Laterally positioned flap with periosteal graft for the treatment of gingival recession, novel technique – A pilot study

Introduction: Periosteum is a highly vascular connective tissue sheath covering the external surface of all bones except sites of articulation and muscle attachment. Regenerative potential of periosteum is due to inner layer which contains mesenchymal progenitor cells. Laterally pedicle flap technique is frequently used for recession coverage in isolated, denuded roots that have adequate donor tissue laterally and vestibular depth. Pedicle flaps have been modified in past, this pilot study utilized the technique which included auto transplant of periosteum in combination with laterally positioned flap. Materials and methods: 20 teeth with gingival recession, Millers’s class 1 and 2 with ≥ 3 mm defect were included and laterally positioned flap with periosteal graft was performed. Results: After 12 months of follow up, a stable result was obtained and the pilot study revealed significant reduction in recession defect. There was a mean percentage of 95.6% for root coverage, 80% predictability for recession coverage. Conclusion: Laterally positioned flap with periosteal graft technique can successfully be clinically utilized for the treatment of gingival recession defects, with less trauma and good esthetic results.

Prevalence of diabetes and pre-diabetes in class III and class IV healthy obese employees of KIMS University, Maharashtra.

Background & objectives: Diabetes is the most common metabolic disorder and its prevalence is increasing in almost all countries. The aim of the study was to estimate the prevalence of undiagnosed diabetes and pre-diabetes in class III and class IV healthy obese employees of Krishna Institute of Medical Sciences (KIMS) University, Karad, Maharashtra. Methods: We screened 600 employees of KIMS University, out of these 105 were included in this study. We studied oral glucose tolerance test (OGGT) and glycosylated hemoglobin (HbA1c) in study group. Classification of new cases was based on the oral glucose tolerance test (OGGT). Results: The prevalence of undiagnosed diabetes among class III and class IV healthy obese employees was 3.8 %, where as pre-diabetics 7.6% making total of 11.4%. Oral glucose tolerance test (OGGT) level was significantly higher (P<0.001) in diabetics and pre-diabetics when compared to non-diabetics. Normal or low level of glycosylated hemoglobin (HbA1c) was found in diabetics and pre-diabetics. Conclusion: The findings of our study and their implication would help to design disease prevention and to reduce morbidity in healthy obese individuals. We recommend that screening for the diabetes and pre-diabetes should be employed as part of routine occupational health check-up programme and OGTT may be the gold standard test to identify undiagnosed diabetes and pre-diabetes in healthy obese individuals.

Reproductive Tract Disorders among Afghan Refugee Women Attending Health Clinics in Haripur, Pakistan.

Afghans comprise one of the largest groups of refugees in the world, with the majority living in Pakistan. The objective of this study was to identify commonly-occurring reproductive tract infections (RTIs), describe knowledge of women about RTIs, and assess physical and behavioural factors contributing to the development of RTIs. Afghan women presenting at Basic Health Units in refugee camps in Haripur, Pakistan, with reproductive health-related complaints, were included in the study (n=634). Data collection included implementation of an interviewer-administered questionnaire, along with a physical examination and laboratory tests. A descriptive analysis was conducted first. Qualitative data were coded and analyzed using predetermined themes. Chi-square test was used for determining the possible relationships between a binary outcome and categorical risk factors. Over three-fourths (76.7%) of those who reported to the health clinics with reproductive complaints had an RTI. Nearly half (49.5%) of these women were diagnosed with some form of vaginitis, and 14.7% were diagnosed with clinical suspicion of pelvic inflammatory disease (PID). Women with cervical prolapse (p=0.033) or who cleansed after intercourse (p=0.002) were more likely to have vaginitis. There was a significant difference (p=0.017) in the prevalence of suspected PID among women who used mud only (11.1%), any water (18.8%), and an old cloth or toilet paper (9.8%) for cleansing after defaecation. Specific physical and behavioural contributors to the high prevalence of RTIs in this population were identified, and recommendations to ameliorate these factors are offered.