Influence of traverse and waveone gold glider glide path files on the amount of apically extruded debris / Influência das limas glide path Traverse e Wave One Gold Glider na quantidade de detritos extruídos apicalmente

Objective: The aim of this study was to evaluate the effect of different glide path files on the amount of apically extruded debris. Material and Methods: Sixty single-canaled mandibular premolars were accessed and randomly divided into three groups (n= 20) according to the file used for glid path creation; group A using Traverse file, group B using WaveOne Gold Glider, group C using stainless steel K file. All teeth were then instrumented using the Reciproc system. The debris extruded apically during instrumentation were collected into pre-weighed Eppendorf tubes which were then stored in an incubator at 70 °C for 5 days. The weight of the dry extruded debris was established by subtracting the pre-instrumentation and post instrumentation weights of the Eppendorf tubes. The data were analyzed using one-way ANOVA test, and post hoc analysis. Results: WaveOne Gold Glider produced the least amount of apical extruded debris (0.41±0.25) followed by the Traverse group (0.59±0.20) then the K-file group (0.64±0.16) with a statistically significant difference (p=0.003). Conclusion: Apical extrusion of debris is inevitable during root canal cleaning and shaping. Creation of glide path using engine-driven files produces less amount of apically extruded debris compared to hand-driven K-files. (AU)

Objetivos: O objetivo deste estudo foi avaliar o efeito de diferentes limas glide path na quantidade de detritos extruídos apicalmente. Metodologia: Sessenta pré-molares inferiores com canal único foram acessados e divididos aleatoriamente em três grupos (n= 20) de acordo com a lima utilizada para criação do glid path; grupo A usando lima Traverse, grupo B usando WaveOne Gold Glider, grupo C usando lima K de aço inoxidável. Todos os dentes foram então instrumentados usando o sistema reciprocante. Os detritos extruídos apicalmente durante a instrumentação foram coletados em tubos Eppendorf pré-pesados que foram então armazenados em uma incubadora a 70°C por 5 dias. O peso dos detritos secos extruídos foi estabelecido subtraindo-se os pesos dos tubos Eppendorf antes e após instrumentação. Os dados foram analisados por meio do teste one-way ANOVA e análise post-hoc. Resultados: WaveOne Gold Glider produziu a menor quantidade de detritos apicais extruídos (0,41±0,25) seguido pelo grupo Traverse (0,59±0,20) e depois pelo grupo K-file (0,64±0,16) com uma diferença estatisticamente significativa (p=0,003). Conclusão: A extrusão apical de detritos é inevitável durante a limpeza e modelagem do canal radicular. A criação do glide path usando limas acionadas por motores produz menos quantidade de detritos extruídos apicalmente em comparação com as limas K manuais. (AU)

Prevalent Beliefs and Attitude toward Vitiligo among Public in Al Baha Province, Southern Saudi Arabia

ntroduction: Vitiligo is an apparent skin condition that has a psychological impact on the affected individuals and their families. Its prevalence is estimated to be about (0.5-2%) globally. Misunderstandings, and negative attitudes toward vitiligo patients are the most important factors affecting the quality of life of vitiligo patients. Objective:The objective of this study was to identify the common misconceptions and attitudes about the nature, causes and prognosis of vitiligoin Al-Baha region, Saudi Arabia. Methods:A cross sectional study collected data from the general population in the public malls in Al-Baha region, Saudi Arabia. We used a questionnaire which was developed by the authors, the questionnaire included questions regarding vitiligo cause, nature, prognosis and the attitude toward vitiligo Results:A total of (453) responses were analysed, of which (53%) were females, and (90.9%) were Saudis. Theparticipants’ ages ranged from (16 -64) with a mean of (28.3). The majority of our sample had a high level of education; university (65.1%), High school (26%) and less than high school (6%). Our population believed that gecko and its saliva were the commonest cause (38.1%). Most of the respondents (44.4%) thought that the condition is exaggerated by stress and anxiety. Regarding attitude; (31.5%) are unwilling to marry a vitiligo patient. Conclusion:The results of the present study show that the misconceptions and attitudes toward vitiligo are prevalent. Health awareness campaigns should be implanted to educate the people and improve the quality of life of the affected individuals

Hypoglycemic and Hypolipidemic Properties of Ethanolic Extract of Brassica oleracea in Streptozotocin-Induced Diabetic Rats

Diabetes mellitus has become the most prevalent metabolic disease worldwide. The edible leaves of Red cabbage(Brassica oleracea L.) is one of the most regularly consumed vegetables in Arabic countries. Thus, it was ofinterest to assess the hypoglycemic and hypolipidemic impacts of ethanolic (50 %) extract of the leaves of redcabbage on blood glucose, glycated hemoglobin (HbA1c) and lipid profile in streptozotocin (STZ)-induceddiabetic rats. Diabetes was induced in male Wistar rats by injecting rats with 60 mg/Kg bodyweight ofstreptozotocin. Diabetic rats demonstrated a significant increase in serum glucose, glycated hemoglobin (HbA1c)total cholesterol (TC), and triacylglycerol (TG). Daily oral supplementation (250 mg/Kg body weight) of extractof red cabbage leaves for 40 days to STZ-induced diabetic rats significantly ameliorated HbA1c (p < 0.01), TG(p < 0.01), serum glucose (p < 0.01), and TC (p < 0.01). By comparison, a standard anti-hyperglycemic drug,Glibenclamide, when administered at a dose of 10 mg/kg body weight, decreased TC, blood glucose, HbA1c, andTGs levels. It is concluded that the ethanolic extract of red cabbage decreased the blood levels of HbA1c, glucose,and lipids and it was more efficient than Glibenclamide in reducing blood glucose.

Awareness about hepatitis C among patients suffering from hepatitis C in Karachi, Pakistan

Objectives: To assess the level of awareness about hepatitis C among patients suffering from hepatitis C in Karachi. Pakistan. Study design, settings and duration: A descriptive, cross-sectional study, conducted among hepatitis C patients recruited from the Aga Khan University Hospital and the Civil Hospital, Karachi, between March and May 2013

Patients and Methods: A sample size of 247 was calculated using the Open Epi software. Data were collected using a questionnaire and all eligible patients were briefed about the study purpose, risks, benefits, and their rights as participants. All patients who agreed to participate gave written informed consent. The completed questionnaire took a maximum of 2530 minutes. For the data analysis, frequencies and percentages were computed to find out the estimated proportions of different variables

Results: A total of 250 HCV patients participated in the study. Most of the patients had incorrect knowledge about transmission of disease where 76.8% said that it is transmitted through sharing of towel/clothes, coughing [75.2%] or eating in same utensils [53.6%]. Tattooing [66.4%], kissing [66%], sexual intercourse [54.4%], ear and nose piercing [53.6%] were also identified as transmission sources. Almost 91% patients had misconceptions that preventive vaccine for hepatitis C infection is available. Almost 61% patients thought that exposure to needles/syringes was the cause of their hepatitis C while 22% said it was medical instruments. Food and water as the cause of their hepatitis was reported by 19.1%

Conclusion: Patients suffering from hepatitis C have misconceptions about disease transmission, its risk factors, and the availability of preventive vaccine for hepatitis C. There is a dire need to improve public awareness about common diseases and their prevention

Microleakage of fusio[TM] liquid dentin self adhesive composite in class v cavities

Microleakage at tooth/restoration interface is one of the major causes for any composite restoration failure. Composite marginal adaptation is more critical in class V Cavities where there is little or no enamel at the cervical margins, and the restoration comes in contact with cementum. This decreases adhesion considerably, facilitating shrinkage of the material in occlusal direction leaving a gingival gap. The aim of this study was to evaluate microleakage of the new self adhesive composite "Fusio™ Liquid Dentin" in Class V cavities with enamel and dentin. Standardized thirty class V cavities were prepared on buccal and lingual surfaces of 15 human premolar teeth, with occlusal and gingival margins at the enamel and cementum/dentin levels respectively. Specimens were divided into 3 groups with 10 samples each. Group 1: 10 cavities restored with Fusio TM Liquid Dentin [FLD] -A2 shade [self adhesive flowable composite, Pentron Clinical Technologies, Wallingford, CT, USA] without etching and bonding, Group 2: 10 cavities restored with FLD -A2 shade with etching only and Group 3: 10 cavities restored with FLD -A2 shade with etching and bonding. After being stored in distilled water and finished, the teeth were thermocycled, immersed in a buffered 2% aqueous solution of methylene blue for 2 hours and then embedded in clear acrylic resin blocks. They were sectioned and the depth of tracer penetration was measured with periodontal probe and magnifying lens. The results were analyzed using one way ANOVA and t-test at 0.05 level of significance. There was a statistically significant difference between the six groups being tested. All the composite materials being tested showed statistically insignificant differences in occlusal dye penetration [P>/=0.05] and significant differences in gingival dye penetration [P

Cigarette smoking and consumption of psychotropic drugs among medical students of Rawalpindi Medical College, Rawalpindi

Objective: To evaluate practice of cigarette smoking and use of psychotropic drugs among medical students of Rawalpindi Medical College, Rawalpindi

Study design, settings and duration: Descriptive cross sectional was done at Rawalpindi Medical College, Rawalpindi during June 2010

Subjects and Methods: A descriptive cross sectional study was carried out among all medical students Rawalpindi Medical College who were present in various classes during June 2010. Informed consent was taken from all students and data gathered through self-administered questionnaire. Information gathered included consumption of psychotropic drugs, initial mode of getting cigarettes, place of smoking, age of initiation of smoking on regular basis, number of cigarettes smoked per day, cessation of smoking and past smoking history. Data was analyzed using SPSS version 20

Results: A total of 975 students agreed to fill the questionnaire and returned it. Out of them, 815 students denied the consumption of any such drug. No response was received from 86 students while 74 [7.6%] were using psychotic drugs which included various stimulants [31] and sedatives and hypnotics [43]. There were 234 [24%] cigarette smokers whose mean age of initiation of smoking on regular basis was 19.5 years. The place of buying cigarette was either shops or street vendors [21%]. Almost 42.7% medical students smoked cigarette in the medical college while 23.1% smoked in public places, 8.9% at friend's house and 8.1%, in social events. Most [48.7%] medical students had tried at least one cigarette in the medical college to see its effect. There were 98 current smokers [84 males and 14 females] out of whom 50 [21.3%] were current daily smokers. Of the total 234 smokers, 46.1% were not willing to quit smoking within next 6 months

Conclusion: In the medical college 24% students were smokers and 7.6% were using psychotropic drugs. Almost 46% students were not willing to quit smoking in near future

Policy message: Regular medical checkups are needed in medical students for their indulgence in addictions like tobacco use and psychotropic drugs. Once convinced and practicing, they can better guide their patients and populations coming to them for various health issues

Outcome of femural neck fracture treated by austin -moor hemiarthroplasty in elderly patients

To determine postoperative complications including with ambulation improvement and condition in elderly patients with fracture neck of femur treated by Austin-Moore hemiarthroplasty during 6 months period postoperatively at Peoples medical university Hospital Nawabshah. Descriptive case series study. This study was carried out at Peoples Medical University Hospital Nawabshah and Liaquat University Hospital Hyderabad from July 2012 to July 2014. Total 100 elderly patients with femoral neck fracture with the age of above 60 years were included in the study. The patients were followed for a period of 6 months postoperatively and all the postoperative complications were documented in the proforma. This study was contains total of 100 elder patients with femur neck fracture majority of male 72%. Most common 69% age group of the elder patients was 60 - 69, years of the age. Fractures were present 55% on the left sides while 45%. Majority of the cases were found with co morbidies 58%, and according to the post operative complications wound problem was found most common 21% along with implant infection 9%, 2[nd] most common complication was bed sore 11%. On the outcome excellent results were found 32.60%, good results were 42.70%, while fair and poor results were as 16.30% and 8.40% respectively. While 17%, death was recorded during 6 month of postoperative time. Austen Moor Hemiarthoplasty is the good surgical technique of the management for the fracture of the femur. It is very cost effect treatment along with very small amount of morbidity and mortality

Current pattern and outcome of closed diaphyseal humeral fracture treated with intramedullary interlocking nail

To determine the current pattern and outcome of the closed diaphyseal humeral fracture treated with intramedullary interlocking nail. Descriptive study. This study was carried out at Orthopedic Department of Liaquat University Hospital Hyderabad and PUMHS Benazirabad Nawabshah from March 2011 to February 2012. All the 40 patients with closed diaphyseal humeral shaft fracture between the ages 15-45 years were included in the study. All the patients after counseling and diagnosed as case with closed diaphyseal humeral shaft fracture on the basis of clinical examination and X-rays. Closed intramedullary nailing management procedure was used for closed diaphyseal humeral shaft fracture regarding with clinical presentation, preoperative findings and functional outcomes were documented including postoperative complications. Total 40 patients were selected in this study with humeral fracture. Male were found in majority. From types of fractures transverse fractures were most common 45% and road accidents were seen in majority. Most common complication was post operative pain in 40% of cases; Excellent results were found in the 55% of the cases while good in 20%, fair in 10% and 5% results were noted poor in the patients. In the conclusion of this study the closed intramedullary interlocking nailing procedure is the very good method for treatment of fracture shaft of humerus including with very good outcome

Analysis of hsp90a gene expression induced by temperature shock and heavy metals in the heart of common carp [Cyprinus Carpio L.]

This study was conducted to analyze the hsp90a gene expression in the heart of carp [Cyprinus carpio] in vivo during exposure to heavy metals [Arsenate, cadmium and copper] and changes in temperature. hsp90a gene induction were measured in the heart by semiquantitative RTPCR. Heat shock resulted in a transient induction of hsp90a [15-fold], while cold shock treatment induced high level [26-fold] of hsp90a expression. Among heavy metals, arsenate proved to be the most potent inducer of hsp90a gene. The hsp90a mRNA levels were elevated 11-fold after 24- h exposure, compared to control. Cadmium at 10 mg/L had no impact on the expression of hsp90a; while cadmium, at 10mg/kg, resulted in significant induction of hsp90a gene [14.5-fold and 17.5- fold] respectively, at 24 h and 48 h exposure. The various induction patterns suggest that hsp90a gene play different role in cardiac protection.

Domestic violence among female healthcare providers: a meta-analysis

Objective: To estimate the prevalence of domestic violence among married female healthcare providers within the Pakistani context

Design: A systematic review has been done

Place and duration: From January 1992 to December 2011 the international and national published literature on domestic violence analyzed and scrutinized

Results: Of the total 54 researched articles revealed that worldwide domestic violence prevalence is ranged of 10% - 69% however, in Pakistan it is 30% to 79%. Verbal violence is the most common type which further leads to other form of domestic violence such as emotional, physical, and sexual violence. Internationally, very limited literatures were available on domestic violence among female healthcare providers but, no literature was found in the Pakistani context

Conclusion: Our literature review reveals that globally female are significantly experiencing in a large proportion with domestic violence and verbal violence in more common. Further research is also need in this regard especially on the ground of domestic violence among healthcare providers

Treatment of dentin hypersensitivity with a combination of nano- fluorhydroxyapatite and Nd:YAG laser

The aim of this study was to evaluate a new treatment modality of dentin hypersensitivity combining nano-fluor-hydroxyapatite [NFH] and Nd:YAg laser and to compare its effect with other therapies such as cyanoacrylate and sodium fluoride using scanning electron microscope. Sixty freshly extracted human premolar teeth were collected. The coronal portion of each tooth was removed and the canals were instrumented and obturated with gutta-percha. A 3 mm wide ring of root surface was cut with a rotary instrument to expose the underlying dentin. Teeth were randomly separated into six groups of ten teeth each: 1] combination of NFH and Nd:YAG laser; 2] Nd:YAG laser; 3] NFH; 4] desensitizing cyanoacrylate resin bonding [Tetric N Ceram]; 5] 2% sodium fluoride; 6] control group. The topography of each group after treatment was determined by scanning electron micro graph. The percentage of occluded tubules was calculated by dividing the total number of occluded tubules by the total number of tubules in each photomicrography. The highest occluding effect of dentinal tubules was obtained for the combination of NFH and Nd: YAG laser [99.8 +/- 3.3%]. However, no significant difference was found among groups 2 [83.1 +/- 5.2%], 3 [82.3 +/- 4.4%], 4 [82.1 +/- 7.2%] and 5 [81.4 +/- 3.5%] [p>0.05]; these treatment modalities showed similar occluding effect on dentinal tubules. The use of NFH and Nd:YAG laser was beneficial for closure of exposed dentinal tubules compared to other treatment modalities. This approach could be promising for dentin hypersensitivity treatment

Rapidly pregressive periodontal disease associated with human immunodeficiency virus

Severe periodontal inflammation with generalized dental plaque accumulation, spontaneous and severe gingival bleeding, fungal infection, and interdental papillae necrosis are presented in a patient infected with human immunodeficiency virus [HIV]. Bite-wing radiographs revealed a generalized horizontal alveolar bone loss of 7-8 millimetres in both arches. Erythematous patches were noted on the gingival mucosa in both jaws. DNA testing was performed to indentify the periodontopathogens. The patient had no signs or symptoms of acquired immunodeficiency syndrome. This case-report presents the massive periodontal destruction that occurred in a patient infected with HIV. Therefore, it is highly recommended that patients infected with HIV should be regularly monitored to aid in early detection and to provide proper management of periodontal inflammatory conditions to minimize its destruction

Detection of Babesia bovis in blood samples and its effect on the hematological and serum biochemical profile in large ruminants from Southern Punjab

Objective:To determine the presence of Babesia bovis (B. bovis) in large ruminants in southern Punjab and its effect on hematological and serum biochemical profile of host animals. Methods:Blood samples were collected from 144 large ruminants, including 105 cattle and 39 buffaloes, from six districts in southern Punjab including Multan, Layyah, Muzaffar Garh, Bhakar, Bahawalnagar and Vehari. Data on the characteristics of animals and herds were collected through questionnaires. Different blood (hemoglobin, glucose) and serum (ALT, AST, LDH, cholesterol) parameters of calves and cattle were measured and compared between parasite positive and negative samples to demonstrate the effect of B. bovis on the blood and serological profile of infected animals. Results:27 out of 144 animals, from 5 out of 6 sampling districts, produced the 541-bp fragment specific for B. bovis. Age of animals (P=0.02), presence of ticks on animals (P=0.04) and presence of ticks on dogs associated with herds (P=0.5) were among the major risk factors involved in the spread of bovine babesiosis in the study area. ALT concentrations were the only serum biochemical values that significantly varied between parasite positive and negative cattle. Conclusions:This study has reported for the first time the presence of B. bovis in large ruminant and the results can lead to the prevention of babesiosis in the region to increase the livestock output.

Critical illness myopathy

Critical illness myopathy [CIM] is a syndrome of widespread muscle weakness and neurological dysfunction which can develop in critically ill patients receiving intensive care. CIM are often distinguished largely on the basis of specialized electrophysiologic testing or muscle and nerve biopsy and its causes are unknown, though they are thought to be a possible neurological manifestation of systemic inflammatory response syndrome usually developing in patients after a brief period of stay in the Intensive Care Unit [ICU]. This case report aims to analyze the Clinical feature, diagnosis and treatment of CIM of 60 years old male case with Chronic Obstructive Lung disease [COPD] admitted to the intensive care. Health professionals working at critical care unit should be aware that any ICU patient may develop CIM

Renal cell carcinoma and acquired cystic disease of the kidneys in a patient on long term haemodialysis

A 65-year-old male Sudanese with end stage disease renal failure [ESRD] on regular haemodialysis [HD] for 5 years developed a painful swelling of his left kidney, which increased in size over a short period of time. He is anaemic and has acquired cystic disease of his native kidneys. Surgical removal and histology proved renal cell carcinoma [RCC]. This is the first case to be reported from Sudan, in a series of 350 haemodialysis patients over the last 14 years

Psycho-social consequences of secondary infertility in Karachi

To explore the experiences of social consequences among women suffering from secondary infertility. Descriptive case series of 400 women with secondary infertility attending tertiary care hospitals in Karachi, Pakistan. More than two thirds [67.7%] of women stated that their inability to give live births or give birth to sons had resulted in marital dissonance. The respondents had been threatened for divorce [20%], husband's remarrying [38%] or to be returned to their parent's home [26%] by their in laws or husbands. Majority [68%] of the women threatened did not have any live births. However, those who had live births [32%] had a girl child only followed by difficulty in conceiving again. Secondary infertility was described as a cause of violence against infertile women. The women reported that they were being physically and verbally abused by husbands [10.5%] and in-laws [16.3%] for being infertile. Nearly 70% of women facing physical abuse and 60% of the women facing verbal abuse suffered severe mental stress. The experience of infertility is a stressful condition itself. This becomes particularly traumatic with previous pregnancies ending up in abortions, stillbirths and neonatal/infant deaths or the live births being daughters only. However, it subjects the woman to contempt and exploitation resulting in severe psychological

Understanding of puberty and related health problems among female adolescents in Karachi, Pakistan

To understand the level of knowledge, a community based study conducted with the objectives as follows: To estimate the proportion of common facilities available and accessible and frequency of utilizing of it. To estimate the proportion of female adolescent utilizing the availability of facilities. To assess the level of understanding related to puberty and related health problems among female adolescents. This cross-sectional study was conducted to determine the understanding and level of knowledge related to puberty and related health problems among female adolescents of Karachi, Pakistan. Data was collected from 150 female adolescents between 10-19 years of age. The pre-coded questionnaire was used to collect the data which was double entered and analyzed in SPSS

Health seeking behavior of couples with secondary infertility

To determine the factors affecting the health-seeking behavior of couples with secondary infertility in Karachi. A descriptive case series. The data was collected from women attending infertility clinics in five tertiary care hospitals in Karachi from March to June 2003. All currently married women, between the age of 15-35 years, with at least one previous conception, irrespective of outcome, attending an infertility clinic and consenting to participate in the study, were included. Women with corrective surgery on vagina and uterus, and cases of primary infertility, were excluded. Multiple logistic regression models were used to determine the association of various factors, affecting the health-seeking behavior, with statistical significance set at p < 0.05 for the covariates and the interaction terms between various factors. The women consulted multiple health care providers for treatment of secondary infertility. The main reasons for seeking treatment were couple's wish [54.2%], family pressure [22.6%] and want of a son by husbands or in-laws [20.4%]. The most commonly sought providers were physicians [74.7%], Traditional Birth Attendants [TBA, 39.5%], Spiritual healers [26%], Hakeems [23%] and Homeopaths [17.2%]. Most of the women who consulted non-physicians were illiterate [69.4%] as compared to those who consulted a physician [37.8%, p-value = 0.00]. The non-physicians were more commonly consulted by women belonging to low socioeconomic group. The posttreatment complications were more common among women who consulted non-physicians. Pressure from husbands and in-laws compels women for consulting multiple providers. Health seeking behavior for infertility is affected by the literacy and socioeconomic status of the women