Journal of Gandhara Medical and Dental Science
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Frequency of Congenital Heart Disease in Patients with Down Syndrome
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Frequency of congenital heart disease in patients with Down syndrome.METHODOLOGY
This study was conducted in Hayatabad Medical Complex, Peshawar from 10th May 2021 to 9th November 2021. A total of 377 patients of age 1 to 10 years and both gender were included in the study. Those with already diagnosed cases of congenital heart disease and dysmorphic features other than Down syndrome were excluded from the study. All patients were undergone echocardiography and patient with PDA, VSD, ASD, ASVSD, and TOF were labeled as having congenital heart diseases.RESULTSMean age was 5.96 ±1.954, Males were 176 (46.7%) while females were 201 (53.3%), Mean birth weight was 3.45 ± 0.801 kg, Mean age of the mother was 38.25 ± 6.797 years, Congenital heart diseases were present in 157 (41.6%) of the patient while it was not present in 220 (58.4%) of patients, there was no association between congenital heart disease and age of mother, age of the child, sex of child or weight of the child (P >0.05).CONCLUSIONCongenital heart disease is very common in patients with Down syndrome. It is recommended that at the time of diagnosis of this disease, the patient should be screened for congenital heart disease
Periodontal Treatment Needs of Patients Undergoing Orthodontic Treatment in Comparison To Non-Orthodontic Treatment Patients: A Comparative Study
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To determine the periodontal treatment needs of patients undergoing orthodontic treatment compared to those not undergoing the treatment.
METHODOLOGY
A cross-sectional comparative study was conducted on 100 patients visiting the Dental OPD of Sharif Medical and Dental College, Lahore, from June 2019 to July 2020. Clinical examination was done using the Community Periodontal index for treatment needs (CPITN) to assess the participants' periodontal health and treatment needs.
RESULTS
There was a statistically significant difference in the scores of CPITN across the treatment and control groups (≤0.001). The patients requiring scaling and prophylaxis and Oral hygiene instructions (TN 2) were more (94%) in the orthodontic treatment group in comparison to the non-orthodontic treatment group (62%). A higher percentage of patients (6%) requiring complex treatment (deep scaling, root planning and complex surgical procedures), scaling and prophylaxis and Oral hygiene instructions (TN3) belonged to the non-orthodontic treatment group, while only 4% required it from the orthodontic treatment group.
CONCLUSION
All orthodontic and non-orthodontic treatment group participants required oral hygiene instructions and had periodontal treatment needs (TN1). The patients requiring scaling and prophylaxis and Oral hygiene instructions (TN 2) were more in the orthodontic treatment group than the non-orthodontic treatment group. A higher percentage of patients requiring complex treatment (deep scaling, root planning and complex surgical procedures), scaling and prophylaxis and Oral hygiene instructions (TN3) belonged to the non-orthodontic treatment group
Symptom Outcome of Walant Technique for Carpal Tunnel Release – A Prospective Study in the Tertiary Care Hospital, Nowshera
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The study aims to determine the outcome of the WALANT technique for Carpal Tunnel Release CTR.METHODOLOGY
A descriptive study was done in the Neurosurgery department at Qazi Hussain Ahmad Medical Complex, Nowshera, from 15th September 2020 to 15th March 2021. A total of 29 consecutive patients of carpal tunnel syndrome (CTS) were undergoing carpal tunnel release (CTR) under wide awake local anaesthesia no tourniquet (WALANT) technique, using a mixture of lidocaine and epinephrine for local anaesthesia, and the outcome was assessed for patient satisfaction by Boston Carpal Tunnel Questionnaire (BCTQ) (symptom severity scales (SSS)) at pre-operatively and six weeks postoperatively.RESULTSWide awake CTR was done in 29 patients; 86.2% were female and 13.8% male. The mean age was 47.3 years. The average time of return to daily activity was three weeks. No complications were noted, like wound infection and dehiscence. BCTQ symptom (BCTQ-S) score significantly improved at six weeks postoperatively. 86% significantly reduced the symptom severity score (SSS). Mean SSS improved from preoperative 3.2 points to 1.7 points postoperatively. There was a significant decrease in distal latencies (p <0.01). CONCLUSIONWide awake surgery is an excellent technique with favourable outcomes and good satisfaction rates for CTR. The study shows that clinical symptoms resolve rapidly after CTR. Without the need for monitored anaesthesia, the cost could decrease dramatically
Gestational Weight Gain and Its Relation to Maternal, Fetal and Neonatal Sequelae: A Future Dilemma
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This study aimed to determine the frequency of women with gestational weight gain (GWG) from recommended values in pregnancy and to establish the association of GWG with the mode of delivery (vaginal delivery (VD), instrumental delivery(ID), cesarean section(CS) and neonatal outcomes( low birth weight (LBW), low APGAR score, macrosomia, stillbirth (SB) and neonatal intensive care unit admissions(NICU).
METHODOLOGY
The prospective study was done in the Department of Obstetrics & Gynaecology LRH Peshawar. A total of 140 women were included in this study by non-probability consecutive sampling technique. Those with congenital anomalies having known medical disorders were excluded. Ethical approval and Informed consent were obtained before the examination. Data were collected and analysed on SPSS version 22.RESULTSThe mean age was 29.4 ± 5.1 years. The mean first trimester BMI of the study sample was 25.2 ± 3.4kg/m2, while the mean BMI in 3rd trimester was 27.7± 2.3 kg/m2. GWG was recorded in 52 (37.1%) women. The mean GWG was calculated to be 12.9 kg ± 2.5. Mode of delivery was VD in 60(42.9%) women, ID in 50 (35.7%), and CS was done in 30(21.4%0) women. LBW in 15(10.7%), low APGAR score was recorded in 32(22.9%), macrosomia in 14(10%), SB in 12 (8.6%) and NICU admission in 39(27.9%).
CONCLUSION
GWG is common in pregnant women; however, there was no statistically significant association between GWG and mode of delivery or neonatal outcomes.
Frequency of Surgical Site Infection in Mesh Repair for Inguinal Hernias
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To determine the frequency of surgical site infection in mesh repair for inguinal hernias. METHODOLOGY
This Descriptive observational study was carried out at the Surgical B unit of Hayatabad Medical Complex Peshawar from November 2021 to October 2022. A total of 179 patients were included in the study were given a single dose of antibiotics, i.e.1, gm Ceftriaxone, one hour before inguinal hernia mesh repair.RESULTS
A total of 179 patients aged between 30-60 years with a mean age of 45 years were enrolled. There were 98(54.7%) male while 81(45.3%) females. The frequency of wound infection was noted in 23 (12.8%) patients following mesh repair for inguinal hernia. Out of 23, most of the patients, 10(43.5%) had Medical redness & tenderness, 8(34.8%) patients had pus discharge from the wound side, and 5(21.7%) patients had wound site abscesses.CONCLUSION
Surgical site infection after mesh repair was higher than the internationally reported incidence. Establishing a baseline SSI rate for inguinal hernia repairs offers a useful benchmark for future studies and surgical programs in thes
Association of Blaoxa-1 Gene with Multidrug Resistance in K. pneumoniae Clinical Isolates
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This study aimed to isolate K. pneumoniae from patients samples and find an association of the plasmid-mediated bla-OXA-1 gene with multidrug-resistant K. pneumoniae.
METHODOLOGY
This cross-sectional study was conducted at Mardan Medical Complex and Khyber Medical University Peshawar. K. pneumoniae was isolated from pus, urine and blood samples by culture and confirmed by biochemical techniques. Antibiotic susceptibility was done by disc diffusion according to the CLSI 2022 guidelines. A polymerase chain reaction was done for the gene after extraction and amplification of plasmid DNA. Furthermore, an association of antibiotic resistance was confirmed with blaOXA-1.
RESULTSA total of 160 K. pneumoniae isolates were cultured from the patient’s samples, including pus (135, 84.37%), urine (15, 9.37%) and blood (10, 6.26%). There were 154 (96.3%) isolates resistant to Penicillin-G, followed by Ceftriaxone 151 (94.4%), Cefepime 143 (89.4%), Amoxicillin 125 (78.1%), Tigecycline 110 (68.8%), Imipenem 92 (57.6%) and Ertapenem 75(49.9%). However, Tetracycline had 1.9% resistance. The blaOXA-1 gene was positive in 41(25.62%) isolates with a different pattern of antibiotics resistance to Penicillin-G, Ceftriaxone, Cefepime, Amoxicillin, Tigecycline, Imipenem and Ertapenem as compared to the negative isolates. Among the blaOXA-1 gene-positive K. pneumoniae isolates, resistance to Penicillin-G was 100%, followed by Ceftriaxone (92.7%), Cefepime and Amoxicillin (80.5%), respectively. However, resistance to Imipenem and Ertapenem was 46.3% and 41.5%, respectively, and Tetracycline was not resistant.
CONCLUSION
Our data suggest that the presence of plasmid associated blaOXA-1 gene in K. pneumoniae isolates may contribute to multidrug resistance in beta lactamase-containing antibiotics along with other internal mechanisms of resistance present in these bacteria
Frequency and Risk Factors of Depression among Medical Students: A Cross-Sectional Study in Karachi
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The study aimed to determine the frequency of depression among medical students and to identify the different risk factors associated with depression.
METHODOLOGY
A cross-sectional study was conducted among medical students at a private medical college in Karachi. The study was initiated after approval was taken from the ethical committee. Consent was taken before the data collection after explaining the details of the study. Students were selected for this study as per inclusion criteria. They were provided with the PHQ-9 questionnaire in which they were inquired about the factors for depression. The total students with depression positive were presented by their frequencies with a 95% confidence interval.
RESULTSThree hundred seventy medical students participated, and 207 (56%) tested positive for depression. Notably, depression was more prevalent among final-year students, with 80% affected. Additionally, the severity of depression gradually increased with advancing medical years, reaching the highest level in the final year, where 61 students (80%) reported significant depression. The most frequent causes of depression were living away from home and facing the challenges of a demanding curriculum.
CONCLUSION
The study findings revealed a higher likelihood of depression among medical students, particularly in their final year. This vulnerability was exacerbated by the stress associated with extensive coursework and peer pressure to achieve excellent exam grades
Correlation of Cervical Vertebral Maturation and Tooth Mineralization of Mandibular Second Molar
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To determine the correlation between skeletal maturity and mandibular second molar calcification.
METHODOLOGY
A descriptive cross-sectional study was conducted at the Saidu College of Dentistry from 15th January to 30th October 2022. One hundred participants of Pakistani descent, aged 8-16 years (both genders), with ANB greater than 50 and presence of all permanent teeth excluding 3rd molars, were included. Medically compromised, syndromic patients, those who had undergone previous orthodontic treatment, and cases with extracted permanent teeth were excluded. Skeletal maturity was determined by analyzing the cervical vertebrae maturation index (CVMI) on lateral cephalogram according to Baccetti et al. and mandibular second molar calcification according to the Demijian Index from panoramic radiographs. The Spearman correlation test was run for correlation assessment.RESULTSThe mean age was 11.81±1.62 years. There were 49 (49%) males and 51 (51%) females. A perfect correlation (100%) was found between CVM stage I and dental stage C. The concordance between CVM stage II and dental stage D was found in 21 (91.30%). The correlation between tooth mineralization and CVM stages was very high and statistically significant (r=0.97, p<0.001). Similarly, the correlation between CVM and chronological age was also high and statistically significant (r=0.8, p<0.001). The correlation was also significantly increased in males and females (r=0.97, p<0.001).
CONCLUSION
The tooth mineralization stages of the mandibular second molar can be used to assess growth as an alternative to cervical maturation staging
Laser Gingivectomy in a Patient Undergoing Orthodontic Treatment: A Case Report
Full text linkABSTRACT
The benefits of using a laser in soft tissue treatment include less oedema, reduced inflammation, and quicker recovery. Nowadays, soft-tissue interventions, including periodontal recontouring, operculectomy, or frenectomy, are possible thanks to the introduction of diode lasers that are strongly absorbable melanin and haemoglobin. In this case, a 17-year-old patient at the near end of her orthodontic treatment was concerned about her gummy smile. She also had a gingival swelling in the lower anterior segment. Furthermore, she had a high labial frenum attachment. It was decided to go for a gingivectomy and frenectomy with the help of a laser (Diode Lasotronix 980nm).
Systemic Comorbidities in Patients with Primary Fascial Space Infections of Odontogenic Orogin: Experience of a Tertiary Care Center
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To assess systemic immune-compromised comorbidities in patients presenting with odontogenic infections that extend to fascial spaces. This study was designed to investigate the incidence of immune-compromising systemic comorbidities among patient presenting with odontogenic infections.METHODOLOGY
This cross-sectional study was performed at the Department of Maxillofacial Surgery, Hayatabad Medical Complex (HMC) Peshawar from October 2018 through April 2019. However, patients older than 10 years of age, presenting with fascial space infections other than odontogenic cause, secondary fascial space infections and patients with multiple organ failure were excluded. The odontogenic infections were categorized according to their anatomical location. The prevalence of comorbidities was also assessed.RESULTSA total of 145 patients were included, where the male to female ratio was 3.8:1, mean age ~ 56 ± 14.74 years (range: 12-80 years) and mean duration of the odontogenic infections was 5± 1.2 days. The submandibular space was the most frequent site involved in odontogenic infections with a frequency of 60 (41.4%), followed by buccal space with 44 (30.3%) patients & canine space with 31 (21.4%) patients. Of the 79 patients with comorbidities out of total 145 patients, diabetes mellitus was recorded in 60 patients. Other comorbidities included hypertension, renal and hepatic impairment.
CONCLUSION
Diabetes mellitus was the most common immune compromising comorbidity presented in patients with odontogenic infections extending in fascial spaces. Assessment of diabetes in routine dental practice is emphasized to avoid exacerbation of the odontogenic infections