Journal of Gandhara Medical and Dental Science
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Frequency of Dyslipidemia in Patients Having Subclinical Hypothyroidism
Get PDFINTRODUCTIONThyroid hormone by binding to the thyroid hormone receptors affects metabolism and growth in nearly all tissues of the body. Thyroid hormones play vital role in the synthesis and metabolism of lipids. The reduced secretion of thyroxine (T4) and triiodothyronine (T3) from the thyroid gland results in hypothyroidism. The subclinical hypothyroidism (SH) is term used for the condition in which there is small elevation of thyroid stimulating hormone (TSH) in the presence of normal thyroid hormone levels. Disorders of thyroid gland are the second most common endocrine abnormalities globally after diabetes mellitus.OBJECTIVETo determinethe frequency of dyslipidemia in patients having subclinical hypothyroidism.METHODOLOGYThis study was conducted at Naseer Teaching Hospital, Peshawar. Duration of the study was one years and the study design was descriptive cross sectional study. The total sample size was 136 patients presenting with subclinical hypothyroidism taking 34.31% proportion of dyslipidemia in subclinical hypothyroid patients12, 95% confidence interval and 8 % margin of error; using WHO software for sample size calculation. More over consecutive (non-probability sampling) technique was used for sample collection.RESULTSIn this study mean age was 40 years with SD 1.26. Sixty three percent patients were female and 37% patients were male. Seventy percent patients had dyslipidemia while 30% patients didn’t have dyslipidemia.CONCLUSIONThe current study shows that the incidence of dyslipidemia was found to be in patients having subclinical hypothyroidism
Calcifying Epithelial Odontogenic Tumor: A Case Report
Get PDFABSTRACTCalcifying epithelial odontogenic tumor (CEOT) is a rare odontogenic tumor, accounts 0.4% to 3 % of all odontogenic tumors arising from odontogenic epithelium. Dr. Jens JorgenPindborg first described this unusual lesion; subsequently Shafer et al coined the term Pindborg tumor. It occurs most commonly in the 4th to 6th decade and bears no gender predilection. A case of CEOT in a 55 years old female extending from themesial aspect of right lower canine to the contralateral third molar region is described
Student’s Perception of Their Academics and Clinical Practice on Graduation from Dental Colleges of Peshawar
Get PDFOBJECTIVE:The objective of the current study was to know the perception of students regarding dental curriculum in clinical practice and academics after their graduation in three dental colleges of Peshawar.MATERIAL AND METHODS:It was a cross-sectional study design, carried out at three dental colleges of Peshawar namely Khyber College of Dentistry, Sardar Begum Dental College and Peshawar Dental College. A total number of 193 house officers were there out of which93 participated in the study. A pilot study was conducted to assess the reliability of questionnaire. The study was conducted through a self-administered questionnaire. The questionnaire consisted questions about academics and clinical practice.RESULTS:Our sample consisted of 93 subjects. There were 79% females and 21% males. The results revealed an overall positive learning experience in undergraduate academics and clinical practice. Over 86% of the graduates were satisfied with their academics and about 69% were satisfied with clinical practice. Almost 90% of the subjects were confident in carrying out specific clinical procedures.CONCLUSION:The major conclusions were that academics and clinical practice was satisfactory to the majority of subjects, although some areas of concern were identified that need improvement
Correlation of Serum Sodium with Severity of Hepatic Encephalopathy
Get PDFINTRODUCTIONHepatic encephalopathy (HE) is neuropsychiatric syndrome for which symptoms, manifested on a continuum, is deterioration in mental status, with psychomotor dysfunction, impaired memory, increase reaction time, poor concentration, disorientation, and in severe form coma and may develop at an annual rate of 8% in cirrhotic patients in Far Eastern studies. Fluctuation in serum sodium level is a frequent complication of advanced cirrhosis related to impairment in the renal capacity to eliminate solute-free water that causes retention of water that is disproportionate to the retention of sodium, thus causing a reduction in serum sodium concentration and hypo-osmolality. Hyponatremia is a common finding in patients with decompensated cirrhosis due to an abnormal regulation of body fluid homeostasis.OBJECTIVETo determine the correlation of serum sodium with severity of hepatic encephalopathyMATERIAL AND METHODSThis study was conducted at Naseer Teaching Hospital Peshawar. Duration of the study was 01 year and the study design was cross sectional (Correlation) study in which a total of 408 patients were observed by using – 0.1411 of correlation coefficient between serum sodium and hepatic encephalopathy 95% confidence level and 80% power of test. More over non probability consecutive sampling was used for sample collection.RESULTSIn this study mean age was 65 years with SD ± 0.315. Sixty two percent patients were male and 38% patients were female. Mean serum sodium level was 123 meq/L with SD ± 0.21. Five percent patients had severity of grade I, 39% patients had severity of grade II, 48% patients had severity of grade III and 8% patients had severity of grade IV. Correlation of severity of hepatic encephalopathy with serum sodium level was analyzed as all the 20 patients with severity of grade I had serum sodium level ranged 131-133 meq/L. All the 159 patients with severity of grade II had serum sodium level ranged 126-130 meq/L. In 196 patients with severity of grade III, 45 patients had serum sodium level ranged 126-130 meq/L while 151 patients had serum sodium level ranged 120-125 meq/L where as all the 33 patients with severity of grade IV had serum sodium level ranged 120-125 meq/L.CONCLUSIONHyponatremia was a common feature in patients with cirrhosis and its severity increased with the severity of liver disease. The existence of serum sodium concentration < 135 mmol/L was associated with greater frequency of hepatic encephalopathy. It was also noticed that more severe the hyponatremia, greater will be the grade of hepatic encephalopathy. Close monitoring of serum sodium concentration should be performed in patients with cirrhosis in order to prevent the rapid development of cirrhosis related complications
Complications of Chronic Suppurative Otitis Media
Get PDFOBJECTIVEThe aim of the study was to find the complications of chronic suppurative otitis media.MATERIAL AND METHODSThe study was descriptive study conducted from 1st January 2008 to 31 December 2010 (3 years duration) at ENT department Khyber Teaching Hospital Peshawar. Total 250 patients of all age having complications due to chronic suppurative otitis media enrolled from admitted patients in ENT department Khyber Teaching Hospital Peshawar were included in the study, using convenience (non-probability) sampling.RESULTSIn total of 250 patients, all (100%) were having history of discharging ear, decreased hearing 250 (100%), earache in 75 (30%), fever in 31(12.4%), headache in 28 (11.2%), nausea and vomiting in 23 (9.2%) patients. The extracranial complications were found in 204/250 (81.6%) patients with mastoiditis being the most common in 155/204 (75.98%) patients followed by sensory reural hearing loss, post auricular abscess, facial paralysis, petrositis, labynthitis, Bezold’s abscess and cetili’s abscess in 7.84%, 6.37%, 5.88%, 1.7%, 0.98%, 0.98% and 0.49% patients respectively. While the intracranial complications were found in 46/250 (18.4%) patients with meningitis being the most common in 28/46 (60.9%) followed by brain abscess in 26%, lateral sinus thrombosis in 8.7% and otitic hydrocephalus in 4.4% patients.CONCLUSIONEarly detection and treatment of complications as a result of chronic suppurative otitis is vital to prevent morbidity and mortality
Predisposing Factors and Treatment Outcome of Otomycosis
Get PDFOBJECTIVES:The aim of this study was to determine the predisposing factors and treatment outcomes of otomycosis.METHODS:This was an observational study conducted from July 2008 to August 2012 at ENT department of Khyber Teaching Hospital, Peshawar. Total of 110 patients of all age and both sexes were selected from OPD for the study, using convenient sampling. The predisposing factors and treatment outcome of otomycosis were observed. Results were recorded in percentages.RESULTS:In our study we documented 110 patients having otomycosis. There were 57.3% (63/110) males and 42.7% (47/110) females. Patients ranged from 21 to 40 years were more affected. Mean follow up time was 2 years. The most common predisposing factors were swimming in 49.1% (54/110) patients followed by topical antibiotic drops, cerumen, immune-compromised status and hearing aid use. The most common presenting symptom was otalgia and itching ear in almost every patient 100% (110/110), followed by hearing loss and ear discharge. In our study 1% clotrimazole drops or lotion was applied to all patients after cleaning the fungus debris and cleansing the ear with acetic acid. The treatment outcome was resolution in 57.3%, residual 24.5% and recurrence 12.7%. 5.5% of patients did not come for follow up. The complications were TM perforation in 13.6% patients, serous otitis media in 3.6% and external auditory canal osteitis in 0.9%.CONCLUSION:Otomycosisis usually resolves with local toilet of ear and instillation of antifungal agents, however eradication of disease is difficult in presence of a mastoid cavity and immune-compromised patients
PINK RIBBON AND PINKTOBER
Get PDFThe month of October comes with a familiar sight of ‘pink ribbon’ display and events organized in this context, globally. While this is an integral part of the international calendar in the developed world, developing countries like Pakistan attach little importance to promotion of this concept brand. One of the reasons for this apathy is a lack understanding amongst the social circles and general population about what the pink ribbon advocates. This editorial is meant to highlight the true spirit and importance of this symbol.
A ‘pink ribbon’ is an international symbol of breast cancer awareness with the month of October referred to as ‘pinktober’ chosen as the breast cancer awareness month in many countries over the world. Breast cancer is the most common cancer amongst the female gender with more than one million women worldwide diagnosed with the disease every year. The WHO in its global health estimate reported 508000 deaths in women worldwide from this disease in the year 20111.More than 58% of deaths from breast cancer are known to occur in less developed countries2, which sets aside the misconception that the disease is a problem of the more affluent class. Early detection of breast cancer with its favorable impact on morbidity and mortality associated with the disease is now established as the cornerstone of management3.
Against the backdrop of the magnitude and impact of this condition there is a dire need for creating awareness about the symptoms and treatment of the disease as well as promoting research and facilities leading to early detection, multimodality treatment and support for those suffering from the disease. Pink ribbon as a concept brand allows a platform to achieve these goals by raising money and encouraging scientific progress. The first known use of Pink Ribbon dates back to 1991 when it was handed out by the Susan G Koman foundation to participants of a New York city race for breast cancer survivors and adopted as an official symbol in 19924. Buying, wearing, displaying or sponsoring pink ribbon is a sign of support for women health. Thousands of pink ribbon products are advertised and sold each year with part of the earnings spent in promoting breast cancer awareness and funding research.
The month of October as the national breast cancer awareness month (NBCAM) was started in 1985 by the American Cancer Society and pharmaceutical company Astra Zeneca. The organization behind NBCAM is keen on promoting mammography as a screening tool for early detection of breast cancer. Running, walking and riding besides observing pink dress day and pink hijab day form the essence of events organized globally as fundraisers under this banner.
The campaign for helping breast cancer patients is not limited to diagnosis and treatment only. Addressing the burden of physical, social and psychological stigma associated with the disease is as important as the initial steps in management. The term She-ro, derived from hero is sometimes used to refer to those suffering from the disease. After treatment, the she-ro regains her femininity by using breast reconstruction, prosthetic devices, wigs, cosmetics, and clothing to present an aesthetically appealingappearance5.Breast cancer culture, or pink ribbon culture, refers to steps taken in public to effectively address different aspects of the disease. It supports the efforts of the doctors, promotes diagnostic modalities such as mammograms and various treatment options on offer for breast cancer patients.
Pakistan has the highest rate of breast cancer in Asia. One out of every nine women is at the risk of breast cancer making the Pakistani women most susceptible to the disease after the non Arab Israeli women6. Studies have shown that a significant number of young women make the afore-mentioned list. Therefore, Pink Ribbon has reading-prc-Iterature been running Youth Awareness Program in collaboration with Higher Education Commission (HEC) since 2012. This program not only educates the young women about the importance of self-examination and screening modalities like ultrasound scan and mammograms but also through their interaction with members of their family and society makes them conscious of the disease and advocating regular check-ups. Benefit is also derived from established women groups and Lady Health workers who are in contact with the population in far-flung areas of the country, in spreading awareness to the grass root level. In collaboration with Pakistan Atomic Energy Commission hospitals, Pink ribbon has launched a free nationwide Breast Cancer screening program and is working on building a dedicated Breast Cancer Hospital in Lahore, Pakistan.
Realizing the disease burden and the health, social and financial implications of breast cancer it is imperative that Pink Ribbon as a source of Breast Cancer awareness is propagated in the society and an all out moral and material support be extended to the organizations working under this banner. 
The Clinical Profile of Oral Lichen Planus
Get PDFOBJECTIVESThe objective of the study was to determine the clinical profile of oral lichen planus.METHODOLOGYThis retrospective cohort study was carried from January 2011 to December 2015 at the Department of Oral and Maxillofacial Surgery, Sardar Begum Dental College, Peshawar.A total of 36 with 14 male and 22 female patients having oral lichen planus from were selected. On defined and population-based sample the age selected was ≥ 20 years and divided into four categories i.e..,20-29 years,30-39 years,40-49 years and 50-59 years. The diagnostic criteria proposed by van der Meij et al 23 in 2003 based on the WHO definition of oral lichen planus were used to identify the cases of oral lichen planus.That entire patient’s with incomplete records and aged > 60 years were excluded. The data was analyzed through SPSS 22 at the significance level of p < 0.05 and Chi-square statistics was applied for site and gender association.RESULTSThe mean age presentation was 39.2 (SD± 15.49) years. The female to male ratio was 1:57:1. The dominant aged group was 30-39 years with n=16 (44.44%).The buccal mucosa was the most common site involved n=28(77.8%).Reticular type of oral lichen planus was the most common form and was present in n=22(61.1%) patients however, bilaterally involved mucosa was commonly seen. Chi-square statistics showed a significant association between bilateral involvement of oral mucosa in oral lichen planus with both male and female (x2= 5.833, p= 0.016).CONCLUSIONThe most common site involved in oral lichen planus was buccal mucosa, most common form was atrophic with female predominance and bilaterally involved oral mucosa was significantly associated with gender
Single Layer Extra-Mucosal Interrupted Anastomoses; Revalidated
Get PDFObjective:To evaluate the safety regarding anastomotic failure of single layer interrupted extra mucosal intestinal anastomosis in comparison with double layer intestinal anastomosisMethodology:This prospective comparative study was conducted in surgical A unit of Lady reading Hospital Peshawar from 1st June 2007 to 1st February 2008 (8 months).Patients were divided into two groups, each comprising 60 patients. First 60 consecutive patients were included in Group A, for single layer extra mucosal anastomosis while Group B included last 60 consecutive patients for double layer inverting anastomosis (continuous inner and interrupted outer Lambert sutures). All the cases were admitted through OPD and emergency. The safety of two techniques of anastomosis was analyzed by comparing the outcome in terms of complications.Results:In this study, anastomosis leakage occurred only in 4 (3.33%) patients, one (1.67%) in group A and three (5%) in group B with a P-Value 0.138. Mean age of patient in group A was 36.15 years (+/- 6.0 years) and in group B was 33.25 years (+/- 5.5 years).Conclusion:Single layer extra-mucosal anastomosis has least anastomotic leakage and other complication like wound infection, septicemia, and collection and burst abdomen than in patients with double layer investing anastomosis
Risk Factors Associated with Ischemic Heart Diseases in Different Age Groups Patients of Tertiary Care Hospitals of Peshawar
Get PDFObjectives:To determine different risk factors associated with ischemic heart diseases in different age group patients of tertiary care hospitals of Peshawar.Methodology:A cross sectional study conducted on 350 patients of different age groups presented with ischemic heart diseases in tertiary care hospitals of Peshawar. Study was conducted for duration of 3 months from December 2013 to February 2014. Non probability convenient sampling technique was used. Sample size was calculated using standard sample size calculator. Semi structured questionnaire was used as data collection tool. Patient’s record and investigations were used as adding tools. Standard definition was made for ischemic heart disease. Different modifiable and non-modifiable factors were assessed and were analyzed using SPSS version 16.Results:This study contains 350 patients in which female patients were 133(38%) and male were 217(62%).The mean age was 57.23±11.36 years. The age of the patients ranges from 22 to 80 years. The frequencies of risk factors were stress (73.1%) followed by hypertension (65.7%), sedentary life style (59.4%), family history (57.1%), smoking (50.6%), over weight and obese (39.1%), below normal HDL (30.3%), high LDL (29.1%), hypertriglyceridemia (28%), hypercholesterolemia (23.7%). 64.3% patients were presenting with acute IHD and 35.7% were with chronic IHD. Stress, HTN, DM and sedentary life style were found to be significantly associated with male gender (p- value <0.05). Age was divided into two groups, <45 years and >45 years. Stress, HTN, DM and hypercholesterolemia had a significant association with >45 years of age group. (P-value <0.05).Conclusion:Stress, HTN, DM, sedentary life styles were the major risk factors. And they were found to be more in male gender and in equal to more than 45 years of age group