Smear layer removal efficacy of conventional endodontic irrigants v/s phytochemical extracts-an in vitro study

This study was conducted to evaluate the effectiveness of two natural extracts for the irrigation of root canal. A descriptive study was conducted at the Department of Operative Dentistry and Department of Oral Biology, Hamdard University Dental Hospital, Karachi, Pakistan. Irrigation solutions were made in Operative Department.100 single rooted extracted teeth were collected from Oral Surgery Department. These teeth were disinfected and cleaned using ultrasonic tip and stored in distilled water until use. These teeth were decoronated below the cementoenamel junction to obtain standardized root length of 10mm.Root canals were instrumented using rotary files at working length 1mm short of the apex .Specimens were randomly divided into 4 groups and subjected to each irrigants for 5 minutes accord-ing to the irrigation protocol, Group A contained distilled water and was taken as control. Group B contained 17 % EDTA while Group C contained herbal extract of lemon grass and Group D contained herbal extract of Green tea. Specimens were longitudinally sectioned and evaluated under scanning electron microscope for smear layer removal efficacy. Statistical analysis was done by using Krus-kal-Wallis test [?=0.05].Group A, Group C and Group D showed the presence of debris and smear layer and they were statis-tically different from Group B where debris and smear layer were totally removed [p < 0.05]. Group D showed removal of debris at middle third and ground portion of the tooth. EDS microanalysis showed the presence of Na, P, and Ca elements on the surface. Among all groups green tea was more effective in removing the smear layer and debris without causing erosion

Outcome of four years experience in laparoscopic ventral hernia repair

To find out the short term outcomes of laparoscopic ventral hernia repair [LVHR] during the last four years. It was a descriptive and prospective case series of 53 consecutive patients out of 107 at Department of General Surgery, Jinnah Post Graduate Medical Center, Unit II, Karachi, from January 2009 to December 2012. These patients were admitted through out patient department with complain of lump, pain and discomfort. Most of the patients were obese. All patients were clinically examined and baseline investigations done. Fifty three [49.5%] patients underwent laparoscopic repair with mesh placement and remaining 54 by open surgical repair. Among 53 patients, mean age was 46 years range [30 - 55]. While females were 33[62.2%] and males 20[37.7%]. We observed variety of hernias, in which midline and epigastric hernia were predominant. The commonest symptom was lump and dragging sensation. The duration of symptoms ranged between 6 months to one year. About 53 patients [49.5%] had laparoscopic repair with mesh placement. Average hospital stay was two days. Out of 53 patients, 4 [7.5%] had cellulitis at trocar site, seroma in 2[3.7%], 2[3.7%] patient complained of persistent pain postoperatively, port site minor infection was in 2[3.7%] patients, while conversion to open approach was done in 2 [3.7%], postoperative ileus was observed in one [1.8%] patients. This study provides the evidence that, laparoscopic repair with mesh placement in ventral hernia is safe and effective approach compared to open surgical procedure. It has a low complication rate, less hospital stay and low recurrence

Testiculaar volume; indicator for male fertility in albino rats

Objective: To determinate that male fertility influenced by testicular volume in albino rats

Study Design: Experimental

Place and Duration of study: Institute of Basic Medical Sciences, Dow University of Health Sciences, Karachi, 10 months [November 2009 to August 2010]

Methodology: Sixty four adult albino rats were obtained from animal house Jinnah Postgraduate Medical Centre for the study and divided into 2 groups. Group A received injection normal saline 1 cc intraperitoneally [IP] daily for 8 weeks. Group B received lead chloride in a dose of 10 mg/kg body weight IP daily. On the day of completion of treatment the animals were sacrificed testes along with epididymis removed and place in Petri dish. The length, breath and width of testes were measured with help of vernier caliper. The spermatozoa were obtained from cauda epididymis

Results: The mean +/- SEM of volume testes in group A and B after eight week of treatment were 0.77142 +/- 0.04778 cm[3] and 0.11768 +/- 0.01673 cm[3] respectively. The volume of testes of group B was significantly decreased as compare to group B [P = 0.000]. Mean +/- . The mean +/- SEM number of sperm cells million / ml in groups A and B after eight week of treatment was 7.65 +/- 186706.553 and 1.84 +/- 132792.770 respectively. Number of sperms in group B were significantly decreased as compared to group A [P = 0.000]

Conclusion: There was relationship between volume of testes and male fertility

Effects of lactobacillus [acidophilus] on cutaneous wound repair with respect to neutrophil count in comparison with steroid

Objective: To evaluate the effects of lactobacillus [acidophilus] in repairing of wound with respect to neutrophil count in comparison with steroid therapy

Study Design: Experimental study

Place and Duration of Study: This study was conducted in the Department of Anatomy of Al-Tibri Medical College Isra University Karachi Campus from June 2014 to October 2014

Materials and Methods: Randomly selected Wistar albino rats were taken and their weight was between 100 -150 gms. The rats were divided in three groups on the basis of topical application. Group I was treated with topical normal saline, Group II with topical lactobacillus[acidophilus], and Group III topical Steroid were applied once daily].Each group is further divided into four sub groups according to the day of sampling like group Ia[day 03], group Ib[day 07], group Ic[day 14] and group Id [day 21]. Samples were taken on day 3,7,14 and 21 from each group and tissues were processed and stained to observe the neutrophil count that showed rapid healing processes. Data was analyzed on SPSS version 21 by applying ANOVA and post hoc tukey'stest

Results: Results compared the neutrophil count of Lactobacillus group with steroid group and control group.Mean +/- SD of numbers of Neutrophils / x400 in group IIa was20.500 +/- 0.577, in group IIb11.250 +/- 1.258, in group IIc5.7500 +/- .0.5000, group IId3.7500 +/- 0.9574and in groupIawas54.25 +/- 2.872, group Ib41.250 +/- 2.629, group Ic23.500 +/- 3.000 and group Id18.750 +/- 0.957. The significant value was in group IIa and group Ia[P<0.000], group IIb and group Ib[P<0.000], group IIc and group Ic[P<0.000] and group IId and group Id [P<0.000]. Mean +/- SD of numbers of Neutrophils / x400 in groups IIa was 20.500 +/- 0.577, in group IIb 11.250 +/- 1.258, in group IIc 5.7500 +/- .0.5000, group IId 3.7500 +/- 0.9574 and group IIIa was54.500 +/- 1.290, group IIIb 42.000 +/- 1.414,group IIIc32.000 +/- 0.8165 and group IIId28.750 +/- 1.258. The significant value was in group IIa and group IIIa[P<1.000], group IIb and group IIIb[P<0.002], group IIc and group IIIc[P<0.000] and group IId and group IIId[P<0.000]

Conclusion: Lactobacillus showed potent anti-inflammatory effect against both therapeutic groups

Attitude and perception of oral health problems in pregnant women

The objective of this study was to assess attitude towards oral and dental health during pregnancy and to examine their self-care practices in relation to oral and dental health. cross-sectional descriptive and analytical study. This study was conducted at the Jinnah Medical and Dental College, Karachi from January 2013 to September 2013. This was a cross-sectional descriptive and analytical study conducted at the Jinnah Medical and Dental College Karachi [JMDC]. The study group comprised of 118 pregnant women attending the Jinnah Medical and Dental College OPD from January 2013 to September 2013 using convenience sampling method. A 15 item questionnaire was used, after it was pre-tested and validated. The data entry was done by the house officers of JMDC. Statistical analysis was done using SPSS version 16. 65% of the total patients were found to have dental caries on overall intraoral examination out of these 52% patients had pain on percussion. 44% of the patients presented with gingivitis and bleeding on probing while 21% presented with clinical periodontitis with mobility. 22.8% of the pregnant women presented with gingival enlargements out of which 13.55% had localized while 9.3% had generalized gingival enlargements. 62% of the pregnant women said they brush twice daily while 27% brush once daily only 3% women said that they brush their teeth occasionally. None of them did flossing. Only 10% of the women had regular dental checkups after every six months. This study observed the oral health care practices of the pregnant women. The study highlighted the lack of awareness of maintenance of oral health. Intensive oral and dental health education in pregnancy can lead to improved oral and dental health, and ultimately safe pregnancy outcomes

Cancers; Sindh based prevalence of different type of cancers reported in civil hospital Karachi

To calculate the prevalence of common types of cancer in SINDH based on Civil Hospital Karachi [CHK] database. Retrospective Observational Study. Clinical Oncology Department Civil Hospital Karachi, from January, 2004 to December 2011[8 Years]. All the Patients attending the oncology department CHK were selected for study. After completing data the cancer registry patients were categorized according to their diagnosis and this data was recorded on Microsoft Excel sheet. During period of January 2004 to December 2011, the total number of patients included in the study was 5504 out of which 2638 were males and 2866 females. The list of prevalence of different types of cancer was created and according to the statistical analysis based on CHK data base, the increasing trend was seen in breast, oral cavity, lymphoid tissue, blood, colorectal, liver and biliary tract, faciomaxillary, lung, uterus, esophagus, gastrointestinal stromal tumor, larynx, ovary, male genital system, Nasopharynx, urinary system and brain cancers. It is concluded that the registration of cancer patients is highly beneficial for the evaluation of cancer prevalence and incidence. This registration is also helpful for calculating the comparative incidence and prevalence of cancers on national and international levels. The recorded data will also help to improve the quality of life of cancer patients as this data is very much helpful to identify the etiology and risk factors of cancers which will improve health prevention and management plans by higher authorities

Atypical spectrum of fundus fluorescein angiography features in central serous chorioretinopathy

Background: Central serous retinopathy [CSR] is an idiopathic disorder of the macula characterized by serous elevation of the neurosensory retina at the posterior pole caused primarily by leaky choriocapillaries. On fundus fluorescein angiography [FFA], two typical patterns of this leakage are defined as inkblot and smoke stalk appearance. But atypical and unusual patterns also occur that can produce difficulty in diagnosis

Objective: To determine the spectrum of atypical presentations of CSR on FFA

Patients and Methods: All patients presenting with a clinical diagnosis of CSR and referred for FFA were included in this descriptive study. After taking consent, FFA was performed and the results were analyzed for atypical features of this disorder. Where FFA features were not conclusive an optical coherence tomography [OCT] was also performed to aid further evaluation

Result: 12 out of 23 patients had atypical FFAfeatures. These include multiple inkblots in one eye, multiple inkblots in both eyes, ink blot and smoke stalk in the same eye, CSR with pigment epithelial detachment in which only the pigment epithelial detachment shows up on FFA, CSR with choroidal eovascularisation in which the CNV only shows on FFA and CSR with no leakage on FFA

Conclusion: Atypical presentations of CSR can cause diagnostic problems. The ophthalmologist must be aware of these features. Furthermore, these cases should be worked up for associated systemic / ocular disease

Atypical spectrum of fundus fluorescein angiography features in central serous chorioretinopathy

Background: Central serous retinopathy [CSR] is an idiopathic disorder of the macula characterized by serous elevation of the neurosensory retina at the posterior pole caused primarily by leaky choriocapillaries. On fundus fluorescein angiography [FFA], two typical patterns of this leakage are defined as inkblot and smoke stalk appearance. But atypical and unusual patterns also occur that can produce difficulty in diagnosis

Objective: To determine the spectrum of atypical presentations of CSR on FFA

Patients and Methods: All patients presenting with a clinical diagnosis of CSR and referred for FFA were included in this descriptive study. After taking consent, FFA was performed and the results were analyzed for atypical features of this disorder. Where FFA features were not conclusive an optical coherence tomography [OCT] was also performed to aid further evaluation

Result: 12 out of 23 patients had atypical FFA features. These include multiple inkblots in one eye, multiple inkblots in both eyes, ink blot and smoke stalk in the same eye, CSR with pigment epithelial detachment in which only the pigment epithelial detachment shows up on FFA, CSR with choroidal eovascularisation in which the CNV only shows on FFA and CSR with no leakage on FFA

Conclusion: Atypical presentations of CSR can cause diagnostic problems. The ophthalmologist must be aware of these features. Furthermore, these cases should be worked up for associated systemic / ocular disease

frequency of preclinical nephropathy in patients of type II diabetes mellitus with diabetic retinopathy

Objective: To determine the frequency of preclinical nephropathy in patients with diabetic retinopathy and its correlation to the severity of retinopathy

Study Design: Prospective case study

Place and Duration of Study: Department of Ophthalmology, Military Hospital [MH], Rawalpindi for six months

Methods: Ninety [90] diabetic patients [thirty in each grade of retinopathy i.e. background, preproliferative and proliferative] with no known renal dysfunction were included in the study. They were investigated for albumin/creatinine ratio a sport urine sample. The outcome of renal function was described as either positive or negative. The cutoff value for albumin creatinine ratio was 200 mg/g. The various grades of retinopathy were compared to the values of urine albumin creatinine ratio, to find the correlation

Results: Five [17%] patients with background diabetic retinopathy had preclinical nephropathy. Seventeen [60%] patients with preproliferative diabetic retinopathy and 27 [90%] of patients with proliferative diabetic retinopathy had preclinical nephropathy. The frequency of nephropathy correlated to the severity of retinopathy [correlation co efficient, r value: 0.630] and p value of <0.001

Conclusion: it is important for ophthalmologists to carefully consider the renal status of any patient with retinopathy as this can influence the progression of retinopathy and its response to treatment