Comparison of two dosages of Submucosal Dexamethasone to control Postoperative Trismus after surgical extraction of Mandibular impacted third molar

Objective: To compare the post surgical effects of two different concentrations' i.e. 4mg [milligram] and 8mg of sub mucosal dexamethasone to decrease trismus by comparing the mean decrease in interincisal distance in patients undergoing impacted mandibular third molar surgery

Study Design: Randomized controlled clinical trial

Place and Duration of Study: Outpatient department of oral and maxillofacial surgery unit, Mayo Hospital, Lahore. The study was completed in 6 months, from Jan 2012 to Jul 2012

Material and Methods: This randomized controlled clinical trial was conducted on 150 patients. Patients were divided into two groups A and B. Mean interincisal distance of all patients was recorded pre operatively and post operatively. All patients were advised to use a mouthwash clorhexidine 0.2 percent before surgery. Group A received 4 mg dexamethasone and group B received 8 mg dexamethasone in the buccal vestibular tissues. Standard surgical procedure was performed by the same operator under same conditions. Postoperative mean interincisal distance of all patients was recorded on day 2 [after 48 hours of surgery]

Results: Average age of patients was 32.62 +/- 7.86 years with minimum and maximum ages of 20 and 50 years respectively. Gender distribution was almost equal. Average [maximum interincisal] mouth opening distance was significantly higher in group B as compared to group A i.e. [36 +/- 3.928 mm [millimeter] versus 26.04 +/- 3.097 mm] with p-value=0.000

Conclusion: Eight mg dose of dexamethasone was statistically more significant in reducing the trismus as compare to 4mg [p-value=0.000]

Practice and enforcement of national Hospital Waste Management 2005 rules in Pakistan

Background: Hospital waste management [HWM] rules in Pakistan were issued in 2005. Despite a decade of enactment, adherence to HWM 2005 rules has been inconsistent and systematic assessment of adherence using a World Health Organization [WHO]-recommended questionnaire has not been done in all teaching hospitals of Peshawar District.

Aims: This study assessed the adherence to HWM 2005 rules by tertiary care teaching hospitals of Peshawar District with respect to HWM personnel, policy and practices.

Methods: Pretested structured questionnaires based on WHO recommendations were used to survey all teaching hospitals of Peshawar District from January to March 2015. Data were also collected on HWM infrastructure and processes from 1 randomly selected medical, surgical, paediatric, and obstetrics/gynaecology unit in each hospital. Besides descriptive statistics, public and private hospitals were compared using Fisher's exact and Wilcoxon rank-sum tests.

Results: Most surveyed hospitals lacked formal HWM plans [70%], written procedures [80%], related job descriptions [80%] or records [90%]. Many hospitals neither had trained HWM supervisors [56%] nor did they organize formal HWM trainings for new staff [40%]. None of the hospitals followed waste segregation and colour coding. When compared to national HWM 2005 rules, multiple gaps in appropriate transportation, storage and disposal were found with no statistically significant difference between public and private hospitals.

Conclusions: Serious gaps in adherence to HWM 2005 rules exist in surveyed hospitals. With recent devolution of environmental function, the Government of Khyber Pakhtunkhwa should enact provincial HWM rules [and ensure their implementation] to facilitate effective HWM practice across provincial healthcare facilities

Diagnostic accuracy of Ultrasound B scan using 10 MHz linear probe in ocular trauma; Results from a high burden country

Objective: To study the diagnostic accuracy of Ultrasound B scan using 10 MHz linear probe in ocular trauma

Methods: A total of 61 patients with 63 ocular injuries were assessed during July 2013 to January 2014. All patients were referred to the department of Radiology from Emergency Room since adequate clinical assessment of the fundus was impossible because of the presence of opaque ocular media. Based on radiological diagnosis, the patients were provided treatment [surgical or medical]. Clinical diagnosis was confirmed during surgical procedures or clinical follow-up

Results: A total of 63 ocular injuries were examined in 61 patients. The overall sensitivity was 91.5%, Specificity was 98.87%, Positive predictive value was 87.62 and Negative predictive value was 99%

Conclusion: Ultrasound B-scan is a sensitive, non invasive and rapid way of assessing intraocular damage caused by blunt or penetrating eye injuries

Seropositivity of hepatitis C, hepatitis B and HIV in chronically transfused beta -thalassaemia major patients

The purpose of this study was to determine the frequency and trend of transfusion transmitted infections [TTI] in chronically transfused beta-thalassaemia major [TM] patients with reference to the duration of transfusions. A cross-sectional study was done on 160 beta-TM patients and 5517 healthy blood donors to find out the prevalence of HCV, HBV and HIV infections. Out of 160 patients, 21 cases [13.1%] were anti-HCV positive, 2 [1.25%] were HBsAg positive. HIV antibodies were not detected in any sample. However, 109 [1.9%] and 104 [1.8%] of 5517 blood donors were positive for HCV and HBV respectively. No donor showed HIV antibodies. Anti-HCV was positive in 9/111[8.4%] thalassaemics [< 10 years of age] while 11/49 [22%] [> 10 years of age] showing significant difference [p = 0.005] among the two groups. For the past 10 - 12 years the screening of blood has reduced the magnitude of the disease significantly as shown by the trend in two age groups. Further improvements need to be done to implement uniform screening throughout the country

Prevalence of anemia among university of Peshawar students

To evaluate prevalence of anemia in male and female students of the university of Peshawar. This was a cross-sectional study conducted on 262 males and 259 females' students. The students were recruited from different Departments of Peshawar University through a convenience sampling procedure after taking informed consent. Students were interviewed and screened for the presence of anemia. Information was collected about socio-demographic background like age and sex on predesigned questionnaire. Blood specimens were collected in EDTA vacutainers and analyzed by using Hematolgy Analyser Huma Reader Plus. The data was analyzed by using computer software package SPSS version 10.0. The mean age of the students was 21.9 +/- 2.3 years. Out of 521 participating students anemia was prevalent in 4/262 boys [1.5%] and 62/259 girls [23.9%] students. Mean hemoglobin [P < 0.001], hematocrit [P < 0.001] and MCH [P < 0.01] were significantly different in men and women. No significant difference was observed in other hematological parameters among the two groups of students. The prevalence of anemia among girls is high as compared to boy's student. This warrants further study on a larger sample of healthy college students to validate these findings and to safeguard the health of these future mothers

effect of size of the needle on the rate of pneumothorax after ct guided transthoracic needle aspiration biopsy of lung masses

Purpose of Study: To analyze the rate of Pneumothorax after CT guided TNAB of lung masses, using multiple needle sizes

Patients and Method: Seventy patients underwent CT guided FNA of the chest masses

Results: Out of seventy, 18 patients i.e.; 26 % developed Pneumothorax. With 18G needle 24 patients underwent FNA and seven of them i.e: 25% developed Pneumothorax. With 20G needle, 26% developed pneumothorax and with the 22G needle 25% developed Pneumothorax

Conclusion: The study shows that the rate of Pneumothorax after CT guided TNAB of Lung Masses remains almost the same regardless of the size of the needle