Poor oral hygiene is a major factor for oral diseases. Urban slums are recognized as a risk group population as the burden of oral diseases is highest among them. Objectives: To evaluate the oral health status of slums using Decayed, Missed, and Filled Tooth index. To evaluate the oral health status of slums using Community Periodontal Index for Treatment Need. Methods: A cross-sectional study was carried out on 385 urban slum people aged between 20 to 50 years. A convenient sampling method was adopted. Data were collected by structured questionnaire included information related to patient’s knowledge, attitude, and behavior towards oral hygiene and interviewed by trained staff. Oral examinations were performed in line with WHO guidelines. After taking informed consent oral examinations were done by fresh graduate and DMFT and CPITN index were evaluated. Results: Study participants were assessed for attitude, knowledge and oral health behavior, 47% had Good Attitude, only 6% had Very Good Knowledge and < 1% had Very Good oral health behavior. Mean DMFT and CPITN score among Slums came 8.91 + 7.627 and 1.93 + 0.971 respectively. More than a third of the slums population required emergency levels dental treatments. Conclusions: The residents of slums have poor oral hygiene and high prevalence of dental caries. Low socioeconomic status, and lack of primary dental care programs and session are main reasons for poor oral health

Dental caries seems to be a significant public health issue and a common non-communicable disease. And is more prevalent in age group 6-12 years. There has never been a national oral health survey conducted in Pakistan between age 6-12 years in recent years. The purpose of this study was to look into the dental health of children between the ages of 6 and 12. Objectives: To determine the oral health status of children age 6-12 years using Decayed, Missed, Filled tooth Index. Methods: A cross-sectional study was carried out which included 385 children age between 6-12 years, using a simple random sampling. Children were evaluated in schools, and data collected included details on caries and the condition of the gingiva. The WHO's methodology and standards were used for oral examination. Results: Mean DMFT index of children age 6-12 years came out to be 2.28 ± 0.97. More than 2/3^rd of children age between 6-12 years needs urgent dental care. Conclusion: The oral health status of children age between 6-12 years is unsatisfactory and higher DMFT index than expected. To effectively prevent and control burden of dental caries and promote gingival health, the oral health program must be implemented. Dental caries seems to be a significant public health issue and a common non-communicable disease. And is more prevalent in age group 6-12 years. There has never been a national oral health survey conducted in Pakistan between age 6-12 years in recent years. The purpose of this study was to look into the dental health of children between the ages of 6 and 12. Objectives: To determine the oral health status of children age 6-12 years using Decayed, Missed, Filled tooth Index. Methods: A cross-sectional study was carried out which included 385 children age between 6-12 years, using a simple random sampling. Children were evaluated in schools, and data collected included details on caries and the condition of the gingiva. The WHO's methodology and standards were used for oral examination. Results: Mean DMFT index of children age 6-12 years came out to be 2.28 ± 0.97. More than 2/3^rd of children age between 6-12 years needs urgent dental care. Conclusion: The oral health status of children age between 6-12 years is unsatisfactory and higher DMFT index than expected. To effectively prevent and control burden of dental caries and promote gingival health, the oral health program must be implemented.

Background: Oral health skills (OHS) programs about brushing techniques have been found to have a lasting impact when repetition and reinforcement are used. Existing dental research doesn't apply to school-based surgeon-led oral health skill programs. Objectives: To determine the effectiveness of Oral Health Skills with regard to proper brushing techniques, based upon repetition and reinforcement on the oral health status of school children through the Community Periodontal Index of Treatment Needs. Methodology: A quasi-experimental intervention study was conducted in a public school of Rawalpindi with 100 students (ages 13-17) demonstrating proper brushing techniques. These students were given intervention for OHS to demonstrate proper brushing technique. Other forms of awareness such as panaflexes and brochures were also shared. Brushing techniques were demonstrated and examined on dummies. Students received four OHS sessions at weeks 0, 3, and months 3 and 6, each followed by oral examinations by a dentist. Results: Proper brushing technique habit at the baseline was 1%. Which rose to 66% at the end of intervention. The CPITN index of participants at baseline was 1.06 and after the 1st, 2nd and 3rd intervention lowered to, 0.94, 0.68, and 0.28 respectively. Paired t-test was conducted with findings of p < 0.001. This highly significant result proved that it is advantageous to include OHS based on repetition and reinforcement to improve the oral health status of children. Conclusion: Programs promoting Oral Health Skills with a focus on repetition and reinforcement have a long-lasting impact on the oral health status of school children.

Background: Chronic daily headache (CDH) and iron deficiency anemia (IDA) are prevalent health issues with significant impact on individuals' quality of life. Understanding the relationship between these conditions is essential for developing effective treatment strategies. Objective: This study aims to investigate the association between iron deficiency anemia and chronic daily headache. Methods: A case-control study was conducted at Pak Emirates Military Hospital, Rawalpindi, Pakistan, from February to July 2023. The study included 140 patients diagnosed with CDH and 140 age- and sex-matched controls without a history of CDH. Demographic data (age, gender, location, education, marital status) were collected along with clinical characteristics (headache frequency, intensity, duration) and hematological parameters (hemoglobin level, serum ferritin level, red blood cell count, mean corpuscular volume, mean corpuscular hemoglobin, platelet count, white blood cell count, hematocrit level, mean corpuscular hemoglobin concentration). Statistical analysis was performed using chi-square tests and ANOVA. Results: There were no significant differences in demographic characteristics between the CDH and control groups. CDH patients exhibited higher headache frequency (57.14% experienced headaches 10-15 times per month), intensity (64.43% reported NRS score of 5-8), and duration (87.15% reported headache duration of over 4 hours) compared to controls. Hematological analysis revealed significantly lower mean hemoglobin (9.85±2.13 g/dL) and serum ferritin levels (30.72±7.65 ng/mL) in CDH patients compared to controls (13.1±2.70 g/dL and 65.09±12.82 ng/mL, respectively). A significant association between IDA and CDH was established (p<0.05). Conclusion: The study demonstrates a significant association between iron deficiency anemia and chronic daily headache, highlighting the potential role of iron deficiency in the development of CDH.

Background: Mechanical ventilation is an advanced intervention employed in neonatal intensive care units (NICUs) to assist neonates who require external ventilation for adequate gas exchange, while minimizing associated complications. Understanding the indications and short-term outcomes of mechanical ventilation is crucial for improving neonatal care, especially in developing countries with limited resources. Objective: To examine the indications and short-term outcomes of conventional mechanical ventilation in a neonatal intensive care unit of a tertiary care hospital in a developing country. Methods: This descriptive cross-sectional study was conducted from July 2022 to February 2023 in the Department of Paediatrics at Combined Military Hospital, Kharian. The study included 227 pediatric patients admitted to the NICU for mechanical ventilation, selected via consecutive non-probability sampling. Written informed consent was obtained from parents or guardians. Data collected included neonatal and pregnancy parameters, primary indication for mechanical ventilation, duration of mechanical ventilation, and length of hospital stay. Patients were monitored for complications such as pneumothorax, sepsis, and ventilator-associated pneumonia. Statistical analysis was performed using IBM SPSS Statistics for Windows, version 26.0. Quantitative variables were expressed as mean ± standard deviation or median and interquartile range, while qualitative variables were presented as frequencies and percentages. Comparisons were made using the Chi-square test, Fisher's exact test, independent samples t-test, or Mann-Whitney U test as appropriate, with a p-value of ≤0.05 considered significant. Results: The study included 128 males (56.4%) and 99 females (43.6%). The mean gestational age at birth was 36.4 ± 1.5 weeks, and the mean birth weight was 2994.1 ± 450.1 grams. Common indications for mechanical ventilation included pneumonia (26.4%), respiratory distress syndrome (24.7%), and sepsis (18.5%). The mean duration of mechanical ventilation was 7.1 ± 2.5 days, and the mean length of hospital stay was 13.4 ± 6.0 days. Complications were observed in 29.5% of patients, with ventilator-associated pneumonia (18.1%) being the most common, followed by sepsis (9.7%) and pneumothorax (5.3%). The overall mortality rate was 18.5%. Significant associations were found between mortality and duration of mechanical ventilation (p<0.001), occurrence of complications (p<0.001), and requirement for re-intubation (p<0.001). Conclusion: The study highlights the significant association between prolonged mechanical ventilation, the development of complications, and increased mortality in neonates. Effective strategies to prevent and manage complications, as well as to limit the duration of mechanical ventilation, are essential to improve neonatal outcomes in resource-limited settings.

Background: Septoplasty is a common surgical procedure used to correct a deviated nasal septum, which can cause nasal obstruction and impact respiratory function. Postoperative management traditionally includes nasal packing to prevent complications such as bleeding and hematoma, although it can be associated with discomfort and other complications. Quilting sutures have been proposed as an alternative technique to reduce these issues. Objective: To compare the postoperative outcomes of nasal packing versus quilting sutures in patients undergoing septoplasty. Methods: This prospective comparative cross-sectional study was conducted at the ENT unit of Combined Military Hospital Rawalpindi, Pakistan, after obtaining ethical approval. The sample size comprised 384 patients, with 192 in the nasal packing group and 192 in the quilting sutures group. Inclusion criteria included patients aged 18 to 70 years undergoing elective nasal septoplasty. Exclusion criteria were patients with nasal polyps, allergic rhinitis, diabetes, coagulation disorders, septal flap tears, those unfit for surgery, and those undergoing combined septoplasty and turbinate intervention. Patients were randomly assigned to either nasal packing or quilting sutures groups. Baseline characteristics, including age, gender, and BMI, were documented. Postoperative assessments were conducted at 48 hours, 1 week, and 3 months, evaluating pain using a visual analogue scale (VAS), bleeding, epiphora, dyspnea, hematoma, and adhesions. Data analysis was performed using SPSS version 26.0, with quantitative data represented as mean ± standard deviation and qualitative data as percentages and frequencies. Statistical significance was determined using chi-square and unpaired two-tailed Student’s t-tests, with p < 0.05 considered significant. Results: The mean age of participants was 34.37 ± 6.95 years. Gender distribution included 256 males (66.7%) and 128 females (33.3%). At 48 hours postoperatively, the nasal packing group had a higher mean pain score (5.96 ± 1.39) compared to the quilting sutures group (2.03 ± 1.05) (p < 0.001). Bleeding was more significant in the quilting sutures group (1.82 ± 0.60) than in the nasal packing group (1.27 ± 0.45) (p < 0.001). Epiphora and dyspnea were more common in the nasal packing group, with 48 patients (25%) and 81 patients (42.2%), respectively, compared to 8 patients (4.2%) and 6 patients (3.1%) in the quilting sutures group (p < 0.001). Hematoma occurrence was low and not significantly different between the groups. After 1 week, pain scores remained higher in the nasal packing group (1.45 ± 1.12) compared to the quilting sutures group (0.58 ± 0.79) (p < 0.001). At 3 months, pain scores were still higher in the nasal packing group (1.45 ± 1.12) compared to the quilting sutures group (0.58 ± 0.80) (p < 0.001), with no significant difference in adhesion formation. Conclusion: Quilting sutures resulted in lower postoperative pain and fewer complications compared to nasal packing in patients undergoing septoplasty, despite a slightly higher risk of bleeding. These findings suggest that quilting sutures may be a preferable alternative to nasal packing for postoperative management in septoplasty.