Perception of Dental House Officers regarding Endodontic File Separation during Endodontic Treatment.

Background: Despite of having improved endodontic file designs as well as the reinforced metal alloy file structure, intracanal endodontic file separation (EFS) is still a very problematic and worrisome dental incident, which usually occurs without any visible signs of permanent deformation. Further, there have been conflicting reports regarding the clinical significance of leaving separated files within root canals. Aims: The aim of this study was to look into the current perceptions and awareness about file separation during endodontic treatment among the dental house officers (DHOs). Materials and Methods: A novel validated questionnaire comprising of 15 close-ended questions was distributed anonymously via Google Forms through email to 1100 DHOs across Pakistan. The questionnaire consisted of two parts: the first component (Section I) collected demographic data and the second component (Section II) investigated the causes of EFS during root canal treatment. Following the completion of socioeconomic information, including age and gender, the DHOs were asked to answer a few questions about the various reasons for endodontic instrument fracture. Results: A total of 800 responses were recorded, with an effective rate of 72.8%. The majority of the DHOs (p value < 0.001) perceived that endodontic instrument fracture occurred in the posterior (61.5%) and apical third of the canal (50.5%) and in older permanent dentition (67.3%), possibly due to patient anxiety (62%). Better choice of instrument (61.15%), operators' experience (95.3%), knowledge (87.5%), and proper root canal cleaning (91.1%) are believed to be the vital steps in reducing endodontic file separation/fracture. Furthermore, majority of them (p value < 0.001) perceived that stainless steel was a superior alloy for filing instruments. Manual files tend to be more prone to fractures due to repeated use than rotary files. Conclusion: This study demonstrated that young DHOs had adequate knowledge and awareness regarding the potential predisposing factors and handling techniques for EFS. This study thereby provides an evaluating tool to access the insights of the current perceptions and awareness of DHOs concerning EFS.

The prevalence of substance abuse and associated factors among male prisoners in Karachi jails, Pakistan.

Objective: Substance abuse and cigarette smoking are now regarded as major public health problems. This study aims to determine the prevalence, risk profile, and associated sociodemographic factors of substance abuse among male prisoners in Karachi jails. Methods: This descriptive cross-sectional study was carried out among 600 male prisoners in Malir and Central Jails in Karachi. The principal investigator collected the data via one-on-one basis interviews, using a survey questionnaire consisting of the WHO ASSIST version 3, and structured demographic proforma. The data analysis regarding ever and current use of ten substances was done according to the standard instruction manual. A Chi-square test was applied to determine the association between categorical sociodemographic variables and current/ever substance use among prisoners. A p-value of <0.05 was considered statistically significant. Results: In this study, 97.1% of prisoners had a history of substance abuse at least once in their lifetime. For the current use of a substance, the majority of the prisoners fell into the low-risk category, except for tobacco for which 80.5% of prisoners were at moderate risk of use. 13%, 12.7%, and 9.5% of prisoners were at high risk for using opioids, cannabis, and tobacco, respectively. Several associations were found between the socioeconomic factors of the study subjects and their substance use. Conclusion: The study demonstrates a high prevalence and alarming current risk profile of substance abuse among prisoners of Karachi Jails. Considering the associated disease burden, substance abuse among prisoners should be considered a public health priority. Further exploration of associated and causative factors can help policymakers devise adequate measures for prevention and rehabilitation.

Work-Related Musculoskeletal Disorders and Their Associated Risk Factors among Pakistani Dental Practitioners: A Cross-Sectional Study.

Background: Work-related musculoskeletal disorders (WMSDs) have a negative impact on quality of life, and dentists are at risk of WMSDs due to the nature of work being static, repetitious, and for a long duration. The study was aimed at measuring the prevalence and distribution of work-related musculoskeletal disorders and determining the risk factors associated with affliction among Pakistani dentists. Methods: An online cross-sectional survey was conducted using a validated questionnaire consisting of four sections. The first section had questions related to sociodemographic information, the second section had questions that assessed the intensity and frequency of musculoskeletal pain (MSP), third section questions were concerned with the effect of MSP on the respondents' daily life, while the last section contained questions on whether they perceived their work in the dental clinic as a cause of their pain. Chi-square and one-way ANOVA tests were used for the analysis of the data in SPSS-23. Results: A total of 600 completely filled questionnaires were received with a response rate of 76.4%, and about 87% of the dental practitioners had some sort of MSD. The intensity and frequency of WMSDs were statistically significant (p < 0.05) in association with all the sociodemographic characteristics. The lower back area was the most reported site of WMSD pain (51.3%) followed by the neck/upper back (21.3%) and shoulder (17.6%). The site of pain was statistically significant (p < 0.05) in association with all the sociodemographic characteristics except gender (p = 0.11). A majority of participants (95.4%) had sought medical treatment and taken sick leaves (70%) due to WMSDs pain during their life. Participants attributed a number of working years and working posture as the two main reasons behind WMSDs. Conclusion: Considering the high prevalence of WMSDs among dentists, preventive strategies that minimize the occurrence of WMSDs should be adopted by dental professionals. The impact of WMSDs can be reduced by maintaining good posture, taking breaks and rest in between work, doing regular exercise, and improving the work environment.

Dental Anxiety and Influencing Factors in Adults.

Dental anxiety is one of the most common conditions present amongst the masses globally. It is this fear that makes individuals avoid seeking dental treatment which results in a deteriorated oral health-related quality of life (OHRQoL). Discrepancies exist in the prevalence of dental anxiety based on gender, education levels, level of deprivation of a society and its socioeconomic status. In this study, a sample size of 522 respondents was collected. Kuppuswamy's socioeconomic status scale and modified dental anxiety scales were used to collect the necessary data. These data were analyzed by cross tabbing and chi-square test of significance was applied to assess the association between dental anxiety and other factors. Female gender was significantly associated with dental anxiety with p-value = 0.03. Higher education levels and dental anxiety also displayed significant associations with each other, with a p-value of 0.048. Seventy-six percent of the individuals of lower socioeconomic status were prone to be more dentally anxious. Dental anxiety was more significant in individuals with higher levels of education in our study. Respondents who were part of a lower socioeconomic class were also more prone to being anxious while receiving dental treatment. Knowing the factors that cause dental anxiety can help dentists effectively manage and treat their patients.

Knowledge, Attitude, and Practices of Dental Practitioners Regarding Domestic Violence in Pakistan.

Domestic violence is a complex social issue worldwide that includes a wide range of physical, sexual, psychological, economic, or emotional trauma to a child or adult. A large proportion of domestic violence cases remain unreported or undocumented. Dentists can play an important role in identifying and reporting these cases, but no such local study is available assessing the dental practitioners' attitudes and knowledge of evaluating physical abuse in Pakistan. The objective of this study was to assess the knowledge and practices of dental practitioners of Pakistan about domestic violence. This cross-sectional study was carried out over 2 months, among 330 dentists across Pakistan, selected by convenience sampling technique. Data was collected via a pre-validated online questionnaire, filled anonymously after taking informed consent. The survey questionnaire collected data about dentists' demographics, awareness, and experiences about domestic violence cases via close-ended questions. Only 10.6% of participating dentists received formal training in the management of domestic violence cases. Approximately 55% of participants knew that physical abuse should be reported in all circumstances; however, half of them could not accurately identify the legal authorities where suspected cases should be reported. Only 20% of the participating dentists had ever suspected a case of physical abuse and 30% of those actually reported it to legal authorities. Participants characterized fear of anger from relatives as the most significant barrier toward reporting suspected cases. The analysis revealed that Pakistan's dentists lack adequate knowledge regarding domestic violence in terms of identification, relevant physical signs/symptoms, and social indicators. Dentists of Pakistan had insufficient knowledge about the identification, management, and reporting of domestic violence cases. However, formal training and dentists' qualification were positively associated with overall awareness and practices regarding domestic violence case management.