Comparison of the learning of two notations: a pilot study

Introduction: MICAP is a new notation in which the teeth are indicated by letters [I-incisor, C-canine, P-premolar, M-molar] and numbers [1,2,3] which are written superscript and subscript on the relevant letters. FDI tooth notation is a two digit system where one digit shows quadrant and the second one shows the tooth of the quadrant. This study aimed to compare the short term retention of knowledge of two notation systems [FDI two digit system and MICAP notation] by lecture method

Methods: Undergraduate students [N=80] of three schools participated in a cross-over study. Two theory-driven classroom based lectures on MICAP notation and FDI notation were delivered separately. Data were collected using eight randomly selected permanent teeth to be written in MICAP format and FDI format at pretest [before the lecture], post-test I [immediately after lecture] and post-test II [one week after the lecture]. Analysis was done by SPSS version 20.0 using repeated measures ANCOVA and independent t-test

Results: The results of pre-test and post-test I were similar for FDI education. Similar results were found between post-test I and post-test II for MICAP and FDI notations

Conclusion: The study findings indicated that the two notations [FDI and MICAP] were equally mind cognitive. However, the sample size used in this study may not reflect the global scenario. Therefore, we suggest more studies to be performed for prospective adaptation of MICAP in dental curriculum

Efficacy of tranexemic acid in preventing alveolar osteitis after third molar extraction

Objective: to determine the efficacy of tranexemic acid in preventing alveolar osteitis after third molar extraction

Study Design: randomized control trial

Place and Duration of Study: June 2013 to June 2014. Oral and Maxillofacial Surgery department, Dental section, Punjab Medical College, Faisalabad

Materials and Methods: thirty patients, between the ages 18-35 years without any gender discrimination, presenting for removal of bilateral mandibular impacted third molars were included in the study. One side was the study group [Group A] and the other side acted as control [Group B]. Group A was given Inj Transamine 500mg IV 10 minutes before surgical removal however no pre-operative medication was given to group B. The rest of the procedure was carried out in a standard fashion in both the groups. The frequency of dry socket was assessed in both the groups and compared using Chi Square test

Results: the age ranged from 18-35 years with a mean age of 23.3+/-3.5 years. Out of these 30 patients 18 were males and 12 females with an overall M:F ratio of 1.5:1. Eight patients out of the 18 males were smokers and 3 females out of 12 were using oral contraceptives. Two patient [6.7%] developed dry socket in Group A, and 4 [13.3%] developed dry socket in Group B. Although the control group showed a greater frequency of dry socket but overall the results were statistically insignificant [P-value>0.05]

Conclusion: although IV tranexemic acid cannot prevent dry socket completely however it can decrease the incidence of dry socket formation and its use may be considered in patients who show an increased predisposition towards formation of dry socket

Diagnostic laparoscopic findings in chronic pelvic pain

To assess the cause of pain on diagnostic laparoscopy in women with chronic pelvic pain and equivocal clinical and ultrasound examination. Cross-sectional observational study. Red Crescent General Hospital, Hyderabad, Sindh, from January 2007 to December 2009. All the women presenting with chronic pelvic pain for more than 6 months duration, without any obvious pathological findings on clinical as well as on ultrasound examination were recruited. Women with chronic pelvic pain and having pelvic pathological lesions detected on clinical and/or ultrasound examination were excluded. Clinical, ultrasound, and laparoscopic data was collected and analyzed on SPSS version 14. The results were described as frequency, proportion, compared by chi-square test with significance at p < 0.05. Highest frequency of chronic pelvic pain was observed in women aged between 26 - 35 years [62.4%], 53 out of 85 women. Most of these women were married [90.6%] and nulliparous [47.1%]. Pain was reported as dull and sharp by 35 women [41.2%], infertility [n = 46, 54.1%] and dyspareunia [n = 45, 52.9%] were the commonest co-existent complaints. On laparoscopic examination, pathological lesions were detected in 65, tuberculosis in 17 [20%] endometriosis in 11 women [12.9%], pelvic inflammatory diseases and pelvic adhesion in 8 [9.4%] women each and ovarian cyst in 6 women [7.1%]. Positive laparoscopic yield was high in women with pelvic pain. Pelvic tuberculosis was the most common pathology detected followed by endometriosis, pelvic inflammatory disease and adhesions

Biliary bypass surgery - Analysis of indications and outcome of different procedures

This study reports the indications and outcome of various biliary bypass surgical procedures from a single centre over a period of 10 years. This is a prospective observational study conducted over a period of 10 years [January 2001-december 2010]. A total of 1500 patients were included, who underwent pancreatico-biliary surgery due to common bile duct [CBD] stones, congenital anomalies of biliary tree, unoperable pancreatico-biliary malignancies, CBD strictures and cases who developed iatrogenic biliary injuries during cholecystectomy [both open and laproscopic] during this period of time. The patients who required biliary bypass surgery were further analysed for indications and outcome. Out of 1500 patients 83 [5.53%] required biliary bypass surgical procedures. The CBD stones were observed as the most common indication [25.3%], followed by CBD injuries after open [10.84%] or laproscopic-cholecystectomy [14.46%], carcinoma head of pancreas [12.05%] and CBD obstruction [14.46%] either due to CBD strictures or unknown distal obstruction. Roux-en-Y-hepatico-jejunostomy [26.51%] was the most frequently performed procedure, followed by choledochoduodenostomy and Roux-en-Y choledocho-jejunostomy [i.e. 25.3% and 12.05% respectively]. Roux-en-Y biliary bypass procedure was observed to be associated with better outcome in terms of rate of complications as well duration of hospital stay. Biliary bypass surgical procedures are the better options to restore the continuity of biliary system in patients with iatrogenic biliary tree injuries and un-operable pancreatico-biliary malignancy. Roux-en-Y biliary bypass procedure is safe and problem solving method in these cases

Comparative study of conventional open versus laparoscopic cholecystectomy for symptomatic cholelithiasis

To compare the results of conventional open with laparoscopic cholecystectomy regarding their operative time and postoperative parameters. This is a comparative study of 400 patients of cholelithiasis operated for either open or Laparoscopic cholecystectomy during five years from January 2004 to December 2008. The cases were compared for operative time and various postoperative parameters in order to assess the advantages and disadvantages of each procedure. The patients were divided into two groups; group OC for open and group LC for laparoscopic cholecystectomy, each comprising of 200 cases. The operative time was longer in OC than LC patients with mean operative time of 54.16 +/- 11.94 minutes in OC and 46.89 +/- 14.83 minutes in LC group [P<0.001]. The overall frequency of postoperative complications was relatively high in OC group 50.5% as compared to LC [37%] including all minor and major problems with combined morbidity of 43.75% [P<0.001]. The mean hospital stay was shorter in LC group as compared to OC group i.e. 3.02 +/- 1.75 [range 1-5] days versus 5.56 +/- 9.8 [range 4-10] days respectively. Return to normal work was also significantly shorter in LC group i.e. 18.06 +/- 5.16days [range 1-4 weeks] as compared to 31.61 +/- 7.6 days [range 3-6 weeks] in OC group with p value <0.001. The laparoscopic cholecystectomy is superior to open cholecystectomy due to short operative time, early mobilization and fast recovery, less postoperative pain and complications, short hospital stay and early return to work

Factors responsible for prolonged postoperative hospital stay after laparoscopic cholecystectomy

To identify various factors which prolong post-operative hospital stay after laparoscopic cholecystectomy. This is an observational prospective study conducted at a teaching hospital over a period of five years [Jan 2005-Dec 2010] and includes 580 patients of symptomatic cholelithiasis, admitted and treated by laparoscopic surgery. All patients were observed from 1st postoperative day to date of discharge and different operative, postoperative and patient related variables were recorded on a proforma which were found responsible for an unduly prolonged post-operative stay in the hospital. The duration decided for short stay was 48 hours and duration more than that was considered as prolonged stay. Out of 580 patients, 187 [32.24%] had prolonged stay extending from 3-28 days. Majority of patients presented in 4[th] and 5[th] decade [60.52%] with pain in right hypochondrium [58.79%] and pain in right hypochondrium combined with pain in epigastrium [27.6%] as main clinical features. Twenty eight variables were identified comprising of 10 patients related [15.86%], 12 surgery related [16.55%] and 6 post-surgery related [16.38%] which contributed to prolong the hospital stay. Patients having co morbid conditions, difficult operative procedure and major postoperative complications were main factors for prolonged stay. The prolonged post-operative hospital stay can be reduced by careful pre-operative assessment, meticulous surgery and proper post-operative management