Assessment of Postoperative Edema in Different Bone Graft Cases in Vertical Defects in Periodontal Surgery: An Original Research.

Background: To replace missing periodontal tissues in vertical defects during periodontal surgery, bone graft materials are frequently used. A frequent occurrence that can affect healing outcomes is postoperative edema. The purpose of this study was to evaluate postoperative edema in various vertical bone graft defects following periodontal surgery. Materials and Methods: 50 participants were split into two groups for a prospective study: Group A received xenografts, whereas Group B received synthetic grafts. Up to 14 days after surgery, baseline and routine postoperative edema measurements were made. Edema levels in each group were compared using statistical analysis. Results: At all postoperative time points, Group A showed substantially more edema than Group B (P < 0.05). Furthermore, edema persisted longer in Group A than it did in Group B. Conclusion: In conclusion, the substance of the bone graft used in vertical defects during periodontal surgery affects postoperative edema. Compared to synthetic grafts, xenografts caused swelling to last longer and at higher levels. To maximize healing results, clinicians should take these findings into account when choosing graft materials.

Choice of Surgeons in Retractors used in Cleft Lip and Palate Surgery: An Original Research.

Background: To ensure optimal exposure and enable precise tissue manipulation, cleft lip and palate abnormalities require surgical repair utilizing retractors. Different retractors may affect surgical outcomes; however, this is not yet evident. Examining surgeon preferences for retractors in cleft lip and palate surgery and assessing their impact on patient outcomes were the goals of this study. Materials and Methods: The patients who underwent primary cleft lip and palate repair were retrospectively analyzed. This study evaluated three widely used retractors: the Langenbeck, Gelpi, and Moult Mouth Gag retractors. This study looked at demographic information, surgical results (including scarring, aesthetic outcomes, and wound healing issues), and surgeon preferences for retractors. Results: The study identified differences in surgical outcomes related to various retractor types. Both Group A (Langenbeck retractor) and Group B (Gelpi retractor) demonstrated similar favorable results, such as little wound healing issues, less scarring, and pleasing cosmetic results. The wound healing issues, scarring, and cosmetic outcomes were all worse in Group C (Moult Mouth Gag retractor). Conclusion: Retractors were not always preferred by surgeons doing cleft lip and palate surgery. The type of retractor had an impact on the surgical results; the Moult Mouth Gag retractor performed less well than the Langenbeck and Gelpi retractors. These results highlight the value of using evidence-based criteria to select retractors more effectively and enhance surgical methods for better patient outcomes in cleft lip and palate repair.

Clinical Evaluation of the Retention of Four Different Pit and Fissure Sealants on the First Permanent Molars - An Original Research.

Objective: In this study, the retention rates of four different pit and fissure sealant materials on the first permanent molars were clinically assessed and compared. Materials and Methods: A total of 120 kids aged 7 to 10 participated in a randomized controlled experiment. On their first permanent teeth, the subjects each got one of the four sealant materials (A, B, C, or D). Over the course of 24 months, the retention rates were evaluated every 6 months. The Chi-square test and Kaplan-Meier survival analysis were used for statistical analysis. Results: At 6, 12, 18, and 24 months, the following retention rates were observed overall: A (85%, 78%, 65%, 52%), B (90%, 82%, 70%, 60%), C (78%, 70%, 55%, 42%), and D (95%, 88%, 75%, 62%). At each time point, the sealant materials showed significant variations in retention rates (P 0.05). While sealants A and C showed lower retention rates, sealant D showed the best retention rates, followed by sealant B. Conclusion: This study shows that different materials have different retention rates for pit and fissure sealants on first permanent molars. Higher retention rates for sealants D and B suggest that they may be superior than sealants A and C. These results highlight how crucial it is to choose the right sealant materials to guarantee long-term retention and effectiveness in avoiding dental cavities.

Evaluation of Crestal Bone Levels using Simvastatin as an Adjuvant Around Immediate Implants - A Clinico Radiographic Study.

Objective: Simvastatin was used as an adjuvant medication in this clinico-radiographic investigation to assess the impact on crestal bone levels around immediate implantation. Materials and Methods: A randomized controlled trial with 50 patients who needed an implant placed right away was done. Simvastatin was used as an adjuvant in groups ((Group A), whereas group (Group B)) served as the control group for the participants. At baseline and during follow-up visits, clinical measures such as probing depth (PD) and bleeding on probing (BOP) were measured. At baseline and 12 weeks, radiographic measurements of crestal bone levels were taken. Results: At 12 weeks, Group A demonstrated a significantly lower PD and BOP than did Group B. Furthermore, at 12 weeks, Group A showed greater crestal bone preservation than did Group B. The results of the statistical analysis showed that the two groups were significantly different. Conclusion: The results of this study indicate that simvastatin use as an adjuvant medication after immediate implant insertion contributes to better clinical outcomes and greater crestal bone preservation. Simvastatin may be helpful in increasing bone regeneration, decreasing inflammation, and soft tissue healing. These findings demonstrate how simvastatin may be used as an additional therapy to enhance the effectiveness of rapid implant implantation operations.

Assessing the Effect of Iron on Oral Health Status among the General Population Residing in High and Low Levels of Iron Blocks in Namakkal District, Tamil Nadu, India: A Cross-Sectional Study.

Aim: This study aims to assess the effect of iron on oral health status among the general population residing in high and low levels of iron blocks in the Namakkal district of Tamil Nadu, India. Materials and Method: A cross-sectional study was conducted to assess the impact of iron on oral health among people in the Namakkal district of Tamil Nadu, India. The sample size was estimated to be 600, which were equally divided into two groups based on the high and low levels of iron (300 samples) content of water in the Namakkal district based on the multistage random sampling method. A pre-tested structured questionnaire was used to collect the demographic data and oral hygiene practices of the people. Dental stains were recorded using a modified Lobene stain index. P value < 0.05 was considered to be statistically significant. Results: The area and intensity of the dental stains were not significant with age, gender, and blocks. There was no statistically significant difference between the high iron and low iron blocks for the area (A), intensity (I), and I × A of stains. Conclusion: The study concludes that the water samples with both high and low levels of iron had a strong impact on the oral health of the people.

Prevalence of Oral Health Status among the General Population in Kallakurichi District, Tamil Nadu, India- A Cross-Sectional Study.

Aim: The aim of this study is to analyze the prevalence of oral health status among the general population in Kallakurichi district, Tamil Nadu, India. Materials and Methods: A descriptive cross-sectional study was conducted among the general public in the Kallakurichi district. A total number of 176 samples were selected and equally divided among urban (88 samples) and rural areas (88 samples). The samples were obtained from various parts of urban and rural areas in the Kallakurichi district based on the multistage random sampling method. The data regarding oral health status was recorded using the World Health Organization (WHO) Proformas 2013 and 1997. The collected data were tabulated and analyzed using the Chi-square test. Results: The prevalence of dental caries (74.1%) was found to be the highest in the Kallakurichi district, followed by malocclusion (71.7%) and periodontal diseases (66.7%). A significant result was found in dental caries, dental fluorosis, dental trauma, and dental erosion between the index age groups. Conclusion: The government of Tamil Nadu should take proper preventive measures and also provide oral health knowledge and awareness among the public to overcome these dental problems.

Systematic Review on Copper Calcium Hydroxide Nanoparticles in the Treatment of Apical Periodontitis.

Apical periodontitis is an inflammation and destruction of the periradicular tissues due to various insults to the pulp in the form of infection, trauma, and faulty dental procedures. Conditions regarding this are treated employing root canal therapy. Recent innovations show that copper calcium hydroxide nanoparticles and their electrophoresis can be used to treat apical periodontitis effectively. To evaluate the effectiveness of copper calcium hydroxide nanoparticles in the treatment of apical periodontitis, a literature search was done using PubMed, Cochrane Central Register of controlled Trials (CENTRAL), Science Direct, and Lilacs using the MeSH (Medical Subject Heading) terms Copper calcium hydroxide, apical periodontitis, nanoparticles, and electrophoresis. Of a total of 167 articles screened, 44 were full-text articles assessed for eligibility and four articles were taken for the qualitative analysis. This review was recorded according to the PRISMA GUIDELINES. Four randomized controlled trials were included in the review process. The copper calcium hydroxide particles were compared with other root canal medicament materials. It was found that copper calcium hydroxide and its electrophoresis were used in the treatment of apical periodontitis and were found to be one of the effective methods. Copper calcium hydroxide nanoparticles were effective against the destruction of the periradicular tissues.

Comparative Analysis of Various Forms of Local Drug Delivery Systems on a Class 2 Furcation - A Systematic Review.

Class II mandibular furcation defect is a periodontal condition characterized by a cul-de-sac lesion, a definite parallel constituent with only a portion of alveolar bone remaining intact. There may be involvement of vertical bone loss. Local drug deliveries such as Boric acid, alendronate gel, and other drugs exhibited anti-inflammatory, antibacterial & osteoblastic differentiation activity. The present systematic review compares the drugs based on their outcomes and pharmacological action. To analzse & compare various forms of local drug delivery systems on a class II furcation. A search was conducted using PubMed, Google scholar, science direct, and Pub Med central using MeSH terms - local drug delivery in periodontics, boric acid in the management of class II mandibular furcation, simvastatin in the treatment of furcation. A total of 560 articles were screened; 58 out of 560 were full-text articles accessed for eligibility, and five articles were included in the systematic review. PRISMA guidelines were used for reporting this review. In addition, five randomized controlled trials were enclosed and used in this systematic review. The various local drugs used in treating class II mandibular furcation defects are effective in the prevention of bleeding on probing, bone resorption, gingival bleeding index and increase in the bone fill, and microbial deposit removal. The managing of class II mandibular furcation defect with the drugs mentioned in this review can be effective by reducing several clinical parameters such as bleeding on probing, gingival indices, osteoblastic differentiation, bone fill, etc., Considering the results of the studies, it can be concluded that it can be used as a therapeutic therapy against class II furcation defects with positive outcomes.

Therapeutic Use of Anti-Sclerostin Antibody in the Treatment of Multiple Myeloma: A Systematic Review.

Multiple myeloma is a malignant cancerous condition that is characterized by abnormal plasma cell production and can lead to bone destruction due to increased osteoclastic activity and decreased osteoblastic activity. Many therapeutic therapies are used to treat diseases, such as chemotherapy and radiotherapy. In recent years, anti-sclerostin antibody treatment has been under investigation for its effect on the multiple myeloma. The present study was conducted to assess the effective therapeutic use of anti-sclerostin antibody in the treatment of multiple myeloma. The literature search was conducted using PubMed, Google Scholar, ScienceDirect, and PubMed Central using the following MeSH terms: "multiple myeloma", "anti-sclerostin antibody", "ubiquitin-proteasome pathway", "proteasome inhibitor", "Wnt pathway". A total of 348 articles were screened. Twenty-five out of 348 were full-text articles assessed for eligibility, and four articles were used in this systematic review. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used for the reporting of this systematic review. A total of four randomized control trials (RCT) were included and used in this systematic review. The anti-sclerostin antibodies were various other drugs, and it was found that the anti-sclerostin antibody was effective in preventing autoantibody formation, decreasing bone destruction, and increasing trabecular bone. Anti-sclerostin antibody was found to be effective in decreasing bone destruction by reducing osteoclastic activity and increasing osteoblastic activity associated with multiple myeloma.

Effect of Asfotase Alfa in the Treatment of Hypophosphatasia- A Systematic Review.

Hypophosphatasia (HPP) is a life-threatening disease that occurs due to the mutation of the TNSALP (Tissue nonspecific isoenzyme of alkaline phosphatase) encoding gene. There is no approved treatment for Hypophosphatasia. Therefore, the only effective treatment for HPP is enzyme replacement therapy using the drug asfotase alfa which increases the patient's life span. The aim of the study is to evaluate the effectiveness and safety of asfotase alfa (enzyme replacement therapy) in treating HPP. A Literature search was done using PubMed, Google scholar, science direct, and Wiley LILACS utilizing MeSH keywords such as - Hypophosphatasia and asfotase alfa. A total of 411 articles were screened, of which four articles were taken for this qualitative analysis. Reporting of this systematic review is done by using PRISMA guidelines. Asfotase alfa/enzyme replacement therapy is examined on patients with different age groups and on congenital HPP patients to assess the effectiveness of HPP treatment. Enzyme replacement therapy using asfotase alfa is an effective and assured treatment for infants, children, and adults suffering from HPP.

Need Analysis of Indian Critical Health Care Delivery in Government Sectors and Its Impact on the General Public: A Time to Revamp Public Health Care Infrastructure.

Background: Poverty is directly linked to public health care delivery in many ways and dimensions. Every aspect of the human sphere is preplanned, but a health crisis is the only emergency which pushes humanity into severe economic stress. Therefore, every nation aims to safeguard its citizens from a health crisis. In this aspect, India needs to improve its public health infrastructure in order to protect its citizens and save them from poverty. Objectives: (1) To assess the current pitfalls in public critical health care delivery, (2) to analyze whether the health care delivery matches the requirements of its population in every state, (3) to produce solutions and guidelines to overcome the stress in this priority area. Materials and methods: Data regarding the critical care workforce, which includes critical care doctors and nurses, were taken from official websites and other sources. Critical care infrastructure data were retrieved from the Internet sources. Data were validated by consulting state government sources and cross-checked for bias elimination. The data were analyzed using the "Statistical Package for Social Sciences" software version 20, and were presented using descriptive statistics. Results: There is a 1:10 percentage of deficit in the case of critical care workforce and infrastructure when compared with its need analysis. Critical care medicine specialists are in 1:75 when compared to other specialties. Conclusion: Overall, the public sector critical care needs a total boost through out of box solutions. According to the Stockholm International Peace Research Institute (SIPRI), India spent the third most on defense in the world in 2021. India spent 76.6 billion dollars on its military in 2021, up 33% from 2012 and 0.9% from 2020. However, since India is considered a fast-growing economy, there is still a huge disparity in critical care. Without resetting critical health care, India cannot grow in welfare indices even if it is among the top gross domestic product (GDP) countries. How to cite this article: Prabu D, Gousalya V, Rajmohan M, Dinesh MD, Bharathwaj VV, Sindhu R, et al. Need Analysis of Indian Critical Health Care Delivery in Government Sectors and its Impact on the General Public: A Time to Revamp Public Health Care Infrastructure. Indian J Crit Care Med 2023;27(4):237-245.

Association of Paternal Individual Deprivation Measure with General Anthropometric Data and Dental Caries among 12 to 15 year old school going children, in Tiruvallur District - A cross sectional study.

AIM: To determine General anthropometric data and dental caries and their association of paternal Individual Deprivation Measure among 12- to 15-year-old school going children in Tiruvallur District. METHODS AND MATERIAL: The Anthropometric data such as Body mass index, Skin fold thickness and mid arm circumference was assessed. The study was also conducted to assess children's paternal deprivation using individual deprivation index (IDM). Paternal deprivation was calculated using Individual deprivation index which comprises of 15 dimensions. Pilot study was done to calculate sample size which is found to be 800. RESULTS: Dimension of paternal individual deprivation measure in parent Education, Housing, toileting, family planning, problem in visiting doctor between Government and Private School children was significant with P value of 0.0005. Interpretation of Paternal individual deprivation measure was found to be significant among Government and private school children. There was no association of individual deprivation measure with dental caries, but there was an association of Individual paternal deprivation measure with one of the anthropometric measure was mid arm circumference. In paternal deprivation index 21.8% of the children's parent were not deprived, 45.8% were somewhat deprived, 22.6% were deprived, 7.3% were very deprived, 2.6 were extremely deprived among school children.

In Vivo Autofluorescence Spectroscopic Study and Evaluation of DNA Damage By Comet Assay in Smokers.

CONTEXT: Tobacco is known environmental factor to alter the chemical composition of cells and the structure of DNA. Cellular level changes of smoker's mucosa are assessed by autofluorescence spectroscopy and the DNA damage can be evaluated by single cell gel electrophoresis (comet assay). AIM: To substantiate the changes in the autofluorescence due to smoking with that of early DNA damage without any clinical change. MATERIALS AND METHODS: Group I consists of 20 individuals with normal mucosa and Group II consists of 40 individuals with smoking habit. Only males were included in this study and their age ranging from 25 to 35 years. In vivo fluorescence spectra from both groups were obtained by using hand held fiber optic probe attached to Varian Cary Eclipse fluorescence spectrophotometer and comet assay was carried out for normal and smokers by their peripheral blood. STATISTICAL ANALYSIS USED: Independent-Samples t-test was used for statistical analysis. P-value was obtained to discriminate the statistical differences between the two groups. RESULTS: The averaged excitation and emission spectra of normal and smoker's mucosa showed significant differences statistically. In comet assay, the mean tail length of smoker group was higher than the normal group. The results showed statistically significant differences (p ≤ 0.05). CONCLUSION: These techniques will be very useful for monitoring of very early changes of mucosa before clinical manifestation of the lesion in high risk smokers and thus prevents the occurrence of premalignant disorders and early invasive carcinoma.

Assessment of oral mucosa in normal, precancer and cancer using chemiluminescent illumination, toluidine blue supravital staining and oral exfoliative cytology.

CONTEXT: Carcinoma in an early stage of development is hard to detect clinically because the lesion may not be palpable and color of the lesional tissue is not necessarily different from the color of the surrounding mucosa. In order to improve the efficacy of the diagnosis, techniques are being developed to complement clinical examination and to facilitate the identification of initial carcinomas. AIMS: To find out the efficacy of chemiluminescent illumination (ViziLite™) for the diagnosis in precancer and cancer patients and compare this result to toluidine blue staining and oral exfoliative cytology. MATERIALS AND METHODS: This study was done in 3 groups. Each group consists of 10 cases. Group I consists of normal appearing mucosa. Group II and III consist of clinically diagnosed pre-cancer and clinically suggestive of cancer respectively. Chemiluminescent illumination, toluidine blue supravital staining, oral exfoliative cytology and biopsy were performed in all cases. STATISTICAL ANALYSIS USED: SPSS version 10.05 was used to calculate positive and negative predictive values. RESULTS: In Group I, all 10 patients showed negative result to ViziLite™. 8 patients showed positivity and 2 patients showed negativity to ViziLite™ test in Group II. 9 patients were positive and one patient was negative for ViziLite™. CONCLUSIONS: Chemiluminescent illumination test was sensitive for precancerous and cancerous lesions, which presented as keratotic lesions and red-white lesions. It showed negative result to erosive lesions. Toluidine blue staining test was reliable in precancerous and cancerous lesions, which present as erosive and red-white lesions. It showed negative result to keratotic lesions. Oral exfoliative cytology has diagnostic value in cancer patients than in precancer patients. These Results indicate that chemiluminescent illumination test is relatively reliable and accurate than toluidine blue staining test and useful chair side diagnostic test.

Determining dental sex dimorphism in South Indians using discriminant function analysis.

Dental forensics forms a vital branch of forensic science which deals with proper handling, examination and evaluation of dental evidences for identification of victims of crime, accidents or calamities. Therefore skull and teeth often provide the identification material. The aim of the study was to investigate the accuracy of odontometric methods in sex determination of permanent teeth and to compute new formula to differentiate male and female teeth using discriminant function analysis for South Indian population. A total of 100 subjects were selected for the study from a parent population of 4800 students by simple random sampling method. Alginate impressions of the upper dental arch were made and casts were poured immediately. A digital vernier calliper was used for the measurement of all upper anteriors. Twelve different tooth measurements were recorded and from those two indexes have been computed. Statistical analysis was performed using the SPSS version 17.0 software. All the predictor variables were subjected to stepwise discriminant function analysis which optimally separates the genders and a best discriminant function was generated. In all the observed mean dimensions, male values exceed the female values. Student's 't' test for the different predictor variables of all teeth selected between male and females were found significant (p < 0.05). Very high significance was found in mean MD of 11, 12 and 13 and |c| of 23. The variables exhibiting best discriminant powers were mesiodistal width of both upper central incisors, DB-ML of 13 and canine crown module of 13. Sexual dimorphism in the size of permanent teeth differs from one population to the other and hence the standards set for one population could not be applied for another population. Hence this technique would be a simple, quick, cost effective, reliable and accurate for sex determination.

Fibrinous anterior uveitis following laser in situ keratomileusis.

A 29-year-old woman who underwent laser in situ keratomileusis (LASIK) for myopic astigmatism in both eyes presented with severe pain, photophobia and decreased visual acuity in the left eye eight days after surgery. Examination revealed severe anterior uveitis with fibrinous exudates in the anterior chamber, flap edema and epithelial bullae. Laboratory investigations for uveitis were negative and the patient required systemic and intensive topical steroids with cycloplegics to control the inflammation. This case demonstrates that severe anterior uveitis may develop after LASIK and needs prompt and vigorous management for resolution.

A novel quantification method of pantaprazole sodium monohydrate in sesquihydrate by thermogravimetric analyzer.

To demonstrate the applicability of thermogravimetric analyzer as a tool for the quantification of pantaprazole sodium monohydrate in sesquihydrate, studies have been conducted. Thermal analysis (DSC, TGA) crystallographic (PXRD) and spectroscopic techniques (FT-IR) were used for the characterization of the polymorphs. Thermogravimetric analysis (TGA) analysis was explored by high-resolution dynamic (Hi-Res-dynamic) and high-resolution modulated (Hi-Res-modulated) test procedures to quantify the hydrate polymorphic mixtures. The two polymorphic forms exhibited significant differences and good resolution in the second derivative thermogram generated by Hi-Res-modulated test procedure. Thus, the TGA with Hi-Res-modulated test procedure was considered for the quantification of monohydrate in sesquihydrate. The calibration plot was constructed from the known mixtures of two polymorphs by plotting the peak area of the second derivative thermogram against the weight percent of monohydrate. Using this novel approach, 1 wt% limit of detection (LOD) was achieved. The polymorphic purity results, obtained by TGA in Hi-Res-modulated test procedure were found to be in good agreement with the results predicted by FT-IR and was comparable with the actual values of the known polymorphic mixtures. The Hi-Res-modulated TGA technique is very simple and easy to perform the analysis.

Retroperitoneal Castleman's disease mimicking soft tissue tumour.

Castleman's disease is a type of non-neoplastic lymphoproliferative disease having lymph nodal hyperplasia. It has two distinct microscopic types: hyaline-vascular type and plasma cell type. Clinically, it may present either as a solitary mass, most commonly in the mediastinum, or as a multicentric form whose features are generalized lymph-adenopathy, splenomegaly and involvement of other organs like the lungs and kidneys. Here we report a case of isolated retroperitoneal Castleman's disease, which presented as a lump in the iliac fossa in a young female. A clinico-radio-logical diagnosis of retroperitoneal soft tissue tumour was made and the patient underwent complete surgical excision. The exact diagnosis was only obtained at histopathology and there is no evidence of recurrence at six months follow-up.