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Introduction: Despite the implementation of resident work hour regulations, studies have not consistently shown beneficial changes in residents’ sleep quality or duration. We hypothesized that inter-individual sleep-related differences may exist prior to training and the pre-existing sleep health and habits may impact training. Objective: To determine interns’ baseline sleep quality, sleep hygiene, chronotypes, and their correlates at the beginning of their residency training program. Methods: A cross-sectional study using an anonymous “Resident Sleep Survey” included baseline demographic information and questionnaires, including the Epworth Sleepiness Scale (ESS), the Pittsburgh’s Sleep Quality Index (PSQI), the Morningness-Eveningness Questionnaire (MEQ), and the Sleep Hygiene Index (SHI). Results: One hundred and twenty-nine subjects participated the study; 45.7 % (n=59) were male and 18.6 % (n=24) were married. Twenty percent of interns had an ESS >10. The PSQI revealed that 28% of interns had poor sleep hygiene. The mean sleep efficiency was 91.2 ±7.4% estimated from the PSQI. Non-married interns had a lower prevalence of morning chronotypes (22.3% vs. 45.8%, p=0.02). Morning chronotype interns had a lower ESS score (6.1 ±3.1 vs. 7.6 ±3.6, p=0.03) and a lower SHI (29 ±7.0 vs. 34.3 ±7.1, p=0.003). Conclusion: About a quarter of interns had poor sleep quality and excessive daytime sleepiness prior to their training. Non-morning chronotype interns appeared to have more daytime sleepiness and poorer sleep quality. Since pre-existing sleep problems may adversely affect learning, we suggest that strategies to improve sleep hygiene and quality in this specific population should be emphasized early in their training.

Objective: Diabetes mellitis, when chronic and uncontrolled, is undeniably associated with myriad health complications, most importantly immune dysfunction and healing abnormalities. The ensuing tissue injury and the ineffective healing, particularly in the foot, is oft en compounded by bacterial and fungal infections, which predispose to the development of infected diabetic foot ulcer (DFU) - a grave complication ending up in foot amputation in significant number of patients. This study assesses the prevalence and patt ern of dermatophytes in diabetic foot ulcer. Material and Methods: In this study we included a total of 298 diabetic patients with diabetic foot ulcers who presented to JPMC from June 2019 till June 2020. We recorded their demographic features and blood glucose level at the time of sample taking. The foot ulcers were graded according to Wagner/Meggit ulcer grading scale. Taking aseptic measures, samples were taken from the ulcers and skin at the ulcers edge and, processed and interpreted according to standard guidelines. Results: Fungal positivity was more in men (61%) than women (39%). Overall mean age (± SD) was 50.0(± 8.1) years. On fungal culture, total fungus positive cases were 92 (30.9%) out of which 49 (53%) were dermatophytes (p<0.01). Prevalence of dermatophytes in the DFU (tinea pedis) of population studied was found to be 16.44%. The most frequently isolated species was Tinea rubrum (43%) followed by Tinea mentagrophytes (29%). Conclusion: This study showed that dermatophytes are associated with Diabetic Foot Ulcer in significant number of cases. Specific antifungals must be prescribed to treat dermatophyte infection (tinea pedis) and prevent its most horrendous complication, foot amputation. This is only possible when a high clinical suspicion is supported by timely and appropriate screening for fungi, such as dermatophytes, especially, when lesions are refractory to repeated anti-bacterial therapy. [ABSTRACT FROM AUTHOR]

Objective: Chronic, uncontrolled diabetes mellitis is associated with dysfunctions of the immune and healing systems. Consequently, repeated infections by bacteria and/or fungi and the sluggish healing process, pose a constant threat to the integrity of tissues, particularly the frequently injuring feet, leading to grave complications. This study assesses the identification of fungal elements in scrapings from diabetic foot ulcer through direct microscopy using 10% potassium hydroxide and lacto-phenol cott on blue. Material and Methods: In this study, we included 298 diabetic patients with foot ulcers from June 2016 to June 2019. We recorded their demographic features, blood glucose at the time of clinical examination, and the grades of the ulcers according to Wagner ulcer grading scale. The samples from scrapings were taken with sterilized instruments from the edges of the ulcers and handled as per recommended guidelines. Results: Fungal positivity was more in men (56.7%) than women (43.3%). Overall mean (±SD) age was 50.0 (± 8.1). On fungal culture, total fungus positive cases were 30.9%. On simple microscopy, using KOH/LPCB, dermatophytes were identified in 95% (p < 0.05) of the true positive cases. Conclusion: The microscopy of skin scrapings from diabetic foot ulcer, using 10-20% potassium hydroxide and lacto-phenol cott on blue, is a simple and effective out-patient technique with an acceptable yield in terms of identifying fungal elements. Other similar studies have shown corresponding conclusions. [ABSTRACT FROM AUTHOR]

Context and Aim: In today's world of advanced dentistry, there are various aspects of restorative, esthetic, and surgical processes. Healing of an extraction socket comprises of bone as well as soft-tissue remodeling with maximum dimensional changes occurring during the first 3 months. Platelet-rich fibrin (PRF) was first developed in France as a therapeutic alternative to platelet-rich plasma to overcome many of its limitations. The present study was planned to evaluate and compare wound healing and bone regeneration in extraction sockets with and without PRF. Materials and Methods: The present study was carried out on 30 patients selected from the outpatient department over a period of 2½ years starting from May 2013 undergoing extraction of maxillary or mandibular teeth simultaneously to conduct a split-mouth study. The research protocol was approved by the Institutional Ethics Committee governing the use of human subjects in clinical experimentation. Statistical Analysis Used: Descriptive and analytical statistics were calculated using Statistical Package for Social Sciences version 19. Chi-square test was used to assess wound healing score in the two groups while paired t-test was used to compare the bone density in the socket and periapical regions at different time intervals, and unpaired t-test was used for the intergroup comparisons. P < 0.05 was considered to be significant while P < 0.001 was considered highly significant. Results: Patients in PRF group had better healing index when compared to without PRF group. Use of PRF showed a comparable increase in bone density too. Conclusion: An appreciable wound healing and bone regeneration was seen in the experimental group when compared to the control sites where no PRF was used substantiating the use of PRF as an inexpensive autologous material for socket preservation and future rehabilitation. The present study, also, showed that minimal operator expertise was required to conduct the procedure of PRF preparation and grafting when compared to bone harvesting from distant sites. The shorter duration between extractions and further rehabilitation obviates the need for a second procedure. [ABSTRACT FROM AUTHOR]

Objective: To study the frequency and diversity of fungi involved in onychomycosis., Methods: The cross-sectional study was conducted from February 2018 to February 2019 at the Department of Microbiology, Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi, and the University of Karachi. Specimens were taken from patients suffering with onychomycosis attending the Dermatology Department of Jinnah Postgraduate Medical Centre and were processed for the isolation of fungi. Specimens were processed for the diagnosis by potassium hydroxide mount for microscopic evaluation and mycological culture to determine the type of fungus involved in onychomycosis. Fungi were isolated using Sabouraud Dextrose Agar with antibiotics cycloheximide and chloramphenicol, and without antibiotics. Plates were observed for the growth periodically until 4th week. Appearance of any colony was studied further for identification on the basis of cultural characteristics and microscopy. Precise identification of Candida species was done., Results: Of the 230 samples, 85(36.96%) were from males and 145(63.04%) from females. Potassium hydroxide mount showed fungal element in 134(58.26%) specimens, while in 111(48.26%) patients the fungal culture was positive. Nine (3.9%) cases were culture-positive but potassium hydroxide-negative, while among the 134(58.26%) potassium hydroxide-positive cases, 32(23.9%) were culture-negative.

Objective: To determine the prevalence of fungal infections causing nasal polyposis (AFRS-Allergic fungal rhino sinusitis) in the local population., Methods: It is a cross sectional study, carried out from October 2010 to January 2015 on 221 patients in the ENT Department of Abbasi Shaheed Hospital and Karachi Medical & Dental College in collaboration with the microbiology department. This study included patients who had a clinical diagnosis of nasal polyposis with or without fungal infection on the basis of nasoendoscopic examinations. All patients underwent Functional Endoscopic Sinus Surgery (FESS) and the diagnosis of (AFRS-Allergic fungal rhino sinusitis) was considered after histopathological confirmation of eosinophilic mucous containing hyphae. Numerator included the total number of patients who presented to the ENT out-patient clinic of Abbasi Shaheed Hospital suffering from nasal polyposis secondary to fungal infection during the follow-up period of the study. On the other hand, denominator included all the patients who attended the ENT out-patient clinics during the same follow-up period. This determined the period prevalence of fungal infections in nasal polyposis at a tertiary care centre in Karachi., Results: Data was collected, a descriptive analysis was performed and a Computed Tomography (CT) grading was done. On the basis of histopathology, 90 (40.7%) patients were found to have fungal infection., Conclusions: The prevalence of fungal infections was 40.7% (90 patients) in nasal polyposis.

Objective: To assess the frequency of Candida in cases of onychomycosis ata tertiary care facility in an urban area., Methods: The cross-sectional study was carried out from September 2009 to July 2010 at the Department of Microbiology, Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi. It involved 124 patients, who were clinically diagnosed as cases of onychomycosis with the collaboration of the hospital's Dermatology Department. The specimens were processed for the diagnosis by mycological culture using Sabouraud's dextrose agar at 25 degrees C and at 37 degrees C. Observation for growth was done periodically for 4 weeks; if growth was present, the pathogen was identified by cultural characteristics and microscopy. Descriptive statistics (with frequency and percentage) of the type of fungus and organisms were evaluated., Results: Of the 124 cases, 52 (42%) tested positive and represented the final study sample. Candida was observed in 16 (30.76%) patients., Conclusion: There was high frequency of Candida involvement in clinically diagnosed cases of onychomycosis.