Prevalence of dental caries and periodontal disease among transgenders in Belagavi district, Karnataka, India: A cross-sectional study

AIM

To assess the oral health practices and the prevalence of dental caries, and periodontal disease among transgenders.

METHODS AND RESULTS

The study was conducted on a sample of 180 participants from the transgender community in Belagavi district over a course of two months. A trained and calibrated examiners recorded oral health status according to WHO dentition status and treatment needs (1997) and Community Periodontal Index (CPI) under the supervision of the subject expert. Chi-square test, spearman's rank correlation coefficient test, multiple linear regression and logistic regression were applied. The statistical significance was set at p ≤ .05 for all the tests. The prevalence of dental caries and periodontal disease among transgenders was 72.2% and 92.2%, respectively. A positive linear correlation and a significant relationship was found between the oral hygiene practices/deleterious habits and dental caries among the transgenders. Multiple linear regression model revealed that the prevalence of dental caries and periodontal disease was significantly associated with age and oral hygiene practices.

CONCLUSION

The prevalence of dental caries and periodontal diseases among transgenders was high. These results may be of use to promote oral health promotion and establishing a paradigm for dentists to work toward improving oral health.

Antimicrobial Efficacy of Essential Oils and Their Combination Against Microorganisms Associated With Postradiation Therapy in Patients With Head and Neck Cancer: An In Vitro Study

Background Head and neck cancer ranks as the sixth most common cancer globally. Reduced saliva production brought on by postradiation therapy upsets the delicate balance between bacterial load and a weakened immune system. Oral hygiene is commonly neglected in patients who have undergone radiotherapy and they often develop dry mouth, mucositis due to radiation therapy, etc., as side effects. Despite being a part of the current standard, chlorhexidine carries numerous disadvantages such as taste alteration, teeth staining, and dry mouth. An extensive review of the literature demonstrates the antibacterial properties of essential oils (EOs) derived from plant materials, which may be able to prevent the development of such opportunistic microorganisms in the oral cavity. Methodology The cinnamon bark EO and Cajeput EO were procured and checked for their solubility. The final ratio at which the oils were found to be soluble was the 1:1 (w/v) ratio. The minimum inhibitory concentration (MIC) of cinnamon bark oil (Cinnamomum verum) and Cajeput oil (Melaleuca leucadendron) against Staphylococcus aureus, Enterococcus faecalis, and Candida albicans was determined by serial dilution method using Resazurin dye, and the minimum bactericidal concentration (MBC) was done by a spread plating method. The polyherbal mouthwash was subjected to cytotoxicity assay against human gingival fibroblasts. All the experiments were performed in triplicates. Results The overall results showed that cinnamon bark EO had the strongest efficacy against S. aureus (0.33 ± 0.14 mg/mL) and E. faecalis (0.41 ± 0.14 mg/mL), but not against C. albicans (2.85 ± 2.11 mg/mL). Cajeput EO showed the least efficacy against all the groups; whereas the combination of EOs proved to be the most efficacious and showed good antimicrobial activity against these most commonly encountered microorganisms in head and neck cancer postradiotherapy. Conclusions Cinnamon and Cajeput EOs in combination proved to be effective in this in vitro study against the most common microorganisms encountered in patients with head and neck cancer postradiotherapy and are comparable to 0.2% chlorhexidine.

Impact of dental caries and periodontal disease on oral health-related quality of life among the Karnataka State Reserve Police Personnel in Belagavi, India

Introduction

The Karnataka State Reserve Police (KSRP) is a state-level police force in India. Good Oral Health-Related Quality of Life (OHRQoL) among them is quintessential for the welfare of the society. The aim of the study was to assess the impact of dental caries and periodontal disease on the OHRQoL among the Karnataka State Reserve Police (KSRP) stationed in Belagavi, India.

Methods

A cross-sectional design was used with a total sample size of 720. The personnel were recruited by simple random sampling. The Oral Health Impact Profile 14 (OHIP 14) was used to assess OHRQoL in 7 domains. The intra-examiner reliability for World Health Organisation (WHO) oral assessment form 2013 was assessed using Kappa statistics and was found to be 0.86. Dentition and periodontal status were recorded using the same. Statistical analysis was performed using descriptive statistics, Analysis of variance (ANOVA), Pearson's coefficient of correlation and multiple linear regression analysis.

Results

Physical pain and psychological discomfort had the highest mean scores among the seven domains of OHIP-14. Constables had higher mean OHIP-14 scores among the study population. A significant positive correlation was found between oral health parameters with the domains of OHIP-14. The highest dependence on the socio-demographic and oral health predictors were found in the domains of physical pain (44.2%), psychological discomfort (38.3%), and physical disability (30.5%).

Conclusions

The study revealed that dental caries and periodontal disease had a significant impact on OHRQoL among reserve police personnel and the OHRQoL was poor particularly among the lower ranked personnel.

Comparative Evaluation of Abrasiveness among Three Dentifrices: An In Vitro Study

Aim

A lot of herbal and medicated toothpastes having natural and antisensitivity properties are creating niches for themselves in the market. However, toothpaste containing high content of abrasives can be harmful to the teeth. The present in vitro study was conducted to assess the abrasiveness of three commercially available dentifrices on human-extracted anterior teeth on sound and demineralized enamel.

Materials and methods

A total of 42 freshly extracted teeth were mounted on acrylic resin and randomly divided into three groups (group I, Colgate; II, Glister; and III, Dant Kanti). Each group consisted of one test tooth (partially) and one control tooth (completely) covered with nail varnish. The study had two phases. Phase 1-baseline average roughness (Ra) value was assessed with a profilometer of all the samples. Phase 2-further, teeth were immersed in the demineralizing solution for 4 days to allow the formation of an artificial carious lesion. Tooth brushing was performed by a customized automated toothbrushing model on all the teeth for 28 days. Ra value was again evaluated with Profilometer.

Result

Data were analyzed, and a statistically significant result was observed with demineralized teeth in all three groups (p = 0.005). The intragroup comparison showed a significant difference with demineralized teeth of Colgate and Dant Kanti, (p =0.018) and (p =0.027), respectively. However, there was no significant difference in demineralized teeth of glister and sound teeth of all three groups.

Conclusion

Glister was found to be the least abrasive of all three toothpastes, followed by Dant Kanti and Colgate.

Clinical relevance

The particle size of the ingredients used in manufacturing toothpaste can lead to abrasion of the teeth.This, in combination with the hard bristles, can cause more harm to the teeth than good. The current study has compared the abrasive potential of three commercially available kinds of toothpaste. Hence daily use of these commercially available dental products should be used cautiously.

How to cite this article

Priyam S, Sankeshwari R, Jalihal S, et al. Comparative Evaluation of Abrasiveness among Three Dentifrices: An In Vitro Study. Int J Clin Pediatr Dent 2023;16(2):264-269.

Evaluation of a "Picture Assisted Illustration Reinforcement" (PAIR) System for Oral Hygiene in Children with Autism: A Double-Blind Randomized Controlled Trial

This study evaluated the potential of a novel pre-validated "Picture Assisted Illustration Reinforcement" (PAIR) communication system and conventional verbal techniques for Oral Health Education (OHE) in terms of dentition status, gingival health, oral hygiene status, and practices in 7- to 18-year-old children with Autism Spectrum Disorder (ASD). A double-blind randomized controlled trial was undertaken in a school for children with autism from July to September 2022. A total of 60 children were randomly assigned into two groups: a PAIR group (n = 30) and a Conventional group (n = 30). Cognition and pre-evaluation of all the children were assessed by standardized scaling measures. A pre-validated closed-ended questionnaire was administered to caregivers of both groups. At a 12-week post-intervention, a clinical examination was performed using the World Health Organization (WHO) Oral Health Assessment form 2013, gingival and Oral Hygiene Index Simplified (OHI-S). The gingival scores in the PAIR group (0.35 ± 0.12) exhibited a statistically significant decline in scores as compared to Conventional group (0.83 ± 0.37), p = 0.043. Meanwhile, the oral hygiene scores in the PAIR group and Conventional group were 1.22 ± 0.14 and 1.94 ± 0.15, respectively (p < 0.05). A significant improvement in oral hygiene practices was observed in the PAIR group. Incorporating the PAIR technique resulted in significant progress in child cognitive ability and adaptive behavior, which reduced gingival scores and improved oral hygiene scores, consequently improving oral hygiene practices among children with ASD.

Unleashing the most effective oral health education intervention technique for improving the oral hygiene status and oral health knowledge in visually impaired young individuals: A systematic review and meta-analysis

Appropriate oral health education (OHE) plays a vital role in prevention of oral diseases and would bridge the gap between dentists and visually impaired individuals. Hence, this systematic review was planned with an aim to evaluate effectiveness of various OHE techniques on the oral hygiene status and oral health knowledge of visually impaired young individuals. An electronic search extended to September 30, 2020 was conducted on PubMed, Wiley, ProQuest, ScienceDirect, Cochrane library, EBSCO, and Google Scholar. Two independent reviewers assessed the studies using a two-stage process; data were extracted according to PRISMA statement. Risk of bias assessment of selected studies was executed according to the study designs. Meta-analysis using the random-effects model was conducted for the outcomes for all oral health education techniques using STATASE 16.1 software. Hand and electronic search identified 3829 articles. After screening for titles and duplicates, 37 articles were retrieved, which were screened through abstract and full text. Of the 37 articles, 17 articles were included for qualitative synthesis, and out of that, 13 were for meta-analysis. Ten variations in oral health education (OHE) techniques were used in the included 17 studies to impart oral health education to visually impaired young individuals. Overall, all OHE techniques demonstrated a positive impact on oral hygiene status. The pooled overall cumulative mean difference of the oral hygiene status after imparting education in ATP, Audio, and Braille was 1.33 [1.06, 1.59], 1.76 [1.11, 2.42], and 1.96 [1.40, 2.55], respectively. An appropriate OHE technique boosts confidence in visually impaired young individuals, making the learning process an enjoyable experience. Use of either Braille or the ATP OHE technique was found to be a reliable and useful method to improve oral hygiene of visually impaired young individuals.

Prevalence of dental caries, oral hygiene status and treatment needs among seafarers and trainee sailors in the state of Goa, India: a descriptive cross-sectional study

BACKGROUND

The fixed regimen and strict dietary habits of seafarers and trainee sailors, make them susceptible to several oral diseases. The aim of the study was to assess prevalence of dental caries, oral hygiene status and treatment needs among seafarers and trainee sailors in the state of Goa.

MATERIALS AND METHODS

This descriptive, cross-sectional study was carried out from January 2023 to March 2023. After a pilot study, convenience sampling technique was employed to recruit 261 participants. The investigators were standardized and calibrated to record World Health Organization Oral Health Assessment Form (1997) and Oral Hygiene Index-Simplified (OHI-S) which were instrumented in the study. Intra-examiner and inter-examiner reliability scores were recorded using kappa statistics (0.81, 0.83) and (0.83, 0.85), respectively. The data was analysed using descriptive analysis, chi-square test, Mann- -Whitney U test and multivariate linear regression analysis at statistical significance (p ≤ 0.05).

RESULTS

The mean ages of seafarers (n = 133) and trainee sailors (n = 128) were 36.41 ± 6.40, and 25.36 ± 7.39, respectively. The prevalence of dental caries among seafarers and trainee sailors was determined to be 59% and 78%, respectively (p = 0.01). The mean OHI-S score of seafarers (1.31 ± 0.68) and trainee sailors (1.53 ± 0.82) was statistically significant (p = 0.015).

CONCLUSIONS

Seafarers and trainee sailors demonstrated high caries prevalence and poor oral hygiene status due to their distinctive lifestyle, representing a vulnerable community in terms of oral health.

Effectiveness of a Visual Interactive Game on Oral Hygiene Knowledge, Practices, and Clinical Parameters among Adolescents: A Randomized Controlled Trial

This study aimed to evaluate the effect of a novel interactive game-based visual performance technique (IGVP) and conventional oral health educational (OHE) talk on plaque control, gingival health, and oral hygiene knowledge and practices in 12−15-year-old schoolchildren. A single-blinded randomized controlled trial was undertaken in a private primary school in Belagavi, Karnataka, India. A total of 100 children aged 12−15 years were randomly assigned to either a conventional OHE talk (control group, n = 50) or the IGVP technique (test group, n = 50), using a computer-generated table of random numbers. A self-designed, pre-validated closed-ended questionnaire was collected from both groups, followed by clinical examination carried out using gingival and plaque index, pre- and post-intervention, at three months follow-up. There was a significant reduction in the mean gingival score and plaque score in the test group after intervention, indicating a 58.7% and 63.4% reduction, when compared to the control group, which had a 2.8% and 0.7% reduction, respectively (p < 0.001). The test group showed a significant increase in the percentage of knowledge gained (22.4%), compared to control group (7.8%). The IGVP technique proved to be more effective than a conventional OHE talk in the reduction of the plaque score, gingival score, and in the improvement of the knowledge of oral hygiene maintenance and its application.

Assessment of knowledge and awareness regarding intellectual property rights among the health-care professionals in Belagavi city: A cross-sectional study

BACKGROUND

Intellectual property rights (IPRs) are increasingly becoming significant for sustainable growth of today's knowledge-based society. An inappropriate knowledge regarding IPR can fail to reserve rights for one's intellectual creation. Hence this study was planned with an aim to assess knowledge, awareness, and practices regarding intellectual property rights in India amongst the health-care professionals in Belagavi city.

MATERIALS AND METHODS

A descriptive cross-sectional study was conducted among the postgraduate students and faculty of six health-care professional institutions in Belagavi, Karnataka. A total of 724 responses were recorded using convenient sampling. Data was collected using self-administered validated questionnaire which included demographic details and total 20 questions pertaining to knowledge, awareness, and practices regarding IPR. Two-point Likert scale was used. Descriptive statistics, Mann-Whitney U-test, and Chi-square test were applied.

RESULTS

A total of 724 responses were recorded, 411 from postgraduate students and 313 from faculty of 6 health-care professional institutions. It was observed that 24.3% and 39.3% of postgraduate students and faculty participants, respectively, had maximum knowledge while 35.5% of faculty and 27.5% of postgraduate students had maximum awareness regarding IPR in India. Only 17.6% and 10.2% of faculty and postgraduate students had previously attended workshops on IPR.

CONCLUSION

The present study identified that both faculty and postgraduate students of health-care profession have less knowledge and awareness regarding IPR. However, both knowledge and awareness regarding IPR were better among faculty when compared to postgraduate students. Thus, the academic community requires a higher level of sensitization and exposure to IPR in India.

Comparison of Retention between Conventional and Nanofilled Resin Sealants in a Paediatric Population: A Randomized Clinical Trial

Background: This study compared conventional-resin-sealant versus nanofilled-sealant retention at different intervals. Methods: A double-blinded split-mouth randomized control trial was performed on sixty-two children aged from six to nine years. Participants with one pair of contralateral permanent first molars with deep fissures or noncavitated carious lesions were randomly selected for sealant application. Conventional resin sealant was applied on one molar and nanofilled sealant on the contralateral molar. Evaluations were performed at one, three, six, twelve and eighteen months to check for retention. The chi-squared test, McNemar test, Wilcoxon signed-rank test and Friedman test were used for statistical analysis. Results: Conventional resin sealant showed complete retention in 91.4%, 86.2%, 74.1%, 62.1% and 55.2% of the teeth, and nanofilled sealant showed complete retention in 89.7%, 81%, 77.6%, 69% and 67.2% of the teeth, at the end of 1 month, 3 months, 6 months, 12 months and 18 months evaluation, respectively. Each sealant exhibited a statistically significant change (p < 0.05) in the retention rate during the evaluation period. However, when both the sealants were compared with each other, there was no statistically significant difference in any phase. At the end of 18 months, caries development was observed in 13.8% of the teeth sealed with conventional sealant, and in 10.3% of the teeth sealed with nanofilled sealant. Conclusion: At eighteen months, the nanofilled resin sealant exhibited complete retention in 12% more teeth than the conventional sealant. However, the difference was not statistically significant. The nanofilled resin sealant yielded an acceptable performance in sealing the occlusal pits and fissures of mandibular permanent first molars, compared to conventional pit-and-fissure sealants.

Dental caries, oral hygiene status and treatment needs of fishermen and non-fishermen population in South Goa, India

BACKGROUND

Occupation plays a major role in the well-being of an individual and has an influence on oral health. Fishing is one such occupation that entails a lot of physical labour and encourages habits that lead to poor oral health. Therefore, it is critical to shed light on the oral health of this isolated population to improve their quality of life by various means. The aim of the study was to assess and compare the prevalence of dental caries, oral hygiene status and treatment needs of fisherman and non-fisherman population in South Goa, India.

MATERIALS AND METHODS

Study design was cross-sectional in nature. After a pilot study, multi-stage random sampling technique was employed and 400 study participants were recruited. World Health Organization Oral Health Assessment Form (1997) and Oral Hygiene Index-Simplified (OHI-S) were used to record the study variables. Inter-examiner reliability assessed using Kappa statistics were found to be 90% and 88%, respectively. The data was analysed using descriptive analysis, Chi-square test, Mann-Whitney U test, Kruskal-Wallis test, and linear and logistic regression analysis.

RESULTS

Fishermen had significantly higher caries prevalence (82%) and poor oral hygiene (46%) than non- -fishermen. Extraction (42.2%) and pulp care (23.6%) were the highest treatment need among fishermen. They were 2.08 times more prone to dental caries than non-fishermen. Fishermen who used a toothbrush were 4.5 times less susceptible to caries. The dependence of caries prevalence and OHI-S score on occupation, oral hygiene aid and age were 14% and 25.8%, respectively.

CONCLUSIONS

Fishermen in South Goa had high caries prevalence, poor oral hygiene status and they required extensive dental treatment when compared to non-fishermen.

Assessment of Knowledge Regarding Infection Control Protocols among Dental Health Professionals during COVID-19 Pandemic: An Observational Cross-sectional Study

Introduction: It is necessary to prioritize occupational welfare, safety of dental students and health professionals to reduce coronavirus transmission, to offer the best benefit for patients. Aim: To assess knowledge regarding standard operating procedures to be adhered in clinical setting during pandemic amongst undergraduate, postgraduate dental students and dental interns of dental colleges in northwest region, Karnataka. Materials and Methods: This observational cross-sectional study was undertaken in dental colleges in northwest region, Karnataka from January 2021 to February 2021. Sample size was estimated to be 360 based on a pilot study. Participants were selected by the simple random sampling technique and were interviewed using a questionnaire comprising of 20 closeended questions. The questionnaire was evaluated for reliability with Cronbach’s α value of 0.82, face validity 0.85%, and content validity ratio 0.76. The collected data was entered in MS Excel and analysed using Statistical Package of the Social Science (IBM-SPSS) statistics-version 21 using descriptive analysis, Chi-square analysis, spearman’s correlation coefficient test, and regression. Results: The mean age of the participants was 24.6±1.35 years with marked gender distribution of 261 (72.5%) females and 99 (27.5%) males. Overall knowledge score for the standard operating procedure to be adhered during the pandemic was found to be 10.92±1.96 (undergraduates), 12.68±1.80 (postgraduates) and 11.55±1.82 (interns). More than half of the respondents 57.78% displayed a moderate level of knowledge. Spearman’s correlation coefficient test revealed a high statistically significant difference between awareness about Coronavirus disease 2019 (COVID-19) among participants and recommended masks during the procedure. Conclusion: Postgraduate students had higher knowledge regarding standard operating procedures to be adhered in dental clinics compared to undergraduate students and interns. It’s necessary that dental students are aware of latest infection control guidelines and implement them into their practices right from beginning.

Determination of the oral health status and behaviors, treatment needs, and guardians' perception of oral health among preschool children attending Integrated Child Developmental Scheme Anganwadi centers of Belagavi, South India: A cross-sectional study

BACKGROUND AND AIM

Anganwadi centers are the epicenters of health services for many Indian children. The study aims to assess the oral health status, treatment needs, and association with demographic variables, oral health behaviors, and parents' perception among preschoolers in these Anganwadis.

METHODS

A descriptive cross-sectional study was conducted among 1200, 3-5-year-old preschoolers from 48 Anganwadis in Belagavi. They were examined in accordance with the WHO Oral Health Pro forma (2013). A self-administered questionnaire assessed their parents' perception of their oral health. SPSS software (version 20) was used for statistical analysis. Chi-square test computed categorical data. One-Way ANOVA test was used for multiple group comparisons. P<0.05 was considered statistically significant.

RESULTS

The prevalence of dental caries was found to be 76.1% and gingival bleeding was found in 30.4% participants. The most common oral mucosal lesions were ulcers (5.1%) followed by abscess in 4.5% of children. About 67% of the parents perceived their child's oral health as good. A staggering 98.5% of parents had not taken their children to the dentist ever. About 76.8% of the children required prompt treatment.

CONCLUSION

Poor oral health status necessitates prompt action with age-specific targeted interventions for the curtailment of the prevalent oral maladies along with preventive strategies for the rejuvenation and resurrection of the plummeted oral health status for restoring the quality of life, coupled with motivation meted out to utilize the abundant dental services available in Belagavi.

RELEVANCE TO PATIENTS

Preschool children attending the ICDS Anganwadi centers form a nested cohort of a triangulation of need, presentation, and requirement for a targeted and focused intervention pertaining to oral health hygiene and other important constructs of overall general well-being. This hypothesis generating exploratory study opens up ways and channels for such oral health related translational activities to be planned, implemented and periodically evaluated, as part of the standard procedures and protocols of the machinery.

Assessment of the antimicrobial efficacy of hydroalcoholic fruit extract of cranberry against Socransky complexes and predominant cariogenic, mycotic and endodontic climax communities of the oral cavity: An extensive in-vitro study

Background and Objective:

Contemporary global complementary and alternative practices in dentistry envisage to manipulate the molecules from traditionally used plant derivatives as adjuncts. The aim of this study was to assess the in-vitro antimicrobial efficacy of hydro-alcoholic fruit extract of cranberry against Socransky complexes and predominant cariogenic, mycotic and endodontic climax communities of the oral cavity.

Materials and Methods:

An extract of Vaccinium macrocarpon was prepared using a hydro-ethanolic solvent (water – 30%: ethanol – 70%) using the standardized maceration protocol. Standard American Type Cell Culture and Microbial Type Culture Collection and Gene Bank strains of Streptococcus mutans, Lactobacillus acidophilus, Candida albicans, Enterococcus faecalis, Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans were used. The minimum inhibitory concentration was determined by the serial broth dilution. The minimum bactericidal concentration was obtained by subculturing method.

Results:

The extract showed satisfactory inhibitory and bactericidal effects against all test pathogens.

Conclusion:

V. macrocarpon can prove to be an adjunct to the existing antimicrobial complexes being routinely used to combat pathogenic oral climax community.

Effectiveness of three mouthwashes - Manuka honey, Raw honey, and Chlorhexidine on plaque and gingival scores of 12-15-year-old school children: A randomized controlled field trial

Objectives:

The aim of this study is to compare the effectiveness of three types of mouthwashes manuka honey (MH), raw honey (RH), and chlorhexidine (CHX) on plaque and gingival scores of 12–15-year-old government school children.

Study Design:

This study was a double-blind, randomized controlled field trial conducted in Belagavi city, India.

Materials and Methods:

One hundred and thirty-five government school children aged 12–15 years were randomly selected and allocated into three groups, RH, MH, and CHX mouthwash groups. Ten milliliters each of honey-based mouthwash formulation and CHX mouthwashes (0.2%) were administered according to the group allocation twice daily for 21 days. All the children were examined at baseline, 22^nd day (after discontinuation of mouthwash) and 28^th day (1 week after discontinuation of mouthwash) for Gingival (Loe and silness 1963) and Plaque Index (Silness and Loe, 1964).

Results:

Descriptive statistics was applied for distribution of study participants according to age and gender. One-way ANOVA followed by Tukey's post hoc test and repeated measures ANOVA test followed by Bonferroni's post hoc were applied for inter- and intragroup comparison, respectively. Statistically significant reductions (P < 0.001) in plaque and gingival scores were observed in all the three types of mouthwash groups at the end of the 22^nd day and 28^th day. MH and RH mouthwash demonstrated equal effectiveness, whereas CHX mouthwash showed the maximum reduction in clinical parameters.

Conclusion:

Honey-based mouthwash showed a promising antimicrobial effect on dental caries and plaque and gingival scores.

The Association between Educational Achievements, Career Aspirations, Achievement Motives and Oral Hygiene Behavior among Dental Students of Udaipur, India

Background

There are several factors which influence oral hygiene behavior of an individual. Educational achievements, career aspirations and achievement motives of individuals are some of those factors. The objective of this study was to investigate whether educational achievements, career aspirations and achievement motives have associations with oral hygiene behavior among dental students of Udaipur, India.

Methods

A descriptive cross-sectional study was conducted among all (n=200) 1_st year dental students from all dental colleges of Udaipur City, India. Self-administered structured questions were used to assess their educational achievements, career aspirations and oral hygiene behavior (OHB). Achievement motives were assessed using Achievement Motive Scale developed by Lang and Fries (2006). Chi-square test and multivariate logistic regression tests were used in data analysis. Confidence level and level of significance were set at 95% and 5% respectively.

Results

Students with better educational achievements undergone regular dental check-up (30.48%) (p=0.03) and used other oral hygiene aids (90.24%) (p=0.01). Tooth brushing frequency, time and replacement time of tooth brush were found to be significantly associated with career aspiration (p=0.007; p=0.002; p=0.00 respectively). Achievement motives did not have statistically significant association with oral hygiene behavior.

Conclusion

Educational achievements and career aspirations appear to be associated with oral hygiene behavior of young dental students. Students with higher career aspirations practiced better oral hygiene behavior. There was no significant relationship between achievement motives and oral hygiene behavior.

Prevalence of malocclusion and orthodontic treatment needs among 12-15 years old school children of Udaipur, India

Objective:

The objective of the study is to assess the prevalence of malocclusion and orthodontic treatment needs among 12-15 years old school children of Udaipur, India.

Materials and Methods:

A cross-sectional descriptive survey was conducted among 887 subjects aged 12-15 years. The prevalence of malocclusion and orthodontic treatment needs was assessed using dental aesthetic index (World Health Organization, 1997). General information on demographic data was also recorded. Chi-square test, analysis of variance and Scheffe's test were employed for statistical analysis.

Results:

Malocclusion and orthodontic treatment need was reported among 33.3% of the study subjects. A significant age and gender difference depicting preponderance among younger age group and a male proclivity was experiential. A significant improvement in anterior crowding and largest anterior maxillary irregularity with age was documented. Males had a significantly higher prevalence of anterior crowding, midline diastema and largest anterior maxillary irregularity than females.

Conclusions:

The prevalence of malocclusion and orthodontic treatment needs among school children of Udaipur city, Rajasthan, India was found to be 33.3%. A significant age and gender difference was observed in prevalence of malocclusion, crowding and largest anterior maxillary irregularity. Midline diastema showed a significant gender difference. The baseline information outlined in the present study can be appropriately utilized for the future planning to meet the orthodontic treatment need among the population.

Hemodynamic, ventilator, and ECG changes in pediatric patients undergoing extraction

BACKGROUND

Dental treatment induces pain anxiety and fear. This study was conducted to assess the changes in hemodynamic, ventilator, and electrocardiograph changes during extraction procedure among 12-15-year-old children and compare these changes with anxiety, fear, and pain.

MATERIALS AND METHODS

A purposive sample of 60 patients selected based on inclusion and exclusion criteria underwent study procedure in the dental OPD of a medical college and hospital. The anxiety, fear, and pain were recorded by dental anxiety scale, dental fear scale, and visual analogue scale, respectively, before the start of the procedure. The systolic blood pressure, diastolic blood pressure, heart rate, oxygen saturation, and electrocardiogram changes were monitored during the extraction procedure. The recording was taken four times (preinjection phase, injection, extraction, and postextraction) and was analyzed.

RESULTS

At the preinjection phase the mean vales were systolic blood pressure (128 ± 11.2), diastolic blood pressure (85.7 ± 6.3), heart rate (79.7 ± 9.3), and oxygen saturation (97.9 ± 5.8). These values increased in injection phases and decreased in extraction phase and the least values were found after 10 min of procedure and this relation was significant for all parameters except oxygen saturation (P = 0.48, NS). ECG abnormalities were seen among 22 patients and were significant before and after injection of Local anesthetic (P = 0.0001, S).

CONCLUSIONS

Anxiety, fear, and pain have an effect on hemodynamic, ventilator, and cardiovascular parameters during the extraction procedure and hence behavioral management has to be emphasized among children in dental clinics.

Comparative assessment of oral hygiene and periodontal status among children who have Poliomyelitis at Udaipur city, Rajasthan, India

Objective: To assess and compare the oral hygiene and periodontal status among children with Poliomyelitis having upper limb disability, lower limb disability and both upper and lower disability at Udaipur city, Rajasthan, India. Study design: Total sample comprised of 344 Poliomyelitis children (upper limb disability: 33.4%; lower limb disability: 33.7%; both upper and lower limb disability: 32.9%) in the age group of 12-15 years. Clinical examination included recording Simplified Oral Hygiene Index and Community Periodontal Index. Analysis of variance (ANOVA), multiple logistic and stepwise linear regression were used for statistical analysis. Results: The mean OHI-S (2.52±1.05) score was found to be highest among children who had both upper and lower limb disability (p<0.05). The highest and lowest mean number of healthy sextants were found among those with only lower limb disability (4.53±2.05) and among those with both upper and lower limb disability (0.77±1.39), respectively (p<0.05). Stepwise multiple linear and multiple logistic regression analysis showed that the best predictor for oral hygiene and periodontal status was limb involved in the disability. Conclusion: The results of the study depicted an overall poor oral hygiene and periodontal status of the group. It was recognized that limbs involved in the disability had an impact on the oral hygiene and periodontal condition. The situation in this specialized population draws immediate attention for an integrated approach in improving the oral health and focus towards extensive research.

Key words:Poliomyelitis, upper limb disability, lower limb disability, oral hygiene, periodontal status.

Acute monocytic leukemia with a novel 10;11 rearrangement resolved by fluorescence in situ hybridization

Fluorescence in situ hybridization analysis in an adult with acute monocytic leukemia revealed the complex nature of a rearrangement between chromosomes 10 and 11, which resulted in disruption of the MLL gene. Using a combination of chromosome 10 and 11 paints, a 10 centromere-specific sequence, and a probe for the MLL locus at 11q23, the rearrangement was deduced to have involved a reciprocal translocation between chromosomes 10 and 11, followed by an inversion within the short arm of the derivative 10. To our knowledge, this novel rearrangement has not been described previously.

Direct Coombs test-negative autoimmune hemolytic anemia and low-affinity IgG class antibodies

Autoimmune hemolytic anemia, in which the direct antiglobulin test (DAT) is negative or weakly positive, may be due to low-affinity autoantibodies. We describe two such cases. An 8-year-old male presented with weight loss, jaundice, a hemoglobin of 33 g/L, reticulocytes of 306 x 10(9)/L, and haptoglobin of < 0.1 g/L. The DAT was negative. After washing the red blood cells (RBCs) with saline at 4 degrees C, the DAT was positive for IgG and an eluate contained an IgG3 autoantibody, thus confirming a diagnosis of autoimmune hemolytic anemia (AIHA). Red cell transfusions and corticosteroids were given with eventual complete recovery. A 73-year-old male had a hemoglobin of 89 g/L and haptoglobin of < 0.1 g/L. The DAT was initially negative but was positive for IgG using cold-washed (4 degrees C) RBCs; it was also positive with unwashed cells in the DiaMed system and an eluate contained IgG1 autoantibody. AIHA was therefore confirmed and prednisolone started but continued hemolysis necessitated splenectomy before full recovery occurred. Although RBCs may be strongly sensitized with low-affinity autoantibodies in vivo, the IgG is easily removed when RBCs are washed at room temperature for a DAT. The DiaMed system that uses unwashed RBCs overcomes this problem, but cold washing the RBCs at 4 degrees C must be used when preparing eluates.

Balanced 7;12 translocation associated with minimally differentiated acute myeloid leukemia

A 4-year-old boy with leukemic blasts of myeloid lineage was shown by bone marrow (BM) examination to have a balanced 7;12 translocation. To our knowledge, this translocation in association with acute myeloid leukemia (AML) has not been reported previously.

Streptokinase neutralisation titres up to 866 days after intravenous streptokinase for acute myocardial infarction

OBJECTIVE

To follow the change in streptokinase neutralisation titres in a group of patients after treatment with streptokinase for acute myocardial infarction.

DESIGN

Venous blood samples suitable for analysis were obtained up to 866 days after treatment with 1.5 million units of streptokinase in 189 patients. The ability of the patient's plasma to inhibit lysis of a thrombin clot by streptokinase was assessed.

SETTING

A coronary care unit in a district general hospital.

PATIENTS

A retrospective review of coronary care records and the district health authority computer showed that 329 patients who had received streptokinase were alive. All were invited for venepuncture and 220 (67%) attended. Satisfactory samples were obtained from 189 patients.

RESULTS

Raised titres of antibody sufficient to neutralise a standard dose of 1.5 million units of streptokinase were found in 90% of patients. There was a fall in streptokinase neutralisation titre with increasing time after administration of streptokinase (r = -0.35, P < 0.0001) and though there was considerable variation among the group the neutralisation titre was higher than in the general population in all patients, even those who had received streptokinase at least two years previously.

CONCLUSION

The ability of streptokinase to lyse a thrombin clot was appreciably inhibited in vitro by the plasma from patients who had received 1.5 million units of streptokinase. High streptokinase neutralisation titres persisted for a long time after the use of streptokinase as thrombolytic treatment for acute myocardial infarction. Readministration of streptokinase may not be efficacious for considerably longer than the one year currently advocated. Until the in vivo effects of streptokinase readministration are known a non-antigenic thrombolytic agent should be used instead.

Serum sickness and purpura following intravenous streptokinase

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The effect on platelet behaviour of treatment with atenolol and the combination of atenolol and nifedipine in healthy volunteers

Two double blind crossover studies have been carried out in healthy volunteers to determine the effect on platelet behaviour and on blood coagulation of treatment with atenolol and with a fixed combination of atenolol and nifedipine. The first study compared atenolol with placebo, whilst the second compared atenolol alone with the combination of atenolol and nifedipine. Treatment with atenolol alone had no effect on platelet behaviour. In contrast, treatment with the combination of the beta blocker and the calcium antagonist gave rise to a small but significant increase in platelet dense granule release ex vivo in response to a wide range of agonists. This was not associated with any change in serum levels of thromboxane B2 nor with any alteration in plasma concentrations of platelet factor 4 and beta-thromboglobulin. Neither treatment had any effects on coagulation parameters. The mechanism and clinical significance of the observed increase in the extent of the platelet release reaction during combined atenolol/nifedipine treatment remain speculative.

Antistreptokinase titres after intravenous streptokinase

Streptokinase neutralisation titres were measured in a series of 25 patients who received streptokinase for the treatment of acute myocardial infarction. Before treatment, neutralisation titres were low (0.3 X 10(6) neutralisation units or less) in all patients. 3 months after treatment, neutralisation titres in 24 were such that a typical therapeutic dose of 1.5 million units of streptokinase would have been fully neutralised. At 4 1/2-8 1/2 months, 18 of 20 patients had neutralisation titres such that at least 50% of a dose of 1.5 million units of streptokinase would have been neutralised. After 8 months, neutralisation titres ranged from 0.4 to 2.0 million units in 8 patients. A decision to readminister streptokinase within 8 months (and probably up to 1 year) of previous thrombolytic treatment should take account of the neutralising capacity of plasma and the dose should be adjusted accordingly.

Cytochemical and immunological characteristics of acute monocytic leukaemia

Immunological and cytochemical findings are presented from 12 cases of morphologically unequivocal acute monocytic leukaemia (AMoL). The results indicate considerable heterogeneity and three main non-morphological subgroups were identified. The blast cells from half the patients were positive for the presence of both cytoplasmic alpha naphthyl acetate esterase (ANAE) and monocyte-associated membrane determinants whereas the cells from three cases lacked detectable monocytic antigens despite the presence of strong cytochemical ANAE activity. A further three cases expressed monocytic antigens but were cytochemically unreactive for ANAE. These cytochemical results, which were extended by electrophoretic studies of ANAE isoenzymes, suggest that the absence of significant cytoplasmic ANAE activity does not preclude the diagnosis of AMoL and that serum lysozyme estimations may be of value in the recognition of immunocytochemically-atypical cases.