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Lung function tests are essential for the diagnosis and management of different respiratory tract diseases; among them the spirometry is the gold standard technique. The accurate diagnosis, management and monitoring require proper interpretation of the results which depends upon the availability of spirometry reference data for that particular region to differentiate the diseased condition from the normal ones. Multiple studies had been done to find out their own area specific reference ranges but it is still lacking. This need was fulfilled by the Global Lung Function Initiative (GLI) in 2012, which reported the first global spirometry equation for all of the age groups. But some of the studies reported difference among GLI reference range and the measured range for that particular region. So here is the review of the reference ranges among 35,603 Asian children and adolescents from the 32 studies done specifically in Asia. The aim was to compare them with the study done by GLI team, along with these, tried to rule out the causal factor that are responsible for the variations in the reference ranges among the children and adolescents of different population. The literature was searched by using Google scholar and PubMed during the month of March up to July 2017.The review of all the articles published in Asia, specifically accounting for normal reference ranges in children and adolescent exhibit a wide variation among the reference ranges. This also suggest involvement of multiple modifiable and non-modifiable risk factors. So it’s necessary to update the reference ranges for spirometry and its prediction equation as well.

Aims:The aim of this study was to compare the efficacy of two mouth washes namely Chlorhexidine 0.2% and 5% green tea mouth rinse when used as pre-procedural rinses in reducing the number of CFU in aerosol generated during ultrasonic scaling. Methodology: 70 subjects were recruited in this study (43 males, 27 females: age range 18-65 years with presence of minimum 20 permanent functional teeth, less than 5 mm mean probing depth and plaque and gingival score between 1-3. Subjects were randomly divided into two groups, group 1 and group 2. Each group comprised of 35 patients. A split mouth design technique was used for collecting the aerosol samples on blood agar Anjum et al.; JAMMR, 31 (7): 1-9, 2019; Article no.JAMMR.53094 2 plates. For every patient, there was a control side and test side of mouth. Ultrasonic scaling was done on control side without pre procedural rinsing and vice versa. Group 1 used 0.2% Chlorhexidine while group 2 rinsed with 5% green tea mouthwash. The blood agar plates were then transported to Microbiology lab and incubated for counting the colony forming units (CFU). Results: Significant reduction of CFU occurred with pre procedural rinsing with both mouthwashes as compared to non-rinsing before ultrasonic scaling and 0.2% Chlorhexidine found to be superior to 5% green tea in reducing bacterial load in aerosol samples Conclusion: Pre procedural mouth rinsing with effective mouthwashes significantly reduces aerosol contamination and should be used before all dental procedures that results in formation of aerosols and splatters along with some other infection control protocol to minimize the risks of cross infection in clinical settings. Original Research Article

To compare the WHO cut-off of the mid-upper arm circumference (MUAC) with the weight for height z-score (WHZ) in different age groups of children (6 months to 59 months of age) with acute malnutrition in Pakistan. MethodologyA cross-sectional study was carried out in the pediatric unit of Ziauddin Medical University and Hospital on malnourished children from six to 59 months of age to compare two different indices of malnutrition, MUAC and WHZ. A total of 450 children with WHZ of <-2SD and <-3SD were included in the study after excluding children with failure to thrive due to chronic illness, congenital defects, and immune deficiencies/malabsorption. ResultsThe study revealed a significant mean difference in weight, height, and MUAC among the participants (0.030, 0.053, and 0.02). The sensitivity of MUAC at <11.5 cm was highest in the 12-24-month age group with a decline at 24-48 months while specificity was highest at six to 12 months of age, which shows a mixed response. ConclusionThe result revealed variation in the cut-off value of MUAC in different age groups; the best specificity of MUAC was found at six to 12 months of age and the best sensitivity at 12-24 months of age.

Background: Electroencephalogram (EEG) is defined as a method of detecting brain waves signifying the electrical conductivity of the brain. Globally, EEG is used to further classify neuropsychiatric disorders. Objective: To evaluate the prevalence of abnormal EEGs and related neurological disorders and it's correlation with age and gender. Methodology: A descriptive cross sectional study was conducted in Neurology department, Ziauddin hospital, Karachi, Pakistan from June 2018 to May 2019. A total of 440 individuals based on inclusion criteria were selected through Non-probability consecutive sampling. Informed consent was obtained from study participants. A self-designed structured questionnaire and EEG record were used for data collection. Data were entered and analyzed using SPSS v 20. Mean and standard deviation was calculated for numerical variable and frequency and percentages were calculated for categorical variable. Independent t-test and chi square was used to check association of abnormal EEG with age and gender. P value of ≤0.05 was considered statistically significant. Results: The mean age of study participants was 52.98 ± 22.68 years. There were 54.5% (n = 240) males. Approximately 45.2% (n = 199) participants had predisposing condition which can lead to abnormal EEG. EEG records of 39.8% (n = 175) of the patients was normal while 60.2% (n = 265) had abnormal records. Diffuse neuronal dysfunction consistent with encephalopathy was found in 45.2%. Mild neuronal dysfunction consistent with encephalopathy accounted for 33.5% of cases. Significant difference was found in Abnormal EEG among different age group (p = 0.01).