Anxiety related to dental procedures among the students of a dental college

The objective of the study was to determine level of dental anxiety related to dental procedures in dental students and comparing the dental anxiety between male and female undergraduate dental students of Rawal Dental College. This cross-sectional study was conducted at Rawal Dental College, Islamabad, Pakistan during October 2016. A validated Corah Dental Anxiety Scale [DAS] questionnaire were distributed among dental students in first, second, third and fourth year students present at the day of study. There were four questions with five options in this scale that assess level of anxiety. Total score ranged from 4-20. This was total of all points of scale items. The score 8 or below 8 showed no anxiety, 9-12 showed moderate level of anxiety, 13-14 showed high level of anxiety and 15-20 showed severe level of anxiety. Chi-Square Test used to determine level of anxiety and Mean Anxiety Score between male and female students. Mean and Standard Deviation of gender was calculated by independent T test and that of Academic classes of dental students were calculated by one-way ANOVA. Results showed female students presented with higher mean anxiety score as compared to male students. The difference was statistically insignificant [P-value = 0.10]. Dental anxiety reduced from first year to final year. Female students had more high to severe level of anxiety as compared to male students. Mean and standard deviation of Mean anxiety score was calculated i.e. 9.11 +/-3.15

Evaluation of house officers confidence level in performing endodontic treatment

The objective of this study was to determine the confidence level of house officers in performing root canal treatment. This cross-sectional study was conducted at Rawal Institute of Health Sciences and Islamic International Dental Hospital from june 2017 to January 2018. An anonymous questionnaire was distributed among house officers of both hospitals. The questionnaire utilized scaled response to determine the level of confidence while performing various steps of root canal treatment. The level of confidence was categorized using 5-point Likert's scale as 1=not at all confident, 2=not very confident, 3=neutral, 4=confident and 5=very confident. Data were entered and analyzed in SPSS version 17.0. Counts and percentages were measured for various parameters of respondent's confidence level. Chi- square test was used to compare confidence level between the two genders and also between the two institutes. Majority of house officers were not confident in placement of rubber dam [44%], working length determination using apex locator [36%] and management of flare-ups [40%]. Male gender was found more confident than female regarding various steps of root canal procedure. House officers of Rawal institute of health sciences were more confident in some steps of root canal than house officers of Islamic international dental hospital. Overall it was concluded that though house officers were confident in performing root canal, however, they were found to have low confidence in performing difficult steps like rubber dam application, use of electronic apex locator and management of flare-ups

Clinical presentation, risk factors and outcome of stroke at a district level teaching hospital

Stroke is a fatal clinical syndrome with mortality rate ranging up to 25%. Hypertension, smoking and diabetes mellitus are common preventable risk factors which are associated with serious outcome. Objective of this study was to determine the clinical presentation, risk factors and outcome of stroke. A cross-sectional study was conducted in the Medical Wards of DHQ Teaching Hospital, Mirpur Azad Kashmir from March 2010 to January 2011. A questionnaire was prepared in accordance with the objectives of the study. Frequency of risk factors in patients with stroke were studied. Different clinical features were also noted and response to the given treatment was checked in the form of mortality and recovery. Frequencies and percentages were calculated using SPSS-12. Two hundred patients with stroke were selected. Of the total, 136 [68%] had hypertension, 55 [27.5%] were smokers, 53 [26.5%] had diabetes and 25 [12.5%] patients had ischemic heart disease. One hundred and two [51%] patients presented with headache, 99 [49.5%] developed hemiplegia and 94 [47%] had loss of consciousness. CT brain showed infarction in 144 [72%] patients while 56 [28%] had haemorrhage. Observed mortality in this study was 18 [9%] while 182 [91%] patients were discharged after treatment. Hypertension, smoking and diabetes mellitus are major modifiable risk factors for stroke. Headache, hemiplegia and loss of consciousness are major clinical features. Ischemic stroke is much common compared to hemorrhagic stroke. With proper care stroke is manageable satisfactorily

Can heart rate and Qtc duration be used as a marker of cirrhotic cardiomyopathy? a case control study

To assess the value of QTc prolongation and heart rate variation as a marker of cirrhotic cardiomyopathy and severity of liver disease. This comparative study was conducted on selected patients with cirrhosis of liver, fulfilling inclusion criteria and were enrolled as group 1. An equal number of non cirrhotic patients were enrolled and included in group 2. QTc and heart rate were calculated and compared between the two groups. Analysis of QTc prolongation and increase in heart rate with regard to severity of liver disease was also made. Fifty confirmed cases of cirrhosis of liver were included in group 1 with equal number of age and sex matched non-cirrhotic patients included in group 2 as controls. The mean +/- SEM of QTc in group1 and group 2 were 0.4707 +/- 0.0065 and 0.3893 +/- 0.00542 seconds respectively. The mean +/- SEM of heart rate was 90.50 +/- 2.839 beats/min and 82.85 +/- 2.207 beats/min in group 1 and 2 respectively. The mean of QTc and heart rate in group 1 was significantly higher as compared to group 2 [p=.001 and p=.0179 respectively]. The mean of QTc and heart rate in subgroup 1A, 1B and 1C was not statistically significant. Patients with cirrhosis have a higher mean QTc and heart rate as compared to non cirrhotic adults. Both tests may be useful markers of Cirrhotic Cardiomyopathy

Presentation of congestive cardiac failure in children with ventricular septal defect

While there is much data on cardiac problems of adults, there is a limited statistical data available to evaluate the magnitude of the cardiac problems in children in Pakistan. Many of these children present with recurrent chest infections and congestive cardiac failure [CCF], and are managed by general practitioners. A careful search for underlying cardiac problems and awareness about the presentation of CCF and its magnitude will definitely decrease the morbidity and mortality of these children. The objective of this study was to see the frequency and clinical presentation of CCF in children with Ventricular Septal Defect [VSD]. Forty-nine patients met the preset criteria during the study period of 6 months. A detailed history and physical examination with special emphasis on symptoms and signs was sought and the findings were noted in a questionnaire. Data was analysed using SPSS-11. Frequencies and percentages were calculated for all categorical variables. CCF in VSD was found more in males, with a male to female ratio of 1.45:1. Majority [63.1%] of the patients presented in infancy. The common symptoms at presentation were dyspnoea [98%], cough [83.7%], and feeding difficulty [9.6%]. Other important symptoms were fever, fatigue, failure to thrive, sweating and wheezing. The common physical signs in order of frequency were murmur 98%, tachypnoea 91.8%, tachycardia 89.8%, hepatomegally 89.9% and crackles in chest 85.7%. Other presenting signs were displaced apex beat 57%, oedema 28.6% and chest deformity 20.4%. Regarding the type of VSD, perimembranous was the commonest 61.2% as confirmed by echocardiography. This study was done on a smaller scale in hospitalised children. The exact studies regarding CCF in paediatric patients are scarce. There is a need to design more studies in children with CCF. Early recognition of signs and symptoms of CCF on paediatric patients with VSD and awareness at primary health care level can prevent the delay in the diagnosis and early referrals by GPs to hospital setup will definitely reduce the morbidity and mortality