Journal of General Practice

Prevention of bisphosphonate related osteonecrosis of the jaws (BRONJ) represents an important challenge for clinicians. Dent alveolar surgery is usually performed to reduce the risk local and systemic complications, In fact, removing the tooth that is the source of the infectious outbreak, brings to the removal of the infected tissue and determines a correct healing of the disease. However, in patients are undergoing bisphosphonate this procedure expose patients to an increased risk of BRONJ. However, in patients who are in treatment with systemic bisphosphonates, this procedure exposes them to an increased risk of BRONJ. When possible, avoid the surgical interventions in favors of endodontic treatment could be an important clinical options in reducing the possibility of BRONJ occurrence. In this paper, we report a case of endodontic re-treatment in a tooth with a floor perforation in a patient was assuming oral alendronate. Limits and advantages of performing endodontic retreatment for the prevention of BRONJ development have still not well elucidated. Due to the very low power of this study, no conclusions should be made to perform an endodontic retreatment instead of performing a tooth extraction. However, this case report support the execution of future studies related to the calculation of BRONJ incidence after surgical extraction vs endodontic retreatment.

This study focuses upon changes in quantifiable parameters of voice production comparing normal voices and patients with complaints of hoarseness for more than two weeks. Acoustical signals and high speed films were data sources for mathematical and physiological formulas statistics of the voices. The software ”Glottis Analysis Tools” (Erlangen, Germany) includes acoustical measurements and data sources in Glottal Area Waveforms (GAW) and Phonovibrograms (PVG), based on high speed film data. High speed film data were captured with high speed camera and software from Wolf Ltd, Germany. Data with statistical significant difference between 12 healthy voices and 12 patients with complaints of hoarse voices in a prospective case/control study were presented. The commonly used acoustical and physiological parameters showed hardly any statistical difference between the normal persons and the persons with complaints of hoarseness for more than two weeks. This suggests that evidence on physiological and acoustical measures of voice pathology is insufficient. Focus should be upon newer methods and tissue function.

Health supplements are marketed as non-pharmaceutical means of improving health and are widely used by gym going youth to enhance their musculature. This is largely driven by peer pressure. The constituents of these supplements may not be regulated and may contain anabolic steroids. We here present a case of a young man who developed cholestasis secondary to use of health supplements that possibly contained anabolic steroids.

Sarcoidosis is a non-infectious, inflammatory disease of unknown etiology which is characterised histologically by presence of noncaseating granulomas. It is a common pulmonary disease in Indian Subcontinent with tuberculosis as the commonest differential diagnosis. Spontaneous pneumothorax have been described in late stages of sarcoidosis but pneumothorax in early disease or the first presenting sign is very rare. This article discusses a rare case of Sarcoidosis where pneumothorax was the first presenting sign.

Background: First aid is a simple step that done outside the hospital setting to save someone’s life or prevent condition from worsening until arrival of health care providers. Objective: Assess awareness about first aid knowledge among the female students of health science colleges before and after awareness presentation. Methodology: A cross-sectional study was done among the female students of health science colleges through pre- and post– awareness assessments. Thirteen selected multiple choice questions about various emergency accidents were included in the questionnaire. The awareness presentation contained how to deal with the various emergency accidents was sent to the students via email and the comparison before and after the awareness presentation was analyzed. Results: A total of 110 female students participated in this study. Only, 58 students completed the answers of the questionnaire to compare between pre- and post- awareness with the response rate of 52.7%. There was a statistically significantly improvement in the best dealing with many situations such as checking for any hazards before doing first aid, loss of consciousness if victim can breathe or not, applying pressure in bleeding limb, supporting the fractured bone with a cushion, cooling the burn under cold water, putting the victim in safe place in convulsion and sit the patient and give him the medication in asthmatic attack. Conclusion: This study showed inadequate knowledge about first aid among the female students. Health science students at Taibah University need first aid training program in their curriculum to improve the basic skill about it.

Pakistan is at high risk of epidemics because of overcrowded cities, unsafe drinking water, inadequate sanitation, poor socioeconomic conditions, low health awareness and inadequate vaccination coverage. The diarrheal diseases contribute to the major disease burden under five along with pneumonia in Pakistan. Unlike vaccine preventable diseases like Polio, measles and maternal & neonatal tetanus, Pakistan does not have any formal responsive surveillance system to monitor the burden of diarrheal diseases and to respond to the outbreaks. Previously, the technical assistance used to be provided by Disease Early Warning System (DEWS WHO) to the outbreaks. Unfortunately, this system is no more functional in Pakistan and WHO had built the technical capacity of the Government staff and had advised health department to carry out their own efforts to monitor the trends of the various diseases including Diarrhea. Thus the objective of this short communication was to identify the gaps in the existing system and to propose a Surveillance mechanism for diarrheal diseases. We conducted in-depth interviews from Government authorities as well as DEWS officials to understand the surveillance system of various diseases especially for diarrheal diseases placed in Pakistan. We met with Surveillance officer and DEWS officials, headed by provincial coordinator at Directorate Health Service Office, Karachi. These officials informed us about the reporting tools and monitoring system at different levels. After having detailed discussions, we were able to identify certain gaps and loop holes in the currently existing surveillance system and based on that we adopted WHO guidelines to propose surveillance system of diarrheal diseases.

Objectives: To conduct a survey of patients who have and have not signed on to an electronic messaging system about their attitudes toward electronic messaging with physicians. Methods: A convenience sample of 500 patients in a university general internal medicine faculty practice completed a survey which used 12 hypothetical scenarios involving clinical problems using electronic messaging or telephone/in office visit to communicate with physicians. The number of correct responses to scenarios was used to compare electronic messaging users and non-users using student’s T test. Results: About 2/3 of respondents had signed up for the electronic messaging system. A large portion of respondents (27-59%) incorrectly used electronic messaging in the hypothetical scenarios. Patients who had signed up for electronic messaging were significantly more likely to appropriately use electronic messaging than those who had not signed up for it (p < 0.001). Conclusions: Patients may have different attitudes from those of physicians about the use of electronic messaging for symptoms of an urgent nature and receiving sensitive test results. Those patients who have not signed up for electronic messaging are particularly at risk for misperceptions. Practice Implications: All patients using electronic messaging should be educated and given guidelines about its appropriate use.