Background The COVID-19 outbreak which developed into a public health crisis has raised concerns regarding infection control among health care workers particularly dentists all over the world. The aim of this survey was to assess awareness, fear and compliance with practice modification according to CDC guidelines during COVID-19 pandemic among Pakistani dentists. Methods A cross-sectional study was conducted using an online survey questionnaire. The questionnaire was designed on Google Forms and was distributed among all seven regions of Pakistan through social media and WhatsApp after carrying out the reliability analysis. Statistical analysis was performed using SPSS 20.0. Question wise analysis using frequencies and percentages was done. Pearson correlation and Kruskal Wallis test was applied to check association of awareness level with qualification and workplace setting. Results A total of 313 dentists participated and submitted the form online from all regions of Pakistan. The response rate was quite satisfactory as Pakistan was under an official lockdown and most of the hospitals/clinics were either closed or operating with minimum staff. Most of the dentists were well aware of the CDC guidelines. However, 75% of the dentists were afraid of getting infected and 88% of them were anxious while providing treatment. Sixty-eight percent of them were avoiding aerosol generating procedures and only 28% were using rubber dam isolation. Regional analysis was also done and areas of poor compliance were identified. Only 38.5% dentists in Balochistan were using N95 masks and none of the dentists (0%) were using rubber dam isolation. A large number of dentists (80.9%) were afraid and wanted to close their dental practice in Khyber Pakhtunkhwa. Furthermore, a positive correlation was seen between the designation and awareness level (p = 0.01). Similarly, significant correlation (p = 0.03) was seen between qualification and workplace setting. Conclusion The results of the study can help devise strategies to ensure adherence with infection control guidelines in regions with poor compliance. Initiation of awareness programs to help overcome fear and train the faculty and staff in the targeted areas would greatly contribute towards reducing the spread of infection and thus lowering the healthcare burden in a third world country like Pakistan.
Purpose To establish a sustainable model for a “Surgical Shadowing Scheme” (SSS) and assess how this affects undergraduate attitudes to surgical careers. Patients and methods Surgeons at university teaching hospitals associated with UCL Medical School and UCL Partners, United Kingdom, were approached for their willingness to participate in the scheme. Medical students were then invited to apply for the scheme, where students were individually matched to operating theater sessions with surgeons in their specialty of choice. Feedback was subsequently obtained, evaluating experiences of the placement and the effect this had on future career aspirations. Results After running for four consecutive years, approximately 220 students have participated in the scheme across a range of surgical units and specialties. A total of 91.5% of the students were pre-clinical (years 1–3), whilst the remainder were clinical (years 4–6). Fifty-four percent were female and 46% male. Eighty-three percent of the students did not have any previous experience of the specialty that they shadowed, and 67% agreed that participating in the scheme had either “increased” or “strongly increased” their desire to pursue a surgical career. Ninety-four percent said they would “recommend” or “strongly recommend” the SSS to a peer. Over a third of students reported scrubbing-up during their placements and 35% of these directly assisted the lead surgeon. Traditionally male-dominated surgical sub-specialties recruited a high proportion of female students. Conclusion This is the first published example of an established “Surgical Shadowing Scheme” for medical undergraduates. Our SSS has been highly valued by students and indicates that even a single high-quality surgical exposure is sufficient to increase the desire of undergraduates to pursue a surgical career. We hope that this SSS will act as a blueprint for other centers to develop their own shadowing schemes, in turn helping to ensure that surgery continues to inspire and attract the very best candidates for the future.
The traditionally use of indigenous medicinal plants in the treatment of burn, dermatrophytes and human infectious diseases and also still essential part of primary public health care. Antimicrobial activities of nine medicinal plants were determined in vitro through agar well diffusion method against pathogenic microorganism species of gastrointestinal tract. Medicinal plants extract of Cocculus pendulus, Malva neglecta, Rhazya stricta, Jaubertia aucheri, Corchorus depressus, Salvia bucharica, Microcephala lamellate, Berberis baluchistanica and Artemisa absinthium were found sensitive to Clostridium spp. The extracts of Malva neglecta, Jaubertia aucheri, Salvia bucharica and Berberis baluchistanica were observed sensitive to E. coli. Similarly the extracts of Malva neglecta, Jaubertia aucheri, Rhazya stricta, Corchorus depressus, and Artemisa absinthium were found sensitive to Salmonella spp. The extracts of Cocculus pendulus, Malva neglecta, Jaubertia aucheri, Corchorus depressus, Salvia bucharica, Microcephala lamellate, Berberis baluchistanica and Artemisa absinthium were sensitive to Shigella spp. The extracts of Cocculus pendulus, Jaubertia aucheri and Berberis baluchistanica were found sensitive to Klebsiella spp. The extracts of Cocculus pendulus, Rhazya stricta, Corchorus depressus, Microcephala lamellate and Artemisa absinthium were revealed resistance to E. coli. The extracts of Cocculus pendulus, Salvia bucharica, Microcephala lamellate and Berberis baluchistanica were revealed resistance to Salmonella spp. The extract of Rhazya stricta was revealed resistance to Shigella spp. The extracts of Malva neglecta, Rhazya stricta, Corchorus depressus, Salvia bucharica, Microcephala lamellate and Artemisa absinthium were revealed to resistance to Klebsiella spp. The extract of Jaubertia aucheri was highly sensitivity against E. coli, Salmonella spp, Shigella spp, Clostridium spp and Klebsiella spp.
OBJECTIVE:The outcome of endodontic treatment is largely dependent on the selection of right armamentarium. The objective of this study was to determine the trends in contemporary endodontic practice of dental practitioners performing root canal treatment in Pakistan using a questionnaire based survey. METHODOLOGY: This was a cross sectional study. To meet the objective of this study 518 questionnaires were distributed among the dental practitioners performing root canal treatment and associated with the academic dental institutions of Pakistan. Incompletely filled questionnaires and practitioners not willing to participate were excluded from the study. The questionnaire comprised of 22 questions addressing various aspects of endodontic treatment and the responses to these questions were analyzed using SPSS 22 to calculate frequencies and percentages. RESULTS: A total of 409 completed questionnaires were returned bringing the response rate to about 79%. Most of the respondents performed more than 10 root canal treatment procedures in a month (51.8%) comprising of a combination of anterior and posterior teeth including retreatment cases (40.1%). The diagnosis of endodontic cases was primarily established by history and radiographs alone (39.1%). Only 19.3% of the respondents reported the use of dental loupes for magnification. The use of preoperative angled radiographs for endodontic procedures was reported by 51.3% of the respondents while only 36.7% made use of film holding devices. About 46.9% reported only occasional use of rubber dam. Most preferred obturation technique and type of endodontic sealer was identified as cold lateral compaction (53.1%) and Calcium hydroxide (32.5%) respectively. While 68.5% respondents preferred multiple appointments with Calcium hydroxide as the most commonly used intracanal medicament (57.2%). The use of anesthesia was restricted to access preparation (36.9%) while 44.5% relied on a combination of antibiotics and NSAIDs for interappointment pain management. Radiographs (39.9%) were the most preferred means for working length determination. Sodium Hypochlorite (39.1%) was the most preferred irrigant with 63.6% making occasional use of EDTA. Activation of irrigants (58.4%) was not routinely employed and use of NiTi (54.5%) rotary instruments was reported to be occasional. CONCLUSION: This study observed deficiencies among dental practitioners in Pakistan providing endodontic treatment which should be addressed to improve the quality of endodontic care.
Aim: The aim of this study was to compare the efficacy of 980 nm diode laser and QMix 2in1 solution (DENTSPLY Tulsa Dental Specialties) alone and in combination, for smear layer removal from the root canals. Background: Smear layer is an amorphous layer formed on root canal walls following instrumentation. This layer should be removed as it can harbor bacteria and bacterial products and prevents the penetration of intracanal medicaments into the dentinal tubules. Irrigation agitation techniques have been proposed recently to remove smear layer from root canals more efficiently. The diode laser has the potential for irrigant activation and studies are needed to establish their efficacy for smear layer removal especially from apical thirds of canals. Methods: Forty extracted single-rooted permanent human teeth were used. Root canals were prepared to full working length using manual K-files (MANI) till 40K. Prepared teeth were divided into four groups (n=10): Group 1, no irrigation; Group 2, QMix 2in1 solution; Group 3, diode laser; Group 4, QMix 2in1 in combination with a diode laser. The roots were split longitudinally and prepared for scanning electron microscopic (SEM) investigation. The split roots were examined for remaining smear layer at the coronal, middle, and apical portion of each canal under a scanning electron microscope (JSM5910, JEOL, Japan) at 1000x magnification. Results: Smear layer removal was scored according to Guttman rating system for remaining smear layer scores (Gutmann et al.). Diode laser in combination with QMix solution had the least smear layer scores. Conclusions: Diode laser irradiation in combination with QMix 2in1 solution effectively removes smear layer from apical thirds of root canals.
Dental radiography is an essential diagnostic tool in endodontics and one of the indispensable indicators of success. However, the potentially harmful effects of radiation cannot be overlooked. The aim of this survey was to assess knowledge, attitude and practice of radiation hazards and exposure protection techniques of dentists in Pakistan. A cross-sectional study was conducted using an online survey questionnaire. The questionnaire was distributed among all regions of Pakistan through social media and WhatsApp after carrying out the reliability analysis. Statistical analysis was performed using SPSS 20.0. Question wise analysis using frequencies and percentages was done. Association between the level of awareness with qualification and workplace setting was carried out using chi-square test and logistic regression analysis. The minimum required sample size calculated for this study was 335. A total of 341 dentists [performing endodontic treatment] participated and submitted the form from all regions of Pakistan. 65% of the dentists were aware with the ALARA principle. 40% were aware with the ICRP and NCRP guidelines. Only 27% were using lead apron and 71.8% had never used thyroid collar on the patient. Furthermore, a positive correlation was seen between the designation and awareness level and practice [p=0.01]. Similarly, a significant correlation p=0.01 was seen between awareness level/practice and workplace setting. The results of the present study can help design continual education programs at regular intervals at institutional and national level for strict observance of radiation protection guidelines with more emphasis on general practitioners and government hospitals.
Aim Coronavirus disease 2019 (COVID-19) presents a variety of unforeseen challenges to medical students and surgical trainees. Adaptations to the content and delivery of medical education are inevitable as institutions respond to the virus. Departments face significant restructuring, with important implications for training. Our aim was to assess the global impact of the first wave of COVID-19 on medical and surgical education. Method Between 12 May and 26 May 2020, an online survey was conducted and circulated to contacts of the International Association of Student Surgical Societies, including medical students and healthcare practitioners. All data were anonymous; no personal identifiable information was collected. Consent was implied by participation in the survey, which was on a voluntary basis. Results We collated 527 responses from 111 institutions across 26 countries. Globally, 93.5% of medical student placements were affected by the first wave of COVID-19, with examination restructuring and alternative teaching methods employed by 87.8% of medical schools. Trainee redeployment was common in both surgical (61.5%) and non-surgical (77.1%) disciplines. Surgical services were significantly affected, with reduced elective procedures in 93% of institutions. On an individual level, COVID-19 resulted in prolonged absence from clinical duties and mental health concerns at all levels of training. Conclusions Our data highlight drastic changes in medical and surgical education and practice as a result of the first wave of COVID-19. These changes are significant at all levels of training, both institutionally and individually. The pandemic is likely to have persistent consequences for future trainees in terms of education and career progression.
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