Association of oral lichen planus with hepatitis-C and diabetes mellitus

The aim of the study is to determine the association of oral lichen planus with hepatitis C and diabetes mellitus

A retrospective cohort study was carried out at the Department of Oral and Maxillofacial Surgery, Sardar Begum Dental College, Peshawar from January 201 1 to July 2015. A total of 34 male and female patients having oral lichen planus were selected with age range 20-60 years and mean age 39.4 +/- 15.8 years. Only clinical features were included to diagnose oral lichen planus which was made through the clinical evaluation of patient's oral cavity by a specialist team at the Department as proposed by van der Meij et al in 2003 based on the WHO definition of oral lichen planus. The data were analyzed through SPSS 22 with significance level ofp-value <0.05 and chi-square statistics were applied for association

The results showed that the data was statistically not significant with p-value >0.05 for all diseases having lichen planus and chi-square statistics revealed that no association exist among lichen planus, diabetes mellitus and hepatitis C. This study fails to find any association between oral lichen planus, hepatitis C and diabetes mellitus

Crash helmet – the harbinger of death: a case report.

In one of the rarest form of freak accident, a young woman surrendered to her death in a manner that belie the reality only to be played back in a slow motion sequence. History is replete of instances in which death struck individuals in otherwise innocent forms. In this case – elaborated below – a helmet tucked under the crook of an elbow became the undoing causing the woman to topple backward in a slow-motion, the head striking the hard surface of the road and precipitating her death later in a hospital.

Pattern and management of iatrogenic displacement of teeth in maxillofacial anatomical spaces

Iatrogenic displacement of teeth is a rare incidence in expert surgical hands but they are frequently encountered when a difficult surgical extraction of the tooth is attempted by inexperienced dental surgeons. The present study is aimed at knowing the frequency, pattern and the surgical technique of retrieval of such displaced teeth. This study comprised of 21 iatrogenically displaced teeth over a period of 9 years in two hospitals i.e., Sardar Begum Dental hospital and Khyber College of Dentistry and Hospital Peshawar. Iatrogenic displacement was predominantly common in males as compared to females with male to female ratio of 2.5:1; the most common age group of the patient was the third decade of life i.e., 38.06% with age ranging from 19 to 57 years and mean age of 32.381 SD +/- 10.195. Only two patients presented delayed, all the rest of the patients presented the very second day of their previous surgery. Eighteen patients were operated under general anesthesia while the rest of the three were managed under local anesthesia using lignocaine 2% with adrenaline. The surgical approaches used for retrieval were intra oral using three corner flap, extra oral, intra oral through the socket using 3 corner flap and Caldwell luc operation

Causes of tooth extraction amongst diabetic patients seen in a dental hospital in Peshawar

The aim of the study was to evaluate the causes of common conditions leading to tooth extraction, male/female ratio in diabetic patients. This was a retrospective cohort study. Data were collected from previous records between January 2011 to July 2015 from the Department of Oral and Maxillofacial Surgery, Sardar Begum Dental College, Peshawar. Among 2,103 total diabetic patients presented to the department, 1,618 diabetic patients have their complete record for tooth extractions. The primary reasons for exodontia specified in the records were Caries, Periodontitis, others. Others include those patients who have extractions either due to preprosthetic purpose, trauma or fracture or any other reason other than caries and periodontitis. The data was analysed through SPSS 22. The mean age presentation was 47.50 +/- 19.82 years and the age range 25-70 years. There were 1,618 extractions carried out in 2,103 subjects [76.94%]. The female diabetic patients predominate n=983 [60.75%] the male patients n=635 [39.25%]. Caries was the dominant cause of tooth extraction in both subjects n= 1042 [64.40%] followed by periodontitis n= 416 [25.71%] and others n=160 [9.90%]. Caries is the dominant cause of extraction in diabetic patients and female diabetic patients predominate male diabetic patients in terms of tooth extraction

Patterns of minor salivary gland tumors in Khyber Pahktunkhwa

Present study was carried out to determine the pattern of minor salivary gland tumors, diagnosed at City Medical Laboratory, Peshawar [Pakistan]. The study was conducted at Sardar Begum Dental College using the Anatomical pathology records of City Medical Laboratory, Peshawar from January 2003 to December 2012 and were analyzed by Statistical Program for Social Sciences version 16. A total of 78 cases were diagnosed as minor salivary gland tumors. Out of these 47 were benign and 31 malignant. The male to female ratio for both benign and malignant tumors was 1:1.7. The mean age was 40.39 years. The most common benign tumor was Pleomorphic adenoma [89.3%] and malignant was Adenoid cystic carcinoma [87.09%]. The hard palate was the most common affected site [57.4% in benign and 32.2% in malignant tumors]. The present study showed a different pattern of occurrence of malignant minor salivary gland tumors among the population of Khyber Pahktunkhwa as compared with the European and American population

Abnormal Lipid levels as a risk factor of eclampsia, study conducted in tertiary care Hospitals of Khyber Pakhtunkhwa Province - Pakistan

To evaluate abnormal lipid metabolism as a risk factor of eclampsia in pregnant women. This cross sectional study was conducted in three tertiary care hospitals of Peshawar. Serum total cholesterol [TC], high density lipoprotein cholesterol [HDL-C], low density lipoprotein cholesterol [LDL-C], very low density lipoprotein cholesterol [VLDL-C], triglyceride [TG], apolipoprotein A1 [APO-A1], APO-B100, lipoprotein-a [Lpa] were measured in 110 women with eclampsia and compared with 90 healthy pregnant women. Mean lipid levels in cases and controls were compared using student's t test. Mean systolic/diastolic blood pressure, TC, TG, VLDL-C and Lpa levels were significantly higher [p < 0.001] in patients compared to control women. Similarly TC: HDL-C, LDL-C: HDL-C and TG: HDL-C ratio in the patients group were significantly higher [p < 0.001] and HDL-C: VLDL-C ratio was significantly lower [p < 0.001] in the patients as compared to control group. Undesirable cholesterol were noted in 35.8% patients, HDL-C in 50.5%, borderline high concentration of LDL-C in 23.6%, high triglycerides levels in 73.2%, undesirable cholesterol ratio in 52.3% and undesirable LDL-C ratio were noted in 82.1% patients of eclampsia. Serum lipids were found significantly higher thus early assessment may be helpful in prevention of complications in the eclampsia patients

First cancer statistics report from Hazara division

'Cancer' is on rise globally. Cancer registry is vital for policy making, resource allocation, progress tracking and overall cancer control. In Pakistan, cancer prevention, screening and standardised clinical trials, as well as quality assurance through surveillance are badly hampered due to the lack of a National Cancer Registry. For Pakistan a well-integrated system of Cancer Registry is need of the day. This retrospective study was conducted on the hospital records at the Oncology Department of Ayub Teaching Hospital, Abbottabad from year 2007-12. Data were collected through a standard data capture form with a final figure of 555 patients. The malignancies were diagnosed clinically and histopathologically at different laboratories of Pakistan. Among these cases, 54.08% were male and 45.92% female. Incidence of cancer in patients below 14 years age was 8.47% and 91.53% above 14 years. Majority [31.95%] cases were from Mansehra followed by Abbottabad with 27.08% and Haripur 14.26% cases. Leukaemias were at top with 15.14% cases followed by breast carcinoma [13.69%], Lymphomas [12.07%], ovarian carcinomas [8.65%], and gastric carcinoma and skin cancers with 2.70% each. Among men, the highest incidence was of Hodgkin's lymphoma [14.9%] followed by lymphocytic leukaemia [14.3%]. Prostate cancer was seen in 8.3% male patients. Another 5.7% patients had lung cancer. In women, the highest incidence was carcinoma breast [19.7%] followed by ovarian carcinoma [13.4%], leukaemia [9.7%], and Hodgkin's lymphoma [4.3%]. A variety of cancers are prevalent in the indigent population. Record-keeping in wards is sub-optimal. Commonest cancers in the area have slight differences with rest of the country

Compliance of anti-smoking regulations by cigarette industry in Pakistan

Background: The hazards of cigarette smoking and its increasing consumption are well known despite the ongoing tussle between the tobacco industry and global governments. To curb the menace of smoking, anti-smoking laws have been enforced from time to time by various governments. In 2003, Ministry of Health [MoH] Government of Pakistan has imposed certain regulations on cigarette manufacturing industry. The aim of this study was to highlight the compliance of the industry with these regulations. Methods: A cross-sectional study of major cigarette selling shops was conducted in Abbottabad. It was aimed at determining the availability of total cigarette brands and their compliance with the regulations and also to find out attributes of cigarette customers. Results: A total of 39 varieties of 18 cigarette brands are available in Abbottabad city, out of which 71.8% are imported varieties. A total of 38.4% varieties have displayed health warnings [28.2% pictorial health warning, 10.2% have written health warning. Majority of cigarette customers ar between 20–40 years of age, while 5.6% customers include youngsters between 10–20 years of age. Female customers, accounting for 8% of total cigarette customers, buy only those brands which have not displayed the health warning. Conclusions: Observed compliance with governmental regulation for displaying health warning is 39% which is far less than desired. Sale of cigarette to children is also practiced. Ministry of Health [MoH] should assure the display of these warnings on all the brands so that smokers must be fully aware about the risk involved in smoking Keywords: Cigarette smoking; anti-smoking regulations; protection of non-smoker health

Risk factors for temporomandibular joint ankylosis in different age groups

To identify the risk factors responsible for the development of temporomandibular Joint ankylosis. The study was carried out in the Department of Oral and Maxillofacial Surgery at King Edward Medical University, Lahore, Pakistan from April 2005 to April 2009. Two hundred patients with Temporo mandibular Joint Ankylosis were recruited in this study. To identify the risk factors, patients were divided in different groups according to their age so that the most common risk factor was identified amongst these patients. The groups were A. 6 months to 8 years, B. 9-17 years, C. 18-25 years. D>25 years. Risk factors identified were history of fall, road traffic accident, middle ear infection, autoimmune diseases and no obvious history. The highest percentage of the patients belonged to Group B [50%] and history of fall was the main risk factor in the development of Temporomandibular joint ankylosis [72.5%] with p value < 0.05. Trauma is the major factor of Temporomandibular joint ankylosis in all age groups in Pakistan. In this context, we conclude that this complication is a preventable entity if early post traumatic rehabilitation is instituted

Vacuum assisted closure of laparostomy wounds a novel technique

Management of a laparostomy wound is contentious. Specific pathologies like severe intraabdominal sepsis, trauma requiring damage control, abdominal compartment syndrome, staged abdominal repair and other complex abdominal pathologies can be managed with a novel technique of Vacuum Assisted Closure dressing. This device applies sub-atmospheric pressure that leads to reduced bowel wall edema, bacterial count and inflammatory burden found in open abdominal wounds. This leads to a reduced need for frequent dressing changes, maintaining intact skin and improvement in fluid management. Controlled clinical studies are needed to establish the safety and effectiveness of this treatment strategy. We present our experience with this technique suggesting it to be safe and effective. A brief outline of the working of Vacuum Assisted Closure dressing is also presented

Effectiveness of combined thoracic epidural and light general anaesthesia in patients undergoing non-cardiac thoracic surgery

The specialty of thoracic anaesthesia has emerged as a scientifically based discipline just 30 years back. At the start of the 20'1i century empyema and tuberculosis were the main indications for the thoracic surgery. Later on with the introduction of antibiotics lung malignancies were more commonly operated. Recent resurgence of tuberculosis and associated medical illnesses put these patients in high risk for surgery and anaesthesia, necessitating introduction of more skilful approach. The objective of this study was to evaluate the effectiveness of combined thoracic epidural anaesthesia and light general anesthesia in patients undergoing non-cardiac thoracic surgery. This study was conducted at the department of Anesthesia and Intensive care, Pakistan Institute of Medical Sciences, Islamabad from 1st Jan 2001 to 31st August 2002. Ten adult patients of both sexes of ASA grade I-III, < 68 years of age, who were undergoing non-cardiac thoracic surgery were included. Thoracic epidural and central venous lines were placed 20 to 30 minutes before the start of procedure. All patients received same premedication, induction agents, analgesics, inhalational agents and muscle relaxants. All patients were transferred to Surgical Intensive Care unit after completion of the procedure. Seventy% patients were operated on lungs, twenty% on mediastinum and one% for carcinoma of esophagus. Only one patient had co morbid disease of hypertension. One patient [10%] died of massive intraoperative hemorrhage. One patient [10%] developed superior vena caval obstruction, that was to be operated for mediastinal growth. Rest of eight [80%] patients were extubated in the operation theatre. All [100%] patients received intraoperative blood transfusion. 20 patients required additional analgesia in the postoperative period. 20% developed postoperative arrhythmias. Combined use of light general anaesthesia and thoracic epidural is effective in patients undergoing non-cardiac thoracic surgery

Frequency of hepatitis B and hepatitis C in healthy blood donors of NWFP: a single center experience

To determine the frequency of hepatitis B and hepatitis C in asymptomatic healthy blood donors. Material and A prospective study was conducted in the department of Pathology, Rehman Medical Institute, Peshawar from April 2002 to March 2003. A total of 4000 healthy blood donors were selected. Blood samples were collected for screening of HBs Ag and anti HCV antibodies using IMX or Axsym, MEIA technology [Abbott, USA]. Even after strict selection of healthy donors 1.9% were found to be reactive for hepatitis B and 2.2% were found to be reactive for hepatitis C. The rate of incidence of hepatitis C was higher in blood group B negative [6.81%] while the rate of incidence of hepatitis B was higher in donors with blood group B positive [2.47%]. Screened blood bags received from other transfusion centers showed higher rates [4.27%] of hepatitis viral infections. These indicate that most of the patients suffering from hepatitis B and hepatitis C do not realize that they have got such deadly viruses in their body and can transmit it to non-infected healthy individuals via different parenteral routes including blood transfusion. The rate of infection of hepatitis B and C found in this study is low compared to other regional studies. One possible explanation could be the introduction of pre-donation filtration by questionnaire method which has been found to be an effective tool in addition to routine virological screening using high quality standard methods