Efficacy of low-level laser therapy and microsurgery on neurosensory recovery following inferior alveolar and lingual nerve injuries: A systematic review.

Purpose: This systematic review evaluates the relative effectiveness of low-level laser therapy (LLLT) and microsurgery for neurosensory recovery following sustained iatrogenic injuries to the inferior alveolar nerve (IAN) and lingual nerve (LN) more than 6 months in Oral and Maxillofacial surgery procedures. Methods: Six articles were included. The mean age of microsurgery studies was 41.5 years and that of LLLT studies was 31.5 with female predominance in all studies. The majority of the included studies have been based on both subjective and objective assessments for neurosensory, two investigating microsurgery and four investigating LLLT following a Six-month post-IAN and LN injury. Results: Each modality demonstrated positive outcomes in both subjective and objective assessments of neurosensory function. Notably, LLLT exhibited efficacy even when employed beyond a six-month interval following the initial injury. Early intervention is generally recommended, particularly for microsurgical approaches. Conclusion: LLLT shows exciting promise as a minimally invasive approach for neurosensory rehabilitation even after six months of injury, while microsurgery studies revealed an improvement and the recommendation for early intervention post-nerve injury, the potential of LLLT and optimize its use for neurosensory rehabilitation, additional randomized controlled trials with larger sample sizes, longer follow-up periods, and blinding protocols are necessary.

Association of Sleep Quality and Stress with Academic Performance among Undergraduate Dental Students of Bhubaneswar, India

ABSTRACT Objective: To assess sleep quality and stress level and to analyze their effect on the academic performance of undergraduate dental students. Material and Methods: A cross-sectional descriptive survey was conducted among 234 undergraduate dental students at Bhubaneswar. Pittsburgh Sleep Quality Index (PSQI), consisting of 18 items rated on a 4-point Likert scale, assessed sleep quality. Kessler Psychological Distress Scale (K10) evaluated the stress level. Google Forms collected demographic details and marks obtained in their previous examination. Chi-square, Mann-Whitney U, Kruskal-Wallis tests, and Spearman correlation coefficient were used for analysis (p≤0.05). Results: Mean PSQI and K10 scores were 4.87±4.5 and 17.60±8.5, respectively. 38% of students had poor sleep quality, and mean actual sleep hours were 8.01±1.7. One-fourth (24.8%) of subjects had moderate to severe stress. Sleep quality significantly differed among the various academic years (p=0.001). A post-hoc test showed a difference between 1st and 2nd-year students and 1st and 4th-year students. A statistically significant difference between genders regarding the components of the K10 scale was observed. A non-significant positive correlation between total marks and K10 score and a negative correlation between marks and global PSQI score was found. Conclusion: Sleep quality and stress harm the academic performance of dental students.

Cyberchondria among information technology professionals of Bhubaneswar by using cyberchondria severity scale (CSS-15).

Background: Internet can act as an excellent resource for gaining valuable health related information. However, excessive online research and investigation about health-related issues may impose a negative impact. The term cyberchondria is used to describe a clinical condition in which frequent internet searches for health-related information leads to exaggerated anxieties about physical well-being. Objectives: To determine the prevalence of cyberchondria and associated factors among the information technology professionals of Bhubaneswar in India. Materials and methods: A cross-sectional study was carried out among 243 software professionals in Bhubaneswar using a previously validated Cyberchondria Severity Scale (CSS-15) questionnaire. Descriptive statistics in terms of number, percentage, mean and standard deviation were presented. Independent t-test and one-way analysis of variance was applied to compare the cyberchondria score between two and more than two independent variables respectively. Results: From 243 individuals 130 (53.5%) were males and 113 (46.5%) were females with mean age 29.82±6.67 years. The prevalence of cyberchondria severity was found to be 46.5%. The mean cyberchondria score of all study subjects was 43.80±10.62. It was significantly higher among those who spend more than 1 hour in the internet during night, feel fear and anxiety in visiting the doctor or dentist, interested in gaining the health-related information from other resources and agreed that gaining health related information has increased after COVID-19 pandemic (p˂0.05). Conclusion: Cyberchondria is a growing issue with regard to mental health in developing countries and has the ability to cause anxiety and distress. Appropriate actions must be taken to prevent it on a societal level.

Validity, reliability and prevalence estimates of nomophobia among undergraduate dental students of Bhubaneswar, India.

Background: Considered a modern phobia, Nomophobia (NO MObile PHOne PhoBIA) is a term describing irrational fear or anxiety of being unable to access one's own mobile phone. Objectives: To develop and validate the nomophobia questionnaire, administering it to a sample of adolescents representing undergraduate dental students. To assess the prevalence of Nomophobia, determine the usage pattern of mobile phones and evaluate the impact due to lack of access to mobile phones among undergraduate dental students. Material and method: A cross-sectional study was conducted on 302 undergraduate students of Bhubaneswar through a self-administered questionnaire via Google Forms consisting of 19 items evaluating the pattern and anxiety related to usage of mobile phones. Responses were recorded on a 5-point Likert scale. Kruskal Wallis, Mann-Whitney U and Chisquare tests were used for statistical analysis. Results: Test-Retest reliability showed kappa of k=0.86 and Internal consistency Chronbach's-Alpha to be α=0.82. Prevalence of nomophobia (score ≥ 58) was 32.1%, and students at risk of being nomophobic (score 39-57) was 61.9%. It was highest in males (32.6%) and amongst the interns (41.9%) and lowest (25.5%) amongst the second-year students. Participants felt nervous/insecure if their phones were away from them because of the fear that somebody might have accessed their data (3.07±1.93) and or tried to contact them (3.09±1.13) which were not statistically significant (p>0.05). Conclusions: The present study confirms that nomophobia is an emerging behavioural addiction among dental students. Adequate prevention strategies would be helpful in reducing the impact of the chronic mobile usage. Effect of the mobile phone on dental students and the fear of not having it with them is increasing elaborately, that needs to be controlled. Otherwise, it would negatively affect their academic achievement and well-being.

Impact of Internet Addiction on Academic Performance of Undergraduate Dental Students of Bhubaneswar, India

ABSTRACT Objective: To assess the level of internet addiction and its impact on the academic performance of undergraduate dental students of Bhubaneswar. Material and Methods: A cross-sectional descriptive survey was steered among 814 undergraduate dental students (representing first year through internship) in Bhubaneswar, India. Internet addiction was assessed with the Internet Addiction Test (IAT) developed by Young, which consisted of 20 items rated on a 5-point Likert scale. Google Forms were used to collect the data. Statistical tests like Chi-square, Kruskal-Wallis, and Spearman correlation coefficient were used to analyze the qualitative and quantitative variables, respectively, with the significance level set at p ≤ 0.05. Results: The prevalence of Internet Addiction was found to be 27.5%. Interns showed the highest mean Internet Addiction (57.91±10.71) score. The proportion of addicted students was higher in males, 74 (31.4%), than in females, 150 (26%). The mean scores for individual domains were overuse (16.31±3.64), non-restraints (7.77±2.66), inhibiting the flow of life (9.52±3.05), emotional state (11.25±2.86), and dependence (10.47±2.53). A correlation coefficient (Spearman's rho value of -.167) indicates a negative correlation between internet addiction and academic scores, which was statistically significant (p=0.001). Conclusion: This study revealed that internet use for varying purposes eventually leads to addiction and affects students' academic performance. The affected students need early intervention and control over internet usage.

Comparison of the effectiveness of 38% silver diamine fluoride and atraumatic restorative treatment for treating dental caries in a school setting: A randomized clinical trial.

BACKGROUND: Dental caries is an infectious microbial disease of the teeth, affecting mostly young children. It is caused by the interplay of numerous factors that are more common in susceptible and lower-income groups. Therefore, there is a dire need for a simple yet effective method of treating dental caries. OBJECTIVES: The aim of the study was to compare the effectiveness of 38% silver diamine fluoride (SDF) and atraumatic restorative treatment (ART) in the treatment of dental caries in a school setting. MATERIAL AND METHODS: A randomized clinical trial (RCT) using a parallel-group design was conducted among schoolchildren aged 6-12 years. Oral hygiene practices and sugar exposure were recorded at baseline. In the schoolchildren, 190 dental caries lesions were restored using 38% SDF (group 1) or ART (group 2). The χ 2 test and the Kaplan-Meier survival analysis were done to assess the 2 treatment modalities. The RCT was carried out and reported in accordance with the CONSORT (Consolidated Standards of Reporting Trials) checklist. RESULTS: A total of 190 children fulfilled the inclusion criteria and the mean age of the study population was 9.3 ±1.3 years. The majority of the participants brushed their teeth once daily, using a toothbrush, rinsed their mouth after meals and had optimal sugar exposure. In measuring the outcome of the interventions after 9 months, 58.9% of the participants from group 1 had their restorations intact as compared to 47.8% in group 2, and this was found to be statistically significant (p = 0.004). The survival analysis using the log rank test showed 38% SDF to be better in comparison with ART. CONCLUSIONS: This study indicated that SDF was better at arresting caries, and hence it can be considered a viable treatment option in areas with limited access to oral healthcare.

Oral Health Literacy - Adult Questionnaire: Psychometric Properties and its Influence on Oral Health Status of School Teachers in Bhubaneswar, India

Abstract Objective: To translate Oral Health Literacy - Adult Questionnaire from English to Odia language and test its psychometric properties and assess its influence on oral health status of school teachers. Material and Methods: A cross-sectional survey was performed among 400; 116 (29%) males and 284 (71%) female school teachers of Bhubaneswar. OHL-AQ questionnaire subsequent to being translated to Odia language utilizing World Health Organization recommended translation back translation protocol was then tested for the establishment of its psychometric properties with assistance from the selected expert panel of academicians. The oral health status of participants was assessed using the WHO oral health assessment form-2013. Chi-square, t-tests, one-way ANOVA, and linear regression were used for statistical analysis. Results: Internal consistency of OHL-AQ-O was acceptable with an alpha value of 0.70. Test-retest reliability showed almost perfect agreement (ICC=0.90, CI=0.85-0.93) indicating highly reliable translated scale (p=0.001). Overall mean oral health literacy scores were 13.02±1.86, with about 80% belonging to the high oral health literacy level group. Caries prevalence was 78%, with a mean DMFT of 3.04±2.55. Shallow pockets were absent majorly in teachers belonging to the high oral health literacy group (p=0.01). The multiple linear regression model depicted that only the teaching experience variable added significantly to the prediction (p=0.008). Conclusion: OHL-AQ-O questionnaire was found valid and reliable to measure OHL. Further application of the instrument in other communities and populations will support establishing the external validity of the OHL-AQ-O.

Evaluation of Lung Volume and Effect of Vital Staining as Motivation to Quit Tobacco among Nicotine Dependents of Kanpur, India

Abstract Objective: To quantify and compare respiratory functions and further screen the oral mucosa of tobacco and non-tobacco users. Material and Methods: First control group, non-tobacco users (n=55); Second group, smokers' group (n=168) who currently smoked cigarettes; Third group smokeless/chewing type, tobacco group (n=81); Fourth group, both smokeless and smoking type tobacco users (n=46). Fagerstrom Test for Nicotine Dependences (FTND) and Fagerström Test for Nicotine Dependence-Smokeless Tobacco (FTND-ST) instruments were used to assess nicotine dependence. Subsequently, spirometry and Toluidine Blue (TB) vital staining were performed. Chi-squared and one-way analysis of variance (ANOVA) were used for statistical analysis. Results: Fagerstrom test resulted in 48.8% of subjects with low dependency, followed by an increase in nicotine dependency from low to moderate (29.2%), moderate (15.6%), and highly dependent (6.4%) groups. All respiratory function tests and oral screening confirmed significant changes amongst tobacco and non-tobacco users. The forced vital capacity of non-smoker group was significantly different from other tobacco users' group (p<0.05). Conclusion: Early effects of tobacco use can lead to complications with the respiratory system and oral cavity. Such data can be used to delineate the harm of tobacco and should be used to urge individuals to evade the utilization of tobacco (AU).

Appraisal of awareness on medical emergencies and its management among dentists in Bhubaneswar, India.

BACKGROUND: Medical emergencies can be distressing for any dental professional, whether in a dental practice, hospital or other sites. OBJECTIVES: To assess the knowledge and awareness of dental practitioners towards medical emergencies and its management in Bhubaneswar. MATERIAL AND METHODS: In this cross-sectional investigation, a self-administered questionnaire which included demographic details and 19 questions regarding knowledge about medical emergencies, was disseminated to a random sample of 183 dentists working in their private dental clinic set up in Bhubaneswar. Chi-square test was used for statistical analysis. RESULTS: Total sample size was 183, out of which 79 (43.17%) were males and 104 (56.83%) were females. The mean age was found out to be 30.7 ± 5.38 years. Practically 96% of the practitioners were not certain enough to deal with the emergency conditions at dental office. Around 67% had not attended any workshop on emergency training. It was amazing to observe that larger part (90%) of the experts didn't possess first aid kit at their dental office. In instances of handling emergency situation at the dental chair no statistical significance (p>0.05) with respect to age and gender was found. CONCLUSION: This investigation showed that hypothetically dental professionals had better knowledge on medical emergencies yet at the same time they were not equipped efficiently to manage the same at their workplace.

In vitro evaluation of antimicrobial efficacy of silver zeolite against common oral pathogens.

Objectives: Antimicrobial efficacy and toxicity analysis of 5 different concentrations of silver zeolite (SZ) compound against 5 common oral pathogens Streptococcus mutans, Streptococcus pyogenes, Lactobacillus sp., Staphylococcus aureus, Candida albicans. Material and methods: The antimicrobial efficacy of 5 different concentrations of SZ was tested against 5 common oral pathogens using the agar well diffusion method and the MIC and MBC values were determined using the micro broth dilution method. The toxicity of all 5 different concentrations was evaluated using brine shrimp assay and lethal concentration (Lc50) value was determined. Results: At 10 µg/mL the antimicrobial activity of SZ was almost negligible. The antimicrobial activity was observed in an increasing trend against all the test microorganisms as the concentration increased. At 75 & 100 µg/mL the zone of inhibitions was more than the control. Furthermore, MIC and MBC values of SZ with concentrations 25, 50, 75, and 100 µg/mL were determined and recorded. SZ was equally effective against all the test organisms. The LC25 (lethal concentration25) value was 1.6 µg/mL, whereas the LC50 value was 1.77 µg/mL and the LC75 value was 1.90 µg/mL, calculated from the probit computational method. Conclusion: SZ has the potential to change the ongoing system and bring about a revolution as an antimicrobial drug. However, the dose must be regulated as it can be toxic in higher concentrations. SZ compounds with the correct study of physicochemical properties and toxicity analysis can increase their pharmacological use and market value.

Effectiveness of trained health workers in improving the oral hygiene of preschool children.

BACKGROUND: Poor oral health among children is common finding in the rural regions of India. But if the existent structure of primary health care is used, favourable oral health habits and importance of oral health can be instilled in the children and their parents at a very early stage. OBJECTIVE: To evaluate the effectiveness of Anganwadi workers (AWWs) in improving the oral hygiene of the preschool children through oral health education. MATERIAL AND METHODS: 250 children in the age group of 2.5-6 years, were included in the study. The study was conducted in three phases over a period of 8 months which included a follow up of six months. Baseline oral health was determined using a questionnaire assessing the oral hygiene practices and DMFT Index, Plaque Index and Gingival Index. This was re-assessed after 6 months using the same questionnaire and indices. Statistical significance was fixed at p value L 0.05. Chi square and paired 't' test were used to assess the difference in the variables after providing oral health education. RESULTS: Out of 250 children, with mean age of 4.24 years, majority were girls (142, 56.8%). The use of fluoridated toothpaste among the study population significantly increased from 34.4% to 41.5% (p=0.001) with the intervention of oral health education (OHE). Decrease in consumption of sticky sugar, addition of sugar in the night-feeds and cleaning of teeth after night-feeds were also found to change significantly. Gingival index showed significant reduction after OHE (p=0.001). CONCLUSION: The study revealed that training of Anganwadi workers (AWWs) could be used to improve the oral health of the Anganwadi children. They represent an untapped source for delivering oral care to rural communities that otherwise have limited access.

Effect of propolis mouth rinse on oral microorganisms - a randomized controlled trial.

OBJECTIVES: To evaluate and compare the efficacy of prepared propolis mouth rinse with Chlorhexidine mouthwash on oral pathogens and also the plaque and gingival index scores. MATERIAL AND METHODS: A triple-blind, concurrent parallel randomized controlled trial was conducted on 120 participants randomized to 4 mouth rinse study groups: (1) Hot Ethanolic Propolis extract; (2) Cold Ethanolic Propolis extract; (3) Chlorhexidine and (4) Distilled water. After a washout period of two weeks, oral prophylaxis and polishing was performed. Participants rinsed twice a day for 3 months. Saliva was collected at baseline, 5 min and 1 h for microbiological analysis. Plaque and Gingival index were recorded at baseline, 15 days, 1 month and 3 months. Repeated measures ANOVA with Bonferroni post hoc tests were used for statistical analysis. RESULTS: A decline in the concentration of S. mutans was observed in samples collected after the use of mouth rinse (p < 0.05). In comparison with baseline, L. acidophilus and S. mutans count decreased simultaneously when exposed to Hot Ethanolic mouthwash group (5.5 × 102) and Chlorhexidine mouthwash (5.8 × 102) respectively. At the end of 3 months, similar reduction in plaque scores was found in Chlorhexidine (0.45), Cold Ethanolic (0.46), Hot Ethanolic (0.47) mouthwash groups. CONCLUSION: Propolis was found to be as efficient as Chlorhexidine in reducing plaque, gingivitis and dental caries pathogens. CLINICAL RELEVANCE: Common microorganisms implicated in oral disease are S. mutans and L. acidophilus. There is great paucity of information on antimicrobial activity of propolis, against these microorganisms. Hence, the present study has been taken up to assess the effects of propolis on these oral pathogens.The effects of propolis on oral health have been proved which is obviously a new finding of significance.

Assessing the effect of oral diseases on oral health related quality of life of institutionalized elderly using Oral Health Impact Profile (OHIP-14) questionnaire: a pilot study.

BACKGROUND: India establishes a geriatric population of about 80 million which is 7.2% of the total population. The geriatric population is often faced by a negative impact on their quality of life due to poor oral health. OBJECTIVES: To assess the impact of oral disease on daily activities and quality of life among the institutionalized elderly in Kanpur, India. MATERIALS AND METHOD: A total of fifty-six patients were purposively selected from two old age homes through convenience sampling technique. To assess the oral health status WHO basic oral health survey form (1997) was used. Short version of Oral Health Impact Profile (OHIP - 14) questionnaire was used to assess the Oral Health Related Quality of Life (OHRQoL). Independent t-test and ANOVA test was done to determine the relationship between the groups. RESULTS: Presence or absence of grossly decayed teeth, chronic periodontitis, based on edentulism and remaining sound teeth status produced no significant differences in any of the domains. In comparison with males, females experienced greater impact of oral diseases with respect to mean OHIP-14 score; however, it was non - significant (p=0.45). CONCLUSION: Oral health status of the institutionalized subjects in Kanpur city is poor, with edentulism and periodontitis. The effect of oral diseases on the lives of elderly is comparatively low and is non-significant.

Emergency management of dental injury; preparedness among school teachers in Bhubaneswar, India.

BACKGROUND: School is the place, identified with a noticeable risk of Traumatic Dental Injuries (TDI) in children which have functional, esthetic and psychological effects. OBJECTIVES: To assess the preparedness of concerning traumatic dental injuries and their management among school teachers and also to empower the clinician to frame a set of instructions for school teachers to handle the emergencies effectively at the site of the incident. MATERIAL AND METHODS: A cross-sectional study was conducted among 330 school teachers enrolled in government and private schools of 24 randomly selected schools in Bhubaneswar city. A self-administered questionnaire was distributed to collect information on participants demographic characteristics, knowledge, attitude and practice about emergency management of Traumatic Dental Injury. Chi-square test with level of significance set at 5% was used for statistical analysis. RESULTS: Statistically significant (p<0.05) correct responses were provided by 66.7% males and 35.6% females and 100% younger age teachers. Larger population perceived that their level of knowledge was not satisfactory as they responded for inadequate and don't know options which was significant in relation to gender and age (p<0.05) but not with respect to the type of school (p>0.05). All the respondents expressed the need for a training program. CONCLUSIONS: This study highlights the instantaneous need for tailor made dental health educational and preventive programs for school teachers in order to effectively manage the Traumatic Dental Injuries.

Risk factors and patterns related to dental caries evaluated with caries assessment spectrum and treatment (cast) among schoolchildren of Bhubaneswar, India

Objectives: To determine the complete range of carious conditions and furthermore to compare the risk factors and patterns of dental caries amongst schoolchildren aged 12 and 15 years in Bhubaneswar. Material and Methods: Cross-sectional descriptive survey was performed among 800 schoolchildren to assess the dental caries status by Caries Assessment Spectrum and Treatment (CAST) scoring. Chi-square, parametric t-test, one-way ANOVA with post hoc Bonferroni and stepwise multiple linear regression were utilized for statistical analysis. Results: Study population comprised of 476 (59.5%) boys and 324 (40.5%) girls, of which 356 (44.5%) and 444 (55.5%) represented the 12- and 15-years age group respectively. Prevalence of dental caries was 60.6% (Mean 0.38+0.545). Younger age group children presented a significant (p<0.05) lower caries prevalence (54.8%) as against 65.3% in 15 years children. Majority, 189 (23.6%) revealed distinct visual change in enamel (code 3). Acuteness of disease constructed on maximum CAST score for each subject showed that teeth with morbidity (28.5%) is higher followed by reversible pre-morbidity (23.6%) and serious morbidity (6.5%). Predominantly first molars were generally influenced. Significant interpreters in plunging order for DMFT were frequency of cleaning teeth and sweet score. Conclusions: A creative instrument named CAST index describes full continuum of dental caries. Its utilization in epidemiological studies is exceptionally encouraging as it is less tedious and more cost effective. It can possibly be a useful tool for planning caries control programs in both individual and community levels.

Risk factors and patterns of traumatic dental injuries among Indian adolescents.

BACKGROUND/PURPOSE: Dental injuries in children have functional, esthetic, and psychological effects, with consequences for the child, parent, and dentist. This study assessed the pattern of traumatic dental injuries and their relationship with predisposing factors among 12- and 15-year-old school children in Kanpur, India. MATERIALS AND METHODS: A cross-sectional study was conducted on 1100 boys and girls aged 12 or 15 years. Anterior permanent teeth were examined based on the modified Ellis classification. Type of damage, size of incisal overjet, and adequacy of lip coverage were also recorded. Chi-square tests and multiple regression analysis were used for statistical analysis. RESULTS: The prevalence of traumatic dental injuries to anterior teeth was 10.9%. Age and gender distribution indicated that most injuries occurred in 15-year-old age group (11.3%) and among boys (11.5%). The gender-related difference was statistically significant (p < 0.024). Maxillary central incisors (83.7%) were frequently involved. The predominant injury type was enamel fracture (68.3%) mainly due to falls (52.5%). Increased overjet, inadequate lip coverage, type of school, and gender were significant contributing factors for traumatic dental injuries. CONCLUSION: Study reveals the frequency and cause of traumatic injuries to anterior teeth, which assists in identifying risk groups and treatment needs in order to establish effective preventive strategies.

Antimicrobial Efficacy of Acacia nilotica, Murraya koenigii L. Sprengel, Eucalyptus hybrid, Psidium guajava extracts and their combinations on Fusobacterium nucleatum and Porphyromonas gingivalis.

BACKGROUND: The herbal extracts have been effectively tried in the treatment and prevention of many oral diseases. AIM: The aim is to assess the antimicrobial efficacy of Acacia nilotica, Murraya koenigii L. Sprengel, Eucalyptus hybrid, Psidium guajava extracts and their combinations on Fusobacterium nucleatum (Fn) and Porphyromonas gingivalis (Pg). MATERIALS AND METHODS: The extraction process was carried out by Soxhlet apparatus using ethanol as solvent. The combinations of the four plant extracts were prepared by combining an equal quantity of 10% solution of each of the four plant extracts. The antimicrobial efficacy testing of the plant extracts and their combinations on Fn and Pg was performed using agar well diffusion method. Columbia 5% of sheep blood agar plates were used for antimicrobial efficacy testing under anaerobic conditions. The qualitative assay was carried out to identify the various phytochemical constituents. Dimethyl sulfoxide and 0.2% chlorhexidine acted as negative and positive controls, respectively. The mean diameter of inhibition zone between different categories was compared using one-way analysis of variance. RESULTS: All the individual plant extracts and their double, triple, and quadruple combinations were effective in inhibiting the growth of these bacteria. However, 0.2% chlorhexidine produced the highest mean diameter of inhibition zone. CONCLUSION: The plant extracts in combinations offer enhanced antimicrobial efficacy due to their synergistic action besides slowing the development of bacterial resistance. Hence, these extracts in combinations could be used tried as effective alternates to chlorhexidine.

Cavitary myiasis and its management.

OBJECTIVE: Myiasis is a parasitic disease of humans and vertebrates, caused by fly larvae feeding on the host's necrotic or living tissue. Myiasis is classified into cutaneous and cavitary myiasis. Cavitary myiasis is rare and occurs more frequently in tropical and subtropical regions of Africa and America associated with low economic status and poor hygiene. This article reviews current literature, provides general descriptions, and discusses life cycles of each species. It also gives diagnosis, treatment techniques and descriptions of each type of illness that result from interaction / infestation.