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Home > Frequencies and Association of Oral Mucosal Alterations And Periodontal Conditions With Type 2 Diabetes Mellitus in Pakistani Individuals

Frequencies and Association of Oral Mucosal Alterations And Periodontal Conditions With Type 2 Diabetes Mellitus in Pakistani Individuals

Thesis Info

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Author

Mohsin, Fareed

Program

PhD

Institute

Baqai Medical University

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2011

Thesis Completion Status

Completed

Subject

Natural Sciences

Language

English

Link

http://prr.hec.gov.pk/jspui/bitstream/123456789/2354/1/2943S.pdf

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676726240581

Similar


Diabetes mellitus is a growing public health concern and a chronic metabolic disease worldwide. It is recognized as a group of metabolic disorder characterized by chronic hyperglycemia and glucose intolerance, due to insulin deficiency, impaired effectiveness of insulin action or both. A number of oral health complications are frequently associated with diabetes mellitus. These include various inflammatory diseases like gingivitis, periodontitis and oral soft tissue pathologies. This study was done to explore an association between oral mucosal lesions and type 2 Diabetes mellitus with reference to clinical periodontal status, self-reported oral symptoms, oral yeast colonization, smoking, as well as tobacco-chewing habits. A total of 800 individuals’ i.e 395 patients with type 2 diabetes mellitus and 405 normal individuals were enrolled in this study. Previously diagnosed type 2 diabetic subjects were recruited from Baqai institute of diabetology and endocrinology and normal individuals from Baqai Medical University (from January 2010 to September 2012). Patients with type 1 diabetes were not included in this study. Four hundred and five systemically healthy subjects without diabetes and other illness with oral diseases were similar in socio-economic level and age recruited as control subjects after checking their fasting blood glucose level. These patients were selected from the department of periodontology and oral medicine, Baqai Medical University at the same time as the type 2 diabetes mellitus group. All clinical examinations were carried out by research scholar with the aid of a plane mouth mirror, gauze and a WHO CPITN probe. Radiography was not applied. Moreover, in cases requiring further confirmation, biopsies were obtained to establish an accurate diagnosis. The oral mucosal alterations were classified in two types’ oral mucosal lesions (OML) and potentially malignant disorders (PMDs), and periodontal disease was classified into Gingivitis and Periodontitis. In this study oral mucosal lesion was highly significant with a p value of < 0.0001 (odd ratio 2.601, CI 1.929-3.509) in type 2 diabetic as compared to non-diabetic. With respect to specific oral mucosal lesions we observed a highly significant association p<0.0001 (Odds ratio4.275, CI 7 2.798-6.534) of coated tongue (26.8%) with type 2 diabetes mellitus patients.Concerning potentially malignant disorder our study did not find any association between diabetes mellitus and potentially malignant disorder. We found a highly significant association of potentially malignant disorder p<0.001(odd ratio15.164, CI 5.119-44.921) and mixed lesions p<0.0001(odd ratio 8.571,CI 2.731-26.896) in individual using smokeless tobacco. In addition another relationship exists between periodontal disease and smokeless tobacco use. It shows that the smokeless tobacco caused a higher prevalence of gingivitis (76.4%) and periodontitis (77.4%) in the study population. Concerning oral hygiene habits, almost 87% of the total sample population surveyed reported daily oral hygiene habits. Brushing was the most frequent technique used (48.1%). Periodontitis was more frequent in diabetics than in non-diabetics. In our study we found a highly significant p<0.0001 association of periodontitis with type 2 diabetes mellitus. This is in agreement with many previous studies which pose diabetes as a risk factor for periodontal disease. With respect to glycemic control this study showed that there was a high percentage of periodontitis in patients with poor glycemic control, however statistical analysis disclosed no association between glycemic control and periodontal disease (odd ratio 1.621, CI 0.768-3.420). The cut-off point for Hemoglobin A1c (7%) used to distinguish those who were poorly controlled from those with better control. This study showed that the prevalence of oral mucosal lesions tends to be higher in diabetic than non-diabetics patients, however no association was observed between potentially malignant disorder and type 2 diabetes mellitus. A highly significant association of periodontitis with type 2 diabetes mellitus has been observed. In addition a highly significant association of potentially malignant disorder and mixed lesions in individual using smokeless tobacco was found. This study provides evidence that diabetes has a strong negative influence on oral health.
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ڈینگی ایک چیلنج

ڈینگی ایک چیلنج
نحمدہ وَ نُصَلِّیْ علی رسولہ الکریم امّا بعد فاعوذ بااللہ من الشیطن الرجیم
بسم اللہ الرحمن الرحیم
صدرِذی وقار معزز اسا تذہ کرام اور میرے ہم مکتب ساتھیو! آج مجھے جس موضوع پر لب کشائی کی سعادت حاصل کرنی ہے وہ ہے:’’ڈینگی ایک چیلنج،،
جنابِ صدر!
آج کل پورے پاکستان میں جس بیماری نے پاکستانیوں کے اعصاب کو مضمحل کر رکھا ہے وہ ڈینگی ہے اور ڈینگی بخار ہی کی ایک قسم ہے، چھوٹے، بڑے، امیر ،غریب ، کالے، گورے سب اس سے خوفزدہ ہیں ، سب اس سے فرار کا رستہ اختیار کرنے کے متمنی ہیں، اس کے نام سے ہی رونگٹے کھڑے ہوجاتے ہیں۔
صد رِمحترم!
فرمان ِباری تعالیٰ ہے ’’کہ ایّا م لوگوں کے درمیان ایک جیسے نہیں رہتے، بدلتے رہتے ہیں۔ ‘‘ وقت کا دھارا گزر جاتا ہے۔ خزاں کے ختم ہوتے ہی بادِ بہاری کو اٹھکیلیاں سوجھنا شروع ہو جاتی ہیں۔ مردہ پتے گرنے لگتے ہیں، اورنئے شگو فے کھلنا شروع ہو جاتے ہیں،چمنستانِ ہستی میں بہار آ جاتی ہے، ستاروں کی گردش، اور زمین کی حرکت ارضی اور سماوی تبدیلیوں کی نشاندہی کرتی ہے۔
اے ہم نشیں ! کلام میرا لا کلام ہے
سُن! زندگی تغیّرِ پیہم کا نام ہے
صدرِذی وقار!
انسان پر بھی حالات ایک جیسے نہیں رہتے،کبھی مسرت و شادمانی کی کیفیت ہوتی ہے، کبھی غم اور اندوہ ساتھ نبھانے کا تہیہ کر لیتے ہیں، کبھی امارات کے بادل سایہ فگن ہو جاتے ہیں، کبھی غربت و افلاس کی چکی میں پسنا مقدر بن جاتاہے۔ کبھی بیماری کا بھیانک چہرا جیسے ڈینگی کی صورت میں سامنے آتا ہے دیکھنا پڑتا ہے اورکبھی تندرستی اور صحت کی نوید جانفرا سنائی دینا شروع کر دیتی ہے۔
جنابِ صدر!
انسان اشرف مخلوقات پیدا فرمایا گیا ہے۔ اس کونشیب و فراز سے واسطہ...

اسلامی ریاست میں داخلی استحکام کے لیے مرکز اور صوبوں کے تعلقات

There is a dire need of an experienced and authoritative mechanism in the polity of Islām in order to run the affairs of the state in a benefiting manner. This mechanism divides the state into different regions and provinces so as to carry out the affairs of the state in an organized way. These provinces must be founded on some administrative basis, not on racial, lingual or regional grounds. It is necessary that these units are autonomous as far as authority and power is concerned. It will help eradicate parochial differences and strengthen integrity of a country. It is essential to keep up and safeguard the freedom and the rights of these units. We can get our desired objectives, if legal and constitutional safeguards are meted out to these administrative units of the state. According to ‘Allāmah Ibn Khaldūn’s point of view, it is imperative to strengthen a state instead of expanding it. There must be small but integrated autonomous units of the state. Such division helps these units to progress and prosper. The golden principle of power distribution is in vogue in all eras, although its structure has been different and varied. In this article, we are going to view the structure of distribution in the perspective in an Islamic state

Genetic Mapping and Mutation Analysis of Genes Causing Disorders of Human Ectodermal Appendages

The study, presented in the thesis, is an effort to explore genetic basis of disorders of ectodermal appendages in different ethnic populations living across Pakistan. Hereditary hypotrichosis and ectodermal dysplasias are large, complex and heterogeneous groups of heritable conditions characterized by congenital abnormalities of ectodermal appendages. They can broadly be characterized into two groups depending upon the absence (isolated) or presence (syndromic) of associated defects in other organ/organ systems. Discovery of genes responsible for these disorders is the key source of insight into the molecular mechanisms of development and differentiation of ectodermal appendages. Focus of the present study was to identify and characterize genes causing hereditary disorders of ectodermal appendages in fifteen families (A-O) of Pakistani origin. Eleven of these families (A-K) were segregating various types of hair loss disorders and four families (L-O) ectodermal dysplasias. Combination of various techniques including microsatellite and SNP genotyping, Sanger sequencing and exome sequence analysis assisted in establishing linkage and identifying disease causing variants in the families. Four families (A, B, C, D) with non-syndromic hair loss failed to show linkage to the known genes. Subsequently, three of them were subjected to whole-genome SNP genotyping. Human genome scan mapped a novel disease locus of 10.85 Mb on chromosome 2q31.1–q32.2 in family A. Sequencing of the three selected putative candidate genes (ITGA6, PRKRA, ATF2), mapped in the linkage interval, did not reveal any functional variant in the family. Family B showed linkage to chromosome 6p25.1–p23, and subsequently a novel variant (c.1493C>T; p.Pro498Leu) in the DSP gene was identified upon sequencing. Whole-genome SNP genotyping coupled with whole exome sequencing identified two compound heterozygous deletions, a novel (c.278_278delA; p.Lys93Argfs*9) and a previously reported (c.659_660delTA; p.Ile220Argfs*25), in the LIPH gene in family D. Genetic Mapping and Mutation Analysis of Genes Causing Disorders of Human Ectodermal Appendages xixAbstract Six families (E, F, G, H, I, J) with non-syndromic hair loss showed linkage to previously reported genes (LIPH, LPAR6, HR) involved in causing hypotrichosis. Linkage in four of these families (E, F, G, H) was established to the LIPH gene on chromosome 3q26.33–q27.3. Sequence analysis of the LIPH revealed a previously described deletion (c.659-660delTA; p.Ile220Argfs*25) in three families (F, G, H). However, sequence analysis failed to detect variant in the LIPH gene in family E. Haplotype analysis showed linkage of the family I to the LPAR6 gene on chromosome 13q14.11–q21.32. Sequence analysis of the gene revealed a previously described variant (c.562A>T; p.Ile188Phe) in the family. In the family J, linkage was established to the HR gene on chromosome 8p21.3. Sequencing of the gene revealed a previously reported variant (c.2070C>A; p.Cys690*). In the family K, segregating novel features associated with hair loss, exome sequence analysis led to the identification of a novel rare variant (c.898G>A; p.Glu300Lys) in ITGB6 gene that co-segregated with the phenotype in the family. Four families (L-O) showed features of different forms of ectodermal dysplasias. The family L showed features of pure hair and nail ectodermal dysplasia (PHNED). Haplotype analysis mapped the family to the previously reported locus on chromosome 12p13.11–q21.1. Three genes (KRT85, HOXC13, KRT74), known to cause PHNED lie in this region, were screened but found to be negative for any potential sequence variant. Haplotype analysis established linkage to the previously proposed locus on chromosome 4q32.3–q34.3 in family M segregating isolated form of congenital nail clubbing (ICNC). HPGD, a cause of ICNC, lies in this region, was sequenced but found to be negative for any potential variant. Genome-wide homozygosity mapping complimented with whole exome sequencing identified a previously reported variant (c.5314C>T; p.Arg1772Trp) in COL7A1 segregating autosomal recessive form of dystrophic epidermolysis bullosa (RDEB) in the family N. In family O, segregating variegate porphyria (VP), exome sequence analysis led to the identification of a previously described sequence variant (c.502C>T; p.Arg168Cys) in the PPOX gene that co-segregated with the disease.