Assessing the Accuracy of Lateral Cephalogram in Quantifying Three-Dimensional Pharyngeal Airway Morphology Compared to Cone-Beam Computed Tomography.

BACKGROUND: When it comes to orthodontic diagnosis and treatment planning, the structures of the upper and lower airway space are crucial because of the role they play in craniofacial development. AIM: The major objective of this study was to evaluate the accuracy of lateral cephalogram in the evaluation of upper and lower pharyngeal space by comparing it to clinical usage of cone-beam computed tomography (CBCT) in quantifying the 3D morphology of the pharyngeal airway. METHODS AND MATERIALS: In total, 70 patients were included in the study. They had both a CBCT scan and a lateral cephalogram performed within a week of each other. Different cephalometric landmarks have been utilized to estimate linear and area dimensions for use in lateral cephalogram airway investigations. By superimposing the lateral cephalogram measurement of the vertical height of the pharyngeal airway over axial CBCT slices of 0.8 to 1 mm in thickness, airway volumes were calculated. For this study, we measured the pharyngeal airway space in each patient in two dimensions (2D) using the airway area from the lateral cephalogram and in three dimensions (3D) using the airway volume from the CBCT scan over the same region of interest, using a uniform scale and magnification throughout all split 3D volumes. RESULTS:  The mean value of the area of pharyngeal space calculated by lateral cephalograph analysis (LCA) was 336.35 ± 86.49 mm2. The maximum value was 551.234 mm2. The minimum value was 206.32 mm2. The mean value of the volume of the same area calculated using CBCT was 3409.11 ± 1237.96 mm3. The maximum value was 5887.23 mm3. When the area calculated using LCA was compared with the volume calculated using CBCT, the correlation between them was significant statistically (r=0.831, p-value =0.000). The mean values of volume evaluated in 3D CBCT in males were 4198±1008 mm3 while for females it was 2980±1134.5 mm3. During the statistical analysis, these observations were found to have a positive correlation with increased volume of pharyngeal space in males as compared to that of females (p=0.006). The values of the area of pharyngeal space calculated using LCA in males was 370.1±60.9 mm2. while it was 301.9±88 mm2  in females. CONCLUSION: The area estimated for the pharyngeal airway on LCA correlates strongly with the volume determined by a CBCT scan. Since we have considered pharyngeal space analysis using CBCT to be a reliable and standard methodology, therefore a positive correlation of area calculated using LCA with volume calculated using CBCT shows that the analysis made by LCA can be reliable.

Assessment of the Anterior Loop and Pattern of Entry of Mental Nerve Into the Mental Foramen: A Radiographic Study of Panoramic Images.

INTRODUCTION: The precise location of the mental foramina is an essential landmark in planning the position of dental implants in the anterior mandible. Injury to inferior alveolar nerve during anterior mandibular implant surgery causes altered sensation which greatly affects patient satisfaction. METHODS: In this study, we assessed the prevalence of anterior loop of mental nerve and the pattern of entry of mental nerve into the mental foramen. Three hundred panoramic radiographs (600 hemimandibles) obtained from records maintained in the Department of Oral Medicine and Radiology were randomly selected for the study. The radiographs were evaluated by two independent observers for the pattern of entry of mental nerve into the mental foramen on either side of the mandible and for the presence or absence of anterior loop of mental nerve. RESULTS: The most prevalent pattern of mental nerve observed was Straight pattern which totals to 67.5% followed by Anterior loop pattern (18.8%) and then the Perpendicular pattern (13.7%). There was no significant association between the gender and subtypes of looping pattern on the left and right side and a highly significant association between the side of the mandible and loop pattern was observed by Chi square test. CONCLUSION: The Anterior loop pattern of mental nerve has been found in 18.8% of the population suggesting to accurate planning with three-dimensional imaging techniques to avoid injury to mental nerve during dental implant placement and other surgical procedure involving the interforaminal region of the mandible.

To Vaccinate or Not to Vaccinate-Reasons of Willingness and Reluctance of Students against SARS-CoV-2 Vaccination-An International Experience.

Despite the vaccine against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) being reported to be safe and effective, the unwillingness to vaccinate and doubts are still common. The aim of this international study was to assess the major reasons for the unwillingness to vaccinate in a group of students from Poland (n = 1202), Bangladesh (n = 1586), India (n = 484), Mexico (n = 234), Egypt (n = 566), Philippines (n = 2076), Pakistan (n = 506), Vietnam (n = 98) and China (n = 503). We conducted an online cross-sectional study that aimed to assess (1) the percentage of vaccinated and unvaccinated students and (2) the reasons associated with willingness/unwillingness to the vaccine. The study included 7255 respondents from 9 countries with a mean age of 21.85 ± 3.66 years. Only 22.11% (n = 1604) of students were vaccinated. However, the majority (69.25%, n = 5025) expressed a willingness to be vaccinated. More willing to vaccinate were students in informal relationships who worked mentally, used psychological/psychiatric services before the pandemic, and studied medicine. There are cultural differences regarding the reasons associated with the unwillingness to vaccinate, but some 'universal' might be distinguished that apply to the whole group.

Contrasting Association Between COVID-19 Vaccine Hesitancy and Mental Health Status in India and Saudi Arabia-A Preliminary Evidence Collected During the Second Wave of COVID-19 Pandemic.

Background: Vaccine hesitancy is a global public health threat. Understanding the role of psychological factors in vaccine hesitancy is often neglected and relatively less explored. Aim and Objectives: To analyze the relationship between mental health and COVID-19 vaccine hesitancy before and after the advent of COVID-19 vaccines (AC19V) in the general population of India and Saudi Arabia (KSA) which vary in severity of the pandemic and vaccine mandates. Materials and Methods: A total of 677 adult participants from India and KSA participated in this cross-sectional online web-based survey. Sociodemographic details and current COVID-19 status pertaining to infection and vaccination were collected. Depression, anxiety, post-traumatic stress disorder (PTSD) symptoms, and perceptive need for mental health support (MHS) were assessed before and after AC19V. A newly constructed and validated COVID19 vaccine hesitancy scale-12 (COVID19-VHS12) scale was used to evaluate the COVID-19 vaccine hesitancy. Results: Prevalence and levels of depression and anxiety symptoms decreased significantly in Saudis but not in Indians after AC19V. PTSD symptoms showed a significant reduction in both India and KSA. Anxiety symptoms were higher in KSA than India before AC19V while PTSD was higher in India before and after AC19V. Except for the place of residence and employment status, the subgroups of sociodemographic variables which were at higher risk of negative mental health before AC19V showed improvement in their mental health after AC19V. The prevalence of COVID-19 vaccine hesitancy in India and KSA was 50.8% (95% CI 45.73-55.89%) and 55.7% (95% CI 50.16-61.31%), respectively. A bidirectional association between vaccine hesitancy and mental health was observed in KSA but not in India. Higher vaccine hesitancy favored higher levels of depression, anxiety, and perceptive need for MHS and vice versa in KSA. None of the mental health parameters predicted vaccine hesitancy in India, while higher vaccine hesitancy increased the risk of anxiety. Conclusion: Vaccine hesitancy has a negative impact on mental health and vice versa over and above the impact of sociodemographic factors and COVID-19 vaccination and infection status which shows variations between India and KSA.

Locomotor Behavior Analysis in Spinal Cord Injured Macaca radiata after Predegenerated Peripheral Nerve Grafting-A Preliminary Evidence.

INTRODUCTION: Primate animal models are being utilized to explore novel therapies for spinal cord injuries. This study aimed to evaluate the efficiency of the transplantation of predegenerated nerve segments in unilateral spinal cord-hemisected bonnet monkeys' (Macaca radiata) locomotor functions using the complex runways. MATERIALS AND METHODS: The bonnet monkeys were initially trained to walk in a bipedal motion on grid and staircase runways. In one group of trained monkeys, surgical hemisection was made in the spinal cord at the T12-L1 level. In the other group, hemisection was induced in the spinal cord, and the ulnar nerve was also transected at the same time (transplant group). After one week, the hemisected cavity was reopened and implanted with predegenerated ulnar nerve segments obtained from the same animal of the transplant group. RESULTS: All the operated monkeys showed significant deficits in locomotion on runways at the early postoperative period. The walking ability of operated monkeys was found to be gradually improved, and they recovered nearer to preoperative level at the fourth postoperative month, and there were no marked differences. CONCLUSION: The results demonstrate that there were no significant improvements in the locomotion of monkeys on runways after the delayed grafting of nerve segments until one year later. The failure of the predegenerated nerve graft as a possible therapeutic strategy to improve the locomotion of monkeys may be due to a number of factors set in motion by trauma, which could possibly prevent the qualities of regeneration. The exact reason for this ineffectiveness of predegenerated nerve segments and their underlying mechanism is not known.

Effectiveness of flipped classroom model in teaching histology for first-year MBBS students based on competency-based blended learning: An interventional study.

BACKGROUND: With recent changes in the curriculum of bachelor of medicine and bachelor of surgery (MBBS) course to meet the global trends and to fulfill the standards expected from an Indian medical graduate, introduction of newer teaching methodologies becomes mandatory. The usage of flipped classroom (FCR) in medical education has always been rewarding. This study was to evaluate the effectiveness of FCR as a teaching method in comparison with traditional lectures in histology sessions in Sri Ramaswamy Memorial (SRM) Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India. MATERIALS AND METHODS: This interventional study was conducted among the 1st year MBBS students in SRM Medical College Hospital and Research Centre for a period of 1 year (2018-2019 academic year). The histology sessions were taught using both traditional lectures and FCR methodology. Pre- and posttests were conducted for each traditional and FCR session with ten multiple-choice questions pertaining to that topic. Students' performance was assessed by paired t-test (for pre- and posttest comparisons) and independent t-test (for traditional and FCR posttest mark comparison) using SPSS software version 26. A feedback survey based on Likert scale was also conducted on the students and was analyzed. P < 0.05 was considered statistically significant. RESULTS: Posttest marks had statistically significantly improved when compared to pretest marks (P < 0.0001) in both traditional and FCR teaching methods. Comparison of posttest marks showed statistically significantly higher marks in FCR when compared to traditional teaching (P < 0.0001). Similarly, students' feedback survey showed that FCR benefitted the students in achieving the competency required. CONCLUSION: FCR methodology of teaching histology had a very impressive outcome and the students' perception was very positive.

Assessment of impact of COVID-19 outbreak & lockdown on mental health status & its associated risk and protective factors in adult Indian population

BackgroundThe novel Corona virus has derailed the entire world and various steps have been taken by the health authorities to tackle this pandemic. Nationwide lockdown has been imposed to control the spread of COVID-19 outbreak in India, which could have psychological impact on the population. AimOur study aims to study the effect of the COVID-19 outbreak & subsequent lockdown on mental health status of adult Indian population along with identifying the high-risk groups. MethodologyAn online survey was conducted during 3rd phase of lockdown gathering details about sociodemographic variables, practice of precautionary measures, awareness and concerns regarding COVID-19 and mental health status of the participants through DASS21 questionnaire from 873 adults. ResultsThe prevalence of depression, anxiety and stress were 18.56%, 25.66%, and 21.99% respectively including higher number of participants with mild depression (15.1%) and stress (14.5%) and moderate anxiety (16.3%). Female gender, age <25 years, unemployment, self-business, employed in private sector, lack of formal education, larger household size, parenthood (>2 kids) were associated with increased likelihood of negative mental health. Confidence in physicians ability to diagnose COVID-19 infection, decreased self-perceived likelihood of contracting COVID-19, lesser frequency of checking for information on COVID-19 and satisfaction of information received were protective against negative mental health. ConclusionThis landmark study identified the protective and risk factors of mental health during COVID-19 pandemic, to help authorities and mental health workers to strategize and deliver interventional methods to maintain psychosocial wellbeing of the population.

Effect of Fluoxetine on the Hippocampus of Wistar Albino Rats in Cold Restraint Stress Model.

INTRODUCTION: Stress has been known to be a potential modulator of learning and memory. Long term stress can lead to depression. Fluoxetine is a selective serotonin reuptake inhibitor group of drug used in the treatment of depression. AIM: The present study was conducted to evaluate the potential of Fluoxetine on cold restraint induced stress in the hippocampus of Wistar rats. MATERIALS AND METHODS: A total of 18 male wistar albino rats were divided randomly into three groups (n=6). Group 1 was the control group which were kept in normal laboratory conditions. Group 2 was the negative control group which were given cold restraint stress for period of four weeks. Group 3 was the experimental group, where the animals were pretreated with fluoxetine 10 mg/kg for a period of one week followed by cold restraint stress for 30 minutes and cotreated with fluoxetine 10 mg/kg for a period of four weeks. The whole study was done for a period of five weeks followed by behavioural studies and subsequently sacrificed with removal of brain for various histological, Immunohistochemical (IHC), neurochemical and antioxidant analysis. The values were expressed as Mean±SEM. One-way analysis of variance followed by Tukey's multiple comparisons test was used for the comparison of means. A probability of 0.05 and less was taken as statistically significant using Prism Graphpad software version 6.01. RESULTS: The results show there was significant improvement in the Morris water maze test after treatment with fluoxetine in Group 2. Similar results were also noted in the levels of neurotransmitters and antioxidant levels in brain and also in the number of cells counted in IHC and histological studies by H&E when Group 3 was compared with Group 2. The treatment reversed the damage in Group 2 which was comparable with the control group. CONCLUSION: The results revealed that administration of fluoxetine 10 mg/kg given orally has a potential antistressor effect by improving the neurogenic and neuroprotective effect on the cold restraint stress induced hippocampal damage.