Dental Insurance as a Mitigating Factor in Reducing the Risk of Mortality Among Working-Age Adults with Dental Caries and Periodontitis

Background Poor oral health had been associated with increased risk of having systemic diseases and thus mortality. The purpose of this research was to find if dental coverage with health insurance could mitigate the risk of death due to untreated dental caries and periodontitis among working age U.S. adults. Methods Data were drawn from NHANES III (1988-1994) and linked to mortality updated till Dec. 31st, 2011. It was restricted to those in the age range of 20-64 years adults. Furthermore, it was restricted to those who had complete data collection on all measures. Unweighted propensity scores were calculated to control for the differential proportion of dental coverage in the population separated by gender. The continuous propensity score obtained was converted into quartiles based on the population distribution of both males and females to ascertain the risk of mortality based on low to high probability of dental coverage. All analyses were weighted and adjusted for complex sampling of NHANES III survey using proc survey procedures in SAS v9.4 for each gender. Andersen’s model of health care utilization was used as a basis for the addition of incremental variables in the models. Results Nearly 10% deaths among males and 7% among females were observed in our sample. Observed deaths were more in those who had increased number of decayed teeth and periodontitis. Similarly, those who had dental coverage with health insurance had fewer deaths as compared to those without dental coverage. Multivariate analyses showed that people who have increased number of decayed teeth had a higher risk of mortality in both males and females. Only among females, all the propensity quartiles had a protective effect on the risk of mortality in associations with dental decay in the final model. Periodontitis was linked to higher risk of mortality in simplified analyses and the risk reduced with the introduction of dental insurance and dental insurance propensity score. However, in both dental caries and periodontitis for both males and females, dental insurance remained insignificant in the final (full) model but the propensity score for dental coverage in females only. Conclusion The dental coverage was not significant in the full models for both dental caries and periodontitis among males and females. Additionally, we did not have any information available on the depth of dental coverage and out of pocket costs associated with dental coverage. However, we do know that access to preventive and curative dental services is guaranteed by dental coverage, therefore, dental coverage should be a mandatory part of health insurance under Medicaid expansion and health care reforms but with little or no financial contribution in the form of co-payments and deductibles for the customer. It is evident from RAND Health Insurance Experiment that improved oral and dental health was seen among those who had free or nominal financial contribution. In future, national surveys should incorporate in-depth details about dental coverage for both out of pocket costs and treatments provided

Maternal history and second trimester uterine artery Doppler in the assessment of risk for development of early and late onset pre-eclampsia and intra uterine growth restriction

Background: To evaluate the value of one step uterine artery Doppler and maternal history in the prediction of early onset pre-eclampsia and intra uterine growth restriction in a random populationMethods: This study was conducted from 2012 to 2014 Lalla Ded hospital which is a tertiary care hospital associated with GMC Srinagar. This was a prospective study conducted on 200 pregnant women in the second trimester between 19-22 weeks of gestation. Singleton pregnant women were recruited from those attending antenatal care clinics at this hospital over a period of two years. Obstetric and medical history was taken. Transabdominal ultrasound was done and then patients were subjected to Doppler examination of uterine arteries.Results: Mean age of study population was 26.3 years with maximum number of patients in 25-29 year age group. Total numbers of primigravida were 59.5%. Maternal history revealed that 9.5% had previous history of hypertensive pregnancy, 3.5% had history of IUGR. Early onset pre-eclampsia (32 weeks) was present in 57.1% cases. Doppler abnormalities were present in 7.5%. In the patients who developed pre-eclampsia 57.1% had uterine artery Doppler abnormalities.Conclusions: Maternal history and uterine artery Doppler at 19-22 weeks gestation is a single step test for the prediction of early onset(<32 weeks) and late onset pre-eclampsia and intra uterine growth restriction

Bowled over by cricket: impact of tape-ball injuries on the eyes

Abstract PURPOSE: The aim of this study was to describe the type and severity of tape-ball cricket-related eye injuries seen at a tertiary care hospital. DESIGN: A descriptive case series. METHODS: This study included all cases of tape-ball cricket-related eye injuries presenting to the Section of Ophthalmology, Aga Khan University Hospital, Karachi, from January 2014 to January 2015. RESULTS: A total of 20 patients with tape-ball cricket-related eye injuries were treated during this period. The right eye was involved in most (14/20) of the cases. The commonest presenting symptoms included reduced/blurred vision, ocular pain, redness, and floaters. Sixty percent (12/20) of the affected eyes had a best corrected visual acuity of less than 20/200 at presentation, with the retina being the most commonly involved ocular structure. All patients reported that they were not wearing protective eyewear at the time of trauma. Despite standard management, half of the eyes had severe or total vision loss at the last follow-up (minimum, 3 months), mainly due to retinal damage. CONCLUSIONS: Our study calls for the compulsory use of protective eyewear by cricket players and for countrywide surveillance data on the true burden of this unnoticed preventable cause of unilateral eye injuries and associated vision loss

Exploring diet, exercise, chronic illnesses, occupational stressors and mental well-being of healthcare professionals in Punjab, Pakistan

OBJECTIVE: This data set was compiled to assess mental well-being, dietary pattern and physical health parameters of health care professionals in Pakistan. DATA DESCRIPTION: The Warwick-Edinburgh mental well-being scale was first evaluated for the Pakistani population then used, along with other measures like body mass index, exercise and dietary habits to assess health and wellbeing of health care providers. The importance of the data lies in the fact that no previous records or data exists in our knowledge that used a subjective index to assess wellbeing in Pakistani population. Furthermore, this data may be used as part of a global analysis to find differences in well-being and health habits of health care providers in developing countries as opposed to developed countrie

Identification and Antimicrobial Susceptibility Profile of Bacterial Pathogens Isolated From Wound Infections in a Teaching Hospital, Peshawar, Pakistan

Background: The resistance profile of bacteria causing wound infections may vary from time to time in a given geographical location. The key objective of this study was to determine the prevalent aerobic and or facultative anaerobic bacterial types and their antibiogram to commonly prescribed antibiotics.Methods: Pus, drainage or wound swabs from various body parts of 200 patients were aseptically collected from Khyber Teaching Hospital (KTH) and processed by standard microbiological techniques for identification of bacterial isolates and later antimicrobial susceptibility profile was determined as per Clinical and Laboratory Standard Institute (CLSI) guidelines by using Kirby-Bauer method.Results: Out of 200 clinical wound specimens processed, Staphylococcus aureus was the most common bacterial pathogen isolated (n=100, 50%), followed by Escherichia coli (n=45, 22.5%),Pseudomonas aeruginosa (n=35, 17.5%), Enterobacter species (n=14, 7%), Proteus species (n=5, 2.5%) and Morganella species (n=1, 0.5%). Staphylococcus aureus (n=100) showed highest resistance to amoxicillin (82%), followed by ofloxacin (80%), sparfloxacin (78%), ciprofloxacin (71%), levofloxacin (46%) and Gentamicin (34%). Out of 100 S. aureus isolates methicillin and vancomycin resistance was found to be in 1.5 and 2% of the isolates, respectively. Among Gram negative isolates (n=100) the vast majority were resistant to augmentin, followed by cephalosporins, quinolones and almost fairly susceptible to carbapenems, cefoperazone + sulbactam and aminoglycosides.Conclusion: There is a need for judicious use of antibiotics in clinical setup. The periodic monitoring of bacterial pathogens and their susceptibility profile is very helpful in understanding the resistance phenotypes in a given area which ultimately help physicians in selecting suitable empirical therapy

A Short Commentary on Non-specialist-mediated Interventions for Children with Autism Spectrum Disorder.

Autism spectrum disorder (ASD) is a lifelong neurodevelopmental disability delineated by social and communication impairments, restricted interests and repetitive behaviors, and sensory hypo- or hyper reactivity to sensory inputs. Early recognition and timely intervention are essential for individuals with ASD and the long-term prognosis for these individuals. The specialist-mediated interventions can be expensive for patients, their families, and the healthcare system. It is important to provide a naturalistic intervention, especially in the context of cost issues, the impact of early intervention of prognosis, limited resources in developing countries, lack of healthcare providers, and healthcare disparities. The current article reviews non-specialist-mediated interventions of children and adolescents with ASD

The Workload Pressures Experienced by Nurses at Public Sector Hospitals, Peshawar

OBJECTIVE The study's objective was to assess that nurses working in in-patient wards were under workload stress. METHODOLOGY Descriptive observational research on nurses working in the in-patient ward of a public sector hospital in Peshawar was undertaken in November 2020. Workload Indicators of Staffing Need (WISN), a tool established by the World Health Organization (WHO) to anticipate the number of health staff needed to cope with workload pressure, was used to determine nurses' workload. To ensure the successful implementation of the WISN methodology, three tiers of committees were developed, including steering, technical, and expert committees. Data were also analyzed using the tool. RESULTS Nurses in the hospital's in-patient unit work 1966 hours per year. Health service activities, support, and other activities account for 47.92%, 33.33%, and 18.75% of all nurses' time, respectively, during this time. Four nurses were working in the hospital during the research study; however, WISN estimated that three nurses were needed to cope with the ward's workload pressure, and one nurse was overstaffed at the time. The WISN ratio calculated was 1.33. CONCLUSIONS The study concluded that there was no workload pressure on nurses (negative), and the ward had an extra nurse who could be accommodated in any other department with greater demand

A 10-year review of indications for penetrating keratoplasty in a tertiary care setting in Karachi Pakistan

Abstract The retrospective study was conducted to determine the indications and outomes of penetrating keratoplasty(PKP) in a tertiary caresetting in Pakistan. All eyes that had undergone PKP between January 2005 and December 2014 at the Aga Khan University Hospital, Karachi, were included.Data were collected on the indications of PKP, graft survival (graft clarity at final follow-up), andbest corrected visual acuity (BCVA).Kaplan-Meier\\u27s method was usedto analyse graft survival.Out of 437 eyes, 383(87%) were for visual purpose. Trauma-related corneal scarring 113(26.2%) was the leading cause of PKP, followed by keratoconus 74(17.1%), redo graft 56(13%), infection-related corneal opacity 46(10.6%), corneal dystrophy 44(10.2%) and bullous keratopathy 36(8.3%). The probability of graft survival at 30 months was 90% for keratoconusversus 75% for the non-keratoconus grafts. Most of the PKPs in this case series were due to preventable causes. Our long-term PKP results were favourable, with a graft survival ratecomparable to those of other centres

To tackle symptoms of computer vision syndrome in era of COVID-19

With the emergence of a novel coronavirus, there has been an increase in the use of electronic gadgets such as laptops, tablets, and mobile phones. There has been an emphasis on social distancing and work from home. Therefore, people are switched to online mode, whether it is office work or education. Both adults and children are getting dependent on electronic devices, which has led to increased symptoms of computer vision syndrome (CVS). Here, we address the symptoms that can occur with enhanced use of digital media and how that could be tackled