Chronic periodontitis, a silent hazardous disease

Chronic periodontitis is a common disease, which occurs as an outcome of tooth supporting tissue's inflammation [periodontal ligament and gums], initiated by the exposure of the periodontium to dental plaque. By the action of various toxic products liberated from pathogenic plaque bacteria there is periodontal destruction, as well as hosts inflammatory responses elicited against plaque bacteria and their products. Inflammatory processes can be considered as the most essential functional part of pathophysiology of atherosclerosis resulting in cardiovascular disease [CVD]. Elevated levels of C -reactive Protein [CRP] have been associated with CVD and regarded as indeperident determinant of atherosclerosis. This study has been carried out to assess the possible relationship between chronic peri-odontitis and CVD determinants. This cross sectional study involved a total of 100 subjects including 50 chronic periodontitis patients and 50 healthy controls between the ages of 35 - 40 years. The patients were obtained from de-Montmorency College of Dentistry, Lahore. A detailed personal history, past medical and dental history was taken. Patients of chronic periodontitis were selected using Community Periodontal Index of Treatment Needs [CPITN], according to inclusion and exclusion criteria. Blood sample were drawn and CRP was measured by using standard enzyme linked immunosorbent assay [EL1SA] method. These parameters were compared in chronic periodontitis patients with age and gender matched healthy controls, to observe the significance of difference. The results of this study showed that serum CRP which was a strong independent risk jnarker of CVD is statistically significantly elevated in chronic periodontitis patients as compared with age and gender matched healthy controls. The correlation between serum CRP and severity of chronic periodontitis was also highly significant. The results of this study suggest that elevated CRP in chronic periodontitis patients may predispose them to the development of early atherosclerosis. Because of the significant association of elevated inflammatory mediators with CVD, their determination may help to improve the prediction and prevention of CVD in chronic periodontitis patients as well as these results is expected to bring awareness in people about oral hygiene

Comparison of locally made phonating device versus oesophageal speech in postlaryngectomy speech rehabilitation

To compare the effectiveness of locally made phonating device with oesophageal speech as a communication method in a laryngectomized patient. Randomized Controlled Trial. Combined Military hospital Lahore from January 2004 to July 2007. Twenty five patients who had undergone total laryngectomy were divided in two groups by random sampling. 13 patients were placed in experimental group and provided with a locally made phonating device El [Electro-larynx, 'BM Talk'] and speech training with this device started between 20th to 30th post-operative day. The results were compared to a Control Group consisting of 12 laryngectomized patients who were provided instruction and training on oesophageal speech for communication. Speech assessment was made at the end of 2nd, 4th and 6th month post-operatively in both the groups. Assessment parameters were defined according to the patient's ability to communicate ten predetermined sentences of Urdu and Punjabi to a team of three speech assessors on each speech assessment day. Speech communication score was fixed at 100 if all the spoken sentences were fully understood by all the three assessors irrespective of character of speech, while it was 0 if none of the sentence spoken could be understood by any of the three assessors. In between the two were different percentages of speech communication scores depending on the number of sentences understood by the speech assessors. The character of voice was assessed by Visual Analogue Score where variation between robotic and normal speech character were divided into ten grades from 1 to 10. At the end of six months, speech communication score was 76.62 with SD 17.29 for EL [Electro-Larynx]; while for control group [oesophageal speech] it was 34.17 with standard deviation of 8.63. Those score was compared by using t test and was highly significant i.e. <0.001 in favor of EL. The character of voice was closer to normal in case of oesophageal speech compared to EL where it was closer to robotic. Locally made EL [Electro-larynx] 'BM Talk' is a useful device for speech rehabilitation in laryngectomised patient. It has added advantage of local availability and cost effectiveness. The character of voice may be robotic and monotonous, nevertheless full sentence can be communicated with relative ease to the listener, which is more important factor in our setup

Frequency of chronic suppurative otitis media in the junior ranks of Pakistan Army

The purpose of this study were to find out the frequency of chronic suppurative otitis media [CSOM] in the junior ranks of army, and to find out the number of such patients serving in low medical category due to CSOM. It was a simple multi-centre descriptive study. This study was conducted in ENT department of Combined Military Hospital Lahore from March 2003 to August 2003. Feedback was also taken from CMH Abbottabad and HIT Hospital Wah during this period. A total of 5000 junior ranks were examined for CSOM. Out of these 56 [1.12%] were suffering from inactive mucosal disease. Seventy nine [1.58%] had active mucosal disease. Attico antral disease was present in 33 [0.66%] subjects and out of these 8 [0.16%] subjects had undergone mastoid exploration in the past. Ninety [1.8%] cases were serving in low medical category due to CSOM. The frequency of CSOM is significantly high in the army [03.36%], considering that all inductions are made after initial medical examination. By observing few precautions the frequency may be reduced, thus decreasing the financial drain on national exchequer