Safety of pharmacological options for the management of COVID-19 in pregnant women: An Indian perspective.

Coronavirus disease 2019 (COVID-19) is a viral illness caused by severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2) presenting with pulmonary and extra-pulmonary manifestations. The first case was reported in Wuhan, China in December 2019 and it has rapidly progressed to the form of a pandemic. The presentation is mild in about 80 percent of the cases but the disease can also progress to a severe form of respiratory illness leading to acute respiratory distress syndrome (ARDS) and sometimes multi-organ failure, especially in people with other co-morbidities. Pregnant women also appear to be at a greater risk of acquiring a severe infection due to physiological changes during pregnancy. Many drugs with in vitro activity against the virus or an immunomodulatory effect have been considered for repurposing or have been tried as off-label drugs. The safety data regarding the use of newly approved or off-label or investigational drugs in pregnant women is limited and this poses a great challenge for clinicians. Therefore, it is important to know the utility and safety of the medications to avoid untoward adverse effects on pregnant women and fetuses. In this review, we aim to provide an overview of the approved, off-label, unlicensed, new and some promising pharmacological options for their use in the treatment of COVID-19 and the safety profile in pregnancy in an Indian scenario.

Assessment of knowledge and attitude before and after a health education program in East Madurai primary school teachers with regard to emergency management of avulsed teeth.

INTRODUCTION: Children attend primary school from as early as 6 years to the mixed dentition stage of about 9 years and spend most of their time in school along with the teachers. School teachers are likely to be among the first to see a child immediately after an injury has occurred, and their knowledge regarding emergency procedures is critical to ensure good prognosis of the clinical treatment. PURPOSE: The purpose of the study was to evaluate, by means of a questionnaire, the primary school teacher's knowledge and attitude with regard to emergency management of traumatized avulsed teeth and to test the effectiveness of a health education tool. METHODOLOGY: A total of 214 primary school teachers from 24 government schools, in and around East Madurai Panchayat, participated in a 3-month long study. Baseline data were collected using a pretested questionnaire in the 1st month. Based on that data, a health educational tool was prepared. The final assessment was made using the same questionnaire in the 3rd month. Baseline data and final data were compared using Z-test. RESULTS: The knowledge level of 70.83% of primary school teachers was in the very good category after the health education tool, which was initially nil. Similarly, the attitude level also raised drastically with 0.90% initially in the very good category, and after the health education tool, it was 41.20%. CONCLUSION: From this study, the importance of the need for the steps to increase the knowledge about the emergency management of avulsion is clearly understood. Thus, the main implication of the study is that a health educational tool regarding the emergency management of avulsion is necessary for the primary school teachers during their teacher training program.

Association between oral health status and oral health-related quality of life among the prison inmate population of kanda model jail, Shimla, Himachal Pradesh, India.

The prison population is a challenging one with many health problems including oral health. In a country such as India, the information regarding the oral health status in prisoners is scant. So, a cross-sectional study was carried out among a 311 prison inmate population of Kanda model jail, Shimla, Himachal Pradesh, India, to assess the dental caries levels, periodontal health status, and oral health-related quality of life (OHRQoL). Dental caries was present among 71.8% of the population and the mean decayed missing and filled teeth index (DMFT) of the population was 5.1 ± 2.1. Calculus was seen among 54.9% of the population. The mean severity score, summed for the 14 items in the scale was 14.57. Dental caries, periodontal disease, the number of missing teeth were significantly associated with OHRQoL. The population had a higher level of oral diseases and one half of the population reported that their oral condition had negatively impacted them in some way, thereby affecting their quality of life.

Oral Cancer Knowledge, Attitudes and Practices: A Survey of Undergraduate Medical Students in Himachal Pradesh, India.

BACKGROUND: Oral cancer is the sixth most common cancer among Indian males and the third most common cancer among Indian females. Early detection of oral cancers makes them more amenable to treatment and allows the greatest chance of cure. Lack of awareness among the health care providers is the most significant factor in delaying diagnosis and treatment of oral cancer. So the aim of the study was to assess the knowledge, attitude and practices of oral cancer among undergraduate medical students in Indira Gandhi Medical College, Shimla, India. MATERIALS AND METHODS: A cross-sectional questionnaire study was conducted among 186 undergraduate medical students between the third to fifth years in Indira Gandhi Medical College, Shimla. The questionnaire consisted of 15 questions, five each on knowledge, attitudes and practices. The data were analysed by Statistical Package for the Social Sciences version 16. Test used were t-test, Chi-square and ANOVA. RESULTS: The response rate of the study was 96.5%. The mean knowledge percent of the sample was good. Mean knowledge percent was higher in females than males. Higher percentage of students in 5(th) year (internship) had excellent knowledge. The knowledge and practices about risk factors was not satisfactory. One hundred and twenty four (66.6%) of the subjects disagreed/strongly disagreed that their knowledge regarding the prevention and detection of oral cancer is current adequate. One hundred and seventy six and (94.6%) agreed/strongly agreed that there is need for additional training/information regarding oral cancer. CONCLUSION: It can be concluded that though the mean knowledge of the population was good but the knowledge and practices about risk factors had to be reinforced among these students so that they can help the patients in tobacco and alcohol cessation and contribute in prevention of oral cancers.

Knowledge, attitude and practices about oral cancers among dental students in H.P Government Dental College, Shimla-Himachal Pradesh.

AIM: The aim was to assess the knowledge, attitude and practices among undergraduate dental students about oral cancer. MATERIALS AND METHODS: A cross-sectional questionnaire study was conducted among undergraduate dental students between the 3rd and 5th years in H.P Government Dental College, Shimla. The questionnaire consisted of 15 questions, five each on knowledge, attitudes and practices. The data were analyzed by Statistical Package for the Social Sciences (SPSS Inc., version 16 for Windows, Chicago, IL, USA). RESULTS: The response rate of the study was 90.6%. There were 23 (21.5%) males and 84 (78.5%) females in the study. There was a predominance of females (78.5%). The average knowledge percentage for the entire population is 81.9% (excellent knowledge). Tobacco and alcohol were correctly identified by 63.5% of the subjects. Squamous cell carcinoma was described as the most common type of oral cancer by 105 (98.3%) of the students. 60.7% of the subjects strongly disagreed that their knowledge regarding the prevention and detection of oral cancer is current and adequate, and 99% agreed that there is a need for additional training/information regarding oral cancer. About 92.5% of the subjects used to educate their subjects about the harmful effects of tobacco and alcohol. CONCLUSION: The study implies that the knowledge, especially about the etiological factors of oral cancer needs to be reinforced throughout the undergraduate dental courses so that they can use the same in educating and motivating the masses to adapt healthy lifestyles.

Evaluating the effectiveness of oral health education program among mothers with 6-18 months children in prevention of early childhood caries.

BACKGROUND: Mothers play a key role as transmitters of oral health behavior for their children. Hence increasing their knowledge about positive attitude toward desirable oral health behaviors regarding their children will lead to the better oral health of the children. AIM: The aim was to evaluate the effectiveness of oral health education program among mothers with 6-18 months old children in the prevention of early childhood caries. MATERIALS AND METHODS: A total of 480 mothers with 6-18 months old children were selected using cluster randomization of the primary health center. The allocated mothers were assigned into three groups: Motivation group (group A), traditional health education group (group B) and control group (group C). Clinical examination was carried out to record the dental decay of the child. STATISTICAL ANALYSIS: The data was analyzed using SPSS 13. Evaluation of statistical significance between groups was made using the Chi-square test, ANOVA and Kruskal-Wallis. RESULTS: Mean number of decayed teeth was 0.23 + 0.58 in group A that was significantly less as compared to 0.39 + 0.79 and 1.17 + 1.32 in group B and C, respectively. CONCLUSION: Motivational intervention was more effective in reducing dental decay in the children as compared to the other two groups.

Relationship between oral health status and oral health related quality of life in adults attending H.P Government Dental College, Shimla, Himachal Pradesh--India.

OBJECTIVES: To describe Oral Health Related Quality of Life (OHRQoL) in adults attending the Outpatient Department (OPD) of Public health Dentistry, H.P Government Dental College, Shimla, and to assess the relationship between clinical measures of oral health status and oral health related quality of life. METHODS: A cross sectional study was carried out for a period of three months on 351 subjects reporting to the OPD of Public health Dentistry, H.P Government Dental College, Shimla. Subjects were examined systemically for dental caries, periodontal disease using DMFT index and CPI index. OHRQoL was measured using the 14 - item Oral Health Impact Profile questionnaire (OHIP-14). Also the data on education, socio economic status and reasons for seeking dental care was collected. RESULTS: There were 158 males and 193 females participating in the study. The mean age of study population was 35.7 ± 9.33. The mean total OHP-14 score was 9.5 ± 9.4; 35.6% of the subjects reported one or more OHIP problems 'fairly often or very often'. When the prevalence of impacts fairly /very often was modeled using logistic regression, presence of decayed teeth, presence of periodontal disease (CPI score >2) and number of missing teeth remained significantly associated with OHRQoL after adjusting for gender and episodic dental care. CONCLUSION: OHIP-14 scores were significantly associated with the clinical oral health status indicators, independently of gender and socio economic inequalities in oral health.

Efficacy of two commercially available Oral Rinses - Chlorohexidine and Listrine on Plaque and Gingivitis - A Comparative Study.

BACKGROUND: Chemotherapeutic agents have been shown to be useful adjuncts to daily oral home care in the control of plaque and gingivitis. The objective of the study was to evaluate effect of two oral rinses; Chlorohexidine and Listerine on Plaque and Gingivitis. MATERIALS AND METHODS: A doubled blind study was done on 150 patients visiting OPD of oxford general hospital for 2 months to compare the efficiency of two commercially available mouth rinses i.e. chlorohexdine (0.2%) & Listerine on plaque & gingivitis, along with a Placebo. RESULTS: At the end of 28 weeks chlorohexdine & listerine significantly reduced plaque growth & gingivitis compared to a Placebo however chlorohexdine was more effective than Listerine. CONCLUSION: Chlorehexidine (0.2%) and a phenolic mouth rinse significantly reduced plaque growth and gingival inflammation compared to a placebo mouthrinse, however chlorhexidine rinse was more effective against plaque regrowth than the phenolic rinse. How to cite this article: Goutham BS, Manchanda K, Sarkar AD, Prakash R, Jha K, Mohammed S. Efficacy of two commercially available Oral Rinses - Chlorohexidine and Listrine on Plaque and Gingivitis - A Comparative Study. J Int Oral Health 2013; 5(4):56-61.

Assessment of relationship between body mass index and periodontal status among state government employees in Shimla, Himachal Pradesh.

BACKGROUND: The literature shows that an increased body mass index (BMI) may be a potential risk factor for periodontitis. Association between BMI and periodontitis has been ascribed to unhealthy dietary patterns with insufficient micronutrients and excess sugar and fat content. AIM: The present study intended to assess the relation between BMI and periodontal status among state government employees in Shimla city, Himachal Pradesh in India. MATERIALS AND METHODS: The study sample comprised 1,008 subjects aged 18-58 years, drawn by a proportional sample from 10,908 employees. BMI was calculated by the Quetelet index as the ratio of the subject's body weight (in kg) to the square of the height (in meters). Periodontal status was recorded using the Community Periodontal Index (CPI). Binary multiple logistic regression analysis was done to assess the relation between BMI and periodontal status. The dependent variable for logistic regression analysis was categorized into control group (scores 0-2 of the CPI) and periodontitis group (scores 3 and 4 of the CPI). RESULTS: The overall prevalence of periodontal disease was 98.9%. Score 2 (bleeding and calculus) was the highest score prevailing among the subjects. They had an increased risk of periodontitis by 56% for each 1 kg/m(2) increase in BMI, which means that a higher BMI could be a potential risk factor for periodontitis among the adults aged 18 to 58 years. CONCLUSION: BMI evaluation could be used in the assessment of periodontal risk.