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BACKGROUND Sensation and perception are two separate processes that are very closely related. Sensation is the input about the outside world obtained by our sensory receptors while perception is the difficult system by which the brain selects, organizes and interprets these sensations. Effects of nitrous oxide on the sensation and perception has not been unturned although role in physiological, anxiolytic, behavioural, psychomotor and analgesic parameters have been examined in both children and adults. The human senses have long been unnoticed, despite their responsiveness being of great importance. The purpose of this study was to evaluate the effectiveness of nitrous oxide inhalation sedation on 5 senses i.e. sight, hearing, touch, smell and taste at different titrations of nitrous oxide and oxygen. METHODS 7 to 12 years old children with Frankl’s behaviour rating score of 2, 3 and 4 with no prior dental experience and requiring dental treatment under nitrous oxide sedation who were systemically healthy were included in the study. The 5 senses (i.e. hearing, touch, smell, taste and vision) were evaluated with different materials at 4 different titration levels to evaluate the effect of nitrous oxide on the 5 senses T0: 100 % oxygen, T1: 30 % nitrous oxide, T2: 50 % nitrous oxide, T3: 100 % oxygen. RESULTS The results of the present study depicted that there is significant difference in the perception of various senses at different concentrations of nitrous oxide and also when compared to baseline values. It was observed that the patient regained the normal perception in 5 minutes after 100 % oxygen post-operatively. CONCLUSIONS Nitrous oxide is found to depress/relax one’s senses too. KEY WORDS Vision, Smell, Taste, Touch, Sound, Perception, Consciousness, Nitrous Oxide Sedation, Oxygen, Behaviour

Silver diamine fluoride (SDF) is a clear and odorless liquid used for dentinal hypersensitivity and arresting caries unless there’s no pulpal involvement for all age groups across all countries. Discoveries let us change old paradigms with the new ones. SDF being cleared for commercial use now can help in achieving the all-time goal of caries prevention. Various studies have established that options like potassium iodide and different restorations can help mask the staining problem of SDF. This can restore form and function as well for the teeth. With the unimaginable COVID 19 situation, dentistry has realized the importance of minimally invasive interventions than ever before. SDF is a blessing in such challenging times and it may be the magical alternative to caries management in the future. Keywords: SDF, Early childhood caries, Parental consent, Oral health, COVID 19

Two sporadic cases of eosinophilic solid and cystic renal cell carcinoma (ESC RCC), at our institution, are presented in this study to contribute to the growing literature on this novel renal neoplasm. The first patient was a 38-year-old female with two synchronous renal masses measuring 3.5 and 1.9 cm on preoperative imaging. The second patient was a 44-year-old female with an incidental renal mass measuring 4 cm. Both patients underwent uncomplicated radical nephrectomies. The 1.9 cm mass in the first patient was consistent with clear cell RCC. The dominant mass in the first patient and the tumor in the second patient had microscopic and macroscopic findings in keeping with ESC RCC including a tan appearance, abundant eosinophilic cytoplasm, and CK20+ and CK7− staining. Both patients had an uncomplicated course following surgery with no evidence of local recurrence or distant metastatic disease for 1 and 2 years for the first and second patient accordingly. These cases contribute to a growing body of literature regarding ESC RCC including, to our knowledge, the first reported case of synchronous ESC RCC and clear cell RCC. Further research about this novel renal neoplasm is needed.

BackgroundGlobally, 20% of young people experience mental disorders. In India, only 7.3% of its 365 million youth report such problems. Although public stigma associated with mental health problems particularly affects help-seeking among young people, the extent of stigma among young people in India is unknown. Describing and characterizing public stigma among young people will inform targeted interventions to address such stigma in India, and globally. Thus, we examined the magnitude and manifestations of public stigma, and synthesised evidence of recommendations to reduce mental-health-related stigma among young people in India.MethodA systematic review and meta-analysis of observational studies was conducted. Nine electronic databases were searched and 30 studies (n = 6767) met inclusion criteria.ResultsMost studies (66%) focused on youth training to become health professionals. One-third of young people display poor knowledge of mental health problems and negative attitudes towards people with mental health problems and one in five had actual/intended stigmatizing behavior (I2>=95%). Young people are unable to recognize causes and symptoms of mental health problems and believe that recovery is unlikely. People with mental health problems are perceived as dangerous and irresponsible, likely due to misinformation and misunderstanding of mental health problems as being solely comprised of severe mental disorders (e.g. schizophrenia). However, psychiatric labels are not commonly used/understood.ConclusionPublic education may use symptomatic vignettes (through relatable language and visuals) instead of psychiatric labels to improve young people’s understanding of the range of mental health problems. Recommended strategies to reduce public stigma include awareness campaigns integrated with educational institutions and content relevant to culture and age-appropriate social roles.

Background: Limited evidence exists on the effectiveness of using an entertainment-education methodology to address multiple public health issues and of using participatory street theatre to improve public understanding related to public health. Objective: To assess the feasibility, acceptability and impact of the Actor–Doctor project, an intervention involving theatre professionals and medical specialists to jointly deliver street-theatre-based public health education. Design: A real-world, mixed-methods post-intervention study evaluated the Actor–Doctor project among 486 participants in Ahmedabad, India, in 2017. Setting and method: Focus group discussions with actors and semi-structured interviews with doctors and implementers assessed project feasibility, acceptability and perceived impact. Post-intervention surveys among actors, audience and a control group assessed impact on knowledge and attitudes related to select public health issues. Quantitative data were analysed using multivariable regression, and qualitative data were analysed using an inductive thematic analysis. Results: The Actor–Doctor project was feasible to implement, as 20 street theatre performances on five public health themes were developed and staged. Members of the audience showed higher knowledge of environmental health, anaemia and openness to discussing sexual health issues, compared to a control group (omega squared 0.03–0.24; p Conclusion: The Actor–Doctor project was instrumental in improving public-health-related engagement between actors, doctors and the public.

Objectives: AdvanSync2 (Ormco, Glendora, California, USA) is a molar-to-molar fixed Class II corrector, based on the philosophy of Herbst which allows the bonding of the both upper and lower arches simultaneously along with fixed functional therapy. The purpose of this study was to cephalometrically compare the skeletal and dentoalveolar effects of AdvanSync2 in the correction of Class II malocclusions in circumpubertal and post-pubertal patients. Materials and Methods: Forty-eight samples were selected and divided into two groups based on their CVMI staging, Group A, i.e., at CVMI Stages 2 and 3 (18 girls and six boys) and Group B, i.e., CVMI Stages 4, 5, and 6 (19 girls and five boys). Cephalograms taken at pre- and post-AdvanSync2 stages were compared and analyzed. Results: The results showed that there was a significant increase in mandibular length in both groups. Both the groups also showed sagittal maxillary restriction, maxillary molar distalization, and retroclination of maxillary incisors. On comparison between Group A and Group B, there was no statistically significant differences in terms of maxillary position, size of maxilla, as well as upper and lower incisor inclinations in Group A except for improvement of mandibular position (SNB; P ≤ 0.01) and greater amount of chin growth (B -Pg; P ≤ 0.01) with respect to Group B. Conclusion: AdvanSync2 can be used as an effective fixed functional appliance in post-pubertal group for sagittal mandibular correction in skeletal Class II patients.

Treatment of traumatized immature teeth poses a challenge for clinician. Apexification is considered to be the treatment of choice for non-vital young permanent teeth. The present report, highlight the case of traumatized young permanent tooth where apexificationwas achieved in a previously endodontically treated tooth. Endodontic treatment of immature permanent teeth without apical barrier leads to failure of treatment due to incomplete sealing of the canal. Also, the success of endodontic treatment is determined by the quality of obturation. In wide canals, traditional obturating technique may result in spaces being left in the canal space. Obturation using rolled cone technique to achieve a good seal is used in the present case. Keywords: MTA Apexification, Rolled cone technique, Traumatic injury.

Introduction: Enterococcus faecalis is a common bacterial species in resistant and recurrent infections. It has an active proton pump which prevents its easy inhibition leading to endodontic treatment failure. LASER and photodynamic therapy have been employed lately in improving antimicrobial chemotherapy of localized infections. Aim: To compare disinfection efficacy of 940nm Diode LASER & Photodynamic therapy(PDT) to Conventional method using 3% Sodium hypochlorite in canals of endodontically treated primary teeth. Method: Single sitting Pulpectomy was performed on 60 mandibular first primary molars, divided into 3 groups, disinfected using mentioned modalities. Disinfection potential was compared collecting samples at 3 stages using paper points, cultured and incubated for 24hrs to check change in Colony Forming Units of the bacteria. Results: Data analysis with SPSS version 20 software using Kruskal-Wallis and Mann Whitney-U test. Conclusion: The three groups showed effective disinfection as revealed by the reduction in the colony forming units of the bacteria at baseline and after intervention. However, diode laser when used in conjunction with sodium hypochlorite as a disinfecting modality was found to be the most effective for the eradication of Enterococcus faecalis from infected root canals.

This article discusses about a fixed dentulous appliance that was constructed to replace the primary upper anterior teeth in a five year old boy. It constituted of a design, where the maxillary primary second molars were used to support the appliance through bands and a wire that contained spurs bearing strip crowns, anteriorly. The appliance was functionally and aesthetically compliant. Keywords: Early childhood caries, Fixed dentulous appliance, Pediatric ridge.

Background The present study was designed to assess variations in physiological, psychomotor parameters, and analgesic effects at various levels of nitrous oxide-oxygen analgesia in 3–12 years old children. Design One hundred children aged 3–12 years were assessed for physiological, psychomotor, and analgesic parameters at various concentrations of N2O, i.e., baseline, 20, 40, 50, and 0% (100% O2). Physiological, psychomotor, and analgesic effects were assessed using a pulse oximeter, bender visual-motor Gestalt test, and response to electric pulp tester, respectively. Results Oxygen saturation (SpO2) showed a significant increase while heart rate (HR) showed a significant reduction at 50% N2O. No significant changes were observed in respiratory rate with a change in N2O levels. Significant reduction in the pain scores was found at the same level of stimulation by an electric pulp tester at 40 and 50% levels. The psychomotor changes were consistently higher at every concentration of nitrous oxide. However, no correlation could be found between various parameters tested. Conclusion N2O caused a significant increase in SpO2 in both the age groups, a decrease in HR, a significant decrease in pain score at 40 and 50% concentration of N2O, and had a significant effect on the psychomotor ability of children. How to cite this article Sharma S, Chopra R, Mathur S, et al. Variations in Physiological, Psychomotor, and Analgesic Parameters during Titration of Nitrous Oxide in 3–12 Years Old Children Managed with Inhalation Sedation. Int J Clin Pediatr Dent 2020;13(6):650–655.

Background Educational interventions engage youth using visual, literary and performing arts to combat stigma associated with mental health problems. However, it remains unknown whether arts interventions are effective in reducing mental-health-related stigma among youth and if so, then which specific art forms, duration and stigma-related components in content are successful. Methods We searched 13 databases, including PubMed, Medline, Global Health, EMBASE, ADOLEC, Social Policy and Practice, Database of Promoting Health Effectiveness Reviews (DoPHER), Trials Register of Promoting Health Interventions (TRoPHI), EPPI-Centre database of health promotion research (Bibliomap), Web of Science, PsycINFO, Cochrane and Scopus for studies involving arts interventions aimed at reducing any or all components of mental-health-related stigma among youth (10–24-year-olds). Risk of bias was assessed using the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies. Data were extracted into tables and analysed using RevMan 5.3.5. Results Fifty-seven studies met our inclusion criteria (n = 41,621). Interventions using multiple art forms are effective in improving behaviour towards people with mental health problems to a small effect (effect size = 0.28, 95%CI 0.08–0.48; p = 0.007) No studies reported negative outcomes or unintended harms. Among studies using specific art forms, we observed high heterogeneity among intervention studies using theatre, multiple art forms, film and role play. Data in this review are inconclusive about the use of single versus multiple sessions and whether including all stigma components of knowledge, attitude and behaviour as intervention content are more effective relative to studies focused on these stigma components, individually. Common challenges faced by school-based arts interventions included lack of buy-in from school administrators and low engagement. No studies were reported from low- and middle-income countries. Conclusion Arts interventions are effective in reducing mental-health-related stigma to a small effect. Interventions that employ multiple art forms together compared to studies employing film, theatre or role play are likely more effective in reducing mental-health-related stigma.

Key Points Question Did underage youth and young adults (13-24 years) self-report changes in use and access to e-cigarettes during the coronavirus disease 2019 pandemic? Findings In this national, online, cross-sectional survey study of 2167 youth and young adults using e-cigarettes, 1198 respondents reported changing their amount of e-cigarette use, with 810 reducing or quitting e-cigarette use; e-cigarette access shifted to alternative retail stores and online. Reduced e-cigarette use or quitting was associated with adhering to shelter-in-place guidelines and was less likely if participants had used e-cigarettes more than 10 times or were nicotine dependent. Meaning Individuals younger than 21 years reported e-cigarette use and accessed e-cigarettes from online and retail stores during the coronavirus disease 2019 pandemic, suggesting a need to strengthen prevention of e-cigarette sales to such youth, including age verification, and provide cessation resources., Importance Understanding patterns of e-cigarette use and access during the coronavirus disease 2019 (COVID-19) pandemic is important because e-cigarettes may put users at risk for more severe respiratory effects and other health problems. Objective To examine whether underage youth and young adults who ever used e-cigarettes self-reported changes in access and use of e-cigarettes since the COVID-19 pandemic began. Design, Setting, and Participants A national, cross-sectional online survey study was conducted from May 6 to May 14, 2020. This sample of 4351 participants aged 13 to 24 years across the US included 2167 e-cigarette ever-users. Quota sampling was used to balance for age, sex, race/ethnicity, and 50% having ever used e-cigarettes. Main Outcomes and Measures Change in e-cigarette use (increase, decrease, quit, no change, and switch to another product) and access to e-cigarettes (easier or harder, and change in point-of-purchase) before and after the COVID-19 pandemic began, reasons for change, number of times e-cigarettes were used, nicotine dependence, and sociodemographic data. Results This study focused on 2167 e-cigarette ever-users among 4351 participants who completed the survey. Among 2167 e-cigarette users, a total of 1442 were younger than 21 years and 725 were aged 21 years or older; 1397 were female (64.5%) and 438 identified as lesbian, gay, bisexual, transgender, queer (20.2%). The survey completion rate was 40%. Since the COVID-19 pandemic began, 1198 of 2125 e-cigarette users (56.4%) changed their use: 388 individuals (32.4%) quit, 422 individuals (35.3%) reduced the amount of nicotine, 211 individuals (17.6%) increased nicotine use, 94 individuals (7.8%) increased cannabis use, and 82 individuals (6.9%) switched to other products. Participants reported that not being able to go to vape shops and product unavailability were the reasons accessing e-cigarettes was difficult after the pandemic began. Since the COVID-19 pandemic began, individuals reported purchasing from alternative retail stores (disposables, 150 of 632 [23.7%]; pod-based, 144 of 797 [18.1%]; and other e-cigarette, 125 of 560 [22.3%], ie, between 18.1% and 23.7%), purchasing online instead of retail (disposables, 115 of 632 [18.2%]; pod-based, 156 of 797 [19.6%]; and other e-cigarette, 111 of 560 [19.8%], ie, between 18.2% to 19.8%), and shifted to retail instead of online (disposables, 11 of 632 [1.7%]; pod-based, 17 of 797 [2.0%]; and other e-cigarette, 13 of 560 [2.3%], ie, between 1.7%-2.3%). Other individuals reported no change: from retail stores (disposables 262 of 632 [41.5%]; pod-based 344 of 797 [43.2%]; and other e-cigarette, 223 of 560 [39.8%], ie, between 39.8% and 43.2%) and online (disposables 94 of 632 [14.9%]; pod-based 136 of 797 [17.1%]; and other e-cigarette, 88 of 560 [15.8%], ie, between 14.9% and 17.1%). Underage youth reported e-cigarette deliveries from vape shops and/or dealers or friends who received such deliveries, and 63 of 229 (27.5%) self-reported accessing e-cigarettes without age verification. e-Cigarette users were 52% less likely to quit or reduce their use if they previously used e-cigarettes between 11 and 99 times (adjusted odds ratio, 0.48; 95% CI, 0.30-0.78), 68% less likely to quit if they previously used e-cigarettes more than 100 times (adjusted odds ratio, 0.32; 95% CI, 0.20-0.51), and 51% were less likely to quit if they were nicotine dependent (adjusted odds ratio, 0.49; 95% CI, 0.35-0.70). Conclusions and Relevance During the COVID-19 pandemic, youth e-cigarette users reported changes in e-cigarette use, point-of-purchase, and ability to purchase e-cigarettes without age verification. The US Food and Drug Administration and local policy makers may find these data useful to inform policies to prevent e-cigarette sales to underage youth., This survey study examines changes in use of e-cigarettes by individuals aged 24 years and younger during the coronavirus 2019 pandemic.

This study examined which socio-demographic factors are associated with susceptibility (lack of commitment to avoid future use), past-12-month and past-30-day use of JUUL and other e-cigarettes, and reasons for and against using JUUL. An online survey of 3,075 Californians ages 15–29, including 24.3% who identified as LGBTQ, were recruited via social media in January-March 2019. Multi-level weighted logistic regression models suggest that LGBTQ participants were more likely to be susceptible to JUUL [AOR = 2.11 (1.60, 2.79) (parentheses include 95% Confidence Intervals)] and other e-cigarettes [AOR = 2.31 (1.75, 3.05)], and more likely to use JUUL [AOR = 1.27 (1.02, 1.58)] and other e-cigarettes [AOR = 1.66 (1.35, 2.05)] in the past 12 months. Susceptibility to using JUUL was more likely among adolescents (ages 15–17) [AOR = 1.72 (1.30, 2.28)] and young adults (ages 18–20) [AOR = 1.26 (1.00,1.58)] than adults (ages 21–29). At the community level, living in jurisdictions with higher median household income was associated with a higher likelihood of being susceptible to using JUUL and other e-cigarettes. Compared to non-Hispanic Whites, Asian/Pacific Islanders were less likely to use JUUL [AOR = 0.68 (0.54, 0.86)] and other e-cigarettes [AOR = 0.60 (0.48, 0.76)] in the past 12 months. Past-30-day JUUL use was more likely among males than females [AOR = 1.44 (1.11, 1.88)]. Common reasons for using JUUL were: friends’ use, flavors, “safer” than cigarettes, no one will notice, and nicotine rush is greater than other devices. Common reasons against using JUUL were: harmful to self/others, contains nicotine and is addictive. E-cigarette prevention and cessation efforts should include tailored messaging for people who identify as LGBTQ and reinforce reasons for not vaping nicotine.

Purpose This study aimed to assess whether youth cigarette and electronic cigarette (e-cigarette) use are associated with coronavirus disease 2019 (COVID-19) symptoms, testing, and diagnosis. Methods An online national survey of adolescents and young adults (n = 4,351) aged 13–24 years was conducted in May 2020. Multivariable logistic regression assessed relationships among COVID-19–related symptoms, testing, and diagnosis and cigarettes only, e-cigarettes only and dual use, sociodemographic factors, obesity, and complying with shelter-in-place. Results COVID-19 diagnosis was five times more likely among ever-users of e-cigarettes only (95% confidence interval [CI]: 1.82–13.96), seven times more likely among ever-dual-users (95% CI: 1.98–24.55), and 6.8 times more likely among past 30-day dual-users (95% CI: 2.40–19.55). Testing was nine times more likely among past 30-day dual-users (95% CI: 5.43–15.47) and 2.6 times more likely among past 30-day e-cigarette only users (95% CI: 1.33–4.87). Symptoms were 4.7 times more likely among past 30-day dual-users (95% CI: 3.07–7.16). Conclusions COVID-19 is associated with youth use of e-cigarettes only and dual use of e-cigarettes and cigarettes, suggesting the need for screening and education.

Background: To establish mixture of zinc oxide and 10% sodium fluoride as a novel root canal obturating material for primary teeth. Aim: This study aims to evaluate clinical and radiographic success of a mixture of zinc oxide and 10% sodium fluoride as root canal obturating material. Settings and Design: This pilot study was conducted among 30 primary molars indicated for pulpectomy. Methods: Thirty grossly decayed primary molars of children aged 4–9 years were selected with signs or symptoms of irreversibly inflamed or degenerative pulp tissue. Single sitting pulpectomy was carried out in all the teeth with a mixture of zinc oxide powder with 10% sodium fluoride, and they were subsequently restored with preformed crown. Teeth were assessed clinically and radiographically at 3-, 6-, 9-, and 12-month intervals. Statistical Analysis: Data were analyzed using SPSS Software Version 20.0 (IBM SPSS Statistics, Chicago, IL, USA) and statistical significance was determined by Chi-square test; level of significance was set at P < 0.05. Results: Overall clinical and radiographic success rate of combination of zinc oxide and sodium fluoride was 92.9% and 85.7%, respectively, at the end of 12 months. Furthermore, resorption rate of material matched resorption of tooth root. Excess filling material was also observed to resorb at the end of 3 months. Conclusion: These results suggest that combination of zinc oxide and sodium fluoride can be considered as suitable alternative root canal obturating materials for primary teeth with low cost to achieve acceptable therapeutic results.

Summary Joint involvement of couples is an effective strategy to increase contraceptive use and improve reproductive health of women. However, engaging couples to understand how their gender attitudes affect their personal and family health is an idea in search of practice. This mixed-methods study explores opportunities and barriers to couples' participation in health promotion in three slums of Delhi. For each couple, surveys and semi-structured interviews were conducted with husbands and wives individually to contrast self and spousal work, time, interest in health, sources of information related to health and depth of knowledge (n = 62). Urban poverty forces men to work long hours and women to enter part-time work in the informal sector. Paid work induces lack of availability at home, lack of interest in health information and in performing household chores and a self-perception of being healthy among men. These factors inhibit men's' participation in community-based health promotion activities. Women's unpaid work in the household remains unnoticed. Women were expected to be interested in and to make time to attend community-based health-related activities. Men recalled significantly less sources of health information than their spouse. Men and their wives showed similar depth of health-related knowledge, likely due to their spousal communication, with women acting as gatekeepers. Health promotion planners must recognize time constraints, reliance on informal interpersonal communication as a source of health information and the need to portray positive masculinities that address asymmetric gender relations. Innovative, continuous and collaborative approaches may support couples to proactively care about health in low-resource settings.

Despite the growth of inclusive education programs adopted by many schools across India, children with special needs rarely find themselves included in them. Autism being a pervasive disorder, it becomes hard for autistic children to communicate and express themselves in a socially appropriate manner. Hence, the objective of this study was to explore the perceptions of parents about inclusion of children with autism in mainstream classrooms. A sample of 20 parents whose children were already enrolled in a mainstream school was selected from a school in Jaipur, Rajasthan, India. Participants were assessed on Parent’s Attitudes to Inclusion (PATI, 1998). The result of the study showed the attitude of parents towards the quality of educational services in mainstream education is negative; whereas, when it comes to child acceptance and treatment in mainstream education the parents have a positive attitude. It was also found that parents of children with autism have a neutral attitude towards the mutual benefits of inclusive education. The findings also revealed that regardless of their positive outlook, parents had certain conjectures about such inclusivity. These pertained primarily to childcare responsibilities, children’s transition tasks and teachers’ challenges of managing everything effectively while teaching both students with and without diagnosis of autism in the same classroom. This study can be used by special educators, school authorities and teachers teaching in an inclusive classroom to better understand the concerns of parents of children with Autism Spectrum Disorder (ADS).

Aim To compare and evaluate the clinical and radiographic success of four different zinc-oxide integrated root canal obturating materials. Materials and method 120 grossly decayed primary molars of children, aged 4 to 9 years were selected with signs or symptoms of irreversibly inflamed pulp tissue and randomly assigned to one of the four groups: zinc oxide eugenol, zinc oxide powder with 10% sodium fluoride, zinc oxide powder with Aloe vera, and Endoflas. Single sitting pulpectomy was carried out in all teeth and subsequently restored with a preformed crown in next sitting. Teeth were assessed clinically and radiographically for 3, 6, 9 and 12 months interval. Results 90 out of 120 treated molars completed 12-month evaluations. Overall clinical and radiographic success rates were highest for endoflas, followed by zinc oxide-sodium fluoride, zinc oxide-aloe vera and least for zinc oxide eugenol. However, no significant differences between success rates were observed amongst the four study groups (P>0.05). Conclusions These results suggest that the sodium fluoride and aloe vera may be considered as suitable alternative root canal obturating materials for primary teeth with low cost to achieve acceptable therapeutic results.

Introduction Approximately one in three high school and one in ten middle school students are current tobacco users per national data in 2019. E-cigarettes are the most commonly used tobacco product by adolescents, with known health harms on the lungs, heart, blood vessels, brain and long-term effects from addiction. While educational school based curriculum are increasingly utilized with the goal of decreasing youth use of e-cigarettes, there have been limited studies on the impact of school-based educational curriculum on student perceptions and intent to …

Objective To investigate the effect of low level laser therapy (LLLT) on PC6 acupuncture point in suppressing gag reflex, regulating pulse rates and oxygen saturation, thereby reducing the anxiety levels. Materials and Method A total of 40 patients who demonstrated hyperactive gag reflex in the age group of 4-14 years were included in the study. In Group A (20 patients), maxillary impression was recorded. In the second step, PC6 acupuncture point was stimulated with LLLT followed by recording of second maxillary impression. In group B (20 patients), steps were reversed. Gag reflex, anxiety levels, pulse rate and oxygen saturation levels were assessed. Results Values of pulse rate and oxygen saturation were regulated to normal, signifying lowered anxiety levels. Gag reflex was also significantly decreased after stimulating PC6 acupuncture point with LLLT. Conclusion LLLT on PC6 point was found to be effective in lowering anxiety levels as observed by faces modified anxiety rating scale. Further, it was authenticated as the pulse rates were significantly reduced and oxygen saturation levels were significantly increased. Also, gag reflex was significantly controlled when LASER stimulation was done at PC6.

Purpose – Lack of understanding around mental illness and stigma are an overwhelming barrier in help-seeking behaviour for mental health concerns. The purpose of this paper is to examine mental health literacy and social attitudes as instrumental factors in building capacity of the demand-side to support and access mental health care at the community level in India. Design/methodology/approach – Knowledge, Attitude and Practice surveys were administered to 521 persons from the general population, distributed equally in the age range of 15-60 years. The study included 52 respondents per district from ten districts across five states in India, namely Andhra Pradesh, Assam, Delhi, Gujarat and Uttar Pradesh. The responses were collected and analysed thematically, keeping in mind the relevance of these findings as contributors to knowledge of mental health and to the construct of stigma. Findings – Pervasive socio-cultural factors, especially stigma inhibit access to basic mental health information and care, despite knowledge that mental illness is treatable. Degrading treatment, loss of personal liberty and social exclusion, i.e. compromised human rights at the community level are widespread. Self-reported attitudes when encountering a person with mental illness show that respondents act out of fear and are guided by misinformation and myths. Extant knowledge on mental health is attributed predominantly to informal networks, as a potential resource to be strengthened. Practical implications – Realising mental health care, including help-seeking behaviour calls for greater knowledge-sharing, sensitisation and community engagement. Originality/value – This paper fulfils an identified need to study current levels of mental health literacy and underlying perceptions that contribute to the persistent treatment gap.

In the face of extraordinary advances in the prevention, diagnosis, and treatment of human diseases, the inability of most tissues and organs to repair and regenerate after damage is a problem that needs to be solved. Stem cell research is being pursued in the hope of achieving major medical breakthroughs. Scientists are striving to create therapies that rebuild or replace damaged cells with tissues grown from stem cells that will offer hope to people suffering from various ailments. Regeneration of damaged periodontal tissue, bone, pulp, and dentin is a problem that dentists face today. Stem cells present in dental pulp, periodontal ligament, and alveolar bone marrow have the potential to repair and regenerate teeth and periodontal structures. These stem cells can be harvested from dental pulp, periodontal ligament, and/or alveolar bone marrow; expanded; embedded in an appropriate scaffold; and transplanted back into a defect to regenerate bone and tooth structures. These cells have the potential to regenerate dentin, periodontal ligament, and cementum and can also be used to restore bone defects. The kind of scaffold, the source of cells, the type of in vitro culturing, and the type of surgical procedure to be used all require careful consideration. The endeavor is clearly multidisciplinary in nature, and the practicing dental surgeon has a critical role in it. Playing this role in the most effective way requires awareness of the huge potential associated with the use of stem cells in a clinical setting, as well as a proper understanding of the related problems.

Early eruption of permanent maxillary premolar appears to be a unique finding, at such an early chronological age. Untimely eruption of permanent maxillary premolar is discussed in a 5-year-old male patient. On intra oral examination grossly carious primary maxillary first molar (tooth number 54,64) were reported. The erupting teeth presented with a hypomineralized cusp tip. Extraction following space maintainer in 64 region was given. Pediatric dentist should consider these kinds of rarities in eruption pattern while examining a pediatric patient.

Variation in the size and form of teeth is not an uncommon finding. Twinned teeth have been described under different terms and the terminology is often confusing. It occurs more frequently in the primary dentition than in the permanent dentition with no gender preference. Gemination may be defined as the incomplete division of a single tooth bud during development, resulting in increased tooth material, but not number, of teeth. The term schizodontia would only fit complete splitting, which results in “twinning” and thus leading to hyperdontia. Twinning is usually asymptomatic and is associated with poor esthetics, caries, malocclusions, arch-length discrepancies, periodontal disease, hyperdontia or hypodontia of the permanent successors, and eruption abnormalities.

Background: C-reactive protein (CRP) is an acute phase reactant that is produced in response to diverse inflammatory stimuli, and is known predictor of cardiovascular disease risk. Aggressive and chronic periodontitis are two main forms of periodontal disease, which differ mainly in the method of disease progression. This study aims at determining and comparing the relative levels of serum CRP and alveolar bone loss in aggressive and chronic periodontitis patients. Materials and Methods: A total of 45 subjects, which were divided into 3 groups diagnosed as having generalized aggressive periodontitis (GAP), chronic generalized periodontitis (CGP) and non-periodontitis controls (NP), were selected for the study. Venous blood samples were collected for quantitative CRP analysis using Turbidimetric immunoassay. Alveolar bone loss (ABL) was measured at proximal sites of posterior teeth on a panoramic radiograph. The relationship between the mean ratio of ABL to root length and serum CRP levels was statistically analyzed using Student unpaired t-test, analysis of variance (ANOVA) and Pearson's correlation coefficient. Results: Mean CRP levels were significantly greater in both GAP (7.49±2.31 mg/l) and CGP (4.88±1.80 mg/l) groups as compared to NP (0.68±0.23 mg/l) with P value

Purpose: Indiscriminate disposal of bio medical waste poses a serious threat to environment and human health and is currently a burning issue with increasing health care facilities and associated waste generation. Hence this study assesses the awareness levels and attitude regarding biomedical waste disposal among post-graduates, under-graduates & auxiliary staff of a dental college.Materials and Method: This was a cross-sectional study conducted among post-graduates, under-graduates & auxiliary staff using a questionnaire. A total of 120 participants, 40 in each group answered the questionnaire. The answers were analyzed and graded for each group.Results: The results depict satisfactory awareness about biomedical waste disposal among post-graduates and under-graduates. However, the auxiliary staff lacks the awareness about proper biomedical waste disposal.Conclusion: The study reveals that there is a need to increase knowledge among the auxiliary staff regarding biomedical waste management by continuing training program.

This report describes the case of two additional roots in the permanent first molar of a 14-year-old girl. Literature fails to reveal any significant data related to variations in root numbers although variation in root canal morphology has been mentioned. This report emphasizes the importance of detecting these variations, a failure of which may lead to the failure of endodontic treatment.

This case reports the findings and the treatment planning of a 16-year-old girl who complained of localized swellings on both sides of the jaws along with pain and restricted mouth opening. Clinical and radiographie examinations revealed bilateral masseter muscle hypertrophy which was associated with severe clenching under stressful conditions. Occlusal splint therapy along with muscle relaxants and infrared therapy was implemented to relieve pain and restricted mouth opening. On subsequent follow-ups, patient reported with significant relief in pain as well as an appreciable increase in mouth opening.

Background: The aim of this study was to compare the in vitro effects of four different root canal sealers on the fracture resistance of endodontically treated teeth. Materials and Methods: Seventy‑five freshly extracted human mandibular premolars were used for the study. Teeth were divided into five groups based on type of root canal sealers used. Gutta‑percha was used for all the samples: Group I: AH Plus root canal sealer, Group II: MTA Fillapex root canal sealer, Group III: Apexit root canal sealer, Group IV: Conventional zinc oxide‑eugenol (ZOE) sealer, Group V: Control (unobturated teeth). The teeth were embedded in acrylic resin blocks and fracture force was measured using a universal testing machine (Asian Test Equipments). Data obtained were statistically evaluated using one‑way ANOVA and post hoc test (Tukey’s test). All groups showed statistically significant result (P < 0.05). Results: Group I and Group II showed higher resistance to fracture than other three groups. There was comparable difference in fracture force between Group I and Group II. Moreover, there was no statistically significant difference between Group III and Group IV and between Group IV and Group V. Conclusion: Based on this in vitro study, resin‑based sealer was more effective as compared to other sealers and the control group. However, no significant differences were observed between ZOE and control group. Key Words: Sealer, fracture, resistance, MTA- Fillapex, zinc oxide‑eugeno

In modern dentistry, like other branches of medicine, a set of principles contribute in establishing codes of ethics. These codes which are based on ethical principles, religious beliefs and the social and cultural considerations guide the dental practitioners in their everyday practice and also establish expectations for dentists in fulfilling their ethical and professional duties to the patients, public and the profession itself. Ethical principles are the moral rules and foundations of justification source to be applied in order to exercise an ethical practice. The four principles of medical ethics; Respect for autonomy, Beneficence, non-maleficence and justice form the base of the modern dentistry that needs to be followed. The article gives an overview of how these principles form the backbone of modern day dental practice and thus, are indispensable to its working.

Background: C-reactive protein (CRP) is an acute phase reactant and has been proved to be a significant predictor of future cardiovascular events. Recent studies have demonstrated a correlation between periodontitis and elevated CRP levels. However, comparison between the levels of CRP in two main forms of periodontitis is ambiguous. This study aims at determining and comparing the relative levels of serum CRP in aggressive and chronic periodontitis patients. Materials and Methods: A total of 240 systemically healthy subjects were divided into three groups of 80 based on having generalized aggressive periodontitis, chronic generalized periodontitis and non-periodontitis (NP; controls). Venous blood samples were collected for quantitative CRP analysis using turbidimetric immunoassay. Results: Mean CRP levels were significantly greater in both generalized aggressive periodontitis (7.49±2.31 mg/l) and chronic generalized periodontitis (4.88±1.80 mg/l) groups as compared to NP (0.68±0.23 mg/l) controls. Moreover, CRP levels were significantly higher in aggressive periodontitis as compared to chronic periodontitis patients. Also, CRP levels positively correlated with the amount of periodontal destruction as measured by probing depth and clinical attachment loss for both chronic generalized periodontitis and generalized aggressive periodontitis. Conclusion: Findings of the present study indicated that periodontitis should be of particular concern in younger individuals, where elevated levels of CRP may contribute to early or more rapid cardiovascular disease in susceptible patients. Thus, further research should be carried out at a community level to ascertain these findings. Key Words: C-reactive protein, cardiovascular disease, periodontitis

BACKGROUND: The growing burden of avoidable blindness caused by diabetic retinopathy (DR) needs an effective and holistic policy that reflects mechanisms for early detection and treatment of DR to reduce the risk of blindness. MATERIALS AND METHODS: We performed a comprehensive health policy review to highlight the existing systemic issues that enable policy translation and to assess whether India's policy architecture is geared to address the mounting challenge of DR. We used a keyword-based Internet search for documents available in the last 15 years. Two reviewers independently assessed retrieved policies and extracted contextual and program-oriented information and components delineated in national policy documents. Using a "descriptive analytical" method, the results were collated and summarized as per themes to present status quo, gaps, and recommendations for the future. RESULTS: Lack of focus on building sustainable synergies that require well laid out mechanisms for collaboration within and outside the health sector and poor convergence between national health programs appears to be the weakest links across policy documents. CONCLUSIONS: To reasonably address the issues of consistency, comprehensiveness, clarity, context, connectedness, and sustainability, policies will have to rely more strongly on evidence from operational research to support decisions. There is a need to involve multiple stakeholders from multiple sectors, recognize contributions from not-for-profit sector and private health service providers, and finally bring about a nuanced holistic perspective that has a voice with implementable multiple sector actions.

A wide array of habits is found in children; of these inserting foreign objects in the oral cavity is a common practice among children. Children often tend to insert sharp objects mainly in the open carious lesions to relieve pain caused due to food lodgment. The objects sometimes break and get embedded in the root canals. Sometimes, the patients do not reveal this to parent out of fear and ultimately are diagnosed accidently by the dentists when the symptoms appear or while diagnosing some other lesion. These foreign objects may act as a possible cause of infection. Early diagnosis and treatment are mandatory in such cases to avoid further complications. Thorough case history, clinical, and radiographic examinations are essential to determine the nature, size, location of the foreign body, and the difficulty involved in its retrieval. This paper discusses series of three such case reports where the foreign objects were diagnosed, retrieved, and treatment was followed.

Traumatic dental injuries of uncomplicated nature are a common finding and upper central incisors are the most commonly affected teeth. Sometimes, the fractured fragment or the tooth gets embedded in the surrounding soft tissues and is often missed. There are few case reports regarding the retrieval and reattachment of tooth fragment. This report presents the case of an 8-year-old girl who came with the chief complaint of pain, irritation, and tingling sensation in the lower lip since one year when her upper central incisors got fractured due to trauma along with lip laceration. A soft tissue radiograph of lower lip revealed the presence of fractured tooth fragment which was then surgically removed and reattached to one of the fractured incisors. The patient was found to be asymptomatic after the procedure. This report further highlights the importance of proper radiographic diagnosis along with clinical examination immediately after trauma in order to prevent any complications in future.