Correlation of self-esteem with oral hygiene behaviour and oral health status among adult dental patients.

Background: Self-esteem is a psychological construct that has been consistently linked to general and oral health. However, most studies interpolating self-esteem and oral health behaviour have been focused on children and adolescents, and there is a dearth of scientific literature on adults. Hence, this study, that is aimed to correlate self-esteem with oral hygiene behaviour and oral health status in Telugu-speaking adult dental patients. Methods: A cross-sectional study involving adult dental patients who were 35-44 years of age and visited the Government Dental Hospital in Hyderabad city, India, was conducted. Self-esteem was assessed using the Telugu-translated version of the Rosenberg Self-esteem Scale, oral health behaviour was determined using the Oral Hygiene Behaviour Index and oral health assessment was performed using the World Health Organization Dentition status, the modified Community Periodontal Index and the Loss of Attachment. Results: A total of 456 patients were included in this study. Most of the participants reported low self-esteem, with a mean score of 11.8 ± 2.7. Patients with primary school education reported higher self-esteem scores than those with high school and university education (p = 0.0001). Furthermore, low Oral Hygiene Behaviour Index scores (64.9%) in the study population and high Decayed, Missing, Filled Teeth scores in females (5.7 ± 4.4; p = 0.09) were noted. None of the variables (Decayed, Missing, Filled Teeth scores, Oral Hygiene Behaviour, gingival bleeding and Loss of Attachment) were significantly correlated with self-esteem. Multivariable regression analysis revealed that younger age, lower educational level and presence of dental caries resulted in higher odds for high self-esteem (p < 0.01). Conclusion: The findings indicated a significant association between self-esteem and oral health. Indivi-duals with dental caries had significantly higher odds for high self-esteem. Thus, this study emphasises the relevance of psychosocial factors, such as self-esteem, as the mediator of oral health.

Psychometric properties of the Telugu version of Rosenberg Self-esteem scale (RSES-T).

Background: The Rosenberg Self-esteem Scale (RSES) is the most commonly used tool for measuring global self-esteem. Till date, RSES has been translated into different languages and the reports are good for their validity and reliability. Telugu being the fourth most spoken language in India, it is timely to translate and validate the Telugu version of RSES. The aim of this study thus is to assess the psychometric properties of the Telugu version of Rosenberg Self-esteem Scale (RSES-T). Study design: Cross-sectional study. Methods: This study was carried out to assess the psychometric properties of RSES-T among undergraduate students of a dental college. For this purpose, the English version of RSES was translated into Telugu and was administered to the participants along with the revised English version of Self-Liking/Self-Competence Scale (SL/SC-R) to evaluate the construct validity. The internal consistency of RSES-T was assessed using Cronbach´s α and the temporal stability was tested by test-retest reliability. Confirmatory factor analysis was conducted to examine the underlying dimensional structure of the questionnaire by assessing the cor-relation of RSES-T with SL/SC-R. Results: Confirmatory factor analysis revealed a positive one-factor structure with Model 3 showing the best fit to data. Internal consistency for RSES-T was found to be good with Cronbach's α of 0.82 at follow-up and the test-retest reliability was found to be satisfactory (0.42) after a two weeks' interval. Furthermore, the item-wise mean score differences showed higher scores for male students than females. Likewise, the item-total correlation of RSES-T showed positive correlation with scores varying from 0.17 to 0.69 at the follow-up. Conclusion: The Telugu version of RSES exhibited a unidimensional structure and showed good psychometric properties in terms of internal consistency, construct validity and reliability. Hence, these findings provide empirical support to evaluate global self-esteem among Telugu speaking population in future.

Optically defined multifunctional patterning of photosensitive thin-film silica mesophases.

Photosensitive films incorporating molecular photoacid generators compartmentalized within a silica-surfactant mesophase were prepared by an evaporation-induced self-assembly process. Ultraviolet exposure promoted localized acid-catalyzed siloxane condensation, which can be used for selective etching of unexposed regions; for "gray-scale" patterning of refractive index, pore size, surface area, and wetting behavior; and for optically defining a mesophase transformation (from hexagonal to tetragonal) within the film. The ability to optically define and continuously control both structure and function on the macro- and mesoscales is of interest for sensor arrays, nanoreactors, photonic and fluidic devices, and low-dielectric-constant films.

Periodontal status of HIV-positive patients.

OBJECTIVE: To assess the periodontal status of HIV positive individuals and to compare it with age-and gender-matched controls. MATERIALS AND METHODS: The cross-sectional study comprised fifty-two HIV positive individuals and fifty-two controls. OHI-S and PI were recorded by a single pre-trained and pre-calibrated examiner. RESULTS: Based on antiretroviral therapy use, mean OHI-S was higher among HIV positive females undergoing therapy. A significant gender difference was observed in the PI score among those on antiretroviral therapy, with females having a lower score (p = 0.04). Also, significant gender difference was observed in the mean PI score among HIV positive individuals, with males having a higher score. CONCLUSION: There was a significant difference in the overall mean OHI-S score among HIV positive individuals and controls (p = 0.03). However, no significant difference was observed when the overall PI score was calculated for both groups (p = 0.95).

Knowledge, Attitude and Practice Regarding Organ Donation among Indian Dental Students.

BACKGROUND: Of the overall 9.5 million deaths annually in India, nearly 100,000 are due to organ failure. To save and extend lives, organ donation and organ transplantation have become the only hope. Health care professionals (HCPs) are a key element in facilitating cadaveric organ donation process. OBJECTIVE: To assess and compare the knowledge, attitude, and practice regarding organ donation among undergraduate dental students. METHODS: A cross-sectional study was conducted among 298 undergraduate dental students of the Panineeya Institute of Dental Sciences and Hospital, Hyderabad, India. A 27-item self-administered questionnaire, which assessed the levels of knowledge (Q1-13), positive attitude (Q14-24) and practice habits (Q25-27) regarding organ donation with dichotomous scale (Yes/No). RESULTS: As compared to males, females reported better mean±SD scores in knowledge (8.22±1.51) and practice (0.91±0.8); higher mean±SD attitude scores (8.55±1.56) were reported among males (p<0.001). While second year dental students had higher scores for their knowledge (8.55±1.56) and practice (1.02±0.44) compared to other year of training, third year students showed a significant higher mean attitude score (1.73±1.17) (p=0.02). Hindus and Muslims scored significantly lower mean knowledge, attitude and practice habits compared to others (Christians, Jains and Athesists) (p<0.001). There was a positive correlation between mean knowledge, attitude, and practice habits. CONCLUSION: There are an average level of knowledge and low levels of positive attitude and practice habits among studied dental students towards organ donation and transplantation.

Effectiveness and tolerability of simeprevir and sofosbuvir in nontransplant and post-liver transplant patients with hepatitis C genotype 1.

BACKGROUND: Hepatitis C virus genotype 1a (HCV-1a), prior treatment, cirrhosis and post-transplant status are historically associated with poor treatment responses. The new oral direct-acting agents appear to be effective and safe in these patients. AIMS: To evaluate the effectiveness and tolerability of simeprevir and sofosbuvir in a diverse real-life cohort of patients, including difficult-to-treat patients. METHODS: We conducted a retrospective cohort study in 198 consecutive patients with hepatitis C genotype 1 (148 nontransplant, 50 post transplant), who were treated with simeprevir and sofosbuvir for 12 weeks between December 2013 and December 2014. Primary outcome was sustained virological response with undetectable HCV RNA 12 weeks after completion of therapy (SVR12). Risk factors evaluated for lack of SVR12 included HCV 1a (vs. 1b), prior treatment (vs. none), and cirrhosis (vs. no cirrhosis). RESULTS: SVR12 rates were similar in non- and post-transplant settings, 82% and 88%, respectively. There were no significant differences in adverse events in patients regardless of cirrhosis or transplant status. On multivariate analysis also inclusive of gender and liver transplant status, negative predictors of SVR12 were having at least 2 or 3 risk factors (OR 0.30, 95% CI 0.10-0.87, P = 0.027 or 0.29, 95% CI 0.09-0.85, P = 0.025, respectively). CONCLUSION: Simeprevir and sofosbuvir combination is a safe and effective regimen for the treatment of non- and post-transplant patients with traditional risk factors for poor treatment response, unless more than 2 difficult-to-treat risk factors are present.

Medical Outcomes Study Short Form 36: a possible source of utilities?

General health-status questionnaires such as the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) are frequently used to measure health-related quality of life. The SF-36, in its current form, cannot be used to measure individuals' utilities or preferences for their health state. Recently, several investigators have explored the possibility of obtaining utilities from the SF-36. This article reviews the SF-36 survey, selected measures of utility, and the differences between health-status and utility measures, with an emphasis on use of SF-36 results to derive utility scores. We searched the literature from January 1966 to July 1999 using MEDLINE and HEALTHSTAR. The terms SF-36, health-status instruments, utilities, and preferences were searched to identify studies that had used both the SF-36 and a utility-based instrument. We first discuss studies that were specifically designed to find a predictive equation to obtain utilities from SF-36 scores. We then discuss studies that examined the correlation between the SF-36 and a utility-based instrument but that were not intended to develop a predictive equation as their primary objective. The studies that have tried to derive utilities from the SF-36 using a predictive equation have used different methodologies; to date, no reliable method has been appropriately validated. The poor correlation reported in most of the studies attests to the complex relationship between utility-based instruments and the SF-36. More work is needed to elucidate if utilities can be obtained from the SF-36.

Influence of cholestyramine resin administration on single dose sulindac pharmacokinetics.

Cholestyramine, a nonabsorbable anion exchange resin, has been reported to bind concomitantly administered drugs and decrease their bioavailability. The objective of the study was to determine cholestyramine effect on the plasma concentrations of sulindac and its sulfide metabolite following concurrent and staggered (sulindac 3 hours before cholestyramine) dosing. Six healthy volunteers participated in an open-label, 3-way crossover study. Subjects received 400 mg sulindac orally followed by serial blood sampling for sulindac and sulindac sulfide plasma concentrations over a 24-hour period. During the concurrent phase, 4 g of cholestyramine was coadministered resulting in a decrease (p < 0.05) in the area under the curve (AUC) for sulindac compared to sulindac alone (7.11 +/- 3.25 micrograms-h/ml vs 31.65 +/- 7.94 micrograms-h/ml respectively). Also, the sulindac sulfide AUC decreased (p < 0.05) to 7.26 +/- 4.37 micrograms-h/ml coadministration of both drugs compared to 44.69 +/- 11.81 micrograms-h/ml when sulindac is given alone. When the same doses of each drug were given 3 hours apart, the AUC for sulindac (17.88 +/- 3.69 micrograms-h/ml) and its sulfide metabolite (20.12 +/- 7.46 micrograms-h/ml) were still significantly decreased (p < 0.05) when compared to sulindac given alone (31.65 +/- 7.94 micrograms-h/ml for sulindac and 44.69 +/- 11.81 micrograms-h/ml for sulindac sulfide). Based on the lower AUCs for sulindac and sulindac sulfide, separating sulindac and cholestyramine by 3-hour intervals did not prevent the interaction. It is likely that the enterohepatic recycling features of sulindac may not prevent the interaction with cholestyramine even when the 2 drugs are staggered.

Gastric slow waves, gastrointestinal symptoms and peptides in systemic sclerosis patients.

Impaired gastric slow waves, frequent gastrointestinal (GI) symptoms and altered GI peptides have been reported in Scleroderma (SSc) patients. The aim of this study was to investigate the associations among these three important components in GI dysmotility. Seventeen fasted SSc patients underwent four channel surface electrogastrography, measuring % of normal gastric slow waves or dysrhythmia. Patients completed a questionnaire designed by us to assess demographics, upper and lower GI symptoms (symptom presence, frequency and impact on quality of life, QOL), by YES/NO, Likert Scales and Visual Analogue Scales 1-100 mm (called GI Dysmotility Questionnaire, GIDQ) and health-related QOL by SF-36. Fasting plasma vasoactive intestinal peptide (VIP) and motilin levels were measured by peptide immunoassays. There were significant correlations between percentages of gastric dysrhythmias (bradygastria or arrhythmia) and a number of major GI symptoms such as nausea, abdominal bloating and pain. The plasma level of VIP was correlated positively with % dysrhythmia but negatively with % normal slow waves. Motilin was positively correlated with slow wave coupling (coordination). No major differences were noted in the measured peptides or gastric slow waves between limited SSc and diffuse SSc. Correlations were noted between SF-36 domain scores and our GIDQ scores. In SSc patients, gastric dysrhythmias are correlated with certain GI symptoms. Correlations are also noted between plasma VIP/Motilin levels and gastric slow waves. Thus in SSc, gastric dysrhythmias may be predictive of development of certain dyspeptic symptoms. Plasma VIP may be involved in the development of dysrhythmias.

Oral manifestations in HIV/AIDS infected patients from India.

OBJECTIVES: To assess types and prevalence of HIV-related oral lesions among HIV-infected individuals in south India and to correlate common oral findings with co-morbidities, gender, age and medication. SUBJECTS AND METHODS: One hundred and one patients with HIV infection or AIDS at infectious diseases units of Attavar Hospital, Mangalore, and medical wards of Kasturba Medical College, Manipal, were selected. Sociodemographic information was obtained using a structured questionnaire. Oral lesions were diagnosed according to the presumptive criteria of EEC-Clearinghouse Classification. Clinical history was retrieved from patient's medical records. RESULTS: Erythematous candidiasis (44.5%), melanotic hyperpigmentaion (34.6%) and xerostomia (29.7%) were among the most common oral manifestations. A significant association was found between oral candidiasis and advanced immunosuppression (P < 0.05). Oral hairy leukoplakia (OHL) was predominant in individuals <35 years (P < 0.05). Melanotic hyperpigmentation was significantly associated with highly active antiretroviral therapy (P < 0.05). OHL was more frequent in patients with HIV-associated tuberculosis. Linear gingival erythema was more predominant in females. CONCLUSIONS: Oral hairy leukoplakia showed a positive relationship with patients younger than 35 years. Oral candidiasis can act as a marker for immunosuppression. Angular cheilitis was predominant in the symptomatic stage.

Short-term stability of atenolol in oral liquid formulations.

The objective of this study was to determine the stability of atenolol in extemporaneously compounded liquid formulations. Two sets of formulations were prepared using either pure atenolol powder or atenolol tablets. Vehicles used for preparation were simple syrup, a methylcellulose-based vehicle, Ora-Sweet, Ora-Plus, and Ora-Sweet SF. The concentration of atenolol in the formulations was 2 mg/mL. Samples were collected at regular time intervals over a period of three months, and atenolol concentration was determined using a stability-indicating, high-performance liquid chromatography (HPLC) assay. All formulations were also visually observed for signs of settling. The HPLC results showed that all formulations prepared using the methylcellulose-based vehicle and Ora-Sweet SF were stable (ie, greater than 90% of atenolol remained unchanged) for more than 28 days. On the other hand, formulations prepared with simple syrup and Ora-Sweet were stable only for 14 days. Formulations prepared using simple syrup and Ora-Sweet as vehicles were also placed at elevated temperatures in order to study the effect of temperature on the stability of atenolol. The concentration of atenolol that remained unchanged depended on the vehicle used and the temperature at which the formulations were stored.

Heart rate measures in blind cave crayfish during environmental disturbances and social interactions.

Most animals continually assess the environment in which they live and alter their behavior according to various stimuli. As an observer, one looks for changes in a behavior indicating that an animal responded to a particular event. When the animal does not make significant behavioral changes as measured by bodily movements, the animal may be characterized as unresponsive to a given stimulus. This study demonstrates that when behavioral body movements can not be observed an internal physiological measure of heart rate (HR) shows dramatic changes following presentation of defined stimuli. This study used the blind cave crayfish and examined their responsiveness to the following stimuli: light (infrared, dim red, and white), water-borne vibrations, removal of water, olfactory cues, and social interaction with partners. This study demonstrates that there is substantial individual variation of HR at basal levels and with the intensity of an social interaction. We find HR is a reasonable measure of the responsiveness of blind cave crayfish to given stimuli even in the absence of observable behavioral changes. This enables the observer to determine if an individual is responsive to and making an assessment of particular cues.

Effect of elevated temperature and light on the stability of butorphanol tartrate.

The purpose of this investigation was to determine the short-term stability of butorphanol tartrate in presence of diluents. A 10-mg/mL solution of butorphanol tartrate was diluted to 5 mg/mL using normal saline, 5% dextrose in water (D5W), or sterile water for injection. The diluted solutions were divided into two groups. The effect of temperature was tested by placing one group of sealed amber vials at room temperature and at 37 degrees C. The effect of light was studied by placing a second group in amber and clear vials, then exposing them directly to light. At regular time intervals over a period of 5 weeks, the solutions were analyzed for butorphanol tartrate and degradation products using a high-performance liquid chromatography assay. The concentration of butorphanol tartrate remained practically unchanged, indicating that butorphanol tartrate is not affected by heat or light in the presence of any of the diluents over a period of 5 weeks.

Uptake and distribution of lidocaine in fetal lambs.

The fetal uptake of lidocaine was measured continually and quantitatively during and after a constant rate intravenous (iv) maternal infusion into five chronically prepared pregnant ewes. Lidocaine, 6 mg/kg (base), was infused at a constant rate for 1 h and measurements continued to 5 h. Rate of fetal uptake was determined from the product of the umbilical venous (UV) and fetal aortic (FA) concentration difference and umbilical blood flow (Qu). Total fetal uptake was determined by integrating fetal uptake rate with respect to time. Maternal and fetal protein binding was determined, and its effect on fetal blood concentrations was evaluated. Mean total fetal uptake as it related to time and infused dose increased linearly (r = 0.998, P less than 0.001) with a constant, weight-normalized fetal-maternal dose fraction of 0.45 during the infusion. Despite rapidly declining blood concentrations after the infusion, uptake increased an additional 17%. The sevenfold variation in uptake appeared to be inversely related to the biodegradation rate of lidocaine. Fetal-maternal concentration ratios (F/M) increased during declining blood concentrations. Protein binding determinations for maternal and fetal blood were 43.6 +/- 2.48% and 26.9 +/- 1.59%, respectively. These values were used to calculate the F/M in conjunction with the maternal and fetal pH. At maternal-fetal equilibrium the calculated F/M, 1.0 +/- 0.05, closely approximated the observed, 1.0 +/- 0.03. Variations in lidocaine concentrations among the vital organs 4 h after the infusion were small, but high concentrations of metabolites were found in the lungs and kidneys. The results challenge the validity of placental transfer estimates commonly based on the F/M and umbilical cord blood concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)

Uptake and distribution of bupivacaine in fetal lambs.

Direct continual measurement of placental drug transfer was introduced to evaluate more precisely the fetal uptake of a commonly used local anesthetic in obstetrics. Bupivacaine, 2.7 mg X kg-1 (base), was infused at a constant rate over 1 h into a maternal jugular vein of five chronically prepared pregnant ewes. Blood was sampled simultaneously from the umbilical vein (UV), fetal aorta (FA), and a maternal artery (MA). Fetal uptake rate was determined from the product of the bupivacaine UV-FA blood concentration difference and the umbilical flow rate (Qu). Total fetal accumulation was determined by integrating uptake rate over 5 h. Correlation of total fetal uptake and the infused mean maternal dose (r = 0.993, P less than 0.001) indicated that during the infusion, mean fetal uptake was a constant fraction (0.16) of the maternal infused dose. Total fetal uptake was linear despite wide individual changes in Qu, suggesting that within limits fetal accumulation is not Qu-dependent. Mean ovine protein binding of bupivacaine by maternal and fetal whole blood was 85.49% +/- 2.61 (SD) and by fetal blood, 40.43% +/- 9.60 (SD). Back-transfer of bupivacaine to the mother proceeded against a higher total bupivacaine concentration because unbound unionized drug concentrations in maternal blood were less than in fetal blood. At maternal-fetal equilibrium when UV and FA total blood concentrations were equal, the calculated fetal/maternal concentration ratio (f/m) (0.36) determined from the maternal and fetal protein binding and pH closely approximated the observed (0.35). The f/m increased during both fetal uptake and back-transfer and cannot be considered a good index of placental transfer.(ABSTRACT TRUNCATED AT 250 WORDS)