Understanding the awareness of health and safety signs amongst health care workers in Pakistan - A cross-sectional study.

BACKGROUND: Safety signs are very important communication tools for accident prevention, fire safety, health hazard information, and emergency evacuation. However, they are helpful only when properly designed and understood by employees. OBJECTIVES: The purpose of the present study was to assess the awareness of health and safety signs amongst health care workers including doctors, dentists and paramedics in different health care sectors across Pakistan. METHODS: Data was collected via Google forms circulated through WhatsApp social media to predetermined groups of health care professionals to assess their understanding of safety signs across different health sectors. The survey included questions pertaining to awareness of 19 different health and safety signs complied with International Organization for Standardization 1710 and the Safety Signs and Signal Regulations 1996 chosen randomly. RESULTS: A total of 987 people participated in our study and were asked to comprehend the meaning of nineteen health and safety signs. The mean comprehension score for 19 signs was 42.2%. The mean score for warning signs was the lowest and fire safety signs was highest. The lowest comprehension scores were for oxygen cylinder sign (W029) 7.5% and highest for first aid sign (E003) 75.9%. Only two signs, that are first aid (E003) and mandatory gloves (M009) had acceptable comprehensive score of 75.9% and 73.7% respectively as per ISO 7010 i.e. >67%. Statistically significant differences were found only for trip hazard sign (W007) with respect to education and for risks of bomb explosion (W002), ionising radiation (W009), evacuation assembly point (E007), location of automated external heart defibrillator (E010) and mandatory gloves (M009) with work experience. CONCLUSION: Based on our results, we conclude that there is dire need of special and frequent training to better recognize the safety signs amongst health care employees since these kinds of interventions promote early detection of hazards and their associated risks. Thus, we propose that health care safety sign training must be included in every health care profession curriculum.

Correlation between glycaemic state and tooth mobility in patients with periodontal disease.

OBJECTIVE: To evaluate the association of tooth mobility with glycaemic levels in patients with periodontitis. METHODS: The cross-sectional study was conducted at the Department of Oral Medicine, Ziauddin Dental Hospital, Karachi, from December 2018 to May 2019, and comprised patients of either gender with chronic periodontitis. After recording demographic details and dental charting, tooth mobility scores were correlated with gingival crevicular blood glucose, finger capillary blood glucose and glycosylated haemoglobin levels using Pearson's correlation. Linear regression was applied to assess the inter-relation between the variables. Data was analysed using SPSS 20. RESULTS: Of the 348 patients, 202(58%) were females and 146(42%) were males. The overall mean age was 43±10.4 years. The mean number of teeth in patients with glucose levels <180mg/dl was 25.5±2.5 compared to 23.2±2.9 in individuals with glucose levels >200mg/dl. A moderate positive correlation (r=0.658) was seen between gingival crevicular blood glucose levels and tooth mobility. Finger capillary blood glucose levels also showed good correlation (r=0.653) with tooth mobility scores. Glycosylated haemoglobin scores showed a strong positive correlation(r=0.733). Linear regression confirmed increased glycaemic levels as a risk factor for tooth mobility (p<0.001). CONCLUSIONS: Tooth mobility and glycaemic levels were found to be strongly interrelated.

Bilateral maxillary canine-first premolar transposition in permanent dentition.

Transposition is a dental anomaly characterized by the exchange of position between two adjacent teeth, especially in relation to their roots, or development and eruption of a tooth in a position normally occupied by a nonadjacent tooth. Transposition of the maxillary canine and first premolar has a low prevalence in the population and it primarily affects maxillary canines and premolars. The aetiology of the transposition remains unclear, although it has been associated with genetic factors. It may also be related to a combination of localised factors such as malformation of adjacent teeth, tooth agenesis, retention of the deciduous canine and a history of local trauma. If uncorrected, the results are often both functionally and esthetically unsatisfactory. This case report presents treatment of a female patient with complete bilateral transposition of maxillary canine and premolar. The patient was treated orthodontically with non-extraction fixed mechanotherapy by simulation of maxillary first premolar as canine bilaterally.

Comparison of different craniofacial patterns with pharyngeal widths.

OBJECTIVE: To compare different craniofacial patterns with pharyngeal widths. STUDY DESIGN: Cross-sectional analytical study. PLACE AND DURATION OF STUDY: Orthodontic Clinic at the Aga Khan University Hospital, Karachi, from June 2002 to June 2010. METHODOLOGY: Data were collected using pre-treatment records including orthodontic files and pre-treatment lateral cephalographs of 360 orthodontic patients. The inclusion criteria were subjects of Pakistani origin, aged between 14-20 years and having no pharyngeal pathology or complaints of nasal obstruction at the initial visit. The sample comprised a total of 360 subjects divided into 2 groups: skeletal Class I (n=180) and skeletal Class II (n=180) subdivided according to the vertical pattern into normodivergent, hyperdivergent and hypodivergent facial patterns. Upper and lower pharyngeal airways were measured using McNamara's airway analysis. The intergroup comparison of upper and lower airways was performed with oneway ANOVA and the Tukey test as the second step. RESULTS: There were 172 males and 188 females with average ages of 15.3±1.3 and 15.4±0.8 years respectively. Hyperdivergent facial pattern subjects belonging either to skeletal Class I or Class II malocclusion showed a statistically significant narrow upper pharyngeal airway width as compared to normodivergent and hypodivergent facial patterns. However, no statistically significant difference was found in lower pharyngeal airway widths in sagittal and various vertical facial patterns. CONCLUSION: Sagittal malocclusion type does not influence upper pharyngeal width. However, hyperdivergent subjects have statistically significant narrower upper pharyngeal width when compared to other two vertical patterns.

Development of a prediction equation for the estimation of mandibular canine and premolar widths from mandibular first permanent molar and incisor widths.

The aim of this study was to develop a prediction equation for estimating the total widths of the mandibular permanent canines and premolars (TCPW) using the total widths of the mandibular first permanent molars and incisors (TWFMI). The sample comprised 288 mandibular dental casts of orthodontic patients (106 males and 182 females, average age 13.8 and 14.4 years, respectively). A digital vernier calliper was used to measure the mesiodistal tooth widths from the mandibular right to the left first permanent molar. An independent t-test was used to determine any gender difference and a multiple linear regression equation to predict TCPW using TWFMI. A paired t-test was used to compare the actual and predicted values of the canines and premolars. The results showed a statistically significant difference (P < 0.01) between the mesiodistal tooth widths of males and females. A moderate correlation and determination coefficient between TCPW and TWFMI was found (r = 0.64 to r = 0.67 and r(2) = 0.41 to r(2) = 0.44, respectively). There was no significant difference between actual and predicted values for males and females. The regression equations proposed are a good prediction method to determine TCPW.

Comparison of three mixed dentition analysis methods in orthodontic patients at AKUH.

OBJECTIVE: To compare the actual sum of canine and premolars and that predicted from three mixed dentition prediction methods in orthodontic patients at the Aga Khan University Hospital (AKUH), Karachi. STUDY DESIGN: Cross-sectional comparative study. PLACE AND DURATION OF STUDY: Orthodontic clinic at the Aga Khan University Hospital from June 2002 to December 2007. METHODOLOGY: Data were collected using pretreatment records including orthodontic files and plaster casts of 121 orthodontic patients. Digital caliper was used to measure the mesiodistal widths of permanent teeth from 1st molar to 1st molar in mandibular arch, and central incisors and 1st molars in maxillary arch. The methods of Tanaka and Johnston, Moyers, and Bernabé and Flores-Mir were used to predict the mesiodistal widths of the canine and premolars. Comparison between the actual and predicted sum of the mesiodistal widths of canine and premolars was made for each prediction method, using paired sample t-test. RESULTS: There were 45 males and 76 females with average ages of 13.3+/-1.3 and 13.4+/-0.8 years respectively. For males statistically significant differences were found for Moyers at the 75th percentile and Bernabé and Flores-Mir method whereas for females only the Bernabé and Flores-Mir's method showed significant results. However, no significant difference was found in both genders for Tanaka and Johnston method. CONCLUSION: In the studied orthodontic patients for males Moyers 50th percentile and Tanaka and Johnston methods could be used; while for females Moyers 75th percentile and Tanaka and Johnston methods were applicable for mixed dentition analysis.