Journal of Bahria University Medical and Dental College

Esthetic and Cost Effective Management of Young Female with Moderate Fluorosis Using Microabrasion;

2022-04-01T06:27:34-06:00

Primary concern of majority of young patients visiting dental OPD is compromised dental esthetics or dental pain.
Discolorations have significant social and esthetic effects. Fluorosis is one of the most common cause. It is prevalent in
different areas of Pakistan. Microabrasion was selected for treatment of discoloration in this case report. Microabrasion
was performed using slurry made by combining 37% phosphoric acid and pumice. This slurry was applied on the labial
tooth surface and mechanically rubbed with a prophylaxis brush in a slow hand piece for a minute, with gentle pressure.
The cycle was performed thrice followed by fluoride application. The results of this conservative treatment were satisfactory
and patient was satisfied with the esthetic outcome.

Air Pollution and Health Hazards: A Menacing Situation in Pakistan

2022-04-01T04:57:15-06:00

With the increasing urbanization and industrialization
around the globe, the problem of air pollution is also
increasing exponentially. At one end it is causing depletion
of ozone layer and global warming and on the other side
responsible for health related issues

Lack of Awareness About Obstetrics Physical Therapy in Pakistan

2022-04-01T06:31:33-06:00

This letter aims to explain the role of obstetrical physical
therapy in pregnancy to highlight the awareness related to
physical therapy in Pakistan

Effects of Chemical Composition of Cholesterol and Pigment Stones on the Gallbladder Mucosa

2022-04-01T05:00:31-06:00

Objective: To compare the effect of chemical composition of cholesterol and pigment stones on gallbladder mucosa.
Study design & setting: This comparative cross-sectional study was conducted in the Department of Anatomy, BMSI,
JPMC, Karachi, Pakistan, from April to September 2021.
Methodology: Total n= 120 gallbladder specimens were collected after cholecystectomies in 10% formalin. Gross
morphological features of gallbladder and stones were observed. Specimens were processed and 5µm sections from fundus,
body & neck of gallbladder were stained and examined for microscopic changes. Chemical analysis of stones was carried
out to differentiate between cholesterol & pigment stones.
Results: We evaluated different histomorphological alterations in gallbladder with reference to both type of gallstones.
Muscular wall thickness in pigment stone group was noted to be (143.89±78.66) and in cholesterol group (158.37±83.95).
Both pigment and cholesterol stone showed increased tendency of muscular hypertrophy. Mucosal ulceration, chronic
inflammatory cell infiltration, capillary congestion and hyperplasia (p-value: 0.04) were observed in both type of stones.
Statistical analysis showed that large cholesterol stones produce significant histopathological changes (p-value: 0.004);
greater the size of stone, more profound was the mucosal hyperplasia. Rokitansky-Ashcoff sinuses were predominant in
gallbladders with cholesterol stone.
Conclusion: Gallstones cause series of histopathological changes ranging from chronic cholecystitis to pre-malignant and
malignant changes. Hyperplasia was observed to be more frequent with long standing, large cholesterol stones

Frequency of Esthetic and Periodontal Complications in Patients of Metal Ceramic Fixed Dental Prosthesis

2022-04-01T05:35:27-06:00

Objective: To determine frequency of complications in patients with fixed metal-ceramic dental prosthesis
Study Design & Setting: A cross-sectional study was designed and conducted on 141 post-treatment patients of Fixed
Dental Prosthesis (FDPs) at Armed Forces Institute of Dentistry, Rawalpindi, Pakistan from Sept 2019 to Feb 2020.
Methodology: This study analyzed the results of 141 patients whose records were completed during study duration of 06
months at Department of Prosthodontics, Armed Forces Institute of Dentistry, Rawalpindi. Patients were called at three
months follow up after provision of fixed dental prosthesis. Intraoral examination for presence of esthetic and periodontal
complications was done by inspection, palpation and probing. Complications were graded according to severity.
Results: Esthetic complications with FPDs were observed in 13.47% (n=19) of the subjects, periodontal complications
were encountered in 9.2% (n=13) and 77.3% (n = 109) showed no complications at all. No significant difference was
observed in terms of type of complication encountered between males and females or between different age groups.
Conclusion: Complications in patients of metal-ceramic FDPs were observed in 22.7% patients only, of which 13.47%
were esthetic and 9.2% were periodontal complications.

Anatomical Variations of Vermiform Appendix on Plain MDCT and Its Association with Acute Appendicitis in Adult Urban Population of Karachi, A Tertiary Care Hospital Experience

2022-04-01T05:42:46-06:00

Objective: To evaluate the anatomical positions of vermiform appendix and its association with acute appendicitis on
Multidetector computed tomography (MDCT).
Study design and setting: A cross sectional study based on hospital database was carried out in Department of Anatomy
in collaboration with Department of Radiology, Liaquat National Hospital.
Methodology: A total of three hundred and six 306 adult urban patients CT axial images were evaluated retrospectively
over period of 6 months from March 2021 to August 2021 who had abdominal MDCT scan for acute abdomen after getting
approval from ethical committee to find out anatomical variations of position of vermiform appendix in a tertiary care
hospital among adult urban Karachi population and its association with appendicitis. Data was analyzed using SPSS version
25. All categorical variables were summarized as frequencies and percentages.
Result: In present study 159(52%) were males and 147(48%) were females with mean age of 32.97 years. The subcecal
anatomical position of vermiform appendix on MDCT was most common n=85(27.8%), followed by postileal n=78(25.5%),
pelvic n=61(19.9%), postcecal n= 36(11.8%), preileal n=29(9.5%), ectopic n=17(5.6%). The association between appendicitis
with anatomical position of vermiform appendix and age was analyzed by chi- square and was statistically significant (p
=0.05). There was no significant association between position of vermiform appendix on MDCT and gender.
Conclusion: The subcecal position of vermiform appendix is most common on MDCT and the postileal position was more
frequent in the inflamed group of vermiform appendix

The Effect of an Educational Intervention on COVID-19 Awareness, Preventive Behaviors, and Risk Perceptions among Secondary School Students

2022-04-01T05:51:23-06:00

Objectives: To determine the impact of an educational intervention on secondary school students' Covid-19 awareness
and risk perception, as well as their preventive practices.
Study design and settings: A quasi-experimental study conducted in private secondary schools.
Methodology: The study duration was two months. Students who gave consent and didn’t have COVID-19 infection in
past were included by non-probability purposive sampling. Raosoft sample size calculator was used to calculate the sample
size and it came out to be 385 but a total of 380 students could be enrolled. Among these, 37 responses were invalid making
the total sample size to be 343. Ethical approval was taken from the institutional ethical review committee with approval
letter number i.e. ERC/ID/126. SPSS version 25 was used for the analysis of data. Frequencies and percentages were
calculated. Paired samples T-test was applied to see the difference in participants’ scores before and after the intervention.
A p-value = 0.05 was taken as significant.
Results: The knowledge of students were improved from moderate to high level and the total percentile score from 74.86%
to 89.76% after intervention. Their practicing preventive behaviors were at a low level with scores of 69.37%. Their risk
perceptions remained at moderate levels and did not see any improvement.
Conclusion: Participants practicing preventive behaviors were at a low level. Their knowledge scores improved from
moderate to high level after intervention but their risk perceptions remained at moderate levels and no change was seen

Association of Resistin with Components of Metabolic Syndrome in Our Local Population

2022-04-01T05:59:55-06:00

Objective: To investigate the association of resistin with components of metabolic syndrome (MetS) in our local population.
Study design & setting: Case-control study, Medical OPD; Lyari General Hospital Karachi (from 15th July 2020 till 15th
December 2020).
Methodology: A total of 164 subjects (83 cases & 81 controls) between the age ranges of 35-65 years were selected.
Subjects with metabolic syndrome were included in concordance with International Diabetes Federation criteria. Serum
resistin levels in both cases and controls were compared. SPSS 20 was used for statistical analysis. Eighty-three patients
with metabolic syndrome were enrolled and compared with 81 healthy unmatched controls. Obesity indices, blood pressure,
lipid profile, fasting blood sugar, insulin resistance and serum resistin levels were evaluated. Predictive values of resistin
for MetS were analyzed using odds ratios.
Results: Significantly elevated levels of resistin were found in subjects with metabolic syndrome compared to healthy
controls (8.23±4.43 vs 6.82±3.64 ng/mL, p<0.05). The odds ratio (95% confidence interval) for metabolic syndrome in
subjects having higher resistin were: males:2.62[1.11–6.19], females: 2.81[1.05–7.49], all Ptrend<0.05.For individual
components of metabolic syndrome, we found the odds ratio to be greatest for hypertension, fasting blood sugar, and insulin
resistance; 2.64, 4.83, 2.85, respectively, all Ptrend<0.05.
Conclusion: The present study suggests significant association of resistin with components of metabolic syndrome such
as hypertension, fasting blood sugar, and insulin resistance. Compared to healthy controls, subjects with MetS had significantly
higher resistin levels. Further research is required to incorporate this biomarker in clinical setting.

Efficacy of Prophylactic Phenylephrine in Prevention of Hypotension in Parturient Undergoing Spinal Caesarean Section

2022-04-01T06:04:42-06:00

OBJECTIVE:
To determine the hemodynamic (pulse, blood pressure) stability of prophylactic bolus dose of phenylephrine in caesarean
section under spinal anaesthesia.
Study design & Setting: Interventional study was done from 13th Feb 2021 to 07th Oct 2021 at Islam Teaching Hospital,
Sialkot.
Methodology: Study approval was taken vide letter no.2021-05/AN dated 26-3-2021, issued by Chairman Ethical Review
Board, Islam Medical College, Sialkot. Statistical software(version.3.1.9.2) with (prob of 0.80, critical 2 value 15.08),
was employed and sample size calculated to be 200 cases i.e. groups-I (injection phenylephrine 100µgm) and group-II
(placebo) divided by lottery method into 100 each given at spinal neuraxial block. Primary study variable being heart rate
and blood pressure variations. Spearman’s Rank correlation statistical test was used to check interdependence between the
two variables i.e., systolic blood pressure and pulse rate. SPSS version 21 was used.
Results: In group-II, in 36% cases atropine was given as compared to 24% cases in group-I, thus 150 % more anti-cholinergic
was used in group-II. In group-II, in 33% cases top-up of injection Adrenaline 10 microgram was used whereas given in
24% cases in group-I, thus 137.5 % more top-ups of vasopressors in group-II. In group-I, heart rate decreased by value
of 9.02 % with respect to baseline value, while comparable reading noted was 3.42% decline in pulse rate in group-II
respectively.
Conclusion: Prophylactic phenylephrine at time of spinal injection resulted in stable blood pressure and pulse rate values
in caesarean spinal delivery.

Are Patients Satisfied with Healthcare Services in Hospitals? Which Dimensions Influence it?

2022-04-01T06:07:30-06:00

Objectives: To determine the patient satisfaction with health care services provided in hospitals, disregard of whether
private or public
Methodology: A cross-sectional online survey was conducted from January to October 2020 who had utilized health
services from private or public hospitals. A questionnaire was used for assessing the satisfaction in various dimensions;
Likert scales were used for quantifying the level of satisfaction. A formal approval of ERC from the parent institution and
informed consent was sought. The sample size was 384 keeping the expected satisfaction at 50%; non-probability sampling
was done. Multiple variables were used to assess patient satisfaction. They were grouped into four thematic areas, and a
mean score was given to each.
Results: The mean age of participants was 25.19 ± 6.99. More than half of the participants (59.9%) visited a private
hospital compared to only 27% visiting a government hospital. Overall, 257 (88.9%) participants were satisfied with their
previous visit. The satisfaction levels varied with various dimensions; with quality of doctor 73.2%; the environment and
basic facilities 76.8%; the process of seeking care - 57.4%; and with medicine and diagnostic facilities 67.4%.
Conclusion: Three-quarters of the study population were satisfied with their last hospital visit. The perceived quality of
doctors, the ambiance and hospitals' general facilities make a difference in patients' satisfaction. The follow-up visits and
compliance with the treatment are influenced by how satisfied one is with the last visit.

Angry Gut: Irritable Bowel Syndrome

2022-04-01T06:21:05-06:00

Irritable bowel syndrome (IBS) is a functional disorder of the intestine characterized by abdominal pain and altered bowel
habits. At present, no biological marker has been identified. Hence, the disease is clinically assessed on the basis of the
symptoms according to ROME IV criteria. Epidemiological data revealed that the prevalence of IBS varies widely around
the world, and more thorough research is needed to pinpoint any discrepancies that may exist between countries, as well
as possible reasons. Both pharmacological and non-pharmacological therapy is being used in order to treat IBS. There is
no specific treatment for irritable bowel disease that has come across the patients and only possible measures have been
taken to treat the severity of symptoms. Symptomatic treatment with spasmolytic agent like mebeverine has been considered
a standard therapy to relieve pain but to deal with constipation and diarrhea different treatment modalities have been adopted
by the physician