Journal of Gandhara Medical and Dental Science
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Evaluation of Sealing Ability of AH Plus And TG Root Canal Sealers in the Presence and Absence of Smear Layer
Full text linkBackground:Smear layer is considered to be the main contributing factor in better sealing and adhesion of a sealer.Objective:The aim of this study is to determine the sealing ability of two root canal sealers (AH Plus and tg). In the presence and absence of smear layerMethodology:Extracted teeth from patients visiting Sardar Begum Dental College 60 in numbers were used in this study. Specimens were divided in to two main groups (group1 and group 2) both groups were instrumented using a step back technique. Irrigation was done during instrumentation with one ml of 5.25% NaOCl solution. In group2 a final flush with 10 ml of 17% EDTA solution followed by 10ml of 5.25% NaOCl was used for smear layer removal. Each group then further divided in to two sub groups (n=15). After obturation specimens were kept in separate containers with wet gauze to maintain 100% humidity. The specimens were coated with nail polish except for apical 2mm. Specimens were then suspended vertically in two % methylene blue dye for 7 days. Longitudinal sectioning was done to determine the extent of dye penetration using a stereo microscope at X30 magnification. Student t test was used for statistical analysis (p≤ 0.05).Results:The results showed that in the presence of smear layer, mean apical dye leakage of AH Plus was2.89 mm and tg was 4.02 mm. While in the absence of smear layer the mean dye leakage of AH Plus was 2.23 mm and tg was 3.28 mm. Student t test was more than p value indicating non significant result for both sealers.Conclusion:Apical sealing ability of AH Plus is better than tg root canal sealer in the presence and absence of smear layer
Frequency of Causative Bacteria in Urinary Tract Infection in Children
Full text linkObjective:This study was designed to know frequency of different bacteria causing urinary tract infection in children in our region.Study design: case seriesPlace and duration of study:This study was performed in Pediatric department of Naseer Teaching Hospital Kabir Medical College Peshawar, from august 2011 to January 2014.Methodology:A total of 550 sample of urine were sent for culture and sensitivity, of which 100 cases were found positive for bacterial growth. Urine samples have been collected with care from preventing from contamination by different techniques like mid stream urine collection, suprapubic aspirate and catheterization in few cases. Bacterial growth of 105 or more were consider positive growth.Results:our results showed that E-coli was the most common bacteria causing UTI in 66% of cases, followed by klebsheila (14%), proteus(12%) and staphaureus(5%).Pseudomonas, Enterobacter and entrococcus were present in 1% cases each. Uti was common in females (58%) than male (42%).Conclusion:UTI is common problem in all age groups of children-coli are the most common pathogen causing UTI. Females are having more common this problem than male, while in infancy males are more prone to UTI as compare to female
EMERGENCY RESPONSE SERVICES IN PESHAWAR
Full text linkThe recent terror attacks on Army Public School and Imam Bargah in Hayatabad, Peshawar once again highlighted the continuing fragile law and order situation that the country is facing in general and the province of KPK in particular. The civilian emergency response mounted to these events and those of a similar nature in the past can at best be described as grossly insufficient and well below the desired standards.
Having been at the heart of ‘war on terror”, and faced with numerous bomb blasts and other forms of militant activities over successive years in the recent past, one would expect a mature and systematic approach inculcated in the country’s response to emergency. Sadly this has not been the case and the same chaos and indifference by the concerned authorities is seen at the site of occurrence, during transportation and in the hospitals as was the case before these events were a regular feature. To add to the spectrum of these woes is the lack of any coordinated efforts to rehabilitate the victims either psychologically, physically or financially.
As I searched for an effective system globally adopted for disaster management of various scales, I came across the existence of various national and international organizations tasked to ensure preparedness and swift response in event of any such eventualities. International organizations such as Red Cross, The International Emergency Management Society (TIEMS), The International Recovery Platform (IRP) and United nations organization help reduce vulnerability and assist cope with natural disasters such as floods and earthquakes, industrial sabotage and other incidences of significant humanitarian crisis. While some of these organizations may help creating awareness and offer technical guidance in managing manmade disasters, they have a very limited role in practically addressing incidents related to localize events of terrorism. This responsibility is borne by respective governments in light of the prevailing law and order situation and resource availability. Different countries then have other umbrella organizations overlooking management of emergency situations arising from terror related disasters in addition to natural calamities eg the Civil Contingencies secretariat in UK, the Federal emergency management authority in US and the National disaster response force in India.
In Pakistan unfortunately there is no concept of an organized response to events resulting in multiple or mass casualties, be it a result of any major accident or an act of terrorism. Organizations such as APDMA and PDMA have limited roles dealing mainly with natural disasters. Need of the hour is for an organization or team to cater for manmade disasters given the recent frequency of these events. In the absence of any responsible organization taking the lead and developing protocols as well as providing guidelines, the workforce available for pre hospital and hospital-based critical care varies enormously.
Every major city of the country and specially Peshawar should have a disaster control management plan involving security agencies, paramedic and ambulance services and all major hospitals who should develop an effective strategy to facilitate management of injured patients.
An effective approach would depend on the ability of the concerned team to anticipate, assess, prevent, prepare, respond and recover from an incident. Security agencies must cordon off the site of incident allowing only emergency vehicles and personnel to approach the site once secured. The hospital nominated to receive the brunt of casualties should be informed well in time for emergency preparedness. If possible all unnecessary traffic flow in the vicinity of the hospital should be diverted according to a predetermined plan.
The Accident and Emergency departments should have a viable communication system of summoning their trauma team and any additional staff needed according to the nature and magnitude of the calamity on a very short notice. Within the hospital all visitors and well wishers as well as media personnel and politicians should be restricted to nominated zones with facilities of a public address system and an information centre updating the list of injured and dead at regular intervals. A spacious TRIAGE hall with designated triage officers (doctors or nurses) should be at hand to sort out the patients and prioritize their treatment according to the nature of their injuries and resources available. The major hospitals must build up their capacity in terms of skilled manpower and equipment/medicine and be ready for any major incident in its catchment area besides being able to receive a spill over in case of any major disaster in adjoining vicinities. Doctors and other support staff in ER should be familiar with the basic principles of Emergency life saving measures. It should be mandatory for the aforementioned to have attended trauma management courses such as Advanced Trauma Life Support, Primary Trauma Care or Emergency Room Trauma Care. There is considerable evidence to show that properly trained staff can make a marked difference when it comes to saving precious lives. There should also be appropriate arrangement for dealing with bodies of dead victims and counseling their near and dear ones.
No doubt, considerable effort and commitment is needed if the above goals have to be achieved. To ensure a well organized and coherent response to any major incident there has to be a lead body running the show. All those involved in emergency management from the scene of the incident to the hospital receiving and managing the injured patients should be part of a team and should be allowed to interact on a regular basis through seminars and conferences framing and developing their own standard operating procedures and guidelines. Effective emergency management has been and will always be the crunch requirement of any civilized society and it is imperative that the government should take practical steps in addressing this issue in the best interest of the public
Self-Reported Prevalence & Associated Factors for Occurrence of Recurrent Aphthous Stomatitis (RAS) in Undergraduate Medical & Dental Students
Full text linkBackground:Recurrent aphthous stomatitis (RAS) is the most common painful oral lesions that occur frequently inyoung adults; however the etiology still remains unknown. The present study was conducted to explorethe prevalence of RAS in undergraduate medical & dental students as these are the group who are in theirearly adulthood and are prone to stress during studies.Materials and Methods:This was a cross-sectional survey carried out in Gandhara University. Two hundred students of MBBS &BDS participated in the questionnaire survey. Interview was done through a close-ended questionnaire toreport the prevalence of RAS, the associated history, clinical features & preferred treatment.Results:Prevalence of RAS was found to be 87.5% in the study population. Most common site was lower lip where20% people have ever experienced oral ulcer. Most of the participants (46%) tried topical gels and 55%found the treatment effective. Majority was not sure which medication they used. Approximately half (48%)of the students associated the ulcer onset with their psychological stress.Conclusion:The prevalence of RAS was found to be alarming (85.7%) among medical and dental students ofGandhara University. The most common associated factors as experienced and reported by the studentswere found to be family predisposition and psychological stress
Association of Thyroid Dysfunction with Female Infertility
Full text linkObjective:To find association of hyperthyroidism with female infertility.To find association of hypothyroidism with female infertility.Cross sectional study design was conducted.Place and Duration of Study:Random Infertile females were selected amongst the patients who attended the outpatient department of Naseer Teaching Hospital (NTH) Peshawar from June 2013 to June 2014.Material and Methods:This study was done on hundred infertile females. They were selected randomly from amongst the patients who attended the outpatient department of Naseer Teaching Hospital Peshawar. A detailed history of patients was recorded on a proper questionnaire. This included information about patient age, weight, marriage duration, menstrual history, drug history, any symptoms and signs of thyroid disorder etc. Peripheral venous blood samples were collected aseptically with patient written consent and tested for thyroid function.Results:Hundred primary infertile patients were included in the study. Out of these 100 patients, TSH was raised in 14(14 %) of infertile females while 27(27 %) infertile females had low TSH levels. Based on the levels of T3 and T4, all the 41(41 %) thyroid dysfunction cases were subdivided further into overt and subclinical thyroid dysfunction. Our study showed that 5 % were suffering from overt hypothyroidism, 11 % from subclinical hypothyroidism, 7 % overt hyperthyroidism while 18 % were suffering from subclinical hyperthyroidism.Conclusion:This study shows that subclinical thyroid dysfunction is more common than overt thyroid dysfunction in infertile females. Therefore, measurement of serum T3, T4 and TSH levels should be included in the workup of infertility. The patient can revert back to the fertile state with appropriate treatment
Psychosocial Effects on Women Presenting with Hirsutism
Full text linkObjectivesTo determine different psychosocial effects in different classes of hirsute ladies and to assess the level of depression in them due to Hirsutism.MethodologyCross sectional study conducted for duration of three months from Jan 10, 2013 to April 30, 2013.at a private clinic of laser therapy on 115 patients who visited the clinic for treatment with some degree of Hirsutism.non probability convenient sampling technique was used for cases selection. A structured questionnaire was used for data collection which was designed with consultation of psychiatrist from lady reading hospital Peshawar. All patients of different classes were included in the study. Patients with other dermatological disorders were excluded from the study. A pilot study was conducted on 10% of sample size. . Prior consent was taken from all respondent after explaining the purpose of the study.The data was collected, tabulated, analyzed, and interpreted by SPSS Version 16 and the results were presented in form of tables and graphs.ResultsWe found in our study that majority of patients of Hirsutism who visited for treatment were of young age i.e.from15 to 25 years (82.5%) and most of them presented with some abnormal psychosocial effects.(81.4%).Abnormal psychosocial effects were found more in patients who came from urban areas(84.7%) as compared to those who came from rural areas(77.4%), more in un married females (86.3%) as compared to married (73%), more common in employed class (91.2%) as compared to un employed. When behavior of the colleagues with them due to their Hirsutism was asked it was found that most of them (83%) responded that the attitude of their colleges with them is abnormal due to their Hirsutism due to which majority of them (86.8%) hide their disease from others.to assess the level of anxiety/ depression in patients due to their disease a standard scale was used, and was found that 73 (83.2%) were having moderate to severe anxiety (score 11-21) while 16(16.8%) were having border line anxiety (score 8-10).ConclusionPatients with Hirsutism usually present with some degree of psychosocial effect which lead them to anxiety and depression. The psychosocial effects in women with Hirsutism were found more common in young age, working class ladies, un married and females residing in urban areas.RecommendationsHealth education regarding the disease, social and moral support to the patients, treatment facilities at all district levels especially laser therapy should be provided
A Comparative Study of Knowledge and Practices about Plaque Control Methods Among Medical and Dental Students of Gandhara University Peshawar
Full text linkBack ground:Plaque control methods are one of the most important tools in promoting and improving oral health of an individual. Plaque can lead to the most prevalent oral diseases that are dental caries and gingivitis2.The available data on prevalence of dental caries show that Pakistan is a low caries country whereasthere is persistently high level of periodontal diseases3. Improvement of oral health by healthcare professional is a vital aspect of preventive dentistry 1.Objectives:The aim of the study was to assess and compare the knowledge and practices of medical and dental students of Gandhara University Peshawar about plaque control methods.Materials and methods:In a cross sectional study a total of 386 students were surveyed by using self administered structured questionnaires which covered student’s knowledge about plaque control methods, dental attendance and smoking. A total of 265 students responded with fully filled questionnaires out of which 121 were filled by medical students and 144 by dental students.Results:Almost 79.8% Dental students knew about plaque out of which 78(54.1%) students thought that iscaused by not cleaning the oral cavity and 65(45.1%) thought that it leads to dental caries. One hundred and thirty nine (96.5%) students clean their teeth out of which 93(64.5%) clean their teeth twice a day with a tooth brush. One hundred and eighteen (81.9%) have visited a dentist before out of which only 49(41.5%) went for regular checkup. Sixteen (11.1%) students smoke.Almost 61.1% Medical students knew about plaque out of which 41(33.8%) students thought that it is caused by not cleaning the oral cavity and 37(30.5%) students thought that it leads to dental caries.One hundred and fourteen (94.2%) students clean their teeth out of which 69(57%) clean their teethtwice a day with a tooth brush. Sixty nine (57%) students have visited a dentist before out of which only 26(37.6%) students went for regular checkup. Twenty nine (23.9%) students smoke.Conclusions:It is concluded that there is a marked difference between the knowledge and practices among themedical and dental students, and there is a need to enhance the knowledge of medical studentregarding dental attendance. Both need more awareness regarding plaque control methods to have a positive role in the oral health education of their patients and the community.Key words: Plaque control, dental attendance, tooth brushing, smokin
Root Canal Configuration Evaluation on the Basis of Sectioning and Clearing Techniques
Full text linkObjectives:Determination of Root canal configuration of maxillary first and second molar teeth was the aim of this study.Study design: An in vitro experimental study.Place and duration of the study:Study was conducted in Gandhara University for a period of six month.Materials and Methods:Specimens were analyzed by sectioning and clearing techniques for evaluation of the pattern and configuration of roots. Dye penetration was the criteria which were then evaluated through microscope.Results:In clearing group, type-I canals are 18% more than sectioning group. While type-II was reversely i.e. 19% more in sectioning group than clearing group.Conclusion:Difference in both the study groups could be mainly due to failure of dye to pass through sclerosed or minute diameter secondary canal in clearing group. This study verifies that method of research has great influence on the results