Knowledge and Awareness about Chair-Side Diagnostic Techniques for the Screening of Suspicious Oral Lesions among General Dental Practitioners - A Cross-Sectional Survey

Introduction: General dental practitioners (GDPs) play an important role in screening and early detection of oral potentially malignant disorders (OPMD) and oral cancer. Aim: This survey aims to assess the knowledge and awareness of general dental practitioners about chairside diagnostic techniques for screening of inflammatory oral lesions, potentially malignant lesions and oral cancer. Materials and Methods: GDPs (n=125) were surveyed about their knowledge about chairside diagnostic techniques for early detection and screening of suspicious oral lesions. The interview was based on a pre-structured questionnaire containing 14 closed ended questions. Chi square test was used for evaluating the association of survey parameters. Result: 95.2% of dentists do diagnosis and management of suspicious oral lesions along with chief complaints. There is a strong association between the educational status of GDPs and their method for management of suspicious oral lesions (p=0.002). 84.5% of the postgraduate GDPs are aware of chemiluminescence methods than graduate level GDPs (p =0.0009). Majority of the graduate GDPs are unaware of VELScope(p=0.0009). Usage of all non-invasive techniques was found to be less among graduate GDPs (p=0.002). Conclusion: The overall awareness of the dentists involved in the study were good and postgraduate GDPs are more aware and practically ahead about the non-invasive diagnostic techniques than graduate GDPs.

Preoperative “R wave amplitude variation” on electrocardiogram predicts severe hypovolemia

Preoperative fasting is essential to prevent aspiration and associated complications. However, quite often patients end up fasting for 12 h or more due to changes in the operating room schedules, delays, and postponements. Preoperative fasting may lead to a fluid deficit, which may contribute to perioperative discomfort and morbidity. We report a case of 44-year-old female posted for total mastectomy with axillary clearance for carcinoma breast, with prolonged fasting where preoperative R wave amplitude variation along with associated changes in the plethysmograph was noticed on the monitor. 500 milliliters of lactated ringer solution was administered before induction of anesthesia, by the time R wave amplitude variation decreased. Variations in plethysmography became normal after 1 L of fluid administration after induction of anesthesia. Gross R wave amplitude variation is not a very common finding and may predict severe hypovolemia in preoperative area in prolonged fasting patients.

Induced systemic resistance by 2,4-diacetylphloroglucinol positive fluorescent Pseudomonas strains against rice sheath blight

Rice sheath blight arising due to lack of systemic resistance against causative agent Rhizoctonia solani has been a major economic threat to rice growers across the globe. This warrants induced systemic resistance (ISR) in plant to make them disease resistant. Application of antibiotic producing Pseudomonads that also secrete defense inducing enzymes is known to impart resistance to plants. Here, we report induction of the induced systemic resistance (ISR) by six strains of rhizosphere fluorescent Pseudomonas possessing 2,4-diacetyl phloroglucinol (2,4-DAPG) antibiotic genes against rice sheath blight pathogen Rhizoctonia solani. In the preliminary screening, isolate EP5 (endophytic Pseudomonas fluorescens) showed 76.5% inhibition against R. solani. EP5 treated rice grains showed the highest germination of 96.6%, mean root length of 15.3 cm, shoot length of 12.6 cm and vigour index of 2104.9. Paddy grains treated with EP5 (through seed treatment followed by root dipping) upon challenge inoculation with R. solani (Rs1) gave higher activity of peroxidase (PO) 2.50 change in absorbance at 470 nm/min/mg protein), polyphenol oxidases (PPO), 2.25 change absorbance at 420 nm/ min/mg protein, phenyl alanine ammonia lyase (PAL) and 28.5 nmol transcinnamic acid/hr/mg protein. 2,4-DAPG positive fluorescent Pseudomonas strains produced PO, PPO, PAL and 28.5 nmol transcinnamic that resulted in ISR against rice sheath blight pathogen R. Solani.

Subungual hyperkeratosis nail biopsy: A better diagnostic tool for onychomycosis.

Background: Onychomycosis is one of the most common nail disorders. Mycological examination by potassium hydroxide (KOH) mount and fungal culture is the most commonly used diagnostic method. However, it is associated with a low sensitivity. Aims: To evaluate the technique of subungual hyperkeratosis nail biopsy in diagnosing onychomycosis in HIV-infected and immunocompetent adults and compare it with mycological examination. Methods: 34 HIV-positive patients who presented clinically with onychomycosis were recruited in the study from the beginning. There was no screening done for patients with onychomycosis. This has been clarified in manuscript under the heading of methods. Results: All the fungal cultures yielded dermatophytes correlating with the biopsy findings. Only hyphal form of fungus was detected in KOH examination, indicating it was not a contaminant. Clinical types of onychomycosis are stated in discussion. Conclusions: PAS stain of subungual hyperkeratosis nail biopsy was the most sensitive in the diagnosis of onychomycosis in both HIV-infected and non-infected groups.