Changing sleep patterns and anxiety due to Covid-19 home confinement among working population: A cross-sectional study.

Introduction: The COVID-19 pandemic took the entire world unawares and people were forced to stay indoors overnight. Due to this a drastic change ensued in lifestyle with many succumbing to various kinds of stresses and psychological problems. This study aims to study the changing sleep patterns and level of anxiety among the working population due to the COVID-19 Pandemic lockdown. Methodology: An online survey was conducted using a cloud-based website. The sleep patterns both prior to and during the lockdown period of the pandemic were assessed using a self-administered questionnaire. The level of anxiety during both these periods (before and during lockdown) amongst the working population was also assessed using the Generalized Anxiety Disorder Scores (GADS). Results: A total of 224 individuals participated in the study of which 52.7% were males and 47.3% were females. On analysis, the lifestyle and sleep deprivation scores showed that before the lockdown only 2.7% reported a low score out of total participants. However, this number was raised to 13.4% during the lockdown. The percentage of people reporting deteriorated sleep quality gradually increased with females reporting moderate to severe category of Generalized Anxiety Disorder scores as compared to Males. Conclusion: The study suggests that there has been a significant change in the sleep quality of the study participants due to Covid enforced lockdown which if unnoticed might lead to significant health problems. The effective use of programs like yoga, meditation, and deep breathing exercises, if followed timely could reduce psychological distress to some extent.

Poor Dietary Habits: A Function of Online Food Delivery Fad among Medical and Dental College Students in India.

BACKGROUND: Globalization has impacted our food choice and the booming online food industry has made it available at the click of a button. Students staying away from home often fail to maintain a healthy diet and lifestyle, impacting their health. METHODS: A survey was conducted amongst interns of medical and dental colleges in Delhi. Simple Random Sampling was done to select every alternate intern as per the list provided by the colleges. The survey included questions on dietary, fitness and food hygiene habits and dental history. Demographic details such as height weight and living arrangements were collected. Dietary habits score and Fitness & Food hygiene score was calculated based on pre-set criteria. Association of poor dietary habits and hygiene with BMI, living conditions and dental history was determined. RESULTS: One-fourth of the population was either overweight or obese. Poor, fair and good dietary habits was seen in 8.9%, 69.8% and 21.4% respectively. Poor, fair and good fitness and food hygiene was seen in 56.3%, 39.6% and 4.2% respectively. Obesity was significantly associated with poor fitness scores and with tendency to order junk food. Consumption of sugary food was associated with positive dental history, and those living with parents displayed good dietary habit score. CONCLUSION: Students with high stress levels and living away from home are susceptible to poor dietary routine which impacts both their health and academic performance. Identifying these problems and triggers which induce such unhealthy lifestyle behaviour can go a long way in controlling the resultant health problems.

Effects of maxillary expansion on hearing and voice function in non-cleft lip palate and cleft lip palate patients with transverse maxillary deficiency: a multicentric randomized controlled trial / Efeitos da expansão maxilar na função auditiva e vocal em pacientes sem fissura labiopalatina e com fissura labiopalatina e deficiência maxilar transversa: um estudo controlado multicêntrico e randomizado

Abstract Introduction The association between the treatment of transverse maxillary deficiency and the recovery of hearing and voice functions has gained attention in recent years. Objective This prospective controlled trial aimed to evaluate the effects of rapid maxillary expansion on hearing and voice function in children with non-cleft lip palate and bilateral cleft lip palate with transverse maxillary deficiency Methods 53 patients (26 non-cleft and 27 bilateral cleft lip palate; mean age, 11.1 ± 1.8 years) requiring rapid maxillary expansion for correction of narrow maxillary arches were recruited for this trial. Eight sub-groups were established based on the degree of hearing loss. Pure-tone audiometric and tympanometric records were taken for each subject at four different time periods. The first records were taken before rapid maxillary expansion (T0), the second after expansion (T1) (mean, 0.8 months), the third after three months (T2) (mean, 3 months) and the fourth at the end of retention period (T3) (mean, 6 months). ANOVA and Tukey HSD post-hoc tests were used for data analysis. Additionally, voice analysis was done using an updated PRAAT software program in a computerized speech lab at T0 and T2. A paired-samplet-test was used for comparisons of mean values of T0 and T2 voice parameters within both groups. Results Rapid maxillary expansion treatment produced a significant increase in the hearing levels and middle ear volumes of all non-cleft and bilateral cleft lip palate patients with normal hearing levels and with mild conductive hearing loss, during the T0-T1, T1-T2, T0-T2, and T0-T3 observation periods (p < 0.05). The significant increase was observed in right middle ear volumes during the T0-T1, T0-T2 and T0-T3 periods in non-cleft patients with moderate hearing loss. For voice analysis, significant differences were observed only between the T0 and T2 mean fundamental frequency (F0) and jitter percentage (p < 0.05) in the non-cleft group. In the cleft group, no significant differences were observed for any voice parameter between the T0 and T2 periods. Conclusion Correction of the palatal anatomy by rapid maxillary expansion therapy has a beneficial effect on both improvements in hearing and normal function of the middle ear in both non-cleft and bilateral cleft lip palate patients. Similarly, rapid maxillary expansion significantly influences voice quality in non-cleft patients, with no significant effect in BCLP patients.

Resumo Introdução A associação entre o tratamento da deficiência maxilar transversa e a recuperação das funções auditivas e vocais ganhou atenção nos últimos anos. Objetivo Avaliar os efeitos da expansão rápida da maxila na função auditiva e vocal em crianças sem fissura labiopalatina e com fissura labiopalatina bilateral com deficiência maxilar transversa. Método Foram recrutados para este estudo 53 pacientes (26 sem fissura e 27 com fissura labiopalatina bilateral; média de 11,1 ± 1,8 anos) que necessitam de expansão rápida da maxila para correção de arcos maxilares estreitos. Oito subgrupos foram estabelecidos com base no grau de perda auditiva. Registros audiométricos e timpanométricos de tons puros foram obtidos para cada indivíduo em quatro períodos. Os primeiros registros foram obtidos antes da expansão rápida da maxila (T0), o segundo após a expansão (T1) (média de 0,8 meses), o terceiro após três meses (T2) (média de 3 meses) e o quarto no fim do período de retenção (T3) (média de 6 meses). Anova e o teste post-hoc de Tukey HSD foram usados para análise dos dados. Além disso, a análise da voz foi feita com um programa PRAAT atualizado em um laboratório de fala computadorizadaem T0 e T2. Foi usado um teste t de amostras pareadas para comparação dos valores médios dos parâmetros de voz em T0 e T2 nos dois grupos. Resultados O tratamento com expansão rápida da maxila produziu um aumento significativo nos níveis auditivos e nos volumes da orelha média de todos os pacientes sem fissura e pacientes com fissura labiopalatina bilateral e níveis auditivos normais e com perda auditiva condutiva leve, durante os períodos de observação T0-T1, T1-T2, T0-T2 e T0-T3 (p < 0,05). Aumento significativo foi observado nos volumes da orelha média direita durante os períodos T0-T1, T0-T2 e T0-T3 em pacientes sem fissura e com perda auditiva moderada. Para a análise de voz, diferenças significantes foram observadas apenas entre a frequência fundamental média T0 e T2 (F0) e a porcentagem de jitter (p < 0,05) no grupo sem fissura. No grupo com fissura, não foram observadas diferenças significantes para nenhum parâmetro de voz entre os períodos T0 e T2. Conclusão A correção da anatomia palatal pela expansão rápida da maxila tem um efeito benéfico tanto na melhoria da audição quanto na função normal da orelha média em pacientes sem fissura e com fissura labiopalatina bilateral. Da mesma forma, a expansão rápida da maxila influencia significativamente a qualidade da voz em pacientes sem fissura, sem efeito significativo em pacientes com fissura labiopalatina bilateral.

Determinants of socio-demographic and environmental barriers in prevention of COVID-19 pandemic.

Aim and Objectives: This study assessed the knowledge, attitude, and practice of patients with ESIC, who are insured patients with the public health sector about COVID-19. Materials and Method: This was a cross-sectional observational study that used a questionnaire developed for the purpose of the survey. The questionnaire was divided into five parts including the demographic variables and environmental variables that are enablers for positive preventive practices of COVID-19, knowledge, attitude, and preventive practices followed with respect to COVID-19. Results: The mean age of the study population was 36.96 ± 13.05 (18-73) years with almost an equal proportion of males and females. The knowledge about measures to be taken for prevention of corona infection such as Balanced diet, Lockdown, Social distance, frequently wash hands often, using face mask and regularly cleaning with disinfectant surfaces was significantly better among females. Majority of the subjects displaying good attitude toward the corona disease prevention. Preventive practices were found to be satisfactory among the study population. Use of soap and handwashing was more than the use of sanitizer. Hand washing, use of mouth mask, and taking bath after returning home from outside was significantly better among males. Conclusion: There are increased worries and apprehensions among the public regarding acquiring the COVID-19 infection. People have higher perceived needs to deal with their anxiety towards acquiring the infection.

Effects of maxillary expansion on hearing and voice function in non-cleft lip palate and cleft lip palate patients with transverse maxillary deficiency: a multicentric randomized controlled trial.

INTRODUCTION: The association between the treatment of transverse maxillary deficiency and the recovery of hearing and voice functions has gained attention in recent years. OBJECTIVE: This prospective controlled trial aimed to evaluate the effects of rapid maxillary expansion on hearing and voice function in children with non-cleft lip palate and bilateral cleft lip palate with transverse maxillary deficiency METHODS: 53 patients (26 non-cleft and 27 bilateral cleft lip palate; mean age, 11.1±1.8 years) requiring rapid maxillary expansion for correction of narrow maxillary arches were recruited for this trial. Eight sub-groups were established based on the degree of hearing loss. Pure-tone audiometric and tympanometric records were taken for each subject at four different time periods. The first records were taken before rapid maxillary expansion (T0), the second after expansion (T1) (mean, 0.8 months), the third after three months (T2) (mean, 3 months) and the fourth at the end of retention period (T3) (mean, 6 months). ANOVA and Tukey HSD post-hoc tests were used for data analysis. Additionally, voice analysis was done using an updated PRAAT software program in a computerized speech lab at T0 and T2. A paired-samplet-test was used for comparisons of mean values of T0 and T2 voice parameters within both groups. RESULTS: Rapid maxillary expansion treatment produced a significant increase in the hearing levels and middle ear volumes of all non-cleft and bilateral cleft lip palate patients with normal hearing levels and with mild conductive hearing loss, during the T0-T1, T1-T2, T0-T2, and T0-T3 observation periods (p<0.05). The significant increase was observed in right middle ear volumes during the T0-T1, T0-T2 and T0-T3 periods in non-cleft patients with moderate hearing loss. For voice analysis, significant differences were observed only between the T0 and T2 mean fundamental frequency (F0) and jitter percentage (p<0.05) in the non-cleft group. In the cleft group, no significant differences were observed for any voice parameter between the T0 and T2 periods. CONCLUSION: Correction of the palatal anatomy by rapid maxillary expansion therapy has a beneficial effect on both improvements in hearing and normal function of the middle ear in both non-cleft and bilateral cleft lip palate patients. Similarly, rapid maxillary expansion significantly influences voice quality in non-cleft patients, with no significant effect in BCLP patients.

Risks and complications associated with dental implant failure: Critical update.

Risks and complications have been identified with dental implant failure though there is continuous innovation in implant systems and various interceptive treatment modalities. The success rate of dental implants has increased over a period of years as a treatment option for the rehabilitation of missing teeth. The dental implants are designed that best suits the various types of bone. Endosseous implants fail due to many reasons. Different reasons for the implant failure and their contributing factors have been discussed in this review article. A better understanding of the factors responsible for the implant failure will provide clinical decision-making and may enhance the field of implant dentistry. This article summarizes the factors causing implant failure. This paper presents the results of a survey of dentists practicing implant dentistry and updates regarding their knowledge of risk factors that they consider to be important for predicting dental implant failure.

Prevalence, knowledge, attitude and nicotine dependence among ESI-insured populations of Delhi NCR region: Institutional study.

AIM: To assess the prevalence of tobacco consumption among the ESI-insured patients. The study also assessed the knowledge, practice, and attitude among industrial workers as well as nicotine dependence with different forms of tobacco products consumed. MATERIALS AND METHODS: A cross-sectional study was conducted among industrial workers from various industries (small and large scale) insured under the employee state insurance corporation scheme. The study was conducted for 3 months included 500 workers of which 470 were males and 30 were females. A predesigned, pretested, and structured interviewed administered questionnaire was used to collect the data on sociodemographic factors, reasons for tobacco consumed, and level of dependencies among industrial workers. Questionnaire also included questions related to awareness regarding health hazards and lesion present in the oral cavity as a result of tobacco consumption. Fegarstrom scale was used to access nicotine dependency level. A Hindi translated version of Fegarstrom test for Nicotine dependence in the questionnaire was used which included six standard questions for both smokeless and smoked form. RESULT: Majority of both males and females consumed tobacco in smokeless (58.8%) form. Out of which 92.85% in males and 7.15% in females followed by the smoke (28.8%) form. 93.04% in males and (7%) in females (79.86%) of the tobacco users in our study were aware that consuming tobacco causes health related problems. 38.6% of the users have moderate dependency in both smoke and smokeless form. Seventy six percent of the consumers feel that they didn't have any changes in the mouth by consuming tobacco and thus never thought of quitting tobacco. CONCLUSION: Tobacco consumption among the ESI-insured patients is high. Execution of tobacco cessation programs are required to curb this trend.

A retrospective cross-sectional study of maxillofacial trauma in Delhi-NCR Region.

AIM AND OBJECTIVES: To evaluate the pattern, prevalence, etiology, site of fractures, and their management in patients with maxillofacial injury in Delhi-NCR region. MATERIALS AND METHODS: A total of 1278 maxillofacial trauma patients visiting different registered hospitals from Delhi-NCR region from January 2012 to December 2017, treated by open reduction and internal fixation under general anesthesia (GA)/local anesthesia (LA) or closed reduction/conservatively, were taken into the study. The parameters considered in the study were age and sex distribution, etiological factors and incidence of maxillofacial trauma, pattern and site distribution of maxillofacial fractures, and management. RESULTS: From a total of 2250 trauma patients, 1278 patients (1053 males and 225 females) had maxillofacial injury. The average prevalence rate was 56.8%. Yearly incidence rate was 20.4%. Road traffic accident (RTA) was the most common cause of trauma in 1029 (80.5%) patients, followed by physical assault [158 (12.3%)] with significant male predominance in different age groups. Isolated mandibular fractures were the most common [48.6% (parasymphysis 31.6%, condyle 28.2%)], followed by midface with maxilla fracture [27.6% (zygomatic bone and arch 50.2% and Lefort II fractures 18%)]. Treatment modalities were conservative management, closed reduction, and open reduction with internal fixation under GA/LA. CONCLUSION: RTA followed by physical assault is still the leading cause of maxillofacial trauma in young males in Delhi-NCR region. Mini plate osteosynthesis is the main treatment procedure for maxillofacial trauma. We need to enforce strict traffic rules, road safety law, and preventive measures along with improvement in education and socioeconomic status in the population to avoid maxillofacial injuries.

Management of myofascial pain dysfunction syndrome with meditation and yoga: Healing through natural therapy.

AIMS AND OBJECTIVES: Aims and objectives of the study were to study the effectiveness of Raj-yoga meditation and pranayama in patients with myofascial pain dysfunction syndrome (MPDS) and compared the effects with ongoing conventional noninvasive treatment modalities. MATERIALS AND METHODS: The study comprised 30 patients divided equally (10 each) into 3 group, i.e., control group (conventional, noninvasive treatment), Experimental A group (conventional, noninvasive treatment with raj-yoga meditation therapy and pranayama), and Experimental B group (Raj-yoga meditation therapy and pranayama only). Parameters such as pain, mouth opening, mandibular deviation, inflammation, swelling, clicking, occlusion, and psychologic evaluation such as anxiety, stress, and depression were assessed before the start of the study and at weekly intervals for 3 months. RESULTS: Posttreatment pain and inflammation improved both in the control group and Experimental A group, but statistically it is highly significant in the Experimental A group. Furthermore, it is effective immediately as well as for a long period in Experimental A group. Improvement in mouth opening was statistically highly significant in control group but not in the experimental groups. Posttreatment anxiety and stress status was improved with statistically highly significant result in the Experimental A and B. The posttreatment depression status along with mandibular deviation, swelling, clicking, and occlusion has not improved significantly in any of the groups. INTERPRETATION AND CONCLUSION: Raj-yoga meditation and pranayama in combination with conventional, noninvasive, treatment modalities showed promising results in MPDS patients as compared to either modalities alone.

Newer proposed classification of periimplant defects: A critical update.

The term peri-implantitis is used to describe a destructive inflammatory process affecting the soft and hard tissues around osseo integrated implants, leads to the formation of a peri-implant pocket and loss of supporting bone. Predisposing factors are Poor Plaque Control, inflammation, infection, Smoking, Diabetes and Occlusal Overload. It is diagnosed on the basis of clinical and radiographic interpretation and still no definite criteria have been proposed for the diagnosis and treatment of peri-implantitis. However treatment can be both conservative and surgical. The cumulative interceptive supportive therapy protocol serves as good guide for the treatment of the peri-implantitis. There is lack of a standard classification system to differentiate the various degrees of peri-implantitis, which produces dilemma in evaluating the stages clinical and radiological status, treatment and its outcome. Many classification has been proposed in medical literature with their pros and cons but still there is lack of standard classification system of implant defects and definite treatment protocol according to the same. The classification should be easy to use, clearly understandable and help in communication by clinicians of different speciality. This review aimed to introduce a classification system based on added clinical, and detailed radiological parameters with prognosis and staged treatment algorithms.

Oral submucous fibrosis: Newer proposed classification with critical updates in pathogenesis and management strategies.

Oral submucous fibrosis (OSMF) is an oral precancerous condition characterized by inflammation and progressive fibrosis of the submucosal tissues resulting in marked rigidity and trismus. OSMF still remains a dilemma to the clinicians due to elusive pathogenesis and less well-defined classification systems. Over the years, many classification systems have been documented in medical literature based on clinical, histopathological, or functional aspects. However, none of these classifications have achieved universal acceptance. Each classification has its own merits and demerits. An attempt is made to provide and update the knowledge of classification system of OSMF so that it can assist the clinicians, beneficial in researches and academics in categorizing this potentially malignant disease for early detection, prompt management, and reducing the mortality. Along with this, pathogenesis and management have also been discussed.

Occupational Stress, Salivary Cortisol, and Periodontal Disease: A Clinical and Laboratory Study.

BACKGROUND: Periodontitis is a multifactorial disease, commonly associated with most of the lifestyle diseases. In the recent years, the association between periodontitis with occupational stress has evolved in various studies in many developed settings. This study aims at studying the prevalence of periodontal disease and its relationship with job stress among industrial labor workers covered under Employee's State Insurance Corporation Scheme. MATERIALS AND METHODS: The study included 180 subjects who were informed about the research goals, and also requested to sign consents. The questionnaire included parts from the generic job stress questionnaire from the National Institute of Job Stress and Health. Dental examinations based on community periodontal index protocol were done using WHO probe. Participants with moderate to severe periodontitis (score 3, 4) were informed about the salivary cortisol test. The saliva samples were collected and transported to the lab. Data were entered in EPI info 3.1.1 and analyzed in SPSS 14. The Chi-square analysis was done to measure association, and logistic regression analysis was done to identify the independent association of job stress to periodontitis. RESULTS: The study shows that 48% of the participants reported to have job stress, and 55% had periodontitis. The mean salivary cortisol level was 3.42 ng/dl. The results also indicated a higher odds of having low levels of salivary cortisol among those who reported job stress. Bi-variant regression analyses show the relationship of periodontitis with job stress to be much higher on controlling for other risk factors. The odds of having periodontitis in relation to positive job stress were 6 times higher than those who did not have positive job stress. CONCLUSIONS: This study shows a high prevalence of job stress related periodontitis among industrial workers in India. This research recommends the health and labor ministry to improve access to dental care especially in rural areas and include psychiatric units and oral health care as a part of primary health care. The factories administration should encourage recreation and retreat of the workers so as to reduce the level of stress at work. The factory administrations were recommended to have counselors to help their employees.

Effectiveness of supervised oral health maintenance in hearing impaired and mute children- A parallel randomized controlled trial.

CONTEXT: Individuals with special needs may have great limitations in oral hygiene performance due to their potential motor, sensory, and intellectual disabilities. Thus, oral health care utilization is low among the disabled people. Hearing disorders affect the general behavior and impair the level of social functioning. OBJECTIVES: The present study was conducted to assess the dental health outcomes following supervised tooth brushing among institutionalized hearing impaired and mute children in Jaipur, Rajasthan. MATERIALS AND METHODS: The study followed a single-blind, parallel, and randomized controlled design. A total of 315 students were divided into three groups of 105 children each. Group A included resident students, who underwent supervised tooth brushing under the supervision of their parents. The non-resident students were further divided into two groups: Group B and Group C. Group B children were under the supervision of a caregiver and Group C children were under the supervision of both investigator and caregiver. RESULTS: There was an average reduction in plaque score during the subsequent second follow-up conducted 3 weeks after the start of the study and in the final follow-up conducted at 6 weeks. There was also a marked reduction in the gingival index scores in all the three groups. CONCLUSION: The program of teacher and parent supervised toothbrushing with fluoride toothpaste can be safely targeted to socially deprived communities and can enable a significant reduction in plaque and gingival scores. Thus, an important principle of oral health education is the active involvement of parents and caregivers.

Acoustic Noise Levels of Dental Equipments and Its Association with Fear and Annoyance Levels among Patients Attending Different Dental Clinic Setups in Jaipur, India.

BACKGROUND: Noise is a source of pervasive occupational hazard for practicing dentists and the patients. The sources of dental sounds by various dental equipments can pose as a potential hazard to hearing system and add to the annoyance levels of the patients. The aim of the study was to analyze the noise levels from various equipments and evaluate the effect of acoustic noise stimulus on dental fear and annoyance levels among patients attending different dental clinic setups in Jaipur, India. METHODOLOGY: The sampling frame comprised of 180 patients, which included 90 patients attending 10 different private clinics and 90 patients attending a Dental College in Jaipur. The levels of Acoustic Noise Stimulus originating from different equipments were determined using a precision sound level meter/decibulometer. Dental fear among patients was measured using Dental Fear Scale (DFS). RESULTS: Statistical analysis was performed using chi square test and unpaired t-test. The mean background noise levels were found to be maximum in the pre-clinical setup/ laboratory areas (69.23+2.20). Females and the patients attending dental college setup encountered more fear on seeing the drill as compared to the patients attending private clinics (p<0.001). CONCLUSION: The sources of dental sounds can pose as a potential hazard to hearing system. It was analyzed that the environment in the clinics can directly have an effect on the fear and annoyance levels of patients. Hence it is necessary control the noise from various dental equipments to reduce the fear of patients from visiting a dental clinic.

Disinfection of dental unit water line using aloe vera: in vitro study.

Context. Dental unit waterlines may be heavily contaminated with microorganisms and are a potential source of infection for both practicing staff and immunocompromised patients particularly. Contamination of dental unit water lines could be inhibited with the use of disinfectants. The present study investigates the effect of aloe-vera-based disinfectant in reducing the microbial growth in dental unit water lines (DUWLs). Aims. To compare the efficacy of aloe vera, hydrogen peroxide (H2O2), and 5% sodium hypochlorite (NaOCl) in controlling microbial contamination of DUWLs. Materials and Methods. After obtaining baseline water samples, the dental unit waterlines were treated with aloe vera, 10% hydrogen peroxide, and 5% sodium hypochlorite. Each of the three disinfectants was used in increasing concentrations and their inhibiting effect was compared. Water samples were analyzed for microbiological quality by the total viable count (TVC) method. Statistical Analysis Used. SPSS 16. Results. There was significant reduction in mean CFU/ml when treated with disinfectants each for a period of one week. Aloe-vera solution was found to be the most effective in reducing the microbial colonies. Conclusions. Improving the water quality from dental unit water lines is of considerable importance; chemical-based disinfectants can be replaced with herbal disinfectants for treating microbial contamination in dental unit waterlines.