Behavioral Patterns Toward Preventive Dental Care at School Dental Camps: An Observational Study in Bengaluru.

Background Dental behavior management problems of children towards preventive dental care at school dental camps in India remain largely undocumented. This study aimed to assess such behavior patterns in preschool and school-age children at a school dental health camp. Materials and methods The cross-sectional study included 462 children, with 261 children each in the preschool (three to five years old) and school (six to 12 years old) age groups in Bengaluru. On the school dental camp day, their behavior and anxiety were gauged using the Frankl Behavior Rating Scale and the Raghavendra, Madhuri, and Sujata Pictorial Scale, respectively. The Chi-square test was used to uncover predictive variables for children's behavior patterns toward preventive dental procedures at the dental school camps. Results A high prevalence of definitely negative Frankl Behavior Rating Scale ratings (59%, n=272) and dental anxiety (53%, n=245) were noted among the participants. Age, sex, the area of residence of the child, and the previous history of dental visits and treatment were predictors of their behavior at a school dental camp setup. Conclusion The present study gives an insight into the behavior of children towards preventive dental care at a school dental camp in a mobile dental van, stressing the need for behavior assessment before the treatment.

A double-blind randomized controlled trial to compare the safety and efficacy of dexmedetomidine alone and in combination with ketamine in uncooperative and anxious paediatric dental patients requiring pulpectomy.

AIM: To compare the sedation regimen Dexmedetomidine alone and its combination with low dose Ketamine through intravenous route in terms of safety, efficacy and recovery profile in uncooperative paediatric dental patients requiring pulpectomy. MATERIAL AND METHODS: Thirty anxious and uncooperative 2-6-year-old children requiring pulpectomy in at least one primary molar were enrolled. Propofol was used as an induction agent. Drugs were administered through the intravenous route as per group assignment, i.e., Dexmedetomidine (1 µg/kg) with ketamine (0.5 mg/kg) administered over 10 min followed by a maintenance dose of Dexmedetomidine (0.2-0.8 µg/kg/h) in group A and Dexmedetomidine (1 µg/kg) administered over 10 min followed by a maintenance dose in group B. The sedation was titrated to achieve Houpt's overall behavior score of 4/5. The primary outcome measure was the successful completion of treatment. Secondary outcome measures were vital signs, quality of sedation, time need for the procedure, recovery time, intra-operative and post-operative adverse sequelae. RESULTS: Results showed that both of the regimens were similar in efficacy, safety and recovery profile. Also, the required dose of dexmedetomidine and the need for rescue boluses was similar in both of the study groups. CONCLUSION: Dexmedetomidine either alone or in combination with ketamine proved to be a safe and efficacious agent for paediatric dental sedation. No beneficial evidence of adding ketamine was observed.

Emergency Preparedness and Modish Practices among Primary Healthcare Delivery Systems Facilitated through Public-private Partnership Models in a South Indian Metropolitan City: A Descriptive Cross-sectional Study.

Background and aim: Access to health care is supposed to be a basic human right but the present scenario of the healthcare sector in India displays a large disparity in the healthcare services provided by the public and private sectors with wide variations in the infrastructure and services delivered by both sectors. Hence, public-private partnership (PPP) in healthcare delivery is an urgent and essential component that needs attention to ameliorate this gap. The aim of this study was to assess the current practices in healthcare services provided through PPPs in Bengaluru city. Materials and methods: A cross-sectional questionnaire survey was conducted among primary healthcare centers (PHC) run under PPP in Bengaluru city, Karnataka, India. The pretested self-designed structured questionnaire consisted of 18 items regarding the current practices of PPP at the primary healthcare level. Descriptive statistics were used to describe the data. Results: A total of 15 PPPs at the primary healthcare level were identified and included in the study. All of the participants provided basic healthcare services, some participants (33%) provided specialized services, and some (27%) mobile healthcare services. The overall impression of the medical officers in charge interviewed was that PPPs are better than individual endeavors by both public and private sectors. They also believed that it was important to have policies and guidelines in place to monitors aspects like the functioning of the setup, risk sharing, etc. Conclusion: The results indicated that all the participants were at the primary healthcare level and mostly involved in preventive practices. It is also important to look at venturing into services that provide curative services as well. Oral health, however, did not prominently feature at any point and is another area that requires attention. How to cite this article: Mukherji I, Eshwar S, Srivastava BK, et al. Emergency Preparedness and Modish Practices among Primary Healthcare Delivery Systems Facilitated through Public-private Partnership Models in a South Indian Metropolitan City: A Descriptive Cross-sectional Study. Int J Clin Pediatr Dent 2022;15(2):153-158.

New Vision for Improving the Oral Health Education of Visually Impaired Children- A Non Randomized Control Trial.

INTRODUCTION: Visually impaired people have poorer oral hygiene when compared to others. Therefore, there is a necessity for individual training by making awareness in oral care and plaque control so as to improve their oral hygiene. AIM: The aim of the present study was to assess the effectiveness of oral health innovative educative method among visually impaired children of Bengaluru city of India. MATERIALS AND METHODS: A non-randomized control trial was conducted among 40 visually impaired individuals attending special school for blind. The study was conducted for a duration of six months. Baseline data regarding oral health knowledge, attitude and practices was obtained through a questionnaire in Braille and oral plaque assessment was done using Silness and Loe plaque index (1964). Music based brushing technique, cast models and an oral health education talk and booklet in Braille was delivered stressing on importance of oral health. The results of Knowledge, Attitude and Practices (KAP) before and after health education were analysed using Chi-square test with SPSS version 22.0. RESULTS: The overall KAP was lower in the preintervention period among the visually impaired children with mean score of 6.98 while after the modified oral health education session, it was increased to a mean score of 14.68 which was statistically significant at p<0.001. There was a significant change in the oral plaque scores with 80% of the children having fair scores in the preintervention period to 30% in the postintervention period. CONCLUSION: This oral health education module showed good results which can be implemented to effectively increase the awareness about dental health.

Effect of Sildenafil Citrate on Pulmonary Arterial Systolic Pressure and Sub-maximal Exercise Capacity in Chronic Obstructive Pulmonary Disease.

Background Pulmonary hypertension (PH) often complicates Chronic Obstructive Pulmonary Disease (COPD). Sildenafil reduces pulmonary arterial pressure associated with multitude of diseases. Objective To evaluate the use of Sildenafil in Pulmonary Hypertension associated with COPD. Method This randomized control study enrolled 72 patients: 61 completed the study. Thirtypatients with COPD received Sildenafil 25 mg thrice daily and 31 patients with COPD received optimal medical therapy for four weeks. Symptom assessment and dyspnoea grading was done with modified Borg scale and Modified Medical Research Council (MMRC) grade. The functional assessment was done with WHO functional classification. The estimation of pulmonary arterial systolic pressure and six minute walking distance was done before and after four weeks of the administration of therapy in both groups. Adverse reaction profiling was done for Sildenafil. The primary outcomes were the changes in pulmonary arterial systolic pressure and six minute walk test. The secondary outcomes were change in modified Borg scale for dyspnoea, MMRC grading and WHO functional class. Result The mean decrease in pulmonary arterial systolic pressure in Sildenafil group was significant as compared to controls (9.87+7.84 mmHg Vs 5.93+7.44 mmHg, P=0.048). The mean increase in six minute walk distance was significantly more in cases as compared to controls (48.13+25.79 m Vs 32.59+32.96 m,P=0.047). The changes in modified Borg scale was not significant (1.20+1.92 to 1.55+1.23; P=0.401). There was significant changes in MMRC grade (p=0.037). There was no significant change in WHO functional class after four weeks (p=0.071). Conclusion Sildenafil marginally decreased pulmonary arterial systolic pressure and increased six minute walk distance in COPD patients. It improved MMRC grading without affecting modified Borg's Scale and WHO functional class.

Determinants of Tobacco Use and Prevalence of Oral Precancerous Lesions in Cab Drivers in Bengaluru City, India.

BACKGROUND: Tobacco is a most important risk factor for various types of cancer as well as some noncommunicable disease. Around 34.6% of Indian population consume tobacco. The tobacco consumption is higher in some vulnerable population such as drivers, daily wage laborers, and policemen. Tobacco consumption is known to cause oral cancers, and screening for oral cancer in these individuals is known to reduce mortality from cancer. The study was designed to assess the determinants of tobacco use and the prevalence of oral precancerous lesions in cab drivers. METHODS: This is a cross-sectional study among cab drivers at prepaid taxi counters in Bengaluru city. A total of 450 cab drivers were enrolled in the study, of which 225 cab drivers were interviewed during morning hours and remaining half at night time using a semi-structured questionnaire. All were screened for oral cancer/precancerous lesions. RESULTS: Nearly 70.88% of cab drivers were consuming tobacco in any form. Long working hours, working at night, and family members consuming tobacco were significant risk factors for tobacco use among cab drivers. Forty-eight drivers were detected to have oral precancerous lesions. CONCLUSIONS: It was very evident that long hours of driving and infrequent shifts played a greater role in acquiring the habit. Behavioral counseling and new laws need to be formed to limit the working hours in drivers to have an effective tobacco control.

Optimization of postharvest ultrasonic treatment of kiwifruit using RSM.

This study reports the optimization of ultrasonic treatment combined with sodium hypochlorite (NaOCl) solution on kiwifruit (Actinidia deliciosa) to evaluate its effect on microbial population, respiration rate and its textural quality. Response surface methodology (RSM) based on four factors three level central composite design was applied to investigate the effects of process variables on ultrasonic treatment. Four independent variables include ultrasonic intensity (184-368W/cm(2)), temperature (25-40°C), treatment time (8-15min) and concentration of the solvent (30-60ppm) were considered for this study. According to RSM analysis, the optimal treatment parameters obtained were ultrasonic intensity (368W/cm(2)), temperature (25°C), treatment time (8min) and concentration of the solvent (30ppm). Microbial population, respiration rate and some quality parameters were compared with NaOCl treated kiwifruits. An ultrasound combined with NaOCl was found to be the most effective treatment in inhibiting the microbial growth (bacteria, yeast and mold) and preserving the quality of kiwifruits, and these results suggest that the ultrasound treatment may provide an alternative for extending the shelf life of whole kiwifruit, maintains the quality of fresh cut kiwifruits and further increases the shelf life of chitosan coated fresh cut kiwifruit.

Manipulation of BCG vaccine: a double-edged sword.

Mycobacterium bovis Bacillus Calmette-Guérin (BCG), an attenuated vaccine derived from M. bovis, is the only licensed vaccine against tuberculosis (TB). Despite its protection against TB in children, the protective efficacy in pulmonary TB is variable in adolescents and adults. In spite of the current knowledge of molecular biology, immunology and cell biology, infectious diseases such as TB and HIV/AIDS are still challenges for the scientific community. Genetic manipulation facilitates the construction of recombinant BCG (rBCG) vaccine that can be used as a highly immunogenic vaccine against TB with an improved safety profile, but, still, the manipulation of BCG vaccine to improve efficacy should be carefully considered, as it can bring in both favourable and unfavourable effects. The purpose of this review is not to comprehensively review the interaction between microorganisms and host cells in order to use rBCG expressing M. tuberculosis (Mtb) immunodominant antigens that are available in the public domain, but, rather, to also discuss the limitations of rBCG vaccine, expressing heterologous antigens, during manipulation that pave the way for a promising new vaccine approach.

Synthesis and Biological Studies of a Novel CB1 Antagonist.

This paper describes the synthesis, early process development, salt selection strategies and pre clinical evaluation of novel, potent and selective CB1 antagonist, 8-Chloro-1-(2,4-dichloro-phenyl)-4,5-dihydro-1H-6-oxa-1,2-diaza-benzo[e]azulene-3-carboxylic acid piperidin-1-ylamide 1. The CB1 antagonism of compound 1 is also confirmed by reversal of CB1 agonist-induced hypothermia in Swiss albino mice. The process for the preparation of the compound 1 as a crystalline solid is also described. The crystalline form of the compound is found to be low bioavailable, therefore attempts have been made to improve its bioavailability through polymorphic transformation and salt formation. None of the salts prepared were found to be suitable for further development. The amorphous form of the compound 1 is found to be better suited. In vivo efficacy study of the amorphous form of compound 1 in 5% sucrose solution intake model in female Zucker fa/fa rats at single oral dose of 10 mg/kg demonstrates better reduction in the sucrose solution consumption than the corresponding crystalline form. The plasma concentration Cmax at AUC exposure of the amorphous form of the compound 1 is significantly improved and better than the Cmax of the corresponding crystalline form of the compound 1. On the basis of the efficacy, pharmacokinetic and toxicological evaluations, the compound 1 in the amorphous form is selected as a pre-clinical lead candidate.

Six Minute Walk Distance and Reference Equations in Normal Healthy Subjects of Nepal.

BACKGROUND: The self-paced six minute walk test is a simple assessment for sub-maximal functional capacity. It correlates well with sophisticated tests and gives good prediction for morbidity, mortality, quality of life and pulmonary functions. OBJECTIVE: To evaluate six minute walk distance in healthy adults to identify reference values and formulate reference equations. METHOD: We conducted six minute walk test on 250 random volunteers at and above 18 years of age as per standard protocol. Age, gender, height and weight were measured. Pretest and post-test vital parameters were recorded including pulse oximetry. The six minute walking distance was identified in all subjects. Multiple regression analysis was done to formulate regression equations to predict six minute walking distance. This also correlated age, gender, height, weight, body mass index with six minute walking distance. RESULT: The mean six minute walking distance was 489±86 meters with males walking 509±82 meters and females 445±78 meters. Age, gender, weight and body mass index had significant contribution for prediction of six minute walking distance. Gender was the single most important predictor. Height had the least significance. Depending on coefficients of these variables we formulated three regression equations and tested them for accurate prediction. The two best equations were identified as: Predicted SMWD = 395-1.5xAge+2.47xWT-35.89xGender and Predicted SMWD = 440-1.82xAge-53.07xGender+5.12xBMI. CONCLUSION: Gender, age and height are the most important predictors of six minute walking distance. Reference values and equations for both genders, different age groups with varying weights were derived for local population.

Use of traditional Indian plants in the inhibition of caries-causing bacteria--Streptococcus mutans.

The aim of the study was to comparatively evaluate the antibacterial activity of six Indian plant extracts and 0.2% chlorhexidine against clinical strains of Streptococcus mutans, which were isolated from the plaque samples of 45 pediatric patients. Six plant extracts were prepared in three different forms, namely aqueous extracts, organic solvent-based extracts and crude (raw) extracts. The antimicrobial sensitivity testing was done by agar well diffusion method. Antimicrobial activity of the extracts was determined by measuring the mean zones of inhibition (mm) produced against the bacterial isolates. Results showed that crude garlic extract exhibited greater antibacterial activity than chlorhexidine. Aqueous extract of amla and organic solvent-based extract of ginger showed the maximum antibacterial activity against S. mutans, whereas aqueous extract of tulsi and organic solvent based extract of amla showed the minimum antibacterial activity. This study suggests that plant extracts like garlic in crude form, amla as aqueous infusion and ginger as alcoholic tincture have potential for the control of S. mutans. These extracts can be used as an alternative remedy for dental caries prevention or in the form of mouthwash, which is safe and economical.

Use of Traditional Indian Plants in the Inhibition of Caries-Causing Bacteria - Streptococcus mutans

The aim of the study was to comparatively evaluate the antibacterial activity of six Indian plant extracts and 0.2% chlorhexidine against clinical strains of Streptococcus mutans, which were isolated from the plaque samples of 45 pediatric patients. Six plant extracts were prepared in three different forms, namely aqueous extracts, organic solvent-based extracts and crude (raw) extracts. The antimicrobial sensitivity testing was done by agar well diffusion method. Antimicrobial activity of the extracts was determined by measuring the mean zones of inhibition (mm) produced against the bacterial isolates. Results showed that crude garlic extract exhibited greater antibacterial activity than chlorhexidine. Aqueous extract of amla and organic solvent-based extract of ginger showed the maximum antibacterial activity against S. mutans, whereas aqueous extract of tulsi and organic solvent based extract of amla showed the minimum antibacterial activity. This study suggests that plant extracts like garlic in crude form, amla as aqueous infusion and ginger as alcoholic tincture have potential for the control of S. mutans. These extracts can be used as an alternative remedy for dental caries prevention or in the form of mouthwash, which is safe and economical.

O objetivo do estudo foi avaliar comparativamente a atividade antibacteriana de seis plantas indianas contra linhagens clínicas de Streptococcus mutans, que foram isoladas das amostras de biofilme dental de 45 pacientes pediátricos, com 0,2% de clorexidina. Seis extratos vegetais foram preparados em três formas diferentes, a saber, extratos aquosos, extratos à base de solventes orgânicos e extratos brutos. Os testes de sensibilidade antimicrobiana foram realizados por método de difusão em agar. A atividade antimicrobiana dos extratos foi determinada através da medição da zona de inibição, em milímetros, produzida contra os isolados bacterianos. Os resultados mostraram que o extrato de alho cru apresentou maior atividade antibacteriana do que a clorexidina. O extrato aquoso de amla e o extrato à base de solventes orgânicos de gengibre mostraram a máxima atividade antibacteriana contra S. mutans, enquanto o extrato aquoso de tulsi (manjericão) e o extrato à base de solventes orgânicos de amla mostraram mínima atividades antibacteriana. Este estudo sugere que extratos de plantas como o alho em forma bruta, amla como infusão aquosa e gengibre como tintura alcoólica tem um potencial para o controle de S. mutans. Estes extratos podem ser utilizados como uma via alternativa para a prevenção de cáries dentárias ou sob a forma de bochechos, que são seguros e econômicos.

Validation of Tanaka and Johnston's analysis in western UP Indian population.

OBJECTIVE: To examine the applicability of the Tanaka and Johnston's method of prediction in a western UP population and to develop a new prediction method for this specific population if necessary. MATERIALS AND METHODS: 150 western UP school children (87 males and 63 females) with a mean age of 15.5 years were randomly selected. The mesio-distal crown diameters of the permanent canine and premolars were measured and comparisons were done between the actual tooth sizes and the values predicted by the Tanaka and Johnston method. RESULTS: Significant sexual dimorphism was found in the tooth sizes. There were significant differences between the actual measurements and the predicted measurements derived by the Tanaka and Johnston prediction method. New linear regression equations were derived for both the genders for tooth size prediction in western UP population. CONCLUSION: There are limitations in the application of the Tanaka and Johnston's prediction method to a western UP population. A gender discrepancy is seen between the males and the females. New regression equations were formulated for both the males and the females separately.

Association of maternal risk factors with early childhood caries in schoolchildren of Moradabad, India.

BACKGROUND: Children who have caries in their primary teeth in infancy or toddlerhood tend to develop dental caries in their permanent dentition. Although risk indicators are helpful in identifying groups at risk, they give little information about the causes of difference in caries experience. AIM: To identify the association between maternal risk factors and early childhood caries among 3- to 5-year-old schoolchildren of Moradabad City, Uttar Pradesh, India. DESIGN: A total of 150 child-mother pairs participated in the study. The maternal risk factors were assessed by a pretested questionnaire. After obtaining the consent, the mothers and their children were clinically examined for dental caries using Radike criteria (1968). Saliva was collected from all the participating mothers for assessing the Streptococcus mutans level. RESULTS: Significant differences were found in mothers' caries activity, high level of S. mutans, educational level, socioeconomic status, frequency of maternal sugar consumption, and their child's caries experience (P < 0.001). CONCLUSIONS: Differences between children's situations in these underlying factors play out as consequential disparities in both their health and the health care they receive.

Expression and modulation of progesterone induced blocking factor (PIBF) and innate immune factors in human leukemia cell lines by progesterone and mifepristone.

Progesterone (P), required for successful pregnancy, influences autoimmune, infectious, and malignant diseases via adaptive and innate immune effects. P induces NK inhibitor progesterone induced blocking factor (PIBF) in CD8+ T cells. PIBF isoforms could permit solid tumor immune escape. Expression and modulation of PIBF and innate immune proteins by P in leukemia cells and leukocyte subpopulations have not been reported. Ten T, seven myeloid, six B, five epithelial, fibroblast BG9, G-CSF mobilized CD34+ stem cells, and peripheral blood mononuclear cells were screened for PIBF mRNA by RT-PCR, and protein by immunohistochemistry in SRIK-NKL, MOT, U937, HL60, R-CLL, MD-E, 729pH6neo, SRIH-B(ATL), SRIK-B(T-PLL), and MeWo. Cell lines expressing PIBF and exemplifying myeloid/monoblast, natural killer/T, and B lineages were cultured with and without 0.5 - 5 microM P or 0.5 - 0.05 microM mifepristone (RU486) for 24 h. Subsequently they were examined for changes in the expression of mRNA by RT-PCR and protein by immunohistochemistry for PIBF and some innate immune factors. All cells expressed PIBF mRNA; protein only in four (SRIK-NKL, U937, SRIK-B(T-PLL) and HL60) out of 10 cell lines tested. P increased and RU486 decreased PIBF in U937, SRIK-B(T-PLL) and SRIK-NKL. P upregulated TLR-4 in U937, and HNP1 - 3, LL-37, IRAK-2, and IRAK-4 in multiple lines and RU486 down regulated these. PIBF may be used by some leukemias to evade immune surveillance and is a potential therapeutic target. P may impact infection and autoimmunity via effects on LPS receptor, TLR signaling, and antimicrobial peptides.

Intimal media thickness, glucose intolerance and metabolic syndrome in Asian Indians--the Chennai Urban Rural Epidemiology Study (CURES -22).

AIMS: The aim of the present study was to assess carotid intimal media thickness (IMT) in different grades of glucose intolerance and the metabolic syndrome (MS) in Asian Indians, a high-risk group for diabetes and coronary artery disease. METHODS: Subjects with normal glucose tolerance (NGT) (n = 1600), impaired glucose tolerance (IGT) (n = 330), newly diagnosed diabetes (NDD) (n = 330) and known diabetes (KD) (n = 1170) were recruited from the Chennai Urban Rural Epidemiology Study (CURES), an ongoing study on a representative population of Chennai (formerly Madras), in southern India. Assessment of carotid IMT was performed using high-resolution B-mode ultrasonography. MS was defined using modified adult treatment parel (ATP) III guidelines. Subjects with self-reported diabetes, hypertension and dyslipidaemia were excluded from the analysis on MS. RESULTS: Subjects with glucose intolerance had significantly higher mean carotid IMT values compared with subjects with normal glucose tolerance (NGT 0.69 +/- 0.12 mm, IGT 0.75 +/- 0.16 mm, NDD 0.79 +/- 0.19 mm and KD 0.87 +/- 0.24 mm, P < 0.001). Regression analysis showed that there was a linear increase in mean IMT values with increasing severity of glucose intolerance, even after adjusting for age and gender. Mean IMT values were higher in those with MS and increased with increase in number of metabolic abnormalities (subjects without any metabolic abnormality 0.66 +/- 0.12 mm, one abnormality 0.67 +/- 0.13 mm, two 0.70 +/- 0.12 mm, three 0.72 +/- 0.12 mm, four 0.77 +/- 0.15 mm, five 0.76 +/- 0.13 mm). Regression models showed MS to be associated with IMT, even after adjusting for age, gender and presence of diabetes (P = 0.021). CONCLUSIONS: In Asian Indians, carotid IMT increases progressively with increasing severity of glucose intolerance and is also associated with the metabolic syndrome, independent of age, gender and presence of diabetes.