Role of cardiovascular magnetic resonance imaging in COVID-19 recovered patients: A short-term follow-up study.

OBJECTIVE: Cardiac involvement in recovered COVID-19 patients assessed by cardiac magnetic resonance imaging (MRI). METHODS: Subjects recently recovered from COVID-19 and with an abnormal left ventricular global longitudinal strain were enrolled. Cardiac MRI in all the enrolled subjects was done at baseline (within 30-90 days following recovery from COVID-19) with a follow-up scan at 6 months in individuals with an abnormal baseline scan. Additionally, 20 age-and sex-matched individuals were enrolled as healthy controls (HCs). RESULTS: All the 30 enrolled subjects were symptomatic during active COVID-19 disease and were categorized as mild: 11 (36.7%), moderate: 6 (20%), and severe: 13 (43.3%). Of the 30 patients, 16 (53.3%) had abnormal CMR findings. Myocardial edema was reported in 12 (40%) patients while 10 (33.3%) had late gadolinium enhancement (LGE). No difference was observed in terms of conventional left ventricular (LV) parameters; however, COVID-19-recovered patients had significantly lower right ventricular (RV) ejection fraction, RV stroke volume, and RV cardiac index compared to HCs. Follow-up scan was abnormal in 4/16 (25%) with LGE persisting in three patients (who had severe COVID-19 [3/4;75%]). Subjects with severe COVID-19 had a greater frequency of LGE (53.8%) and myocardial edema (61.5%) as compared to mild and moderate cases. Myocardial T1 (1284 ± 43.8 ms vs. 1147.6 ± 68.4 ms; p < .0001) and T2 values (50.8 ± 16.7 ms vs. 42.6 ± 3.6 ms; p = .04) were significantly higher in post COVID-19 subjects compared to HCs. Similarly, T1 and T2 values of severe COVID-19 patients were significantly higher compared to mild and moderate cases. CONCLUSIONS: An abnormal CMR was seen in half of the recovered patients with persistent abnormality in one-fourth at 6 months. Our study suggests a need for closer follow-up among recovered subjects in order to evaluate for long-term cardiovascular sequelae. COVID-19 causes structural changes in the myocardium in a small segment of patients with partial spontaneous resolution.

Global Oral Health Policies and Guidelines: Using Silver Diamine Fluoride for Caries Control.

Silver diamine fluoride (SDF) was developed in Japan in the 1960s. It is a clear solution containing silver and fluoride ions. Because of its anti-bacterial and remineralizing effect, silver diamine fluoride has been used in managing dental caries for decades worldwide. This paper aims to summarize and discuss the global policies, guidelines, and relevant information on utilizing SDF for caries management. SDF can be used for treating dental caries in most countries. However, it is not permitted to be used in mainland China. Several manufacturers, mainly in Australia, Brazil, India, Japan, and the United States, produce SDF at different concentrations that are commercially available around the world. The prices differ between contents and brands. Different government organizations and dental associations have developed guidelines for clinical use of SDF. Dental professionals can refer to the specific guidelines in their own countries or territories. Training for using SDF is part of undergraduate and/or postgraduate curriculums in almost all countries. However, real utilization of SDF of dentists, especially in the private sector, remains unclear in most places because little research has been conducted. There are at least two ongoing regional-wide large-scale oral health programs, using SDF as one of the components to manage dental caries in young children (one in Hong Kong and one in Mongolia). Because SDF treatment does not require caries removal, and it is simple, non-invasive, and inexpensive, SDF is a valuable strategy for caries management in young children, elderly people, and patients with special needs. In addition, to reduce the risk of bacteria or virus transmission in dental settings, using SDF as a non-aerosol producing procedure should be emphasized under the COVID-19 outbreak.

A Survey of Self-perceived Physical Discomforts and Health Behaviors Related to Personal Protective Equipment of Indian Dental Professionals during COVID-19 Pandemic.

AIM: In the current situation of COVID-19 pandemic, personal protective equipment has to be mandatorily worn by dental professionals all times in the dental clinical settings. The aim of this study was to assess the physical discomforts and related health issues faced by dental professionals while wearing personal protective equipment in dental clinical settings during the pandemic. METHODS: This was an online cross-sectional survey conducted in November to December 2020 among dental professionals of various regions of country. A prevalidated questionnaire was sent through email/WhatsApp groups to 650 dental professionals. Informed consent was taken from all the participants. Information was collected about the demographics, type of dental set-up, average daily working hours, types of PPE worn, physical discomforts related to the various procedures in dentistry. Association was analyzed between demographics and the discomforts using Chi-square test. RESULTS: A total of 309 dental professionals (163 females, 146 males) from all parts of the country responded to the online questionnaire. Maximum respondents were postgraduates or pursuing MDS (79%), majority (42.1%) were pediatric dentists followed by general dentists. Sweating, difficulty in vision, difficulty in breathing, and headache were the common discomforts reported by majority of the respondents. Headache and difficult breathing were more significantly associated with female dental professionals (p < 0.05). N95 wear was associated with breathing difficulty (56%) while use of faceshield led to the discomforts in visual acuity in 46% respondents. CONCLUSION: The survey has depicted several challenges and various physical discomforts being experienced by the dental professionals during this pandemic. Although wearing PPE is associated with difficulties to dentists but it is extremely essential to wear PPEs for self-protection during the ongoing pandemic. HOW TO CITE THIS ARTICLE: Bansal K, Saji S, Mathur VP, et al. A Survey of Self-perceived Physical Discomforts and Health Behaviors Related to Personal Protective Equipment of Indian Dental Professionals during COVID-19 Pandemic. Int J Clin Pediatr Dent 2021;14(6):784-789.