3D assessment of ear morphology.

Introduction: Auricular reconstruction is a technically challenging and aesthetically demanding procedure as the ear has a complex anatomy. Anthropometry aids in achieving aesthetic ear reconstruction. We considered that implication of stereophotogrammetric technology will lead to a better understanding of human ear morphology. Material and methods: A cross-sectional study was conducted in our institutional OPD in a tertiary health care centre in the Northern part of India.400 people were chosen based on selection criteria. facial scans were done for 3D pictures using Canfield VECTRA® H2 3D imaging device. Study variables were assessed after marking landmarks on the 3D-generated auricular image of an individual. Discussion: This study consisted of 55.5% males and 44.5% females belonging to the age group of 5-25 years (30.3%), 26-40 years (38.8%) and>40 yr (31.0%). Out of 400 cases, the majority had; oval shaped auricle, normally rolled helix, square earlobe; knob shaped tragus. The attached type of earlobe attachment was more in the right auricle (37%) and the partial attachment ear lobe was more in the left side auricle (35.5%). Darwin's tubercle showed more proportion in the case of males. The mean length and width of the auricle & attachment length are higher in males compared to females. Ear Angulation is highest among females. Conclusion: Assessment of ear morphology using technologically sound methods like stereophotogrammetry paves the way for a more quick, reliable and easy-to-use method for understanding ear morphology. Precise assessment of ear morphology using stereophotogrammetry helps in providing more cosmetic and acceptable ear restoration.

CHSI costing study-Challenges and solutions for cost data collection in private hospitals in India.

INTRODUCTION: Ayushman Bharat Pradhan Mantri Jan Aarogya Yojana (AB PM-JAY) has enabled the Government of India to become a strategic purchaser of health care services from private providers. To generate base cost evidence for evidence-based policymaking the Costing of Health Services in India (CHSI) study was commissioned in 2018 for the price setting of health benefit packages. This paper reports the findings of a process evaluation of the cost data collection in the private hospitals. METHODS: The process evaluation of health system costing in private hospitals was an exploratory survey with mixed methods (quantitative and qualitative). We used three approaches-an online survey using a semi-structured questionnaire, in-depth interviews, and a review of monitoring data. The process of data collection was assessed in terms of time taken for different aspects, resources used, level and nature of difficulty encountered, challenges and solutions. RESULTS: The mean time taken for data collection in a private hospital was 9.31 (± 1.0) person months including time for obtaining permissions, actual data collection and entry, and addressing queries for data completeness and quality. The longest time was taken to collect data on human resources (30%), while it took the least time for collecting information on building and space (5%). On a scale of 1 (lowest) to 10 (highest) difficulty levels, the data on human resources was the most difficult to collect. This included data on salaries (8), time allocation (5.5) and leaves (5). DISCUSSION: Cost data from private hospitals is crucial for mixed health systems. Developing formal mechanisms of cost accounting data and data sharing as pre-requisites for empanelment under a national insurance scheme can significantly ease the process of cost data collection.

Cost of Surgical Care at Public Sector District Hospitals in India: Implications for Universal Health Coverage and Publicly Financed Health Insurance Schemes.

BACKGROUND: In low- and middle-income countries (LMICs), provisioning for surgical care is a public health priority. Ayushman Bharat Pradhan Mantri-Jan Aarogya Yojana (AB PM-JAY) is India's largest national insurance scheme providing free surgical and medical care. In this paper, we present the costs of surgical health benefit packages (HBPs) for secondary care in public district hospitals. METHODS: The costs were estimated using mixed (top-down and bottom-up) micro-costing methods. In phase II of the Costing of Health Services in India (CHSI) study, data were collected from a sample of 27 district hospitals from nine states of India. The district hospitals were selected using stratified random sampling based on the district's composite development score. We estimated unit costs for individual services-outpatient (OP) visit, per bed-day in inpatient (IP) and intensive care unit (ICU) stays, and surgical procedures. Together, this was used to estimate the cost of 250 AB PM-JAY HBPs. RESULTS: At the current level of utilization, the mean cost per OP consultation varied from US$4.10 to US$2.60 among different surgical specialities. The mean unit cost per IP bed-day ranged from US$13.40 to US$35.60. For the ICU, the mean unit cost per bed-day was US$74. Further, the unit cost of HBPs varied from US$564 for bone tumour excision to US$49 for lid tear repair. CONCLUSIONS: Data on the cost of delivering surgical care at the level of district hospitals is of critical value for evidence-based policymaking, price-setting for surgical care and planning to strengthen the availability of high quality and cost-effective surgical care in district hospitals.

A single-blinded assessment of the effect of communication on psychological burden among oral cancer and oral potentially malignant disorder patients.

Objective: Lack of communication begets distress in patients and often hampers patient care. This study aims to assess the effect of communication on psychological distress among patients with Oral Cancer (OC) and Oral Potentially Malignant Disorder (OPMD). Methods: This is a prospective single-arm study wherein the psychological burden in terms of depression, anxiety, and stress was evaluated in 120 patients through Beck's anxiety inventory, Beck's depression inventory, and perceived stress scale respectively when they were diagnosed with OPMD or OC. All patients were then communicated and informed about their disease through an audiovisual mode and their queries were resolved. Their psychological status was re-evaluated 15 min after this communication. Results: Wilcoxon signed ranks test revealed a statistically significant decline in the scores of each domain for both OC and OPMD post communication. When OC and OPMD were compared, a statistically significant difference was observed for only depression and anxiety domains. Conclusion: Audiovisual communication by healthcare professionals reduces the psychological burden of patients and is immensely useful in providing tailored information to the patients and their families. It is recommended to initiate such communication set ups at the waiting area of all outpatient departments as a good practice, where detailed tailored information can be provided to the patients. Practice implications: The intervention used in this study was not time-consuming and expensive, and can be used by the clinicians or health professional in their clinical practice to improve upon their treatment outcome. However, it should not be considered as a substitute to treatment.

A Psychologic Assessment of the Parents of Patients With Cleft Lip and Palate.

The aim of this study was to evaluate the psychologic burden in terms of depression, anxiety, and stress among the parents of children with congenital craniofacial deformity, nonsyndromic cleft lip and/or palate (CL/P) with early and late diagnosis and/or treatment. In this study, total 240 patients were enrolled, out of which 72 were parents (either mother/father) of CL/P children, below 10 years (group A: before adolescence), 70 were parents of CL/P children, above 10 years of age (group B: after adolescence), and 98 were parents of children with no CL/P or any other genetic disorder (group C). Depression, anxiety, and stress scale-21 was administered in all groups after obtaining the informed consent. Mean ranks of group B revealed a higher score for all the 3 psychologic domains. The CL/P was further divided into only cleft lip, only cleft palate, and both cleft lip and palate groups. A statistically significant difference was observed in group B for all the psychologic domains. Analysis of variance was applied between the groups and a P-value <0.05 was considered as statistically significant. Analysis revealed severe to extremely severe depressed state of mind and moderate to severe levels of stress in maximum parents (above 20%) of group B. However, approximately 50% parents of group B showed extremely severe anxiety. Therefore, psychologic assessment helps in providing a psychiatric or psychologic counseling and treatment to the parents of CL/P children.

Assessment of digital literacy and use of smart phones among Central Indian dental students.

OBJECTIVES: Education has largely been digitalized. More so, for professional education, keeping updated in this fast paced world has become a necessary requisite and dentistry has not been left untouched. This cross sectional questionnaire based study aimed to assess the digital literacy and smartphone usage amongst the 260 Central Indian dental students including their perspicacity about smartphone/internet usage for learning purposes. The students' attitude for implementation of digital technology in study programs/education system was also evaluated. METHODS: The questionnaire was distributed among total 260 dental students from different dental institutes of Central India. The data was collected and analyzed using SPSS software. RESULTS: Out of 260 students, 250 were internet users, out of which 56% had internet access all time. 94.23% students owned a smartphone. 46.53% (114/245) students had some app related to the dentistry in their smartphone device. The commonest site for surfing related to knowledge seeking was google scholar (72%) followed by Pubmed and others. Nearly 80% dental students believed that social media helps them in their professional course studies. Post graduate students showed statistitically significant difference from undergraduates and interns in terms of knowledge of keywords, dental apps and reading research journals. 89.23% students were keen for implementation of e-learning in their curriculum. CONCLUSION: This study reflects willingness of dental students to adopt digital revolution in dental education which in turn may present an opportunity for educators and policy makers to modify educational methods and thereby advance student's current learning approaches.