Public Awareness on Perio-systemic Interplay: A Cross-Sectional Survey in South India.

BACKGROUND: The oral cavity has been referred to as "the gateway to overall health." It is also said to be the meeting point of medicine and dentistry. AIMS: Our study sought to determine the extent to which the public was aware of the connection between oral/periodontal conditions and general health. SETTINGS AND DESIGN: The observational cross-sectional study's questionnaire was sectioned into oral health awareness, systemic influence on oral health, and personal oral health assessment. MATERIALS AND METHODS: A total of 994 responses were recorded and a Chi-square test was performed to uncover the relationships using SPSS version 22.0. According to responses, 70% of the population on average comprehended the responses to the majority of the oral health awareness-related questions. RESULTS: It has been noticed that only 30% of the general public was aware of the prevalent health issues like diabetes, hypertension, and malnutrition's impact on dental health. However, more than 60% had confidence in their oral health and gave a rating of at least 5. CONCLUSION: The study indicates that a good number of the population was prioritizing their oral health. However, there exists a definitive need to improve oral health awareness thereby ameliorating the overall health of an individual.

Comparative Evaluation of Various Lens and Ring Flash Combination for Intraoral Photography.

BACKGROUND: Extraoral and intraoral dental photographs serve as preoperative records and document the entire treatment. Correctly composed orthodontic photographs are crucial for remote diagnosis and may serve as a bulwark against medicolegal challenges. MATERIALS AND METHODS: In this prospective study, intraoral frontal photographs of patients with ideal occlusion were taken using two types of lenses (EF-S 18-55 mm f/3.5-5.6 IS STM lens (Canon, Tokyo, JP), SP 90 mm F/2.8 MACRO VC lens (Model F017 Tamron, NY, USA)) and two different ring flash systems (Meike FC-100 Macro Ring LED Light (Meike, China), Macro Ring flash Lite YN-14EX (Yongnuo digital, China)). The combination of lens and flash used was grouped into four groups. Twenty-eight intraoral photographs of patients were taken. An image quality assessment survey was distributed among two groups - 50 orthodontists and 50 other dental specialists. RESULTS: The participants were asked to assess all the intraoral images and subjectively score them on a scale of one to ten, with one being very poor and ten being excellent, considering the sharpness, color, brightness, contrast, and overall quality of the image. The general dentists rated the images taken with a 90-mm macro lens and ring flash as the best quality photographs. Images obtained using an 18-55 mm lens and ring LED received significantly lesser scores and were graded good by dentists. CONCLUSION: This combination of lens and flash may prove a valuable investment in the long-term aiding in excellent dental images for diagnosis and treatment monitoring.

Validation of Diagnostic Utility of Salivary Urea in Patients with Chronic Kidney Disease in Chennai: A Cross-Sectional Study.

BACKGROUND: Serum urea levels are essential for the diagnosis of chronic kidney disease (CKD), as they are a measure of renal function. Salivary urea has been used as an alternative to serum urea in patients with CKD. AIM: To estimate serum urea levels and their correlation with salivary urea levels in order to validate the use of saliva as an alternative diagnostic tool for renal dysfunction. PATIENTS AND METHODS: Thirty healthy individuals and 150 patients with CKD (30 from each CKD stage) were recruited for the study. Serum and salivary samples were collected to estimate the urea levels, and statistical analyses were performed. RESULTS: Statistically significant (P < 0.05) differences in the mean serum and salivary urea levels were observed between the healthy and each stage of the CKD group; significance at P < 0.05 was observed within the stages of CKD as well. Correlation analysis also showed significant differences between the serum and salivary urea levels at each stage of the disease. Receiver operating characteristic analysis revealed a higher area under the curve of 0.917 at a 95% confidence interval with a salivary urea cut-off of 28.25 mg/dl (sensitivity and specificity: 88% and 84%, respectively). CONCLUSION: The variability in salivary urea levels in the early and late stages suggests the use of salivary urea in the late stages of CKD. It is suggested that salivary urea levels may be used as an alternative to serum to assess and monitor the progression of renal impairment along with other standard renal function markers.

Comparison of bacterial colonization on absorbable non-coated suture with Triclosan- or Chlorhexidine-coated sutures: a randomized controlled study.

OBJECTIVE: The oral cavity is a colossal reservoir for the bacteria. The healing of tissues is compromised after flap surgery, particularly in the presence of sutures, as they can act as repositories for bacteria, ultimately leading to surgical site infections. Hence, antibacterial-coated sutures have been considered as an alternative to reduce the risk of these infections and further improve the wound healing of the tissues after flap surgery. Since minimal information is available on the effect of antibacterial-coated sutures on periodontal tissues, this study aims to clinically and microbiologically assess the antibacterial efficacy of Triclosan (TCS) and Chlorhexidine-coated sutures (CCS) on periodontal tissues compared to non-coated sutures (NCS). PATIENTS AND METHODS: A total of 75 subjects with moderate to severe periodontitis were included in the study and randomly allocated to one of the three groups, (TCS, CCS, and NCS groups) equally. Suture removal was performed on postoperative day 8, and parameters such as wound healing and post-operative pain were evaluated. The retrieved suture samples were subjected to microbiological analysis and the bacteria were identified quantitatively and qualitatively. RESULTS: Intragroup analysis of the wound healing index and post-operative pain for all the groups showed a significant improvement (p<0.01), from day 8 to day 30. Intergroup analysis of the wound healing index revealed significant wound healing (p<0.05) on day 15 and day 30. For post-operative pain, intergroup analyses showed significantly low pain scores (p<0.01) for the TCS group. Microbiologic analysis of aerobic colony counts in both anterior and posterior regions revealed significantly (p<0.01) least colony counts in TCS and highest colony counts in NCS groups, respectively. Although anaerobic colony counts were not statistically significant, relatively fewer colony counts were identified in the TCS group. Whereas, relatively higher anaerobic colony counts were seen in the CCS group in the anterior region and in the NCS group in the posterior region. Qualitative assessment revealed higher amounts of Streptococcus and Staphylococcus species in all the three groups (TCS, CCS, and NCS groups). CONCLUSIONS: Antibacterial-coated sutures, particularly Triclosan-coated sutures, are effective in reducing bacterial accumulation compared to non-coated sutures. Therefore, these sutures can be effectively utilized in periodontal flap surgery.

Evaluation of scanning accuracy for two commercially available intraoral scanners in reproducing orthodontic bracket dimensions.

OBJECTIVE: The aim of this study was to compare the scanning accuracy of two different intra-oral scanners- MEDIT i500 and TRIOS 3 shape in reproducing orthodontic bracket dimensions. MATERIALS AND METHODS: This in vivo cross-sectional study comprised seven subjects with a full complement of permanent dentition without third molars. Complete arch scanning was carried out with two intraoral scanners, such as MEDIT i500, TRIOS 3 shape, after bonding with brackets. The control group consisted of bracket dimensions measured directly by using Vernier calipers before bonding. Bracket dimensions of three-dimensional (3D) images were measured by using OrthoAnalyzer software. The accuracy of intraoral scanning was investigated by comparing bracket dimensions among the three groups using One-way ANOVA and Post-Hoc Tukey HSD test, and by evaluating outcomes for each quadrant and an individual tooth in complete-arch scans. RESULTS: When comparing bracket dimensions of 3D images with manual measurements using a traditional Vernier caliper, MEDIT i500 showed no significant difference when compared to the control group (p>0.05) in full arch scanning as well as the quadrant and single tooth scans in complete arch scanning. TRIOS 3 shape showed a significant difference when compared to the control and MEDIT i500 group (p<0.05) for all parameters. CONCLUSIONS: MEDIT i500 showed higher accuracy and better reproduction of orthodontic bracket dimensions than TRIOS 3 shape.

Root surface changes following manual and ultrasonic instrumentation - a scanning electron microscopic study.

OBJECTIVE: The aim of this study is to assess the efficacy of hand and ultrasonic scaling and to evaluate the surface roughness on the root surface of periodontally involved teeth using a scanning electron microscope. PATIENTS AND METHODS: A sample of 90 single-rooted teeth with a hopeless prognosis was selected for the study and divided into three separate groups. Group I consist of no treatment. In Group II, hand scaling was done using Gracey curettes, and in Group III, ultrasonic scaling was done. The teeth were then extracted and fixed in 10% formaldehyde solution for 24-48 hours and subjected to scanning electron microscopic (SEM) evaluation. RESULTS: The SEM analysis revealed that the remaining calculus index was found to be similar in the ultrasonic group and the hand scaling group, whereas the surface roughness was found to be the least in the ultrasonic group. CONCLUSIONS: Hand instrumentation has resulted in more surface roughness as compared to ultrasonic instruments.

Antimicrobial Efficacy of Blended Essential Oil and Chlorhexidine against Periodontal Pathogen (P.gingivalis)-An In Vitro Study.

Background: Essential oils (EOs) have a considerable amount of therapeutic and preventive effect in treating dental diseases due to their wider potential as antibacterial and anti-inflammatory agents. EOs like virgin coconut oil, eucalyptus oil, peppermint oil thyme oil, and clove oil, when used in combination, may further have enhanced antimicrobial effects. However, limited information exists on the synergistic effect of these oils when used in combination, especially on the primary periodontal pathogen Porphyromonas gingivalis. Aim: The current study aims to compare the antimicrobial efficacy of commercially available EO on the periodontal pathogen, P. gingivalis, in comparison to chlorhexidine (CHX). Materials and Methods: Antimicrobial efficacy of EO and CHX was assessed at various concentrations against the periodontal pathogen P. gingivalis, by evaluating the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). Results: P. gingivalis was seen to be sensitive at a MIC of 100 µg/ml and 50 µg/ml concentration of the EO, which is regarded as the MIC of EO against P. gingivalis and CHX effectively inhibited microbial growth at 0.4 µg/ml. Conclusion: A combination of EOs possesses a potent antibacterial activity against P. gingivalis, and the antibacterial efficacy increases with increasing concentration of EOs.

Anti-microbial efficacy of root canal preparation in deciduous teeth with manual and rotary files: A randomized clinical trial.

Background: In a pulpectomy, the eradication of microbes from the primary root canal is accomplished through biomechanical preparation, which could be carried out with either manual or rotary instruments. Aims: The objective of this clinical trial was to evaluate the efficiency of manual K-files, H-files, and Kedo-S Square rotary files in reducing microbial flora after canal preparation in primary molars. Materials and Methods: This randomized clinical trial consisted of 45 primary molars requiring pulpectomy. The teeth were randomly allocated to one of the three groups: Group I: Manual K-files, Group II: Manual H-files, and Group III: Kedo-S Square rotary files, based on the type of instrumentation. Pre-and Post-instrumentation sampling was performed using clean absorbent paper points and kept in a clean Eppendorf tube having thioglycolate broth as the transport medium. Culturing was performed on agar media from which both aerobic and anaerobic microbial counts were estimated. Collected data were statistically analyzed using one-way analysis of variance (ANOVA) and Wilcoxon signed-rank test. Following root canal preparation, 87-89% reduction of the aerobic and anaerobic microbial load was noted in group I, whereas it was an 89-92% reduction in group II and a 93-95% reduction in group III. Results: Biomechanical preparation with Kedo-S Square rotary file showed higher efficacy in microbial reduction compared to manual instrumentation. Conclusion: Manual and rotary files were equally effective in removing root canal microbes. Biomechanical preparation with a KedoS Square rotary file resulted in greater microbial efficacy. Hence In children, effective root canal cleaning in a short period of time is a major consideration.

Fagonia cretica: Identification of compounds in bioactive gradient high performance liquid chromatography fractions against multidrug resistant human gut pathogens.

Plants are alternative source of natural medicines due to secondary active metabolites. Fagonia cretica extracts and Gradient High-Pressure Liquid Chromatography fractionations were checked against multidrug-resistant gastrointestinal pathogens including, Salmonella typhi, Escherichia coli and Shigella flexneri. ESI-MS/MS analysis of bioactive HPLC fractions was performed to elucidate antibacterial compounds. F. cretica extracts exhibited potential antibacterial activity. Twenty-four (24) HPLC fractions were obtained from methanol, ethanol and aqueous extracts of F. cretica. Eighteen (18) fractions showed antibacterial activity, while no activity was observed by the remaining six (6) fractions. HPLC fractions, F1 (25g ± 0.20 mm) and F2 (15f ± 0.12 mm) of aqueous extract exhibited activity against multidrug resistant GI pathogens. Gallic acid, quinic acid, cyclo-l-leu-l-pro, vidalenolone, liquirtigenin, rosmarinic acid and cerebronic acid were identified in F1 fraction of aqueous extract, while succinic acid, cyclo (l-Leul-Pro) and liquirtigenin were identified in F2 fraction of aqueous extract through ESI-MS/MS analysis. F. cretica extracts and HPLC fractions showed potential activity against MDR GI pathogens. Vidalenolone, Cyclo-1-leu-1-pro and Cerebronic acid are first time reported in F. cretica. Further characterization of bioactive compounds from F. cretica may be helpful to elucidate antibacterial therapeutic molecules.

Fagonia cretica: Identification of compounds in bioactive gradient high performance liquid chromatography fractions against multidrug resistant human gut pathogens

@#Plants are alternative source of natural medicines due to secondary active metabolites. Fagonia cretica extracts and Gradient High-Pressure Liquid Chromatography fractionations were checked against multidrug-resistant gastrointestinal pathogens including, Salmonella typhi, Escherichia coli and Shigella flexneri. ESI-MS/MS analysis of bioactive HPLC fractions was performed to elucidate antibacterial compounds. F. cretica extracts exhibited potential antibacterial activity. Twenty-four (24) HPLC fractions were obtained from methanol, ethanol and aqueous extracts of F. cretica. Eighteen (18) fractions showed antibacterial activity, while no activity was observed by the remaining six (6) fractions. HPLC fractions, F1 (25g ± 0.20 mm) and F2 (15f ± 0.12 mm) of aqueous extract exhibited activity against multidrug resistant GI pathogens. Gallic acid, quinic acid, cyclo-l-leu-l-pro, vidalenolone, liquirtigenin, rosmarinic acid and cerebronic acid were identified in F1 fraction of aqueous extract, while succinic acid, cyclo (l-Leul-Pro) and liquirtigenin were identified in F2 fraction of aqueous extract through ESI-MS/MS analysis. F. cretica extracts and HPLC fractions showed potential activity against MDR GI pathogens. Vidalenolone, Cyclo-1-leu-1-pro and Cerebronic acid are first time reported in F. cretica. Further characterization of bioactive compounds from F. cretica may be helpful to elucidate antibacterial therapeutic molecules.

Relationship of asthma control test scores with pulmonary function tests, quality of life and adiposity in asthmatic children.

OBJECTIVE: This study aimed at assessing asthma control test (ACT score), quality of life (QOL), and pulmonary functions in asthmatic children, and to see the correlations between ACT score, QOL, and pulmonary functions. PATIENTS AND METHODS: This cross-sectional study was conducted at the departments of pediatrics and physiology, College of Medicine, King Saud University Medical City (KSUMC), Riyadh, Saudi Arabia. A total of 109 (53 asthmatics and 56 controls) children (aged 6 to 13 years) of both genders were studied. All subjects underwent clinical evaluation, 36-Item Short Form Survey (SF-36) for QOL, Spirometry, and cognitive assessment through mini mental state examination (MMSE). RESULTS: QOL showed significantly lower scores in asthmatic compared to non-asthmatic children. The higher social functioning [SF] (p=0.0012) and less role limitation due to physical health [RLPH] (non-asthmatic patients had had higher physical functioning [PF] (p=0.0001), less energy/fatigue [EF] (p=0.0008=0.0068). On the opposite side, no significant difference was found regarding role limitations due to emotional problems [RLEP] (p=0.0644) and Emotional well-being [EW] (p=0.0758) between the two groups. A significant positive correlation was seen between QOL items and ACT score in PF (r=.535, p<0.01), less RLPH (r=.593, p<0.01), less FE (r=.379, p<0.01), higher EW (r=.310, p<0.05), and higher SF (r=.495, p<0.01). No significant correlation was found between body mass index (BMI) and lung functions in children with asthma. Interestingly, a positive correlation was found in asthmatic children between BMI and MMSE scores (r=.298, p=0.030). CONCLUSIONS: Our study concluded that QOL in asthmatic patients was significantly lower than healthy subjects in terms of patient's physical functioning and social life. However, the emotional aspects of QOL were not significantly affected in asthmatic children.

Operative versus conservative treatment for giant omphalocele: Study of French and Ivorian management.

INTRODUCTION: The giant omphalocele is currently a surgical challenge. The morbidity and mortality associated with its care is non-negligible. Nowadays, different studies have revived the debate between conservative and surgical management for giant omphalocele. The purpose of this study is to compare the conservative and surgical management of the giant omphalocele in terms of morbidity and mortality. METHODS: Retrospective study including all giant omphaloceles comparing surgical management (French University hospital centers) and tanning (Ivory Coast University hospital center). Epidemiology was studied as well as medical and surgical managements both intra and post operative. RESULTS: One hundred and forty-seven patients included (98 patients in the "tanning" group and 49 in the "surgery" group). Hospital length of stay is significantly shorter in the "tanning" group as they do not spend time in intensive care unit. Morbidity is higher in "surgery" group. The average duration for oral empowerment was acquired at 179 days in the "surgery" group, whereas in the "tanning" group 90% was immediately and exclusively breastfed. No significant differences in terms of epithelialization time. CONCLUSION: The tanning treatment has its own place in the therapeutic arsenal in the management of the giant omphalocele no matter where it takes place. However, its realization in surgical environments prevents certain complications related to the technique or the pathology.

Density functional calculations reveal a flexible version of the copper paddlewheel unit: implications for metal organic frameworks.

Density functional theory calculations on [Cu2(O2CR)4L2] systems reveal a change in ground state with increasing Cu-L bond strength. For L = N-heterocyclic carbene (NHC), the Jahn-Teller axis switches from parallel to orthogonal to the Cu-Cu vector and the copper coordination geometry becomes highly flexible. While the calculated dimer/monomer equilibrium for isolated complexes slightly favours monomers, the preformed paddlewheel units embedded in many metal organic frameworks are potential targets for developing novel materials.

Learning from defects using a comprehensive management system for incident reports in critical care.

Incident reporting systems are often used without a structured review process, limiting their utility to learn from defects and compromising their impact on improving the healthcare system. The objective of this study is to describe the experience of implementing a Comprehensive Management System (CMS) for incident reports in the ICU. A physician-led multidisciplinary Incident Report Committee was created to review, analyse and manage the department incident reports. New protocols, policies and procedures, and other patient safety interventions were developed as a result. Information was disseminated to staff through multiple avenues. We compared the pre- and post-intervention periods for the impact on the number of incident reports, level of harm, time needed to close reports and reporting individuals. A total of 1719 incidents were studied. ICU-related incident reports increased from 20 to 36 incidents per 1000 patient days (P=0.01). After implementing the CMS, there was an increase in reporting 'no harm' from 14.2 to 28.1 incidents per 1000 patient days (P<0.001). There was a significant decrease in the time needed to close incident report after implementing the CMS (median of 70 days [Q1-Q3: 26-212] versus 13 days [Q1-Q3: 6-25, P<0.001]). A physician-led multidisciplinary CMS resulted in significant improvement in the output of the incident reporting system. This may be important to enhance the effectiveness of incident reporting systems in highlighting system defects, increasing learning opportunities and improving patient safety.