Physical therapy students’ perceptions of the educational environment at physical therapy institutes in Pakistan / 보건의료교육평가

This study assessed doctor of physical therapy (DPT) students’ perceptions of the educational environment at public and private physical therapy institutes in Pakistan. This cross-sectional study was conducted at 6 physical therapy institutions in Punjab, Pakistan from April 2018 to December 2019. In total, 500 Dundee Ready Educational Environment Measure (DREEM) questionnaires were distributed among DPT students identified through convenience sampling (response rate, 86.4%). The correlations between each item of the DREEM score were analyzed. The mean overall DREEM score was 128±19.63 for all 5 subscales (range, 33 to 166; standard error of the mean, 0.954). The correlations of atmosphere, learning, and self-perception with the overall educational environment were r=0.896, r=0.853, and r=0.846, respectively. Student-centered approaches were found to be more effective than teacher-centered approaches for promoting a positive educational environment.

Role of weight-bearing exercises in the treatment of post-menopausal osteoporosis

Objective: To determine the change in T-score of post-menopausal osteoporosis patients with weight-bearing exercises

Study Design: A quasi-experimental study

Place and Duration of Study: Physiotherapy Department and Orthopedic Unit I, Mayo Hospital, Lahore, from May to October 2014

Methodology: Two hundred and seventy-four patients were randomly divided into two groups according to inclusion and exclusion criteria using non-probability purposive sampling technique. The group 1 was treated by medication and weightbearing exercises and group 2 was given medication alone. The dual energy X-ray absorptiometry [DEXA] scan was used to find the T-score before and after treatment and improvement was compared. A p-value less than 0.05 was taken as significant

Results: The results showed that improvement was occurred in both groups after treatment. The DEXA scan median values after treatment were changed to 3.00 [0] for group 1 [exercises and medication] and 2.00 [1] for group 2 [medication]

Conclusion: The physical activity along with medication play vital role in the treatment of post-menopausal osteoporosis than medication alone

Insidious sensorineural hearing loss in chronic suppurative otitis media

Background: Sensorineural hearing loss may be one of the outcome of chronic suppurative otitis media

Objective: To evaluate the association of chronic suppurative otitis media with sensorineural hearing loss and also to find out whether the disease duration had any impact on hearing

Methodology: This was a cross sectional study conducted at Aga Khan University Hospital. Charts of all patients who underwent surgery for chronic suppurative otitis media from 1stJanuary 2004 to 31stDecember 2009 were reviewed. One hundred and fifty five patients out of 562 met our inclusion criteria and were included in the study. The contralateral ear was taken as control. History record and audiograms were reviewed from the patient charts for the duration of disease and evidence of SNHL at three speech frequencies [[500, 1000, and 2000 Hz]. The data was entered and analyzed by SPSS version 16

Results: Of 155 patients, 46 [29.6%] had SNHL. In a group of patients with epithelial disease[cholesteatoma] 16 out of 45 patients had SNHL whereas in the group of patients with mucosal disease [formerly known as tubotympanic type] 30 out of 110 patients had SNHL. This hearing loss found to be worsening with the duration of disease in both groups [p=0.000]

Conclusion: A significant association of SNHL was found with CSOM and disease duration. Early surgicaltreatment should be offered in order to prevent irreversible SNHL

Frequency of serum cortisol suppression in patients using 0.05% clobetasol propionate as topical steroid for more than 3 weeks

Objective: To determine the frequency of serum cortisol suppression in patients using 0.05% clobetasol propionate as topical steroid for more than 3 weeks

Study Design: Cross sectional Study

Place and Duration of Study: Both outdoor and indoor patients of Dermatology Department, Military Hospital [MH] Rawalpindi for duration of 6 months i.e. from 18[th] April 2012 to 17[th] October 2012 were selected

Patients and Methods: A total of 189 patients were included in the study. Non-probability purposive sampling technique was used. Early morning [0800 hrs] serum for cortisol levels was taken before starting the treatment and same was repeated after 3 weeks at AFIP. Effect modifiers like age and gender were controlled through stratification. The data was analyzed using SPSS version 10. The quantitative variables like age, duration of illness were calculated by taking standard deviation and mean whereas the qualitative variables like gender, suppression of serum cortisol levels were calculated by taking percentages and frequency. Frequency of serum cortisol suppression was presented according to gender and age groups

Results: Majority of the patients selected were between 31-40 years i.e. 44.98% [n=85]. Gender distribution was 61.90% [n=117] males and 38.10% [n=72] females. Frequency of serum cortisol suppression in patients using 0.05% Clobetasol propionate as topical steroid for more than 3 weeks was seen in 33.33% [n=63]

Conclusion: The frequency of serum cortisol suppression was significantly higher amongst patients using clobetasol propionate 0.05%. Therefore patients prescribed clobetasol propionate 0.05% topically should be checked for serum cortisol suppression regularly if the application is intended to be used for more than 3 weeks

Dental anxiety level of patients presenting to operative dentistry department

Dental anxiety is a fear of visiting a dental health care provider for preventive or therapeutic care that leads to deterioration in oral health. The aim of this study was to measure the dental anxiety levels of patients presenting to the Operative dentistry department of Dental Section Dow International Medical College. It was a cross sectional study conducted between December 2014 and February 2015. Norman Corah's dental anxiety scale was used to measure the anxiety levels of patients.1 A questionnaire was developed based on this scale and a valid record of 383 forms was obtained. Amongst 383 patients, 125 were male patients [32%] while 258[67%] were female. Descriptive analysis was performed. Frequencies and cross tab calculations were carried out using SPSS version 20. Among other stressors, dental handpiece stood out as the most frightening. 12% of the respondents replied that they would get extremely anxious, making them feel physically sick while anticipating the use of a dental drill. Result showed that most of the patients [49%] had moderate dental anxiety that could be managed by simple non pharmacological means and counselling. While only 5% and 8% of the patients had high and severe [phobia] dental anxiety respectively. The mean dental anxiety level was 9.35 with Standard Deviation of +/- 3.06. More females had severe dental anxiety as compared to males [9% as compared to 5%]

Comparison of post instrumentation pain in teeth during root canal treatment with or with out occlusal reduction

The objective of the study was to compare the post instrumentation pain in teeth undergoing root canal treatment with or without occlusal tooth reduction. This randomized control trial was conducted at Outpatient Department of Operative Dentistry at Altamash Institute of Dental Medicine from September 2011 to March 2014. A total of 402 patients with irreversible pulpitis and normal periapical radiographic appearance of posterior teeth were included in this study. Patients were randomly allocated into two groups i.e occlusal tooth reduction [OTR] group and no occlusal tooth reduction [NOTR] group. After root canal instrumentation, patients were instructed to complete a Visual Analogue Scale [VAS] to score their pain at 6 hours, 12 hours, 18 hours, 24 hours, 2 days, 3 days, 4 days, 5 days, and 6 days. The final outcome that is mean post instrumentation pain score was measured at 6 days of post instrumentation. This randomized control trial was conducted at Outpatient Department of Operative Dentistry at Altamash Institute of Dental Medicine from September 2011 to March 2014. A total of 402 patients with irreversible pulpitis and normal periapical radiographic appearance of posterior teeth were included in this study. Patients were randomly allocated into two groups i.e occlusal tooth reduction [OTR] group and no occlusal tooth reduction [NOTR] group. After root canal instrumentation, patients were instructed to complete a Visual Analogue Scale [VAS] to score their pain at 6 hours, 12 hours, 18 hours, 24 hours, 2 days, 3 days, 4 days, 5 days, and 6 days. The final outcome that is mean post instrumentation pain score was measured at 6 days of post instrumentation. Mean post instrumentation pain score at 6 days was significantly low in OTR group than NOTR groups [2.44 +/- 0.86 vs. 3.24 +/- 0.89; p=0.0005]. Thus, it is concluded that occlusal reduction help in the prevention of post instrumentation pain in teeth with irreversible pulpitis, sensitivity to purcussion, pre- treatment pain and absence of periradicular radiolucency. Whereas the presence of all four conditions are the strong predictors, the presence of any one or more of the conditions is enough to indicate a need for occlusal reduction

Bonding of acrylic resin teeth with denture base resin

The debonding of acrylic resin teeth with the denture base resin has been related to several different factors of which contamination of the bonding surfaces with wax has been suggested as the major cause. The purpose of this study was to determine the efficient method of wax removal from denture teeth using hot water at different temperatures ranges. Acrylic rods were used as tooth analogues and Raman spectroscopy was used to detect the presence of wax on the surfaces of the specimens. It was found that none of the techniques studied was able to remove all of the wax. Abraded ridge-lap surface showed least wax contamination when dewaxed at 100 degree C as compared to dewaxed at 85 degreeC and 65 degree C respectively. The spectrum for each specimen demonstrated peaks at different wavelengths and varying intensities, the spectra demonstrated traces of wax on abraded surfaces showed least wax when dewaxed at 100 degreeC as compared abraded surfaces dewaxed at 65 degree C and 85 degree C temperatures respectively

Comparison of accuracy of working length measured by apex locator and periapical radiograph

The aim of this study was to compare the accuracy of working length measured by electronic apex locator andperiapical radiograph. This cross sectional analytical study was conducted at Department of Operative Dentistry, Dental section, Dow International Medical College, DUHS from November 2014 till December 2014. Thirteen teeth with twenty three canals were selected in patients having age between 18 to 60 years, who were advised extraction of teeth due to any reason. Access opening was performed and working lengths of all canals were measured using Kfile with apex locator and periapical radiographs. Access opening was filled with restorative GIC with the files present in canals. Teeth were then subjected to extraction. All extracted teeth were evaluated by sectioning the lower half or lower one third of the apices longitudinally. The distance of the file tip from the minor constriction was measured and recorded. Data were analyzed by using SPSS version 16. Intraclass co-efficient test was applied to see the agreement between the lengths measured with radiograph and apex locator than compared to the actual lengths as noted after sectioning. P-value of <0.05 was considered as significant. The results of the study showed that accuracy of apex locator were 65% [n=15] with the file tip at minor constriction, while 22% [n=5] for periapical radiograph. Thus it is concluded that electronic apex locator is more accurate and reliable then periapical radiograph

Effect of smoking on serum xanthine oxidase and malondialdehyde levels in patients with acute myocardial infarction

To evaluate the effect of smoking on blood levels of xanthine oxidase and malondialdehyde in acute myocardial infarction patients. The cross-sectional study was conducted from June to November 2013 and comprised myocardial infarction in-patients at Liaquat University of Medical and Health Sciences Hospital, Jamshoro, and Isra University Hospital, Hyderabad. Serum samples from age and gender matched smoking and non-smoking patients were investigated for the levels of xanthine oxidase and malondialdehyde by kit methods. Of the 88 serum samples investigated, 68[77.3%] belonged to men and 20[22.7%] to women. Among the 44 smokers, 35[79.5%] were men and 9[20.5%] were women. The overall mean age of the group was 49.6 +/- 8.0 years. Among the 44 non-smokers, 33[75%] were men and 11[25%] women. The overall mean age of the group was 50.9 +/- 8.4 Years. Smokers compared to non-smokers had significantly raised mean serum xanthine oxidase [0.31 +/- 0.05 vs 0.28 +/- 0.03mg/dl; p<0.05] and malondialdehyde [32.29 +/- 3.30 vs 30.30 +/- 2.87 micromol/L; p<0.04] levels. Smokers as against the non-smokers were at higher risk of developing acute myocardial infarction owing to increased level of oxidative stress caused by smoking

Antimicrobial salicylaldehyde schiff bases: synthesis, characterization and evaluation

As the pathogens soon develop resistance to the existing antibiotics, the demand for new and more effective anti-microbial agents is a continuous phenomenon. In this paper we are reporting synthesis and spectral data of eight Schiff bases of salicylaldehyde with different amines, and evaluation of their anti-microbial activities against different bacterial strains. The bases were synthesized by reflux method, and their structures were determined based FT-IR,[1]HNMR,[13]C-NMR and Mass spectrometric data. The Schiff bases synthesized included 2-[[[Z]-[2-hydroxyphenyl] methylidene] amino]benzoicacid [SB1], 4-[[[Z]-[2-hydroxyphenyl] methylidene] amino] benzoic acid [SB2],2- [[naphthalene-2-ylimino] methyl] phenol [SB3],2-2'-[benzene-1,4- iylbis [nitrilomethylylidene]] diphenol [SB4], 2-2'- [benzene-1,2-diylbis [nitrile-[E]-methylylidene]]diphenol [SB5], 2-[[2- phenylhydrazineylidene] methyl]phenol [SB6], 2- 2'-[ethene-1,2-diylbis[iminomethanediyl]]diphenol [SB7] and 2-[[Z]-[phenylimino] methyl]phenol [SB8]. The antimicrobial activities of synthesized Schiff bases were determined in terms of zones of inhibition and minimum inhibitory concentrations [MICs]. All the bases showed moderate to good activities against all the tested microorganisms. The MICs of most compounds were 100-200microg/mL against different microorganisms. However, it was 50micro g/mL for SB1 against P. aeruginosa [1], SB3 against P. aurantiaca, P. aeruginosa [1], E. coli [2], S. typhi [2] and C. freundii, SB4against E. coli [2], S. typhi [1] and S. maltophilia, SB5 against K. pneumoniae and S. typhi [2], SB6 against P. aeruginosa [3] and C. freundii, SB7 against E. cloacae and A. lipoferum, andSB8against E. coli [2]. Considerably active bases may prove to be potential candidates for future antibiotic drugs

Diagnostic value of ultrasonography in evaluation of blunt abdominal trauma

To evaluate the diagnostic value of ultrasound in detecting intraabdominal injuries in patients with blunt abdominal trauma. The study was conducted in the department of radiology, Combined Military Hospital Lahore, from 13[th] September 2006 to 29[th] September 2007. A total of 70 patients with blunt abdominal trauma were included. They all underwent Ultrasonography [US] followed by Computed Tomographic [CT] scan of abdomen. Sensitivity, specificity, positive and negative predictive values and accuracy of US in detecting intraabdominal injury were calculated keeping CT findings as gold standard. The cases in which laparotomy was performed; the surgical findings were taken as the standard. US examinations were positive in 34 patients. Of these, US showed free fluid in 18 [52.9%], and abdominal organ injury in 12 [35.3%] and only abdominal organ injury in 4 [11.8%]. True-positive findings were seen in 28 [82.35%] of these on CT and/or laparotomy. There were two false negative cases. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of US in detecting intraabdominal injury were 93.3%, 85.0%, 82.3%, 94.4% and 88.5%, respectively. Ultrasonography has high diagnostic performance in the screening of patients 2 with blunt abdominal trauma