Comparative Evaluation of Quality Management Practices in the Public and Private Hospitals in Visakhapatnam District: An Original Research.

Background: In the Visakhapatnam District, this study compares the quality management procedures used by public and private hospitals. Knowing how these practices are similar and different from one another can help inform policy decisions and improve the quality of health care. Materials and Methods: A cross-sectional study design was used, and 100 hospitals from both public (50 hospitals) and private (50 hospitals) were included in the sample size. A standardized questionnaire that evaluated different aspects of quality management practices was used to gather the data. Descriptive statistics and inferential tests were used in the quantitative analysis. Results: Significant variations in quality management procedures between public and private hospitals were found. In terms of patient happiness, service responsiveness, and technological use, private hospitals scored better. Regarding accessibility, cost, and equity of healthcare services, public hospitals fared better. Conclusion: The report emphasizes the necessity of focused initiatives to improve quality management procedures in both public and commercial institutions. Collaboration between the two sectors can make it easier to deploy evidence-based tactics and share best practices to raise overall healthcare quality in the Visakhapatnam area.

Clinical Evaluation of Two Distinct Materials for Implant-Supported Interim Fixed Partial Prostheses: An Original Research.

Aim: This study aimed to evaluate the clinical efficacy of posterior resin implant-supported fixed partial dentures (FPDs) made from two different computer-aided design and computer-aided manufacturing (CAD-CAM) materials: polymethylmethacrylate (PMMA) and polyoxymethylene (POM). Materials and Methods: Twenty-one patients received a total of 49 interim implant-supported FPDs. The same participant received PMMA and POM as part of the control and experimental groups, respectively. The restorations were evaluated 1 week, 3 months, and 6 months after placement. In addition, their functional wear and color stability were assessed. Nonparametric statistics (α = 0.05) were used to analyze the data. Results: The study found that PMMA outperformed POM in surface and color parameters, with more fractures occurring with internal conical connection implants. The color stability analysis showed ΔE*ab values of 7.18 for PMMA and 8.8 for POM, with no significant differences. After 6 months of operation, both materials showed a significant increase in wear, but no significant differences were found within the materials. Conclusion: The study found that PMMA interim implant-supported FPDs outperformed POM in surface and color parameters, while polymer posterior implant-supported FPDs with internal conical connection implants were more fracture-prone.

Choice of Surgeons in Retractors used in Cleft Lip and Palate Surgery: An Original Research.

Background: To ensure optimal exposure and enable precise tissue manipulation, cleft lip and palate abnormalities require surgical repair utilizing retractors. Different retractors may affect surgical outcomes; however, this is not yet evident. Examining surgeon preferences for retractors in cleft lip and palate surgery and assessing their impact on patient outcomes were the goals of this study. Materials and Methods: The patients who underwent primary cleft lip and palate repair were retrospectively analyzed. This study evaluated three widely used retractors: the Langenbeck, Gelpi, and Moult Mouth Gag retractors. This study looked at demographic information, surgical results (including scarring, aesthetic outcomes, and wound healing issues), and surgeon preferences for retractors. Results: The study identified differences in surgical outcomes related to various retractor types. Both Group A (Langenbeck retractor) and Group B (Gelpi retractor) demonstrated similar favorable results, such as little wound healing issues, less scarring, and pleasing cosmetic results. The wound healing issues, scarring, and cosmetic outcomes were all worse in Group C (Moult Mouth Gag retractor). Conclusion: Retractors were not always preferred by surgeons doing cleft lip and palate surgery. The type of retractor had an impact on the surgical results; the Moult Mouth Gag retractor performed less well than the Langenbeck and Gelpi retractors. These results highlight the value of using evidence-based criteria to select retractors more effectively and enhance surgical methods for better patient outcomes in cleft lip and palate repair.

Evaluation of Failure in Single-Piece Implant Systems: A One-Year Follow-Up Study.

Objective: This study's goal was to assess the failure rate and peri-implant complications of single-piece implant systems over the course of a one-year follow-up. Materials and Methods: Patient records were examined retrospectively. 150 single-piece dental implants were analyzed. Clinical results, implant features, and demographic information were gathered. Implant failure, which is characterized as the total loss of osseointegration, served as the key outcome indicator. Patient satisfaction and peri-implant problems were secondary outcomes. Data analysis employed descriptive statistics. Results: During the one-year follow-up period, the failure rate for single-piece implant systems was 6.7%. The two main factors leading to implant failure were found to be poor osseointegration (60%) and biomechanical overload (40%). 20% of the cases had peri-implant problems, such as peri-implantitis. 85% of the panelists felt that single-piece implants had satisfied their patients. Conclusion: A 6.7% failure rate in single-piece implant systems was seen in this one-year follow-up investigation. The major causes of implant failure were found to be poor osseointegration and biomechanical loading. In 20% of the cases, peri-implant problems such as peri-implantitis, were noted. There was great patient satisfaction. These results highlight the significance of regulating occlusal forces, optimizing osseointegration, and applying preventive measures to ensure the long-term viability of single-piece implant systems.

Evaluation of Efficacy of Different Plating Systems in ZMC Fractures: An Original Research.

Objective: This study's objective was to assess and contrast the performance of several plating techniques in the treatment of zygomaticomaxillary complex (ZMC) fractures. Group A (Microplate System), Group B (Titanium Mesh System), and Group C (Absorbable Plate System) plating systems were the ones that were studied. Materials and Methods: With 10 patients in each group, a retrospective analysis of 30 patients with ZMC fractures was done. The following information was gathered: fracture reduction, stable fixation, complications, and patient satisfaction. Analysis was done on patient-reported outcomes, surgical outcomes, and demographic factors. Results: Group B (Titanium Mesh System) came in second with rates of 70% and 80%, respectively, while Group A (Microplate System) showed the highest rates of fracture reduction (90%) and stable fixation (100%). For fracture reduction and stable fixation, Group C (Absorbable Plate System) demonstrated rates of 80% and 90%, respectively. For Groups A, B, and C, the complication rates were 20%, 30%, and 10%, respectively. For Groups A, B, and C, the patient satisfaction levels were 90%, 80%, and 70%, respectively. Conclusion: According to the results, the Microplate System (Group A) is better than the Titanium Mesh System (Group B) and the Absorbable Plate System (Group C) in terms of fracture reduction and stable fixation when treating ZMC fractures. All plating systems had acceptable complication rates, and overall patient satisfaction ratings were high. Fracture features and patient-specific considerations should be taken into account while making individualized treatment options.

Mental Health Status of Health Care Professionals Working in Public and Private Sectors in Visakhapatnam: A Cross-Section Study.

Introduction: The material that is currently available on the psychological issues that doctors deal with is restricted to a few national surveys and certain particular hospital surveys. The motive of the current study was to define the mental health status of medical as well as surgical professionals working in the public and private sectors of Visakhapatnam, Andhra Pradesh, India. Methodology: A self-reported questionnaire survey was used in an observational cross-sectional study to appraise the mental health state of both private and public medical practitioners. The Kessler Psychological Distress Scale (K10) by William C. Menninger was applied. Results: The majority of study participants experienced psychological anguish, showing a substantial difference in the total level of psychological distress. When the Wellinger's Distress and the Kesslers Distress tools were compared, it was found that there was a substantial difference for all the variables taken into account in the current study, including gender, experience, marital status, children, and occupation, designation, and sector of work. Conclusion: Stress and burnout were more prevalent among medical specialists with lower yearly income, young ages, and fewer years of practice. Clinicians and policymakers must be proactive in creating programes that help healthcare professionals cope with stress and burnout.

Isolation Systems and its Effectiveness in Oral and Maxillofacial Surgery: A Systematic Review.

Introduction: The success of restoration processes depends on the efficient control of moisture and microorganisms. Dental restorative procedures frequently use rubber dams as an isolation technique. There is still room for evidence-based discussion over how rubber dam use affects the durability and caliber of dental restorations. In this review, the effects of rubber dam isolation vs alternative isolation techniques for dental restorative procedures are compared. Materials and Procedures: An extensive online search in the various databanks of the EMBASE, Medline, Pubmed, and Scopus was conducted. The keywords searched were "isolation, oral surgery, dental surgery, retractors, rubber dam, and methods of isolation." The studies selected were longitudinal research design and randomized trials. To ascertain the risk of bias, meta-analysis was carried out. The outcome was measured as the successful restoration at the end of follow-up period representing the thorough isolation. Results: A total of 1342 people were involved in six studies from across the world that were carried out between 2010 and 2015. High bias risk existed in all the studies. Five investigations compared the rubber dam vs cotton rolls. Due to discrepancies in the data supplied, one study was omitted from the analysis. Three of the four trials that were still running showed restored survival rates with all having a follow-up of at least six months. The survival of the restored composite teeth for six months in rubber dam isolation with odds ratio of 2.29, 1.38, and 1.00 at the end of six months, one year and one and half year respectively. However, the evidence was very low and speculative. The isolation was seen effective in the primary teeth specifically for the proximal lesions. None of the included studies discussed side effects or provided information on the treatment's upfront costs. Conclusion: The application of rubber dams in dental techniques may result in successful outcome compared to cotton rolls, according to some low-certainty evidence revealed in this research. Other times, the evidence is really ambiguous. It is necessary to conduct additional, high-quality studies investigating how rubber dam use affects various restorative procedures.

COVID Infections Breakthrough Post-Vaccination: Systematic Review.

Introduction: Many new variants of the coronavirus are infecting the already vaccinated people. There have been reports of deaths also among the already vaccinated subjects. Hence, we conducted a systematic review and meta-analysis of the infection breakthrough after COVID vaccination. Materials and Methods: We piloted a review of the healthcare workers who completed the vaccination for COVID. The data were collected from the online resources for the breakthrough infections after vaccination. We then enumerated those subjects who had a breakthrough infection post-vaccination. The data collected were meta-analyzed for the incidence of the infection among the vaccinated individuals. Results: We observed that among nearly 2.3 lakh subjects, less than 3% were infected with the various new strains of the virus. The ratio of the breakthrough infection was different for the vaccinated (1.2%) and the partially vaccinated (3.2%) individuals with greater infection among the partially infected individuals. Discussion: The breakthrough infections are very low among vaccinated individuals and even lower among fully vaccinated individuals. Hence, vaccination is highly recommended to prevent the loss of life.

Evaluation of per Vaginal Bleeding With Different Drugs in Successful Pregnancy in Patients With Recurrent Pregnancy Loss: An Original Research.

Introduction: One of the hormones that are crucial in safe pregnancy is the Progesterone. Its defect may cause bleeding and abortion. Hence, in this study, we evaluated two different drug modalities of progesterone for their efficacy. Material and Methods: We piloted a prospective observational study among 100 pregnant women in their first trimester. They were divided to two equal groups to receive oral dydrogesterone and vaginal progesterone. The clinical and the demographic data with detailed history were taken and noted. The patients were followed up till the pervaginal bleeding stopped and till second trimester end. The comparisons were made between the groups using Chi square test deliberating P < 0.05 as significant. Results: The age, BMI, and the progesterone levels were comparable between the groups. No significant difference between the groups was seen for the adverse reactions and for the continuation of pregnancy till 24 weeks. However, there was a significant variation in the cessation of the pervaginal bleeding, with lower time for the oral dydrogesterone. Conclusion: Compared to the vaginal progesterone, oral dydrogesterone performed better in preventing the pervaginal bleeding and prolonging the viability of the pregnancy till the second trimester end.

Ultrasonographic Evaluation of Gallbladder Diseases: An Original Study.

Introduction: The diagnostic accuracy for the diseases of the gall bladder is high for the Ultrasound. Hence, in the present study, we aimed to evaluate the application of the ultrasound as a major diagnostic aid for the gallbladder diseases. Materials and Methods: We piloted observational study among 100 patients with gallbladder diseases. The clinical, ultrasonograhic, and the histopathological parameters were compared to check the validity of the tests using t-test deliberating P < 0.05 as significant. Results: We observed that number of the cases that were positively identified radiographically were 93 out of 82 actual cases and 67 identified by the Fine Needle Aspiration Cytology (FNAC). There was no significant difference between the clinical, pathological diagnosis and the ultrasonograhic diagnosis indicating a accuracy similar to the clinical and FNAC methods. Conclusion: Ultrasonograhic diagnosis performed similar to the other forms of diagnosis and can be suggested as a convenient and accurate diagnostic test for the diseases of gallbladder.

Factors Affecting Quality of Life in Zygomatic Fractures: An Original Research.

Introduction: Zygoma is one of the facial bones that are impacted in the accidents. Hence, we aim to evaluate the patient's profiles in the fracture associated with zygomatic bone. Materials and Methods: We conducted a prospective clinical study with 60 subjects who were divided equally into cases (30) and controls (30); controls were general population and the cases underwent surgery of zygomatic complex fracture. Health-related quality of life (HRQoL) was assessed by the means of the questionnaire. The values were compared for the significance keeping P < 0.05 as significant. Results: The preoperative 15D score was lesser for cases than controls. Soon after surgery, it was statistically least and after a month, the mean score surpassed the controls. Infraorbital sensory loss was seen even after 6 months. Conclusions: As expected, the HRQoL decreases only to improve after the surgery. However, the infra-orbital nerve sensory loss may continue for over 6 months after the zygomatic complex fracture.

Evaluation of Soft-Tissue Grafting in Peri-implantitis - An Original Research.

Introduction: With the increased application of the implants for the restoration of the lost teeth, the peri-implantitis cases are seen on a rise. Hence, we conducted a study retrospectively to evaluate, among the peri-implantitis cases, the success of the soft-tissue grafting. Material and Methods: We piloted a retrospective study among 50 subjects of both genders who underwent the soft-tissue grafting for the treatment of the peri-implantitis of a total of 69 implants. The clinical parameters noted were at the baseline and at various years of follow-ups. The data of the clinical parameters were noted, and the data thus noted were compared deliberating P < 0.05 as significant. Results: Thin soft-tissue biotype was noted among all the subjects, with the increased width of the keratinized mucosa. Significant lowering of the probing depth, bleeding on probing, and the mobility of the tissue were noted. Conclusions: We can conclude that soft-tissue grafting Is a benificial method for the peri-implantitis treatment.

Evaluation of Efficiency of Dyes in Detection of Cancer Cells: An Original Research.

Introduction: The early detection of the cancer will dramatically improve the prognosis. There are many diagnostic aids that can be employed for screening. Hence, in our study, we aim to evaluate the efficiency of dyes in detection of cancer cells. Materials and Methods: We piloted a prospective clinical study among 30 subjects to detect the efficiency of two dyes-Lugol's iodine and toluidine blue. They were grouped equally for potentially malignant and malignant lesions. The areas were analyzed for the diagnostic accuracy of the dyes using the histopathological examination and compared using chi square test deliberating P < 0.05 as significant. Results: We observed that both the dyes showed a diagnostic accuracy of over 90% when used alone or in combination. Both the dyes had greater sensitivity while specificity was 20%. Conclusion: The combination of these two dyes can be used as an efficient screening aid for the identification of the cancer cells.

Occlusal Vertical Dimension and Its Association with Length of Thumb: An Original Research.

Introduction: Establishing an accurate vertical dimension at occlusal (VDO) is a challenge. Hence, we aim to find the association between the VDO and the Thumb Length (TL). Materials and Methods: We piloted an observational study by evaluating the VDO and the TL among the Dravidian and Aryan ethnicities with 200 volunteers. The comparisons were made applying the "linear regression analysis" to find the correlation of both. Results: We observed that a strong and positive relation was established for the two parameters of VDO and TL for both the ethnicities. Conclusion: We can suggest from our study that the thumb length can be used as an aid for the occlusal vertical dimension estimation.

Low-Level Laser Therapy Role in Surgical Extractions: An Original Research.

Introduction: Low-level laser therapy (LLLT) has been of interest in the clinical application in dentistry. Hence, we evaluated the LLLT on the wound healing in the mandibular surgical extraction. Materials and Methods: We conducted a prospective clinical study with 50 male subjects, equally distributed as controls and cases. Routine surgical extraction was done for control group, and in case group, LLLT was applied after the extraction. Evaluation was done for various parameters and after comparison the P value was less than 0.05 which was considered as significant. Results: Significant difference was seen between the groups for the socket depth on 7th day, swelling on 1st, 3rd, and 5th days, and pain on all the days. Conclusion: LLLT can be successfully used for the surgical extractions.

Comparative Evaluation of Three-Dimensional Plating Systems in Maxillofacial Trauma: An Original Research.

Introduction: Many advanced techniques and materials have been introduced in the recent years with the advent of the new designing technology. Hence, in our study, we aimed to compare in maxillofacial trauma, the three-dimensional (3D) plating systems. Materials and Methods: We piloted a prospective clinical study among 50 subjects of both genders with mandibular parasymphysis fracture. We compared the 3D miniplates with the two-dimensional (2D) miniplates where the subjects were divided into 2 groups equally. The clinical parameters were compared at different times of follow-up after the surgery. Results: We observed that there was a similar distribution of the genders and the side of the fracture of the parasymphysis. There was a significant difference between the groups for the mouth opening while there was no significant difference for the sensory deficit. The subjects recovered better with the 3D mini-plates. Conclusion: The mandibular fractures can be successfully treated with the 3D miniplates that help in a quick and efficient recovery.

Level of Evidence Analysis in Journal of Maxillofacial Oral Surgery: A Twelve-Year Bibliometric Analysis of 1300 Publications (2009-2020).

AIM: Analysing Level of Evidence (LOE) provides an insight to evidence-based medicine (EBM). The aim of our study was to evaluate and analyse trends in Levels of Evidence (LOE) in Journal of Maxillofacial and Oral Surgery (MAOS) since inception, i.e. December 2009 along with categorization into subtopics. METHODOLOGY: LOE for each article was determined according to modified American Society of Plastic Surgeons (ASPS) scale and National Health and Medical Research Council (NHMRC) Evidence Hierarchy. RESULTS: A total of 1264 articles were included in the final analysis, out of which high-quality evidence (Level A) accounted for 7% of the journal. The percentage of Level I/II (Level A) has increased from 2.09% in 2009/2010 to 12.74% in 2019/2020, representing a promising trend toward higher-quality research in just 10 years. Case reports and narrative reviews with Level of Evidence value "D" account the highest number (36%) of all the published articles. The majority of articles fell under Class 2 (Maxillofacial pathology) classification (35%) highlighting myriad of articles covering pathologies and various reconstruction methods, followed by trauma (16%). CONCLUSION: The status of LOE and categorizing of published articles are the first step to audit and quantify the nature of literature published by JMOS and may further help in refining the quality of research jointly by the researchers and the editorial board.

COVID and Animal Trials: A Systematic Review.

Extensive work is being done to form targeted drugs against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection; however, it is imperative to have a safe and effective vaccine against the same to win the war against this pandemic. For creating an efficacious vaccine, a proper animal model needs to be selected which can have an acceptable similarity of response as well as effects when administered to humans. For the present research, extensive search was conducted in MEDLINE and bioRxiv and medRxiv servers which were published in the English language from January 1, 2020, to August 20, 2020. Search terms included animal models, SARS-CoV-2, COVID-19, immune response against coronavirus, nonhuman primates, mice, ferrets, and macaques. In our study, creating an adequate immune response mimicking the response as in humans, as the endpoint, was considered as inclusion criterion while assessment of any additional therapies like safety as well as minimal tolerable dose using animal models as well as formation of adequate sample size of these models against COVID-19 was not considered. In our search, 163 articles were shortlisted, of them only 20 articles were finally included in our study which addressed to our inclusion and exclusion criterion. Our research articles focused on nonhuman primates, mice, hamsters, ferrets, cats, and dogs, with the main goal to investigate the role of animal models in the pathogenesis of COVID-19. It was evident in our research that animal models only mimic limited signs and symptoms experienced in COVID infection as compared to infections in humans. However, they are still essential to understand the pathogenesis, transmissibility of viral particles, and vaccine testing.

Various Assisted Bone Regeneration in Apicectomy Defects Systematic Review and Meta Analysis.

INTRODUCTION: In the endodontic surgery, the common applications are the procedures that apply regenerative methods. There are various methods that help in the regeneration after the endodontic root end cutting or apicectomy. The outcome of the apicectomy depends on the procedure and the material. Hence in the present study, we intend to conduct the systemic review and meta-analysis of the various assisted bone regeneration in apicectomy defects. MATERIALS AND METHODS: The study was conducted by the online search of the data that included the studies for the regenerative procedure in the endodontic surgery in patients with various periapical pathologies. The data search engines were Scopus, Web of Science, Google Scholar, and PubMed. The risk of the bias was calculated. The study participants were divided into case and control groups. Case group had undergone the regenerative surgery for the persistent periapical lesions, while the control group had not undergone the regenerative surgery for the persistent periapical l. The clinical and the radiograph outcomes were compared between the control and the case groups. Meta-analysis was done and the subgroups were evaluated. RESULTS: From a total of 1561 articles, only 11 were finalized for the study to conduct the meta-analysis. The bias was noted for majority of the studies most of which were clinical trials. It was observed that the regenerative methods used in the endodontic surgery have significantly improved the outcome. The application of the expanded polytetrafluoroethylene only has no significant effect; however, application of the autologous platelet concentrates or collagen membranes only had good outcomes. The combination of the materials showed a significant outcome than when applied alone. CONCLUSIONS: From this meta-analysis, it is evident that regenerative procedures are beneficial in the endodontic apicectomy procedures. The materials used in these procedures will augment the outcome. A better prognosis is expected if the combination of the materials is used.

COVID 19 Scoping: A Systemic Review and Meta-Analysis.

INTRODUCTION: The world has faced the pandemic of COVID-19 in the march of 2020 and still it continues to effect in 2021. Hence, in the present study we aim to evaluate the gulps in the research so that certain recommendations can be made for the future research. We conducted a scoping review of the COVID meta-analysis. MATERIALS AND METHODS: Online data was collected from the search engines of EBSCO, PubMed, Google Scholar, and Scopus. The searched terms were COVID-19, CORONA, SARS-CoV-2, clinical features, Wuhan, etc. The study articles were collected that from January 2020 to February 2021. Based on the PRISMA guidelines, the meta-analysis was performed. RESULTS: In the present study, we finalized 316 articles. On February 2020, the first article was published. We observed a spike in the meta-analysis later on. Most of the meta-analysis were issued in the virology and infection magazines. As expected, the majority studies were from Wuhan. The other countries that published the meta-analysis were the USA, the UK, and Italy. The studies included in each meta-analysis were nearly 25 and the subjects were approximately 16 thousand. However, we noticed a poor quality in majority of these meta-analysis and <10% of all the meta-analysis showed higher confidence. CONCLUSION: A poor quality of the meta-analysis has predominated the data and very few are of high quality. All the journal editors and the reviewing team should verify and thoroughly organize the protocol so that only high quality meta-analysis are encouraged.