Modified extrinsic tooth stain index and its clinical applicability

Aim

The first index for the assessment of extrinsic stain was published by Lobene in 1986. Using the Lobene stain index in the field is very cumbersome as well it does not meet the general requirement of an index, i.e., the index is to be simple, rapid, highly reproducible, and sensitive enough to detect small changes in the staining level. Hence, there was a need to develop an alternative index for the same purpose. Hence, the only present study was undertaken to propose a modified stain index with more simplicity and clarity.

Materials and Methods

An observational study was carried out among 16-44-year-old participants who had at least six natural teeth and were generally healthy. For the revised index, the criteria and codes for intensity were kept the same as MacPherson Index but the criteria for recording area were modified. The data scoring for each tooth was mentioned in the proposed table and was recorded for each of the surfaces according to the proposed area and intensity codes. Analysis was carried out using SPSS version 21 (IBM, Inc. Virginia, United States). Inferential statistics were performed using the Mann-Whitney U-test. Nonparametric tests were applied following the imposition of a numerical interval scale the same as the Lobene index.

Results

No statistically significant difference was appreciated for the area, intensity, and product of area × intensity when compared for measurements recorded by two indices as P > 0.05. Hence, validating the proposed index for the clinical application.

Conclusion

The proposed modified index may be advantageous over its conventional counterpart due to its ease of recording and concise scoring and also less complexity in the area to be recorded.

Assessment of Knowledge, Attitude, and Practice Regarding Oral Cancer among Dental Graduates-A Web-Based Survey

The present study was conducted to assess the knowledge, attitude, and practice among new dental graduates across India. A web-based questionnaire was generated as a link through Google Drive which was sent to approximately 250 dental graduates using Whatsapp messenger. A total of 205 complete responses were received and analyzed. Frequency analysis was done using SPSS software version 21. Oral squamous cell carcinoma (OSCC) was identified as most common cancer by 48% of the subjects while the stage of oral cancer in which it is most often diagnosed was only responded correctly by 15.5% as advanced stage. Approximately one fourth (25.4%) of the participants performed dental examination to detect cancer routinely in all patients. Half of the study subjects were confident in detecting oral cancer, still majority (70.6%) of the subjects were interested in attending continuing education course on oral cancer in the future. This study revealed that the majority of the new dental clinicians were not having legitimate knowledge regarding oral cancer. Thus, this lacuna in knowledge and skills can be eliminated by conducting workshops and continuing education programs. This may subsequently aid to improve patient care.

Post Cesarean Surgical Site Infection with Mycobacterium Abscessus Sp. Massiliense

Objective: Surgical site infections (SSIs) owing to nontuberculous Mycobacteria (NTM) have emerged as an important cause of hospital-acquired SSI leading to great morbidity and mortality. Among NTM, Mycobacterium abscessus is reported in these sites. Epidemiology and transmission of M. abscessus in humans is noticing crux changes. Case report: We hereby describe a case of SSI after lower segment cesarean section (LSCS), presenting as a skin and soft tissue infection (SSTI) owing to a NTM. Conclusion: Clinicians should be aware of the possibility of infections caused by M. abscessus in patients who develop SSIs, particularly if they do not respond to conventional first-line antimicrobial therapy.

Genotoxicity in Oral Mucosal Epithelial Cells of Petrol Station Attendants: A Micronucleus Study

Introduction:

Occupational exposure to petrol derivatives possesses an increased risk of various cancers including that of the oral mucosa. Scientific studies have shown the correlation of micronuclei assay (MN) with the cytogenotoxic changes in petrol station attendants. However, very few have reported the use of MN assay as a promising tool for assessing the impact of smoking in these workers.

Aim:

To explore the cytogenotoxic damage in exfoliated buccal cells obtained from petrol station attendants and control subjects using the MN assay along with additional effects due to smoking.

Materials and Methods:

The study comprised 60 males who were divided into Group I–IV with each having 15 subjects. These subjects were categorized as exposed smokers, exposed nonsmokers, unexposed smoker group, and unexposed nonsmokers. The MN and additional nuclear abnormalities (karyorrhexis [KH], binucleation [BN], pyknosis [P], and karyolysis [KL]) were calculated in PAP-stained slides.

Results:

Statistically higher mean frequencies of overall nuclear anomalies were observed in petrol pump workers in comparison with the control group. Petrol pump smokers carry the highest nuclear anomalies followed by non-exposed smokers than exposed non-smokers and the count was the least among unexposed non-smoker workers.

Discussion and Conclusion:

The present study indicated that the petrol pump workers are under higher cytogenotoxic damage. Also, smoking added to the frequency of damage. Thus, MN and other nuclear anomalies are in-vitro reliable biomarker assays available and should be routinely employed as a screening tool in their periodic medical evaluation.

Smoking Rationalisation, Tobacco Dependence and Intention to Quit Among Indian Adults and Adolescents

Introduction

Unfortunately, indicators of tobacco dependence are present even after low levels of exposure in young smokers. Early emergence of these signal risk for subsequent chronic smoking and nicotine dependence is negatively associated with cessation in young adults. One important yet understudied modifiable predictor of intention to quit among smokers is smoking rationalization. Smokers often subscribe to smoking rationalisation beliefs, also known as self-exempting beliefs, to justify or rationalize their smoking behaviors. Smoking rationalizations can predict a lack of intention to quit.

Objective

To assess the correlation between smoking rationalisation, tobacco dependence and intention to quit among Indian adults and adults.

Methodology

A cross-sectional pilot study was carried out among 18-60-year-old subjects. Data were collected for tobacco dependence, smoking rationalisation and intention to quit (no/yes) by structured interview. Data were analysed using IBM SPSS statistics for windows, version 16 (IBM Corp, Armork, NY.) The independent t-test and one way ANOVA and binary logistic regression were performed for inferential statistics.

Results

Smokers with no intention to quit and high tobacco dependence scores had significantly higher smoking rationalisation than those to quit and low dependence scores. Logistic regression models demonstrated that all types of rationalisation beliefs were consistently inversely associated with the intention to quit and low tobacco dependence.

Conclusion

Findings suggest that smoking rationalisation plays an important role in the lack of intention to quit among Indian smokers. Future interventions should tackle smoking rationalisation beliefs as a strategy to promote smoking cessation.

Intraluminal endometriosis: A rare entity

The case presents an incidental finding of a rare variety of endometrioses in both the fallopian tubes termed intraluminal endometriosis in a 52-year-old female.

Oral Hygiene Status and Gingival Status of the 12- to 15-year-old Orphanage Children Residing in Delhi State: A Cross-sectional Study

Aim and objective

To assess oral hygiene status and practices among 12- to 15-year-old orphanage children in Delhi State, India.

Study design

In this cross-sectional study, a one-stage cluster sampling design was carried out with orphanages as a cluster unit to assess oral hygiene status and practices among orphanage children in Delhi state, India.

Results

The majority of the orphanage children had good oral hygiene status (53.8%) followed by fair (32.3%) and poor (13.9%) oral hygiene status. A large proportion (48.3%) of the orphanage children had mild gingival status followed by moderate (34.9%) and severe (16.8%) gingival status. No statistical difference was reported for the distribution of oral hygiene status and gingival score across all the age-groups. Most (53%) of the orphanage children among all age-groups had good plaque status. The correlation of gingival index (GI) scores with plaque index (PI) score and oral hygiene index-simplified (OHI-S) scores showed a significant correlation of GI scores with PI scores (r = 0.815) and OHI-S scores (r = 0.799).

Conclusion

The oral hygiene practices and oral hygiene status along with gingival status were found to be satisfactory among orphanage children in the present study.

Clinical significance

Gingival and periodontal diseases have a high prevalence among orphanages because of poor hygiene practices. Untreated oral diseases could lead to general health problems. Thus, the preventive strategies can be planned with the exact knowledge of the oral hygiene status of these special needs children in Delhi state.

How to cite this article

Kumari A, Marya C, Oberoi SS, et al. Oral Hygiene Status and Gingival Status of the 12- to 15-year-old Orphanage Children Residing in Delhi State: A Cross-sectional Study. Int J Clin Pediatr Dent 2021;14(4):482–487.

Clinical mimickers of epidermoid cyst in scalp: a retrospective histopathological study

Background: Cystic lesions of the scalp with a clinical diagnosis of an epidermoid cyst are encountered in clinical practice. However, these lesions had a different diagnostic interpretation on histopathology examination. Therefore our study focused on the lesions clinically resembling the presentation of epidermoid cyst in the scalp region. Materials and Methods: Forty-one cases of scalp lesions with a clinical diagnosis of epidermoid cyst over 2 years were reviewed. Details of the patients such as clinical diagnosis, age, gender, duration, gross findings, and histopathology diagnosis were obtained from the medical and histopathology records. Results: Epidermoid cysts diagnosed both clinically and on histopathology examination accounted for 29.26% whereas the clinical mimickers constituted 70.73%. The mean age of the patient was 35-years with an equal sex ratio. The commonest location was the parietal region (41.37%). Benign and malignant lesions consisted of 97.56% and 2.4% respectively. A trichilemmal cyst was the most common clinical mimicker diagnosed. Conclusions: Clinicians should be aware of wide differential diagnosis of epidermoid cyst in the scalp region as the management and outcome vary with each lesion. Histopathology examination proved to be a diagnostic tool in differentiating these lesions.

Adverse events occurring post-covid-19 vaccination among healthcare professionals - A mixed method study

BACKGROUND

Healthcare professionals (HCPs) are at the front line of the nation's fight against COVID-19 and are always at a greater risk of contracting contagious disease. But amidst the crisis, the vaccines were not accepted by all the HCPs due to adverse events occurring post-COVID-19 vaccination. Hence, the present study was designed to assess adverse events occurring among HCPs post-COVID-19 vaccination both quantitatively and qualitatively.

METHOD

Sequential mixed-method approach was employed. A cross-sectional E-survey was conducted among the healthcare professionals of a North Indian (*Statistically significant (p < 0.05)) college and hospital. The second phase included a semi-structured qualitative interview of the participants who were willing to participate.

RESULTS

Among all the HCPs with age groups ranging from 20 to 70 years, majority of them experienced pain at the site of injection (88.8-100%) followed by tiredness (87.7-60%) and body ache (86.6-40%) post-vaccination. There is an increased frequency of adverse events in females as compared to males. Qualitative findings are summarised in three major domains i.e vaccine adverse effects, fear and hesitancy for vaccines and vaccine acceptance.

CONCLUSION

Short term adverse events of COVISHIELD vaccine were very few and were mild in severity yet interviews showed hesitancy of study participants for vaccination.

Oral health indicators of oral health related quality of life among Indian elderly: A cross-sectional study

Aim

To assess the impact of tooth loss and periodontal status on oral health related quality of life among Indian elderly.

Methodology

This study was a cross-sectional study conducted among 1200 elderly subjects of Faridabad district of Haryana. Study subjects were selected by a combination of systematic, cluster and multistage sampling techniques. The data were collected through a clinical oral examination for tooth loss and periodontal status assessment (WHO Oral Health Survey 2013) and a self-administered questionnaire to assess the OHRQoL. Dental behaviours such as dental visiting patterns, tobacco chewing habits and oral hygiene practices were also recorded.

Results

In bivariate analysis significant associations were found among age, gender, education, tooth mobility and Oral health related quality of life (OHRQoL). Multivariate logistic regression showed significant impact of number of missing teeth and mobility on OHRQoL (P < 0.05).

Conclusion

The conclusions derived from this study are of considerable importance for Indian policy makers in their work with planning and implementing public oral health strategies for geriatric population.

Association of sense of coherence with oral health behaviors and gingival bleeding among adolescents

Context:

Adolescents experience many types of gingival and periodontal diseases, including gingivitis, localized or generalized aggressive periodontitis, and periodontal complications of various systemic diseases. The occurrence of periodontal diseases is not only related to biotic factors but may also be affected by nonbiotic factors such as oral health behaviors and practices. Various factors that influence an individual's health-related behaviors include a psychosocial construct named sense of coherence (SOC).

Aim:

The aim of this study is to investigate the association of SOC with oral health behaviors and gingival bleeding.

Settings and Design:

This was a cross-sectional, analytical study that was done in the school setting.

Materials and Methods:

A random sample of 850 adolescents was selected from nine schools of the Faridabad block of Faridabad district (Haryana) through the multistage cluster sampling technique. Methods of data collection included a combination of questionnaire administration and clinical examination. The questionnaire comprised sociodemographic variables, questions related to oral health behaviors, and Antonovsky's SOC scale. The questionnaire was interviewer administered.

Statistical Analysis:

Unadjusted and adjusted rate ratios of gingival units having bleeding on probing were estimated by Poisson regression multilevel analysis in Statistical Package for the Social Sciences (SPSS) software for Microsoft Office.

Results:

Adolescents whose mothers had studied <8 years (relative risk [RR] 1.26; 95% confidence interval [CI] 1.04–1.38), who were males (RR 1.198; 95% CI 1.01–1.29), low SOC (RR 15.93; 95% CI 13.06–19.35), and toothbrushing frequency of less than once a day (RR 1.43; 95% CI 1.21–1.67) and children with plaque index >1 (RR 2.765; 95% CI 2.12–3.25) presented with the higher number of gingival units having bleeding.

Conclusion:

SOC is associated with gingival bleeding through oral health behaviors.

Comparative assessment of low-level laser therapy (LLLT) vs. topical application of amlexanox + lidocaine to treat recurrent aphthous ulcers (RAUs): A randomized controlled trial

Background. The present study aimed to assess and compare the pain perception and ulcer sizes before and after applying low-level laser therapy (LLLT) and Amlexanox + lidocaine.

Methods. Twenty-six patients referring to the out-patient department of the institution and diagnosed with recurrent aphthous ulcers (RAU) were assigned to two groups to receive either LLLT or Amlexanox + lidocaine. In group 1, the patients were provided with amlexanox + lidocaine to apply topically four times daily. In group 2, the patients underwent LLLT with no tissue contact in inward circular motions for two cycles for 30 seconds. This study was registered in "the Clinical Trials Registry- India" (CTRI), with the registration number CTRI/2019/09/028222. The data were analyzed with SPSS 16.

Results. The intergroup comparison was performed using Mann-Whitney U test, and intragroup comparisons were made using Wilcoxon’s signed-rank test. The level of significance was set at P <0.05. The results showed that pain perception and ulcer size were significantly lower in group 2 subjects than group 1 subjects (P <0.05).

Conclusion. LLLT was more effective than amlexanox + lidocaine in the management of RAU. It is a cost-effective therapy for treating RAU.

Fish-like three-dimensional swimming with an autonomous, multi-fin, and biomimetic robot

Fish migrate across considerable distances and exhibit remarkable agility to avoid predators and feed. Fish swimming performance and maneuverability remain unparalleled when compared to robotic systems, partly because previous work has focused on robots and flapping foil systems that are either big and complex, or tethered to external actuators and power sources. By contrast, we present a robot-the Finbot-that combines high degrees of autonomy, maneuverability, and biomimicry with miniature size (160 cm³). Thus, it is well-suited for controlled three-dimensional experiments on fish swimming in confined laboratory test beds. Finbot uses four independently controllable fins and sensory feedback for precise closed-loop underwater locomotion. Different caudal fins can be attached magnetically to reconfigure Finbot for swimming at top speed (122 mm s^-1≡ 1 BL s^-1) or minimal cost of transport (CoT = 8.2) at Strouhal numbers as low as 0.53. We conducted more than 150 experiments with 12 different caudal fins to measure three key characteristics of swimming fish: (i) linear speed-frequency relationships, (ii) U-shaped CoT, and (iii) reverse Kármán wakes (visualized with particle image velocimetry). More fish-like wakes appeared where the CoT was low. By replicating autonomous multi-fin fish-like swimming, Finbot narrows the gap between fish and fish-like robots and can address open questions in aquatic locomotion, such as optimized propulsion for new fish robots, or the hydrodynamic principles governing the energy savings in fish schools.

Comparative Efficacy of Cow Milk, KNO3, and Warm Saline Rinses in Treating Dentin Hypersensitivity Following Nonsurgical Periodontal Treatment: A Randomized Controlled Trial

AIM

This study aimed to assess the desensitizing efficacy of commercially available cow milk compared to potassium nitrate (KNO₃) mouthwash and warm saline rinses after nonsurgical periodontal treatment.

MATERIALS AND METHODS

A randomized controlled trial was conducted in the Department of Public Health Dentistry of a dental college from August 21, 2018 to September 10, 2018. A total of 75 patients who reported hypersensitivity after scaling and root planing (SRP) were recruited and randomly assigned into three groups: cow milk (I), KNO₃ mouthwash (II), and warm saline rinses (III). Dentine hypersensitivity (DH) was assessed at six time points using the verbal rating scale (VRS) for thermal stimuli and visual analog scale (VAS) for air blast and thermal stimuli. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 21 (IBM Corp., Armonk, NY). Mean reduction in DH in each group was measured using non-parametric tests.

RESULTS

Patients in all the three groups were found to be comparable with respect to baseline characteristics. Mean reduction in VRS and VAS scores for DH in milk and KNO₃ mouthwash was found to be significantly high as compared to warm saline rinses group.

CONCLUSION

From the results, cow milk was found to be equivalent in efficacy as compared with KNO₃ mouthwash but superior to warm saline rinses in treating DH post-SRP.

Epithelioid angiosarcoma of the masseter muscle: a rare clinicopathological diagnosis

Epithelioid angiosarcoma (EA) is a subtype of angiosarcoma which is a rare tumor of endothelial origin. Here, we report a case of 15-year-old boy who presented with soft tissue mass lesion in the parotid region mimicking as a benign parotid tumor. Cytology was suggestive of inflammatory swelling. Patient underwent superficial parotidectomy along with the wide excision of the swelling. On histopathology, it was diagnosed as EA. To the best of our knowledge this is the first case report of epithelioid angiosarcoma of the masseter.

Incidentally Discovered Appendiceal Mucinous Neoplasm in a 5-month-old Patient: A Case Report and Review of Literature

Mucocele of the appendix is a rare entity in pediatrics, and few case reports have been reported in the literature. We present the case of a 5-month-old male with abdominal distension, constipation, and vomiting who was found to have an appendiceal mucocele while being evaluated for total colonic aganglionosis. Laparoscopic-assisted resection was performed, with pathology confirming a low-grade mucinous neoplasm of the appendix. He underwent complete resection, rendering him cured without the need for any further resection or treatment.

Diagnostic dilemma in soft tissue swelling of a finger

Myopericytoma is a benign tumor that shows a pericytic line of differentiation. The lesion is generally located in the dermis and subcutaneous tissue and has a predilection for distal extremities, but may be found in any part of the body. We present a case of 48-year old male who came with painful swelling in right middle finger for the past 2 years. Histopathology showed proliferation of spindle-shaped cells exhibiting a hemangio-pericytomatous pattern with various sized vessels lined by flattened endothelium and surrounded by a concentric arrangement of spindle-shaped cells. Tumor cells showed membranous positivity for smooth muscle actin but negative for desmin and CD34. Hence diagnosis of intravenous myopericytoma was established.

Temporomandibular Disorders among Adolescents of Haryana, India: A Cross-sectional Study

AIM

The aim of the present study was to determine the prevalence and determinants of temporomandibular disorders (TMD) among 12- to 15-year-old adolescents of Faridabad.

MATERIALS AND METHODS

The study included a sample of 300 adolescents (132 males and 168 females) with age ranging from 12 to 15 years. Data were collected through clinical examination and Fonseca anamnestic questionnaire. The prevalence of TMD signs was assessed through Fonseca anamnestic questionnaire while TMD symptoms were measured by clinical examination. Various determinants of TMDs such as Angle's classification, crossbite, overjet, overbite were also recorded. Data were then analyzed using SPSS version 21. Inferential statistics were performed using Chi-square test.

RESULTS

The overall prevalence of both TMD signs and symptoms was 51%. Females had higher prevalence (57.1%) of TMD symptoms when compared to males (43.2%). TMD signs has shown a statistical significant relationship with overbite (p = 0.007) and bruxism (p < 0.0001) only. No significant association was found between age, gender, Angle's molar relation, crossbite, and TMD signs. Statistical significant association was found between gender (p = 0.016), Angle's molar relation (p = 0.005), overbite (p = 0.001), crossbite (p = 0.030), bruxism (p < 0.0001), and TMD symptoms.

CONCLUSION

No Significant relationship was reported between malocclusions and TMD sign except for overbite and bruxism, but significant relationship were found between TMD symptoms and malocclusion.

HOW TO CITE THIS ARTICLE

Taneja P, Nagpal R, Marya CM, et al. Temporomandibular Disorders among Adolescents of Haryana, India: A Cross-sectional Study. Int J Clin Pediatr Dent 2019;12(6):500-506.

Kimura disease: case report and brief review of literature

Kimura disease is a rare chronic inflammatory disorder of unknown cause, primarily seen in young Asian males. The disease is characterized by painless subcutaneous swelling, blood and tissue eosinophilia and raised IgE levels. Early diagnosis of Kimura's disease may spare the patient from unnecessary invasive diagnostic procedure. We describe a case of Kimura disease in a 14-year old male presenting with left submandibular swelling and also provide a brief review of the literature.

Impact of Early Childhood Caries on Oral Health-related Quality of Life Among 4-6-year-old Children Attending Delhi Schools: A Cross-sectional Study

Introduction

Oral diseases like early childhood caries (ECC), trauma, teething pain, and eruption disturbances are widely prevalent among the 4-6-year subgroup of population and are considered a public health problem worldwide.

Aim

To assess the impact of ECC on oral health-related quality of life (OHRQoL) among 4-6-year-old children attending schools in Delhi.

Materials and methods

A cross-sectional epidemiological study was carried out to assess the impact of ECC on OHRQoL among 4-6-year old children. Data were collected by a combination of the structured questionnaire of sociodemographic details and early childhood oral health impact scale (ECOHIS). The clinical examination was conducted for the assessment of dentition status and pufa index according to WHO criteria 2013. Statistical analysis was performed using the Chi-square test, the Kruskal-Wallis test, and the Mann-Whitney U test.

Results

The prevalence of ECC was found to be 20% among preschoolers which was lower among younger children and increased with age. The ECOHIS responses reported that items related to pain, irritation, difficulty in eating some foods, and difficulty to drink hot or cold beverages, felt guilty, feeling of frustration, and been upset were the most frequent on the child impact section (CIS).

How to cite this article

Jaggi A, Marya CM, et al. Impact of Early Childhood Caries on Oral Health-related Quality of Life Among 4-6-year-old Children Attending Delhi Schools: A Cross-sectional Study. Int J Clin Pediatr Dent 2019;12(3):215-221.

Assessment of Oral Health Related Quality of Life Among the Institutionalised Elderly in Delhi, India

PURPOSE

To assess the oral health related quality of life (OHRQoL) among older people residing in old-age homes in Delhi, India.

MATERIALS AND METHODS

Oral health related quality of life was measured by using the Hindi version of Geriatric Oral Health Assessment Index (GOHAI) which was tested for its reliability and validity. Sociodemographic data were collected and questions regarding the self-perception of general health, oral health and perceived need for dental treatment were put forward. Clinical assessment was also performed.

RESULTS

The mean additive-GOHAI score of the study population was found to be 41.57 ± 6.07. Statistically significant associations were found between GOHAI and perceived measures. GOHAI scores decreased with a decrease in the number of teeth present and a decrease in the number of teeth having coronal and root caries. Those subjects who were in need of multi-unit prostheses or full prostheses had significantly poorer OHRQoL compared to those without any prosthetic need or need of single-unit prostheses.

CONCLUSION

This study revealed the extent of dental problems in old-age home residents and may help to plan appropriate preventive measures.

Efficacy of Chlorhexidine, Xylitol, and Chlorhexidine + Xylitol against Dental Plaque, Gingivitis, and Salivary Streptococcus mutans Load: A Randomised Controlled Trial

PURPOSE

To compare the antiplaque, antigingivitis and antibacterial efficacy of chlorhexidine (CHX), XYL and a mouthwash combining CHX and XYL against Streptococcus mutans (S. mutans).

MATERIALS AND METHODS

A parallel design, randomised controlled trial was conducted among 75 dental students. Participants were randomised into CHX, CHX+XYL and XYL-only groups using the lottery method. Subjects were instructed to use 10 ml of the provided mouthwash for 15 s twice daily for 3 weeks. All the outcome measures, gingival index (GI), plaque index (PI) and number of salivary S. mutans CFU were recorded at baseline and 3 weeks post intervention. Nonparametric tests were used for inferential statistics.

RESULTS

All outcome variables (GI, PI scores and log10 salivary S. mutans counts) decreased significantly from baseline compared to post intervention among all three groups. Intergroup comparison demonstrated that reduction in GI was not significantly different among the three groups. The decrease in PI scores was found to be significantly higher in the XYL group, while the decrease in the log10 salivary S. mutans count was significantly higher in the CHX+XYL group.

CONCLUSION

The present study provided sufficient data to suggest that all the three mouthwashes are effective against plaque, gingivitis and S. mutans load in saliva. Further investigations should be carried out to confirm the results and develop strategies for using such products to prevent tooth decay.

Cytological Diagnosis of an Uncommon High Grade Malignant Thyroid Tumour: A Case Report

Anaplastic Thyroid Carcinoma (ATC) is a relatively uncommon highly malignant tumour originating from the follicular cells of thyroid gland having poor prognosis. It accounts for 2% to 5% of all thyroid carcinomas and patients typically present with a rapidly growing anterior neck mass with aggressive symptoms. A 53-year-old male presented with diffuse neck swelling measuring 8x6 cm and right cervical lymph node measuring 2x2 cm since one month which was associated with dyspepsia and dyspnoea. Ultrasound and Contrast Enhanced Computed Tomography (CECT) neck revealed enlarged right lobe of thyroid and multiple enlarged cervical lymph nodes with soft tissue density nodules in bilateral lungs. Fine Needle Aspiration (FNA) from the swelling revealed giant cell, spindle cell and squamoid pattern. Focal areas showed follicular epithelial cells arranged in repeated microfollicular pattern suggesting an underlying follicular neoplasm. FNAC smears from the lymph node also revealed similar findings. Based on the cytomorphological and radiological findings, final diagnosis of ATC probably arising from underlying follicular carcinoma with cervical lymph node and lung metastasis was given. FNAC leads to prompt and definitive diagnosis, so that therapy can be initiated as soon as possible for better outcome. Multimodality therapy (surgery, external beam radiation, and chemotherapy) is the mainstay of treatment.

Gut dysbiosis following C-section instigates higher colonisation of toxigenic Clostridium perfringens in infants

Herein we investigated the intestinal carriage of α-toxigenic and enterotoxigenic Clostridium perfringens during infancy, focusing on its association with other gut microbes and mode of delivery and feeding. Faecal samples from 89 healthy term infants were collected at age 7 days, 1 month, 3 months, 6 months and 3 years. C. perfringens was quantified by qPCR; other gut bacteria were quantified by reverse-transcription-qPCR. Alpha-toxigenic C. perfringens was detected in 3.4% infants at day 7 but was present in 35-40% infants at subsequent time-points, with counts ranging from 10³-10⁷ cells/g faeces. Enterotoxigenic C. perfringens remained undetected at day 7 but was detected in 1.1, 4.5, 10.1 and 4.5% infants at 1 month, 3 months, 6 months and 3 years, respectively. Intriguingly, infants carrying α-toxigenic C. perfringens had lower levels of Bacteroides fragilis group, bifidobacteria, lactobacilli and organic acids as compared to non-carriers. Further analyses revealed that, compared to vaginally-born infants, caesarean-born infants had higher carriage of C. perfringens and lower levels of B. fragilis group, bifidobacteria, lactobacilli and faecal organic acids during first 6 months. Compared to formula-fed infants, breast-fed infants were slightly less often colonised with C. perfringens; and within caesarean-born infants, breast-fed infants had slightly lower levels of C. perfringens and higher levels of B. fragilis group, bifidobacteria, and lactobacilli than formula-fed infants. This study demonstrates the quantitative dynamics of toxigenic C. perfringens colonisation in infants during the early years of life. Caesarean-born infants acquire a somewhat perturbed microbiota, and breast-feeding might be helpful in ameliorating this dysbiosis. Higher carriage of toxigenic C. perfringens in healthy infants is intriguing and warrants further investigation of its sources and clinical significance in infants, particularly the caesarean-born who may represent a potential reservoir of this opportunistic pathogen and might be more prone to associated illnesses.

Microanalysis: The Ethical Minefield

Mental health professionals had always yearned for an intervention, which was restricted to them alone, was safe and had a commercial potential. Narco analysis or chemical hypnosis with or without the supervision of an anesthetist presented such an opportunity in India's largely poorly regulated medical practice. The turning point however was the unrestricted use of narco analysis for forensic reasons often against the will of the recipient that caught the attention of the judiciary. Professionals in candid confessions spoke of the tool replacing normal polite enquiries and unnecessary voyeuristic information being fettered out. Anecdotal evidence suggested police resorting to this tool without client consent or judicial permission. A series of fiats after searching enquiry on the statute has led to complete disarray. The legal issues have relegated the ethical issues of consent, the usefulness of “forced” information, the aftermath of “forced” information to the backburner. Currently, the tool is regulated by the judiciary and selectively applied with consent. In the clinical setting, it is fast disappearing.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

IECs, Drug Trials and Regulators–the Hounds Barking up the Wrong Tree

As India hurtles on into the 21st century with dizzying speed, the constantly evolving ethics, law and its interpretations fall behind. The cut and paste policy makers constantly impose regulations out of sync with the geopolitical realities. The Mental Health Care Bill now awaiting approval arose because we signed first on a global body convention and now are forced to comply. The family, a ubiquitous feature of our patient support system is slowly being derecognized. Instead, NGOs are the new approved caregivers. Our patriarchal society, earlier a repository of warmth and security is now jeered at. The mental health professional, the last mile delivery of mental health is in a quixotic position and some of the tantalizing issues of surreptitious drug administration, informed consent, the newer laws enacted or being enacted, narcoanalysis and drug trials will be discussed with pragmatic solutions offered to a disinterested regulator.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Surreptitious Drug Administration: Collective Decision Making Over Riding Personal Autonomy

A quaint problem indeed. This is an issue where ethical and practical management issues lock horns. An individual with no insight on a rampage, a threat to self and others cannot be given medicines without consent except in an indoor facility and admitted under a specific provision of the current statute. Contrary to the law, the mental health policy envisages community care of the individual. For a time defined interval, surreptitious medication can be administered providing much needed relief to the caregivers and calms the recipient. Surreptitious medication can of course be an instrument of control and hence would necessitate a system of checks and balances. Surreptitious medication tests legal and ethical boundaries. It offers relief to caregivers but can be an instrument of abuse. The act of administering a drug without the individual's consent is prima facie wrong but if the context is woven in, a whole new dimension arises.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

A Cross-sectional Study for Assessment of Untreated Dental Caries and Its Consequences among Slum-dwelling Children

INTRODUCTION

Dental caries affects humans of all ages throughout the world and remains the major dental public health problem among children globally.

MATERIALS AND METHODS

A cross-sectional study was conducted using the cluster sampling technique to obtain the required sample size of 400 children from urban slum population of Faridabad, Haryana, India. Data were collected using World Health Organization dentition status 1997 criteria and PUFA/pufa index.

TYPE OF STUDY

Cross-sectional study.

RESULTS

Among 6- to 12-year-age group, 68.5% subjects had one or more decayed deciduous teeth, of which 65.3% subjects had one or more pufa score, and 26.4% subjects were having one or more decayed permanent teeth, of which 16.7% subjects were having one or more PUFA score. The overall caries prevalence was 79.64% and overall prevalence of one or more than one PUFA+pufa was reported in 69.2% subjects.

CONCLUSION

The findings of the study showed the relevance of PUFA/pufa index to address the neglected problem of untreated caries and its consequences. The study also suggests the importance for implementation of the primary oral care programs for this deprived population.

HOW TO CITE THIS ARTICLE

Marya C, Kataria S, Nagpal R, Oberoi SS, Dhingra C, Arora D. A Cross-sectional Study for Assessment of Untreated Dental Caries and Its Consequences among Slum-dwelling Children. Int J Clin Pediatr Dent 2017;10(1):29-33.

A questionnaire survey on forensic odontology: Are we really aware?

Introduction:

The role of a dentist is not only to examine and treat the oral diseases but also to assist the legal authorities by means of its branch—forensic odontology. Through forensic odontology, a dentist plays a very important role in crime investigation of any type.

Objective:

To analyze the knowledge, awareness, and interest of forensic odontology among the dental teaching staff who are working in the dental colleges within the Delhi NCR.

Materials and Methods:

A questionnaire of 12 questions (both open-ended and close-ended) was prepared and the survey was conducted with 200 dental teaching staff.

Results:

A sufficient knowledge but poor awareness and interest among the dental teaching staff was observed.

Conclusion:

The study highlighted that although dental teaching staff themselves have sound knowledge regarding forensic odontology, their awareness and interest need to be upgraded on a regular basis. The success of acquiring such extensive knowledge would be valid if better job opportunities in these fields would be increased.

Age estimation in Indian children and adolescents in the NCR region of Haryana: A comparative study

Introduction:

Age estimation is a preliminary step in the identification of an individual. It is a crucial and often most critical step for forensic experts. The assessment has been standardized utilizing common dental diagnostic x-rays, but most such age-estimating systems are European population-based and their applicability has not been determined in the context of the Indian population.

Aims and Objectives:

To assess the applicability and to compare the methods of dental age estimation by Demirjian's method and the same method as modified by Willems (i.e. the Willems method) in Indian children of the National Capital Region (NCR). Also, to find a correlation among skeletal maturity using the Cervical vertebrae maturation index (CVMI), dental maturity, and chronological age in the same population.

Materials and Methods:

This cross-sectional study was conducted using dental radiographs of 70 orthodontic patients (37 males, 33 females) in the age range 9-16 years selected by simple random sampling. pantomogram were used to estimate dental age by Demirjian's method and the Willems method using their scoring tables. Lateral cephalograms were used to estimate skeletal maturity using CVMI. The latter was compared with Demirjian's stage for mandibular left second molar.

Results:

Overestimation of age among males by 0.856 years and 0.496 years was found by Demirjian's and the Willems methods, respectively. Among females, both the methods underestimated the age by 0.31 years and 0.45 years, respectively. Demirjian's stage G corresponded to CVMI stage 3 in males and stage 2 in females.

Conclusion:

In our study, the Willems method has proved to be more accurate for age estimation among Indian males, and Demirjian's method for Indian females. A statistically significant association appeared between Demirjian's stages and CVMI among both males and females. Our study recommends the derivation of a regression formula by studying a larger section of the Indian population instead of applying the European system of age estimation directly to the Indian scenario.

Gut microbiota in health and disease: an overview focused on metabolic inflammation

In concern to the continuously rising global prevalence of obesity, diabetes and associated diseases, novel preventive and therapeutic approaches are urgently required. However, to explore and develop such innovative strategies, a meticulous comprehension of the biological basis of these diseases is extremely important. Past decade has witnessed an enormous amount of research investigation and advancement in the field of obesity, diabetes and metabolic syndrome, with the gut microbiota receiving a special focus in the triangle of nutrition, health and diseases. In particular, the role of gut microbiota in health and diseases has been one of the most vigorous and intriguing field of recent research; however, much still remains to be elucidated about its precise role in host metabolism and immune functions and its implication in the onset, progression as well as in the amelioration of metabolic ailments. Recent investigations have suggested a significant contribution of the gut microbiota in the regulation and impairment of energy homeostasis, thereby causing metabolic disorders, such as metabolic endotoxemia, insulin resistance and type 2 diabetes. Numerous inflammatory biomarkers have been found to be associated with obesity, diabetes and risk of other associated adverse outcomes, thereby suggesting that a persistent low-grade inflammatory response is a potential risk factor. In this milieu, this review intends to discuss potential evidences supporting the disturbance of the gut microbiota balance and the intestinal barrier permeability as a potential triggering factor for systemic inflammation in the onset and progression of obesity, type 2 diabetes and metabolic syndrome.

A Review of Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) and Enamel Remineralization

White-spot lesions are the earliest macroscopic evidence of enamel caries. In such a situation, the enamel surface layer stays intact during subsurface demineralization, but without treatment the subsurface loss will continue, and eventually the surface layer will collapse and lead to a cavity formation. By introducing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) at this stage the lesion can be reversed. CPP-ACP is a unique, naturally derived protein-based remineralizing technology that is now used globally in chewing gums and topical creams. The aim of this review is to expound on the potential for reversal of demineralization through the use of products such as CPP-ACP, and to provide guidance to clinicians considering remineralization as a viable treatment option.

Periodontal status and oral health-related quality of life in elderly residents of aged care homes in Delhi

AIM

The aim of the present study was to explore the associations between clinical periodontal findings and oral health-related quality of life in elderly people residing in the aged care homes of Delhi, India.

METHODS

A cross-sectional study was carried out among 500 residents of aged care homes across Delhi. Data were collected by carrying out clinical oral examinations and by filling a self-administered questionnaire. Oral health-related quality of life was assessed by a pretested Hindi version of the Geriatric Oral Health Assessment Index (GOHAI-Hi). Periodontal status was assessed using the Community Periodontal Index - CPI, and loss of attachment and tooth mobility was assessed using a modified Miller's index.

RESULTS

Of a total of 500 participants, 221 (44.20%) were men and 279 (55.80%) were women The mean additive score GOHAI score was 41.57 ± 6.07 and the mean number of negative impacts or mean simple count GOHAI score was 6.27 ± 1.54. Mean GOHAI scores were significantly higher among men than women, and were found to be decreasing continuously with the increasing age categories. Tooth mobility and loss of attachment scores were found to be significantly associated with oral health-related quality of life, whereas Community Periodontal Index scores showed a negative correlation with it.

CONCLUSION

The geriatric population, especially those in aged care homes, is a special need group because of their inability to access dental care rather than some particular feature of their oral or general health The findings of the present study point to a need to improve access to oral healthcare for this elderly population.

Preliminary Clinical Evidence of the Antiplaque, Antigingivitis Efficacy of a Mouthwash Containing 2% Green Tea - A Randomised Clinical Trial

PURPOSE

To assess the efficacy of a mouthwash containing 2% green tea as compared to a placebo mouthwash for the control of plaque and gingivitis.

MATERIALS AND METHODS

A randomised controlled clinical trial was conducted on 110 male subjects 18-60 years of age. The inclusion criteria were having a minimum of 20 sound natural teeth, a plaque index (PI) of at least 1.5 and a gingival index (GI) of at least 1.0. The subjects were randomised into two parallel groups, test and control. Subjects in the test group and control group were instructed to rinse twice daily for 1 min with 10 ml of test (mouthwash containing 2% green tea) and placebo mouthwash, respectively. After 28 days of using the mouthwash, inter- and intragroup differences for mean plaque index and gingival index scores were analysed.

RESULTS

There was a significant (p < 0.05) reduction in mean GI and PI scores among the test group from baseline to 28 days, whereas it was not significant in the control group. A statistically significant (p < 0.05) reduction was found in the mean difference in GI scores in the test group (0.67 ± 0.22) as compared to the control group (0.05 ± 0.11) and a statistically significant (p < 0.05) reduction was observed in the mean difference in PI scores in the test group (1.65 ± 0.68) compared to the control group (0.45 ± 0.99).

CONCLUSION

The results showed that the green tea mouthwash was effective in the reduction of plaque and gingivitis scores.

Estimation of stature in a young adult indian population using the Carrea's index

The stature or height of an individual is useful for assisting in forensic identifications. Teeth can act as a valuable tool for stature estimation when only the skull is available. Carrea's index estimates the stature of a person from the dimensions of lower anterior teeth. The aim of this study was to assess the reliability of the Carrea's index in an Indian population. Data was collected from plaster models of 125 undergraduate students for examination. Each hemiarch was considered separately equaling 250 inferior hemi-arches, which were divided according to the dental alignment into normal, crowded and diastema and the measurements (Arch and Chord) were made with a 'divider caliper'. A statistically significant difference between the types of dental arch was obtained for both males and females with regards to the different dental alignments; where normal dentition (94.03%) obtained the highest success rates for males and crowded dentition (87.87%) for females. Statistically significant differences were also found between the types of arches for both right and left side (p < 0.001; p=0.004). The presence of diastema reduced the success rates when compared in terms of both sex and side of the arch. It was concluded that the Carrea ́s index is a reliable method for height estimation in arches with normal and crowded dentitions, useful for both sexes, and for both right and left side of the arch. However, the method was not reliable for hemiarches with a diastema.

Usage of betel quid, areca nut, tobacco, alcohol and level of awareness towards their adverse effects on health in a north Indian rural population

AIM

To assess the overall prevalence of betel quid, areca nut, tobacco and alcohol use in the rural population of Muradnagar tehsil of Ghaziabad district and their awareness level towards adverse effects of these habits on general as well as oral health.

METHODS

A total of 422 persons from 63 households of four (4) villages were enrolled for the participation in the study. A preformed, pretested questionnaire was used to collect the information on prevalence of risk behaviours of chewing tobacco, areca nut, betel quid, smoking and alcohol consumption.

RESULTS

72.5% of respondents reported indulgence in one or more habits of chewing areca nut, betel quid, tobacco, smoking and alcohol consumption. Smoking tobacco was the most common type of adverse habit in males while chewing tobacco in females. 26% of respondents believed that the community residents would quit the habit only if they personally experience any health problem due to the habit.

CONCLUSION

In spite of being aware of risk of having multiple health problems, a major proportion of respondents were using betel quid, areca nut, tobacco and alcohol.

Tobacco consumption among 12- to 15-year-old schoolchildren in Delhi

OBJECTIVE

This study aims to assess the knowledge, attitude, and practice of tobacco use and its cessation among children in schools of Delhi.

METHODS

A cross-sectional study involving 1094 schoolchildren (577 boys and 517 girls), 12-15 years old, was conducted using the modified Global Youth Tobacco Survey questionnaire. Mann-Whitney U-test and Kruskal-Wallis test were applied (p<0.05).

RESULTS

Among these, 132 boys (22.87%) and 120 girls (23.21%) were smokers. "Ever smokers" were 13.80% and "current smokers" were 9.23%, whereas 76.97% were "never smokers".

CONCLUSION

Interventions that raise awareness at a young age, equip students to overcome peer influence, and provide counseling to quit using tobacco need to be designed.

Dental adhesion: mechanism, techniques and durability

Contemporary dental adhesives show favorable immediate results in terms of bonding effectiveness. However, the durability of resin-dentin bonds is their major problem. It appears that simplification of adhesive techniques is rather detrimental to the long-term stability of resin-tooth interface. The hydrostatic pulpal pressure, the dentinal fluid flow and the increased dentinal wetness in vital dentin can affect the intimate interaction of certain dentin adhesives with dentinal tissue. Bond degradation occurs via water sorption, hydrolysis of ester linkages of methacrylate resins, and activation of endogenous dentin matrix metalloproteinases. The three-step etch-and-rinse adhesives still remain the gold standard in terms of durability. This review discusses the fundamental process of adhesion to enamel and dentin with different adhesive techniques, factors affecting the long-term bonding performance of modern adhesives and addresses the current perspectives for improving bond durability.

Position statement and guidelines on unmodified electroconvulsive therapy

BACKGROUND

In modern day psychiatric practice, it is assumed as a matter of fact that when electroconvulsive therapy (ECT) is administered, it will be administered under anesthesia and with succinylcholine (or its equivalent) modification. Yet, as surveys indicate, there is considerable practice of unmodified ECT in developing countries and, to a small extent, in the developed world, as well.

MATERIALS AND METHODS

This document examines historical and recent literature on the geographical practice, physiology, efficacy, and adverse effects of unmodified ECT. Particular attention is paid to musculoskeletal risks.

RESULTS

Although almost all the research is of poor methodological quality, there is a good reason to accept that unmodified ECT is associated with a wide range of adverse consequences, important among which are musculoskeletal complications, pre-ECT anxiety, and post-ECT confusion. However, it appears from recent data that these risks are not as large as historically portrayed. Possibly explanations are suggested, with seizure modification using parenteral benzodiazepines as a special possibility.

CONCLUSIONS

Under exceptional circumstances, if ECT is strongly indicated and seizure modification with succinylcholine is not feasible, unmodified ECT, especially benzodiazepine-modified ECT, may be a viable option. A detailed set of recommendations for such use of unmodified ECT is proposed along with necessary checks and balances. This document has been approved by the Indian Psychatric Society, the Indian Association of Biological Psychiatry, and the Indian Association of Private Psychiatry (which commissioned the preparation of the document).

Milk, milk products, and disease free health: an updated overview

The cow and its milk have been held sacred in the world since the dawn of human civilization. Indian ancient Vedic texts describe the virtues of milk and dairy products, as is authenticated by modern scientific principles and proofs. Therefore, milk has been considered as one of the most natural and highly nutritive part of a daily balanced diet. Currently, the integration of advanced scientific knowledge with traditional information is gaining incredible momentum toward developing the concept of potential therapeutic foods. Furthermore, new advances toward understanding the therapeutic roles of milk and milk products have also given a new impetus for unraveling the age old secrets of milk. At present, the best-known examples of therapeutic foods are fermented milk products containing health promoting probiotic bacteria. In the present article, we have tried to review the various aspects of the therapeutic nature of milk and fermented dairy products in a highly up-dated manner, and offer an in-depth insight into the development of targeted therapeutic future foods as per the requirements of consumers.

Comparative evaluation of shear bond strength of various esthetic restorative materials to dentin: an in vitro study

AIM

To comparatively evaluate the shear bond strength of recent tooth-colored restorative materials to dentin.

MATERIALS AND METHODS

Flat dentinal surface were prepared from 60 caries free, extracted human permanent molars and were mounted in acrylic rings. These were randomly divided into four groups - Group A to Group D, according to the restorative material used i.e. Glass ionomer cement (Fuji IX), Giomer (Beautifil), an Ormocer-based composite (Admira) and Nano Ceramic restorative material (Ceram X). These restorative materials were applied on dentinal surface of all the specimens using nylon cylinders. The mounted samples were stored in distilled water for 24 hours and thermocycled. They were then subjected to shear bond strength test using universal testing machine. Data was analyzed using a one-way analysis of variance (ANOVA) and student's 't'-test.

RESULTS

Ceram X (16.63 ± 0.94 MPa) and Admira (17.31 ± 0.95 MPa) were comparable in their bond strength values, but depicted significantly higher bond strength when compared to Beautifil (12.39 ± 1.05 MPa) and Fuji IX (7.76 ± 1.07 MPa).

CONCLUSION

Nano-ceramic and ormocer-based restorative materials showed better bonding potential to dentin as compared to GIC and Giomer.