Frequency of Surgical Impactions of Mandibular Third Molar in Orthodontic Patients with Different Antegonial Notching

Background: Few studies have been reported so far on the frequency of lower third molar impactions in patients with different morphological characteristics. Our aim in this study was to find out the frequency of impacted lower third molars in orthodontic patients with different antegonial notch depths. Material and Methods: This cross-sectional research was conducted at Orthodontics Department of Dental Section, Faisalabad Medical University, Faisalabad, and de’Montmorency College of Dentistry, Lahore, Pakistan from June 2017 to June 2019. A total of 60 orthopantomograms (OPGs) of patients with impacted lower third molars were included. The depth of antegonial notch was calculated on all the selected OPGs by measuring distance between the deepest area of the notch cavity and the tangent on the inferior border of the mandible. The patients with depth of antegonial notch of 1 mm or less were labeled as having shallow antegonial notch, while those with 3 mm or more were considered as having deep antegonial notch. Percentages and mean + SD were calculated for different variables. Depth of antegonial notching was compared between genders using ANOVA with P-value <0.5 considered as significant. Results: Of 60 orthodontic patients, there was an equal number of male and female patients (n=30). The average age of the patients was 25.5±4 years. Overall frequency of impactions was similar in both the genders and frequency of impacted lower third molars was found to be greater in patients with deeper antegonial notches. Conclusion: Mandibular third molar impactions were most frequent in orthodontic patients with deep antegonial notche

Histological pattern of ovarian neoplasma.

Abstract Objective: To see the morphological pattern of benign and malignant ovarian neoplasms. Method: Retrospective study of all consecutive cases of ovarian neoplasms diagnosed at Aga Khan University Hospital between 1st January 1993 and 30th September 1998. Setting: The Section of Histopathology, AKUH, Karachi. Observation: Of 855 ovarian tumours 506 (59.18%) were benign and 349(40.81%) malignant. Surface epithelial - stromal tumours comprised 63.50% of all tumours. Benign cystic teratoma was the commonest benign tumour (35.17% of all benign tumours) and serous cystadenocarcinoma was the commonest malignant tumour (33.33% of all malignant tumours). Mucinous cystadenocarcinomas are more common in our population as compared to the West and borderline and malignant mucinous tumours occur at a younger age group. Malignant germ cell tumours are also common in our population. Conclusion: Except for the greater frequency of malignant mucinous and germ cell tumours, the findings of our series correspond to the published Western data (JPMA 50:416, 2000)

Medicolegal Evaluation of Suspected Alcohol Consumption

Background: To note diagnostic methodology employed by medicolegal officer for evaluation of subjects brought by Police for confirmation of suspected alcohol consumption. Methods: In this cross sectional, observational study,. data of subjects evaluated for suspected alcohol intake was retrieved. Police statement regarding reason for suspecting alcohol consumption, statement of the subjects accused of alcohol consumption, examination findings of medicolegal officer (MLO), details regarding chemical evaluation of body fluids, and conclusion or final report of MLO were sought. Results: 3253 subject’s details were available. 97% (n=3165) of these were making noise with or without din, when apprehended. Standard procedure for evaluation of suspected alcohol was not followed by MLO in most of cases. MLO gave a positive final opinion for alcohol consumption in 95.2% (n=3099) subjects. In 93.12% (n=2887) of these subjects, it was substantiated by laboratory report, while in 6.84% (n=212) subjects no laboratory evaluation was sought. A negative opinion about alcohol consumption was given in 3.50% (n=114) of the subjects. Police suspicion of alcohol consumption and positive final opinion by MLO correlated significantly(p value <0.00001). Conclusion: Police suspicion of alcohol intake and positive medicolegal opinion (clinical and laboratory) of alcohol intake correlate significantly. Medicolegal officers do not comply with standard operating procedures in most of cases

Improved flood mapping for efficient policy design by fusion of Sentinel-1, Sentinel-2, and Landsat-9 imagery to identify population and infrastructure exposed to floods

A reliable yet inexpensive tool for the estimation of flood water spread is conducive for efficient disaster management. The application of optical and SAR imagery in tandem provides a means of extended availability and enhanced reliability of flood mapping. We propose a methodology to merge these two types of imagery into a common data space and demonstrate its use in the identification of affected populations and infrastructure for the 2022 floods in Pakistan. The merging of optical and SAR data provides us with improved observations in cloud-prone regions; that is then used to gain additional insights into flood mapping applications. The use of open source datasets from WorldPop and OSM for population and roads respectively makes the exercise globally replicable. The integration of flood maps with spatial data on population and infrastructure facilitates informed policy design. We have shown that within the top five flood-affected districts in Sindh province, Pakistan, the affected population accounts for 31 %, while the length of affected roads measures 1410.25 km out of a total of 7537.96 km.Comment: IEEE IGARSS 202

Macrolide and fluoroquinolone resistance in helicobacter pylori isolates: An experience at a tertiary care centre in Pakistan

Objective: To assess fluoroquinolone and clarithromycin susceptibility pattern along with the types of genomic mutations involved in the resistance of Helicobacter pylori isolates.Methods: The cross-sectional study was conducted at the Department of Pathology and Microbiology, Aga Khan University Hospital, Karachi, from June 2009 to July 2010, and comprised 162 gastric biopsy samples which were tested with GenoTypeHelicoDR (Hain Lifescience GmbH, Germany), a reverse hybridisation multiplex polymerase chain reaction (PCR) line probe assay (LiPA). Also, 23S rRNA (ribosomal ribonucleic acid) gene was analysed with three-point mutations at A2146G, A2146C and A2147G for clarithromycin, and gyrA gene was analyzed at two codon positions 87 and 91 for fluoroquinolone susceptibility testing. SPSS 19 was used for statistical analyses.Results: Clarithromycin resistance was seen in 60 (37.0%) of the isolates mainly involving mutation at A2147G (85%) followed by A2146G (n=35; 21.6%) and A2146C (n=19; 11.6%). Fluoroquinolone resistance was noted in 101(62.3%) isolates, while gyrA mutations at codon 87 was seen in 64 (39.6%) and at codon 91 in 66 (40.6%). Isolates showing combined resistance to both antibiotics were 44 (26.9%).Conclusion: High rate of resistance to fluoroquinolones was seen despite the fact that the drug was not part of the first-line anti-helicobacter therapy. There was moderate increase of clarithromycin resistance beyond the cutoff rates where empirical use of this antibiotic is abandoned. The findings warrant the need for pre-treatment susceptibility testing in Helicobacter pylori infections, especially in Pakistan where burden of disease is high and very limited data is available, to improve patient care by providing targeted therapy

Workplace violence against healthcare workers in rural health facilities of Bangladesh and their quality of life: A cross-sectional study

Background: The prevalence of verbal and physical violence against healthcare workers (HCWs) is reportedly high in Bangladesh. We aimed to determine the prevalence and risk factors associated with violence against HCWs in Bangladesh. Methods: This cross-sectional study was done in May-June 2021 among 378 physicians and nurses working in 19 randomly selected rural government health facilities. A self-administered validated Bangla version of the WHOQOL-BREF questionnaire on workplace violence (WPV) and the quality of life (QoL) was used. Multiple logistic regression analyses were done to find out the independent risk factors of WPV. Results: The prevalence of overall WPV was about 48.0% (psychological 46.6%, physical 5.0%, and sexual harassment 1.9%). However, the WPV reporting rate was very low (27.8%). Being a male (aOR= 2.18; 95% confidence interval: 1.22−3.90) and a physician (aOR = 2.93; 95% CI: 1.56−5.52) had increased the likelihood of experiencing WPV. HCWs who were encouraged to report WPV were less likely to experience WPV (aOR = 0.36; 95% CI: 0.18−0.70). Study participants exposed to WPV had sig-nificantly lower QoL (P<0.01) in all the domains of WHOQOL-BREF (physical, psychological, social, and environmental). Conclusion: The study findings revealed that half of the HCWs working at rural government health facilities experienced WPV, which warrants proper investigation to adopt effective measures to reduce future occurrence. Moreover, the QoL of HCWs working in the aforementioned health facilities was significantly influenced by exposure to WPV

Commonest cancers in Pakistan - findings and histopathological perspective from a premier surgical pathology center in Pakistan.

Abstract CONTEXT: There are no recent authoritative data about incidence and prevalence of various types of cancers in Pakistan. AIM: To determine the frequency of malignant tumors seen in our practice and provide a foundation for building a comprehensive cancer care strategy. MATERIALS AND METHODS: 10,000 successive cases of solid malignant tumors reported in 2014 were included. All cases had formalin fixed, paraffin embedded specimens available and diagnosis was based on histological examination of H and E stained slides plus ancillary studies at the Section of Histopathology, Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi. The latest WHO classifications were used along with the latest CAP protocols for reporting and the most updated TNM staging. RESULTS: There were 9,492 (94.9%) primary tumors while 508 (5.1%) were metastatic. Some 5,153 (51.5%) were diagnosed in females and 4,847 (48.5%) in males. The commonest malignant tumors in females were breast (32%), esophagus (7%), lymphomas (6.8%), oral cavity (6.7%) and ovary (4.8%), while in males they were oral cavity (13.9%), lymphomas (12.8%), colorectum (7.9%), stomach (6.9%) and esophagus (6.6%). Malignant tumors were most common in the 5th, 6th and 7th decades. About 8% were seen under 20 years of age. CONCLUSIONS: Oral cavity and gastrointestinal cancers continue to be extremely common in both genders. Breast and esophageal cancers are prevalent in females. Lung and prostate cancer are less common than in the west. Ovarian cancer was very common but cervix cancer was less so

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020