Investigation of divergent thinking among surgeons and surgeon trainees in Canada (IDEAS): a mixed-methods study.

OBJECTIVE: To assess the creative potential of surgeons and surgeon trainees, as measured by divergent thinking. The secondary objectives were to identify factors associated with divergent thinking, assess confidence in creative problem-solving and the perceived effect of surgical training on creative potential, and explore the value of creativity in surgery. DESIGN: We used a mixed-methods design, conducting a survey of divergent thinking ability using a validated questionnaire followed by two semi-structured interviews with top-scoring participants. PARTICIPANTS & SETTING: Surgeons and surgeon trainees in the Department of Surgery at McMaster University. OUTCOMES: The primary outcome was divergent thinking, assessed with the Abbreviated Torrance Test for Adults. Participants also self-assessed their confidence in creative problem-solving and the effect of surgical training on their creative potential. We performed descriptive analyses and multivariable linear regression to identify factors associated with divergent thinking. We conducted a thematic analysis of the interview responses. RESULTS: 82 surgeons and surgeon trainees were surveyed; 43 were junior trainees and 28 were senior trainees. General surgery, orthopaedic surgery and plastic surgery represented 71.9% of the participants. The median participant age was 28 years (range 24-73), 51.2% of whom were female. Participants demonstrated levels of divergent thinking that were higher but not meaningfully different from the adult norm (62.39 (95% CI 61.25, 63.53), p<0.001). While participants scored significantly higher than the average adult on fluency (the ability to produce quantities of ideas) and flexibility (the ability to process information in different ways) (p<0.001 for both), they scored below average on originality (the ability to produce uncommon, new or unique ideas) (p<0.001). Regression analysis identified higher divergent thinking scores among females (estimated ß=-3.58 (95% CI -6.25 to -0.90), p=0.010). CONCLUSIONS: The divergent thinking ability among surgeons and surgeon trainees was not meaningfully different from the adult normative score; however, their ability to generate original ideas was below average.

Oral findings as predictors of obstructive sleep apnea- A case-control study.

Objective: To evaluate the role of dental parameters that may contribute to increasing apneic activity in patients with or without obstructive sleep apnea (OSA). Materials and Method: The study comprises a total of 120 patients (60 diagnosed with sleep apnea visiting a sleep center at Delhi and 60 controls). Patients were assessed based on body mass index, age, neck circumference, and gender (BANG), which were recorded for both the patients and controls. Oral and general examination was carried out using predetermined criteria for Angle's class of malocclusion, maxillary arch constriction, facial profile, Mallampati score for uvula, tongue size, depth of palatal vault, mouth breathing, and periodontitis. Results: Among 120 study subjects, 92 were males and 28 females, with a mean age of 49.08 + 13.13 years in the study group and 45.28 + 14.78 years in the control group. All the variables except Angle's class of malocclusion, periodontitis, mouth breathing, and hypertension showed significant differences in the study group. Multivariate analysis for patients with OSA revealed that obese patients were almost 1.5 times more possibly to report OSA symptoms than their non-obese counterparts. It was also found that patients with OSA were 4.12 times more likely to have neck circumference >40 cm, 2.25 times more likely to have maxillary arch constriction, 1.43 times deeper palatal vault, 8.7 times macroglossia, and 1.7 times class III & IV Mallampati score for uvula. Conclusion: The oral structural findings appear to be more closely related with OSA.

Prevalence of periodontitis and its association with smokeless tobacco (SLT) Use amongst the adult population of Greater Noida, India - A cross-sectional study.

Context: Smokeless tobacco (SLT) has been consumed in India since times immemorial. It is the need of an hour to emphasise about awareness and harmful effects of SLT in relation to periodontium. Aim: The aim of the study was to access the prevalence of periodontitis and its association with SLT amongst the adult population of Greater Noida, India. Settings and Design: Hospital-based study and cross-sectional design. Methods and Material: This cross-sectional study included 512 SLT subjects between the ages of 18 and 79 years. The study was carried out from December 2019 to January 2022. A self-designed questionnaire was used for recording demographic details, forms of SLT, frequency, duration of use, and sites of retention of SLT products. The clinical periodontal parameters such as periodontal pocket depth (PPD) and clinical attachment level (CAL) were recorded in a given point of time. Statistical Analysis Used: Chi-square test and logistic regression analysis. Results: The prevalence of periodontitis among SLT was 81.6% with the highest occurrence of Stage III Periodontitis (35.4%). The use of SLT for ≥10 years [odds ratio (OR) = 3.05, 95% confidence interval (CI) 1.86-6.27] showed threefold the risk for periodontitis compared to others who consumed SLT for 4-5 years. Gutkha consumers [OR = 2.56 (95% CI = 0.75-3.48)] were 2.56 times more prone to have periodontitis as compared to other forms of SLT. Conclusions: Periodontitis is positively associated with SLT use. Awareness, timely intervention, and periodic screening in the SLT users will help to prevent the progression of periodontitis.

Characterization of an Anti-Ebola Virus Hyperimmune Globulin Derived From Convalescent Plasma.

BACKGROUND: Convalescent plasma has been used to treat many viral diseases including Ebola. The manufacture of a purified anti-Ebola virus (EBOV) intravenous immunoglobulin (IVIG) from pooled convalescent plasma is described in this paper. METHODS: An enzyme-linked immunosorbent assay (ELISA) targeting an EBOV surface glycoprotein antigen was used to determine the immunoglobulin titer of pooled plasma and purified anti-EBOV IVIG. Anti-EBOV IVIG was also tested in neutralization assays using a vesicular stomatitis virus pseudovirion expressing EBOV glycoprotein on its surface and with live EBOV. Finally, the efficacy of the anti-EBOV IVIG was assessed in a mouse model of EBOV infection. RESULTS: In the ELISA, the anti-EBOV IVIG was shown to have a 7-fold increase in immunoglobulin G (IgG) titer over pooled convalescent plasma. In both the pseudovirion and live virus assays, the anti-EBOV IVIG showed approximately 5- to 6-fold increased potency over pooled plasma. Anti-EBOV IVIG also significantly improved survivability in mice infected with the virus when administered concurrently or 2 days after infection. CONCLUSIONS: These data support this purified anti-EBOV IVIG merits additional investigation and clinical trials for treatment and postexposure prophylaxis of Ebola virus disease. The experience gained can be applied to manufacture hyperimmune globulins against other emerging viruses.

Effect of second-hand smoke on systemic, oral and psychological health of primary school children in Western Uttar Pradesh: a biochemical analysis.

BACKGROUND: Secondhand smoke (SHS) exposure causes several systemic problems like asthma, dental problems like caries and effects overall wellbeing. This study was conducted to study the impact of SHS on primary school children by associating it with dental caries, cotinine level, asthma severity and overall wellbeing. METHODS: A case control study was conducted amongst 200 children (9-15 years old) that came to the Dental College in Muradnagar-Ghaziabad, India. Children who lived in smoking households were identified as SHS subjects-100 children and those who lived in nonsmoking households were identified as control group-100 children. Parents completed questionnaire regarding their smoking status. In children's questionnaire severity of asthma was determined by using expert panel report (EPR3), dental caries was recorded by dmft Index and psychological assessment of children was done using WHO-5 Wellbeing Index. Collection of unstimulated saliva of children was done in sterile plastic tubes and cotinine level was measured using Enzyme-Linked-Immunosorbent Assay (ELISA). Students' t-test and One-Way Analysis of Variance (ANOVA) were used to analyze data. RESULTS: Mean number of children suffering from asthma was higher in SHS subjects in comparison to control group i.e. 348.9±166.509 and 247.3±15.86 respectively. dmft and WHO wellbeing scores increased as level of cotinine increased. Mean cotinine level was higher in SHS subjects than control group i.e. 348.9±166.509 and 247.3±15.86 respectively. CONCLUSIONS: SHS has an adverse impact on young children reflected by poor dmft scores and psychological wellbeing, increased cotinine levels and asthma severity in comparison to control group.

Cultivating change: Engaging residents in research.

BACKGROUND: The American Council of Graduate Medical Education (ACGME) guidelines for scholarly activities by family medicine residents require at least one activity per resident and encourage conference presentations. Meeting these guidelines has traditionally been challenging due to a multitude of factors from lack of time to limited administrative support. Studies have shown that resident participation in research was associated with higher levels of satisfaction with training. We aimed to develop and evaluate the effectiveness of a dedicated research curriculum in achieving ACGME goals for our residents. METHODS: We performed a need assessment that identified strengths and obstacles related to research which then guided the actions taken to build the curriculum. Revised curricular elements included a research focused lecture series, a restructured journal club, financial support for presentations and project expenses, a specific timeline for project completion, and the development of a regional research day involving multiple family medicine programs. Dedicated research time was built into the resident schedule and presentations at local, regional and national conferences were encouraged and supported. RESULTS: Following implementation of the curriculum there was a marked increase in the number of scholarly projects performed by residents. Prior to implementation there had only been one presentation at a national conference in the previous five years. This increased to an average of four presentations per year in the following five year period. On a regional scale, the initial success of the local research day led to a continued expansion and now includes six family medicine programs. CONCLUSION: Implementation of a dedicated multifaceted research curriculum significantly increased the participation of our residents in scholarly activities and led to a near five-fold increase in presentations at regional and national levels. Additionally, resident satisfaction in scholarly activities increased and a far greater number of graduating residents went on to complete fellowships.

Oral health literacy: A practical strategy towards better oral health status among adult population of Ghaziabad district.

BACKGROUND AND AIMS: Despite tremendous considerable effort by health professionals to promote oral health to create beautiful smiles, gap between oral health knowledge and practice undoubtedly still remains. Thus the aim of this study was to assess the Oral health literacy level and its impact on socioeconomic and oral health status among adult population in Ghaziabad district. METHODS: A total of 600 study subjects aged 18-64 years from all 4 blocks of Ghaziabad visiting various outreach programmes using a multistage random sampling technique were included in the study. A specially designed questionnaire assessed the demographic variables. Oral health literacy level (OHL) was assessed with help of a bilingually adapted Hindi OHL tool. Clinical examination was recorded using WHO (World Health Organization) Oral Health Assessment Form 2013. RESULTS: The mean age of the study subjects was 43.9 ± 14.36 years. Majority 300 (50%) study subjects had inadequate oral health literacy level followed by Marginal oral health literacy level which was seen among 180 (30%) subjects and 120 (20%) subjects had adequate oral health literacy level. Oral health literacy level was slightly higher among females as compared to male subjects although the results were not statistically significant. A statistically significant difference was found between oral health literacy and oral health status as well as socioeconomic status. (P value ≤ 0.05). CONCLUSION: A significant association between OHL and oral health status was found stating Oral health literacy as an efficient role in influencing oral health outcome of any individual.

Comparison of the liquid and lyophilized formulations of Prolastin®-C for Alpha1-Antitrypsin deficiency: Biochemical characteristics, pharmacokinetics, safety and neoantigenicity in rabbits.

Multiple analytical and preclinical studies were performed to compare the biochemical characteristics, pharmacokinetics (PK), safety and neoantigenicity of a new 5% liquid formulation of Alpha-1 Proteinase Inhibitor (Liquid A1PI, Prolastin®-C Liquid) with the lyophilized version (Lyophilized A1PI, Prolastin®-C). Liquid A1PI and Lyophilized A1PI had similar average mass (~52 kDa), and both forms exhibited glycoform patterns consistent with the known banding pattern of A1PI (dominated by the M6 and M4 bands, including deconvoluted masses). Both Liquid A1PI and Lyophilized A1PI yielded average percent purity values ranging from 96% to 99% and had active content ranging from 53  mg/mL to 59  mg/mL. The PK profile of Liquid A1PI was similar to Lyophilized A1PI. Safety assessments in rabbits showed good tolerability and no test article-related changes in mortality, clinical signs, clinical pathology, body weight, food consumption, or urinalysis parameters. Following immunodepletion of antibodies that recognize Lyophilized A1PI, there were no significant differences in the anti-drug titers among animals immunized with Lyophilized A1PI and Liquid A1PI (p > 0.05), indicating that no antibodies to neoantigens were generated. Liquid A1PI and Lyophilized A1PI have similar profiles with respect to biochemical characteristics, PK, safety and neoantigenicity.

Health literacy and oral health literacy: are they associated? A cross sectional survey among undergraduate students of tricity (Chandigarh, Mohali, Panchkula), India

INTRODUCTION: Health Literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate decisions. As with general health; achieving and maintaining oral health requires one to be able to understand, interpret and act on various types of health information. OBJECTIVE: The present study was conducted to determine the association between health literacy and oral health literacy among undergraduate students in tricity (Chandigarh, Mohali, Panchkula), India. MATERIAL AND METHODS: A cross-sectional study was conducted among 490 undergraduate students studying in tricity, from randomly selected 10 colleges. The data was collected by a single trained examiner, using a structured proforma. The questionnaire consisted of two parts, REALM-66 and REALD-30. The subject was given a copy of list of words to be pronounced and score one was given for each word pronounced correctly. RESULTS: REALM-66 scores showed that subjects with health literacy level equivalent to fourth- sixth grade is 1%, seventh- eighth grade was 64.4% and 29.6% for ninth grade and above. REALD-30 scores showed that 37.6% subjects had low level of literacy, 33.1% had moderate and 29.3% had high level of literacy. REALM and REALD scores were found to be positively correlated for qualification and genders. CONCLUSIONS: To our knowledge, this is the first study reporting association between health and oral health literacy. As the correlations were not strong, thus the results should be regarded as a first step to provide evidence.

Reasons for extraction in primary teeth among 5-12 years school children in Haryana, India- A cross-sectional study.

BACKGROUND: Due to high prevalence of oral diseases extraction of primary teeth is a common and a major concern in developing countries. These teeth are given least importance as they are believed to shed off automatically, thus leading to serious problems like crowding and malocclusion. MATERIAL AND METHODS: A cross sectional study was carried out among children aged 5 to 12 years among 1347 children. The data was recorded on a prestructured questionnaire. Reasons for extraction of teeth were based on Kay and Blinkhorn criteria. RESULTS: 20.4% children were having tooth loss due to various reasons. The main reason for extraction was found to be caries in 64.3% followed by trauma in maxillary teeth among 43.02% of children. CONCLUSIONS: Presence of early loss of primary teeth result in occlusal disturbances and space loss among children. Hence, proper treatment regimens must be followed by the dental professionals and should be the need of the hour. Key words:Extraction, children, primary teeth, caries.

Perception of dental practitioners regarding the use of antioxidants in oral health.

BACKGROUND: Free radicals play a key role in the development of several pathological conditions. Therefore, antioxidants (AOs) are the first line of defense against free radical damage and are critical for maintaining optimum health and well-being. OBJECTIVES: To assess the perception of dental practitioners regarding use of antioxidants in oral health. METHOD: A cross-sectional questionnaire study was conducted among 296 dental practitioners in Tricity (Chandigarh, Mohali, Panchkula, India). A self-structured close-ended questionnaire was used to assess the perception of dentists regarding the use of antioxidants in their patients. It consisted of 12 questions with dichotomous response and five point likert scale ranging from strongly agree to strongly disagree. Descriptive statistics were used to summarize the data, followed by the Chi-square test to check significant differences between the responses. Correlation between responses were analysed through the Spearman's rank correlation. Statistical analysis was done using Statistical Package for Social Sciences version 20 (Illinois, Chicago, USA). RESULTS: A statistically significant difference was observed between genders, with females 181 (61%) having more knowledge than males 115 (39%) regarding the use of antioxidants in their clinical practice. It has been found that dental professionals in academics prescribes more antioxidants to their patients than the private practitioners. Postgraduates 76 (77.6%) had a higher level of knowledge than graduates 86 (43%). CONCLUSIONS: Knowledge about antioxidants should be highlighted in the health sciences curriculum. It is recommended to expand the use of antioxidants in oral health to bring down the burden of chronic diseases like periodontitis and catastrophic diseases like precancerous lesions and oral cancer. KEY WORDS: antioxidants, free radicals, mouth neoplasms, oral health.

Tooth Jewellery- Its Knowledge and Practice Among Dentists in Tricity, India.

INTRODUCTION: The world of fashion is ever changing and this dynamics applies to dentistry. As dentistry and dental treatments have become necessary facet of a healthy life and therefore down the line fashion prospect of tooth jewellery are also getting fused into it. AIM: To assess the knowledge and practice of tooth jewellery among practicing dentists of Tricity, India. MATERIALS AND METHODS: A descriptive, cross-sectional study was conducted among 310 dental practitioners in Tricity (Chandigarh, Mohali and Panchkula), India. A self-administered, close-ended questionnaire was distributed among all the dental practitioners in order to assess their knowledge and practice regarding tooth jewellery. Responses of the questionnaire was obtained on the dichotomous scale with Yes and No. Right answers were given a score of 2 whereas the wrong answers were given as score of 1. The data was analyzed using unpaired students t-test, one way ANOVA (analysis of variance) and multivariate logistic regression. RESULTS: A significant difference was observed among the genders with males being three times more knowledgeable (OR=3.5, 95%CI: 0.8-2.8). It has been found that knowledge and practice scores of dental practitioners who spend more than 10 hours per day have two times more knowledge (OR= 2.3, 95%CI:0.08-1.1) than others. The dentists holding the masters degree were having three times more knowledge than the graduates' ones (OR= 2.3, 95%C.I:0.1-1.9). CONCLUSION: The present study concluded that dental practitioners had sufficient knowledge about tooth jewellery. Practice of tooth jewellery in the dental clinics was found to be adequate but it was also associated with some complications. To overcome this, it is advised that professional and government bodies should create strategies for enhancing and improving people's knowledge as well as make them aware of the pros and cons while using tooth jewellery which shall further enhance their smile.

Knowledge regarding Zika virus infection among dental practitioners of tricity area (Chandigarh, Panchkula and Mohali), India.

BACKGROUND: Zika virus (ZIKV), a vector-borne virus affecting a large number of people, has today become a major public health concern in the developed and developing countries worldwide. AIM: The purpose of this study was to assess the knowledge of ZIKV among dental practitioners residing in Tricity area (Chandigarh, Panchkula and Mohali), India. SUBJECTS AND METHODS: A total of 412 private dental practitioners were randomly sampled of whom 254 (61.6%) responded to participate in this cross-sectional survey. A self-structured, closed-ended questionnaire was administered to each participant to record demographic and professional characteristics followed by their knowledge regarding ZIKV. Statistical analysis was performed using SPSS Version 20 (IBM Corp, Armonk, NY). The results were expressed in percentages. Multivariable linear regression analysis was carried out to assess the association of participant's demographics and professional characteristics with knowledge. RESULTS: The sample consisted of 152 (59.9%) male and 102 (40.1%) female practitioners. Majority of the practitioners belonged to the age group of 25-34 years (66.1%). High knowledge was reported by only 38.2% of the practitioners. A statistically significant difference was seen when mean knowledge scores were compared with the qualification of the participants (P = 0.04), with postgraduates having more knowledge than graduates regarding ZIKV. Most of the knowledge of the practitioners came from television (37.8%) while journals only represented 4.7% of the total information gained. CONCLUSION: ZIKV infection, a new public health emergency, needs to be addressed urgently. All health care professionals should have adequate knowledge of the virus and be conversant with necessary precautionary measures to be taken making it imperative that dental practitioners strive to continually update their knowledge from time to time.

Association of occupational stress factors on nicotine dependence among patients visiting dental care unit of Indo-Tibetian border police force station in India.

BACKGROUND: Tobacco use is the foremost preventable cause of death and disease in the world today and work strain might be related with nicotine dependence by its provoking effect. OBJECTIVE: To assess the association between occupational stress and nicotine dependence. MATERIAL AND METHODS: A cross sectional survey was conducted among 200 subjects visiting a satellite dental clinic of Swami Devi Dyal Hospital and Dental College, Barwala, Panchkula, India. Nicotine dependence was measured using the Fagerstrom Test for Nicotine Dependence (FTND). The extent of the stress factors experienced at work was assessed using the Effort-Reward Imbalance scale (ERI). Chi-square test and multiple logistic regression analysis were employed for statistical analysis. Confidence level and level of significance were set at 95% and 5% respectively. RESULTS: The results of bivariate analysis revealed association of occupational stress with age, marital status, educational status, level of nicotine dependence, frequency of cigarette smoking and religious attendance. However, multivariate analysis elicited the significant association of occupational stress with only two variables, level of nicotine dependence and frequency of smoking. CONCLUSION: Occupational stress was found to be associated with nicotine dependence in the present study implying a need of other tranquil measures to be incorporated for the relief of work related stress.

Role of Lycopene in Preventing Oral Diseases as a Nonsurgical Aid of Treatment.

Without pigments, we are nothing. Life presents us with a kaleidoscope of colors. From the green grass of home to a forest's ruddy autumn hues, we are surrounded by living colors. Living things obtain their colors, with few exceptions, from natural pigments. In addition to their role in coloration, natural pigments carry out a variety of important biological functions. Of the various classes of pigments in nature, the carotenoids are among the most widespread and important ones, especially due to their varied functions. Lycopene is a red plant pigment found in tomatoes, apricots, guavas, watermelons, papayas, and pink grapefruits, with tomatoes being the largest contributor to the dietary intake of humans. Lycopene exhibits higher singlet oxygen quenching ability. Due to its strong color and nontoxicity, it is a useful food coloring agent. Moreover, it plays a multifunctional role as a nonsurgical aid in the treatment of oral diseases like leukoplakia, oral submucous fibrosis, lichen planus, oral squamous cell carcinoma, and also prevents the destruction of periodontal tissues. This review article focuses mainly on the role of lycopene in the prevention of various oral diseases.

Plasma fibrinogen degradation products in oral submucous fibrosis.

CONTEXT: Plasma fibrinogen degradation products (FDPs) and oral submucous fibrosis (OSMF). BACKGROUND: OSMF is a chronic, progressive, scarring disease of multifactorial etiology. Areca nut is found to be the main cause of this disease. But it has been found in the routine clinical practice that some individuals with the habit of areca nut chewing may not show any clinical evidence of OSMF, while some individuals without the habit of areca nut chewing are found to have OSMF. So, there must be some other factors associated with OSMF. Recently, plasma FDPs have been identified as an early indicator of disease in OSMF patients. A systematic review of their role would help to elucidate whether there is an association of these FDPs in the pathogenesis of OSMF or not. OBJECTIVE: To review studies reported in the literature elucidating the role of these plasma FDPs in OSMF. MATERIALS AND METHODS: Articles were searched in PubMed; MEDLINE using appropriate key words like "plasma fibrinogen degradation products" and "oral submucous fibrosis." Hand search of journals was also performed. Articles were reviewed and analyzed. RESULTS: The search strategy revealed nine relevant articles which studied the role of these plasma FDPs in the etiopathogenesis of OSMF and further progression of this disease with the increased clinical grades and the risk of carcinoma, but the exact role of these factors is still obscure. CONCLUSION: The data validate the role of plasma FDPs in the etiopathogenesis of OSMF. Studies with a large sample size are still required to evaluate the definite association between these FDPs and OSMF. It has the advantage of being a noninvasive method to evaluate the stage of OSMF patients, instead of using the invasive techniques like biopsy.

Knowledge regarding Ebola Hemorrhagic Fever among private dental practitioners in Tricity, India: A cross-sectional questionnaire study.

BACKGROUND: Ebola viral fever, a highly contagious haemorrhagic disease has today become a major public health concern in the developing countries worldwide. AIM: The purpose of this study was to assess knowledge among dental practitioners regarding Ebola Haemorrhagic Fever (Ebola HF) in Tricity, (Chandigarh, Panchkula and Mohali). MATERIALS AND METHODS: A total of 500 private dental practitioners were randomly approached to participate in this cross-sectional survey. A self-structured, closed ended questionnaire was administered to each participant to record demographic and professional characteristics followed by their knowledge regarding Ebola HF. Knowledge section included questions related to communicability; symptomatology and diagnostics; at-risk individuals; prevention and treatment; and, virus characteristics of Ebola HF. RESULTS: The results were expressed in percentages. Multivariable linear regression analysis was carried out to assess the association of participants's demographic and professional characteristics with the knowledge scores. Statistically significant difference was seen when mean knowledge scores were compared based on the locality and qualification of the participants (P < 0.05). CONCLUSION: Dental practitioners from urban areas with higher qualification had better knowledge yet there were notable deficiencies regarding the virus characteristics, diagnostics, elimination and treatment.

Effect of Adhesive Application on Sealant Success: A Clinical Study of Fifth and Seventh Generation Adhesive Systems.

OBJECTIVES: The aim of the study was to compare the effect of fifth and seventh generation bonding agent on sealant success. MATERIALS AND METHODS: Sixty-four school children aged six to nine years received sealants in four permanent molars in a split mouth design, such that each patient received sealant in the first permanent molar with fifth generation bonding agent in one arch and seventh generation bonding agent in the other arch; contra-lateral molars were sealed with sealant alone. The evaluation was carried out at baseline, three months, six months and 12 months, according to the criteria by Feigal et al, in 2000. Chi- square test was used to analyze data at P<0.05 level of significance. RESULTS: Statistically significant differences were found for sealant retention between fifth generation and sealant group, and fifth generation and seventh generation groups; whereas, no significant difference was found for sealant retention between seventh generation and sealant group at three, six and 12 months. CONCLUSION: As separate etch and rinse steps are not required for seventh generation bonding agents, and almost similar results were obtained for both sealant and seventh generation groups, it can be concluded that application of sealant along with a seventh generation bonding agent may enhance sealant success and can be used for caries prevention in preventive programs.

Efficacy of dental floss and chlorhexidine mouth rinse as an adjunct to toothbrushing in removing plaque and gingival inflammation - a three way cross over trial.

BACKGROUND: Maintaining good oral hygiene is important to combat periodontal diseases. The use of tooth brush alone does not serve the purpose of removing plaque which demands the use of some adjuncts such as proximal cleaning aids. AIM: The study was conducted to compare the efficacy of Dental Floss and 0.12% Chlorhexidine Gluconate Mouthrinse as an adjunct to toothbrushing on plaque accumulation and gingival inflammation. SETTINGS AND DESIGN: Department of Public Health Dentistry, Kothiwal Dental College and Research Centre, Moradabad, India. This was a randomized, double blind, three-way cross over clinical trial. MATERIALS AND METHODS: Forty five dental students in the age group of 19-25yr. were enrolled into the study. Subjects were randomly assigned into three groups (n=15) i.e. Group A- Toothbrushing with Dental floss (TB+DF), Group B- Toothbrushing with 0.12% Chlorhexidine Gluconate Mouthrinse (TB+CHX-MR) and Group C- Toothbrushing alone (TB Alone) in a three-way crossover manner. After 21 d of trial period, plaque index (PI) and gingival index (GI) were assessed for each group, oral prophylaxis followed by a washout period for 14d. STATISTICAL ANALYSIS USED: Mean, standard deviations and p-values were obtained. ANOVA test was used to compare the intergroup difference and Post hoc test to compare between the two groups. RESULTS: The inter-group comparison for GI and PI at all interventions showed statistically significant difference (p<0.001). While comparing between group A and group C at second and third follow up, no significant difference were observed though group A showed reduction in mean values for both the clinical parameters whereas while comparing between group A and group B, statistically significant difference was observed, which is in line when compared with group B and group C. The Group B showed more reduction in plaque and gingival scores which was found to be statistically significant (p<0.001). CONCLUSION: CHX-MR when used as an adjunct to toothbrushing is more effective in the reduction of plaque and gingival scores than a toothbrush alone or in combination with DF.

Safety evaluation of a recombinant plasmin derivative lacking kringles 2-5 and rt-PA in a rat model of transient ischemic stroke.

BACKGROUND: Tissue type plasminogen activator is the only approved thrombolytic agent for the treatment of ischemic stroke. However, it carries the disadvantage of a 10-fold increase in symptomatic and asymptomatic intracranial hemorrhage. A safer thrombolytic agent may improve patient prognosis and increase patient participation in thrombolytic treatment. A novel direct-acting thrombolytic agent, Δ(K2-K5) plasmin, promising an improved safety profile was examined for safety in the snare ligature model of stroke in the rat. METHODS: Male spontaneously hypertensive rats were subjected to 6 hours middle cerebral artery occlusion followed by 18 hours reflow. Beginning 1 minute before reflow, they were dosed with saline, vehicle, Δ(K2-K5) plasmin (0.15, 0.5, 1.5, and 5 mg/kg) or recombinant tissue-type plasminogen activator (10 and 30 mg/kg) by local intra-arterial infusion lasting 10 to 60 minutes. The rats were assessed for bleeding score, infarct volume, modified Bederson score and general behavioral score. In a parallel study, temporal progression of infarct volume was determined. In an in vitro study, whole blood clots from humans, canines and rats were exposed to Δ(K2-K5). Clot lysis was monitored by absorbance at 280 nm. RESULTS: The main focus of this study was intracranial hemorrhage safety. Δ(K2-K5) plasmin treatment at the highest dose caused no more intracranial hemorrhage than the lowest dose of recombinant tissue type plasminogen activator, but showed at least a 5-fold superior safety margin. Secondary results include: temporal infarct volume progression shows that the greatest expansion of infarct volume occurs within 2-3 hours of middle cerebral artery occlusion in the spontaneously hypertensive rat. A spike in infarct volume was observed at 6 hours ischemia with reflow. Δ(K2-K5) plasmin tended to reduce infarct volume and improve behavior compared to controls. In vitro data suggests that Δ(K2-K5) plasmin is equally effective at lysing clots from humans, canines and rats. CONCLUSIONS: The superior intracranial hemorrhage safety profile of the direct-acting thrombolytic Δ(K2-K5) plasmin compared with recombinant tissue type plasminogen activator makes this agent a good candidate for clinical evaluation in the treatment of acute ischemic stroke.