Assessment of radiographic morphology of mandibular condyles: a radiographic study.

BACKGROUND: Panoramic radiographs are the most common radiographic tool used by the dental clinicians to evaluate teeth, mandible and other related structures of the jaws. Mandibular condyle is an important anatomical landmark for facial growth, expressed in an upward and backward direction. The presentation of mandibular condyle differs widely among different group of ages and individuals. MATERIALS AND METHODS: The retrospective cross-sectional study was conducted from November 2018 to March 2019 at Dow International Dental College Karachi that includes radiographic evaluation of 500 mandibular condyles. All retrievable orthopantomograms were obtained and data were extracted regarding age, gender and condylar morphology. RESULTS: The morphological appearances of mandibular condyle have great variation among different age groups and subjects. Normally, we recognise five basic shapes i.e. oval, bird beak, crooked finger, diamond and mixed. Out of 250 pair of condylar heads that were evaluated, 50% were oval, 40% bird beak, 4.8% crooked finger and diamond 4.8%. CONCLUSIONS: All four morphological types of mandibular condyles were observed and the oval shape condyles were most prevalent among both genders and all age groups. In future studies, the inclusion of other parameters and large sample size may provide unique information.

Laboratory cross training needs assessment.

OBJECTIVE: To define the continuing education topics and methods in the area of chemistry and hematology, that if developed, would best support the cross-training needs of hospital based laboratories in the State of Georgia. DESIGN: A cross sectional study of hospital based laboratories in Georgia was completed using surveys sent to 181 hospital laboratory managers and administrators. Descriptive statistics were used to evaluate the survey results. SETTING: Department of Medical Technology, Medical College of Georgia, Augusta GA. PARTICIPANTS: Laboratory managers and administrators. INTERVENTION: Not applicable. MAIN OUTCOME MEASUREMENTS: Four descriptive outcome measurements were requested from each participant: 1) demographic questions, 2) cross-training topics desired, 3) training material desired, and 4) computer literacy and equipment assessment. RESULTS: Sixty-six surveys were completed and returned in a usable form (36% return rate). Demographically, the respondent group is a representative sample of hospital based laboratories in the State of Georgia with 46% of the respondents from facilities of 100 hospital beds or less. Respondents desired that case study training topics be developed using paper and computer assisted instruction mediums. Additionally, respondents desired that Professional Acknowledgement for Continuing Education (P.A.C.E.) be associated with the training material. They were willing to pay for this administrative service. CONCLUSION: This cross sectional study assessed the cross-training needs of hospital based laboratories in Georgia. Findings will allow educators to focus and develop continuing education packages that best meet the needs of the laboratorian workforce.

Clinical laboratory technician to clinical laboratory scientist articulation and distance learning.

Laboratory workers and educators alike are challenged to support access to education that is current and provides opportunities for career advancement in the work place. The clinical laboratory science (CLS) program at the Medical College of Georgia in Augusta developed a clinical laboratory technician (CLT) to CLS articulation option, expanded it through distance learning, and integrated computer based learning technology into the educational process over a four year period to address technician needs for access to education. Both positive and negative outcomes were realized through these efforts. Twenty-seven students entered the pilot articulation program, graduated, and took a CLS certification examination. Measured in terms of CLS certification, promotions, pay raises, and career advancement, the program described was a success. However, major problems were encountered related to the use of unfamiliar communication technology; administration of the program at distance sites; communication between educational institutions, students, and employers; and competition with CLT programs for internship sites. These problems must be addressed in future efforts to provide a successful distance learning program. Effective methods for meeting educational needs and career ladder expectations of CLTs and their employers are important to the overall quality and appeal of the profession. Educational technology that includes computer-aided instruction, multimedia, and telecommunications can provide powerful tools for education in general and CLT articulation in particular. Careful preparation and vigilant attention to reliable delivery methods as well as students' progress and outcomes is critical for an efficient, economically feasible, and educationally sound program.

Food insecurity in metropolis of the developing world--observations from central district of Karachi, Pakistan.

OBJECTIVE: To assess the prevalence of household food insecurity at various income levels in urban areas of Karachi. METHODS: A cross sectional survey of different localities in the central district of Karachi was carried out. The data was collected through household interviews of housewives conducted by trained nutritionist. Housewives were interviewed about food security status of the household. RESULTS: A total of 797 families were visited from the central district of Karachi. Mean Food Security Score increased with income level. The difference was statistically significant (ANOVA) between 1st and second (P=0.000) and 2nd and 3rd group (P=0.000) but not between 3rd and fourth group. At the very low and low income levels 83% & 51% families respectively were food insecure in any degree, while this percentage was very low at the middle (6.3%) and high income level (1.8%). The difference in prevalence of food insecurity between the VLI and LI, and, LI and MI income groups was statistically significant (chi.sq. test, p<0.001 in each case). Hunger (because of lack of money) was experienced in the preceding year only by "very low income" (37%) and "low income" families (17%). Use of coping strategies was most frequently mentioned for parents and then for children and only occasionally for infants or grand parents. Females were more likely to be effected by food insecurity than males. Meat, milk and fruits were the food groups which were preferred and considered healthy but were avoided because of lack of money by a majority (51%-86%) of families. CONCLUSIONS: In spite of having an impression of being an affluent city of Pakistan, the prevalence of food insecurity with and without hunger is rampant not only among very low income (slum dwellers) but also among low income families of Karachi.

Socioeconomic differences in housewife's ability to take nutritional care.

OBJECTIVE: To explore socio-economic differences in 'Nutritional Care Potential' (NCP) of housewives belonging to three distinctively different income groups living in urban areas of Karachi. METHODS: Data was collected from families living in small, medium and large sized houses located in the authorized urban residential areas of Karachi. A total of 180 housewives (60 each for low, middle and high income groups) were interviewed. Trained data collectors visited the households, interviewed the housewives about family's socio-demographic characteristics and their own nutritional knowledge, health locus of control and decision making. RESULTS: The total NCP scores increased with income level (Low = 14.8+/-5.6; Middle 16.58+/-5.5; High = 17.28+/-5.3) but the difference was statistically significant only between low and high income groups (t-test P = 0.015). The mean nutrition knowledge score of low income group was lower (mean score = 11.7+/-4.1) and significantly different from both middle (mean score = 13.5+/-3.4 t-test P = 0.013) and high income group (mean score = 14.2+/-4.0, t-test P = 0.001). All the three income groups had firmer belief in internal health locus of control (mean score less than one out of a total of 4). Though, the mean score was highest for the high income group and lowest for the middle income group but the difference were not statistically significant. There were no marked differences in decision making power of the three groups. CONCLUSION: The results of this study document socioeconomic difference in nutrition care potential. Though nutrition care potential of housewives was not found to be commendable at any income level, the fact that it is low at lower income levels indicates that poor nutritional status at lower income level is not because of income only.

Chronic renal failure in children.

OBJECTIVE: To determine the clinical presentation and find out the underlying cause of chronic renal failure (CRF). METHODS: This is a descriptive prospective study of patients attending children hospital, Chandka Medical College Larkana and National Institute of Child Health (Paediatric Nephrology Unit) Karachi from January 1993 to December 1996. RESULTS: Seventy eight confirmed cases of chronic renal failure (CRF) were included in the study. Out of them 51 were male and 27 females (M:F ratio 1.8:1). Most of the children (90%) presented after 3 years of age. Common clinical presentation were anaemia (93.5%) cases, growth retardation (74.3% cases), urinary complaints (65.3%) cases and hypertension (53.8%) cases. Common causes leading to CRF were reflux nephropathy (24.5%), posterior uretheral valves (23%), chronic glomerulonephritis (15.4%) and urolithiasis (14%). CONCLUSION: Early diagnosis and management of most common causes of CRF may prevent and delay the progression to end stage renal disease (ESRD).

Determination of skeletal age in children aged 8-18 years.

Skeletal age determination exercise was performed by Greulich-Pyle method in 402 normal children (219 males and 183 females) aged 8-18 years during 1993-94 at Chandka Medical College, Larkana. On the average, the males were 1 year and the females were 0.5 years retarded from 8-15 years and from 8-13 years respectively. This retardation during childhood might be due to malnutrition, ill health or other environmental factors. However, males after 15 years and females after 13 years (round about puberty and afterwards) were found advanced in their skeletal age indicating earlier maturity in our children as compared to western children.

The accuracy and inter-observer reliability of acetate templating in total hip arthroplasty.

AIM: The accuracy and inter-observer reliability (IOR) of acetate templating on hard copy X-rays in 33 primary total hip arthroplasties as measured by consultant and trainee surgeons was analyzed to find out how accurate are junior surgeons undertaking specialty training. METHODS: The study was questionnaire-based using a prospective cohort over a 4 weeks period. The Surgeon measurements of acetabular cup, femoral stem and femoral offset sizes were noted following acetate measurements and then compared with the final implant chosen during surgery. RESULTS: Prediction of sizing to within one size of the final match size was 75% accurate for cup and 91% accurate for femoral stem. Prediction of exact femoral offset sizes was 91% accurate. Templating showed strong IOR between senior consultant surgeon and junior trainee registrar within one size for cup (83%) and stem (100%) and for exact hip offset prediction (92%). CONCLUSION: We conclude that acetate templating on hard copy X-rays is beneficial to surgeons to gauge acetabular cup and femoral stem size to within one size range. This further helps in predicting nearly exact femoral offset size.

A systematic procedure for selection of automated instruments in the clinical laboratory.

A five-step systematic procedure for comparison and selection of automated instruments for the clinical laboratory is presented. Thirteen criteria commonly used for selection of instruments in the clinical laboratory are discussed, and from these an opinion survey form is developed for use in decision making. A procedure for using this opinion survey form, tabulating the survey data, and making the final recommendation is also discussed.

Safety procedures in clinical laboratories.

Five types of hazards encountered in the clinical laboratory and a list of safety procedures designed to avoid or minimize them are identified. The safety procedures are written in a precise and easy-to-follow manner so that they can be adopted and used in any clinical laboratory. Medical technology educators are encouraged to teach safety procedures and enforce them in the student laboratory.

Assessment of linear growth of affluent urban Pakistani adolescents according to CDC 2000 references.

BACKGROUND: The appropriateness of using international reference data for assessing growth of children and adolescents from developing countries has been debated. If the growth performance in at least those sections of the society that may be considered affluent has reached the levels represented by the international reference, the case for adoption of the NCHS reference would be strong. Findings from studies in younger children indicate appropriateness of these standards but data from older children are lacking. AIM: The study aimed to compare the linear growth of affluent Pakistani adolescents living in Karachi with the NCHS reference so as to assess the appropriateness of using these standards for assessing the growth status of Pakistani adolescents. SUBJECTS AND METHODS: Data were collected from 876 girls and 819 boys aged 10-15 years studying in well known and established affluent urban public schools in Karachi. A portable stadiometer (Minimeter by CMS, London) was used for measuring heights. Heights were compared using the United States Center for Disease Control (CDC 2000) reference values to assess growth status. RESULTS: The mean ages of boys and girls were 12.82 and 12.63, respectively. Mean Height for Age Z score (HAZ) (-0.02) was very close to CDC 2000 reference values but the growth pattern was not similar. Younger children were relatively taller and the older children were shorter than CDC standards. Mean HAZ scores for 10, 11, 12, 13, 14 and 15-year-old boys and girls were 1.12 and 1.03, 0.54 and 0.55, 0.47 and 0.26, 0.29 and -0.21, -0.08 and -0.64, -0.19 and -0.53, respectively. The mean HAZ for boys (0.12) was slightly higher and that for girls slightly lower (HAZ = -0.14) than the reference population. Even among the relatively affluent group of children studied HAZ scores increased with relative socio-economic status. CONCLUSIONS: Although in terms of averages for 10-15-year-old boys and girls the height status was not very different from CDC standards, the growth curves of Pakistani children was slightly different from CDC 2000 standards. Further studies are needed to assess the appropriateness of using international growth standards for assessing height status of Pakistani adolescents.