Assessment of Some Habits and Practices related to Complete Denture Wearing – A Survey of Subjects Reporting to Watim Dental Hospital

Objective: To assess some habits and practices related to denture wearing among subjects reporting to Watim Teaching Dental Hospital, Rawalpindi. Materials and Methods: This is a cross-sectional study conducted at Watim Dental College, Rawalpindi, from December 2018 to August 2019. Using a pre-structured questionnaire, data were collected from 155 subjects having used complete dentures for a minimum of 6-months. The questionnaire consisted of information including the type of dentures, duration and frequency of denture wearing, and denture cleaning habits. Data were analyzed using SPSS version 20. Results: Out of 155 participants, 80 (51.6%) were male and 75 (48.4%) were females. 89 (57.4%) patients use toothbrushes and soap for denture cleaning. 139 (89.7%) participants didn’t wear dentures while sleeping and soaked them in water. 98 (63.2%) respondents were not using antiseptic oral rinse and were casual in mouth-cleaning. Conclusion: From this study, it is concluded that 65 (41.9%) subjects were cleaning their dentures once a day. The study also reveals that 65 (41.9%) edentulous participants were not able to clean their oral cavity. Dentists should emphasize the importance of recall visits to evaluate the status of denture hygiene along with mucosal surface examination. Patient motivation to follow hygiene instructions and informing them about the harmful effects of overnight wearing of dentures should be part of delivering the prostheses to them.

Platelet Indices as Potential Monitoring Biomarkers in COVID-19: A New Hope

Objective: To investigate the relationship between established acute inflammatory markers in COVID-19 patients with Mean platelet volume (MPV) and Platelet large cell ratio (P-LCR). Materials and Methods: This was a retrospective longitudinal study conducted at Fauji Foundation Hospital, Rawalpindi from 10th June to 10th August 2020. Biochemical parameters i.e. CRP, serum ferritin, LDH, and pro-BNP as well as hematological parameters (MPV and P-LCR) were noted once every week during admission of all the COVID-19 positive patients.Data were analyzed using IBM-SPSS version 23. Repeated measure ANOVA using a generalized linear model was done to check the trend of values during the duration of their stay. Pearson Correlation analysis and regression models were estimated to check the relationship of MPV and P-LCR with C- reactive protein, serum Ferritin, LDH, and pro-BNP. P-values less than 0.05 were considered statistically significant. Results: The mean age of the studied group was 55.47 (SD=±15.0) years with the female to male ratio being 2:1. Mean platelet volume showed a statistically significant positive correlation with the established set of inflammatory markers other than pro-BNP with a p-value of less than 0.05.P-LCR however showed a positive correlation with CRP (p-value of less than 0.05) only with no significant correlation with other biochemical markers. Conclusion: MPV is reported on routine complete blood count report (CBC). It is readily available at even the most under-resourced health centers; therefore reporting the platelet indices does not require extra testing, sampling, or reagent cost. A statistically significant positive correlation amongst the established acute inflammatory markers and relatively understudied platelet indices (MPV) in COVID-19 provides a cost-effective, readily available, and time-efficient tool for marking disease progression.

Sodium-Glucose Cotransporter 2 (SGLT-2) Inhibitor drugs: Assessment of safety in Fasting Diabetics

Introduction: Ramadan is a holy month and the majority of Muslims fast in it, without considering background illnesses. SGLT-2 drugs were available for Pakistani patients recently, and this was the first year to fast in their presence.Objectives: To assess the risk of hypoglycemia in fasting diabetics using SGLT-2 drugs, comparing it with Sulphonylurea (SU) drugs. Also, a change in HbA1c and eGFR was checked. Hence, evidence was collected to recommend their use in fasting Diabetics with safety. Material and Methods: A total of 5500 patients from three different sites were included. Only 500 fulfilled the criteria of inclusion. Pregnant, lactating, advanced Chronic Kidney Disease (CKD), and those recording hypoglycemia frequently were not included. Ages between 20 to 70 years, HbA1c between 7 to 11, and patients taking SU or SGLT-2 were included. Conclusion: The eGFR was comparable in both groups post-Ramadan. HbA1c was significantly reduced in the SGLT-2 group. Bitter taste and thirst were common with the SU group. Hypoglycemia was comparable in both groups. We concluded that SGLT-2 drugs were safe during Ramadan, and caused more HbA1c reduction.

Effect of Red Bull on Histology of Renal Mesangium

Objective: To determine the consequences of energy drink (Red bull) on renal mesangium of albino rats.Materials and Methods: This study was carried out at the Anatomy Department of King Edward Medical University, Lahore, from August 2018 to December 2019. It was an experimental randomized controlled trial. Total 90 adult albino male rats, 8-12 weeks old, weighing 130 to 160 grams were taken. Healthy animals were included. Rats were divided into three groups Group A and B experimental groups received 1.5ml/kg and 2.2ml/kg body weight of red bull energy drink, respectively. Group C received 1ml/kg body weight of distilled water.Results: The mean initial and final weight of animals was around 150g and 170g, respectively. The mean paired kidney weight and relative tissue weight index for all three groups were found insignificant. Microscopic examination showed mesangial hypercellularity and vascular congestion in renal cortex of groups A and B, none in group C. These were significant among two experimental groups with a p-value less than 0.001.Conclusion: It was found that the use of energy drinks induces histopathological changes in the renal mesangium.

Clinico-Histological presentation of Head and Neck Lesions in a Tertiary Care Hospital

Objective: This study aimed to see the clinical presentation and histological pattern of various head and neck lesions.Materials and Methods: This descriptive study was conducted in the Department of Pathology, Bannu Medical College in association with the Department of Surgery and ENT, Khalifa Gul Nawaz Teaching Hospital, Bannu. A total of 184 cases of head and neck lesions biopsy were subjected to histopathological diagnosis. Patients' age, gender, anatomical location, and other relevant necessary clinical findings were recorded on an already designed proforma. All biopsies were received in 10% buffered formalin, fixed overnight, and processed for histopathological examination and diagnosis. Inclusion criteria were patients with head and neck lesions including skin, salivary gland, lymph node, and oral cavity of any age and gender. Exclusion criteria were thyroid, nasal cavity lesions, autolysed, and insufficient biopsy specimen. Results: In this study, the mean age was 28.58 ± 17.34 years, and the age range was from 10 to 80 years. The male-to-female ratio was 1.3:1. The most common age group was 36-45 years followed by 46-55 years and 26-35 years etc. The most common inflammatory lesion was granulomatous lymphadenitis 14.67% followed by reactive lymphoid hyperplasia 9.23%. Common benign lesions were pleomorphic adenoma 5.97% followed by lipoma and hemangioma 3.80% and 3.26% respectively. Amongst malignant lesions basal cell carcinoma 23.91% of the face was the commonest lesion followed by squamous cell carcinoma 22.28% of the oral cavity. Conclusion: This study show spectrum of lesions from inflammatory to benign and malignant, occurring in the head and neck region. Malignant lesions are more common as compared to benign and inflammatory lesions, basal cell carcinoma of the skin is the commonest malignant lesion followed by squamous cell carcinoma of the skin and oral cavity.

Association of long term sodium valproate monotherapy and vitamin D3 levels in epileptic children

Objective: To determine the association of long term sodium valproate monotherapy and vitamin D3 levels in epileptic children Methods: This cross-sectional study was conducted in the Department of Pediatrics, Children Hospital, Pakistan Institute of Medical Sciences, Islamabad for six months from 15th February 2019 to 14th August 2019. A total of one hundred and thirty (n=130) children and adolescents of either gender between age 3-18 years who had a history of two seizures at least 24 hours apart in their life and were on sodium valproate monotherapy for more than one year were enrolled in this study through non-probability, consecutive sampling. Serum vitamin D3 (25-hydroxy vitamin D) levels were measured in all the patients at the time of enrolment into the study. All the demographic data and laboratory investigations were entered on the predesigned proforma and analyzed through SPSS version 17. Results: Vitamin D3 deficiency was found in 47 (36.2%) children which were significantly higher among patients with older age and longer duration of treatment (P<0.05) while gender and BMI of the patients did not show any significant difference (P>0.05). Conclusion: Significant percentage of epileptic children on sodium valproate monotherapy was found to have vitamin D3 deficiency. Therefore we recommend routine screening of vitamin D3 deficiency in all the epileptic children on long-term sodium valproate therapy followed by vitamin D supplementation in deficient patients.

Perinatal Outcome of Twins Delivered Vaginally in a Tertiary Care Hospital

Objective: To determine the perinatal outcome of first and second twin delivered vaginally in terms of frequency of poor APGAR score and NICU admission in the patient at term in a tertiary care health facility.Introduction: This study aims to improve the perinatal outcome of twin pregnancies through awareness of the need for antenatal care, the recommendation of regular antenatal visits, early recognition of complications, and the presence of neonatal intensive care facilities to improve neonatal outcome by knowing the burden of adverse outcomes in our population.Materials and Methods: This is a descriptive study, conducted at the Department of Obstetrics and Gynaecology at DHQ Hospital, Rawalpindi from January 2019 to June 2019.A total of 91 individuals (female pregnant ladies) who delivered twins (Dichorionic Diamniotic) babies through normal vaginally were selected for descriptive study in the Department of Obstetrics and Gynaecology, DHQ hospital Rawalpindi. All consecutive patients admitted in the labour ward with twin pregnancies were included. Before delivery, the fetal wellbeing of both the twins was evaluated also by ultrasonography. Data collection was done by interview schedule from the patients. Data were analyzed using descriptive statistics using SPSS version 17. For all the quantitative variables like age, gestational age and intertwine interval in seconds.Results: Out of 6278 deliveries during the study period, 91 twin births gave a frequency of 15.16/1000 births. Patients' mean age was 30.14+2.64 years, and mean gestational age was 37.47+0.72 weeks. The mean inter twin delivery interval (mins) in the study was 23.74+4.75. Perinatal outcome of first and second twin in terms of frequency of poor APGAR score and NICU admission in a patient at term was 09 (9.9%) and 27 (29.7%), (p<0.001) respectively.Conclusion: The study concludes that there was a high risk of perinatal outcomes in the second twin as compared to the first twin delivered vaginally. Poor Apgar score and neonatal intensive care admission were more so for the second twin.

Antiulcerogenic Activity of Vitamin E on Gastric Ulcers produced by Indomethacin

Objective: To study the morphological and histological effects of vitamin E on gastric lesions produced by indomethacin.Materials and Methods: This was an animal interventional study, 48 adult healthy albino mice were selected and were split into four groups A, B, C and D. Number of animals in each group was 12. Group A was categorized as control. Evion 400mg/kg was administered to Group B. Indocid 25mg/kg was given to group C. Indocid and Evion both (25mg/kg &400 mg/kg respectively) were administered to Group D. In all group, six animals were selected and treated for three days and rest for eight days with calculated doses of drugs. Mice were sacrificed and dissection was done 24 hours after the last dose. The stomach was identified, washed, and observed under dissecting microscope to study the number and shape of ulcers. The dimension of ulcers was measured under a compound microscope.Results: No ulcers were seen in groups A and B. 35 and 10 ulcers were observed in groups C and D respectively. The mean number of ulcers in groups C and D was statistically significant (p-value=0.000). In comparison to group D, Pindot, linear, Irregular, and punched-out ulcers were more prevalent in group C and were statistically significant (p-value < 0.05). The mean linear dimension of ulcers in group C was much greater than in group D. The mean dimension of ulcers in group C1 and C2 was 262.50µm and 232.5µm respectively. Whereas in group D1 and D2 given both Indocid and vitamin E the dimensions were 56.5µm and 50µm.Conclusion: Vitamin E has an anti-ulcerogenic effect on stomach mucosa by reducing the number and dimension of ulcers.

The knowledge regarding Breast Cancer, its risk factors, and screening practices among women from Islamabad, Pakistan

Introduction: Breast Cancer is the rising Public health problem of the world. Pakistan is bearing a high disease burden not only in Asian countries but in the whole world. Pakistan ranks highest in Breast cancer and accounts for almost 34.6%of female cancers. The incidence of the disease in Asian countries is quite different from that in Western countries regarding age i.e. (40-50 years.) while (60-70 years) in Western countries. This study was based on assessing the knowledge regarding breast cancer, risk factors, and screening practices to determine the barriers in the path of the community to seek medical care.Materials and Methods: A cross-sectional study was done between October to December 2019 on 310 females participants of ages from 25 to 70 years, residents of Islamabad, the capital of Pakistan, and knowledge was assessed by applying a self-responding questionnaire.Results: Using SPSS version 23 and chi-square tests, the results showed that 87.7% of participants knew about the prevalence of Breast Cancer. Whereas, 90.3% of the females with the disease are not aware of their illness and show a strong association (p-value is less than 0.05) between knowledge regarding breast cancer and screening tests. Conclusion: The study concluded that 90% of socio-cultural barriers are in the path of access to medical facilities and 90% of participants believed that the non-availability of female doctors in health facilities is a big barrier to access to health. Access to medical facilities should be made easy by promoting health education and removing the fear of results, making small health facility units.

Success rate of Nasolacrimal Duct Probing in children with Congenital Nasolacrimal Duct Obstruction after the age of one year

Introduction: The objective of this study was to determine the success rate of nasolacrimal duct probing for congenital nasolacrimal duct obstruction in children after the age of one year.Materials and Methods: It was a descriptive case series conducted on 145 children presented to Ophthalmology Department, Allied Hospital, Faisalabad with CNLDO. The probing and syringing of the nasolacrimal duct were performed under general anesthesia. The patency of the nasolacrimal system was evaluated by irrigation of saline stained with pyodine through the superior punctum, flow of saline into the nose was confirmed by soaking of throat gauze with pyodine stained fluid and/or oozing of pyodine stained fluid through nose. Patients were advised topical antibiotics and steroids for 3 weeks after the probing and follow-up checkups after 6 weeks. Data were analyzed using SPSS computer software version 17.0. Effect modifier like age and gender was controlled by stratification. The post-stratification chi-square test was applied. P-value <0.05 was considered significant.Results: In our study, the frequency of success of nasolacrimal duct probing for congenital nasolacrimal duct obstruction in children between 1 to 2 years was 80.3%, children between 2 to 3 years of age were 53.1%, and children between 3 to 4 years of age were 32.4%.Conclusion: We concluded that the success rate of nasolacrimal duct probing for congenital nasolacrimal duct obstruction is higher in children after the age of one year and decreases gradually as the age progresses.