Development, validation, and usability testing of prototype mobile application for oral health promotion during pregnancy in India.

Background: Oral diseases are a silent epidemic. Objectives: The objectives of the study were to develop, validate, and assess the usability of an oral health prototype mobile application for oral health promotion among pregnant women in India. Materials and Methods: A cross-sectional study was conducted in Tertiary Care Hospital in Delhi, India, after obtaining Ethical Clearance from the Institutional Ethical Committee Board. The study was conducted in three phases: development of the prototype app, its validation, followed by usability testing of the app. Mobile app was validated by 30 pregnant women and 30 subject experts using Heuristic Analysis Scale and usability testing by 30 pregnant women based on System Usability Scale (SUS). Data were analyzed with IBM SPSS version 21.0. Results: Majority (over 90%) of pregnant women and subject experts strongly acknowledged that the app educated the users using positive motivation strategies, instilling comprehensive knowledge and faced no issues with the appropriate functionality of the app. The prototype app scored 73.75 on SUS, indicating high usability. Conclusion: This study holistically explored various dimensions of oral health care in pregnant women. Its novelty is proven by the fact that the content of the prototype application has been phase wise developed and validated by pregnant women and subject experts. Usability testing of the app indicated its high acceptability and ease of use among pregnant women in India.

Health technology assessment for oral health in the past decade: a scoping review.

BACKGROUND: Health technology assessment (HTA) is the systematic evaluation of various properties and effects of a health technology. HTA can serve as a bridge between the world of knowledge and that of decision making, offering decision makers the best summary of scientific evidence. Scoping HTA reports in the context of dentistry can help researchers identify grey areas; help practitioners make evidence-based decisions and further initiate better policy making. AIM: To provide an overview on HTAs pertaining to oral health and dentistry in the past decade, map the extension and scope of the methodological practices, key findings, and limitations. METHODOLOGY: A scoping review was conducted using the Joanna Briggs Institute framework. A comprehensive search for HTA reports was done through the International Network of Agencies for Health Technology Assessment Database from January 2010 to December 2020. Consecutively, electronic databases (PubMed and Google Scholar) were searched. Finally, thirty-six reports were included in this review and analyzed. RESULTS: A total of 709 articles were initially identified, of which thirty-six met the inclusion criteria. Reviewed HTAs focused on various specialties of dentistry worldwide. Maximum number of reports (N = 5) were related to "prosthodontics and dental implants" and technologies related to preventive dentistry were most commonly assessed (N = 4). CONCLUSION: Functional, appropriate, and evidence-based information provided through HTA pertaining to oral health on a regular basis will enable decision makers to have enough data to make decisions on the future use of new technology, modify existing policies, accelerate its translation into practice, and ensure provision of robust dental healthcare services.

Personality Traits Influence on Perception and Hesitancy Towards COVID-19 Vaccination Among Tertiary Care Dental Hospital in Delhi: A Cross-Section Study.

Background  In the COVID-19 pandemic, vaccination is recognized as a global public-health goal for preventing, containing, and stopping transmission. But the reluctance of people to receive safe and recommended available vaccines (i.e., vaccine hesitancy) was a growing concern. One of the key elements that influence how people are perceived and their reluctance to get the COVID-19 vaccine was found to be personality traits. Hence, the aim of the study was to assess the influence of personality traits on perception and hesitancy towards COVID-19 vaccination among patients attending tertiary dental care hospitals in Delhi. Methodology A cross-sectional questionnaire survey was conducted among a sample of 322 participants aged 15-70 years attending the outpatient department of a public sector tertiary care dental hospital in New Delhi. Data was collected over a two-month period using a validated self-administered questionnaire which recorded demographic variables, individual perceptions, hesitancy towards COVID-19 vaccination, and personality traits [using 20-item mini international personality item pool (IPIP)]. Descriptive analysis followed by a Chi-square test and correlation test was applied. Results A total of 322 participants were contacted among which 300 participants (93%) responded which comprised 157 males (52.3%) and 143 females (47.7%). Dominant agreeableness personality shows a statistically significant positive correlation with individual perception (r=0.124, p=0.032) while a negative correlation with vaccine hesitancy (r= -0.146, p= 0.011). Among reasons for vaccine hesitancy, fear of side effects showed a significant association with personality traits (p= 0.018). Conclusion This study concluded that personality trait (dominant agreeableness) was an important factor in shaping individual perception and hesitancy towards COVID-19 vaccination.

Role of Digital Media in Promoting Oral Health: A Systematic Review.

Oral disease has affected almost half of the world's population, causing an enormous economic burden. To overcome this huge problem, oral health promotion is one of the most cost-effective methods. Digital media can play a pivotal role in achieving the goal of reducing this burden by providing a wider platform to reach out to the population even in the areas of deficit oral health care service. The aim of this systematic review is to assess the effectiveness of digital media in oral health promotion. The combinations of terms in the following two broad categories were used to search the literature on PubMed, Cochrane Library articles, WHO guidelines on oral health promotion through digital media, and Google Scholar: Intervention (digital media, Mobile phones, Text messages, social media, Cell phones, MHealth application, Telemedicine, Television, Videos) and Outcome (Oral Health education, Oral health, Oral health promotion, Oral health literacy, Oral health knowledge, Oral health attitude, Oral health practice, Oral hygiene improvement). The review was conducted in two phases, using the standardized checklist applicable to studies. Initially, abstracts were retrieved, followed by the assessment of the full papers against the review criteria. Among the selected studies, digital interventions helped in providing continuity of care and services in seven studies, eight addressed the increase in knowledge, attitude, and practice, and all the studies analyzed oral health needs. The findings concluded that digital media-based interventions can enhance oral health literacy and help in tackling this problem among different age groups.

Infodemiology for oral health and disease: A scoping review.

INTRODUCTION: Increasing affordability, accessibility and penetration of internet services worldwide, have substantially changed the ways of gathering health-related information. This has led to the origin of concept infodemiology that allows the information to be collected and analysed in near real time. Globally, oral diseases affect nearly 3.5 billion people; thus, volume and profile of oral health searches would help in understanding specific community dental needs and formulation of pertinent oral health strategies. AIM: To review the published literature on infodemiological aspects of oral health and disease. METHODOLOGY: This scoping review was conducted in accordance with PRISMA-ScR guidelines. Electronic search engines (Google Scholar) and databases (PubMed, Web of science, Scopus) were searched from 2002 onwards. RESULTS: Thirty-eight articles were included in this review. The infodemiological studies for oral health and disease were mainly used in two domains. Out of 38 articles, 24 accessed the quality of available online information and 15 studied online oral health-related information seeking behaviour. CONCLUSION: The most commonly searched oral diseases were toothache, oral cancer, dental caries, periodontal disease, oral maxillofacial surgical procedures and paediatric oral diseases. Most of the studies belonged to developed countries and Google was the most researched search engine.

Primary Health Care Workforce in Southeast Asia Region, Existing Status and Strategies for Non-Communicable Diseases and Oral Health Alliance: A Scoping Review.

Oral diseases and non-communicable diseases (NCD) share modifiable risk factors and common social determinants, thus creating new opportunities for improving oral health. The existing primary health care workers can play an integral role in NCD and oral health care integration by creating awareness, promoting oral health, controlling risk factors, and referring for timely dental care. This study aimed to identify and understand the roles of the existed human health resources working at primary health care and develop strategies to build on a unified NCD and oral health alliance human resources at this level. A scoping review was conducted to identify the primary health workforce in the Southeast Asia region, their roles and responsibility, and integration in oral health care. Various databases like NCBI (PubMed), Google Scholar, World Health Organisation (WHO)-Southeast Asia region (SEAR), Ministry of Health and Family Welfare websites in SEAR were comprehensively searched from January 1980 to December 2020 for reports, reviews, and original research. The keywords used were "primary health care workers," "community health care workers," "primary oral health care in SEAR," etc. Only full-text articles in English language and reports available in Ministry of Health and Family Welfare (MOHFW) sites of SEAR were included in the study. Information was taken from 39 full-text articles, six WHO reports, and two reports from Ministry of Health sites of SEAR. Primary health workers (PHW) are known by multiple names in different countries of Southeast Asia. They share various common roles and responsibilities. There are many opportunities for the prevention and control of oral diseases in the SEAR. Basic systems and human resources for the control of NCD are in place in many countries. Oral health can be integrated with NCD programs and policies to reduce the burden of diseases.

Development and Validation of a Comic Tool: An Innovative Approach to Raise Awareness about Tobacco Control among School Teachers.

Background: National legislation (COTPA) in India has focused on school children with dedicated section (6a and 6b) for tobacco control at Educational Institutions. Innovative mediums like Comic offer unique and engaging medium for dissemination of health information. However, its true potential remains unexplored in tobacco control. The study was conducted to develop and validate Comic for promotion of tobacco control laws in school settings. Materials and Methods: The present cross-sectional study was conducted among school teachers in Delhi in three phases: (1) need assessment, (2) development of Comic, and (3) validation (face/content validity by experts in public health/tobacco control, and construct validity by school teachers). Ethical clearance was obtained from Institutional Ethical Review Board. Prevalidated, structured, close-ended, and self-administered Questionnaire was used for the data collection. SPSS version 21 was used for descriptive and inferential results. Results: Phase 1 showed, out of 150 school teachers, 121 participated (80.66%). Mean age and teaching experience was 41.85 ± 9.76 years and 10.35 ± 6.53 years, respectively. Overall awareness about COTPA was 47.9% (n = 58) and COTPA sections 4 and 6 were 37.2% (n = 45). Majority 59.5% (n = 72) reported lack of access to training material. Phase 2 and 3 showed overall content validity index (CVI) score of 0.84. Construct validity evaluation from pre-postintervention yield mean ± SD scores of 3.94 ± 0.99 and 7.97 ± 1.17, respectively, (P < 0.001). Conclusion: Comic was developed on sound theoretical basis with satisfactory face, content and construct validity, to raise awareness about tobacco control among school children, and teachers to promote tobacco-free school.

Feasibility of the novel 'Tobacco-Free Hospital' model and its compliance assessment at a tertiary care hospital of New Delhi, India.

BACKGROUND: Tobacco is one of the biggest threats to the public health. Tobacco harms not only human health but also the environment. The Cigarette and Other Tobacco Products Act (COTPA) was implemented in India in 2003. Compliance of these laws in public places is mandatory. This study presents an innovative model to make hospitals tobacco-free. The aim is to assess the effectiveness of implementation of tobacco-free hospitals among security guards, tobacco users, and key observers visiting a tertiary care dental hospital through a comprehensive strategy. MATERIALS AND METHODS: An exploratory study was conducted in three phases. Structured training was organized for all security guards (n = 25) along with pre- and post-assessment using a validated questionnaire. All the patients and attendants entering the hospital were screened for tobacco products by security guards. Those patients who were carrying tobacco products to the hospital (n = 107) were interviewed using a validated questionnaire. Opinions of key observers (n = 223) who witnessed the event were also recorded. Descriptive statistics (means, frequency distribution) and inferential statistics (Chi-square test) were calculated. RESULTS: At the baseline, only 20% security guards were aware about tobacco legislations, whereas after 1 month, more than 80% security guards were aware about the laws. Around two-third of study participants of both the groups were aware of COTPA Section 4. Approximately 33.6% of tobacco users and 58.4% of key observers were aware of COTPA Section 6b. Forty tobacco users in the study availed tobacco cessation services of the hospital. CONCLUSION: Every staff should be a torch bearer of tobacco control. The study highlights a comprehensive approach of integrating hospital staff and linking vital cessation services by implementing Sections of COTPA.

Self-Perceived Halitosis and Related Factors Among the Mask-Wearing Population During the COVID-19 Pandemic in Delhi, India: A Cross-Sectional Study.

Introduction Halitosis (oral malodor) is a common health condition throughout the world. In India, data on self-reported halitosis and related factors is limited. Mouth mask usage has been made compulsory after the coronavirus disease 2019 (COVID-19) pandemic. This could possibly alter oral microflora and environment and contribute to halitosis. The aim of the study was to determine the prevalence of self-perceived halitosis (SPH) among mask-wearing patients visiting a tertiary care dental hospital in Delhi, India. Methods A cross­sectional study was conducted among a convenience sample of 300 patients visiting a tertiary care dental hospital in the capital of India. SPH status was measured using a self-designed and structured questionnaire containing socio-demographic factors, mask-related habits, and self-perceived oral health status. Statistical analysis was done using Jamovi software (The jamovi project, Sydney, Australia) version 1.8. Descriptive analysis followed by a chi-square test and a multivariate logistic regression test was applied. Results Bad breath was perceived by 86 study subjects. Of the participants, 16.7% felt that they had bad breath before the pandemic, and 38% of the participants had an increased perception or feeling of bad breath since regular mask usage. Of the participants, 42.7% felt that they had an increased feeling of dryness in the mouth post-pandemic. SPH status was associated with mask usage frequency (p<0.001), change (p<0.001) and type of mask (p=0.004), increased feeling of dryness (p<0.001), frequency of toothbrushing (p<0.001), self-reported oral disease (p=0.007), and dental treatment in the past 12 months (p=0.005). Conclusion The SPH status of the study population was associated with mask-related habits and self-reported oral health status. The findings highlight the importance of possible amendments in preventive and curative care for patients with halitosis post-COVID-19 pandemic.

Stakeholder perspectives on the integration of oral health into national health schemes: A mixed-method study research design in Delhi, India.

AIM AND OBJECTIVES: To assess the factors and perception of various stakeholders on the integration of oral health into the national health schemes using a mixed-method research design. MATERIALS AND METHOD: A mixed-method study was carried out in 2018 in two phases. In the first phase of the study, a pretested and prevalidated self-designed close-ended questionnaire was used to assess the knowledge, attitude, perception, barriers, myths, and feasibility of the integration of oral health in national health schemes. This questionnaire was administered to 96 stakeholders consisting of a medical officer (MO), accredited social health activists (ASHA), auxiliary nurse midwifery (ANM), and dental surgeon in nine Delhi Government dispensaries. The questionnaire consisted of 42 close-ended questions and four open-ended questions. The domains and themes were identified along with the challenges and opportunities of integration for focus group discussion (FGD) after analyzing the results of the first phase. The FGD consisted of seven members representing each of the above stakeholders along with one moderator and one recorder. RESULTS: 88.3% of the ASHA workers and 85.7% of the ANM accepted that oral screening should be incorporated in their routine practice. The major barrier to the incorporation of oral health in general health was the lack of training and insufficient provision of monetary incentives. Job burnout, work situation, inadequate pay, opportunities, workload, and limited carrier development were the demotivators, whereas respect, goodwill, and recognition from the general public were the inducers. CONCLUSION: There was a strong agreement for National Oral Health schemes to be given space and priority in India. The majority agreed that they can be used as a medium for imparting oral health education. The majority of the stakeholders believed that oral health should be a part of general health and they are open to any scheme or program which would add an oral health component.

Emotional Intelligence and Perceived Stress among Dental Undergraduates in Delhi.

BACKGROUND: Emotional intelligence (EI) is understanding one's own feeling and able to handle those feelings without disturbing themselves. Medical schools are stressful and the ability to manage stress is a major factor of success for these students. The current study contributes further insight to body of research in EI as it relates to students' stress in education, especially among dental undergraduates of Delhi. MATERIALS AND METHODS: A cross-sectional, convenient sampling-based survey was conducted among 323 dental undergraduates from all the 3 dental Institutions across Delhi. The Schutte Emotional Intelligence and Perceived Stress scale instruments were administered to all the students of four professional years. The data analysis was done using SPSS V.17 and various statistical tests were used to determine significant difference. RESULTS: No significant differences were found among gender as well as among professional groups for EI. There was a significant difference (0.008) among gender with respect to perceived stress. Correlation analysis showed an inverse relationship between EI and PS (r = -0.227) which was found to be statistically significant. CONCLUSION: Training in dental education could be quite stressful due to their time-bound work, but regular student performance assessment and associated factors would allow understanding student behavior in handling situations. HOW TO CITE THIS ARTICLE: Yadav V, Mohanty V, Balappanavar AY, et al. Emotional Intelligence and Perceived Stress among Dental Undergraduates in Delhi. Int J Clin Pediatr Dent 2020;13(4):344-347.

Cross-cultural Adaptation and Validation of Hindi Version of Child Oral Impacts on Daily Performance Index.

INTRODUCTION: Oral diseases may have an impact on quality of life (QoL) and the oral health-related quality of life (OHRQoL). As compared to clinical measures which are unable to provide a complete picture, OHRQoL indices quantify the oral health impact on overall health. Worldwide indices have been developed to measure the OHRQoL in children but none can be applicable in Indian context. AIM: The aim of the study was cross-cultural adaptation and psychometric analysis of Hindi version of child oral impacts on daily performance (C-OIDP) index. MATERIALS AND METHODS: Translation and back translation were done for index using prescribed guidelines for cross-cultural adaptation. A pilot study was conducted in 32 children and required modifications were done. The final Hindi version was tested for reliability and validity on a convenience sample of 64 children aged 11-14 years selected from public schools in Delhi. The psychometric properties of the Hindi version were tested for face, content, construct validity along with internal consistency, and test-retest reliability. RESULTS: The mean age of the final sample (n = 64) was 13.02 ± 0.93 years with boys (51.6%) and girls (48.4%). The mean C-OIDP score was 8.8 ± 7.8. Significant association was obtained when C-OIDP was compared with self-perceived oral health. Interitem correlation ranged from -0.008 to 0.45. Kappa for categories of child OIDP ranged from 0.711 to 1.00 and intraclass correlation coefficient was 0.91. CONCLUSION: The Hindi version of C-OIDP is a valid and reliable tool to measure OHRQoL in Hindi-speaking children in India. HOW TO CITE THIS ARTICLE: Chahar P, Mohanty V, Balappanavar AY, et al. Cross-cultural Adaptation and Validation of Hindi Version of Child Oral Impacts on Daily Performance Index. Int J Clin Pediatr Dent 2020;13(2):124-129.

Bacterial contamination of packaged smokeless tobacco sold in India.

INTRODUCTION: About 21.4% of India's population uses smokeless tobacco products (SLT), yet limited data are available on their microbial contamination. To understand the potential microbiological risks associated with SLT use, the present study aims to investigate bacterial contamination of tobacco and the types of microbes that could be cultured from SLT products. METHODS: Twenty-two brands of SLT products, including paan masala, khaini, gutka and tobacco-containing dentifrices were examined and cultured by using appropriate selective and differential media including MacConkey agar and CLED agar. This was followed by a sequence of further identification by biochemical tests. RESULTS: All 22 types of SLT products showed growth of aerobic bacteria. The most common bacteria isolated were Pseudomonas aeruginosa followed by Streptococcus faecalis. Other bacteria that were isolated from products, in traces, included Klebsiella spp., E. coli, and Bacillus subtilus. CONCLUSIONS: This study raises and addresses the issue of bacterial contamination of packaged SLT products. SLT users might be subjected to a significant health hazard, especially those who are immunocompromised.

Effectiveness of different parenting interventions on oral hygiene of cerebral palsy children: A randomized controlled trial.

AIM: To assess the effectiveness of different parenting interventions for improving oral hygiene of cerebral palsy (CP) children aged 4-12 years. METHODOLOGY AND RESULTS: A randomized controlled trial was done among 60 CP children and parents visiting a tertiary care center in New Delhi. The study population was randomly assigned to experimental or control group (30 in each group). Parents/caregivers in the experimental group (Group 1) received video-based dental health education (DHE) and the control group (Group 2) received conventional DHE. Each group also received two telephonic reinforcements at fourth and eighth week after the first intervention at baseline. The groups were assessed for sociodemographic, familial factors, medical history, oral hygiene practices, and oral hygiene status. At 3-month follow-up, the mean reduction in simplified oral hygiene index (OHI-S), plaque index (PI), and gingival index (GI) scores was 0.27, 0.17, and 0.09, respectively, in Group 1 (P-value < .05). The mean reductions seen in Group 2 were 0.03 in OHI-S, 0.14 in PI, and 0.04 in GI index (P-value < .05, except for GI score: P-value = .6). CONCLUSION: Video-based DHE is effective and brings about significant improvement in oral hygiene status and oral health among CP children.

Effectiveness of dental health education on oral hygiene among hearing impaired adolescents in India: A randomized control trial.

AIM: To assess the effectiveness of two different methods of dental health education (DHE) for improving oral hygiene among hearing impaired adolescents in school aged 11-20 years. METHODOLOGY AND RESULTS: A randomized double blind controlled parallel time series trial was done among 178 hearing impaired adolescents. Considering existing literature, the required sample size was found to be 82 per group, at 95% confidence interval, design effect = 1, type I error = 5%, power of study = 80%, and 20% attrition rate. Two out of five schools were randomly selected. Different methods of DHE were used, schools were coded as School A (DHE using sign language by the investigator) and School B (DHE by conventional visual method, using only posters). The mean reduction in Simplified Oral Hygiene Index (OHI-S), Plaque Index (PI), and Gingival Index (GI) scores was 1.13 ± 0.81, 0.66 ± 0.31, and 0.58 ± 0.32, respectively, in school A. The mean reductions seen in school B was 0.52 ± 0.89 in OHI-S, 0.44 ± 0.44 in PI, and 0.34 ± 0.32 in GI index (P-value < 0.05). CONCLUSION: Basic training of dental professionals in sign language is both effective and feasible, and brings about greater improvement in oral hygiene status and gingival health as compared to the conventional methods of health education.

Compliance Assessment of Cigarette and Other Tobacco Products Act in Public Places in Delhi Government Hospitals

Objective: Tobacco-free policies in hospital campus reduce exposure to tobacco smoke; change the demeanour of the professionals, patients and people visiting hospitals towards tobacco use. Section-4, 5 and 6 of COTPA (Cigarettes and Other Tobacco Products Act) necessitates the need for implementation of the prohibition on smoking in public places. Against this background, the present work was designed to evaluate the status of compliance Section 4, 5 and 6 of COTPA in Delhi Government hospitals Methods: A cross-sectional observational study was conducted within Government hospitals. Multistage random sampling was used to select 18 hospitals out of 39 hospitals from 5 zones. Standard assessment Proforma developed by John Hopkins School of Public Health for assessing compliance to Tobacco-Free Law was used and modified to address certain aspects of Section-4, 5 and 6 of COTPA. Hospital campuses were assessed by dividing them into zones like hospital buildings, office buildings, public places outside the hospital and residential areas. Result: Signs of active tobacco use observed in 40.6% of hospital buildings, 35.3% in office buildings, and 75.4% in public places outside the buildings. 'No smoking signage was not as per the COTPA guidelines in 21.4% of the hospitals and 72% were not tobacco free outdoors in these positions. Conclusion: The study highlighted a lower compliance rate than expected which raises questions on law enforcement concerning tobacco. Hence necessary measures have to be used up for sustained awareness campaigns, backed by enforcement drives. Periodic compliance surveys will strengthen the implementation of tobacco free legislation in health care institutions.

Hookah products and online retail marketing strategies in India: A content analysis.

INTRODUCTION: Hookah smoking is becoming increasingly popular among the youth. Evidence shows that exposure to marketing of the unhealthy products through social media platforms may impact adolescent health behaviors. The aim of the study was to perform a content analysis of online portals selling hookah products. MATERIALS AND METHODS: A content analysis of online retail market was conducted on Google India using three keywords hookah, hookah products, and shisha. Retail websites popular in India that were selling hookah products were randomly selected and explored. A total of 15 themes were developed and used to describe various promotional strategies for hookah products. RESULTS: In all, 41 (19.2%) products claimed to be tobacco/nicotine-free and only 14 products (6.5%) displayed age/health-specific warnings. About 86% of products were available at discounted rates; glamorizing words for describing products in form of superior, premium, and legendary were found on 189 (88.3%) products. Phrases such as "ultimate way to celebrate," "perfect excuse to chill with your friends," and "now enjoy the world of smoking without any doubt of harm" are commonly used to promote hookah products. CONCLUSION: Easy availability of newer forms of smoking at online markets could play a role in promoting the use of hookah among the youth. Most products are being sold without any warnings and there is no means to control the selling of the products to minors. There is a need to raise the issue of hookah products in the same tune as done for other forms of tobacco.

Compliance with Tobacco Promotion and Sale Laws in School Neighbourhoods in India

Objective: Regulation of sale of tobacco has given sufficient attention in India and little information exists about the impact of bans near schools. Our study aim was to check the levels of tobacco promotion, advertising and sales in school neighborhoods' of Central Delhi. Methods: Using multistage random sampling 15 schools were selected in Central Delhi. Areas 100 meters around each were mapped using a map tool and screened using a self designed questionnaire consisting of 26 questions, both closed and open ended, to determine the details of outlets, sales of tobacco and tobacco products, advertising, promotions, school roles, and children seeking tobacco. The data were subjected to statistical analysis. Results: The response rate was 65%. Outlet licenses were present in only 6 (3.47%). The point sale of tobacco was most frequently in tea stalls and a total of 173 (41.2%) outlets had some form of tobacco sale. The brands of smokeless tobacco sold more were shikar (50%) and classic citrus (30%). Advertisement or promotion of sales was mainly in the form of signs and displays (53%). Major schools did not have any no tobacco boards displayed. Conclusion: Sale of tobacco continues in central Delhi with a lack of compliance with the rules of COPTA. The implications of this non compliance in the Capital region is of major significance for the rest of the country.

Electronic Nicotine Delivery Systems (ENDS): Mapping the Indian Online Retail Market.

INTRODUCTION: Motivating tobacco consumers to change their behavior, and harm reduction strategies, are the predominant traditional approaches to tobacco cessation. Recent trends worldwide have shown the emergence of Electronic Nicotine Delivery Systems (ENDS), such as electronic cigarettes (e-cigarettes), as a purported harm reduction strategy to traditional cigarettes. Considering the global rise in the popularity of ENDS, our study aims to survey the online retail market for ENDS in India. METHODS: The current study was conducted in September-October, 2015 and 4 keywords were used to search Google India to identify online retail websites marketing ENDS. Each website was searched using the same keywords and all specific website pages displaying ENDS models were considered. Thus, data was obtained for various measures of ENDS present on the model descriptions. RESULTS: A total of 6 retail shopping websites were searched which revealed 65 different models of ENDS (34 brands). Forty-five models (69%) were flavored and 21 models (33%) mentioned about nicotine strengths. Seventeen models (26%) provided health warnings in their product descriptions. "No tar no tobacco" was most common claim accounting to 34 models (51%). CONCLUSIONS: This article provide insight into the current status of evident online sales of ENDS in India. There is urgent need to implement regulations on online sales of these products and protect the future from such approaches of tobacco control which still have divided opinions. IMPLICATIONS: The study permits the use of web search engine to explore market availability of ENDS at various online retail websites. Recommendations from the study can be used to guide policy makers in developing strategies tailored to regulate availability and online sales of ENDS in India.

Morphometric analysis of pulp size in maxillary permanent central incisors correlated with age: An indirect digital study.

CONTEXT: Teeth are hardest part of the body and are least affected by the taphonomic process. They are considered as one of the reliable methods of identification of a person in forensic sciences. AIM: The aim of the following study is to establish morphometeric measurements by AutoCad 2009 (Autodesk, Inc) of permanent maxillary central incisors in different age groups of Udaipur population. SETTING AND DESIGN: Hospital-based descriptive cross-sectional study carried out in Udaipur. MATERIALS AND METHODS: A study was carried out on 308 subjects of both genders with the age range of 9-68 years. Standardized intra-oral radiographs were made by paralleling technique and processed. The radiographs were scanned and the obtained images were standardized to the actual size of radiographic film. This was followed by measuring them using software AutoCad 2009. STATISTICAL ANALYSIS USED: F-test, post-hoc test, Pearson's correlation test. RESULTS: For left maxillary central incisor, the total pulp area was found to be of 38.41 ± 12.88 mm and 14.32 ± 7.04 mm respectively. For right maxillary central incisor, the total pulp size was 38.39 ± 14.95 mm and 12.35 ± 5 mm respectively. Males (32.50, 32.87 mm(2)) had more pulp area when compared with females (28.82, 30.05 mm(2)). CONCLUSION: There was a decrease in total pulp area with increasing age which may be attributed to secondary dentin formation.