Objective. To investigate the role of implant surface debridement alone and in conjunction with systemic antibiotics on the clinical and microbiological variables of periimplantitis. Materials and Methods. Data of forty‐six patients with at least one dental implant having bleeding‐on‐probing (BoP), probing pocket depth (PPD) of more than 5 mm, and radiographic bone loss of more than 3 mm were retrieved from clinical records. Data was recorded for dental implant with the deepest PPD, BoP, and bone loss from each patient. “Group‐A” received implant surface debridement alone, while “group‐B” additionally received systemic antibiotics. Clinical and microbiological data of patients were compared before and after the treatment. Results. At the implant level, a significant reduction of PPD, mucosal recession (MR), and BoP was achieved for all patients. Group B achieved significant improvement in MR and BoP compared to group A at implant level. PPD, MR, and plaque scores showed improvement at implant site level. At 3 months recall visit, 44% of group A and 52% of group B implants required surgical treatment. The presence and proportions of studied bacteria of both groups did not differ significantly at the recall visit when compared to the initial visit. However, P. intermedia and P. micros showed a significant reduction in group A at the recall visit. Conclusions. Implant surface debridement improved the clinical parameters of periimplantitis. In addition, adjunctive use of systemic antibiotics increased mucosal recession and improved bleeding on probing in periimplantitis.

The global prevalence of type 2 diabetes is alarmingly high, and a considerable proportion of diabetes patients suffer from anxiety and depression. The presence of anxiety and depression worsens the prognosis of diabetes; it increases non-compliance to the treatment and mortality rate. A cross-sectional study of adults ages 20 years or older was conducted in 24 districts of Khyber Pakhtunkhwa (KP). Individuals diagnosed by a certified medical doctor with type 2 diabetes were recruited using multistage stratified cluster sampling. The Agha Khan University Anxiety and Depression Scale (AKUADS) was used for assessment. Chi-square and logistic regression were used to assess the association between depressive disorder and characteristics of the study participants. The results showed that 31.64% of type 2 diabetic patients suffered from anxiety and depression. Prevalence was higher in individuals aged ≤40 years (37.75%), females (40.58%) compared to males (26.48%), individuals without formal education (38.48%), and underweight participants (55%). Anxiety and depression were also prevalent among housewives (38.04%), rural residents (34.76%), and current smokers (43.14%). Multivariate logistic regression indicated significantly higher odds of anxiety and depression among individuals with primary education (OR = 4.73, p-value = 0.03), underweight individuals (OR = 4.46, p-value = 0.001), and those reporting pain (OR = 2.82, p-value < 0.001). The high prevalence of anxiety and depression in the known diabetic population in the KP province of Pakistan requires the development of strategies for screening, awareness related to the contributing factors, and treatment of co-morbid depression at community level.

Background: Type 2 diabetes mellitus (T2DM) is significantly associated with both morbidity and mortality, particularly in low- and middle-income countries. Diabetes related complications are influenced by clinical, socioeconomic and psychological factors. This study involves assessment of prevalence and severity of diabetes related complications in a longitudinal community-based cohort from Khyber Pakhtunkhwa, Pakistan.Methods: A longitudinal study was conducted among adults with known T2DM. These individuals were identified in 2015-16 and followed back in the community in 2025. Baseline data included demographic, socioeconomic, clinical, psychological and health related quality of life variables. Follow up assessment of the presence and severity of complications was performed using the DCSI tool. DCSI scores were classified into mild, moderate and severe risk categories. Risk categories were compared using chi-square tests and ANOVA while multivariable linear regression was used for identification of independent predictors of DCSI scores.Findings: In a total of 65 participants, 26 (40.0%) were categorized as severe risk, 15 (23.1%) as moderate risk and 36.9% as mild risk. Mean age varied significantly (p=0.03) with participants in the severe risk group older (64.8 years) compared to moderate (60.1%) and mild (58.0%) risk groups. Duration of diabetes was significantly associated with greater complication severity (16.3 in severe risk group vs 12.5 years in mild risk group; p=0.01). Both monthly income and marital status were also significantly associated with higher risk severity (p=0.004 and p=0.03, respectively). In multivariable regression analysis, older age (β=0·05, p=0·05), Higher BMI (β=0·09, p=0·04) and married status (β=1·98, p=0·01) were associated with higher DCSI scores.Conclusion: A higher proportion of adults with T2DM developed moderate to severe diabetes related complication over time. Older age, longer disease duration, higher BMI and marital status were significantly associated with higher complication severity. The findings of this study suggest early risk assessment, long-term follow up and timely interventions to reduce diabetes related complications.