Journal of Islamabad Medical & Dental College
Not a member yet
636 research outputs found
Sort by
Frequency of different groove patterns seen on the occlusal surface of mandibular second premolars
Get PDFBackground: The Mandibular second premolar has commonly three different type traits depending on the occlusal groove patterns. In addition to that they are also recognized on the basis of number of cusps. The objectives of the study were to determine the frequency of different occlusal groove patterns of mandibular second premolars and to acquire base line data for future studies in this population and field of research.Material and Methods: This study was conducted in Islamabad Dental Hospital (IDH), from September 2017 to December 2017. A total of 600 patients (1200 teeth) with fully erupted mandibular second premolars of normal occlusal morphology, in age group of 15 years and above were screened in the Out Patient Department (OPD). Groove patterns on occlusal surfaces and their anatomical variations on both sides i.e. right and left, were observed and noted in a proforma. Data was analyzed using SPSS version 22.Results: Three different patterns of occlusal grooves (Y, U and H) were found in our study population. Y groove pattern was observed in 364 teeth (30.33%), U pattern in 447 teeth (37.25%) and H pattern was noted in 389 (32.41%) teeth. Among males, U pattern was predominant (43.84%) followed by H and then Y pattern. In females, H pattern grooves was found mostly (34.41%), followed by Y and U pattern.Conclusion: The most frequent occlusal groove pattern observed in our population was U followed by H and Y type
Comparative Study of Conventional Electrocautery Versus Ultrasonic Dissector in Laparoscopic Cholecystectomy
Get PDFBackground: Laparoscopic cholecystectomy (LC) is very commonly performed for removal of gallstones. In routine, ultrasonic devices are used for laparoscopy involving the deeper operating fields, while electrosurgical devices are preferred for LC. However, nowadays both of these devices are used for LC. The objective of this study was to compare the surgical outcomes of ultrasonic dissector over conventional electrocautery in patients planned for LC. Material and Methods: This non-randomized clinical trial was conducted in general surgery unit, Jinnah hospital Lahore. The study duration was 15th January 2015 to 31st December 2016. In group A (n=100), patients were operated through three-port standard laparoscopic cholecystectomy and conventional electrosurgical cautery was used for dissection. While in group B (n=50), patients were operated through single incision laparoscopic surgery (SILS) and Harmonic dissector was used for sealing of cystic artery and cystic duct. SPSS version 23 was used for data analysis. Complications between electrocautery and ultrasonic dissector were compared using chi-square test/Fischer exact test and operative time was compared using student’s t-test with p-value ≤ 0.05 considered as statistically significant.Results: Out of 150 patients planned for laparoscopic cholecystectomy, 33 (22%) were males and 117 (78%) females. The mean age was 40±6.45 years with an age range of 12-80 years. In group A, intraoperative gall bladder perforation was found in 5 patients whereas in group B, there was only one patient with perforation. A total of 4 cases were converted to open cholecystectomy in group A due to difficult dissection in Calot’s triangle as compared to 1 case in group B. In group A, 3 cases had postoperative bile leakage in the drain. In two patients it settled over a period of 3 days. About 03 cases had wound infection in group A and 1 in group B. Mean operative time in group A was 42.2±8.93 minutes versus 35.7±4.85 minutes in group B (p-value 0.001).Conclusion: In this study, the rate of post-operative complications was similar between the two groups, but operative time was significantly shorter in the group B. Harmonic dissector enabled easy dissection of tissues with good hemostasis and less trafficking of instrument, avoiding use of clips and sutures during minimal invasive surgery
Psychological Stress among Parents of Hearing Impaired versus Intellectually Disabled Pakistani Children
Get PDFBackground: Parents of special children face physical, psychological and social impact of their child’s disability, including hopelessness and depression. This study is important as it will help professionals plan and provide effective coping strategies so parents could have a positive perception and behavior for disabilities (like hearing impaired and intellectual disability) in their children. The objective of this study was to analyze level of psychological stress among parents of children with hearing impaired (HI) versus intellectual disability (ID) and relationship between disability and psychological stress.Material and Methods: This cross-sectional study comprised of parents (n = 200) of 100 HI and 100 ID children, of both genders, aged 1 to 16 years. These were recruited by non-probability convenience sampling after taking consent from special education centers of Punjab (Pakistan), over a period of six months from May 2017 to October 2017. After collecting demographic details, quantitative assessment of parental stress was done using Parental Stress Scale (PSS). Statistical analysis was carried out using SPSS v21.Results: The sample population (n=200) consisted of 32.5% male and 67.5% female respondents, with a mean age of 41.23 ± 6.7 years. The mean of total parental psychological stress score was 61.85 ± 17.1 with significant association between disabilities (HI and ID) and psychological stress (p<0.01). In HI group, moderate psychological stress was seen (n=53, 26.5%), while in ID group, profound level of psychological stress was noted in majority (n=70, 35%) of participants.Conclusions: Parents of both HI and ID children showed psychological stress, however, parents of ID children suffered higher level of stress
Superficial Parotidectomy by Retrograde approach through Marginal Mandibular Nerve Dissection
Get PDFBackground: Parotid gland is most commonly involved in tumors, comprising about 80% of the salivary gland neoplasms. Majority of parotid tumors are benign in nature, the most common being pleomorphic adenoma. Superficial Parotidectomy is the preferred treatment option, using either anterograde or retrograde approach. The objective of this study was to determine the post-operative facial nerve status and other complications following superficial Parotidectomy by retrograde dissection for benign lesions of parotid gland.Material and Methods: This prospective clinical study included a total of 22 patients who had superficial Parotidectomy by retrograde technique involving marginal mandibular nerve dissection. These patients were studied post-operatively for facial nerve status, Frey’s Syndrome, wound infection and salivary fistula.Results: Out of a total of 22 patients, 54.54% developed temporary facial palsy on ipsilateral angle of mouth and all of them recovered by the end of 3 months post-surgery. Two patients (9.09%) developed salivary gland fistula and both of them healed spontaneously within two weeks. Frey’s Syndrome and wound infection were not seen in any of the patients included in the study. Histopathology of these lesions revealed pleomorphic adenoma (n=20) and Warthin’s tumor (n=2), respectively.Conclusion: The use of marginal mandibular nerve as a landmark for retrograde dissection of facial nerve in superficial Parotidectomy is a reliable method to ensure lower percentage of facial nerve injury and associated complications
Breast Feeding Remains a Strong Protection against Infant Infections.
Get PDFBackground: Breast feeding prevents infections in infants. Those who are partially or never breast-fed and receiving bottle feeds are at higher risk of infections as compared to exclusive breast-fed infants. The objectives of this study were to record the effect of exclusive breast feeding versus partial and never breast feeding on infections in infants and also to find an association of infection with type of feed, gestation and vaccination status in infants till six months of age.Material and Methods: A total of 500 Infants were included in this cross-sectional study. Information regarding pattern of feeding and infections was obtained by verbal interview of mother and the questionnaire was filled by the study physician. The outcome evaluated was infections in infants till one year of age. Categorical comparisons were made using chi square test. A ‘p’ value < 0.05 was considered statistically significant.Results: Out of 500 infants, 59.4% were males. About 59.6% were exclusively breast-fed till 6 months of age, 31.2% were partially breast-fed and 9.2% were never breast-fed. In exclusively breast-fed group, 29.5% infants reported infections as compared to 40.4% in partial breast-fed group and 65.2% in never breast-fed infants (P < 0.000). Similarly, 40.6% of infants in exclusively breast-fed group, 55.1% in partial breast feed and 58.7% in the never breast-fed reported infections in 4-6 months of age, which was statistically significant (P = 0.003). There was no significant difference in infection rates among the three study groups in 7-9 (P=0.192) and 10 -12 months (P=0.42) of age.Conclusions: Exclusive breast feeding till six months of age significantly reduces the risk of infections in infancy
Clinicopathological Characteristics of Breast Carcinoma in Premenopausal Women
Get PDFBackground: Breast cancer is one of the leading causes of mortality world-wide. The objective of this study was to see the pattern and characteristics of carcinoma breast in premenopausal women reporting at a tertiary care hospital.Material and Methods: This cross-sectional study was conducted at surgical unit of Pakistan Institute of Medical Sciences (PIMS), Islamabad from May 2012 to April 2015. A total of 144 female patients were admitted during this period as diagnosed cases of carcinoma breast. Of these patients, all cases of breast carcinoma diagnosed in premenopausal women were selected and assessed for tumor type, TNM classification and involved breast quadrants.Results: Out of 144 patients 70 (48.6%) cases of carcinoma breast were reported in premenopausal women. The ages ranged from 14 to 48 years with a mean age of 33 ± 7.95 years. According to TNM classification, 2.9% patients were in T1, 25.7% were in T2, 32.9% were in T3 and 38.6% were in T4. Similarly, 37.1% patients presented with a nodal status of N0, 38.1% with N1, 21.4% with N2 and 2.9% with N3. Out of 70 patients, 11 (15.7%) presented with distant metastasis (M1) at the time of diagnosis. The upper outer quadrant of breast (32.9%) was most commonly involved site, followed by upper inner, lower outer and lower inner quadrants, respectively. Most common tumor type was invasive ductal carcinoma (85.7%), followed by invasive lobular carcinoma (7.1%), papillary carcinoma (4.3%), medullary carcinoma (1.4%) and malignant phylloides (1.4%). Regarding exposure to risk factors of breast cancer in these patients, 35.7% women did not breast feed and 27.1% were nulliparous. There was no history of use of oral contraceptive pills in 82.8% and positive family history was reported in 27.1% patients.Conclusions: Late presentation with advanced disease in premenopausal women is more common in our part of the world as compared to international literature. More studies on larger sample sizes should be carried out to validate these findings
Comparison of Caralluma tuberculata with Metformin for Anti-Diabetic Activity: An Animal Study
Get PDFBackground: Caralluma tuberculata, is a wild herb, which grows in the hills of Balochistan and has been known to have medicinal and nutritional properties since antiquity. This experimental research was designed to study the hypoglycemic properties of Caralluma tuberculata and to compare them with Metformin.Material and Methods: This was a laboratory-based animal experimental study. It was conducted in the Pharmacology laboratory of Khyber Medical University, Peshawar from February 2016 to August 2016. Two types of extracts of Caralluma tuberculata [crude extract and carbon tetrachloride (CCl4) extract] were prepared and administered to normal and alloxan treated diabetic rabbits. To study anti-diabetic activity, eighty-four rabbits were divided into two main groups. Group I (Normal/Non-Diabetic Rabbits; n= 21) and Group II (Diabetic/Alloxanized Rabbits; n=63). Each group was further divided into sub-groups (7 rabbits in each). Effect of Caralluma tuberculata, Metformin and 2% gum tragacanth on blood glucose levels were checked at 0, 2, 4, 6, 8, 12 and 24 hours of drug administration. The extracts were given in capsule form and in cooking oil. Data analysis was done using SPSS version 16. For calculation and comparison of the hypoglycemic effects at various doses and different time intervals, analysis of variance (ANOVA) and Tukey’s post hoc test were applied.Results: The crude extract, 200mg/kg body weight of Caralluma tuberculata showed significant decrease (p<0.001) in mean blood glucose levels from 2-hour till12 hours. Whereas, highly significant reduction of blood glucose was seen from 2 hours after treatment till 24 hours, when carbon tetrachloride (CCl4) fraction of Caralluma (100mg/kg body weight) in capsule form was administered. Metformin 500mg/kg body weight was given to compare its effects with plant crude extract and it was found that metformin appeared to be less effective in comparison with Caralluma tuberculata.Conclusion: Caralluma tuberculata lowered the blood glucose level and turned out to be more significant in developing hypoglycemia when taken with cooking oil. More work is essential to provide stronger evidence for the use of this natural agent in the management of Diabetes Mellites
Vitamin D Deficiency in HCV Antiviral Treatment Responders versus Non-Responders
Get PDFBackground: Hepatitis C virus (HCV) is a major cause of chronic liver disease (CLD). Pakistan has a high burden of infectious diseases, including HCV. Its prevalence varies according to geographic regions in the country from about 2·4% to 6·5%. The objective of the study was to compare the frequency of vitamin D deficiency in responders and non-responders of antiviral treatment for chronic hepatitis C.Material and Methods: This comparative cross-sectional study was conducted in Hepatitis Clinic, Jinnah hospital, Lahore from 20th May to 20th November 2013. After ethical approval, participants were selected by using purposive non-probability sampling, 52 responder patients i.e. who were labeled negative for HCV RNA by PCR after 12 weeks of antiviral treatment and 52 non-responder patients were included in this study. Data was collected by using pretested structured questionnaire. Vitamin D3 levels were measured by ELISA and a cut-off value of below 30ng/ml was labeled as Vitamin D deficiency. SPSS version 21 was used to analyze data with p value less than 0.05 taken as statistically significant.Results: Out of 104 patients (mean age 35±8.1 years), 61.5% were males and 38.5 % were females. There was a significant difference in frequency of vitamin D deficiency in treatment responder group when compared to non-responders (p = 0.016). Mean level of vitamin D was 21.8±10.8ng/ml in responders whereas it was 15.6±7.5 in non-responders with a statistically significant difference (p = 0.001).Conclusion: This study concludes that there is a significant vitamin D deficiency among treatment non-responders as compared to treatment responders in patients with chronic hepatitis C
Role of Magnetic Resonance Imaging and Spinal Tap in Early Diagnosis of Tuberculous Meningitis
Get PDFBackground: Tuberculous meningitis (TBM) is difficult to diagnose in early stages due to nonspecific symptoms. There should be high index of suspicion to diagnose TBM at an early stage. The objective of the study was to find out the role of magnetic resonance imaging (MRI) and spinal tap in early diagnosis of tuberculous meningitis.
Material and Methods: A cross sectional study was conducted from July 2015 till July 2018 at Neuromedicine ward, Jinnah Postgraduate Medical Centre (JPMC), Karachi. All patients above 12 year of age, both male and female with nonspecific symptoms like headache, malaise and drowsiness or suspicion of TBM (stage I, II, and III according to British Medical Research Council TBM staging criteria) were included in the study. Patients diagnosed with other CNS disease like encephalitis, malaria and acute bacterial meningitis were excluded. Magnetic Resonance Imaging (MRI) of the brain and early spinal tap for cerebrospinal fluid (CSF) analysis were used to diagnose TBM and findings were noted. Results of MRI and CSF analysis were analyzed by SPSS version 24.
Results: A total of 110 patients of TBM, with 60 (54.5%) male and 50 (45.5%) female patients were included in the study. Most of the patients belonged to a younger age group of 12-40 years (81.8%), while 18.2% were above 40 years of age. About 90% patients were diagnosed in stage I TBM and 10% in stage II and III. MRI brain findings included meningeal enhancement (60%), hydrocephalus (41.81%) cerebral edema (82.73%), tuberculoma (19%) and infarct (14.5%), respectively. CSF analysis showed low protein in 80%, low glucose in 91.8% and lymphocytic pleocytosis in 97.2%, respectively.
Conclusion: Both MRI brain and spinal tap with CSF analysis played a role in the early diagnosis of TBM, which is important to prevent the lethal complications associated with late diagnosis of this disease
Causes of Gross Hematuria in Patient at a Tertiary Care Hospital
Get PDFObjective: To determine the causes of hematuria in patients coming to a tertiary care hospital. Patients and Methods: This cross-sectional study was carried out at Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan. Data was collected over a period of six months (June 2016 to December 2016). Data of all the adult male and female patients presenting with complaint of gross hematuria during the period were gathered and analyzed for etiological profile.Results: In the study the most common cause was urological malignancy, which was present in 29 (58%) of patients. This includes all the urological cancers. Among other causes, 11 (22%) patients had urolithiasis while 5 (10%) patients had gross hematuria due to trauma to renal tract. 3 (6%) males had hematuria due to enlarged vascular prostate and only 2 (4%) females had gross hematuria due to urinary tract infection. Conclusion: Urological malignancy was the most common cause of gross hematuria, which is associated with male gender, older age and history of smoking. Other causes were urolithiasis, trauma, BPH and UTI. We recommend screening for malignant disease of all the patients presenting to the departments of urology with the complaint of gross hematuria