Coping strategies and impact of disease among people living with HIV/AIDS: A qualitative study

Objective: The current study was undertaken to qualitatively investigate the coping strategies and impact of disease in HIV/AIDS patients. Methodology: The study was conducted at the Divisional Headquarters Teaching Hospital, Mirpur, Azad Jammu and Kashmir. The hospital is a divisional hospital for three districts namely Mirpur, Kotli, and Bhimber catering to a population of approximately 1.5 million. In-depth interviews and focus group discussions were conducted with twenty HIV/AIDS patients. For the analysis, the Interpretative Phenomenological Analysis technique was used. The major domain of the impact of HIV/AIDS was further divided into nine major themes. The other major domain was coping with HIV/AIDS which included themes of spiritual coping, problem-focused coping, and avoidance coping. Results: Findings highlighted depression among people living with HIV/AIDS. The first sub-theme was the positive aspect which explains the family attitude towards illness as now they have become more caring and supportive towards the participant. The impact of disease is multifaceted including social, emotional, financial, and occupational. The participants were more inclined towards spiritual coping and problem-focused coping as compared to the avoidance coping. Conclusion: The findings of the study highlighted the need of the assessment and management of the participants through a psychologist. HIV/AIDS patients need counseling and awareness on the disease and the things to consider while on treatment to cope with the stress. They must be provided the updated information on HIV/AIDS. The management of HIV/AIDS patients requires that issues of psychological stresses be coped with professionalism

Silk-Cellulose Acetate Biocomposite Materials Regenerated from Ionic Liquid

The novel use of ionic liquid as a solvent for biodegradable and natural organic biomaterials has increasingly sparked interest in the biomedical field. As compared to more volatile traditional solvents that rapidly degrade the protein molecular weight, the capability of polysaccharides and proteins to dissolve seamlessly in ionic liquid and form fine and tunable biomaterials after regeneration is the key interest of this study. Here, a blended system consisting of Bombyx Mori silk fibroin protein and a cellulose derivative, cellulose acetate (CA), in the ionic liquid 1-ethyl-3-methylimidazolium acetate (EMIMAc) was regenerated and underwent characterization to understand the structure and physical properties of the films. The change in the morphology of the biocomposites (by scanning electron microscope, SEM) and their secondary structure analysis (by Fourier-transform infrared spectroscopy, FTIR) showed that the samples underwent a wavering conformational change on a microscopic level, resulting in strong interactions and changes in their crystalline structures such as the CA crystalline and silk beta-pleated sheets once the different ratios were applied. Differential scanning calorimetry (DSC) results demonstrated that strong molecular interactions were generated between CA and silk chains, providing the blended films lower glass transitions than those of the pure silk or cellulose acetate. All films that were blended had higher thermal stability than the pure cellulose acetate sample but presented gradual changes amongst the changing of ratios, as demonstrated by thermogravimetric analysis (TGA). This study provides the basis for the comprehension of the protein-polysaccharide composites for various biomedical applications

Association between type of fixation and alength of stay amongst maxillofacial fracture patients: a retrospective charts review

We aimed to explore the predictors of hospital length of stay for patients admitted and with maxillofacial injuries. Patients presenting with maxillofacial trauma were included. Poly-trauma involving neurosurgery and/ or needing orthopedics intervention were excluded. Logistic regression was applied to explore the predictors associated with the hospital stay of > 4 days. There were 241 patients with mean age 29.35 ± 12.5 years (age range 12-80 years). Mandibular fracture was the commonest observation 121(50.2%), followed by maxillary 48(19.9%), and zygomatic bone fracture 9 (3.7%). Road traffic accident 196 (81.3%) appears to be the most common etiology of maxillofacial injuries in the studied sample. The mean length of hospital stay among bone plating patients was 5.96 ±6.8 days compared to 4.15±6.2 days for ones treated without bone plating; p-value 0.05. It was concluded that longer length of stay is required in patients with more complex management including bone plates. Keywords: Maxillofacial injury; road traffic accident; bone plating; length of stay

Is there a difference between disease-free survival of oral squamous cell carcinoma referred by dentists versus other physicians? -A systematic review

Objectives: To compare disease-free survival rates in oral squamous cell carcinoma patients initially attended to and referred by dentists versus other physicians. Methods: The systematic review was conducted after registration with the International prospective register of systematic reviews at the University of York, the United Kingdom, and comprised search on Medline, PubMed, Cochrane and CINAHAL Plus databases for studies published up to December 2021.  The Population-Intervention-Comparison-Outcomes-Study criteria was used to search for studies involving patients diagnosed with oral squamous cell carcinoma receiving referrals by dentist or by other healthcare providers. Disease-free survival of patients was taken as the main outcome. Customized data collection proforma was used to record data in line with the Preferred Reporting Items in Systematic Reviews and Meta-Analysis guidelines. Data was subjected to systematic, qualitative review. Results: Of the 344 studies found, 8(2.3%) were analysed in detail. Patients referred by dentists ranged from 22.6% to 54%. Males comprised 53% to 70.3% of the sample. The highest number of referrals was made by primary physicians, ranging from 27.4% to 71.6%. Upto 67.6% cases were diagnosed with stage 1 and 2 oral cancer. The highest 5-year survival rate was 75% in a study where 59% patients were diagnosed at an early stage of disease. Conclusion: The relative scarcity of studies makes it impossible to draw an association between oral cancer survival rate and type of referral. Key Words: Oral squamous cell carcinoma, Cancer-free survival, Early detection, Referrals

Oral Maxillofacial Surgical residency and its impact on the academic and research productivity at different levels in Pakistan

Oral and maxillofacial (OMF) surgery is a unique speciality. In many countries, OMFS is a dental speciality but the scope of its practice significantly overlaps with other specialities, including otolaryngology, head and neck surgery, plastic surgery, and orthopaedics. Thus, OMF surgery represents a true amalgamation of medical and dental specialities. There are different requirements of OMF residency training, which include a dental undergraduate training, medical training, or both. The training pathways for this speciality have evolved much in the last three decades and there is still no consensus over a single uniform path of becoming an OMF surgeon. An OMF surgeon deals with trauma, cysts, tumours and other pathologies of the maxilla, mandible, and zygomatic complex that need surgical correction. In addition to being a diverse speciality, ---Continu

Migratory dental implant in the maxillary antrum: A case report

Dental implants offer a predictable solution for the replacement of missing dentition. This report describes the case of a patient who underwent dental implant surgery several years ago but due to negligence on the part of previous dentist, her implant pushed into the maxillary sinus. The patient presented with vague pain and swelling in the right maxillary region. Orthopantomogram (OPG) showed that the implant was lying in the right maxillary sinus which the patient had no clue of. It was decided to retrieve the implant and later restore the missing teeth for definitive function and aesthetics. However, at the time of surgery, the implant in question was missing from the anticipated position as it had migrated to the most posterior-superior compartment of the antrum making its retrieval difficult in the first attempt. Later, a maxillofacial surgeon carried out the retrieval. Fortunately, the implant moved back to a more favourable position at the time of second surgery

Response from F R Khan, S M R Kazmi, H K Siddiqui, et al. (J Pak Med Assoc. 2023; 73: 1275-1279) Prosthetic complications with dental implants: A bibliometric analysis of 20 top cited articles

dental implants: a bibliometric analysis of 20 top cited articles. J Pak Med Assoc. PMID: 37427629.”1was published in June 2023. We believe that the reader has mixed up this paper with an earlier paper of ours, titled “A bibliometric analysis of the studies on dental implant failure. J Pak Med Assoc. PMID: 35202375.2 Dental implants have two types of failures: surgical (related to implant fixture, its placement techniques and bone biology etc.) and prosthetic (related to implant prosthesis, crown, abutment, other components, or technical issues arising from laboratory made implant prosthesis). The former paper was about identifying the top-cited publications on the surgical failures of implants whereas the latter bibliometrics related to the implant prosthetic complications. Regarding methodology of bibliometrics, the search terms we adopted for the first paper was “dental implant failure” whereas for the second paper, we employed “Prosthetic complication in dental implant” without using any Boolean operator. These key terms were searched in the abstracts using Web of Science, Google Scholar, and other electronic sources published in English language upto June 2021. We employed the option of “cited reference search” for ascertaining the number of citations. To review and synthesise the data, multiple parameters were explored. These included authors, journal, citation count, citation density, keywords and study design, and geographic and institutional affiliation of the first or corresponding authors. The country of literature emergence was determined by the address of the corresponding author. The details of methodology are already shared in the above-mentioned papers. Another important observation made by the reader was that the table 2 and table 3 displayed the same information that has already been shared in table 1. So why was it done? And that too in both the papers. The answer to this question is that although table 1 in both the papers displayed the primary bibliometric data but to stratify the data, based on author, institution, and the journal, table 2 was composed and to emphasize the study designs table 3 was made. That helped us to identify that there is just one clinical trial among top 30 cited papers on dental implant failures and more alarmingly, no randomized controlled trials in the list of top 20 cited papers on the implant prosthetic failures. Thus, table 2 and table 3 represented the subset of the data

Response from F R Khan, S M R Kazmi, H K Siddiqui, et al. (J Pak Med Assoc. 2023; 73: 1275-1279) Prosthetic complications with dental implants: A bibliometric analysis of 20 top cited articles

dental implants: a bibliometric analysis of 20 top cited articles. J Pak Med Assoc. PMID: 37427629.”1was published in June 2023. We believe that the reader has mixed up this paper with an earlier paper of ours, titled “A bibliometric analysis of the studies on dental implant failure. J Pak Med Assoc. PMID: 35202375.2 Dental implants have two types of failures: surgical (related to implant fixture, its placement techniques and bone biology etc.) and prosthetic (related to implant prosthesis, crown, abutment, other components, or technical issues arising from laboratory made implant prosthesis). The former paper was about identifying the top-cited publications on the surgical failures of implants whereas the latter bibliometrics related to the implant prosthetic complications. Regarding methodology of bibliometrics, the search terms we adopted for the first paper was “dental implant failure” whereas for the second paper, we employed “Prosthetic complication in dental implant” without using any Boolean operator. These key terms were searched in the abstracts using Web of Science, Google Scholar, and other electronic sources published in English language upto June 2021. We employed the option of “cited reference search” for ascertaining the number of citations. To review and synthesise the data, multiple parameters were explored. These included authors, journal, citation count, citation density, keywords and study design, and geographic and institutional affiliation of the first or corresponding authors. The country of literature emergence was determined by the address of the corresponding author. The details of methodology are already shared in the above-mentioned papers. Another important observation made by the reader was that the table 2 and table 3 displayed the same information that has already been shared in table 1. So why was it done? And that too in both the papers. The answer to this question is that although table 1 in both the papers displayed the primary bibliometric data but to stratify the data, based on author, institution, and the journal, table 2 was composed and to emphasize the study designs table 3 was made. That helped us to identify that there is just one clinical trial among top 30 cited papers on dental implant failures and more alarmingly, no randomized controlled trials in the list of top 20 cited papers on the implant prosthetic failures. Thus, table 2 and table 3 represented the subset of the data

Knowledge, attitudes and practices of physicians and dentists on medication-related osteonecrosis of the jaw: A cross-sectional survey

Background Bisphosphonate medication can cause osteonecrosis of the jaw, which is an uncommon but serious complication. This survey explores the knowledge, attitudes and practices of dentists and physicians regarding medication-related osteonecrosis of the jaw (MRONJ).Methods A cross-sectional study was conducted among physicians and dentists of Pakistan\u27s secondary and tertiary care hospitals between March and June 2021. Data were collected through a web-based questionnaire distributed among the eligible clinicians involved in prescribing bisphosphonates to patients or management of osteonecrosis. SPSS Statistics 23.0 was used for the data analysis. The frequencies and proportions of the descriptive variables were reported.Results A response rate of 29% was achieved. Only six dentists (n = 6/61; 9.8%) were aware that mammalian target of rapamycin inhibitors could lead to osteonecrosis. Only one-third (n = 9/26; 34.6%) of physicians informed their patients about the possible side effects of bisphosphonates. The most commonly identified risk factor among them was the duration of the drug (n = 77/87; 88.5%) and the least identified was gender (n = 34/87; 39.0%).Conclusions Our study revealed insufficient knowledge among the respondents about the recently updated established guidelines available on MRONJ. The majority of physicians don\u27t refer patients to dentists before prescribing bisphosphonates and other associated medication