Pakistan Heart Journal

Patient Confidence, Convincement & Positive Attitude Influencing the Quality Radio Visuographic Images

2025-09-20T09:35:34+00:00

Introduction: Patient motivation and counseling play a key role in obtaining high-quality radiographs, as patient cooperation directly affects diagnostic accuracy. Age, education, and occupation are important factors that may influence the quality of radiographic outcomes. Materials and Methods: A total of 150 patients were included in the study and divided into three age groups: 18–29 years, 30–44 years, and above 45 years. Information regarding their education and occupation was also collected. All patients underwent radiographic procedures, and the quality of the radiographs was carefully assessed. Procedure: Patients were given proper instructions and counseling prior to radiographic exposure to improve their understanding and cooperation. Radiographs were then evaluated for clarity, positioning, and overall diagnostic value, and findings were compared across different groups. Results: The study showed that patients above 45 years had radiographs of comparatively lower quality when compared with the younger age groups. Education and occupation were also observed to influence patient cooperation and the resulting radiographic quality. Conclusion: Patient age, education, and occupation significantly affect the quality of radiographs. Older patients demonstrated more difficulty in producing good-quality radiographs. This highlights the importance of patient motivation and counseling as effective measures to enhance cooperation and achieve reliable diagnostic imaging.

Keywords: Patient Confidence, Positive Attitude, Radio Visuographic Images, Motivation, Counseling, Diagnostic Imaging

A Study To Evaluate The Effect Of Sterilization And Disinfection On Tensile Strength Of Orthodontic Elastomers

2025-09-23T05:15:51+00:00

ABSTRACT

Introduction: Sterilization refers to a process that eliminates all living organisms, including both pathogenic and non-pathogenic entities, in their vegetative state or as spores found the exterior of the material intended for sterilization. Throughout the years, the predominant methods of physical heat sterilization utilized practices in dentistry have included saturated steam, dry heat and chemical vapour. The processes of sterilization and disinfections are fundamental elements of any infection control program within a healthcare environment. Although elastomeric chains and intraoral elastics are widely accepted and utilized, there remains a degree of uncertainty regarding their mechanical and biological characteristics following sterilization and disinfection procedures.

Material and methods: A sample of 60 orthodontic elastomers were collected. These samples were further divided into two groups, as elastomeric chain and intraoral elastics. Each group will be further subdivided into 6 sub-groups depending upon the different sterilization and disinfectant methods - Control Group; 2% Glutaraldehyde; 70% Alcohol; 1% Peracetic acid; Hot Water (70°); and Autoclave. The samples were tested for evaluation of tensile strength in a Universal Testing Machine. The data collected underwent statistical analysis.

Results:The study showed that in Elastomeric Chain group, there was a statistically meaningful difference in Control Group versus 1% Peracetic Acid and Autoclave with respect to tensile strength. In Intraoral Elastics group, there was a statistically meaningful difference in tensile strength between the control group versus 2% glutaraldehyde, 1% peracetic acid and hot water.

Conclusion:The statistically significant differences observed in study regarding the disinfection and sterilization of orthodontic elastomers lead us to conclude that alcohol, 2% glutaraldehyde and hot water were suitable for the sterilization of Elastomeric Chains, while alcohol and autoclaving were appropriate for Intraoral Elastics.

Keywords: Elastomeric Chain; Intraoral elastics; Sterilization; Disinfection; Orthodontic elastomers.

Comparative Evaluation Of Effect Of Curing Lights On Shear Bond Strength And Ari Of Different Adhesive Materials: An In Vitro Study

2025-09-23T05:27:50+00:00

ABSTRACT

Introduction: Orthodontists initially used bands to straighten teeth, but banding was intensive and prone to obstacles. With the advent of adhesives, the ideal adhesive should have optimal bond strength that can withstand orthodontic forces and leaving minimal residual after debonding.

Material and methods: This study comprised of 60 non-carious human premolars using three adhesive materials and six subgroups of LED curing lights (Low Intensity and High Intensity). Each subgroup had 10 samples bonded with metal brackets on the buccal surface using different adhesives at varying intensities and times. The specimens were tested for SBS using a UTM machine at 1mm/min, and the maximum load required to debond the bracket was recorded. Fracture modes were evaluated using a stereomicroscope.

Results:SBS was significantly higher in groups using high-intensity LED curing light, with Enlight having the highest, followed by Transbond XT and Heliosit. Low-intensity LED curing light showed a similar pattern, resulting in low ARI scores while high-intensity LED curing light increased them.

Conclusion:Both high-intensity and low-intensity LED curing lights bonded effectively, with no significant difference in SBS and ARI. High-intensity LED curing lights are recommended for time savings, patient, and orthodontist comfort.

Keywords: Bonding, Banding, SBS, LED and ARI.

A Study Comparing The Reliability And Accuracy Of Various Cephalometric Softwares To Hand Tracings

2025-09-23T07:14:23+00:00

ABSTRACT

Introduction: Cephalometry is extensively used indiagnosis, planning & evaluation of craniofacial development and growth. Both manual and digital techniques can be used to perform cephalometric tracings.

Material and methods: A sample of 40 pre-treatment lateral cephalograms of the individuals were traced manually on the lead acetate sheets and 23 cephalometric measurements were obtained. The soft copies of the same 40 lateral cephalogramswere imported to three computer-aided softwares i.e. NemoCeph, AutoCEPH, UniCeph; the same landmarks used in manual tracing were marked in the digital tracing softwares and the measurements were computed. The collected data was then tabulated, analyzed and subjected to statistical tests.

Results: All the 23 parameters tested using NemoCeph tracing software showed significant correlation with manual tracings while 22 out of 23 parameters tested using AutoCEPH tracing software showed significant correlationexcept linear measurement i.e. LI to A-Pog line. 22 out of 23 parameters tested using UniCeph tracing software showed significant correlation with manual tracing except angular measurement i.e. UI to SN Angle.

Conclusion: The digital cephalometric tracings using all three cephalometric softwares were as reliable and accurate as manual tracings.

Keywords: Lateral cephalogram, manual cephalometric tracings, digital cephalometric tracings, NemoCeph, AutoCEPH, UniCeph

Oxidative Stress Index as a Biomarker of Metabolic Imbalance in Thyroid Disorders

2025-09-26T11:07:40+00:00

ABSTRACT

Background: Thyroid dysfunction is associated with profound metabolic disturbances, including altered lipid metabolism and redox imbalance. Oxidative stress, resulting from excess reactive oxygen species and impaired antioxidant defenses, may exacerbate lipid abnormalities and increase cardiometabolic risk.

Objective: To evaluate lipid profile alterations in relation to oxidative stress markers—total oxidant status (TOS), total antioxidant status (TAS), and oxidative stress index (OSI)—among patients with hypothyroidism, hyperthyroidism, and euthyroid controls.

Methods: A cross-sectional study was conducted on 285 participants (161 hypothyroid, 76 hyperthyroid, 48 euthyroid). Serum thyroid hormones, lipid profile, and oxidative stress parameters (TOS, TAS, OSI) were measured using standard biochemical methods. Group comparisons were performed using ANOVA with post hoc tests. Correlations between lipid parameters and oxidative stress indices were assessed, and regression analysis identified predictors of metabolic imbalance.

Results: Both hypothyroid and hyperthyroid groups exhibited significantly elevated TOS and OSI with reduced TAS compared to euthyroid controls (p < 0.001). Hypothyroid patients showed higher total cholesterol, LDL-C, and triglycerides, while hyperthyroid patients demonstrated reduced HDL-C and elevated VLDL-C. Correlation analysis revealed that OSI positively associated with atherogenic lipid fractions (LDL-C, TG) and negatively with HDL-C. Regression analysis identified TOS as a positive and TAS as a negative predictor of OSI, confirming that oxidative stress and dyslipidemia jointly contribute to metabolic imbalance in thyroid dysfunction.

Conclusion: Thyroid disorders are characterized by both lipid abnormalities and oxidative stress imbalance, with OSI emerging as a robust biomarker of metabolic disturbance. Integration of oxidative stress markers with lipid profiling may improve risk stratification and management of patients with thyroid dysfunction.

Keywords: Thyroid dysfunction, oxidative stress index, lipid profile, hypothyroidism, hyperthyroidism, metabolic imbalance

Oxidative Stress and Lipid Biomarkers as Predictors of Hypertension Severity: A Cross-Sectional Study

2025-09-26T11:14:41+00:00

ABSTRACT

Background: Hypertension is a major risk factor for cardiovascular morbidity and mortality, yet predicting disease severity remains a clinical challenge. Oxidative stress and lipid biomarkers are increasingly recognized as important contributors to vascular dysfunction. This study aimed to assess the predictive role of malondialdehyde (MDA), oxidized LDL (ox-LDL), and lipid profile parameters in determining hypertension severity.

Methods: We conducted a cross-sectional study among hypertensive patients aged 30–65 years. Clinical data and fasting blood samples were obtained. Serum lipid profile was analyzed using enzymatic assays; MDA and ox-LDL concentrations were measured by ELISA. Multiple linear regression was applied to identify independent predictors of systolic blood pressure (SBP), and receiver operating characteristic (ROC) curve analysis was used to evaluate diagnostic accuracy for severe hypertension.

Results: Regression analysis revealed that MDA and ox-LDL were significant independent predictors of SBP, while HDL-C showed an inverse association, indicating a protective role. Traditional lipid parameters, including total cholesterol, triglycerides, and LDL-C, did not demonstrate significant predictive value. ROC analysis indicated that MDA had the strongest predictive ability for severe hypertension, whereas ox-LDL and LDL-C showed limited discriminative performance.

Conclusion: MDA and ox-LDL are significantly associated with hypertension severity, with MDA demonstrating moderate predictive performance. HDL-C exhibited a protective effect, while routine lipid parameters were less informative. These findings highlight the potential of incorporating oxidative stress biomarkers into hypertension risk assessment to improve early detection and personalized management.

Gender-Specific Patterns of Adipokines in Coronary Artery Disease: A Clinical Study

2025-09-26T11:18:37+00:00

Abstract

Background: Coronary artery disease (CAD) is influenced by multiple metabolic and hormonal factors, including adipokines such as adiponectin and leptin. Gender differences in these biomarkers may contribute to variations in disease severity and progression. Aim: To evaluate serum adiponectin and leptin levels in male and female patients with CAD and to examine their association with disease severity.Materials and Methods: A total of 190 patients aged >40 years diagnosed with CAD were included (141 males, 49 females). Serum adiponectin and leptin levels were measured using ELISA. CAD severity was classified using CAD-RADS criteria into mild (Group 1), moderate (Group 2), and severe (Group 3). Gender-based comparisons were performed using Student’s t-test, and differences across CAD severity groups were analyzed using one-way ANOVA. Results: Females exhibited significantly higher mean adiponectin (28.28 ± 8.76 ng/mL) and leptin (40.39 ± 14.45 ng/mL) levels compared to males (adiponectin: 25.06 ± 7.97 ng/mL; leptin: 35.73 ± 12.80 ng/mL, p < 0.05). Adiponectin levels tended to decrease and leptin levels slightly increased with CAD severity in both genders, though these trends were not statistically significant. Gender-specific patterns in adipokine distribution persisted across all CAD severity groups. Conclusion: Significant gender differences exist in serum adiponectin and leptin levels among CAD patients, with females showing higher concentrations. These adipokines exhibit distinct trends with disease severity, highlighting their potential role in sex-specific risk assessment and management of CAD. Further studies are needed to explore their utility as biomarkers and therapeutic targets.

Keywords: Coronary artery disease, Adiponectin, Leptin, Gender differences, CAD severity, Biomarkers

Impact of Oral Maxillofacial Morphological Changes on Snoring: An Empirical Comparative Study

2025-09-28T05:34:26+00:00

Abstract

Introduction: Snoring is a prevalent condition that greatly affects public health. Snoring refers to the noise generated when a person breathes while asleep, caused by the airflow disruption through a partially blocked airway. It is seen as a prevalent clinical indicator of obstructive sleep apnea (OSA). Abnormalities in the facial skeleton may play a role in the development of obstructive sleep apnea (OSA), impacting both hard and soft tissues. Numerous studies have examined how inter-dental width and palatal shape influence the onset of OSA in developing patients. Previous research agrees that children with a narrow or high-arched hard palate are more likely to develop OSA. Significant deviation of the septum (SD) can result in substantial nasal obstruction, which may lead to sleep apnea. Aim: This study aims to assess the association between the shape of the maxillary arch, deep palatal vault, and nasal septal deviation in snoring patients. Methodology: A total of 40 patients (20 snoring, 20 non-snoring) are included in the study. Maxillary arch shape, depth of palatal vault and nasal septal deviation are evaluated in all patients and are compared between snoring and non-snoring groups. Results and Conclusion: A V-shaped palate is exclusively found in snoring patients (100%), whereas a U-shaped palate is more common in non-snoring patients (57.1%) with statistical significant difference. Mean depth of palate and nasal septal deviation shows no statistically significant difference between snoring and non-snoring groups.

Keywords: Oral Maxillofacial Morphological Changes, Snoring, Obstructive Sleep Apnea, Dental Crowding, Malocclusion Nasal Septal Deviation

Effect of post mastectomy nursing intervention program on elderly women’s knowledge, practices and complications’ prevention

2025-10-03T07:58:20+00:00

Background: Mastectomy is a cornerstone of disease management for breast cancer. Nurses are in a prime position to prevent postoperative complications, including seroma formation, wound infection, arm pain, stiffness, lymphedema and compromised range of motion of the shoulder and arm.Aim:to evaluate the effect of post mastectomy nursing intervention program on elderly women’s knowledge, practices, and complications’ prevention. Design: Quasi experimental pre/post one group design was utilized. Setting: The study was conducted in the inpatient and outpatient clinics of the breast cancer hospital, at the National Cancer Institute affiliated to Cairo University.Sample:120 elderly women aged 60 years or older who were assigned for mastectomy were included in the study. Tools:1- A structured Personal and Medical History Questionnaire, 2-The Disabilities of the Arm, Shoulder, and Hand (DASH) Questionnaire,3-Exercises Observational Checklist,4-Pre /Post Mastectomy Elderly women's Knowledge Questionnaire,5-Pain Assessment Scale and6- Post Mastectomy Complications Checklist. Results: age of elderly women ranged from 65 to 69 years with mean age of 68.5 and SD =± 9.2.Regarding to arm, shoulder & hand disabilities, in the pretest there were no disabilities as compared to majority of elderly women who hadmoderate difficulties at the post & follow-up assessment. Pain, numbness and restricted shoulder movement was prevalent among study sample.Conversely, some complications demonstrate consistent prevalence rates across both assessments, such as "Lymphedema. A highly statistically significant improvement was found in the elderly women regarding their practices and knowledge levels in post-program implementation than pre-program with P-value <0.001 **.Conclusion: Application of post mastectomy nursing intervention program had a positive effect on performance and knowledge of elderly women after mastectomy which contributed to complications’ prevention.Recommendations: Replication of the study on a larger number of breast cancer patients.

Effect of Acupressure Protocol of Care on Mechanically Ventilated Patients’ Outcomes at Cairo -Egypt

2025-10-04T12:34:42+00:00

Background: Recent studies have emphasized the use of non-invasive complementary approaches to facilitate critically ill patients, weaning from mechanical ventilation by improving respiratory parameters. Critical care nurses play pivotal role in the implementation of acupressure protocols as part of holistic patient care in the ICU. Aim of the study: to evaluate the effect of acupressure protocol of care on mechanically ventilated patients’ outcomes. Research design: a quasi- experimental research design was utilized. Research hypothesis: four research hypotheses were stated in the current study. Setting: This study was carried out at the surgical intensive care unit of the emergency hospital at one of university hospitals in Cairo. Sample: A purposive sample consisting of 70 adult critically ill patients receiving invasive mechanical ventilation and divided into two equal and matched groups. Tools of data collection: three tools were utilized to collect data penitent to the current study: critically ill mechanically ventilated patients’ demographic and medical characteristics, critically ill mechanically ventilated patient's assessment sheet, and critically ill mechanically ventilated patients' outcomes. Results: the acupressure group showed significant improvements in tidal volume and minute ventilation (p ≤ 0.05) immediately post-intervention, with benefits persisting at all-time points. Rapid shallow breathing index improved immediate post acupressure and at 0.5 h post-intervention (p ≤ 0.05), while respiratory rate and oxygen saturation also showed favorable changes. Most hemodynamic parameters and complication rates remained comparable between groups (χ²= 11.2, p > 0.05) indicating no significant differences between two groups. Conclusion: acupressure had positive effects on weaning indices, respiratory rate, and oxygen saturation in the mechanically ventilated patients; indicating support of the stated research hypotheses. Recommendations: Replication of this study on a larger probability sample in different geographic areas; and integrate acupressure protocol into nursing care for mechanically ventilated patients.