Search

ObjectivesTo present a case of foreign body granuloma (FBG) development after injection of calcium hydroxylapatite as a urethral bulking agent and to review all documented cases of this phenomenon in the literature.MethodsWe analyzed a new case of calcium hydroxylapatite-induced FBG. We also conducted a literature review of the PubMed, Embase, CINAHL, and Web of Science databases through March 2022. Reports were included if they contained stress urinary incontinence patients that developed an FBG after calcium hydroxylapatite injection. The cases were reviewed for presenting symptoms, patient demographics, granuloma details, and surgical treatment.ResultsWe screened 250 articles and included six articles between 2006 and 2015 in addition to the present case. The median age of the patients was 65.5 years (range 45-93), and all patients were female. The most common presenting symptoms and the proportion of patients affected were difficulty voiding (4/8), recurrent urinary incontinence (3/8), and dyspareunia (2/8). The median time between the first CaHA injection and discovery of the FBG was 5 months (range 1-50). The median longest dimension of the FBGs was 1.85 cm (range 1.0-3.0). The 8 masses observed were evenly distributed throughout the urethra, with 3 in the bladder neck, 2 in the midurethra, and 3 in the distal urethra. Surgical excision was the predominant management choice, with some variation in technique.ConclusionsSevere, persistent lower urinary tract symptoms after calcium hydroxylapatite injection may indicate an FBG, which has been successfully managed with surgical excision.

Background: Blue light imaging (BLI) has been shown to improve the characterization of colorectal polyps among the endoscopy experts. We aimed to determine if this technology could be taught to endoscopy trainees while maintaining high accuracy and interobserver agreement. Methods: Twenty‐one gastroenterology trainees (fellows) from two academic institutions participated in this prospective study. Each trainee completed a web‐based learning comprising four modules: pre‐test, didactic videos explaining the BLI Adenoma Serrated International Classification (BASIC), interactive examples, and post‐test assessment. The pre‐ and post‐test modules consisted of reviewing video images of colon polyps in high definition white light imaging and BLI and then applying the BASIC classification to determine if the polyps were likely to be adenomatous. Confidence in adenoma identification (rated '1' to '5'), accuracy in polyp (adenoma vs. non‐adenoma) identification, and agreement in characterization per BASIC criteria were derived. Results: Trainee accuracy in the adenoma diagnosis improved from 74.7% (pre‐test) to 85.4% (post‐test) (P < 0.01). There was a trend towards higher accuracy in polyp characterization with subsequent years of training (1st year fellows 77.4%, 2nd year 88.5%, and final year 94.0%) with consistent improvements after the e‐learning across years of trainees. Overall, trainees were able to identify adenoma with a high sensitivity of 86.9%, specificity 83.9%, positive predictive value of 84.4%, and negative predictive value of 86.5%. However, their interobserver agreement in adenoma diagnosis was moderate (k = 0.52). Conclusion: The novel BLI classification can be easily taught to gastroenterology trainees using an online module and accuracy improves with years of training reaching >90% for colorectal polyp characterization. [ABSTRACT FROM AUTHOR]

Pain in the orofacial region or within the tooth is one of the most common complaints patients report to a dental office. An efficient practitioner must have adequate knowledge and tools to address and remedy the problem. Pain control in dentistry has a rich history and learning about it gives an insight into how the current modalities being used came into existence. As dentistry keeps evolving, newer and more efficient modalities have been developed for pain control. Dental pain is primarily remedied by dental practitioners and clinicians involved in emergency medicine; it may result due to various causes, mainly insulting the tooth or complications involved in and after oral surgery. Several modalities have been developed to reduce and eliminate this, including pharmacological and non-pharmacological treatment modalities. Pharmacological modalities include using drugs. Many medications are used for pain management, such as non-steroidal anti-inflammatory drugs, corticosteroids, and muscle relaxants. Non-pharmacological modalities include behavior control methods based on several theories of pain. These modalities are used mainly for children, but some can also be used for adult patients. Several advances in delivery systems for local anesthesia involve using newer technologies to deliver a sustained dose of anesthetic agent. This review aims to enlist both modalities of pain control management in dental practices along with the newer advancements in this field., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Pahade et al.)

The aim of this literature review was to compile and present information on the use of mobile dental vans (MDVs) in India and to figure out if the use of these vans can be used to eliminate the barriers that prevent Indian people from getting access to quality and affordable dental care. Since the working of an MDV is quite complex, this article also serves to summarize the information available in the existing literature in a much simpler yet elaborate manner. An electronic database search was done using relevant keywords such as MDVs, mobile health units, dental vans, mobile dentistry, and portable dentistry on search engines PubMed, Scopus, and Medline. After removing the irrelevant and duplicate articles, 30 were shortlisted and reviewed. It is a difficult task to provide access to affordable dental care to every person in a country like India, which has such a large population and a large number of people living in rural areas. People who live in rural areas and/or belong to a lower socioeconomic class are more susceptible to oral diseases. Lower economic status, geographical location, motivational barriers, lack of public transportation, etc., deter people from receiving adequate dental care. MDVs are vehicles that can work as independent, efficient operatories to provide dental care and act as an adjunct as well as an alternative to conventional methods of improving the oral health of the community. The global impact of MDVs, coupled with efficient and organized implementation, can make them an instrumental tool for the good. The various barriers to providing dental care to the underserved groups of the population can be easily overcome through this powerful tool., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, John et al.)

This article reviews and critically analyzes the literature on mini-implants (temporary anchorage devices) for anterior en masse retraction in orthodontics. The search methods used were an E-database search, a secondary computerized search of orthodontics journals, and a reference list of selected studies. Eligibility criteria included individuals who underwent orthodontic treatment for correction of malocclusion with premolar extraction. Data were taken from PubMed and Scopus as well as the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews. Keywords used for searching the article were temporary anchorage devices, premolar extraction, orthodontics, and anterior en masse retraction, Anterior en masse retraction with sliding mechanics in pre-adjusted edgewise appliances was considered for the study. Data collection and analysis involved three different researchers performing three steps of selection. All titles were initially filtered for irrelevant review articles. In the first step, all summaries from the selected studies were reviewed, and in the second, the entire content of the papers was read. The study was then discarded based on qualifying standards. A chart was created using the data from the final chosen research as well as the findings. The following information was evaluated for the final table: author, publication year, research structure, study group, sample size, methods/measures, study findings, and conclusion about frictionless mechanics. Results showed that a meta-analysis was not feasible due to clinical and statistical variability, as well as variations in study design, sample selection, and sample size. Thus, it was concluded that sliding mechanisms are widely employed in orthodontic treatment, but temporary anchorage devices and sliding mechanisms deliver great results. There is a need to raise awareness about these devices and use them with care., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Ahuja et al.)