Atorvastatin as an adjuvant with betamethasone valerate reduces disease severity and cardiovascular risks in Psoriasis

Objectives: To evaluate the effect of Atorvastatin as an adjuvant with betamethasone valerate on disease severity and cardiovascular risks in chronic plaque type psoriatic patients

Methods: It is an interventional study conducted in Pharmacology Department of BMSI, JPMC with the collaboration of Dermatology Department of JPMC, Karachi. The duration of study was from June 2013 to June 2016. Seventy five psoriatic patients were prescribed Tablet Atorvastatin 40-20 mg/day [40mg for first three months twice daily followed by 20mg once daily for the next three month] plus topical Betamethasone Valerate 0.1% once daily for 6 months [three week apply than one week interval]. The efficacy and safety profile of drugs was measured by PASI, DLQI, hsCRP, LFTS and Lipid profile

Results: The percentage change of PASI is 86.749+/-0.547, DLQI is 82.697+/-.2.61 and hsCRP is 40.371+/-8.505, which showed highly significant improvement in patient at the end of last follow up. LFTs and CPK for safety profile of therapy showed non-significant results

Conclusion: Atorvastatin used as an adjuvant therapy with currently existing standard therapy [topical betamethasone] in patients having mild to moderate plaque type psoriasis reduces disease severity and cardiovascular risks

Oral health status in public school children

This study was aimed to evaluate the oral health status, oral diseases' prevalence in public school children [which represent a section of the majority of our nation's population] and to transcribe these results for assisting and directing oral health education campaign towards these less privileged public schools of Karachi. A cross-sectional study was conducted amongst 470 students [279 males and 191 females] between 4-19 years of age in a government school in Karachi. A WHO oral health assessment form was filled with heed for each student by a dentist using CPITN probes and other examination instruments in daylight to assess the oral health status and disease conditions of the students. The data were formulated in frequency distribution as pie-charts using SPSS version 15. The oral health status was found unsatisfactory and dental decay was observed in n=287 [61%] participants. Periodontal diseases like calculus, bleeding gums and poor oral hygiene were observed in n=256[54%], n=56[8%] and n= 339[72%] respectively represented the major dental disease finding evaluated from the study group. In view of the results obtained, it can be concluded that the oral health status of children in this school was pitiful with the presence of common dental problems that can be alleviated by directing prompt health promotion policies and campaigns towards such public schools all over Pakistan for spreading education regarding basic oral hygiene method and mechanism

Comparing the quality of life by using two therapeutic approaches [10% sulphur ointment and 5% permethrin cream] in scabies patients

To compare the quality of life by using two therapeutic approaches [10% sulphur ointment and 5%permethrin cream] in patients with scabies. Retrospective / comparative study. This study was conducted in Basic Medical Science Institute and Dermatology Department of Jinnah Postgraduate Medical Centre in Karachi from 1[st] Dec 2010 to 30[th] May 2011. This study sample consisted of 130 [4 dropped out] clinically diagnosed cases of scabies divided into two groups; A and B. Each group was further subdivided into three age groups. Group A was asked to apply 5% permethrin cream on day 0 and to be repeated after 15 days and GroupB treated with 10% sulphur ointment for three consecutive nights and repeated on day15. Data was gathered by a questionnaire. Patients follow up was done on days 3, 15 and 30 and quality of life was determined on day 0 and 30 by using Dermatological Life Quality Index. Quality of life was found to be low in scabies patients and treatment with 10% Sulphur ointment and 5% permethrin not only improved clinical symptoms but also their quality of life significantly. Scabies affects quality of life because of severe itching and lack of sleep and proper topical therapy significantly improves clinical symptoms and quality of life

Practice of written feedback in nursing degree programmes in Karachi: the students' perspective

To identify students' perceptions about the practices of provision and utilization of written feedback in the nursing degree programmes in Karachi. Cross-sectional descriptive study. Nine Nursing Institutions in Karachi, Pakistan were selected for the study, from February to October 2011. The sample consisted of 379 second year nursing students from nine institutions in Karachi. The data was collected through a modified Assessment Experience Questionnaire [AEQ] developed by Gibbs and Simpson. The data obtained through AEQ was analyzed in the SPPS. Students reported wide variations in the practices related to written assignments, and the provision of written feedback. Although 80% of the students, reported receiving written feedback with or without oral feedback, 20% of them, received only verbal feedback on their assignments. For 44 - 46% of the students, the quality, quantity, timing, and utilization of feedback was below the reference scores, which is indicative of negative perceptions. Only 40% reported receiving feedback on regular basis. Assignment guidelines were not always provided in a written form. In most cases, the guidelines were ambiguous as well as the feedback was not always reflective of the guidelines. The findings have implications for teachers, students, and institutions similar to the context of this study. Teachers need to be aware of the role and the impact of written feedback on students' learning and develop competence for giving effective feedback. Finally, institutional commitment and policies are needed to promote the practices of written feedback.

Pattern of third molar impaction: frequency and types among patients attending urban teaching hospital of Karachi

The aims of this study was to determine the frequency and type of third molar impaction between 15 years and above age group of patients attending the outpatient's department of Bahria University Dental Hospital. This is a cross sectional study conducted from January 2012 to November 2013. The subjects were investigated and examined for third molar position, angle and impaction were re-corded. Chi Square test was used to analyze the association of impaction of third molar with respect to gender. A total 169 patients participated in the study; out of which majority were male that is 130 [76.9%] and 39 [23.1%] were females. The overall prevalence of impacted third molar was 169 [26%] with mean age of 29.17 +/- years and [STD] +/- 10.7. Study results showed that majority of the impacted teeth were present in mandible 32 [72.7%] than in the maxilla 12 [27.27%]. Majority of the impacted third molars were present in both maxillary and mandibular arch in the age group of 15-25 years. Furthermore, mesioangular impaction was the most common of all impacted third molars. It is concluded that impacted third molar is predominantly seen in mandibular arch than maxillary. The mesioangular impaction was the most common

Beneficial effect and safety of 5% permethrin cream in scabies patients

To evaluate the efficacy and safety of 5% permethrin in scabies patients. Scabies is a contagious, itchy ectoparasitic infection. It is a common public health problem with an estimated global prevalence of 300 to 400 million cases. They increases day by day.5%permethrin is one of the effective treatment of scabies, it is highly effective, well tolerated, poorly absorbed and rapidly metabolized by skin. Open label clinical trial. This study conducted in Basic Medical Sciences Institute with collaboration of Dermatology Department from . This study sample involved 65 clinically diagnosed scabies patients one was lost from follow up, the duration of study was 90 days. They were treated with 5% permethrin cream, clinical data was collected by using questionnaire. Patients were divided into three age groups and given two applications of permethrin cream on first and 15 day. Follow up was done on Day 3, Day 15, Day 30 and Day 90. It was found that efficacy and safety of permethrin cream in scabies patients was highly significant which clinically improved the symptoms of patients. Scabies patients should advised 5% Permethrin cream with conventional therapy which improves symptoms significantly following proper local

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

Assessment of oral cavity lesions by the patients through self-examination

There is a significant lack in the awareness of oral cancer and its risk factors among the community. The objective of this study was to determine whether those at risk of developing oral cancer are able to correctly detect oral cancers through mouth self-examination [MSE], if given adequate oral health education. 100 Participants received an oral mucosal examination by the dentist to check the presence or absence of potentially malignant oral lesions, then patients performed MSE after education through a self-read leaflet. Following MSE, participants were requested to complete a brief questionnaire. The prevalence of disease was found to be 34%.The sensitivity of MSE was 70%, and the specificity was 93%. MSE had positive predictive value [PPV] of 77% and a negative predictive value [NPV] was 91%. Mouth self-examination can be used as an effective tool to improve the awareness of oral cancer and for the early detection of lesions

Oral hygiene habits among patients attending tertiary care dental unit

The aim of the study was to find out the oral hygiene habits of students, professionals and domestic staff at Bahria University Karachi Campus and to compare the association between the oral hygiene practices, oral health status, gender, age, educational status and occupation of the study group. Oral mucosal examination was carried out in 872 walk in patients. Oral hygiene Habits were determined by asking type of tooth cleaning devices used for cleaning teeth, frequency of tooth brushing and timings of toot brushing. Caries were detected by the criteria given in 'WHO Oral Health Survey 1981'. Out of 872 patients in out patient department of Bahria Dental Hospital, there were 551 males [63%] and 321 females [37%] with average age of 26 years. 833 [95.5%] used tooth brush, 799 [91.6%] participants brushed once daily or occasionally. Mean DMFT [Decayed, Missing, Filled Teeth] of the study group was 1.36. Those who were not cleaning their teeth at all had DMFT 1.87. DMFT increased with increasing age, with p-value of 0.00 which is statistically significant

Evaluation of efficacy of budesonide in prevention of cardiovascular risks in chronic obstructive pulmonary disease patients

Cardiovascular disease is a major cause of mortality and morbidity in COPD patients. Systemic inflammation plays a major role in the pathogenesis of cardiovascular disease in COPD. It has, therefore, been suggested that anti-inflammatory agents may prevent cardiovascular disease. It would be plausible that inhaled steroids, such as Budesonide, reduce the local inflammation and subsequent cardiovascular morbidity, thus a local effect on the lung resulting in diminished spill-over of inflammation systematically to the cardiovascular system is an attractive hypothesis. To assess the impact of Budesonide in reducing the cardiovascular risk in COPD patients. Experimental Randomized Study. This study was conducted in the Department of Pharmacology and Therapeutic, Basic Medical Sciences Institute, JPMC Karachi in collaboration with Department of chest medicine, JPMC, Karachi from Dec. 2010 to March, 2011. Thirty five patients with moderate stable COPD, hsCRP level >3mg/lit, were evaluated in an open label, intention to treat clinical trial. The patients were assigned to give Budesonide [Pulmicort] inhaled 200mcg BD for 12 consecutive weeks. The primary study outcome was to evaluate the reduction in cardiovascular risk by evaluating the improvement in FEV1 and reduction in hsCRP levels, was evaluated at day 30, 60 and day 90. Thirty four [96%] patients were completed the study. At baseline hsCRP levels was 6.68 +/- 0.26 which decrease to 5.82 +/- 0.20 [P<0.010] at day 90. FEV1[L] at baseline was 2.12 +/- 0.05 and at day 90 FEV1 increased up to 2.40 +/- 0.04 [P<0.001]. This shows that, the Budesonide can statistically significant decrease the hsCRP levels and increase the FEV1. In conclusion, Budesonide effectively decrease the cardiovascular risk by decreasing the systemic inflammation which were indicated by decreasing the hsCRP levels and also improve pulmonary functional capacity in COPD patients

To study therapeutic effect and benefit on quality of life in scabies patients

To determine the quality of life by using 5% permethrin cream in scabies patients. Scabies is a contagious, itchy ectoparasitic infection caused by sarcoptes scabiei mite. It is a common public health problem with an estimated global prevalence of 300 to 400 million cases. They increases day by day due to resistance/ recurrence and largely effect the quality of life. 5% permethrin is one of the effective treatment of scabies it is highly effective, well tolerated, poorly absorbed and rapidly metabolized by skin. Open Label Clinical Trail study approved by ethics committee of Jinnah Postgraduate Medical Centre, Karachi. This study was conducted in Basic Medical Sciences Institute with Collaboration of Dermatology Department of JPMC, Karachi from 1st Dec 2010 to 30th Jan. 2011. This study sample involved 65 clinically diagnosed scabies patients who were treated with 5% permethrin cream. Clinical data was collected by using questionnaire. Patients were divided into three age groups and given two applications of permethrin cream on first and 15 day. Follow ups was done on Day 3, Day 15 and Day 30 and there quality of life assessed using dermatological life quality index on day 0 and 30. It was found that quality of life in scabies patients was low and treatment with permethrin cream clinically improved the symptoms of patients and their quality of life significantly. Scabies has a social stigma and the quality of life of patient get effected because of night itching and lack of sleep which improves significantly following proper local therapy