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Purpose: To develop a nomogram in cases with mismatch between subjective and Topolyzer cylinder, and based on the magnitude of the mismatch, customize a treatment plan to attain good visual outcomes post?laser?assisted in situ keratomileusis (LASIK) surgery. Methods: The patients were evaluated preoperatively using corneal tomography with Pentacam. Five optimal corneal topography scans were obtained from the Topolyzer Vario were used for planning the LASIK treatment. For the nomogram purpose, the patients were divided into three categories based on the difference between the subjective cylinder and Topolyzer (corneal) cylinder. The first group (group 1) consisted of eyes of patients, where the difference was less than or equal to 0.4 D. The second group (group 2) consisted of eyes, where the difference was more than 0.4 D and the subjective cylinder was lesser than the Topolyzer cylinder. The third group (group 3) included eyes where the difference was more than 0.4 D but the subjective cylinder was greater than the Topolyzer cylinder. LASIK was performed with the WaveLight FS 200 femtosecond laser and WaveLight EX500 excimer laser. Assessment of astigmatism correction for the three groups was done using Aplins vector analysis. For comparison of proportions, Chi?square test was used. A P value less than 0.05 was considered statistically significant. Results: The UDVA was statistically significantly different when compared between groups 1 and 2 (P = 0.02). However, the corrected distance visual acuity (CDVA) was similar among all the three groups (P = 0.1). Group 3 showed an increase of residual cylinder by ?0.25 D, which was significant at intermediate and near reading distances (P < 0.05). Group 3 showed significantly higher target?induced astigmatism (TIA) compared to groups 1 and 2 (P = 0.01). The mean surgically induced astigmatism (SIA) was the least in group 2, which was statistically significant (P < 0.01). Conclusion: The outcomes for distance vision using our nomogram postoperatively were excellent, but further refinement for improving the near vision outcomes is required
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Wound healing is a dynamic process that involves a series of molecular and cellular events aimed at replacing devitalized and missing cellular components and/or tissue layers. Recently, extracellular vesicles (EVs), naturally cell-secreted lipid membrane-bound vesicles laden with biological cargos including proteins, lipids, and nucleic acids, have drawn wide attention due to their ability to promote wound healing and tissue regeneration. However, current exploitation of EVs as therapeutic agents is limited by their low isolation yields and tedious isolation processes. To circumvent these challenges, bioinspired cell-derived nanovesicles (CDNs) that mimic EVs were obtained by shearing mesenchymal stem cells (MSCs) through membranes with different pore sizes. Physical characterisations and high-throughput proteomics confirmed that MSC-CDNs mimicked MSC-EVs. Moreover, these MSC-CDNs were efficiently uptaken by human dermal fibroblasts and demonstrated a dose-dependent activation of MAPK signalling pathway, resulting in enhancement of cell proliferation, cell migration, secretion of growth factors and extracellular matrix proteins, which all promoted tissue regeneration. Of note, MSC-CDNs enhanced angiogenesis in human dermal microvascular endothelial cells in a 3D PEG-fibrin scaffold and animal model, accelerating wound healing in vitro and in vivo. These findings suggest that MSC-CDNs could replace both whole cells and EVs in promoting wound healing and tissue regeneration.
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Objective@#aaMutations in the KMT2B gene have been identified in patients previously diagnosed with idiopathic dystonia. Literature on KMT2B-related dystonia is sparse in the Indian and Asian populations. @*Methods@#aaWe report seven patients with KMT2B-related dystonia studied prospectively from May 2021 to September 2022. Patients underwent deep clinical phenotyping and genetic testing by whole-exome sequencing (WES). A systematic literature search was performed to identify the spectrum of previously published KMT2B-related disorders in the Asian subcontinent. @*Results@#aaThe seven identified patients with KMT2B-related dystonia had a median age at onset of four years. The majority experienced onset in the lower limbs (n = 5, 71.4%), with generalization at a median duration of 2 years. All patients except one had complex phenotypes manifesting as facial dysmorphism (n = 4), microcephaly (n = 3), developmental delay (n = 3), and short stature (n = 1). Magnetic resonance imaging (MRI) abnormalities were present in four cases. WES revealed novel mutations in the KMT2B gene in all patients except one. Compared to the largest cohort of patients with KMT2B-related disorders, the Asian cohort, comprising 42 patients, had a lower prevalence of female patients, facial dysmorphism, microcephaly, intellectual disability, and MRI abnormalities. Protein-truncating variants were more prevalent than missense variants. While microcephaly and short stature were more common in patients with missense mutations, facial dysmorphism was more common in patients with truncating variants. Deep brain stimulation, performed in 17 patients, had satisfactory outcomes. @*Conclusion@#aaThis is the largest series of patients with KMT2B-related disorders from India, further expanding the clinico-genotypic spectrum. The extended Asian cohort emphasizes the unique attributes of this part of the world.
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Concerns have been raised in the media that ‘the third wave’ will severely afect children. Here, an experience of SARSCoV-2 infection in children is reported. Of the 8,626 SARS-CoV-2 RT-PCR tests performed in children (0–17 y) from March 2020 to July 2021 at the authors' institute, 1470 (17%) were positive, [711/4821 (14.7%) during the frst wave (July 2020 to January 2021), and 759/3583 (21.2%) during the second wave (February 2021 to July 2021)]. The children in both waves were similar in presentation (74.1% mildly symptomatic versus 80.2% mildly symptomatic; rest asymptomatic). None of them had COVID pneumonia. Five children died (0.3%), all of a serious primary non-COVID disease. Seventy-three cases of MIS-C during August 2020 to July 2021, with low mortality (2.7%) were also identifed. The similarity in COVID-19 infection in children between the frst and the second waves seems to suggest that the likelihood of the ‘third wave’ hitting children hard is low.
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Objectives: To evaluate the incidence of aminoglycoside-related nephrotoxicity and ascertain drug causality and its risk factors. Methods: This prospective study was conducted from January, 2019 to January, 2021, and recruited 110 consecutively admitted children aged 1 month to 12 years, receiving aminoglycosides for ?4 days. Drug causality was assessed using Liverpool adverse drug reaction causality assessment tool. Results: 42 (38.2%) children developed acute kidney injury (AKI), with 71 (64.5%) having composite nephrotoxicity (AKI and/or tubular-dysfunction). Only 17 (15.5%) had AKI definitively attributable to aminoglycosides. Hypotension [OR 0.016 (95% CI 0.01-0.71), P=0.03], PRISM-III score 20-29% [OR 55.48 (95% CI 3.66-840.53), P=0.004] and post-surgery patients [OR 3.2 (95% CI 1.01-10.1), P=0.047] were independent predictors of AKI. Conclusions: Only a small proportion of children receiving aminoglycosides had AKI definitively attributable to the drug.
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Colorectal cancer is a one of the leading causes of death globally and its clinical management of cancer involves chemotherapy. Increase in the development of resistance to the drugs used in the cancer treatment and serious side effects associated with chemotherapeutic drugs are the major limitations in cancer therapy. Hence, there exists a huge need to develop safer natural therapeutic products for cancer therapy. In this study, ethanolic extract of Stoechospermum marginatum was evaluated for its anticancer activity. The cytotoxicity of S. marginatum extract was evaluated on HT-29 cells by MTT assay. Trypan blue cell viability was also carried out to evaluate cytotoxicity and antiproliferative effect. The apoptosis-inducing potential of the extract was analyzed by acridine orange and ethidium bromide dual staining method, mitochondrial membrane potential assay and FITC Annexin V-Propidium iodide staining method. The ethanolic extract of S. marginatum showed significant dose-dependent cytotoxicity in HT-29 cells Treatment with S. marginatum extract increased number of apoptotic cells in HT-29 cells and caused damage to mitochondrial membrane potential. The findings of the present study confirmed in vitro anticancer activity of ethanolic extract S. Marginatum
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Justification: The emerging literature on prevalence of vitamin D deficiency in India, prevention and treatment strategies of rickets, and extra-skeletal benefits of vitamin D suggest the need for revising the existing guidelines for prevention and treatment of vitamin D deficiency in India. Objectives: To review the emerging literature on vitamin D prevalence and need for universal vitamin D supplementation. To suggest optimum vitamin D therapy for treatment of asymptomatic and symptomatic vitamin D deficiency, and rickets. To evaluate the extra-skeletal health benefits of vitamin D in children. Process: A National consultative committee was formed that comprised of clinicians, epidemiologists, endocrinologists, and nutritionists. The Committee conducted deliberations on different aspects of vitamin D deficiency and rickets through ten online meetings between March and September, 2021. A draft guideline was formulated, which was reviewed and approved by all Committee members. Recommendations: The group reiterates the serum 25- hydroxy vitamin D cutoffs proposed for vitamin D deficiency, insufficiency, and sufficiency as <12 ng/mL, 12-20 ng/mL and >20 ng/mL, respectively. Vitamin D toxicity is defined as serum 25OHD >100 ng/mL with hypercalcemia and/or hypercalciuria. Vitamin D supplementation in doses of 400 IU/day is recommended during infancy; however, the estimated average requirement in older children and adolescents (400-600 IU/day) should be met from diet and natural sources like sunlight. Rickets and vitamin D deficiency should be treated with oral cholecalciferol, preferably in a daily dosing schedule (2000 IU below 1 year of age and 3000 IU in older children) for 12 weeks. If compliance to daily dosing cannot be ensured, intermittent regimens may be prescribed for children above 6 months of age. Universal vitamin D supplementation is not recommended in childhood pneumonia, diarrhea, tuberculosis, HIV and non-infectious conditions like asthma, atopic dermatitis, and developmental disorders. Serum 25-hydroxy vitamin D level of >20 ng/mL should be maintained in children with conditions at high-risk for vitamin deficiency, like nephrotic syndrome, chronic liver disease, chronic renal failure, and intake of anticonvulsants or glucocorticoids.
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Background & objectives: The delay in communicating the results to tuberculosis (TB) patients leads to increased rates of initial loss to follow up of treatment. The gap in communication among healthcare providers requires application of new tools that will address the challenges. Mobile phone technologies could be a useful tool in this context for the delivery of information. The objective was thus to evaluate communication by mobile applications such as the WhatsApp Messenger to decrease initial loss to follow up after initial treatment for TB. Methods: Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India undertook a community prevalence survey to find the burden of TB. During this survey, mobile phone-based technology (WhatsApp messenger) was employed as an intervention among the healthcare providers and researchers involved for communicating. This was further evaluated for its usefulness by examining the initial loss to follow up and patients initiated on treatment. Results: The study covered four blocks of Thiruvallur district of Tamil Nadu, South India, namely Kadambathur, Poondi, Thiruvalangadu and Periyapalayam. The survey population was around 20,000 from each block, and the average patients diagnosed by community TB prevalence survey were 30 patients from each block. Among the patients diagnosed through this survey, in the first block, only 55 per cent were initiated on treatment; subsequently, with the intervention, the initial loss to follow up was significantly reduced from 45 to zero per cent. Interpretation & conclusions: After integrating of WhatsApp messenger application for communication among healthcare providers and research
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Pentatrichomonas hominis is a flagellated protozoan parasite that resides in the digestive tract of humans and is generally nonpathogenic. Although parasites of diarrheal etiology are widespread, neonatal infection with P. hominis is an uncommon incident. This case report depicts an instance of active P. hominis in an 8-month- old child with complaints of fever, vomiting, and loose stools. Stool examination was done with saline and iodine wet mount that showed motile trophozoites of P. hominis with a jerky movement. Treatment with metronidazole was effective as no parasite was found on repeated stool examinations. Pentatrichomonas hominis should be recognized as a cause of diarrhea in neonates, despite being rare.
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Penile fracture (PF) is a surgical emergency. Given its rarity, we queried a national cohort over an 11-year period to study the temporal and demographic variations in presentation, evaluation, and management of patients with PF compared with a cohort of control patients. The National Inpatient Sample was queried between the years 2005 and 2016 for patients with a diagnosis of PF. Appendectomy patients were selected as a control cohort, given the non-discriminatory nature of this disease. Clinical and demographic data of the patients were compared with that of controls. Presenting symptoms, rates of surgical repair, and rates of associated surgical procedures were evaluated in the PF cohort. During the study period, 5802 patients were hospitalized for PF. The annual incidence of PF remained unchanged at 1.0-1.8 cases per 100 000 hospitalizations over the study period. Compared with the control cohort, PF patients were more likely to be younger (38.7 years vs 41.2 years, P ≤ 0.001), have lower rates of comorbidities except erectile dysfunction (1.4% vs 0.1%, P ≤ 0.001), and were more likely of Black race (25.4% vs 6.2%, P ≤ 0.001). Notably, PF patients had significantly higher rates of substance abuse (26.4% vs 18.1%, P ≤ 0.001), despite no difference in the diagnosed psychiatric disorders. PF rarely presented with hematuria (3.5%); however, urethral evaluation was performed in 23.1%, most commonly with cystoscopy (19.2%). PF occurs more commonly in a younger, healthier male population, and among minorities. Importantly, rates of substance abuse appear to be higher in the PF cohort compared with those of controls.
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Context: Stereotactic body radiotherapy (SBRT) is increasingly being used for early-stage lung cancer and lung oligometastases. Aims: To report our experience of setting up lung SBRT and early clinical outcomes. Settings and Design: This was a retrospective, interventional, cohort study. Subjects and Methods: Patients were identified from multidisciplinary tumor board meetings. They underwent four-dimensional computed tomography-based planning. The ROSEL trial protocol, the Radiation Therapy Oncology Group (RTOG) 0236, and the UK-Stereotactic Ablative Body Radiotherapy Consortium guidelines were used for target volume and organs-at-risks (OARs) delineation, dosimetry, and plan quality assessment. Each SBRT plan underwent patient-specific quality assurance (QA). Daily online image guidance using KVCT or MVCT was done to ensure accurate treatment delivery. Statistical Analysis Used: Microsoft Excel 2010 was used for data analysis. Results: Fifteen patients were treated to one or more lung tumors. One patient received helical tomotherapy in view of bilateral lung oligometastases at similar axial levels. All the remaining patients received volumetric modulated arc therapy (VMAT)-based treatment. The prescription dose varied from 40 to 60 Gy in 5–8 fractions with alternate-day treatment. The mean and median lung V20 was 5.24% and 5.16%, respectively (range, 1.66%–9.10%). The mean and median conformity indexes were 1.02 and 1.06, respectively (range, 0.70–1.18). After a median follow-up of 17 months, the locoregional control rate was 93.3%. Conclusions: SBRT was implemented using careful evaluation of OAR dose constraints, dosimetric accuracy and plan quality, patient-specific QA, and online image guidance for accurate treatment delivery. It was safe and effective for early-stage nonsmall cell lung cancer and lung metastases. Prospective data were collected to audit our outcomes
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Background: The prevalence of infertility ranges from 3.5% to 16.7% in more developed nations and from 6.9% to 9.3% in less developed nations, with an estimated overall median prevalence of 9%. The present study was aimed to evaluate the role of hysterolaparoscopy in the study of primary and secondary infertility, to identify the various pathological conditions in female reproductive tract leading to primary/ secondary infertility, to develop a plan for therapy and management at the same time.Methods: This is a one-year prospective study conducted in obstetrics and gynecology department at D. Y. Patil hospital, Navi Mumbai, Maharashtra, India. All infertility patients seen in outpatient department, who were medically fit, willing for surgery and willing to get enrolled for study were included in this study.Results: Out of total 120 cases for infertility evaluated, tubal factor is the most common cause (28.3%) in both primary (23.3%) and secondary (43.3%) infertility group as seen on laparoscopy. Followed by ovarian factors (28.3%), peritoneal (11.6%) and uterine factors (10.8%). In 27 cases (22%), there were no detectable pathology at laparoscopy. In this study, hysteroscopy findings show 5.8% cases to have submucous fibroid uterus, 3.3% submucous polyp, 1.6% subseptate uterus, 0.8% septate uterus, 0.8% intrauterine adhesions, 0.8% bicornuate uterus and cervical stenosis 1.6% of patients.Conclusions: From this study, it is concluded that the diagnostic hysteroscopy and laparoscopy is an effective and safe tool in evaluation of female infertility. It provides direct and magnified view of all pelvic organs.
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Background: In a well-equipped hospital, trial of vaginal delivery is done in selected cases of previous C-section (CS). Epidural analgesia administration has been proved to be good adjunct in trial of labor after caesarean (TOLAC).Methods: This study is a prospective observational study done in a tertiary care institution in Tamil Nadu from May 2019 to July 2019. 50 cases with previous history of one CS were selected. Single ton pregnancy, previous transverse lower segment cesarean section admitted cases with adequate pelvis with no other co-morbidities were selected. Epidural analgesia was administered once mother was in established labor. TOLAC was continued till satisfactory progress and emergency repeat caesarean was taken in case of Suspected scar dehiscence (SSD) or abnormal fetal heart rate tracings. Quantitative data was expressed in mean and standard deviation. For qualitative data percentage was used.Results: In 50 cases observed the mean age of the cases was 26±3.64 years. TOLAC was successful in 41 (82%) mothers out of 50. The mode of delivery in 41 TOLAC mothers was found to be forceps in 18 cases (36%) and ventouse delivery 18 cases (36%). Only 9 cases had needed emergency CS (18%). The major indication for CS in TOLAC was found to be fetal distress in 4 number of cases (8%). 43 babies delivered were healthy, 6 babies (12%) admitted in NICU.Conclusions: With the application of epidural analgesia on attempted vaginal delivery in previous cesarean, vaginal delivery was 82% cases.
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Background: The incidence of gall stones is in increasing trend. The old axiom that a typical gall stone sufferer is a fat, fertile, female of fifty, is only partially true, as the disease is found in women soon after their first delivery, in underweight and thin people. So, while searching for other parameters, iron deficiency was found to be a new parameter of interest in the aetiology of gall stones.7Methods: 50 cases of cholelithiasis and 40 cases of anaemia with low serum ferritin levels from September 2017 to August 2019 was studied. Serum iron was estimated by carbonyl metallo-immunoassay method. Serum cholesterol was estimated by the CHOD-POD Enzymatic method. Biliary cholesterol was estimated after extraction of biliary lipids from bile from the gallbladder specimen of the patients by the method of Folch et al which was followed by the procedure similar to the analysis of serum cholesterol by CHOD-POD enzymatic method. Fischer’s chi square exact test was used as statistical method.Results: It was observed that 70% of the group A study group with cholelithiasis had normal serum ferritin levels and 30% had low serum ferritin levels. It was observed that 95% had normal sonographic findings and 5% had cholelithiasis with normal ferritin levels in group B.Conclusions: In our study low serum ferritin levels with cholelithiasis was associated with raised bile cholesterol levels and so it can be concluded that low serum ferritin level is causing biliary stasis and hence leading to increase in the incidence of cholelithiasis.
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Varicocele is the dilatation of pampiniform plexuses which can cause infertility. Incidence of varicocele is around 15-80 % and remains the most common treatable cause of infertility in men. The aim of this study was to identify the preferred method of varicocelectomy in patients with infertility, which gives optimal improvement in semen parameters. This study compares laparoscopic varicocelectomy and subinguinal varicocelectomy.METHODSThis is a prospective interventional study carried out in the Department of Urology, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai from August 2017 to July 2019. We included patients with documented infertility with clinical varicocele. Only couples with no other attributable causes including female factors for infertility were included. Patients with previous history of surgery for inguinal hernia, testicular pathology were excluded from the study. We included 25 patients who satisfied the inclusion criteria. They were subjected to physical examination, doppler study and semen analysis. The patients were randomised into 2 groups, A & B by random allocation. Group A (12 patients) underwent laparoscopic varicocelectomy and group B (13 patients) underwent subinguinal varicocelectomy. All patients were regularly followed up at 3 months and 6 months period post-surgery.RESULTSReview at immediate post-operative period, follow ups at 3 & 6 months were undertaken. History of conception, clinical examination, semen analysis according to WHO 2010 manual and doppler studies by Sarchetsi scale were performed. Three factors in seminal parameters namely sperm concentration, motility & morphology were assessed. Varicocele recurrence was also assessed. There had been a statistically significant improvement in semen parameters in all the patients who underwent varicocelectomy (p value p< 0.005). On comparing the laparoscopic and sub-inguinal surgical techniques, there was no significant variation in increase in sperm concentration, sperm motility and morphology.CONCLUSIONSVaricocelectomy improves the semen parameters. No significant variation was observed when the different surgical approaches of varicocelectomy were compared.
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Background: Cesarean section is becoming a more common delivery type worldwide. The objective of this study was to compare surgical morbidity in extraperitoneal versus transperitoneal techniques of cesarean section.Methods: A total of 60 patients was included in this study out of which 30 underwent extraperitoneal cesarean section(ECS) and 30 patients underwent transperitoneal cesarean section (TCS) and compared both the techniques with respect to nausea or vomiting intra-operatively, pain score (as measured by visual analogue scale) post operatively, return of bowel function and blood loss.Results: Intra-operative nausea and vomiting was noted in 33.34% of patients in TCS group while none of the patients in ECS group had any such complaints. No difference was noted in average blood loss between the 2 groups. Post-operative pain in ECS was 4.13 as compared to 6.86 in TCS. Return of bowel sounds in ECS group was much earlier (5.46 hours) as compared to TCS group (11.33 hours).Conclusions: We conclude that extraperitoneal technique is advantageous over transperitoneal approach. Decreased nausea and vomiting, early return of bowel function in the post-operative period, decreased post-operative pain allowing early feeding and mobilization are definite benefits of this technique. This further helps in making a relatively smoother post-operative recovery.
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A 4-year-old female child born out of a consanguineous marriage, full-term normal vaginal delivery, presented with multiple hypopigmented macules giving mottled pigmentation over the face and neck. There was a history of swelling and pain in the right ear and recurrent skin infections. On examination, she had a silvery gray hair, mottled pigmentation over the face and neck, perichondritis of right ear, impetiginous lesions over the lower limbs, hepatomegaly. Ophthalmological examination revealed partial oculocutaneous albinism and nystagmus. Routine blood investigations were within normal limits. Peripheral smear examination revealed prominent granules within the leukocytes. Hair shaft examination revealed regularly arranged small clumps of melanin. It was diagnosed as a case of Chediak–Higashi syndrome. This case is presented for its rarity.
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Background: Seizures are the most common pediatric neurological disorder. With this a study was conducted to determine the frequency of abnormal neuroimaging in children aged between 6 months to 16 years with new onset afebrile seizures.Methods: Study was conducted in the department of pediatrics, GSL Medical College. Children aged six months to sixteen years, presented with the symptoms of first episode of afebrile seizures were included in the study. After through clinical examinations, findings were recorded, and all the participants underwent imaging studies such as CT and MRI. And the findings were recorded. p<0.05 was considered statistically significant.Results: Total of 80 participants were included in the study; in this, 22.5% (18) had simple partial, 41.3% (33) had complex partial and 5% (4) had partial seizures with 20 generalization and 31.3% (25) had generalized seizures. Seizures were more common among non-vegetarians (p<0.05). Bain CT shows localization to the parietal lobe in 54% of these cases.Conclusions: Neurocysticercosis and tuberculoma are common causes of seizures. Although cysticercosis incidence is greater in pork eaters, but vegetarians shouldn't be excluded. Studies on large sample size for long time are recommended.
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Background: Dental caries is challenging infectious disease, which is wide spread and difficult to control. Although it's multifactorial, microorganisms especially cariogenic Streptococcus mutans plays a wide role in initiation and progression of dental caries. Objective: The present review mainly aimed to evaluate and assess the antibacterial efficacy of herbal versus conventional products on Streptococcus mutans. Data Sources: A search was execute in electronic database (i.e., PUBMED CENTRAL,COCHRANE, LILAC, SCIENCEDIRECT, GOOGLE SEARCH) using following search terms alone and in combination by means of PUBMED search builder from January 1990 up to July 2019. Study Eligibility Criteria: Studies were stipulate if they met the following criteria: In vivo studies comparing herbal and conventional products on anticariogenic or antibacterial activity on Streptococcus mutans were selected. Participants and Intervention: Adult patients aged from 18-65 years with dental caries undergoing intervention of herbal products. Study Appraisal and Synthesis Material and Methods: Out of 225 studies collected from databases, only 6 studies were included and other 6 were collected by hand search. Finally 12 included studies were analyzed out of which 5 studies were considered for meta-analysis. Results: The results unveil that natural products exerted virtually homogeneous antibacterial effect against Streptococcus mutans when compared with the counterpart. Limitations: Review was assessing on patients with dental caries and studies previously assessed did not mention about the caries risk. Prevalence varies based on caries risk assessments. Study was concentrating only on single species Streptococcus mutans. But ideally caries is multifactorial. Conclusion: Although natural products were effective, the present systematic review does not furnish concrete evidence to a show increased antibacterial efficacy of natural products as compared to conventional products. (AU)
Introdução: A cárie dentária é um desafio para as doenças infecciosas, que são amplamente disseminadas e de difícil controle. Embora seja multifatorial, os microrganismos cariogênicos, em especial o Streptococcus mutans, desempenham um amplo papel na iniciação e progressão da cárie dentária. Objetivo: A presente revisão teve como objetivo principal avaliar a eficácia antibacteriana de produtos fitoterápicos em comparação com produtos convencionais frente a Streptococcus mutans. Os dados foram obtidos através de uma pesquisa executada em um banco de dados eletrônico (PUBMEDCENTRAL, COCHRANE, LILAC, SCIENCEDIRECT, GOOGLE SEARCH) usando termos isoladamente ou associados, por meio do construtor de pesquisa PUBMED, de janeiro de 1990 a julho de 2019. Foram selecionados estudos que atendessem aos seguintes critérios de elegibilidade: estudos in vivo comparando produtos à base de plantas e produtos convencionais sobre a atividade anticariogênica ou antibacteriana de Streptococcus mutans. Os participantes envolvidos consistiam de pacientes adultos de 18 a 65 anos com cárie dentária submetidos a intervenção de produtos fitoterápicos. Material e métodos: de 225 estudos coletados de bancos de dados eletrônicos, apenas 6 estudos foram incluídos e outros 6 foram selecionados por pesquisa manual. Finalmente, 12 estudos incluídos foram analisados, dos quais 5 foram considerados para meta-análise. Resultados: Os resultados revelaram que os produtos naturais exerceram efeito antibacteriano homogêneo contra o Streptococcus mutans quando comparados com a contraparte. Limitações: A revisão avaliou pacientes com cárie dentária e os estudos prévios não mencionavam o risco de cárie. A prevalência varia com base nas avaliações de risco de cárie. O estudo se concentrou apenas em uma única espécie de Streptococcus mutans, mas a cárie dentária é de origem multifatorial. Conclusão: Embora os produtos naturais tenham sido eficazes, a presente revisão sistemática não fornece evidências concretas para mostrar um aumento da eficácia antibacteriana dos produtos naturais em comparação com os produtos convencionais.(AU)
Subject(s)
Plants, Medicinal , Streptococcus mutans , Chlorhexidine , Dental Caries , Anti-Bacterial AgentsABSTRACT
Background: The global issue that urges the public health emergency is the outbreak of the Novel Corona Virus strain (COVID-19). Dentists being are highly prone to airborne transmission during dental treatment due to aerosols generated by various dental procedures on patients with COVID-19. Taking this fact into consideration, the present survey research was mainly aimed at evaluating the knowledge, attitude, and practice of dentists in preventing the disease transmission of Novel Coronavirus (COVID-19). Material and methods: The present study is prospective research, where the online survey questionnaire was distributed among 300 dentists in Andhra Pradesh and Telangana states in India, who were randomly recruited for the study. The participants were recruited based on the clinical experience ranging from less than five years to more than ten years, who were working in both the private and government sectors. 15 close-ended questions were formulated and validated. The questionnaire consisted of the necessary demographic details of the participants and equally distributed into three sections that contained questions that assessed the knowledge, attitude, and practice of dentists in preventing the disease transmission of Novel Coronavirus (COVID-19). Results: The results revealed that dentists have an adequate knowledge and awareness on COVID-19 transmission and most of the dentists felt that dentists have a major role in preventing the disease transmission. Majority of the participants raised the importance of awareness programs have to be conducted on various measures in preventing COVID-19 transmission among dental fraternity and in public. Conclusions: From the survey research it can be concluded that dentists have an adequate knowledge and awareness on COVID-19 disease. Majority of them are trying their level best in the present situation to prevent COVID-19 transmission. (AU)
Histórico: A questão global que instiga a emergência de saúde pública é o surto do Novel Corona Virus (COVID-19). Os dentistas são altamente propensos à transmissão aérea durante o tratamento dentário devido aos aerossóis gerados por vários procedimentos odontológicos em pacientes com COVID-19. Levando esse fato em consideração, a presente pesquisa teve como objetivo principal avaliar o conhecimento, a atitude e a prática dos dentistas na prevenção da transmissão da doença pelo novo coronavírus (COVID-19). Material e métodos: O presente estudo é uma pesquisa prospectiva, na qual o questionário online de pesquisa foi distribuído entre 300 dentistas, que foram recrutados aleatoriamente para o estudo, nos estados de Andhra Pradesh e Telangana, na Índia. Os participantes foram recrutados com base na experiência clínica que variava de menos de cinco anos até mais de dez anos, que trabalhavam nos setores privado e público. Quinze perguntas fechadas foram formuladas e validadas. O questionário consistiu nos detalhes demográficos dos participantes e três seções com distribuição igualitária, as quais continham perguntas que avaliavam o conhecimento, a atitude e a prática dos dentistas na prevenção da transmissão da doença pelo novo coronavírus (COVID-19). Resultados: Os resultados revelaram que os dentistas têm um conhecimento e conscientização adequados sobre a transmissão do COVID-19 e a maioria considerou que os dentistas têm um papel importante na prevenção da transmissão da doença. A maioria dos participantes levantou a importância de que programas de conscientização devem ser conduzidos sobre várias medidas para impedir a transmissão do COVID-19 entre a comunidade odontológica e com o público. Conclusões: A partir da pesquisa realizada pode-se concluir que os dentistas possuem conhecimento e conscientização adequados sobre a doença de COVID-19. A maioria deles está contribuindo da melhor maneira possível na situação atual para impedir a transmissão do COVID-19. (AU)