The Challenges Faced By Dental Students in Studying Oral Pathology Online During Covid-19: A Cross-Sectional Study

OBJECTIVES The way of practising and teaching dentistry has changed significantly worldwide due to the COVID-19 pandemic, and the impact on dental education should not be neglected. Therefore, sharing experiences about online teaching from in-person education is essential to a better learning process during this period. This study aimed to assess the challenges faced by dental students in studying oral pathology online during covid-19: a cross-sectional study. METHODOLOGY It was a descriptive cross-sectional study in the Department of oral pathology at Altamash Institute of dental medicine to assess the challenges students faced during the COVID-19 pandemic. A total of 110 participants were approached, and among them, 105 participants responded. Of 105 participants, 78% were females, and 22% were males. Data were analyzed using SPSS version 23.RESULTSAlmost 93.3% of the students felt in-person lectures are more effective than online lectures. Fourth-year students showed higher satisfaction with the number of online tutorial / practical classes taken to provide an in-depth view of the subject than 3rd year students (8.8% vs 91.2%, p=0.045). Fourth-year students showed significantly higher satisfaction with several online theory classes to provide an in-depth view of the subject than 3rd year students (p=0.045). CONCLUSION The present study concluded that most students prefer in person classes over virtual learning and face a lack of online interaction with the faculty.

Anti-Caspr 2 Antibody Encephalitis: A Case Report

Encephalitis is a term denoted to Inflammation in the brain which can be due to infection, autoimmunity, or can be a part of a paraneoplastic phenomenon with malignancy. Anti-CASPR 2 antibody encephalitis is a rare form of encephalitis that can be associated with malignancy, paraneoplastic phenomenon or can be an autoimmune disease. We present a case of a young boy who presented with new onset seizures and altered sensorium and was diagnosed with anti-CASPR 2 antibody encephalitis. Anti-CASPR 2 Antibody Encephalitis is a rare form of encephalitis which due to its great diverse presentation should be kept in the differential diagnosis of conditions like limbic encephalitis

Antibiotic Resistance Pattern of Salmonella Species in Children in a Tertiary Care Hospital

Objective: To determine the recent antibiotic resistance patterns of Salmonella species in children in a tertiary care hospital. Materials and Methods: This descriptive cross-sectional study was conducted in the Department of Pediatrics of Akbar Niazi Teaching Hospital, Bhara Kahu, from 18th March 2020 to 31st January 2021. A total of one hundred and seventy-eight (n=178) patients of either gender having age between 1 month to 12 years who had signs and symptoms of enteric fever and positive blood culture report of Salmonella species were enrolled in this study through non-probability, consecutive sampling. The demographic characteristics of patients along with the antibiotic sensitivity pattern of the Salmonella species were recorded on the predesigned proforma and analyzed through SPSS version 25. Results: Out of the total of 178 patients, reports of blood cultures of 164(92.1%) patients showed Salmonella Typhi while those of 14(7.9%) patients showed Salmonella Paratyphi. Out of the total of 178 Salmonella cases, 11(6.2%) were extensively drug-resistant and 58(32.6%) were multidrug-resistant. All XDR cases were of Salmonella Typhi. Out of 14 Salmonella Paratyphi, 2(14%) were MDR but no XDR Salmonella Paratyphi was found.  Nalidixic acid had the highest resistance (96.4%) followed by sulphamethoxazole (65.5%). Azithromycin had the least resistance (0%) followed by imipenem (1.8%), piperacillin-tazobatam (1.9%), and meropenem (2%). Resistance of ceftriaxone was 20.8% and that of ciprofloxacin was 28.2%. Conclusion: No resistance of Salmonella species against azithromycin was found in our study. The presence of XDR typhoid fever cases and the rising resistance of Salmonella species to ceftriaxone and carbapenems are very alarming. To prevent this resistance, we should reserve carbapenems for complicated cases of resistant typhoid fever only. Minocycline and pipercillin-tazobactam are two other good cost-effective drugs in resistance to typhoid fever

Comparative effects of mulligan’s mobilization and proprioceptive neuromuscular facilitation technique on pain and disability in patients with sacroiliac joint dysfunction

Purpose: To evaluate the efficacy of Mulligan’s Movement of Mobilization and contract- relax technique on pain and disability in patients suffering from sacroiliac joint Dysfunction. Method: A randomized clinical trial was done at DHQ hospital Jhang. 38 persons including both genders old enough 20-35 years were associated with this review who meet the inclusion criteria were recruited by consecutive sampling technique and allocated to the groups by simple random sampling process and by sealed opaque enveloped labeled as 0 for group A and 1 for group B and indiscriminately allocated into two sets. One set A was specified to mulligan mobilization technique and the second set B was specified to contract-relax technique for 6 weeks as three sessions per week. Baseline treatment of hot pack and ultrasound was given to both groups. All the patients were assessed for pain with NPRS and for disability with MOPDQ before and after treatment. Data was analyzed using SPSS 22. Results: After treatment, both groups significantly improved in terms of pain and disability. Mean value of NPRS was reduced from 6.89±1.15 to 1.68±.58 in MWM Group while in Contract-Relax from 6.78±1.18 to 2.57±.90. Mean Value of MOPDQ improved from 31.00±6.24 to 2.95±.911 and 32.26±7.14 to 4.31±1.20 in MWM and Contract-Relax group. However, group that received mulligan technique had significantly better improved NPRS and MOPDQ values than contract-relax group in patients with Sacro-iliac dysfunction (p<0.05). Conclusion: In the management of sacroiliac joint dysfunction, Mulligan mobilization is more efficient than contract-relax approach

Psychiatric Comorbidity in People with Epilepsy

Background and Objective: People with epilepsy often experience psychiatric comorbidity. This study aims to investigate the relationship among seizure regulation, psychiatric comorbidity, and antiepileptic drug use in a group of individuals with epilepsy in Pakistan. Methods: This is an observational study conducted at Pakistan Institute of Medical Sciences, over a period of six months (1st June – 31st Dec 2022). One-hundred-twenty people (sample size) with epilepsy above the age of 18 with confirmed diagnosis of epilepsy were included in the study who completed a questionnaire that assessed their seizure control, psychiatric comorbidity, and antiepileptic drug use. Data was analyzed using SPSS version 25 Results: The majority of participants (80.8%) reported effective seizure control , while 19.2% reported ineffective seizure control . Regarding psychiatric comorbidity, 84.2% of the participants reported some form of psychiatric comorbidity, with depression being the most commonly reported (31.7%). In terms of antiepileptic drug use, 69.2% of the participants reported being on monotherapy, 28.3% reported being on polytherapy, and 2.5% reported not being on any medication. Conclusion: People with epilepsy have a significant likelihood of experiencing psychiatric comorbidity which highlights the need for screening and therapy

Association of Hyperuricemia with Ischemic Stroke in Adult Population

Background and Objective: Stroke is the second most prevalent cause of dementia, the third biggest cause of mortality, and the top cause of disability globally. Hyperuricemia is frequently seen in patients with vascular risk factors. The objective of this study was to determine the association of hyperuricemia with ischemic stroke in adult patients presenting to neurology department of a tertiary care hospital. Methods:This was a case-control study of 200 patients, 100 patients with stroke and 100 unmatched controls were accessed for vascular risk factors and hyperuricemia. The setting was Pakistan Institute of Medical Sciences, Islamabad and study duration was six months (August 2021 to February 2022). Odds Ratio (OR) was calculated to measure the association of ischemic stroke with hyperuricemia for each group. OR\u3e1 was taken as significant. Results:Out of 100 patients in the case group, 25 (25%) had hyperuricemia. Whereas, out of 100 patients in the control group, 07 (7%) had hyperuricemia. The P-value was 0.001. Odds ratio was 4.42. Out of 100 patients in the case group, the median patient age was 35 and the highest patient age was 75. The mean age, symptom duration, and uric acid level were 55.216.24 years, 20.588.97 hours, and 7.212.24 mg/dl, respectively. The control group had 100 patients with an average age of 35 and a maximum age of 75. The median age was 52.48 years old, and the median uric acid level was 2.48 mg/dl. Conclusion:Hyperuricemia is linked positively to occurrence of ischemic stroke as evidenced by the positive odds ratio. Further studies need to be done to investigate whether uric acid lowering therapy is useful in preventing stroke or reducing mortality

Exploring The Relationship Between Egris and The Need For Mechanical Ventilation In Guillain Barré Syndrome

Background and objective: Guillain-Barré syndrome (GBS) is an immune system-mediated polyradiculoneuropathy that accounts for approximately 100,000 new patients per year globally. GBS has also been linked to respiratory failure in 20% to 40% of cases. The objective of this study was to find an association between Erasmus GBS respiratory insufficiency score (EGRIS) and the need for mechanical ventilation. Methods: We conducted our cross-sectional study at department of Neurology, Pakistan Institute of Medical Sciences from November 2019 to February 2020. Sixty patients were selected for this study. Data including demographic profile, variant of GBS, and EGRIS was calculated from all the study participants. Data was entered and analyzed using SPSS version 25. Results: All 60 patients enrolled in the study underwent continuous monitoring during admission time. Out of 60 patients, three (5%) endured mechanical ventilation with a mean EGRIS of 4.5. Others who didn\u27t need mechanical ventilation had mean EGRIS of 1.5. The three patients requiring mechanical ventilation were one each from Acute Inflammatory Demyelinating polyradiculoneuropathy, Acute Motor Axonal Neuropathy, and Acute Motor and Sensory Axonal Neuropathy variants of GBS. p-value was non-significant for the presented data. Conclusion: EGRIS could not meet statistical significance in identifying the requirement of mechanical ventilation for GBS in this study. This may be due to low sample size

Design, synthesis, characterization and computational docking studies of novel sulfonamide derivatives

This study reports three novel sulfonamide derivatives 4-Chloro-N-[(4-methylphenyl) sulphonyl]-N-propyl ben- zamide (1A), N-(2-hydroxyphenyl)-4-methyl benzene sulfonamide (1B) and 4-methyl-N-(2-nitrophenyl) ben- zene sulfonamide (1C). The compounds were synthesised from starting material 4-methylbenzenesulfonyl chlo- ride and their structure was studied through 1H-NMR and 13C-NMR spectra. Computational docking was per- formed to estimate their binding energy against bacterial p-amino benzoic acid (PABA) receptor, the dihydrop- teroate synthase (DHPS). The derivatives were tested in vitro for their antimicrobial activity against Gram+ and Gram- bacteria including E. coli, B. subtilis, B. licheniformis and B. linen. 1A was found active only against B. linen; 1B was effective against E. coli, B. subtilis and B. linen whereas 1C showed activity against E. coli, B. li- cheniformis and B. linen. 1C showed maximum activity with minimum inhibitory concentration (MIC) of 50, 100 and 150 µg/mL against E. coli, B. licheniformis and B. linen respectively. 1C exhibited maximum affinity to DHPS with binding free energy of -8.1 kcal/mol. It enriched in the top 0.5 % of a library of 7663 compounds, ranked in order of their binding affinity against DHPS. 1C was followed by 1B which showed a moderate to low level MIC of 100, 250 and 150 µg/mL against E. coli, B. subtilis and B. linen respectively, whereas 1A showed a moderate level MIC of 100 µg/mL but only agai st B. linen. These derivatives may thus serve as potential anti-bacterial alternatives against resistant pathogens

Biological activity of synthesized 5-{1-[(4-chlorophenyl)sulfonyl]piperidin-4- yl}-2-mercapto-1,3,4-oxadiazole derivatives demonstrated by in silico and BSA binding studies

We synthesized a series of compounds bearing pharmacologically important 1,3,4-oxadiazole and piperidine moieties. Spectral data analysis by 1 H-NMR, 13C-NMR, IR and EI-MS was used to elucidate the structures of the synthesized molecules. Docking studies explained the different types of interaction of the compounds with amino acids, while bovine serum albumin (BSA) binding interactions showed their pharmacological effectiveness. Antibacterial screening of these compounds demonstrated moderate to strong activity against Salmonella typhi and Bacillus subtilis but only weak to moderate activity against the other three bacterial strains tested. Seven compounds were the most active members as acetyl cholinesterase inhibitors. All the compounds presented displayed strong inhibitory activity against urease. Compounds 7l, 7m, 7n, 7o, 7p, 7r, 7u, 7v, 7x and 7v were highly active, with respective IC50 values of 2.14±0.003, 0.63±0.001, 2.17±0.006, 1.13±0.003, 1.21±0.005, 6.28±0.003, 2.39±0.005, 2.15±0.002, 2.26±0.003 and 2.14±0.002 µM, compared to thiourea, used as the reference standard (IC50 = 21.25±0.15 µM). These new urease inhibitors could replace existing drugs after their evaluation in comprehensive in vivo studies