Background: Smoking is considered a major risk factor of oral cancer. The oral health and hygiene are majorly affected by tobacco products. It is needed to provide the periodontal health status of smokers for better understanding to treat and to develop a periodontal treatment guideline for smokers. The objective of this study was to assess the effect of smoking on periodontal health of patients attending the dental section of Bacha khan Medical College Mardan. Methods: This was descriptive cross-sectional study carried out among 227 adult smokers attending dental unit of Bacha khan Medical College for treatment from the duration of September 2018 to November 2019. After taking written consent from the head of department, an assessment questionnaire was developed, and face validated from the respective field experts. A written formal consent was taken from each patient willing to participate in the study. The predesigned validated questionnaire was filled after assessment of patients from respective experts. The collected data was about probing depth, gum recession, attachment loss, color of gingival, presence and amount of plaque, calculus deposits and mobility of teeth. Data was collected and analyzed by using SPSS version 16. Results: A total 227 cigarette smokers male patients were assessed for different periodontal parameters. Study provided that 98(43%) and 68 (30%) smokers were with the age range 31-45 years and 46-60 years respectively. It was also found that 92(40.5%) smokers male patients were found with bleeding on probing and the bleeding frequency were high in elder ages and study provided a significant difference of bleeding frequency with respect to age p<0.00001. A significant difference was found in gum recession between different age group and elder patients were with high frequency in gum recession p=0.0073.The study also provided that majority of smokers patients were having a moderate stain 103(45.4%) in their teeth and it was found a significant difference in the severe stain level and plaque on teeth p<0.0001. A strong association was found between plaque and stain level. Conclusion: The study provided that smoking is a major factor in periodontitis. The health severity of periodontal parameters were high among smokers patients and the high age smokers were found more prone to periodontitis and associated anomalies.

Background: Acute appendicitis is a frequent indication of emergency abdominal surgery in the pediatric population. In younger children, especially toddlers, and preschoolers, the presentation is comparatively late resulting in complicated appendicitis. This study was done to determine the frequency and outcome of complicated appendicitis in toddlers and preschoolers. Methods: This is a cross-sectional study done at the Department of Pediatric Surgery, Lady Reading Hospital Peshawar, during August 2018 and February 2019. The medical records of 144 toddlers and preschoolers who presented with acute appendicitis were reviewed for demography, clinical presentation, operative findings, and outcome. Frequency and types of complicated appendicitis were recorded. Results: The mean age of study participants was 3 years (±2.84), including 46(32%) toddlers and 98(68%) preschoolers. Overall 62% of patients were male while 38% of patients were female. Complicated appendicitis was documented in 75% of patients. The common types of complicated appendicitis were perforation of the appendix with a localized abscess in 68 patients, gangrenous appendicitis in 4 patients, generalized peritonitis in 24 patients, and mass formation in 12 patients. All patients did well after surgery, except one who succumbed to complications of leukemia. Conclusion: In our study, a great deal (75%) of toddlers and preschoolers had complicated appendicitis especially perforated appendicitis with localized peritonitis.

OBJECTIVE: To find out number of roots, root-canals and canal configuration in permanent mandibular third molars through tooth clearing technique. METHODS: In this cross-sectional study, 193 extracted human mandibular permanent third molars with completely formed apical foramen and intact roots were collected from both genders treated at dental hospitals in Peshawar, Pakistan from 1st July to 31st December 2019. After collection teeth were visually inspected to count number of roots, followed by access cavity preparation, pulp extirpation and canal staining with black Indian ink. Decalcification was done by placing teeth in nitric acid for 5 days followed by dehydration in ascending concentrations of alcohol. Complete transparency was achieved by immersing teeth in methyl-salicylate for 72 hours. Transparent teeth were inspected again for number of roots and root-canals. RESULTS: Among 193 extracted mandibular third molars, (n=161; 83.4%) had two-roots and (n=24; 12.4%) were single-rooted. Two-canals were present in vast majority (n=142; 73.6%) whereas three and one-canal were seen in (n=37; 19.2%) and (n=13; 6.7%) teeth respectively. Most common type of root canal pattern was Vertucci’s Type-I in mesial-roots (n=79; 63.7%) and distal-roots (n=120; 96.8%). Vertucci’s Type-II and Type-IV were (n=15; 12.1%) and (n=12; 9.7%) in the mesial-roots respectively. Mandibular third molars didn’t present with any configurations that didn’t fullfill Vertucci’s criteria. Correlation between number of roots and root-canals of mandibular third molars was non-significant. CONCLUSION: Two-roots and two-canals were common patterns for mandibular third molars. Mesial and distal roots were predominant in Type-I followed by Type-II and Type-IV Vertucci’s classification.

Background: The objective of this study was to determine the frequency of gingivitis in pregnant females reporting to Bach Khan Dental College, Mardan. Methods: This cross-sectional descriptive study was conducted on 70 pregnant women by using non-probability consecutive sampling technique. Pregnant females with age range of 20 to 45 years, having adequate oral hygiene, no systemic disease affecting gingival health and Pakistani nationals were included in the study. Age, trimester of pregnancy, employment, brushing habit and presence of gingivitis were recorded. Loe and Silness gingival index was used to record the various grades of gingivitis (normal gingiva, mild, moderate, and severe gingivitis). Descriptive statistics were computed. Comparison was done for the presence of gingivitis by age, employment, brushing habits, and trimester using Chi-Square test. P?0.05 was considered significant. Results: The mean age of the study was 28.44 years (SD, 5.65 years). The gingivitis was present in 40 (57.1%) participants. Of total 22 (31.4%) were government employees. Most common pattern of brushing teeth was ‘twice a day’ (n=28, 40%) and most common trimester of pregnancy was third (n=28, 40%). Most of the pregnant female belonged to age group 26 to 30 years (n=28, 40%) and 20 to 25 years (n=21, 30%). Most common form of gingivitis was severe (n=25, 35.71%) followed by moderate (n=13, 18.57%). In pregnant females the effect of brushing pattern, employment, trimesters and age on gingivitis was not statistically significant (P>0.05). Conclusion: The frequency of gingivitis in pregnancy is quite high in our study. The dental practitioners should be vigilant and advise the plaque control and prompt treatment of gingivitis to pregnant females to prevent progression to periodontitis.

Introduction:  The probe placement site for an electric pulp tester. (EPT) will have a significant outcome for the threshold readings. These relationships in previous studies have been documented. As dental flourosis is an endemic in regions of Pakistan the aim of this study was to compare and determine the appropriate EPT probe placement sites on fluorotic and non flourotic teeth. Methodology: In this cross-sectional clinical study equal number of flourotic and non flourotic maxillary central incisors(40 volunteers)  were selected from a known region of Pakistan for endemic of flourosis to measure threshold levels on EPT on four different parts of each tooth. (Incisal edge, incisal third, middle third and cervical third). Before the readings were taken flourotic teeth were also categorized on the bases of severity (Deans Index).The purpose was to assess if severity of dental flourosis had an impact on the EPT readings.  Once the mean values were taken the Dunn–Bonferroni post hoc tests was used to assess the statistical significance (p<0.05) between the four site in both groups. Results:  Mean values from the EPT presented that the threshold values increased from incisal to cervical in gender and both age groups i.e. 20-29 and 30-40. It was also found that the threshold values increased from incisal edge to the cervical third in flourotic and non flourotic teeth. Statical significance was found between the reading of flourotic and non flourotic groups across the four probe site readings taken (p value= 0.00).  Like previous literature the insical edge was considered the most ideal site for EPT assessment on anterior incisors. As this is where the lowest threshold response was recorded in our study .Dental flourosis does have a significant effect on the EPT threshold values. This is most likely due to structural changes because of dental flourosis. Recommendations: From the study conducted it can be recommended that clinicians need to be aware of the fact that fluorotic teeth response will vary from natural teeth on the EPT. Also further research needs to be done to assess if other vitality test methods will also alter in their response due to dental defects like flourosis.