University Dental College Research Articles

Faculty development: Need assessment survey in a newly established Medical College of Lahore.

Objective: To assess the needs of faculty regarding teaching, assessment and research methods so as to develop a program in a newly established medical college of Lahore. Study Design: Descriptive Cross-sectional study. Setting: Rashid Latif Khan University (RLKU) Medical and Dental College, Lahore. Period: July–December 2023. Methods: Descriptive study was conducted in RLKU Medical College within six months. Structured self- administered questionnaires were used for data collection via Google forms. A total of 50 faculty members gave data after verbal consent. IRB approvals were taken. Data was analysed using Excel. Frequencies and percentages were calculated. Results: Majority faculty members (88%) preferred student cantered teaching approach with the usage (94%) of different methodologies in small group teaching. Feedback was being taken regarding teaching and assessment by majority (90%). Workshops on teaching methodologies was the area of interest especially small group teaching (62%), peer assisted learning (54%), problem based learning (54%) and large group teaching (52%). Most of them expressed need of workshops on assessment especially assessment types (60%), MCQ (56%), OSPE/OSCE (54%) construction. Faculty was of the opinion that workshops on mentoring (72%), reflection (56%), portfolio development (64%), research methodology (76%), computer skills (70%), ethics (60%) and soft skills (82%) need to be conducted. Conclusion: Workshops on teaching methodologies and assessments are essential our study concludes that although most of the faculty is trained but they still feel the need for workshops to keep them updated and trained in major aspects of curriculum delivery as well as research, mentoring, computer and soft skills highlighting the need of a robust faculty development program.

CBCT based investigation of frequency of Middle Mesial Canal in Mandibular First Molars of Saudi Sub-population.

One key factor in determining endodontic treatment outcome is the clinicians' comprehension of tooth anatomy, as missed canals may harbor bacteria ultimately leading to apical periodontitis. The study aimed to investigate the prevalence of middle mesial canal (MMC) in Mandibular first molars (MFMs) of Saudi subpopulation. The cross-sectional retrospective study was conducted at Qassim University Dental College from June to August 2023. Overall, 302 CBCT images with 604 bilateral lower first molars were examined by two calibrated assessors. The existence of MMC was noted. The data were coded, and analysis was done in SPPS-24. The reliability of inter-evaluator and intra-evaluator agreement for detecting MMC were estimated using Cohen's kappa. The patients' average age was 30.95±11.61years. The sample's female to male ratio was 1:1.75. The overall frequency of MMC was 14.2%. The differences in the frequency of MMC on the basis of gender, quadrants and age groups were found to be insignificant. Inter-evaluator and intra-evaluator reliability was noted to be 0.78 and 0.74, depicting acceptable reliability. The MMC is an uncommon occurrence with rare bilateral presentation in MFMs of Saudi population. Endodontists performing endodontic treatment in such subjects should mindfully investigate inter mesiobuccal- mesiolingual canals area for locating, negotiating, and managing any present MMC's.

Effectiveness of spaced repetition for clinical problem solving amongst undergraduate medical students studying paediatrics in Pakistan

BackgroundStudies using spaced repetition for teaching and learning in undergraduate clinical rotations such as paediatrics are limited, even more so in the South Asian region. Therefore, this study aimed to identify the effectiveness of utilizing spaced repetition compared to traditional learning methods among undergraduate medical students during their paediatric rotation at a medical university in Pakistan.MethodsBahria University Medical and Dental College (BUMDC) conducted quasii-experimental research in Karachi. Four topics were identified from the Year 5 Pediatrics curriculum to be used in the study, using which the study content was developed along with 50 multiple choice questions (MCQs) for assessment. All BUMDC Year 5 medical students rotating in Pediatrics were included and randomly allocated to the control or intervention group. In the control group, they provided the students with traditional study methods consisting of books and lectures to learn topics. In the intervention group, we created an Anki flashcard deck of the same topics to enable learning via spaced repetition. The researchers conducted a pretest and post test assessment of the 50 MCQs in both groups at the beginning and after the four-week study interval. The data were analysed using SPSS 19.ResultsA total of 115 BUMDC medical students agreed to participate in the study; 70 (59.1%) were in the intervention group, and 45 (41.7%) were in the control group. The pretest mean score of the control group was 27.96 ± 3.70, and the posttest mean score was 27.22 ± 5.02, with no statistically significant difference at the 95% confidence level. The mean score of the pretest for the intervention group was 27.93 ± 4.53, and that of the posttest was 30.8 ± 4.56, with a statistically significant difference at the 95% confidence level. The intervention showed a significant effect size of 0.8.ConclusionThe use of spaced repetitions resulted in significantly greater scores for medical students studying paediatrics than for those using more traditional methods of learning, compromising medical books and lectures. Considering that medical students need to retain a vast amount of information, using spaced repetition through flashcards can be a more effective learning tool that is more cost-efficient and time-efficient than traditional learning methods.

Radiological safety perspectives among undergraduate dental students, interns, and dental assistant certificate students at Taibah University Dental College and Hospital, Saudi Arabia

ABSTRACT Background: Dental imaging accounts for <1% of human exposure to ionizing radiation from of all types of medical imaging. Radiation-induced damage to cells has deterministic and stochastic consequences. The international commision for radiological protection recommends that any radiographic examination must be justified. However, studies measuring dental assistant (DA) knowledge and attitude towards radiation protection measures are lacking. Aim: Our study aimed to evaluate the knowledge and attitudes toward radiation protection measures among clinical dental students, interns, and DA certificate students. Settings and Design: The study was a cross-sectional observational analytical online questionnaire-based study. Materials and Methods: The questionnaire distributed over undergraduate students, DA certificate students, and dental interns. Statistical Analysis: Stata/BE 18.0 for Mac was used, Chi-square tests with a P < 0.05 indicating a significant difference in knowledge between groups. Results: A questionnaire was distributed to 203 of the participants. The average overall correct responses 46.14%. However, the DA student average correct answers were 38.71%. Conclusion: Students must improve their knowledge about radiation protective measures through educational sessions or pamphlets, particularly the DA. Radiology lectures should cover new safety precautions such as as low as diagnostically acceptable, shielding, and radiation to pregnant mothers, while incorporating national guidelines and recommendations.

Assessing the Professionalism Levels of Undergraduate Medical Students at a Medical College.

Objectives: To evaluate the professionalism of medical students at Bahria University Medical and Dental College (BUMDC), at the same it will let us know the range of differences among students in different classes (1-5 years). Methodology: It was a cross-sectional study conducted on 583 students of BUMDC, ranging from 1st year to 5th year (academic session 2021-2022). A validated tool was utilized to collect data. The tool assessed 6 aspects of professionalism: excellence, respect for others, altruism, duty, accountability, honor, and integrity, using a 5-point Likert scale. Results: The results indicated a notable variance in the overall professionalism score (p=0.000), altruism (p=0.000), duty (p=0.000), accountability (p=0.000), excellence (p=0.000), honor and integrity (p=0.000), and respect for others (0.001) based on the clinical status of students. Conclusion: It is evident from the study that the level of professionalism among the graduating 5th year class is significantly below the ideal standard. Additionally, it is concerning to observe a notable decline in professionalism from 1st year to 5th year medical students. It is crucial to educate medical students on all essential skills required to deliver top-notch healthcare services efficiently during their practice. Key Words: Professionalism, medical students, undergraduate, attitude, behavior.

Prevalence and Variation of Medical Comorbidities in Oral Surgery Patients: A Retrospective Study at Jazan University.

BACKGROUND An aged population is susceptible to chronic diseases, which impacts oral surgery treatment procedures. This retrospective study aimed to evaluate the incidence of medical comorbidities in 640 oral surgery patients treated at the College of Dentistry, Jazan University. MATERIAL AND METHODS This single-center observational study investigated medical records of outpatients who visited Jazan University Dental College Hospital in a 1-year period (2018-2019). Patients’ clinical and radiographic archives were screened to obtain relevant data. Categorical and continuous variables were expressed in terms of frequency and mean values, respectively. Differences in variables were statistically analyzed using the chi-square goodness of fit and proportional test, with a probability value P≤0.05 considered significant. RESULTS Analysis of 640 patient records included records of 300 men and 340 women who underwent oral surgery, of whom 176 patients (27.5%), including 97 men and 79 women, had medical comorbidities. The most common comorbidities were endocrine disease (7.03%), cardiovascular disease (6.71%), respiratory disease (4.53%), and hematological disorders (3.43%). Individual diseases that showed higher prevalence were diabetes mellitus (4.68%), hypertension (3.43%), bronchial asthma (2.65%), and anemia (1.4%). Differences by sex were observed in many individual disorders. CONCLUSIONS Outpatients in oral surgery clinics presented a significant variance in the incidence of medical comorbidities, among which diabetes and hypertension were most common. A proper case history is the best preventive measure that helps a surgeon avert medical emergencies and post-surgical complications.

Assessing the Impact of Self-Medication with Antibiotics Among Medical Students

Self-medication is different from self-care in that it uses drugs, which might be helpful or detrimental. According to a number of studies, improper self-medication carries significant health concerns like unpleasant side effects, prolonged pain, and drug dependence. Objective: To explore the adverse effects of self-medication with antibiotics among medical students. Methods: Over the course of seven months, from November 2022 to May 2023, a multi-institutional cross-sectional study was conducted at the University Medical and Dental College of the University of Faisalabad and Bahria University Health Sciences, Karachi (BUHS). The ethical approval was obtained from the Ethical Review Committee of BUHS (Ref: ERC/05/2023) and Institutional Review Board of The University of Faisalabad (Ref: TUF/IRB/153/2022). A sample size was calculated by OpenEpi website calculator. Microsoft excel was used to store the data and IBM SPSS version 23.0 was used for data analysis. A self-designed performa was used to collect data. Results: There was a total of 1340 students in our survey, and an equal number of students 670 (50%) were recruited from each institute. 414 (61.8%) students from BUHS and 494 (73.7%) from UMDC were found to have self-medication practices. 39.9% and 38.2% of the students from 1st year and 2nd year of medical education were found to self-medicate. 69.5% of the hostelite students were found to self-medicate antibiotics. Conclusions: Our research can be concluded as self-medication of antibiotics is a common practice among future health care professionals, with the highest incidence seen in the 1st and 2nd year of medical education. Several adverse symptoms arising due to this practice were seen with the highest being tiredness and dizziness.

Illicium verum anticancer activity against MDA-MB-231 cell line.

To evaluate the anticancer activity of methanolic extract of Illicium verum against triple-negative breast cancer MDA-MB-231 cell line. A cell culture experimental study was carried out at Pharmacology department of Bahria University Medical and Dental College (January to June 2021) in collaboration with Aga Khan University, Karachi, Pakistan. Cell viability and proliferation assays were used to quantify dead and alive cells by utilizing a tetrazolium assay and an enzyme immunosorbent plate reader was used to calculate their absorbance. For the apoptosis initiation assay, these cells were dyed with a fluorescent stain and observed for fluorescence and apoptosis. During cell viability testing, various I. verum methanolic extract doses (0.125, 0.25, 0.5, 1, 3, 6, 12, and 25µg/ml) were employed to treat MDA-MB-231 cells, while the IC50 dose of 2.8µg/ml was used for both the cell proliferation and apoptosis initiation assays. In the cell viability assay, all I. verum methanolic extract doses exhibited a substantial decrease in the viability of MDA-MB-231 cells (less than 0.01 p-value). In cell proliferation assay and apoptosis initiation, the IC50 dose of 2.8µg/ml of I. verum methanolic extract also exhibited a substantial decrease in cell division (less than 0.01 p-value) and the initiation of apoptosis in MDA-MB-231 cells. Illicium verum methanolic extract have strong anticancer activity against triple-negative breast cancer MDA-MB-231 cell line through cytotoxicity, proliferation reduction, and apoptosis initiation mechanisms.

Gamifying Assessments in Medical Education: A Novel Approach to Tackling Test Anxiety in Medical Students

Introduction: Test anxiety is a specific type of anxiety that typically occurs during assessments and may compromise students’ academic performance. The use of gamification in assessment has the potential to reduce test anxiety. Aims &Objectives: This study aims to provide an understanding of the potential benefits of gamification as an intervention in formative assessments to reduce test anxiety in medical students. The objective of this study was to investigate the effect of gamification on the academic performance and test anxiety scores of medical students during formative assessments. Place and Duration of Study:The study was conducted at Shifa Tameer-e-Millat University and Bahria University Medical and Dental College from July to December 2022 Material &Methods: The present mixed-method study used Nist& Diehl Patrick-Henry-Community-College (PHCC) questionnaire to measure test anxiety in 251 medical students of Year 1&2 MBBS after formative MCQ assessments based on the Biochemistry course related to the structure and Metabolism of carbohydrates delivered during their respective modules using gamified and non-gamified online applications in the quantitative phase. Qualitative data was collected through interviews with students based on their test anxiety scores. Sciences (SPSS) version 26.0 was used to analyze the quantitative data, a p-value of ?0.05 was considered significant. Results: Mean anxiety scores of male students in all groups were significantly lower than female students. There was no significant difference in the test anxiety score of students taking assessments through gamified and non-gamified assessment tools. Conclusion: Female students reported significantly higher anxiety scores both in gamified and non-gamified formative assessments. There was no significant difference in the test anxiety scores of students taking assessments through gamified and non-gamified assessment tools. Qualitative analysis revealed a positive effect on the motivation of the learners using gamified assessment tools.

Illicium verum anticancer activity against MDA-MB-231 cell line

Objective: To evaluate the anticancer activity of methanolic extract of Illicium verum against triple-negative breast cancer MDA-MB-231 cell line.
 Methods: A cell culture experimental study was carried out at Pharmacology department of Bahria University Medical and Dental College (January to June 2021) in collaboration with Aga Khan University, Karachi, Pakistan. Cell viability and proliferation assays were used to quantify dead and alive cells by utilizing a tetrazolium assay and an enzyme immunosorbent plate reader was used to calculate their absorbance. For the apoptosis initiation assay, these cells were dyed with a fluorescent stain and observed for fluorescence and apoptosis. During cell viability testing, various I. verum methanolic extract doses (0.125, 0.25, 0.5, 1, 3, 6, 12, and 25µg/ml) were employed to treat MDA-MB-231 cells, while the IC50 dose of 2.8µg/ml was used for both the cell proliferation and apoptosis initiation assays.
 Results: In the cell viability assay, all I. verum methanolic extract doses exhibited a substantial decrease in the viability of MDA-MB-231 cells (less than 0.01 p-value). In cell proliferation assay and apoptosis initiation, the IC50 dose of 2.8µg/ml of I. verum methanolic extract also exhibited a substantial decrease in cell division (less than 0.01 p-value) and the initiation of apoptosis in MDA-MB-231 cells.
 Conclusion: Illicium verum methanolic extract have strong anticancer activity against triple-negative breast cancer MDA-MB-231 cell line through cytotoxicity, proliferation reduction, and apoptosis initiation mechanisms.
 doi: https://doi.org/10.12669/pjms.40.1.7860
 How to cite this: Pahore AK, Khan S, Karim N. Illicium verum anticancer activity against MDA-MB-231 cell line. Pak J Med Sci. 2024;40(1):---------. doi: https://doi.org/10.12669/pjms.40.1.7860
 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The Effect of WhatsApp Messaging on Learning Paediatrics During Clinical Rotation of Final Year MBBS Medical Undergraduates

Objective: To determine the impact of WhatsApp Messaging on learning paediatrics during clinical rotation of final year MBBS medical undergraduates. Study Design: Quasi-Experimental study Place and Duration of Study: Bahria University Medical and Dental College, Karachi Pakistan, from Apr to Oct 2018. Methodology: Final year MBBS students attending the Department of Paediatrics for three months of clinical rotation were randomly allocated to two Groups. Group-A was the control Group without WhatsApp, and Group-B was the intervention Group with WhatsApp messaging. Both Groups had a pre-test and post-test before and after their clinical rotation. The evaluation was performed before and after clinical rotation using Multiple choice questions (MCQs) for the final evaluation. Results: Of a total of 80 students, 19(23.8%) were males, and 61(76.3%) were females, with a median age of 23(22-23) years. Of 40 students in the WhatsApp Group, active participation was observed in 37(92.5%) students, whereas the quality of the shared content by students was found to be adequate/relevant in 35(87.5%) cases. The median score was significantly higher in both Groups' clinical rotation test than in the pre-clinical rotation assessment (p-value <0.001). However, the median score of the post-clinical rotation test was significantly higher in the WhatsApp Group than in the non-WhatsApp Group (p-value <0.001). Conclusion: WhatsApp was found to be a highly effective tool for learning paediatrics among medical students during their clinical attachment.

Consequences of Thumb Sucking Habit among School Going Children: A Cross Sectional Study

Background: Thumb-sucking, a non-nutritive sucking behavior, is a natural reflex seen in infants but can persist into childhood if not addressed leading to various dental and orofacial issues, including malocclusion, dental arch deformities, speech difficulties, and facial asymmetry. The aim of the study was to explore the consequences of thumb-sucking habits among the school going children. Methods: This cross-sectional study involved among purposively selected 124 school going children, aged between 5-8 years with their parents attended in the outpatient department of University Dental College at Moghbazar, Dhaka, Bangladesh. The data were obtained through a pretested structured questionnaire and checklist through face-to-face interview from parents regarding background characteristics, consequences of thumbs sucking and oral examination of children respectively. Then, data were analyzed using statistical package for social sciences (SPSS) software version 27 for descriptive analysis (frequency, percentage) and inferential statistics (chi-square test or fisher’s exact test) at 5% level of significance (P<0.05). Results: The study revealed that 77.4% of children aged 5-6 years and about 41.9% of parents reported that their child had thumb sucking habit. The thumb sucking habit was found to be statistically significant with start of age thumb sucking( p= <0.001), duration of thumb sucking ( p= <0.001), pronunciation of word clearly( p= <0.001), proclination of maxillary anterior teeth (P=0.002), asymmetry of face (P=0.002) and seek for dental advice or treatment(p=0.002). Majority of children (21.8%) start thumb sucking at the age 6-7 years. Only 8.1% of the children didn’t pronounce words clearly whereas only 5.6% had proclined maxillary anterior teeth, facial asymmetry and sought dental advice or treatment. Conclusion: This study found a significant association of thumb-sucking habit among children with notable consequences. It highlights the importance of early intervention and parental education and awareness regarding this habit's potential consequences on children's oral health and overall development. Update Dent. Coll. j: 2023; 13(2): 19-22

Mandibular Asymmetry in Orthodontic Patients with Different Malocclusion Patterns an Orthopantomographic Evaluation

Objectives: To investigate the variation in mandibular asymmetry on right and left sides for different malocclusions. Study design and setting: It was a cross sectional study carried out in Orthodontic Department at Bahria University Dental College. OPG’s of 171 orthodontic patients were collected. The sample was divided into class I, II and III malocclusions. Methodology: The OPG was traced for condylar and ramal heights for both right and left sides. From these readings, the asymmetry index (AI) was calculated for each side. The significance of height variations between the right and left sides, for each malocclusion was calculated using independent sample t-test. Pearson correlation was used to find the association of asymmetry between the two sides when comparing each malocclusion with the other. One-way ANOVA was used to find the significance of differences in asymmetry index of both sides between different malocclusions. Results: The ramal heights were significantly different for each malocclusion with p values of 0.00 and 0.02 for right and left side, the p value of the variations in condylar heights was however 0.66 and 0.12 for the two sides. There was a strong positive correlation of the condylar and ramal height on both sides between all three malocclusions. The p value for condylar AI was 0.97 and 0.15 for ramal AI. Conclusion: The ramus height showed a significant variation in asymmetry while the asymmetry index variations were insignificant between different malocclusion groups.

Programmatic Assessment Prototype Design Using Integrated System Thinking And Design Thinking Framework.

To design a prototype programmatic assessment model using integration of system thinking and design thinking frameworks, and to explore barriers in the way of its implementation in medical education. The qualitative case-study was conducted at Bahria University Medical and Dental College, Karachi from September to December 2022. Methodological approaches used were systems thinking and design thinking. Philosophical paradigm used was critical realism. Maximum variation purposive sampling technique was used for selecting faculty members and medical students. Data was collected in two sets of semi-structured interviews. The initial interviews were at the levels of empathise, define and ideate. After that low-fidelity prototype programmatic assessment design was created and presented to the participants. The second set of interviews were focussed on feedback on prototype of programmatic assessment design. Pattern matching method was used for data analysis. Of the 65 subjects, 20(30.7%) were faculty members; 5(25%) lecturers and 5(25%) professors each from basic and clinical sciences. The remaining 45(69.2%) were students; 5(11.1%)from each year of medical and dental streams. Initial interviews revealed that after failure, students struggle to understand the cause of failure as assessment system lacked narrative feedback mechanism and numbers or pass/fail decisions were not self-explanatory. Students lacked attitude towards continued improvement, formative assessment were not taken seriously as they carried only 10% weightage. After the programmatic assessment design was presented to the participants, faculty members voiced concerns regarding faculty training, shortage of resources and legal issues related to its implementation. Students supported the design, especially continued narrative feedback for their academic improvement. Portfolio development was considered a time-consuming task and they had reservations regarding their ability to make quality assessment portfolio. Implementation of programmatic assessment required faculty development and was resource-intensive, but stakeholders, especially students, were found interested in its implementation in medical education.

Flipped Classroom Learning among Medical and Dental Faculty of Bahria University Medical and Dental College

Background: Flipped classroom technique (FCR) is a pedagogical approach where students watch pre-recorded video lectures or read educational materials before coming to class. During class, students engage in activities, discussions, and problem-solving exercises related to the pre-recorded content, with the teacher acting as a facilitator and guide. The key to the effective utilization of this instructional method is that both the teachers and the students understand its educational philosophy and technique. This study aims at exploring the faculty’s understanding and perceptions regarding flipping the classroom. Method: A Cross-sectional Descriptive study was carried out at Bahria university medical and dental college (BUMDC), Karachi, Pakistan from January to June 2020, after approval from the institutional ethical review committee. Data was collected through a self-designed questionnaire after obtaining verbal consent from 197 faculty members through non-probability purposive sampling. Data were analyzed by version 23.0 of Statistical Package for Social Sciences (SPSS). The mean scores of these identified factors were compared between genders, departments, designations, and teaching experience using an independent sample t-test and one-way ANOVA. P-values less than 0.05 were considered statistically significant. Results: The results revealed that more than half of the studied participants had a moderate perception regarding Flipped Classroom and more than one-third of those who were female (67.5%), had a highly positive perception (<0.01). According to designation and teaching experience, mean scores were higher for senior faculty as compared to junior faculty (p=0.02). Conclusions: Contrary to popular belief, senior faculty also perceives this new technique as being beneficial for their teaching. This opportunity should be utilized to train the faculty in conducting flipped classrooms in order to optimize its benefits.

Evaluation of the Impact of Audio-Visual Aids in Reducing Dental Patients' Fear in Pakistan

Objective: To assess the use of employing visual information to alleviate dental anxiety in individuals undergoing tooth extraction under local Anesthesia.Methodology: An experimental study was done in three dental institutes of Lahore, University Dental Hospital, Sharif Medical and Dental College and Azra Naheed Dental College. This included a sample size of 80 patients who were divided into two groups of 40 each. The first group was the control group which received verbal information before the extraction of teeth under local anesthesia. The second group was the study group and was shown a video clip containing information about the procedure and non-probability consecutive sampling was carried out. Statistical analyses were performed by using SPSS version 25.Results: Pre-operative anxiety scores in both the groups undergoing extractions revealed the patients were relatively anxious before undergoing dental extraction. A pre-operative comparison drawn between the groups showed the data to be statistically insignificant (p-value=0.222). Verbal communication and the use of audio-visual aid for Group 2 resulted in a decrease in anxiety scores. Group 1 showed a mean anxiety score of 5.4 whereas Group 2 showed 28% reduction in anxiety with a mean of 4.6. The data was found to be statistically significant (p-value<0.001). Similarly a postoperative comparison between the two groups revealed drastic decrease in dental distress and anxiety score for the patients in Group 2 with p<0.001 with the results being statistically significant. Pre-operative and post-operative paired sample statistics of these groups showed 55% reduction postoperatively in Group 2 as compared to Group 1 which showed only 27% reduction in anxiety levels.Conclusion: By showing a tooth extraction video to patients before surgery, dentists can reduce the dental anxiety and panic associated with local anesthetic dental extractions.

Management of Oral Surgery in Patients by Anticoagulant Therapy

Background: Oral surgery is a common procedure performed on patients for various reasons such as implant placement, tooth extraction, and other surgical interventions. Anticoagulant therapy is prescribed to patients to prevent blood clot formation, which can lead to serious conditions. Post-operative management of patients on anticoagulant therapy is also critical to minimize bleeding complications. Study design: It is a systematic and controlled based study conducted at Azra Naheed Dental College/ Superior University, Lahore and DOW International Dental College, Karachi for the duration of six months from July 2022 to December 2022. Material and Methods: The participants were divided into two groups. Group A (n=35) included patients treated with direct oral anticoagulants (DOACs) after oral surgery and group B (n=20) had patients treated with vitamin K antagonists. The average age of patients in DOACs and VKA group was 71.3±2.33 and 72.1±1.6 years respectively. Results: Stroke, atrial fibrillation venous thromboembolism and acute coronary syndrome was found in 4,5,24 and 2 patients respectively. In case of VKA group there were 2,3,14 and 1 patient hat suffered from stroke, atrial fibrillation venous thromboembolism, and acute coronary syndrome in the VKA group. The duration of surgery in DOACs and VKA group was 34.5±2.33 and 31.8±3.2 respectively. Conclusion: This study concludes that bleeding risk in patients having some dental surgeries can effectively be controlled by interrupting the DOACs therapy and then restarting it after surgery along with some local hemostatic agents. However, the efficiency of VKAs and DOACs will be the same when DOAC therapy will not be interrupted right before an invasive surgical procedure in case of patients having higher bleeding risk treatment. Keywords: Oral surgery, anticoagulant therapy and thromboembolic events.

Platelet Rich Plasma PRP in Dental and Oral Surgery: Wound Healing to Bone Regeneration

Background: The aim of this study to evaluate the outcome of the efficacy of the PRP use to promote wound healing and bone regeneration. Study design: The study was cross sectional being conducted in the department of Dentistry, Bahria University Dental College, Karachi six months from June 2022 to November 2022. Methods: A total number of the participants were 150. The male and female genders were both included who suffered dental surgery. The sample of blood was taken around 55cc by a trained medical expert. After that, blood will be centrifuged to separate the platelet-rich plasma from the remaining components of your blood. For the greatest results, your blood will often be spun two to three times. Results: The age range was 20-60 years and > 61 years old, with an average of 51.1±12.5 years, which indicate highly significant tooth loss at above 61 years old age p<0.005**. The PRP treatment was showing significant improvement in the dental and oral postoperative treatment p<0.005. After postoperative analysis of the participants by the treatment of PRP, which show significant improvement CAL, gingival recession, repair bone defect, stop tooth extraction and root coverage show significant result <0.005** as compared to control group. Conclusions: Following tooth extraction, the application of PRP in the alveolar socket can improve soft tissue healing and favorably affect bone regeneration. Root lengthening, apex closure, and dentin wall thickening were all higher, and they all encourage the rejuvenation of the pulp tissue and further root development. Keywords: Platelet rich plasma, cytokine, growth factor and blood.

Outcomes of Pioglitazone and Metformin on Anthropometric, Metabolic and Endocrine variables in POS

Aim: To evaluate the outcomes of Pioglita zone and Metformin on anthropometric, metabolic and endocrine variables in PCOS. Methods: This randomized controlled trial was executed at Pharmacology Department of Bahria University Medical and Dental College in collaboration with Mamji Hospital Karachi from September 2018 to March 2019. Eighty PCOS infertile patients as per Rotterdam 2003 criteria,aged 20-40 years were enrolled. They were divided into two groups of 40 patients each by using computer generated numbers. All patients had fasting insulin levels of >9 μU/mL, serum glucose levels ≥126 mg/dl and suffering from oligomenorrhoea or amenorrhoea. Group A received Tablet Pioglitazone 30 mg once daily and group B was given tablet Metformin 500 mg for three months along with lifestyle changes. Results: Sixty-one participants completed the study. Anthropometric variables included weight, BMI and W/H ratio. Metformin treated group reduced more weight and BMI as compared to Pioglitazone. Metabolic variables included glycaemic indices, lipid profile and hs-CRP estimation. Pioglitazone group improved glycaemic indices more compared to Metformin. Serum progesterone level was significantly increased in Pioglitazone group (5.20±1.18) than Metformin group. Pioglitazone produced more ovulation in comparison to Metformin. Hence it is proved that it is better option in those patients who are unable to tolerate Metformin and cannot continue treatment for infertility. Conclusion: Pioglitazone group produced highly significant increase in serum progesterone level indicating ovulation and improved insulin resistance than the metformin group. Keywords: Female infertility, ovulation induction, Metformin, Pioglitazone, polycystic ovarian syndrome

Perception of medical students to “NEW NORMAL” and its Reflection on their studies during COVID 19.

Objective: To find the effectiveness of online teaching and its reflection on their academics during COVID19 pandemic in basic medical science. Study Design: Cross Sectional Descriptive study. Setting: University Medical and Dental College, Faisalabad. Period: March 2019 to November 2021. Material & Methods: A total of 531 undergraduate MBBS & BDS (1st & 2nd year) students were included. A questionnaire was designed and shared online in Google classroom to get students’ feedback. The data obtained was analyzed on SPSS 25 by using ANOVA and Chi-Square Tests. Results: 62.76% students declared that learning in physical classrooms is more understandable than e-learning, while 58% students were satisfied with this transformation of online teaching and secured better grades in e- assessments, while 69% students agreed with the fact that on campus assessment is more productive. According to our results 68.24% students preferred physical teaching and assessment methodology and 67.11% students agreed that team work with peers is more productive in on campus classes than e-classes. Conclusion: We investigated various aspects of e-learning experience of medical students and found a mixed opinion. By improving our infrastructure and using modern techniques we can make online medical education system more effective and productive for our students in future.