Year 2019, Volume 35 - Issue 3

Open access Original Article | October 08, 2021
Impact of Socio-demographic Factors on Awareness of Smoking Effects on Oral Health Among Smokers and Non-smokers Dental Patients Visiting Private Clinics

Asad R, Nadeem M, Christopher M, Ahmed H, Awais F, Majeed H.A

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Background and Objective: Many chronic diseases including oral diseases, respiratory diseases, lung cancer and cardiovascular diseases are directly associated with smoking. The objectives of this study were to assess the awareness regarding effects of smoking on oral health among smokers and non-smokers dental patients; and to explore the impact of socio-demographics on patient’s awareness.
Methods: A total of 854 patients were recruited for this analytical study. Patients were interviewed in private dental clinics using a semi-structured survey questionnaire. Frequencies, percentages and measures of central tendency were calculated for data. Chi-square test was rendered to comparison between non-smokers and smokers. A multiple linear regression (MLR) model was used to explore the impact of sociodemographic factors on patient’s awareness of such effects.
Results: In both groups, only few patients i.e. 20.4% and 7.7% were able to identify four to five potentially harmful effects of smoking on oral health, respectively. Smokers versus non-smokers showed significant difference (P < 0.050) in rural background, gender and educational status. Moreover, socioPsmoking impact on oral health.
Conclusion: Smokers are least aware of the harmful effects of smoking on oral health than nonsmokers. Patient awareness regarding such effects is influenced by various socio-demographic factors.

Open access Original Article | October 08, 2021
Caries Risk Assessment and its Association with Socio-demographic Factors Among General Population of Lahore, Pakistan

Qasim M, Muneer M.U, Iqbal Z, Asad R, Iqbal F, Awais F

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Background and Objective: Dental caries is the major public health problem and prevalent chronic disease worldwide. The objective of the study is to conduct caries risk assessment (CRA) in general population and find its association with age and gender. The use of CRA deserves special emphasis because it benefits the dental professional as well as patients.
Methods: A total of 267 individuals participated in the study which was conducted in four months (May 2017 to August 2017) in Lahore Medical & Dental College. Risk Assessment was done on a proforma developed by American Dental Association which included both history and clinical examination related parameters.
Results: Out of 267 participants, 53.9% were at high risk, 34.8% at moderate risk and 11.2% were at low risk of developing future caries. No association was found between age groups (P = 0.106) and gender (P= 0.060) with caries risk.
Conclusion: The results suggest that majority of the population are at high risk of developing caries and awareness must be increased among masses.

Open access Original Article | October 08, 2021
Gender Differences in Self-Care Practices Among Diabetics Presenting at Tertiary Care Hospital in Lahore

Ashfaq F, Manzoor I, Zafar T, Irfan H, Masood H, Ashfaq H

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Background & Objective: Self-care practices adherence helps diabetics in better glycemic control and prevents complications associated with uncontrolled diabetes. Worldwide emphasis is being laid down to improve self-care practices among diabetics to reduce associated comorbidities. The objective of this study was to assess the gender difference in self-care practices among diabetic patients attending a tertiary care hospital, Lahore-Pakistan.
Methods: A cross-sectional study was conducted at Diabetic center of Sheikh Zayed Hospital, Lahore from 1st January 2018 to 30th August 2018. A sample of 388 participants having either type I or type II diabetes was taken by using non-probability type of consecutive sampling technique. A structured closed ended questionnaire was filled by interview technique, after taking informed consent from the participants. Data was entered and analyzed on SPSS Version 24. Data was presented in the form of frequency tables, bar charts and pie charts. Chi square test of significance was applied to assess the gender differences in self-care practices keeping P value at ≤ 0.05 as significant.
Results: Out of 388 participants, 181 (46.6%) were males and 207 (53.4%) were females. Patients affected with type 1 diabetes were 54 (14%) and with type 2 diabetes were 225 (58%) and 109 (28%) participants, were unaware of the type of diabetes they had. Duration of diabetes was more than ten years in 133 (34.2%). Oral hypoglycemic drugs were used by 201 (51.8%) whereas Insulin was used by 186 (47.9%) by the participants. Significant difference was observed in two genders and their self-care practices among the participants. Skipping meal to control diabetes was a common practice amongst female patients (P = 0.011). Usage of artificial sweeteners was more common in males (P =0.025). Use of diabetic diet for maintaining blood sugar level was believed by male participants (P= 0.045). Visit to dietician was considered beneficial by males (P = 0.007).
Conclusion: Self-care practices regarding diabetes differ with gender in Pakistan population. Significant difference was observed in self-care practices among two genders in diabetics attending diabetic center of Sheikh Zayed Hospital, Lahore-Pakistan.

Open access Original Article | October 08, 2021
Allelic Frequency of MAO A Gene Among Convicted Offenders and Diagnosed Cluster B Trait Psychiatric Patients

Ashraf MF, Noreen S., Akhtar N, Faheem A, Ali R., Ali S, Rakha A

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Background and Objective: The MAOA-uVNTR polymorphism is known for its association with aggressive impulsive behaviors. A case control association study is conducted to investigate the influence of the allelic variants of the MAOA gene on tendency to violent behavior.
Methods: Fifty-eight psychiatric patients, 68 convicted and 90 healthy control subjects, were included. MAOA-uVNTR genotyped at the promoter region. Variation of six alleles i.e. 2.5, 3, 3.5, 4, 4.5, 5-repeats was investigated. Allele distributions of MAOA-uVNTR in control, convicted and psychiatric samples was calculated.
Results: Statistically significant differences were observed in genotypic frequencies among control, convicted and psychiatric males. Intergroup comparison showed that allele variant 3, 3.5, 4 and 5- repeats were found significant in control group while applying Pearson’s chi-square test (χ2). A significant difference was observed when comparing the 5-repeat allele frequency in psychiatric patients with control (P = 0.005), suggesting a possible association with aggression in this group. Odds ratio > 1 indicated more risk of aggression towards psychiatric as compared to control.
Conclusion: It is concluded that both high and low activity alleles of the MAOA-uVNTR 30-bp polymorphism are correlated with antisocial behavior both in offenders and psychiatric patients.

Open access Original Article | October 08, 2021
Clinical Profile and Its Relationship with CD4+ Count in Treatment Naive HIV &ndash; Infected Subjects

Javaid M.I, Iqbal H.M.N, Ghazanfar M, Haider S, Mazhar S, Natiq M, Ahmad R, Anwar A

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Background and Objective: The human immunodeficiency virus (HIV) infects, destroys and paralyzes the immune system of human body. There is steady rise in the number of cases having AIDS (acquired immunodeficiency syndrome). Decision regarding when to initiate antiretroviral treatment or chemo-prophylaxis for opportunistic infections and clinical monitoring is done with the help of CD4+ counts. Flowcytometry is very expensive and available at specialized centers. Therefore, clinical indicators are needed to be explored to fore see low CD4+ counts and disease progress.
Methods: It was a cross-sectional study and conducted among 106 HIV infected, treatment naive individuals with all genders and age range of 18-65 years. Responses regarding clinical signs and symptoms were entered on pre designed structured proforma by history and clinical examination. Blood samples were taken and base line CD4+lymphocyte count evaluated on flowcytometer. Data was analyzed in software SPSS 23 and P value of < 0.05 was considered statistically significant.
Results: Participants in this study commonly reported weight loss, fever and cough in 79.2%, 94. 3% and 34.9% of the subjects respectively. Generalized lymphadenopathy and pallor were predominant signs in 22.6% and 54.7% of the subjects. Tuberculosis and HCV infection were seen in 12.3% and 17% subjects. CD4+ counts were lower in symptomatic patients and those having oral thrush, weight loss and other clinical conditions.
Conclusion: Oral thrush and weight loss predicted low CD4+ counts and these may be considered as indicator of disease progression in HIV infection. Systematic studies are required on the natural history of disease on larger scale to identify clinical features or conditions that may have some prognostic significance in HIV infected individuals.

Open access Original Article | October 08, 2021
Effect of Acacia Catechu on Aspirin Induced Gastric Ulcers in Albino Rats

WaseemU, Shahbaz M, Gul A, Baloch M.B, Munir Q, Qureshi F

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Background and Objectives: Aspirin, one of the most widely used drugs, causes deleterious effects on gastric mucosa. Anti-inflammatory properties of Acacia catechu have already been established. This study is unique as it evaluated the histopathological changes induced by aspirin in the stomach of albino rats and assessed the protective effect of different doses of Acacia catechu.
Methods: Forty eight adult albino rats, both males and female, were divided randomly into four groups A, B, C and D; each comprising of 12 rats. Group A, (control) was given chow and water ad libitum. Group B was treated with aspirin 100 mg/kg. Group C and D were given aspirin 100 mg/kg along with Acacia catechu 250 mg/kg 500 mg/kg respectively by oral route. Half of the rats from individual group were sacrificed on 3rd day and the rest on 7 th day. Stomach was examined for macroscopic (ulcer index) and microscopic (inflammatory
cells) parameters.
Results: Gross and microscopic findings on days 3 and 7 were similar. Control groups A1 and A2 showed normal healthy gastric mucosa and the least number of inflammatory cells. In group B, aspirin produced ulcerations and linear breaks; with highest ulcer index. On microscopic examination, numerous inflammatory cells were noted. Group C and D rats had minimum ulcer index and fewer inflammatory cells.
Conclusion: Aqueous solution of Acacia catechu has protective role against gastric ulcers by decreasing ulcers, and inflammation.

Open access Original Article | October 08, 2021
Molecular Characterization of ABCA1 and CACNA1C Associated with Type 2 Diabetes

Ahmed A, Ahmed K, Babar N, Ali A, Babar M.E, Ismail M, Hussain T, Kazmi A.R, Mansoor Q.

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Background and Objectives: Diabetes mellitus is a chronic metabolic disorder that is mainly characterized by a rise in the plasma glucose levels above the normal range, glucose intolerance and insulin resistance. There are various subtypes of diabetes mellitus of which type 2 diabetes mellitus (type 2 DM) is the most prevalent form. Mutations in the Adenosine Binding Cassette Transporter Proteins Subfamily A Member 1 (ABCA1) have been associated with abnormal lipid levels and certain variants have been linked with type 2 DM. The CACNA1C facilitates calcium channels which are responsible for transporting calcium ions into the cells especially in heart and brain. The objective of the study was to find the association of mutations in ABCA1 and CACNA1C with the risk of developing type 2 DM and to find the genotype and allelic frequency of ABCA1 2230808 and CACNA1C 2239127.
Methods: The present study analyzed the association of ABCA1 rs2230808 polymorphism and CACNA1C 2239127 with type 2 DM patients in a local population. The study for ABCA1 2230808 was carried out on 94 subjects who were divided into 49 normal (control) and 45 type 2 DM patients, whereas the sample size for CACNA1C 2239127 was 150 divided into 94 type 2 DM patients and 56 normal samples. Genotyping of ABCA1 rs2230808 polymorphism was carried out by tetra-primers Amplification Refractory Mutation System Polymerase Chain Reaction (ARMS-PCR) technique, while RFLP technique was used for genotyping of CACNA1C rs2239127.
Results: The ABCA1 rs2230808 genotypes in the type 2 DM patients was found to be CC (53.33%), CT (31.11%) and TT (15.55%), while in the control group was found to be CC (46.93%), CT (38.77%) and TT (14.28%). While the CACNA1C rs2239127 genotypes in type 2 DM patients was observed as TT (54.25%), CT (34.04%) and CC (11.70%), while in control group it was found to be TT (53.57%), CT (37.5%) and CC
Conclusion: The P-value for both genotype and allelic frequency was found to be greater than 0.05% which shows no significant association of ABCA1 rs2230808 and CACNA1C 2239127 polymorphism with type 2 DM in our study group

Open access Original Article | October 08, 2021
Correlation Between Interalar Width and Size of Natural Maxillary Anterior Teeth

Mahmood Z

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Background and Objective: The maxillary anterior teeth are the key elements for dentofacial esthetics. A large number of patients seek dental care especially for anterior maxillary teeth due to any of the possible reasons. The study aims to determine the correlation between interalar width (IAW) and size of natural maxillary anterior teeth (NMAT) in a sample of Pakistani population for evaluating the reliability of use of nasal index as a guide in selection of artificial maxillary anterior teeth (AMAT).
Methods: Interalar width (IAW) measurements of 280 dental students were recorded directly from faces while intercanine width (ICWTTC, ICWDDC, ICWTTS) was measured from the stone cast and correlation was determined using computer software SPSS25.
Results: Results showed a significant correlation between nasal width and AMAT in the study sample. Using regression analysis the predicted values of size of natural maxillary anterior teeth of the entire
sample showed no significant difference between recorded and predicted values of intercanine width (ICWDDC).
Conclusion: It was concluded that use of interalar width directly to determine the size of six maxillary anterior teeth can lead to selection of appropriate sized maxillary anterior artificial teeth. The validity of use of IAW in selection of AMAT and making of esthetically pleasing dentures can thus be reliably predicted.

Open access Original Article | October 08, 2021
Seroconversion of Hepatitis B and C in Paediatric Patients with Thalassemia Major and Its Awareness Among Parents

Abid M.Z.U, Ali S.M, Hassnain S, Altaf Z, Khalid M.U, Tariq S

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Background and Objectives: Thalassemia is an autosomal recessive disorder. In Pakistan, there are about ten million patients of Thalassemia Minor and if both parents are carriers there are about 25% chances of having Thalassemia Major child. This study was conducted to find the prevalence of hepatitis B and C in thalassemia major patients and also to assess the awareness of disease in their parents.
Methods: This study was cross sectional study with probability cluster random sampling having a sampling size of 95. Four thalassemia centers were selected. Data was collected using structured questionnaire after informed consent. SPSS version 22 was used to analyze the data.
Results: The result of study showed 57.9% parents of thalassemia patients had knowledge of transfusion transmitted infections (TTI). Only 71.6% screened their blood before transfusion. Only 66.3% patients were able to manage the cost of treatment by their own.
Conclusion: Despite of screening practice still significant proportion of recipients had developed Hepatitis B & C infection. But in this study prevalence of Hepatitis C is significantly higher than Hepatitis B. It is therefore imperative to use sero assays in screening and awareness should be made regarding screening.