bluuebunny/crossref_metadata_2025 huggingface dataset:
Supernumerary tooth in the nasal cavity
Authors: Mathur Stuti , Verma Bhavika , Dabholkar Yogesh , Saberwal Akansha
Published: April 2023

Intranasal ectopic dentition is a rare clinical entity. The presence of teeth has been reported in ovaries, testes, anterior mediastinum and presacral regions. In the maxillofacial region, teeth have been found in maxillary sinus, mandibular condyle, coronoid process, chin, nose and even orbit. A 21-year-old female patient presented with complaints of intermittent right-sided epistaxis and a history of occasional headache for 6 months. An anterior rhinoscopic examination revealed a hard white mass surrounded by granulation tissue lying in the floor of the right nasal cavity. The clinical appearance was that of a rhinolith. Supernumerary teeth are extra to normal complement in dentition. They may occur unilaterally or bilaterally, single or multiple. A variety of complications can occur ranging from crowding to cyst formation. Hence, early identification and treatment are essential for management.
Antibacterial effects of aqueous and alcoholic extracts of Zataria multiflora in comparison with chlorhexidine mouthwash on some pathogenic oral streptococci: An in vitro study
Authors: Noveiri Parnian Baradaran , Rezvaninejad Rayehehossadat , Azarm Ali , Rezvaninejad Raziyehsadat
Published: April 2023

Background:

Increasing antibiotic resistance to pathogenic microorganisms (Streptococci) has led scientists around the world to turn to medicinal plants. In this study, the effects of aqueous and alcoholic extracts of Zataria multiflora on the in vitro growth of Streptococcus mutans and Streptococcus sanguis have been considered and compared with 0.2% chlorhexidine mouthwash.

Materials and Methods:

In this in vitro study, the inhibitory growth zone was accessed by the disc diffusion method after 48 h of incubation at 37 C. To find out the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of treatments, colony counts of cultured bacteria on nutrient agar have been considered at serial dilution at 1/2-1/1024 dilution rates. An independent t-test was used to compare the antibacterial effects of extracts while the level of significance of was considered to be 5% (P < 0.05).

Results:

The inhibitory growth zones of aqueous and alcoholic extracts on S. mutans were 26.8 mm and 35.8 mm, respectively, whereas growth zones for S. sanguis were considered as 25.8 mm and 33.2 mm, sequentially. Comparisons showed better effects of alcohol compared to aqueous extract (P > 0.05). The MIC and MBC assessments showed the same results (P > 0.05). In all comparisons, the effects of 0.2% chlorhexidine mouthwash were significantly better than both Z. multiflora aqueous and alcoholic extracts (P > 0.05).

Conclusion:

The different solvents may have contributed to the better effects of an alcoholic to aqueous extract of Z. multiflora on the growth of both bacteria. These two extracts could be used for early inhibition of the growth of the planktonic phase, as well as for better oral taste after chlorhexidine applications.
Effects of oxygen therapy on the outcome of patients with acute myocardial infarction
Authors: Ziaei Maryam , Rastegari Najafabadi Hojjat , Keykha Mahjoubeh , Galavi Mehdi , Abdolrazaghnejad Ali , Bahmani Alireza
Published: April 2023

Objective:

To investigate the therapeutic effects of supplemental oxygen on patients with myocardial infarction.

Methods:

This study was a randomized, double-blind clinical trial. The study population included all patients who were admitted to the emergency room of Ali-ibn-Abitaleb and Khatam-al-Anbia hospitals in Zahedan within six hours of the onset of classic symptoms of myocardial infarction. The patients (n=47) were divided into two groups: the case group (with oxygen therapy) and the control group (without oxygen therapy). The initial follow-up was evaluated after one month and the second follow-up was evaluated after three months in the target population in terms of mortality caused by acute myocardial infarction, mortality caused by any other cause, and re-hospitalization caused by acute myocardial infarction.

Results:

Out of the 47 patients, 27 were male (57.4%). The average age of the patients was (60.9±8.1) years. One month after admission, 2 patients (8.7%) in the case group and 2 patients (8.3%) in the control group died due to acute myocardial infarction. A total of 7 patients (14.9%) died three months after admission. There was no significant difference between the control and case groups in terms of mortality caused by acute ischemia within one and three months. After one month, 2 patients (8.7%) in the case group and 1 patient (4.2%) in the control group died of other causes. After three months, 4 patients (8.5%) in total died for other causes. There was no significant difference between the control and case groups in terms of mortality due to other causes within one and three months. One month after admission, 5 patients (21.7%) of the case group and 4 patients (16.7%) of the control group were re-hospitalized due to acute myocardial ischemia. During the next three months, 3 patients (13.0%) of the case group and 5 patients (20.8%) of the control group were re-hospitalized. There was no significant difference between the control and case groups regarding the rate of re-hospitalization caused by acute myocardial infarction within one and three months after admission.

Conclusions:

There is no significant relationship between oxygen therapy and death by acute myocardial ischemia, or any other causes. The relationship between oxygen therapy and the rate of re-hospitalization caused by acute myocardial ischemia is not found within one and three months after admission. The results show that oxygen therapy does not affect patients with acute myocardial ischemia within three months after admission.
Perceived stress and coping capacities among frontline healthcare workers of AIIMS during COVID-19 pandemic
Authors: Sharma Mudita , Chundawat Digpal Singh , Richhariya Rohit , Tailor Sunil Kumar , Pareek Shatrughan
Published: April 2023

Objective:

To assess perceived stress and coping capacity of frontline health workers from AIIMS during COVID-19 pandemic.

Methods:

This cross-sectional study conducted from May to July 2021 enrolled 694 participants. An online questionnaire based on Google Forms was developed to collect the data. Participants were assessed using the validated Perceived Stress Scale and the Coping Resources Inventory Scale.

Results:

The age of participants were 27 (23-52) years old. The majority of respondents (73.5%) felt moderately stressed. Of the 694 participants, 83.0% of the 576 participants had average stress management skills. Sex, marital status, and profession were significantly associated with perceived stress. In addition, marital status and profession were significantly associated with coping capacity.

Conclusions:

The majority of participants have moderate stress levels and average coping skills. Frontline healthcare workers have to maintain mental and physical health. Achieving this requires early screening and stress management for healthcare workers.
Stress perceptions of nurses serving in home healthcare services during the COVID-19 pandemic
Authors: Karakaya Arzu , Uçar Mehmet
Published: April 2023

Objective:

To investigate the stress perceptions of nurses serving in home healthcare services during COVID-19.

Methods:

This study was qualitative research with a phenomenological design. Data were collected and recorded through in-depth interviews with 6 nurses working in Muş State Hospital, Home Healthcare Services Unit using a form consisting of 12 questions on an online platform between May 2021 and July 2021. The audio recordings were transcribed by the researcher and content analysis was performed by creating codes, categories, and themes.

Results:

The interviews yielded 10 categories and 59 sub-codes. These codes were addressed under the theme of "COVID-19 pandemic". Under this main theme, nurses expressed the problems they experienced in issues such as stress, support mechanisms, and family and social problems during COVID-19. They mentioned that they experienced high stress in this process, as well as social isolation and negative thoughts of society about them and that they could not spare time for themselves and their families.

Conclusions:

Nurses working in home healthcare services frequently express negativities such as high stress, isolation from society, and increased workload. Therefore, actions should be taken to raise awareness of society on these issues, increase the number of personnel, conduct more research, and share the results with the public.
Post-COVID recurrent dyspnoea
Authors: Balani Kiran A. , Sahasrabudhe Tushar R. , Barthwal M. S.
Published: April 2023

Rationale:

Post-COVID symptoms need aggressive evaluation.

Patient’s Concern:

A 29-year-old male patient who had suffered from COVID-19 eight weeks earlier, presented with an acute onset of breathlessness and right-sided chest pain due to pneumothorax. Emergency tube thoracostomy was performed. However, it failed to improve hypoxia.

Diagnosis:

High-resolution computed tomography of the thorax with computed tomography pulmonary angiography revealed pulmonary arterial thrombosis, ground-glass opacities, and bilateral pneumatoceles.

Interventions:

Hospital admission and treatment with low molecular weight heparin at a dose of 1.5 mg/kg every 24 h.

Outcomes:

The large pneumatocele showed significant resolution after three months of follow-ups.

Lessons:

Being increasingly reported after having a SARS-CoV-2 infection, pneumatocele formation, due to post-COVID lung scarring and late vascular thrombotic events, is a peculiar sequela and can present as acute dyspnoea. Long-term preventive anticoagulants after recovery from COVID-19 are necessary. Breathing exercises during recovery should be done with caution.
Primary care level prevalence of osteitis pubis in non-athlete patients in hill region: A short communication and a proposal for simple radiological grading
Authors: Dharmshaktu Ganesh Singh
Published: April 2023

ABSTRACT

Background:

Osteitis pubis (OP) is inflammation of pubic symphysis associated with varying degrees of supra-pubic, pelvic, or lower abdominal pain. The condition may be severe in many patients with significant disability and protracted course of recovery. The condition is frequently described in sportspersons or athletes but consensus on classification and treatment guidelines is non-existent due to rarity of the condition. Its presence in non-athletic population is limited to a series of few cases or anecdotal case reports. Our study describes salient features of pattern of this disorder diagnosed on clinico-radiological basis in cases referred from primary care centers to our tertiary care center.

Materials and Method:

A total of 26 patients (mean age of 36.28 years, 25 females, and 1 male case) with radiological features suggestive of OP were included in the study and relevant demographic details were noted for each. A radiological grading (Grade A to E) for notification was developed and the cases were categorized accordingly.

Results:

Most of the cases were hard-working women from villages. Pregnancy was the major condition for which they ever consulted a health-care facility. Chronic, but not disabling, supra-pubic pain was the chief complaint in most cases. In some cases, the primary presentation was for some other disorder like low back pain in two, hip pain in six cases, adjacent fracture in three, and old lumbar osteoporotic compression fracture in one case. Other notable associated disorders included polio, ankylosing spondylitis, femoroacetabular impingement, and hip dysplasia. Conservative management was done in all cases except one with associated fracture. Good clinical outcome was noted in all but one case. Grade A cases were maximum (7) followed by grade B (6), grade D (4), and grade C (3). Only one case of grade E was noted with almost ankylosed symphysis.

Conclusion:

This article highlights acknowledgment and knowledge of OP in primary care settings and its anticipation even in normal population for a better understanding of prevalence and radiological presentation.
Program management challenges of clinical studies: A qualitative critical assessment
Authors: Gupta Girjesh , Mahor Rajendra , Pawar Neeraj , Gumashta Raghvendra , Gumashta Jyotsna
Published: April 2023

ABSTRACT

Background:

Organization, coordination, and discipline are required to complete any intricate operation, conducting a clinical experiment is no different. There are usually many moving components, from designing a plan, to conveying changes, to calculating risk, and excellent project management which are necessary to guarantee the study works successfully. Past evidence suggested that roadblock at any level hampers the progress of the clinical research. Understanding program management challenges hence becomes the key for timely and effective completion of clinical research.

Methods:

A cross-sectional qualitative enquiry involving stakeholders in clinical research program management. We used problem tree-based approach wherein we documented views of various stakeholders to understand the interaction, interdependence, and related interventional needs of bottlenecks for long-term research gains using modern management methods applicable in clinical settings. The best fit approach was also explored to augment maximum benefit in limited resource settings.

Results:

Non-alignment with state policy aims, a lack of effective coordination and communication among members, challenging logistic management, limited use of technology, a need for training, and an inefficient monitoring mechanism were among the major issues highlighted, and solutions were proposed.

Conclusion:

Study concludes that an Integrated Process-cum-Timeline-Based Management strategy with multisectoral emphasis is ideal for program management of clinical projects.
Household secondary attack rate in mild COVID-19
Authors: Narayan Ananthu , Saraswati Ushasi , Kaur Ishmeet , Kumari Aakansha , Kumar Arvind , Vishwakarma Vishal Kumar , Kumar Upendra , Sahoo Vishwajeet , Wig Naveet
Published: April 2023

ABSTRACT

Background:

The coronavirus disease 2019 (COVID-19) pandemic has reached a staggering number of almost 280 million cases worldwide, with over 5.4 million deaths as of 29 December 2021. A further understanding of the factors related to the household spread of the infection might help to bring about specific protocols to curb such transmission.

Objective:

This study aims to find the secondary attack rate (SAR) and factors affecting SAR among the households of mild COVID-19 cases.

Methods:

An observational study was designed where data of patients admitted at All India Institute of Medical Sciences, New Delhi due to mild COVID-19 were collected, and outcome was noted after the discharge of the patient. Index cases who were the first in the household to have a positive infection only were included. Based on these data, the overall household SAR, factors related to the index case and contacts that affected transmissibility were noted.

Results:

A total of 60 index cases having contacts with 184 household members were included in the present study. The household SAR was measured to be 41.85%. At least one positive case was present in 51.67% households. Children below 18 years old had lower odds of getting a secondary infection compared to adults and elderly [odds ratio (OR) = 0.46, 95%CI = 0.22–0.94, p = 0.0383). An exposure period of more than a week was significantly associated with a higher risk of infection (p = 0.029). The rate of transmissibility drastically declined with effective quarantine measures adopted by the index case (OR = 0.13, 95%CI = 0.06–0.26, p < 0.00001). Symptomatic index cases contributed more to the SAR than asymptomatic primaries (OR = 4.74, 95%CI = 1.03–21.82, P = 0.045). Healthcare worker index cases had lower rates of spread (OR = 0.29, 95%CI = 0.15–0.58, P = 0.0003).

Conclusion:

The high SAR shows the household is a potential high-risk unit for transmissibility of COVID-19. Proper quarantine measures of all those exposed to the index case can mitigate such spread and lead to reduction of risk of COVID-19 within a household.
Social challenges experienced by Hepatitis B patients: A mixed method study
Authors: Tomar Meenakshi , Sharma Tarika , Prasad Manya
Published: April 2023

ABSTRACT

Background:

Hepatitis B has a wide range of effects on patients’ lives due to its chronic nature. Living with Hepatitis B has been associated with various social challenges such as stigma, disclosure, and discrimination.

Aim:

To assess the social challenges experienced by Hepatitis B–positive patients seeking treatment at a super specialty liver hospital of the country.

Methods and Results:

A mixed-method research design was used to explore various social challenges experienced by Hepatitis B–positive patients. Descriptive research design was used in the first phase and thematic analysis was done in the second phase of the study. Data were collected using a modified Hepatitis B stigma assessment tool and semi-structured interview guide. Total 180 Hepatitis B–positive patients were recruited for the first phase. Face to face interviews were recorded for the 9 patients facing high stigma in the second phase of the study. Mean age of the patients was 45 ± 13.1 years and 80% of the patients were male. Mean overall stigma score was found to be 74.34 ± 10.13. Of all, 5.1% patients experienced high stigma, 2.1% moderate stigma, and 92% patients experienced low stigma. Thematic analysis method uncovered various attributing factors to social challenges broadly classified into reaction on getting diagnosed with Hepatitis B, psychological issues, stigmatization in families, stigmatization at workplace, and stigmatization in healthcare settings.

Conclusion:

Patients with Hepatitis B experience social challenges in aspect of lack of awareness, psychological issues, and stigmatization by healthcare providers, family members, and by the colleagues at their workplace. A better understanding and awareness regarding Hepatitis B is needed to eliminate stigma and discrimination among these patients. Hence, a holistic approach is must to treat patients with Hepatitis B.
Kimura disease: A rare cause of painless lymphadenopathy in South Asia
Authors: Rijal Prabhat , Banjade Madhav , Kumar Nirmal , Raina Rohit , Pathania Monika , Kant Ravi
Published: April 2023

ABSTRACT

Kimura disease is an uncommon disease entity that typically involves the lymph nodes predominantly in the head and neck region together with frequent involvement of salivary glands. Very few cases of it have been reported in literature globally, and in the context of India, it is even rare. Early suspicion of Kimura disease may prevent the patient from unnecessary invasive diagnostic tests. We present a case scenario of a 35 years old female, from a hilly area who presented with painless neck swelling for 3 months that was followed by fever, new onset pain at the site of neck swelling, and skin rashes. Diagnosis of Kimura disease was made based on histopathological findings aided by peripheral eosinophilia and elevated serum Immunoglobulin E (IgE) levels. Following the diagnosis, the patient was treated with a short course of oral steroids which produced an excellent response with a consequent decrease in the size of lymph nodes and resolution of the skin rashes.
Effectiveness of brief counseling (5As): Antenatal tobacco cessation support program among pregnant women availing antenatal care
Authors: Sehgal Akansha , Tayade Motilal , Kunkulol Rahul
Published: April 2023

ABSTRACT

Introduction:

It is likely that a pregnant woman is more motivated and receptive to accepting healthy habits and practices if talked about the benefits to the fetus. When explained about the harmful effects of tobacco on the health of the baby, the mother can be encouraged to modify her tobacco consumption habits and work toward quitting tobacco.

Aim:

Our aim was to study the effectiveness of brief counseling (5As)—Antenatal Tobacco Cessation Support Program among pregnant women availing antenatal care (ANC).

Methodology:

A quasi-randomized study design was used to conduct the study. The participants were identified by screening during ANC visits, and women consuming tobacco were subjected to detailed history taking and very brief counseling with the help of 5A’s framework.

Results:

We found that Mishri was the commonest form of tobacco consumed by these women. Around 93.33% of the women consume Mishri, followed by 6.66% of women consuming chewing tobacco. The method of brief counseling made an impact in the cessation of tobacco consumption in 13.37% of the study subjects.

Conclusion:

We conclude that the use of brief counseling and motivational interviewing is feasible in most settings without inhibiting the other important aspects of ANC or disrupting the patient flow.
Immediate outcome assessment of the rapid response team of home health care services at King Abdulaziz Medical City in Riyadh
Authors: Bawazeer Manal , Alsowailmi Banan , Masud Nazish , BenSalih Ayah , Alfaraidi Lama , Said Feryal
Published: April 2023

ABSTRACT

Background:

Paediatrics rapid response team (RRT) is a newly developed service under paediatrics home health care (HHC) programme which is a standby visiting team that responds to non-critical emergency calls. The current study aimed to compare the total emergency visits and hospital admissions before and after implementation of RRT project.

Method:

A retrospective chart review was conducted from December 2018 to December 2020. Paediatric patients registered under the home health care (HHC) programme were the target population. The admission and hospitalization rates were assessed before and after the implantation of an RRT. The variables related to patient profile were assessed to explore the association between hospitalization and admission.

Result:

Data for 117 patients and a total of 114 calls attended under HHC covered by RRT were analysed. In the first year after the implementation of RRT, the mean number of ER visits per patient per year was reduced from 4.78 ± 6.10 to 3.93 ± 4.12 with (P value, 0.06). Also, a slight decrease in the mean number of admissions from 3.74 ± 4.43 to a mean of 3.46 ± 4.1 with (P value, 0.29). Follow-up after receiving an RRT call for an initial complaint was statistically significant in reducing both ER visits and hospital admissions within 7 days with a P value of 0.03 and 0.04, respectively.

Conclusion:

The RRT was effective in decreasing the ER visits and hospital admissions for a very special group of patients. Additionally, the emplacement of proper triaging code at the time of attending to patients helped in reducing unnecessary ER visit and hospital admission.
A clinico-epidemiological profile, coinfections and outcome of patients with Influenza Like Illnesses (ILI) presenting to the emergency department during the COVID-19 pandemic
Authors: Hazra Darpanarayan , Chandy Gina Maryann , Thanjavurkar Abirahmi , Gunasekaran Karthik , Nekkanti Ankita Chowdary , Pal Rathijit , Moorthy Mahesh , Abhilash Kundavaram Paul Prabhakar
Published: April 2023

ABSTRACT

Background:

During the COVID-19 pandemic, many patients presented to the emergency department (ED) with features of Influenza-like illnesses (ILI) and with other atypical presentations. This study was done to determine the etiology, co-infections, and clinical profile of patients with ILI.

Methods:

This prospective observational study included all patients presenting to the ED with fever and/or cough, breathing difficulty, sore throat, myalgia, gastrointestinal complaints (abdominal pain/vomiting/diarrhea), loss of taste and altered sensorium or asymptomatic patients who resided in or travelled from containment zones, or those who had contact with COVID-19 positive patients during the first wave of the pandemic between April and August 2020. Respiratory virus screening was done on a subset of COVID-19 patients to determine co-infection.

Results:

During the study period, we recruited 1462 patients with ILI and 857 patients with the non-ILI presentation of confirmed COVID-19 infection. The mean age group of our patient population was 51.4 (SD: 14.9) years with a male predominance (n-1593; 68.7%). The average duration of symptoms was 4.1 (SD: 2.9) days. A sub-analysis to determine an alternate viral etiology was done in 293 (16.4%) ILI patients, where 54 (19.4%) patients had COVID 19 and co-infection with other viruses, of which Adenovirus (n-39; 14.0%) was the most common. The most common symptoms in the ILI-COVID-19 positive group (other than fever and/or cough and/or breathing difficulty) were loss of taste (n-385; 26.3%) and diarrhea (n- 123; 8.4%). Respiratory rate (27.5 (SD: 8.1)/minute: p-value < 0.001) and oxygen saturation (92.1% (SD: 11.2) on room air; p-value < 0.001) in the ILI group were statistically significant. Age more than 60 years (adjusted odds ratio (OR): 4.826 (3.348-6.956); p-value: <0.001), sequential organ function assessment score more than or equal to four (adjusted OR: 5.619 (3.526-8.957); p-value: <0.001), and WHO critical severity score (Adjusted OR: 13.812 (9.656-19.756); p-value: <0.001) were independent predictors of mortality.

Conclusion:

COVID-19 patients were more likely to present with ILI than atypical features. Co-infection with Adenovirus was most common. Age more than 60 years, SOFA score more than or equal to four and WHO critical severity score were independent predictors of mortality.
Perceptions and practices related to menstruation and reproductive health in adolescent girls in an urban population - A cross sectional study
Authors: Vinod Anuna , Kaimal Resmi S.
Published: April 2023

ABSTRACT

Introduction:

Menarche is an important biological milestone in a woman’s life as it marks the onset of the reproductive phase of her life. It is, often considered an impure phenomenon in Indian society owing to cultural taboos and insufficient and incorrect information and causes unnecessary restrictions in the day-to-day normal activities of menstruating girls.

Aim:

To assess the perception and practices related to menstruation and reproductive health among school-going adolescent girls in the urban population in Kochi, Kerala.

Objectives:

To elicit the practices regarding menstruation and reproductive health among the school-going, adolescent girls. i. To elicit the beliefs, perceptions, and sources of information regarding menstruation and reproductive health among the school going, adolescent girls. ii. To find out the relation between perceptions/practices and other factors.

Methodology:

A cross-sectional study was conducted among 100 adolescent girls of a secondary school situated in Ernakulam, Kerala, with the help of a pre-designed and pre-tested questionnaire. Data were analyzed statistically by simple proportions.

Result:

89% of the girls were aware of menstruation before menarche. A major source of information was found to be mothers. More than 70% used sanitary pads and 99% of girls knew menses as a natural phenomenon. 80% of girls with good perception had no menses-related anxiety. 54% haven’t even heard of Pre-Menstrual Syndrome. 40% have inhibition talking about menses to their father or brother. Among girls with good practice, 87% had a good perception.

Conclusions:

Before bringing any change in menstrual practices, Family physicians can play a role in educating the girls about the significance of menstruation and the development of secondary sexual characteristics, the selection of a sanitary menstrual absorbent, and its proper disposal. Trained personnel, school teachers, and knowledgeable parents can play a very important role in imparting menstrual health-related information to adolescent girls.
Accidental kerosene oil ingestion in under-five age children in Nigeria – The need for vigilance in primary care settings in low- and middle-income countries (LMICs)
Authors: Oreh Adaeze C. , Uchemefuna Ibifuro , Mmamelu Ngozi , Imagbenikaro Etin-osa U. , Nafiu Marian A. , Moses Lawrence A.
Published: April 2023

ABSTRACT

Four children aged between 15 months and two years presented in several different out-patient emergency departments with a history of recent ingestion of kerosene. Majority of the patients lived in crowded domestic settings, and they all presented with varying degrees of respiratory distress, different presentations of respiratory clinical symptoms and signs, after being subjected to various potentially dangerous home remedies to counter the effect of the kerosene. Majority of the children presented late, but all recovered following appropriate management. The presented cases demonstrate the vital importance of prompt emergency management in primary care settings, family counseling on childcare and domestic safety, and community enlightenment on reducing the complications and frequency of childhood poisoning in increasingly overcrowded and less affluent communities.
Is it “the conflict of interest” that is influencing our efforts on Climate change, tobacco control and primary care?
Authors: Raina Sunil K. , Kumar Raman
Published: April 2023

ABSTRACT

What seems to work against making climate change relevant, tobacco control necessary or primary care a felt need despite the efforts being claimed to the contrary? Emerging evidence points to a conflict of interest with academic institutions and academics fighting on both sides with clear support from the industry and others.
Attitudes and practices of physicians toward law enforcement on dispensing antibiotics without prescription antibiotics: Findings from a cross-sectional survey
Authors: Darraj Ali , Almutairi Mansour , Alhassan Omar , Aljammaz Abdulrhman , Almansour Ibrahim , Alotaibi Shaya , Abohelaibah Faisal , Alseleem Abdulaziz , Alsumayt Abdullah , Alarifi Osman , Alabdullatif Ghaith , Almutairi Fouad , Tabish Mohammad
Published: April 2023

ABSTRACT

Background:

The government of Saudi Arabia implemented a law to enforce the law and regulations prohibiting the dispensing of antibiotics without a prescription, and studies have been conducted to assess the impact of such a law in Saudi Arabia. However, the extent to which law enforcement has changed the perceptions and attitudes of health care professionals, mainly physicians, toward antibiotic resistance is unknown in Saudi Arabia.

Material and Methods:

A cross-sectional study was conducted in Riyad, Saudi Arabia, on 378 physicians. These physicians were mainly working in primary care centers. An online questionnaire was sent to the physicians, and it consisted of 35 items and was divided into four sections: 6 items were on sociodemographic characteristics of participants; 13 items were on the knowledge of physicians about antibiotic resistance; 8 items were on the attitude the physicians toward enforcement law, and the final 8 items were on the attitude the patients toward enforcement law in an outpatient setting.

Results:

Around 90% of the physicians acknowledged that physicians should stop prescribing antibiotics without indication. About 29.1 % of the physicians agreed, and 56.3% showed strong agreement that law enforcement is for the patient’s benefit. Similarly, 33.6% agreed, and 50.8% strongly agreed that law enforcement limits the resistance of bacteria. Around 24.3% of the patients disagreed, and 23% strongly disagreed that law enforcement does not affect anything. Around one-third of the physicians (34.4%) agreed, and 23.5% strongly agreed that the new regulation of law enforcement of antibiotic prescription increases public awareness regarding the misuse of antibiotics.

Conclusion:

It seems that law enforcement has impacted the knowledge and attitude of physicians as they agree with law enforcement and its associated benefits for patients. They also acknowledged that law enforcement could limit the resistance to bacteria. However, not all physicians agree that law enforcement has an effect on anything, and new regulation of antibiotic prescription law increases public awareness regarding the misuse of antibiotics.
Food literacy & food labeling laws—a legal analysis of India’s food policy
Authors: Bera Om Prakash , Singh Ranjit , Bhattacharya Sudip
Published: April 2023

ABSTRACT

Aggressively marketed, cheaper and more easily available pre-packaged foods, often considered as foods high in fat, salt, and sugar (HFSS) is finding a growing preference amongst consumers in India. These HFSS foods are the major causes of heart and other non-communicable diseases worldwide. To prevent or control further widespread of NCDs, Food Safety and Standard Authority of India (FSSAI) has issued numerous food and packaging laws and acts to control their manufacture, storage, distribution, sale, and import so that a safe and wholesome food is available to the consumers. The Front-of-pack labeling (FOPL), proposed by FSSAI in 2019, is a key strategy to alert and educate consumers in making an informed choice. This article aims to enlist and describe various food and labeling laws and acts enacted in India since the last two decades and identify that what type of label would be best suited to India.
Unusual case presentation of an aneurysmal bone cyst of maxilla in geriatric patient
Authors: Doddawad Vidya G. , Shivananda S , Ravi MB , Ganganna Aruna
Published: April 2023

An aneurysmal bone cyst (ABC) is a non-neoplastic, rapidly expanding pathologic bone lesion that mostly affects the mandible and is most commonly found in the first to third decade of life. The most of the ABC cases are locally aggressive osteolytic lesion with a high recurrence rate. As a result, we present a swelling with pus discharge at the maxillary alveolus in a 68-year-old female who was diagnosed with ABC after a computed tomography scan and histological analysis. The conservative surgical excision was performed without considerable bleeding, and no recurrence was observed even after a five-year follow-up period.
Anti-fibrotic activity of licorice extract in comparison with colchicine on areca nut-induced fibroblasts
Authors: James Amritha , Gunasekaran Nandhini , Krishnan Rajkumar , Arunachalam Preethi , Mahalingam Ramya
Published: April 2023

Objective:

Oral submucous fibrosis (OSMF) is a debilitating chronic disease of the oral cavity with a high potential for malignant transformation. The main etiological agent attributed to the development of OSMF is the use of smokeless tobacco products like areca nut. There is no known cure for the disease. Current modalities of treatment do not provide a complete cure and often prove invasive for the patient. Herbal preparations using natural compounds and medicinal plant extracts have long since been used in India, as an acceptable, noninvasive and cost-effective method in the treatment of various diseases. Hence, the present study aims to assess the anti-fibrotic effect of licorice in comparison with colchicine on areca nut-induced fibroblasts.

Materials and Methods:

Extracts of areca nut, licorice and colchicine were prepared in accordance with established protocols. Human fibroblast cell lines were procured from ATCC®(PSC-201-018). Fibroblast cultures were established, and upon reaching confluence the cells were subjected to the 25 μg/ml areca nut extract for 24 h to induce fibrosis, with CCl4 used as control fibrosing agent. The areca nut and CCl4 induced cells were then subjected to varying concentration of the test antifibrotic agent, licorice extract for the periods of 24 and 48 h, with colchicine used as positive control. Total collagen quantification was done using spectrophotometry.

Results:

Collagen accumulation decreased with increase in the concentration of licorice extract with maximum reduction seen at 200 μg/ml. Kruskal–Wallis test was done to analyze the difference in collagen accumulation. Analysis revealed that the P < 0.05 for both periods in both the areca and CCl4 induced cell lines following the addition of licorice extract. The data were found to be statistically significant.

Conclusion:

The current study proves the antifibrotic efficacy of licorice in areca nut induced cell lines and hence, this agent can be used for the therapeutic management of OSMF.
Senescent Fibroblast in Oral Submucous Fibrosis Aids in Disease Progression and Malignant Transformation
Authors: Karnam Shyamala , Girish H C , Nayak Vaidhehi N.
Published: April 2023

Aim:

To study the role of senescent fibroblasts (SFs) and its secretory phenotypes promoting fibrosis and malignancy in oral submucous fibrosis (OSMF).

Material Methods:

A total of 20 cases of OSMF and 20 normal oral mucosal tissues were taken for the study. The tissue sections were stained for IHC-immunohistochemistry with senescent cell marker p16INK4a. The supernatant solution of the transport medium was studied for leached out senescent associated secretory proteins (SASP): matrix metalloproteinases 9 (MMP9), interleukins 6 (IL6), vascular endothelial growth factor (VEGF). Tissues were studied for malignant transformation with p53 and Ki67. Fibrosis in the OSMF was tested with lysyloxidase (LOX). The Statistical Package for the Social Sciences (SSPS) statistical software was used to analyze the data.

Results:

IHC staining for p16INK4ashowed positivity in the connective tissue of OSMF cases which was statistically significant. Antibody assay using enzyme-linked immunosorbent assay (ELISA) showed elevated levels of secretoproteins IL6, MMP9, VEGF in OSMF cases. LOX enzyme levels were also significantly increased in OSMF cases. Proliferative markers Ki67 and p53 were positive in IHC staining in the epithelium of OSMF.

Conclusion:

This study confirms the presence of SF and its secreto phenotypes in OSMF and showed increased LOX expression which is implicated in fibrosis. These findings suggest that SF may contribute to fibrosis in OSMF. The study also confirms the malignant transformation of the overlying epithelium as shown by p53 and Ki67 positivity.
Evaluation of the effect of moringa oleifera gel and autologo platelet-rich fibrin in the treatment of rabbit intra bony defects. (Radio graphic and Histological study)
Authors: El Soudany Kareman S. , F. El Said Heba A. , A. EL Gendi Huda A.
Published: April 2023

Purpose:

Periodontitis is the most common condition, which causes bony defects; the ultimate goal of periodontal therapy is the regeneration of the destroyed tissues. There is always a need to search for better biomaterials that can be used for the treatment of intrabony defects. This study evaluated the effect of Moringa oleifera (MO) gel and platelet-rich fibrin (PRF) in the treatment of bone defects.

Hypothesis:

We hypothesized that MO gel may increase the bone mineral contents and density of bone.

Methods:

The study was conducted on 16 defects in 8 adult male rabbits divided into 2 groups; group (1) buccal bone defect treated with moringa hydrogel and PRF (right site), group (2) buccal bone defect treated with PRF (left site). Computed tomography (CT) radiography and histological examination were assessed at baseline, 14 and 28 days. The defects were induced in the form of one osseous wall defect between the 1st and the 2nd molars. Comparisons between groups were done using an unpaired t-test. For comparison within each group, analysis of variance (ANOVA) was used.

Results:

CT radiograph results showed there was a significant increase in bone density at 28 days in group 1 than in group 2 (843.13 ± 97.82 to 713.0 ± 51.09). The histological result revealed the defect area on the (PRF + Moringa) was almost filled completely by newly formed bone with few spots of retarded calcification. While (PRF) showed complete filling of the defect area by more fibrous tissue. The healing score showed a significant elevation of bone defect healing score in (PRF + Moringa group) when compared to (PRF group) at both times of evaluation.

Conclusion:

Radiographical examination, and histological and healing scores confirmed the superiority of Moringa + PRF results in an increase in bone fill and density in induced periodontal intrabony defects regeneration. Clinical trials should be considered to detect the effectiveness of MO in intrabony defects.
Cysticercosis
Authors: Narayan Bhaskar , Priya Bhanu , Urs Aadithya B.
Published: April 2023

Cysticercosis, a helminthic disease caused by T. Solium, is a major health concern in developing and underdeveloped nations of the world. If left untreated, it may lead to severe neurological and ophthalmic complications. The diagnosis of oral cysticercosis depends on the identification of the larva in the biopsied tissue. However, an accurate diagnosis can be challenging, if the larva is dead because of which it cannot be identified. In such a scenario, step by step approach to unearth the worm is discussed here.
Peripheral adenomatoid odontogenic tumour
Authors: Ramachandra Prashanth , Bavle Radhika M. , Muniswamappa Sudhakara , Venugopal Reshma
Published: April 2023

The Adenomatoid Odontogenic Tumour (AOT) is more than 100 years old, known by different names and the term AOT was coined in 1969 by Philipsen and Birn. AOT frequently occurs in intra-osseous location in gnathic skeleton and rarely seen in peripheral forms. These are rare odontogenic tumours, accounting for 2.2--7.1% of all odontogenic tumours, whereas the central or intraosseous variant of AOT in follicular and extra-follicular presentation, accounts for 95.6% of all AOTs. The peripheral variant presents as a gingival mass, which may cause slight saucerization of alveolar bone or might not affect the bone at all. These peripheral variants constitute 4.4% or less, of all AOTs of the gnathic skeleton. Here, we present a rare case of a peripheral variant of AOT in a 35-years-old female, 1.5 to 2 cm in dimension seen on the labial gingiva in right canine-premolar area. The lesion showed marked bone loss in 13 and 14 teeth region, causing mobility of 13. Histopathology showed a well encapsulated tumour mass with metaplastic bone in the capsule. A conventional AOT with ductal and rosette pattern was seen with tumour droplets and amyloid like material. The case clinically presented a moderately aggressive behaviour.
Comparison of culture and polymerase chain reaction–restriction fragment length polymorphism for identification of various Capnocytophaga species from subgingival plaque samples of healthy and periodontally diseased individuals
Authors: Idate Ulka , Bhat Kishore , Kulkarni R D , Kotrashetti Vijayalakshmi , Kugaji Manohar , Kumbar Vijay
Published: April 2023

Introduction:

Capnocytophaga are facultative anaerobic Gram-negative bacilli and recognized as opportunistic pathogens of various extraoral infections. Only a few studies attempted to identify all the seven species of Capnocytophaga phenotypically and genotypically in healthy individuals and patients with chronic periodontitis. Studies to determine the prevalence of Capnocytophaga in subgingival plaque samples from healthy individuals, chronic gingivitis and periodontitis among Indian population are lacking.

Aim:

The aim of this study was to identify and compare the presence of Capnocytophaga species phenotypically through microbial culture and biochemical tests and genotypically through polymerase chain reaction–restriction fragment length polymorphism (PCR-RFLP) in subgingival plaque of healthy individuals and patients with chronic gingivitis and chronic periodontitis.

Materials and Methods:

A total of 300 subjects, 100 each with gingivitis, periodontitis and periodontally healthy gingiva subjected, were included. Subgingival plaque was collected and was cultured for phenotypic identification (microbial culture and biochemical test), and for genotypic identification, DNA extraction was done and PCR-RFLP analysis was performed to identify the genus Capnocytophaga and also to identify different species of Capnocytophaga.

Results:

Of 300 individuals, Capnocytophaga species were identified from 237 (79%) individuals by PCR and 82 (27.33%) by culture. The prevalence of Capnocytophaga ochracea was found to be higher with both the methods followed by Capnocytophaga gingivalis and Capnocytophaga granulosa. Capnocytophaga genospecies, Capnocytophaga leadbetteri and Capnocytophaga Sputigena were isolated only by culture with very low prevalence that is 1.33%, 1.33% and 0.66%, respectively. We could not get any isolate of Capnocytophaga haemolytica by any of the two methods.

Conclusion:

Capnocytophaga species could be found in gingival sulci as well as periodontal pockets and can be detected by culture and PCR-RFLP. However, higher prevalence of these species in healthy compared to disease requires further analysis to determine their role in healthy and diseased periodontium.
Association of periodontal disease with oral lichen planus
Authors: Sanadi Rizwan M. , Khandekar Priyanka D. , Chaudhari Shraddha R. , Javali Mukhatar A. , Gurav Nikhil U.
Published: April 2023

Background:

Gingival lesions in oral lichen planus can indirectly increase the risk of plaque-induced periodontal disease when symptoms associated with such lesions hamper the proper oral hygiene maintenance by the patients and can increase the risk of periodontal tissue destruction. This systematic review analyses the existing evidence on the association between oral lichen planus and periodontal disease.

Aim:

This systematic review of case-control studies aimed to analyse the association between periodontal disease and oral lichen planus.

Material and Methods:

An electronic database search for randomised controlled trials, experimental studies, case-control studies, and cohort studies published in peer-reviewed Journals in the English language was conducted from the following databases: PubMed, EBSCOHost, Science Open, EMBASE, and Google Scholar.

Results:

A total of 12,507 were identified on an electronic database search. Only eight studies fulfilled the eligibility criteria and were included for quantitative analysis. A data extraction sheet was prepared, and studies were analysed.

Conclusion:

Bleeding on Probing and Probing depth were seen to be significantly associated with Oral Lichen Planus. The symptoms in Oral Lichen Planus impede efficient oral hygiene maintenance by a patient and predispose them to the occurrence of long-term Periodontal Disease.
Unravelling the role of immunohistochemistry in giant cell lesions of jaws
Authors: Gupta Shruti , Sharma Deepti , Hooda Anita , Sharma Vishal Kumar , Kamboj Mala
Published: April 2023

Controversies exist in literature regarding nature, pathogenesis, and behaviour of giant cell lesions (GCLs) of jaws. Studies were attempted to solve these mysteries with immunohistochemical analysis, using various biological markers. Thus, the aim of this review is to appraise the role of immunohistochemistry (IHC) in evaluating the pathogenesis, cellular phenotype, nature, and behaviour of GCLs of jaws. PubMed, PubMed Central, and Clinical Key (Medline) databases were searched electronically irrespective of date of publication with assortment of several independent terms. Fifty-five articles that fulfilled the eligibility criteria were included in the review. Out of 55 included articles, 49 were associated with nature, pathogenesis, and behaviour and six articles were associated with treatment and outcome prediction. Although IHC solved some of the controversies associated with GCLs of jaws such as the osteoclastic phenotype of multinucleated giant cells, immunoexpression of proliferative markers does not distinct non-aggressive from aggressive central GCL but the nature, histogenesis, pathogenesis, and exact behaviour still remain debatable. With regard to formulation of treatment plan, immunohistochemical analysis revealed that expression of glucocorticoid and calcitonin receptors could act as a tool to decide the therapeutic strategy and aid in therapeutic adjustments according to evolution of the lesion.