29 research outputs found
Smear Layer Removal Efficacy of EDTA and Citric Acid in Endodontics
No full textIntroduction: Smear layer is formed by organic and inorganic components generated during endodontic instrumentation. Smear layer has many deleterious effects on the success of root canal treatment. So removal of smear layer is advocated. Sodium Hypochlorite (NaOCl) and a chelating agent like Ethylene Diamine Tetra Acetic Acid (EDTA) or Citric Acid is commonly used alternatively to remove smear layer. But the alternate use increase dentine erosion in root canal surface. This in vitro study attempts to compare the smear layer removal efficacy of 15% EDTA & 10% Citric Acid as a final rinsing solution. Materials and Methods: Forty extracted, single rooted and single canal human anterior tooth were used. Endodontic preparation of the root canal was done after grouping and access cavity preparation. Final irrigation was given with 15% EDTA & 10% Citric Acid to the test groups and distilled water control groups and kept for one minute. Photomicrograph of the root canal surface at 3000X magnification at coronal, middle and apical regions were taken with the help of SEM and scoring for smear layer removal was done. Data was analyzed using SPSS version 16 and were compared with the control samples and subjected to statistical analysis by one way ANOVA and Bonferroni multiple comparison tests at 5% level of significance. Result: The test solutions removed smear layer but none could be removed completely from all of the three root canal regions. 10% Citric Acid removed smear layer better from the coronal and middle region but in apical region 15% EDTA produced a better result. The difference of smear layer removal efficacy of 15% EDTA & 10% Citric Acid with the Control solution was found statistically significant (p<0.001) but in between 15% EDTA & 10% Citric Acid it was not significant in all three root canal regions. Conclusion: Regarding the smear layer removal efficacy of 10% Citric Acid was found better as a final rinse solution.
Update Dent. Coll. j: 2023; 13(2):9-1
PW 0211 Impact of child-friendly activities on patient satisfaction in the pediatric emergency department of a low to middle income country
No full textChild- and family-centered care in the Pediatric Emergency Department (PED) is imperative for patient quality and safety, as well as for allaying anxiety in both parents and their children. To assess satisfaction of children before and after introduction of child-friendly activities in PED of a low-resource country. This was an interventional trial conducted at Aga Khan University PED, Karachi, Pakistan, between October 2014 and February 2015. Children (6 months – 16 years) presenting to PED and categorized as priority levels 3–5 per Emergency Severity Index were enrolled in two phases. No intervention was provided in first phase (control group). In second phase, after a month, age-appropriate, low cost child-friendly activities were introduced (intervention group). Satisfaction was gauged using the modified Wong-Baker scale administered to patients (over 6 years) or parents (with children under 6 years), by pre-trained data collectors before and after introduction of child-friendly activities in PED. There were 303 patients enrolled in each group. Mean age was around 5 years, with over half male, for both groups. No significant difference was observed in mean satisfaction levels for overall treatment between the two groups (2.2 in control vs 2.3 in intervention). Although patients most commonly presented with pain to the PED, no significant difference was observed between the groups for degree of pain/fear. Child-friendly activities in the PED did not improve patient satisfaction. Additional strategies are needed to help the pediatric population deal with emotional turmoil during their visits to the low-resource PED
Tip-over injuries among children: Data from an urban emergency department of Karachi, Pakistan
No full textIntroduction: Most unintentional injuries among children occur in the home environment. Tip-overs, defined as incidents where heavy objects fall on children due to some type of interaction, are one of the reasons for injuries inside the home. This study aims to determine injury patterns and outcomes for child injuries resulting from tip-overs in the home environment as reported in the emergency department.Methods: We performed a retrospective chart review of pediatric (under 18 years) tip-overs injuries occurred in years 2010 to 2015 at the Aga Khan University Hospital. Furthermore, parents of injured children participated in phone interviews to provide information about the injury scene. File review and telephonic interviews were conducted in the year 2015 and 2016.Results: A total of 75 children visited the emergency department with tip-over injuries, out of which 55 (73%) were boys. The majority of incidents (75.5%) happened inside the home, and the most common places were the living room and bedroom (32% and 21% respectively). More than half (53%) of the children were not under adult supervision at the time of the incident and less than half (47%) of the household took safety measures after the incident. Tip-over injuries were common among 3-year-old children with decreasing frequency as children grew older. The most common causes of tip-overs were TV/TV trolley (32%), followed by furniture (28%), and wall and roof (23%). The most common sites of injuries were head (n = 33, 44%) and extremities (n = 33, 44%). A majority of the cases (n = 66, 88%) were admitted to the hospital from the emergency department, under care of both general (n = 51, 68%) and critical care units (n = 15, 20%). More than a quarter (n = 27, 36%) required at least one surgical procedure during their hospital stay. The median length of hospital stay was one days (interquartile range, IQR 1-5 days). There were two cases of mortality (3%).Conclusion: Most tip-over injuries among children were caused by TV, furniture, and TV trolleys. These injuries can be prevented with public education around home safety measures, such as mounting them on the wall
Randomised controlled trial to assess the effectiveness of apnoeic oxygenation in adults using low-flow or high-flow nasal cannula with head side elevation versus usual care to prevent desaturation during endotracheal intubation in the emergency department (ApOxED): Study protocol
No full textIntroduction: Apnoeic oxygenation is a process of delivering continuous oxygen through nasal cannula during direct laryngoscopy. The oxygen that is delivered through these nasal cannulas is either low flow or high flow. Although the effectiveness of apnoeic oxygenation has been shown through systematic reviews and randomised controlled trials, a comparison of high-flow versus low-flow oxygen delivery has not been tested through a superiority study design. In this study we propose to assess the effectiveness of giving low-flow oxygen with head side elevation versus high-flow oxygen with head side elevation against the usual practice of care in which no oxygen is provided during direct laryngoscopy.Methods and analysis: This will be a three-arm study instituting a block randomisation technique with a sample size of 46 in each arm (see table 1). Due to the nature of the intervention, no blinding will be introduced. The primary outcomes will be lowest non-invasive oxygen saturation measurement during direct laryngoscopy and during the 2 min after the placement of the tube and the first pass success rate. The intervention constitutes head side elevation up to 30° for improving glottis visualisation together with low-flow or high-flow oxygen delivery through nasal cannula to increase safe apnoea time for participants undergoing endotracheal intubation. Primary analysis will be intention to treat.Ethics and dissemination: The study is approved by the Ethical Review Committee of Aga Khan University Hospital (2019-0726-2463). The project is an institution University Research Committee grant recipient 192 002ER-PK. The results of the study will be disseminated among participants, patient communities and healthcare professionals in the institution through seminars, presentations and emails. Further, the findings will be published in a highly accessed peer-reviewed medical journal and will be presented at both national and international conferences
140 Paediatric injuries resulting from television/tv trolley and other furniture and appliance tip-overs seen in an urban emergency department in karachi, pakistan
No full textPW 0309 Epidemiology of dog bite injuries in patients presenting to emergency departments of tertiary care facilities in karachi, pakistan
No full textPW 2163 Knowledge of heat emergencies and management among healthcare professionals and community dwellers: a qualitative study
No full textCulture-Based Identification of Causative Organisms in Ascitic Fluids of Patients with Spontaneous Bacterial Peritonitis Secondary to Decompensated Liver Disease and their Sensitivities to Ceftriaxone as an Empiric Therapy
No full textOBJECTIVES
To identify the pathogens in the ascitic fluids of patients with spontaneous bacterial peritonitis and then to determine their sensitivity pattern to ceftriaxone.
METHODOLOGY
The cross-sectional study was conducted at the Medical Unit-A, Department of Medicine, Hayatabad Medical Complex, Peshawar, from November 2021 to April 2022. Before ceftriaxone treatment was started, a minimum of 10 ml of ascitic fluid was introduced into a blood culture vial. Only patients with a positive culture were registered, and their information was gathered using a proforma. For statistical analysis, SPSS version 23 was used.
RESULTSA total of 96 patients were enrolled in our study. There were 62 (59.52%) male and 34 (40.48%) female patients. Based on the isolation and identification of bacteria, the most prevalent bacteria isolated was Escherichia coli in 36 (37.5%) patients, followed by Acinetobacter Spp in 13 (13.54%) patients, Streptococcus spp in 14 (14.58%), Enterococcus spp in 11 (11.45%), Staphylococcus aureus in 9 (9.39%), MRSA in 8(8.33%) and K. Pneumonia in 5(5.21%) patients. The overall sensitivity of ceftriaxone to gram-positive bacteria was observed in 12 (42.85%) isolates, whereas the overall sensitivity of ceftriaxone to gram-negative bacteria was observed in 25 (36.76%) isolates. (p=0.091) (Figure 6).
CONCLUSION
Our study concludes that gram-negative bacteria were more prevalent than gram-positive bacteria in ascitic fluids of patients with spontaneous bacterial peritonitis. The most common isolated pathogen was E.coli. Gram-negative was more resistant to ceftriaxone as compared to gram-positive bacteria
