Medical prescription adherence among patient visiting gynecology department

Objective: The aim of this study was to explore the level of Medical prescription adherence among gynecological patients of Pakistan

Study Design: Cross-sectional study

Place and Duration of Study: The study was conducted in Punjab province and data were collected from June 2015 to April 2016

Material and Methods: This cross-sectional study was carried out in main cities of Punjab province of Pakistan; Lahore, Gujranwala, Faisalabad and Sheikhupura. The survey data was collected from different location of cities. Patients visiting the gynecological and going to chemists for getting the prescribed medicine were selected through probability based random sampling for this study. The questionnaire consisted on the extent to which they adhere to time, dose, frequency and procedure prescribed from their doctors. The questions were asked in native language [Urdu]. The data analysis was performed by using SPSS software [Ver.21]

Results: Results of this study, based on sample from four big cities of Punjab province of Pakistan, showed that the level of medical prescription was associated with the age, qualification and background of the patients. Adherence level of patients reporting with rural background was observed higher than the adherence level of patients from urban areas

Conclusion: Over all the patient require counseling regarding adherence to medical prescription irrespective of the nature of the disease

Diagnostic accuracy of mid upper arm circumference [MUAC] for screening low birth weight babies

Objective: To determine the diagnostic accuracy of Mid Upper Arm Circumference [MUAC] for screening low birth weight babies

Study Design: Cross-sectional study

Place and Duration of study: This study was conducted at the Pediatric Unit II and Gynecology Unit II at Civil Hospital Karachi, Pakistan, from January to June 2012

Materials and Methods: A hospital base study was carried out on full term, singleton 112 live born babies. Birth weight was taken through digital weighing scale as gold standard against anthropometric measurement of MUAC in centimeters

Correlation between MUAC and low birth weight was calculated with 95 % confidence interval

Sensitivity, specificity, positive and negative predictive values were calculated

Results: Out of 112 newborn babies studied, 44 [39 %] were male and 68 [61%] were female. The mean birth weight was 2.316 +/- 0.563 kgs and 51 [45.5%] newborns were low birth weight [LBW]

The mean MUAC was 8.90 +/- 1.08. In low birth weight mean MUAC was 8.41 +/- 0.87; 95% CI [8.21; 8.61] and in normal birth weight mean MUAC was 9.90 +/- 0.70; 95% CI [9.66; 10.13].Pearson correlation between low birth weight and MUAC was found statistically significant [r= 0.858;P-value <0.001]. A cut-off point of <9.3 cm of MUAC showed 81.1% sensitivity and 78.3% specificity

Conclusion: Mid upper arm circumference was statistically significant anthropometric surrogate of birth weight at cut-off point < 9.3 cm in the study population. Further studies are needed to validate the finding of this study in community setting. MUAC is a simple, practicable, quick and reliable indicator for predicting LBW newborns in the community and can be easily measured by paramedical workers in developing nations

Gender and occupation wise knowledge, awareness and prevention of tuberculosis among people of district Muzaffarabad AJ and K

To assess the awareness about the spread and control of tuberculosis as well as to investigate the gender and occupation wise differences among people regarding knowledge and attitude towards tuberculosis in the State of AJ and K. A cross-sectional descriptive study was conducted in district Muzaffarabad and a sample of 4000 respondents was selected by using stratified random sampling technique. The stratification was done with respect to gender and occupation. The occupation wise classification includes households, labors, and shop keepers, government employers, under graduate students of social and natural sciences, medical students and doctors. A close ended structured questionnaire was developed to collect the data and data were analyzed by using SPSS [Statistical Package for Social Sciences]. Chi-Square test was used for association and Logistic Regression model was used to find out the most significant risk factors with gender. Majority of the males were more aware of tuberculosis than females regarding different aspects related to tuberculosis. The respondents from household, labors and shopkeepers have less awareness and knowledge than those who belong to other professions. The doctors and medical students have almost 100% awareness and knowledge of tuberculosis. It was examined that all the variables were associated with gender except threat, curable and transmissible. Only three variables mentioned above showed non- significant result, while all other variables were strongly associated with gender. Males were found more aware about TB than females. Moreover, the literate people were more conscious concerning the prevalence and threats of the disease

Medically unexplained symptoms and emotional disorders among school children

Objective: To determine the frequency of unexplained physical symptoms in 5-15 years old children and its association with emotional disorder in psychiatric clinic of a public sector hospital

Study Design: Cross-sectional descriptive study

Place and Duration of Study: This study was conducted in the Department of Paediatric OPD, DIMC, DUHS, Karachi from January 2015 to June 2015

Materials and Methods: 144 samples of 5-15 years old children of both genders with somatic /physical symptoms fulfilling the inclusion criteria which were referred to the Psychiatry clinic. Semi structured questionnaire based on Urdu version of SDQ parent version were filled by the parents to assess the emotional problems in these children

Results: Analyses were completed for sample of 135 patients. 9 were excluded due to incomplete questionnaire. The mean age of children was 10.95 years. Pain predominated as physical symptoms in 5-10 years age group was pain, it included abdominal pain, headaches, limb pain, backache, chest pain. Fatigue, difficulty in breathing tremors, jerky movement and nausea and vomiting were more common in females. Anxiety disorder n=51 [50%], depression n=28 [28%], and somatoform disorder n=22 [22%] were the psychiatric comorbidities observed in these children

Conclusion: Children presenting with unexplained medical symptoms are often not managed appropriately by the Pediatricians due to lack of awareness. Majority of children presenting with MUS suffer from emotional disorders

Foreign bodies in ear - its type, diagnosis and management

OBJECTIVES: To evaluate the presentation, nature and fate of aural foreign bodies

STUDY DESIGN: Descriptive Study

SETTING: E.N.T. and Head and Neck Surgery department, Liaquat University Hospital Hyderabad from June 2014 to May 2015

METHODOLOGY: A prospective study of 224 patients who presented with different aural foreign bodies. All patients having suspected history of aural foreign body and whom who haven't history but during examination foreign body present in ear are included in the study. The patient of all age group of both the genders was enrolled. All the data was collected on a pre-designed Performa. Statistical analysis was carried out using SPSS 16

RESULTS: Out of 224 cases of aural foreign bodies, 50.4% were less than seven years of age, with male outnumber female. 93.3% of patients were having foreign body in one ear and 6.7% have foreign body in both ears respectively. Majority of aural foreign bodies were Beads and pearls that were seen in 30.4%. Most of the cases [87.5%] did not develop any complication during extraction

The complications observed were canal abrasion in 11 [4.9%] patients, otitis externa in 12 [5.3%] and tympanic membrane perforation in 02 [ 0.8%] patients

CONCLUSION: Aural foreign bodies are commonly encountered during otorhinological practice

Various varieties of aural foreign bodies are prevalent at different parts of the world

These cases should be removed under good magnification and illumination and/or sedation/general anesthesia if needed for prevention of complication

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

Treatment of odontogenic ameloblastomas and their long term follow up at tertiary centre

Fifty-two patients of ameloblastoma were operated with special emphasis on radiographic and histological appearance. The unicystic radiographico-histological [38] cases were managed conservatively with marsupialization followed by enucleation [Group A' 15 Patients] and enucleation with peripheral ostectomy [Group B' 23 Patients]. The radiographico-histological multicystic [solid] variety [Group C' 14 Patients] was treated aggressively by resection. In conservative treatment regimens Carnoy's solution was applied after enucleation of the tumour whereas, the patients of aggressive surgery were operated with minimum 5mm safety marginal clearance of the tumour. The recurrence rate with average four years follow up was 0.0% for resection, 13.33% for marsupialization followed by enucleation and 8.69% for enucleation with peripheral ostectomy. The results were encouraging for unicystic ameloblastoma treated patients [Group A' and B'], in best interest of jaw bone contour preservation

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

Effects of electromagnetic radiations from cell phones on the concentration of sperm in albino rats

To observe the changes in the number of sperms in semen in response to exposure to the electromagnetic radiation [EMR] from cell phones. Experimental comparative study. The study was conducted in Institute of Basic Medical Sciences [IBMS], Animal house of Dow University of Health Sciences [DUHS] and Dow Diagnostic Research and Reference laboratory, Ojha campus. Karachi from February 2011 to October 2011. Seventy male Albino rats obtained from the animal house of IBMS. DUHS, Karachi were divided into two main groups. Group A [control] and Group B [exposed], each containing 35 rats. Both groups were subdivided in five subgroups Al, A2, A3, A4. A5 for control group A and B1, B2, B3, B4, B5 for exposed group B, each consisting of 7 rats. The EMR was given by cell phones to exposed group for 3 hours/day and were sacrificed on 30, 50, 70. 90 and 110 days of exposure. Mean values of concentration of sperm in group A were compared with exposed group B. Statistical analysis was performed by SPSS using One Way Analysis Of Variance to find significance among groups. T-test was used to compare mean differences between groups. The concentration of sperm was found to be significantly decreased in exposed groups. This study concluded that exposure to EMR from cell phones affects the semen quality by producing significant decrease in concentration of sperm

Diabetes mellitus and osteomyelitis of the jaws

The Diabetes Mellitus is a prevailing medical condition worldwide [6%] and also in Pakistan. Infection in the orofacial wounds of these patients is common. The aim of the study was to determine the effect of diabetes mellitus on the healing process of alveolar sockets/bone after tooth removal. Eighteen diabetic patients with chronic jaw bone infections were examined and managed in oral and maxillofacial surgery department of de, Montmorency College of Dentistry, Lahore from 2009 to 2013. All patients gave history of tooth extraction about two months earlier. Orthopantomograph [OPG] were used to confirm the diagnosis. Fourteen patients [77.77%] were on oral hypoglycemic agents, four did not know their diabetic status, four patients [22.22%] were on intermediate acting insulin. All patients were managed under general anesthesia for involucrum sequestrectomy followed by primary closure. One insulin dependent patient with radiated lower jaw developed osteomyelitis after tooth extraction and was also on bisphosphonate medication followed by breast cancer surgery. This patient was operated twice to resolve the osteomyelitis of the lower jaw in follow up six months. It was concluded that diabetes effects the healing of sockets after tooth removal

Pattern of hearing loss on pure tone audiogram in heavy industrial workers

Background: Hearing loss in industrial worker may be devastating for the workers, with poor quality of life

Objective: This study was conducted to find out the degree of hearing loss and audiometric pattern of hearing loss in local industrial workers

Patients and method: This cross sectional study was conducted at department of ENT, head and neck surgery, Kulsoom Bai Valika Social Security Hospital, SITE, affiliated hospital of Hamdard University, Karachi, from 1[st] January, 2010 to 31[st] December, 2010. A total of 100 persons were included in this study who were industrial workers for more than 15 years and came to hospital for some reasons other than hearing loss or any ENT problem. The data was entered and analyzed by using SPSS version 15

Results: Majority of the subjects were male [96%] while only 4% were females. 18 patients were below the age of 35 years, 29 were between 36-45 years, 32 were between 46-55 years and 21 were above the age of 55 years. 74% of the workers were not using any protective device or method against loud machinery noises. Mean hearing threshold of all the subjects was above 25 dB in all frequencies tested i.e. from 250 to 8000 Hz. Mean hearing loss was maximum at the frequency of 4000 Hz

Conclusion: All of the workers included in this study has some degree of hearing loss at least in some frequencies [more pronounced at 4000 Hz], although majority were not aware of this hearing loss

Retrieval of gallbladder through epigastric port as compared to umbilical port after laparoscopic cholecystectomy

This comparative prospective study was conducted at the Ghulam Muhammad Mahar Medical College Hospital and Red Crescent General Hospital, Sukkur, Pakistan, for a period of two years from July 2012 to June 2014. The study included 1800 patients who underwent laparoscopic cholecystectomy for symptomatic cholethiasis. These patients were divided in to two groups. Group I included 900 patients, who underwent conventional laparoscopic cholecystectomy with the four port technique. In these patients, the gall-bladder was retrieved through umbilical port by a sterile surgical hand glove [size 6[1/2] or 7 inches] endobag. The fascial defect of 10 mm umbilical port was closed by vicryl "0" with J-shaped needle, while three 5 mm ports closed by applying steri strips. Group-II also included 900 patients. In these patients laparoscopic cholecystectomy was done by using three ports, 10 mm epigastric working port, 5 mm umbilical port for 5 mm telescope and lateral 5 mm port for assistant. The gall-bladder was retrieved through epigastric port without endobag. The results of both these techniques were collected and analyzed on SPSS version 14. The mean age of patients was 45 years. The male to female ratio was 1:3. In group-I, after laparoscopic cholecystectomy, gall-bladder was retrieved safely through 10 mm umbilical port in surgical glove endobag. In acutely inflamed cases, the gall-bladder was opened at the umbilical port site inside the endobag and decompressed before retrieval. In this group, wound infection of umbilical port occurred in 5.11% patients, port-site hernia in 3.66%, port-site bleeding in 1.33% while difficulty in retrieval of gall-bladder in acutely inflamed cases in 1.88% patients. In group-II, wound infection in epigastric port was found in 1.55% patients, port-site hernia in 0.11%, port-site bleeding in 4%, difficulty in retrieval of gall-bladder in 5.33% while leakage /perforation of gall-bladder in 4.11% patients. The serious complications like wound infection and port-site hernia are more frequently found in group-I patients as compared to group-II

effects of insulin on the volume, absolute and relative weight of liver in HFD/streptozocin induced diabetic rats

In present study, the effects of insulin on the volume, absolute and relative weight of liver was studied in Wistar albino rats for a period of 4 weeks. Retrospective / observational study. This study was conducted in the Animal House of DUHS and it took 8 months 1[st] June 2011 to 1[st] Feb 2012 to be completed. The Male Wistar albino rats which were randomized into 3 groups; each group containing 10 rats. Group A served as control, Group B as insulin treated and Group E as untreated diabetic rats. All the other rats except the Group A were kept on in-house prepared High Fat Diet [HFD] throughout the study. After 2 weeks of exclusive HFD, diabetes was induced by intraperitoneal [IP] injection of low dose streptozocin [STZ 3.5mg/100gm]. After the induction, one group was left untreated [Group E] and one group [Group B] was treated with insulin for 4 weeks. The rats were then, sacrificed, liver was isolated, weighed, and its dimensions were noted. The mean absolute liver weight [ALW] of rats was observed as 8.60 +/- 2.54 gm, 13.18 +/- 0.68 gm and 9.40 +/- 3.18.gm in control, untreated and insulin treated groups respectively. And the mean percent liver weight [PLW] was calculated as 2.99 +/- 0.66%, 5.10 +/- 0.73% and 3.99 +/- 1.37% in control, untreated and insulin treated groups respectively. Statistically significant difference was noted between ALW, PLW and liver volume of rats of the three groups. Insulin decreases the volume, absolute and relative weight of liver of diabetic rats when used for a short period

An experience of steroid in recurrent ethmoidal nasal polyps at tertiary care hospital

OBJECTIVE: To evaluate the effect of preoperative short course of oral steroids followed by postoperative topical nasal steroids sprays on nasal polyp recurrence after classical intranasal Polypectomy

METHODS: Fifty five patients of both genders with symptoms and signs of nasal polyps were included in this prospective study between January 2010 and December 2012. Their ages ranged between 20 and 65 years. The patients were divided into two groups. Group I constituted 30 patients treated by classical sinus surgery [simple nasal polypectomy and intra nasal ethmoidectomy] without oral and local steroid therapy. Group II consisted of 25 patients also treated by intranasal polypectomy but received preoperatively 60mg prednisolone tablets daily for one week and postoperatively topical nasal steroid spray [Mometasone furoate suspension] for three months. All patients were followed up for at least one year. Recurrence of nasal polyps was assessed endoscopically at three, six and twelve months after surgery. Any evidence of nasal polyp formation of whatever size was considered as recurrence

RESULTS: Fifty five patients [35 male and 20 female] with sinonasal polyposis were included in this study. Male to female ratio was 1.75:1. The patients' age ranged from 20 to 65 years and median age was 45 years; median age was 43 years. Recurrence rates at three; six and twelve months after surgery for the first group of patients were 8.33% [2 patients], 25% [6 patients] and 41.6% [10 patients] accordingly, while the recurrence rates for the second group were 4.1% [1 patient], 8.3% [2 patients] and 12.5% [3 patients] accordingly

CONCLUSIONS: Preoperative short course of oral steroid followed by postoperative nasal steroid spray show significant reduction in the recurrence rate of nasal polyps after intranasal polypectomy

Assessment of hearing loss in tympanic membrane perforation at tertiary care hospitals

OBJECTIVE: To evaluate and analyze the degree of deafness in tympanic membrane perforation based on size, site and duration of perforation

METHODS: 90 patients of both sex were selected randomly for this study with age 20 years and above randomly. Size of tympanic membrane perforation was evaluated under operating microscope

Patients were divided into three groups according to size; group I [small], Group II [medium], Group III [large]. Hearing loss was measured in each case with pure tone audiometry

RESULTS: Deafness increased as the perforation size increased [I vs. II [t - 3.23,p <0.01], II vs. III [t - 7.19, p < 0.001], I vs. III [t - 10.88, p < 0.001]]. The degree of deafness was more in posterior quadrant perforation than anterior quadrant perforation but difference was not significant statistically [t - 1.25, p [0.05]. The degree of deafness was more in malleolar perforation [t - 4.64, p < 0.01]. Deafness increased as the duration of disease increased [A vs. B [t - 3.01, p < 0.03], A vs. C [t - 6.49, p < 0.001], B vs. C

Suction cleaning of the external auditory canal in otomycosis: is it really helpful?

OBJECTIVE: This study was conducted with the objective to find out whether suction cleaning of the external auditory canal in cases of otomycosisis helpful or not

STUDY DESIGN: Prospective, randomized comparative study

PLACE AND DURATION OF STUDY: This multi-center study conducted at the departments of ENT, head and neck surgery of Liaquat University Hospital, Hyderabad, Sheikh Zayed Hospital, Rahim Yar Khan and Zubaida Medical Centre, Karachi. The study was conducted from March 2013 to February 2014 for a period of one year

PATIENT AND METHODS: A total of 200 patients were included in this study. These patients were serially divided into two groups A and B. Both groups received topical antifungal solution of 1% clotrimazole, 3 to 4 drops three time per day..In group A at the time of first consultation suction cleaning of the fungal debris was also done while in group B only above mentioned treatment was given without suction cleaning of the external auditory canal. All these patients were followed up regularly till the complete resolution of the disease

RESULTS: The minimum time duration for group A was 5 days and for group B was 9 days. The maximum time duration for group A was 18 days while for group B was 23 days. The mean time duration for complete resolution in group A was 9.6 days while in group B was 15.2 days [p<0.05]

CONCLUSION: Suction cleaning of the external auditory canal for removal of fungal debris is very helpful and it reduces the time duration for complete resolution. So it should be performed in every patient of otomycosis to remove fungal debris

Microbiological spectrum in tubotympanic type of chronic suppurative otitis media

OBJECTIVE: The objective of this study was to determine the local pattern of bacterial involvement in tubotympanic type of Chronic Suppurative Otitis Media

STUDY DESIGN: Descriptive, Cross sectional study

SETTING and DURATION: Department of ENT, Liaquat University Hospital Hyderabad. Two years from January 2012 to December 2013

METHODOLOGY: A total of 150 cases presenting with ear discharge for last six months were included in this study, irrespective of age and gender. Operated cases and disease of external ear were excluded from this study. Ear discharge sample [Pus Swab] was taken from deeper part of external auditory canal with sterile cotton swab on stick and sent for bacterial culture and sensitivity to the diagnostic and research laboratory. Statistical analysis carried out using SPSS 16

RESULTS: This study includes 150 patients of Chronic Suppurative otitis media. Males outnumbered females [M: F = 1.4:1]. Result of swab sensitivity for aerobic organism showed growth of single organism in 65%; while 25% showed mixed growth and 10% did not grow any organism. Pseudomonas aeruginosa[42%] was the commonest organism isolated, followed by staphylococcus aureus[24%], less common organism isolated includes Proteus mirabilis 8.7%, Klebsiella pneumonia 6.7%, E. Coli 5.3% and Coagulase negative Staphylococci 3.3%.Sensitivity of P. aeruginosa was good to Imipenem [97%], followed by ceftazidime [95%], ciprofloxacin [90%] and tobramycin [90%]

CONCLUSION: It is concluded that gram negative aerobic bacteria especially pseudomonas aeruginosa is the most common isolate organism significantly associated with tubotympanic type of CSOM followed by Staphylococcus aureus. Periodic monitoring of the microbiological profile along with their sensitivity pattern is essential for formulating an effective antibiotic policy for CSOM

Intra-operative complications increase with successive number of cesarean sections: Myth or fact?

OBJECTIVE: To determine whether complications related to surgery increase with increasing number of cesarean sections (CSs) in upper segment placenta. To compare the complications in urgent and elective high order (4-6) repeat CSs. METHODS: A retrospective analysis of 519 women who underwent repeat CS was performed from January to December 2012. Women were divided into 3 groups: group 1 with previous 3 CS (n=325), group 2 with previous 4 CS (n=139), and group 3 with previous > or =5 CS (n=55). RESULTS: Statistically significant differences (P < 0.001) were observed among 3 groups, regarding mean gravidity, type of CS, midline incision and bilateral tubal ligation performed. The risks of severe intra-peritoneal adhesions, thin out lower uterine segment and bladder injury were significantly increased (P < 0.001) with increasing number of CS deliveries. Only one cesarean hysterectomy was done in group 1 due to post partum hemorrhage. No significant differences were found in blood loss, duration of surgery, post operative hospital stay as well as birth weight and Apgar scores of newborns. The elective and emergency CS groups of high order repeat CS had no remarkable differences in operative, post operative complications and fetal outcome. CONCLUSION: Women with repeat CS are at increased risk of having multiple intra-operative surgical complications which increase with each subsequent CS. Pregnant women must be informed of the related risks which may affect counselling regarding possible tubal ligation.Women with repeat CS are at increased risk of having multiple intra-operative surgical complications which increase with each subsequent CS. Pregnant women must be informed of the related risks which may affect counselling regarding possible tubal ligation.

Intercomparison of environmental gamma doses measured with A NaI (Tl) survey meter and thermoluminescent dosimeters (TLDs) in the Poonch division of Azad Kashmir, Pakistan / 生物医学与环境科学（英文）

This study presents the intercomparison of the outdoor environmental gamma dose rates measured using a NaI (Tl) based survey meter along with thermoluminescent dosimeters (TLDs) and estimation of excess lifetime cancer risk (ELCR), for the inhabitants of Poonch division of the Azad Kashmir, Pakistan. CaF2: Dy (TLD-200) card dosimeters were installed at height of 1 m from ground at fifteen different locations covering the entire Poonch division comprising of three districts. During three distinct two month time periods within the six month study period, all the installed dosimeters were exposed to outdoor environmental gamma radiations, retrieved and read out at Radiation Dosimetry Laboratory, Health Physics Division, PINSTECH laboratory, Islamabad. The ambient outdoor gamma dose rate measurements were also taken with NaI (Tl) based portable radiometric instrument at 1 m above the ground. To estimate the annual gamma doses, NaI (Tl) based survey data were used for one complete year following the deployment of the dosimeters. The mean annual gamma dose rates measured by TLDs and survey meter were found as 1.47±0.10 and 0.862±0.003 mGy/y respectively. Taking into account a 29% outdoor occupancy factor, the annual average effective dose rate for individuals was estimated as 0.298±0.04 and 0.175±0.03 mSv/y by TLDs and survey meter, respectively. For outdoor exposure, the ELCR was calculated from the TLD and survey meter measurements. The environmental outdoor average annual effective dose obtained in present study are less than the estimated world average terrestrial and cosmic gamma ray dose rate of 0.9 mSv/y reported in UNSCEAR 2000. The possible origins of gamma doses in the area and incompatibilities of results obtained from the two different measurement techniques are also discussed.

Cortical changes in orthopantomogram [OPG] of human mandible as early detector of osteoporosis

To see whether the cortex of mandible on an OPG can be employed for early detection and screening tool for osteoporosis. Cross sectional study. The study was conducted in IBMS, DUHS Karachi and stretched over a period of eight months from December 2011 to July 2012. One hundred and seventy four female subjects, aged 25 to 85 years, were divided into premenopausal [Group I] and postmenopausal [Group II] groups. Each group was subdivided into normal [pre A, post A], osteopenic [pre B, post B] and osteoporotic [pre C, post C] groups by Dual Energy X- ray Absorptiometry [DXA] Scan. Mandibular morphological changes seen on OPG in subgroups of Group I were compared with each other and with subgroups of Group II. Cortical thickness at mental foramen [CMF] was observed on OPG. Statistical analysis was performed by SPSS version 16 using One Way Analysis Of Variance [ANOVA] to evaluate intra group significance and for intergroup significance independent samples T-test was applied. The thickness of Mandibular cortex at mental foramen [CMF] was found to be significantly decreased in osteoporotic patients. In conclusion a simple method of screening was established which can be used as early detector of osteoporosis in a cost effective manner