Study on mitigation of workplace violence in hospitals.

BACKGROUND: A workplace is any location, permanent or temporary, where an employee performs work-related duty. Workplace violence includes threats, beating, stabbing, shooting, psychological trauma, suicides, near suicides, and harassment of any kind. We can see slow changes in attitude of care providers when they encounter violent behavior and incidents. It is a world-wide issue. Of late, in developing countries where out of pocket payment mode is the main healthcare financing option for a family, the medical professionals are being demonized as professional pick-pocketers by few sections of the society. Hence, we explored to garner opinion of the employees regarding what constitutes violence in hospital setting and identified the factors among doctors, nurses, environmental duty workers, which are contributing toward work-place violence by patients and visitors. The aim was to improve the work environment for healthcare givers. METHODS: Descriptive, cross-sectional study with a close-ended questionnaire under sections of physical environment factors, patient processes, equipment factors, and types of events taking place was administered. A sample size was 540, including 120 doctors, 240 nurses, and 180 environment health workers. About 127 patients were also interviewed to understand their opinion about event leading to attacks on doctors and nurses. RESULTS: Patient attendants yelling at healthcare personnel, verbal threats of violence, and using offensive language against staff are the perceptions of hospital staff as incidents of workplace violence. Non-communicative staff, sudden death of patients, and non-satisfactory treatment lead to aggressive behavior as opined by patient families. CONCLUSION: In the process of providing safe work environment, each potential contributing factor needs to be addressed independently by administrators. The hospital has training programs to nurses on customer relationship management, interpersonal relations trainings.

Evaluation of randomised controlled trials published in Indian specialty dental journals for statistical testing of baseline differences: A meta-epidemiological study.

Background: In randomised controlled trials (RCTs), the application of a test of significance to compare the baseline differences between the intervention groups is a common practice, though it has been condemned by many researchers. Objective: This study aimed to assess the proportion of RCTs on human participants comparing the baseline differences between intervention groups using the test of significance in nine dental specialty journals published in India and to estimate the proportion of studies reporting baseline demographic and clinical characteristics in a table. Materials and Methods: RCTs published in nine dental journals published by dental specialty associations of India were screened. A literature search was limited to the time duration of five years from 2017 to 2021. Results: The authors analysed 326 RCTs. Of 326 RCTs published, 237 RCTs (72.7%) did not report the baseline demographic and clinical characteristics table. Tests of significance were applied to compare baseline differences between the intervention arms in 148 (45.4%) RCTs published. Conclusions: Although criticised by the Consolidated Standards of Reporting Trials (CONSORT) statement, the majority of the trials published in dental specialty journals failed to avoid comparison of baseline differences with significance test and failed to report baseline characteristic table.

Outcome of partial pulpotomy verses full pulpotomy using biodentine in vital mature permanent molar with clinical symptoms indicative of irreversible pulpitis: A randomized clinical trial.

Aim: The aim of the study is to evaluate and compare the clinical and radiographic outcome of partial pulpotomy and full pulpotomy in mature permanent molars with symptomatic irreversible pulpitis using biodentine. Materials and Methods: A total of 66 vital mature permanent molars with irreversible pulpitis were randomly allocated to a partial pulpotomy (n = 33) and full pulpotomy group (n = 33). Biodentine was used as a pulp capping material which was covered with resin-modified glass ionomer cement (RMGIC) followed by composite restoration. Clinical and radiographic evaluation was done at 3, 6, and 12 months follow-up for tenderness, periapical radiolucency, dentine bridge formation, and root canal calcification. Data from the study were analyzed using a Friedman and Mann-Whitney test and the success rate was analyzed by Chi-square value. Result: No statistically significant difference was found between partial and full pulpotomy (P > 0.05) and the success rate was 80.7% and 92.8%, respectively, at 12 months follow-up period. Conclusion: Both partial and full pulpotomy can be used as a permanent treatment modality in symptomatic irreversible pulpitis of vital mature permanent molars.

Immunohistochemical expression of Ki-67 and Glypican-3 to distinguish aggressive from nonaggressive benign odontogenic tumors.

Background: The benign neoplasms are normally slow growing, indolent with no invasive potential. However, there exist a few locally aggressive benign odontogenic tumors that have a tendency to invade and deform the surrounding structures. The exact reason for the aggressiveness of these benign neoplasms remained an enigma. Their biology and clinical expression can often be destructive and ominous. An appropriate treatment protocol needs to be followed to combat the high recurrence rate and aggressiveness of these entities. Aggressive and noniaggressive epithelial odontogenic tumors were analyzed immunohistochemically with Ki-67 and glypican 3 (GPC3). Materials and Methods: Fifty-nine cases of tumors were divided into aggressive odontogenic tumors (20 solid ameloblastomas, four unicystic ameloblastoma, and 28 keratocystic odontogenic tumors) and nonaggressive odontogenic tumors (five adenomatoid odontogenic tumors and two calcifying cystic odontogenic itumors). Results: Statistical analysis using Pearson correlation showed Ki-67 to be a better marker for differentiating aggressive from nonaggressive odontogenic tumor as compared to GPC3 (P < 0.001, highly significant), whereas among aggressive tumors, GPC3 turned out to be more useful as compared to Ki-67 (P < 0.001, highly significant). Conclusion: The present study provides an insight into the different biological behavior of odontogenic tumors, which can thus be helpful in determining the therapy strategies for more aggressive odontogenic tumors.

Comparative evaluation of Demirjian's four teeth and alternate four teeth methods for the dental age estimation in children and adolescents of Varanasi region.

Background: Age estimation is an important approach in the field of forensics and medical sciences to assists in clinical practice, medico-legal cases, and in criminal cases of judicial punishment. Aim: This study aim the applicability and comparison of four-teeth method and the alternate four-teeth method of Demirjian's approach among the Varanasi population. Settings and Design: This is a cross-sectional prospective study on the population of Varanasi region children and adolescents. Materials and Methods: Four hundred and thirty-two panoramic images of children and adolescents (237 boys and 195 girls) aged 3-16 years, from the population of Varanasi region oriental was assessed using the four-teeth method and the alternate four-teeth method of Demirjian's approach, for the estimation of dental age. Statistical Analysis: Pearson's two tailed test was applied to establish the correlation between chronological age and estimated dental age and Paired t-test was applied to check the statistical significance between mean chronological age and mean estimated dental age. Results: The dental age of boys was overestimated by 0.39 ± 1.15 years (P < 0.001) and dental age was underestimated by - 0.34 ± 1.15 years (P < 0.001) among girls using the Demirjian's four teeth method. According to Demirjian's alternate four teeth method, the sample of boys overestimated the dental age by 0.76 ± 1.00 years (P < 0.001) with the statistically significant difference. While the sample of the girls had negligible overestimation of 0.04 ± 1.03 years (P = 0.580) with no statistically significant difference. Conclusion: Demirjian's four teeth method is better to estimate dental age in boys, whereas Demirjian's alternate four teeth method in girls of Varanasi region.

Comparative assessment of conventional periodontal probes and CEJ handpiece of electronic probes in the diagnosis and primary care of periodontal disease.

OBJECTIVES: Conventional probes (CPs) have been considered acceptable as diagnostic tools to measure probing pocket depth (PPD) and clinical attachment level (CAL) but are affected by multiple variables. Electronic probes (EPs) provide controlled force, digital readout and data storage in computers. The objectives were to compare the reproducibility in the measurement of PPD and CAL by CP and the newly introduced CEJ handpiece of EP and intra-examiner and inter-examiner errors done in two phases. METHODS AND MATERIAL: Selected 720 periodontal sites in 1st molar of 30 persons with chronic periodontitis ≤4 mm and >4 mm pockets were analysed by two trained investigators in two phases at 2 hours difference by CP and CEJ handpiece of EP. Standard deviation, mean difference, correlation coefficient, P value and student 't' test were done to analyse data. RESULTS: The intra- examiner and inter-examiner analyses revealed that Pearson's correlation coefficient was above 0.080 and 0.722 in the ≤4 mm and >4 mm pockets, respectively. Mean difference was not statistically significant in both groups except in the intra- examiner findings in the 2nd phase. Interprobe analysis depicted a standard error of mean of <0.03 in ≤4 mm pockets, whereas it varied from 0.047-0.056 in >4 mm pockets. CONCLUSION: In conclusion, EP is advantageous for research purposes by providing automatic recording and long-term maintenance of data storage without the need of an assistant and patient education and motivation, whereas CP appears to be more useful in routine periodontal examination.

Clinical Profile and Treatment Outcomes in Patients Treated with Intensity-Modulated Radiotherapy (IMRT) for Carcinoma Nasopharynx: A Retrospective Analysis.

OBJECTIVE: To retrospectively evaluate the clinical outcome of carcinoma nasopharynx patients treated with the IMRT technique. METHODS: Eighty-one nasopharyngeal carcinoma patients who were treated with IMRT with or without chemotherapy between the period January 2011 and December 2014 at a comprehensive tertiary cancer center, Kerala, India, were included in the study. The mean age was 43 years (range 13-77 years), and majority of the patients were males (67.9%). The stagewise distribution of disease at presentation was 2 (2.5%) in stage I, 19 in stage II (23.5%), 31 (38.3%) in stage III, and 29 (35.8%) in stage IV. All patients were treated using simultaneous integrated boost (SIB) schedule using IMRT with 6 MV photon to a dose of 66 Gy in 30 fractions, 2.2 Gy per fraction prescribed to high-risk PTV; 60 Gy in 30 fractions, 2 Gy per fraction to intermediate risk PTV; and 54 Gy in 30 fractions, 1.8 Gy per fraction to low-risk PTV. Concurrent chemotherapy with cisplatin was offered to patients with stage II and above disease. Neoadjuvant chemotherapy with cisplatin and 5FU was given to patients with initially advanced disease (T3, T4, N2, and N3). Survival estimates were generated using the Kaplan-Meier method. The univariate analysis was performed using log-rank tests. RESULTS: The 5-year locoregional control (LRC), distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival (OS) rates were 87.5%, 87%, 61.6%, and 62.5%, respectively. The 5-year OS was 100% for stage I (n = 2), 67% for stage II (n = 19), 70.4% for stage III (n = 31), and 68.1% for stage IV (n = 29). The DFS at 5 years was 100% for stage I, 61.1% for stage II, 56.2% for stage III, and 84.8% for stage IV disease. The univariate analysis showed that age, nodal stage, and use of induction chemotherapy showed an improved trend towards OS, though the results were not statistically significant. The predominant pattern of failure in the present study was distant metastasis. Most patients who developed distant metastasis in our study had either an advanced T stage or N3 disease at presentation. CONCLUSION: The present study shows our initial experience with IMRT for nasopharyngeal carcinoma. The compliance to RT was good in this study. The 5-year LRC and OS rate of nasopharyngeal carcinoma patients treated with IMRT were 87.5% and 62.5%. Distant metastasis was the main pattern of failure.

Effect of electron-phonon interaction and valence band edge shift for carrier-type reversal in layered ZnS/rGO nanocomposites.

The artificial stacking of nanohybrid films helps to enhance their properties and thus intrigues researchers to explore this possibility in emerging technologies. The layer-by-layer approach was used to fabricate samples of zinc sulfide/reduced graphene oxide (ZnS/rGO) by using spin coating technique. The structure and optoelectronic properties has been extensively studied by X-ray diffraction (XRD), field emission scanning electron microscopy (FESEM), UV-VIS-NIR spectroscopy, Raman spectroscopy, X-ray photoelectron spectroscopy (XPS) and Hall measurements. Raman spectrum elucidates the phonon contribution of ZnS and breathing mode of κ-point phonons and sp2 bonds of carbon atoms of rGO. The electron-phonon interactions reveal reduction in electron mobility and enhancement in holes contribution with rGO content leading to surface charge transfer doping (SCTD). XPS results explain the valence band edge and conduction band edge to form type-I band alignment to reconfirm carrier-type reversal. A change in the dispersion of refractive indices along with a small rise in the value of absorption coefficient in terahertz (THz) region for ZnS/rGO nanocomposite films has been observed. These results will open up new opportunities to furthering the science of this technologically important class of materials for future electronics.

Prevalence of Dental Caries among Smoking and Smokeless Tobacco Users Attending Dental Hospital in Eastern Region of Uttar Pradesh.

INTRODUCTION: The relationship of tobacco use to dental caries is still unclear. The aim of this study is to assess the relationship between smoking and smokeless tobacco usage and prevalence of dental caries and its pattern in the Varanasi population. MATERIALS AND METHODS: In this study, 472 elderly dentate and consenting individuals were included. Individuals were examined with the aid of mouth mirror, No. 23 explorer, and cotton rolls. The age of the study group ranged from 16 years to 75 years. Individuals were categorized as smoking tobacco users, smokeless tobacco users, and the combination of these two. Frequency and dosage of tobacco usage was recorded. Dental caries was measured using decayed, missing, and filled teeth (DMFT) index. Oral hygiene practices such as mode, material, and frequency of brushing were also recorded. Data were assessed using SPSS 17.0 using Chi-square, t-test, ANOVA test, and binary regression. RESULTS: Caries rate was similar in both males and females (2.57 and 2.70), and the difference was not statistically significant. Caries was higher in individuals with habits when compared to those who were not having habits. There was no statistically significant association between individuals who were smokers, using smokeless tobacco, frequency, mode, and material of brushing with caries pattern. Among smokers, DMFT increased with frequency and duration of smoking, and it was statistically significant; however, in smokeless tobacco users, this was not the case. There was a positive correlation with DMFT and frequency of smoking. CONCLUSION: The study has shown that tobacco habit is a risk factor for increased caries activity, and it is higher in smokers as compared to smokeless tobacco chewers.

Volumetric evaluation of various obturation techniques in primary teeth using cone beam computed tomography - An in vitro study.

AIM: The aim of this study was to compare and evaluate the efficiency of five different obturation methods in delivering the filling material into the canals of primary teeth using cone beam computerized tomography (CBCT) scan. METHOD: A total of fifty prepared canals of primary teeth which further divided into five groups with ten canals in each group were obturated with zinc oxide-eugenol cement using five different obturation methods such as endodontic plugger, lentulo spiral (handheld), lentulo spiral mounted on slow speed handpiece, local anesthetic syringe, and tuberculin syringe. Using CBCT scan, the pre- and post-obturation volume and the percentage of obturated volume (POV) were calculated for each group. The results obtained were statistically analyzed using one-way analysis of variance and Tukey's post hoc test. RESULTS: Following CBCT scan, the method obturated with lentulo spiral mounted to handpiece showed the highest POV value followed by the method of lentulo spiral mounted to handpiece, hand plugger, and tuberculin syringe. Local anesthetic syringe gave the least POV (P < 0.05). CONCLUSION: Lentulo spiral mounted to handpiece showed the best technique of obturation using CBCT evaluation among the five groups evaluated in primary teeth. However, more studies are highly essential to prove it a boon for estimating obturation quality in primary teeth.

Periodontal status and its risk factors among young adults of the Sebha city (Libya).

BACKGROUND: The occurrence of periodontal diseases in humans has been a global problem. Certain risk factors affect the initiation, progression, and severity of periodontitis. The present study has been designed to assess the periodontal status in relation to risk factors such as age, gender, oral hygiene practices, and smoking among the young adults of the Sebha city in Libya. MATERIALS AND METHODS: A cross-sectional study was carried out among 1,255 subjects aged between 18 years and 34 years. 1,006 (80.15%) subjects were females and 249 (19.84%) subjects were males. Data was generated by conducting interview and clinical examination. The periodontal status was assessed by using Community Periodontal Index of Community Periodontal Index of Treatment Needs. The Chi-square test and analysis of variance were used for statistical analysis at 5% level of significance. RESULTS: A total of 89.08% reported the use of toothbrush and toothpaste for cleaning and 10.91% used other aids, such as finger and Siwak. Of the 1,255 subjects, 3.98% were current smokers (all males). Only 4.7% had healthy periodontium (CPI code 1), while majority of 44.30% were detected with calculus (CPI code 2). Nearly 40.63% had shallow pockets (CPI code 3), 6.29% had bleeding (CPI code 1), and 4.06% had deep pockets (CPI code 4). The overall mean CPI score was 2.33 (0.84). Age and gender showed a statistically significant difference with the CPI codes. CONCLUSION: The result of this study provides baseline information for planning a preventive program. With preventive procedures being implemented at this young age, there is a possibility that the prevalence of periodontal disease will be lesser during adulthood.

Descriptive analysis of toothbrushing used as an aid for primary prevention: a population-based study in Sebha, Libya.

This study aimed to assess toothbrushing behavior and descriptively analyze the effect of age and gender. Two thousand and six people from the city of Sebha, Libya, aged 1 to 64 years (mean age 26.9 ± 11.6 years, 1,463 females and 543 males) constituted the study sample. Data was collected using a self-administered questionnaire. Overall, 85.3% were using a toothbrush and toothpaste as a cleaning aid, whereas 6.3% never brushed their teeth. Only 36.1% brushed twice daily. Age and gender were significantly associated with use of a toothbrush and frequency of toothbrushing. This data serves as a baseline to implement a "preventive self-care instruction program."

Periodontal Status and Risk Factors among Adults of Sebha City (Libya).

The present study was aimed at assessing the periodontal status and risk factors like age, gender, tooth brushing habit, and smoking among the adult population of Sebha city, Libya. 452 adults, aged 35-54 years, comprised the study sample. 266 (58.84%) were females and 186 (41.15%) were males. Data was collected by interview and clinical examination using CPI of CPITN index. Chi-square test and ANOVA were used for statistical analysis at 5% level of significance. Results indicate that 76.32% used toothbrush and paste; 8.84% were current smokers and were all males. Majority, 52.65% were, detected with shallow pockets followed by 30.08% with calculus, 12.17% had deep pockets, 3.31% had bleeding, and only 1.33% were healthy. Age, gender, current smoking status and frequency of tooth brushing showed statistically significant difference with CPI codes. Health professionals can utilize this data to identify individuals at risk and to target population level interventions.