Burnout among Dental Students of Private and Public Dental Colleges in Pakistan - A Cross-Sectional Study

ABSTRACT Objective: To assess the prevalence of burnout among dental students of public and private institutions in Khyber Pakhtunkhwa and Punjab, Pakistan. Material and Methods: A cross-sectional descriptive survey was conducted at five public and private dental institutions from June 2021 to May 2022. A validated twelve-item closed-ended Burnout Clinical Subtype Questionnaire was distributed among the dental students of two private and two public institutes in Pakistan. The research questions focused on demographic information and students' academic experiences. Data analysis is presented through tables and descriptive methods. Results: A total of 274 dental undergraduate students - second (42.3%), third (35.4%), and final (22.3%) academic year participated in this study. The mean age of the respondents was 21.9, with the range of 20-26 years. Most participants were females (74.1%) compared to the males (25.9%). The findings for burnout syndrome among dentistry students and students in the private and public sectors were not significant. Conclusion: In the current study, burnout levels among dental undergraduates, both private and public, were low.

Pharmacokinetic and drug interaction studies of Pefloxacin with paracetamol [NNAID] in healthy volunteers in Pakistan

In the present study, the pharmacokinetic and drug interaction evaluation of two drugs pefloxacin and paracetamol was carried out by a single-dose, two-treatment and two-sequence crossover design. Total fifteen healthy volunteers participated out of which ten completed the study. All were male volunteers, aged 22.36 years [means], with a mean weight of 76.45 +/- 12.05 Kg. The washout period between treatments was 5 week. Initially the method utilized for quantitative analysis of the drug was developed which was further validated. The study involved plasma protein precipitation with ethyl acetate and detection was done at 275nm. The retention time for pefloxacin 18 +/- 1 min and paracetamol were approximately 6 +/- 1 min, respectively. The calibration curve for pefloxacin was linear in the concentration range of 0.125-12.0 micro g/ml with r[2]=0.9987 in plasma. Standard concentration solution was maintained on the same temperature as that of volunteer's samples to optimize the periods for the determination of drug concentration in the plasma samples. Blood samples were collected from volunteers at different time intervals. The pharmacokinetics and drug interaction studies were anticipated by plotting concentration versus time-profiles. The value of AUC[0-infinity] in control was 67.355 +/- 3.174 micro g.h/ml, in treatment 61.242 +/- 3.868 micro g.h/ml along with relative bioavailability =91.395 +/- 4.864. Under the control and treatment condition the mean maximum plasma concentrations were found to be 4.679 +/- 0.248 micro g/ml and 4.6595 +/- 0.266 micro g/ml respectively. The average T[max] for plasma concentrations was 1.819 +/- 0.1743hr and 1.605 +/- 0.1134hr respectively. The biological half-lives in the two phases of studies were found to be 7.953 +/- 0.33hr in control and 7.7257 +/- 0.355hr in treatment. No significant effect were observed on the bioavailability and pharmacokinetics of pefloxacin by the concomitant administration with paracetamol, however very minor effect were observed that might be related with inter-individual variation in human volunteers. This pharmacokinetic studies also indicated that the level of drug [Cmax] do not differ from previous studies in different races

Distally-based sural island flap for soft tissue coverage of ankle and heel defects

To determine the outcome of heel and ankle reconstruction with distally-based sural island flap. Case series. The study was carried out in Plastic Surgery Department, Chittagong Medical College Hospital, from January 2007 to April 2009. Twenty two subjects with soft tissue defect of heel and ankle requiring coverage were included in the study. The flap was first outlined on the posterior aspect of leg at the junction of upper and middle-third. Having incision made over the designed flap and along the line of the fascial pedicle, the vessels and the nerve were ligated at the proximal margin and severed. The skin island was elevated with the deep fascia. The sub-cutaneous fascial pedicle was then raised, with a width of 2.5 cm to include the sural nerve and vessels. The recipient defect was covered after tunneling the island flap. The donor site was closed directly when the wound was less wide and with a split skin graft when the wound was large. Results were analyzed in terms of graft acceptance and complications determined as percentage frequencies. Of the 22 patients, 15 had uneventful recovery with almost complete take of flaps. Although 5 patients showed marginal necrosis initially, they later on healed by secondary intention without requiring any secondary graft coverage. The rest two had a marked loss of flap in the peripheral part and required secondary graft coverage. Immediate venous congestion was commonly encountered which disappeared within a few days. There were no delayed complaints regarding sensation of the flaps. Distally-based sural island flap can be performed as a one-step procedure without sacrifice of any major artery. It is reliable, safe and should be the choice for reconstruction of ankle and heel defects

Development and validation of a HPLC method for determination of pefloxacin in tablet and human plasma

Developing and validating a simple, efficient, reproducible and economic reversed phase high performance liquid chromatographic [RP-HPLC] method for the quantitative determination of pefloxacin in bulk material, tablets and in human plasma. A shim-pack CLC-ODS column and a mobile phase constituting acetonitrile: 0.025 M phosphoric acid solution [13:87 v/v, pH 2.9 adjusted with KOH] was used. The flow rate was 1 ml/min and the analyses performed using ultraviolet [UV] detector at a wavelength of 275 nm using acetaminophen as an internal standard. The developed method showed good resolution between pefloxacin and acetaminophen. It was selective to pefloxacin and able to resolve the drug peak from internal standard and from formulation excipients. The percentage of coefficient variation [CV] of the retention times and peak areas of pefloxacin from the six consecutive injections were 0.566% and 0.989%, respectively. The results showed that the peak area responses are linear within the concentration range of 0.125 mg/ml-12 mg/ml [R2=0.9987]. The limits of detection [LOD] and limits of quantitation [LOQ] for pefloxacin were 0.03125 mg/ml and 0.125 mg/ml. The intra-day and inter-day variation, RSD were 0.376-0.9056 and 0.739-0.853 respectively; also, inter-day variation with relative standard deviation [RSD] were 0.1465-0.821 in plasma. The accuracy results of 70%, 100%, and 130% drugs were 100.72%, 100.34%, and 100.09%, respectively. The method is linear, quantitative, reproducible and could be used as a more convenient, efficient and economical method for the trace analysis of drug in biological fluids, in raw material and tablets

TB-DOTS program; appraisal of role of lady health workers as treatment supporters

To assess the performance of Lady Health Workers [LHWs] in collection, storage and distribution of drugs and evaluate their effectiveness regarding TB suspect identification, referral, directly observing the intake of medicine, default identification and health education in TB-DOTS program. A cross-sectional study. In district Toba Tek Singh from January to Sep 2006. One hundred and two LHWs were selected randomly and interviewed using a structured pre-tested questionnaire. Among 102 LHWs, 76.5% were trained in TB-DOTS. Sixty four [62.7%] had qualification matric and above. Collection of the drugs was being performed properly by 87.3%, while 83.4% were storing the anti-TB drugs at proper places. Anti-TB drugs were being distributed to patients daily by 95.1%. Under the direct supervision of LHWs 69.6% of TB patients had completed treatment. In the areas of 58.8% LHWs, TB patients were declared cured after 8 months treatment. Defaulted TB cases were present, in the areas of 19.6% LHWs, while 12.8% of the LHWs had relapsed TB cases in their areas. Most of the LHWs [85.3%] had proper record of medicine and of the patients [84.3%]. The experienced and TB-DOTS trained LHWs of urban areas, in the age group of 41 -50 years had overall good performance. The LHWs having qualification matric and above had better performance than the LHWs having middle qualification. TB-DOTS program in district Toba Tek Singh was working successfully and it should be continued with some improvements and innovations

Prevalence of undetected refractive errors among school children

In Pakistan 11.4% of the blindness is due to uncorrected refractive errors. This study was carried out in two schools of Lahore to find the prevalence of refractive errors among high school children. It was an institution - based, cross sectional study involving the use of structured questionnaire and visual examination of the students. A total of 540 children studying in class 6th to 10th were examined over a period of two weeks. Vision of all the children was checked. The children with visual acuity less than 6/12 in one or both eyes, underwent objective retinoscopy and subjective refraction. The results revealed that 107 out of 540 [19.8%] of the children had refractive errors. Myopia was the most common refractive error being 43% [46/107] of the total. Astigmatism, both simple as well as mixed / compound was 35.5% [38/107 while hypermetropia was least common i.e. 21.5% [23/107]. Strong correlation was found between a positive family history of wearing glasses, watching television closely, close study, studying in dim light and over indulgence in computer or video games. It is recommended that adequate preschool examination of the children be made mandatory and part of the admission policy of all the schools in Pakistan. In addition, there should be periodic examination of the school children at least on annual basis

Studies on the effects of cyclodextrin polymer as a tableting aid on some selected analgesics

The clinical effectiveness of tablets depends on at least two factors; [i] the medication must be present in labeled amount [ii] it must be availble to the body. The drug availability is usually determined by the rate of release of drug from the tablet, which is governed by the processes of disintegration and dissolution. In present study, the effect of beta-Cyclodextrin on disintegration and rate of dissolution of analgesic tablets [paracetamol] have been studied. The results show that the tablets containing beta-Cyclodextrin polymer as a disintegrant enhances the rate of dissolution and reduces the disintegration time as compared to the commercially available tablets which lack beta-Cyclodextrin

Role of progesterone estimation in infertility

This study was conducted on 50 subjects [30 infertile and 20 fertile] taken from Sir Ganga Ram and Lady Aitchison Hospitals, Lahore and hormonal assays carried out at PGMI, Lahore. The infertile subjects were between 18-35 years of age and were married for more than 2 years. The results showed that 18 out of 30 infertile patients [64%] had luteal phase deficiency [LPD] and 12 out of 30 [56%] had normal progesterone levels. It was thus concluded that estimation of serum progesterone levels in infertile subjects is simple, easy but important investigation. It determines the presence of L.P.D or otherwise. This assay is closely correlated to endometrial biopsy results and therefore can be used as an alternate non-invasive procedure in the work up of infertility

Use of avicel and spray dried lactose in the development of levofloxacin 250mg tablets by direct compression method

In present study a formulation of Levofloxacin tablet 250mg was prepared by direct compression method, using two directly compressible excepients, i.e Avicel PH101 [62.5mg] and spray dried lactose [62.5mg] with magnesium stearate [5mg] as lubricant glidant on Erweka single punch machine. These tablets are round in shape having mean weight of 373.55 +/- 8.463mg with mean diameter and thickness of 12.3 +/- 0.03mm and 2.4 +/- 0.11mm. The hardness of the tablets was 12 +/- 0.39kg. Friability of tablets were 0.67% using Roche friabilator and disintegration time was 10 min in Erweka basket rack assembly. Dissolution test was performed on USP apparatus-I and%Q was found to be 94.59. Assay results was 100.54% when performed by HPLC technique using CIS column. This formulation gives excellent results using minimal excepient and simple manufacturing procedure. This type of work gives direction to try to make formulation simple and cost effective. As direct compression method is not cheap in terms of raw materials but also produces batch in short period of time. Moreover considering biopharmaceutical aspects, tablet manufactured by direct compression dissolved rapidly in gastrointestinal tract due to prime particle dissociation as compared to that of wet granulation method