Journal of Islamabad Medical & Dental College
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Pattern of Angulations and Common Indications for Extraction of Impacted Mandibular Third Molar at KMU-Institute of Dental Sciences, Kohat
Get PDFBackground: The extraction of an impacted mandibular third molar (MTM), with associated pathologies or clinical manifestations is an important and one of the most frequent decisions in dentistry. The angle formed by the longitudinal axis of second and third molar is used to determine angulation of impacted MTM. The aim of this study was to identify the pattern of angulations of impacted mandibular third molar and common indications for extraction associated with these angulations.Material and Methods: This descriptive cross-sectional study was carried out at Department of Oral & Maxillofacial Surgery, Khyber Medical University Institute of Dental Sciences, Kohat, Khyber Pakhtunkhwa (KP) from November 2017 to July 2018. A total of 349 patients presenting with impacted mandibular third molars were included in this study. Name, age, gender, address, the angulation of the impacted tooth and the indication for extraction of the impacted tooth were recorded. Data comprising of qualitative and quantitative variables were analyzed using SPSS version 17.Results: Out of 349 patients, 206 were male and 143 females, with the male to female ratio of 1.4:1. The age range of the patients was from 18 years to 60 years with a mean age of 26 ± 6 years. The most common age group with impacted third molar was ≤ 25 years followed by 26 to 30 years’ age group. The most common angulation was mesioangular followed by vertical, horizontal and distoangular impacted mandibular third molar. Pericoronitis was the most common indication for extraction in all angulations except horizontal impaction where root resorption of the second molar was more common.Conclusion: Mesioangular is the most common angulation in impacted mandibular third molars. Pericoronitis is the main indication for all angulations of impacted mandibular third molars except horizontal angulation, occurring mostly in the third decade of life
Use of Zinc and ORS in Home Management of Diarrhea: Knowledge of Mothers attending a Tertiary Care Hospital
Get PDFBackground: Diarrhea is the second leading cause of mortality in children below 5 years of age in Pakistan. Use of Zinc and ORS has been proven in clinical trials to be beneficial in reducing morbidity and mortality. Poor knowledge regarding home management of diarrhea leads to mortality due to severe dehydration. The objective of this study was to assess the level of knowledge of mothers of under five-year-old children regarding, diarrheal home management in Cantonment General Hospital, Rawalpindi.Material and Methods: This was an observational cross-sectional study carried out at Department of Pediatrics, Cantonment General Hospital, Rawalpindi, from 1st August, 2017 to 31st January, 2018. About 400 mothers of under five-year-old children, coming to the outpatient department of the hospital were enrolled in this study. A self-designed structured and validated questionnaire was used to assess the level of knowledge of mothers regarding home management of diarrhea using Oral Rehydration Solution (ORS) and Zinc. Data was analyzed using SPSS version 23 with a p value < 0.05 considered statistically significant.Results: About 91% (n=364) of mothers had awareness regarding use of ORS as a means of diarrheal home management. Regarding level of knowledge variable results were found. A good percentage of mothers had knowledge of the purpose of ORS use (78.3%), administration (60%) and initiation of ORS (68%), but only 20.8% mothers rightly answered the timing of ORS administration. Mothers knowledge about the use of zinc, daily administration and duration of administration (10-14 days) was 38.8% ,20.5% and 17.3% respectively. Mothers who were more educated especially secondary and above and of the age group 22-31, had better awareness of ORS than others, as P value is less than 0.05. Among mothers who were aware of the use of ORS, only 41.8% of them were also aware of the use of zinc.Conclusion: A high awareness level regarding ORS use in mothers was reflected fairly in terms of purpose, administration and initiation of ORS but the kn
Multiple Cranial Neuropathies Involvement in Varicella Zoster Virus Infections
Get PDFUnlike the children, Varicella Zoster Virus (VZV) rarely cause disseminated infection of the CNS except those who have immunocompromised state in the form of HIV infection or using immunosuppressents. However, it may cause focal root infection in the form of shingles and rarely as an involvement of the cranial nerves. Infection involving the multiple cranial nerves has been observed only in some case reports. It is usually a self-limiting disease however early diagnosis and timely treatment may help in quick recovery. We are reporting an interesting case of VZV infection having typical rash and multiple cranial neuropathies.Key Words: Immunocompromised, Meningoencephalitis, Postherpetic neuralgia, Radiculopathy, Ras
The Expression of Progesterone Receptors in Meningiomas of Different Grades
Get PDFBackground: Meningiomas are slow growing intracranial and intraspinal neoplasms with a tendency to recur locally. WHO grades them as I (benign), II (atypical) and III (anaplastic) in order of their increasing aggressiveness, based on histological parameters and brain parenchymal invasion. Progesterone receptors (PR) are more prevalent amongst the lower grade meningiomas. The objective of this study was to determine the immunohistochemical expression of progesterone receptors in meningiomas of different grades.Material and Methods: A total of 100 cases were selected over a period of 2.5 years. Three to five microns’ thick sections stained with Hematoxylin and Eosin were examined microscopically by a team of two Histopathologists and graded into grades I, II and III, according to 2016 WHO classification criteria. Another section of the original tumor was stained with progesterone receptor antibody using the conventional immunoperoxidase method. Stained slides were than examined by the same team of Histopathologists and declared positive (if nuclear staining was observed in more than 10% of tumor cells) or negative. Statistical analysis was done using SPSS version 21.Results: Out of a total of 100 cases of meningioma, there were 79 cases of benign/typical WHO grade I, 15 cases of atypical/ WHO grade II and 6 cases of anaplastic/ WHO grade III tumor. PR status was positive in 89.8 % (71/79) of grade I meningiomas and 46.6 % (7/15) of grade II/Atypical meningiomas. The 06 cases of Anaplastic/WHO grade III tumors were negative for PR. There was a higher prevalence of Progesterone receptors in female patients (89.8%; 53/59) as compared to male meningioma patients (60.9%; 25/41).Conclusion: We observed a decreased expression of progesterone receptor in higher grades of meningioma in this study. It is an effort to explore conservative treatment options for inoperable lesions, as anti-progesterone therapy may hold a promise as a new treatment option in the near future
Primary Renal Squamous Cell Carcinoma: An Unusual Malignancy
Get PDFMalignancies of the upper urinary tract are rare, accounting for about 8% of all malignancies of the renal system, presenting mostly as urothelial carcinoma. Squamous cell carcinoma (SCC) arising from the upper urinary tract is even more rare, accounting for about 0.5% of all malignancies of the renal system and 10% of all renal pelvic tumors. There are very few case reports in the indexed literature regarding renal squamous cell carcinoma. Here we present a case of SCC arising from the lower pole of left kidney, in a 35-year-old male resident of Muzaffarabad, Azad Kashmir
Sudden Maternal Death from Suspected Amniotic Fluid Embolism and a Dead Baby Delivered with Natal Teeth
Get PDFAmniotic fluid embolism (AFE) is a rare presentation in obstetric emergencies that carries great risk for the life of both mother and fetus. It is usually characterized by sudden cardiovascular collapse, respiratory distress and disseminated intravascular coagulation. Here we present a case of sudden death of a pregnant woman due to suspected AFE. We also present a rare finding of natal teeth in her deceased baby, which along with reported AFE in the mother, is an unlikely event in the medical literature
Frequency of Surgical Impactions of Mandibular Third Molar in Orthodontic Patients with Different Antegonial Notching
Get PDFBackground: Few studies have been reported so far on the frequency of lower third molar impactions in patients with different morphological characteristics. Our aim in this study was to find out the frequency of impacted lower third molars in orthodontic patients with different antegonial notch depths.
Material and Methods: This cross-sectional research was conducted at Orthodontics Department of Dental Section, Faisalabad Medical University, Faisalabad, and de’Montmorency College of Dentistry, Lahore, Pakistan from June 2017 to June 2019. A total of 60 orthopantomograms (OPGs) of patients with impacted lower third molars were included. The depth of antegonial notch was calculated on all the selected OPGs by measuring distance between the deepest area of the notch cavity and the tangent on the inferior border of the mandible. The patients with depth of antegonial notch of 1 mm or less were labeled as having shallow antegonial notch, while those with 3 mm or more were considered as having deep antegonial notch. Percentages and mean + SD were calculated for different variables. Depth of antegonial notching was compared between genders using ANOVA with P-value <0.5 considered as significant.
Results: Of 60 orthodontic patients, there was an equal number of male and female patients (n=30). The average age of the patients was 25.5±4 years. Overall frequency of impactions was similar in both the genders and frequency of impacted lower third molars was found to be greater in patients with deeper antegonial notches.
Conclusion: Mandibular third molar impactions were most frequent in orthodontic patients with deep antegonial notche
