World Health Organization MPOWER for tobacco control in India: a 6-year retrospective analysis.

Background: Prevalence and practices of tobacco usage in India are diverse and incongruent and Government of India has enacted various laws to overcome this burden. To make tobacco control measures effective and powerful, WHO introduced MPOWER in 2004 and India was one of the first countries that implemented the MPOWER. Objective: This study is aimed to quantify the implementation of MPOWER tobacco control policies in India. Material and Methods: In this retrospective analysis, data was gathered from the WHO MPOWER of India from 2015 to 2021. This analysis was based on the checklist which was designed previously by Iranian and international tobacco control specialists in their study on tobacco control. Results: In the present comparative analysis, India was categorized by scores and these were acquired from each indicator for each activity and 2021 year got the highest scores as compared to the previous year scores i.e. 27 in 2015. In context to individual indicators, noticeable increase in scores has been seen in both health warning on cigarette packages and adult daily smoking prevalence, whereas no progress was observed in smoking related policies. Conclusion: Although MPOWER programmes are widely accepted by the Indian government, but still substantial improvement in fewer sections is required.

Acquaintance and Approach in the Direction of Tobacco Cessation Among Dental Practitioners-A Systematic Review.

BACKGROUND: Nowadays, tobacco consumption has become one of the major public health problems and is the leading cause of escapable illness and death. A significant role is played by dental professionals in the identification of smokers; they are, thus, in a better position to offer preventive care. The aim of the present study was to systemically review the knowledge and attitude of dental practitioners toward tobacco cessation. METHODS: A literature search was performed in PubMed Central and Cochrane Library, Medline-PubMed, Embase, Google Scholar up to 2018 to identify appropriate studies. Full-text original research articles of the cross-sectional design were only included in the study. Our target was to systemically review the knowledge and attitude of dental practitioners toward tobacco cessation. RESULTS: The present review included a total of nine articles (studies) that fulfilled the eligibility criteria. Two articles which were hand searched and one article which was obtained through contact with experts were included. The results of the review revealed that the dental practitioners in most of the included studies lack satisfactory knowledge and were unaware of existing referral pathways to specialist smoking cessation services. At the same time, most of the dentists have a positive attitude toward tobacco cessation. CONCLUSIONS: Dental professionals are aware of their obligations toward smoking cessation counseling for patients but certain barriers including lack of time, confidence, and training prevent them from practicing the same in their daily routine. The dental professionals should obtain appropriate training and attain knowledge along with quantifiable skills for the prevention and cessation of tobacco use.

Rashtriya Swasthya Bima Yojana (RSBY) and outpatient coverage.

The healthcare industry worldwide is undergoing a radical transformation. An enthusiastic healthcare system of the Government of India (GOI) continually tries to tackle numerous challenges facing the system. The Rashtriya Swasthya Bima Yojana (RSBY) program has provided secondary level healthcare facilities to more than 36 million families across most states in India. This particular health insurance initiative was taken by the GOI with the purpose to safeguard the pitiable or marginalized Indian population or those households who are facing economic risks due to hospitalization and their everyday expenditures. RSBY provides affordable and accessible healthcare services along with insurance coverage for secondary care. However, it is limited to inpatient treatment or hospitalization. For outpatient coverage many strategies have been applied but low enrolment is still an existing flaw under this streamer. The present paper discusses various features of RSBY, outpatient projects undertook, and various obstacles that can be removed to integrate this insurance scheme with primary healthcare in India.

Influence of the previous dental visit experience in seeking dental care among young adults.

INTRODUCTION: Dental fear is one of the highly prevalent types of fear which deters patients from seeking dental cares. AIM: This study aims to assess the influence of a previous dental visit experience for seeking dental care among adults. METHODOLOGY: Young adults (n = 150, 15-26 years) with previous dental visit for care were selected randomly among outpatients' visit in tertiary dental teaching hospital. To assess the influence of previous experience of dental visit in seeking care, we self-administered a Post-traumatic Check List-Civilian Version [posttraumatic stress disorder (PTSD)], an Autobiographical Memory Questionnaire (AMQ), and a Dental Fear Survey (DFS). The relationship of negative and positive experience of previous dental treatment, dental fear, and symptoms of PTSD was assessed using Pearson's correlations. Spearman's rho was used to find out the correlation between the DFS and PCL-C and history of dental treatment undergone. RESULTS: The mean score of the DFS and PCL-C was found to be 69.57 and 40.17, respectively. The characteristics of the most negative experience including physical reactions (P = 0.936), emotional intensity (P = 0.935), sight (P = 0.941), smell (P = 0.917), and sound (P = 0.911) of dental treatment showed a significant relationship with dental fear, whereas the characteristics of the most positive memory of dental treatment showed only a few statistically significant associations with dental fear. Most of the symptoms of PTSD also show significant associations (P < 0.05) with characteristics of the most negative memory. Spearman's correlation between the DFS and the PCL-C was also statistically significant, r (150) =0.365, indicating that dental fear is indeed associated with symptoms of PTSD. CONCLUSION: There is a significant association between the characteristics of the most negative experiences of dental treatment and increased dental fear in young adults, while positive experiences did not show the inverse relationship with dental fear.

Assessment of knowledge and attitude regarding management of patients with substance usage in dental clinics in Modinagar- A cross-sectional study.

INTRODUCTION: The consequences of oral issues among drug users necessitate the implementation of a comprehensive dental care program. Integrated oral health-care services should be programmed for the management of drug addiction as a multi-organ disease needs a multi-disciplinary approach. AIM: The aim of the present study was to assess the knowledge and attitude regarding the management of patients with substance usage at a dental clinic. METHODOLOGY: A cross-sectional study was conducted among 208 dentists working as clinicians. A self-structured 27-item questionnaire consisting of questions related to the management of patients with substance usage at a dental clinic was distributed to them. Data were analyzed using Statistical Package for Social Sciences (SPSS) 20.0 (SPSS Inc., Chicago, IL, USA) and descriptive and analytical tests, including mean, standard deviation, and Chi-square test were used. P < 0.05 was considered statistically significant. RESULTS: Majority of the dentist irrespective of qualification were unaware of the modalities regarding the management of the patients with substance usage at the dental clinic. Most dental clinicians were having a positive attitude regarding such patients and agreed that abuser should be identified and managed in dental settings. CONCLUSION: Educating dental graduates and postgraduates about the oral implications of substance usage and making it a part of the dental curriculum may help us deal with the global issues of substance usage. The dental setting is recognized increasingly as an untapped venue for the delivery of medical screenings, given the long-term nature and frequent contacts associated with the patient-dentist relationship.

Out-patient coverage: Private sector insurance in India.

BACKGROUND: There has been a growth of 25% in the health insurance business in India during the last few years with the expansion of the private health insurance sector. The share of the private health insurance companies has increased considerably, despite the fact that from the patients' point of view, health insurance is not a good deal. AIM: To provide information and assess the current status of private sector insurance with regard to out-patient coverage in India. MATERIALS AND METHODS: The present review was conducted after doing extensive literature search of peer review journals in Pubmed and various search engines like Google. Data of Indian private health insurance companies was also utilized. No limitation in terms of publication date and language was considered. The main focus of the present review would be on the private health insurance sector with a spotlight on the out-patient coverage and various obstacles faced by the private health insurance sector. RESULTS: Out-patient (OPD) coverage is one of the important emerging trends in the private sector health insurance. OPD cover assists the insured to claim expenses other than that incurred during hospitalization. However, it is still not a full-fledged offering under health insurance and major insurance companies are providing this cover for an additional premium. CONCLUSION: Private is strongly being advocated and receiving growing consideration by our country's policy makers that can deal with alarming health care challenges in India. However, it is not the only option.

Nomophobia: A Cross-sectional Study to Assess Mobile Phone Usage Among Dental Students.

INTRODUCTION: Mobile phones were originally seen as a gadget for communication but currently, the internet enabled mobile phones have become an integral part of our daily life. Their benefits are incomparable but at the same time, they have some negative effects too. AIM: To assess the pattern of usage of mobile phones and its effects on the academic performance of students. MATERIALS AND METHODS: A descriptive cross-sectional study was conducted amongst 554 students of D. J. College of Dental Sciences and Research through a self-administered questionnaire to collect the data regarding the usage and associated anxiety with mobile phone. RESULTS: About 39.5% students agreed that they score low marks in professional exams if they spend more time on phone. The number of students who frequently checked their cell phone during their classes or while doing clinical work were 24.7% . A total of 24.12% of the students were found to be nomophobic and at risk of being nomophobes were 40.97%. A statistically significant difference was found among preclinical, clinical, interns and postgraduates regarding the usage and effect of mobile phone on them. CONCLUSION: The pattern of usage of mobile phone among dental students showed alarming indication that students have been addicted to mobile phone which in turn affect their academic performance in a negative way. It would be useful to advise the students about the controlled as well as proper usage of mobile phone.

Imaging More Imagining less: An Insight into Knowledge, Attitude and Practice Regarding Radiation Risk on Pregnant Women among Dentists of Ghaziabad - A Cross Sectional Study.

INTRODUCTION: The safety of diagnostic imaging during pregnancy is an important aspect for all clinicians. Pregnant women often do not receive proper dental care as the dentists are not aware of low diagnostic radiation doses involved in dental radiation. AIM: To assess awareness of radiation risks on pregnant women among dentists of Ghaziabad city. MATERIALS AND METHODS: A total of 268 practicing dentists in Ghaziabad were selected for a questionnaire based cross-sectional study. Data consisted of 18 questions which assessed the knowledge, attitude and practice of dental professionals regarding radiation risks on pregnant women. The questionnaire was distributed and collected personally by the principal investigator. Data was analyzed by Mann Whitney U test and chi-square test. The level of significance was set at p ≤ 0.05. RESULTS: The results showed that the dentists who had attended continuing dental education program had increased level of knowledge regarding radiation effects among pregnant women as compared to the dentists who had not attended continuing dental education programs (p<0.05). Among them who had attended continuing dental education programs 93.3% were aware of the safe dose of radiation and 62% were aware of threshold radiation doses of pregnancy termination. On the contrary there was no significant difference in the knowledge, attitude and practice scores regarding radiation risks on pregnant women based on their academic qualification (p≥0.05). CONCLUSION: The level of knowledge among dentists was found to be satisfactory, this outcome shows that continuing dental education regarding radiation protection principles and its risks on pregnant women is required to ensure maximum safety both for clinician as well as pregnant women.

Graphical Assessment Technique (GAT) - An Objective, Comprehensive and Comparative Hand Hygiene Quantification Tool.

INTRODUCTION: There has been a profound leap in developing countries in sectors of human development but it falls short of millennium development goals. Diarrhoea, respiratory infections are primary cause of child deaths around the world due to improper hygiene practice. There is lack of systematic objective analysis, follow-up and quantification of hand hygiene guidelines. So, there is an urgent requisite of a tool to assess the same. AIM: To conduct a pilot test for assessing the efficacy of Graphical Assessment Technique (GAT) in objectively evaluating and comparing intervention based hand hygiene among students of National Association of Blind School (NABS) and a government school. MATERIALS AND METHODS: GAT was used to assess the baseline and post-intervention improvement of 80 students considered for the study. Data was analyzed using SPSS software version 20.0 and was subjected to quantitative analysis and parametric tests. RESULTS: Non-significant difference (p≥0.05) was found at baseline and immediate post-intervention on percentage mean scores of blind school students and government school student, while government school children also showed non-significant difference at one week. Significant difference (p≤0.05) was found at baseline, post-intervention one week and post-intervention one month for blind school children along with baseline and post-intervention mean percentage scores for government school children. CONCLUSION: The primary agenda behind the study was to test a tool which can objectively evaluate, quantify and compare the follow-up of hand hygiene guidelines and aid in better hand hygiene promotion.

An Insight into Health Care Setup in National Capital Region of India using Dimensions of Learning Organizations Questionnaire (DLOQ)- A Cross-Sectional Study.

INTRODUCTION: Over the past decades India, though being a developing country has progressed in multiple sectors but has not shown a substantial qualitative progress in healthcare. To be able to evaluate learning organization in a healthcare setup would thrust millennium development goals and infuse continuous learning model into health sector. AIM: To assess health care context using the Dimensions of the Learning Organization Questionnaire (DLOQ) in a health care setting in National Capital Region of India. MATERIALS AND METHODS: DLOQ proforma were distributed among 315 employees at all levels of the hospital. Data was analysed using SPSS software version 19.0 and was subjected to quantitative analysis and non-parametric tests. RESULTS: The Kruskal-Wallis test indicated a significant difference between the means of the different professions where as Mann-Whitney tests compared the relation between each of the profession and a significant difference (p < 0.05) was noted, except dimension "systems connection". CONCLUSION: The results provided sufficient inputs about the multidimensional learning organization capacity of a health care setting in a rapidly developing country.

The Clinical Effectiveness of Post-Brushing Rinsing in Reducing Plaque and Gingivitis: A Systematic Review.

INTRODUCTION: Dental plaque is the major etiological factor associated with the development of gingivitis. Hence, maintenance of oral hygiene is very essential. AIM: To systematically review the literature on the effects of a post toothbrushing rinsing on plaque and parameters of gingival inflammation. MATERIALS AND METHODS: A literature review was performed in PubMed Central and Cochrane library, embase, google scholar were searched up to February 2015 to identify appropriate studies. The primary outcome measure was plaque and gingival inflammation reduction. RESULTS: Out of the total 56 titles appeared, 08articles fulfilled the criteria and were selected for the review. One article which was hand searched and one article which was through e-mail was included. A statistically significant reduction in overall plaque and gingivitis was noted when different mouth rinses were compared to the control (p<0.05). It was seen that chlorhexidine is the best antiplaque and antigingivitis agent but due to its side effects after continuous use, was not indicated for long term use. Probiotic was superior to chlorhexidine in terms of reduction of gingival inflammation. CONCLUSION: There are relatively few studies evaluating the association between post toothbrushing rinsing and gingivitis. A clear effect was observed, indicating that different mouthrinses (chlorhexidine, probiotic, herbal, essential oil mouthrinse) when used as an adjunct to mechanical means of oral hygiene, provides an additional benefit with regard to plaque and gingivitis reduction as compared to a placebo or control.

Experience from Classroom Teaching to Clinical Practice Regarding Shortened Dental Arch (SDA) Concept Among Dentists - A Questionnaire Study.

INTRODUCTION: Periodontal disease and dental caries are the common oral conditions which cause loss of teeth, mostly molars. This further leads to Shortening of Dental Arch and Shortened Dental Arch (SDA) concept provides the overall requirements of functional dentition at reduced cost without compromising the health. AIM: The aim of the present study was to assess the Knowledge, Attitude and Practices (KAP) towards SDA concept among dentists of Ghaziabad city (Uttar Pradesh, India). MATERIALS AND METHODS: A cross-sectional study was conducted among 514 dentists working as academicians or clinicians or both. KAP questionnaire consisting of questions related to SDA concept was distributed to them. Data were analyzed using Statistical Package for Social Sciences (SPSS) 18.0 (SPSS Inc., Chicago, IL, USA) and descriptive and analytical tests, including mean, standard deviation, and Chi square test were used. RESULTS: Of the 514 dentists, only 493 dentists responded to the questionnaire, generating the response rate of 95.5%. Only 113 (22.9%) had knowledge about this concept. Clinicians were found to have more knowledge regarding the SDA concept (p<0.05). Also years of experience and level of knowledge among dentists regarding SDA was found to be statistically significant (p<0.05). CONCLUSION: The study showed lack of knowledge regarding SDA concept among dentists and also only few dentists practice the SDA concept on their patients. If used judiciously the SDA concept can serve as a cost effective and functionally oriented approach in clinical management of patients.

Tobacco Control in India; A Myth or Reality- Five Year Retrospective Analysis Using WHO MPOWER for Tobacco Control.

INTRODUCTION: Tobacco use is a major public health challenge in India and government of India has taken various initiatives for tobacco control in the country. India was among the first few countries to ratify WHO the Framework Convention on Tobacco Control (WHO FCTC) in 2004 and to make it easy, WHO introduced the MPOWER measures. OBJECTIVE: This study aimed to quantify the implementation of MPOWER tobacco control policies in India. MATERIALS AND METHODS: In this retrospective analysis information was collected from the WHO report on the Global Tobacco Epidemic Program, India for the year 2009, 2011 and 2013 using MPOWER and this analysis was based on the checklist which was designed previously by Iranian and international tobacco control specialists in their study on tobacco control and its cut-offs were set according to the scoring of key sections of the MPOWER 2011 report. RESULTS: In this study India was ranked by scores and these scores were obtained from each indicator for each activity. The highest scores were achieved in 2013 and there are marked increase in scores in health warning on cigarette packages but as far as the cessation programmes and taxation is concerned, there is decline in the progress. CONCLUSION: MPOWER programmes are accepted in the India but there is considerable room for improvement as we are still far from the ideal situation.

Is Oral Health of the Sugar Mill Workers Being Compromised?

INTRODUCTION: Occupational environment has an immense influence on the general as well as oral health. The specific exposure to sugar and its byproducts might influence the dental health of sugar mill workers. AIM AND OBJECTIVES: The present study was conducted to assess and compare the oral health status of production line workers and administration staff working in the sugar mills of Western Uttar Pradesh. MATERIALS AND METHODS: A cross-sectional study was conducted in four Government aided and four Private sugar mills of West Uttar Pradesh, India among the production line workers and administration staff. Multistage random sampling methodology was employed to select total of 600 sugar mill factory workers (449 production line workers and 151 administration staff). The oral health status of the study subjects was assessed using the modified WHO Oral health survey Performa 1997. STATISTICAL ANALYSIS: SPSS 19 Version was used for statistical analysis. Mean, Standard Deviation and proportions were calculated for each clinical parameter. Student t-test and Chi-square analysis was done to analyse inter group comparison. RESULTS: Mean DMFT for production and non production line workers was 7.67± 2.99 and 0.15 ± 1.34 (p= 0.001) respectively. 80.17% of production line workers had maximum CPI score 2 in contrast to 63.57% of administration staff (p=0.324). CONCLUSION: The dental health was found to be debilitated among the production line workers of Sugar mill as compared to the Administrative staff. It is therefore recommended to raise the awareness among the sugar mill workers regarding the same.

Bibliometric analysis of journal of clinical and diagnostic research (dentistry section; 2007-2014).

BACKGROUND: The role of scientific journals in diffusion of data concerning researches in the field of Public Health Dentistry is of premier importance. Bibliometric analysis involves analysis of publications reflecting the type of research work. AIM: The present study was conducted with an aim to determine the number and trends of published articles in Journal of Clinical and Diagnostic Research (JCDR) from Feb. 2007 to Oct.2014. SETTINGS AND DESIGN: A retrospective observational study was conducted for JCDR. MATERIALS AND METHODS: All issues of JCDR were electronically searched for the parameters : study design, area of interest of research, state /college where research was conducted, authorship pattern, source of articles published each year, changing study trends, disease under study and publication bias. STATISTICAL ANALYSIS USED: The data was organized and analyzed using software SPSS - version 21.0; descriptive statistics was used. RESULTS: Bibliometric analysis was done for 601 articles of JCDR published from Feb. 2007 to Oct. 2014. The total number of articles published under Dentistry section have tremendously increased from mere 2 articles in 2007 to 328 articles in 2014.Majority of the study designs published in both the journal were case reports (42.6%) followed by cross sectional studies (24.8%). 96.3% of the articles were from India. Majority of the articles published were of multi authors (65.2%) and from Educational institutes (98.4%). The trends of the articles published indicated that the case reports/series formed the major bulk (others=59.1%) followed by research studies (21.3%). CONCLUSION: It was concluded that most articles published were case reports followed by researches indicating an inclination towards better quality methodology. The SJR and the citation count of the articles published also indicated the quality of the scientific articles published.

Tobacco Cessation Counselling Practices and Attitude among the Dentist and the Dental Auxiliaries of Urban and Rural Areas of Modinagar, India.

BACKGROUND: The increasing use of tobacco among youths warrants the need for dental health professionals to effectively provide tobacco cessation counselling (TCC) in the office and community settings. However, there have been concerns among the dental professionals regarding TCC in dental settings. AIMS AND OBJECTIVES: To assess the attitude of dental professionals including the dentist and dental hygienist towards the TCC and identify the possible barriers towards the implementation of these practices in the rural and urban areas of Modinagar district. MATERIALS AND METHODS: The present questionnaire based survey was carried among the qualified dentist and dental hygienist from the urban and rural areas of the Modinagar district to attitudes in tobacco cessation, practices in tobacco cessation interventions and related barriers towards implementation. The survey data were analyzed using the SPSS 16 version software package. The descriptive statistics (frequency) was generated for the each question to assess their attitude and practice. RESULTS: The response rate of the questionnaire among the dentist and dental hygienist was 100%. The attitude of the majority of dentist towards the tobacco cessation counselling was positive as compared to the dental hygienist. 69.2% of the dentist were of the view that the dental health professionals should provide TCC as compared to 54.2% among the hygienist. Regarding the practice, only 12.5% and 5.8% of the dentist and dental hygienist had ever used the nicotine replacement therapy in their dental practice. The lack of the knowledge and information regarding TCC was the only perceived barrier among the dentists (51.7%) and dental hygienist (68.3%). CONCLUSION: Dental professionals must expand their horizon and armamentarium to include TCC strategies inclusive of their regular preventive and therapeutic treatment modalities. Also, the dental institutions should include TCC into the curriculum, but it should not be just theoretical knowledge rather it must have a practical component.

Reach the unreached - a systematic review on mobile dental units.

Provision of health care facilities and the extent of their utilization is one of the indices of human development. The services for the masses need to be designed with the basic objective of alleviating and preventing the vast amounts of diseases of the mass. This could be achieved by mobile dental units (MDUs). The present systemic review access the efficacy of MDUs for community settings. A review of literature was performed both electronically and manually using MeSH Terms- Mobile Dental Units/clinics. Eight articles, which fulfilled inclusion and exclusion criteria were selected for the review. MDUs help in overcoming the accessibility, affordability and sustainability barrier. They are able to reach more people than fixed-site clinics. Even in Government sector, mobile dental vans can help reach the underserved at an affordable cost.The present systematic review revealed that MDUs prove to be an effective adjunct to the oral health service providers like dental colleges and private practitioners.