Front-Line vs Second-Line Healthcare Workers: Susceptibility Prediction to COVID-19 Infection in a Tertiary Care Teaching Institute.

Background Since the beginning of the novel coronavirus disease in Wuhan city of China in 2019 and its spreading worldwide and taking the form of a pandemic, many healthcare workers (HCWs) were affected by coronavirus disease 2019 (COVID-19) infection. Though we have used many types of personal protective equipment (PPE) kits while taking care of COVID-19 patients, we have seen COVID-19 susceptibility in different working areas were different. The pattern of infection in different working areas depended on HCWs following COVID-19 appropriate behavior. Therefore, we planned to estimate the susceptibility of front-line HCWs and second-line HCWs to getting COVID-19 infection. Aim To determine the risk of COVID-19 in front-line healthcare workers as compared to second-line healthcare workers. Method and materials We planned a retrospective cross-sectional analysis of COVID-19-positive healthcare workers from our institute within six months. Their nature of duty was analyzed and they were divided into two groups: 1) Front-line HCWs were defined as those who were working or who have worked in screening areas of the outpatient department (OPD) or COVID-19 isolation wards within the prior 14 days and provided direct care to patients with confirmed or suspected COVID-19. 2) Second-line HCWs were those who were working in the general OPD or non-COVID-19 areas of our hospital and did not have contact with COVID-19-positive patients. Results A total of 59 HCWs became COVID-19 positive during the study period, 23 as front-line and 36 as second-line HCWs. The mean (SD) duration of work as a front-line worker was 51 and as a second-line worker was 84.4 hours. Fever, cough, body ache, loss of taste, loose stools, palpitation, throat pain, vertigo, vomiting, lung disease, generalized weakness, breathing difficulty, loss of smell, headache, and running nose were present in 21 (35.6%), 15 (25.4%), 9 (15.3%), 10 (16.9%), 3 (5.1%), 5 (8.5%), 5 (8.5%), 1 (1.7%), 4 (6.8%), 2 (3.4%), 11 (18.6%), 4 (6.8%), 9 (15.3%), 6 (10.2%) and 3 (5.1%), respectively. To predict the risk of getting COVID-19 infection in HCWs, binary logistic regression with COVID-19 diagnosis as the output variable was modeled with hours of working in COVID-19 wards as front-line and second-line workers as independent variables. The results showed that there was a 1.18 times increased risk of acquiring the disease for every one-hour excess of working as a front-line worker, whereas, for second-line workers, it was slightly lower, with a 1.11 times increased risk for developing COVID-19 disease with every one hour increase in duty hours. Both these associations were statistically significant (p=0.001 for front-line and 0.006 for second-line HCWs). Conclusion COVID-19 has taught us the importance of COVID-19 appropriate behavior in preventing the spread of respiratory organisms. Our study has shown that both the front-line and second-line HCWs are at increased risk of getting the infection and proper use of a PPE kit or mask can decrease the spread of such respiratory pathogens.

A Fixed-Dose Combination of Ofloxacin-Ornidazole Induced Fixed Drug Eruption: A Case Report.

Cutaneous drug eruptions are commonly occurring adverse drug reactions. Food and Drug Association does not recommend a fixed dose combination of ofloxacin-ornidazole; still, it is commonly practised in developing countries. Many patients take this combination of drugs for episodes of gastro-enteritis, often as self-medication. We are reporting a 25 years old male patient presenting with repeated episodes of adverse drug reaction to a fixed dose combination of ofloxacin-ornidazole.

Exchange of Pb from Indian to Atlantic Ocean is driven by Agulhas current and atmospheric Pb input from South Africa.

Using a spatiotemporal dataset of dissolved lead (dPb) from the subtropical oceans surrounding South Africa, this study quantifies the exchange of dPb between the Indian and Atlantic Oceans. Despite the absence of a major Pb source within the South Atlantic sector and the complete phase-out of leaded petroleum in Southern Africa, the ecologically important southeast Cape Basin shows an elevated surface dPb concentration (21-30 pmol kg-1). We estimated up to 90% of the measured dPb in surface waters of the Cape Basin was delivered from the Indian Ocean via the Agulhas Current (AC). Eddy dynamics and leakage at Agulhas retroflection result in an increased Pb flux from winter to summer, while a long-term (2008-2019) temporal change in dPb in the AC-derived water of Cape Basin was contemporaneous to a change in atmospheric Pb emissions from South Africa. The South African-origin atmospheric Pb, however, contributes first to the Agulhas waters in the West Indian Ocean, which is then transported to the South Atlantic, thereby regulating the dPb inventory of the Cape Basin. This indirect mechanism of Pb transfer emphasizes the importance of regulating Pb emissions from Southern Africa to protect rich fishing grounds associated with the Benguela marine ecosystem.

Spectrophotometric Analysis and Determination of Anti-inflammatory Effect of Punica granatum and Woodfordia fruticosa in Subjects With Chronic Periodontitis - A Randomized Controlled Clinical Trial.

INTRODUCTION: Long-term use of chemical plaque control methods has led to adverse effects. In the current scenario, herbal mouthwashes have adequately remediated periodontal disease. Moreover, in the salivary interactome, biomarkers such as salivary amylase, a key protein secreted in the saliva, have been immensely useful in detecting the progression of periodontal disease. Therefore, we aimed to determine the anti-inflammatory effect of ethanolic crude extracts of Woodordiafruticosa leaf and Punicagranatum peel and to estimate salivary amylase levels in subjects diagnosed with chronic periodontitis. METHODOLOGY: Ethanolic extracts of both plants were prepared using the soxhlet extraction method, and the obtained metabolites were confirmed by thin-layer chromatography. After a mouthwash was prepared, 100 subjects were randomly divided into two groups. Group I received Punica peel (Pgp) mouthwash, and Group II received Woodfordialeaf (Wfl). Clinical parameters such as probing depth and clinical attachment loss were recorded to determine the grades of periodontitis. Unstimulated whole saliva was collected, and amylase levels were analyzed at three-time intervals using spectrophotometric assay. RESULTS: For both groups, the mean reduction in salivary amylase levels was calculated at baseline after 1 hour and 1 week of using the mouthwash. A statistically highly significant reduction was seen with (p=0.000*) at the 1-hr interval in Group I. CONCLUSION: The anti-inflammatory effect was more effective with Pgp mouthwash when compared to Wfl mouthwash.

Patients' Satisfaction on Telemedicine Service in Relation to COVID-19 and Non-COVID-19 Problems: A Cross-Sectional Comparative Study.

BACKGROUND: Telemedicine service was historically started for ambulatory and hospice care patients. Since 2020, we have been in the midst of the COVID-19 pandemic. The availability of healthcare facilities became limited due to repeated locked down during the COVID-19 pandemic. Thus, telemedicine service has gained tremendous popularity among healthcare services. Telemedicine service was started at All India Institute of Medical Sciences (AIIMS), Deoghar, as a COVID Helpline facility to provide guidance and care to the home isolated COVID-19 patients during the second wave of COVID-19. But we observed that more than 40% of calls were due to non-COVID-19-related problems, but we managed the non-COVID-19-related calls by discussing with a specialist in conference calls or WhatsApp consultation. Therefore, we planned to compare individual satisfaction with telemedicine services in patients with COVID-19 and non-COVID-19-related problems. METHODS AND MATERIALS: This study was a cross-sectional retrospective analysis of the register of telemedicine maintained in AIIMS, Deoghar, callers were grouped into two- COVID-19 and non-COVID-19-related problems. We obtained feedback from the patients and recorded it in a google form, collected data were analyzed in both groups. Telephonic consent was taken for participating in the study. The sample size was calculated to be 252, the COVID-19 group: 126, and the non-COVID-19 group: 126, and simple random sampling was used to choose the participants from the 730 total callers of the first month of telemedicine service. Their response was graded on 4 points Likert scale (1=Poor, 2=fair, 3=Good, 4=Excellent) and outcomes were analyzed by IBM SPSS (version 20.0) software. A p-value of <0.05 was considered statistically significant. OBJECTIVE: The primary objective is to estimate the level of satisfaction in both groups and compare their level of satisfaction. The secondary objective is to determine the department-specific telemedicine services requirement for people in need. RESULTS: Out of a total of 252 patients, most (54%) callers were 18-45 years old, and 44% were above 45 years old. 64% of patients were male. 90% of callers were from urban or semi-urban districts. 90% of callers had a 10th-grade or more education. 89% of patients were willing to use telemedicine services in the future. An Independent sample t-test was used to compare the means of both the groups showed a significant difference (p < 0.05) in the level of satisfaction in the COVID-19 group to the non-COVID-19 group. It showed that satisfaction in the COVID-19 group was higher than the group with non-COVID-19-related problems. CONCLUSION: COVID-19 has changed the whole spectrum of healthcare needs of the community. Our study findings showed that there is a need for separate department-wise telemedicine services to provide satisfactory service for attending to problems related to that department. For example, problems with diabetes should be attended to by an endocrinologist or an internal medicine specialist. This study finding helped us to change the policy and start department-wise telemedicine service.

Oceanographic anomalies coinciding with humpback whale super-group occurrences in the Southern Benguela.

Seasonal feeding behaviour of humpback whales (Megaptera novaeangliae) has been observed in the coastal waters of the Southern Benguela where the species has been observed forming super-groups during the austral spring in recent years since 2011. Super-groups are unprecedented densely-packed aggregations of between 20 and 200 individuals in low-latitude waters and their occurrences indicate possible changes in feeding behaviour of the species. We accessed published data on super-groups occurrence in the study area in 2011, 2014 and 2015, and investigated oceanographic drivers that support prey availability in this region. We found that enhanced primary production is a necessary but not sufficient condition for super-groups to occur. Positive chlorophyll anomalies occurring one month prior to the super-group occurrences were identified, but only a concurrent significantly reduced water volume export from the region throughout October were conducive to the aggregations in the specific years. Hydrodynamic model results attributed the anomalous decreased volume export to the strength and orientation of the Goodhope Jet and associated eddy activity. The combination of random enhanced primary production typical of the region and emerging anomalous conditions of reduced water export in October since 2011 resulted in favourable food availability leading to the unique humpback whale aggregations. The novelty of this grouping behaviour is indicative of the lack of such oceanographic conditions in the past. Given the recency of the events, it is difficult to attribute this reduction in ocean transport to climatic regime shifts, and the origin should be likely investigated in the distant water mass interaction with the greater Agulhas system rather than in local intensifications of the upwelling conditions. A positive trend in the humpback whale population abundance points to the need to monitor the exposure of the species to the changing climate conditions.

Antibacterial and Antifungal Efficacy of Platelet-Rich Fibrin and Platelet-Rich Fibrin Matrix against Root Canal Microflora.

BACKGROUND: Binding of such proteins with a developing fibrin mesh or to the extracellular matrix has the ability to create chemotactic gradients aiding the recruitment of stem cells, thereby, stimulating cell migration and differentiation this may promotes repair and regeneration. There is a unique concept in platelet concentrates called platelet-rich fibrin matrix (PRFM) which is processed using higher attraction without the utilization of bovine thrombin. AIM AND OBJECTIVES: The aim of this study is to evaluate the antibacterial and antifungal effects of platelet-rich fibrin (PRF) and PRFM against root canal microflora. MATERIALS AND METHODS: Blood samples were taken from 20 adults, age ranging from 20 to 40 years who were systemically healthy, nonsmokers with no symptoms of infection, or on antibiotics at least 3 months before experiments. The procedures and the protocols involved in the study were accepted by the Institutional Ethical Committee. Written informed consent was obtained from the donors and patients. Approximately 10 ml of blood was collected from each donor. 5 ml of blood was used for the preparation of PRF and 5 ml for PRFM. RESULTS: The antifungal scores among the groups. The highest antifungal scores were seen in metapex followed by PRF and PRFM group. Kruskal-Wallis test was applied to check the statistical difference among the groups, and there was a statistically significant difference seen among the groups (P = 0.00). The antibacterial scores among the groups. The highest antibacterial scores were seen in Metapex followed by PRF group and PRFM group Kruskal-Wallis test was applied to check the statistical difference among the groups, and there was a statistically significant difference seen among the groups. CONCLUSION: PRF demonstrated antibacterial activity against passage isolates but had no antifungal efficacy. This antibacterial property may be a valuable adjunct when using PRF for regenerative procedures in endodontics. Both PRF and PRFM have to be analyzed for antimicrobial properties for extended duration and various other clinical strains with larger sample size.

Potential generation sites of internal solitary waves and their propagation characteristics in the Andaman Sea-a study based on MODIS true-colour and SAR observations.

The presence of large-amplitude Internal Solitary Waves (ISWs or solitons) is quite common in the Andaman Sea, located in the north-eastern Indian Ocean basin. ISWs are known to induce strong vertical velocities which can play an essential role in the mixing transport of nutrients and are proven hazardous to offshore oil platforms. The surface signatures of ISWs can be detected using remote sensing instruments like Synthetic Aperture Radar (SAR) and sunglint true-colour images. The present study makes an effort to delineate as well as detect the possible potential generation locations of mode-1 long living ISWs in the Andaman Sea using remote sensing observations. To accomplish this, the Moderate Resolution Imaging Spectroradiometer (MODIS) true-colour images of Terra/Aqua satellites for the months of March and April during 2014-2016 are used to map the distribution and propagation characteristics of ISWs. These maps along with SAR imgaes from ENVISAT and TerraSAR-X are used to detect the possible generation locations of ISWs. The study considers the possible generation location of ISW as the circumcentre of each wave packet as they radially propagate along a two-dimensional frame. The analysis reveals five potential ISW generation hotspots that are distributed along the Northern Andaman Sea, as well as locations in the discontinuities off the Nicobar Islands and the great passage. The ISWs that form over these regions are hitting the continental shelf within the Andaman Sea. Interestingly, the waves from two potential generation sites between the Nicobar Islands appear to radiate waves in two opposite directions, towards the Andaman Sea and the southern Bay of Bengal.

In vitro Comparison of Impact of Different Bleaching Agents on the Microhardness of Enamel.

BACKGROUND: Various agents are used these days for increasing the esthetics. One such procedure is bleaching that offers various advantages, as it is minimal invasive and cheap option to color the teeth and remove stain. The altered enamel after the bleaching process shows surface demineralization and porosities. The present study aimed to evaluate the effect of different bleaching agents on the microhardness of enamel. MATERIALS AND METHODS: A total of 100 freshly human extracted maxillary premolar teeth were selected for the study. Teeth with sound tooth structure were included for the study. All the specimens were randomly divided into four groups with 25 specimens in each group depending upon the type of bleaching agent used: Group A, artificial saliva (Control group); Group B, 35% hydrogen peroxide (HP); Group C, 25% HP; Group D, 10% carbamide peroxide (CP). Knoop Hardness Number (KHN) was calculated at 24, 48-hour, and 7-week interval. RESULTS: Results showed no statistical significant differences between the microhardness of enamel of different groups (p < 0.005). A slight fall in the value of KHN was seen in all the groups, except for the control group, although the results were statistically nonsignificant (p > 0.005). CONCLUSION: Although nonsignificantly, all the bleaching solutions produced some amount of alterations in the microstructure of enamel. More studies with higher study groups and more advanced estimation technologies are required to minimize microstructure alterations and promote for better outcome of bleaching procedures.

Cuspal movement and microleakage in premolar teeth restored with posterior restorative materials.

BACKGROUND: With the increase in various resin-based composites with varying monomeric formulations and fi llers had led to a significant number of problems, and one of such is postoperative pain. Clinician is in a dilemma what to select and what not to. The latest nanocomposite is there for a short while that no individual research is available currently, hence, this study was undertaken. The aim of this present study was to assess the cuspal deflection at each stage of polymerization for the incremental restoration of standardized large (mesio occlusal distal [MOD]) cavities with three posterior restorative resins. And also to assess the cervical microleakage. MATERIALS AND METHODS: 18 extracted upper premolar teeth were selected. Teeth were divided into three groups (A, B, and C), each group consisting six teeth, large (MOD) cavity preparation was done. Groups A, B, and C were restored with P60, Filtek supreme (3M, ESPE), and ormocer material (Admira:Voco). The lingual cusps of the extracted teeth were approximated to the receptor of a compactor - deflection measuring gauge, following each stage of polymerization using light emitting diode curing light a measurement of the cuspal deflection was recorded. The restored teeth were prepared for microleakage testing and were examined under stereomicroscope at ×25 for the extent of the cervical gingival microleakage. RESULTS: The cuspal deflection was the greatest for Filtek P60 and least for filtek supreme - nanocomposite with ormocer ranked between the two. For the microleakage, none of the materials were identified as producing less gingival microleakage. CONCLUSION: The lesser cuspal deflection values with filtek supreme nanocomposite could be due to resin chemistry and also filler particle size. Hence, this nanocomposite could be the first choice of material for use in large esthetic restorations.

Evaluation of efficacy of combinations of five endodontic sealers with five antibiotics against Enterococcus Faecalis - An in-vitro study.

BACKGROUND: To evaluate and compare in vitro the antibacterial efficacy of five antibiotics when added individually to five endodontic sealers against Enterococcus faecalis (EF). MATERIALS & METHODS: This controlled trial with systematic allocation method was carried out to detect the combined antibacterial activity of five endodontic sealers (Kerr sealer EWT, Endomethasone, AH26, AH Plus, Roekoseal) with five antibiotics regularly used (Amoxicillin, metronidazole, azithromyacin, gatifloxacin, doxycycline) on EF. For each sealerantibiotic combinations, thirty BHI agar plates (15 aerobic and 15 anaerobic) were inoculated with EF, containing five sterile paper discs- three of various sealer- antibiotic combinations, one of sealer alone (positive control) & plain disc as negative control were incubated at 370C for 48 hrs and the zone of inhibition was measured. Data analysis was done by ANOVA and Tukey's post- hoc test using SPSS( version 17). RESULTS: The findings of this study revealed that sealer-antibiotic combination containing amoxicillin had the significant difference (p<0.001) in the mean zone of inhibition compared to other combinations. Metronidazole showed the minimum zone of inhibition among used antibiotics. The sealers in the decreasing order according to their effectiveness on EF were Kerr sealer endomethasone, AH26, Rockseal, AH plus. CONCLUSION: Addition of antibiotics to endodontic sealers enhances their antibacterial activity against Enterococcus faecalis. How to cite the article: Sharma D, Grover R, Pinnameneni PS, Dey S, Raju PR. Evaluation of efficacy of combinations of five endodontic sealers with five antibiotics against Enterococcus Faecalis - An in-vitro study. J Int Oral Health 2014;6(2):90-5.