Visible Light-Mediated Carbamoylation of para-Quinone Methides.

We report a photocatalytic approach for the installation of the amide moiety onto para-quinone methides. This transformation features a net reductive approach for the generation of carbamoyl radicals from amide-substituted Hantzsch ester derivatives under transition metal-free conditions. This protocol exhibits wide scope and allows access to diarylacetamides employing a C-C bond formation approach.

Visible-light mediated, oxygen-promoted regioselective cross-dehydrogenative coupling of coumarins and dimethylanilines.

Herein, we report a regioselective, photocatalytic C3 α-aminoalkylation of coumarins via a cross-dehydrogenative coupling of dimethylanilines and coumarins. Molecular oxygen was utilized as the oxidizing agent in this transformation, which exhibits a wide substrate scope and affords the products in good yields. It was established that 4-amino-substituted coumarin reacts via a different mechanism compared to coumarin derivatives that are unsubstituted at the 4-position.

Role of Serum Homocysteine, C-Reactive Protein (CRP), Uric Acid & Pro-Brain Natriuretic Peptide (Pro-BNP) in Predicting the Functional Outcome in Patients with Ischemic Stroke- A Prospective Observational Study from North India.

Ischemic Stroke is an acute and rapidly progressing neurological disease. Stroke is the second largest cause of global death (5.5 million) after ischemic heart disease. Numerous biomarkers have been identified and studied related to acute ischemic stroke but currently, none of the biomarkers are available for prognostication in such cases. In this study, we measured the levels of four widely available, rapidly measured biomarkers and evaluated their association with the functional outcome at discharge. MATERIAL: This was a prospective observational study conducted on 81 patients of acute ischemic stroke after obtaining informed consent. A detailed history was taken and clinical examination was done. Serum levels of homocysteine, uric acid, C-reactive protein (CRP), and Pro-brain natriuretic peptide (Pro-BNP) were measured at admission and their association with functional outcome using mRS (modified Rankin Scale) were analyzed. OBSERVATION: During the study period, 81 cases of acute ischemic stroke were evaluated; among them, 13 had a cardioembolic stroke. Ischemic stroke was more common in the older age group. The mean age was 49 ± 16.2 years. 61.7 % of patients were males. Diabetes Mellitus (45.7%), Hypertension (45.7%), CAD (8.6%), Dyslipidemia (27.2%), Smoking (37%), and alcohol intake (29.6 %) were some major risk factors. The average duration of hospital stay was 13.3 ± 7.5 days. 22 cases expired during the hospital stay. Mean serum levels of homocysteine, CRP, and Pro-BNP were higher than normal values (22.7 ± 16.3 umol/l; 59.5 ± 42.7 mg/dl; 1949 ± 3265.7 pg/ml). The mean serum uric acid level was 6.1 ± 3.3 mg/dl. A significant association between MRS score and serum homocysteine was found [p=0.007]. There was also a significant association between Pro-BNP levels and MRS score in patients with cardioembolic stroke (p=<0.001). CONCLUSION: Higher serum levels of homocysteine, CRP, and Pro-BNP are associated with a higher risk of acute ischemic stroke. Homocysteine level at admission can predict the poor outcome at discharge in patients of acute ischemic stroke. Pro-BNP levels can be used as a predictor of poor outcomes in cardioembolic stroke.

Severe acute respiratory illness surveillance for coronavirus disease 2019, India, 2020.

Background & objectives: Sentinel surveillance among severe acute respiratory illness (SARI) patients can help identify the spread and extent of transmission of coronavirus disease 2019 (COVID-19). SARI surveillance was initiated in the early phase of the COVID-19 outbreak in India. We describe here the positivity for COVID-19 among SARI patients and their characteristics. Methods: SARI patients admitted at 41 sentinel sites from February 15, 2020 onwards were tested for COVID-19 by real-time reverse transcription-polymerase chain reaction, targeting E and RdRp genes of SARS-CoV-2. Data were extracted from Virus Research and Diagnostic Laboratory Network for analysis. Results: A total of 104 (1.8%) of the 5,911 SARI patients tested were positive for COVID-19. These cases were reported from 52 districts in 20 States/Union Territories. The COVID-19 positivity was higher among males and patients aged above 50 years. In all, 40 (39.2%) COVID-19 cases did not report any history of contact with a known case or international travel. Interpretation & conclusions: COVID-19 containment activities need to be targeted in districts reporting COVID-19 cases among SARI patients. Intensifying sentinel surveillance for COVID-19 among SARI patients may be an efficient tool to effectively use resources towards containment and mitigation efforts.

Novel regimen of combined intralesional triamcinolone and salmon calcitonin nasal spray to treat a large central giant cell granuloma.

About 10% benign tumors of the jaw are known to be central giant cell granulomas (CGCGs) affecting mandible more than maxilla. They are more commonly seen among young females, mean age range being 10-25 years. The aggressive variants of CGCG require surgical intervention, leaving colossal disfiguring defects. This being the reason for many nonsurgical alternative therapies as calcitonin injections and nasal spray, intralesional steroid injections and subcutaneous interferon injections advocated for its management. Although the exact success rate of using these nonsurgical therapies are not fully known, they provide the advantage of being conservative in nature, as majority of the patients are young adults. This lack of accurate regimen is due to paucity of randomized control trials and systematic reviews addressing the topic. This manuscript attempts to present a novel regimen protocol which was followed for a case of CGCG, right mandible on a 22-year-old female patient, for a period of 1.5 years and trailed by a follow-up of 2 years.

Knowledge Attitude and Practice of Dentists Regarding Toothbrush Hygiene and Disinfection in Private Dental Colleges of Lucknow City India: A Cross-sectional Study.

Background: A toothbrush is one of the most important aids used for cleaning teeth by most people in the world. So, knowledge regarding toothbrush disinfection is of utmost importance to everyone, especially the dental fraternity. With this in mind this study aims to understand the Knowledge Attitude and Practice of dentists regarding toothbrush hygiene and disinfection in private dental colleges of Lucknow City. Materials and methods: This was a cross-sectional questionnaire-based study, which included the undergraduates (UGs, interns), postgraduates (PGs), and faculty members of the four private dental colleges who gave the consent to participate in the study. The statistical analysis was done using SPSS version 22, the Chi-square test was used and p- value <0.05 was considered statistically significant. Results: There was a statistically significant difference regarding toothbrush contamination, mode of storing the toothbrush, and the various practice used for toothbrush disinfection among the interns, postgraduates, and faculty members who participated in the study. It was also seen that the general awareness and practice of toothbrush disinfection was higher among the female participants in the study, which was also a statistically significant result. Conclusion: There was a statistically significant difference in the perceptions about toothbrush contamination and disinfection among postgraduates and interns that might be attributed to their higher academic knowledge and clinical experience. How to cite this article: Potlia I, Singh P, Chauhan H, et al. Knowledge Attitude and Practice of Dentists Regarding Toothbrush Hygiene and Disinfection in Private Dental Colleges of Lucknow City India: A Cross-sectional Study. Int J Clin Pediatr Dent 2022;15(1):79-84.

Osteotomy in lateral sinus augmentation: A comparative study of rotary technique and Lateral Approach Sinus Kit®.

Background: Various sinus lift techniques have been tried to minimize the rate of perforations, especially in Type I and Type II sinus membrane thickness. Aims and Objectives: The aim and objectives of this study was to present our own experience compare and the efficacy of conventional direct sinus lift technique and direct sinus lift using LAS Kit. Material and Methods: Our study included 14 patients in which seven patients in conventional technique and seven patients in Lateral Approach Sinus (LAS) Kit®. Result: The results showed that the sinus membrane perforation rate, using LAS Kit® with specially designed drills, is less than that of the conventional technique, especially in Type I and II sinus membrane with the added benefit of reduced operative time. The mean operative time in conventional technique was 28.29 ± 2.21min and in LAS Kit®, it was 19.43 ± 2.88min which was statistically significantly less than the conventional technique group (P < 0.001). In both the groups, 100% implant integrity was achieved (measured using reverse torque technique) after 6 months of follow-up. It was observed that there was no statistically significant difference between the groups in pain, swelling, flap dehiscence, and infection at different time intervals. Conclusion: We conclude that the use of LAS Kit® for sinus lift procedure in atrophied maxilla with Type I and II sinus membrane is a much safer approach over the conventional technique. Further, the results obtained also showed that blood coagulum gave better gain in bone height over a period of 6 months.

Major Stressors and Coping Strategies of Internal Migrant Workers During the COVID-19 Pandemic: A Qualitative Exploration.

COVID-19 forced lockdown in India, leading to the loss of job, crisis of food, and other financial catastrophes that led to the exodus migration of internal migrant workers, operating in the private sector, back to their homes. Unavailability of transport facilities led to an inflicted need to walk back to homes barefooted without lack of any other crucial resources on the way. The woeful state of internal migrant workers walking back, with all their stuff on their back, holding their children, was trending on social media worldwide. Their problem continued even after reaching home, including misbehavior of villagers, indifferent mannerism of family members toward them, inability to fulfill family responsibility, and financial crisis, which led to stress, fear, and trauma for these internal migrant workers. The present paper aimed to assess the idiosyncratic stressors of internal migrant workers throughout the pandemic era and their responses toward those problems, which helped them cope with it. In-depth semistructured telephonic interviews were conducted with 25 internal migrant workers who were working in different cities in India before lockdown. The analyses revealed that multiple stressors include financial crisis, unavailability of food, inability to continue education, inability to pay house rent, lack of support from neighbors and family, and other psychological stressors that affected them. However, they also tried multiple strategies to deal with the problems, including a cognitive appraisal of the problem and making oneself psychologically competent to deal with the situation. Social support of family and friends played a vital role in enhancing hardiness and increasing the level of happiness at scarce times. At the same time, some of them could not deal with stressors and opted for psychiatric help to manage the physical symptoms of stress.

Determining the Influence of Oral Health Infotainment Module on Behavior and Oral Hygiene of 6-year-old School-children and their Mothers in Davangere City.

AIM AND BACKGROUND: Dental plaque and calculus are common in school-aged children worldwide causing unsatisfactory oral health. This stage is a critical time to establish attitudes, beliefs, and shape an individual's health-related behavior. Moreover, parental oral health knowledge and attitudes are known to influence their child's oral health and hygiene. MATERIALS AND METHODS: A cross-sectional study with a two-stage intervention trial involving a sample of 6-year-olds from two schools in Davangere city was done. Children were randomly allocated into three intervention groups by lottery method. Data included plaque index (PI) modified for 6-year-old children at baseline, 30th day, and at 60th day. Children and their mothers were requested to fill a self-administered questionnaire. The statistical analysis used ANOVA followed by Tukey's post hoc test and measures ANOVA. p ≤ 0.05 was considered statistically significant. RESULTS: There was a significant reduction in the PI modified in 6-year-olds within and among the three groups at the end of 60 days (p = 0.001). Maximum reduction was seen in group II followed by group III and thereafter group I in both the age-groups. CONCLUSION: The study shows that at 60 days, the oral health infotainment module involving parental support was able to achieve appreciable improvement in the child's oral health and hygiene and inculcate a better attitude toward oral self-care. HOW TO CITE THIS ARTICLE: Potlia I, Naveen Kumar PG, Ramesh MV, et al. Determining the Influence of Oral Health Infotainment Module on Behavior and Oral Hygiene of 6-year-old Schoolchildren and their Mothers in Davangere City. Int J Clin Pediatr Dent 2021;14(5):633-639.

Comparing COVID-19 mortality across selected states in India: The role of age structure.

BACKGROUND: Mortality rates provide an opportunity to identify and act on the health system intervention for preventing deaths. Hence, it is essential to appreciate the influence of age structure while reporting mortality for a better summary of the magnitude of the epidemic. OBJECTIVES: We described and compared the pattern of COVID-19 mortality standardized by age between selected states and India from January to November 2020. METHODS: We initially estimated the Indian population for 2020 using the decadal growth rate from the previous census (2011). This was followed by estimations of crude and age-adjusted mortality rate per million for India and the selected states. We used this information to perform indirect-standardization and derive the age-standardized mortality rates for the states for comparison. In addition, we derived a ratio for age-standardized mortality to compare across age groups within the state. We extracted information regarding COVID-19 deaths from the Integrated Disease Surveillance Programme special surveillance portal up to November 16, 2020. RESULTS: The crude mortality rate of India stands at 88.9 per million population (118,883/1,337,328,910). Age-adjusted mortality rate (per-million) was highest for Delhi (300.5) and lowest for Kerala (35.9). The age-standardized mortality rate (per million) for India is (<15 years = 1.6, 15-29 years = 6.3, 30-44 years = 35.9, 45-59 years = 198.8, 60-74 years = 571.2, ≥75 years = 931.6). The ratios for age-standardized mortality increase proportionately from 45 to 59 years age group across all the states. CONCLUSION: There is high COVID-19 mortality not only among the elderly ages, but we also identified heavy impact of COVID-19 on the working population. Therefore, we recommend further evaluation of age-adjusted mortality for all States and inclusion of variables like gender, socio-economic status for standardization while identifying at-risk populations and implementing priority public health actions.

A comparative evaluation of bone regeneration using mesenchymal stem cells versus blood coagulum in sinus augmentation procedures.

OBJECTIVE: The present study evaluated the quality and quantity of new bone formation in the maxillary sinus lift procedures and stability of implants in posterior atrophic maxilla. MATERIALS AND METHODS: This prospective randomized controlled split-mouth study included 20 patients (16 males and 4 females having a mean age of 36.7 years) having atrophic maxilla. They were divided randomly into two groups: Group A using mesenchymal stem cells and Group B into blood coagulum. They were radiographically evaluated using cone-beam computed tomography (CBCT) for residual bone height preoperatively and availability of new bone formation around implants, density, and stability of implants 6 months postoperatively. RESULTS: The placement of dental implants in posterior maxilla is challenging due to rapid resorption of alveolar bone after extraction of teeth due to pneumatization of maxillary sinuses. In both the groups, more pain and swelling were observed in the 2nd postoperative day which gradually decreased over a period of 7 days. Membrane perforation occurs in only four cases (20%). A significant gain in alveolar bone height was observed in Group A (7.69 mm ± 2.5 mm) and Group B (9.32 mm ± 2 mm) after 6 months. On comparing both the groups, there is a similar significant increase in bone density in Hounsfield units postoperatively at various levels buccally and palatally. Total 40 sinuses were lifted and 42 implants were placed, respectively. All implants showed primary stability. CONCLUSIONS: Such findings provide a significant contribution in future perspective studies that the use of stem cells had the same success rate as blood coagulum.

Genomic characterization and epidemiology of an emerging SARS-CoV-2 variant in Delhi, India.

Delhi, the national capital of India, experienced multiple severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks in 2020 and reached population seropositivity of >50% by 2021. During April 2021, the city became overwhelmed by COVID-19 cases and fatalities, as a new variant, B.1.617.2 (Delta), replaced B.1.1.7 (Alpha). A Bayesian model explains the growth advantage of Delta through a combination of increased transmissibility and reduced sensitivity to immune responses generated against earlier variants (median estimates: 1.5-fold greater transmissibility and 20% reduction in sensitivity). Seropositivity of an employee and family cohort increased from 42% to 87.5% between March and July 2021, with 27% reinfections, as judged by increased antibody concentration after a previous decline. The likely high transmissibility and partial evasion of immunity by the Delta variant contributed to an overwhelming surge in Delhi.

Submental intubation in panfacial injuries: our experience.

Panfacial fractures present a unique set of problems to the anaesthesiologist and surgeon. Airway management in panfacial fractures is still a challenge to the anaesthesiologist as all modalities available such as orotracheal intubation, nasotracheal intubation, tracheostomy, etc., have their own advantages and disadvantages. When all the conventional modalities to secure airway seem unsuitable then submental route offers an excellent alternative to manage airway in such patients. Here we describe our experience with submental intubation technique in 10 patients with panfacial injuries over a period of two years.

Rare and unusual occurrence of ectopic hidradenoma papilliferum in maxillofacial region.

Hidradenoma Papilliferum (HP) is a rare, benign, cutaneous adnexal tumor of middle-aged females arising mainly in the apocrine sweat glands of perianal and genital region. Initially, HP was considered to be an apocrine sweat gland tumor however recent research showed that it descends from the anogenital mammary-like glands, HP can be regarded theoretically as the cutaneous complement of mammary intraductal papilloma. Nongenital HP is an infrequent manifestation, ectopic forms of this entity have been defined with bulk of them occurring on the head and neck region (60%) and 85% of cases being 1.5 cm in the greatest diameter or lesser. Average age of patients with ectopic HP is 1-2 decades older than the age range of onset in patients with anogenital HP. Here, we present a 15-year-old adolescent female with an unusually large, ectopic occurrence of nodular HP on right cheek since 2 years.

Incidence and Distribution of Jaw Pathologies among 0-15 Years Age Group at a Tertiary Rural Health-Care Center of Maharashtra: A Retrospective Study of 10 Years.

OBJECTIVE: This study was undertaken to investigate the prevalence of intraosseous jaw lesions among pediatrics (0-15 years of age) in a rural health-care center of Maharashtra and to determine the most common types of lesions and their distribution according to gender and anatomical site involved. STUDY DESIGN: Histopathological data were collected from a database of lesions classified as intraosseous jaw lesions dated between January 1, 2005, and December 31, 2015, from the archives of the Department of Oral and Maxillofacial Surgery, Rural Dental College, Maharashtra, India. All the cases of jaw cysts and tumors among children under 16 years of age group were segregated and scrutinized further under the headings of type of pathologies, anatomical locations where they are most commonly seen, and the age/gender most pertinent to these pathologies. RESULTS: The present study revealed that 114/3896 jaw lesions were pediatric jaw pathologies, of which odontogenic cysts were 67/114 and jaw tumors were 47/114. Among the cysts, 70% were developmental cysts and 30% were inflammatory cysts. The majority (71.6%) of the jaw cysts were found in the mixed dentition phase (7-15 years). Among the jaw tumors, 55% of them were categorized under odontogenic tumors and 45% were under fibro-osseous lesions. Similar to intraosseous jaw cysts, tumors of jaws were more prevalent under the age of mixed dentition, which was found to be 87%. Male predominance was seen and the overall male:female ratio was calculated as 1:0.52 and 1:0.5 for cysts and tumors, respectively. Mandibular posterior segment was found to be the most commonly encountered anatomical site in both the groups of cases. CONCLUSION: A large number of cases were recorded, which led us to a path of interrogation through which the reason for increased incidence was extracted, and it was agreed that though the pathogenesis remains the same in every individual, routine health checkups and early diagnosis may reduce the incidence and aggressiveness of pathologies, respectively, which was lacking at the rural area.

Comparison of Immediate Implant Placement Following Extraction with and Without Socket-Shield Technique in Esthetic Region.

INTRODUCTION: Immediate implant with socket shield and immediate implant without socket shield are the two techniques which can be used to preserve the already thin labial bone in the esthetic region, thus eliminating the need for graft materials. AIM: To compare the efficacy of immediate implant placement after extraction without socket-shield technique and with socket-shield technique in the esthetic region. MATERIALS AND METHODS: Sixteen patients who reported with unsalvageable maxillary anterior teeth with labial bone thickness of less than 2 mm, depicted on preoperative CBCT, were chosen for the study and randomly assigned one of the two groups: Group A comprising socket-shield technique patients and Group B comprising immediate implant placement without socket shield. The labial bone thickness was analyzed along its entire length through CBCT scan at definite follow-up intervals up to a period of 12 months after the procedure. RESULTS: Follow-up of 1 year demonstrated a statistically significant reduction in the labial bone thickness at the crest in Group B after 8th and 12th months of implant placement. CONCLUSION: The two techniques need further comparison though our study results demonstrated better preservation of bone through the socket-shield technique, thus eliminating the need for any bony substitutes.

Study of Normal Anatomy of Mandibular Canal and its Variations in Indian Population Using CBCT.

INTRODUCTION: Identification of detailed anatomy of mandibular canal (MC) with its contents including the position, course, and morphology is extremely important for the management of various surgical procedures including dental implant placement, third molar surgery, dental anesthesia, mandibular osteotomy, bone-harvesting procedure from the ramus and body of mandible, bone plating in angle and body region of mandible, or any other surgical procedure involving the mandible. METHODS: This prospective randomized study was carried out in the Department of Oral and Maxillofacial Surgery, Saraswati Dental College, Lucknow, on 100 randomly selected cone-beam computed tomography (CBCT) mandibular views displaying the entire mandible. RESULTS: Various parameters of the canal were studied in detail and subjected to statistical analysis using SPSS 20 software. For all the observations, paired t test was applied to compare right and left sides and independent t test for the comparison of gender. CONCLUSION: For centuries MC has been a paramount topic of discussion, and with the contraption of CBCT, we can finally decipher the canal in great detail. CBCT acts as a guide to prevent damage to the neurovascular bundle as the canal traverses its course and sometimes with certain variations.

Comparison between immediate vs. delayed lateral expansion technique to augment narrow alveolar ridges for placement of implants - A pilot study.

OBJECTIVE: Narrow alveolar ridges pose a serious challenge for successful placement of endosseous implants and alveolar ridge widening procedure is indicated in cases of crest thickness of ≤4.0 mm. The study evaluated and compared, immediate and delayed techniques of implant placement using split crest technique to augment atrophic narrow alveolar ridges. METHODS: The study was carried out in 10 patients randomly divided into two groups of five each for immediate or delayed placement of implants. Implants were placed simultaneously after split crest procedure in immediate technique and after 3-4 weeks of healing in delayed technique. Data collected was statistically analyzed by SPSS version 22 using unpaired t-test, ANOVA and Pearson's correlation with p value = 0.05. RESULTS: Statistically significant (p = 0.000) difference was observed for implant stability at intra-op, 4 months and 6 months post-op between the two groups, however there was no statistically significant difference in amount of augmentation achieved between the two groups. CONCLUSION: We observed that both the techniques were comparable on the basis of augmentation achieved, implant success and survival rates, whereas implant stability was significantly higher in delayed technique group.

Pediatric cancer pain management at a regional cancer center: implementation of WHO Analgesic Ladder.

PURPOSE: To collect data on the prevalence of various types of cancer pain in a sample of children with cancer, and to implement the WHO Analgesic Ladder in the management of pain in pediatric cancer. METHODS: Eighty four pediatric patients suffering of cancer pain were studied during the period 2001-2006. Patients were requested to rate their global intensity of pain on 0-100 mm visual analogue scale (VAS 0 = no pain, 100 = maximum pain). Pain management was performed in accordance with the WHO Analgesic Ladder for cancer pain. Patients were followed up weekly for three weeks. RESULTS: Of the 84 pediatric children with cancer, pain was nociceptive in 26 (31%), neuropathic in 12 (14.3%) and mixed in 46 (54.8%). Almost 7 (8.3%) of patients were on WHO step 3 at baseline. Thereafter the WHO step 3 increased; first week visit 36 (43%) patients; second week visit 58 (69%), and third week 69 (82.1%). At baseline, 40 (47.6%) patients took NSAID only, 2 (2.4%) patients took adjuvant, while 38 (45.2 %) patients took combination of NSAID and adjuvant treatment. There was statistically significant (p = 0.000) reduction in VAS as time progressed. CONCLUSION: Cancer pain in pediatric age group can be well managed in accordance with the WHO Analgesic Ladder. Aggressive symptoms and control of treatment of related side effect are also needed to ensure successful implementation and the WHO Analgesic Ladder.

Eagle's syndrome mimicking dental pain: A case report with a novel surgical approach.

PAIN in the craniofacial and neck region can be both intriguing and equally frustrating for the surgeon. This is principally because there is a multitude of related pain syndromes in this region, many of which are lacking in physical signs. Diagnosis then becomes even more dependent on an accurate description of the pain in terms of character, localization, duration, radiation, relieving and exacerbating factors. Familiarity and identification of a more obscure causative factor in a particular case lends itself not only to liberate the patient but also an increased awareness of the practitioner for the need to consider the coinciding minute diagnostic points of otolaryngology, ophthalmology and rhinology besides dentistry and oral surgery. The characteristic elongation of a styloid process may explain some occasions of pharyngeal, ear pain and sometimes headache, which have defied exhaustive diagnostic studies. A large spectrum of signs and symptoms has been mentioned in various reports of Eagle's syndrome. Diagnosis can be made with careful clinical evaluation and confirmed with radiographs showing an elongated styloid process or calcification of the stylohyoid complex. Styloidectomy is the procedural choice for Eagle's syndrome having high success rate. In our case, the intraoral approach for styloidectomy was not the routine one, for which the post-operative outcome was exceptionally good without any complications.