To Assess the Serum and Salivary Biomarkers in People with and Without Diabetes.

The study was conducted to assess the serum and salivary biomarkers in people with and without diabetes. Among the 100 participants in this cross-sectional comparative study, 59 men and 61 women aged 32 to 59 years old were randomly assigned to category I (consisting of 50 diabetes mellitus (DM) patients of both types 1 and 2) or category II (consisting of 50 healthy volunteers) to serve as comparisons. Since there is no difference in the amounts of salivary biomarkers across the various types of diabetes, they are all grouped together. Several biochemical indicators were measured by measuring the amounts in the participants' saliva and serum samples. There was little to no difference between the two categories when comparing saliva and serum levels. Although there was a strong correlation between serum and salivary glucose, amylase, total proteins, albumin, and globulin levels in DM patients, there was also a strong correlation between diabetics and non-diabetics for these same markers.

To Evaluate the Correlation between the ABO Blood Group, Lip, and Fingerprint Pattern.

This research set out to see whether there was a connection between the ABO blood type and the unique patterns found on people's lips and fingerprints.As many as a hundred people were surveyed for this study. Red lip gloss, cellophane tape, white A3 paper, a stamp pad with blue ink, and a magnifying glass were also used.O+ blood type, a full vertical lip print, and a loopy fingerprint pattern were the most common types of individuals.Lip patterns, fingerprints, and blood types are just a few of the personally identifiable characteristics that have been shown to be useful in forensic identification. We found no evidence of a link between these three variables in our analysis.

A Comparative Study on the Shaping Ability and Cleaning Efficiency of Two Different Single-File Systems, Reciprocating Wave One Versus Continuous Rotation F360, Evaluated by Scanning Electron Microscope: An In Vitro Study.

Background: In endodontics, the three processes of biomechanical preparation, disinfection, and obturation are each essential. The electron microprobe and scanning electron microscope (SEM) allowed for the detection and identification of the smear layer and debris. The purpose of the current investigation was to use a scanning electron microscope to evaluate the relative merits of two single-file systems, the reciprocating WaveOne and the continuous motion F360 files, in the cleaning and contouring of root canals in removed teeth. Materials and method: The 50 central maxillary permanent teeth Data was gathered from the Oral and Maxillofacial Surgery Division at Sri Ganganagar's Maharaja Ganga Singh Dental College and Research Centre for a number of reasons. Group A followed the manufacturer's guidelines for using the WaveOne instrument, whereas Group B utilised the F360. Reciprocating motion WaveOne system (group A) and continuous motion F360 system (group B) root canals were scored at three levels: coronal third, middle third, and apical third (group B). SPSS version 22 was used for the data analysis. The data were examined using the chi-square test and the one-way analysis of variance. Results: A greater quantity of smear layer was found in the apical third, whereas better results were achieved in the coronal and middle thirds. When compared to the F360 file system, the WaveOne file system is subpar when it comes to clearing the canal of debris. While both groups showed a large amount of debris in the apical third, outcomes were somewhat better in the coronal and middle thirds. Conclusion: The WaveOne and F360 file systems were both more effective in removing trash from the coronal and middle thirds of the disc than they were from the apical thirds. In comparison to the continuous motion F360 file system, WaveOne files demonstrated a statistically significant reduction in the amount of debris cleared from root canals in all three root zone thirds (coronal, middle, and apical). The reciprocating action of the WaveOne file system, in contrast to the continuous motion of the F360 file system, resulted in more extensive cleaning of the root canal smear layer in the coronal and middle thirds and less thorough cleaning in the apical thirds of the canal.

Prevalence and Distribution of Developmental Defects of Enamel in Children Aged 12-15 Years in Fazilka District, Punjab, India, and Their Correlation With Drinking Water Fluoride Level.

BACKGROUND AND OBJECTIVES: Dental fluorosis is a developmental disturbance of dental enamels, caused by successive exposures to high concentrations of fluoride during odontogenesis, leading to enamels with lower mineral content and increased porosity. The objective of the present study was to assess the prevalence and severity of developmental defects and their relationship to fluoride levels in drinking water.  Methods: Ten villages were selected from Fazilka district, Punjab, India. A total of 1000 (519 males, 481 females) school children aged 12-15 years formed the study population. Eutech ION 2700 (Thermo Fisher Scientific, Waltham, Massachusetts, United States) was used for the estimation of fluoride levels in water. Developmental defects were screened and assessed using the modified Developmental Defects of Enamel (DDE) Index. Statistical evaluation was done using Karl Pearson's coefficient of correlation and the Chi-square test with IBM SPSS Statistics for Windows, Version 23, (Released 2015; IBM Corp., Armonk, New York, United States). RESULTS: The fluoride concentration in drinking water ranged from 0.5 to 2.0 ppm. The prevalence of developmental defects among the study population was 73.4% (range 59% to 100%). The most commonly observed type of defect was diffuse opacity (score 4) in 22.8% of the children. The premolars were the most commonly affected teeth. There was a significant positive correlation between the type (r=0.95; p<0.001) and extent (r=0.82; p<0.001) of developmental defects to the fluoride levels in drinking water.  Conclusion: The drinking water from about 50% of the villages had fluoride levels of 1 ppm or >1 ppm. A significant positive correlation between the severity of enamel defects and increased fluoride levels in water was deciphered. Thus, a simple, effective, and inexpensive method of de-fluoridation of drinking water should be prioritized if alternative sources of drinking water are not made available.

A Patient Safety Rounds Pilot Program at Clinics Affiliated With a Large Research and Education Institution.

OBJECTIVE: In 2012, a 6-month Patient Safety Rounds pilot program was conducted to examine the provider perspective of patient safety and to educate personnel about national patient safety goals at clinics associated with a large research and education institution. METHODS: The Patient Safety Rounds (PSR) team, consisting of 3 to 4 rotating members from executive leadership, physician and nursing groups, and administrative staff, identified contacts within clinical departments and made arrangements for monthly visits. Patient safety issues were preselected by committee for presentation and discussion at a premeeting held with supervisors and administrators during the first few minutes of PSR. After the premeeting, the PSR team split up and met individually with care providers, between patient visits, to review the monthly safety topic and any patient safety concerns that they wanted to discuss during the visit. RESULTS: Approximately 37 patient safety issues were identified, recorded, and classified during these PSR team visits. If the issues could not be immediately addressed, they were either addressed shortly thereafter or referred to appropriate personnel for resolution. CONCLUSIONS: This PSR pilot program was viewed as a success by participants because it identified provider perspective concerns, which led to the identification and resolution of numerous patient safety issues. This interesting pilot program, however, was discontinued owing to the departure of key leadership and the reorganization and reprioritization of resources.

A study to find the status of probiotics in New Delhi, India and review of strains of bacteria used as probiotics.

CONTEXT: Probiotics are living microorganisms, principally bacteria, that are safe for human consumption and, when ingested in sufficient quantities, have beneficial effects on human health, beyond basic nutrition. However, in India people are not aware of their benefits and availability. AIMS: To find status of probiotics in India and to assess the awareness regarding probiotics among chemists in New Delhi, India. SETTINGS AND DESIGN: A cross-sectional survey was conducted among 300 chemist shops in different areas of New Delhi, India. MATERIALS AND METHODS: Data were collected through a structured questionnaire, which was responded by the chemist in the course of a telephonic interview. The questionnaire addressed on the availability of probiotic products at their chemist shop. STATISTICAL ANALYSIS USED: The data so gathered were subjected for descriptive analysis using t test. RESULTS: As per availability of probiotic products, total of 25 probiotic products were available at different chemist shops. None of the chemist shop had all the 25 products available. 10% shops had 75% products available and there were 5% such shops which didn't have any of the products available. CONCLUSION: Efforts should be made to increase the awareness among chemists about the probiotic products.

Nonmedical factors associated with prolonged hospital length of stay in an urban homebound population.

BACKGROUND: Prolonged length of stay (LOS) is a major concern for hospitalized populations at risk for adverse events. Homebound patients are at particular risk for long stays and may have unique discharge needs because of their commitment to be cared for at home despite poor functional status. OBJECTIVE: The goal of this study was to describe factors contributing to long hospitalizations in the homebound population. DESIGN: This retrospective observational pilot study included all 2007 discharges that occurred for patients at The Mount Sinai Hospital enrolled in the Mount Sinai Visiting Doctors Program. MEASURES: Long-stay patients were defined as those having an LOS 2 standard deviations above the mean. Hospitalization days were defined as "nonmedical" when patients medically ready for discharge remained in the hospital. Patients discharged immediately after determination of medical readiness were characterized as "medical stay" cases. The University HealthSystems Consortium Database was used to calculate expected LOS and the LOS ratio. Chart reviews were performed to describe long-stay cases as nonmedical or medical. RESULTS: The average LOS for 479 discharges was 7.84 days, with a mean LOS Ratio of 1.23. Seventeen cases were determined to be long stays. Eight of these cases (47%) were defined as nonmedical stays. These accounted for 136 days of hospitalization and 32% of total long-stay days. The most common reason for a nonmedical stay was nursing facility placement delay. CONCLUSIONS: Nonmedical factors accounted for nearly one-third of all long-stay days in the hospitalized homebound population. Increased interdisciplinary collaboration may help address homebound patient LOS.

Improving patient satisfaction with pain management using Six Sigma tools.

BACKGROUND: Patient satisfaction as a direct and public measure of quality of care is changing the way hospitals address quality improvement. The feasibility of using the Six Sigma DMAIC (Define, Measure, Analyze, Improve, Control) methodology to improve patient satisfaction as it relates to pain management was evaluated. METHODS: This project used the DMAIC methodology to improve patients' overall satisfaction with pain management on two inpatient units in an urban academic medical center. Pre- and postintervention patient surveys were conducted. The DMAIC methodology provided a data-driven structure to determine the optimal improvement strategies, as well as a long-term plan for maintaining any improvements. In addition, the Change Acceleration Process (CAP) was used throughout the project's various DMAIC stages to further the work of the team by creating a shared need to meet the objectives of the project. RESULTS: Overall satisfaction with pain management "excellent" ratings increased from 37% to 54%. Both units surpassed the goal of at least 50% of responses in the "excellent" category. Several key drivers of satisfaction with pain management were uncovered in the Analyze phase of the project, and each saw rating increases from the pre-intervention to postintervention surveys. Ongoing monitoring by the hospital inpatient satisfaction survey showed that the pain satisfaction score improved in subsequent quarters as compared with the pre-intervention period. DISCUSSION: The Six Sigma DMAIC methodology can be used successfully to improve patient satisfaction. The project led to measurable improvements in patient satisfaction with pain management, which have endured past the duration of the Six Sigma project. The Control phase of DMAIC allows the improvements to be incorporated into daily operations.

Economic and healthcare forces of hospitalist movement.

The field of hospital medicine has become a widely accepted model for inpatient care and has grown rapidly in the past ten years. The impetus for growth has largely been pressure to contain costs for inpatient care and improve efficiency in the hospital. Studies have shown that care by hospitalists is generally more cost-effective than care by faculty or private practice physicians without affecting quality. The field faces challenges in continuity of patient care and retention of physicians in the workforce.

Breast and cervical cancer screening among South Asian women in New York City.

The purpose of this paper is to document the breast and cervical cancer screening practices of a community sample of South Asian women living in the New York City area. A convenience sample of 98 women was engaged in face-to-face interviews regarding their socio-demographic characteristics and cancer screening utilization. Sixty-seven percent of women had ever had a Pap test; 54% had one in the last 3 years. Seventy percent of women over 40 had ever had a mammogram; 56% had one in the last 2 years. Sixty-six percent of women had knowledge of breast self-exam (BSE); 34% of women ever practiced BSE. Multiple logistic regression analysis indicated that insurance status was a significant predictor of ever having a Pap test or mammogram, receiving timely Pap tests, and ever practicing BSE. Education was a significant predictor of ever having a Pap test and having knowledge of BSE. Marital status was a predictor of receiving timely Pap tests, and having spent more time in the U.S. was a predictor of ever practicing BSE. The study concludes that increased educational efforts must be developed targeting immigrant South Asian women of low socioeconomic status with limited access to healthcare.

Teaching professionalism within a community context: perspectives from a national demonstration project.

Most medical schools now include some component of professionalism in their curriculum, ranging from "white coat" ceremonies to didactic and small-group, case-based discussions. Often this format does not provide a context for the course content nor does it necessarily make the curricular themes relevant to population groups and communities most vulnerable to the inequities and injustices present in health care. The authors describe a community-based professionalism curriculum for preclinical and clinical year medical students and report evaluation data from three years (2001-2003) of this national demonstration project. The curriculum emphasized four themes: service, community, advocacy, and ethical behavior and was based on a service-learning pedagogy applied within community-based organizations. As part of the program evaluation, 95 students from 33 medical schools between the years 2001 and 2003 (response rate: 84.8%) completed an anonymous questionnaire. When asked what did they learn about professionalism that they did not learn (or expect to learn) in their medical school curriculum, the most common themes were (1) factors and influences affecting professional behavior, with many specifically citing pharmaceutical companies and insurance carriers (46.3%); (2) the role and importance of physician advocacy on behalf of their patients (37.9%); and (3) issues specific to the needs of vulnerable and disadvantaged populations (20.0%). This project demonstrates that community-based experiences can provide unique and relevant learning in a professionalism curriculum that can complement existing medical-school-based efforts.