Articles

Knowledge and Attitude of Dental Practitioners about Professional Indemnity Insurance in Davangere District: A Cross Sectional Survey

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Background: It is essential that dentists should have an adequate knowledge of professional Indemnity insurance to safeguard themselves.

Aim: To assess the knowledge and attitude of dental practitioners about professional     indemnity insurance (PII) in Davangere district.

Materials and methods: A descriptive cross-sectional questionnaire study was conducted involving data collection from 101 dental practitioners in Davangere district at their respective clinics using a pretested, validated, investigator‑administered closed‑ended 10 items questionnaire. Statistical significance was set at P < 0.05. IBM SPSS Statistics for Windows, version 21 (IBM Corp., Armonk, N.Y., USA) was used for statistical analysis. Descriptive statistics were generated in terms of percentages and chi square test was used to compare the responses across groups.

Results: The mean age of participants was 41.4±8.1 years. Majority of the participants were females (51.5%) and qualified with a masters degree (70.3%). Majority did not have a professional indemnity insurance (PII) (69.3%) as they were unaware of it (51.5%). Many (56.4%) were informed about PII by their professional colleagues. Around 51.5% felt that it was not mandatory to have a PII. Around 83.2% maintained patient records and around 76.2% paid compensation to their patients for negligent dental practice.

Conclusion: Majority of dental practioners in Davanagere district did not have Professional Indemnity Insurance as many were unaware about it.

Clinical Audit on Hypoglycemic Symptoms in Type 2 Diabetic Patients

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: Hypoglycaemia is an important complication in the treatment of type 2 diabetes mellitus, because it   causes   recurrent   physical   and   psycho-social morbidity, and is sometimes fatal. The main objective of the study is to clinically audit the hypoglycaemic symptoms in type 2 diabetic patients in Jinnah Hospital, Lahore. This cross sectional clinical audit was done in Jinnah Hospital, Lahore during May 2020. The data was collected with the permission of ethical committee of hospital. The data was collected from type 2 diabetic patients who were enrolled during last 6 months in the hospital. We critically analyse the hypoglycemic symptoms of type 2 diabetic patients. The data was collected from 150 patients of Nishtar hospital, Multan for audit analysis. There were 70 males and 80 females. The age range was 40 to 70 years and the mean age was 58.95±5.67 for hypoglycaemic symptoms patients and 55.15±10.67 for without symptoms patients. It is concluded that hypoglycaemic symptoms are a common complication   of   diabetic   treatment,   and   efforts should be focused especially on insulin-treated patients    to    prevent    hypoglycaemia,    including education    on    hypoglycaemia    awareness,    self-monitoring of blood glucose and dietary advice.

Role of Aminotransferase in Patients of Type 2 Diabetes Mellitus

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Introduction: Diabetes mellitus is a heterogeneous group of disorders characterized by persistent hyperglycemia with carbohydrate, lipid, and protein metabolism resulting from defects in insulin secretion and/or insulin action.

Objectives: The main objective of the study is to find the role of aminotransferase in patients of type 2 diabetes mellitus. Methodology of the study: This cross sectional study was conducted in BVH, Bahawalpur during 2021. The data was collected from 100 patients of both genders. Patients whose fasting plasma glucose (FPG) ≥126 mg/dl on 2 occasion were included in the study. Patients with any concomitant diseases which can alter liver function and patient with hepatitis, alcoholic and taking any medicine were excluded from the study.

Results: The data was collected from 100 patients with a mean age of 53.72 ± 9.82 years old and mean duration of disease of 7.41 ± 6.01 years were included in the final analysis. There were no significant difference in the levels of Fas, AST, Cl, K, Ca, BUN, creatinine and uric acid in type II diabetics compared to the non-diabetic healthy control group.

Conclusion: Serum alanine aminotransferases are frequently high in patients of type 2 diabetes mellitus. However, there was no association with gender, body mass index, or duration of diabetes.

Surgical Treatment of Gallstones in Patients Undergoing Gastric Bypass Surgery as a Treatment of Obesity

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Introduction: Sustained weight loss after gastric bypass is achieved by a combination of gastric restriction and a variable degree of malabsortion and has therefore a greater risk for gallstone development than purely restrictive procedures like adjustable gastric banding.

Objectives: The main objective of the study is to analyse the surgical treatment of gallstones in patients undergoing gastric bypass surgery as a treatment of obesity.

Material and methods: This randomized control trial was conducted in Jinnah Hospital, Lahore during 2021 to 2022. Patients who underwent bariatric surgery for obesity were included in the study. Those who had cholecystectomy before bariatric surgery, those who underwent concomitant cholecystectomy (CC) during bariatric surgery, those with concomittant gall stoness and those who did not attend their follow-up regularly were excluded from the study.

Results: The data was collected from 100 patients and we reviewed records from all patients treated for acute biliary pancreatitis. The average age was 36.43±9.52 years and, the ratio of women/men was 151 (81.6%)/34 (18.4%). Mean BMI was determined as 44.16±5.09. When comorbidities were evaluated, 116 (62.7%) patients had comorbidity, while 69 (37.3%) patients did not. Conclusion: It is concluded that prophylactic and selective management can be safely performed and the only significant difference with patients not submitted to concomitant cholecystectomy is mostly observed in operative times that are higher in those who do undergo cholecystectomy.

Assessment of Mitochondrial Dysfunction in Autistic Individuals by Measuring Plasma Lactate Levels

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Introduction: Autistic disorder, Asperger syndrome and pervasive developmental disorder-not otherwise specified comprise a heterogeneous group of neurodevelopmental disorders known as autism spectrum disorders (ASDs). ASDs are behaviorally defined by impairments in communication and social interaction along with restrictive and repetitive behaviors.

Objectives of the study: The main objectives of the study will determine the mitochondrial dysfunction in autistic individuals by measuring plasma lactate levels.

Material and methods: This cross sectional study was conducted in DHQ Hospital Sahiwal. This study will include 200 children aged 7 to 9 years. Randomly selected sampling technique will be used for the data collection. For the purpose of analysis of mitochondrial dysfunctionality we will collect the blood samples of each individual.

Results: The data was collected from 200 children. In this study, blood ammonia, serum lactate, AST, ALT and CK level were higher in 29(90%), 18(80%), 23 (30%), 20(20%) and 14 (40%) subjects of study group.

Conclusion: It is concluded that mitochondrial dysfunction occur in children with autism spectrum disorder children

Thiamethoxam Induced Oxidative Stress and Histopathological Alterations in Male Patients

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Thiamethoxam is one of the second-generation neonicotinoids, a new class of insecticides. The study was designed to investigate the effect of thiamethoxam on fertility in bucks. For this purpose, sixteen male adult male chinchilla rabbits were divided in two groups. Thiamethoxam intoxicated group was treated with thiamethoxam at dose of 250 mg/Kg body weight for 3 months. Semen analysis revealed distinct changes in sperm characteristics including significant decrease in sperm motility (both mass and individual) and sperm count. In addition, significant increase in dead spermatozoa and sperm deformities. Moreover, elevation in testicular concentration of MDA and GST was significant. GSH was significantly decreased. Degeneration and necrosis of spermatogenic cells with intertubular edema and vacuolations in seminiferous tubules were the major observed histopathological changes in the testis of intoxicated animals. In conclusion, thiamethoxam administration for 3 months induced significant decrease in fertility and oxidative stress in the reproductive system of adult male.

Incidence of Urosepsis in Patients Undergoing Flexible Ureteroscopy

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Introduction: Urosepsis is a systemic response to and potentially life-threatening sequela of urogenital tract infection.

Objectives: The main objective of the study is to find the incidence of urosepsis in patients undergoing flexible ureteroscopy.

Material and methods: This cross sectional study was conducted in Fatima Jinnah Medical University during June 2021 to January 2022. 241 patients full filling the inclusion criteria was included through the Emergency / OPD of hospital. An informed consent was obtained from patients. Demographic data (Name, age, gender, and stone size) was recorded.

Results: The data was collected from 241 patients. Out of 241 there were 118 males and 123 female patients. There was a significant difference in age between patients who developed sepsis and patients who did not develop sepsis. Patients who developed sepsis also had albumin concentrations <35 g/L, globulin concentrations ≥30 g/L, AGR <1.2, pre-operative fever, WBC count ≥10,000 cells/µL, pre-operative positive UC, positive urine WBC, and positive urine nitrite.

Conclusion: It is concluded that patients with solitary proximal ureteral stones are more likely to have post-fURS sepsis when they have positive pre-operative UC or low pre-operative AGR.

 

Assessment of Average Correction of Cobb’s Angle Post Instrumentation in Adolescent Idiopathic Scoliosis in Lenknee Type 1 Curve

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Introduction: Preferred instrumentation for adolescent idiopathic scoliosis (AIS) remains controversial. Surgical correction is classically indicated for progressive curves more than 40° in the skeletally immature patient.

Aims and objectives: The basic aim of the study is to analyse the average correction of Cobb’s angle post instrumentation in adolescent ideopathic scoliosis in lenknee type 1 curve.

Material and methods: This descriptive study was conducted in Services hospital, Lahore during 2020 to 2021. This study was done with the approval of ethical committee of hospital. There are 27 patients that were included in this study. The age range for the selected patients was 14-20 years from which 15 female and 12 male. The total duration of the study was 2 years.

Results: The data was collected from 27 patients.  In three patients with Lenke type 1 curve, the apex of curve was the disc at T8/9 or the vertebral body at T9. The mean coronal Cobb angle of the main thoracic curve was 43.7° and the Cobb angles of the compensatory curves on thoracolumbar or lumbar region were less than 20°. On scoliometer measurement of the rib hump averaged 18.5°. On the lateral bending film the mean Cobb angle of main thoracic curve was corrected to 15.7°.

Conclusion: It is concluded that patients with Lenke 1 increasing the cost density of instrumentation does not translate into improving the Cobb angle of the uninstrumented spine and does not change any of the cosmetic parameters measured on clinical patient photographs.

Average Correction of Cobb’s Angle in Congenital Scoliosis Using Growing Rode as a Mode of Correction

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Introduction: Scoliosis with rotational imbalance is mainly characterized by the vertebral rotation related to the curve in the coronal plan.
Aims and objectives: The basic aim of the study is to assess the average correction of Cobb’s angle in congenital scoliosis using growing rode as a mode of correction.
Material and methods: This descriptive study was conducted in DHQ hospital Sargodha during 2019 to 2021 for the period of two years. The data was collected with the permission of ethical committee of hospital. The data was collected from 12 patients from age range 4-12 years. Among that 12 patients there were 7 male and 5 female patients. We carried out a convenience sampling, including all scoliosis patients who received surgical treatment with elongating rods in the period studied, and excluded all patients diagnosed with syndromic scoliosis, and with incomplete records in their clinical history.
Results: There were 12 patients of scoliosis under 10 were reviewed. Of these, 35 (5%) required surgical treatment with growing rods and met the selection criteria. The presurgical and postsurgical radiographic change showed a 47.7% reduction in the Cobb angle (31.8° ± 14.6° difference), which was statistically significant (p<0.001; t-student). During the study period, 8 patients showed some procedure-related complication; another 2 patients (22.9%) showed instrumentation failures, and 2 cases (5.7%) showed infection in the operated area which, it should be noted, was associated with instrumentation failure. Univariate analysis was performed to define which variables could be potential predictor factors of complications in our patient sample. Conclusion: Treatment of scoliosis in patients under age 10 with growing rods has achieved a significant reduction in the magnitude of the deformity before final bone fusion.

Haematological Parameters and Oxidative Stress in Malarial Patients

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Introduction: Malaria has been in existence for so long and is responsible for worrisome health and economic impact in different parts of the world.
Objectives: The main objective of the study is to find the haematological parameters and oxidative stress in malarial patients. Material and methods: This cross sectional study was conducted in THQ Hospital Fort Abbas Bhawalngar during 2020 to 2021. The data was collected from 200 male and female patients. Participants remembered for the review were under-5-year-old youngsters, either conceded in the kids’ ward or going to any center on short term premise.
Results: The information was gathered from 200 malarial patients. There was a genuinely huge decrease in hemoglobin (p<0.005), platelet count (p<0.001) and all out leukocyte count (p<0.001) levels in patients with malaria contrasted with patients without the sickness. The level of neutrophils in the subjects with malaria was fundamentally higher (p<0.005) than in the non-malaria bunch. Conclusion: It is inferred that Low platelet count is a trademark finding of malarial contamination and thrombocytopenia might be more normal than weakness in intense malaria disease.