effect of counselling in preoperative anxiety among the patients undergoing third molar surgery

Objective: to determine the effect of counselling on pre-operative anxiety among the patients undergoing third molar surgery

Methods: a randomized controlled trial was conducted in the department of maxillofacial surgery, Punjab Dental Hospital and Mayo Hospital, Lahore from September, 2013 to December, 2013. A total of 100 patients planned for third molar surgery by the maxillofacial surgeon on the basis of symptomatology and investigations and also having baseline anxiety above the cutoff point on Hamilton Anxiety Rating Scale [HAM-A] were selected and randomly divided into the control and the experimental groups. The pre- operative anxiety was assessed objectively and subjectively on Hamilton Anxiety Rating Scale [HAM-A] and Dental Anxiety Scale [DAS] [Urdu version] respectively at the time of booking the patient for the operation [session 1] and scoring was done. Detailed counselling was done to the experimental group in addition to providing information as usual which included routine briefing which was given to all the patients of both the groups. Preoperative anxiety was assessed again on the same scales in the same manner in both the groups just before the surgery [session 2] and the results were compared

Results: a statistically significant difference was found in pre-operative anxiety scores of both the experimental and control groups between session 1 and session 2. In the experimental group, preoperative anxiety was significantly reduced after intervention [p-value=0.00] as compared to the control group in which it was significantly increased [p- value=0.00] just before the surgery

Conclusion: counselling is an effective method for reducing preoperative anxiety in patients undergoing third molar surgery

Feto-maternal outcomes in women with congenital heart disease

To determine Pregnancy Outcomes in Women with Congenital Heart Disease. Cross sectional study. This study was conducated at Obstetrics and Gynaecology ward 9 Jinah Postgraduate Medical Centre Karachi and National Institute of Cardiovascular Diseases [NICVD], from May 2008 and January 2011. All Pregnant women with congenital heart disease presenting at OPD of National Institute of Cardiovascular Diseases delivering at Obstetrics and Gynaecology ward 9 Jinah Postgraduate Medical Centre Karachi were included. Cardiac complications were subdivided into primary and secondary Cardiac events. A primary cardiac event consisted of cardiac death, cardiac arrest, stroke, symptomatic sustained bradyarrhythmia or tachyarrhythmia requiring therapy, or pulmonary edema documented by physical examination or radiography. Decline in >/= 2 NYHA functional classes, need for urgent invasive cardiac interventions during pregnancy or within 6 weeks postpartum, and symptomatic nonsustained bradyarrhythmia or tachyarrhythmia requiring therapy were considered secondary cardiac events. Obstetric events consisted of preeclampsia, postpartum hemorrhage, and noncardiac death. Neonatal events were defined as preterm delivery [<37 weeks of gestation], birth weight small for gestational age respiratory distress syndrome, cerebral intraventricular hemorrhage, fetal death or neonatal death. Spontaneous abortion was defined as fetal loss before 20 weeks of gestation. 36 women with congenital heart disease. Spontaneous abortions occurred in 6 pregnancies at 10.8 +/- 3.7 weeks, and 2 underwent elective pregnancy termination. There were no maternal deaths. Primary maternal cardiac events complicated 19.4% of ongoing pregnancies, with pulmonary edema in 16.6% and sustained arrhythmias in 8.3%. Adverse neonatal outcomes occurred in 27.7% of ongoing pregnancies and included preterm delivery [19.4%], small for gestational age [8.33%], respiratory distress syndrome [833%], intrauterine fetal demise [2.77%], and neonatal death [2.77%]. Feto-maternal outcome in women with congenital heart disease can be improved further with proper management and counseling

Susceptibility pattern of streptococcal isolates from oral cavity against commonly used antibiotics

To assess the susceptibility pattern of streptococcal isolates from oral cavity against commonly used antibiotics. Oral samples, including subgingival swabs, were collected from 120 patients aged 12 to 60 years. Two swabs were collected; first for rapid-strep testing for the presumptive diagnosis of Group A Streptococcal infection and second to culture for definitive bacterial identification. Antibiotic sensitivity of the isolated strains of streptococcus was done by direct disk diffusion method. Four different classes of antibiotics; Penicillin, Cephalosporin, Macrolide, and Vancomycin were tested to determine the sensitivity pattern. Out of 100 isolates recovered, the prevalence of streptococcal species was74%. The greatest zone of inhibition was achieved with amoxicillin, amoxicillin-clavulanic acid, and vancomycin [16, 17, and 18 mm respectively]. Zones of inhibition measured for cephalosporins and macrolides were less than the other groups [10.5 and 11 mm respectively]. Amoxicillin is still the drug of choice for prophylactic and therapeutic use in our dental settings not only for its better coverage on the streptococcus species but also due to its easy availability and affordability. This corresponds with the international literature, however, the importance of obtaining specimens for culture and sensitivity should be observed as a standard procedure, to minimize the chances of development of resistance and identify the changing trends of the infectivity mode

Frequency of esophageal varices in patients with upper gastrointestinal bleeding

To calculate the frequency of esophageal varices in patients with upper gastrointestinal bleeding. It is a cross sectional study. One hundred patients of upper Gl bleeding were included in the study. After initial history and clinical examination, upper Gl endoscopy was performed to assess the cause of bleeding and all the relevant data was entered in the specific proforma designed by authors. One hundred patients [56 male and 44 females] of upper Gl hemorrhage were included. Fifty three patients had esophageal varices while 12 patients had duodenal ulcer, 14 had gastric ulcer, 16 had Gastroduodenal erosions, two patients had erosive esophagitis, one patient had Mallory Weiss tear, one had gastric carcinoma and one had coagulopathy. Esophageal varices are the most common cause of upper Gl bleeding in this area where this study was conducted

Frequency of risk factors in acute coronary syndrome

To measure the frequency of risk factors in patients of ACS, Observational descriptive study. It was conducted in the'emergency department of Nishtar Hospital Multan from January 2008 to January 2009. Consecutive 400 patients who presented with history of chest pain were enrolled in the study. These patients underwent clinical examination, ECG and Trop T testing, Patients were inquired about the risk factors by the help of a Proforma. STEMI was the most common diagnosis [66.7%]. One or more risk factors were present in each patient; Hypertension [37.2%], Smoking history [50.1%], Diabetes Mellitus [29.2%], Family history [41.5%] and sedentary habits [33.2%].Hypertension and smoking are most common risk factors in patients with ACS

Frequency of ABO blood groups among medical students

To find out the frequency of ABO blood groups among medical students. Cross sectional study. At the Department of Physiology and Medicine at Nishtar Medical College [NMC] Multan, from March 2008 to May 2008. All the medical students of the first year were included in the study. Blood was collected by finger prick method. A drop of monoclonal anti-A, anti-B was added to a drop of finger prick blood on clean glass slide and mixed well. Results of agglutination were recorded immediately. There were a total of 221 students of whom 106 were females and 115 males. Frequency of different blood groups were as follows; A: 31.3%, AB: 6.7%, B: 42.1% and O: 29.9%. The distribution of blood groups among females [F] and males [M] was as follows: Group A: 46.8% F, 53.2% M; Group AB: 13.3% F, 86.7% M; Group B: 55.9% F, 44.1% M and Group O: 45.5% F, 54.5% M. The study showed that blood group B was more common among the students

Frequency of post-traumatic stress disorder and its association with types of physical injuries and depression in earthquake victims

To examine the frequency of Post Traumatic Stress Disorder [PTSD] in victims of October 2005 earthquake in Pakistan and to evaluate its association with type of physical injuries and depressive disorder. 210 victims were assessed for PTSD and depression by using semi-structured clinical interview and HADS respectively. These subjects were selected at random. Victims, both with or without physical injuries, were assessed. Of the two hundred ten victims, 141 had sustained physical injuries. Among those, 51% had soft tissue injuries, 36% had bony injuries and 13% had spinal injuries. Among physically injured victims 87 [62%] developed PTSD and 54 [38%] did not. Sixty nine victims who did not sustain physical injuries, 32 [46%] developed PTSD while 37 [54%] did not. The results indicate significant relationship between PTSD and physical injury [Chi square=4.43, df=1, p<0.05]. Frequency of PTSD was markedly increased in people suffered from physical injuries as compared to those who did not sustained injuries

Effect of nystatin, gentian violet and garlic extract on candidiasis patients undergoing radiation therapy in head and neck region

To evaluate the in-vivo anticandidal activity of Nystatin, Gentian Violet and Garlic extract on candidiasis patient receiving radiation therapy in Head and Neck region. The in-vivo antifungal activity of Nystatin, Gentian Violet and Garlic Extract were carried out on 60 patients. These patients were divided into 3 groups [Group I = Nystatin, Group 2= Gentian violet, Group 3= Garlic extract]. Each group consisted of 20 patients. The clinical lesion were recorded and graded during the treatment according to the Lindquist/Hickey scale on 0th 7th and 15th day and the anticandidal effect of these drugs were evaluated by oral lesion index evolution through simple mean. Result showed that Nystatin, Gentian violet and Garlic Extract were found to be very effective. It can be concluded from the study that all the drugs were effective against Candida albicans and secondly the organism has not developed any resistance to these drugs

Prevalence of hepatitis B and C virus in health care worker [paramedical staff] of tertiary care hospital

Viral hepatitis is a major public health problem throughout the world. Viruses, which can lead viral hepatitis, are hepatitis A virus [HAV], Hepatitis B virus [HBV], Hepatitis C virus [HCV], hepatitis D virus [delta antigen], Hepatitis E virus [HEV] and hepatitis G virus [HGV]. To see the frequency of hepatitis B and C in paramedical staff [Nurses, Dispensers and laboratory workers] of tertiary care hospital. This Descriptive study was conducted among paramedical staff during the period from April 2003 to July 2005. A total of 200 cases from paramedical staff was included in the study. After taking permission or consent a proforma was filled for each volunteer about any history of previous surgery, blood transfusion, accidental needle prick. Blood samples were collected from these staff. A total number of subjects who were studied from April 2003 to July 2005. Out of which 150 were nurses, 25 were dispensers and 25 were laboratory workers. HBV positive cases in 50 males and 150 females. Anti HCV was detected in 50 males and 150 females. A campaign to discourage unnecessary injection therapy and intravenous drips must be started and public should be given awareness of their danger. Moreover public should also be instructed to avoid tattooing, ear and nose piercing and circumcision by formal barbers

In vitro effect of nystatin, gentian violet and garlic extract on candida albicans isolates from oral cavity

To evaluate in-vitro anticandidal activity of Nystatin. Gentian Violet and Garlic extract on Candida albicans isolates from oral cavity. For screening of antifungal activity of Nystatin. Gentian Violet and Garlic Extract, 100 clinical isolates were collected from the department of Radiotherapy. Jinnah Postgraduate Medical Center and Fatima Jinnah Dental College and Hospital, Karachi. The samples were collected from the oral cavity and the sample site was buccal mucosa, tongue and hard palate. These isolates were finally identified on the basis of morphology and cultural characteristics and confirmed using germ tube method. The antifungal activity of Nystatin, Gentian Violet and Garlic Extract were carried out by disc diffusion method. Result showed that the mean zone of inhibition of Nystatin was 17.9mm, Gentian violet was 16.6mm and Garlic Extract was 16.6mm and all the drugs used were found to be very effective. It can be concluded from the study that all the drugs are very effective against clinical isolates of Candida albicans and secondly the organism had not developed any resistance to these drugs