Innovative two-part impression technique for an extensive maxillary defect

Patients reporting with large maxillary defects pose great difficulty in prosthodontic practice. After thorough history and clinical examination, prosthetic rehabilitation of these patients usually starts with an impression. In such cases conventional single step impression technique solely may not give the desired results. If the defect is of large size then impression making becomes difficult and complicated procedure. Therefore, conventional impression technique can be modified according to the needs and requirements. This report describes a modified and innovative technique of making impression in two parts, which can be withdrawn from mouth in two segments and easily reoriented outside the mouth

Monoblock obturation technique for non-vital immature permanent maxillary incisors using mineral trioxide aggregate: results from case series

Ten patients presented with non-vital immature teeth for root canal treatment. In all these cases the pre-operative clinical examination revealed apical periodontitis with a buccal sinus tract of endodontic origin. These cases were treated by a mineral trioxide aggregate [MTA] monoblock obturation technique. Follow-up evaluations were performed at 1 - 2 years after treatment. Eight out of 10 cases were associated with periradicular healing at follow-up evaluation. Mineral trioxide aggregate Monoblock obturation technique appears to be a valid material to obtain periradicular healing in teeth with open apices and necrotic pulps

Role of magnesium sulfate in the management of acute asthma

Objectives: To determine the supportive role of magnesium sulfate in the management of acute sthmatic patients

Study design: A descriptive comparative study

Place and duration: The Study was conducted from January 2010 to June 2010 at Department of Medicine, Isra University Hospital, Hyderabad, Liaquat University Hospital, Hyderabad and Institute of Chest Diseases, Kotri, Sindh

Methodology: Acute asthmatic patients between ages of 10 to 40 years reporting to emergency department were enrolled in the study. They were divided into two groups. Groups I patients [n = 36] received oxygen inhalation, nebulization by ventoline and intravenous hydrocortisone. Group II patients [n = 37] received oxygen, ventoline nebulization, intravenous hydrocortisone and IV magnesium sulfate 25 ml /kg body weigh diluted in 100 ml of normal saline delivered over a period of 30 minutes

Results: Seventy three patients were included in this study. Baseline parameters were compared in the two groups. Both group showed significant improvement in pulse rate which was 90.9 +/- 8.46 in group I [without magnesium] and 82.3 +/- 5.11 beat per minute in group II [with magnesium]. Oxygen saturation after 120 minute was 95.9 +/- 2.02 and 96.2 +/- 1.5% in group I and group II, respectively. Similarly, after 120 minutes, PEFR was 205 L/minute in group I as compared to 237 L/minute in group II

Conclusion: This study suggested that there was benefit of adding IV magnesium sulfate to ventoline nebulization and intravenous hydrocortisone in the treatment of severe or life threatening asthma

comparative study to assess post obturation flare-ups with and without using calcium hydroxide as an intracanal medicament

Objective: To compare post obturation flare-ups with and without using calcium hydroxide as intracanal dressing

Study design: A cross sectional comparative study

Place and duration: Department of Operative Dentistry, Liaquat University Hospital/Civil Hospital Hyderabad from 1[st] January 2007 to 30[th] June 2007

Methodology: A total of sixty adult patients of either male or female were included in this study. Permanent teeth diagnosed with irreversible pulpitis were included in this study. The teeth were randomly assigned into 2 groups; one group root canal treatment was done and calcium hydroxide was used an intracanal medicament and the other group was treated without calcium hydroxide. The flare-ups were observed in the cases with a visual analogue scale and frequency of pain was reported depending upon the frequency of pain, i.e. no pain, mild, moderate or severe pain. The data was collected and a social science [SPSS 20] was used to analyze data

Results: The results of the present study have shown that endodontic treatment with intracanal medicament has similar results to endodontic treatment without intracanal medicament. No significant difference in frequency of pain was observed between both group at any of the 24 hours and 72 hours postobturation time period

Conclusion: Under the conditions of this study, no significant difference in postobturation flare ups was observed between the two groups at any time period. The application of calcium hydroxide as an intracanal medication was unrelated to the incidence and/or severity of postobturation flare ups

Clinical outcome of MTA apical plug and MTA monoblock technique for apexification of non-vital immature permanent incisors. in vivo study

Objective: To compare the clinical outcome between mineral trioxide aggregate apical plug and mineral trioxide monoblock technique of endodontic apexification procedure of non vital permanent incisors with open apexes

Study design: Clinical in vivo Cross sectional comparative study

Place and duration: Endodontic department/College of Dentistry Ziauddin University, Karachi. Study duration was from January 2010 to January 2013

Methodology: Total fifty patients of male or female visited Endodontic department with non vital permanent maxillary incisors with open apexes were selected. The selected teeth were divided into 2 groups by simple random method. Group A was treated with MTA apical plugtechnique and the group B was treated with MTA monoblock technique. The assessment of clinical outcome was carried out at 12 and 24 month follow-up appointments. The presence of signs and symptoms with treated cases were considered as clinical failure, while treated cases without symptoms were considered as clinical successful cases. The treated cases were also checked radiographically according to the published criteria of evaluation and categorized as successful, uncertain outcome and failure cases. The recorded data were analyzed by using the statistical software

Results: The results of the study showed clinical success in both group and radiographic success was found to be 68% and 76% in MTA apical plug group and 84% and 92% in MTA monoblock group at 12 and 24 months intervals

Conclusion: This study have showed no significant difference in clinical outcome of MTA apical plug and mineral trioxide monoblock technique for endodontic apexification procedure of non vital permanent incisors with open apexes

Association of smoking and low serum bilirubin antioxidant concentrations

Objectives: The objective of this study was to identify the association between cigarette smoking and serum bilirubin antioxidant concentrations

Study Design: A descriptive cross sectional study

Place And Duration: Study was conducted at the Department of Biochemistry at Sheikh Zayed hospital Lahore over a period of one year from January 2012 to December 2012

Methodology: The sample size was sixty with an equal distribution of healthy and control group. Thirty were known smokers and thirty were healthy controls. Thirty smokers who had been smoking for at least five pack years [20 cigarettes per day for one year is equal to one pack year] were included after ruling out coronary artery disease by Exercise Tolerance Test. Same no. of healthy control subjects were selected from general population with no history of smoking, CAD, Diabetes and hypertension

Results:The results of the study have shown that smoking decreases the serum bilirubin concentrations. The mean value of serum bilirubin in 50%[n=30] smokers was 0.59 + 0.034. While in control group 50%[n=30], it was 0.85 + 0.057

Conclusion: From the results, it was concluded that cigarette smoking lowers the bilirubin antioxidant concentration

Association of serum bilirubin concentration with risk of coronary artery disease

Objectives: Objective of this study was to assess the serum bilirubin concentration [within the reference range] as a marker for coronary artery disease [CAD]

Study Design: It was a descriptive cross sectional study and simple random sampling technique was adopted for the proceedings

Place And Duration: The study was conducted in the Department of Biochemistry and Cardiology at Sheikh Zayed hospital Lahore over a period of one year

Methodology: Thirty known patients of CAD diagnosed by angiography were selected. Same numbers of healthy controls were selected

Results: The results have shown that there was a significant difference in serum bilirubin levels of both groups, when compared statistically

Conclusion: The study suggests an inverse association between serum bilirubin concentration [within the reference range] and risk of CAD and it can be used as a marker to assess predisposition towards ischemic heart disease

Comparision between radiographic and electronic working length determination in root canal treatment in vivo study

Objective: To compare radiographic and electronic working length measurement of the root canal in patients presenting at Liaquat University Hospital Hyderabad

Study Design: Cross sectional comparative study

Place and Duration: Department of Operative Dentistry, Liaquat University Hospital/Civil Hospital Hyderabad from 4[th] October 2006 to 4[th] April 2007

Methodology: A total of hundred Patients of either gender, presented with irreversible pulpitis of permanent first mandibular premolars were included in this study. Before starting any procedure a periapical radiograph of tooth was taken to allow proper selection. An endodontic access was prepared and the pulp tissue was extripated. A working length radiograph was taken with a file in the canal and the radiographic working length was established. The apex locator root Zx was used to establish the electronic working length. The working length obtained by using the radiographic technique was compared with those obtained by using the apex locator

Results: Hundred patients were selected for out of which sixty-seven patients [67 %] were female and thirty-three patients [33 %] were male. The mean working length was 19.8mm +/- 1.03 SD for radiographic working length determination and 18.9mm +/- 1.05 SD for electronic working length determination. Mean difference between radiographic and electronic working length with 0.05 level of significant were 0.87 mm that was statistically significant

Conclusion: This study have showed statistically significant difference between the electronic measurements compared with the radiographic measurements in working length determination of a root canal

Effect of paracetamol on pharmacokinetics of isoniazid in Teddy goats

In this study the effect of paracetamol on pharmacokinetics [PK] of isoniazid [INH] in Teddy goats was investigated. INH was administered as a single oral dose at 10 mg/kg body weight to every experimental goat. After a wash out period of 7 days, INH and paracetamol [at the rate of 15 mg/kg body weight] were given simultaneously through oral route for investigation of drug interactions. Both times, following drug administration, blood samples were collected at predetermined time intervals from the jugular vein of each animal and analyzed for INH by spectrophotometric analysis. PK parameters were calculated using two compartment open model. When used with paracetamol, the value of biological half life [t1/2beta] of INH was significantly decreased [p<0.05] from 2.391 +/- 0.216 to 2.17 +/- 3.46 hours. The value for apparent volume of distribution [Vd] was also significantly decreased [p<0.05] from 0.905 +/- 0.327 to 0.786 +/- 0.161 L/kg and total body clearance [CL] was increased insignificantly [p>0.05] from 3.59 +/- 2.03 to 4.04 +/- 2.61 mL/min/kg. Based on these results, it was concluded that dose of isoniazid should be increased when concomitantly used with paracetamol

Crossing vessels as a cause of pelvi-ureteric Junction [PUJ] obstruction

Foetal hydronephrosis is commonly caused bycongenital pelviureteric Junction [PUJ] obstruction.It is either due to nerve deficiency or due to intrinsicmuscular defect at PUJ or it may be due to lowerpolar aberrant crossing vessel just compressing thePUJ. The purpose of this study is to see thecontribution of crossing vessels in causing the PUJobstruction

Aims and objectives: [1] to find thecontribution of crossing vessels in causing PUJobstruction on naked eye examinationperoperatively, [2] To histologicaly verify the causeof PUJ obstruction in cases of crossing vesselscompressing the pelvi-ureteric junction [PUJ]

Patients and methods: 27 cases of Congenital PUJobstruction were taken during four year period whowere candidatesfor operation. All underwent Anderson HynesPyeloplasty and specimen of PUJ with narrowsegment below it was taken and preserved in 10%formalin. The specimen was sent to histopathologistalong with other specimens where PUJ obstructionwas not caused by crossing vessels for nervedetection by S-100 immunohistochemistry and forhistopathological examination

Results: Five out of27 cases of PUJ obstruction were caused by crossingvessels and in these five cases, four [80%] werehaving normal histology showing that crossingvessels were the cause of PUJ obstruction merelycompressing the PUJ mechanically

Vesicovaginal fistula, causative factors and outcome of surgical management: an experience at PMC/allied hospital Faisalabad

Objectives: To assess the causative factors and outcome of surgical management of Vesicovaginal fistula [VVF] in our set up

Duration and Design of Study: Retrospective descriptional study from January 2008 to June 2012 conducted at Department of Urology PMC/Allied Hospital Faisalabad

Methodology: All patients with VVF who presented in our out patient department and underwent surgical repair in our department were included in this study. The records of patients were reviewed and data was entered in a structured proforma and analyzed. After history, physical examination, relevant investigations, IVU, Cystoscopy and vaginoscopy, patients were divided into two groups. Patients with supratrigonal fistula were operated through abdominal approach and those with infratrigonal fistula were operated through vaginal approach. The outcome of surgical procedures and post operative complications were noted

Results: This study included 68 patients. In 42 [61.76%] patients, cause of VVF was iatrogenic injury during hysterectomy, and 26 [38.24%] patients developed VVF due to obstetric causes. Fifty patients [73.53%] had supratrigonal fistula and eighteen patients [26.47%] were having trigonal or subtrigonal fistula. We achieved 90% and 83.33% success rate with abdominal and vaginal repair respectively

Conclusion: The most common cause of VVF is iatrogenic injury during hysterectomy. Both approaches of surgical repair had almost equally good results

An in vitro evaluation of synergistic activity of vancomycin and kanamycin on staphylococcus aureus and escherichia coli

OBJECTIVE: The aim of our study was to analyze the in vitro activity of vancomycin and kanamycin combination against Staphylococcus aureus and Escherichia coli

STUDY DESIGN: It was an experimental study

PLACE AND DURATION: The study was conducted in the month of February, 2007 at the University of East London

METHODS: Checkerboard synergy tests were performed in broth microdilution trays

RESULTS: FIC [Fractional Inhibitory Concentration] of 0.625 was calculated for the two drugs against E. coli that showed additive effect making this combination not effective against this organism. FIC of 0.182 was observed when the same combination of drugs was tested against Staph. Aureus

CONCLUSION: Vancomycin and Kanamycin have synergistic effect on Staphylococcus aureus and Escherichia coli

Use of monopolar electrocautry in transurethral resection of prostate [TURP] in the presence of permanent cardiac pacemaker

A 75 years old man having a permanent pacemaker [PPM] presented to the Department of Urology Allied Hospital Faisalabad, with severe lower urinary tract symptoms. On history he had strangury, burning micturition, dysuria and hematuria. His International Prostate Symptom Score [IPSS] was severe [29 out of 35]. On Digital Rectal Examination [DRE] there was a moderately enlarged prostate with firm consistency. On ultrasonography prostate size was about 40gm. Transurethral resection of prostate [TURP] was planned. Due to PPM it was hazardous to use monopolar electrocautery in TURP. Indifferent electrode plate of diathermy was placed under the gluteal region bypassing the chest [heart and pacemaker] to remain the circuit in limited area. During surgery no fluctuation in blood pressure and no any extra ECG changes were found on cardiac monitor. Peroperative procedure and postoperative recovery was uneventful

Bone mineral density in patients with metastatic prostate cancer with or without androgen deprivation therapy

Prostate cancer commonly metastatize to skeletal sites. Androgen deprivation therapy [ADT], the primary treatment of metastatic prostate cancer, may result in osteoporosis. Bone mineral density evaluation during androgen deprivation therapy can detect patients at risk of osteoporotic fractures

Objectives: 1-To determine BMD [T-score] in patients with metastatic prostate cancer with or without androgen deprivation therapy. 2-To compare BMD in metastatic prostate cancer patients with age matched controls

Study Design: case-control study

Setting: Urology Department, Allied Hospital Faisalabad

Materials and Methods: BMD of patients with metastatic prostate cancer [30 with ADT, 30 without ADT sampled with nonprobability convenience method] were compared with age matched control group of 60 subjects. Inclusion criteria. Group-I: 60-80 years aged consecutive patients of carcinoma prostate who have been taking anti androgen therapy at least six months. Group-II: 60-80 years consecutive patients with metastatic prostate cancer who have not started any antidrogen deprivation therapy. Group-III: 60-80 years aged healthy men from general population [preferably from patient's family] without prostate cancer. Exclusion criteria: From all groups, men taking for any reason, chemotherapy, radiation thyroxin, warfarin, corticosteroids, methrotrexate, anticonvulsants, post organ transplant therapy, chronic heparin, antipsychotic medications, long term lithium therapy and calciuretic diuretics were not included in the study

Results: Out of 120 subjects, 31% had normal BMD, 27% osteopenia, 42% osteoporosis. In metastatic prostate cancer patients taking ADT [n=30], 7% subjects had normal BMD, 37% osteopenia and 56% osteoporosis. In metastatic prostate cancer patients without ADT [n=30], 13% subjects had normal BMD, 63% osteopenia, 24% osteoporosis. In healthy controls [n=60], 52% subjects had normal BMD, 33% osteopenia, 15% osteoporosis

Conclusions: BMD is affected by prostate cancer and its treatment. Bisphosphonates use should be rationalized according to the patients need

Biodisposition of isoniazid after oral administration in teddy goats

Objective: to investigate the bio disposition of isoniazid in Teddy goats

Design: Experimental study

Material and methods: bio disposition of isoniazid [INH] was investigated in eight Teddy goats after single oral administration at the rate of 10 mg/Kg body weight. Blood samples were collected from each animal at pre-determined time intervals after drug administration. Plasma was isolated after centrifugation and analyzed for INH using spectrophotometer

Results: concentration versus time profile of each animal was used to determine the bio disposition of INH. Data was best described by two compartment open pharmacokinetic [PK] model and various PK parameters were calculated which were significantly different from the values in the literature

Conclusions: based on the results of this study it was concluded that disposition studies of imported antimicrobial drugs should always be conducted under indigenous conditions to rationalize their dosage regimen for local animal species

Identification of bacteria from human oral microflora having azoreductase activity

Objective: to find out if the bacteria present in human oral cavity have the ability to produce azoreductase enzyme and to identify the types of bacteria from the human oral flora that can decolourise the azo dye amaranth

Design: experimental study

Materials and methods: human oral microbial flora were screened for their abilities to reduce azo compound by growing them on brain heart infusion agar plates containing 100 µµMolar of the azo dye amaranth. Bacteria that reduced amaranth were detected by the appearance of clear zones around the colonies. Bacteria were identified using standard microbiological techniques. Organisms belonging to Micrococcaceae family were further identified by API Staph kit from BioMérieux SA

Results: there was more decolourisation of the amaranth dye in the plates that were incubated anaerobically as compared to plates grown in aerobic conditions. Azoreduction of the amaranth dye proceeded at a slower rate when performed under aerobic condition as compared to when performed under anaerobic environment. Bacteria having azoreductase activity were identified as Neisseria flavescens, Lactobacillus, Staphylococcus hominis and Staphylococcus lentis

Conclusion: this study suggests that azo dyes present in food and drink can be reduced by some common oral microflora and the environment in the oral cavity is also favourable for the reduction of these compounds

Pharmacokinetics and dosage regimen of ciprofloxacin following single intramuscular administration in Teddy goats

The objective of this study was to determine the pharmacokinetics and dosage regimen of ciprofloxacin in Teddy goats. Ciprofloxacin was administered intramuscularly at 5 mg/kg body weight in each of eight animals. Following drug administration, blood samples were collected at different time intervals and analyzed for ciprofloxacin using HPLC. Pharmacokinetic parameters were calculated using two compartment open model. Peak plasma concentration [C[max] of ciprofloxacin, 1.77 +/- 0.20 microg/ml was achieved at 0.90 +/- 0.04 hours [T[max]. Values for half-life of absorption [t [1/2] abs], distribution [t [1/2] alpha] and elimination [t [1/2] beta] were 0.52 +/- 0.04, 0.52 +/- 0.04 and 2.62 +/- 0.39 hours, respectively. The value for apparent volume of distribution [Vd] was 3.76 +/- 0.92 1/kg, area-under-the-curve [AUC] 5.89 +/- 0.91 microg.hr/ml and total body clearance [CL] was 1.09 +/- 0.11 1/hr/kg. Based on these results, it was concluded that calculated dose should be higher than the dose recommended by the manufacturer to treat susceptible bacteria in goats

Comparison of maxillary anterior teeth width in natural and artificial dentition

This study characterizes the distribution of the mesiodistal widths of 6 maxillary anterior natural teeth [NMAT] for comparison with the widths of the most commonly used artificial denture teeth moulds [AMAT]. The width of the six maxillary anterior teeth was measured on a curve defined by the facial surfaces of the teeth. 280 casts of dentate subjects [140 men and 140 women] were measured. The width of the maxillary anterior natural teeth was compared to that of 5 different brands of commonly used artificial denture teeth moulds. The mean +/- standard deviation [SD] width of the six anterior teeth for men and women [54.09 +/- 2.5 mm and 52.08 +/- 2.8 mm, respectively] differed significantly [P < .001], 35% of the women and 51% of men had anterior teeth that measured 53 mm or wider. In contrast, the mean width of the most widely used artificial maxillary denture teeth [Welbite] is 45 mm while 45.3 for all 98 AMAT moulds. Of the 98 AMAT moulds available, only 4 have a width between 51- 53.4 mm, two of them from Yamahachi and one each from Shofu and Ivoclar. These findings suggest an acute shortage of AMAT moulds in sizes above 50mm. The lack of physiologically sized tooth molds could be one reason for the inappropriate selection of comparatively small maxillary denture teeth