Natural Recovery From Cannabis Use in People With Psychosis: A Qualitative Study.

OBJECTIVE: There is rapidly growing evidence of natural recovery from cannabis use in people with psychosis, but little is known about how it occurs. This qualitative study explores what factors influence the decision to cease cannabis use, maintain cessation, and prevent relapse. METHODS: Ten people with early psychosis and lifetime cannabis misuse, who had been abstinent for at least a month, were recruited from public adult mental health services. These six men and four women participated in a semi-structured qualitative interview assessing reasons for addressing cannabis use, effective change strategies, lapse contexts, and methods used to regain control. Interpretative phenomenological analysis was used to identify themes in their responses. RESULTS: Participants had a mean age of 23 years (SD = 3.7), started using cannabis at age 13.7 (SD = 1.6), began daily use at 17 (SD = 3.1), and had abstained from cannabis for 7.9 months (SD = 5.4). Awareness of the negative impact of substance use across multiple domains and the presence of social support for cannabis cessation were seen as vital to sustained success, as was utilization of a combination of coping strategies. The ability to address pressure from substance-using peers was commonly mentioned. CONCLUSIONS: Maximally effective treatment may need to focus on eliciting a range of benefits of cessation and control strategies and on maximizing both support for change and resistance to peer pressure. Further research might focus on comparing perceived effective strategies between individuals who obtain sustained cessation versus those who relapse.

The fully equipped physician: An ancient Indian competency framework.

Objective: There has been an observable trend towards developing medical competency frameworks across the globe. These competency frameworks are intended to improve societal trust in the medical education system in developing appropriately competent medical practitioners. A framework developed by the Royal College of Physicians and Surgeons; Canada has been widely accepted by several institutions across the world. Medical Council of India has also published a similar framework of medical competencies. Most of these frameworks does not consider ancient Indian frameworks which have existed for several thousand years. Current paper examines the medical competency frameworks from ancient India and compares it with current frameworks. Method: A review of literature available in reputable libraries and online on the medical competency framework from ancient India has been attempted. Key words including 'competency framework, medical framework, ancient India and fully equipped physician' were used. Results: A medical competency framework was written and implemented more than two thousand years ago. The framework identified key competencies including: Medical expertise, Communication skills, Scholar, Health advocacy and Professionalism. This framework was used for medical practitioners at the time and used during the training and subsequent medical practice. Conclusion: There is striking similarity between ancient Indian and current model of competency framework. Teachings and wisdom from ancient India can prove invaluable while developing future medical competency frameworks.

"Triple Tooth Synodontia" of Primary Incisors in Triangular Configuration: A Rare Aberrant Case Report.

Aim: This case report aims to present triple tooth synodontia of primary teeth and its management. Background: Synodontia refers to the fusion of teeth and is a morphological developmental dental aberration. This anomaly is also acknowledged with different terminologies like fusion, germination, and concrescence. Synodontia with two teeth is not uncommon however it is found sporadic in primary dentition. This type of anomaly can include two or more teeth; if the number is two, it is called as double tooth and if three, is called as triple tooth or triplication defect or triploid tooth. Case Description: In this article, we report an unusual case of triplication of primary teeth occurring unilaterally between the upper deciduous right central, lateral incisor and supernumerary tooth. The triple tooth was extracted under local anesthesia and was sectioned at three levels that are coronal, middle, and cervical one-third, and analyzed by Cone-beam Computerized Tomography (CBCT) respectively. The coronal segment revealed three individual pulp chambers, middle third and apical third revealed one single unified pulp chamber. Conclusion: Triple tooth in a triangular configuration with mixture of incomplete fusion at the coronal portion and cervical third and complete fusion at middle and apical third of root is an elusive anomaly. Clinical significance: This aberrant fusion of two deciduous incisors with supernumerary tooth had been documented as rare anomaly, so its early diagnosis and management protocol is imperative to comprehend. How to cite this article: Ahuja V, Verma J, Bhargava A, et al. "Triple Tooth Synodontia" of Primary Incisors in Triangular Configuration: A Rare Aberrant Case Report. Int J Clin Pediatr Dent 2022;15(6):779-783.

Prevalence of tobacco-associated oral mucosal lesion in Hazaribagh population: A cross-sectional study.

Background: Smoking and chewing tobacco carry significant risks for the development of oral cancer and premalignant lesions. The present study was conducted to find the prevalence of tobacco-related habits in Hazaribagh population and its association with oral mucosal lesion. Methodology: The present study was carried out on patients who visited the Department of Oral Medicine And Radiology, Hazaribagh College of Dental Sciences And Hospital. A total of 5,000 subjects were screened for tobacco-related habits and associated mucosal changes. Detailed clinical history about tobacco-related habits was obtained. Oral mucosal lesions were screened using the WHO format for diagnosis of oral lesions. The findings were tabulated and analyzed statistically. Results: Of the 5,000 subjects enrolled for the study, 1,085 (21.7%) used tobacco in some forms. Habit of smoking tobacco was present among 273 (25.2%) and using smokeless tobacco among 811 (74.7%) individuals. Tobacco pouch keratosis (46.1%) was found to be most common lesion, followed by oral submucous fibrosis (OSMF) (16.1%), lichenoid reaction (14.1%), smokers palate/melanosis (12.2%), leukoplakia (7.2%), erythroplakia (2.3%), and oral cancer in (2%). Conclusion: The results provide insight into prevalent tobacco habits and associated oral mucosal lesions in Hazaribagh population. These may act as baseline data for the formulation of preventive programs and help future studies explore the prevalence of tobacco-associated lesions in vulnerable populations. Current knowledge, including findings from the present study, about the prevalence of tobacco use and various oral lesions associated with it may help primary health care physicians to promote among patients visiting them the awareness about the adverse effects of tobacco consumption and treatment options available for tobacco-related lesions at the early stage.

Correlation of lip print with blood group in forensic science.

BACKGROUND: Cheiloscopy is the study of furrows and grooves present on the red part, or the vermilion border of the human lips. The type of groves is unique for an individual and can be used for person identification. AIM: The aim of this study is to ascertain whether the uniqueness of lip print (LP) can help in identifying a person. In addition to evaluate the comparison of LP types and blood groups was taken up to see if there is any correlation between the two. MATERIALS AND METHODS: A cross-sectional study was conducted on 200 participants (77 males and 123 females), aged between 25 to 45 years, to determine any correlation between LP types and blood groups. These lip patterns were analyzed and interpreted using Tsuchihashi's classification and later associated blood group matching was performed to determine the predominant LP type with the ABO and Rh blood grouping system. RESULTS: The present study showed a positive correlation between LP pattern and blood group among males and females. Thus, distribution of LP patterns, and ABO blood groups might help in the identification of an individual. CONCLUSION: Since LP and blood group are unique for a person. Hence, cheiloscopy along with blood group can play a vital role in person identification.

Quantification and distribution of mast cells in oral periapical inflammatory lesions.

Background: Periapical granuloma and periapical cysts develop as a sequela of inflammation of dental pulp, usually a consequence of an infected root canal. Mast cells (MCs) have most frequently been implicated in the pathophysiology of periapical lesions such as periapical granulomas and cysts. Aims: The present study was undertaken to emphasize the presence and quantification of MCs in periapical lesions (granulomas and cysts) using toluidine blue stain, with an aim to elucidate their role in the pathogenesis of these lesions. Materials and Methods: The study comprised a total of 55 previously diagnosed cases (30 cases of radicular cyst and 25 cases of periapical granuloma) selected from the departmental archives. The MCs were quantified in all the sections in the three zones, namely the epithelial, subepithelial, and deeper connective tissue zones. The results were sent for statistical analysis. Statistical Analysis: Wilcoxon paired t-test and Mann-Whitney U test were applied for intra- and intergroup comparison MCs in different zones of periapical granulomas and radicular cyst, respectively. Results: A statistically significant difference was observed between the two lesions in all the three zones, i.e., epithelial, subepithelial, and in deeper connective tissue zone with P = 0.001. Conclusion: Although MCs were present in all the three zones of both periapical cysts and granuloma, they were predominantly observed in radicular cysts than in periapical granuloma. This suggests a significant role of MC in initiation, development, and progression of these periapical lesions.

Prospective recovery of cannabis use in a psychotic population: A qualitative analysis.

INTRODUCTION: There is growing evidence for natural recovery from cannabis use by people with psychosis, but mechanisms underpinning it need further exploration. This study prospectively explored this issue. METHOD: Twenty-two people with psychosis and cannabis misuse were recruited: 19 provided data for at least one follow-up assessment, and 13 of these (68%) reduced or ceased using cannabis. A semi-structured interview with the latter group explored reasons for initiating the attempt, strategies they employed, and context/s where any relapse occurred. Interpretative phenomenological analysis was used to identify themes. RESULTS: Participants who reduced or ceased cannabis use had fewer negative symptoms at Baseline, and were more likely to only use cannabis. Major reasons for starting an attempt were worsening mental health, relationship and lifestyle difficulties. Effective strategies fell into psychological, relationship, lifestyle and medication themes. Only three participants reported a relapse: triggers involved substance-using peers, relationship difficulties, and problems with negative emotions including ones from past trauma. CONCLUSIONS: An encouragingly high rate of maintained reductions in cannabis use was seen. Increased awareness of the benefits across multiple life domains from addressing cannabis use may be critical to the initiation and maintenance of attempts, both to maximise motivation, and avoid over-dependence on improvements in any single domain. Negative symptoms, multiple substance use, dysphoria and pressure from substance-using peers clearly offer additional challenges for control.

Psychiatrists' follow-up of identified metabolic risk: a mixed-method analysis of outcomes and influences on practice.

Aims and method To describe and explain psychiatrists' responses to metabolic abnormalities identified during screening. We carried out an audit of clinical records to assess rates of monitoring and follow-up practice. Semi-structured interviews with 36 psychiatrists followed by descriptive and thematic analyses were conducted. Results Metabolic abnormalities were identified in 76% of eligible patients screened. Follow-up, recorded for 59%, was variable but more likely with four or more abnormalities. Psychiatrists endorse guidelines but ambivalence about responsibility, professional norms, resource constraints and skills deficits as well as patient factors influences practice. Therapeutic optimism and desire to be a 'good doctor' supported comprehensive follow-up. Clinical implications Psychiatrists are willing to attend to physical healthcare, and obstacles to recommended practice are surmountable. Psychiatrists seek consensus among stakeholders about responsibilities and a systemic approach addressing the social determinants of health inequities. Understanding patients' expectations is critical to promoting best practice.