Assessment of Children's Oral Health-Related Knowledge and Self-Efficacy in Expectant Mothers of Najran, Saudi Arabia

Abstract Objective: To assess the knowledge of pregnant women regarding their child's oral health. Material and Methods: A questionnaire was developed and the 1st section comprised sociodemographic variables. The second section contained questions about the eruption of teeth, fluoride importance, cariogenic food, and dental visits. The questionnaire was shared electronically via a link to the receptionist of the gynaecologist at different health centres of Najran to be filled by expectant mothers. The convenient sampling method was used to collect the responses. Data were presented using descriptive statistics. Results: A total of 572 pregnant women participated in this survey. Three hundred and fifteen (55.1%) knew that 1st primary tooth erupts at the age of 6 months. The majority of the respondents (n=332) agreed that toothbrushes and toothpaste could be used to clean a child's teeth; only 5.4%, 10%, and 24.5% preferred miswak, mouthwash, and toothbrush, respectively. Participants were well familiar with cariogenic food and occasionally allowed their children to take it. They have enough knowledge about fluoride toothpaste, but they were not familiar with the benefits of fluoride varnish. Almost 50% of the respondents agreed that the child should visit the dentist within six months, and 27.4% said they should visit the dentist whenever there is a problem. Conclusion: Almost 50% of participants showed a positive attitude towards most questions. However, there is a need to improve their behaviour and knowledge about many aspects of dental care.

A Retrospective Study on Use of Antihypertensive drugs in Type 2 Diabetes Mellitus – A Hospital Based Study

Background: Association of Hypertension and diabetes has already been established. Hypertension is risk factor for development of diabetes as well for complications like nephropathy, CAD and neuropathy etc. Therefore, Hypertension control is vital to prevent and retard progression of microvascular and macrovascular complications. With this aim, we undertook this study to evaluate treatment patterns in diabetic patients with hypertension, those are being followed at our institute. Materials & Methods: This study was conducted on diabetic patients suffering from hypertension as well. Analysis of Antihypertensive drugs prescriptions was undertaken in all diabetic patients with hypertension reporting to OPD at Department of Medicine, Grant Government Medical College and Sir JJ Group of Hospitals, Mumbai, India.  Results: Of 125 patients screened initially, only 100 were eligible for participation. Out of n=100 patients, 58 were males and 42 were females. Mean age of group was 55.2 years. 38 (38%) patients were on monotherapy and remaining 62 (62%) patients were on combination antihypertensive drugs. There were a total of n= 170 antihypertensive drug exposures. Angiotensin receptor blockers were the most commonly prescribed drugs. Angiotensin inhibitors (angiotensin receptor blockers and ACE inhibitors) were utilized in 74% patients. Conclusion: Our study showed that majority of diabetic hypertensive patients needed multiple drug therapy to control hypertension. Most of the patients were on ARBs/ACE inhibitors. This was according to recommendation by ADA or JNC8.

Role of Procalcitonin and C-reactive protein in differentiating culture negative bacterial sepsis and systemic inflammatory response

Background: It is very important to distinguish between non-infectious systemic inflammatory response (SIRS) and culture negative sepsis as the management of the two conditions is different this often creates diagnostic challenge in day to day practice. The aim of present study is to investigate the diagnostic accuracy of serum PCT and CRP to differentiate between culture negative bacterial sepsis and non-infective SIRS. We have also studied their diagnostic efficacy in culture-positive sepsis. Materials and methods: 178 cases who were admitted in acute medical care unit in tertiary care centre, were included in the study. The cases were divided into three groups. Group I (culture positive sepsis) patients with positive microbial culture and 2 or more signs of sepsis. Group II (culture negative sepsis) includes patients with 2 or more sign of SIRs and clinical suspicion of infection with negative culture result. Group III (non-infective SIRs) includes patient with 2 or more sign of SIRS without evidence of any infection. Samples were collected for blood culture, differential count, PCT and CRP along with other routine investigation. The diagnostic performance of PCT and CRP was demonstrated with ROC curve analysis. Results: The median Procalcitonin was approximately 9 fold higher in culture negative group compared to non-infective SIRS and it was statistically significant (P<0.01) whereas CRP showed Siraj Ahmed Khan, Iyyapu Krishna Mohan, Bhavya Sirivelu, Rachel Jacob. Role of Procalcitonin and C-reactive protein in differentiating culture negative bacterial sepsis and systemic inflammatory response. IAIM, 2017; 4(3): 24-29. Page 25 only 2-3 fold increase between these groups. ROC curve analysis for PCT and CRP between culture negative and SIRS groups for prediction of systemic infection were performed. The area under the curve for PCT and CRP were 0.986 and 0.785 respectively. Conclusion: Biomarkers such as PCT and CRP are strongly associated with infection likelihood and sepsis and they can serve as useful adjuncts to routine clinical information. These markers were also able to distinguish between patients with non-infective SIRS and sepsis.

Chikungunya outbreak in Garo Hills, Meghalaya: an epidemiological perspective.

Background & objectives: Chikungunya (CHIK) fever is a mosquito-borne disease caused by chikungunya virus (CHIKV). Chikungunya infection was first reported from India in 1963 from Kolkata. We report the serological and molecular evidence of an outbreak of chikungunya in northeast India that occurred in Tura, a hilly and forested terrain in Garo Hills district of Meghalaya. Methods: blood samples (3 ml) collected from hospitalized patients during the outbreak were tested for IgM antibodies against CHIKV and followed up four months later. A repeat survey was carried out in the same area after four months from where cases had been reported. Blood samples were also collected from people with history of fever and body ache in the last four months. Persons showing IgM positivity against CHIKV in the repeat survey were followed up one and a half years later. All samples were also processed by RT-PCR assay for CHIK Envelope (E) 1 gene. Immature mosquitoes were collected, link reared and identified with standard keys. Virus incrimination studies were done on Aedes aegypti and Ae. albopictus mosquitoes collected during the survey. Results: Fever, headache and joint pain were the primary clinical presentations. Twenty three (35.93 %) of 64 samples reported during the outbreak were IgM positive for CHIK. Three samples showed PCR amplification. All these were IgM positive. The sequenced E1 gene revealed that the strains belonged to East Central South African (ECSA) genotype. Interpretation & conclusions: Field survey done after four months revealed that some individuals still had joint pain associated with episodes of headache and fever. It could be inferred that these persons might have contracted infection during the CHIK outbreak four months ago or during the intervening period which caused persistence of sequelae. ECSA genotype was found to be involved in the outbreak. Aedes albopictus was the predominant mosquito species collected during the outbreak.