seen through this study that infants with less than 10% of their TBSA involved were hospitalized for less than 10 days due to scald, fire or chemical burn. However in fire burn the duration of stay was prolonged as compared to scald burn if TBSA was more than 10% or having both second and third degree burn. The length of stay is also affected for those infants who developed secondary bacterial wound infections. Infants who had more than 40% of their TBSA involved and had third degree burn, survived for less than 5 days
ABSTRACT
To determine the urinary citrate [UC] level in stone formers [SF] versus controls. Case control study. Department of Pediatric Nephrology, National Institute of Child Health [NICH], Karachi from January- July 2008. Eighty six children of 1-13 years, 43 in each group, stone former [SF] and controls were studied. In both groups, 24-hours UC was measured by citrate lyase method. Hypocitraturia was defined as 24- hours UC-level < 5mg/kg for children under 9 years and <7mg/kg for 9 years and above. Data including age, sex, weight, 24-hours urine volume [UV] and UClevel were analyzed using descriptive statistics on SPSS version 15. Of the 86 children, 59 [68.6%] were males and 27 [31.4%] females. Overall mean age was 5.65 + 3.05 years, while that of SF and controls was 5.61+ 3.1 and 5.70 + 3.04 years respectively. Mean 24-hours UV and UC-level in total of 86 samples was 385.10+130 ml and 88.10 + 62.11mg respectively. Mean + SD 24-hours UC-level [mg] in SF and controls was 69.4 + 53.55 [95%CI 53.39-85.41] and 106.8 + 65 [95%CI 87.37-126.23] respectively. Overall hypocitraturia was found in 42[48.8%] children. Frequency of hypocitraturia was high in SF [n 30, 69.8%] compared to controls [n 12, 27.9%] with a significant difference between the two groups [p<0.001]. Overall hypocitraturia was found in 48.8% of cases. Though hypocitraturia was prevalent in both groups, but was significantly high [69.8%] in SF compared to controls [27.9%]. Hypocitraturia may be an important metabolic risk factor and urinary citrate level should be included in the metabolic evaluation in all stone formers
ABSTRACT
Pseudomonas aeruginosa (P aeruginosa) is one of the most common nosocomial pathogens. We report our experience of a device-related outbreak of postoperative ventriculitis caused by P aeruginosa thus initiating investigation of the unusual occurrence. Five neurosurgical patients were affected, postoperatively. The investigations entailed extensive screening of the common sources of contamination for colonization of P aeruginosa. Sterilized instruments used for surgery, including the ultrasonic aspirator (USA) sets and other hollow devices, were randomly sampled and cultured. Conventional culture methods yielded P aeruginosa, with almost similar antibiotic sensitivity pattern in all the patients and the ultrasonic aspirator, clinching the source of contamination. Routine surveillance, identification of unusual patterns, molecular epidemiological typing would be helpful in quick control of outbreaks of postoperative infections.