Interexaminer agreement among pediatric dental specialists in assessment of tonsil size, Friedman tongue position, and Friedman staging of obstructive sleep apnea in children: An observational study.

BACKGROUND: The evaluation of tonsil size, Friedman Tongue Position (FTP), and Friedman staging in pediatric obstructive sleep apnea (OSA) holds significant clinical importance, offering manifold advantages in diagnosis and surgical management. AIMS AND OBJECTIVES: This study aimed to assess the reliability of pediatric OSA evaluation by determining inter-examiner agreement among pediatric dental specialists. MATERIALS AND METHODS: Conducted at the Department of Pediatric Dentistry, PMS College of Dental Science and Research Hospital (2023-2024), this observational study utilized conventional consulting rooms, headlights, and examination chairs. Thirteen medical practitioners reviewed video recordings of the oropharyngeal regions of twelve pediatric patients exhibiting mouth breathing. Friedman staging was determined based on tonsil size and tongue position gradings.Inter-examiner agreement was evaluated using Fleiss kappa analysis. RESULTS: Observers, including residents and practitioners in pediatric dentistry, demonstrated poor agreement regarding FTP and tonsil grading. CONCLUSION: Understanding the nuances of tonsil size and FTP in pediatric OSA evaluation, along with identifying avenues for refinement, can enhance medical decision-making among healthcare providers, including pediatric dentists.

Knowledge, attitude, and practice regarding different domains of pediatric obstructive sleep apnea among pediatric dentists from Kerala: A cross-sectional study.

Background: Pediatric dentists should play an essential role in obstructive sleep apnea (OSA) screening, referral, and management of their child patients. However, few studies have investigated pediatric dentists' knowledge, attitude, and practice aspects regarding different domains of pediatric OSA. Aim of the Study: This cross-sectional survey aimed to assess the knowledge, attitude, and practice aspects of different domains of pediatric OSA among pediatric dentists from Kerala. Methods: This cross-sectional study was conducted in Kerala. The sample frame consisted of 163 dentists, and the minimum required was 115. Ethical approval was obtained before starting the study. Settings and Design: An invitation E-mail explaining the purpose of the study with a survey link was sent to the pediatric dentists from Kerala (n = 163). Nonrespondents were contacted at timely intervals. Statistical Analysis: Categorical and quantitative variables were expressed as frequency (percentage) and mean ± standard deviation, respectively. Chi-square test was used to find an association between categorical variables. Statistical analysis was performed using a statistical software package, SPSS, version 20.0. Results and Conclusion: This cross-sectional study showed that pediatric dentists in Kerala have a moderate-to-good level of knowledge, along with a positive attitude toward different domains of pediatric OSA, but lag behind in the practice aspects. Hence, they are required to direct themselves toward continuing dental education programs in order to boost their routine practice. For this, steps must be taken to ensure proper networking of the practitioners and amendments in the dental billing system similar to the medical counterpart.

Nitrogen uptake and remobilization from pre- and post-anthesis stages contribute towards grain yield and grain protein concentration in wheat grown in limited nitrogen conditions.

Background: In wheat, nitrogen (N) remobilization from vegetative tissues to developing grains largely depends on genetic and environmental factors. The evaluation of genetic potential of crops under limited resource inputs such as limited N supply would provide an opportunity to identify N-efficient lines with improved N utilisation efficiency and yield potential. We assessed the genetic variation in wheat recombinant inbred lines (RILs) for uptake, partitioning, and remobilization of N towards grain, its association with grain protein concentration (GPC) and grain yield. Methods: We used the nested association mapping (NAM) population (195 lines) derived by crossing Paragon (P) with CIMMYT core germplasm (P × Cim), Baj (P × Baj), Watkins (P × Wat), and Wyalkatchem (P × Wya). These lines were evaluated in the field for two seasons under limited N supply. The plant sampling was done at anthesis and physiological maturity stages. Various physiological traits were recorded and total N uptake and other N related indices were calculated. The grain protein deviation (GPD) was calculated from the regression of grain yield on GPC. These lines were grouped into different clusters by hierarchical cluster analysis based on grain yield and N-remobilization efficiency (NRE). Results: The genetic variation in accumulation of biomass at both pre- and post-anthesis stages were correlated with grain-yield. The NRE significantly correlated with aboveground N uptake at anthesis (AGNa) and grain yield but negatively associated with AGN at post-anthesis (AGNpa) suggesting higher N uptake till anthesis favours high N remobilization during grain filling. Hierarchical cluster analysis of these RILs based on NRE and yield resulted in four clusters, efficient (31), moderately efficient (59), moderately inefficient (58), and inefficient (47). In the N-efficient lines, AGNa contributed to 77% of total N accumulated in grains, while it was 63% in N-inefficient lines. Several N-efficient lines also exhibited positive grain protein deviation (GPD), combining high grain yield and GPC. Among crosses, the P × Cim were superior and N-efficient, while P × Wya responded poorly to low N input. Conclusions: We propose that traits favouring pre- or post-anthesis biomass accumulation and pre-anthesis N uptake may be targeted for breeding to improve grain-yield under limited N. The lines with positive GPD, a first report of genotype-dependent GPD associated with both AGNpa and AGNa in wheat, may be used as varieties or genetic resources to improve grain yield with high GPC for sustainable development under limited N conditions. Supplementary Information: The online version contains supplementary material available at 10.1186/s43170-023-00153-7.

Comparative Evaluation of Antimicrobial Efficacies of 0.2% Chlorhexidine and 4% Tulsi Extract in the Decontamination of Child Toothbrushes: An Observational Analytical Study.

Aims: The aim of this study was to evaluate the efficacy of 0.2% chlorhexidine and 4% tulsi extract as toothbrush decontaminants. Materials and Methods: Of 100 children, who attended the outpatient unit of Department of Pediatric dentistry, 81 children, who satisfied all the inclusion criteria were subjected to systematic sampling, after arranging them in the alphabetical order and were grouped into three. The first child came under Group I, second under Group II, third under Group III, fourth one again under Group I, and so on till the 81st child. In the baseline phase, the children were provided precoded toothbrushes and toothpastes and instructed to place those brushes to be put after use, in single-use glasses. After obtaining the baseline value of Streptococcus mutans colony count, the participants of Group I was given 0.2% chlorhexidine, Group II was given 4% tulsi extract, and distilled water for Group III, to be used as toothbrush decontaminants for 5 days. The toothbrushes were then collected back, and were subjected to microbial analysis. Statistical analysis was performed by using Kruskal-Wallis one-way analysis of variance (ANOVA) and Mann-Whitney U test with P < 0.05. Results: All test solutions, 0.2% chlorhexidine and 4% tulsi extract, except for distilled water, showed a statistically significant reduction of S. mutans count. There was no statistical difference between the efficacies of 4% tulsi extract and 0.2% chlorhexidine, although the latter showed a better reduction. Conclusion: Tulsi extract may well be a perfect replacement to chlorhexidine for reducing the S. mutans count in the child toothbrushes.

Awareness, Views, and Expectations about COVID-19 Vaccinations: A Cross-Sectional Study of Dental Clinic Patients in India.

INTRODUCTION: Several vaccines against coronavirus disease 2019 (COVID-19) have been licensed and are being administered worldwide in various countries. However, the awareness, behaviors, and expectations of COVID-19 vaccines among dental clinic patients are poorly understood. METHODS: An e-survey was carried out among 1800 patients who visited dental clinics in India. The survey was carried out using a questionnaire of four parts and informed consent (i.e. sociodemographics, knowledge, attitudes, and perceptions). The investigators used Internet methods for data collection during the pandemic. RESULTS: The mean awareness score was significantly higher among participants who reported having a university/higher level of schooling, being in the upper socioeconomic status community, living in cities, and having previously received all required vaccines. The mean attitude score was slightly higher for participants who reported being female and had a history of getting all required vaccinations. Just over half (52%) of participants felt everyone should be vaccinated. This interpretation was slightly higher among females than males (56.9% vs. 47.9%, P = 0.004). CONCLUSIONS: The results indicate that patients attending dental clinics in India have insufficient awareness but more optimistic attitudes about the COVID-19 vaccine. Immediate health promotion campaigns must be implemented before vaccine schedules in order to increase awareness.