Oral Hygiene practices and Oral Health Related Quality of Life observed in patients reporting to Dental Institution in North India during COVID-19 Pandemic.

Objective: The purpose of the study was to ascertain Oral Health Related Quality of Life (OHRQOL) and evaluate oralhygiene practices in patients visiting a dental institution during COVID-19 time. Materials and methods: Face-to face interviews were conducted using a semi-structured close-ended questionnaire,assessing oral hygiene practices and self-reported oral problems perceived in last 6 months, using both Hindi and English version of Oral Health Impact Profile (OHIP-14) Questionnaire. Frequency distribution of oral hygiene practices were obtained, and Descriptive statistics computed the scores of OHIP-14. Kruskal-wallis test and Independent t-test were used to match the association of OHIP-14 with demographic variables. Multiple linear regression analysis was utilized to compute the association of OHIP-14 with independent variables, age and gender. Results: Subjective evaluation of OHRQOL (Oral Health Related Quality of Life) using OHIP-14 Porforma resulted in high score for physical pain and psychological discomfort but subjects expressed less discomfort in connection to functional limitation, physical disability, psychological discomfort, social disability and handicap domains of OHIP-14. With progressive increase in age OHRQOL worsened. Females had poor OHRQOL, with significant difference as compared to males. Gender and marital status observed variance in OHIP-14 with statistically significant difference (P <0.000). Conclusion: More than two-third subjects preferred cleaning their teeth using toothbrush and toothpaste. Therefore, COVID-19 consequently impacted OHRQOL of the general population.

Evaluating Combined Effect of Oral Premedication with Ibuprofen and Dexamethasone on Success of Inferior Alveolar Nerve Block in Mandibular Molars with Symptomatic Irreversible Pulpitis: A Prospective, Double-blind, Randomized Clinical Trial.

INTRODUCTION: The success rate of inferior alveolar nerve block decreases exorbitantly in teeth with symptomatic irreversible pulpitis. The purpose of this prospective, double-blind, randomized clinical trial was to evaluate the combined effect of oral premedication with ibuprofen and dexamethasone on the success rate of inferior alveolar nerve block in mandibular molars with symptomatic irreversible pulpitis. METHODS: Ninety-four adult patients actively experiencing pain and diagnosed with symptomatic irreversible pulpitis willingly participated in this study. Preoperative pain was recorded on the Heft-Parker visual analog scale. Patients were randomly allocated to 4 different groups and received placebo, 0.5 mg dexamethasone, 800 mg ibuprofen, or a combination of 0.5 mg dexamethasone and 800 mg ibuprofen. One hour after oral premedication, all patients received standard inferior alveolar nerve block containing 2% lignocaine with 1:200,000 adrenaline. Access cavity preparation was initiated 15 minutes after the administration of anesthesia. Pain scores were recorded on VAS after anesthesia, at dentin penetration to pulp chamber opening, and on file placement. Success was defined as no or mild pain (0-54 mm) throughout the procedure. RESULTS: The chi-square test was used for qualitative data comparison. The 1-way analysis of variance test and post hoc Bonferroni test showed a statistically significant difference between the combination of 0.5 mg dexamethasone and 800 mg ibuprofen group and the other 3 groups (P < .001). CONCLUSIONS: Preoperative administration of a combination of dexamethasone and ibuprofen improved the success rate of inferior alveolar nerve block in mandibular molars with symptomatic irreversible pulpitis.

Comparing Early Outcomes using Non Absorbable Polypropylene Mesh and Partially Absorbable Composite Mesh through Laparoscopic Transabdominal Preperitoneal Repair of Inguinal Hernia.

INTRODUCTION: Laparoscopic hernia repair is in vogue in the present era. Both the operating surgeon and the patient are concerned about the postoperative inguinodynia which has now replaced recurrence as the predominant factor affecting quality of life. AIM: Our study aimed to compare early postoperative outcomes with the standard non absorbablepolypropylene and the newer partially absorbable composite meshes. MATERIALS AND METHODS: A total of 60 patients with unilateral uncomplicated inguinal hernia were included in the study and randomly divided into two groups, one each for one kind of mesh. Patients underwent Transabdominal Preperitoneal (TAPP) repair of hernia after taking written informed consent. Follow up was done in the immediate postoperative period and at three months. Patients were compared for inguinodynia, sensation of heaviness, seroma/haematoma formation and return to work activities. Standard statistical tests were applied and a p-value <0.05 was taken as significant. RESULTS: Patients in the composite group complain of significantly less pain as compared to those with the non absorbable mesh at three months (p-value 0.003). They also report less sensation of heaviness over the groin area. However, incidence of seroma formation was higher in the composite group (20%) when compared to the non absorbable group (6.67%). An earlier return to work was seen in the patients with composite mesh. CONCLUSION: Use of composite mesh in TAPP is associated with better patient outcomes in terms of less postoperative pain and an earlier return to work.

Acute gastric volvulus: A vicious twist of tummy-case report.

INTRODUCTION: Gastric volvulus is an uncommon disorder and can present either in the acute or chronic setting with variable symptoms. A robust blood supply of the stomach from different sources does not allow ischemia to develop early. When it occurs in the acute scenario, patients present with severe epigastric pain and retching without vomiting. Together with inability to pass nasogastric tube, they constitute Borchardt's triad. PRESENTATION OF CASE: We report a case which presented in the emergency department with severe abdominal pain, abdominal distension and vomiting and a previous history of pulmonary tuberculosis. An incidental finding of uterovaginal prolapse was present. A diagnosis of acute gastric volvulus with peritonitis was made and total gastrectomy with Roux-en-Y esophagojejunostomy for gangrenous and perforated stomach was performed. DISCUSSION: Primary gastric volvulus occurs in the absence of any defect in the diaphragm or adjacent organ pathology and may be caused by weakening of gastric supports. We wish to highlight if there is a possible association of primary gastric volvulus with uterovaginal prolapse reflecting a general laxity of body ligaments or with fibrosis of the lung secondary to pulmonary tuberculosis resulting into the twisting of the stomach. CONCLUSION: Acute gastric volvulus is a surgical emergency requiring early diagnosis and aggressive management, as a delay results into complications like gangrene and perforation which substantially increase the morbidity and mortality in these patients.

Management of a large internal resorption lesion with metal reinforced glass ionomer cement.

Mineral trioxide aggregate is the mainstay of treatment of large internal resorption defects. But its cost may be a deterrent to its use in some patients. The present case report describes the successful endodontic management of an extensive internal resorptive lesion in a mandibular molar with metal reinforced glass ionomer cement.