Long-Term Trends in the Utilization of Cone Beam Computed Tomography in Oral and Maxillofacial Radiology.

Background: Cone beam computed tomography (CBCT) has become a cornerstone in oral and maxillofacial radiology due to its high-resolution, three-dimensional imaging capabilities and lower radiation exposure compared to traditional computed tomography (CT). The purpose of this retrospective study is to examine long-term patterns in the use of CBCT in a tertiary care context, with an emphasis on patient characteristics, CBCT indications, and variations in use patterns over time. Methods: During the course of 5 years, a tertiary care facility performed 500 CBCT scans, all of which were included in the study. Information on the age, sex, and source of referral for each patient was gathered from their electronic medical records. Radiology data were used to categorize CBCT indications, which included implant planning, impacted tooth assessment, and pathology evaluation. Regression analysis and descriptive statistics were used to examine utilization trends. Results: Throughout the study period, there was a consistent rise in the use of CBCT, with implant planning being the most often cited indication. Impacted tooth assessment and pathology evaluation were next in line. Considerable differences were noted in the use of CBCT for various age groups and indications. The results demonstrate how CBCT is improving oral and maxillofacial radiology's diagnostic precision and treatment planning. In summary, this study offers a significant understanding of the long-term patterns in CBCT use in a tertiary care context. With ramifications for resource allocation, patient care, and future research objectives, the observed trends highlight the increasing acceptability and incorporation of CBCT into standard clinical practice.

Analysis of Psychological Distress and Dental Anxiety in Patients Attending Dental Care During the COVID-19 Pandemic.

Background: The COVID-19 epidemic has affected all facets of patient care, including dentistry services, and placed hitherto unheard-of demands on healthcare systems throughout the world. More and more emphasis is being paid to psychological discomfort and dental anxiety that epidemic patients face when seeking dental care. The purpose of this research was to examine the psychological distress and dental anxiety levels of patients receiving dental care during the COVID-19 pandemic in a tertiary care setting between 2021 and 2022. Methods: For this study, 300 patients with regular dental checkups were selected as a convenience sample. Self-report questionnaires measuring dental anxiety and psychological discomfort were filled out by participants. Descriptive and inferential statistics were used to analyze the data once demographic information was gathered. Findings: The majority of participants experienced psychological anguish (66.7%) and dental anxiety (73.3%) at moderate-to-severe levels. When compared to pre-pandemic values, there was a substantial increase in psychological distress (P < 0.001) and dental anxiety (P < 0.001) throughout the pandemic period. Conclusion: Current research shows how the COVID-19 pandemic significantly affected the mental health of patients receiving dental care, underscoring the need of catering to patients' mental health needs in dental practices during public health emergencies.

Analysis of the Impact of Sleep Apnea on Cardiovascular Health and Mortality: A Long-Term Cohort Study.

Background: A common sleep problem linked to poor cardiovascular outcomes and death is "sleep apnea (SL)." Nevertheless, little is known about how SL affects cardiovascular health in the long run. The purpose of this research was to investigate the relationship between a tertiary care center's long-term cohort's cardiovascular morbidity and mortality and the severity of their SL. Methods: Between January 1, 2010, and December 31, 2020, 500 individuals at a tertiary care facility who had been diagnosed with SL participated in this retrospective cohort research. Electronic medical records were used to collect patient data, which were then examined for cardiovascular outcomes, treatment methods, comorbidities, sleep research findings, and demographics. Heart failure, myocardial infarction, stroke, and cardiovascular-related mortality were among the cardiovascular events that were noted throughout the follow-up period, and the severity of SL was classified using the "apnea-hypopnea index." Findings: Of the 500 patients in the cohort, 60% were men and the mean age was 55.7 years. Fifty percent of people had one or more cardiovascular risk factors, including diabetes, high blood pressure, and smoking. During the course of the follow-up, 100 cardiovascular-related fatalities were reported, and 40% of patients had at least one cardiovascular event. The severity of SL was shown to be positively correlated with the occurrence of cardiovascular events (16.7% in mild, 25% in moderate, and 40% in severe SL, P < 0.05). Conclusion: In a cohort of patients receiving tertiary care, this research shows a substantial correlation between the severity of SL and cardiovascular morbidity and death. It is crucial to identify and treat SL early on to reduce cardiovascular risks and enhance patient outcomes. To further understand the underlying processes and develop treatment approaches for people with cardiovascular comorbidities and SL, more research is necessary.

Retrospective Analysis of Treatment Outcomes and Survival Rates in Oral Squamous Cell Carcinoma Patients.

Background: Because of its high rates of morbidity and death, oral squamous cell carcinoma (OSCC) poses a serious threat to world health. To maximize patient care and direct clinical decision-making, it is important to comprehend treatment results and survival rates. Methods: Treatment results and survival rates for OSCC patients treated at a tertiary care facility between 2010 and 2022 were assessed in this retrospective research. Demographic data, tumor features, treatment options, and follow-up results were all included in the data. The relationships between treatment methods and survival rates were evaluated by statistical analysis. Results: There were 107 OSCC patients in all. Compared to radiation and chemotherapy, surgery had reduced recurrence rates and greater overall survival rates as the most common treatment option. There were notable variations in survival rates across the various treatment regimens (P < 0.05). Conclusion: Surgery is the mainstay. Adjuvant treatments, however, are complementary in the management of illness. The significance of customized treatment strategies based on unique patient attributes and tumor features is highlighted by this study in order to maximize results for patients with OSCC. To confirm these results and investigate cutting-edge treatment approaches, more investigation is necessary.

Assessment of Temporomandibular Joint Disorders: Retrospective Study of Clinical Presentations.

Objective: This retrospective research aimed to assess the clinical presentations and management strategies for "temporomandibular joint (TMJ)" disorders. Methods: Medical records of patients diagnosed with TMJ disorders between 2017 and 2022 were retrospectively analyzed. Data collected included demographic information, clinical symptoms, radiographic findings, treatment modalities, and treatment outcomes. Statistical analysis was performed to examine associations between variables and treatment outcomes. Results: A total of 150 patients were included in the research, with a mean age of 42.5 years. The most common presenting symptoms were pain (80.0%), limited mouth opening (60.0%), and clicking/popping sounds (40.0%). Muscle tenderness (53.3%) and jaw deviation (20.0%) were also observed. Treatment modalities encompassed pharmacotherapy, physical therapy, occlusal splints, and surgical interventions. Statistical analysis revealed significant associations between certain demographic characteristics and clinical presentations. Conclusion: This research provides valuable insights into the clinical presentations and management strategies for TMJ disorders. Pain, limited mouth opening, clicking/popping sounds, muscle tenderness, and jaw deviation were among the common symptoms observed. A multi-disciplinary approach involving various healthcare professionals is essential to optimize patient outcomes and improve quality of life for individuals affected by TMJ disorders.

Comparison of Surgical Techniques for Correction of Mandibular Asymmetry in TMJ Ankylosis Patients.

Background: Temporomandibular joint (TMJ) ankylosis frequently results in mandibular asymmetry, which impairs an affected person's ability to function and look good. Because of the intricacy of TMJ ankylosis and the variety of surgical procedures available, correcting mandibular asymmetry surgically can be difficult. Methods: Patients with mandibular asymmetry and TMJ ankylosis who had surgery at a tertiary care facility between certain periods were the subject of a retrospective investigation. Medical records were used to gather information on patient demographics, pre-operative imaging, surgical methods, and post-operative results. Surgical methods included condylectomy with or without reconstruction, joint reconstruction with or without orthognathic surgery, and unilateral or bilateral mandibular distraction osteogenesis (MDO). Occlusion, patient-reported results, and facial symmetry made up the evaluation criteria. Findings: The study had a total of 50 patients, with different surgical method distributions. Comparing unilateral and bilateral MDO to condylectomy and joint reconstruction, notable gains in face symmetry and occlusion were seen. The largest complication rate was seen with condylectomy, mostly from recurrence and device-related issues, albeit the rates of other procedures varied as well. Conclusion: In conclusion, customized treatment planning is necessary for the correction of mandibular asymmetry in individuals with TMJ ankylosis. Although mandibular distraction osteogenesis produces better results for occlusion and facial symmetry, it is crucial to carefully weigh the risks involved. While still feasible treatments, condylectomy and joint reconstruction require strict monitoring for any consequences. In order to enhance patient care in this difficult patient group, future research should concentrate on improving treatment procedures and long-term results.

Performance-based protocol for selection of economical portable sensor for air quality measurement.

An effective micro-level air quality management plan requires high-resolution monitoring of pollutants. India has already developed a vast network of air quality monitoring stations, both manual and real time, located primarily in urban areas, including megacities. The air quality monitoring network consists of conventional manual stations and real time Continuous Ambient Air Quality Monitoring Stations (CAAQMS) which comprise state-of-the-art analysers and instruments. India is currently in the early stages of developing and adopting economical portable sensor (EPS) in air quality monitoring systems. Protocols need to be established for field calibration and testing. The present research work is an attempt to develop a performance-based assessment framework for the selection of EPS for air quality monitoring. The two-stage selection protocol includes a review of the factory calibration data and a comparison of EPS data with a reference monitor, i.e. a portable calibrated monitor and a CAAQMS. Methods deployed include calculation of central tendency, dispersion around a central value, calculation of statistical parameters for data comparison, and plotting pollution rose and diurnal profile (peak and non-peak pollution measurement). Four commercially available EPS were tested blind, out of which, data from EPS 2 (S2) and EPS 3 (S3) were closer to reference stations at both locations. The selection was made by evaluating monitoring results, physical features, measurement range, and frequency along with examining capital cost. This proposed approach can be used to increase the usability of EPS in the development of micro-level air quality management strategies, other than regulatory compliance. For regulatory compliance, additional research is needed, including field calibration and evaluating EPS performance through additional variables. This proposed framework may be used as starting point, for such experiments, in order to develop confidence in the use of EPS.

Three-dimensional printing in the field of oral and maxillofacial surgery.

Advanced imaging techniques and modalities coupled with computer-assisted surgical planning and simulation has been in use in the field of medicine. However, it is worth noting that it is now being frequently used for the evaluation and exploration of the craniofacial structures. It had gained ingress in the planning as well as forecasting of the surgical outcomes of oral and maxillofacial surgical interventions. Numerous surgical guides and devices which are tailor-made can be fabricated using three-dimensional (3D) printing technology. The article is intended to put forth an overview of 3D printing technology and its applications in the field of oral and maxillofacial surgery.

Role of general anesthetic agents in postoperative nausea and vomiting: A review of literature.

Postoperative nausea and vomiting (PONV) is considered to be the most unpleasant experience associated with surgery and is believed to be one of the most common reasons for poor patient satisfaction in the postoperative period. It also results in prolonged hospitalization and increased use of resources such as intravenous fluids and drug supplements along with prolonged medical attention, all of which have psychological and financial implications. In addition to this, PONV can result in aspiration, laryngospasm, dehydration, electrolyte disturbances, gastric bleeding, increased intracranial pressure, increased intraocular pressure, and wound dehiscence particularly when the surgical intervention is performed through an intraoral approach. It is a well-known fact that there are many etiological factors as well as predisposing factors for PONV. Hence, this review is intended to evaluate as an individual factor what the role was played by the anesthetic agents used for GA in the incidence of PONV.

Quantitative assessment and mitigation measures of air pollution from crematoria in NCT of Delhi.

The modernization of crematoria and replacement of existing fuel requirements for better air quality is a key challenge in view of the associated religious beliefs in India where conventional open pyre funeral practices are followed. Unlike developed nations, the lack of appropriate site selection criteria, combustion efficient crematorium oven designs, and pollution control devices at these facilities necessitates formulation of appropriate policy measures to reduce emissions. The existing practices do not address such localized sources that affects the micro air pollution patterns owing to their marginal contribution in the total air pollution load of the city. The present study is thus an attempt to estimate emissions from 51 cremation grounds identified in NCT of Delhi. The study considers both particulate and gaseous pollutants which are released due to burning of fuels like wood, CNG, and cow dung. It is estimated that cremation activities contributed 393 tons/year of PM2.5, 142 tons/year of NOx, 29 tons/year of SO2, and 2686 tons/year of CO in year 2019. The maximum load was emitted from Central district as only Nigambodh Ghat crematoria receives on an average 60 bodies per day. Furthermore, air quality impact zone around crematoria has been demarcated using dispersion modelling considering crematorium with minimum and maximum number of bodies burnt in a day. The study also suggests control measures for reduction of pollution from cremation activities and delineates a buffer zone that could aid policymakers in establishing a site selection criterion to prevent the immediate population from likely exposure.

Identification of air pollution hotspots in urban areas - An innovative approach using monitored concentrations data.

Critical assessment of spatio-temporal variations in pollution levels is a crucial step for identifying and prioritizing air pollution hotspots (APH) in urban areas. There is no universally accepted methodology for defining and delineating air pollution hotspot which can be source-specific, pollutant-specific and time-specific. The present research article is an attempt to develop a protocol for identifying APH for any pollutant within a city where-in three criteria-based innovative methodology has been derived. The three criteria are frequency of exceedance (% of days), scale of exceedance and consistency in exceedance (consecutive number of days) to the specified standards that need to be met continuously for at least three years. The suggested methodology has been applied on a three-year database (2018-2021) of 37 continuous ambient air quality stations to identify PM2.5 specific APH. The analysis indicates 11 APH in April, 9 in May, 2 in June and almost the entire city during the October-February months. Given prioritization of implementation of control actions, the identified APH during summer has been further physically examined to map source activity types and their suitability for ambient air quality monitoring stations as per the guidelines. The APH can be the priority areas for the implementation of control actions by urban local bodies. The management of air pollution at these priority areas would be more effective instead of city-scale management practice, which is difficult to implement and monitor.

Understanding COVID-19 transmission, health impacts and mitigation: timely social distancing is the key.

COVID-19 is a highly infectious disease caused by SARS-CoV-2, first identified in China and spread globally, resulting into pandemic. Transmission of virus takes place either directly through close contact with infected individual (symptomatic/asymptomatic) or indirectly by touching contaminated surfaces. Virus survives on the surfaces from few hours to days. It enters the human body through nose, eyes or mouth. Other sources of contamination are faeces, blood, food, water, semen etc. Parameters such as temperature/relative humidity also play an important role in transmission. As the disease is evolving, so are the number of cases. Proper planning and restriction are helping in influencing the trajectory of the transmission. Various measures are undertaken to prevent infection such as maintaining hygiene, using facemasks, isolation/quarantine, social/physical distancing, in extreme cases lockdown (restricted movement except essential services) in hot spot areas or throughout the country. Countries that introduced various mitigation measures had experienced control in transmission of COVID-19. Python programming is conducted for change point analysis (CPA) using Bayesian probability approach for understanding the impact of restrictions and mitigation methods in terms of either increase or stagnation in number of COVID-19 cases for eight countries. From analysis it is concluded that countries which acted late in bringing in the social distancing measures are suffering in terms of high number of cases with USA, leading among eight countries analysed. The CPA week in comparison with date of lockdown and first reported case strongly correlates (Pearson's r = - 0.86 to - 0.97) to cases, cases per unit area and cases per unit population, indicating earlier the mitigation strategy, lesser the number of cases. The overall paper will help the decision makers in understanding the possible steps for mitigation, more so in developing countries where the fight against COVID-19 seems to have just begun.

Corona virus disease bring a new challenge for the dentistry: A review.

An outbreak of coronavirus disease 2019 (COVID-19) caused by the 2019 novel coronavirus (SARS-CoV-2) began in the city of Wuhan in China and has widely spread worldwide. While human strains of coronavirus (CoV) are associated with about 15% of cases of the common cold, the SARS-CoV-2 may present with varying degrees of severity, from flu-like symptoms to death. It is currently believed that this deadly CoV strain originated from wild animals at the Huanan market in Wuhan, a city in Hubei province. Bats, snakes, and pangolins have been cited as potential carriers based on the sequence homology of CoV isolated from these animals and the viral nucleic acids of the virus isolated from SARS-CoV-2 infected patients. Common clinical signs of the infection comprises of respiratory symptoms in the form of fever, cough, shortness of breath, and breathing difficulties. In more severe cases, infection results in pneumonia, severe acute respiratory syndrome, kidney failure, and even death. Standard recommendations advocated to prevent spread of infection consist of frequent hand washing, covering mouth and nose when coughing and sneezing. This article, based on our experience and relevant guidelines and research, introduces essential knowledge about CoV in dental settings and provides recommended management protocols for dental practitioners affected areas.

Assessment of the effectiveness of policy interventions for Air Quality Control Regions in Delhi city.

Government has implemented various scattered and un-quantified control actions in Delhi city to reduce the air pollution levels; however, it still exceeds the National Ambient Air Quality Standards (NAAQS). The present study has been designed to assess the air quality status, identify Air Quality Control Region (AQCR), and evaluate control strategies in the city. Out of eight selected locations, ambient PM10, PM2.5, and NO2 concentrations were found exceeding the daily as well as annual standards at selected AQCR with peak levels during post-monsoon than winter and summer. Anand Vihar was found to be most polluted and thus, selected as an AQCR. AERMOD performed satisfactorily in predicting pollutant concentration during winter and summer having an index of agreement in the range 0.54-0.80. PM10 and PM2.5 can be reduced substantially by increasing frequency of efficient mechanized cleaning of roads and sprinkling of water on the roads. Progressive decrease in NO2 concentrations can be achieved by restricting entry of truck in the study area through alternate path. The cumulative impact of all selected control strategies indicates a substantial decrease in air pollution within AQCR. The study also suggests a policy framework to manage the urban air quality through local scale air quality guidelines.

Urban local air quality management framework for non-attainment areas in Indian cities.

Increasing urban air pollution level in Indian cities is one of the major concerns for policy makers due to its impact on public health. The growth in population and increase in associated motorised road transport demand is one of the major causes of increasing air pollution in most urban areas along with other sources e.g., road dust, construction dust, biomass burning etc. The present study documents the development of an urban local air quality management (ULAQM) framework at urban hotspots (non-attainment area) and a pathway for the flow of information from goal setting to policy making. The ULAQM also includes assessment and management of air pollution episodic conditions at these hotspots, which currently available city/regional-scale air quality management plans do not address. The prediction of extreme pollutant concentrations using a hybrid model differentiates the ULAQM from other existing air quality management plans. The developed ULAQM framework has been applied and validated at one of the busiest traffic intersections in Delhi and Chennai cities. Various scenarios have been tested targeting the effective reductions in elevated levels of NOx and PM2.5 concentrations. The results indicate that a developed ULAQM framework is capable of providing an evidence-based graded action to reduce ambient pollution levels within the specified standard level at pre-identified locations. The ULAQM framework methodology is generalised and therefore can be applied to other non-attainment areas of the country.

The influence of odd-even car trial on fine and coarse particles in Delhi.

The odd-even car trial scheme, which reduced car traffic between 08.00 and 20.00 h daily, was applied from 1 to 15 January 2016 (winter scheme, WS) and 15-30 April 2016 (summer scheme, SS). The daily average PM2.5 and PM10 exceeded national standards, with highest concentrations (313 µg m-3 and 639 µg m-3, respectively) during winter and lowest (53 µg m-3 and 130 µg m-3) during the monsoon (June-August). PM concentrations during the trials can be interpreted either as reduced or increased, depending on the periods used for comparison purposes. For example, hourly average net PM2.5 and PM10 (after subtracting the baseline concentrations) reduced by up to 74% during the majority (after 1100 h) of trial hours compared with the corresponding hours during the previous year. Conversely, daily average PM2.5 and PM10 were higher by up to 3-times during the trial periods when compared with the pre-trial days. A careful analysis of the data shows that the trials generated cleaner air for certain hours of the day but the persistence of overnight emissions from heavy goods vehicles into the morning odd-even hours (0800-1100 h) made them probably ineffective at this time. Any further trial will need to be planned very carefully if an effect due to traffic alone is to be differentiated from the larger effect caused by changes in meteorology and especially wind direction.