Comparative Evaluation of Quality Management Practices in the Public and Private Hospitals in Visakhapatnam District: An Original Research

Background

In the Visakhapatnam District, this study compares the quality management procedures used by public and private hospitals. Knowing how these practices are similar and different from one another can help inform policy decisions and improve the quality of health care.

Materials and Methods

A cross-sectional study design was used, and 100 hospitals from both public (50 hospitals) and private (50 hospitals) were included in the sample size. A standardized questionnaire that evaluated different aspects of quality management practices was used to gather the data. Descriptive statistics and inferential tests were used in the quantitative analysis.

Results

Significant variations in quality management procedures between public and private hospitals were found. In terms of patient happiness, service responsiveness, and technological use, private hospitals scored better. Regarding accessibility, cost, and equity of healthcare services, public hospitals fared better.

Conclusion

The report emphasizes the necessity of focused initiatives to improve quality management procedures in both public and commercial institutions. Collaboration between the two sectors can make it easier to deploy evidence-based tactics and share best practices to raise overall healthcare quality in the Visakhapatnam area.

Evaluation of Efficacy of Different Plating Systems in ZMC Fractures: An Original Research

Objective

This study's objective was to assess and contrast the performance of several plating techniques in the treatment of zygomaticomaxillary complex (ZMC) fractures. Group A (Microplate System), Group B (Titanium Mesh System), and Group C (Absorbable Plate System) plating systems were the ones that were studied.

Materials and Methods

With 10 patients in each group, a retrospective analysis of 30 patients with ZMC fractures was done. The following information was gathered: fracture reduction, stable fixation, complications, and patient satisfaction. Analysis was done on patient-reported outcomes, surgical outcomes, and demographic factors.

Results

Group B (Titanium Mesh System) came in second with rates of 70% and 80%, respectively, while Group A (Microplate System) showed the highest rates of fracture reduction (90%) and stable fixation (100%). For fracture reduction and stable fixation, Group C (Absorbable Plate System) demonstrated rates of 80% and 90%, respectively. For Groups A, B, and C, the complication rates were 20%, 30%, and 10%, respectively. For Groups A, B, and C, the patient satisfaction levels were 90%, 80%, and 70%, respectively.

Conclusion

According to the results, the Microplate System (Group A) is better than the Titanium Mesh System (Group B) and the Absorbable Plate System (Group C) in terms of fracture reduction and stable fixation when treating ZMC fractures. All plating systems had acceptable complication rates, and overall patient satisfaction ratings were high. Fracture features and patient-specific considerations should be taken into account while making individualized treatment options.

Choice of Surgeons in Retractors used in Cleft Lip and Palate Surgery: An Original Research

Background

To ensure optimal exposure and enable precise tissue manipulation, cleft lip and palate abnormalities require surgical repair utilizing retractors. Different retractors may affect surgical outcomes; however, this is not yet evident. Examining surgeon preferences for retractors in cleft lip and palate surgery and assessing their impact on patient outcomes were the goals of this study.

Materials and Methods

The patients who underwent primary cleft lip and palate repair were retrospectively analyzed. This study evaluated three widely used retractors: the Langenbeck, Gelpi, and Moult Mouth Gag retractors. This study looked at demographic information, surgical results (including scarring, aesthetic outcomes, and wound healing issues), and surgeon preferences for retractors.

Results

The study identified differences in surgical outcomes related to various retractor types. Both Group A (Langenbeck retractor) and Group B (Gelpi retractor) demonstrated similar favorable results, such as little wound healing issues, less scarring, and pleasing cosmetic results. The wound healing issues, scarring, and cosmetic outcomes were all worse in Group C (Moult Mouth Gag retractor).

Conclusion

Retractors were not always preferred by surgeons doing cleft lip and palate surgery. The type of retractor had an impact on the surgical results; the Moult Mouth Gag retractor performed less well than the Langenbeck and Gelpi retractors. These results highlight the value of using evidence-based criteria to select retractors more effectively and enhance surgical methods for better patient outcomes in cleft lip and palate repair.

Clinical Evaluation of Two Distinct Materials for Implant-Supported Interim Fixed Partial Prostheses: An Original Research

Aim

This study aimed to evaluate the clinical efficacy of posterior resin implant-supported fixed partial dentures (FPDs) made from two different computer-aided design and computer-aided manufacturing (CAD-CAM) materials: polymethylmethacrylate (PMMA) and polyoxymethylene (POM).

Materials and Methods

Twenty-one patients received a total of 49 interim implant-supported FPDs. The same participant received PMMA and POM as part of the control and experimental groups, respectively. The restorations were evaluated 1 week, 3 months, and 6 months after placement. In addition, their functional wear and color stability were assessed. Nonparametric statistics (α = 0.05) were used to analyze the data.

Results

The study found that PMMA outperformed POM in surface and color parameters, with more fractures occurring with internal conical connection implants. The color stability analysis showed ΔE*ab values of 7.18 for PMMA and 8.8 for POM, with no significant differences. After 6 months of operation, both materials showed a significant increase in wear, but no significant differences were found within the materials.

Conclusion

The study found that PMMA interim implant-supported FPDs outperformed POM in surface and color parameters, while polymer posterior implant-supported FPDs with internal conical connection implants were more fracture-prone.

Evaluation of Failure in Single-Piece Implant Systems: A One-Year Follow-Up Study

Objective

This study's goal was to assess the failure rate and peri-implant complications of single-piece implant systems over the course of a one-year follow-up.

Materials and Methods

Patient records were examined retrospectively. 150 single-piece dental implants were analyzed. Clinical results, implant features, and demographic information were gathered. Implant failure, which is characterized as the total loss of osseointegration, served as the key outcome indicator. Patient satisfaction and peri-implant problems were secondary outcomes. Data analysis employed descriptive statistics.

Results

During the one-year follow-up period, the failure rate for single-piece implant systems was 6.7%. The two main factors leading to implant failure were found to be poor osseointegration (60%) and biomechanical overload (40%). 20% of the cases had peri-implant problems, such as peri-implantitis. 85% of the panelists felt that single-piece implants had satisfied their patients.

Conclusion

A 6.7% failure rate in single-piece implant systems was seen in this one-year follow-up investigation. The major causes of implant failure were found to be poor osseointegration and biomechanical loading. In 20% of the cases, peri-implant problems such as peri-implantitis, were noted. There was great patient satisfaction. These results highlight the significance of regulating occlusal forces, optimizing osseointegration, and applying preventive measures to ensure the long-term viability of single-piece implant systems.

Isolation Systems and its Effectiveness in Oral and Maxillofacial Surgery: A Systematic Review

Introduction

The success of restoration processes depends on the efficient control of moisture and microorganisms. Dental restorative procedures frequently use rubber dams as an isolation technique. There is still room for evidence-based discussion over how rubber dam use affects the durability and caliber of dental restorations. In this review, the effects of rubber dam isolation vs alternative isolation techniques for dental restorative procedures are compared.

Materials and Procedures

An extensive online search in the various databanks of the EMBASE, Medline, Pubmed, and Scopus was conducted. The keywords searched were "isolation, oral surgery, dental surgery, retractors, rubber dam, and methods of isolation." The studies selected were longitudinal research design and randomized trials. To ascertain the risk of bias, meta-analysis was carried out. The outcome was measured as the successful restoration at the end of follow-up period representing the thorough isolation.

Results

A total of 1342 people were involved in six studies from across the world that were carried out between 2010 and 2015. High bias risk existed in all the studies. Five investigations compared the rubber dam vs cotton rolls. Due to discrepancies in the data supplied, one study was omitted from the analysis. Three of the four trials that were still running showed restored survival rates with all having a follow-up of at least six months. The survival of the restored composite teeth for six months in rubber dam isolation with odds ratio of 2.29, 1.38, and 1.00 at the end of six months, one year and one and half year respectively. However, the evidence was very low and speculative. The isolation was seen effective in the primary teeth specifically for the proximal lesions. None of the included studies discussed side effects or provided information on the treatment's upfront costs.

Conclusion

The application of rubber dams in dental techniques may result in successful outcome compared to cotton rolls, according to some low-certainty evidence revealed in this research. Other times, the evidence is really ambiguous. It is necessary to conduct additional, high-quality studies investigating how rubber dam use affects various restorative procedures.

Mental Health Status of Health Care Professionals Working in Public and Private Sectors in Visakhapatnam: A Cross-Section Study

Introduction

The material that is currently available on the psychological issues that doctors deal with is restricted to a few national surveys and certain particular hospital surveys. The motive of the current study was to define the mental health status of medical as well as surgical professionals working in the public and private sectors of Visakhapatnam, Andhra Pradesh, India.

Methodology

A self-reported questionnaire survey was used in an observational cross-sectional study to appraise the mental health state of both private and public medical practitioners. The Kessler Psychological Distress Scale (K10) by William C. Menninger was applied.

Results

The majority of study participants experienced psychological anguish, showing a substantial difference in the total level of psychological distress. When the Wellinger's Distress and the Kesslers Distress tools were compared, it was found that there was a substantial difference for all the variables taken into account in the current study, including gender, experience, marital status, children, and occupation, designation, and sector of work.

Conclusion

Stress and burnout were more prevalent among medical specialists with lower yearly income, young ages, and fewer years of practice. Clinicians and policymakers must be proactive in creating programes that help healthcare professionals cope with stress and burnout.

Various Assisted Bone Regeneration in Apicectomy Defects Systematic Review and Meta Analysis

INTRODUCTION

In the endodontic surgery, the common applications are the procedures that apply regenerative methods. There are various methods that help in the regeneration after the endodontic root end cutting or apicectomy. The outcome of the apicectomy depends on the procedure and the material. Hence in the present study, we intend to conduct the systemic review and meta-analysis of the various assisted bone regeneration in apicectomy defects.

MATERIALS AND METHODS

The study was conducted by the online search of the data that included the studies for the regenerative procedure in the endodontic surgery in patients with various periapical pathologies. The data search engines were Scopus, Web of Science, Google Scholar, and PubMed. The risk of the bias was calculated. The study participants were divided into case and control groups. Case group had undergone the regenerative surgery for the persistent periapical lesions, while the control group had not undergone the regenerative surgery for the persistent periapical l. The clinical and the radiograph outcomes were compared between the control and the case groups. Meta-analysis was done and the subgroups were evaluated.

RESULTS

From a total of 1561 articles, only 11 were finalized for the study to conduct the meta-analysis. The bias was noted for majority of the studies most of which were clinical trials. It was observed that the regenerative methods used in the endodontic surgery have significantly improved the outcome. The application of the expanded polytetrafluoroethylene only has no significant effect; however, application of the autologous platelet concentrates or collagen membranes only had good outcomes. The combination of the materials showed a significant outcome than when applied alone.

CONCLUSIONS

From this meta-analysis, it is evident that regenerative procedures are beneficial in the endodontic apicectomy procedures. The materials used in these procedures will augment the outcome. A better prognosis is expected if the combination of the materials is used.

Functional Role of Inorganic Trace Elements on Enamel and Dentin Formation: A Review

Calcium and phosphate are the major components of hydroxyapatite crystals that form the inorganic portion of the teeth. Apart from these, certain elements are present in little amounts in enamel and dentin of the human teeth. Although they are required in minute quantities, their absence may alter healthy development of enamel and dentin and may result in developmental tooth defects as well as dental caries. Furthermore, excessive intake of some trace elements may inversely affect tooth development and health. The exact of effects that trace elements have on teeth and oral health is still an unexplored territory. The present paper reviews the presence of trace elements in teeth and their role in tooth health and development.

COVID 19 Scoping: A Systemic Review and Meta-Analysis

Introduction:

The world has faced the pandemic of COVID-19 in the march of 2020 and still it continues to effect in 2021. Hence, in the present study we aim to evaluate the gulps in the research so that certain recommendations can be made for the future research. We conducted a scoping review of the COVID meta-analysis.

Materials and Methods:

Online data was collected from the search engines of EBSCO, PubMed, Google Scholar, and Scopus. The searched terms were COVID-19, CORONA, SARS-CoV-2, clinical features, Wuhan, etc. The study articles were collected that from January 2020 to February 2021. Based on the PRISMA guidelines, the meta-analysis was performed.

Results:

In the present study, we finalized 316 articles. On February 2020, the first article was published. We observed a spike in the meta-analysis later on. Most of the meta-analysis were issued in the virology and infection magazines. As expected, the majority studies were from Wuhan. The other countries that published the meta-analysis were the USA, the UK, and Italy. The studies included in each meta-analysis were nearly 25 and the subjects were approximately 16 thousand. However, we noticed a poor quality in majority of these meta-analysis and <10% of all the meta-analysis showed higher confidence.

Conclusion:

A poor quality of the meta-analysis has predominated the data and very few are of high quality. All the journal editors and the reviewing team should verify and thoroughly organize the protocol so that only high quality meta-analysis are encouraged.

Is Open Reduction and Internal Fixation Sacrosanct in the Management of Subcondylar Fractures: A Comparative Study

PURPOSE

This paper is intended to compare and evaluate the better treatment option in the management of subcondylar fractures of the mandible.

MATERIALS AND METHODS

This study included 20 patients who were diagnosed clinically and radiologically to have sustained an isolated subcondylar fracture of the mandible. They were divided into two groups randomly. Group I included 10 patients who underwent treatment by intermaxillary fixation alone followed by active physiotherapy in the form of conservative management. Group II included 10 patients who underwent treatment by surgical intervention for open reduction and internal fixation under general anesthesia following elastic guidance. Factors such as maximal mouth opening, pain scores, and deviation of mandible on mouth opening were taken into consideration and evaluated.

RESULTS

It is observed that the patients in Group I had weight loss and restrictions in their social well-being in the early recovery phase, in addition to delay in return to function. In spite of the early return to function, patients in Group II were subjected to all kinds of surgical complications such as transient facial nerve injury, infection, and unesthetic scar. The maximal mouth opening and deviation of the mandible on mouth opening remained almost the same in both groups.

CONCLUSION

A regular follow up of operated patients post trauma is essential to obtain morphological and functional recovery. When the respective advantages and disadvantages of both treatment options were compared and evaluated, it was observed that patients treated by closed reduction had a better clinical and psychological outcome.

Prevalence of Titanium Hypersensitivity in Patients with Titanium Implants: A Systematic Review and Meta-analysis

BACKGROUND

With increase in exposure to titanium in daily life and its use in medical procedures, there is a greater chance for developing titanium hypersensitivity. Our aim and objective is to examine whether patient patients with titanium implants had a greater incidence of titanium hypersensitivity or not. Titanium is widely considered to have good biocompatibility. A passivating surface layer of TiO₂ is formed when exposed to air which gives it good corrosion resistance. These properties along with its high strength, lightweight, and improvements in smelting technologies have led to its widespread use as an intraosseous and periosteal implant in dentistry and orthopedics.

MATERIALS AND METHODS

Only case-control studies were used for the meta-analysis. Studies with a sample size of <5 were excluded. Cutaneous and epicutaneous tests were used in the study.

RESULTS

Three studies met the inclusion criteria. Titanium hypersensitivity is more prevalent in patients with titanium implants.

CONCLUSIONS

It is also used in a variety of medical devices such as pacemakers and insulin pumps. Moreover, our external exposure to titanium is increasing. It is used in aerospace, chemical, and automobile industries. It is also used in jewelry, home furnishings, and in making sports and marine equipment. Titanium implants increase the possibility of developing titanium hypersensitivity, and thus, it should be considered as a major factor in unexplained implant failure where other causes have been excluded.

Cardiovascular Complications and its Impact on outcomes in COVID-19: An Original Research

INTRODUCTION

The viral infection COVID-19 is highly infectious and has claimed many lives till date and is still continuing to consume lives. In the COVID-19, along with pulmonary symptoms, cardiovascular (CV) events were also recorded that have known to significantly contribute to the mortality. In our study, we designed and validated a new risk score that can predict CV events, and also evaluated the effect of these complications on the prognosis in COVID-19 patients.

MATERIALS AND METHODS

A retrospective, multicenter, observational study was done among 1000 laboratory-confirmed COVID-19 patients between June 2020 and December 2020. All the data of the clinical and laboratory parameters were collected. Patients were randomly divided into two groups for testing and validating the hypothesis. The identification of the independent risk factors was done by the logistic regression analysis method.

RESULTS

Of all the types of the clinical and laboratory parameters, ten "independent risk factors" were identified associated with CV events in Group A: male gender, older age, chronic heart disease, cough, lymphocyte count <1.1 × 10⁹/L at admission, blood urea nitrogen >7 mmol/L at admission, estimated glomerular filtration rate <90 ml/min/1.73 m² at admission, activated partial thromboplastin time >37 S, D-dimer, and procalcitonin >0.5 mg/L. In our study, we found that CV events were significantly related with inferior prognosis (P < 0.001).

CONCLUSIONS

A new risk scoring system was designed in our study, which may be used as a predictive tool for CV complications among the patients with COVID-19 infection.

The Effectiveness of the Bilobed Pectoralis Major Myocutaneous Flap at a Tertiary Care Hospital: A Retrospective Analytical Study

BACKGROUND

Cosmetic defects after the major orofacial disease corrections may have an effect on the overall well-being of the patient. Head-and-neck cosmetic surgeries after a major episode of oral cancer impact the functional ability of the individual in several ways. In general, two types of flap are used in reconstructive surgery: microvascular free flaps and regional pedicle flaps. In socioeconomically poor countries like India, bilobed pectoralis major myocutaneous (PMMC) flap has been seen as a mainstay in facial reconstructive surgeries.

MATERIALS AND METHODS

The present study was conducted on 100 individuals with oral neoplasm who underwent resective surgery had a soft-tissue defect. All the complications that arose after reconstructive surgery were noted. Simple proportions were recorded.

RESULTS

Majority of the individuals had the buccal mucosa as the common site of oral neoplasm, and the tumor nodes and metastases staging was I + II. One individual sustained total flap necrosis. Wound infection and dehiscence were the most common complications.

CONCLUSIONS

PMMC is best proven for flap reconstruction in oral neoplasm cases. It is established to be effective with good acceptability and very few complications. Due to these reasons, in spite of the known advances in facial reconstructive surgeries, this technique is widely followed in developing countries.

Efficiency of Laser versus Bur in Impacted Mandibular Third Molar Surgery: An Original Research

INTRODUCTION

In oral and maxillofacial surgery, their clinical application has largely been restricted to soft tissue. Hence, the aim of this study was to assess the feasibility of erbium-yttrium aluminum garnet (Er: YAG) laser in bone cutting for removal of impacted lower third molar teeth and to compare its outcomes with that of surgical bur.

MATERIALS AND METHODS

The study comprised forty subjects requiring removal of impacted mandibular third molar, randomly categorized into two equal groups of 20 each, who had their impacted third molar removed either using Er: YAG laser or surgical bur as per their group, using standard methodology of extraction of impacted teeth. Clinical parameters such as pain, bleeding, time taken for bone cutting, postoperative swelling, trismus, wound healing, and complications were compared for both groups.

RESULTS

Clinical parameters such as pain, bleeding, and swelling were lower in laser group than bur group, although the difference was statistically not significant. However, postoperative swelling showed a significant difference in the two groups. Laser group required almost double the time taken for bone cutting with bur. Trismus persisted for a longer period in laser group. Wound healing and complications were assessed clinically and there was no significant difference in both the groups.

CONCLUSION

Based on the results of our study, the possibility of bone cutting using lasers is pursued, the osteotomy is easily performed, and the technique is better suited to minimally invasive surgical procedures. The use of Er: YAG laser may be considered an alternative tool to surgical bur, especially in anxious patients.

COVID and Animal Trials: A Systematic Review

Extensive work is being done to form targeted drugs against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection; however, it is imperative to have a safe and effective vaccine against the same to win the war against this pandemic. For creating an efficacious vaccine, a proper animal model needs to be selected which can have an acceptable similarity of response as well as effects when administered to humans. For the present research, extensive search was conducted in MEDLINE and bioRxiv and medRxiv servers which were published in the English language from January 1, 2020, to August 20, 2020. Search terms included animal models, SARS-CoV-2, COVID-19, immune response against coronavirus, nonhuman primates, mice, ferrets, and macaques. In our study, creating an adequate immune response mimicking the response as in humans, as the endpoint, was considered as inclusion criterion while assessment of any additional therapies like safety as well as minimal tolerable dose using animal models as well as formation of adequate sample size of these models against COVID-19 was not considered. In our search, 163 articles were shortlisted, of them only 20 articles were finally included in our study which addressed to our inclusion and exclusion criterion. Our research articles focused on nonhuman primates, mice, hamsters, ferrets, cats, and dogs, with the main goal to investigate the role of animal models in the pathogenesis of COVID-19. It was evident in our research that animal models only mimic limited signs and symptoms experienced in COVID infection as compared to infections in humans. However, they are still essential to understand the pathogenesis, transmissibility of viral particles, and vaccine testing.

CD4 cells count as a prognostic marker in HIV patients with comparative analysis of various studies in Asia Pacific region

Purpose:

To evaluate the correlation between CD4+ cells count with orofacial and systemic manifestations in newly diagnosed HIV seropositive patients and comparison of results with the previous studies.

Materials and Methods:

Hundred (100; 57 males and 43 females) newly diagnosed HIV seropositive patients, before starting antiretroviral therapy (ART) were included in the study. These patients were clustered according to CD4+ cells count into three groups: 0–200 cells/mm³, 201–499 cells/mm³, and more than 500 cells/mm³. Orofacial and systemic manifestations of these patients were recorded and correlated with CD4 cells count values.

Results:

There was no significant correlation found between CD4+ cells count values of males and females using independent t-test. Chi-square test showed significant correlation between the systemic manifestations and CD4+ cells count categories. Tuberculosis was found to be the most common systemic manifestation in both the genders. In addition, a significant correlation was between the CD4+ cells count and orofacial manifestations, where oral candidiasis was found to be the most common manifestation in both the genders.

Conclusion:

The prevalence of systemic and orofacial manifestations increases with decrease in the CD4+ cells count of HIV seropositive patients. Hence, it can be used as diagnostic and prognostic marker for immune suppression in HIV positive patients.

Rare case of gemination of mandibular third molar-A case report

Fusion and germination are the anomalies that occur due to some developmental eccentricity during the time of morpho-differentiation of the tooth bud and have a close resemblance to each other. The gemination is an attempt of the division of a single tooth into two and, hence, appears as an enlarged single tooth while the tooth count is normal when the affected tooth is counted as one. Its exact pathogenesis is ambiguous. This anomaly has been observed mostly in deciduous dentition as compared to that in permanent dentition. Gemination is rarely associated with the third molar and, hence, the terminology is arguable when this condition is seen in relation to the third molar. In the present article, a case of germination of mandibular third molar has been reported.

Novel coronavirus- A comprehensive review

Recently coronavirus outbreak which started in Wuhan, China, has caused international concern that has affected more than 29 lakh people worldwide and with no vaccine or specific antiviral drugs present as well as oblivious testing of carriers who are generally asymptomatic, the use of general health intervention techniques are failing to comply. As compared to other epidemics like severe acute respiratory syndrome-coronavirus (SARS-CoV) and the Middle-East respiratory syndrome (MERS-CoV), coronavirus (also named as COVID-19) exhibit mild symptoms in the majority of cases. But in the case of a vulnerable population, it can prove to be life-threatening. Relying on proper barrier technique, use of chest computed tomography scans, managing co-morbid conditions of susceptible patients, identifying the pattern of disease spread as well as the use of polymerase chain reaction to assess the specificity of cases will eventually prove to be efficacious since most of the positive cases are asymptomatic at the beginning which poses a challenge to the primary health care physicians. The development of vaccines will also take some time so it is better to know about COVID-19 better and also follow quarantine restrictions properly till then. In this review, we try to put forward all the relevant studies which have been published by the end of March 2020 so as to summarize the natural history, diagnosis as well as treatment strategies for eradicating COVID-19, which will help in managing this pandemic.

The study of placentrex and hydrocortisone as an adjunct treatment in oral submucous fibrosis

BACKGROUND

Submucous fibrosis with a high incidence rate in the Indian subcontinent is a devastating disease affecting the oral cavity and oropharynx.

AIMS AND OBJECTIVE

To evaluate the efficacy of injection placentrex and injection hydrocortisone in oral submucous fibrosis patients in increasing mouth opening, burning sensation, and improve the mucosal lining.

MATERIALS AND METHODS

We recruited 60 patients with Stage II and Stage III of the ailment, who were randomly divided into Group A and Group B. They were administered submucosal injections of hydrocortisone and placentrex along with physiotherapy and oral iron, nutrients, and B-carotene supplements over a period of 2 months.

INTERPRETATIONS AND RESULTS

The pinnacle rate of the incidence was found in the age group of 30 to 40 years among both the genders. Statistically significant difference (P = 0.0001), that is, 5.19 ± 1.33 in Group A and 11.69 ± 1.26 mm in Group B was noted in the mean mouth opening values. Statistically significant difference in burning sensation was noted to be better in Group A than in Group B.

DISCUSSION AND CONCLUSION

Overall hydrocortisone seems to be a better regimen for improving the mucosal health and increasing the mouth opening as compared to placentrix regimen. Although Placentrex is better than hydrocortisone in reducing burning sensation.

Multiple radiolucencies in the mandible: A diagnostic dilemma

Diagnosis and treatment planning of maxillofacial pathologies is an art. It requires careful evaluation and correlation of clinical presentation and radiologic investigations. When the pathology concerned is an intraosseous lesion, the radiographic findings assume a significantly more important role. While carrying out the radiographic assessment, we rely on typical findings regarding the number, location, and appearance of radiolucent areas which point towards certain types of pathologies. Whenever these findings are atypical or at variance with the clinical presentation, it creates a diagnostic dilemma for the clinician. We report a case of a 34-year-old man who presented with a simple clinical history but multiple radiolucencies on the radiograph.

Massive radicular cyst involving multiple teeth in pediatric mandible- A case report

Radicular or periapical cysts are one of the most commonly occurring odontogenic cysts of the jaws. The present article reported a case of a 12-year-old female with the chief complaint of swelling and pain on the right lower back tooth region. The radiographic examination revealed the presence of a well-defined radiolucency surrounded by a corticated border with respect to the right mandibular 1^st, 2^nd and 3^rd molar. The case was managed by complete enucleation under general extraction with the extraction of right mandibular 1^st, 2^nd and 3^rd molar. The success of the surgery was apparent by the uneventful healing during the follow-up period and evidence of complete healing after 1-month follow-up. Early diagnosis of the lesion would have lead to a less aggressive treatment plan.

Extensive pelvic and abdominal lymphadenopathy with hepatosplenomegaly treated with radiotherapy-A case report

This is a case report of a 65-year-old female patient diagnosed with Grade II Follicular Lymphoma of the pelvic and abdomen was treated with a combination of R-CHOP chemotherapy and radiotherapy.

Metabolic response to maxillofacial trauma revisited: A retrospective study

Purpose:

Management of a trauma patient aims at stabilization or resuscitation and revival from critical condition resulting from various sequences of systemic pathophysiological responses in the body. Hematological changes are the first signs reflecting the homeostasis mechanisms starting in the body after injury. The aim of the current study is to evaluate the physiological changes following maxillofacial trauma and extrapolate the findings to understand the posttrauma responses.

Patients and Method:

This is a retrospective study involving 192 subjects divided into two groups, trauma group and control group. In both the groups, baseline vitals and complete blood picture were recorded for comparison. In trauma group, the recordings were made within 24 h after maxillofacial injury.

Results:

All the parameters were analyzed using SPSS version 18. Independent sample t-test was used to assess the nature of data distribution and statistical significance was considered only at P value < 0.05. On comparison of complete blood picture mean values of hemoglobin (13.63 vs 12.18), RBC count (4.51 vs 4.10), WBC count (8835.48 vs 8336.56) were seen to be higher in trauma patients compared to control subjects. The mean bleeding times are almost equal (2.35 vs 2.47) but the clotting times (5.42 vs 5.26), random blood glucose (94.78 vs 90.13), and blood urea (27.14 vs 26.30) were marginally higher in trauma group but were statistically insignificant. The mean value of serum creatinine (0.84 vs 0.80) was comparatively higher in trauma patients and was statistically significant. Study of vitals revealed that mean systolic blood pressures were almost equal (120.65 vs 121.08) in both the groups. The mean diastolic blood pressures (79.46 vs 88.49) and oxygen saturation (93.73 vs 98.86) in trauma patients are comparatively reduced. The mean values of temperature (99.30 vs 98.50) and pulse rate (102.38 vs 97.14) were on relatively higher side in trauma group compared with control group.

Summary and Conclusion:

Using basic blood parameters and vitals in the present study, the compensatory mechanisms happening in the body after maxillofacial trauma can be seen. These changes although significant on side by side comparison can still fall within the normal physiological range provided by various diagnostic setups. Hence, the need for maxillofacial surgeon to be sensitive to minor variations in these aspects to ensure safety of the patient cannot be overemphasized.

Shaping Ability of 2Shape and WaveOne Gold Files Using Cone-Beam Computed Tomography

Aim and Objective:

The aim of this study is to evaluate the apical transportation, centering ability, and volume of removed dentin of WaveOne Gold (WOG) and 2Shape with the use of cone-beam computed tomography.

Materials and Methods:

Freshly extracted mandibular teeth with sample size of thirty were carefully chosen and instrumented using the 2Shape and WOG rotary files. Preoperative and postinstrumentation cone-beam computed tomographic scans were done to accomplish mesial and distal dentin walls’ measurements and volume of removed dentin calculations, apical transportation, and centering ratio. Statistical analysis was performed and confirmed by independent t-test. Statistical significance was set at 5%.

Results:

When shaping ability of 2Shape and WOG was evaluated, it was reported that there was no statistically significant differences noted among the groups in relation to the total volume of removed dentin, apical transportation, and centering ratio.

Conclusion:

It can be concluded that 2Shape and WOG preserved the original canal anatomy well and did not eliminate excess dentin during shaping and cleaning. Rotary nickel–titanium files which work on the principle of rotary movement attained an outcome analogous to that of the rotary files working on reciprocating motion in relation to alteration in angle.

Adult immunization-Need of the hour

Immunization is the process or the act of making individuals immune, which is usually done during childhood. Everyone is aware about immunization during childhood, however, very few know about adult immunization. This led us to review the adult immunization literature for the preventive strategies through various vaccination protocols. Adults do require vaccination protocols with booster doses for hepatitis B, Shingles, communicable diseases, traveler's diseases, etc. In this context, this article revises much of the available adult immunization literature and presents comprehensive guidelines. This article will increase the awareness regarding the importance of vaccination for adults to prevent a variety of conditions prevalent in our country as well as epidemics. The article comprehensively provides insights into the available vaccination and preventive strategy of human papilloma virus (HPV), hepatitis, and human immunodeficiency virus (HIV) infection in this part of the review. We strongly recommend all the health care professionals to educate their co-professionals and the public to use the benefits of adult immunization. It is the need of the hour and reduces the burden of treatment and increases productivity.