Survey of the Reasons for Dental Extraction in patients of Kashmiri Population

Background: Extraction of teeth is the commonest surgical procedure carried out in the dental surgery setting. The purpose of this survey was to identify the causes of teeth extraction in Kashmiri population. Material & Methods: This study was done on the patients who were referred to Department of Oral and Maxillofacial Surgery Government Dental College Srinagar for tooth extraction for the period of 6 months from February 2019 to July 2019. Total of 3000 patients were included in this study. Results: There were 1680 (56%) extractions in males and 1320 (44%) in females with male?to?female extraction ratio of 1.2:1. In both male and female gender, there were more teeth extractions between the ages of 11 and 30 years. The commonest tooth to be extracted was 1st molar both in upper (27.2%) and lower (30.4%) arch. The commonest reasons for teeth extraction were caries (53.4%; 1602/3000). Conclusions: The result of this study shows that dental caries is the commonest reason for tooth extraction in Kashmiri population. It is hoped that the study will facilitate the development of treatment and preventive procedures relevant to the problems, thus minimizing the loss of teeth and its expected adverse consequences.

Evaluating the Safety and Effectiveness of Super?cial Cervical Plexus Block in Oral and Maxillofacial Surgery as an Alternative to General Anesthesia and Local Anesthesia in Space Infections: A Prospective Clinical Study

Background: Regional anesthesia is the most commonmethod to anesthetize the patient prior to office basedprocedures. Many techniques can be employed to achieveanesthesia of the dentition and surrounding hard and softtissues of the maxilla and mandible. Aim of the study Toassess the safety and effectiveness of super fi cial cervicalplexus (SCP) block in oral and maxillofacial surgical (OMFS)practice as an alternative to general anesthesia in selectivecases.Materials and Methods: The total number of patients was 50,out of which 35 were male and 15 were female patients.Informed & written consent were obtained from the patientsafter they had the procedure explained tothem. Medicallycompromised patients and those who were excessivelyanxious and apprehensive, patient who did not want theprocedure to be done under regional anesthesia, and patientswitha history of allergy tolocal anesthetic were excluded. Allpatients had their surgical procedures under regionalanesthesia (SCP block with supplemental nerve blocks)performed by the same surgeon under the supervision ofanesthesiologist with continuous monitoring.Results: SCP block with concomitant mandibular nerve andlong buccal nerve block has a high success rate, lowcomplication rate, and high patient acceptability as shown inthe study.Conclusion: Superficial cervical plexus block anesthesia is asafe and useful anesthetic technique with the low risk ofaccidents and complications, thus a good alternative forregional anesthesia in OMFS cases.

Assessment of Changes in Paraclinical Indexes Due to Intermaxillary Fixation: A Prospective Clinical Study

Background: One of the treatment modalities of mandibular and midface fracture is closed reduction with the use of intermaxillary fixation (IMF), in which the fractured segments are immobilized adjacent to each other and this procedure results in the reunion of the separated segments. It has been shown that there is a direct relation between nutrition and the healing process of the body therefore treatment with IMF could possibly affect the healing process. In this study, we evaluated the effects of IMF on paraclinical factors like protein profile and lipid profile which are markers for malnutrition condition, so further thoughts can be given to prevent malnutrition by using different supplements. Methods:30 Patients having mandibular fracture which needed closed treatment was selected for this study. All patients were treated with a 4 weeks period of IMF. Lipid profile factors [total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG)] and protein profile factors [hemoglobin (Hb), albumin (Alb)] were measured before the start of IMF and after the 4 weeks period of IMF. Results: there occur decrease in the level of Alb and the reduction was statistically significant. There occur slight increase in Hb level at the end of treatment however the result was statistically insignificant. also there occur decrease in the level of TC, HDL, LDL and TG after the treatment but the result was statistically insignificant. Conclusion: it was concluded that treatment with IMF can result in malnutrition conditions although not severe. so when close reduction techniques are used as the treatment plan in maxillofacial region, a supplemental nutrition planning is very thoughtful thing to do.

Role of weight-bearing exercises in the treatment of post-menopausal osteoporosis

Objective: To determine the change in T-score of post-menopausal osteoporosis patients with weight-bearing exercises

Study Design: A quasi-experimental study

Place and Duration of Study: Physiotherapy Department and Orthopedic Unit I, Mayo Hospital, Lahore, from May to October 2014

Methodology: Two hundred and seventy-four patients were randomly divided into two groups according to inclusion and exclusion criteria using non-probability purposive sampling technique. The group 1 was treated by medication and weightbearing exercises and group 2 was given medication alone. The dual energy X-ray absorptiometry [DEXA] scan was used to find the T-score before and after treatment and improvement was compared. A p-value less than 0.05 was taken as significant

Results: The results showed that improvement was occurred in both groups after treatment. The DEXA scan median values after treatment were changed to 3.00 [0] for group 1 [exercises and medication] and 2.00 [1] for group 2 [medication]

Conclusion: The physical activity along with medication play vital role in the treatment of post-menopausal osteoporosis than medication alone

Decalcification: A Simpler and Better Alternative.

Background: Decalcification of calcified tissues plays an important part in histological techniques. However, as it often takes a long time and some procedures decrease the staining qualities of the specimen, many attempts have been made to find methods for accelerating this procedure and ensuring good staining properties. One of the factors that regulates decalcification is temperature. Controlled increase of temperature yields decalcification at a faster rate and also retains the basic molecular arrangement. The aim of the study is to formulate a simpler and better alternative for conventional decalcification. Methods: Thirty freshly extracted periodontally compromised molar teeth without evidence of dental caries were used for decalcification in three groups. In each group 10 teeth were used. Group A: 5% HNO3 was used. Group B: 10% HNO3 and 10% formalin was used. Group C: 10% HNO3 and 20% formalin was used. A constant temperature of 55⁰C was maintained. Complete decalcification was checked using X-ray method. The teeth were sent for routine processing and stained using Haematoxylin and Eosin. Results: Decalcified teeth of Group C containing 10 % HNO3 and 20% formalin proved to be advantageous completing decalcification faster among the 3 groups while maintaining good tissue details. Conclusion: In the present study, it was observed that, regardless of the employed fixative solution, preservation of pulp architecture was best, when a combination of 10% HNO3 and 20% formalin was used as a decalcifying agent.

Honey in the Management of Dry Socket.

Background: The most common post-operative complications following extraction of tooth is dry socket or alveolar osteitis. The aim of our study is to evaluate the efficacy of honey in the management of dry socket. Methods: Sixty patients of dry socket were selected from the outpatient department of oral and maxillofacial surgery. A diagnosis of dry socket was made clinically. Honey was used as a dry socket dressing in all the patients. The parameters like pain, swelling, hyperemia, lymphadenopathy and formation of granulation tissue were assessed in the postoperative period upto 3 weeks. Results: In this study there was significant reduction in inflammation, hyperemia, and swelling after honey dressing that resulted in soothing effect and reduction in pain and discomfort. .No side effect of honey was observed in our study, so it can be used as an alternative for the management of dry socket. Conclusions: There are no side effects of honey. Excess use of eugenol can lead to necrosis of bone. The honey can be used as medicament for the management of dry socket.

Effectiveness of manual physical therapy in treatment of plantar fasciopathy

Background: Plantar fasciitis is now known as plantar fasciosis or fasciopathy [PF], is a common foot pain disorder in athletes and non-athletes. There is a pain along plantar side of the foot especially in heel and at the site of insertion of the fascia

Objective: To determine the effectiveness of manual physical therapy in management of plantar fasciopathy

Methods: Referred patients of plantar fasciopathy filled a self-reported questionnaire, containing the Foot and Ankle Ability Measure [FAAM] and the Numeric Pain Rating Scale [NPRS]. All measures were taken at baseline and at 6 weeks follow up. Treatment of PF in term of pain and function was measured with paired sample T-test

Result: Thirty [30] eligible patients [mean age 45.63 years [+/-SD10.81]; 73.3% female] signed the consent form. The manual physical therapy group showed clinically sensitive and significant progress in term of pain and function over group II of ultrasound and exercise. The group I showed clinically significant results in terms of FAAM [CI: 3.171, 2.08] [p=0.001] after 6 weeks follow up. The group I also showed clinically significant improvment in terms of NPRS [CI: 0.861, 2.07], [p=0.001] after 6 weeks follow up

Conclusion: The result of our study showed that manual physical therapy [MPT] is an effective treatment approach in treatment of plantar fasciopathy

Prevalence of gingivitis in school children at different government schools of district hyderabad

Objective: To estimate the prevalence of gingivitis and periodontitis in 5-15 years school going children at different government schools of district Hyderabad

Materials and Methods: This cross sectional study was conducted in government schools on children from nursery to grade 8 in Hyderabad, Sindh from 5th October, 2015 to 6th November, 2015. A total 1093 students varying in age from 5-15 yrs. were counted in the study. We used Periodontal Disease Index [PDI] to assess the prevalence of gingivitis and periodontitis. Apreformedquestionnaire was used; one house officer and 2 Assistant professors examined the students according to PDI and completed the data form. After evaluation the score was calculated. Data was analyzed via SPSS version 21. Descriptive statistics such as percentage, frequency distribution, cross tabulation were included in data analysis. The level of significance was set at <0.05%

Results: This study revealed that 70.4% students were suffering from gingivitis; 25.2% of students suffered from periodontitis and only 4.4% of students were healthy

Conclusion: The prevalence of gingivitis and periodontitis in government school children of Hyderabad is found to be high

Warfarin Therapy: Survey of Patients’ Knowledge of their Drug Regimen

Background: Warfarin is utilised for the treatment of thromboembolic disease. Its use demands a careful and continual monitoring given its narrow therapeutic index and potentially life-threatening complications. The aim of this study was to assess the extent of patients’ knowledge of their warfarin therapy. Methods: A total of 200 consecutive patients from a single community hospital completed an online survey questionnaire (www.eSurveysPro.com). Using the responses to the questionnaire, we recorded compliance to warfarin therapy, knowledge about drug interactions, adverse effects of warfarin therapy, complications, and resulting hospitalisation. Results: We recruited 200 patients, 55% (109/200) women and 45% (91/200) men, among which 88% were compliant with their daily medication. Of the 200 patients, 56% were unaware of any potential drug interactions, 58% were unaware of any adverse effects, 27% had experienced adverse effects, 12% had been hospitalised because of adverse effects (33% of which were due to bleeding), and 65% kept a personal record of their international normalised ratio. Conclusions: Despite the high level of compliance, patient knowledge of warfarin therapy was low. Given the potential drug interactions and complexities involved with warfarin therapy, it is of high importance that medical professionals educate their patients and make them aware of any impending signs of emergent medical complications.

Management of pain in cancer patients at a South Indian Hospital.

The main objectives were to study the incidence of cancer in the locality, pattern of drug prescribed and management of pain in cancer patients. In a total of 30 patients, 18 (60%) were male and 12 (40%) were female. Patients between the age group 51 and 60 were found to be more (n=7; 23.33%) to get hospitalized for the treatment of cancer. Right breast cancer (n=3; 10%) is more predominant in the cancer patients as a past medical history, which is followed by Left breast cancer, Penis cancer, Acute myeloid leukemia in 6.66% (n=2) and Non- Hodgkin lymphoma, B-cell acute lymphoblastic leukemia, T-cell lymphoma, Acute lymphocytic leukemia and airway obstruction, Burkett’s lymphoma, Right lung cancer, Carcinoma of mild transverse colon, etc. Diagnosis in the study population shown that Hodgkin lymphoma (n=4; 13.33%) and Right breast cancer (n=4; 13.33%) were predominant cancer, which is followed by B-cell acute lymphoblastic leukemia, left breast cancer, penis cancer, acute myeloid leukemia in each of 2 (6.66%) patients. The most commonly used pain medications were Tramadol and Diazepam, these drugs are prescribed in 8 patients each (26.66%), and it is followed by Morphine, Phenobarbital and Flurazepamwere found in 4 patients each (13.33%).