Auxiliary delivered school based oral health promotion among 12-14-year-old children from a low resource setting-A cluster randomized trial

OBJECTIVES

This community intervention study compared the changes in oral health knowledge, attitude, practices (KAP), and oral health indicators among 12-14-year-old children who received a school based oral health promotion delivered by auxiliaries in a rural setting in India.

METHODS

The interventions in this school based cluster randomized trial were delivered using schoolteachers and school health nurses. Oral health education (once in 3 months), weekly classroom based sodium fluoride mouth rinsing and biannual oral health screening/ referral were provided for 1 year. The control arm did not receive these interventions. Oral health indicators and self-administered KAP questionnaire were evaluated at baseline and 1-year follow-up. Oral health indicators included oral hygiene index simplified, DMFT/DMFS net caries increments, prevented fraction, number of sites with gingival bleeding, changes in care index, restorative index, treatment index, and dental attendance.

RESULTS

The improvement in total KAP score, oral hygiene, and gingival bleeding from baseline to follow up was higher in the intervention arm (p < 0.05). The prevented fraction for net caries increment were 23.33% and 20.51% for DMFT and DMFS, respectively. Students in the intervention group had a higher dental attendance (OR 2.92, p < 0.001). The change in treatment index, restorative index, and care index were significantly higher in the intervention arm (p < 0.001).

CONCLUSIONS

Inclusion of available primary care auxiliaries like school health nurses and teachers in oral health promotion is a novel, effective, and sustainable strategy to improve oral health indicators and utilization in rural areas in low resource settings.

Challenges, experiences, and postoperative outcomes in setting up first successful lung transplant unit in India

Background

Lung transplantation (LT) has emerged as a definitive cure for a plethora of end-stage lung diseases (ESLDs). With improvements in immune-suppression protocols, the posttransplantation survival rates have gone up.

Aim

The study reported the initial experience of the India's single largest lung transplant program on clinicopathological profile, procedures, challenges encountered, and outcomes.

Settings and Design

A retrospective analysis was done from data available at three centers of Institute of Heart and Lung Transplant, Gleneagles Global Hospitals across Chennai, Bengaluru, and Mumbai.

Materials and Methods

A total of 132 patients underwent lung (single or bilateral) or combined heart and lung transplant between April 2017 and March 2020. All the participants had 30 days' follow-up. Postoperative complications, graft rejection, and 30-day mortality were reported. Kaplan-Meier survival analysis and logistic regression analysis were performed.

Statistical Analysis Used

Kaplan-Meier survival and binary logistic regression was performed.

Results

Interstitial lung diseases, 65.91%, were the most common diagnosis. Bilateral LT (81.3%) was the most common type of LT performed. Grade III primary graft dysfunction was observed in 16 (12.1%). Distal airway stenosis (21.97%) was the most common complication followed by anastomotic stenosis (14.30%). Gram-negative bacterial sepsis (52%) was the leading cause of death. Cumulative probability of survival at 1 month was 0.85 (95% confidence interval [CI] 0.80-0.92), and at 1 year, it was 0.78 (95% CI, 0.72-0.86).

Conclusion

This study establishes the fact that despite multiple challenges, LT is a viable option for selected patients with ESLDs in India and should encourage early referrals to a transplant center.

Self-perception on oral health and related behaviours among antenatal mothers attending a public antenatal clinic - Kerala

Background and Aims:

Antenatal oral care has been given least priority on a global scale. The study assesses self-perception of oral health knowledge and related behaviors among antenatal mothers.

Method:

A cross-sectional study was done among 400 pregnant women attending antenatal care clinic of a tertiary care center in Kerala, India. Details regarding knowledge, attitude, and practice were obtained, after getting an informed consent. The dental caries experience and gingival status were measured. To test the significance (p ≤ 0.05) between variables, Chi-square test was used.

Results:

Poor oral health knowledge was observed among 75.5% of the pregnant mothers. Oral health problems were reported by 63.2% of them. Low priority for oral health (59.4%) and fear for fetal safety (17.5%) were the reasons for delaying dental services. Oral examination showed that more than half of the study subjects had a high prevalence of dental caries (67.5%) and low gingival bleeding status (26.2%). The study highlights that more than half of the study population (60.8%) were influenced by the elderly in the family to avoid certain food items. A better oral health knowledge was observed among the upper middle class (OR - 2.8) who had visited dentists within the last six months (OR - 3.6) and child bearing mothers (OR- 0.46) (p ≤ 0.05).

Total cholesterol concentration in relation to superovulatory responses in crossbred cows

Blood serum total cholesterol levels of crossbred Taur-indicus donor cows (n=22), in their 1st to 4th parity, were studied as an indicator of embryo yield. These cows were superovulated either with FSH or PMSG + anti-PMSG on the 12th day of the synchronized estrous cycle. The total and transferable number of embryos did not differ significantly between the treatment groups. The number of corpora lutea and total and transferable embryos in donors having total cholesterol levels <140 mg/dl were significantly (P < 0.05) lower than those of cows having >140 mg/dl, indicating that low total cholesterol levels might adversely affect superovulatory response. Thus, estimation of total cholesterol concentrations of potential donors can be a useful tool for predicting superovulatory responses.