Orthodontic Pain and Patients’ Quality of Life: Patient Experiences and Provider Assessments

Objectives:To compare orthodontic pain and its Influence on quality of patient’s life as perceived by them with that assessed by their orthodontic care providers.Materials and Methods:It was crosses sectional study involving 75 patients attending the orthodontic clinic and14 orthodontic care providers from September to October 2010. Patients aged 16 and older, receiving fixed orthodontic treatments were included. Patients and orthodontists scored painduring different orthodontic procedures using a qualitative pain intensity scale which graded pain for different orthodontic procedures. Oral health related quality of life (OHRQoL) was assessed by means of a 4-point likert scale to measure the influence of orthodontic treatment related pain on different aspects of life.Results:For change of consistency of diet (p=0.02) statistically significant difference was observed between mean ranks of patients and orthodontists. For pain during record taking, higher mean ranks were reported for patients aged between 20-30 years (p = 0.01) whereas for pain after separator placement, patients aged above 30 had higher mean ranks (p = 0.05).Conclusions:Orthodontists can accurately estimate the degree of pain their patients’ experience. Significant proportions of patients experience substantial degrees pain during the visits, subsequent to orthodontic visits and pain due to fixed orthodontic appliance therapy transiently affects patients’ OHRQoL

Knowledge, Attitude and Practice Regarding Infection Control Procedures among Dentists of Karachi

Aim: Infection control is crucial in any clinical setting. It is vital that all dentists must follow the infection control protocols in their clinics to prevent cross-infection. In a dental clinic, even simple dental procedures including extractions, scaling and root planning, dental crown preparations and root canal treatment, have a high risk of exposure to blood, which may cause transmission blood-borne diseases. Dentist’s compliance with these guidelines and recommendations have been recently studied in different parts of the world. Hence this study was performed to evaluate the knowledge, attitude, and practice regarding infection control measures among private dental practioners in Karachi, Pakistan.Study Design:Cross-sectional study.Place and Duration of Study:This study was conducted for a period of four months in Karachi, Pakistan. Materialsand Methods: Present cross–sectional study was performed by interviewing 234dentists via a questionnaire based upon various questions regarding infection control. Sample were collected using convenience sampling, from private dental clinics in Karachi, Pakistan. Setting:Questionnaire were sent to 400 general dentist in Karachi,out of which 234 replied.Results: Mostly (69%) dentists who took part in the study were males. Regarding infection control, most of the individuals had a comprehensive understanding of infection control techniques. Isolation was considered to play a vital role in cross-infection prevention by 97.3% of the dentists. 93.2% used autoclave for sterilization and majority had thorough knowledge of the process involved. Regarding preventive measures, 66.7% of the dentists were vaccinated against major infectiousagents in our society and 92.2% took protective measures required to prevent cross-infection.Conclusion: Knowledge, attitudes and practices regarding infection control of dentists in private clinic of Karachi, Pakistan are satisfactory.

Diagnostic Utility of Bronchoalveolar Lavage Xpert MTB/RIF Assay in Suspected Cases of Pulmonary Tuberculosis

Introduction: Limited data on the diagnostic accuracy of the Xpert MTB/RIF assay using bronchoalveolar lavage fluid from patients with suspected pulmonary tuberculosis have been reported in India. The aim of this study was to evaluate Xpert MTB/RIF on bronchoalveolar lavage fluid in suspected PTB patients by comparing with AFB smear microscopy and culture Material and methods: A cross sectional observational study was carried on a total of 450 bronchoalveolar lavage fluid were processed by Xpert MTB/RIF between January 2018 and December 2018. Culture results were considered as the gold standard for diagnosis of TB. Sensitivity, specificity, PPV, and negative predictive value (NPV) for the diagnosis of active PTB were calculated using the website http://vassarstats. net/clin1.html. SPSS statistics version 17.0 software (SPSS Inc., Chicago, IL, USA) was used for the statistical analysis. Results: Xpert MTB/RIF had a sensitivity of 97.05% (95% CI 88.8-99.4) while the specificity of 90.05% ( 95% CI 86.4-92.7) in culture confirmed cases and those for smear microscopy was 36.7% (95% CI 25.6-49.3) and 100% (95% CI 98.7-100) respectively. Conclusion: The Xpert MTB/RIF assay is a rapid and simple technique with significantly higher sensitivity for diagnosing pulmonary TB compared to smear microscopy.(p < 0.005

E-Cadherin as a Marker for Nodal Metastasis in Head and Neck Squamous Cell Carcinoma

Aim: Head and neck cancers, all over the world, contribute greatly to the number of deaths, despite the advancements in the therapeutic strategies. It is characterized by locoregional disease with a tendency for metastasis to the cervical lymph nodes. The pre-operative detection of lymph node metastasis is critical for the effective treatment of patients with head and neck squamous cell carcinoma. Therefore the objective of this study was to identify E-cadherin as a marker for prediction of lymph node metastasis in head and neck squamous cell carcinoma (HNSCC).Study Design:Cross-sectional study.Place and Duration of Study: Dow University of Health Sciences, Karachi. 1 Year duration.Methodology:Cross-sectional analysis of 54 subjects with HNSCC, who underwent neck dissections, was carried out. Expression of E-cadherin was evaluated using immunohistochemical analysis and traditional histological parameters, and correlation of E-Cadherin with histologically verified presence of regional metastases was determined. Data was subjected to descriptive statistics and chi-square using Spss v.16.0.Results:54 patients included 33 males (61.1%) and 21 females (38.9%) aged from 18 to 73 (mean 44.8±12.7). A statistically significant relationship between the Downregulation of E-cadherin and histologically verified presence of nodal metastasis was established. (p value= 0.01).Conclusion:This study shows that low E-cadherin expression is useful for predicting lymph node metastases in cases of head and neck carcinoma.