PREDICTIVE FACTORS OF THE OUTCOME OF EXTRACORPOREAL SHOCKWAVE LITHOTRIPSY FOR UPPER TRACT UROLITHIASIS

Extracorporeal Shock Wave Lithotripsy (ESWL) is one of the treatment options for renal and upper ureteric calculus; however, the outcome depends on multiple factors. Our study aims to evaluate the factors that may inuence ESWL outcomes in Indian patients with upper urinary tract calculi. Between 2018 and 2020, a total of 300 adult patients who underwent ESWL for renal and upper ureteral calculus sizing 5 to 20 mm were included in the study program. Patients with

Assessment of Perception about Immunization Among the Mothers of Under-Five Children at Urban Slum Area of Vijayapura City

Introduction: Immunization is one of the most cost-effective health investments worldwide. The World Health Organization (WHO) launched the expanded programme on immunization (EPI) in 1974 with the aim of immunizing children throughout the world. Objective: Assessment of perception about immunization among the mothers of under-five children at urban slum area of Vijayapura city. Methods: Cross-sectional study was conducted in Urban Field practice area of Community Medicine department among the mothers of under-five children residing permanently in the area and were interviewed regarding the perception about immunization to their children by using pre-structured proforma. Results: level of knowledge & perception was found average (around 50%). Nearly 40 to 60% of the participants agreed to the statements which signifies the immunization is very important to the child’s growth and development and should not be avoided. Conclusions: Providing mothers of under-five children with information about vaccination effectively increases the immunization coverage and was highly cost-effective also

Alteration in Serum Lipid Profile Pattern in Oral Squamous Cell Carcinoma and Potentially Malignant Disorders

ABSTRACT Objective: To evaluate and compare lipid profile level in oral submucous fibrosis (OSMF), oral leukoplakia (OL) and oral squamous cell carcinoma (OSCC) patients. Material and Methods: Thirty histopathologically diagnosed subjects each of OL, OSMF, OSCC were recruited along with 30 healthy controls. 5ml of venous blood is collected and estimated using standard diagnostic kits. Results: The mean of Total cholesterol level in controls was 219.03 mg%, in OSCC, OL and OSMF was 142.89 ± 10.21mg%, 155.44 ± 17.63 mg% and 180.60 ± 13.25 mg%, respectively. The mean low-density lipid level in controls was 137.24 mg and in OSCC, OL and OSMF groups were 109.28 ± 2.16 mg%, 126.63 ± 0.85 mg% and 119.15 ± 0.93 mg%, respectively. The mean of high-density lipid level in controls, OSCC, OL and OSMF was 42.87 ± 0.42 mg%, 36.50 ± 2.31 mg%, 21.13 ± 0.77 mg% and 28.37 ± 1.11mg%, respectively. The mean of very low density lipids level in controls, OSCC, OL and OSMF was 30.12 ± 1.51 mg%, 17.24 ± 0.80 mg%, 22.25 ± 0.93 mg% and 25.89 ± 0.43 mg%, respectively. The mean triglyceride level in controls, OSCC, OL and OSMF was 118.80 ± 9.47 mg%, 91.2 ± 3.03 mg%, 105.05 ± 2.96 mg% and 106.19 ± 3.09 mg%, respectively. Conclusion: Lipid profile levels could be early indicators of precancer and cancer.

Effectiveness of Transcutaneous Electrical Nerve Stimulation Therapy on whole Salivary Flow in Patients with Xerostomia and Healthy Adults

ABSTRACT Objective: To evaluate and compare the effectiveness of transcutaneous electrical nerve stimulation (TENS) therapy on whole salivary flow in patients with xerostomia and healthy adults. Material and Methods: Thirty subjects with a history of xerostomia and subjects withunstimulated salivary flow equal to or less than 0.5 ml in 5 min were included in the study group, and 30 healthy subjects were included in the control group. Low forced spitting unstimulated saliva was collected for five minutes in a test tube fitted with a funnel. Then electrode pads of the TENS unit were applied bilaterally on skin overlying the parotid glands and at optimal intensity, stimulated saliva was collected for 5 minutes with the same method in a separate graduated test tube. The salivary flow rate (per minute) was calculated by dividing the amount of collected saliva (volume in mL) by the duration of collection period (5 minutes) and the salivary flow rates prior and after electrostimulation were compared for both groups. The Student's t-test (unpaired and paired) was performed for group-wise comparisons. Results: In study group, the mean unstimulated salivary flow rate was 0.07 ± 0.01 mL/min. There was an 85.71% increase in salivary flow (0.13 ± 0.03 mL/min) during the TENS application and the difference was highly significant (p<0.001). In control group, the mean unstimulated salivary flow rate was 0.37 ± 0.07 mL/min. There was a 21.62% increase in salivary flow (0.45 ± 0.07 mL/min) during the TENS application and the difference was highly significant (p<0.001). An increase in mean salivary flow rate both in males and females after TENS application in both groups (p<0.001) was noted. The difference between unstimulated, stimulated and mean difference in salivary flow rate between males and females was notstatistically significant in both groups (p<0.05). Conclusion: TENS can be an effective therapy in increasing whole salivary flow rates in patients with xerostomia.

Awareness, Knowledge, and Attitude of Saudi Students towards Basic Life Support: A Cross-Sectional Study

ABSTRACT Objective: To evaluate the knowledge and attitude in relation to basic life support (BLS) and cardiopulmonary resuscitation (CPR) skills among the dental undergraduates and interns in Sakaka, Saudi Arabia. Material and Methods: This cross-sectional study was undertaken between October 2019 and December 2019 in Sakaka, Saudi Arabia. One hundred and eighty randomly selected dental students aged over 18 years participated in the study. Their knowledge and attitude towards BLS were gathered through a questionnaire. Results: A total of 158 (out of 180) UG students and interns participated in this study, making the responses of 87.8%. The mean age of the participants was 24.6 years. The samples comprised 86 (54.4%) males and 72 (45.6%) females. The assessments showed that overall the participants had average knowledge towards BLS and CPR, with males responding significantly better than the females (p˂0.05). Furthermore, as students climb the academic ladder, their knowledge regarding BLS and CPR tends to rise. Also, their attitude was positive, and they were willing to receive CPR training. Conclusion: Attitude toward acquiring knowledge about CPR was very positive. However, their knowledge about the topic was average. Students should understand the importance of such skills and efficiently involve in these life-saving procedures.

Efficacy of Oil Pulling in the Management of Oral Submucous Fibrosis: A Preliminary Study

ABSTRACT Objective: To evaluate the effectiveness of oil pulling in the management of oral submucous fibrosis (OSMF). Material and Methods: A total of 62 patients clinically and histopathologically diagnosed as OSMF were incorporated in the present study. The subjects are randomly divided equally into two groups, Group A (oil pulling group) and Group B (placebo group). Subjects in Group A were asked to perform OP with sesame oil on an empty stomach in the morning for 3 months and Group B was given placebo capsules for 3 months. Assessment of various clinical parameters was done regularly, and data were analyzed using the Chi-square test. Results: Eighty-two percent had a habit of betel nut chewing, while 18% of the patients had tobacco chewing habits, which were among the main causative factors for OSMF. Clinical improvements in mouth opening, tongue protrusion, difficulty in speech and deglutition, and burning sensation were significant in the Group A. None of the patients reported any discomfort or side effects. The symptoms were not severe in nature and resolved in few days without stopping the therapy. Conclusion: Oil pulling can bring about significant clinical improvements in the symptoms like a mouth opening and tongue protrusion.

The Effect of Pain and Swelling Related to Third Molars on Oral Health-Related Quality of Life

ABSTRACT Objective: To evaluate the effect of pain and swelling related to third molars on patients' quality of life prior to third molar surgery. Material and Methods: The effects on quality of life with reference to oral health of 246 healthy patients seeking treatment of third molars were analyzed using the 14-item Oral Health Impact Profile (OHIP) questionnaire before surgery. The patients' sociodemographic characteristics, medical and dental history, reasons for third molar removal were recorded. Adverse effects of pain and swelling on oral health-related quality of life were recorded. Results: The mean age of the patients included in the study was 23.15 years, with maximum male patients and the mean OHIP-14 score of 8.01 ± 7.51. About 36.97% of patients reported that their chief complaint was pain/swelling due to third molar infection, and 27.9% of subjects reported one or more of the 14 OHIP items. The odds of reporting for age with ≥25 years was approximately 2 times greater than age with ≤25 years (OR=1.56, 95% CI: 1.01-2.57) and tooth loss due to traumatic history (OR=3.14, 95% CI: 2.12-6.54). Conclusion: Adverse influences on quality of life were seen in a significant number of patients seeking third molar removal. The probabilities increased by 3-fold for patients who had experienced pain or swelling than asymptomatic individuals.

Tooth Coronal Index: A Novel Tool For Age Estimation on Cone-Beam Computed Tomography

ABSTRACT Objective: To evaluate dental age assessment reliability through Tooth Coronal Index (TCI) method. Material and Methods: The cone-beam computed tomography (CBCT) scans of 160 individuals aged between 20-70 years were analyzed in the present study. The height of the crown, i.e., coronal height, and the height of the coronal pulp cavity, i.e., coronal pulp cavity height, of mandibular second premolars and first molars were calculated and then TCI was measured. The actual age of a subject was compared with TCI of tooth and the acquired data were subjected to Pearson's correlation and unpaired t-tests. Results: Negative correlation was observed between the real age and TCI of mandibular first molar (r = -0.094, p=0.382) and second premolar (r = -0.176, p=0.0961. Statistically significant difference was observed between actual age and TCI for mandibular second premolar and first molar (p<0.001). Conclusion: Tooth coronal index has the potential to estimate age of an individual on CBCT scans. It is simple, cost-effective than histological methods and can be applied to both living and unknown dead.

Congenital penile epidermal cyst: a rare location

A 22 years old male presented with a mass over the penis since birth, which was painless and gradually increasing in size. The mass was excised and it was found to be penile epidermal cyst. Epidermal cyst is one of the most common benign tumors occurring in the body, which commonly occurs either congenitally or following trauma or surgery, where the epidermal elements get trapped within closed space. But here this case had no trauma and surgeries in the past and the mass present since birth-a case of congenital penile epidermal cyst.

Prevalence of anaemia in pregnant and lactating women in rural Vijayapur

Background: Nutritional anaemia is defined as a condition in which the haemoglobin content of the blood is lower than normal as a result of deficiency of one or more essential nutrients. Anaemia is the late manifestation of deficiency of nutrient(s) needed for haemoglobin synthesis. The prevalence of anaemia in developing countries is estimated to be 43% and that of developed countries is 9%. Anaemia is estimated to contribute to more than 115000 maternal deaths and 591000 prenatal deaths globally per year. The objectives of the present study were to determine the prevalence of anaemia among the pregnant women and lactating mothers and to explore the associated factors with anaemia.Methods: A cross sectional study was conducted among pregnant and lactating women in Ukkali a rural field practice area Shri B. M. Patil Medical College, Vijayapur. Criteria for inclusion were pregnant women- current pregnancy of more than 6 months and lactating mother with child aged up to 6 months of age. Estimation of haemoglobin was carried by standard Sahlis pipette method. Anaemia was classified according to WHO grading criteria.Results: The maximum number of pregnant women (85.71%) in the age group of 35-49 years was anaemic followed by those who were in the age group of 20-34 years (61.54%). Prevalence of anaemia was 72 % in women of less than 20 years, whereas it was as high as 80% among lactating women of 35-49 years age group.Conclusions: Anaemia continues to be a problem with the existing health care resources. Socio-economic status, literacy of women and awareness related to health concerns are the major determinants that contribute to the problem of anaemia.

Clinical Consequences of Untreated Dental Caries among Primary School Children: A Cross-Sectional Study

Abstract Objective: To evaluate the dental caries experience and clinical consequences of untreated dental caries (UDC) among primary school children of Al Jouf region, Saudi Arabia and to determine the correlation between dental caries experience and clinical consequences of UDC. Material and Methods: A 250 primary school children 6-7 years were recruited using systematic random sampling. The prevalence of dental caries in deciduous dentition was assessed by following WHO criteria using the dmft index and the clinical consequence of UDC was assessed with the pufa index. The pufa score was calculated cumulatively following the pufa diagnostic criteria. The Student's t-test was used to equate the mean dmft and pufa scores between boys and girls. The correlation between the dmft and the pufa scores was evaluated using Pearson's correlation coefficient (r), and the p-value was set at 0.05 for statistical significance. Results: Out of which 154 (61.60%) boys and 94 (37.60%) were girls. The mean (SD) values of dmft for boys reported to be 5.37 (± 3.31) and for girls 6.35 (± 3.27), which was statistically significant with gender (p<0.001). Statistically, significant mean values of pufa were 1.20 (± 1.37) in boys and 1.71 (± 1.58) in girls, respectively was observed (p<0.001). The Pearson correlation between dmft and pufa values showed a highly significant positive correlation among dmft and pufa values (r= 0.635, p<0.001). Conclusion: The present study revealed that high caries prevalence and experience of the clinical consequences of UDC in the primary dentition, and there was a strong positive correlation between dmft and pufa score values.

Accuracy of Cone Beam Computed Tomography in the Assessment of Mandibular Molar Furcation Defects

Abstract Objective: To evaluate the accuracy of cone-beam computed tomography (CBCT) in the assessment of mandibular molar furcation defects. Material and Methods: Thirty patients with furcation defects were selected, oral hygiene instructions, scaling, and root planing with ultrasonic devices and hand instruments and occlusal adjustments were performed. Pre-surgical clinical measurements were carried out at the buccal aspect of the selected mandibular molars. The horizontal furcation measurements were measured with a Nabers Probe starting at the furcation entrance to the greatest horizontal depth. The degree of furcation involvement was graded from 0 to III. Bone loss in the horizontal and vertical direction and the width of the furcation entrance were measured on CBCT and after reflecting the full-thickness flap and debridement of the defects. The data were analyzed using t-test and Pearson's correlation coefficient. Results: The width of furcation entrance in clinical method was 3.27 ± 0.77, while in CBCT method was 3.35 ± 0.71, clinically the vertical bone loss was 3.61±1.09, while in CBCT was 3.57 ± 1.15, horizontal bone loss in clinical method was 5.08 ± 2.21, while in CBCT was 5.11 ± 2.23. No significant difference between the two methods was noted, and a high correlation between the two methods was observed. With regards to the agreement between the two methods of assessment, the width of furcation entrance revealed a difference between the two methods by 0.08 ± 0.21, while vertical bone loss showed difference between the two methods by -0.04 ± 0.19, the horizontal bone loss showed a mean difference between the two methods by 0.03 ± 0.21. Conclusion: CBCT provided high accuracy for the furcation involvement detection and anatomy of surrounding periodontal tissues.

Assessment of Maximum Bite Force in Oral Submucous Fibrosis Patients: A Preliminary Study

Abstract Objective: To determine the maximum bite force (MBF) in oral submucous fibrosis (OSMF) patients and to compare them with that of healthy subjects. Material and Methods: Twenty patients who were clinically confirmed, as OSMF and 20 healthy controls matched for age, gender, and number of intact functional teeth were included in this study. For each subject, age, gender, weight, height and body mass index (BMI) were recorded. The MBF registration was carried out by the two evaluators, who were previously calibrated. Bite force was measured in the first molar region using a force transducer occlusal force meter for each subject seated at the upright position, with Frankfort's plane nearly parallel to the floor, and no head support. The Student's independent t-test was used to determine the statistical significance in relation to mean height, weight, BMI and the presence of number of intact teeth and MBF between the healthy subjects and OSMF individuals. A comparison of grades of OSMF with all variables was carried out by one-way ANOVA test. Results: No significant difference was found in mean age, mean height, weight, BMI and the presence of the number of intact teeth between healthy individuals and OSMF patients. The mean MBF in healthy subjects was 628.23 ± 24.39 N and 635.47 ± 31.22 N in OSMF patients. Even though the healthy subjects reported a higher MBF than OSMF patients did, the difference was statistically non-significant. With regards to sides, no significant difference was observed in mean MBF in healthy subjects and OSMF patients on the right (p=0.7818) and left side (p=0.6154). Conclusion: The healthy subjects reported higher MBF values than OSMF patients did and the difference was statistically non-significant.

Assessment of Caries Spectrum of First Permanent Molars in 7- to 8-Year-Old School Children in Northern Saudi Arabia: A Cross-Sectional Study

Abstract Objective: To estimate caries spectrum in first permanent molars (FPMs) of 7- to 8-year-old children in Saudi Arabia using Caries Assessment Spectrum and Treatment (CAST) index, and examine the correlation between distributions of CAST codes among contralateral and opposite arches. Material and Methods: A cross-sectional survey was conducted of 7- to 8-year-old Saudi school children in Sakaka, Aljouf, Saudi Arabia. A total of 385 children were examined. CAST codes were determined for FPMs, and their distribution was analyzed using Spearman's rank correlation coefficient. Statistical significance was set as p<0.05. Intra-examiner reliability was determined using the unweighted kappa coefficient. Results: The results indicated most of the FPMs were scored as code 3 (enamel lesions) such as upper contralateral FPM 44.40% for right, 53.50% for left, respectively, and lower contralateral molars were 61.30% for right and 64.90% for left, respectively. It was also observed that upper FPMs had scored code 0 (sound teeth) more than that of lower FPMs. Serious morbidity (codes 6 and 7) and mortality (code 8) showed a low prevalence in FPMs. Strong correlations were observed between upper contralateral FPMs (r=0.586) and lower contralateral FPMs (r=0.567, p<0.001). Conclusion: A high prevalence of enamel caries lesions (code 3) was observed in FPMs; in addition, a strong correlation was present between upper contralateral FPMs and between lower contralateral FPMs.

Frequency and Characteristics of Mesiodens in Indian School Children: A Retrospective Radiographic Study

Abstract Objective: To determine the frequency and characteristics of mesiodens in Indian school children. Material and Methods: 1232 radiographs of patients attending the Department of Oral Medicine and Radiology of the age group of 4-15 years studied for the present retrospective study. The intraoral periapical radiographs and occlusal radiographs of the premaxilla were examined to determine the presence of mesiodens. The data regarding the presence of mesiodens, number, position, location on the arch, shape and associated complications were recorded. Results: Eleven patients had 14 mesiodens, with a frequency of 0.8%. The ratio of boys to girls was 1.2:1. Maximum mesiodens observed in the age group of 7-9 years. Most of the mesiodens were conical in shape and found on the palatal side. Fifty percent of the mesiodens were unerupted. The majority of patients (57.1%) had vertically positioned mesiodens. Midline diastema was the most common complication due to mesiodens (66.7%). Conclusion: Routine check-up during the primary dentition and mixed dentition stages helps for early detection of mesiodens and thus preventing complications. Early identification is useful for planning comprehensive management, initiating proper consultation and referral for evaluation and treatment.

Prevalence of Peg-Shaped Lateral Incisors in Non-Syndromic Subjects: A Multi-Population Study

Abstract Objective: To evaluate the prevalence and gender-wise distribution of peg-shaped maxillary permanent lateral incisors among populations in Saudi Arabia representing different geographical locations (Saudi, Jordan, Egypt, Syria, Philippine, Pakistan, India and Bangladesh). Material and Methods: Panoramic radiographs of 9945 patients attending outpatient university dental clinics of College of Dentistry, Jouf University, Saudi Arabia between February 2014 and January 2018 were collected from the archives randomly. Two calibrated investigators examined the data, which were collected from the dental radiology department archives with prior permission from the authorities. The anomalies of maxillary lateral incisors (right and left) were investigated. Results: Among all geographic locations, the prevalence of peg laterals was more in males in comparison to females except in Pakistani and Philippine populations. Among the Saudi population, peg laterals' prevalence was more in case of right lateral incisor than the left incisor. Conclusion: A higher prevalence of peg laterals was found in Saudi. Conclusion: A higher prevalence of peg laterals was found in Saudi region, followed by Egypt. Among all geographic locations, the prevalence of peg laterals was higher in males than females except for Pakistan and Philippines populations. Among Saudi population prevalence of peg laterals was found to be higher in case of right lateral incisor when compared to the left.

Oral Health-Related Quality of Life (OHRQoL) in Patients with Dental Prosthesis

Abstract Objective: To determine the Oral Health-Related Quality of Life (OHRQoL) for post-treated fixed dental prostheses in selected sample of patients. Material and Methods: 120 patients treated with fixed dental prostheses, either single crowns or fixed partial dentures in maxillary or mandibular arches were asked to express their views about their quality of life. Patients' files were randomly selected from the archives of Department of Prosthetic Dental Sciences, College of Dentistry, Jouf University, Saudi Arabia. For this purpose, a self-structured questionnaire was prepared and their responses recorded. The responses were categorized on a 5 point scale and frequencies calculated. Results: Of 120 patients approached, 79 responded with the mean age group of 37 years. From the survey, it was noted that only three variables were statistically significant, those relating to the importance of natural teeth over fixed prostheses (p=0.046), the ability to chew all kinds of foods (p=0.021) and satisfaction with the occlusion (p<0.001). Conclusion: Oral health remains important, which directly or indirectly is related to many systemic diseases. In the present study, the majority of patients were satisfied with the treatment given.

Comparative Measurement of Tooth Length: Actual vs. Orthopantomography and CBCT-Based Measurements

Objective: To compare the reliability of cone beam computed tomography (CBCT) in assessing the tooth length in comparison to orthopantomography (OPG). Material and Methods: Forty patients scheduled for extraction as result of caries or periodontal involvements were randomly selected. Panoramic radiographs and CBCT images were obtained and subsequently patients were subjected for extraction. Teeth with poor prognosis were extracted and stored in 10% formalin. Radiographic teeth measurements were carried out on OPG and CBCT images using a software and the actual tooth length (A-L) measurements were carried out with a digital vernier caliper. The data collected were statistically analyzed for paired "t" test significance of differences and Pearson's correlation at 5% level of confidence. Results: There was significant difference comparing all three actual tooth length (A-L) and CBCT- and OPG-measured tooth lengths. A significant positive correlation was observed among all the measurements. Conclusion: CBCT images exhibited accuracy over panoramic images even though the measurements are still significantly different from actual anatomical tooth lengths.

Comparative Evaluation of Remineralizing Potential of a Paste Containing Bioactive Glass and a Topical Cream Containing Casein Phosphopeptide-Amorphous Calcium Phosphate: An in Vitro Study

Objective: To evaluate and compare the remineralization potential of a dentifrice containing bioactive glass and a topical cream containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) in remineralizing artificial carious lesion on enamel. Material and Methods: Forty-five freshly extracted human permanent premolar teeth were selected. Samples were divided into three groups: GI - regular tooth paste without specific remineralizing agent; GII - tooth paste containing calcium sodium-phosphosilicate (novamin) and GIII - topical cream containing casein phosphopeptide-amorphous calcium phosphate. All the sound enamel samples were viewed under scanning electron microscope (SEM) to assess the topographical pictures of enamel surface and energy dispersing x-ray analysis (EDAX) was done to estimate quantitatively the amounts of mineral (calcium and phosphorous). The mineral content of calcium and phosphorus after demineralization in each group was noted. The samples were then subjected to SEM and EDAX. Results: GI does not show any increase in the calcium and phosphorus after applying toothpaste without any remineralizing agent but GII and GIII showed a net increase in calcium and phosphorous values after applying concern-remineralizing agents. Inter group comparison showed GIII yield higher net calcium and phosphorous values than GII. Conclusion: Two remineralizing agents showed remineralization potential on enamel surfaces. Casein phosphopeptide-amorphous calcium phosphate showed better remineralizing potential than calcium sodium phosphosilicate. Hence CPP-ACP can be considered as the material of choice in remineralizing early enamel carious lesions.

Prospective Analysis of Thyroidectomy Cases in a Tertiary Care Hospital

Introduction: The incidence of thyroid disorders is on the rise. The preferred treatment for most of the thyroid conditions is total thyroidectomy. The associated complications are transient hypocalcemia, recurrent laryngeal nerve palsy, and post-operative hematoma. Objective: The objective of this study is to find out the causes of thyroidectomy and their post-operative complications. Materials and Methods: This is a prospective study conducted over a period of 1 year 6 months (May 2015–November 2017) at the Department of Surgery, Maheshwara Medical College and Hospital, Hyderabad. Results: The rates of thyroidectomy are increasing. They are common among women and mostly following Graves’ disease, nodular goiter, and malignancy. Subtotal thyroidectomy has decreased hypoparathyroidism or nerve injury. However, second look surgeries in cases of recurrence have significantly increased complication rate. Total thyroidectomy is a safe and effective alternative when performed skillfully