Effect of Chronic Apical Periodontitis in Primary Molars on Succedaneous Permanent Teeth: An Observational Retrospective Study.

INTRODUCTION: Periapical infection of primary molars affects the development of permanent teeth (premolars). Therefore, the present study was conducted to test the null hypothesis in children aged 4-10 years with chronic apical periodontitis (CAP) of the primary molars. MATERIALS AND METHODS: A retrospective, cross-sectional study was conducted on 185 panoramic radiographs of healthy children aged 4-10 years with CAP in the primary molars. A total of 256 infected primary molars (144 teeth in females, 112 teeth in males) were analyzed, radiographically, and compared with 245 healthy primary molars on the contralateral side. Permanent successors were evaluated for follicular damage, maturation, morphology, and deviation in the eruption path. Primary molars were evaluated for root resorption. Sixteen permanent teeth on the affected side and five teeth on the control side were excluded due to abnormal development. Student's t-test and the chi-square test were used to analyze the data. RESULTS: The null hypothesis is rejected. There were significant differences in the developmental status of permanent successors on the affected side, compared to the normal side at four to seven years (p<0.05). There were no significant sex differences in the abnormalities of permanent successors on the affected side (p>0.05). As the root resorption of the primary molars increased, the follicular damage observed in the permanent successors also increased (p<0.05), which suggests that, as the infection of primary molars increases, more damage is caused to underlying permanent successors (premolars). CONCLUSION: Apical periodontitis of the primary molars retards the development of permanent successors (premolars), affects their shape, causes follicular damage, and alters the eruption path.

Accessibility of Treatment Among Women With Opioid Use Disorder: A Brief Review.

Opioid-use disorder (OUD) has become a social pandemic with a rising incidence and prevalence among women. Notably, women with OUD were more likely to have psychiatric comorbidities like major depressive disorder, anxiety disorder, and bipolar disorder. Evidence suggests that opioid exposure and subsequent disease among women compared to men is unique and attributable to hormonal estrogen levels. However, there remains a dearth of literature on their ability to access treatment when needed. There is also a gap in the perceived access to women as compared to men. Hence, our review will focus on factors that may affect women from seeking OUD treatment as compared to men.

Uropathogens Antimicrobial Sensitivity and Resistance Pattern From Outpatients in Balochistan, Pakistan.

Objective To determine the pattern of microbes responsible for urinary tract infections and their susceptibility to different antibiotics. Method This is a cross-sectional study conducted at Quetta, Pakistan. The urine samples of 400 patients were collected and sent for culture and sensitivity analysis. The results were recorded on an excel datasheet. Descriptive statistics were used to describe the data. Results Out of 400 urine samples, 266 samples were culture positive for microorganisms. The most common organism on analysis was Escherichia coli 123/266 (46.24%) followed by Staphylococcus saprophyticus 59/266 (22.18%) and Klebsiella pneumonia 49/266 (18.42%). Gram-negative microorganisms were most susceptible to fosfomycin, cefoperazone/sulbactam, and meropenem. Gram-positive microorganisms were most susceptible to fosfomycin, cefoperazone/sulbactam, meropenem, and amoxicillin/clavulanate. High rates of resistance in E. coli were observed to most commonly prescribed broad-spectrum antibiotics; ceftriaxone (64.35%), cefotaxime (76.54%), ceftazidime (49.43%), cefepime (53.44%), levofloxacin (71.26%), and amoxicillin/clavulanate (70.31%). E. coli was the major multidrug-resistant organism. Conclusion High rates of antibiotic resistance and multi-drug resistance were revealed in this study due to the widespread and injudicious use of broad-spectrum antibiotics. Thus, it is highly recommended to regulate the pharmacies. Physicians should judiciously prescribe antibiotics and practice the culture and sensitivity of urine samples rather than blind prescription. Continued surveillance on uropathogens prevalence and resistance, new and next-generation antibiotics, and rapid diagnostic tests to differentiate viral from bacterial infections is the need of time.

Comparison of reproducibility of natural head position using two methods.

UNLABELLED: Lateral cephalometric radiographs have become virtually indispensable to orthodontists in the treatment of patients. They are important in orthodontic growth analysis, diagnosis, treatment planning, monitoring of therapy and evaluation of final treatment outcome. AIM: The purpose of this study was to evaluate and compare the maximum reproducibility with minimum variation of natural head position using two methods, i.e. the mirror method and the fluid level device method. MATERIALS AND METHODS: The study included two sets of 40 lateral cephalograms taken using two methods of obtaining natural head position: (1) The mirror method and (2) fluid level device method, with a time interval of 2 months. Inclusion criteria • Subjects were randomly selected aged between 18 to 26 years Exclusion criteria • History of orthodontic treatment • Any history of respiratory tract problem or chronic mouth breathing • Any congenital deformity • History of traumatically-induced deformity • History of myofacial pain syndrome • Any previous history of head and neck surgery. RESULTS: The result showed that both the methods for obtaining natural head position-the mirror method and fluid level device method were comparable, but maximum reproducibility was more with the fluid level device as shown by the Dahlberg's coefficient and Bland-Altman plot. The minimum variance was seen with the fluid level device method as shown by Precision and Pearson correlation. CONCLUSION: The mirror method and the fluid level device method used for obtaining natural head position were comparable without any significance, and the fluid level device method was more reproducible and showed less variance when compared to mirror method for obtaining natural head position. CLINICAL SIGNIFICANCE: Fluid level device method was more reproducible and shows less variance when compared to mirror method for obtaining natural head position.

Pattern and management of renal injuries at Pakistan Institute of Medical Sciences.

OBJECTIVE: To determine the types and grade of various renal injuries and methods adopted for their management at the Department of Urology, Pakistan Institute of Medical Sciences, Islamabad. STUDY DESIGN: An observational study. PLACE AND DURATION OF STUDY: Department of Urology, Pakistan Institute of Medical Sciences, Islamabad, from January 2005 to December 2007. METHODOLOGY: The study included 50 patients with both blunt and penetrating renal trauma of either gender and aged above 13 years. Injuries, grade management and outcome was recorded. The data was entered in structured proforma and analyzed for descriptive statistics using SPSS version 10. RESULTS: Frequency was higher in males (82%). The mode of renal injury was blunt in 78% and penetrating in 22% cases. Blunt injuries were mostly due to road traffic accident (94.9%) and penetrating injuries due to firearm (63.6%). Hematuria was present in 86% and absent in 14% cases. Minor renal injury was seen in 74% and major injury in 26% cases. Seventy-two percent of cases were managed conservatively. All grade-V (14%) and one grade-1V injury (2%) patients underwent nephrectomy. Renorrhaphy was done in 6% cases. Urinary extravasation was seen in one case (2%). One patient developed renocolic fistula. No mortality was observed in non-operative group; however, 4% patients expired in operative group due to associated injuries. CONCLUSION: Blunt trauma accounts for majority of the cases of renal injury and non-operative treatment is the suitable method of management for most cases of blunt as well as selected cases of penetrating renal trauma, who are stable hemodynamically and without peritonitis.

Comparison of CT scan and colour flow Doppler ultrasound in detecting venous tumour thrombous in renal cell carcinoma.

BACKGROUND: Renal cell carcinoma has marked tendency to spread into renal vein, inferior vena cava and right side of heart. Extension of tumour thrombus into these veins will alter the surgical approach. We have compared the CT scan with Colour flow Doppler ultrasound in detecting venous tumour thrombus in renal vein and inferior vena cava. METHODS: This cross-sectional study included 30 adult patients presenting with renal tumour. Patients of either gender were included in the study. Non probability convenience sampling was used. All patients underwent colour flow Doppler ultrasound and CT scan with contrast to asses the renal vein and inferior vena cava. The results were confirmed by intra operative findings and histopathology. The data was analyzed using SPSS version 12. RESULTS: Out of 30 patients, 20 (66%) were males and 10 (34%) female. The tumour was predominantly on the right side (60%), as was renal venous tumour thrombus (44%). Inferior vena cava was involved in 4 cases predominantly due to right sided tumours. The sensitivity of Doppler ultrasound in detecting renal venous tumour thrombus (88% on right and 100% on left side) was higher than CT scan (63% on right and 60% on left side). Doppler ultrasound was also superior to CT scan in detecting vena caval thrombus. CONCLUSION: The overall sensitivity of Doppler sonography was higher than CT scan in detecting tumour extension into renal veins and inferior vena cava. Therefore, it can be used as a complementary tool in equivocal cases.