Awareness and Perception of Dentists Regarding Role and Future of Artificial Intelligence in Dentistry

Background: Every single field preferred artificial intelligence with great passion and thereby the discipline of dental science is no exemption. Aims: To evaluate the awareness and perception of dentists regarding artificial intelligence among dentists working in Karachi Methods: The current online cross-sectional survey conducted in Karachi during july 2021 . The survey included house officers, post-graduate trainees, and general dental practitioner and specialist consultant dental surgeons of either gender. A questionnaire was adopted from an existing similar study and modifications were made according to our settings. The link of survey was created using Google Docs and disseminated through various open social media groups of dental practitioner in Karachi. Results: Total 118 complete responses were received with almost equal responses from males (n=56, 47.5%) and females (n=52.5%). The mean age of study participants was 30.3±5.9 years. 83(70.3%) had awareness of the artificial intelligence driven tools in dentistry. 75.9%, 77.1%, 10.8%, 28.9%, 39.8%, 2.4% and 10.8% reported the use of digital intraoral radiographs, CAD-CAM, CBCT, digital dental records, clinical decision support system and none of the tool in their practice respectively. All of the participants had opinion that AI applications should be part of dental trainings. Conclusion: The present survey showed that the majority had awareness of AI applications in dentistry and had positive perception regarding its future role but there was lacking in the utilization rate of AI tools in their practice. Therefore, it is recommended to attend AI trainings to bring and adapt the AI related changes in local settings. Keywords: Artificial intelligence, dentistry, online survey, perception, awareness, Karachi

ULTRASOUND GUIDED CENTRAL VENOUS CANNULATION BY ANESTHESIA TRAINEE: NEED OF THE HOUR DURING COVID PANDEMIC

Covid pandemic has created deciency of doctors needed to administer skilled procedures in ICUs and operating rooms. Post graduate trainees need to acquire skills fast and perform it safely on patients. Ultrasound (USG)-guided central venous cannulation (CVC) is one such. The study aimed at nding the feasibility of training USG-guided CVC cannulation to anesthesia trainee as opposed to landmark method in terms of ease, speed and safety. Patients needing CVC were divided into 2 groups of 50 each, where Group 1 was subjected to Landmark method and Group 2 to USG-guided method. Continuous variables were compared using unpaired t test and categorical variables using either the Chi square test. Access time (in seconds) was signicantly less in the USG group (258.78 ± 11.17) as opposed to Landmark technique (301.60 ± 14.03) (p 0.03). Accidental carotid artery puncture was seen in 9 patients in Landmark group as opposed to none in the USG group. No patient in any group developed pneumothorax. USG-guided technique is superior and safer than the traditional landmark technique in hands of anaesthesia trainee in terms of a shorter access time, and less incidence of arterial puncture which is desirable in COVID patients to shorten the exposure time. USG-guided method needs an assistant to focus the probe. Nonetheless, this training should be imparted to the trainee to ll the gap created by skilled doctors falling sick during COVID pandemic.

Coping strategies adopted by post graduate trainee in dealing with work related stress: (A mixed method study)

Back Ground: During residency period, doctors all around the globe, experiences stressful working environment and prolonged working hours. These factors leads to lack of concentration, distress and higher level of fatigue; however, residents counter the effects of these extensive, high demanding duty hours by various coping strategies. Although the effects of extended duty hours and various coping strategies used by the doctors have been studied at large. Yet, the difference between the effects & coping styles of trainees of various high demanding specialties’ have not been studied. Therefore, this study was carried out to identify and explore the difference in coping strategies for dealing with stress, adopted by post graduate trainees in surgical and non-surgical specialties. Methods: Mixed method approach, with explanatory sequential design was opted for this study. In phase one (quantitative) data was collected by a web based survey; carried out in five teaching hospitals of Rawalpindi & Muzaffarabad in 2020. Data was analysed on SPSS, frequencies and major trends were recorded. An open ended questionnaire was developed on the basis of phase 1 results. In phase two (qualitative), six focus group discussions were carried out with 24 participants to explore the various coping strategies adopted in different situations among the post graduate trainees working in different specialties. Later on, verbatim transcription was done & data analysed manually. Results: Out of 250 (100%) possible participants, 146 (58%) participant responded on-line survey. Where, residents of surgical discipline has a higher response rate (60%, n=87) than non-surgical. Moreover, female participation (54%, n=79) was greater than males (46%, n= 67). Mann-Whitney U test was statistically significant only for seeking medical advice to cope with stress (P= .029). In focus group discussions, female involvement was more (58% n=14) as compare to males (42% n=10). Following themes were developed after data analysis, that is; self-regulation, tailor made strategies, educational focus and support system. Conclusion: Quantitatively, no significant difference was found between the coping strategies of post graduate trainees of surgical & non-surgical trainee, against work related stress. However, minor differences were obtained qualitatively.

Modifications in Orthodontic Practice Post COVID Lockdown in Pakistan

OBJECTIVE: To assess the frequency of positive changes in orthodontic practice in Pakistani governmental and private workplaces after lifting of COVID-19 lockdown. METHODOLOGY: This cross sectional questionnaire-based study was carried out on 143 Pakistani orthodontic practitioners for the duration of 3 months. A well-constructed, computerized closed ended questionnaire was designed at an online website i.e., google drive and the link was circulated through social media and e-mail. Change in dental practice was assessed by comparing the results with CDC guidelines, keeping positive response cutoff 70%. Data was analyzed by using SPSS 22, Confounders, like educational qualification, gender and workplace were controlled through stratification. Post stratification Chi square Test was applied to assess the association of dentist's response with gender, educational level, age and workplace, keeping P value < 0.05. RESULTS: There were total 143 participants (80 female and 63 male) with age range from 23 to 56 years, with a mean age of 31.24 ± 6.82 years. Majority of the participants (75.52%) belonged to the age range of 23-33 years. Most of the orthodontists were post graduate trainees (66.4%). Out of all these participants, 67 were working at orthodontic OPD, 22 at private practice and 51 worked at both. 68.5% Implementation of positive modifications in dental practice were recorded. The chi square test results were significant (P <.05) for education and workplace of orthodontist. CONCLUSION: Most orthodontists have positively modified their dental practice post COVID-19 lockdown in Pakistan, by following WHO and CDC guidelines for Covid-19 to curtail spread of infection. KEYWORDS: Changes, Orthodontics, COVID

Antibiotic Prescribing Practices of Endodontic Postgraduate Trainees in Karachi, Pakistan

OBJECTIVE: The aim of this study was to assess the knowledge of Endodontic Postgraduate trainees regarding clinically relevant situations where an antibiotic cover is needed and is focused on the prescription patterns of various antibiotics depending on the clinical evaluation of the patients. METHODOLOGY: A cross sectional study was performed in which data was collected from five different dental institutes offering post-graduate residency in endodontics all over Karachi, Pakistan. Preferred antibiotic for odontogenic infections and the duration for the antibiotic coverage were evaluated amongst postgraduate clinicians. A total of 100 questionnaires were distributed out of which only 82 questionnaires came back with responses. The study was conducted for a period of one month from August 2018- September 2018. The data collected was analyzed by SPSS version 21. RESULTS: A combination of amoxicillin with Clavulanic acid was the first choice of antibiotic in patients with no known allergies to penicillin (40.6%), whereas erythromycin was the first choice of antibiotic in patients having allergic reactions to penicillin (39.3%). The duration of treatment on average was 5 days. In clinical situations of irreversible pulpitis, with or without apical periodontitis, 74.3% and 67% of the respondents prescribed antibiotics. 78 % of respondents have prescribed antibiotics in cases of necrotic pulp with acute apical periodontitis. CONCLUSION: Our study concludes that antibiotic over prescription is very common amongst post graduate trainees and is contributing towards a larger issue of antibiotic resistance. Proper protocols of prescription should be followed by professionals and further refinement is required focusing on need, duration and choice of the antibiotic being used. KEYWORDS: Antibiotics, Odontogenic infections, Endodontics, Microbial resistance

An Introduction to Cognitive Restructuring for COVID-19 Induced Stress in Post-graduate Trainees

Background: Healthcare professionals have experienced a wide range of psychological problems during the COVID-19 pandemic. Frontline workers and trainees are particularly vulnerable to such effects. This study aimed to share the experience of Cognitive Restructuring workshops for COVID-19 induced Stress in Post-graduate Trainees, highlighting their stress levels and effect of cognitive behavior therapy intervention in processing and managing stress.Methods: Workshops based on a Cognitive Behavior Therapy model were introduced to trainees at the Aga Khan University Hospital to self-assess stress and identify coping mechanisms. We collected data from the stress scale and workshop responses along with a focus group discussion. We performed item analysis of the stress scale and a documentary analysis of participant responses to assess the effectiveness of this intervention.Results: The majority of the participants had moderate stress. A statistically significant relationship was observed between stress level and perceived helplessness (p value 0.002). The feedback of the workshop was largely positive based on sharing of adverse experiences, developing a different perspective and a newer way of processing feelings; about 10% of the participants did not find this workshop useful. In the focus group discussion, the participants described stress scale to be helpful for stress quantification, ABC tool to be useful with repeated practice and reframing technique to reduce stress over time. Conclusion: The COVID-19 pandemic has caused stress in healthcare workers and impacted professional and personal lives. Interventions like group cognitive behavior therapy can be useful in recognizing and managing stress in trainees and can be incorporated in training programs to build resilience for similar events.

Impact of Covid-19 Virus on Ophthalmology Residents and Fellows in a Tertiary Care Hospital

Purpose: To determine the impact of COVID-19 pandemic on the training of Ophthalmology residents and fellows in a tertiary care hospital. Study Design: Cross sectional survey. Place and Duration of Study: The study was conducted in a tertiary care hospital, Peshawar from august 1st to august 20th 2020. Methods: A self-designed questionnaire was distributed among 50 ophthalmology residents and fellows. Under-graduate students, house officers and post-graduate trainees from other specialties were excluded. Questions comprised of demographic data, and questions which were meant to investigate the changes experienced by the trainees during COVID-19. The data was analyzed by SPSS Software (Version 19). Results: Among 50 participants of this study, 16 (32%) were females and 34 (68%) were males. The age ranged from 27 to 35 years. There was no statistically significant difference in the perspectives of resident trainees and fellows regarding negative impact of COVID-19 on their training. Ninety-five percent of the residents and fifty five percent of the fellows had effect on their clinical skills with p values of less than 0.05. Hundred percent residents agreed that online case presentation could not replace the traditional long rounds and simulator based training could improve the surgical skills in pandemic. Twenty five (60.97%) trainees and 6 (66.66%) fellows mentioned that pandemic affected them psychologically and they felt fear while working. Conclusion: COVID-19 has adversely affected the training of post graduate trainees. Training directors should ensure to provide modern technological tools to improve trainees’ clinical and surgical skills until the crisis is over. Key Words: COVID-19, Ophthalmology, Training, Conference.