Quality assessment of global health care system in the shadow of COVID-19: - a systematic review.

INTRODUCTION: The healthcare system is critical to the country's overall growth, which involves the healthy development of individuals, families, and society everywhere. This systematic review focuses on providing an overall assessment of the quality of healthcare delivery during COVID-19. METHODOLOGY: The literature search was conducted from March 2020 till April 2023 utilising the databases "PubMed," "Google Scholar," and "Embase." A total of nine articles were included. Descriptive statistics was performed using Microsoft Excel. PROSPERO registration ID- CRD42022356285. RESULTS: According to the geographic location of the studies included, four studies were conducted in Asia [Malaysia(n = 1); India (Madhya Pradesh) (n = 1); Saudi Arabia(n = 1); Indonesia (Surabaya) (n = 1)], three in Europe [U.K. (n = 1); Poland (n = 1); Albania (n = 1)] and two in Africa [Ethiopia(n = 1); Tunisia (n = 1)]. Overall patient satisfaction was found highest among studies conducted in Saudi Arabia (98.1%) followed by India (Madhya Pradesh) (90.6%) and the U.K. (90%). CONCLUSION: This review concluded five different aspects of patients satisfaction level i.e. reliability, responsiveness, assurance, empathy, and tangibility. It was found that the empathy aspect had the greatest value of the five factors, i.e., 3.52 followed by Assurance with a value of 3.51.

Patient satisfaction for telemedicine health services in the era of COVID-19 pandemic: A systematic review.

Introduction: In the year 2019, the whole world witnessed the COVID-19 pandemic. The pandemic has negatively impacted the health care delivery system. This has risen the necessity among health systems across the world to deliver health care services through telemedicine. This systematic review would assess the level of patient satisfaction with telemedicine health services during the time of the COVID-19 pandemic. Methodology: The literature search was conducted in June 2022 using "PubMed" "Google Scholar" and "Embase" databases. A total of eight articles were included. ROBVIS Analysis was performed for the assessment of bias. Descriptive statistics were performed using Microsoft Excel. Results: All included studies were conducted in seven countries/states/cities: India (n = 2), Philippines (n = 1), Saudi Arabia (n = 1), UAE (n = 1), Los Angeles (n = 1), Iran (n = 1), and New York City (n = 1). Most used telemedicine tools were voice calls, video calls and messaging/email. Maximum patients used video for consultation (5 out of 9 studies) followed by voice call (4 out of 8 studies), messaging/emails (2 out of 8 studies) and other telemedicine Apps (2 out of 8 studies). Overall, the level of satisfaction was found highest amongst studies conducted in developed countries/states/cities such as New York City (94.9%), Los Angeles (82.7%), UAE (81%) and Saudi Arabia (77.9%) in contrast to studies conducted in developing countries which includes Philippines (82%), India (73.9; 51.3%) and Iran (43.4%). Conclusion: Most of the participants were found to be satisfied with the quality of telemedicine they were offered. This systematic review will help to improve telemedicine services which will eventually improve the health care delivery system. Systematic review registration: https://www.crd.york.ac.uk/prospero/#myprospero.

A steroidal derivative from Trigonella foenum graecum L. that induces apoptosis in vitro and in vivo.

Trigonella foenum graecum L. is a dietary herb used in traditional medicine system. In this study, we investigated the cytotoxicity, antitumor, antimetastatic and antiangiogenic effect of the steroidal compound, ethyl iso-allocholate isolated from T. foenum graecum L. seeds against A549 lung cancer cells in vitro and in vivo. Among all the isolated compounds, the ethyl iso-allocholate rendered the highest cytotoxicity potential. It showed least percentage cell viability in trypan blue assay and lowest nuclei count in hoechst staining. The caspase glo assay and western blot analysis showed the significant caspase 3 cleavage, indicating caspase dependent apoptosis. Consistent with the in vitro data, ethyl iso-allocholate showed highest percentage tumor growth inhibition i.e. 80 ± 5% in zebrafish, equivalent to doxorubicin. It significantly reduced angiogenesis to 5 ± 0.8% (**P < 0.01), compared to negative control group which was 60 ± 2%. The ethyl iso-allocholate showed 55 ± 3% inhibition in liver metastasis. To investigate the safety of the compounds on normal tissues, the percentage mortality was examined. The ethyl iso-allocholate showed zero percent mortality of zebrafish. These results indicate that the steroidal derivative isolated from T. foenum-graecum seeds induces caspase dependent apoptosis in cancer cells and reduces tumor growth, metastasis and angiogenesis in vivo, as well as it is safe on the normal tissues. The in vitro and in vivo anticancer studies suggest that the cytotoxic compound ethyl iso-allocholate has potential application in pharmaceutical industry.

A clinical trial comparing antimicrobial efficacy of "essential oil of Ocimum sanctum" with triple antibiotic paste as an intracanal medicament in primary molars.

OBJECTIVES: To evaluate the aerobic and anaerobic antimicrobial efficacy of Ocimum Sanctum (Tulsi) essential oil and compare it with that of triple antibiotic paste (TAP) by collecting microbiological samples from the root canals of primary molars. STUDY DESIGN: Forty children were selected for the study and were randomly divided into two groups of twenty each, namely, TAP group and O. sanctum group (basil). Six intracanal samples were collected for every patient, comprising of two each after access opening, irrigation and after 3 days of intracanal medicament placement. These samples were cultured in aerobic and anaerobic environment and later colony-forming units (CFUs) were counted and intragroup as well as intergroup comparison was done. RESULTS: Analysis of the results showed that there was a statistically significant reduction in CFUs after using essential oil of O. sanctum as an intracanal medicament. Saline use also leads to a statistically significant reduction in CFUs irrespective of the intracanal medicament used. TAP showed better antibiotic properties in comparison with that of O. sanctum. CONCLUSION: Antibiotic use is often associated with the adverse effects and development of resistance due to injudicious use. O. sanctum can be used in cases of long-standing infection owing to its antimicrobial efficacy and anti-inflammatory potential as an intracanal medicament in primary teeth.

Degradation of Resin Restorative Materials by Streptococcus Mutans: A Pilot Study.

OBJECTIVE: To evaluate the degradation of three resin based restorative materials by S Mutans. STUDY DESIGN: Class I cavity was prepared in extracted premolars and were randomly divided into 3 groups (Group I - Conventional composite (CC), Group II - Resin Modified GIC and Group III-Giomer). Teeth were then restored by respective restorative material and equally divided in two subgroups (Control and Experimental). Experiment subgroup samples were then incubated in 2 ml of BHI with 1:10 dilution of SM (MTCC-497) grown overnight in BHI whereas control subgroup samples were incubated in BHI without SM. The incubation solution was collected at 2,14 and 30 days interval, and the analysis for identification and quantification of Bis-HPPP was done by High performance Liquid Chromatography. RESULTS: Statistical analysis of the collected data revealed a statistically increased Bis HPPP production in the presence of SM in all the tested materials, with minimum in Resin Modified GIC and a maximum in Conventional Composite (CC). CONCLUSION: SM degrades the resin based restorative materials & among the tested materials Resin Modified GIC appears to be most Biostable.

Influence of Television Advertising on Behavior of Children across Socioeconomic Backgrounds.

INTRODUCTION: This research analyzed the influence of television on the behavior of children belonging to urban and rural socioeconomic backgrounds of Bhopal city and its vicinity. MATERIALS AND METHODS: About 400 parents with children between 1 and 18 years of age were subjected to a self-designed questionnaire, which sought information regarding the television viewing habits of children. Differences in responses were noted between the subjects of urban and rural areas. Obtained data were subjected to statistical analysis using Pearson's chi-square test to determine the level of significance. RESULTS: The urban class showed a dominating pattern in the positive aspects of television viewing, such as significantly better awareness of oral health, more emphasis shown toward oral care adverts, and a higher knowledge of the cause of dental caries. However, the urban class also possessed a poor attitude; the appearance of a dentist on television did not remind them about oral needs, products with gifts pleased their children to a greater extent, they had more demanding children, parents fulfilled their children's demand more, and they relied on the self for selection of toothpaste. Overall, in all aspects, the rural class lacked significantly. CONCLUSION: Television exerts a positive as well as negative influence on children's behavior among urban and rural communities, with the influence being more obvious in the urban class. CLINICAL SIGNIFICANCE: The results of this study can be utilized in bringing about better and effective advertising oriented toward attaining optimum oral health of children; overall general health through adverts that discourage obesogenic diet and promote a diet rich in protein and fiber can also be focused on.

Natural Compounds A Weapon to Ameliorate Breast Cancer Cells: A Review.

Breast cancer is the heterogeneous disease and leading cause of death in women, worldwide. It is generally caused by the perturbation of various signaling pathways responsible for cell apoptosis. Due to genetic variability, different signaling pathways are disrupted in different breast cancer patients; so, to overcome this multifaceted condition, the personalized treatment is preferred. Since, various potential targets exist in breast cancer cells; it raised the need of new prospective of lead compounds. A large number of evidences show that, due to the presence of various secondary metabolites in plants, natural compounds are frequently examined for search of new bioactive molecules. This review includes the pathological aspects of breast cancer and the effect of natural compounds on breast cancer cells along with their possible mechanism of action. (Databases searched were PubMed, Science Direct, Web of Knowledge, Scopus, and Google Scholar).

A comparative microleakage evaluation of three different base materials in Class I cavity in deciduous molars in sandwich technique using dye penetration and dentin surface interface by scanning electron microscope.

INTRODUCTION: A major objective in restorative dentistry is the control of marginal leakage, which may occur because of dimensional changes or lack of adaptation of restorative material to the cavity preparation. Numerous techniques have been advocated to overcome polymerization shrinkage in composite restorations. AIM AND OBJECTIVES: This study investigated microleakage of three different bases under composite resin in sandwich technique using dye penetration and dentin surface interface using scanning electron microscope (SEM). MATERIALS AND METHODS: Sixty extracted deciduous molars were stored in distilled water and Class I cavities with a width of about one-fourth of intercuspal distance and a depth of 0.5-1 mm below the dentino-enamel junction was prepared without bevels. In Group 1 - glass ionomer cement (GIC); Group 2 - mineral trioxide aggregate (MTA); Group 3 - Biodentine™ was placed as a base under composite. Teeth were longitudinally sectioned in two halves, through the centers of the restoration, immersed in 2% methylene blue and microleakage was evaluated under stereomicroscope and surface interface between base and dentin was evaluated under SEM. RESULTS: Under the condition of in vitro study, less microleakage and less internal gaps were seen in Biodentine™ (0.00 ± 0.00 and 4.00 ± 1.59) group than MTA (0.00 ± 0.00 and 6.08 ± 1.82) and GIC (25.25 ± 6.57 and 14.73 ± 3.72, respectively) and showed very strong positive correlation between microleakage and internal gaps. CONCLUSION: Biodentine™ exhibits superior marginal sealing ability as well as marginal adaptation under composite resin as compared to MTA and GIC.

Evaluation and comparison of the efficacy of low fluoridated and calcium phosphate-based dentifrice formulations when used with powered and manual toothbrush in children with autism.

BACKGROUND: Autism is a neurobiological disorder characterized by impaired social interaction, communication difficulties, and lacking manual dexterity. These limitations make the oral hygiene maintenance very difficult. AIM: The aim of this present study is to evaluate and compare the efficacy of low fluoridated and calcium phosphate-based dentifrice formulations when used with powered and manual toothbrush in children with autism. SETTING AND DESIGN: Sample comprised 22 children with autism who daily visited a day care and education center named ARUSHI - a center for children with special health care needs in Bhopal. METHODS: Children were divided into two groups (Group A and B) according to toothbrush used and further divided into subgroups (A1 and B1 [low fluoridated - Pediflor toothpaste] and A2 and B2 [calcium sucrose phosphate - Enafix toothpaste]). Oral hygiene instructions and brushing technique demonstration were given every day for a period of 1-month. Oral health status was evaluated before and after the study using simplified oral hygiene index (OHI-S) and its Miglani's modification for primary dentition, plaque index (PI), gingival index (GI), and decayed, missing, and filled teeth (DMFT)/deft index. The perception of parents regarding oral hygiene practices for their kids was also evaluated by an awareness and attitude questionnaire. STATISTICAL ANALYSIS: OHI-S, GI, PI, and DMFT/deft were statistically evaluated using Mann-Whitney U- test. RESULTS AND CONCLUSION: Mean value of OHI-S decreased significantly with powered toothbrush (0.035 [P < 0.05]) in both groups. However, PI decreased significantly for Enafix when used with powered toothbrush (0.042 [P < 0.05]). Perception of parents was seen to improve significantly after 1-month study (0.000 [P < 0.05]).

Evaluation of treatment related fear using a newly developed fear scale for children: "Fear assessment picture scale" and its association with physiological response.

INTRODUCTION: Dental treatment is usually a poignant phenomenon for children. Projective scales are preferred over psychometric scales to recognize it, and to obtain the self-report from children. AIMS: The aims were to evaluate treatment related fear using a newly developed fear scale for children, fear assessment picture scale (FAPS), and anxiety with colored version of modified facial affective scale (MFAS) - three faces along with physiologic responses (pulse rate and oxygen saturation) obtained by pulse oximeter before and during pulpectomy procedure. SETTINGS AND DESIGN: Total, 60 children of age 6-8 years who were visiting the dental hospital for the first time and needed pulpectomy treatment were selected. Children selected were of sound physical, physiological, and mental condition. Two projective scales were used; one to assess fear - FAPS and to assess anxiety - colored version of MFAS - three faces. These were co-related with the physiological responses (oxygen saturation and pulse rate) of children obtained by pulse oximeter before and during the pulpectomy procedure. STATISTICAL ANALYSIS USED: Shapiro-Wilk test, McNemar's test, Wilcoxon signed ranks test, Kruskal-Wallis test, Mann-Whitney test were applied in the study. RESULTS: The physiological responses showed association with FAPS and MFAS though not significant. However, oxygen saturation with MFAS showed a significant change between "no anxiety" and "some anxiety" as quantified by Kruskal-Wallis test value 6.287, P = 0.043 (<0.05) before pulpectomy procedure. CONCLUSIONS: The FAPS can prove to be a pragmatic tool in spotting the fear among young children. This test is easy and fast to apply on children and reduces the chair-side time.

Catalase and sodium fluoride mediated rehabilitation of enamel bleached with 37% hydrogen peroxide.

BACKGROUND: Bleaching agents bring about a range of unwanted changes in the physical structure of enamel which needs to be restored qualitatively and timely. Catalase being an antioxidant ensures the effective removal of free radicals and improvement in fluoride mediated remineralization from the enamel microstructure which if retained may harm the integrity and affect the hardness of enamel. MATERIALS AND METHODS: Thirty freshly extracted incisors were sectioned to 6 slabs which were divided into 5 groups: Group A, control; Group B, treatment with 37% hydrogen peroxide (HP); Group C, treatment with 37% HP and catalase, Group D, treatment with 37% HP and 5% sodium fluoride application, Group E, treatment with 37% HP followed by catalase and 5% sodium fluoride. Scanning electron microscope and microhardness analysis were done for all slabs. One-way ANOVA test was applied among different groups. RESULTS: Vicker's microhardness number (VHN) of Group B and C was significantly lower. No significant difference between VHN of Group B and C. VHN of Group D was significantly higher than Group A, B, and C; but significantly lower than Group E. VHN of Group E was significantly higher than any other experimental group. One-way ANOVA revealed a highly significant P value (P = 0.0001) and so Tukey's post-hoc Test for the group comparisons was employed. CONCLUSION: Subsequent treatment of bleached enamel with catalase and fluoride varnish separately results in repairing and significantly increasing the microhardness.

Effect of Catalase and Sodium Fluoride on Human Enamel bleached with 35% Carbamide Peroxide.

AIM: To evaluate the effects of postbleaching antioxidant application fluoridation treatment on the surface morphology and microhardness of human enamel. MATERIALS AND METHODS: Ten freshly extracted human maxillary central incisors were cut at cementoenamel junction. Crown portion was sectioned into six slabs which were divided into five groups: group A - untreated controls; group B - 35% carbamide peroxide (CP); group C - 35% CP and catalase; group D - treatment with 35% CP and 5% sodium fluoride; group E - 35% CP, catalase and 5% sodium fluoride. Thirty-five percent carbamide peroxide application included two applications of 30 minutes each at a 5-day interval. After treatment, the slabs were thoroughly washed with water for 10 seconds and stored in artificial saliva at 37°C until the next treatment. Two percent sodium fluoride included application for 5 minutes. Three catalase included application for 3 minutes. RESULTS: After 5 days, groups B and C showed significantly decreased enamel microhardness compared to control. Group D specimens showed relatively less reduction in enamel micro-hardness than group C specimens. There is a marked increase in enamel microhardness in group E specimens. CONCLUSIONS: Fluoride take up was comparatively enhanced after catalase application resulting in less demineralization and increased microhardness. How to cite this article: Thakur R, Shigli AL, Sharma DS, Thakur G. Effect of Catalase and Sodium Fluoride on Human Enamel bleached with 35% Carbamide Peroxide. Int J Clin Pediatr Dent 2015;8(1):12-17.

Providing activity for people with dementia in care homes: a cluster randomised controlled trial.

BACKGROUND: Activity levels remain low in care homes, but activity engagement can enhance residents' quality of life. AIM: This study aimed to assess an occupational therapy programme designed to enable care home staff to increase activity provision. METHOD: A cluster randomised controlled trial with blinded assessment of outcome was conducted. A total of 210 residents with dementia in 16 care homes were recruited. Intervention homes received the programme, and control homes were provided usual care. Primary outcome is quality of life; secondary measures are dependency, challenging behaviour, depression, anxiety, severity of dementia and number and type of medication. RESULTS: Quality of life decreased overall with statistically significant change in staff ratings (p < 0.001). At follow-up, staff-rated quality of life was slightly lower in the intervention group (mean difference in staff ratings = -1.91, 95% CI -3.39 to -0.43, p = 0.01). There were no significant differences between the two groups for self-rated quality of life or secondary outcomes. CONCLUSION: The results may be related to the following: wide variability in how the intervention was implemented, such as low staff attendance at the education and coaching sessions, and patchy provision of additional activities to residents; or the residents' severity of dementia or the choice of outcome measures. Future studies need to pay more attention to process measures such as implementation and fidelity strategies, and outcome measures that better capture the focus of the intervention such as level of engagement and activity.