Self-assessment and clinical diagnosis of periodontal status among patients visiting dental institution in Bangalore city: a cross-sectional study

Background: Periodontal diseases are a group of lesions affecting tissues surrounding and supporting the teeth. Periodontal diseases are considered as a group of highly prevalent infectious, inflammatory conditions of the supporting structures of the teeth which affects more than 50% of the world’s adult population. The present study was undertaken to evaluate the extent of agreement between clinical and self-assessed periodontal health status among patients visiting the outpatient department of Rajarajeswari Dental College and Hospital, Bangalore, India. Methods: A cross-sectional study was done among 250 patients who attended the outpatient department of Rajarajeswari Dental College and Hospital, Bangalore. The study population was subjected to a self-administered questionnaire which was followed by periodontal examination. The clinical examination included an assessment of the periodontal condition using CPI and mobility. Results: There was a marked discrepancy between the two values of self-assessed and clinically diagnosed periodontal health status which shows that the self-assessed periodontal tool was a poor indicator of the periodontal health status. Conclusions: The present study showed that there is a discrepancy between the subjectively and objectively assessed periodontal health status. Increasing people’s awareness and knowledge of their own dental disorders and changing their attitudes and behavior towards oral health care will help in improving oral as well as general health.

Oral health status treatment needs among 12 years old children living in orphanages and parental homes in Bangalore city: a cross sectional study

Background: Enjoying good oral health includes more than just having healthy teeth. Many children have inadequate oral and general health because of active and uncontrolled caries. In orphans the oral hygiene practices are usually neglected which may affect various aspects of life, including function, appearance, interpersonal relationships and even career opportunities. Aim of study was to assess oral health status, treatment needs among 12 years old children living in orphanages and compare with that of children living in parental homes and attending government school. Methods: A descriptive cross sectional comparative study was carried out among 460 twelve year old children living in orphanages and parental home. Oral health status and treatment needs was assessed using the World health Organization’s oral health assessment (tooth surface) form for children- 2013. Proportion was calculated using chi-square test and T-test. Results: Present study found mean decayed surface, mean missing surface and mean filled surface was higher in orphanage children (4.57±3.9), (0.17±0.91) and (3.2±0.37) and as compared to school children i.e. (3.88±3.91), (0.16±0.370) and (2.3±0.14). 68.7% school children required prompt treatment (including scaling) 24.3% required immediate treatment due to pain or infection of dental and oral origin, 5.7% required preventive or routine treatment. Conclusions: The study highlighted untreated caries, less filled component and high missing component among orphanage children compared to school children. There is need for dental care, primary prevention such as oral health education programmes in schools.

Assessment of knowledge and decision-making regarding dental trauma among primary school teachers in south Bangalore- a cross-sectional survey

Background: Injury to primary and permanent dentitions is one of the most common dental problems seen in school going children. Teachers play an important role in prevention of dental trauma and immediate management of the injured tooth. Hence, the aimed of the study was to evaluate primary school teachers’ knowledge and decision making regarding dental trauma in South Bangalore, Karnataka. Methods: A cross-sectional survey was conducted among 400 primary school teachers in South Bangalore, using self-administered pretested questionnaire consisting 16 close-ended questions. Results: Among 400 primary school teachers, 212 participants could identify the damaged front teeth likely to be permanent teeth. Almost half of the participants would seek the dentists help immediately and only 74 respondents would not mind the delay of 30 minutes. Most of the respondents would clean the dirty tooth in tap water and only 16 respondents would use milk for transporting the avulsed tooth. A great majority of the respondents were satisfied with the knowledge on the management of dental trauma but most of them expressed desire for further knowledge. Conclusions: The research clearly revealed that majority of school teachers had very less knowledge related to handling of traumatic dental injuries. First aid training program with dental content and acquisition of dental injury management should be included in the curriculum of teachers training program.

Phytochemical screening of Acacia nilotica extract: an in vitro study

Background: The present study aim was to identify the presence of phytochemical screening of flower extract of Acacia nilotica. Methods: The flower extract of Acacia nilotica was prepared using Soxhlet apparatus. The preliminary phytochemical analysis of methanol flower of Acacia nilotica was carried out by using simple chemical tests and compared with ethanol and aquesous extract of the same plant. The antimicrobial testing was done using agar well diffusion method. Minimum inhibitory concentration (MIC) was carried out by micro dilution assay and minimum bactericidal concentration (MBC) was done using colony forming unit (CFU) method. SPSS version 20 was used for statistical analysis. Results: The results of phytochemical screening of methanol flower extract of Acacia nilotica showed the presence of alkaloid, flavonoid, glycosides, tannin, terpenoids, steroids whereas ethanol shows the presence of flavonoid, glycosides, tannin, terpenoids, saponin, steroids and aqueous extract shows presence of alkaloid, flavonoid, glycosides, tannin, terpenoids, saponin, steroids. The antibacterial activity of the (flower) extract of Acacia nilotica showed relatively high zone of inhibition (21 mm,19 mm) at 40 mg/ml against S. mutans and L. acidophillus. The MIC OD at 600 nm showed maximum inhibition at 40 mg/ml against S. mutans and L. acidophillius was about 78% and 91% respectively. Conclusions: The present study signifies the phytochemical screening of Acacia nilotica which could be considered in the evolution of an indigenous herbal mouth rinse or toothpaste as the formulation inhibited all the micro-organisms tested in this study at low concentrations.

Intracranial Inflammatory Myofibroblastic Tumor: A Review of 49 cases

Inflammatory Myofibroblastic Tumor (IMT) is a rare pathologic entity that was first described in 1973. This lesion is most commonly found in the lungs, but other organs' involvement has also been reported. Intracranial location of Inflammatory Myofibroblastic Tumor is rare, and the first case was reported in 1980. An intriguing fact about the intracranial IMT is its resemblance with meningioma on clinical presentation and neuroimaging. We came across a case of intracranial Inflammatory Myofibroblastic Tumor (IIMT) in a 27-year-old male who presented with recurrent episodes of seizures and was diagnosed as meningioma on neuroimaging. The lesion did not subside with medical management and kept on progressing in size. The patient had to undergo surgery, and diagnosis of Inflammatory Myofibroblastic Tumor was ascertained on histopathology. This 'surprise' diagnosis prompted us to review the literature on all cases of IIMTs reported to date to better understand the entity and its implications. In this review article, we present our observations regarding various studied parameters, including patient profile, clinical presentation, site of involvement, focality of the lesion, special associations, and lines of management of the 49 published cases of IIMTs.

An observational study to monitor cutaneous adverse drug reaction profile in Dermatology Department of tertiary care teaching hospital

Background: Incidence of cutaneous adverse drug reactions (CADRs) in developed countries is 1 to 3% and in developing countries, it is much higher i.e. 2 to 6%. 1 in 1000 hospitalized patients will develop severe cutaneous adverse reaction. Maculopapular rash represents majority of cutaneous drug reaction followed by urticaria. Most frequently elicited CADRs are associated with antimicrobials and NSAIDs. This study was designed to monitor Cutaneous adverse drug reaction profile of tertiary care teaching hospital.Methods: This is a prospective observational study of 6 months� duration to monitor cutaneous adverse drug reactions in dermatology department of tertiary care teaching hospital. CADRs were analysed with respect to demographic details, suspected drugs and type of reaction. Causality assessment is by Naranjo algorithm. Data is represented in tables and graphs. Data is analyzed in Microsoft excel 2007.Results: Total 57 cases of cutaneous adverse drug reactions were reported. Among them, 57.9% were in males and 42.1% were in females. Majority of CADRs were due to antiretroviral drugs (38.5%) followed by antibacterial (28%) and antiepileptics (14%). Maculopapular rash is most common CADR (35%). Causality of 74% CADRs were probable according to Naranjo algorithm.Conclusions: CADRs are more commonly associated with antiretroviral therapy (ART), antibacterial drugs and antiepileptic drugs. In case of ART, antiepileptic drug and drugs used in chronic illness compliance plays a major role in the success of therapy. Adverse drug reactions lead to problem of non compliance and failure of therapy. Cutaneous adverse reactions like FDE heal with hyper pigmentation leads to cosmetic problem. Stevens Johnson syndrome (SJS) is life threatening that requires prompt withdrawal of drug and intensive medical management. Many drugs are available without prescription in India leading to problem of misdiagnosis of CADRs. So, data obtained from this study helps in proper diagnosis and treatment of CADRs.

Monitoring, evaluation and comparison of adverse effect profile of ciprofloxacin and ofloxacin in acute bacterial exacerbation of chronic bronchitis patients attending pulmonology department of tertiary care teaching hospital: a prospective observational study

Background: In 2016, FDA recommended that 搒erious side effects associated with flouroquinolones generally outweigh the benefits for the patients with acute sinusitis, acute bronchitis and uncomplicated UTI�. Throughout India the most commonly used flouroquinolones for above conditions are Ciprofloxacin, Ofloxacin, and Levofloxacin. In this scenario, the present study was undertaken to monitor, evaluate and compare the adverse effect profile of Ciprofloxacin and Ofloxacin in acute exacerbation of chronic bronchitis patients.Methods: Prospective, observational study done in 200 patients of tertiary care teaching hospital. The patients diagnosed with, acute bronchitis treated with Ciprofloxacin 500mg BD or Ofloxacin 400mg BD for 7 days were included in the study. The study duration was 6 months. ADR causality assessment was done with Naranjo algorithm. Statistical test applied was chi- square test.Results: 63 ADR were reported in Ofloxacin group and 19 ADR in Ciprofloxacin group. Insomnia was most frequent ADR (40%) in patients treated with Ofloxacin. There is high incidence of ADRs in ofloxacin group. chi square test showed this difference is statistically significant (p<0.05). Insomnia was significantly higher in ofloxacin group (p<0.05).Conclusions: In India frequently used and misused antimicrobials are fluoroquinolones. The present study concluded that no serious ADRs but ofloxacin group of patients have shown increased incidence of ADRs associated with CNS especially Insomnia. However, further large scale, multi-centric studies are needed to confirm these results.

Prevalence of Pneumocystis jirovecii and Mycoplasma pneumoniae in Patients Presenting with Pneumonia at Hospitals in Port Elizabeth

The study was conducted to determine the prevalence of Pneumocystis jirovecii and Mycoplasma pneumoniae in patients presenting with community-acquired pneumonia; in order to improve treatment management programmes. Sputum specimens from 45 patients presenting with pneumonia/symptoms of pneumonia admitted to hospitals in the Port Elizabeth region were assessed. Details of patient's gender; age; HIV and Mycobacterium tuberculosis status were provided by the hospitals. PCRs were performed employing primers directed at the following genes: P. jirovecii for detection of mitochondrial large subunit ribosomal RNA (mtLSUrRNA) and for cotrimoxazole resistance mutation analysis dihrdropteroate synthase (DHPS) and dihydrofolate reductase (DHFR); M. pneumoniae for detection of P1 adhesin and 16SrRNA. Women were seen to be at high risk for community-acquired P. jirovecii colonisation. Overall; prevalence of P. jirovecii was 73(33/45 patients). P. jirovecii was mainly associated with HIV (28/30 P. jirovecii-positive patients for which clinical data were available) and co-colonisation with M. tuberculosis was observed in 10 HIV cases and one HIV-negative patient. DHPS and DHFR primers seriously lacked sensitivity and on six and four PCR products obtained; respectively; no resistanceassociated mutations were found. M. pneumoniae was detected in one patient. The high prevalence of P. jirovecii and presence of M. pneumoniae in cases of pneumonia investigated emphasises that in the absence of definitive diagnoses; it is crucial to monitor treatment responses carefully; especially when first line antibiotic preferences are a-lactams or cephalosporins

Percepçäo e registro de abuso de álcool e de doenças relacionadas num hospital geral universitário / Perception and registration of alcohol abuse and alcohol related diseases by nurses and medical staff of an university general hospital

Objetivo. Avaliar a associaçao entre o resultado do teste CAGE aplicado em pacientes internados num hospital geral universitário (Hospital de Clínicas de Porto ALegre - HCPA) e a percepçao e registro de abuso de álcool e de doenças relacionadas pelas equipes de saúde. Pacientes e Métodos. O delineamento envolveu três fases: a) aplicaçao do teste CAGE aos 385 pacientes adultos e adolescentes internados considerados elegíveis para o estudo; b) revisao dos prontuários dos pacientes CAGE-positivo e de um número igual de pacientes CAGE-negativo, estratificados por área de internaçao e sorteados, para identificar hábitos alcoólicos e a presença de doenças relacionadas ao uso de álcool; c) entevista com os membros das equipes médicas responsáveis para avaliar sua percepçao sobre o hábito alcoólico em seu paciente. As diferenças encontradas foram analisadas através do teste Qui-quadrado e do teste t de Student, com significância estatística em nível de 5 por cento bicaudal. Resultados. Foram encontrados 51 pacientes CAGE-positivo (13 por cento). A equipe médica registrou abuso de álcool no prontuário de 51 por cento dos pacientes CAGE-positivo e 10 por cento dos CAGE-negativo, e a equipe de enfermagem fez este registro no prontuário de 31 por cento dos pacientes CAGE-positivo e 8 por cento dos CAGE-negativo (p=.724). Nao houve diferença entre o registro e a percepçao da equipe médica (p=.184). A prevalência de doenças relacionadas ao abuso de álcool foi 27 por cento quando se examinou os prontuários médicos e 26 por cento quando se entrevistou a equipe médica (p=.861), sendo maior entre os pacientes CAGE-poistivo (43 por cento) do que entre os CAGE-negativo (10 por cento) (p=.0003). Conclusoes. O abuso de bebidas alcoólicas e a presença de doenças associadas ao mesmo sao condiçoes prevalentes nos pacientes admitidos ao HCPA. Entretanto, mais de metade dos casos nao foram detectados pela equipe de saúde, havendo correspondência entre os registros de prontuário e a entrevista.

Hepatitis C virus genotypes in Southern Brazil

The prevalence of hepatitis C virus (HCV) genotypes in Southern Brazil was studied in the plasma of 100 HCV-RNA-positive patients attended in Porto Alegre, South of Brazil. Reverse transcriptionpolymerase chain reaction (RT-PCR) products from the 5' noncoding region were double digested with RsaI-HaeIII and BstNI-HinfI and analyzed by restriction fragment length polymorphism (RFLP). Three genotypes (1, 2 and 3) were demonstrable, the most prevalent being HCV type 1 (55 of 100 patients, 55 per cent), followed by HCV type 3 (37 of 100 patients, 37 per cent) and HCV type 2 (8 of 100 patients, 8 per cent). There was an unusual high prevalence of genotype 3, in contrast to the majority of published data from the Southeast region.