Drone a technological leap in health care delivery in distant and remote inaccessible areas: A narrative review.

In developing countries, last-mile delivery of medical products is a challenge, especially in hilly and rural areas where there is no road connectivity. As helicopters or other air services are not affordable all the time, drones can be used for the supply of medical products. They are cost-effective as compared to other air or road transport. However, the carrying capacity of drone is less, it is not able to carry heavier payloads. Also, operating drones requires trained operators, and it is a new venture in a developing country so possibilities of confusion and lack of clarity on operating procedures are there. Drones are becoming increasingly reliable for the health care delivery. This narrative review explores the use of drones in healthcare delivery globally.

Electronic cigarettes: Ally or an enemy in combating tobacco-use-associated diseases - An integrative review.

Introduction: E-cigarettes (ECs) portable battery-operated devices developed as a strategy for tackling tobacco-related harm are now becoming a global threat to human health. Objectives: This integrative review aims to throw some light on the effect of ECs on human health and determine the safety of ECs with or without nicotine with long-term usage. Methods: This integrative review includes findings from Randomized and non-randomized clinical trials, and laboratory-based Human studies; published in the English language in the last four years. Literature search sources were online databases such as PubMed, Medline, EMBASE, Web of Science, Google Scholar. Results: Following systematic search using inclusion and exclusion criteria, 21 articles were included in the final review. ECs result in an acute increase in cardiac Sympathetic Nerve Activity (SNA), pronounced as Electrocardiogram (ECG) changes resulting in a greater risk of sudden death for those with co-morbidities. ECs with or without nicotine can adversely affect lung function and can precipitate obstructive pulmonary diseases. ECs may also adversely affect oral health due to increased bacterial pathogenicity and periodontitis. At last, these nicotine-containing ECs can yield nicotine comparable to Traditional cigarettes (TCs) and sometimes to a much greater extent, thus posing the threat of the user becoming nicotine dependent. Conclusion: Although ECs are less harmful than TCs in combustible inhaled constituents, their long-term safety can still not be ascertained due to the scarcity of long-term studies and conflicting results.

Kangaroo mother care (KMC) for procedural pain in infants: A meta-analysis from the current evidence of randomized control trials and cross-over trials.

Background: Kangaroo mother care (KMC), which is also known as Skin-to-skin (STS) care, is supposed to be effective in alleviating the pain of the neonates occurring during various procedures carried out in routine medical care or during the medical examination. Objectives: The meta-analysis aimed to determine the effect of the kangaroo mother care method on procedural pain in infants receiving KMC to those receiving only standard care (SC). Search Strategy: For this meta-analysis, a systematic literature search was conducted in online database PubMed, Medline, Web of Science, Google Scholar, and the CENTRAL database using MESH terms such as kangaroo mother care method/classification, kangaroo mother care method, kangaroo mother care method/instrumentation, kangaroo mother care method/methods, pain threshold, pain, pain management/methods, pain management/instrumentation, pain management/therapy, and pain management/therapeutic with the help of Boolean terms. Selection Criteria: Only randomized control trials or cross-over trials published within ten years and reporting pain assessment during or within five minutes of the pain stimulating procedure assessed using Premature Infant Pain Profile (PIPP) score were considered. Data Collection and Analysis: The primary outcome measures were procedural pain assessed by PIPP score and reported in mean and standard deviation along with 95% confidence interval (CI). In cross-over trials, data were taken from the first phase, i.e., before cross-over. Main Results: The pooled estimate of the six studies revealed a potential statistically significant benefit of KMC over SC in pain reduction following a pain stimulating procedure (P = 0.01, Mean difference = -2.04, 95% CI: -3.65, -0.43, Chi2 = 69.86, I2 = 93%). A high level of heterogeneity was found, i.e., 93%. Conclusion: Kangaroo mother care seems to be an effective intervention in alleviating the procedural pain due to routine procedures or medication examination.

How short or long should be a questionnaire for any research? Researchers dilemma in deciding the appropriate questionnaire length.

A questionnaire plays a pivotal role in various surveys. Within the realm of biomedical research, questionnaires serve a role in epidemiological surveys and mental health surveys and to obtain information about knowledge, attitude, and practice (KAP) on various topics of interest. Questionnaire in border perspective can be of different types like self-administered or professionally administered and according to the mode of delivery paper-based or electronic media-based. Various studies have been conducted to assess the appropriateness of a questionnaire in a particular field and methods to translate and validate them. But very little is known regarding the appropriate length and number of questions in a questionnaire and what role it has in data quality, reliability, and response rates. Hence, this narrative review is to explore the critical issue of appropriate length and number of questions in a questionnaire while questionnaire designing.

Effectiveness of chewable toothbrushes compared to manual toothbrushes in removing dental plaque - A systematic review and meta-analysis.

Objective: Chewable toothbrushes (CT) are considered an effective tool for dental plaque removal; however, their effectiveness is still uncertain compared to Manual toothbrushes (MT). Aim: To evaluate the effectiveness of CT compared to MT in dental plaque removal. Methods: Studies comparing the efficiency of CT and MT in dental plaque removal measured by Turesky Modification of Quigley-Hein Plaque Index (TMQHI), Quigley-Hein Plaque Index (QHI), or Silness Loe Plaque Index (SLPI) were identified in PubMed, Medline Web of Science, Google Scholar, and the CENTRAL. Results and effect sizes estimate are presented as mean difference, and subgroup analysis is presented separately for non-randomised interventional studies and randomised intervention studies. Risk of bias was assessed using the Cochrane risk of bias tool (ROBINS-I and ROB2 tool). Results: A total of 10 studies were included in the systematic review, whereas six out of 10 studies were included in the meta-analysis. Both CT and MT were effective in plaque reduction over time when compared individually using the TMQHI and SLPI scores. The overall pooled summary showed no difference in CT and MT's dental plaque removal ability when measured using the TMQHI score. Similarly, there was no difference in CT and MT's dental plaque removal ability when measured using the SLPI score. Conclusion: There is no significant difference in CT and MT's plaque removal ability. Therefore, CT should only be recommended for children and individuals with a disability or manual dexterity. Objective: Chewable toothbrushes (CT) are considered an effective tool for dental plaque removal.

Effect of Boron Supplementation on Nutrient Utilization and Productive Performance of Peripartum Murrah Buffaloes.

Boron (B) has been established as a beneficial micronutrient for some farm animals. However, its impact on coping negative energy balance during transition and subsequent production performance needs critical perusal. Therefore, the present study was undertaken to determine the effect of B supplementation on productive performance, apparent nitrogen (N), and mineral utilization in peripartum Murrah buffaloes. Thirty advanced pregnant buffaloes (60 days prior to expected date of calving) were allocated into three groups, i.e. control, B-200, and B-400, and supplemented with pharmacological concentration of B at 0, 200, and 400 ppm, respectively, from 45 days prior to expected date of calving till 120 days post calving. Two metabolism trials were conducted (with animals having similar expected date of calving), one during prepartum (30 days prior to the expected date of calving) and another during postpartum (90 days post calving) phase to evaluate nutrient utilization and balance of N as well as minerals. Results revealed that B supplementation decreased (P < 0.05) overall plasma nonesterified fatty acids (NEFA), whereas plasma level of ß-hydroxybutyric acid, insulin, triglyceride, and glucose did not differ (P > 0.05) among the groups. Dry matter intake, nutrient digestibility, and N balance remained unaffected with B supplementation. Higher (P < 0.05) apparent absorption coefficient for magnesium (Mg) and zinc (Zn) was observed in pregnant animals, while during lactation, absorption coefficient of calcium, Mg, and Zn was increased (P < 0.05) in B-supplemented groups. Hence, it can be concluded that alteration in NEFA concentration and variation in apparent absorption coefficient of minerals with B supplementation suggest its role in energy and mineral metabolism. However, further investigations are required to determine the underlying mechanism of action for the present findings.

Prevalence and determinants of early childhood caries among children enrolled in anganwadi centres in Bhilai of Central India: A cross-sectional study.

Introduction: Early childhood caries (ECC), which results in rapid involvement and progression of several teeth, is a growing concern in preschool children. It directly affects a child's overall health and quality of life. Aim: To assess the prevalence and determinants of ECC among children enrolled in Anganwadi centres in Bhilai city of Chhattisgarh. Methodology: This descriptive cross-sectional study was conducted among 360 children enrolled in Anganwadi of Bhilai. An oral examination and findings were recorded in 'dmft' using the WHO oral health assessment form for children 2013. The mothers' knowledge, attitude, and practice were determined by a professionally administered 10-item pre-tested short questionnaire with Cronbach's alpha of 0.86. The data were compiled and analysed using Microsoft Excel vs. 2013 and Statistical Package of Social Science (IBM SPSS version 23; Chicago Inc., USA). Results: The prevalence of ECC was 25.83%, out of which 13.33% in boys and 12.50% in girls. Children of middle school-educated mothers have 35.48% ECC, followed by high school and primary school, that is, 24.73 and 23.66, respectively. Mothers who assisted the children in tooth brushing have less prevalence of ECC (8.15%) as compared to non-assisted (17.8%) (P = 0.044). Conclusion: Although mothers' knowledge was appreciable regarding reasons for tooth decay, still 1/4th of the children were found to be affected by ECC. This necessitates the importance of regular/periodic screening campaigns for the children, implementing institutional preventive programmes, and referral for children to secondary/tertiary healthcare centres.

Statistical significance or clinical significance? A researcher's dilemma for appropriate interpretation of research results.

It is incredibly essential that the current clinicians and researchers remain updated with findings of current biomedical literature for evidence-based medicine. However, they come across many types of research that are nonreproducible and are even difficult to interpret clinically. Statistical and clinical significance is one such difficulty that clinicians and researchers face across many instances. In simpler terms, the P value tests all hypothesis about how the data were produced (model as whole), and not just the targeted hypothesis that it is intended to test (such as a null hypothesis) keeping in mind how reliable are the of the research results. Most of the times it is misinterpreted and misunderstood as a measure to judge the results as clinically significant. Hence this review aims to impart knowledge about "P" value and its importance in biostatistics, also highlights the importance of difference between statistical and clinical significance for appropriate interpretation of research results.

A comparative survival analysis of high viscosity glass ionomer restorations using conventional cavity preparation and atraumatic restorative treatment technique in primary molars: A randomized clinical trial.

BACKGROUND: This randomized clinical trial (RCT) aimed to compare the 3-year survival rates of high viscosity glass ionomer restorations (HVGIC) using conventional cavity preparation and atraumatic restorative technique (ART) in primary molars. MATERIALS AND METHODS: In this RCT, 139 schoolchildren aged 6-9 years with dentinal caries in primary molars were randomly allocated to groups, i.e. the ART group and the conventional group, utilizing a random number generator. Adequate allocation concealment was done. Intervention was delivered using standard procedure and GC Fuji IX ART HVGIC was used as restorations in both the groups. Analysis was carried in 92 participants, and survival rates in both the groups were compared at 12, 24, and 36-month intervals. IBM SPSS software was utilized to analyze the time taken for the procedure and the Kaplan-Meier estimate was used to assess the survival rates. P value of 0.05 was considered statistically significant. RESULTS: The ART took longer to complete (16.48 ± 2.02 min) versus conventional rotary instrumentation (13.15 ± 1.32 min). The conventional method was slightly superior as compared to ART; excellent survival rates (i.e. >90%) were achieved in both groups at the end of 12-month follow-up with no significant differences at the end of 24 and 36 months as evident from Kaplan-Meier estimate (P = 0.255). CONCLUSION: Three-year follow-up showed that GIC restorations with ART and conventional method carried out using GC Fuji IX ART HVGIC were acceptably successful, substantiating the use of ART for the primary dentition in areas with high caries prevalence and limited access to dental care.

Insight into modern-day plagiarism: The science of pseudo research.

In today's world, when there is a rapid surge of biomedical publications, maintaining research integrity of articles is of prime importance. It is expected that the submitted work is genuine of submitting authors'. Ease in the availability of these digitally published biomedical papers and pressure to publish for academic and professional advancement had resulted in numerous novice scientists and students falling into unethical practice of plagiarizing others' work to get the job done quickly. Plagiarists are continuously in search of finding new and easy ways to plagiarize someone else's work, currently seen as different forms of plagiarism. Hence, this narrative review intends to help young and upcoming researchers to understand plagiarism, its type, the reason for plagiarists getting involved in that, and possible ways to detect and prevent it.

Predatory conferences in biomedical streams: An invitation for academic upliftment or predator's looking for prey.

Scientific conferences, once deemed essential in scholars' lives, are now converting into a high-profit business. These predatory conferences are often organized by some profit-making predatory publishers or manufacturing companies for marketing their product or luring young researchers and scientists to submit their research manuscripts to these so-called predatory journals. Various tactics are used by these conferences to extract money from the researchers and students such as organizing conferences at attractive tourist places with multidisciplinary scope, invitation to submit a research paper to be published at the earliest or to become part of an editorial board/editor-in-chief. It should be realized that these predatory conferences do not provide any benefit to registering individuals for the development of science. The only remedy to expose and stop the business of all such predatory conference organizers is by creating awareness among young scholars and researchers, regarding these predatory conferences and the demerits of attending them, through the established medical and dental institutions, along with specialized associations and societies. A zero-tolerance policy should be created to ban such conferences with a refusal to provide promotion or funding to scholars or researchers attending these conferences. Hence, this narrative review aims to create awareness regarding these predatory conferences, the tactics used by them to trap researchers and ways which young researchers and academic scholars can use to delineate them from legitimate ones.

Unusual routes for transmission of coronavirus disease (COVID-19): Recommendations to interrupt the vicious cycle of infection.

The outbreak of the novel COVID-19, which began silently in Wuhan City, China, has now taken the form of a pandemic, with its claws spreading rapidly in many countries, with new and new cases emerging rapidly. The COVID-19-associated CoV is a beta coronavirus, which spreads at such a deadly rate that the World Health Organization (WHO) has to declare it a Public Health Emergency of International Concern (PHEIC). The objective of the narrative review is to describe what is COVID-19-related coronavirus (CoV), its structure and particle size, potential transmission routes, the risk of infection in patients undergoing blood transfusion or in patients with diabetes and cancer, and recommendations to prevent its spread in office settings, travel / recreation settings, residential and health facilities. This paper also discusses several groundbreaking approaches that are used to counter COVID-19. With this narrative review, we hope to raise awareness of the usual and unusual pathways of transmission and prevent the spread of this pandemic disease.

Prevalence of Oral mucosal lesions and their association with Pattern of tobacco use among patients visiting a dental institution.

BACKGROUND: Oral mucous membrane is an integral part of the complex oral cavity which is associated with maintenance of oral as well as general body health. Oral mucosal lesion (OML) is one of the most prevalent diseases in India, which is caused by consumption of smokeless and smoked forms of tobacco. AIM: To assess the prevalence of OMLs and their association with pattern of tobacco use among patients visiting dental institution in Bhilai. MATERIALS AND METHODS: This descriptive cross-sectional study included 872 participants who visited the Department of Oral Medicine and Radiology, Rungta College of Dental Science and Research, and fulfilled the inclusion criteria, and the study was carried out from July to September 2016. Self-designed proforma was used for recording demographic details, and WHO Assessment Form for Oral Mucosal Diseases was used to record the tobacco use status and findings of the clinical and laboratory investigation. Statistical analysis was performed using IBM SPSS version 23, and the mean, frequency, and percentage were calculated. RESULTS: Among the 872 participants, 69.26% were male and 30.74% were female. The mean age of the study population was 46.19 ± 12.33 years. The prevalence of tobacco use among study participants was 51.26% and that of the OML was 36.36%. Aphthous ulcer was the most prevalent OML followed by oral submucous fibrosis and leukoplakia. CONCLUSION: The study emphasizes the harmful effects of tobacco use toward oral mucous membrane and also serves as a path for future tobacco cessation programs that would be helpful to prevent OML.

Is positive publication bias really a bias, or an intentionally created discrimination toward negative results?

Today in publish or perish era, where manuscripts and research with successfully proven hypothesis or positive results are given more importance by journals, editors, funders, and institutions. The publication of researches with negative or null results is on the verge of extinction, thus creating an intentional bias known as publication bias. This review aims to discuss the consequence of the undermined importance of negative results and problems associated with it and will elaborate the importance of reporting negative results. Under-reporting of negative results not only wastes other researchers time, money, and manpower on which their researchers will be based but also introduces bias in meta-analysis leading to distortion of the scientific literature and misleads researchers, doctors, and policymakers in their decision-making. Many such important studies with negative results remain unpublished and therefore unavailable to the scientific community for understanding their values. A large number of human studies with huge risk to life's are carried out with the assurance that the proposed study will be performed with the aim to benefit, and results will be dissipated to everyone concerned, non-publication of such studies with negative results will not only be morally wrong but will also have ethical obligations to deal with. Therefore, all journals and their editor along with researchers and stakeholders need to be generous in giving importance to disseminating negative and positive findings alike.

Translation and validation of hindi version of oral health impact profile-14, a measure of oral health-related quality of life of geriatrics.

BACKGROUND: The oral health impact profile-14 (OHIP-14) scale developed originally in English has been translated from time to time in different languages revealing to be valid and reliable instruments. AIM: The present study was carried out with an aim to translate and validate Hindi Version of OHIP-14 instrument among geriatrics to measure the oral health-related quality of life. METHODOLOGY: This was a descriptive cross-sectional study, which employed 400 individuals aged 60 years and above who were residents of Durg, Chhattisgarh India. Participants were selected through convenient sampling method. The English version of the OHIP-14 was translated into Hindi, pretested and subsequently administered to the participants by a trained interviewer. Each patient signed informed consent and responded to the Hindi version of the questionnaire. RESULT: Cronbach's alpha of the translated scale was 0.89-0.90 when words were deleted individually. Comparison of English and translated Hindi version of OHIP-14 by unpaired t-test showed no significant difference (P = 0.562). Pearson correlation coefficient test showed very strong positive correlation (0.892). Furthermore, a very strong positive correlation was observed between the recorded OHIP-14 scores and Decayed Missing Filled Teeth (DMFT) scores of examined geriatric individuals (Pearson correlation coefficient = 0.952 and P = 0.001). CONCLUSION: The Hindi translation of the OHIP-14 is a valid and reliable instrument to measure the oral health-related quality of life in older adults of India.

Nanotechnology in dentistry: Unleashing the hidden gems.

Nanotechnology in dentistry refers to new generation research carried out to develop newer technologies, restorative materials and drugs of Nano dimensions. The word "Nano" refers to Nanoscale particles. Although the science of nanotechnology in dentistry is recent and less developed, but still has vast potential to show advancement and improvement in the field of dentistry. As nanotechnology is making firm grip in other fields such as drug delivery system and reducing toxicity by the emergence of more biocompatible materials. Clinicians, researchers, and manufacturers are taking keen interest and participation in the advancement of this field. This paper is an attempt in unleashing the hidden gems of nanotechnology-focusing latest developments in field restorative and surgical dentistry to enhance the quality and biocompatibility of newer generation dental materials and technology. This paper will also focus on potential hurdles encountered in the development of newer materials by utilizing the science of nanotechnology and their potential safety issues concern.

Authorship in biomedical research: A sweet fruit of inspiration or a bitter fruit of trade.

Achieving a place in the authorship of published scientific research is a matter of pride and fame associated with creativity, recognition, better evaluation, and financial gains. This had made assigning of authorship in a scientific publication, a complex and challenging issue. Gaining a position in authorship in scientific publications not only prompts or encourages authors to carry out more research but also recourse many of them to the unethical practice of different kinds of authorship abuses. These authorship abuses are done so cleverly and skillfully that neither the journal editors nor the readers of the journals realize that bias had crept in authorship of the publication. This nonstandard act of biased authorship has a tremendous potential to compromise the credibility of scientific research and scientific publications. The present review aims in focusing on issues pertaining to authorship and its misuse in biomedical research. Thus, it can be concluded from this review that new policies, guidelines, and laws should be made by the government agencies in association with journal editors, institution, and government agencies to curb this malpractice by protecting whistleblowers and providing adequate punishment for those who are involved.

Assessment of two-way relationship between periodontal disease and gestational diabetes mellitus: A case-control study.

BACKGROUND: Gestational diabetes mellitus (GDM) is glucose intolerance which begins during pregnancy. Few studies have examined the association between periodontal disease and GDM. AIM: The aim of this study was to assess the association between periodontal disease and GDM. MATERIALS AND METHODS: The study population comprised ninety patients, out of which thirty were cases and sixty were controls. All cases underwent a laboratory screening test for GDM between 24 and 30 weeks of gestation based on the recommendation of the obstetricians and gynecologists. To assess the periodontal status, a full-mouth periodontal examination assessing the probing depth, periodontal depth, bleeding on probing, clinical attachment level, and gingival recession was performed on all study participants by a single trained examiner. Tests for associations were performed using Chi-square statistics and multivariate logistic regression analysis. RESULTS: None of the periodontitis conditions was found to be a significant predictor of GDM. In GDM patients, 70% of females were having periodontal disease whereas non-GDM patients 77% of patient had periodontal disease. CONCLUSION: The present study did not show any positive association between periodontal disease and GDM.

Antifungal efficacy of three medicinal plants Glycyrrhiza glabra, Ficus religiosa, and Plantago major against oral Candida albicans: A comparative analysis.

INTRODUCTION: From ancient times, plants with medicinal values are being tested and used in the treatment of various infectious diseases. AIMS AND OBJECTIVES: The present in vitro study was designed to assess the antifungal activity of three commonly available medicinal plants Glycyrrhiza glabra, Ficus religiosa, and Plantago major on inhibiting oral Candida albicans in comparison to standard antifungal agents. MATERIALS AND METHODS: Bark of G. glabra, stem of F. religiosa, and husk of P. major were collected, crushed into fine powder, and dissolved in 67% ethanol. Extracts were subjected to antifungal efficacy test against oral C. albicans (ATCC 66027) using Kirby-Bauer disc diffusion method. Mean zone of inhibition (ZOI) was measured by HI antibiotic zone scale. One-way ANOVA using Tukey's post hoc and t-test were applied for statistical analysis. RESULTS: G. glabra was found to be most effective among the three with highest mean ZOI measuring 19.8 ± 0.83, 19.4 ± 0.54, and 18.2 ± 1.09 at 24, 48, and 72 h, respectively. Tukey's post hoc test showed statistically nonsignificant difference between antifungal activity of F. religiosa and P. major with itraconazole 10 mcg. CONCLUSION: G. glabra, F. religiosa, and P. major showed acceptable potency against C. albicans (ATCC 66027) comparable to that of synthetic antifungal agents. However, further studies should be undertaken to affirm the same and test their efficacy in different concentrations and clinical utility.

Antimicrobial efficacy of three medicinal plants Glycyrrhiza glabra, Ficus religiosa, and Plantago major on inhibiting primary plaque colonizers and periodontal pathogens: An in vitro study.

INTRODUCTION: From ancient times, plants with medicinal values are being tested and used in treatment of various infectious disease. AIMS AND OBJECTIVES: The presentin vitro study was designed to assess the antimicrobial activity of three commonly available medicinal plants Glycyrrhiza glabra, Ficus religiosa, and Plantago major on inhibiting Primary plaque colonizers and periodontal pathogens. MATERIALS AND METHODS: Bark of G. glabra, Stem of F. religiosa, and husk of P. major were collected, crushed into fine powder, and dissolved in 67% ethanol. Extracts were then subjected to test antimicrobial efficacy against primary plaque colonizers and periodontal pathogens using Kirby-Bauer disc diffusion method. Mean zone of inhibition (ZOI) was measured by HI antibiotic zone scale. One-way ANOVA using Tukey's post hoc and t-test were applied for statistical analysis. RESULTS: G. glabra was found to have potential antibacterial activity against primary plaque colonizers and periodontal pathogens with highest mean ZOI measuring 9.2 ± 1.09 mm and 10.6 ± 0.54 mm at 24 h, respectively. F. religiosa showed antibacterial activity against primary plaque colonizers only at 48 h with mean ZOI of 2.6 ± 0.54 mm. P. major showed no antibacterial activity against any of the microorganism in this study. Tukey's post hoc test showed statistically nonsignificant difference between G. glabra and standard antibiotic (vancomycin 10 mcg) for periodontal pathogens. CONCLUSION: G. glabra and F. religiosa showed antibacterial activity against primary plaque colonizers and periodontal pathogens. However, further studies should be undertaken to affirm the same and test their efficacy in different concentration and clinical utility.