Exploring the Relationship between Psychoneuroimmunology and Oral Diseases: A Comprehensive Review and Analysis.

The relationship between psychoneuroimmunology (PNI) and oral health has recently garnered increasing attention due to the intricate interaction among psychological factors, the nervous system, immune responses, and oral diseases. This comprehensive review aims to elucidate the multifaceted connections between PNI and various oral conditions and conduct an in-depth analysis. Psychological factors, such as stress, anxiety, and depression, have been linked to oral microbiome alterations and immune function and the development and progression of oral diseases, such as periodontal disorders, oral ulcers, and temporomandibular disorders. Conversely, oral health conditions, particularly chronic periodontitis, have been associated with systemic inflammation, affecting mental health and overall well-being through neuroendocrine-immune pathways. Moreover, neural mechanisms, including the brain-gut axis and the autonomic nervous system, significantly influenced oral health through immune modulation and inflammatory responses. Understanding these complex interactions has implications for therapeutic interventions that target both psychological well-being and oral health outcomes. This review synthesizes current research findings from various disciplines, including immunology, neuroscience, dentistry, and psychology, to offer a comprehensive understanding of the bidirectional relationship between PNI and oral diseases. The implications of these interactions on treatment strategies, preventive measures, and interdisciplinary approaches underscore the need for integrated healthcare models that address psychological and oral health aspects to improve outcomes and quality of life in patients.

Prescription-based cost analysis of medicines for cardiovascular risk factors at Indian Council of Medical Research-Rational Use of Medicine Centre Hospitals of India.

OBJECTIVES: India has taken several initiatives to provide health care to its population while keeping the related expenditure minimum. Since cardiovascular diseases are the most prevalent chronic conditions, in the present study, we aimed to analyze the difference in prices of medicines prescribed for three cardiovascular risk factors, based on (a) listed and not listed in the National List of Essential Medicines (NLEM) and (b) generic and branded drugs. MATERIALS AND METHODS: Outpatient prescriptions for diabetes mellitus, hypertension, and dyslipidemia were retrospectively analyzed from 12 tertiary centers. The prices of medicines prescribed were compared based on presence or absence in NLEM India-2015 and prescribing by generic versus brand name. The price was standardized and presented as average price per medicine per year for a given medicine. The results are presented in Indian rupee (INR) and as median (range). RESULTS: Of the 4,736 prescriptions collected, 843 contained oral antidiabetic, antihypertensive, and/or hypolipidemic medicines. The price per medicine per year for NLEM oral antidiabetics was INR 2849 (2593-3104) and for non-NLEM was INR 5343 (2964-14364). It was INR 806 (243-2132) for generic and INR 3809 (1968-14364) for branded antidiabetics. Antihypertensives and hypolipidemics followed the trend. The price of branded non-NLEM medicines was 5-22 times higher compared to generic NLEM which, for a population of 1.37 billion, would translate to a potential saving of 346.8 billion INR for statins. The variability was significant for sulfonylureas, angiotensin receptor blockers, beta-blockers, diuretics, and statins (P < 0.0001). CONCLUSION: The study highlights an urgent need for intervention to actualize the maximum benefit of government policies and minimize the out-of-pocket expenditure on medicines.

Unhealthy food consumption patterns among Indians: A qualitative analysis based on parliamentary questions documented between 2001 and 2021.

Background: From the dawn of the 21st century, there has been an exponential increase in junk food consumption among Indians. The Indian parliament holds periodic question and answer sessions wherein several key issues of the nation are discussed by representatives across the country. Materials and Methods: Questions pertaining to junk foods and soft drinks that were documented between January 2001 and July 2021 in both houses of the parliament were included in the study. They were organized using MaxQDA software. Thematic analysis of the questions was done using Braun and Clarke's phases for thematic analysis. Results: A total of 424 questions (0.08%) were asked collectively on junk foods including soft drinks in both the houses of which 160 questions (0.03%) were exclusively on junk food and 264 questions (0.05%) were on soft drinks respectively. Out of a total of 28,240 questions asked on all topics across both houses to the MOHFW, a total of 166 questions (0.6 %) were on junk food and soft drinks. Only 84 unique parliamentarians from 21 states have raised their voices on the present topic of concern. Conclusion: A majority of questions were on the adverse effects of junk food and soft drinks. Though there has been consistency in certain states on raising their voices on this topic, around 12 states/union territories failed to represent this issue even once. Further discussions have to be raised under the themes of food poisoning due to junk foods, marketing regulations, stricter media/advertisement regulations and future research objectivess.

An observational multi-centric COVID-19 sequelae study among health care workers.

Background: India has seen more than 43 million confirmed cases of COVID-19 as of April 2022, with a recovery rate of 98.8%, resulting in a large section of the population including the healthcare workers (HCWs), susceptible to develop post COVID sequelae. This study was carried out to assess the nature and prevalence of medical sequelae following COVID-19 infection, and risk factors, if any. Methods: This was an observational, multicenter cross-sectional study conducted at eight tertiary care centers. The consenting participants were HCWs between 12 and 52 weeks post discharge after COVID-19 infection. Data on demographics, medical history, clinical features of COVID-19 and various symptoms of COVID sequelae was collected through specific questionnaire. Finding: Mean age of the 679 eligible participants was 31.49 ± 9.54 years. The overall prevalence of COVID sequelae was 30.34%, with fatigue (11.5%) being the most common followed by insomnia (8.5%), difficulty in breathing during activity (6%) and pain in joints (5%). The odds of having any sequelae were significantly higher among participants who had moderate to severe COVID-19 (OR 6.51; 95% CI 3.46-12.23) and lower among males (OR 0.55; 95% CI 0.39-0.76). Besides these, other predictors for having sequelae were age (≥45 years), presence of any comorbidity (especially hypertension and asthma), category of HCW (non-doctors vs doctors) and hospitalisation due to COVID-19. Interpretation: Approximately one-third of the participants experienced COVID sequelae. Severity of COVID illness, female gender, advanced age, co-morbidity were significant risk factors for COVID sequelae. Funding: This work is a part of Indian Council for Medical Research (ICMR)- Rational Use of Medicines network. No additional financial support was received from ICMR to carry out the work, for study materials, medical writing, and APC.

A cost analysis and availability scenario of drugs and oral care products prescribed for common oral conditions with reference to the current Indian market prices, Jan Aushadhi, and the state medical commissions.

Context: The prevalence of oral mucosal lesions across various countries varies from 4.9% to 64.7%. The cost barrier is an important factor that prevents people in low-middle income countries from seeking professional help for dental problems. Aims: The present study aims to analyze the costs of medicines and oral care products prescribed for common oral lesions and to find the most expensive and the most economic brands. Methods and Material: The list of medicines and oral care products prescribed for the management of four oral conditions namely, recurrent aphthous stomatitis, oral candidiasis, oral herpes, and gingivitis were taken and their median retail prices, cost variation percentages were calculated from the current Indian market brands. The median retail prices were compared with their corresponding Jan Aushadhi prices. Also, the availability of the drugs and oral care products were evaluated across the state drug procurement lists of Tamil Nadu, Rajasthan, Uttar Pradesh, Telangana, and Bihar. Results: Wide cost variations were seen in most of the drugs and oral care products. The Jan Aushadhi prices of included drugs were very economical compared to the median market prices. However, the availability of the drugs was less in the Jan Aushadhi list and also in the state medical commission lists. Conclusions: The availability of such commonly used drugs in oral conditions has to be ensured in state and central departments by the policy makers. Price regulations of drugs routinely prescribed by dentists will help reduce the overall treatment costs for dental care.

Wide Cost Variations Observed in Antibiotics and Analgesics Prescribed for Dental Care in India: A Price and Affordability Analysis.

Introduction With high prevalence rates across the population, dental pain is the most common symptom that drives a patient to visit the dentist. Dentists prescribe analgesics and antibiotic prophylaxis apart from routine dental treatments. The increasing costs of medications are a major factor that adds to the financial burden of patients seeking oral care. Methods A list of antibiotics and analgesics recommended by the American Dental Association for dental pain, swelling, and post-procedural pain management was analyzed for the cost variation and cost ratio. The affordability was calculated by the World Health Organization/Health Action International (WHO-HAI) methodology. The most expensive and the least expensive brands of all drug regimens were compared. Results Wide cost variations were observed between the different brands of antibiotics and analgesics. The highest cost variation was found in ampicillin 500 mg injection (13579.2%). In the affordability analysis; when the most expensive brands were analyzed, the lowest-paid unskilled worker had to lose 2.1 days of wages to afford the drug regimen. The price range was widest for injection ampicillin 500 mg (Rs. 4.24-580.0) and lowest for tablet ibuprofen 400 mg (Rs. 0.7-1.6).  Conclusion Dental surgeons need to be well aware of the pharmacoeconomics behind medications that directly decides the affordability of treatments. Careful selection of drugs by the dentists considering their quality, availability, and costs is of pivotal importance. Prescribing generic medications and increasing the availability of drugs in public health sectors can help provide cost-effective dental care for all.

The Impact of Mindfulness Meditation on the Psychosomatic Spectrum of Oral Diseases: Mapping the Evidence.

The psychological aspect of dis-ease, which is indeed a lack of 'ease' is generally overlooked in the management of myriad maladies that affect the human body. The concept of mindfulness meditation, which is an interesting hybrid born from the meditative discipline of the east and the intellectual discipline of the west is gaining attention in the past two decades for its benefits in the holistic development of individuals. When individuals with ailments are trained under therapists supervised by the clinicians, significant results can be seen in alleviating symptoms like pain, stress, anxiety and an improvement in the quality of life is observed. This review article focuses on the structure and basics of mindful meditation and the mechanisms of mindfulness and its positive effects on various diseases like lichen planus, urticaria, psoriasis, eczema, myofacial pain dysfunction syndrome, to name a few. There are various arenas within the discipline of oral and maxillofacial medicine where mindfulness-based techniques can be explored for its effectiveness in combating psychosomatic conditions. The article highlights the importance of holistic approach in treating diseases in which mindfulness meditation techniques play an important role.

A qualitative analysis of the Parliamentary questions on the issue of obesity raised over the past two decades in India.

BACKGROUND: Obesity is a major health issue that is drastically affecting the Indian population in the recent years. It is a major predisposing factor for non-communicable diseases. INTRODUCTION: The parliament is a powerful organization that holds sessions on regular basis and allows a question hour at the end of each session. Members ask varied questions on major issues and these documented questions are a valuable source of data for policy analysis. MATERIAL AND METHODS: Questions on obesity were collected from the official websites of Lok Sabha and Rajya Sabha and thematic analysis was done with inductive reasoning. Themes and subthemes were categorized and questions were coded into nodes using N Vivo software. RESULTS: A total of 134 questions on obesity were asked in both the houses, out of which 101 questions were from Lok Sabha and 33 questions were from Rajya Sabha. Majority of the questions were asked to the ministry of health and family welfare. Only a total of 48 unique parliamentarians from 13 states have asked questions on obesity in the past two decades. DISCUSSION: The questions were of competing interests with majority of questions on incidence of obesity. A number of questions on school and community based interventions were asked and new suggestions were given by members. Questions on BMI documentation of individuals and gender predisposition showed presence of awareness and knowledge among the members on obesity. Most of the existing policies are malnutrition based and obesity has not been adequately addressed. More questions with stronger representation from all states of the country can help in effective policy planning and implementation of programs to eliminate obesity.