Efficacy Of Alpha-Adrenergic Receptor Antagonists In The Treatment Of Distal Ureteric Stones: A Paediatric Study.

BACKGROUND: European association of urology (EAU) recommended α- blockers for managing distal ureteric stones in the paediatric population. This paper will help to understand the efficacy of Silodosin as a medical expulsive agent for distal ureteric stones in children, along with the required time duration of stone expulsion. METHODS: Forty participants were enrolled and evaluated for complaints, pain severity, associated symptoms, and ultrasound was done to confirm the position and size of the distal stone. Follow-ups were scheduled after every 7 days (1 week) for redo ultrasound and assessment of the stone position. Data was entered and analyzed in the SPSS version 23. To evaluate the significance of data chi-square test was performed, p-value <0.005 was considered significant. RESULTS: The minimum and maximum age limits recorded are 3 years and 18 years respectively with a mean age of 9.5±4.5 years and mean stone size was measured as 0.6±0.1 cm. Distribution of stone size indicated the minimum size of 0.4 cm and maximum of 1.0 cm stone in study subjects. Maximum stone expulsion was reported within 14 days or an initial 2 follow-up scans. CONCLUSIONS: The efficacy of Silodosin and medical expulsive therapy evaluated the effect on pain management as pain episodes declined with Silodosin treatment and spontaneous passage of stones were increased within the first 14 days of treatment. This study will be a beneficial contribution in literature especially in a developing country population where paediatric urolithiasis is on expansion and ongoing.

Bleaching during orthodontic treatment and its effect on bracket bond strength.

BACKGROUND: This study investigated the effect of two different methods of bleaching during orthodontic treatment on bracket bond strength. MATERIALS AND METHODS: A total of 45 extracted premolar teeth were selected in this experimental study and divided into three groups (office bleaching with 35% hydrogen peroxide, home bleaching with 22% carbamide peroxide, and control). The color of the teeth was assessed initially before the application of bleaching agents and Thermocycling. Orthodontic brackets were subsequently bonded on the treated surfaces. Bleaching procedures were then performed. A final color measurement was performed at two points on the buccal surface both underneath and adjacent to the bracket base. The initial and final color measurements and the bond strengths were compared between the groups using the analysis of variance. P < 0.05 was considered as statistically significant. RESULTS: Bracket bond strength was significantly reduced in both bleaching groups compared with the control group (P < 0.01). The color difference before and after the bleaching procedures was significant in the office bleaching group (P < 0.01), while the control group did not demonstrate a statistical difference between initial and final color assessments (P > 0.05). CONCLUSION: Bleaching procedures performed during orthodontic treatment reduce bond strength. Enamel beneath the bracket base experiences a whitening effect though to a lesser degree compared with an uncovered surface.

Quality improvement initiatives by Aga Khan Health Service in the mountains of northern Pakistan.

Improving health care quality in a resource constraint environment in an emerging economy that is in a hard-to-reach geographic terrain can become a challenge especially when it has to follow the international standard which AKHS, P envisions to implement across the nation in all of its health facilities. Healthcare of the nation is a responsibility which is shouldered by both the government and the private sector. Private-sector, however, remains under pressure as its resource size is limited and it remains subject to stringent regulation and quality control requirements regardless of whether it is in the remotest corner of the country where proper land routes are either lacking or not safe. This article shares the unique experience of AKHS, P in achieving ISO 9001:2008 International Quality Management System Certification. Particularly at one of the "world's highest valleys -situated at Gilgit Baltistan at an altitude of 13,083 ft. above sea level in Northern Pakistan. The experience was unique in terms of demonstrating and recording how a quality management system can be implemented in one of the most difficult to reach areas where compliance to international quality standards was previously unthinkable.

Are older women likely to use medicines than older men? (Results from AHAP study).

BACKGROUND: The health of elderly population in the world has been an important issue in recent century and the use of appropriate or inappropriate medications is challenging among them. The purpose of this study was to assess the pattern of medication in elderly population in Amirkola, northern of Iran. METHODS: This study was conducted on 1534 elderly subjects who participated in Amirkola Health and Ageing Project (AHAP) in 2013. The number of drugs that was used regardless of their indication in terms of age, level of education, disease, cognitive or depression and social support were recorded and compared in both sexes. RESULTS: The mean number of drugs used in men and women was 2.1±2.45 and 3.59±2.75, respectively (P=0.000). Concurrent use of > 4 drugs was seen in 16.5% of men and in 35.12% of women (P=0.000). The difference for using the number of drugs was significant between sexes with low educational level, but was similar in educated individuals. The use of polypharmacy was associated with the number of concurrent diseases (r=0.58, P=000), cognitive status (r=0.065, P=0.012), social support (r=-0.1, P=0.008), and depression (r=0.273, P=0.000). CONCLUSION: The results show that the use of polypharmacy in the elderly population in Amirkola is relatively high and they need to be educated. Considering the other indices, this problem highly manifested more in the elderly women.