Barriers in Dental Care Utilization-An Explorative Study among Transgender Community of Bhubaneswar, Odisha.

Introduction: Transgenders (TGs) are one of the vulnerable groups in our society. Trans people experience substantial health disparities and barriers to appropriate health care services that keep them from achieving the highest possible health status. Methodology: The study was conducted over the course of 12 months at the Transgender Shelter Home. Focus group discussion (FGD) took place with 6-12 participants and the researcher acted as moderator. The questions were asked under four domains; sociodemographic variables, behavioral variables, medical and health status variables, and access and utilization of dental services barrier variables. Transcripts were coded and data analysis was concurrent with data collection to allow to know new insights. The data analysis was done by MAXQDA software 2022.0.0. It is being developed and distributed by VERBI Software based in Berlin, Germany. Results: The barriers and facilitators explored were categorized at three levels: (1) the personal level, relating to those barriers and facilitators that the individual faced for their oral health care, and the perspectives regarding the delivery of care; (2) the inter-personal level; and (3) the system level, for identifying the wider elements and their influence. Discussion: Social stigma and marginalization have been linked to adverse health effects, including personal attributes, structural and environmental factors, and personal perceptions of stigmatization. Conclusion: It is evident that lesbian, gay, bisexual, transgender, and queer (LGBTQ) communities have specific but varied health care needs, and the greatest way to treat these necessities is via exposure to professional, health care coverage.

Evaluation of the Blunt Pancreatic Injury, a Long-Term Tertiary Care Center Study: An Original Research.

Introduction: Pancreatic trauma is uncommon and challenging to diagnose. Contrarily, severe injuries to the kidney, spleen, and liver are frequent and typically easy to detect with imaging methods. Pancreas injuries can cause a significant amount of morbidity and mortality. Reviewing the institution's experience with this rather infrequent injury was the goal of this study. Materials and Method: The patients' records were collected from the data records at the tertiary care center for patients who had pancreatic damage and were followed up for a year. The American Association for the Surgery of Trauma pancreatic damage grade scores were assigned to each patient using the radiologic and surgical findings. Clinical examination and CT results were predominantly used to make the diagnosis in patients who underwent non-operative treatment. The data are presented as descriptive statistics. Results: Only 2.2% of the total cases that presented to the trauma center were finalized as pancreatic injuries. Trauma to the abdomen was seen in nearly half the cases brought. Most of the subjects in pancreatic injuries were in grade 3. Mortality was noted maximum for the grade 3 and 4 cases. Conclusions: While high-grade pancreatic injury almost always requires an operational intervention, low-grade pancreatic injury with an intact main pancreatic duct may be effectively handled non-operatively. When possible, distal pancreatectomy with spleen preservation is the ideal procedure for distal pancreatic trans-action. A patient who is hemodynamically stable with complex pancreaticoduodenal damage, which is related to a high death rate, should undergo Whipple resection.

Assessment of oral health status amongst the Sevayats of Shree Jagannath Temple, Puri, Odisha: A cross sectional study.

Aim: To assess the oral health status amongst the Sevayats of Shree Jagannath temple, Puri, Odisha. Methodology: A cross-sectional study was conducted to evaluate the oral health status among 488 Sevayats of Shree Jagannath Temple, Puri, using a simple random sampling technique. Data were obtained by utilizing the WHO oral health assessment form for adults-2013. The documented data were assembled, entered into an MS Excel spreadsheet, and analyzed using SPSS version 26. The statistical tests applied for the analysis were one-way analysis of variance and the Chi-square test. The P value of < 0.05 was considered statistically significant. Results: The majority of the participants, around 30.3%, had an educational qualification of higher secondary, followed by high school, 26.2%. A total of 84.4% of participants cleaned their teeth with a toothbrush. Around 48.0% of participants were consuming paan and 11.7% were gutkha. The majority, 77.8% of the participants had periodontal pockets, and 79.09% of them had 4-5 mm of periodontal loss of attachment. The mean DMFT of all the participants was 5.23 ± 4.71. In the 25-44 and 45-60 years of age groups, 34.2% and 31.4% of the participants had tobacco pouch keratosis. About 72% of the subjects had bleeding gums. Conclusion: There was a higher prevalence of dental caries and periodontal disease among the subjects. The majority of the servitors who had a history of consuming paan were diagnosed with oral mucosal lesions.

Assessment of oral health status and treatment needs of drug abusers in Bhubaneswar city: A cross-sectional study.

INTRODUCTION: Oral health of drug abusers has received less attention. Drug users may also have special needs in relation to receiving dental care. Evaluation of the oral health status of drug abusers is important as in India, where the disease burden is enormous, and availability of curative treatment is quite inadequate, preventive approach shall prove to be better than curative treatment. AIM: To determine the oral health status and treatment needs of drug abusers residing in rehabilitation centers in Bhubaneswar. MATERIALS AND METHODS: A cross-sectional study was conducted in the drug de-addiction cum rehabilitation centers in Bhubaneswar city, Odisha. A self-administered questionnaire was used to record oral health practices of the inmates and the type of drugs used by them in the past. Oral health was recorded using modified WHO 2013 pro forma. Mann-Whitney U-test and Kruskal-Wallis test were applied to find any significant differences between different variables in groups. RESULTS: All the participants were male and alcohol was the most commonly used drug, followed by tobacco and ganja. The horizontal brushing technique was the most widely used technique. Mean decayed, missing, and filled teeth (DMFT) score was recorded to be 1.48. Leukoplakia, acute necrotizing ulcerative gingivitis, candidiasis, and ulceration were among the few oral lesions found in the inmates. Around 67.66% of inmates exhibited erosion of the enamel surface, while 6.59% had signs of enamel fracture. Statistically, significant difference was found for the types of drugs used and DMFT score and type of drug used and dental erosion. CONCLUSION: Oral health status of drug users is poor and needs immediate attention. Oral health education needs to be imparted among them. The government needs to enforce the establishment of dental clinics in these centers so that the oral health of these people can be taken care of.

The Birhor tribes of Ramgarh District, Jharkhand - a ferret into their oral health status and treatment needs.

AIM AND OBJECTIVES: Jharkhand is a land of 32 listed Tribes, out of which eight tribes have been categorized as 'Primitive Tribes' and the Birhors are one among these. The study was aimed at assessing the oral health status and treatment needs of the native Birhors. MATERIAL AND METHODS: A cross-sectional household survey of 400 Birhors in the panchayats of Basantpur, Kuju Purvi and Mandu Chatti was conducted. A modified World Health Organization (WHO) Oral Health Assessment Form (1997) was utilized and examined according to the WHO methodology (1997). The recorded data were statistically analyzed using the SPSS version 15. RESULTS: Based on the occupation, it was found that 141 (35.25%) subjects were hunters and 90 (22.50%) subjects practiced agriculture. A majority of 337 (84.25%) subjects were using the Sakhua twigs (Shorea robusta) to clean their teeth. It was observed that 381 (95.25%) subjects were quite healthy and had no oral mucosal lesions. Almost half of the study subjects (45%) were habituated to tobacco and among them 101 (56.11%) subjects were using khaini, followed by 46 (25.56%) subjects who used bidis. The mean decayed, missing, and filled teeth (DMFT) Index scores among males and females was 1.05±2.59 and 1.02±2.17, respectively. Subjects with bleeding gums were predominantly seen in the age group of 2-5 years (26.75%) and those with shallow pockets were more commonly seen in the age group of 16-34 years (47.12%). A total of 53 (13.25%) subjects and 33 (8.25%) subjects had a LOA of 4-5 mm and 6-8 mm, respectively. Among males, 0.44±2.60 subjects each needed one/two surface fillings. A total of 14 (3.5%) and 15 (3.75%) subjects needed one-unit prosthesis in the upper and lower jaws, respectively. CONCLUSION: The study showed that a majority of Birhor tribals (84.25%) used Sakhua twigs to clean their teeth. Almost half of the study subjects (45%) were habituated to tobacco in myriad forms.

Use of plasma-enriched demineralized freeze-dried bone matrix in postsurgical jaw defects.

AIM AND OBJECTIVES: The aim is to know the augmented new bone formation in postsurgical bony defects in the maxillofacial region when filled with plasma-enriched demineralized freeze-dried bone allograft (DFDBA). MATERIALS AND METHODS: The study group included 45 patients, selected randomly, and divided in three equated groups. In Group I (control) patients, the wound was closed primarily without incorporating any graft in the bony defect. In Group II, the defect was filled with DFDBA alone and in Group III with DFDBA enriched with platelet-rich plasma (PRP). The said graft material was procured from the (to be discarded) femur head, treated to get rid of its antigenicity, made suitable to be incorporated as a graft material, sterilized by gamma irradiation and then implanted into the jaw defects. RESULTS: The results were evaluated and interpreted both clinically and radiographically by studying the changes post 1 week, 1 month, 3 months, and 6 months, respectively. Bone density was evaluated using computed tomography scan in addition to standard conventional radiographs. Evidence of trabecular formation and calcification were noted down. Measurements were recorded by taking note of Hounsfield units. Statistically, one-way ANOVA test followed by least significant difference post hoc test was done. Final results showed that the patients in the Group III had more bone density at the grafted site when compared to the Group II and I patients. These findings were significant. CONCLUSION: PRP-enriched DFDBA is a superior grafting material in terms of other grafting materials available. It possesses both osteoconductive and osteoinductive properties and elicits the least immunological response, thereby making it one of the best effective combinations of grafting material to be used in oral and maxillofacial reconstructive purposes.

Assessment of Knowledge, Attitude, and Practice of Dental and Medical Interns toward Toothbrush Maintenance and Replacement in Bhubaneswar City, Odisha, India.

BACKGROUND: Toothbrushes are an important medium for maintaining good oral hygiene, and hence there arises a need to maintain and replace toothbrushes at a regular interval. Assessing the knowledge, attitude, and practice (KAP) of the medical and dental interns would help the society in promoting oral hygiene in a broader aspect. MATERIALS AND METHODS: A cross-sectional questionnaire study was conducted among 759 medical and dental interns residing in Bhubaneswar, Odisha, India. The data on oral health KAP were collected using a self-structured questionnaire. Descriptive statistics was evaluated using SPSS software package, version 19. RESULTS: Of 759 participants, 445 were dental interns and 314 were medical interns. Knowledge about toothbrush maintenance was seen to be more in the dental interns. The attitude toward maintenance was seen to be better among the dental interns compared with the medical interns. The practice of toothbrush maintenance was seen in both the groups but more dominantly in the dental interns. CONCLUSION: Education regarding the effective use and maintenance of the toothbrush would help improve the KAP toward toothbrush maintenance and replacement. The lack of knowledge holds back the attitude of properly maintaining the toothbrush in a regular basis.

Awareness, Attitude and Practice Regarding Disinfection and Handling of Extracted Teeth among the Students in a Dental College in India.

OBJECTIVE: The main objective of this study is to assess about the awareness, attitude, and practice regarding disinfection and handling of extracted teeth among the students of a dental college in Odisha, India. MATERIALS AND METHODS: The survey was done with a self-designed questionnaire distributed among the students of a dental college in Odisha, India. Data analysis was done using the Statistical Package for the Social Sciences Software (SPSS for Windows, Version 16.0., Released 2007, Chicago, SPSS Inc.) and the results obtained. RESULTS: Of the many methods available, the safest and practical methods to sterilize and disinfect the extracted human teeth could be autoclaving, submersion in 10% formalin and 5.25% sodium hypochlorite solutions. In addition, it was found that there is a significant need to educate the potential handlers of such extracted teeth about the latest statuary protocol and guidelines. CONCLUSION: Most of the participants in the study were aware of the established safety protocols regarding how to handle the pathogenic specimens and were putting in practice those standardized guidelines. But still another good number of handlers need to change their casual attitude while following the safety guidelines so as to protect themselves, others and the environment from the pathogenic clinical specimens.

Management of maxillofacial injuries in bear mauling cases: a review of 20 cases.

OBJECTIVES: As the craniofacial and neck regions are prime areas of injury in bear attacks, the careful management of soft and hard tissue injuries and selection of reconstructive options is of the utmost importance. This study will review the incidence and patterns of bear mauling in eastern India reported to our department and the various modalities used for their treatment over a period of 7 years. It also documents the risks of infection in bear mauling cases and the complications that have occurred. MATERIALS AND METHODS: Twenty cases were treated over the study period. Cases were evaluated for soft and hard tissue injuries including tissue loss and corresponding management in the craniofacial region. Cases were also evaluated for other associated injuries, organ damage and related complications. RESULTS: Various modalities of treatment were used for the management of victims, ranging from simple primary repairs to free tissue transfers. Simple primary repairs were done in 75% of cases, while the management of the injured victims required reconstruction by local, regional or distant flaps in 25%. Free tissue transfers were performed in 15% of cases, and no cases of wound infection were detected in the course of treatment. CONCLUSION: Knowledge of various reconstructive techniques is essential for managing maxillofacial injuries in bear mauling cases. Modern reconstructive procedures like free tissue transfer are reliable options for reconstruction with minimal co-morbidity and dramatic improvement in treatment outcomes.

Kimura's Disease: Report of a Case & Review of Literature.

Kimura's disease is an uncommon allergic disorder of unknown etiology affecting sporadic populations. A male patient in his third decade presented with a swelling in his left facial region. His investigations showed a raised eosinophil count. The lesion was excised surgically. He was put on a short term steroid therapy. Biopsy revealed it as Kimura's disease. Subsequent follow-ups have been satisfactory with no recurrences.

Unusual case of postextraction bleeding.

Vascular anomalies often affect the soft tissues though primary intraosseous lesions are uncommon. A 29-year-old patient reported to the Oral and Maxillofacial Surgery department of SCB Dental College, Cuttack, with the complaint of unusual bleeding from his extracted tooth socket. After undergoing routine hematological and radiological investigations and an angiogram, a diagnosis of arteriovenous malformation of the right posterior maxilla involving the posterior superior alveolar artery was established. Subsequently, the patient was treated by right external carotid artery ligation followed by partial maxillectomy. Follow-up has been satisfactory all through.

A rare ocular complication following treatment of oral submucous fibrosis with steroids.

Oral submucous fibrosis (OSMF) is one of the most commonly found pre-cancerous conditions prevalent in Southeast Asian countries. The treatment method used by most patients is the use of intralesional steroids. With intralesional steroids used commonly, one might come across an unusual ocular complication - central serous chorioretinopathy (CSCR). We report a case of a patient with OSMF who was treated by corticosteroids, subsequent to which he developed CSCR. He was put off steroidal treatment and treated conservatively to which he responded positively.