Preferred methods for the selection of artificial teeth in a complete denture patient in a tertiary care hospital at Rawalpindi

This study was conducted to find the most convenient method for the selection of teeth for complete denture patients between Consultant, Residents and House officers in prosthetic services. A questionnaire was designed specifically prepared and distributed to 45 dentists working in tertiary care hospitals in the twin cities of Rawalpindi and Islamabad. All participants answered questions and responded to the survey. Majority preferred patient's facial form as a guideline in choosing the shape of anterior denture teeth [40%], the most widely used guide in choosing the color of the front teeth was the tone of the patient's skin [48.9%], and more often appearance used in selecting the size of front teeth were the corners of the mouth [35.5%]. Fifty-one percent of dentists prefer to use anatomical teeth for back teeth in prosthesis. Bulk of the participants [97.8%] preferred acrylic resin material for artificial teeth. It can be accomplished as the preferred method to opt for artificial teeth and general dentist in Rawalpindi and Islamabad agree with the approaches by dentists internationally, as evidenced by the data published on the subject

Comparison of quantitative bronchoscopic lavage cultures [B-BAL] with blind NG Tube lavage [N-BAL] cultures in the diagnosis of ventilator associated pneumonia [VAP]

To compare quantitative Bronchoscopic Bronchoalveolar Lavage [B-BAL] cultures with blind nasogastric tube bronchoalveolar lavage [N-BAL] cultures in the diagnosis of Ventilator Associated Pneumonia [VAP]. Cross-sectional comparative study. The study was conducted in Medical ICU and Chest ICU at Liaquat National Hospital [LNH], Karachi, from January till August, 2007. Patients admitted in ICU with clinical suspicion of VAP, fulfilling inclusion criteria viz. fever, leukocytosis, new or worsening infiltrate in chest radiograph or purulent secretions were included. Exclusion criteria were deranged coagulopathy, extreme ventilatory and oxygenation demands and tracheal obstruction. All patients had N-BAL using 16 fr Nasogastric tube [NG] without lubrication followed by B-BAL. Samples collected were submitted to the laboratory for quantitative cultures and sensitivities. Results were documented on predesigned proforma. Fifty four patients underwent paired B-BAL and N-BAL sampling. The N-BAL sensitivity and specificity for N-BAL were 87.87% and 85.71% respectively and p-value was <0.001. N-BAL showed sensitivity of 87.87%, specificity of 75.71%, positive predictive value of 89.65%, negative predictive value of 77.77% and p <0.001, which was statistically significant. Significant differences in time required for sample collection and cost of both procedures were also observed. The results favour the use of blind NG tube bronchoalveolar lavage quantitative cultures as it is simple, safe, cost-effective and minimally invasive method of diagnosing VAP