Identifying the Potential Determinants of Tobacco Counseling Implementation among Oral Health Professionals of India: A Cross-Sectional Survey

ABSTRACT Objective: To identify the potential determinants of tobacco counseling implementation among oral health professionals in India. Material and Methods: A cross-sectional survey was carried out among the 298 dentists of Aligarh and Gwalior. The questionnaire used in the study had sections on dentists' sociodemographic data and a 35-item questionnaire to assess the potential determinants of tobacco cessation counseling. Descriptive statistics were carried out, and a Chi-square test was utilized to determine the association. P-value <0.05 was considered statistically significant. Results: Domains "knowledge", "Professional Responsibility and Identity", and "Remembrance, awareness, and judgment" showed a statistically significant correlation with most tobacco cessation counseling behaviors. In addition, undergraduate education received in Tobacco Cessation counseling, and Continuing education received in Tobacco Cessation counseling had significantly impacted the practice of tobacco cessation counseling (p=0.02 and 0.04, respectively). Conclusion: This study suggests that "Knowledge", "Professional Responsibility and Identity" and "Remembrance, awareness, and judgment" are the potential determinants that could be used to design effective strategies to enhance tobacco counseling among dentists in India.

COVID-19 Related Knowledge, Attitude, Practice Evaluation among Indian Dental Patients: A Cross-Sectional Survey

ABSTRACT Objective: To assess the awareness about COVID-19 among dental patients and determine the association between COVID-19 awareness and perceived stress among dental patients. Material and Methods: A selfadministered knowledge, attitude and practices (KAP) questionnaire and perceived stress scale (PSS) were employed to assess the knowledge and attitude among dental patients visiting the outpatient department. A p-value of ≤ 0.05 was considered statistically significant. An independent t-test was used to compare the KAP and PSS scores based on age, gender, occupation and the responses to unscorable questions. Spearman's correlation was employed to assess the association between KAP and PSS scores. Results: The older participants (mean KAP score = 16±2.2), the participants who answered that the Coronavirus outbreak changed their daily routine (mean KAP score = 15.8±2.2) and the participants who answered that they changed their plans due to the Coronavirus outbreak (mean KAP score = 16±2.14) had significantly higher KAP scores when compared to their respective counterparts. The Spearman's correlation value of -0.45 suggested a moderate negative association between the KAP and PSS scores, but this correlation was not statistically significant. Conclusion: The participants had a moderate to good level of knowledge related to COVID-19 and were positive in their approach and outlook on overcoming the pandemic.

Comparison of Oncostatin M in Patients with Chronic Periodontitis with and without Diabetes

Abstract Objective: To compare the Oncostatin M (OSM) concentrations in tissues of patients with chronic periodontitis with and without diabetes. Material and Methods: Sixty-four subjects visiting the dental outpatient department were categorized as "healthy" (Group 1), "periodontitis" (Group 2), and "diabetes with periodontitis" (Group 3) groups. The clinical oral examination included assessment of plaque, gingivitis, probing depth, clinical attachment level. Blood glucose was assessed for group 3 patients. OSM concentration in the tissues was assessed using ELISA in all groups. Results: The mean OSM was 0.02 ± 0.04 pg/mg in the healthy group, 0.12 ± 0.09 pg/mg in the chronic periodontitis group and 0.13 ± 0.10 pg/mg in the diabetes-periodontitis group. A significantly higher mean OSM was seen in Group 2 and Group 3 than Group 1. The amount of OSM positively correlated with probing depth and clinical attachment level. Conclusion: Periodontal disease causes a rise in Oncostatin M, independent of the diabetic status. Expression of OSM in the gingival tissues can serve as an inflammatory marker.

Incidence and risk factors for major infections in hospitalized children with nephrotic syndrome / Incidência e fatores de risco para infecções graves em crianças hospitalizadas com síndrome nefróticas

ABSTRACT Introduction: Children with nephrotic syndrome are at increased risk of infections because of disease status itself and use of various immunosuppressive agents. In majority, infections trigger relapses requiring hospitalization with increased risk of morbidity and mortality. This study aimed to determine the incidence, spectrum, and risk factors for major infections in hospitalized children with nephrotic syndrome. Methods: All consecutive hospitalized children between 1-12 years of age with nephrotic syndrome were enrolled in the study. Children with acute nephritis, secondary nephrotic syndrome as well as those admitted for diagnostic renal biopsy and intravenous cyclophosphamide or rituximab infusion were excluded. Results: A total of 148 children with 162 admissions were enrolled. Incidence of major infections in hospitalized children with nephrotic syndrome was 43.8%. Peritonitis was the commonest infection (24%), followed by pneumonia (18%), urinary tract infection (15%), and cellulitis (14%), contributing with two thirds of major infections. Streptococcus pneumoniae (n = 9) was the predominant organism isolated in children with peritonitis and pneumonia. On logistic regression analysis, serum albumin < 1.5gm/dL was the only independent risk factor for all infections (OR 2.6; 95% CI, 1.2-6; p = 0.01), especially for peritonitis (OR 29; 95% CI, 3-270; p = 0.003). There were four deaths (2.5%) in our study, all due to sepsis and multiorgan failure. Conclusions: Infection remains an important cause of morbidity and mortality in children with nephrotic syndrome. As Pneumococcus was the most prevalent cause of infection in those children, attention should be paid to the pneumococcal immunization in children with nephrotic syndrome.

RESUMO Introdução: Crianças com síndrome nefrótica apresentam maior risco de infecções devido ao próprio status da doença e ao uso de vários agentes imunossupressores. Em grande parte, as infecções desencadeiam recidivas que exigem hospitalização, com risco aumentado de morbidade e mortalidade. Este estudo teve como objetivo determinar a incidência, o espectro e os fatores de risco para infecções graves em crianças hospitalizadas com síndrome nefrótica. Métodos: Todas as crianças hospitalizadas consecutivamente entre 1 e 12 anos de idade com síndrome nefrótica foram incluídas no estudo. Crianças com nefrite aguda, síndrome nefrótica secundária, bem como aquelas admitidas para biópsia renal diagnóstica e infusão intravenosa de ciclofosfamida ou rituximabe foram excluídas. Resultados: Foram cadastradas 148 crianças com 162 internações. A incidência de infecções graves em crianças hospitalizadas com síndrome nefrótica foi de 43,8%. A peritonite foi a infecção mais comum (24%), seguida por pneumonia (18%), infecção do trato urinário (15%) e celulite (14%), contribuindo com dois terços das principais infecções. Streptococcus pneumoniae (n = 9) foi o organismo predominantemente isolado em crianças com peritonite e pneumonia. Na análise de regressão logística, a albumina sérica < 1,5gm / dL foi o único fator de risco independente para todas as infecções (OR 2,6; 95% CI, 1,2-6; p = 0,01), especialmente para peritonite (OR 29; IC95% 3 -270, p = 0,003). Houve quatro mortes (2,5%) em nosso estudo, todas devido a sepse e falência de múltiplos órgãos. Conclusões: A infecção continua sendo uma importante causa de morbimortalidade em crianças com síndrome nefrótica. Como o Pneumococo foi a causa mais prevalente de infecção nessas crianças, deve-se atentar para a imunização pneumocócica em crianças com síndrome nefrótica.

Prevalence of non A to E hepatitis in Mumbai, India / Prevalencia de la hepatitis no A /E en Mumbai, India

Introduction: Acute viral hepatitis is a common problem in India. World wide data shows that 5 to 20 percent of this is caused by non A-E hepatitis. There is no data in India regarding non A-E hepatitis. We carried out this study to evaluate the epidemiology, clinical features, risk factors and outcome of non A-E hepatitis. Material and methods: In this single centre study, we evaluated all patients admitted with features of acute viral hepatitis at our hospital between the period of February to July 2015. A detailed history about the epidemiology, risk factors and clinical features was done. Patients were evaluated with bilirubin, transaminases and prothrombin time. Each patient was investigated for IgM HAV, IgM HEV, HBsAg and Antibody against hepatitis C. Patients turning out negative were investigated for presence of autoimmune hepatitis or Wilson's disease. All viral markers were repeated a week later to confirm non A-E status. Results: A total 265 patients were included of which 41 (15.4%) patients were non A-E hepatitis. They had higher age (28.55 vs 34.99, p<0.05) but similar gender and sub urban location. Median SEC classification was A2 in hepatitis A/E group as compared to A3 in non A-E group. The duration of symptoms and clinical features between the two groups were similar with Anorexia, Malasie, Nausea/vomiting being most common. The risk factors between the two groups were similar. The bilirubin and transaminases were non significantly lower than hepatitis A/E patients while albumin levels were significantly lower. The outcomes of both groups were similar with no mortality or fulminant hepatitis. Conclusion: Non A-E hepatitis patients tends to be older, lower SEC class and had lower albumin levels as compared to hepatitis A/E

Introdución: La hepatitis viral aguda es un problema común en la India. Los datos mundiales indican que el 5 al 20% es causada por hepatitis no A-E. No hay datos en la India sobre hepatitis no A-E. Objetivo: Se realiza este estudio para evaluar la epidemiología, clínica, factores de riesgo y pronóstico de la hepatitis no A-E. Material y métodos: En este estudio de un solo centro evaluamos a todos los pacientes que se admitieron con clínica de hepatitis viral aguda en nuestro hospital en el periodo de febrero a julio del 2015. Se realizó una historia detallada para evaluar la epidemiología, características clínicas. Se les tomó bilirrubinas, transaminasas y tiempo de protrombina. A cada paciente se le realizó HAV IgM, HEV IgM, HbsAg y anticuerpo anti hepatitis C. Los que fueron negativos se les estudió para hepatitis autoinmune y enfermedad de Wilson. Todos los marcadores virales se repitieron a la semana para confirmar hepatitis no A-E. Resultados: Se incluyeron 256 pacientes, 41 de ellos (15,4%) fueron hepatitis no A-E. Tuvieron más edad (28,55 vs 34,99, p<0,05), pero el mismo género y ubicación urbana. La clasificación media SEC fue A2 en el grupo hepatitis A/E, comparada con 3 en el grupo de no A-E. La duración de los síntomas y el desarrollo clínico fue similar en ambos grupos, siendo la anorexia el malestar general, las náuseas y los vómitos los más frecuentes. El factor de riesgo fue similar, al igual que las transaminasas, mientras que la albúmina fue significativamente menor. El resultado fue similar sin caso alguno de hepatitis fulminante. Conclusión: Los pacientes con hepatitis no A-E tienden a ser mayores, de clase SEC más baja y con valores de albumina más bajos que los pacientes con hepatitis A-E

Idiopathic Musculoskeletal Pain in Indian children-Prevalence and Impact on Daily Routine / Prevalência e impacto nas atividades diárias da dor musculoesquelética idiopática em crianças da Índia

ABSTRACT Objectives: To study the prevalence of idiopathic musculoskeletal pain (IMSP) in school going children and its impact on daily life. Methods: One thousand eighteen apparently healthy school children aged 5–16 years were assessed and analysed for IMSP and its associated problems. Standard tests for significance were applied. Results: One hundred and sixty-five (16.2%) children mostly males (55.2%) reported IMSP. Lower limbs (52.1%) were the most common location of pain. More than 1 year of pain history was present in 15%. Thirty-seven percent children complained of discomfort during walking, 30.9%, had pain during physical exercise, 29.2% had difficulty attending lessons and 4.2% had interference in pursuing hobbies. The children were also further sub grouped into preadolescents and adolescents. There was significant difference in pain duration and duration of each pain episode in the two groups (p = 0.01). A significant number of children (21.2%) with IMSP reported school absenteeism (p < 0.001). A significant number of adolescents had history positive for contact sports (p = 0.001). Sleep disturbances were also reported to be higher in children with IMSP (29% vs. 5.7%, p = 0.001). Other associated problems in children with IMSP found were day time tiredness (51.1%), headache (47.3%) and abdominal pain (24.8%). Conclusions: Prevalence of IMSP in school children aged 5–16 yrs was found to be 16.2% and a significant percentage of these children experience interference with daily activities including school absenteeism.

RESUMO Objetivos: Estudar a prevalência de dor musculoesquelética idiopática (DMEI) em crianças em idade escolar e seu impacto nas atividades diárias. Métodos: Foram avaliadas e analisadas 1.018 crianças em idade escolar aparentemente saudáveis entre cinco e 16 anos quanto à presença de DMEI e seus problemas associados. Foram aplicados os testes de significância padrão. Resultados: Relataram DMEI 165 (16,2%) crianças, em sua maior parte do sexo masculino (55,2%). Os membros inferiores (52,1%) foram a localização mais comum da dor. A história de dor presente havia mais de um ano foi encontrada em 15% das crianças; 37% delas queixaram-se de desconforto durante a caminhada, 30,9%, tinham dor durante o exercício físico, 29,2% tinham dificuldade de frequentar as aulas e 4,2% sofriam interferência na participação em passatempos. As crianças foram ainda subagrupadas em pré-adolescentes e adolescentes. Houve diferença estatisticamente significativa na duração da dor e na duração de cada episódio de dor nos dois grupos (p = 0,01). Uma quantidade significativa de crianças com DMEI (21,2%) relatou absentismo escolar (p < 0,001). Uma quantidade significativa de adolescentes tinha história positiva de prática de esportes de contato (p = 0,001). Os distúrbios do sono também foram relatados como maiores em crianças com DMEI (29% vs. 5,7%, p = 0,001). Outros problemas associados encontrados em crianças com DMEI foram o cansaço durante o dia (51,1%), a cefaleia (47,3%) e a dor abdominal (24,8%). Conclusões: A prevalência de DMEI encontrada em crianças entre cinco e 16 anos foi de 16,2%. Uma percentagem significativa dessas crianças relata interferência nas atividades diárias, incluindo absentismo escolar.

High Clinical Manifestation Rate in an Imported Outbreak of Hepatitis E Genotype 1 Infection in a German Group of Travellers Returning from India

Abstract: Background. There are only few reports about travel-associated, imported tropical hepatitis E virus (HEV) genotype 1 infections within Western travellers. We describe the clinical course of a single outbreak of hepatitis E in a German travellers group returning from India and compare the results of two commercial HEV-seroassays. Material and methods. After identifying hepatitis E in an index patient returning from a journey to India all 24 members of this journey were tested for anti-HEV-IgG and IgM using two commercial seroassays (Wantai and Mikrogen), for HEV-RNA by PCR and HEV-Ag by an antigen-assay (Wantai). Results. 5/24 (21%) individuals were viraemic with viral loads between 580-4,800,000 IU/mL. Bilirubin and ALT levels in these patients ranged from 1.3-14.9 mg/dL (mean 7.3 mg/dL, SD 5.6 mg/dL) and 151-4,820 U/L (mean 1,832U/L, SD 1842U/L), respectively and showed significant correlations with viral loads (r = 0.863, p < 0.001; r = 0.890, p < 0.001). No risk factor for food-borne HEV-transmission was identified. All viraemic patients (5/5) tested positive for anti-HEV-IgG and IgM in the Wantai-assay but only 4/5 in the Mikrogen-assay. Wantai-HEV-antigen-assay was negative in all patients. Six months later all previously viraemic patients tested positive for anti-HEV-IgG and negative for IgM in both assays. However, two non-viremic individuals who initially tested Wantai-IgM-positive stayed positive indicating false positive results. Conclusions. Despite the exact number of exposed individuals could not be determined HEV genotype 1 infections have a high manifestation rate of more than 20%.The Wantai-antigen-test failed, the Wantai-IgMrapid-test and the Mikrogen-IgM-recomblot showed a better performance but still they cannot replace real-time PCR for diagnosing ongoing HEV-infections.

Association of tinnitus and hearing loss in otological disorders: a decade-long epidemiological study in a South Indian population / Associação de zumbido e perda auditiva em distúrbios otológicos: estudo epidemiológico de uma década em uma população do Sul da Índia

Abstract Introduction: Tinnitus is a common disorder that occurs frequently across all strata of population and has an important health concern. Tinnitus is often associated with different forms of hearing loss of varying severity. Objective: The present study aimed to identify the association of tinnitus with hearing loss in various otological disorders of a South Indian population. Methods: A total of 3255 subjects referred to the MAA ENT Hospital, Hyderabad, from 2004 to 2014, affected with various otological diseases have been included in the present cross-sectional study. Diagnosis of the diseases was confirmed by an ear, nose, and throat (ENT) specialist using detailed medical and clinical examination. Statistical analysis was performed using the χ 2 test and binary logistic regression. Results: Tinnitus was observed in 29.3% (956) of the total study subjects that showed an increased prevalence in greater than 40 years of age. There was a significant increase in risk of tinnitus with middle (OR = 1.79, 95% CI = 1.02-3.16) and inner (OR = 3.00, 95% CI = 1.65-5.45) inner ear diseases. It was noted that 96.9% (n = 927) of the tinnitus subjects was associated with hearing loss. Otitis media (60.9%), presbycusis (16.6%) and otosclerosis (14.3%) are the very common otological disorders leading to tinnitus. Tinnitus was significantly associated with higher degree of hearing loss in chronic suppurative otitis media (CSOM) subjects. Conclusion: The present study could identify the most prevalent otological risk factors leading to development of tinnitus with hearing loss in a South Indian population.

Resumo Introdução: O zumbido é um distúrbio comum que ocorre com frequência em todos os estratos da população, constituindo um problema importante de saúde. O zumbido é frequentemente associado a diferentes formas de perda auditiva e sua gravidade é variada. Objetivo: O presente estudo teve como objetivo identificar a associação entre zumbido e perda auditiva em várias doenças otológicas na população do Sul da Índia. Método: No total, 3.255 indivíduos encaminhados ao Hospital MAA ENT em Hyderabad de 2004 a 2014, com diversas doenças otológicas, foram incluídos neste estudo transversal. O diagnóstico das doenças foi confirmado pelo otorrinolaringologista por meio de exames médico e clínico detalhados. A análise estatística foi realizada com o teste do χ2 e regressão logística binária. Resultados: Zumbido foi observado em 29,3% (956) do total de participantes do estudo, com maior prevalência em indivíduos com mais de 40 anos de idade. Houve um aumento significante do risco de zumbido em doenças da orelha média (OR = 1,79, IC 95% = 1,02-3,16) e interna (OR = 3,00, IC 95% = 1,65-5,45). Observamos que em 96,9% (n = 927) dos indivíduos com zumbido houve associação com perda auditiva. Conclusão: O presente estudo pôde identificar os fatores etiológicos mais prevalentes que levam ao desenvolvimento de zumbido associado à perda auditiva em uma população do Sul da Índia. Otite média (60,9%), presbiacusia (16,6%) e otosclerose (14,3%) são doenças otológicas frequentemente associadas ao zumbido. Em indivíduos com otite média crônica supurativa (OMCS), o zumbido foi significantemente associado ao maior grau de perda auditiva.

Socio-economic and demographic determinants of childhood anemia / Fatores socioeconômicos e demográficos determinantes de anemia infantil

ABSTRACT OBJECTIVE: To evaluate socio-economic and demographic determinants of anemia among Indian children aged 6-59 months. METHODS: Statistical analysis was performed on the cross-sectional weighted sample of 40,885 children from 2005 to 2006 National Family Health Survey by using multinomial logistic regression to assess the significance of some risk factors in different degrees of child anemia. Anemia was diagnosed by World Health Organization (WHO) cut-off points on hemoglobin level. Pearson's chi-squared test was applied to justify the associations of anemia with different categories of the study population. RESULTS: The prevalence of anemia was 69.5%; 26.2% mild, 40.4% moderate, and 2.9% severe anemia. Overall prevalence rate, along with mild and moderate cases, showed an increasing trend up to 2 years of age and then decreased. Rural children had a higher prevalence rate. Of 28 Indian states in the study, 10 states showed very high prevalence, the highest being Bihar (77.9%). Higher birth order, high index of poverty, low level of maternal education, mother's anemia, non-intake of iron supplements during pregnancy, and vegetarian mother increased the risks of all types of anemia among children (p < 0.05). Christian population was at lower risk; and Scheduled Caste, Scheduled Tribe, and Other Backward Class categories were at higher risk of anemia. CONCLUSION: The results suggest a need for proper planning and implementation of preventive measures to combat child anemia. Economically under-privileged groups, maternal nutrition and education, and birth control measures should be priorities in the programs.

RESUMO OBJETIVO: Avaliar os fatores socioeconômicos e demográficos determinantes de anemia em crianças indianas de seis a 59 meses. MÉTODOS: A análise estatística foi feita na amostra transversal ponderada de 40.885 crianças da Pesquisa Nacional de Saúde da Família de 2005-2006, Governo da Índia, com a técnica de regressão logística multimodal para avaliar a relevância de alguns fatores de risco em diferentes graus de anemia infantil. A anemia foi diagnosticada pelos pontos de corte de nível de hemoglobinas da OMS. O teste qui-quadrado de Pearson foi usado para justificar as associações da anemia com diferentes categorias de população estudada. RESULTADOS: A prevalência de anemia foi de 69,5%, 26,2% de anemia leve, 40,4% de anemia moderada e 2,9% de anemia grave. A taxa de prevalência geral, juntamente com a de anemia leve e moderada, mostrou uma tendência de aumento até os dois anos e depois disso de queda. As crianças da zona rural têm maior taxa de prevalência. Dos 28 estados indianos do estudo, 10 apresentaram prevalência muito alta. Bihar foi o maior deles (77,9%). A ordem de nascimento elevada, o alto índice de pobreza, o baixo nível de escolaridade materna, a anemia materna, a não ingestão de suplementos de ferro durante a gravidez e o vegetarianismo materno aumentaram os riscos de todos os tipos de anemia entre crianças (p < 0,05). A população cristã tinha o menor risco; e as categorias casta reconhecida, tribo reconhecida e outras classes atrasadas tinham o maior risco de anemia. CONCLUSÃO: Os resultados sugerem a necessidade de planejamento e implantação adequados de medidas preventivas contra a anemia infantil. Grupos economicamente carentes, a nutrição e a escolaridade maternas e o controle da natalidade devem ser prioridades nos programas.

Oral health status and treatment needs of iruligas at ramanagara District, Karnataka, India / Estado de la salud oral y necesidades de tratamiento de los iruligas, en el Distrito de Ramanagara, Karnataka, India

OBJECTIVES: To assess the oral health status and treatment needs of Iruliga tribal community residing at Ramanagara District, Karnataka, India. METHODS: The total population of 2605 Iruligas residing at 26 villages of Ramanagara District was included for the study. Data were collected using World Health Organization (WHO) 1997 'Oral Health Assessment Form'. Examination was done under good natural light using a mouth mirror and community periodontal index (CPI) probe. RESULTS: The total study population was 2605, comprising 1545 males and 1060 females in the age group of 1-80 years with the mean age of 30.56 ± 19.51. The majority of Iruligas (79.8%) used chew sticks as an oral hygiene aid. Subjects with leukoplakia were found to be 3 (0.12). The most commonly seen enamel opacity/hypoplasia was diffuse opacity affecting 930 (35.7%) subjects. A mild form of dental fluorosis affected 1658 (63.65%) subjects. Subjects with bleeding were only 4.22%; subjects with calculus were 57.9%; those with shallow pockets (4-5 mm) were 22.0% and subjects with deep pockets (> 6 mm) were 3.67%. The prevalence of dental caries among Iruligas was found to be 7.52%. The mean number of decayed, missing, filled (DMF) permanent teeth per person was 0.55 ± 0.1. Definite malocclusion, which required elective treatment, was noted in 14.1%. Iruligas with need for referral were found to be 29.94% (n = 780) according to the various treatment needs required for different oral diseases. CONCLUSION: This study revealed less prevalence of oral diseases among Iruligas, highlighting the role of good oral health practices prevalent among this isolated population.

OBJETIVOS: Evaluar el estado de salud oral y las necesidades de tratamiento en la comunidad tribal Iruliga, que reside en el Distrito de Ramanagara, Karnataka, India. MÉTODOS: La población total de 2605 Iruligas que residen en 26 aldeas del Distrito de Ramanagara, fue incluida en el estudio. Los datos fueron recogidos usando el Formulario de evaluación de la salud oral (OMS) de 1997. El examen se hizo bajo buena luz natural, usando un espejo bucal, y la sonda Índice Periodontal Comunitario (IPC). RESULTADOS: La población total del estudio fue 2605, y abarcó 1545 varones y 1060 hembras en el grupo etario de 1-80 años, con una edad media de 30.56 ± 19.51. La mayoría de los Iruligas (79.8%) usaban palillos de masticar como medio para la higiene oral. Se halló que los sujetos con leucoplasia oral eran 3 (0.12). La hipoplasia u opacidad del esmalte más común fue la opacidad difusa que afectaba a 930 (35.7%) sujetos. Una forma leve de fluorosis dental afectaba a 1658 (63.65%) de los sujetos. Los sujetos con sangramiento fueron sólo el 4.22%. Los sujetos con cálculo fueron el 57.9%; los que presentaban bolsas poco profundas (4-5 mm) fueron el 22.0% y los sujetos con bolsas profundas (> 6 mm) fueron el 3.67%. Se halló que la prevalencia de las caries dentales entre los Iruligas fue de 7.52%. El número promedio de dientes permanentes con caries, faltantes y obturados (DMF) fue 0.55 ± 0.1. La maloclusión definida, que requirió tratamiento electivo, se hizo evidente en 14.1%. Se halló que los Iruligas con necesidad de ser remitidos fue un 29.94% (n = 780) de acuerdo con las diferentes necesidades de tratamiento requeridas para las diferentes enfermedades orales. CONCLUSIÓN: Este estudio reveló menos prevalencia de enfermedades orales entre los Iruligas, destacando el papel de las buenas prácticas de la salud oral prevalentes entre esta población aislada.

Delimitation of kala-azar risk areas in the district of Vaishali in Bihar (India) using a geo-environmental approach

Remote sensing and geographical information technologies were used to discriminate areas of high and low risk for contracting kala-azar or visceral leishmaniasis. Satellite data were digitally processed to generate maps of land cover and spectral indices, such as the normalised difference vegetation index and wetness index. To map estimated vector abundance and indoor climate data, local polynomial interpolations were used based on the weightage values. Attribute layers were prepared based on illiteracy and the unemployed proportion of the population and associated with village boundaries. Pearson's correlation coefficient was used to estimate the relationship between environmental variables and disease incidence across the study area. The cell values for each input raster in the analysis were assigned values from the evaluation scale. Simple weighting/ratings based on the degree of favourable conditions for kala-azar transmission were used for all the variables, leading to geo-environmental risk model. Variables such as, land use/land cover, vegetation conditions, surface dampness, the indoor climate, illiteracy rates and the size of the unemployed population were considered for inclusion in the geo-environmental kala-azar risk model. The risk model was stratified into areas of "risk"and "non-risk"for the disease, based on calculation of risk indices. The described approach constitutes a promising tool for microlevel kala-azar surveillance and aids in directing control efforts.

Community prevalence of methicillin and vancomycin resistant Staphylococcus aureus in and around Bangalore, southern India / Prevalência de Staphylococcus aureus resistente à meticilina e à vancomicina em comunidade no entorno de Bangalore, Índia do Sul

INTRODUCTION: Staphylococcus aureus is a known colonizer in humans and has been implicated in community acquired soft tissue infections. However emergence of methicillin resistant S. aureus (MRSA) has aroused great concern worldwide. This study aimed to determine the prevalence of MRSA in the community of Bangalore, southern India. METHODS: Swabs were collected from anterior nares, forearm, dorsum and palm of the hands of 1,000 healthy individuals residing in and around Bangalore, belonging to different socioeconomic strata and age groups. RESULTS: Analysis verified that 22.5 percent and 16.6 percent of the individuals presented Staphylococcus aureus and MRSA, respectively, at any of the three sites. Vancomycin resistance was observed in 1.4 percent of the S. aureus isolates, which was confirmed by detection of the vanA gene. It was interesting to note that 58.8 percent of the children in the age group 1-5 years-old presented MRSA, the highest percentage compared to other age groups of < 1 (44.4 percent) year-old, 5-20 (21.7 percent) years-old, > 40 (11 percent) years-old and 20-40 (9.9 percent) years-old. Among the population of various socioeconomic strata, maximum MRSA colonization was observed among doctors (22.2 percent), followed by upper economic class (18.8 percent), lower economic class (17.7 percent), apparently healthy hospital in-patients (16.5 percent), nurses (16 percent) and middle economic class (12.5 percent). Most of the MRSA isolates were capsular polysaccharide antigen type 8 (57.1 percent). CONCLUSIONS: There is a need for continuous surveillance and monitoring of the presence of MRSA in the community and a clearer understanding of the dynamics of the spread of MRSA will assist in controlling its dissemination.

INTRODUÇÃO: O Staphylococcus aureus é conhecido por ser um colonizador em humanos sendo implicado em infecções comunitárias dos tecidos moles. Contudo, a resistência à meticilina e emergência de S. aureus meticilina resistentes (MRSA) têm despertado preocupação em todo o mundo. O presente estudo visa encontrar a prevalência de MRSA na comunidade de Bangalore, sul da Índia. MÉTODOS: Suabes foram coletados de narinas anteriores, antebraço e dorso da palma de 1.000 indivíduos saudáveis, residentes em Bangalore e nas proximidades, pertencentes a diferentes estratos socioeconômicos e faixas etárias. RESULTADOS: Observou-se que 22,5 por cento e 16,6 por cento dos indivíduos foram abrigar Staphylococcus aureus e MRSA, respectivamente, em qualquer um dos três locais. Dos S. aureus isolados, 1,4 por cento também foram resistentes à vancomicina, o que foi confirmado pela detecção do gene vanA. Foi interessante notar que 58,8 por cento das crianças na faixa etária de 1-5 anos foram abrigar MRSA, o mais elevado em comparação com outros grupos etários de < 1 (44,4 por cento) ano, 50-20 (21,7 por cento) anos, > 40 (11 por cento) anos e 20-40 (9,9 por cento) anos. Entre a população de diferentes estratos socioeconômicos, a colonização de MRSA máxima foi observada entre os médicos (22,2 por cento), seguida pela classe econômica superior (18,8 por cento), classe baixa (17,7 por cento), pacientes aparentemente saudáveis (16,5 por cento), enfermeiros (16 por cento) e classe econômica média (12,5 por cento). A maioria dos MRSA isolados eram do tipo polissacarídeo capsular antígeno 8 (57,1 por cento). CONCLUSÕES: Há uma necessidade de vigilância e monitorização contínua da presença de MRSA na comunidade, bem como uma melhor compreensão da dinâmica de propagação de MRSA pode ajudar no controle da disseminação.

Oral hygiene and periodontal status among Terapanthi Svetambar Jain monks in India

The main objective of the study was to determine the oral hygiene levels and periodontal status among Jain monks attending a Chaturmass in Udaipur, India. To date, no study has been conducted on Jain monks. The study comprises of 180 subjects and the overall response rate was 76 percent among them. Oral hygiene status was assessed by the Simplified Oral Hygiene Index (OHI-S) of Greene, Vermillion14 (1964), and periodontal status was assessed by the Community Periodontal Index. Additional information was collected regarding food habits, education level and oral hygiene habits. Analysis of variance (ANOVA), Chi Square Test and Step-wise multiple linear regression analysis were carried out using SPSS Software (11.0). The results showed that the oral hygiene status of Jain monks was poor and only 5.6 percent of the subjects had good oral hygiene. Overall periodontal disease prevalence was 100 percent with bleeding and shallow pocket contributing a major part (72.8 percent) among all the age groups (p < 0.001). Multiple linear regression analysis revealed that oral hygiene habits, caloric intake and education level explained a variance of 11.7 percent for the Oral hygiene index collectively. The findings confirmed that Jain monks have poor oral hygiene and an increased prevalence of periodontal disease compared to that of the similarly aged general population because, as a part of their religion, many Jain individuals avoid brushing their teeth especially during fasting, keeping in mind not to harm the microorganisms present in the mouth.

Clinical etiology of myiasis in ENT: a reterograde period - interval study / Etiologia clínica da miíase em otorrinolaringologia: um estudo retrospectivo

Myiasis in ENT, once a deadly disease still presents as a significant outdoor problem, though advances in management including supportive therapy has led to early healing with significant reduction in bed occupancy rate. AIMS: To assess the clinico etiology, relationship of myiasis to habit and habitat of patients and to assess the changes in age, seasonal, socioeconomic incidence, nasal bacterial flora and usefulness of certain commonly done tests with reference to a gap of 25 years. MATERIALS & METHODS: The presenting study was conducted on 80 patients selected over a period of two time intervals ; first 40 cases were chosen from 1979 to 1980 and next 40 over 2003 to 2004. Cases were studied in a retrograde manner and data tabulated. RESULTS & CONCLUSIONS: Atrophic turbinates was the commonest pathological finding in nose in 30 percent of cases . Significant change seen was in the age group 51 and above with a rise of 30 percent. Mode during 2003-04 was 60 years. Incidence of palatal perforation dropped from 17.88 to 2.5 percent . Klebsiella emerged as a significant contributor to the nasal microbial flora. VDRL and split skin smear showed poor etiological association for the diseases.

Miíase em ORL não é mais uma doença fatal, mas ainda está presente como um significativo problema em ambientes externos. Entretanto, progressos alcançados no tratamento, incluindo terapêutica de suporte, têm levado à cura precoce com significativa redução na taxa de internação hospitalar por causa dessa enfermidade. OBJETIVOS: Avaliar a etiologia clínica e as associações entre miíase e os hábitos e habitats dos pacientes; e avaliar diferenças no tocante à idade, estação do ano, incidência socioeconômica, flora bacteriana nasal e a utilidade de certos exames comumente feitos - um estudo retrospectivo de 25 anos. MATERIAIS E MÉTODOS: O presente estudo envolveu 80 pacientes selecionados em dois períodos; os primeiros 40 casos foram selecionados de 1979 a 1980, e os 40 seguintes foram coletados entre 2003 e 2004. Os casos foram estudados de forma retrospectiva e os dados foram analisados em tabelas. RESULTADOS E CONCLUSÕES: Cornetos atróficos representaram o achado nasal patológico mais comum - em 30 por cento dos casos. Alterações significativas foram encontradas na faixa etária dos 51 anos e acima, com um aumento de 30 por cento nestes. A média etária entre 2003-04 foi de 60 anos. A incidência de perfuração palatina caiu de 17,88 por cento para 2,5 por cento. Klebsiella foi o germe mais significativamente presente na flora microbiana nasal. Os exames de VDRL e teste cutâneo mostraram pobre associação etiológica entre as doenças.

Oral health status and treatment needs of a rural Indian fishing community / Estado de la salud oral y necesidades de tratamiento en una comunidad rural pesquera India

A study was conducted to assess the oral health status and treatment needs of a rural Indian fishing community. The fishing community had poor access to dental care. The survey was carried out using the WHO 1997 criteria in natural daylight. Convenience sampling method was employed and all the subjects available were examined. The results of this survey revealed that a large percentage of the population was afflicted with dental caries and periodontal disease. The unmet treatment need was found to be high in the study population. Appropriate oral health education and treatment is needed for this rural community.

Se llevó a cabo un estudio con el objeto de evaluar el estado de la salud oral y las necesidades de tratamiento en la comunidad rural pesquera India. El acceso de la comunidad pesquera al cuidado dental era pobre. La encuesta se llevó acabo con los criterios de la OMS 1997 a la luz natural del día. Se empleó el método de muestreo por conveniencia y se examinaron todos los sujetos disponibles. Los resultados de este estudio revelaron que un gran porcentaje de la población padece de caries dentales y enfermedades periodontales. Se halló que la necesidad de tratamiento sin atención era alta en la población bajo estudio. Se necesita tanto tratamiento como educación para la salud oral adecuada en esta comunidad rural.