Assessment of knowledge, practices and attitudes of dentists toward coronavirus disease while performing aerosol-generating procedures in dentistry: A cross-sectional survey from India.

BACKGROUND: Dental procedures that generate aerosols, if not performed with precautions, are the source of infection during the coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVES: The aim of the present study was to analyze dentists' awareness, knowledge and practice regarding the spread of coronavirus in India, to fill the knowledge gaps and to limit the spread of the virus while performing aerosol-generating procedures (AGPs). MATERIAL AND METHODS: A cross-sectional survey containing 23 close-ended questions was conducted using the Google Forms platform. The questionnaire was knowledge, practice and attitude-based (KPA). It was completed by Indian dentists stratified according to gender, designation, years of experience, and residence type. Data was analyzed with the χ2 test, and summarized using frequency and percentage. The independent samples t test and the one-way analysis of variance (ANOVA) were used to analyze intergroup differences. RESULTS: With regard to knowledge, females, specialists with 10 years of experience and those living in metro cities scored higher. For practice-based questions, males, the teaching staff, dentists with less than 5 years of experience, and those living in suburban areas provided more correct answers. For attitude-based questions, females, general practitioners (GPs), dentists with less than 5 years of experience, and those residing in suburban areas provided more correct answers. CONCLUSIONS: Dentists in India demonstrated a high level of understanding with regard to COVID-19. However, they showed a limited understanding of the extra preventative procedures to safeguard against the disease. The study findings have significant implications for the measures aimed at increasing dentists' level of KPA toward coronavirus.

Burns and COVID-19-Initial Experience and Challenges.

The COVID-19 pandemic has brought with it many challenges in the field of healthcare around the world. Managing burn patients has its own challenges as they require a long duration of care and are more susceptible to infection. We conducted a retrospective observational study from January 30 to July 15, 2020 at our center to study the epidemiology of burns treated & patients and healthcare workers affected by COVID-19 during this period. The number of burn admissions showed a 42.6% reduction as compared to last year. A total of 17 patients (3.67%) and 29 health care workers (8.68%) tested positive for COVID-19 in the burns department. Our strategy underwent changes based on the changing dynamics of COVID-19 and changes in government and institutional policies. We have described the various challenges we faced in managing burns during this time. We found that effective screening of patients and healthcare workers, proper segregation of negative and positive/ suspect population and a low threshold for COVID-19 testing were essential to mitigate transmission of infection.

The Impact of COVID-19 and Lockdown on Plastic Surgery Training and Practice in India.

Background A nationwide lockdown due to the outbreak of COVID-19 has posed unforeseen challenges. Lockdown, physical distancing, and restrictions on medical practice have affected the training of residents and the professional and personal life of plastic surgeons. An online survey was conducted to assess this impact. Methods A questionnaire was circulated on Whatsapp groups from 15 to 21 of May and snowball sampling was done. The survey was designed to have a separate set of questions for residents and practitioners. The obtained results were analyzed, according to SPSS software version 25. Results A total of 206 responses were obtained (107 residents and 96 consultants) from across the country. The average age of consultants was 38.10 years, with mean experience of 4 years (range 0.5-33 years). As much as 56.3% of practitioners and 87.8% of residents were working in hospitals treating COVID-19. Average fall in number of OPD cases and elective surgeries was 75%. This led to financial strain on 86.5% of consultants and adversely affected training of 86% residents. As much as 86.9% of residents and 67.7% of consultants hoped that the online teaching pattern continued after the pandemic. Conclusion Universities need to recognize the loss in training for residents due to the pandemic and formulate plans to overcome it. Institutions and associations conducting webinars can streamline and archive them for future use.

The "Safdarjung Method" of Estimation of Total Body Surface Area (TBSA) Burns in Major Amputees.

Accurate estimation of total body surface area (TBSA) burns is the cornerstone of initiating correct fluid therapy in burns. The current formulae are designed for patients with intact body. However, the authors having worked at a high-volume burns center (Safdarjung Hospital, New Delhi, India) have encountered patients with major amputations presenting with burns. The existing formulae are inaccurate for estimating TBSA in major amputees, leading to inaccurate fluid estimation in such cases. The authors have designed a novel method to estimate TBSA burns in patients with major amputations that involves a "correction factor" to account for the amputated parts.

Comparative evaluation of crestal bone levels around endosseous implants as influenced by conventional and diode laser during second-stage surgery in mandibular implant-supported overdenture: An in vivo study.

AIM: This study aims to evaluate and compare the crestal bone levels around implants as influenced by conventional and diode laser during second-stage surgery in an edentulous mandible using cone beam computed tomography (CBCT) and digital radiography (DR). SETTINGS AND DESIGN: A split-mouth in vivo prospective study on edentulous patients involving placement of two implants in mandible followed by the comparison of two different techniques for second-stage surgery. MATERIALS AND METHODS: The study was undertaken to evaluate the crestal bone change around 16 implant sites distributed in two groups (eight implants each) following two methods during second-stage surgery, i.e., Group 1 - Conventional second stage and Group 2 - Diode laser. Measurements were made on two sides (mesial and distal) using intraoral periapical and four sides (labial, lingual, mesial, and distal) using CBCT scans for both groups. These measurements were conducted at two time intervals for both, i.e., immediately after implant loading and twenty 4 weeks after implant loading. The values obtained were subjected to statistical analysis. STATISTICAL ANALYSIS USED: The normality of data was checked by Shapiro-Wilk's test. Intragroup comparison was compared using independent t-test by post hoc comparison by Bonferroni method (P < 0.05). RESULTS: Crestal bone loss at the time of loading for Group 1 evaluated by CBCT was 0.950 ± 0.988 while after 24 weeks of loading, it was 1.388 ± 0.576. For Group 2, mean crestal bone loss was 1.200 ± 0.925 at the time of loading, and after 24 weeks, it was 1.512 ± 0.674. Crestal bone loss at the time of loading for Group 1 evaluated by DR was 1.075 ± 0.849 while after 24 weeks of loading, it was 1.562 ± 0.480. For Group 2, mean crestal bone loss was 1.162 ± 0.833 at the time of loading and after 24 weeks, it was 1.700 ± 0.498. CONCLUSIONS: In the present study, no statistically significant difference was observed in crestal bone loss between conventional and diode laser technique.

Hard and soft-tissue evaluation of bar-clip, ball-socket, and kerator attachments in mandibular implant overdenture treatment: An in vivo study.

AIM: The aim of this in vivo study was to evaluate and compare the soft and hard tissue changes in implant supported mandibular overdenture with three different attachment system. SETTINGS AND DESIGN: In vivo - observation study. MATERIALS AND METHODS: After evaluation of prosthetic space, fifteen edentulous subjects received two implants in the inter-foramina region of the mandible and were divided into 3 groups with 5 subjects each, delayed loading protocol was followed in all the patients. The crestal bone loss, modified sulcular bleeding index, plaque index values were evaluate with the attachments at baseline and after 6 months was measured in a standardised way. STATISTICAL ANALYSIS USED: Oneway ANOVA test and post hoc Bonferroni multiple test. RESULTS: At the end of six months modified sulcular bleeding index and plaque index values was higher in Group 2 (bar and clip attachment) as compared to Group 1 (ball and socket attachment) and Group 3 (Kerator attachment) and crestal bone loss was equal in groups 1, 2 and 3. Analysis of variance with repeated measures showed significant differences in modified sulcular bleeding index and plaque index among the three attachment types. CONCLUSION: (1) Group 2 (bar-and-clip attachment) exhibited higher Modified Sulcular Bleeding Index and Plaque Index values than Group 1 (ball-and-socket attachment) and Group 3 (kerator attachment). (2) Crestal bone loss was equal in Group 1 (ball-and-socket attachment), Group 2 (bar-and-clip attachment), and Group 3 (kerator attachment).

Retention and patient satisfaction with bar-clip, ball and socket and kerator attachments in mandibular implant overdenture treatment: An in vivo study.

AIM: The aim of this in vivo study was to evaluate and compare the retention and patient satisfaction in implant supported mandibular overdenture with three different attachment system. MATERIALS AND METHODS: After evaluation of prosthetic space, fifteen edentulous subjects received two implants in the inter-foramina region of the mandible and were divided into 3 groups with 5 subjects each, delayed loading protocol was followed in all the patients. The retention force and satisfaction level with the attachments at baseline and after 6 months was measured in a standardised way using retentive device and VAS questionnaire. The study was based on evaluation of retention and patient satisfaction. 15 subjects were included in the study. The results obtained were statistically analyzed using one-way ANOVA test, and multiple comparisons were carried out using the Bonferroni tests. RESULTS: At the end of six months, the retention force and satisfaction level was higher in Group 3 (Kerator attachment) as compared to Group 1 (ball and socket attachment) and Group 2 (bar and clip attachment) and patient satisfaction was equal in groups 1, 2 and 3 but the total number of interventions is significantly higher in the attachment bar. Analysis of variance with repeated measures showed significant differences in retention force among the three attachment types. CONCLUSION: (1) Group 3 (kerator attachment) exhibit higher retentive capacities than Group 1 (ball and socket attachment) and Group 2 (bar and clip attachment). (2) patient satisfaction was higher in Group 3 (Kerator attachment) in compare to Group 1 (ball and socket attachment) and Group 2 (bar and clip attachment).

Comparative Evaluation of Shear Bond Strength of Newer Resin Cement (RelyX Ultimate and RelyX U200) to Lithium Disilicate and Zirconia Ceramics as Influenced by Thermocycling.

BACKGROUND/PURPOSE: The purpose of this study was to compare the shear bond strength of high strength ceramics to cut dentine as influenced by different resin cement types after thermocycling. MATERIALS AND METHODS: Shear bond strength testing was carried out for 56 sound, freshly extracted first permanent molars. Specimens were divided at random into 2 groups (n = 28) Lithium disilicate and Zirconia. Lithium disilicate and Zirconia specimens were further subdivided depending upon luting with Rely X ultimate cement bonded with single bond universal adhesive and Rely X U200 cement. Half of the specimens of each material luted with cements were subjected to thermocycling. Shear bond strength was evaluated using Universal testing machine at a crosshead speed of 5 mm/min. Results were compared and evaluated using t-test at a significance level of 0.05. The nature of bond failure was observed under a stereomicroscope for each sample. RESULTS: The mean difference of Lithium disilicate test specimens bonded with Rely X ultimate cement bonded with single bond universal adhesive with and without thermocycling was found to be 42.95+/-17.41MPa and 120.62+/-56.46 MPa respectively. The mean difference of Zirconia test specimens with Rely X ultimate cement bonded with single bond universal adhesive, with and without thermocycling, was found to be 8.74+/-2.90 MPa and 164.28+/-43.78 MPa respectively. The mean difference of Lithium disilicate test specimens bonded with Rely X U200 with and without thermocycling was found to be 2.36+/-0.63 MPa and 36.79.62+/-17.21MPa respectively. The mean difference of Zirconia test specimens bonded with Rely X U200 with and without thermocycling was found to be 5.96+/-3.11MPa and 122.46+/-23.01MPa respectively. CONCLUSION: Zirconia was found to have better shear bond strength than Lithium discilicate. The use of single bond universal adhesive improves bonding to newer higher strength ceramics such as Zirconia. Cohesive failure was predominant at cement dentine interface.

Geriatric forensics - Part 2 "Prevalence of elder abuse and their potential forensic markers among medical and dental patients".

CONTEXT: This study is a continuation of the earlier studies and has been extended to investigate the potential forensic markers of elder abuse. AIMS: To determine the prevalence of elder abuse in various outpatient departments (OPDs). To study the associated parameters related to the abuser and the abused. To determine the existence of potential forensic markers of elder abuse. SETTINGS AND DESIGN: The subjects were randomly selected from the medical and the dental OPDs of the university. MATERIALS AND METHODS: Eight hundred and thirty two elderly subjects in the age range 40-60 years were interviewed using a questionnaire to determine the existence of elder abuse. The subjects were investigated and examined for weight, nutrition and hydration, vital signs, habits, existing visual and auditory capabilities, medications, disclosure of wills/deeds, signs of depression, and documented cleanliness. The mini-mental state examination, the Geriatric Depression Scale, the Clock drawing test, and the Brief Psychiatric Rating Scale were used to determine the potential forensic markers. STATISTICAL ANALYSIS USED: Mean values in percentage were determined by dividing the number of determined subjects by the total number of subjects for that parameter. RESULTS: About 37% in medical and 41% in dental OPDs were found to have suffered from abuse, mostly in the age group 60-70 years. Females received more abuse and a combination of son and daughter-in-law constituted most abusers. Various potential markers of elder abuse and neglect investigated among the elder abuse victims included depression (89%), signs of improper feeding (83%), changes in personal hygiene (69%), need for medical/dental treatment (78%), medication misuse (67%), changes in wills/deeds (26%), decubiti (10%), bruises (17%), skin tears (27%), and confusion (23%). CONCLUSIONS: Elder abuse exists in one or more forms in both medical and dental OPDs among both males and females in all age groups.