Efficacy of using a dual layer of membrane (d PTFE placed over collagen) for ridge preservation in fresh extraction sites: a micro‐computed tomographic study in dogs

Objective To assess if overbuilding the buccal plate or using a dual‐layer socket grafting technique prevents alveolar bone resorption and enhances final ridge width, height, and volume after tooth loss in an animal model. Material and methods In eight beagle dogs bilateral second (P2)‐, third (P3)‐, and fourth (P4) premolars were endodontically treated. All bilateral mandibular first premolars and distal roots of P2, P3, and P4 were hemisectioned and atraumatically extracted. Animals were randomly divided into four groups: (i) Control–Socket alone, (ii) Particulate allograft in the alveolum, socket covered with high‐density polytetrafluoroethylene ( dPTFE ) membrane and sutured over the alveolum, (iii) Particulate allograft in the alveolum and overbuilding the buccal plate, socket covered with dPTFE membrane and sutured over the alveolum, (iv) Particulate allograft in the alveolum and covered with dual layer ( dPTFE placed over collagen membrane), and sutured over the alveolum. After 16 weeks, the animals were sacrificed. Mandibular blocks of the jaws were assessed for bone volume ( BV ), vertical bone height ( VBH ), alveolar ridge thickness, and bone mineral density ( BMD ) using micro‐computed tomography. Results The BV in groups 1, 2, 3, and 4 was 169.5, 207.57, 242.4, and 306.1 mm 3 , respectively. The VBH in groups 1, 2, 3, and 4 was 4.2, 6.4, 6.2, and 7.3 mm, respectively. Ridge widths in groups 1, 2, 3, and 4 were 5.45 ± 0.75, 5.91 ± 0.86, 6.05 ± 0.63, and 6.28 ± 1.01 mm, respectively. There was no significant difference in BMD between the groups. Conclusions The RP using a dual layer of membrane following tooth extraction results in more BV , VBH , and alveolar ridge width as compared to when a single layer of membrane is used.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/100133/1/clr2526.pd

HEALTH STATUS AND IMPRISONMENT PROFILE OF JAIL INMATES OF DISTRICT JAIL RAHIM YAR KHAN, PAKISTAN

Out of 850 total prisoners of district jail, Rahim Yar Khan, 100 were selected at random and examined for prevalence of HIV. Apart from HIV screening, data was collected about different diseases, narcotics use, occupations, reasons for imprisonment, ages and marital status of the prisoners through a questionnaire. None of these prisoners was suffering from HIV, the results regarding narcotics habits showed that 3% of the prisoners were used to bhang, 4% took heroin, 5% were using snuff, 34% cigarette smokers and 54% were not taking any narcotics. Nineteen percent of the prisoners suffered from various diseases like asthma, allergy, chest infection, hernia, heart problem, jaundice, lung infection, ulcer, weakness, typhoid and gastric problems whereas 81% were healthy

Risk factors associated with Helicobacter pylori infection treatment failure in a high prevalence area

Triple therapy is commonly used for the treatment of Helicobacter pylori infection. We determined risk factors associated with its failure in compliant Patients focusing on H. pylori density, virulence marker and 23S ribosomal RNA (rRNA) point mutations associated with clarithromycin resistance. H. pylori infection was diagnosed by (14)C urea breath test ((14)C UBT) and rapid urease test or histology. Triple therapy with esomeprazole 20 mg b.i.d., amoxicillin 1 g b.i.d. and clarithromycin 500 mg b.i.d. was prescribed for 10 days. 14C UBT was repeated 4 weeks after treatment. In total, 111 Patients [69 (62%) males] with a mean age of 46 +/- 16 years were enrolled. The mean age of treatment failure was 39 +/- 14 years compared to 48 +/- 16 years with eradication (P=0.002). Treatment failure was associated with younger mean age, point mutations in the 23S rRNA gene of H. pylori and vacA s1a and m1 when associated with cagA negativity

Incidence of Primary Brain Tumors: A Hospital Based Study of 200 Cases

Object:  The main objective of this study was to determine the incidence of primary brain tumors. It’s a hospital based study, which was conducted in the department of Neurosurgery Nishtar Hospital, Multan between 1996 and 1999. Patients of either sex were included in the study on the basis of history, clinical evaluation, laboratory and imaging investigations. The patients were admitted from outpatient department and by referrals from other medical units. After admission in the unit a uniform protocol of history taking, clinical and neurological examination, investigations and histopathological diagnosis was adopted for each patient. The information thus gathered was entered in a pro forma. The data analysed were age, sex, histological type, frequency and intracranial location of tumors. Results:  Among the 200 patients with primary brain tumors, there were 133 (66.5%) male and 67 (33.5%) female patients; the ratio being 1.98. The mean patient age was 33 years. The 31-40-year-old age bracket was found to be most highly represented, corresponding to 22.5% of total patients. In the younger age group, there were 34 (17%) male and 10 (5%) female patients, the ratio being 3.4 and the age mean of the patients was 7.6 years, with the range of 12 months to 15 years.  Conclusion:  The overall results conclude that primary brain tumors are more prevalent in males, with the age range of 31 and 50 years. Astrocytic tumors are the most frequent type of brain tumors with overall predilection for supratentorial compartment. Meningiomas and acoustic neuromas are rare in children

Low rate of recurrence of Helicobacter pylori infection in spite of high clarithromycin resistance in Pakistan

Background The aim was to investigate the reinfection rate of H. pylori during a follow-up period of 12 months in adults who had undergone eradication therapy. Methods One hundred-twenty patients; 116 with gastritis, 3 with duodenal ulcer and 1 gastric ulcer, were studied. Their mean age was 41 ± 13 years (range 18–77) and male: female ratio of 2:1. H. pylori were cultured and antibiotic sensitivity was determined by Epsilometer test (E-test) for clarithromycin (CLR) and amoxicillin (AMX). Primers of urease C gene of H. pylori and Sau-3 and Hha I restriction enzymes were used for polymerase chain reaction-restriction fragment length polymorphism analysis (PCR-RFLP). 14C urea breath test (14C-UBT) was performed 4 weeks after the eradication therapy. The successfully treated patients were observed for 12 months with 14C-UBT to assess H. pylori status. If 14C-UBT was negative, it was repeated after every 12 weeks. If 14C-UBT was positive, endoscopy was repeated with biopsies. Result The eradication therapy was successful in 102(85%) patients. Out of forty-seven H. pylori isolates cultured, clarithromycin sensitivity was present in 30(64%) and amoxicillin in 45(98%), respectively. Follow-up 14C-urea breath tests of all 102 patients who eradicated H. pylori remained negative up to 9 months. However, in 6 patients, the 14C-UBT confirmed recurrence at 12 months. The recurrence rate was 6%. Conclusion A low rate of recurrence of H. pylori infection was found in patients with dyspeptic symptoms. H. pylori isolates demonstrated a high invitro clarithromycin resistance

Multidimensional Inequality and Well-being in Pakistan: Evidence from Household Level Data

The present study investigated changes in multidimensional inequality in Pakistan. The study used Pakistan Social and Living Standard Measurement (PSLM) Survey datasets for three years 2001-02, 2007-08 and 2013-14. Three welfare distributions such as household per capita expenditures, access to education and health status are used in the study. The study employed Gini index, generalized entropy and stochastic dominance when inequality is measured for each dimension separately. The inequality is the highest in terms of education access. The stochastic dominance criteria demonstrate different orders for three attributes. The composite index is useful but social evolution function is not easy to construct as different formulations are considered. The pair wise technique has very useful policy implication when different attributes of welfare are distributed. The recommendations are made as specific regions or states should be focused where inequality is high. Moreover, efforts should also be made to narrow the skewed distribution of education

Spatial and Gender Based Comparison of Multidimensional Poverty: Household Level Analysis from Pakistan

The present study examines the multidimensional poverty in Pakistan by using three waves of (PSLM) survey data 2001-02, 2007-08 and 2013-14. Ten indicators such as enrolment, school attendance, immunization, prenatal care, electricity connection, gas, water, sanitation, crowding and assets are used for the measurement of multidimensional poverty. Alkire Foster and binary logistic techniques are employed for the measurement of multidimensional of poverty. Multidimensional poverty is measured at national and provincial, gender and regional level. The incidence of multidimensional poverty in Pakistan is high in rural areas as compared to the urban areas. Punjab province has the lowest while Balochistan province has the highest incidence of multidimensional poverty

Spatial and Gender Based Comparison of Multidimensional Poverty: Household Level Analysis from Pakistan

The present study examines the multidimensional poverty in Pakistan by using three waves of (PSLM) survey data 2001-02, 2007-08 and 2013-14. Ten indicators such as enrolment, school attendance, immunization, prenatal care, electricity connection, gas, water, sanitation, crowding and assets are used for the measurement of multidimensional poverty. Alkire Foster and binary logistic techniques are employed for the measurement of multidimensional of poverty. Multidimensional poverty is measured at national and provincial, gender and regional level. The incidence of multidimensional poverty in Pakistan is high in rural areas as compared to the urban areas. Punjab province has the lowest while Balochistan province has the highest incidence of multidimensional poverty

Pakistan Randomized and Observational Trial to Evaluate Coronavirus Treatment (PROTECT) of Hydroxychloroquine, Oseltamivir and Azithromycin to treat newly diagnosed patients with COVID-19 infection who have no comorbidities like diabetes mellitus: A structured summary of a study protocol for a randomized controlled trial

Objectives: To evaluate the effectiveness of Hydroxychloroquine Phosphate/Sulfate (200 mg orally 8 hourly thrice a day for 5 days), versus oseltamivir (75 mg orally twice a day for 5 days), and versus Azithromycin (500 mg orally daily on day 1, followed by 250 mg orally twice a day on days 2-5) alone and in combination (in all seven groups), in clearing the coronavirus (COVID-19) nucleic acid from throat and nasal swab and in bringing about clinical improvement on day 7 of follow-up (primary outcomes).University of Health Sciences (UHS) Lahore, Punjab, Pakista

Behavior of Sensitive Clay Subjected to Static and Cyclic Loading

Sensitive clay is the type of clay, which loses its shear strength when it is subjected to cyclic loading. High-rise buildings, towers, bridges etc., founded on sensitive clays and subjected to overturning moment are usually suffer from a steady reduction of the bearing capacity of their foundations and accordingly the safety factor. Cyclic loading of foundation on sensitive clay during the undrained period may lead to quick clay condition and catastrophic failure of the structure. In the literature, governing parameters are listed as: cyclic deviator stress, pore water pressure, axial strain, pre-consolidation pressure, confining stress, initial degree of saturation, water content, liquidity index and the number of cycles. The present study has introduced the governing parameters in two categories; namely physical and mechanical as a function of sensitivity number of the clay material. A well planned experimental investigation was conducted to examine the effect of these governing parameters during the undrained and the drained periods of sensitive clay subjected to static or cyclic loadings. The soil samples, known as “Champlain clay” were obtained from the city of Rigaud, Quebec (Canada). Consolidation tests, static and cyclic undrained and drained triaxial tests were performed on representative samples of this clay. Tests were conducted to identify the role of the key parameters governing this complex behavior during the drained and the undrained periods. The study examined individually the effect of cyclic loading, deviator stress, frequency, pre-consolidation pressure/OCR, and the confining pressure during the drained and undrained conditions. Absence or presence of the matric suction in fully saturated or partially saturated clay, effect of sensitivity number and liquidity index were also examined. Based on the results of the present experimental investigation, a hypothetical model was introduced to explain the process of shear strength reduction for the case of static and cyclic loading of sensitive clay subjected to cycling loading. The model was capable to define the term remolding agent or degree of remolding, the reduction in shear strength due to remolding. The increase in the water content is identified as the most critical or intrinsic shear strength for sensitive clay. The present study used the “Modified Cam Clay Model” to predict the factor of safety for a foundation on sensitive clay subjected to cyclic loading as function of the physical and mechanical parameters. A design procedure is developed to determine the safe zone for the undrained and drained responses, within which a combination of the cyclic deviator stress and the number of cycles for a given soil/loading/site conditions can achieve a quasi-elastic resilient state without reaching failure. The proposed design procedure is applicable to all regions around the world, where sensitive clays can be found. Furthermore, this procedure can be adopted to examine the conditions of existing foundations built on sensitive clay at any time during its lifespan