Variation in the Reporting of Elective Surgeries and Its Influence on Patient Safety Indicators.

BACKGROUND: US hospital safety is routinely measured via Patient Safety Indicators (PSIs). Receiving a score for most PSIs requires a minimum number of qualifying cases to meet specific criteria; for example, whether an admission was elective. Because admission type is determined by hospitals' internal policies, the study team suspected that hospitals may be exempted from elective-based PSI scores as a result of their internal admission classification policies. METHODS: Multiple regression was combined with machine learning to analyze Medicare inpatient claims data reported by 3,484 hospitals during the 2015-2017 PSI measurement period. The researchers examined the average percentage of elective admissions across surgical diagnosis-related groups (DRGs) (average percent elective [APE]) in relation to hospital characteristics, surgical claims volumes, and numbers and types of surgical DRGs. This study asked whether hospitals with exceptionally low APE shared particular characteristics, reported claims for similar DRGs, or were disproportionately exempted from elective-based PSIs. RESULTS: Cross-validated multiple regression explained 73.9% of variation in APE among hospitals and identified surgical claims volume and 16 surgical DRGs as consistently important variables. However, the exceptionally low APE of 96 hospitals could not be explained by surgical claims volume, surgical DRGs among claims, or hospital characteristics. These outliers were disproportionately exempt from elective-based PSI scores. CONCLUSION: Some hospitals may have classified admissions in a way that exempted them from elective-based PSI scores. Transparency into admission classification policies is needed to ensure fair and reliable use of PSIs when ranking hospitals and adjusting payments. Alternatively, PSIs may need modifications to rely on externally validated criteria.

A Study to Assess the Knowledge and Perception of Practicing Dental Professionals Toward COVID-19 in Lucknow City.

Introduction: Coronavirus belongs to family of Coronaviridae, which primarily infect the upper respiratory and gastro intestinal tract of birds & mammals. It is an enveloped virus with positive-sense single-stranded RNA. Patients with COVID-19 are usually present with symptoms of fever, dry cough, myalgia, dysgeusia, nausea, diarrhoea, hyposmia and later it progresses into pneumonia. Dentists are at potential risk because they are in consistent exposure of blood and saliva, so they should have knowledge of COVID-19 infection, transmission & prevention for proper infection control practices. Aims and Objectives: The aim of the study is to assess the knowledge and perception of DHPs toward COVID-19. Methodology: A cross-sectional study was undertaken among practicing dental professionals in Lucknow city (U.P) India. A total of 302 Dental Health Practitioners (DHPs) participated in the study. Knowledge was assessed using self-administered, structured questionnaire. The questions were administered online through Google Forms by sending link to the registered Dentist through E-mail. Results: A total of 350 DHPs were participated in the study, among which 302 DHPs has given complete responses and was included in the analysis. Simple linear regression showed a significant relationship between knowledge with age of dentist (p < 0.001), qualification as MDS (p = 0.025), practice as private (p < 0.001), experience between 5 and 10 years (p = 0.009), and experienced more than 10 years(p = 0.006). Correct answers in each sections of questionnaire were defined an internal consistency was assessed using Cronbach`s alpha. Conclusion: Despite having high standard of knowledge, practices and perceptions DHPs around the world are in a state of anxiety and fear while working in their respective field due to COVID-19 impact. DHPs are advised to follow the guidelines for clinical recommendations given by health authorities like WHO, CDC, ADA and IDA.

Review of current vaccine development platform to prevent coronavirus disease.

On January 30, 2020, the World Health Organization (WHO) declared a severe respiratory disorder syndrome which originated in Wuhan city as a global public health emergency, and the pandemic declaration by the WHO was made on March 11, 2020. Persons infected with SARS-CoV-2 are frequently asymptomatic, yet they have high respiratory viral loads, and they are major purveyors of viral spread. These factors have led to the current explosion of COVID-19 hospitalizations and deaths. Vaccines could play an important role by preventing severe diseases and increasing population immunity and reducing the ongoing health crisis. There is wealth of information for the review available since it is a current topic of interest. Initially, Google Scholar was utilized to take an initial sample of what types of articles are available. We searched other databases such as PubMed, EMBASE, and COCHRANE LIBRARY for research articles published up to March 2021, with no language restrictions. We found seven peer-reviewed publications available on the efficacy of SARS-CoV-2 vaccines: AZD1222 (AstraZeneca/University of Oxford), a ChAdOx1-based vaccine with a reported efficacy of 70.4% and two mRNA-based vaccines: BNT162b2 (Pfizer/BioNTech) with a reported efficacy of 95% and mRNA-1273 (Moderna/NIAID) with a reported efficacy of 94.1%. Internet was used as a source because of its limitless networking of resources. Sources used from the internet were written by professionals in their fields and published on reliable sites, in referred publications, or on professional organization sites. The cited references were within the last 2 years.

A Study on Metabolic, Nutritional and Biochemical Profile of Tobacco Users With and Without Oral Precancer Lesions.

INTRODUCTION: The tobacco use and the dietary intake/levels of vitamin C and E, and the trace elements, iron, copper, zinc, and selenium are interrelated with the development of oral precancer. These micronutrients are necessary for maintaining good oral health. AIMS: To estimate the nutritional status, vitamin E, C and micronutrient level of zinc, iron, copper, and selenium, and basic vitals in all study groups. MATERIAL METHOD: The study sample is comprised of 384 subjects. There were three study groups, and in each study group, there were 128 subjects. Group A was tobacco users without oral precancer/dysplasia. Group B was tobacco users with oral precancer (H/P confirmed). Group C was healthy individuals with no history of tobacco or areca nut use and oral precancer. Data have been collected using a standard structured predesigned questionnaire for evaluation of the nutrition level of the subject; 5 mL blood has been collected for estimation of micronutrients; and basic vitals such as pulse rate and blood pressure have been examined using the digital machine. Questionnaire data will also be entered in the worksheet for the purpose of analysis. The analysis will be performed using the commercially available Statistical Package SPSS. RESULT: The serum level of zinc, iron, selenium, vitamin E and C was decreasing in Groups A and B, i.e., users with precancer and users without precancer as compared to Group C, i.e., controls. But serum copper level was increasing in Groups A and B, i.e., users with precancer and users without precancer, and the level was found to be decreased in Group C, i.e., controls. Later on, in the present study, basic vitals such as blood pressure and pulse rate of all the study subjects in all the three groups were clinically examined. No significant differences were found in blood pressure, pulse rate (radial pulse), and height in all groups. But the weight was slightly higher in Groups A and B as compared to Group C. DISCUSSION: Diet plays an aggressive role in the development of oral precancer. The deficiency of certain micro nutrients may lead to disease progression. We can say that a healthy diet comprising of vegetarian and plain food may lead to solving issues of oral health. CONCLUSION: The above-highlighted text shows that micronutrients play dominant role in maintenance of oral health and its deficiency may result in the growth of oral precancer. So involving diet rich in zinc, iron, selenium, vitamin E and C may help in maintaining healthy nation.

Study on prevalence and sociocultural aspects of tobacco use in India.

AIM: The present study focuses on the prevalence of tobacco use and aims to determine various sociocultural aspects of tobacco use in Indian population. MATERIALS AND METHODS: The study sample comprised 384 participants. There were three study groups, and in each study group, there were 128 participants. Group A was tobacco users without oral precancer, Group B was tobacco users with oral precancer, and Group C was healthy individuals with no history of tobacco or areca nut use and oral precancer. Both male and female adults in the age group of 18 years and above visiting the Outpatient Department of Oral and Maxillofacial Surgery at King George's Medical University were recruited for the study. The study participants were explained in detail about the study, and informed consent was obtained through them. Data have been collected using a standard structured predesigned questionnaire. The questionnaire consisted of the details of the demographic profile of the study participants, details of tobacco use, and the major social and cultural reasons which motivated them to consume tobacco. Data were extracted from the case sheet, and the data were entered into a worksheet for the purpose of analysis. The analysis was performed using the commercially available Statistical Package SPSS. CONCLUSION: The rate of tobacco prevalence is very high among the Indian population, and a number of social and cultural factors are responsible for its use. To curb this problem, more studies could be done to find the causes responsible for its use.

Co-delivery of 5-Fluorouracil and Curcumin Nanohybrid Formulations for Improved Chemotherapy Against Oral Squamous Cell Carcinoma.

PURPOSE: The chemotherapeutics agent, 5-fluorouracil (5-FU), and curcumin (Cur), a natural antioxidant, has a wide pharmacological window to treat oral carcinoma; however, both drugs have limited bioavailability. This research study designs to develop a nanoemulsions (NEs) formulation by combining 5-FU and Cur to improve anticancer activity against oral cavity squamous cell carcinoma (OSCC) cells from the diversified origin for in vitro analysis, SCC090 (human tongue) and SCC152 (human hypo-pharynx). METHODOLOGY: NEs formulated through homogenization, applying high-energy ultrasonication technique. The prepared 5-FUNE/Cur-NE/5-FU-Cur-NE were characterized and optimized by different in vitro assays to evaluate release system and treatment of OSCC cells to monitor cellular acceptability, such as in vitro anticancer activity by MTT assay, cell uptake studies and protein expression associated apoptotic study. RESULTS: 5-FUNE/Cur-NE/5-FU-Cur-NE successfully formulated and show mean-value of the particle size (150-200 nm), surface charge (- 25.70 to - 37.91 mV), and PDI (0.194). In vitro release of 5-FUNE/Cur-NE/5-FU-Cur-NEs was monitored over a course of 04 days, where acidic pH shows higher release as compared to alkaline pH, along with acceptable stability data. Cytotoxicity study has shown higher-dose-dependent anticancer effect with a reduced IC50 value of NEs as compared to BLNE. Cellular uptake study of 5-FUNE/Cur-NE/5-FU-Cur-NEs upgraded many folds, comparatively BLNE and show potential cell arrest. Additionally, the cell protein (Blc2, Bax, P53, and P21) expression was revised and raised cell apoptosis. CONCLUSION: The combinational loaded, 5-FU and Cur in nanoformulation system have proven their potency to deliver improved anticancer activity, against oral cancer.