Profile of health care workers infected with SARS-CoV-2 infection in a central district in Kerala with focus on infection control practices.

There were reports of severe acute respiratory syndrome coronavirus 2 infection cases among health-care workers from all around the world. We did a cross sectional study among 533 COVID19 affected health-care workers. About 87.43% of participants were involved in duties not directly related to COVID-19 management. About 19.6% contracted the disease from their colleagues. About 15% of the affected health-care workers had at least one comorbidity and diabetes mellitus was the most common (5%). 57% of participants presented with fever followed by body ache in 40%. Only 0.4% of the participants needed ventilator support during treatment. 36% of the participants reported household transmission from them. Adequate personal protective equipment (PPE) usage and functioning infection control committee in their hospital were reported by most of the participants. The study points towards the need of adequate PPE use in the nonCOVID settings and the need for periodical assessment of infection control practices.

COVID-19: Situation analysis in the district of Ernakulam.

Context: Corona Virus Disease 2019 (COVID-19) has become a pandemic causing millions of deaths and causing a devastating blow to the global economy. Like all other countries and territories, the Ernakulam district (Kerala, India) is affected by COVID-19. When the number of COVID-19 cases reported in the other states started coming down, the Ernakulam district continued to record a large number of cases. Aims: To analyse the situation of the COVID-19 pandemic in the district of Ernakulam, Kerala. Material and Methods: The authors were part of the COVID-19 surveillance unit of Ernakulam district, and hence, had access to the data collected. The available data were analysed in the following phases of the pandemic: First phase: From the reporting of the first case in Kerala in January to the reporting of the first case in the Ernakulam district. Second phase: Cases reported mostly in those with a travel history and their contacts to the period of community spread. Third phase: From the start of community spread. Results and Discussion: As of July 5, 2021, the Ernakulam district reported 3,60,345 cases of the COVID-19 infection with 1,317 deaths and the recovery rate being 96.45%. Despite factors like high human development index (HDI), access to the Internet and social media, access to affordable healthcare, etc., factors like high population density, airports, seaports, railway stations, container terminals, IT parks, major highways, tourist spots, beaches, large shopping malls, large floating population, a huge number of migrant labourers, a large proportion of the elderly population, high prevalence of non-communicable diseases, etc., are the some of the major challenges. The preparedness of the fight against COVID-19 included the training of all healthcare workers, ward level rapid response teams (RRT), upgradation of health facilities, district-level patient management system, provisions to manage biomedical waste, etc., The containment zone strategy is currently based on the local self-government area-wise weekly test positivity rate (TPR). The cluster containment is focused on the early identification of clusters. Currently, the Ernakulam district reports one of the highest numbers of COVID-19 cases in India. This is mainly because of the high number of tests (five to six times to national average) and targeted testing strategy. This is scientifically proven by the very low case fatality rate (0.35%), low-bed occupancy rate of the COVID treatment facilities and the latest seroprevalence study by Indian Council for Medical Research (ICMR). Conclusions: So far, the Ernakulam district could excel in its efforts to fight against COVID-19. But even now, when we are moving forward with the immunisation of the healthcare workers, front-line workers, elderly population, our main strategies to prevent COVID-19 remain the same-proper social distancing, hand hygiene, use of masks, avoiding unnecessary travels and gathering, early identification of cases and treatment.

Analyzing COVID-19 mortality in Ernakulam district of Kerala: A retrospective review of death reports.

Background: COVID19 pandemic caused considerable mortality and had a huge impact on the health system and the world economy. In this context, it is important to characterize the demographic and clinical features of the fatal cases and to have a basic understanding on the additional burden caused by COVID19 on the health care system. Methods: Mortality reports of 408 patients who were diagnosed with COVID-19 in Ernakulam district during the period of 28th March 2020 - the day which reported the first COVID19 death in the district- till 28 February 2021 were collected using a uniform reporting format prepared by the district COVID19 surveillance unit. Results: Out of the 408 fatal cases 260 (64%) were males. The mean age of the cases was 69 years (SD:12, IQR:16-102 years). 31% (n=124) of the patients were admitted to more than one facility for treatment before the death. The median duration between the documented date of onset of symptoms to death was 11 days (IQR:0-46). Mean duration between the onset of COVID19 suspected symptoms to the collection of samples for laboratory test was 3 days and the duration up to the admission to a treatment facility was 4.5 days. The median duration between the admission to a facility and death was 7 days (mean 10, SD:7) with a range 0 to 40 days. The mean duration of hospital stay was 10 days for females and 8.5 days for males. Most frequent symptom at presentation was breathlessness 50% (n=211), followed by fever 43% (n=179). 96% of the cases were reported to have any comorbidity and among those most common was Diabetes mellitus and stroke 60%, followed by Hypertension 54%. However, there was no significant difference in duration of hospital stay and survival period across age group, sex or number of comorbidities which may need further analysis. Conclusion: 6 out of 10 of the fatal cases were males and the mean age was 69 years, Though the mean age was similar for both sexes, median age was slightly higher for females. The proportion was found increasing as the age advanced. One third of the patients were admitted and treated at more than one facility and moreover 6 out of 10 utilized government facilities for treatment. Median duration of survival was 11 days while the median duration of hospital stay was 10 days. Symptomatology was found similar to cases reported worldwide. More than 9 out of 10 had reported at least one comorbidity and the most frequent comorbidities reported were Diabetes mellitus and Cerebrovascular accident. Most frequently observed combination was of a triad of Hypertension-Diabetes-Stroke. This data is of prime importance as Kerala is at an advanced level of epidemiological transition and demographic transition compared to other Indian states and emerging infections like COVI19 could be a double burden to the community.

Comparative Evaluation of the Effectiveness of Denture Cleansers on Surface Hardness of Permanent Silicone Denture Liners - An In vitro Study.

AIM: This study aimed to determine the effect of three commercially available denture cleansers on surface hardness of two different silicone denture liners at various time intervals. MATERIALS AND METHODS: A total of 120 cylindrical specimens of permanent silicone-based soft liners were prepared from a custom made metal mold with dimensions of 15 mm × 10 mm, of which 60 specimens were fabricated using Voco™ and the remaining 60 specimens with Molossil™ permanent denture liners. All specimens were divided into four major groups based on cleansing treatments, comprising 30 specimens each. And then, all cleansers dissolved in 250 mL water as recommended by the manufacturer. Specimens of the first group were cleansed daily by rinsing with water and second group with Periogard™ denture cleansing solution and third group with Secure™ denture cleansing solution and the fourth group with Polident™ denture cleansing solution. Specimens of all groups were tested on 1st week, 1st month, and 6th month time interval using a Shore A Durometer. Three readings were noted for each sample and the mean of those readings was taken. RESULTS: Surface hardness of all the samples was significantly higher after a period of 6 months irrespective of the cleansing treatment. Statistically significant changes were observed between Polident™, Secure™, and Periogard™ denture cleanser groups over control with time. Minor changes were observed in surface hardness of Voco™ denture liners as compared to Molossil™ soft liners for all groups, as time progressed. CONCLUSION: Voco™ soft denture lining material can be performed significantly better than Mollosil™ soft denture lining material in all cleansing treatments and Polident™ denture cleanser has the least effect on surface hardness of soft liners than Periogard™ and Secure™ denture cleansing agents.

Pharmacogenomic landscape of COVID-19 therapies from Indian population genomes.

Aim: Numerous drugs are being widely prescribed for COVID-19 treatment without any direct evidence for the drug safety/efficacy in patients across diverse ethnic populations. Materials & methods: We analyzed whole genomes of 1029 Indian individuals (IndiGen) to understand the extent of drug-gene (pharmacogenetic), drug-drug and drug-drug-gene interactions associated with COVID-19 therapy in the Indian population. Results: We identified 30 clinically significant pharmacogenetic variants and 73 predicted deleterious pharmacogenetic variants. COVID-19-associated pharmacogenes were substantially overlapped with those of metabolic disorder therapeutics. CYP3A4, ABCB1 and ALB are the most shared pharmacogenes. Fifteen COVID-19 therapeutics were predicted as likely drug-drug interaction candidates when used with four CYP inhibitor drugs. Conclusion: Our findings provide actionable insights for future validation studies and improved clinical decisions for COVID-19 therapy in Indians.

6-Formyl-2-meth-oxy-3-nitro-phenyl 4-toluene-sulfonate.

In the title compound, C(15)H(13)NO(7)S, the inter-planar angle between the two aromatic rings is 26.04 (3)°. The crystal structure is stabilized by C-H⋯O interactions.

An In Vitro Study on the Effects of Post-Core Design and Ferrule on the Fracture Resistance of Endodontically Treated Maxillary Central Incisors.

BACKGROUND: Endodontically treated teeth have significantly different physical and mechanical properties compared to vital teeth and are more prone to fracture. The study aims to compare the fracture resistance of endodontically treated teeth with and without post reinforcement, custom cast post-core and prefabricated post with glass ionomer core and to evaluate the ferrule effect on endodontically treated teeth restored with custom cast post-core. MATERIALS AND METHODS: A total of 40 human maxillary central incisors with similar dimensions devoid of any root caries, restorations, previous endodontic treatment or cracks were selected from a collection of stored extracted teeth. An initial silicone index of each tooth was made. They were treated endodontically and divided into four groups of ten specimens each. Their apical seal was maintained with 4 mm of gutta-percha. Root canal preparation was done and then post core fabrication was done. The prepared specimens were subjected to load testing using a computer coordinated UTM. The fracture load results were then statistically analyzed. One-way ANOVA was followed by paired t-test. RESULTS: 1. Reinforcement of endodontically treated maxillary central incisors with post and core, improved their fracture resistance to be at par with that of endodontically treated maxillary central incisor, with natural crown. 2. The fracture resistance of endodontically treated maxillary central incisors is significantly increased when restored with custom cast post-core and 2 mm ferrule. CONCLUSION: With 2 mm ferrule, teeth restored with custom cast post-core had a significantly higher fracture resistance than teeth restored with custom cast post-core or prefabricated post and glass ionomer core without ferrule.

Interdisciplinary Full Mouth Rehabilitation of a Patient with Amelogenesis Imperfecta: A Case Report with 8 Years Follow-up.

This case report deals with the interdisciplinary approach of a 28-year-old lady with Amelogenesis imperfecta of the hypoplastic kind. The patient came with a chief illness of worn out teeth, unsatisfactory esthetics and severe sensitivity of teeth. Her family history revealed a related situation in her father's brother and her sister. On clinical assessment, the crowns of all teeth were worn out. The plan of the treatment was to protect as much tooth structure, restore the vertical dimension, and improve esthetics and masticatory function. The treatment procedures involved prosthodontic, endodontic, and periodontic interventions. After recording the vertical height, endodontic treatment and crown lengthening were performed with respect to the lower anteriors. The lost vertical height was regained in stages by insertion of full coverage crowns for all the teeth. The patient's esthetic and functional needs were met with systematic and sequential interdisciplinary treatment approach.

A labially positioned mesiodens and its repositioning as a missing central incisor.

Hyperdontia is an increased number of teeth within the dental arches. This is of particular interest to pediatric dentists who commonly make the initial diagnosis. Most often a large portion of these teeth is completely embedded or impacted within the jaws and can be viewed only radiographically. Hyperdontia can occur on virtually every tooth-bearing surface. However, the most frequent is the mesiodens, in the anterior maxillary region. Anterior maxillary teeth are one of the most important features contributing to aesthetics of an individual. Missing anterior teeth can cause undue psychological stress in children, during their growing years. Most of the literature available show that the mesiodens are situated on the palatal aspect of the permanent incisors. Their treatment frequently involves an early recognition, extraction through a traditional palatal technique and guiding the associated permanent tooth to its original position. The purpose of this article is to enlighten the clinician of the need of deviating from the traditional approach of early extraction in particular situations and to conserve the mesiodens if favorable as an alternative treatment to a malformed permanent tooth, which may fail to erupt. This report describes a successful multidisciplinary approach to treatment of a unerrupted, labially placed mesiodens in conjunction with a dilacerated and impacted permanent tooth, in a child with a missing left central incisor. Treatment consisted of localizing and confirming the placement of the mesiodens to be labial, surgically exposing the crown of the mesiodens through a labial surgical approach, orthodontically guiding it to the position of the missing central incisor, extracting the malformed permanent incisor, and restoring the mesiodens to the required anatomy with composites, to establish aesthetics and function of the affected region.

Studies on intermolecular interaction on binary mixtures of methyl orange-water system: excess molar functions of ultrasonic parameters at different concentrations and at different temperatures.

Density (ρ), viscosity (η) and ultrasonic velocity (u) of binary mixtures of methyl orange and water were measured at different concentrations and at different temperatures; several useful parameters such as excess volume, excess velocity, and excess adiabatic compressibility have been calculated. These parameters are used to explain the nature of intermolecular interactions taking place in the binary mixture. The above study is helpful in understanding the dye/solvent interaction at different concentration and temperatures.

Taste perception in kallmann syndrome, a model of congenital anosmia.

OBJECTIVE: To investigate taste, a component of flavor perception, using electrogustometry (EG) in patients with congenital anosmia associated with Kallmann syndrome (KS). METHODS: Four patients with KS and 4 control subjects participated in this study. During the first phase of the investigation, the study subjects were administered the University of Pennsylvania Smell Identification Test. During the second phase of the study, EG testing of 2 regions on the anterior tongue tip was performed through an electrode. RESULTS: Patients with KS, as expected, scored in the anosmic range on the University of Pennsylvania Smell Identification Test, whereas the control group had a normal sense of smell. The difference in the olfaction scores was significant between the 2 study groups (P<0.015). The result of taste assessment of patients with KS and control subjects with use of EG was not significantly different between the 2 study groups (P = 0.874). CONCLUSION: The current study demonstrates that patients with KS have a normal sense of taste, as determined by EG. This finding is consistent with the fact that the deficit in KS is purely olfactory. Because flavor perception is not a common complaint in patients with this condition, it may be postulated that persons with KS compensate for the absent sense of smell. Further studies need to be undertaken to explore how patients with KS compensate for the olfactory dysfunction, information that should contribute to the understanding of the interplay of the various components of flavor perception.