Journal of Gandhara Medical and Dental Science
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To Determine the Frequency of Dural Tear in Patients Presenting with Depressed Skull Fracture: An Experience of 96 Cases in a Tertiary Care Hospital
Get PDFOBJECTIVEThe objective of this study was to determine the frequency of dural tear in patients with depressed skull fractures.MATERIAL and MethodThis cross-sectional study was conducted in department of Neurosurgery Pakistan institute of Medical Sciences Islamabad from January 2010 to December 2011. All patients of either gender with depressed skull fracture above one year of age were included in the study. CT brain with bone window done in all patients. Per-operative dura in the region of depressed skull fracture was closely observed for any dural tear. The data collected on pre designed proforma. and analyzed using SPSS version 20.0RESULTSA total of 96 patients were recruited in the study out of which 58(60.4%) were male and 38(39.5%) were female. Male to female ratio was 1.5:1. And mean age was 19.23 + 2.54 years. The most common location of depressed skull fracture was parietal 37(38.5%), followed by frontal in 27(28.1%), 15(15.6%)in temporal region,13(13.5%) in occipital region and only 4(4.1%) located in posterior fossa. Dural tear was present in 33(34.3%) while in 63(65.6%) it was absent. Other finding associated with depressed skull fracture per operatively were extradural hematoma in 16(16%), subdural hematoma in 11(11.4%), contusion in 16(16.6%) and pneumoencephalus was observed in 20(20.8%) cases.CONCLUSIONThe frequency of dural tear in DFS is quite high, so one should be vigilant to identify the defect and repair it properly to minimize post operative complications
Factors Associated with Endodontic Flare-Ups
Get PDFOBJECTIVE:The objective of the current study was to determine the frequency and factors of endodontic flare-ups and to compare the post obturation pain in single visit and multi visit root canal therapy, at the department of operative dentistry Sardar Begum Dental College (SBDC), Peshawar.MATERIALS AND METHODS:It was a cross sectional study, carried out at the department of operative dentistry, Sardar Begum Dental College, Peshawar. A total sample of 200 subjects was studied. Treatment protocols were standardized and, after taking informed consent endodontic procedure was carried out. Chi-square test was used to explore the relationship between endodontic flare ups with study variables.RESULTS:Our sample consisted of 54% females and 46% males. Frequency of endodontic flare ups was experienced by 48% subjects.96.2% had used antibiotics, Endodontic flare ups was found to be significantly associated with gender, preoperative diagnosis ,preoperative pain and medication while it was not found to be associated with any other variable studied.CONCLUSION:It was concluded that prevalence of post preparation pain during root canal treatment was high and significantly affected by pre-operative pain, preoperative diagnosis and medication. However, careful selection and adherence to the basic principles of endodontic therapy may reduce the occurrence of flare ups
Bartter Syndrome, a Rare Cause of Malnutrition in Children: Case Report
No full textThree and half year old Haleema presented to OPD with complaints of failure to thrive polydipsia and polyuria. In past she visited different clinicians and hospitals. Scrutiny of the previous record showed alkalosis persistently, but other electrolytes values were different from different labs. We admitted her and investigations were repeated, which showed hypo-kalemia, hypo-chloremia, hypo-natremia, metabolic alkalosis, hyper-calciuria, and normal urine osmolality and specific gravity. Her plasma rennin and aldosterone level were also raised. She was discharged on treatment for Bartter syndrome. On follow up, 15 days later her weight and clinical symptoms were improved
Acrocallosal Syndrome in a 6-Month-Old Pakistani Infant: Case Report
No full textAcrocallosal syndrome is a rare autosomal recessive disorder. The prevalence of the disease is not known but fewer than 55 cases have been published since 1979. ACS is characterized by the total or partial absence of the corpus callosum, Minor craniofacial anomalies (prominent forehead, hypertelorism, short nose with anteverted nostrils and large anterior fontanel) moderate to severe psychomotor retardation (with hypotonia), polydactyly or polysyndactyly. We are reporting a case of 6 month old infant child who was admitted to the hospital with pneumonia, measles, episodes of fits, large anterior fontanelle, prominent forehead, high arched palate, fused tongue, micrognathism , hypotonia, motor developmental delay , polysyndactyly and absent corpus callosum. His clinical diagnosis was confirmed by CT-Brain. The patient was managed for superimposed pneumonia and measles. He was provided with other supportive treatment as well as parental counseling, physiotherapy sessions, and multiple disciplinary approaches was undertaken for further management
The Effectiveness of Single Shot Intravesical Chemotherapy with Mitomycin-C in Preventing Recurrence of Non-Muscle Invasive Bladder Cancer: Town Teaching Hospital, Peshawar
No full textOBJECTIVES:To determine the efficacy of single dose intravesical chemotherapy with Mitomycin-C following transurethral resection of non-muscle invasive bladder cancerMETHODS:It was a Descriptive case series study conducted in the admitted patients of bladder cancer in the institute of kidney disease, Peshawar within one year duration. Total of 128 patients were enrolled in the study. After TURBT patient were catheterized with 22 FR 3 ways foley’s catheter and urinary bladder irrigation was started with normal saline. Mitomycin 40 mg dissolved in 20 ml of normal saline was instilled once hematuria settles within 24 hours. All the patients were called back after 3 months for check cystoscopy and the findings were recorded so as to detect recurrence of bladder tumorRESULTS:In this study, 128 patients with transurethral resection of non-muscle invasive bladder cancer have been observed; male to female ratio was 5:1. The age ranges of patients were from 18 to 75 years. Average age was 51.13 years + 14.33SD. Recurrence was found in 20(15.62%) of cases while the remaining 108(84.38%) were free of recurrence.CONCLUSION:Our study confirmed the effectiveness of a single shot immediate Mitomycin-C instillation in patients with non-muscle-invasive bladder tumors
Causes and Patterns of Tooth Extraction among the Patients Attending a Dental Hospital in Peshawar, Pakistan
Get PDFOBJECTIVEThe aim of this study was to determine the primary reasons for tooth extraction and the type of tooth involved in extraction.METHODOLOGYA cross-sectional study was conducted after the approval of the ethical committee of the hospital at the Department of Oral and Maxillofacial Surgery, Sardar Begum Dental Hospital from July 2015 to December 2015. A total of n=4230 permanent tooth extractions were included with female n=2532 and male n=1698. The primary reasons for tooth extraction specified were caries, periodontal diseases, prosthetic and orthodontic purposes, impaction and trauma. The data was analyzed using SPSS-22. Descriptive statistics was applied for causes and frequency of tooth extraction. Chi-square tests were performed using p ≤0.05 significance level to determine if any significant difference existed among the genders.RESULTSThe mean age presentation was 39.6±15.9 years and the age range 13-70 years. The female patient predominate n=2532 (59.85%) the male patients n=1698 (40.12%). Caries was the dominant cause of extraction in both subjects n=2652 (62.70%), followed by periodontal disease n=930 (22.00%), prosthetic purpose n=366 (8.70%), orthodontic purpose n=156 (3.70%) while cause of extraction due to trauma n=30 (0.70%) was the least one in both subjects. In female the dominant arch is mandibular arch n=1404 (55.45%) than maxillary arch n=1128 (44.55%) while in male maxillary arch n=906(53.36%) predominate the mandibular arch n=792 (46.64%). First permanent molars n=936(11.07% ) were the most common tooth type involved in tooth extraction in both genders [upper: n=408 (9.64%), lower: n=528 (12.50%)]. Upper central incisor n=120 (2.84%) is the least common tooth involved in tooth extraction. The chi-square test illustrates that there is no significant difference exist among both subjects (chi-square=0.9797, p=0.323).CONCLUSIONCaries is the dominant cause of extraction and the most frequent teeth involved in extraction is lower first molar
Frequency of Diarrhoea and its Risk Factors among Children Under-Five Years of Age in Three Teaching Hospitals of Peshawar
Get PDFOBJECTIVE:To determine the frequency of diarrhea and its risk factors among children under-five years of age.METHODOLOGY:Study design was descriptive observational. Duration of the study was three months (Jan – March 2014). Study was conducted in three tertiary hospitals of Peshawar namely Lady reading hospital, Khyber teaching hospital & Hayatabad Medical Complex.MATERIALS AND METHODS:Sample size for this study was calculated based on diarrhea prevalence of 21% in Peshawar by using WHO sample size calculator. A total of 450 children under 5 years of age who were attending outpatient department of three tertiary hospitals of Peshawar were studied. After getting consent from parents of children, data was collected from parents. A semi structured questionnaire was used as study tool. Data was presented in the form of tables and graphs.RESULTS:Frequency of diarrhea was found to be 59% among those 450 children who attended pediatric OPD. Most susceptible age group was less than 2 years (88%). Common risk factors found to be involved in cases of diarrhea were illiteracy of mothers 77%, poverty 86.4% parents were having household income less than 20,000 PKR per month, bottle feeding 34%, improper hygiene (83% either don’t wash or occasionally wash hands before feed, 52.3% mothers wash their hands with plain water after attending toilet), Joint families 58%, lack of proper immunization 54%, lack of clean drinking water 66%.CONCLUSIONS:Diarrhea is more common in younger children i.e.; less than 2 years of age. Illiteracy, low household income, bottle feeding, hand washing especially after attending toilet, joint family system and poor immunization status are the key risk factors
WORLD HEALTH DAY–DIABETES, A GROWING MENACE
Get PDFWorld Health day, celebrated each year on 7th of April is all about creating awareness regarding health issues confronting the global population. The theme this year is Diabetes — a metabolic disorder of menacing proportion. There are a host of misconceptions and lack of understanding amongst the general public regards its exact etiology, prevention, control and socio-economic impact. As of 2015 the prevalence of the disease worldwide is estimated around 415 million affectees1. This number is expected to rise to 592 million by 2035 2. The incidence and resultant mortality secondary to this epidemic is on the rise in low and middle economy countries such as Pakistan, with the disease expected to be the 7th leading cause of death by 2030 3 . Diabetes occurs when the pancreas loses its ability to produce the required insulin or the body fails to utilize the later resulting in raised blood sugar levels 4. As a consequence, malfunctioning of various organ systems ensues and various life threatening illnesses including heart attacks, strokes, nerve damage, kidney failure, blindness, impotence and infections takes a toll on the patient's health. Broadly it is classified into 3 types - Type I or Insulin dependent diabetes mellitus also referred to as 'juvenile diabetes' in which the production of insulin is affected - Type II or Non insulin dependent diabetes mellitus characterized by insulin resistance, and having a strong correlation with increased body weight and lack of exercise 5. It is also called `adult onset 'diabetes'. - Gestational diabetes affecting pregnant women with no past history of the disease, usually in the 2Ild or 3rd trimester 6. The disease usually manifests with the symptoms of frequent urination, thirst and hunger. Once a diagnosis is made based on Blood sugar estimation and monitoring levels of glaciated hemoglobin - HbAl c, management ensues directed at achieving optimum level of blood glucose and avoiding systemic complications. This goal is achieved by introducing life style changes from a sedentary to more active and less stressful way of living, supplemented with a balanced diet and regular exercise. This is especially helpful in Type II DM. Treatment is offered by means of Oral hypoglycemic or injectable insulin as guided by the physician/endocrinologist. More recently bariatric Surgery has shown considerable promise as an effective measure to control blood sugar levels.7 This year the main objective of observing the world health day is to enhance awareness about prevention, care and surveillance of this disease. This will form the basis for launching the first ever global report on Diabetes. The core functions of WHO in this regard are as follows: - To frame internationally acceptable standards and guidelines for prevention, diagnosis and treatment of Diabetes and its associated complications - To closely monitor the morbidity and mortality associate with this disease. - Capacity building at different levels to address different aspects of this disease - To project diabetes as a global health issue and identify the population at risk Efforts to prevent and treat diabetes are essential to achieve the global sustainable development goal target of reducing premature mortality from non communicable diseases by one third by 2030. The community at large and the health care professionals and organizations in particular have a key role to play in highlighting the steps to be taken in this regard through organizing seminars and lectures and making use of the media to effectively communicate their message to the masses.Globalhealth dayfocusing onDiabetes certainlypromises tobe akeyeventin raising awareness andproposing effective measures supplementing themanagement of this disease ona globalstage
Knowledge, Attitude and Practice of Dentists Regarding Cross Infection in Dental Teaching Hospitals of Peshawar
Get PDFOBJECTIVES:The objective of the current study was to assess knowledge, attitude and practices of dentist regarding cross infection in Khyber College of Dentistry (KCD) and Sardar Begum Dental College (SBDC) Peshawar.MATERIALS AND METHODS:This descriptive cross sectional study was conducted at two tertiary care hospitals having sample size 214 with 94 males and 121 females. A pilot study was conducted at Hayatabad Medical Complex to assess the reliability of questionnaire. Self administered anonymous questionnaire was administered to 214 dentists. The dentist in each health care facility was observed for their knowledge, attitude and practice regarding cross infection.RESULTS:Knowledge of dentist’s was optimum but they were lacking sufficient knowledge in areas of sterilization and cross infection due to waste material present in pipes of dental units. Significant numbers of them 28.8% were not agreed with the role of wearing rings in cross infection during dental procedure. Although lack of hand washing and impression was considered as a source of cross infection and 33.9% reported poor attitude regarding hand washing, 39.9% were not regarding the hygiene of nails in cross infection control. Similarly only 59% of them have shown positive attitude towards the vaccination of dental professionals. Although the knowledge and attitude was seen acceptable but their practices regarding the infection control were lacking in area of use of N95 respirator, taking off jewelry during dental surgeries, use of filtered water, use of anti-retraction valve, use of rubber dam for aerosols, use of separate box for sharp disposal and use of disinfectants in dental units..CONCLUSION:From current study it was concluded that dentists have good knowledge but poor practice regarding various aspect of infection control which provide an indication either lack of availability facilities or poor supervision and monitoring, due to lack of policy and implementation regarding cross infection control in dental unit
Frequency of Risk Factors Leading to Acute Respiratory Infections Among Children Under Two Year’s Age and their Gender and Age Wise Comparison
Get PDFOBJECTIVETo determine the frequency of different risk factors leading to Acute Respiratory Infections among children under two yearsTo determine the most susceptible age group and to compare frequency of disease in both gendersMETHODOLOGYStudy design was cross sectional observational. Duration of the study was three months (September – November 2014. Study was conducted in two tertiary care hospitals of Peshawar namely Khyber Teaching hospital & Hayatabad Medical Complex. A total of 200 children under 2 years of age who were attending outpatient department of two tertiary hospitals of Peshawar were studied. After getting consent from parents of children, data was collected from parents. A semi structured questionnaire was used as study tool. Pilot study was conducted prior to the actual study to check the feasibility of questionnaire. Children with acute respiratory tract infections were included in the study while immune compromised and children with other serious systemic diseases were excluded from the study Data was presented in the form of tables and graphs.RESULTSFrequency of acute respiratory infections was common among males (65%) as compare to female children under two year of age. The most susceptible age group was found to be less than 06 months (46%), then is 7-12 months (33%). Environmental risk factors found to be involved in cases of ARI were poverty (73.5%), rural residency with poor cross ventilation in houses (poor or no cross ventilation 66%), no or partial immunization was 35% with malnutrition of sick children 76% may contribute to development of illness more quickly than other children. Illiteracy among mothers (78%) and 39% among fathersCONCLUSIONSARI is more common in infants less than 6 months of age and males are more affected as compared to female children. Poor socioeconomic status, Illiteracy, poor or no cross ventilation in houses, poor immunization status and malnutrition are the key risk factors