Awareness, knowledge and practice of evidence-based dentistry amongest dentists in Karachi

The purpose of this study was to determine the understanding, awareness and practice of Evidence Based Dentistry [EBD] amongst dentists working at dental colleges in Karachi. Total participants in this study were 200 who were randomly selected from different dental colleges in Karachi. Participants completed a pre-tested self administered questionnaire. 87% of the participants were graduates and were either trainees or had completed post-graduation. Data analysis was done by SPSS version 16. One-way ANOVA was applied. P- value < 0.05 were considered statistically significant. Only 23% of the participants reported that they always practiced Evidence based dentistry. Lack of training on EBD was considered as a barrier to Evidence Based Dentistry and the second most common cause reported was lack of access to resources. Majority of the participants 69% were not taught or trained earlier to practice Evidence Based Dentistry. Interestingly 87% of the participants showed their willingness to be trained for Evidence-Based Dentistry. With respect to barriers in EBD Education level [0.018] and field of specialty of dentist [0.014] were found to be statistically significant. Therefore more emphasis should be given in training students as well as faculty members in Evidence Based Dentistry. It should also be ensured that all possible resources for accessing current dental research should be provided in Dental colleges

Hypocalcaemia secondary to iatrogenic hypoparathyroidism as a rare cause of dilated cardiomyopathy

Postoperative hypocalcaemia caused by hypoparathyroidism is one of the most common morbidities of total thyroidectomy. Hypoparathyroidism is associated with chronic hypocalcaemia which can have a variety of manifestations including cardiovascular changes. Hypocalcaemia is a very rare reversible cause of dilated cardiomyopathy [DCM] which can concern one or both ventricles. In this article, we present a case of iatrogenic hypoparathyroidism leading to hypocalcaemia, associated with systolic dysfunction of left ventricle presenting as congestive cardiac failure due to dilated cardiomyopathy in addition to other manifestations of hypocalcaemia. After treatment of heart failure and calcium-vitamin D supplementation, signs and symptoms of heart failure improved rapidly

Frequency of torus palatinus; a study done in a teaching hospital in Karachi

The objective of the study was to determine the frequency, size and shape of torus palatinus [TP] in a teaching hospital in Karachi. The study further investigated the relationship with age, sex and ethnicity in the study sample. A total of nine hundred and nine [909] subjects were included in the study. The presence or absence of TP was examined by clinical examination and study casts were made for its evaluation. SPSS version 15.0 was used for data analysis. Out of 909 subjects studied, 34[3.7%] had torus palatinus [TP]. The TP was present in 12 [35.3%] males and 22 [64.7%] females. TP was found to be more prevalent in fifth decade of life [23.5%] and was least recorded in the first decade of life [8.8%]. Most of the patients that is 16 [2.4%] showing TP belonged to Urdu speaking community. Out of 34 cases of TP, medium size and spindle shaped tori were more prevalent with a frequency of 15 [44.2%] and 18 [52.9%] respectively

Catastrophic antiphospholipid syndrome - case report

A 26 year old lady, her first pregnancy complicated by abruption placenta at term without obvious cause, outcome was fresh stillbirth. In her second pregnancy, she developed severe headache at seven weeks gestation, confusion, apathy, dementia, fits and left lower limb swelling within a period less than 10 days. Magnetic resonance imaging [MRI] revealed bilateral sinus thrombosis. Low molecular weight heparin [Innohep] was started immediately and gradually increased adjusted by [PTT]. The patient gradually improved and discharged on Innohep. In spite of, injectable anticoagulant therapy, she developed intrauterine fetal death at seven month. She delivered spontaneously. The first result of screening for antiphospholipid antibodies was positive with low protein S. She was diagnosed as probable catastorophic antiphospholipid syndrome [APS]. She was discharged on oral anticoagulant [warfarin] with adjusted dose according to PT and INR. After a year of warfarin therapy, with laboratory follow-up, the second result of screening antiphopholipid antibodies remained positive with lower protein S., compared with the first result and; drop in protein C, which increases the incidence of thrombosis and makes further pregnancy unadvisable

Prevention of infective endocarditis: insight on AHA 2007 guidelines for the prevention of infective endocarditis

Infective endocarditis [IE] is an uncommon but life threatening infection. Despite advances in diagnosis, antimicrobial therapy, surgical techniques,and management of complications, patients with IE still have high morbidity and mortality rates related to this condition. Since the last American Heart Association [AHA] guidelines on prevention of IE in 1997 [2] many published studies have questioned the efficacy of antimicrobial prophylaxis to prevent IE in patients who undergo a dental, gastrointestinal [Gl], or genitourinary [GU] tract procedure and have suggested a revision of these guidelines [3]. The purpose of this article is to provide an insight on the AHA 2007 Guidelines for the prophylaxis of infective endocarditis

Intra-uterine fetal echo cardiography in high-risk pregnancies

The purpose of this study was to evaluate the accuracy of prenatal fetal echocardiography in detecting congenital heart defects pregnant women at high and low risk for structural cardiac anomalies. A prospective outcome of two cohorts study was performed, 50 pregnant women with non complicated [low risk] and 100 high risk pregnant patients underwent routine four chamber and left ventricular outflow tract evaluation whereas high risk, patients had detailed fetal echocardiographic examination. Accuracy of the ultrasonographic diagnosis was evaluated from neonatal discharge data. The study detects one fetus, had small sized apical muscular ventricular septal defect [VSD]. Fetuses of high risk group have smaller and diastolic, end systolic left ventricular cavity dimensions, interventricular septal thickness, left ventricular wall thickness, aortic root diameter and left atrial diameter than the matched control. It can be concluded that high risk cause studied showed changes in fetal heart chamber dimensions but not to the extent of known congenital fetal cardiac malformation

In vitro antimcrobial activity of Mangifera indica

The chloroform, methanol and aqueous extracts of Mangifera indica seeds were subjected to preliminary antimicrobial activity against two Gram- positive bacteria [Bacillus subtilis, Staphylococcus aureus] three Gram-negative bacteria Escherichia coli, Proteus vulgaris, Pseudomonas aeruginosa and two fungi, Aspergillus niger and Candida albicans.The seeds chloroform and methanol extracts showed high activity against all organisms tested. The aqueous extract showed high activity against both Gram-positive organisms and one Gram-negative bacteria namely Proteus vulgaris, low activity against Escherichia coli, and was inactive against Pseudomonas aeruginosa. Therefore the active chloroform and methanol extracts were further tested against sixty clinical Staphyllococcus aureus [n=15], Escherichia coli [n=15], Proteus vulgaris [n=15] and Pseudomonas aeruginosa [n=15] and the aqueous extract was tested against thirty clinical isolates of Staphyllococcus aureus [n=15] and Proteus vulgaris [n=15] collected randomly from specimens from Sudanese patients. The clinical isolates exhibited low susceptibility compared to the standard organisms. The standard organisms were tested against reference antibiotics [Ampicillin and Gentamicin]. It was found that the chloroform extract of Mangifera indica seeds at 200 mg/ml was more effective than 20 micro g/ml Ampicillin and l5 ug/ml Gentamicin against the majority of the organisms tested. The methanol extract at 200mg/ml was more effective than 40 micro g/ml Gentamicin against the organisms tested. The aqueous extract was more effective than 40 micro g/ml Ampicillin against the majority of the organisms tested. All extracts were inactive against Aspergillus niger. Both chloroform and methanol extracts were active against Candida albicans while the aqueous extract was inactive. Therefore C.albicans is more susceptible than A. niger. The chloroform extract inhibited C.albicans with inhibitory action between 25-50 micro g/ml Nystatin and the methanol extract inhibited C.albicans with inhibitory action almost similar to 10 micro g/ml Clotrimazole. Therefore the high activity of the plant might justify its uses in traditional medicine

Hepatitis C virus [HCV] in pregnancy: prevalence and risk factors for infection

Maternal and child health issues relating to hepatitis C virus [HCV] infection have recently assumed greater importance than ever before. The aim of this work was to find out the magnitude of the problem of HCV seroprevalence among pregnant women and the relations between HCV infection and the risk factors [age, gravidity, blood transfusion, surgical operations, hospital admission, multiple injections and past history suggestive of hepatitis]. This study was carried out on 1832 pregnant women. Serum samples were subjected to HCV antibodies and positive samples were subjected to liver function tests and HCV RT- PCR. The results were discussed in details