Journal of Islamabad Medical & Dental College
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Effect of Novel COVID-19 Infection on Different Organs of Human Body: A Narrative Review
Get PDFThe COVID-19 (corona virus disease-2019) infection produces detrimental effect on vital organs of the human body leading towards mild to severe organ damage. The most drastic effects associated with COVID-19 infection include respiratory failure, cardiac arrest, liver injury and brain damage. The drugs which are used for the treatment of novel coronavirus are also associated with various side effects, which may prove fatal during treatment. This viral infection also reduces patients’ immunity by binding with ACE2 (angiotensin-converting enzyme 2) receptors and modulates immune responses. Older people are particularly at a greater risk. The literature selected for this narrative study was searched and collected from two databases, Google Scholar and PubMed by using specific key words, from March 2020 to June 2020. The objective of this study was to increase understanding about COVID-19, particularly its effects on vital organs so that a better treatment strategy can be established
Aggressive Central Giant Cell Granuloma: A Case Report
Get PDFCentral giant cell granuloma (CGCG) is a benign non odontogenic lesion of jaw that may show aggressive behavior. It is classified as aggressive and non-aggressive lesion on the basis of biological behavior and radiographic features. Central giant cell lesion is more frequent in children and young adult before the age of 30 years with female predilection, with characteristic radiological and histopathological features. Here we present a case of a 35 years old female with clinical and radiological diagnosis of central giant cell lesion in posterior mandible confirmed by histopathology. A surgical approach with regular follow up is the treatment of choice in most of the cases.
Key Words: Calcitonin, Corticosteroid, Curettage, Enucleation, Giant cell lesio
Van Der Knaap Disease in a 3-year-old Male Child: A Case Report
Get PDFVan der Knaap disease or megalencephalic leukoencephalopathy with subcortical cysts is a leukodystrophy with autosomal-recessive inheritance caused by mutation in the gene MLC1 which is localized on chromosome 22q. It is characterized by macrocephaly, motor developmental delay, seizures, spasticity, ataxia, and mild mental deterioration. On neuroimaging, involvement of cerebral white matter along with subcortical cysts in frontal and temporal lobes are hallmarks of the disease. There is no definite treatment of this disease. We report a case of Van Der Knaap disease in a 3-year-old male child who presented with seizures and delayed developmental milestones
Frequency of Neck and Upper Extremity Musculoskeletal Disorders in Dentists
Get PDFBackground: Musculoskeletal disorders are not only becoming prevalent among health care professionals in our country but are affecting their health and performance adversely. They are caused by poor ergonomics and awkward posture during work activities. The purpose of this study was to determine the frequency of neck and upper limb musculoskeletal disorders in dentists of Lahore, Pakistan.
Material and Methods: This cross-sectional study was conducted during October 2017 to March 2018. The data was collected using convenient sampling technique from 162 Dentists including 52 males and 110 females of Children hospital Lahore, Punjab Dental hospital and Fatima Memorial Hospital, Lahore. Data was collected by using Mangalore Questionnaire for identification of musculoskeletal disorders. Descriptive analysis of the data was done using SPSS version 22.0.
Results: Of 162 dentists, 115 (71%) suffered from musculoskeletal disorders. Shoulder was the most commonly affected region (30.9%) followed by neck (25.9%), arm (6.2%), wrist (4.3%), elbow (3.1%) and forearm (0.6%). Pain (45.7%) was found to be the most common complaint followed by muscle weakness (20.4%), paraesthesia (3.7%) and swelling (1.2%).
Conclusions: It was concluded that majority of the dentists were suffering from musculoskeletal disorders with shoulder as the most affected region and pain as the most frequent complaint.
Key words: Dentists, Musculoskeletal disorders, Neck pain, Upper extremit
Prevalence of Dental Caries and its Association with Risk Factors amongst Preschool Children of Bharakahu, Islamabad
Get PDFBackground: It is necessary to understand the prevalence and pattern of distribution of dental caries for better planning and execution of preventive activities in the right dimension. This study provided the base line data about prevalence of dental caries in pre-school children of Bharakahu, Islamabad, and its association with brushing, sugar consumption and previous dental visits.
Material and Methods: A total of 384 preschool children aged 3-5-year-old were screened from periurban area of Bharakahu, Islamabad, using type IV screening method. Data about decayed, missing and filled teeth was recorded using decayed-missing-filled teeth (DMFT) index. Socio-demographics, brushing, sugar consumption and previous dental visits were also recorded and analyzed and their association with dental caries was assessed using Chi square and Odds ratio.
Results: The overall caries prevalence among the sample was 49%. The mean DMFT score with 1 SD was 2.07±3.215. There was no significant difference in caries prevalence in relation to gender of the children. The most significant association was for brushing and low DMFT. Children who brushed their teeth were 4 times more likely to have a low DMFT score of <1 than those who did not brush at all (P<0.001). Likewise, those who had visited a dentist in the past were twice more likely to have a low DMFT (P=0.003). The association of low sugar consumption and a low DMFT score was statistically insignificant (OR 1.4; P=0.878). Hence, brushing turned out to be the most significant factor in determining the caries experience for a child.
Conclusions: This study provided us with the baseline data regarding the prevalence of caries in primary school going children of Bharakahu. The prevalence of unmet dental treatment needs was reflected through a high number of ‘decayed teeth’ as compared to missing and filled ones highlighting the need for restorative care in these children
Comparison of Intravenous Co-amoxiclav and Benzyl Penicillin in Children with Severe Streptococcal Tonsillitis
Get PDFBackground: Streptococcal tonsillitis is a common pediatric ailment which is faced by physicians on a daily basis and is associated with disastrous complications if not treated adequately. The objective of this study was to compare the efficacy, safety and cost-effectiveness of intravenous co-amoxiclav with benzyl penicillin in the treatment of severe streptococcal tonsillitis in children.
Material and Methods: This Randomized Controlled Trial was carried out at CMH Mardan, Khyber Pakhtunkhwa from January 2018 to November 2019. A total of 310 children with severe tonsillitis, aged between 5 to 15 years were selected from outpatient department of Combined Military Hospital Mardan. The cases were divided into two groups. Injection co-amoxiclav was given to patients in Group A (n=155) and injection benzyl penicillin was administered to patients in Group B (n=155). Both groups were compared in terms of effectiveness of treatment, safety and cost effectiveness. All the data was assessed with help of SPSS (Statistical Package for Social Sciences) version 21. Chi square and independent T test were used with P-value < 0.05 taken as statistically significant.
Results: There were 310 children with severe tonsillitis, 155 in each group. Mean age in Group A was 9.35 ± 3.17 years and in Group B, 9.96 ± 2.96 years, respectively. In Group A, 2 cases developed hypersensitivity to injection co-amoxiclav after initial test dose as compared to 3 cases in Group B. Mean duration for complete resolution of symptoms (i.e. hospital stay) was 4.13 ± 0.375 days for Group A as compared to 4.09 ± 0.377 days for Group B (P=0.458). Mean cost of antibiotic drugs for each child in Group A was Rs. 965.88 ± 298 and in Group B was Rs. 152.36 ± 53. Benzyl penicillin was found to be significantly cost effective as compared to co-amoxiclav (P=0.000).
Conclusions: Both the drugs have similar efficacy and safety profile in the treatment of severe streptococcal tonsillitis in children. However, benzyl penicillin is more cost effective than co-amoxiclav in our study population.
Clinical Trail Registration: Clinicaltrials.gov: NCT0421577
Renal Transplant Unit, National Institute of Solid Organ and Tissue Transplantation, Dow University of Health Sciences, Karachi, Pakistan: On a Road to Minimize ESRD Burden
Get PDFEnd Stage Renal Disease (ESRD) is clinically defined as the progressive and irrevocable impairment of kidneys to perform life-sustaining functions and represents the final stage of Chronic Kidney Disease (CKD). With bulging morbidity and mortality and rampant rise in economic burden globally, ESRD is now recognized as a major public health issue. Certainly, it goes without saying that coming decades will observe a high prevalence of ESRD, and chronic non-communicable diseases such as hypertension and diabetes mellitus, with accumulating aging population as the driving force. This prognosticated upsurge in ESRD pool has been gauged to occur mainly in the developing countries
Comparison of Clipless and Clipped Laparoscopic Cholecystectomy at Nishtar Hospital Multan, Pakistan
Get PDFBackground: Laparoscopic cholecystectomy has become the procedure of choice in the management of gall stone diseases which is commonly performed using titanium clips. Harmonic scalpel is an option for the clipless surgery. The objective of the study was to compare the efficacy of clipless cholecystectomy using harmonic scalpel and clipped conventional laparoscopic cholecystectomy.Material and Methods: This randomized controlled trial was conducted at Nishtar Hospital Multan, Pakistan from October 1st 2019 to March 31st 2020. Total 188 patients of gallstone related cholecystitis were enrolled in the study. Patients were divided by simple randomization into two equal groups for clipless and the conventional clipped laparoscopic cholecystectomy, respectively. Age, gender, duration of cholecystitis, duration of procedure, hospital stay, usefulness in difficult procedures and biliary leakage were recorded for all the patients. Data was compared between the two groups by applying Student t-test on quantitative variables and Chi square test on the qualitative variables.Results: Mean operation time was more for clipped (28.35±7.92 minutes) as compared to clipless cholecystectomy (21.15±4.47 minutes) (P < .001). Mean hospital stay was 2.37±0.60 days in clipped surgery group and 1.71±0.74 days in clipless surgery group (P < .001). Biliary leakage was reported in 2 (2.1 %) patients of the clipped group and 1 (1.1%) patient of the unclipped group (P = .561). Clipless procedure was found to be more useful in difficult cases (n=8; 8.5%) as compared to the clipped cholecystectomy (P = .004).Conclusions: The results in the current study show that clipless surgery is a better option as compared to the clipped conventional laparoscopic cholecystectomy, as it is associated with a shorter operating time and hospital stay along with better usefulness in difficult cases
Psychological impact of COVID-19 pandemic on mental health of general population of Pakistan
No full textBackground: Most of the ongoing research on COVID-19 is related to development of an effective vaccine and treatment for this illness, while psychological impact on mental health remains underexplored. The objective of this study was to determine the psychological impact of COVID-19 pandemic on the mental health of the general population of Islamabad.Material and Methods: This cross-sectional study was conducted among the general population of Islamabad, during a period of two months from 15th May to 15th July 2020. A total of 278 participants were given a structured questionnaire based on Hospital Anxiety and Depression Scale (HADS) scoring system to calculate depression and anxiety. The possible scores for depression and anxiety ranged 0-21. A cut off value of 8 and above was used to identify anxiety and depression with higher scores indicating increased severity.Results: The mean age of the participants was 33.42 ± 9.67 years and 148 (53.2%) were males. Among these, 238 (85.6%) were residents of urban area, and 167 (60.1%) were married. Most of the participants were graduate 102 (36.7%). Thirty-six (12.9%) participants had a known patient of COVID-19 in their family or friends. Most of the participants 196 (70.5%) had no comorbidity. The mean anxiety score was noted to be 6.47 ± 5.51 and mean depression score was 6.65 ± 4.17. Presence of any comorbidity showed a highly significant association with anxiety and depression score (P < .01).Conclusions: There was no significant psychological impact of COVID-19 on mental health of the population of Islamabad. However, people with comorbidities showed a significantly raised anxiety and depression status on the HADS score