KNOWLEDGE AND PRACTICE OF RESTORING ENDODONTICALLY TREATED TEETH BY DENTISTS IN NORTHERN SAUDI ARABIA

The aim of this study was to determine the knowledge, current approaches, techniques and practices for the restoration of endodontically treated teeth (ETT) among general dentists and specialists in northern Saudi Arabia. A standard questionnaire based survey containing 16 multiple choice questions about techniques and treatment methods, frequency of post, type of post, choice of luting cement, core material, reason for failure of endodontic treatment was distributed by hand and through email among 255 general dentists and specialists. The data was processed by using SPSS statistical software. The majority of clinicians (54%) believed that post reinforces the remaining tooth structure and reduces fracture probability. The ferrule effect was considered an important factor in increasing fracture resistance of the ETT (72%). The preferred technique for restoring ETT was core material along with 1-2 mm of ferule followed by prefabricated post and core build up. On the basis of post material, the most common was metal followed by fiber post. 2/3rd length of the root canal for the post length , 4-5mm apical seal of gutta percha after post placement and for the post diameter, 1/3rd of root diameter was agreed by most of the participants. Composite resin was the most popular material for core foundation followed by amalgam. The majority of surveyed practitioners had not a sound knowledge of the techniques and materials for restoring ETT and they believed that post reinforces the remaining tooth structure and reduces fracture probability

KNOWLEDGE AND PRACTICE OF RESTORING ENDODONTICALLY TREATED TEETH BY DENTISTS IN NORTHERN SAUDI ARABIA

The aim of this study was to determine the knowledge, current approaches, techniques and practices for the restoration of endodontically treated teeth (ETT) among general dentists and specialists in northern Saudi Arabia. A standard questionnaire based survey containing 16 multiple choice questions about techniques and treatment methods, frequency of post, type of post, choice of luting cement, core material, reason for failure of endodontic treatment was distributed by hand and through email among 255 general dentists and specialists. The data was processed by using SPSS statistical software. The majority of clinicians (54%) believed that post reinforces the remaining tooth structure and reduces fracture probability. The ferrule effect was considered an important factor in increasing fracture resistance of the ETT (72%). The preferred technique for restoring ETT was core material along with 1-2 mm of ferule followed by prefabricated post and core build up. On the basis of post material, the most common was metal followed by fiber post. 2/3rd length of the root canal for the post length , 4-5mm apical seal of gutta percha after post placement and for the post diameter, 1/3rd of root diameter was agreed by most of the participants. Composite resin was the most popular material for core foundation followed by amalgam. The majority of surveyed practitioners had not a sound knowledge of the techniques and materials for restoring ETT and they believed that post reinforces the remaining tooth structure and reduces fracture probability

Frequency of Anastomosis Leak in Primary Repair in Ileal Perforation

OBJECTIVES: To determine the frequency of anastomotic leak in primary closure patients presenting with enteric perforation. METHODOLOGY:  Through a Descriptive case series Study Design, 253 patients with the perforated ilium and subjected to primary closure were included and followed up post-operatively to determine the anastomosis leak. RESULTS: The mean age of our sample was 42.2 years with a standard deviation of 8.6 years. Out of 253 patients, 70.8% were males, and 29.2% females were. The mean BMI of the study sample was 24.6 + 2.2kg/m2. 61.3% of patients belonged to urban settings, 41.1% were from lower socioeconomic class, and 36.4% had a middle school level education. On follow up, the anastomotic leak was recorded in 18.2% of patients. CONCLUSION: Ileal perforation subjected to primary defect closure is the most performed surgery for treatment, with a significant number of patients developing the anastomosis leak. The frequency of anastomosis leaks is high, and other treatment strategies must be researched to reduce the burden of these complications

A multi-hop angular routing protocol for wireless sensor networks

In this article, we propose two new routing protocols for wireless sensor networks. First one is AM-DisCNT (angular multi-hop distance-based clustering network transmission) protocol which uses circular deployment of sensors (nodes) for uniform energy consumption in the network. The protocol operates in such a way that nodes with maximum residual energy are selected as cluster heads for each round. Second one is iAM-DisCNT (improved AM-DisCNT) protocol which exploits both mobile and static base stations for throughput maximization. Besides the proposition of routing protocols, iAM-DisCNT is provided with three mathematical models: two linear-programming-based models for information flow maximization and packet drop rate minimization and one model for calculating energy consumption of nodes. Graphical analysis for linear-programming-based mathematical formulation is also part of this work. Simulation results show that AM-DisCNT has 32% and iAM-DisCNT has 48% improved stability period as compared to LEACH (low-energy adaptive clustering hierarchy) and DEEC (distributed energy-efficient clustering) routing protocols. Similarly, throughput of AM-DisCNT and iAM-DisCNT is improved by 16% and 80%, respectively, in comparison with the counterpart schemes. © The Author(s) 2016

Comparison of Peritonsillar Bupivacaine versus Peritonsillar Dexamethasone in Post-Tonsillectomy Pain Management

Objective: To compare efficacy of Peritonsillar Dexamethasone with Peritonsillar Bupivacaine in managing post-tonsillectomy pain in children. Study design: Randomized Controlled Trial Setting & Period: ENT Department Fauji Foundation Hospital (FFH) Rawalpindi from 01-06-2019 to 31-11-2020. Material &Methods: A total of sixty patients of both genders between ages of 5-15 years fulfilling the recognized criteria for tonsillectomy were selected. They were equally divided into two groups; Group A received peritonsillar Bupivacaine while Group B received peritonsillar Dexamethasone. Mean post-tonsillectomy Visual Analogue Score (VAS) at 1st, 2nd and 7th day were recorded in both groups and compared using independent sample ‘t’ test. Results: In group A Mean post-tonsillectomy VAS at 24 hours was 6.73±1.44 SD while in group B it was 5.93±1.26 SD (p-value 0.025). Mean post-tonsillectomy VAS at 48 hours was 5.60±1.25 SD and 4.37±1.03 SD (p-value 0.000) respectively in groups A and B. At 7th post operative day, Mean VAS was noted as 3.27±0.74 SD and 2.30±0.79 SD (p-value 0.000) respectively in group A and B.  Conclusion: Peritonsillar Dexamethasone is more effective than peritonsillar Bupivacaine in controlling post-tonsillectomy pain in children. Statistically significant difference was noted for mean post-tonsillectomy VAS at 1st, 2nd and 7th day. Key Words: Tonsillectomy, visual analogue score, postoperative pain, dexamethasone, bupivacaine

Dysphagia among Middle-Aged Females

Objective: To assess the association of dysphagia with iron deficiency anemia in female patients. Study Design: Descriptive Study Setting & Duration: Department of ENT at Fauji Foundation Hospital Rawalpindi from April 2019 to April 2021. Material and Methods: Approval of the study was obtained from the Hospital Ethical Committee and then Informed Consent was obtained from all the patients. A total of 42 female patients with dysphagia were selected by Consecutive convenient sampling. After detailed history and physical examination, Complete Blood Count and X-ray Barium Swallow were done in all these patients, followed by Rigid Endoscopy under GA. Tissue biopsy was done in all the patients from suspicious areas. The data was analyzed for frequencies by SPSS 24. Results: 42 female patients were included in this study. The mean age of these patients was 46.30 years, ranging from 32 to 65 years. 40 (95%) of these patients showed Esophageal webs in the cricopharyngeal region, while 2 (5%) of them had irregular strictures in the post cricoid region of Hypopharynx. Iron deficiency anaemia was found in 32 (76.19%) patients. Histopathology report showed Squamous Cell Carcinoma in 2 patients with post cricoid strictures, while the rest 40 with webs showed chronic inflammation with fibrosis. Rigid esophagoscopy with web dilatation was highly effective procedure for treatment in 40 (95%) patients. Repeated dilatations were needed in 14 (33%) of the patients. The 2 patients with malignancy underwent Chemo-radiotherapy. Conclusion:  Iron deficiency anemia has a strong association with dysphagia in middle age female patients and is a potential risk factor for malignant transformation. Timely diagnosis and prevention of anaemia may result not only in decrease in PVS but also a decreased incidence of hypopharyngeal carcinoma in the vulnerable population. Key words: Dysphagia, Iron deficiency anemia, Post cricoid Carcinoma

Peer Assisted Learning; The Perspective of Peer Tutors

Objective: To determine the perspective of PAL tutors regarding the effectiveness of PAL in promoting knowledge and skills among the undergraduate students using small group discussions in an integrated module. Methodology:  A prospective qualitative method study was conducted at Rawal Dental College, Islamabad, from April to June, 2021, for 12 weeks. Students from the second year of BDS (n = 50) were divided into five small groups. Five students’ volunteers were chosen from those who completed the previous units with more than 80% summative assessment score and with good communication skills. The group discussion centered on the application of core knowledge and skills in pathology. Responses from the tutors for the qualitative data were obtained using in depth one-on-one semi-structured interviews with audio recorded. The verbatim in the form of audio and notes were transcribed, and the qualitative analysis was performed by two independent investigators, generating codes, themes, and subthemes. Results: The results showed the comprehensive understanding of the insights of tutors and the motivational elements for achieving academic goals and improving teamwork and teaching skills. Many factors encouraged their participation as tutors, including the acquisition of knowledge and leadership skills. The students felt that their compassionate attitude encouraged active participation by the fellow students, increasing their confidence and learning. The students perceived that they had attained essential attributes that would benefit them in professional life in the future. Conclusion: The students enjoyed the Peer-assisted learning experience and recognized its importance for their academic and professional development. While learning in a relaxed environment, the students achieved their basic learning goals, developed leadership skills, improved communication skills, and gained confidence. Keywords: Peer Group, Integrated curriculum, Near-Peer tutoring.

Dysphagia among Middle-Aged Females

Objective: To assess the association of dysphagia with iron deficiency anemia in female patients. Study Design: Descriptive Study Setting & Duration: Department of ENT at Fauji Foundation Hospital Rawalpindi from April 2019 to April 2021. Material and Methods: Approval of the study was obtained from the Hospital Ethical Committee and then Informed Consent was obtained from all the patients. A total of 42 female patients with dysphagia were selected by Consecutive convenient sampling. After detailed history and physical examination, Complete Blood Count and X-ray Barium Swallow were done in all these patients, followed by Rigid Endoscopy under GA. Tissue biopsy was done in all the patients from suspicious areas. The data was analyzed for frequencies by SPSS 24. Results: 42 female patients were included in this study. The mean age of these patients was 46.30 years, ranging from 32 to 65 years. 40 (95%) of these patients showed Esophageal webs in the cricopharyngeal region, while 2 (5%) of them had irregular strictures in the post cricoid region of Hypopharynx. Iron deficiency anaemia was found in 32 (76.19%) patients. Histopathology report showed Squamous Cell Carcinoma in 2 patients with post cricoid strictures, while the rest 40 with webs showed chronic inflammation with fibrosis. Rigid esophagoscopy with web dilatation was highly effective procedure for treatment in 40 (95%) patients. Repeated dilatations were needed in 14 (33%) of the patients. The 2 patients with malignancy underwent Chemo-radiotherapy. Conclusion:  Iron deficiency anemia has a strong association with dysphagia in middle age female patients and is a potential risk factor for malignant transformation. Timely diagnosis and prevention of anaemia may result not only in decrease in PVS but also a decreased incidence of hypopharyngeal carcinoma in the vulnerable population. Key words: Dysphagia, Iron deficiency anemia, Post cricoid Carcinoma