Cerebral Sinus Thrombosis and Immune Thrombocytopenia Post COVID-19 Vaccination: A Case Report and Narrative Review.

Vaccine-induced immune thrombocytopenia and thrombosis (VITT) following the adenoviral vector COVID-19 vaccine is a rare adverse event. Although the risk of VITT following the COVID-19 vaccine appears to be low, early diagnosis and management can be lifesaving. We present a case of VITT in a young female who presented with persistent headaches and fevers followed by anisocoria and right-sided hemiplegia. Initial imaging was unremarkable, and labs showed thrombocytopenia and elevated d-dimers. Repeat imaging revealed thrombosis in the left transverse and superior sagittal sinuses, and she was diagnosed with VITT. She received combined treatment with intravenous immunoglobulins and systemic anticoagulation, resulting in an increased platelet count and resolution of her neurological symptoms.

An Establishment of Various Cephalometric Parameters in an Urban Setup in Odisha and Linking it with the Discernment of Pleasant Profiles by Lay Persons.

Aim: To evaluate cephalometric parameters of orthodontic population in an urban setup in Odisha using Steiner's, Tweed's and Rakosi's analysis and compare it with the established Caucasian norms. Methodology: Pre-treatment patient records from a dental hospital were collected. Lateral cephalograms of the normal and supernormal sample were traced. Cephalometric features relating to various facial hard tissue that determine balance and harmony were measured using Steiner's, Tweed's and Rakosi's analysis. The values obtained were compared with the established Caucasian norms. Comparison of mean values were done via independent sample t test and ANOVA. Subsequently post hoc Tukey's was used to establish the significance of the mean difference of all the variables used. Results: Significant differences were obtained for lower incisor to NB, mandibular plane angle, FMA, FMIA, articular angle, basal plane angle, inclination angle, Rakosi Jarabak ratio and interincisal angle. Conclusion: Fundamental variations were seen in various parameters. Perception of lay persons can be of aid to the clinician in assembling commendations for alternative treatment plans.

Assessment of oral health status and treatment needs of HIV positive transgenders in Odisha - a cross-sectional study.

Introduction: Human Immunodeficiency virus (HIV) causes the human immunodeficiency infection which is a major global health problem. Oral health status of people infected by HIV is also compromised. There is limited literature on oral health status of HIV/AIDS transgenders in Odisha. Aim: This study was conducted to assess the oral health status of HIV-positive transgenders. Methodology: A cross-sectional study was conducted among the HIV positive transgenders in Odisha. Snowball sampling technique was employed to reach the population. Oral health was recorded using modified WHO 2013 proforma. Clinical examination using disposable mouth mirror and explorer. Chi square statistics was used for finding the association between the socio-demographic variables and DMFT, CPI, and LOA scores. Results: The study included 153 participants out of which seventy participants belonged to the age group 18-30 years. Majority of the participants were unemployed and most of them had spent around 6-10 years in school. Majority of the participants used toothbrush for cleaning their teeth and the average duration of cleaning tooth was less than two minutes. Toothpick was the most common method used for cleaning interdental areas and none of the participants used dental floss or interdental brushes. The mean DMFT score which was recorded to be 1.424. Around 28.10% (43) inmates had pockets of depth 4 mm to 5 mm. Loss of attachment of 6 mm to 8 mm was found in majority (57, 37.25%) of the participants. Most of the participants did not require any prosthesis both in the upper and lower arches. Around 32 participants (20.91%) had very mild fluorosis, 29 participants (18.95%) exhibited signs of moderate fluorosis. Age was found to be significantly associated with loss of attachment score (p = 0.023). Occupation had an association with the DMFT score (p = 0.002) while years in school was found to be significantly associated with CPI score (p = 0.045). Conclusion: The oral health status of transgenders is poor and needs immediate attention.

Substance use and oral health sensations among substance users residing in rehabilitation centres in an Indian City.

Background: The term substance is usually used to address psychoactive/psychotropic drugs which include both licit and illicit drugs. These substances have varied consequences, including long-term and short-term effects, which include sensations post-consumption. Aim: To determine patterns of substance use and short-term oral health effects among substance users. Materials and Methods: A self-administered questionnaire-based study was conducted on the inmates of drug deaddiction and rehabilitation centres in Bhubaneswar city. Results: All the subjects were males and majority (60.6%) were polydrug users. Alcohol (87.3%) was the most commonly used substance, followed by ganja (57%), bhang (35.3%) and brown sugar (33%). A wide range of oral health sensations like dryness of mouth, taste change, numbness in mouth, feeling like chewing something, loose teeth and stammering/difficulty in speaking were found to be significantly associated with substance use. The age of start of substance use (P < 0.0001), socioeconomic status (P = 0.026) and marital status (P < 0.0001) were significantly associated with the pattern of substance use. About 37.6% of inmates felt that they had very good oral health before starting drug use, while only 15.4% described their oral health as very good at present. Having no oral health problem was the most common reason for not visiting a dentist, followed by ignorant attitude towards oral health. Conclusion: A wide range of oral health sensations were found to be caused due to substance use. Understanding of oral health sensations can aid practitioners detect and report cases of substance use in its early phase.

Assessment of oral mucosal lesions among HIV positive transgenders residing in Odisha with and without Antiretroviral therapy.

Purpose/Background: Transgenders are a highly vulnerable subset within the high-risk group for human immunodeficiency virus (HIV) in India. Oral manifestations are among the early signs of HIV infection. This study was conducted with the aim to assess the oral mucosal lesions among the HIV-positive transgenders in Odisha taking antiretroviral therapy as well as those not taking antiretroviral therapy. Methods: A cross-sectional study was carried out among HIV-positive transgenders in four districts of Odisha. Snowball nonprobability sampling technique was adopted, and type IV clinical examination was performed using the modified WHO record form for oral manifestations in HIV/AIDS (2013). Independent sample t test was used to compare mean age among those taking ART with those not taking ART. Chi-square test was used to detect the associations among categorical variables. Results: The study comprised of 163 participants, 109 (71.24%) who were taking antiretroviral therapy, while 44 (28.76%) not taking antiretroviral therapy. The mean age was 32.56 + 7.69 years. Sex work was the most predominant occupation. Majority of the participants reported of having hyperpigmentation of different parts of oral mucosa. Aphthous ulcer and angular cheilitis was noticed in 14.72% and 9.20%, respectively. Other manifestations noticed included erythematous candidiasis, pseudomembranous candidiasis, oral hairy leukoplakia, necrotizing ulcerative gingivitis, necrotizing ulcerative periodontitis, herpetic stomatitis/gingivitis and/or labialis, herpes zoster, warty like lesions/human papillomavirus, other ulcerations (not otherwise specified/necrotizing ulcerative stomatitis), and dry mouth due to decreased salivary flow. Conclusion: Careful evaluation of oral manifestations can improve the quality of life of these marginalized, highly vulnerable population.

Assessment of oral health status and treatment needs amongst the tribals residing in Northern Bhubaneswar, Odisha.

INTRODUCTION: Odisha has the third highest percentage of tribal population in India. This study was conducted to evaluate the oral health status and treatment needs of tribal population residing in northern Bhubaneswar. MATERIAL AND METHODS: A crosssectional household survey was conducted using the modified WHO Oral Health Assessment Form (2013). Cluster random sampling technique was employed. Type III clinical examination was done. Statistical analysis was carried out using Chi square test, t test and ANOVA. RESULTS: A total of 877 participants were examined out of which 589 were males and 288 females with age ranging from 2-74 years. The mean dmft score was 4.13 ± 0.73 in 2-5-year-old participants, and in the age groups of 35-44 years and 65-74 years, the scores were 5.32 ± 2.36 and 7.56 ± 4.29 respectively. Statistically significant differences were observed in the presence of healthy gums, bleeding gums and presence of shallow pockets across the different age groups. Preventive treatment was required mostly by the participants in the age group 13-15 years. CONCLUSION: The present study showed a high prevalence of dental caries and periodontal disease among the study participants. Preventive treatment was required mostly by the participants in the age group 13-15 years.

Assessment of oral health status and treatment needs of drug abusers in Bhubaneswar city: A cross-sectional study.

INTRODUCTION: Oral health of drug abusers has received less attention. Drug users may also have special needs in relation to receiving dental care. Evaluation of the oral health status of drug abusers is important as in India, where the disease burden is enormous, and availability of curative treatment is quite inadequate, preventive approach shall prove to be better than curative treatment. AIM: To determine the oral health status and treatment needs of drug abusers residing in rehabilitation centers in Bhubaneswar. MATERIALS AND METHODS: A cross-sectional study was conducted in the drug de-addiction cum rehabilitation centers in Bhubaneswar city, Odisha. A self-administered questionnaire was used to record oral health practices of the inmates and the type of drugs used by them in the past. Oral health was recorded using modified WHO 2013 pro forma. Mann-Whitney U-test and Kruskal-Wallis test were applied to find any significant differences between different variables in groups. RESULTS: All the participants were male and alcohol was the most commonly used drug, followed by tobacco and ganja. The horizontal brushing technique was the most widely used technique. Mean decayed, missing, and filled teeth (DMFT) score was recorded to be 1.48. Leukoplakia, acute necrotizing ulcerative gingivitis, candidiasis, and ulceration were among the few oral lesions found in the inmates. Around 67.66% of inmates exhibited erosion of the enamel surface, while 6.59% had signs of enamel fracture. Statistically, significant difference was found for the types of drugs used and DMFT score and type of drug used and dental erosion. CONCLUSION: Oral health status of drug users is poor and needs immediate attention. Oral health education needs to be imparted among them. The government needs to enforce the establishment of dental clinics in these centers so that the oral health of these people can be taken care of.

Knowledge, attitudes and behaviour towards oral hygiene of transgenders in Bhubaneswar during COVID-19.

INTRODUCTION: Reducing harmful oral hygiene practices can minimize the negative impacts of periodontal diseases. Transgenders are among the most vulnerable groups. Knowledge of their oral hygiene awareness, attitude and behaviour shall help in improving their oral health and also in planning oral health strategies specific to this group. AIM: To explore the oral hygiene-related knowledge, attitude and practices of transgenders residing in the Bhubaneswar during COVID-19. METHODOLOGY: A cross-sectional study was conducted among the transgenders residing in Bhubaneswar using a self-structured questionnaire containing questions on knowledge, attitude and practices related to oral hygiene. Mann-Whitney U test was applied to find any significant differences between different variables in groups. RESULTS: A total of 205 transgenders participated in the study. Around 43.9% of the transgenders in rural areas felt they had bad breath and there was no statistically significant difference between the two groups. Majority of the participants in the rural areas did not know how to describe the health of their teeth and gums while 43% of the participants in the urban areas felt their oral health was good. There was statistically significant difference between the two groups in the type of material used for cleaning teeth [p = 0.020]. There was statistically significant difference between the two groups in terms of brushing their teeth everyday [p = 0.005, duration of brushing [p = 0.052], tools used for cleaning teeth [p = 0.023] and method employed to control mouth odour. CONCLUSION: The information presented in this study adds onto our understanding of the oral hygiene related behaviour among the transgenders.