Assessment of Nursing Staff's Knowledge, Attitude and Practice Regarding Oral Hygiene Care in Intensive Care Unit Patients: A Multicenter Cross-sectional Study.

Background: Oral care is one of the fundamental nursing care procedures used to decrease oral colonization, dental plaque, respiratory infections, patient stay, and cost. The importance of good oral hygiene for patients in intensive care units (ICUs) is well recognized, however, the most effective way to achieve good oral care in the ICU is unclear. Therefore, the aim of this study was to assess the knowledge, attitude, and practice of nursing professionals regarding oral healthcare in ICUs among various medical institutes across India. Materials and methods: A questionnaire-based multicentric cross-sectional survey was conducted among registered nursing professionals employed at ICUs of three government tertiary healthcare centers (THC) of India: THC-I, THC-II, and THC-III located in the eastern and northern parts of India between February 2022 and July 2022. Results: A total of 150 nurses completed the questionnaire form (response rate: 62.5%) comprised of 49 (32.7%) males and 101 (67.3%) females with a mean age of 35.69 ± 7.7 years. Nursing officers' knowledge surpassed that of staff nurses regarding the duration of toothbrushing (p = 0.033). Among interinstitutional comparisons, THC-I nurses showed the greatest knowledge regarding the duration of toothbrushing and the mechanism of preventing saliva accumulation to reduce microbial growth (p = 0.013 and p = 0.003, respectively). Based on total work experience, participants were segregated into three groups: Group I (<7 years), group II (7.1-13.9 years), and group III (>14 years). Group II surpassed the knowledge of denture removal during sleep, cleaning after every meal, and storing in personalized air-tight containers (p = 0.001 and p = 0.036, respectively). The majority from group II recommended plain saline as the material for oral hygiene maintenance in ICU patients (p = 0.008). Group III predominantly practiced the ideal handwashing technique pre- and post-patient contact which was statistically significant (p = 0.001). Conclusion: This study observed that a knowledge gap exists among the nurses of the three institutes across India pertaining to the oral hygiene care of ICU patients. Nurse's education and implementation of the proper oral hygiene measures for intubated patients in ICU setup is an essential need. How to cite this article: Kumar S, Singh B, Mahuli AV, Kumar S, Singh A, Jha AK. Assessment of Nursing Staff's Knowledge, Attitude and Practice Regarding Oral Hygiene Care in Intensive Care Unit Patients: A Multicenter Cross-sectional Study. Indian J Crit Care Med 2024;28(1):48-57.

Quantitative Analysis of Publication Trends in the Journal of Indian Prosthodontic Society between 2011 and 2020.

AIM: To analyze quantitatively the trends in publication and compare the scientific content published during 2011-2015 and 2016-2020. MATERIALS AND METHODS: An online search for all the different manuscripts published from 2011 to 2020 was performed electronically on the website of the Journal of Indian Prosthodontic Society (JIPS). The manuscripts were grouped into the following broader categories: Author, article grouping, original article subtype, prosthetic division, and statistical analysis. RESULTS: The authors from private institutions showed higher publication trends than the authors from government institutions. The period 2016-2020 showed a higher number of publications with four or more authors. There was more original research published, followed by case reports. There was an increasing trend in a systematic review during 2016-2020 as compared to the period 2011-2015. There were a greater number of in vitro experimental studies published with a comparison of the means in the statistical analysis. There was more publication on materials and technology, followed by implants in the prosthetic division of articles. CONCLUSION: The analysis shows the overall progress of the journal explains the characteristics of the authors involved in the research, highlights the types of research done, statistical methods used, and important areas of research and trends in research in prosthodontics at a national level. CLINICAL SIGNIFICANCE: The publication trends will focus on the research thrust areas and the type of research done in the specialty, pointing out the gaps in the research and identifying the future course of action for authors and journals. It also helps for comparison with international publication trends in prosthodontics and provides information to prospective authors to focus research on the priority areas of the concerned journal for better acceptance.

Efficacy of photobiomodulation in the management of oral Lichen Planus in comparison to topical corticosteroids: Systematic review, meta-analysis, and GRADE-based assessment of certainty of evidence.

BACKGROUND: There is an urgent need to update the evidence available on the efficacy of photobiomodulation (PBM) in comparison to topical corticosteroids in the management of Oral Lichen Planus (OLP). METHODS: Cochrane Oral Health's Trials Register, Cochrane Central Register of Controlled Trials in the Cochrane Library, MEDLINE Pubmed, SCOPUS, Lilacs and Google Scholar were searched. Other sources included US National Institutes of Health Ongoing Trials Register, World Health Organization International Clinical Trials Registry Platform and Clinical Trial Registry - India were searched using variations of the keywords "Laser" and "Oral Lichen Planus". Randomized controlled trials comparing PBM and topical corticosteroids in the resolution of pain among OLP patients were included. The studies were assessed using the Cochrane Risk-of-Bias assessment tool. Publication bias was assessed using a funnel plot, and the certainty of evidence was evaluated according to the GRADE guidelines. RESULTS: Ten studies were included for qualitative assessment and of these eight were included in the meta-analysis. The included studies used laser parameters of varying strengths and duration. Meta-analysis favoured PBM (n = 274, MD =-0.48, CI -0.66- -0.30) for pain score. No adverse effects were reported for laser therapy. There was high heterogeneity and moderate certainty of evidence, and most studies had a high risk of bias. CONCLUSION: There is improvement in the clinical parameters of OLP when treated with PBM in comparison to topical corticosteroids. However, the strength of the evidence for these findings in limited. It is recommended to conduct better long-term trials with large sample size.

Effectiveness of fluoride mouthrinse in prevention of demineralization during fixed orthodontic treatment: A systematic review and meta-analysis.

Enamel demineralization is a very common occurrence around bonded brackets in an orthodontic practice. Fluoride (FLR) applications have been used to prevent decalcification and further progression of white spot lesions. The purpose of this systematic review and meta-analysis was to systematically appraise available literature on the effectiveness of fluoride mouthrinse in the prevention of demineralization around fixed orthodontic appliances. A search was conducted for randomized controlled clinical trials among four electronic databases (MEDLINE, Google Scholar, PubMed, and Cochrane Review) through MeSH terms and keywords. Studies were excluded if random allocation was not conducted, or if they were animal or in vitro studies. About 146 articles were screened and 5 studies were selected for the present review. Only two studies were selected for MA due to variations in the measurement of outcomes among studies. This review concluded that rinsing with FLR in the course of the fixed orthodontic treatment lessens demineralization around the bracket. Using FLR mouthrinse to inhibit the formation of white spot lesions or dental caries in patients with multiple cavities or restoration can be considered in clinical practice.

Ten-year prognostic outcomes of molar survival using the Miller-Mcentire Periodontal Prognostic Index - A longitudinal prospective study.

Background: A 10-year survival analysis was performed to assess the predictive validity of the periodontal risk score (formerly known as Miller-McEntire Periodontal Prognostic Index [MMPPI]) to predict long-term survival of periodontally diseased molars in a longitudinally assessed cohort. Materials and Methods: The MMPPI scores were computed at baseline by summarizing scores allocated for individual factors. The cohort was treated, followed up, and placed under regular periodontal maintenance. Molar survival data collected up to 10 years of follow-up were analyzed. Cox proportional regression was performed, and hazards ratio (HR) were computed for each prognostic factor and the MMPPI score. To estimate the predictive value of MMPPI, a receiver operating curve (ROC) curve analysis was performed. Results: From 1032 molars, 155 molars were extracted over the 10-year follow-up duration. Cox proportional hazard analysis showed significant hazard ratios for tooth loss for the component variables significant HR was noted for age: 4.92 (3.34:7.27), smoking: 1.74 (1.38-2.22), diabetes: 1.66 (1.49-1.86), molar type: 1.39 (1.15-1.67), probing depth: 2.00 (1.63-2.46), furcation: 2.64 (2.30-3.03), mobility: 3.45 (2.98-4.01), and total MMPPI score: 1.98 (1.85-2.12). ROC curve analysis showed an area under the curve value of 0.94 for the MMPPI index as a predictor of molar loss at 8 years, and the Youden index was maximized at the optimal cutoff point score of 7. Conclusions: All component scores of MMPPI showed significant hazard ratios at 10 years. These findings support the previous results from the 5-year analysis of this university-based cohort and warrant validation in independent cohorts.

Effects of smoking shisha, cancer risk, and strategies for prevention of shisha habit.

Smoking tobacco through a water pipe, also referred to as Shisha, is prevalent in Middle Eastern countries but has gained popularity worldwide, especially among youth. The increasing global trend of shisha use is mainly led by misleading information about it being safe. The shisha smoke has potentially harmful chemicals, including several human carcinogens and other toxic products. There are recognised adverse effects on passive smokers exposed to second-hand smoke. It is a potential risk factor for several cancers and risks pregnant women and the foetus. A session of shisha smoking for 40 minutes is equivalent to smoking 100 or more cigarettes. There should be awareness about Shisha's harmful effects to reduce the risk to health through a coordinated global effort.

E-learning during the COVID-19 Pandemic in Various Healthcare Institutes of India.

Introduction: A multicentric study on the benefits and outcomes of e-learning was lacking during the pandemic. This study aimed to find out the participation, satisfaction, and insights of dental and medical undergraduate learners toward digital learning during the COVID-19 pandemic in various healthcare institutes of India. Material and Methods: A questionnaire-based cross-sectional study was conducted using Google Forms online on e-learning among students from the first to the final year of MBBS and BDS courses in five healthcare institutions. Results: Most participants (72.7%) reported cellular data as their mode of internet connection. Seventy point eight percent of participants stated online classes did not affect health. Eyestrain (54.6%) was the most common, followed by headache and fatigue, whereas only 21.2% chose obesity and disturbed sleep as a consequence of e-learning. Conclusion: Most students had experience in digital learning, in which the use of smart phones with cellular data was the most common mode of digital learning during the pandemic.

A 5-year Prospective validation of the Miller-McEntire Periodontal Prognostic Index.

Background: This 5-year prospective survival analysis study aimed to examine the prognostic validity of a periodontal prognostic score specific for diseased molars: Miller-McEntire Periodontal Prognostic Index (MMPPI). Materials and Methods: One thousand and twenty-three molars were evaluated from 129 patients. The MMPPI scoring factors included age, smoking, diabetes, probing depth, mobility, molar type, and furcation involvement. MMPPI was computed as the sum of scores for all seven prognostic factors. Appropriate periodontal treatment and supportive periodontal therapy were provided. All patients were evaluated at baseline and annually posttreatment up to 5 years. Hazard risk ratios (HR) were computed for each prognostic factor, MMPPI scores assigned. The MMPPI score were then analyzed using Kaplan-Meier survival analyses. Results: A total of 31/1023 (0.3%) molars were extracted over the 5-year follow-up duration. Significant and positive hazard risk ratio (HR = 1.9) was noted for the total MMPPI score, validating its prognostic value for molar survival at 5 years prospectively. Kaplan-Meier survival analysis showed a significantly lower probability of molar survival with increasing MMPPI scores, where total score >8 showed worse survival probability over time. The hazard risk ratio was significant for individual prognostic factors: mobility (HR = 1.63), smoking (HR = 1.61), diabetes mellitus (DM) (HR = 1.4), molar type (1.97), and furcation involvement (2.22). Conclusions: The findings of the current study demonstrate significant prognostic validity of MMPPI scores for molar loss for 5 years, and a score >8 showed markedly worse molar survival probability in a well-maintained, university-based, prospective cohort. Mobility, smoking, DM, molar type, and furcation were component factors that were significant individual predictors.

Prospective evaluation of periodontally diseased molars in smokers using the Miller-McEntire Periodontal Prognostic Index.

BACKGROUND: The purpose of this 2-year prospective survival analysis study is to determine a statistically validated periodontal prognostic score for diseased molars in smokers using the Miller-McEntire Periodontal Prognostic Index (MMPPI). MATERIALS AND METHODS: Two hundred molars were evaluated from 25 patients who were smokers with moderate-to-severe chronic periodontitis. The factors evaluated included age, probing depth, mobility, furcation involvement, smoking, and molar type. A modified, 5 level, scoring criterion for smoking based on smoking-dose was adopted. MMPPI was computed as the sum of scores for all six prognostic factors. Appropriate periodontal treatment and supportive periodontal therapy were provided. All patients were evaluated at baseline and 2 years posttreatment. Hazard risk ratio (HR) was computed for each prognostic factor. RESULTS: A total of 3 (1.5%) teeth of the 200 molars were extracted over the 2-year follow-up duration, with a mean of 0.015 teeth lost. The HR was found as significantly higher for three individual prognostic factors: mobility (HR = 5.57, P = 0.02), smoking (HR = 3.35, P = 0.04), and furcation involvement (HR = 7.30, P = 0.01). Significant and positive HR (HR = 1.70, P = 0.01) was noted for the total MMPPI score, validating its prognostic value for molar survival at 2 years prospectively. CONCLUSIONS: The findings of the current study demonstrate the prognostic validity of MMPPI incorporating a more detailed smoking score criterion. The factors smoking, furcation involvement, and mobility significantly impacted the likelihood of survival of periodontally diseased molars. Further studies with a larger sample size and longer follow-up are required to confirm these findings.

Evaluation of periodontally diseased molars in diabetics with Miller-McEntire Periodontal Prognostic Index.

AIM AND OBJECTIVE: The aim of this study was to prospectively determine and establish the periodontal prognosis of diseased molars in diabetic patients using the Miller-McEntire Periodontal Prognostic Index (MMPPI) with an additional criterion for diabetes (changes in glycosylated hemoglobin levels), at 2-year postperiodontal therapy. MATERIALS AND METHODS: A sample of 200 molars in 25 patients with diabetes mellitus (DM) and chronic periodontitis were evaluated. The prognostic parameters evaluated include age, probing depth (PD), mobility, furcation involvement, diabetes, and molar type. The total score calculated from all parameters was used considered prognosis score for each molar. All patients were evaluated at baseline and 2-year posttreatment. RESULTS: The results of this study suggest that following prognostic factors, DM (hazard ratio [HR] =5.2), age (HR = 0.4), and molar type (HR = 0.6) were clinically significant at the end of the 2-year posttherapy from baseline. A total of 4 (2%) teeth were extracted from the 200 teeth with a mean of 0.02 for the tooth lost during 2-year posttreatment. Significant improvements (P < 0.05) in the frequency PD, furcation, and mobility scores were noted at 2 years. CONCLUSIONS: These findings demonstrate that score for DM as prognostic criterion is a valid addition to MMPPI. The factors such as DM, age, and molar type can impact the prognosis of molar survival. Studies with a larger sample size and longer follow-up are required to affirm the findings of this preliminary study.