Naturopathic Interventions for Reduction of Perceived Pain in Patients Suffering from Arthritis: A Systematic Review and Meta-Analysis.

Arthritis affects millions of lives with its pervasive effects on physical health and quality of life. Addressing the complexities of managing symptoms such as swelling, inflammation, and pain requires prolonged treatment. Naturopathy is a treatment method that enhances the body's innate ability to restore optimal health through a holistic approach including natural products and lifestyle modifications. This systematic review addresses the intersection of naturopathy and arthritis treatment to provide current evidence about its potential benefits. Four databases (PubMed, AYUSH Research Portal, Web of Science, and Google Scholar) were searched with the keywords "Naturopathy" AND "Arthritis". Randomized, non-randomized, and cross-over studies in English were included. Studies reporting perceived pain using a visual analogue scale (VAS) were selected for meta-analysis. A total of 15 studies were included in the systematic review. The studies were from Denmark, Egypt, France, Hungary, Israel, Italy, Spain, and Turkey, and the study periods ranged from 1992 to 2017. They suggested that naturopathic treatment modalities like exercise, mud compress, sand bath, or hydrotherapy may be used in addition to conventional modes of treatment for added benefit. There was a diversity of naturopathic treatment modalities and outcome evaluation methods. Most studies used mud compress or mud baths with reported improvement of symptoms. The meta-analysis of 10 studies (11 sets of data) showed a significant improvement in pain measured by VAS. The studies included in the review have a high level of heterogenicity. There is a need for more studies and uniform assessment methods with standardization of interventions for robust evidence. More clinical trials from countries where naturopathy is approved treatment modalities are needed.

Cancer care and economic burden-A narrative review.

Cancer care poses a significant economic burden in India, where noncommunicable diseases contribute to a large number of deaths and disability-adjusted life-years. Despite economic growth, equitable wealth distribution remains a challenge, leading to inequalities in healthcare access. India's healthcare system is primarily privatized, financed through out-of-pocket expenditure (OOPE), and lacks coverage for a majority of the population. As a result, individuals without financial means face catastrophic health consequences when seeking necessary healthcare. OOPE in India's healthcare system is a major concern, with medicines accounting for a significant portion of expenses, followed by diagnostic tests and consultation fees. Nonmedical expenses also contribute to the financial burden. Cancer care specifically faces substantial financial challenges, with high treatment costs, reduced workforce participation, and the need for distress financing. Cancer-related OOPE is predominantly borne by patients and their families, leading to significant financial strain. The lack of comprehensive health insurance coverage and limited access to publicly funded healthcare services exacerbate the problem. Catastrophic health expenditure (CHE) in cancer care is prevalent, pushing households into financial distress and potentially impoverishment. Efforts have been made to address this issue, such as increasing public spending on healthcare and implementing health insurance schemes. However, challenges remain in ensuring their effectiveness and reach. The role of family care physicians is crucial in supporting patients and their families during catastrophic health expenditures related to cancer-related palliative care. They coordinate care, provide advocacy, emotional support, symptom management, and facilitate end-of-life discussions. Comprehensive measures are needed to strengthen healthcare infrastructure, improve access to affordable cancer care, enhance health insurance coverage, and implement supportive measures for cancer patients. Additionally, promoting preventive measures and early detection can help reduce the need for expensive treatments and decrease the risk of catastrophic health expenditures.

Knowledge of Dental Ethics and Jurisprudence Among Dental Practitioners in Pune: A Questionnaire Survey.

Objective Dental ethics is a moral obligation that solicits professional behaviour imposed by the members of the dental profession. In addition, a set of legal regulations by each state's legislature describing the legal limitations and regulations related to dentistry, dental hygiene, and dental assisting is a part of dental jurisprudence. The present study aims to evaluate the knowledge regarding ethics and medical law for the practice among private practitioners in Pune, India. Materials and methods This was a cross-sectional study. The snowball sampling method (a randomization method) was used to contact all the registered practitioners for the study. A total of 250 dentists agreed to provide written informed consent and participate in the study. The collected data were entered into Microsoft Excel 2013 sheet (Microsoft Corporation, Redmond, WA) and cleaned, and statistical analysis was carried out using Epi Info software (CDC, Atlanta, GA). All p-values below 0.05 were considered to be statistically significant. Results A total of 250 dentists participated in the present study. Female postgraduate dentists had lesser knowledge of abbreviations used on dental boards. Master of Dental Surgery (MDS) dentists had more knowledge regarding dental jurisprudence than Bachelor of Dental Surgery (BDS) practitioners. Conclusions The present study highlighted the lack of awareness regarding dental ethics and jurisprudence among dental practitioners. It underlines the need for more education programs and curriculum changes with a focus on ethics, jurisprudence, and legal matters pertaining to clinical practice.

A systematic review of four decades of prevalence of oral soft tissue infections and conditions among adult HIV patients in India.

Oral lesions are a cue for decreased immunity among Human Immunodeficiency Virus (HIV) positive patients. There is no cumulative data available related to the prevalence of oral soft tissue lesions among the HIV positive patients. Hence, the present review was carried out to assess the various oral lesions reported among adult HIV patients across India. Two search engines were used-Google Scholar and PubMed, with key words of HIV/Acquired Immune Deficiency Symdrome(AIDS), soft tissue, oral cavity, India, and adults for searching the articles from January 1990 to December 2020. After initial review, 21 articles that fulfilled the criteria were included in the review. We used 9 parameters to access the quality of the reports. Most common lesion reported was that of oral candidiasis. Not all articles reported about sample size determination or of sampling design and technique. Other lesions like hyperpigmentation, gingivitis, and periodontitis were also found to be highly prevalent. Most reports were from South India. Further epidemiological data are required from different regions for using it to develop planning and execution related to oral health care for the HIV positive patients in India.

A systematic review on the guidelines for nutritional assessment for head and neck cancer patients managed by surgery.

There are a number of guidelines to assess the nutrition status of cancer cases. None of these guidelines are specifically head and neck cancer related; except for the European guidelines. This article reviews the different guidelines in nutrition for cancer cases and also their drawbacks.

Oral Health-related Quality of Life in HIV: A Systematic Review.

AIM: To systematically evaluate the literature evidence related to oral health and quality of life (QoL) among HIV-positive adults. BACKGROUND: The oral health-related quality of life (OHRQoL) is an essential entity to be measured for understanding the domains affected due to oral health problems. HIV comes with an array of complexities in the oral cavity and is also reflection of the systemic illness of the oral cavity. Hence, it is essential to know the area affected and also the lesions that contribute the most to decrease the QoL in this aspect. A systematic review was carried out in relation to studies across PubMed and Google Scholar regarding HIV and OHRQoL from January 1970 to May 2019. Of the 1,374 articles screened, 11 studies were filtered for the final review. REVIEW RESULTS: The physical domain followed by the psychological domain is the most affected in the HIV-positive patients. The maximum effect is due to dental caries and periodontitis. No studies report about oral substance abuse and its effect. CONCLUSION: Studies are further needed on a larger sample size and on similar scales and parameters to ensure greater evidence for intervention related to areas that should be focused upon for improving the QoL of HIV-positive patients. CLINICAL SIGNIFICANCE: There is a greater need to include quality-based assessment while treating HIV-positive people. Also not just physical indicators like pain or dental caries, even social indicators like mental and social dimensions of a patient's life should be included while deciding the treatment approach.

Dental caries prevalence among HIV adult population in India: A systematic review.

Dental caries is a universal disease. Untreated dental caries adds to the existing burden of diseases. It is necessary to have national data on the same, especially in HIV cases, to understand the epidemiological aspects and formulate a treatment plan for the population. Hence, a systematic review was carried out to collectively report the dental caries prevalence among this population. A systematic search for articles was done in PubMed and Google Scholar using the keywords: Dental Caries, India, HIV, AIDS and adults from January 1990 to December 2019. All freely available full-text articles were evaluated based on the inclusion criteria. Only four articles fulfilled the criteria based on qualitative analysis. Decayed, Missing and Filled Teeth index was used to record dental caries. Risk factors related to the same were not specified by any of the authors. Studies were not from different regions of India. More epidemiological studies are needed to understand the prevalence rate and correlated to dental caries among HIV-positive population in India.

Assessment of the existing dental education environment at a dental teaching institution.

INTRODUCTION: An important aspect of creating a competent medical practitioner is the teaching-learning environment that shapes the mentality and instigates an urge among the students to learn. To facilitate a motivating learning setup, the faculty members need to inadvertently establish a successful and safe learning environment which is extensively feasible, given that the faculty gets to control their own style of teaching. A lot of research focuses on student's perception of the learning environment, seldom studies have reported the teacher's perspective. This present study focuses on the teacher's side of the story regarding the current scenario of the workplace that is one of the essential factors to alter the approach toward andragogy. MATERIALS AND METHODS: A cross-sectional questionnaire study was carried out using the Assessment of Medical Education Environment by Teachers (AMEET) questionnaire. The AMEET questionnaire was administered to 50 staff members at MA Rangoonwala College of Dental Sciences and Research Centre, Pune. All the participants were assured of confidentiality of their personal details and they all signed a written informed consent before participating in the study. RESULTS: Majority of the participants had a positive attitude which was seen more in the seniors compared to the juniors. The teacher's perception of teaching is that there needs to be a greater emphasis on what the student learns rather than what the teacher does. Junior staff members felt that students do not prepare and come for classes nor are the expected outcomes clear to them. Assignments are also a task for the students that are never on time. CONCLUSION: It was observed that more senior faculties were positive toward the existing education environment. In addition, even though opportunities are available for the staff as well as students for upgrading and imbibing newer information, they were not being benefitted by the same due to underutilization.

Oral Health Literacy and Oral Health Knowledge among 2,263 First-time Pregnant Urban Women: A Cross-sectional Questionnaire Study.

AIM: The present study aimed to see the oral health literacy rate among first-time pregnant women across 12 corporate hospital setups in the city of Pune, India. MATERIALS AND METHODS: For the survey, the REALD 30 questionnaires were used to assess the adult literacy rate (with 0 being least score and 30 being the highest score) and the knowledge of the participants related to oral health was assessed using a set of 6 questions. The study was carried out for a period of 1 year from January 2018 to December 2018. The total participants at the end of the study were 2,263. All the women were pregnant for the first time, in their 1st trimester of pregnancy. Written consent was taken from all the participants. Epi Info was used to carry out the statistical analysis. All the p values less than 0.05 was considered to be statistically significant. RESULTS: The mean REALD 30 score was 23.8 ± 8.34. The REALD score was higher for those with a postgraduate degree; this could be due to more number of participants in the group. There were higher percentages of women with correct answers to all the knowledge-based questions. We observed that there was a positive correlation with the REALD total scores and the correct answers provided to the questions on oral health (r = 0.76). There was a positive correlationship between the REALD scores and the oral health knowledge of the participants. CONCLUSION: The educated pregnant women had a high oral health literacy rate. There was a positive correlation of literacy with the REALD 30 score. CLINICAL SIGNIFICANCE: Healthcare providers should focus on clearing the myths and misconceptions that are still prevalent in a small portion of the urban population.

Prevalence of Soft-Tissue Lesions among Women in Sex Work in the Red Light Area of Pune, India: A Cross-Sectional Survey.

AIM AND OBJECTIVE: The women in sex work have no felt need for oral health and much of the stress has always been on sexually transmitted infections (STIs). There is a need for a baseline data for the oral lesions of these women to further assist in the policy formulations and training of personnel for the identification of the oral conditions which need treatment. The aim of the study was to evaluate the presence of oral lesions among female sex workers in the red light area of Pune, India. MATERIALS AND METHODS: The Community Periodontal Index and loss of attachment (LA) index was recorded along with the other soft-tissue lesions as per the WHO Oral Health Assessment from 1997. The calculated sample was 350. Systematic sampling technique was followed. The data collected were subjected to statistical analysis and analysis was done using SPSS package 16.0. RESULTS: A total of 110 (31.4%) women had leukoplakia, 6 women (1.7%) had ulceration, 41 (11.7%) women had candidiasis, and 1 woman (0.3%) had swollen gingiva. As the age increased, there was an increase in the number of pockets. The percentage of women above 60 years had higher LA. CONCLUSION: The women in sex work are mainly spoken to about HIV and STIs. With almost all of these women requiring some or the other form of treatment, utilization of the available dental workforce with both government and public partnership could be the route.

Dentition Status and Treatment Needs among Women involved in Sex Work as a Profession in the Red Light District of Pune, Maharashtra, India: A Cross-sectional Study.

INTRODUCTION: The overall rehabilitation of women in sex work is unfortunately limited most of the time only to moving them to another profession, but it should be focused on including health as an important factor. Factors that restrict regular dental care include misconceptions, dental fear and expense of dental care, unpleasant dental experiences, and socioeconomic factors, but such a direct correlation cannot be made in the case of such women. Until now, no study has been conducted related to the complete dentition status and treatment needs of women in sex work. AIM: The aim of our survey was to evaluate the dentition status and treatment needs among the brothel-based women engaged in sex work. MATERIALS AND METHODS: A pilot study was conducted on 30 women and the final sample size was estimated to be 350. All the women were above 18 years old. Systematic random sampling method was followed after line listing of the brothels. The dentition status and treatment needs were recorded using the World Health Organization assessment form, 1997. The data collected were tabulated and analyzed using Statistical Package for the Social Sciences (SPSS), version 16.0. The Chi-squared test was carried out to check the association, and all p-values below 0.05 were considered to be statistically significant. RESULTS: The mean number of decayed teeth per person was 5.05 (±4.81), missing teeth per person was 0.96 ± 2.71, filled teeth per person was 0.04 (±0.34), and the mean of decayed missing filled permanent teeth per person was 6.05 (±5.84). There was a significant association between dental caries and age, using finger to clean the teeth, and not visiting the dentist. CLINICAL SIGNIFICANCE: Due to different risk factors, such as diet, improper oral hygiene maintenance, and substance abuse, the overall dental health was found to be compromised in this population. Economic burden is an important factor that influences their attitude toward oral health and is likely to be inherited by their next generation also.

Assessment of orthodontic treatment need among tribal children of Indore division, Central India.

INTRODUCTION: India is home to many tribes which have an interesting and varied history of origins, customs and social practices. Oral health care in tribal areas is limited due to shortage of dental manpower, financial constraints and the lack of perceived need for dental care among tribal masses. OBJECTIVE: To assess orthodontic treatment need among tribal children of Indore division, Central India. METHODS: A cross-sectional house to house survey was carried out among 800 tribal children aged 5 to 15 years old in two major tribal districts of Indore division. Permissions and consent were obtained from local administrative authorities, ethical committee and parents respectively. A structured proforma was used to record demographic data. Examination for dentofacial anomalies was conducted according to WHO 1997 survey methods. Descriptive tables and analytical tests like ANOVA, post-hoc and chi-square test were employed. RESULTS: The mean age was 9.75(±2.43) years. The mean DAI score among 12 to 15 years old children was 23.19±5.22. Female exhibited higher (24.51±5.34) mean DAI score compared to males (22.12±4.87) (p<0.05). The Patelia tribes (24.38±5.13) reported higher mean DAI score than Bhilala (23.02±5.69) and Bhil tribe (22.73±4.79) (p<0.005). CONCLUSION: The tribal children had minor malocclusion with no or slight treatment need. Categorization of orthodontic treatment need according to malocclusion severity is particularly important for the planning of corresponding public policies. The isolation of the villages, lack of transportation options imposes limitations on the availability of health professionals to provide dental services.

Prevalence of Periodontitis and Soft Tissue Lesions among Human Immunodeficiency Virus-positive Patients on Antiretroviral Therapy in Raichur Taluk, Karnataka, India.

INTRODUCTION: In countries where human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) is widespread and highly active antiretroviral therapy (HAART) medications are too expensive, or patients are failing HAART, oral disease management and risk remain an important issue. AIM: The aim of the study was to evaluate the prevalence of oral mucosal lesions and periodontitis among the HIV-positive adult patients and assess the association of these lesions with age, sex, duration of HIV, time on ART, dietary habits, and oral hygiene habits. MATERIALS AND METHODS: Sample size was 170. Demographic data of the patients along with community periodontal index (CPI) and loss of attachment (LA) were recorded. Oral soft tissue lesions, such as ulcerations, sores, erosions, and fissures were also recorded. The study was carried out in Raichur Taluk, Karnataka, India. Convenience sampling design was followed. Statistical Package for the Social Sciences (SPSS) version 20.0 (Chicago, USA) was used for data analysis. Chi-square test was carried out; p < 0.05 was considered to be statistically significant. RESULTS: There was no association between the oral mucosal conditions and the age and the adverse habits, such as tobacco and alcohol, CD4 count, and the time duration of HIV and ART among these patients. A higher percentage of people with 4 to 5 mm of pockets was seen with those who cleaned their teeth with a finger, which was statistically significant. CLINICAL SIGNIFICANCE: The present study highlights the poor condition of the oral health of these patients and their unmet dental needs.

Dentition status and treatment needs and its correlation with oral health-related quality of life among men having sex with men and transgenders in Pune city: A cross-sectional study.

INTRODUCTION: Dental diseases are universal in nature. Their presence and severity may vary from one individual to another and is also affected by multiple factors such as gender, knowledge, attitude and the affordability of dental/oral care. Gay, bisexual and transgender community is one among the socially disadvantaged community in our country. The present study was carried out in the city of Pune, India, to evaluate the prevalence of dentition status and the treatment needs among the men who have sex with men (MSMs) and transgenders (TGs) and its correlation with the oral health-related quality of life. MATERIALS AND METHODS: The sample size was 270. Convenience sampling was followed. The WHO oral health assessment for 1997 was used to record dentition status and treatment needs. Oral Health Impact Profile-14 was used to record the oral health-related quality of life. SPSS 22.0 (Chicago, IL, USA) was used for statistical analysis. All P < 0.05 were considered to be statistically significant. RESULTS: There was no statistically significant difference seen across the various domains in the overall impact of the oral quality of life. There was a significant correlation between the decayed teeth, missing teeth and overall decayed, missing and filled teeth scores with respect to the seven domains. Problems arising due to past dental experience (dental caries), lost natural tooth structures replaced with restorative material and a cumulative impact significantly affected the outcome of the oral health-related quality of life of the participants. CONCLUSION: There was an alteration in quality of life of the MSMs and TGS with respect to dental caries. This calls for an intervention that is tailor-made to meet the needs of this group.

Stigma and Discrimination faced by HIV-infected Adults on Antiretroviral Therapy for more than 1 Year in Raichur Taluk, Karnataka, India.

AIM: The aim of this study was to evaluate the stress and discrimination faced by human immunodeficiency virus (HIV)-affected adult patients on antiretroviral therapy (ART) for more than 1 year. MATERIALS AND METHODS: A cross-sectional study was carried out among 170 adults on ART, reporting to the ART center of the District Civil Hospital, for more than 1 year in Raichur Taluk, Karnataka, India. Convenience sampling technique was followed. Descriptive statistics was performed (Chi-square test) using Statistical Package for the Social Sciences version 16.0. RESULTS: A total of 156 (91.8%) patients' families had knowledge about their seropositive status. Seventeen (10.9%) HIV-positive patients reported of change in the attitude of their family members. The main reasons for not revealing the HIV status were the internalized stigma and fear of rejection. Women faced greater discrimination from family, friends, and neighbors than men. CONCLUSION: It is necessary to not undermine the effect of rejection due to HIV. It is the only infection that has so many associated social and psychological norms which we need to tend at the earnest. Till date, there is an existence of condescendence toward treatment approach. CLINICAL SIGNIFICANCE: The presence of stigma and the fear of being discriminated could be a major hurdle in the rehabilitation of these patients into the mainstream society. Furthermore, it serves as an existing challenge to ascertain these individuals to achieve overall health.

Dentition status and treatment needs of human immunodeficiency virus-positive patients on anti retro viral therapy in Raichur taluk, Karnataka, India: A cross sectional study.

OBJECTIVE: The aim of the study was to assess the dentition status and the treatment needs of the HIV-positive patients on ART for more than a year in Raichur, Karnataka. MATERIALS AND METHODS: Convenience sampling was followed. The sample size was 170. The dentition status and treatment needs of the patients were recorded as per the WHO guidelines. RESULTS: The overall prevalence of dental caries was 79.4%. Males had higher percentage of dental caries than the females, and this was found to be statistically significant. The prevalence of dental caries was higher among the participants who used finger to clean their teeth compared to the toothbrush, neem stick, and charcoal users, and this was found to be statistically significant. CONCLUSION: Higher prevalence of dental caries was observed among the study population. Most of them required some type of treatment. Patients with a low CD4 count required higher treatments than the others.