Fascial slings: a new adjunct to Brachiobasilic Fistula Elevation fascial slings

Objective: To introduce a new technique of fascial slings created from fascia over biceps muscle as an adjunct to Brachiobasilic fistula elevation contributing in the ease of cannulation and position of arm for both nursing staff and the patient

Study Design: Retrospective study

Place and Duration of Study: This study was carried out in Combined Military Hospital Rawalpindi, form Jan 2016 to Apr 2017

Patients and Methods: The demographic and outcome data of the patients, who underwent Brachiobasilic Elevation using fascial slings, were collected and analyzed retrospectively

Results: A total of 89 [60 males, mean age 44.2 +/- 14 years and 29 females mean age 42.6 +/- 12 years] patients underwent brachiobasilic fistula elevation. The distance of fistula vein from skin incision at mid arm was found to be consistent from the per op measurement till the last assessment at 6 months. In our study it was 5 +/- 0.7 cm. Slinged vein was found to be easy to cannulate in first prick as per dialysis nursing staff. Fistula maturation rate was 91 Percent. A total of eight [9 Percent] fistulae were never put on dialysis because of thrombosis. The mean maturation time was 40 +/- 14 days. Fifteen [16 Percent] patients had arm edema, and twelve [13 Percent] had infections. Patients had similar ease of arm position as of brachiocephalic AVF during dialysis

Conclusion: Considering the consistent post op distance of fistula vein from scar site, ease of cannulation for the dialysis staff and comfort of arm position for the patient during dialysis after fascial slings it is concluded that fascial slings are good adjunct to basilic vein elevation technique

Frequency of TMJD among medical students vis-a vis non-medical students

The temporomandibular joint [TMJ] is the synovial joint that connects the lower jaw to the base of the skull. Temporomandibular Joint Dysfunction TMJD is the commonest disorder seen with this joint which appears with common signs and symptoms like clicking sounds, limited mouth opening, jaw pain, headaches, earaches, toothaches and other types of facial pain. TMJ disorder is seen to be an increasing problem especially among the students with higher burden of studies and excessive stress during exams

Methods: This study was conducted to determine the frequency of TMJ dysfunction in medical students in comparison to non-medical students and its association with different variables. A structured questionnaire was designed and administered on 80 medical students and 80 non-medical students irrespective of gender, age ranging from 17-25

Results: The data collected was then entered into the SPSS-16 and tabulated into percentages and bar charts. It is seen that the TMJD is seen to be more common among Medical Students [p= 0.001] and has a significant correlation with study hours and stress [p = 0.032 and 0.00] respectively

Conclusion: Frequency of TMJD is more among medical students than non-medical students in regard of tough studies, excessive stress during exams and study hours

Dental erosion frequency among its different etiological factors

Dental Erosion one of the uprising threat to the community and a challenge to a dentist represents with specific signs and pattern depending upon its etiological factors though having common symptoms

Aims and objective: To determine the frequency of dental erosion among its different etiological factors and the patterns formed by each

Methods: Study was done at four tertiary health care centers, three educational institutes and one chemical industry in which a total of 463 individuals aged 5-75 years [mean=35 years] were examined and assessed for dental erosion. A structured questionnaire was designed and administered on these 463 individuals, dental erosion grading was done according to Eccles and Jenkins erosion scale. The data collected was then entered into the SPSS-11 for analysis and tabulated into percentages

Results: Highest frequency with a strong correlation is seen among GERD and dental erosion i.e., 82.4% with [p < 0.000] followed by occupational exposure to acidic environment 67%, asthma 56%, cerebral palsy 50% and juices and beverages 16%

Conclusion: General dental practitioners should know and identify these patterns in order to determine the causative factor and hence prevent further tooth loss through proper management and treatment

Knowledge, attitude and practices of dentists of pakistan regarding informed Consent

Though ongoing medical advancements has helped the man kind in many ways but it has also tailored the attitude of both the doctors and the patient to insecurity. It has now become immensely important to protect legal and ethical rights of the patients and as well as that of the doctors. Therefore, the application of the informed consent has become immensely important almost in all health care disciplines

Aims: The aim of the study was to gather base-line information on consent knowledge, attitude and practices of dentists of the different cities of Pakistan with the view of utilizing this information in dental practice of this population

Methods: A cross sectional survey was done at different cities of Pakistan including Lahore, Karachi, Peshawar, Quetta and Islamabad. A total of 359 dentists were studied for the practice of informed consent [1C] by filling a self-designed, semi-structured questionnaire in a one-to-one interview by the researcher

Results: The data recorded was then entered in SPSS. 16 and analyzed. Knowledge and attitude of the dentists is seen to be considerably high as compared to their practices which means that they are over reporting in relation to what they know about the essence of consent and hence its application. A need of proper legislature and its implementation is necessary for the improvement of practice of informed consent

Conclusion: Refresher courses regarding 1C practice should be introduced on regular basis among the medical and dental professionals

Non obstructive coronary artery disease in patients admitted for elective coronary angiography

To determine the frequency of non-obstructive coronary artery disease in patients admitted electively without known heart disease at a local tertiary care cardiac hospital. During the period May 1[st] 2012 to April 30[th] 2013, we have collected data from TABBA Heart Institute [THI] Cath Registry, for patients who came for elective coronary angiography without known heart disease at TABBA Heart Institute a local tertiary cardiac care centre. The patient demographic characteristics, risk factors, symptoms and the result of noninvasive testing were correlated with the presence of non obstructive and obstructive coronary artery disease. Data was analyzed through SPSS version 17 and chi square test was applied for significance of the data. Out of 1478 cases examined, 368 cases were enrolled in this study that fulfilled the inclusion criteria. Out of these, 273 [74.2%] were obstructive CAD cases whereas 95 [25.8%] were found to have non-obstructive coronary angiogram. In these 95 cases, 67 cases had gone for cath without non-invasive testing i.e. 18.2%. Although only 18.2% cases had gone for unnecessary angiogram procedure, it could be easily avoided just by following the American Heart Association [AHA] guidelines

In-hospital complications of acute right ventricular myocardial infarction

To determine the in-hospital complications of acute right ventricular myocardial infarction[RVMI]. This study was conducted at Cardiology Department, Lady Reading Hospital, Peshawar from May to October 2009. A total of 100 patients with acute RVMI were evaluated for in-hospital complications. Male patients were 77 [77%] and females 23 [23%]. Patient's mean age was 59.96+12.3 years with age range 28-82 years. Total in-hospital complication events were 174. In-hospital complications were present in 77% patients. Cardiogenic shock was the commonest complication with frequency of 25.8%followed by acute left ventricular failure [LVF] in 17.8% and atrioventricular blocks [AV Blocks] in 14.3% respectively. Re-infarction occurred in 5.7% [10] patients. Thirty eight patients died in our study [21.8%]. Among RVMI patients, 65% stayed in-hospital for more than 4 days. Frequency of complications is higher and cardiogenic shock is the most common complication in acute RVMI patients

gentleman with acute onset hallucinations and delusions

Acute psychotic disorders with a remitting course have a long history. The diagnosis of "Brief Psychotic disorder" is based on DSM IV criteria. Relatively low doses of antipsychotic drugs lead to significant symptom amelioration. Generally, brief psychotic disorder has a good prognosis and runs its course in less than a month. A good prognosis is usually associated with sudden onset, short duration of symptoms, and good premorbid adjustment