Frequent consumption of sports and energy drinks among athletes is of concern due to its detrimental impact on oral health. The present study aimed to assess sports and energy drink consumption, oral health status and impacts on daily activities and sports performance among elite athletes from Pakistan. Data regarding socio-demographic characteristics, sports and energy drink consumption, oral health and hygiene practices, self-reported oral health and psychosocial and performance impact was assessed using a self-administered, structured questionnaire followed by clinical oral examination by a single, experienced dentist. A total of 104 athletes, a majority of whom were male (80.8%), participated in the study. Around two third of the participants reported consumption of sports and energy drinks, energy gels or bars at least once a week, the commonest being Sting. Despite good oral hygiene practices, the athletes generally had poor oral health with high prevalence of dental caries (63.5%), gingivitis (46.1%), irreversible periodontitis (26.9%) and erosive tooth wear (21.2%). More than a quarter (28.8%) of the athletes rated their oral health as fair—very poor. Four in five athletes (80%) also experienced at least one oral problem with negative impacts on daily activities (64.4%) and participation training and sports performance (36.5%). Regression analyses revealed a significant association between periodontal disease and impact on both daily activities and sports performance. To our knowledge, this is the first study reporting that high-prevalence sports and energy drink consumption and oral problems among elite athletes from Pakistan has a negative impact on daily activities and sports performance. These findings may have important implications for oral health education programs, and the need to create awareness among the athletes regarding the use of sports and energy drinks, as well as regular oral health screening of athletes to minimize the impact on performance.
In Pakistan, there is limited evidence for the levels and relationship of 25 (OH) Vitamin D (25(OH)D) status in pregnant women and their newborns, while the association between maternal 25(OH)D and newborn anthropometric measurements remains unexplored. Sociodemographic data were collected from 213 pregnant mothers during their visit to a tertiary care hospital at the time of childbirth. Anthropometric measurements were performed on all mothers and their newborns and blood samples collected from both for 25(OH)D levels. Participants were classified into two groups according to their 25(OH)D status: sufficient (25(OH)D ≥50 nmol L−1) and deficient (25(OH)D <50 nmol L−1). Simple and multiple regression models were used for analysis. Among 213 pregnant women, prevalence of 25(OH)D deficiency was 61.5%, and their newborn was 99.5% (mean 25(OH)D levels: 46.3 [11.3] and 24.9 [5.4] nmol L−1, respectively). Maternal sociodemographic characteristics were similar between 25(OH)D deficient and sufficient mothers, whereas newborn 25(OH)D levels were significantly lower in the former (22.60 [4.53] vs. 27.67 [3.82] nmol L−1, respectively, P < 0.001). There was a strong positive association between maternal and newborn 25(OH)D levels (r, 0.66; r2, 43%, B [SE], 0.3 [0.02]; P < 0.001). Association of maternal 25(OH)D levels with newborn weight, length and head circumference was not significant (all P > 0.05). Our study shows a high prevalence of 25(OH)D deficiency in pregnant women and their newborns and a strong positive association between maternal and newborn 25(OH)D levels. Findings of this study indicate the importance of maintaining sufficient 25(OH)D levels during pregnancy.
To explore, through face to face interviews with a selection of General Dental Practitioners (GDPs), their views and experiences of having used the International Caries Detection and Assessment System (ICDAS) within primary care research studies for recording caries. This qualitative study involved one on one interviews with eight GDP’s who had previously used ICDAS on patients in their dental practices as part of a research study. The participants were selected from among those who had taken part in two clinical studies in the UK using convenient, but purposive sampling. The interviews were tape-recorded and transcribed; the data analysis was conducted by thematic analysis. GDP’s indicated their beliefs that ICDAS had an important role in caries prevention but reported four main barriers while using the full (6 caries stages) ICDAS coding system in their practices: lack of simplicity of coding, financial implications and time consumption (in both training and use of ICDAS) and inadequate undergraduate training. An overarching theme identified from the GDPS was the willingness to offer potential solutions to their barriers which might improve the utilisation of the system in primary care. The GDPs experienced common obstacles in using ICDAS in the primary care setting, many of which have relatively straight-forward solutions which they put forward themselves such as: incentivisation, undergraduate-level training in ICDAS for both dentists and nurses and computerized data entry. Further qualitative and quantitative research is needed on how to facilitate the utilisation of the system in dental practice. It is also recommended to explore the influences of wider agencies on influencing primary dental care professionals’ caries management, including appropriate recording of diagnosis and risk assessment.
The COVID-19 pandemic has resulted in the scaling back or postponement of non-emergency hospital services, including care of cancer patients. The present qualitative study explored the experiences of newly diagnosed oral cancer patients during the first wave of the COVID-19 pandemic in Pakistan. Patients who attended the Department of Maxillofacial Surgery, Khyber College of Dentistry in July 2020 were selected using a maximum variation purposive sampling method. Seventeen semi-structured interviews were conducted in Pashto, the local language of Khyber Pakhtunkhwa. All interviews were audiotaped, transcribed verbatim, and translated into English. Thematic content analysis yielded eight major themes: pain and generalised physical weakness, shock at diagnosis, psychological distress of the COVID-19 pandemic, faith and religion, double hit loss of employment, social isolation, social support from caregivers, and lack of support from health care professionals. In conclusion, the COVID-19 pandemic has a clear impact on the life experiences of newly diagnosed oral cancer patients. Distress due to delay in accessing health care and lack of support from health care providers are a matter of great concern. Appropriate interventions should be introduced to ensure psychological and social support strategies are in place for patients during interruptions of health care services.
Transwomen are one of the most marginalised groups globally, with their experiences of prejudice significantly impacting their access to dental care and leading to social isolation. This study aimed to explore the experiences of transwomen in accessing oral health care services in Khyber Pakhtunkhwa, Pakistan. A qualitative phenomenological study design was utilised to gain in-depth insights. Eight transwomen were purposively recruited from the districts of Haripur, Abbottabad, and Mansehra in the Hazara division of Khyber Pakhtunkhwa, Pakistan. Semi-structured interviews were conducted in Urdu, transcribed, and translated. A descriptive approach was utilised for thematic analysis. The analysis revealed several barriers faced by transwomen in accessing oral health care, organised into key themes: (1) Healthcare discrimination and marginalisation, (2) Quality of care and dental professionals’ attitudes, (3) Cost and affordability of dental care, (4) Social stigma and absence of community support, and (5) Inclusive dental care facilities. This research highlights barriers faced by transwomen in Pakistan when accessing dental care, leading to delayed treatment and poor oral health outcomes. Financial constraints and a lack of empathy from dental professionals further exacerbate these challenges. Participants recommended policy reforms such as anti-discrimination laws, separate waiting rooms, and counters to improve access. These findings underline the need for policymakers to create inclusive dental service systems tailored to the needs of transwomen.