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Background and Aims: There is limited research on the impact of COVID-19 pandemic on caregivers of patients with severe mental illness (SMI) during its late phase when sufficient and widespread knowledge about management and preventive aspects existed. We aimed to assess the impact of COVID-19 pandemic on caregivers of patients with SMI during Omicron wave. Methodology: We assessed 100 caregivers of patients with preexisting SMI diagnosed on the Diagnostic and Statistical Manual of Mental Disorders-5, 50 each of schizophrenia and related psychotic disorders (SCZ) and bipolar disorder (BD) from December 14, 2021, to February 9, 2022. We assessed symptoms of depression, anxiety, stress, and family burden in caregivers and their coping strategies by the Depression, Anxiety, and Stress Scale-21 Hindi version, Family Burden Interview Schedule (FBIS), and Brief-Coping Orientation to Problem Experienced, respectively. Results: Caregivers of SMI experienced symptoms of depression (51%), anxiety (72%), and stress (13%), with significantly more symptoms of depression (P = 0.002) and anxiety (P = 0.025) in caregivers of SCZ. High caregiver burden (score: 25.76, > half of the total score on FBIS) was found with no significant difference in the two groups. Caregivers of SCZ used a greater number of emotion-focused coping strategies, whereas those with BD used more problem-focused coping, but the difference was not significant. A significant association was seen between coping strategies of substance use and depressed symptoms (P = 0.003), substance use and anxiety symptoms (P = 0.007); anxiety symptoms with denial (P = 0.001) anxiety symptoms and venting (P = 0.008) in caregivers of BD. Conclusion: Caregivers of patients with preexisting SMI experienced depression, anxiety, and high family burden during Omicron wave. They used both emotion- and problem-focused coping strategies. [ABSTRACT FROM AUTHOR]

Introduction: Family resilience is strongly influenced by religious coping and spiritual/religious well-being (RW). In the context of the COVID-19 pandemic in Indonesia, this study intends to investigate the relationship between religious coping, spiritual well-being, and family resilience. Methods: A cross-sectional survey (n = 242) was conducted from December 2021 to January 2022 in Indonesia. The Spiritual Coping Strategies Scale-Chinese version, Spiritual Well-Being Scale, and Family Resilience Assessment Scale were used for data collection. Smart Partial Least Square (SmartPLS) software (version 3.2.7) was used to analyze the data. Results: Most respondents aged range from 46 to 55 years-old (30.9%). Also, most of them were having senior high school educational level (47.7%), earn <3 million rupiah (90.5%), and jobless (66.7%). Family resilience to COVID-19 has been influenced by the relationship between RW and existential well-being (EW) (81.2%) (β =0.901, t = 24,836, P = 0.001). Religious Non-coping (RNC)- Religious well-being(RW) is 0.124, which indicating that RNC affecting RW by 12.4%, and it also impacting on family resilience to COVID-19 (β = -0.310, t = 3.275, P = 0.001, f 2 = 0.085; minor). Conclusion: Religious coping, RW, and EW are all important factors influencing family resilience during the COVID-19 pandemic. Currently, the COVID-19 pandemic has ended. However, with the dynamic development of world health, an outbreak may occur in the future, so the findings of this research will be helpful in providing a warning about spiritual factors that significantly influence family resilience. [ABSTRACT FROM AUTHOR]

Background: The first 1,000 days of a child’s life is a critical window for growth faltering, deficiencies, and common childhood illnesses. Even with optimum breastfeeding, children 6-23 months are at higher risk of being undernourished if they do not receive adequate and appropriate complementary feeding. Therefore, this study was carried out to assess the nutritional status of children 6-23 months and find the association between sociodemographic profile and nutritional status. Materials and Methods: Mothers of 411 children of age 6-23 months in an urban area of Raipur were interviewed using a pretested questionnaire based on the WHO indicators to record their complementary feeding practices. Weight, height, and mid-upper arm circumference (MUAC) was taken to assess the nutritional status. Overall and specific (sex-wise and severity-wise) prevalence rate of stunting, wasting, and underweight were calculated. The distribution of these according to various factors like infant and young child feeding practices, and details of study subject and family were calculated. Chi-square test of significance was applied to find the association between nutritional status and independent variables and their strength of association. Results: The prevalence of wasting was 25%, underweight 30%, and stunting 15%. Statistically significant association of underweight with age of the parents, both mother and father, was observed (P < 0.05). Minimum dietary diversity was achieved by only 4.1% and minimum acceptable diet by 2.4% children. Conclusions: The prevalence of wasting and undernutrition was assessed. Complementary feeding indicators were unsatisfactory among children. Ending all forms of malnutrition is the global goal. The Sustainable Development Goals (SDGs) that directly affect or indirectly influence nutrition have to be recalled at this stage and addressing malnutrition is a key element required to achieving them. [ABSTRACT FROM AUTHOR]

Introduction: Researchers must concentrate their focus on whether patients understand various treatment options available among removable complete and partial denture patients and whether they are aware of the maintenance protocol of the prosthesis. Materials and Methods: All the patients who completed removable partial or complete denture treatment in a period of 6 months were included in the study. Collected data were statistically analyzed using Chi-square test at a significance level of P < 0.05. Results: Awareness needs to be increased regarding the treatment options available for removable complete and partial denture treatment causes because many subjects in this study were only aware of the removable partial denture and complete denture treatment for missing teeth and not the other options, especially among individuals in the lower socioeconomic group. Conclusion: The findings indicate that awareness needs to be increased regarding the functions of prostheses such as esthetics and phonetics because many subjects in this study were only aware of the masticatory function performed by prosthesis. [ABSTRACT FROM AUTHOR]

Background: Psoriasis is an inflammatory systemic disease with a chronic relapsing course. Methotrexate, a dihydrofolate reductase inhibitor, and Apremilast, an oral phosphodiesterase type 4 inhibitor, are currently the mainstay drugs in the treatment of psoriasis. Aims and Objectives: To compare the efficacy of Methotrexate with a combination of Methotrexate and Apremilast in treating chronic plaque psoriasis. Materials and Methods: The present study was a prospective comparative study conducted among 40 patients, aged above 18 years, with clinically diagnosed psoriasis attending Dermatology OPD of a tertiary care hospital in North India. The study utilised a pre-structured proforma to record a detailed demographic profile and clinical examination related to chronic plaque psoriasis. The patients were divided into two groups of 20 each. Group A was treated with oral Methotrexate, while Group B was treated with oral Apremilast and Methotrexate, and they were evaluated every 4 weeks for 12 weeks. Necessary investigations were done wherever indicated. Results: The male-to-female ratio was 1.35, and the majority (55.0%) of patients belonged to the age group of 31-50 years. 27.5% of patients had comorbidities like diabetes, hypertension, etc., The mean PASI score of group A at the first, second and third follow-ups was higher than that of group B. The reduction in mean PASI score was statistically significant in group B at successive follow-ups, with a percentage improvement of 89.4% at the end of 12 weeks. Conclusions: When comparing monotherapy with methotrexate and multidrug therapy with Methotrexate and Apremilast, multidrug therapy had better efficacy. [ABSTRACT FROM AUTHOR]

Introduction: Kidney transplantation is the treatment of choice for patients suffering from end‑stage renal disease and health‑related quality of life (HRQoL) is routinely used for measuring the outcome. Although the generic HRQoL questionnaire provides useful information on multiple dimensions, they fail to capture emotional and behavioral components of well‑being, which is supplemented by the Transplant Effects Questionnaire (TxEQ). The present research studies the impact of these two questionnaires on various parameters affecting the health of kidney transplant recipients. Methodology: This cross‑sectional study included 500 postrenal transplant patients within 5 years of transplant (18–70 years) evaluating HRQoL using a Short Form Survey‑36 Questionnaire and emotional/behavioral outcomes using a TxEQ. Results: Mean age of participants was 44.92 ± 5.86 years and males constituted the majority (>75%). The mean physical component score (PCS) was 41.3 ± 9.2 and the mental component score (MCS) was 48.1 ± 8.4. The highest score was observed for bodily pain, followed by role limitations attributable to emotional problems (RE). The PCS was significantly higher among younger participants, among males, among participants who have got a transplant >24 months ago, and among participants who had serum creatinine levels <2 mg/dl (*P < 0.05). However, the mental component score did not differ significantly in any of the matched variables. In TxEQ, medication adherence had the highest mean score, followed by perceived responsibility toward others. Conclusion: In our study, we concluded that reduced physical functioning among female gender, illiterate patients, with increasing age, in employed section, and with associated comorbidities such as hypertension and with a history of rehospitalization. [ABSTRACT FROM AUTHOR]

Background: In randomised controlled trials (RCTs), the application of a test of significance to compare the baseline differences between the intervention groups is a common practice, though it has been condemned by many researchers. Objective: This study aimed to assess the proportion of RCTs on human participants comparing the baseline differences between intervention groups using the test of significance in nine dental specialty journals published in India and to estimate the proportion of studies reporting baseline demographic and clinical characteristics in a table. Materials and Methods: RCTs published in nine dental journals published by dental specialty associations of India were screened. A literature search was limited to the time duration of five years from 2017 to 2021. Results: The authors analysed 326 RCTs. Of 326 RCTs published, 237 RCTs (72.7%) did not report the baseline demographic and clinical characteristics table. Tests of significance were applied to compare baseline differences between the intervention arms in 148 (45.4%) RCTs published. Conclusions: Although criticised by the Consolidated Standards of Reporting Trials (CONSORT) statement, the majority of the trials published in dental specialty journals failed to avoid comparison of baseline differences with significance test and failed to report baseline characteristic table. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to measure the amount of material extruded in the periapical area using three irrigation needles (Max-I-Probe, NaviTip Fx and IrriFlex flexible needle). Materials and Methods: Mandibular premolars were selected for this study and glass vials were used to gather the extruded debris and they were preweighed. The samples were divided into two groups: Group A (1 mm penetration of needle from working length), which was subdivided into three subgroups: Subgroup A1: Irrigation was made by Max-I-Probe. Subgroup A2: Irrigation was made by NaviTip Fx. Subgroup A3: Irrigation was made by IrriFlex flexible needle. Group B (3 mm penetration of needle), which was subdivided into three subgroups: Subgroup B1: Irrigation was made by Max-I-Probe. Subgroup B2: Irrigation was made by NaviTip Fx. Subgroup B3: Irrigation was made by IrriFlex flexible needle. XP-endo Shaper was used for chemomechanical preparation. After removal from vials, the teeth were incubated and then removed from the incubator and weighed again three times. The average of the readings was taken. Analysis of variance (ANOVA) and least significance difference tests were applied to analyse data. Results: All of the needles caused debris extrusion. There was a significant difference between groups (P = 0.001) according to the depth of penetration. The lowest value for debris was observed in subgroup B3 while subgroup A2 had shown the highest mean. Conclusion: Results revealed that the design and depth of needles significantly affected the debris extrusion. Using more flexible needles and shorter penetration depth for irrigation so that we don't need to push the needles so far apically. [ABSTRACT FROM AUTHOR]

Background: Psychological impact of COVID-19 is an emerging area of interest among researchers worldwide. We aimed to study the prevalence of anxiety and depression among COVID-19 survivors and its association with individual characteristics including demographic variables. Methods: One hundred and fifty COVID-19 survivors from a tertiary care hospital were contacted to collect information regarding anxiety and depression using the Generalized Anxiety Disorder-7 (GAD-7) scale and Patient Health Questionnaire-9 (PHQ-9). The Pearson's Chi-square was used for univariate analysis of categorical variables. The Mann–Whitney test was used to check the significance between group medians. Results: 21.3% of the survivors (n = 32) reported postdischarge COVID-19 anxiety. Mild, moderate, and moderately severe anxiety was reported by 17.3%, 3.3%, and 0.7% of the patients, respectively, on using the GAD-7 questionnaire. PHQ-9 revealed that 29.3% (n = 44) had depression. Minimal, mild, moderate, and moderately severe depression was reported by 19.3%, 24.0%, 2.0%, and 3.3% of the respondents, respectively. None of the survivors had severe anxiety or depression. In both the questionnaires, variation in median scores was statistically significant with age, whereas for GAD-7 scores, the difference in median scores was statistically significant only for gender. On analysis, age above 40 years was a statistically significant determinant for both anxiety (P = 0.041) and depression (P = 0.018) while male gender showed a statistically significant association in case of anxiety (P = 0.028). The correlation between age and respective scores and GAD-7 scores and PHQ-9 scores was also found to be significant (P < 0.001). Conclusion: These preliminary screening results provide convincing evidence of anxiety and depression among COVID-19 survivors, thus reiterating the need of timely detection and management of mental health issues through formulation of strategies to tackle the concurrent psychological comorbidities amid the ongoing pandemic. [ABSTRACT FROM AUTHOR]

Background: The rise in awareness programs with regard to the maintenance of oral hygiene in children with diabetes has led to a hypothetical question if children with juvenile diabetes are still under the risk of developing dental caries and having poor oral hygiene. Aim: To compare the oral hygiene status of the children with and without juvenile diabetes. Materials and Method: The study was conducted as age and sex matched case-control study. Sixty-six children diagnosed with juvenile diabetes were compared with the age and sex matched 66 healthy controls with respect to the oral hygiene index, gingival index and DMFT/def index. Mean of the obtained scores of the variables were compared between the groups using Mann-Whitney test with significance level set at 5%. Results and Conclusion: No statistically significant differences were noted in the gingival condition and dental caries experience between the children with and without juvenile diabetes (P = 0.820; 0.504; 0.422). However, the overall oral hygiene status was found to be poor in children with juvenile diabetes (P = 0.003). No significant differences were observed in the gingival status and the dental caries prevalence between the two groups. [ABSTRACT FROM AUTHOR]

Context: Pollution-related health hazards are very common among people living and/or working in industrial areas, particularly near industries and metro cities. These air pollutants contribute to allergens, increase inflammation, and affect lung function. Aim: The present study aimed to examine the effect of yoga training on lung functions and inflammation in terms of soluble interleukin-2 receptor (sIL-2R) in people working and living in a polluted area. Settings and Design: This is a randomized controlled interventional pilot study. Methods and Materials: Forty-eight male volunteers from the industrial area, aged 20--50 years, were randomly assigned to the experimental group and the control group. Each group comprises 24 study participants. Lung function and sIL-2R were studied at the baseline and post-yoga intervention period of 16 weeks. Statistical Analysis Used: Study data were analyzed using descriptive methods, a one-tailed t-test, a paired t-test, and an independent t-test. Result: Study results showed directional and significant improvements in forced vital capacity, forced expiratory volume in the first second, and peak expiratory flow rate compared to the control group participants. The results pertaining to sIL-2R showed a directional and significant decrease in the experimental group compared to the control group. Conclusion: The present study showed that yoga helps to promote better health, improve lung function and reduce inflammation among people residing in polluted environments. [ABSTRACT FROM AUTHOR]

Background: Tea leaves are natural rich source of fluoride and are known as fluorine absorbants. It is consumed on large scale in India and thus needs to be monitored for its daily fluoride consumption by customers. Tea manufacturers should mention fluoride concentrations on the packages to avoid overdose through unknown consumption by consumers. Objectives: To detect the levels of fluoride in tea at different periods of boiling and to compare the fluoride levels in various brands of tea at different periods of boiling. Methodology: A survey was conducted in 25 tea stalls of Salem on the type of tea and time of boiling black tea. The five most common brands of tea will bought for the study. The stainless-steel vessel will be used in the methodology for boiling tea. Mettur water will be used for the preparation of black tea and 1 g of tea leaves to 100 ml of hot (~95°C) deionized water (1% w/v tea infusion) and allowed the mixture to stand for 5 min in a glass beaker. After 5 min, the infusions were filtered and again left standing until they are cooled to room temperature. All fluoride measurements will be completed within 4 h of the preparation of the infusion. About 2 min and 4 min boiling will be followed. The fluoride present in each brand of tea will be calculated from black tea prepared using 2-(parasulfophenylazo)-1,8-dihydroxy-3,6-naphthalenedisulfonate (SPADNS) calorimetric method. Results: The distribution of mean score of fluoride level in tea powders available in tea shops of Salem when boiled in distilled water was (559.00 ± 112.12). The mean score of fluoride level in tea powders available in tea shops of Salem boiled in Mettur water was (689.05 ± 116.34).To test the significance of difference between the average fluoride in tea powders available in tea shops of Salem when boiled in distilled water and Mettur water, the independent t-test was used. the P value is <0.05, and hence, it is found that there is significant difference between the average fluoride in tea powders available in tea shops of Salem boiled in distilled water and Mettur water. Conclusion: Thus, the study showed tea consists of significant amount of fluoride concentration that is consumed on daily basis. The study also evaluated fluoride concentration in tea preparations using different water. The study shows necessity for regulations of mentioning fluoride concentration on tea packs. [ABSTRACT FROM AUTHOR]

Purpose: To estimate the postoperative astigmatism after small-incision cataract surgery (SICS) done by junior residents at the end of 1 and 3 months. Methods: This observational longitudinal study was conducted at the Department of Ophthalmology of a tertiary eye care hospital and research center. 50 patients enrolled in the study underwent manual small incision cataract surgery by junior residents. Preoperative detailed ocular examination was done, which included keratometric estimation using autokeratometer (GR-3300K). Incision length, distance of incision from the limbus, and type of suturing technique were noted. Postoperatively, keratometric readings were noted at 1 and 3 months. Astigmatism (surgically induced astigmatism [SIA]) was estimated using Hill's SIA calculator version 2.0. All the analyses were performed using Statistical Package for the Social Sciences (SPSS) ver. 26.0 (IBM Corp., USA) software, and the statistical significance was tested at a 5% level. Results: Out of 50 patients, 54% had SIA between 1.5 and 2.5 D and 32% had SIA of more than 2.5 D. Only 14% had SIA less than 1.5 D at the end of 1 month. While 52% had SIA between 1.5 and 2.5 D, 22% had SIA between 1.5 and 2.5 D and 26% had SIA less than 1.5 D at the end of 3 months. Conclusion: The SIA in most of the SICS done by junior residents was above 1.5 D. It depended mainly on the incision length, its distance from the limbus, and the suturing technique. [ABSTRACT FROM AUTHOR]

Background: Combined Oral Contraceptive (COC) pill is associated with atherogenic and cardiovascular changes. Some service providers use individual lipid parameters to assess these changes unlike objective calculation using standard formulae. Objective: To determine and compare the atherogenic changes in women on COCs using six lipid ratios; coronary heart disease risk ratio, atherogenic index of plasma, atherogenic co-efficient, Cholesterol index, Castelli risk index I, and Castelli risk index II. Materials and Methods: A prospective, comparative study among new acceptors of contraceptives at four family planning clinics in Ilorin, North-Central Nigeria. Participants were categorized into COCs acceptors (group I, n=120) and acceptors of non-hormonal contraceptives (group II, n=120). Participants were followed up with serial lipid profiles at 0, 3 and 6 months after uptake. Atherogenic risks were calculated using six standard formulae; statistical analysis was with SPSS version 21.0 and Analysis of variance (ANOVA) was used to compare the differences of more than two means, Bonferroni Post Hoc test was used to test for specific significance within the group and p-value <0.05 was considered significant. Results: A total of 225 participants (111 COC users, 114 non-COC users) aged 19 to 48 years completed the study. Serum levels of Low-Density Lipoprotein showed a statistically significant rise among the COC users over the study period (p=0.038), especially between the third and sixth months. The lipid ratios were statistically increased using all six methods despite apparently normal lipid parameters. Conclusion: Atherogenic changes may occur in the presence of apparently normal lipid parameters among COC users; therefore, serial lipid ratio using standard method formulae is recommended. [ABSTRACT FROM AUTHOR]

Background: Undergoing coronary artery bypass graft (CABG), a major heart surgery can trigger off emotional and cognitive reactions. Depression pre- and postsurgery can impair the quality of life (QOL) of these patients. Aim: This study was done to assess the prevalence of depression and QOL in patients undergoing CABG surgery over a period of 3 months. Materials and Methods: A total of 33 patients of age group 56-75 years at a tertiary care hospital undergoing CABG were administered Depression in Medically Ill Scale before and after 15 days and 3 months of surgery. The World Health Organization QOL-BREF Scale was applied before and 3 months after the surgery. Results: The mean age of patients was 64.03 years. The prevalence of depression was 36.36% before surgery and 30.30% and 24.24% after 15 days and 3 months of surgery, respectively. QOL improved at 3 months of surgery specifically in physical, psychological, and environmental domains. Depression scores were negatively correlated with QOL before and after the surgery. Conclusions: A number of patients have persistent depression after CABG although its prevalence and severity decrease. All patients undergoing CABG should be screened for depression. Timely detection and treatment can result in a better QOL after surgery. Identifying and addressing psychosocial problems are of paramount importance in cardiac rehabilitation. [ABSTRACT FROM AUTHOR]

Occlusal analysis is important to analyze any disharmony in occlusion. Atraumatic dental occlusion leads to evolution of T-scan. T-scan gives a valuable procedure for clinical assessment and perception of occlusal problems. T-scan can also be used in periodontitis patients for checking the occlusal pattern. Occlusal problems and periodontal disease relationship remains controversial. Further research is needed to determine whether occlusal adjustment is necessary for periodontal treatment. The main aim of the study was to assess the occlusal pattern using T-scan in periodontitis patients. Thirty periodontitis subjects were taken and checked for occlusion using T-scan. The subject's age group was 35–55 years. The study included 15 males and 15 females. Plaque index, gingival index, attachment loss, probing depth, centric occlusion (CO), protrusion, right lateral, and left lateral were the parameters studied. Occlusal adjustments were needed to decrease and dissipate the abnormal occlusal forces. The significance of statistical tests for various movements are as follows: CO (right and left) (P = 0.077) P > 0.05; protrusion (right and left) (P = 0.09) P > 0.05; left side lateral (right side and left side) (P = 0.01) P < 0.05; right lateral (right side and left side) (P = 0.00) P < 0.05. CO and protrusion (right, left) for males and females are not significant. Left lateral and right lateral (right, left) for males and females were significant. The T-scan manages adequate specificity and sensitivity. Hence, these act as a distinctive tool for diagnosis and better unreliable when used intraorally. The T-scan method is definitely a valuable tool for examining and evaluating the occlusal contacts during maximal intercuspation. [ABSTRACT FROM AUTHOR]

Background: According to statistics, the number of rhinoplasty applicants is increasing. Rhinoplasty is performed to improve the nose shape fit into the face. Objective: The main objective of this study was to determine the effect of rhinoplasty on changing body images in rhinoplasty candidates. Methods: The statistical population of the present prospective study, including those referring to the Otorhinolaryngology Clinic of Rafsanjan University of Medical Sciences (Iran) with complaints of dissatisfaction with the appearance of the nose and demand for rhinoplasty, completed Body Image Concern (BIC) Inventory and Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) before and 6 months after surgery at the clinic. Data were analysed using SPSS software version 16 using Mann–Whitney U and Wilcoxon tests at a significance level of 0.05. Results: In total, 95 subjects were examined, of which 85 (89.5%) were women and 57 (60%) were single. There was no difference in the mean scores of BIC and Y-BOCS between women and men as well as between single and married subjects (p < 0.05). The Wilcoxon test results showed that the mean score of post-operative Y-BOCS was significantly increased in the rhinoplasty subjects (p < 0.001). Moreover, the mean score of post-operative BIC was significantly decreased in the rhinoplasty subjects (p < 0.001). Conclusions: The results of this study demonstrated that the rhinoplasty could improve the body image status and increase the obsessive thoughts and actions in an individual. Therefore, psychological primary care for avoiding pointless surgical plan and pre-operative psychological counselling, is suggested to examine the individual's psychological status and to assess the individual's expectations of surgery along with the necessary explanations. [ABSTRACT FROM AUTHOR]

Context: Minimally invasive sphincter preserving procedures like ligation of intersphincteric fistula tract (LIFT) and video-assisted anal fistula treatment (VAAFT) are being increasingly used in the treatment of fistula-in-ano. The addition of adjuncts like fibrin glue has improved the results for VAAFT. Our unit has used platelet-rich fibrin (PRF) as an innovative adjunct for VAAFT. Aims: To compare the effectiveness of two different adjuncts, fibrin glue and autologous PRF, used to fill the treated fistula tracts following VAAFT. Settings and Design: Retrospective observational study on a cohort of patients undergoing VAAFT at a tertiary centre between 2015 and 2020 comparing two adjuncts used with VAAFT procedure. Subjects and Methods: Data of patients who underwent VAAFT for fistula-in-ano were obtained from the hospital database. Group A included patients treated with fibrin as adjunct and PRF as adjunct in Group B. Patients were followed up at 1, 3 and 6 months post-operatively and by a telephonic interview in 2020 to ascertain recent status. All data were entered into an excel sheet. Statistical Analysis Used: Data were analysed using SPSS V20 to test the statistical significance of the difference in the mean healing time between two groups, Mann--Whitney U-test was used and for age, Student's t-test was used. Results: There were 41 patients in Group A and 24 in Group B. There was a significant reduction in recurrence rate in Group B (p = 0.032) and in those patients who had a single internal opening (p = 0.045), single external opening (p = 0.03) and complex tracts (p = 0.033). PRF was cheaper than Fibrin glue. Conclusions: PRF is more effective and economical with lower recurrence rates. [ABSTRACT FROM AUTHOR]

Background: Global health care is moving toward function, quality of life, and occupation. Occupational therapy (OT) has been the only profession using "occupation" as core intervention since inception. With advancements in intervention techniques, occupational therapists (OTs) need to ensure the continued use of "occupation" as core intervention type. Previous surveys were conducted to analyze the use of specific intervention types: occupation-based interventions (OBIs), creative activities, acute-hospital-based rehabilitation, and different interventions used in pediatric OT practice. However, information on OT practices and types of interventions used by Indian OTs versus global OTs is unavailable. Objectives: The objective of this study was to analyze differences, if any, in the OT practices and types of interventions frequently used in daily practice by Indian versus global OTs. Study Design: This was an online, survey-based, cross-sectional study. Methods: The Google Forms questionnaire link was sent to OTs on E-mail with electronic written informed consent from May 2020 to March 2021 using convenient sampling. The questionnaire included participant's demographics, 17 clinical practice areas, and 9 intervention types and factors influencing OT practice. Total 201 (84 Indian OTs and 117 global OTs) fulfilled the selection criteria: OTs with at least bachelor's degree and minimum 3 years of work experience. Results: Indian OT workforce showed significantly more male OTs than global OTs (31 [36.9%] vs. 11 [9.4%]; 95% confidence interval [CI]: [0.0236-0.2964]; P = 0.0001) and OTs with master's degree (56 [66.7%] vs. 41 [35.04%]; 95% CI: [0.1852-0.4480]; P = 0.0001). Global OTs have more OTs with additional qualifications in non-OT fields (58 [49.57%] vs. 27 [32.10%]; 95% CI: [-0.3088--0.0406]; P = 0.013) and more OTDs (13 [11.11%] vs. 1 [1.23%]; 95% CI: [-0.1641--0.0335]; P = 0.006) than Indian OTs. Indian OTs practiced significantly more in the private sector: clinic and hospital (52 [61.90%] vs. 40 [35.80%]; 95% CI: [0.1273-0.3947]; P = 0.0001), whereas global OTs practiced significantly more in the government sector (46 [39.31%] vs. 19 [22.61%]; 95% CI: [-0.2930--0.0410); P = 0.0124). Among the organizational roles, Indian OTs work significantly more as consultants (50 [50.95%] vs. 35 [29.91%]; 95% CI: [0.0751-0.3457]; P = 0.0001) while global OTs work significantly more as managers (36 [30.76%] vs. 12 [14.28%]; 95% CI: [-0.2770--0.0526]; P = 0.0069). Among patient population treated, Indian OTs majorly (54.76%) treat children (up to 15 years) but significantly more in "all age groups" (35 [41.67%] vs. 18 [15.38%]; 95% CI: [0.1388-0.3870]; P = 0.0001) while global OTs treat significantly more adults (21-65 years) (61 [52.13%] vs. 25 [29.76%]; 95% CI: [-0.3569--0.0905]; P = 0.0015) and geriatric (>65 years) (50 [42.73%] vs. 17 [20.23%]; 95% CI: [-0.3492-0.1008]; P = 0.0008). Indian OTs practice significantly more in developmental disability rehabilitation (78 [92.85%] vs. 68 [58.11%]; 95% CI: [0.2424-0.4524]; P = 0.0001), ante- and postnatal women's care (15 [17.85%] vs. 3 [2.56%]; 95% CI: [0.0662-0.2396]; P = 0.00018), and hemophiliac rehabilitation (14 [16.67%] vs. 2 [1.70%]; 95% CI: [0.0666-0.2328]; P = 0.00012) areas of practice than global OTs. Indian OTs practice significantly more in clinic outpatient department (OPD) (62 [73.80%] vs. 55 [47%]; 95% CI: [0.1375-03985]; P = 0.0001), hospital OPD (40 [47.61%] vs. 27 [23.07%]; 95% CI: [0.1141-0.3767]; P = 0.0002), and inpatient (37 [44.04%] vs. 30 [25.64%]; 95% CI: [0.0516-0.3164]; P = 0.0006) while global OTs practice significantly more in natural environment settings (53 [45.29%] vs. 24 [28.57%]; 95% CI: [-0.2994--0.0350]; P = 0.016). Most preferred types of interventions among both groups are relatively the same: client education, counseling, and consultation and interview; therapeutic relationships; and therapeutic use of self. Besides these, Indian OTs prefer performance skills training and adaptive interventions, while global OTs prefer activities as therapeutic media and OBIs over other types. Preventive interventions and advocacy were the least preferred types of intervention among each group. Despite these relative preferences, significant differences were found between groups with regard to number of OTs practicing these 5 types of interventions: client education, counseling, and consultation (46 [54.76%] vs. 47 [40.17%]; 95% CI: [0.0073-0.2845]; P = 0.04]; performance skills training (41 [48.80%] vs. 34 [29.05%]; 95% CI: [0.0626-0.3324]; P = 0.004); preventive intervention and health promotion (29 [34.5%] vs. 24 [20.51%]; 95% CI: [0.0148-0.308]; P = 0.026]; adaptive interventions (39 [46.42%] vs. 23 [19.65%]; 95% CI: [0.1390-0.3964]; P = 0.001]; and preparatory interventions: (35 [41.67%] vs. 28 [23.93%]; 95% CI: [0.0467-0.3081]; P = 0.0075). Conclusion: The study provides the current stand for preferences and practices of therapeutic interventions by OTs in India versus globally, thus aiding in repositioning of OT practice, focusing on core OT domains as well as providing a baseline for monitoring practice trends over time. [ABSTRACT FROM AUTHOR]

Aim of the Study: To evaluate the quality of obturation and postoperative pain in primary molars using Kedo-SG and Kedo-S plus files. Methodology: After access opening and working length determination, root canal shaping is done through Kedo-SG files (Group I) and Kedo-S plus files (Group II). Then, BMP & Obturation will be done; the quality of obturation will be assessed by IOPAR, followed by postendo restoration. The post-operative pain is assessed through Faces Pain Scale after 3 h, 6 h, 12 h, 24 h, and 48 h. Statistical Analysis: To test the statistical significance, Mann-Whitney U test for skewed data will be used. Results: Results yet to be tabulated. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the prevalence of prescribing panoramic radiographs in children less than 6 years of age. Materials and Methods: The retrospective study was conducted in a dental institution in Chennai between December 2019 and January 2021. Details of all the children less than 6 years subjected to panoramic radiographs were collected. The reason for taking panoramic radiographs was also recorded. Chi-square tests were done to statistically analyze the data, and the significance level was set at 0.05. Results: Out of 2,847 children less than 6 years of age visiting the dental institution, 1.08% (31 children) were advised to take an orthopantomagram (OPG) during the study period. Early childhood caries (75% in males and 66.7% in females) was found to be the most common reason for taking panoramic radiographs followed by developmental disturbances (12.5% in males and 13.3% in females). Chi-square test showed statistical significance between males and females (P- value = 0.003 and 0.002) for the reasons for taking panoramic radiographs in children. Conclusion: Usage of radiographic techniques, especially panoramic radiographs should be limited for children under 6 years of age unless absolutely necessary. [ABSTRACT FROM AUTHOR]

Introduction: The aim of ankle fusion is to create a stable and pain-free hind foot. A decrease in bone density secondary to postoperative immobilization is well established. It is commonly accepted that bone density is restored toward normal values when normal weight bearing is permitted. To the current authors' knowledge, this restoration of bone density has not been definitively established via clinical studies. Subjects and Methods: Patients who underwent an isolated ankle fusion between January 1998 and March 2015, to address advanced degenerative or posttraumatic osteoarthrosis or rheumatoid arthritis were included. Clinical and radiological examination, Foot Function Index (FFI), and American Orthopedic Foot and Ankle Society-Score (AOFAS) scoring systems were utilized. Pain intensity was calculated using the Visual analogue scale (VAS). We use semiquantitative ultrasound osteodensitometry to measure bone density. Results: Bone density was determined in 60 patients, at an average follow-up of 9 years following ankle fusion. The mean T-score for bone density of the calcaneus was significantly lower in the treated foot compared to the contralateral side (-1.4 vs. -0.4; P = 0.001). With the numbers available, a reduction in bone density was found without a significant difference in the AOFAS score (P = 0.875), FFI (P = 0.655), VAS (P = 0.804), and body mass index (P = 0.272). Seven (12%) developed a nonunion. Conclusions: These results demonstrate that a reduction in bone density as a consequence of immobilization while bone union was achieved did not completely return to baseline values even at 10 years postoperative. This persistent reduction in bone density does not correlate in a statistically significant way with higher pain scores, inferior AOFAS scores or nonunion rates. Postoperative partial weight bearing should be instigated as soon as possible to minimize bone loss. [ABSTRACT FROM AUTHOR]

PURPOSE: To evaluate choroidal vascularity index (CVI) among normal subjects using image binarization of swept source optical coherence tomography (SS-OCT). MATERIALS AND METHODS: Four hundred and sixty eyes of 230 normal participants were included. Total circumscribed choroidal area, luminal area, stromal area (SA), and CVI were derived from SS-OCT scans using open-source software (ImageJ) with the modified Niblack method. Both CVI and subfoveal choroidal thickness (SFCT) were correlated with age, refractive error, intraocular pressure, and mean ocular perfusion pressure (MOPP) using mixed linear model analysis. Pearson's correlation coefficient was used to determine the relationship between age and each dependent factor. Analyses were performed using the SPSS software version 20.0 (IBM Corp., Armonk USA) and statistical significance was tested at 5%. RESULTS: The mean age was 42.1 (±17.6) years. Mean SFCT was 307 ± 79 μm. Mean CVI was 66.80 (±3.8)%. There was statistically significant positive correlation between CVI and increasing age (r = 0.259, P < 0.0001) and statistically significant negative correlation between SFCT and age (r = −0.361, P < 0.0001). There was positive linear correlation between refractive error and CVI (r = 0.220, P < 0.0001) and negative correlation between SFCT and refractive error. There was no significant effect of MOPP on both CVI (P = 0.07) and SFCT (P = 0.7). CONCLUSION: CVI and SFCT are significantly correlated with age and refractive error in normal Indian eyes. [ABSTRACT FROM AUTHOR]

Context: Tuberculosis (TB) is one of the main causes of death due to infectious diseases worldwide. Multidrug resistance/rifampicin resistance (MDR/RR) TB remains a public health crisis. India has the highest burden of tuberculosis and multidrug resistant TB (MDR TB) in the world. There is wide geographical variation in the epidemic and its trends that can be updated by regular reporting and sound surveillance systems. The current study tries to fill this gap by analyzing the data of TB patients from a Tuberculosis Unit, studying socio-demographic and clinical profile from December 2017 to November 2019 in Nadia district of West Bengal. Aims: The aims of this work were to study socio-demographic and clinical profile of TB patients attending Tuberculosis Unit of West Bengal, and to find out factors associated with drug-resistant TB. Settings and Design: Record-based study from Tuberculosis Unit. Methods: Records of all patients who undergo CBNAAT in TU are stored as monthly unit. We randomly selected 10 months from a period of December 2017 to November 2019 by using lot method. Data of all patients undergoing CBNAAT at Kalyani – Gayeshpur Tuberculosis Unit during randomly selected 10 months were accessed. Statistical Analysis Used: Monthly data was entered in Microsoft Excel and descriptive tests of significance, proportions and Chi-square were applied. Results: There was male preponderance for testing of tuberculosis. Seven percent of the TB suspects were HIV positive. The positivity rate of MTB by CBNAAT was 23%. Four percent of the samples were Rifampicin resistance. Tobacco consumption, contact with TB case and Diabetes were common risk factors of TB. Most of the information was missing in the records. Conclusions: Most of Rifampicin Resistant cases showed very low Ct value in CBNAAT. Previous history of TB treatment and positive HIV status was significantly associated with RR TB. There is a need to capture complete information on the records of presumptive TB cases. [ABSTRACT FROM AUTHOR]

Background: An effective interview can strengthen the clinician-patient relationship and improve treatment outcomes. We aimed to assess the effect of communication skills training using the Calgary-Cambridge model on interviewing skills among midwifery students. Materials and Methods: In this randomized controlled trial, 30 midwifery students of Golestan University of Medical Sciences were selected using the convenience sampling method and randomly assigned through minimization into the intervention (n = 15) and control (n = 15) groups in 2018. The routine interventions were administered for the control group, and four sessions of communication skills training based on the Calgary-Cambridge model was performed in small groups for the intervention group. Evan and colleague's History-taking Rating Scale was used before and four weeks after the intervention. Data were analyzed using paired and independent-sample t and Mann-Whitney U tests at the significance level of less than 0.05. Results: The mean (SD) scores of interviewing skill before and after the intervention was 33.71 (7.34) and 54.50 (8.16), respectively, in the intervention group (t13 = 9.26, p < 0.001) and 33.64 (6.02) and 33.93 (5.39) in the control group, respectively (p = 0.85). The difference between the two groups was significant (t26 = 7.86, p < 0.001). Conclusions: Communication skills training based on the Calgary-Cambridge model can be used as an effective method to improve interviewing skills among midwifery students. [ABSTRACT FROM AUTHOR]

Purpose/Aim: Forward planned intensity-modulated radiotherapy (forward IMRT) with breath-hold (BH) technique is considered optimal by most practitioners for treating left-sided breast cancer. Regional nodal irradiation including axilla and supraclavicular fossa (SCF) increases can increase dose-to-organs at risk (OAR) especially lung. This study was done to assess the potential of inverse planned IMRT (inverse IMRT) to achieve significant reduction in dose to OAR. Materials and Methods: Ten patients with left-sided breast cancer treated with Active Breath Co-ordinator BH technique were included in the study. Forward IMRT plans were generated in both BH and free breathing (FB) scans. Inverse IMRT plans were generated in FB scan using Tomotherapy-Direct and Tomotherapy-Helical techniques. Contouring was done as per the ESTRO consensus contouring guidelines. The dose prescribed was 40 Gy in 15 fractions. Statistical significance was tested using one-way ANOVA for parametric data and Kruskall-Wallis test for nonparametric data. Multiple comparison tests were done by using Bonferroni test. P <0.05 was considered to denote statistical significance. Results: Inverse IMRT plans achieved superior homogeneity index compared to forward IMRT with BH. Tomotherapy-Direct reduced dose to ipsilateral lung, compared to the forward IMRT with BH while achieving similar doses to other OAR. Tomotherapy-Helical plans achieved significantly better conformity index and reduced maximum dose to left anterior descending artery compared to forward IMRT plans, but low dose to other OAR was significantly worse. Conclusion: For left-sided breast, axilla, and SCF radiotherapy, inverse IMRT with Tomotherapy-Direct plan achieved better homogeneity index and reduced dose to ipsilateral lung compared to forward IMRT with BH. [ABSTRACT FROM AUTHOR]

Context: The aim was to identify the current training standard of laparoscopy skills among the urology residents. Aims: This paper presents the residents' subjective perception of their laparoscopy skills and evidence of an objective assessment of their actual skills. Settings and Design: An online survey was mailed, and completed by urology residents in training. The residents' perception of laparoscopy training received, exposure to laparoscopy procedures, and training facilities were queried. The assessment was done on the skill levels of the residents presenting at an annual training program. Subjects and Methods: 103 residents responded to the online survey and 115 residents were assessed at the training program. Statistical Analysis Used: Discrete data were compared using the t-test to test for significance of the means; P < 0.05 was considered significant. Pearson's correlation coefficient was used to obtain the relationship between variables. Results: An overwhelming 91% rated their laparoscopy skill as just "satisfactory" or worse, and 60% did not have any training facilities in their department. 66% continue to be "assistants only" in conventional laparoscopy surgeries. Assessment of basic laparoscopy skills in the dry lab revealed 92% of residents having poor laparoscopy skills; similar to the subjective opinion in the survey. Only 6% (n = 5) of the residents showed a good or better skill score in the dry lab; similar to the survey. Conclusions: Based on the survey, a large number of residents have a poor opinion of their own laparoscopy skills, and the training facilities available to them. The data objectively prove the self-assessment of the residents on their laparoscopy skill level. [ABSTRACT FROM AUTHOR]

Only doing I post hoc i analysis for power on the suggestion of the peer reviewer in such a situation is not advisable; nevertheless, in case the authors do it, the explanation has to be provided as to how, why and for what outcome measures and defined effect sizes the I post hoc i analysis has been done. Often, the investigators do not specify whether the test is paired or unpaired (in such tests as the I t i -test, Wilcoxon's test) and whether it is one or two-tailed. The application of well-known tests like the Shapiro-Wilk test and Kolmogorov-Smirnov test at this juncture can help to reduce these errors. Indian J Anaesth 2021;65:600-5. 32 Gupta P, Chaudhari SH, Nagar V, Jain D, Bansal A, Dutt A. Prospective analysis of goal-directed fluid therapy vs conventional fluid therapy in perioperative outcome of composite resections of head and neck malignancy with free tissue transfer. [Extracted from the article]

Introduction: Impression making is an integral part of prosthetic dentistry. Development of material science has allowed integrating qualities of hydrophilic polyether and hydrophobic polyvinyl siloxane into a newer hybrid material, vinyl polysiloxane (VPS) ether. This study was aimed to compare the VPS ether with the polyether and polyvinyl siloxane in terms of accuracy and dimensional stability. Materials and Methods: Stainless steel dies with the American Dental Association specification 19 were made. Die has three horizontal and two vertical lines which are used for taking the impression. Two cross-points at the junction of the vertical lines with line 2 were marked as x and x' and served as beginning and end points of measurements for dimensional accuracy. Accuracy was evaluated 30 min after making each impression. If at least two of the three horizontal lines were reproduced continuously between cross-points, this impression was considered satisfactory. The specimens are poured with Type IV gypsum product and allowed to set completely for 24 h. Then, dimensional stability was measured in the model by measuring the distance between the two lines and comparing the distance with the measurement of line on metal die, which was used to make the impression. Results: The mean value obtained for light- and medium-bodied VPS ether was 0.05370 and 0.05330 and for light and medium-bodied polyvinyl siloxane was 0.06370 and 0.07150, respectively. The mean value for polyether monophase was 0.06430. Two-way ANOVA and post hoc test showed statistical significance. Conclusion: The newer VPS ether material showed good surface detail reproduction and dimensional stability when compared with polyvinyl siloxane and polyether. [ABSTRACT FROM AUTHOR]

Aim: This ex vivo study was designed to evaluate and compare different endodontic irrigation and activation systems, the self-adjusting file (SAF) instrumentation/irrigation system, and XP-endo finisher for removal of intracanal smear layer. Materials and Methods: Fifty recently extracted, noncarious human intact single-rooted premolars were selected and divided into five groups (n = 10) according to the root canal irrigation systems; syringe and needle irrigation, passive ultrasonic irrigation (PUI), EndoVac irrigation system, SAF system, and XP-endo finisher. All groups were prepared to apical size F4 file except for the SAF group which was prepared to apical size 20 K-file and then instrumented with the SAF file. Each sample was subjected to final irrigation using different irrigation/activation systems. After splitting the samples, one half of each root was selected for examination under scanning electron microscope. The irrigation systems were compared using the Fisher's exact test with significance set at P < 0.05. Results: In the coronal part, there was no difference among the groups. In the mid-root section, the results of the PUI, EndoVac, SAF, and XP-endo finisher groups tended to be better than syringe and needle irrigation, but the difference was not significant. The apical part of the canal, the SAF system, and XP-endo finisher group seemed to be cleaner than those of the EndoVac group, but this difference was not significant. Conclusions: Within the limitations of the present study, SAF system and XP-endo finisher group cleaned the apical part of the canal more efficiently than EndoVac, PUI, and syringe and needle irrigation. [ABSTRACT FROM AUTHOR]

BACKGROUND: The effect of cyberbullying varies from the small levels of discomfort to serious psychological and social issues. Studies on parents' perception of cyberbullying in Saudi Arabia are scarce. The aim of this study was to determine parents' awareness and perception of cyberbullying of their children in Saudi Arabia. MATERIALS AND METHODS: A cross-sectional study was done on 1249 parents in Saudi Arabia using a standardized validated questionnaire. The questions were on cyberbullying and its association with the school, the difference between cyberbullying and traditional bullying, the importance of parents' attention and their knowledge of cyberbullying, and the platform on which they think cyberbullying occurs. Data were analyzed using SPSS version 24. Qualitative data were presented as frequencies and percentages while mean and standard deviation were computed for quantitative data. Student's t-test or Mann–Whitney and Kruskal–Wallis tests, as appropriate, were applied to test for statistical significance. RESULTS: About 43% parents strongly agreed that cyberbullying was more harmful than bullying in the schoolyard. Parents reported that video games were the most common social platform for cyberbullying. About 64% parents strongly believed that cyberbullying caused psychological harm, and 78% parents responded that it was important to monitor the child's use of the Internet. Seventy-eight percent of parents strongly believed that schools should be proactive in addressing cyberbullying. As for the parents' role, 72.8% strongly believed that parents should be more proactive in addressing cyberbullying, whereas 27.9% thought that parents' involvement would reduce it. Most participants (75.1%) said that more laws should be passed to prevent or punish cyberbullying. CONCLUSION: There is a need to raise the awareness of the Saudi community about the effects and consequences of cyberbullying. [ABSTRACT FROM AUTHOR]

Aims: To study the impact of vestibular suppressant drugs (VSD) on provocative positional tests (PPT) in patients with benign paroxysmal positional vertigo (BPPV). Settings and Design: A prospective case-control observational study. Materials and Methods: Patients with a history suggestive of BPPV were tested for PPT. Patients with vertiginous symptoms and with nystagmus on PPT were classified as objective BPPV (O-BPPV, control group), while those without nystagmus with no alternate diagnosis were classified as subjective BPPV (S-BPPV, case group). Details of VSD treatment were noted in all the patients. In both groups, patients were instructed to discontinue VSD and were further assigned as the VSD and non-VSD subgroups. Patients were followed for 2 months with PPT every week. PPT positive patients were treated by vestibular rehabilitation maneuvers. Statistics: Student t-test with two-tailed, unpaired, was used for continuous scale and Chi-square test for categorical differences between the two groups. Results: 295 consecutive BPPV patients were enrolled in the study, 55 in the S-BPPV group and 240 in the O-BPPV group. Significantly higher proportion of patients in the S-BPPV group were on VSD at presentation, 80.00% vs. 53.75% (OR 2.52; 95% CI: 1.30-4.86), P = 0.006. In an unadjusted analysis of the S-BPPV group following discontinuation of VSD, PPT became positive in 79.54% of patients as compared to 18.19% in the non-VSD group (OR 35.0; 95% CI: 6.2-197.3), P < 0.001. Conclusion: A higher proportion of S-BPPV patients were receiving VSD in comparison to O-BPPV at the initial visit. The PPT converted positive four times higher after ceasing the VSD in S-BPPV patients. Study Design: Prospective case-control observational study. [ABSTRACT FROM AUTHOR]

Context: Preventive orthodontic treatments are performed in the primary or mixed dentition period and provide a proper development of occlusion to avoid dentofacial anomalies.Aims: This study aims to evaluate the Baby-Risk of Malocclusion Assessment Index (ROMA) index regarding ease of use, reproducibility, and the epidemiological assessment of major orthodontic problems in children aged 4-6-year-old in Kerman (Iran) kindergartens.Setting and Design: This cross-sectional study was conducted on 1000 children aged 4-6 in Kerman (Iran) kindergartens, selected by cluster sampling, and data were collected using the Baby-ROMA index.Methods: After recording a demographic data collection form, the clinical examination of the teeth was carried out by a dental student. The data were analyzed with SPSS 18 using t-test, analysis of variance, Chi-squared test, and Mann-Whitney test at a significance level of P < 0.05.Results: In this study, the most common cause of malocclusion was dental caries (7.5%), followed by crossbite (6.1%). Furthermore, 31.6% of the subjects had one type of malocclusion, and 20.5% needed monitoring the occlusion before the growth spurt, while 11.1% needed immediate orthodontic treatment (mostly 6-year-old children). Moreover, 15.3% of the subjects had systemic problems; 3.4% had craniofacial, 22% had dental, and 2% had functional problems. The prevalence of class I canine relationship in the right canines was 82.32%, with 82.5% on the left side. The prevalence of open bite was higher in females with thumb-sucking habit.Conclusion: The Baby-ROMA index presented good reliability and ease of use for evaluating early orthodontic treatment needs in primary and mixed dentition periods. [ABSTRACT FROM AUTHOR]

Background: The primary care has an important role to prevent fractures and make sure of complete healing without any complications like a Malunion which arises when a fracture has healed in a non-anatomical position, and a delayed union which defined as a healing time of more than 12 weeks and a non-union which occurs when absence of fracture healing progression on series of radiographs or with no evidence of healing over 10 weeks. Objectives: To identify the proportion of fracture healing failure types and identify Patient-dependent Factors. Methodology: cross sectional study consecutive sampling till completing sample size (90) patients. Data collection tool was Pretested Pre-Coded self-administered questionnaire it was subjected to a probe to test for validity and reliability. Data analyzed Using SPSS P value of less than 0.05 considered as significant results. Chi-square test was the test of significance. Results: From 90 adult male participants, 71% were 35 years of age and above and below 55 years. Our result indicated that the commonest risk factor was smoking in 62.2% of respondents, and 27.8% have Diabetes mellitus. 50% of fractures failure was diagnosed as delayed union while non-union accounts for 40% and malunion for 10%. We've noticed that smokers mostly had delayed union, while diabetic patients had mostly non-union. Conclusion: the study found that the most associating Patient-dependent Factors were cigarettes smoking and Diabetes mellitus, also most fractures failure were diagnosed as delayed union, non-union, and malunion respectively and we can help prevent these complications by controlling DM and stop cigarettes smoking. [ABSTRACT FROM AUTHOR]

Context: Obtaining intravenous (IV) access is one of the very frequent invasive procedures performed in hospital care settings. This has several complications some of which are serious in nature. However, the incidence and seriousness of these complications as well as the burden of this complication on patient management are often underestimated. Identification of susceptible patients and the risk factors are important to ensure better outcomes. Aims: The aim of this study was to document the various local complications of intravenous access and to identify the risk factors associated with it. Settings and Design: Prospective observational study with three hundred and one surgical patients. Study duration of 1 year. Methods and Material: Indication of IV access, site, size of IV cannula used, category of personnel involved as well as local complications at access site were documented. Dressing at cannula site were changed every 72 h or earlier. Cannula and site of access were changed in case of any complication. Statistical Analysis Used: Results analysed using SPSS software (IBM Inc). Frequency calculated as average and percentage. Chi-square test used for statistical significance. Relative risk calculated. Results: Females, overweight, diabetics and smokers were found at more risk. Requirement of major surgery, IV access by paramedical personnel, IV access over joints and when kept beyond 3 days were found to have more complications. 5.7% of patients had serious complications requiring surgical intervention. Conclusions: Our study shows that local complications at IV access site are very common with occurrence in more than fifty percent patients. Several risk factors are identified. Not all demographic and clinical risk factors are readily modifiable. However many of the complications can easily be minimized by following basic precautions. [ABSTRACT FROM AUTHOR]

Context: Anemia is a serious public health concern especially in women of reproductive age (WRA) as it causes a high burden of morbidity and mortality and persists through intergenerational cycle. As most of the risk factors are preventable, a thorough understanding of its risk factors is necessary to design better interventions. Aims: Current study aimed to estimate the burden of anemia as well as explore determinants of various grades of anemia among WRA in a rural area. Settings and Design: A community-based cross-sectional study was conducted among non-pregnant, non-lactating women of reproductive age in rural field practice area of All India Institute of Hygiene and Public Health. Methods and Materials: House to house visit was conducted for interviewing with pre-designed pre-tested questionnaire along with blood hemoglobin and anthropometric measurement. Statistical Analysis Used: Descriptive statistics and test of significance like multinomial logistic regression and Kruskal-Wallis test (with post-hoc) were used. Results: Majority (70.8%) of participants were anemic. Proportion of mild, moderate, and severe anemia were 24.16%, 37.5%, and 9.16%, respectively. Different levels of anemia were significantly associated with higher age, lower education, poor iron-rich food intake, lack of dietary diversity, and adiposity. Significantly low hemoglobin level in both underweight and obesity was noticed suggesting U shaped relationship between BMI and anemia. Conclusion: Periodic screening for anemia among WRA especially in both extremes of malnutrition, i.e., undernutrition and obesity should be considered at the policy level. Year-round behaviour change communication campaigns must be carried out for the promotion of necessary food groups in diet. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim of this study was to assess the mean overjet in school-going Libyan children and to examine the relationship between increased overjet and permanent incisor's trauma.Materials and Methods: This study is a part of a cross-sectional investigation of aspects of dental health of 2015 school going Libyan children aged between 6 and 16 years old of both genders from both rural and urban areas. Overjet was measured as the horizontal distance in millimetres between the upper and lower incisors. Trauma to permanent incisors was assessed according to Elli's Classification.Results: SPSS version 20.0 for percentages was used for statistical analysis. The relationship between increased overjet and incisor trauma was tested using the Chi-square test at 0.05 significance level. The overjet measurement ranged from -2 mm to 8 mm with the mean overjet of 3.062 (1.23, SD). The prevalence of incisor trauma was statistically significantly higher in children with increased overjet (P < 0.0001).Conclusion: The average mean overjet value in Libyan children is between 2 mm and 3 mm and below or above these values, considered decreased or increased, respectively. Traumatic injuries to permanent incisors significantly increased with increased overjet. [ABSTRACT FROM AUTHOR]

Context: World'spopulation is ageing and increase in geriatric population demands improved oral health care. Previous epidemiologic studies in general population of India and particularly in Kerala (state with maximum proportion of elderly) provided very little information about oral mucosal lesions in elderly. Aims: To find out the prevalence, pattern and distribution of oral mucosal lesions in geriatric patients and to explore their association with different study variables. Settings and Design: A descriptive, hospital-based, cross sectional study was conducted for a period of 9 months in the out-patient clinic, Department of Oral Medicine and Radiology, Government Dental College, Kozhikode (tertiary healthcare centre in Kerala, India). Methods and Materials: Participants aged 60 and above were selected by consecutive sampling. Data were collected through clinical examination and by using a structured proforma.Statistical Analysis Used: Descriptive statistics with tests of significance of associations were done. Results: The geriatric population (N=750, 66.89 ± 6.07, M: F=1.4:1), was recruited by screening 43,180, and 447 (67.29 ± 6.15, M: F=2:1) were identified having oral mucosal lesions withprevalence of 59.6% (95% CI=56.05–63.05). Most common lesion group was red and white (73.2%), followed by pigmented (15.5%). Oral mucosal lesions were significantly associated with age over 65, male gender, presence of habit and denture usage (P < 0.05). Conclusions: The prevalence of oral mucosal lesions in geriatric people is high. Hence setting up of geriatric dental clinics, with appropriate preventive and palliative intervention strategies is mandatory. [ABSTRACT FROM AUTHOR]

Introduction: Open reduction and internal fixation (ORIF) can be complicated by miniplate exposure, loosening, or infection. Infected miniplates lead to exposure, extrusion, fistula formation, bony nonunion, and osteomyelitis. Whenever any posttreated cases of ORIF become infected, it is treated blindly with a high dose of antibiotics and surgical removal of infected miniplates or screws. The aim and objectives of the study were to identify the frequency and site of infection in craniomaxillofacial implants and significance of microbes isolated from the infected region. Materials and Methods: Removal of miniplates was being performed on 19 patients. Among them, 14 had infection or sinus opening, 3 had plate exposure, and 2 were removed asymptomatically according to patient willingness. Aspirated fluid/pus was collected and sent for microbial culture and sensitivity test. Test of significance of individual microbes was done using Z-test and the value of P was calculated. Results: Among 14 patients associated with miniplate infection, 11 (78%) had infection in the mandible and 3 at zygoma. The bacteria isolated were mainly Staphylococcus aureus (7) along with coagulase-negative Staphylococcus (2), Pseudomonas aeruginosa (3), Escherichia coli (2), Streptococcus salivarius (2), and Acinetobacter genre (1). S. aureus was predominantly present in majority of the samples and statistically significant at P = 0.023. Discussion: The present study observed that in contrast to other sites in the body, there is versatility in microbial flora in the craniomaxillofacial region. It is essential for routine microbial analysis of samples and antibiotic susceptibility test for proper treatment of such cases. [ABSTRACT FROM AUTHOR]

Context: Parkinson's disease (PD) is a neurodegenerative disease characterized by traditional motor features. Non-motor symptoms (NMS) are also seen in PD, which inevitably emerge through the disease progression and are often under-recognized and untargeted. Aims: We studied the prevalence of NMS in PD and their impact on health-related quality of life (HRQoL). Materials and Methods: A cross-sectional observational study from January 2017 to July 2017 of PD patients (n = 100) was done. NMS and HRQoL are measured using NMS scoring scale; PD questionnaire-39 and Hoehn and Yahr scale, respectively. Motor symptoms were assessed using scales for outcome in Parkinson's disease (SCoPA) - motor scoring scale. Statistical Analysis: Descriptive statistics calculated for NMS' prevalence. Continuous variables were assessed by two-tailed t-test and discrete and categorical variables by chi-square test. Multiple linear regression analysis was done among scoring scales to identify the influence on 39-item Parkinson's disease questionnaire (PDQ-39) scoring scale. All statistical data collected are analyzed with SSPS software version- 20 for windows. Results: In 100 study population, 66 were males and 34 females. The mean age was 68.35 years and median onset of duration of PD was 3.49 with 64.6% on treatment. Fatigue, pain, and lightheadedness were more prevalent NMS with 78%, 75%, and 69%, respectively. With regression analysis, strongest predictor was NMSS score (P = 0.000), with each unit increase, it is associated with nearly 0.65 increase in PDQ-39 score. Conclusion: Though motor symptoms define the disease, NMS have a larger impact on HRQoL in PD and on caregiver's life. Understanding the pattern and effect of NMS is needed for targeted treatment strategies. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to evaluate and compare the accuracy of master casts obtained by different splinting techniques for implant level impressions in All-on-Four implant treatment protocol using a coordinate measuring machine. Settings and Design: The study design involves an in vitro study. Materials and Methods: In this in vitro study, a reference clear acrylic resin (AR) model comprising four regular platform implant 3.6 mm x 10.0 mm (Dentium Implant India Pvt. Ltd, Bengaluru, India) which was placed following the All-on-Four implant protocol is prepared. Impressions were categorized into three different groups: Group 1 - impression copings were nonsplinted; Group 2 - impression copings were splinted using AR sectioned 17 min after setting and rewelded with the same resin; and Group 3 - impression copings were splinted by titanium bar using an intraoral welder. A total of 33 (n = 11 in each group) impressions were made to evaluate three different splinting techniques. Impressions were poured with Type 4 dental stone. A coordinate measuring machine was used to record the x, y, and z co-ordinates and angular displacement. The measurements were compared with those obtained from the reference model. Statistical Analysis Used: One-way ANOVA test was used as a test of significance. Results: There was less linear and rotational displacement for the metal-splinted group (P < 0.001) In the x-axis, nonsplinted group showed a statistically significant difference in straight implants (2 and 3 implants) (P = 0.001) of All-on-Four treatment protocol. Conclusion: The splinting methods have a direct effect on the accuracy of definitive casts. The metal-splinted direct technique produced the most accurate casts followed by AR-splinted direct technique and nonsplinted direct technique. [ABSTRACT FROM AUTHOR]

Background: Old age is often associated with functional decline and physical dependence, thus compromising the ability to carry out basic tasks required for daily living. There are very few community‑based studies on functional disability among elderly, especially in India. This study was done to find out the prevalence of functional disability and associated risk factors among the elderly in urbanized villages of Delhi. Methods: A cross‑sectional study was conducted in two urbanized villages of East Delhi. A semi‑structured interview schedule was used to record the socio‑demographic and relevant personal details of the elderly (>60 years). Functional disability was defined as a disability in activities of daily living (ADL) or blindness or bilateral hearing impairment or a combination of these. Statistical analysis included simple descriptive analysis and tests of significance like Chi‑square test. The multiple logistic regression was used to identify predictors of functional disability. Results: Data were collected from 360 study participants. Around one‑fourth (25.6%) of the study participants were having a functional disability. Older age, presence of chronic disease, and having possible malnutrition were found to be significant predictors of functional disability among the elderly by applying the multiple logistic regression. Conclusions: Functional disability needs to be identified at an early stage using appropriate tools so that proper interventions can be directed to those who need it to ensure healthy aging. [ABSTRACT FROM AUTHOR]

Biomedical research relies on proving (or disproving) a research hypothesis, and P value becomes a cornerstone of "null hypothesis significance testing." P value is the maximum probability of getting the observed outcome by chance. For a statistical test to achieve significance, the error by chance must be less than 5%. The pros are the P value that gives the strength of evidence against the null hypothesis. We can reject a null hypothesis depending on a small P value. However, the value of P is a function of sample size. When the sample size is large, the P value is destined to be small or "significant." P value is condemned by one school of thought who claims that focusing more on P value undermines the generalizability and reproducibility of research. For such a situation, presently, the scientific world is inclined in knowing the effect size, confidence interval, and the descriptive statistics; thus, researchers need to highlight them along with the P value. In spite of all the criticism, it needs to be understood that P value carries paramount importance in "precise" understanding of the estimation of the difference calculated by "null hypothesis significance testing." Choosing the correct test for assessing the significance of the difference is profoundly important. The choice can be arrived by asking oneself three questions, namely, the type of data, whether the data is paired or not, and on the number of study groups (two or more). It is worth mentioning that association between variables, agreement between assessments, time-trend cannot be arrived by calculating the P value alone but needs to highlight the correlation and regression coefficients, odds ratio, relative risk, etc. [ABSTRACT FROM AUTHOR]

Background: Adequate removal of previous root filling materials is an important objective during endodontic retreatment. Aim: This study was aimed to evaluate the influence of obturation quality and sealer type on the removal of root filling materials during endodontic retreatment using micro-computed tomography (μ-CT). Materials and Methods: Ninety extracted mandibular premolars were randomly assigned to two groups (n = 45) based on the type of sealer (AH Plus and BioRoot RCS) and three sub-groups based on the obturating technique used, i.e., cold lateral condensation, warm vertical compaction, and thermoplasticized injectable techniques. Specimens were scanned using μ-CT before and after retreatment to assess the amount of filling material, and time taken for removal was recorded. Statistical Analysis: Data were analyzed using two-way analysis of variance and Tukey's multiple post hoc test at 5% significance level. Results: Filling debris percentage and retreatment time were not significantly affected by the type of sealer (P ≥ 0.05). The percentage of remaining filling material was higher in teeth obturated with thermoplasticized technique (P < 0.05). Significantly more filling material debris was observed in apical third (P < 0.05). Conclusions: The type of obturating technique used for initial root canal treatment has influenced the amount of remaining filling material and retreatment time. Retreatability of the BioRoot RCS sealer was similar to the AH Plus sealer. [ABSTRACT FROM AUTHOR]

Proper use and interpretation of confidence intervals are more important than just the P values which can be dispensed with if the confidence intervals are stated. As is true for other clinicians, research skills for anaesthesiologists are important not only for individual progress, but also for advances in this fast-evolving discipline. Statistical significance versus clinical importance of observed effect sizes: What do P values and confidence intervals really represent? Too wide confidence intervals indicate lack of precision of the estimates as a consequence of small sample size. [Extracted from the article]

Aims and Objectives: To evaluate the styloid process (SP) and its anatomical variations on digital panoramic radiographs from the database and also to synthesize the current evidence of literature on SP and anatomical variations along with the systematic review of the relevant studies after making the necessary exclusions. Materials and Methods: A total of 500 panoramic radiographs from the database were examined and evaluated for the length of SP using OmniVue software and for the calcification patterns which were categorized into three types as described by Langlais. The obtained values were analyzed using t-test and Chi-square tests with a significance level of 0.005 and SPSS version 20.0 software. Results and Conclusion: The mean length of the SP in females was found to be 3.7 cm on the right side and 3.8 cm on the left side. The mean length of the SP in males was found to be 3.4 cm on the right side and 3.3 cm on the left side with significant difference between the genders with the P values of 0.0002 and 0.0001, respectively. The length of the SP was significantly longer in females than in males. Type I was the most common SP and was more prevalent in females. The results of the present study along with the wide range of reported incidence of anatomical variations in the form of elongation from the literature extracted through the systematic review suggests the need to reevaluate the range of the normal length of the SP. [ABSTRACT FROM AUTHOR]

Background: Pipelle biopsy is ideal for obtaining endometrial sample in outpatient department. It samples only 4% of the endometrial surface and has sensitivity up to 97%. A positive biopsy can avoid inconvenience to a patient, but a nonspecific finding should be interpreted with caution. Thus, the objectives of this study were to analyze the efficacy of pipelle biopsy by adequacy of the sample obtained and also to establish the reliability by comparing the histopathology report obtained by pipelle biopsy with that of the hysterectomy specimen. Materials and Methods: A prospective study conducted at a tertiary care hospital on 104 women with abnormal uterine bleeding (AUB). They were scheduled for pipelle endometrial sampling before hysterectomy. The sensitivity, specificity, negative and positive predictive values, and accuracy of pipelle biopsy in diagnosing various endometrial pathologies were analyzed. The validity of pipelle biopsy was studied for endometrial hyperplasia and carcinoma and their statistical significance was tested. Results: The overall concordance rate was 63.8%. The sensitivity, specificity, positive and negative predictive values, and accuracy of pipelle biopsy for endometrial hyperplasia was 64.2%, 88.8%, 94.1%, 85.5%, and 47.3% and for endometrial carcinoma was 75%, 100%, 100%, 97.9%, and 98%, respectively. The P value for endometrial hyperplasia and carcinoma was 0.001 (statistically significant). Conclusion: Pipelle biopsy is valuable in diagnosing endometrial pathology of AUB cases. It has very high sensitivity and specificity for endometrial malignancies. A hysteroscopic dilatation and curettage is required for definitive diagnosis in cases of polyps and focal endometrial lesions. [ABSTRACT FROM AUTHOR]

Background: Iron supplementation during pregnancy in programmatic settings has failed to produce desired results. Formulation of iron supplementation may have a role in compliance and hematological parameters. Objective: We did this study to compare the compliance to iron supplementation, change in mean hemoglobin and serum ferritin level after iron supplementation in capsule form and tablet form during pregnancy. Materials and Methods: In this single-blinded (investigator blinded), active comparator, randomized controlled trial we enrolled pregnant women (aged ≥18 years) from May to November 2014 during second trimester to receive iron supplementation either as capsule (ferrous fumarate) or tablet (ferrous sulphate) during entire pregnancy. The outcome was compliance (good compliance ≥ 90%) to iron supplementation assessed by pill count and change in mean hemoglobin and serum ferritin. Statistical significance was tested using Chi-square test and Student's t test. Results: We enrolled and randomized 204 pregnant women for iron supplementation; capsule form (n = 100) and tablet form (n = 104). Out of which 52 (25.5%) women (23 in capsule arm and 29 in tablet arm) were lost to follow up. As compared to tablet arm, the capsule arm had higher good compliance (22% vs 16.8%), increase in mean hemoglobin (0.79 vs 0.44 gm/dL) and increase in mean serum ferritin (2.50 vs -2.14 ng/mL), but the difference was not statistically significant. Conclusion: Pregnant women who received either of the formulation reported a low compliance. Iron supplementation in capsule formulation resulted in more increase in blood hemoglobin level, though clinically insignificant. [ABSTRACT FROM AUTHOR]

Background: Androgenetic alopecia (AGA) has a significant psychosocial impact on the patient, especially early-onset AGA patients. The severity and prevalence increase with age in all races worldwide. "Metabolic syndrome" (MetS) is a combination of risk factors of cardiovascular and diabetes-related parameters. Aim of the Study: The aim of the study is to study the association of early-onset AGA with MetS. Materials and Methods: A case–control study was done in a tertiary care hospital, Bengaluru, from December 2015 to November 2016 with 46 cases and controls in the age group of 20–30 years. The Norwood–Hamilton classification was used to grade the AGA patients. Diagnosis of MetS was done based on the national cholesterol education program adult treatment Panel III. Independent t-test will be used as a test of significance. Categorical data were assessed using Chi-square test of significance. Value of P < 0.05 was considered to be statistically significant. Results: MetS was seen in 39.13% of cases and 4.35% of controls (P < 0.001) which was statistically significant. The mean systolic blood pressure (P = 0.017 and P < 0.05) was statistically significant when compared to healthy controls. However, no statistically significant values were seen in the mean values of other parameters. Conclusion: A higher prevalence of MetS was seen in early-onset AGA. Early screening for MetS is important in patients with early-onset AGA to minimize the complications in the future. [ABSTRACT FROM AUTHOR]

Purpose: The recurrence of a lumbar disc herniation (LDH) is a common cause of poor outcome following lumbar discectomy. The aim of this study was to assess a potential relationship between the incidence of recurrent LDH and the surgical technique used. Furthermore, we tried to define the best surgical technique for the treatment of recurrent LDH to limit subsequent recurrences. Materials and Methods: A retrospective study was conducted on 979 consecutive patients treated for LDH. A multivariate analysis tried to identify a possible correlation between (1) the surgical technique used to treat the primary LDH and its recurrence; (2) technique used to treat the recurrence of LDH and the second recurrence; and (3) incidence of recurrence and clinical outcome. Data were analyzed with the Pearson's Chi-square test for its significance. Results: In 582 cases (59.4%), a discectomy was performed, while in 381 (40.6%), a herniectomy was undertaken. In 16 cases, a procedure marked as "other" was performed. Among all patients, 110 (11.2%) had a recurrence. Recurrent LDH was observed in 55 patients following discectomy (9.45%), in 45 following herniectomy (11.8%), and in 10 (62.5%) following other surgery. Our data showed that 90.5% of discectomies and 88.2% of the herniectomies had a good clinical outcome, whereas other surgeries presented a recurrence rate of 62.5% (Pearson's χ2 < 0.001). No statistical differences were observed between discectomy or herniectomy, for the treatment of the recurrence, and the incidence for the second recurrences (P > 0.05). A significant statistical correlation emerged between the use of other techniques and the incidence for the second recurrences (P < 0.05). Conclusions: The recurrence of an LDH is one of the most feared complications following surgery. Although the standard discectomy has been considered more protective toward the recurrence compared to herniectomy, our data suggest that there is no significant correlation between the surgical technique and the risk of LDH recurrence. [ABSTRACT FROM AUTHOR]