Retrospective evaluation of the morphometric properties of intact maxillary sinus using cone-beam computed tomography for sex estimation in an Indian population.

Background: Sex estimation is crucial to forensic examinations. In order to estimate sex, intact bones are used if the majority of bones are severely deformed and recovered in fragments. This study aims to analyze sexual dimorphism in intact maxillary sinuses using CBCT scanning to evaluate morphometric properties for sex identification. Methods: A total of 318 subjects, consisting of 159 males and 159 females, aged between 20 and 60 years without sinus pathology were included in this diagnostic, retrospective cross-sectional study. Bilateral measurements of the volume, height, width, and length of the maxillary sinuses were obtained and compared to evaluate the differences between sexes. Subsequently, a descriptive analysis using mean and standard deviation was performed, followed by a comparison between sexes with a p-value being less than 0.05 and Student's t-test. Finally, a discriminant analysis was performed separately for the right and left maxillary sinuses. Results: Males and females showed statistically significant variations in the length, width, and volume of the maxillary sinuses. Specifically, on the right side, males had longer maxillary sinuses than females (t = 5.6203, p < 0.0001). Meanwhile, on the left side, females had wider maxillary sinuses than males (t = 8.621, plt0.0001). In addition, males had greater volumes of maxillary sinuses on the right (t = 6.373, p < 0.0001) and left (t = 3.091, p < 0.0001) sides than females. The results of the discriminant analysis showed that the left width parameter had the highest accuracy of sex estimation (74.21%), followed by the Right Length (70.07%) and left volume (66.66%) parameters. The left height parameter had the lowest accuracy of sex estimation (49.37%). Conclusion: In forensic odontology, the volume of maxillary sinus can serve as a valid radiographic indicator of sex estimation.

Estimation of Age implementing pulp tooth volume ratio in maxillary canines of an Indian population by means of CBCT scans.

BACKGROUND: Forensic odontology is a subfield of forensics that can assist in determining age, gender, and other demographic factors. OBJECTIVE: The focus of this research is to ascertain age by tooth volume ratio of permanent maxillary canines using a CBCT scan. METHODS: In this retrospective investigation, 1000 CBCT images were gathered and focused on only fully developed maxillary canines. For each of the maxillary canines, the researchers measured and calculated the volume of the pulp chamber, root canal, and entire tooth using the ITK Snap programme. The pulp volume to tooth volume ratio was computed. The equation AGE = 59.208 - (583.652 x pulp volume/tooth volume) was then used to compute age. The samples were divided into 5 age groups; 13-20, 21-30, 31-40, 41-50, and 51-60. The age was calculated for samples in each group and it was compared to the actual age. RESULTS: Between individuals' actual age and computed age, the study discovered a statistically significant positive association. While groups 3, 4, and 5 demonstrated positive but weaker correlations (r= 0.854, r= 0.658, and r= 0.612, respectively), groups 1 and 2 displayed statistically significant strong positive correlations (r= 0.987 and r= 0.923, respectively). The average total discrepancy between the age that was computed and the actual age was 2.45 1.344. CONCLUSION: The study found a statistically significant positive correlation between computed age and actual age, with the younger age groups 1 (13-20) and 2 (21-30) showing the strongest relationships. This underlines its potential success in court, particularly when dealing with young criminals.

Bibliometric Analysis of Context, Trends, and Contents of Digital Health Technology Used in Dental Health.

Digital tools and apps are revolutionizing healthcare and provide creative answers to urgent problems. Through teamwork and the incorporation of digital technologies, dentistry has experienced a remarkable revolution. A large body of scholarly research backs up this trend. The context, trends, and content of digital health technology in oral and dental health are examined in our bibliometric analysis. Using targeted keywords and synonyms, an organized searching technique was used in the Scopus database, yielding 1942 articles that were extracted into a CSV file. To acquire insights into the content, trends, and context, visualization using VOSviewer 1.6.18 and a variety of analyses-including coauthorship, citation, cooccurrence of author keywords, bibliographic coupling, and cocitation-were executed. The analysis revealed that the USA and the UK contributed to a significant quantity of the literature, with newer contributions coming from nations like India. Cone Beam Computed Tomography, Dental Caries, and Artificial Intelligence were prominent keywords. It is important to note that BMC Oral Health was associated with a sizable number of the papers. This bibliometric analysis provides insightful information about the context, content, and trends of digital health in the field of oral and dental health. By implementing the right technology, policymakers can use this information to increase oral health, encourage dental literacy, and improve access to dental treatment. It is vital to take into account the wide variety of technologies and their classifications based on dental services and contextual variables.

Comparative Evaluation of Oral Health and Behavior Changes in Children after Motivational Interviewing and Traditional Method of Oral Health Education among Mothers: A Systematic Review and Meta-analysis.

Aim: To analyze the effectiveness of motivational interviewing (MI) compared to traditional health education among mothers in improving children's oral health and behavioral changes. Review methods: The search strategy was framed using relevant MeSH terms and free text terms in PubMed, Medical Literature Analysis and Retrieval System Online (MEDLINE), Directory of Open Access Journals (DOAJ), Cochrane Library, and Google Scholar for the articles published in the English language between 1st January 2000 and 31st December 2020. Only randomized controlled trials, non-randomized controlled trials, and clinical trials comparing MI with traditional health education were included. Cochrane risk of bias (ROB) tool was used for the quality assessment of the included studies, and Review Manager 5.3 software was used for computing results. Results: A total of 9 studies were included for qualitative synthesis and 5 for quantitative synthesis from an initial search of 3,708 articles. The cumulative mean difference for dental caries was -1.03 [95% confidence interval (CI)-1.37-0.70] p < 0.00001, for frequency of toothbrushing Pooled odds ratio was 1.69 (95% CI-0.68-4.25) p = 0.26 and for in-between snacking was 0.83 with (95% CI-0.48-1.44) p = 0.51. A significant difference was present in dental caries among children with mothers in the MI group, while no difference was present in in-between snacking and frequency of toothbrushing between both the groups. Conclusion: Motivational interviewing (MI) prove to be significantly effective in reducing newer dental caries for shorter duration; however, long-term effectiveness could not be assessed. Clinical significance: Motivational interviewing (MI) can be considered an effective and feasible method for oral health education to mothers, which will, in turn, improve the oral health of their children. Protocol registration: International prospective register of systematic reviews (PROSPERO) under registration code. CRD42021224278. How to cite this article: Karande PH, Shetty VB, Vinay V, et al. Comparative Evaluation of Oral Health and Behavior Changes in Children after Motivational Interviewing and Traditional Method of Oral Health Education among Mothers: A Systematic Review and Meta-analysis. Int J Clin Pediatr Dent 2023;16(3):464-473.

Efficacy of a proprietary combination of Tamarindus indica seeds and Curcuma longa rhizome extracts in osteoarthritis: a clinical investigation.

Background: NXT15906F6 (TamaFlex™) is a proprietary blend containing standardized Tamarindus indica seeds and Curcuma longa rhizome extracts. Earlier, NXT15906F6 supplementation demonstrated reduced knee joint pain and improved musculoskeletal functions in healthy and knee osteoarthritis (KOA) subjects. Objective: The present randomized, double-blind, placebo-controlled study was focused on validating the clinical efficacy of NXT15906F6 in a larger number of subjects with KOA. Methods: Male and female subjects (age: 40-70 years; body mass index [BMI]: 20-29 kg/m2] were randomized into three groups receiving placebo (n = 50), NXT15906F6 (n = 50) or a blend of C. longa and Boswellia serrata extracts (CLBS) (n = 50). Subjects consumed 250 mg NXT15906F6, 1,000 mg CLBS or a matched placebo daily after breakfast over a period of 30 consecutive days. The primary efficacy outcome was the improvement in total Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, and the secondary efficacy measures included various tests on joint pain and musculoskeletal functions and evaluations ofserum high-sensitivity C-reactive protein (hs-CRP) and a cartilage degradation marker, C-terminal telopeptide of type II collagen in urine (uCTX-II). Results: NXT15906F6 significantly (P < 0.001) reduced the WOMAC scores and improved musculoskeletal function scores in the participants as compared with baseline and placebo. NXT15906F6 participants reduced knee pain and improved musculoskeletal functions as early as day 5 of supplementation. In contrast, CLBS supplementation failed to show early efficacies in pain and functional scores, except for 30s-CST and primary knee flexion. The NXT1506F6-supplemented participants significantly reduced serum hs-CRP and uCTX-II levels from baseline and as compared with the placebo. Both supplementations did not alter the subjects' clinical chemistry, hematology, and vital parameters. Conclusion: The anti-inflammatory botanical composition NXT15906F6 supplementation mitigated joint pain and improved musculoskeletal functions and joint motility in KOA subjects. This botanical composition was also well-tolerated by the volunteers.

Effectiveness of Oral Health Educational Methods among School Children Aged 5-16 Years in Improving their Oral Health Status: A Meta-analysis.

Background: Oral health is an essential component of health throughout life. Two major oral diseases, dental caries and gingival conditions are prevalent in young population. School-based oral health education (OHE) programs with recognized technology and traditional lecturing could be strategic in promotion of oral health behavior in developed and developing countries. Aim: The aim of the study is to summarize existing evidence in order to evaluate the effectiveness of OHE programs in school children aged 5-16 years in improving their oral health status. Methodology: Clinical trials with school children between 5 and 16 years were included. Eligible studies were those which had outcomes as caries, plaque and gingival indices, and oral hygiene status. Articles published from 2010 to 2019 in English language from PubMed, Directory of Open Access Journal (DOAJ), and Google Scholar were searched. Forty-one articles were identified and relevance was determined by examining title and full article. Nine articles were included for qualitative synthesis and seven were eligible for meta-analysis. The risk of bias was assessed by Cochrane Handbook. A meta-analysis was done using Review Manager 5.3 software. Results: After the meta-analysis results for cumulative mean difference was found as 0.05 (-0.17, 0.27), -0.37 (-0.74, 0.00), -0.20 (-0.33, -0.07), and -0.17 (-0.73, 0.38) for plaque status, Oral Hygiene Index-Simplified (OHI-S), debris status, and dental caries, respectively showing a significant difference favoring the experimental group than traditional group. Conclusion: Interventions given by various aids like lectures, albums, models, flipcharts, leaflets, E-programs, games, drawings, and presentations proved effective in improving oral hygiene status and dental caries, but no reduction in plaque levels and gingival inflammation as compared to oral health talk/counseling by dentists. How to cite this article: Gurav KM, Shetty V, Vinay V, et al. Effectiveness of Oral Health Educational Methods among School Children Aged 5-16 Years in Improving their Oral Health Status: A Meta-analysis. Int J Clin Pediatr Dent 2022;15(3):338-349.

Diagnostic Accuracy of Salivary Biomarkers in Detecting Early Oral Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis.

BACKGROUND: Biopsy is the gold standard for oral squamous cell carcinoma (OSCC) diagnosis. Salivary biomarkers provide promising complementary alternative diagnostic adjunct for its simple non- invasive collection and technique and to screen large population. OBJECTIVE: To summarize and compare the existing evidence on diagnostic accuracy of salivary biomarkers with their estimation method in detecting early oral squamous cell carcinoma. METHODS: The review protocol is registered under PROSPERO(CRD42021225704). PubMed, Google Scholar, EBSCOhost were searched from 2000 to 2020 to identify the screening potential of eight salivary biomarkers: mRNA, miRNA, DUSP100, s100P, IL-8, IL-1B, TNF-a and MMP-9. True-positive, false-positive, true-negative, false-negative, sensitivity, specificity values were extracted or calculated if not present for each study. Quality of selected studies was evaluated based on QUADAS 2 tool. Meta-analysis was performed using a bivariate model parameter for the sensitivity and specificity and summary points, summary receiver operating curve (SROC), confidence region, and prediction region were calculated. RESULTS: Eighteen studies were included for qualitative synthesis and out of that 13 for meta-analysis. Sensitivity and specificity were calculated with AUC. For mRNA it was 91% and 90% with 0.96 AUC, miRNA had 91% and 91% with 0.95 AUC for PCR. IL-1B had 46% and 60% with 0.61 AUC, S100p had 45% and 90% with 0.57 AUC for ELISA. IL-8 had 54% and 74% for ELISA and 89% and 90% for PCR with 0.79 AUC and DUSP1 had 32% and 87% for ELISA and 76% and 83% for PCR with 0.83 AUC respectively. CONCLUSION: Early detection of OSCC was best achieved by screening for salivary mRNA and miRNA estimated by PCR. Further investigation is required into salivary RNA as novel biomarkers and these salivary biomarkers may be potentially used for non-invasive diagnosis of early OSCC.

Effectiveness of Audio and Audio-Visual Distraction Aids for Management of Pain and Anxiety in Children and Adults Undergoing Dental Treatment- A Systematic Review And Meta-Analysis.

Dentists have a wide variety of techniques available to them such as tell -show-do, relaxation, distraction, systematic desensitisation, modelling, audio analgesia, hypnosis, and behaviour rehearsal. There is no concrete research as systematic review and meta-analysis indicating which explains the most effective distraction technique. AIM: To summarize effectiveness of audio and audio-visual (AV) distraction aids for management of pain and anxiety in children undergoing dental treatment. STUDY DESIGN: Literature search: PubMed/MEDLINE, DOAJ, Science Direct from June - July 2020 with randomized control clinical trials conducted on children with audio and AV distraction aids as intervention and those which had anxiety and pain as outcomes were searched. Fifty articles were identified and relevance was determined. 14 studies were included for qualitative synthesis and 05 were eligible for meta-analysis. Cochrane handbook used to assess the risk of bias. The meta analysis conducted using review manager 5.3 software. RESULTS: Meta-analysis, cumulative mean difference for audio and AV distraction techniques was calculated with main outcomes as pulse rate, O2 level, Vehman's picture and clinical test. These findings showed significant difference favoring the intervention (audio and AV) group when compared with control but indicating more effectiveness of AV distractions. CONCLUSION: Different audio-visual aids assist in reducing pain and anxiety in children but using audio distraction aids when audio-visual aids are not available could be acceptable way for distracting and treating children.

Tamarindus indica Seed Extract-Based Botanical Compositions Alleviate Knee Pain and Improve Joint Function in Mild-to-Moderate Osteoarthritis: A Randomized, Double-Blind, Placebo-Controlled Clinical Study.

OBJECTIVE: Knee pain and reduced joint function affect the quality of life of subjects suffering from knee osteoarthritis (KOA). The present randomized, double-blind, placebo-controlled study aimed to assess the clinical efficacy of two botanical compositions, NXT15906F6 and NXT19185, in pain relief and improvement in the musculoskeletal function of knee osteoarthritis (KOA) subjects. NXT15906F6 contains ethanol/aqueous extract of Tamarindus indica seeds and aqueous ethanol extract of Curcuma longa rhizome, and NXT19185 is a combination of NXT15906F6 and an aqueous ethanol extract of Garcinia mangostana fruit rind. METHODS: The present trial recruited ninety subjects with mild-to-moderate KOA, using a radiographic Kellgren-Lawrence (KL) grading system. The participants were randomized into one of three groups (n = 30) to receive either placebo, NXT15906F6 (250 mg/day), or NXT19185 (300 mg/day) for 56 days. The change in Western Ontario and McMaster Universities Arthritis Index (WOMAC) score was the primary efficacy measure of the study. Improvements in the functional scores, serum proinflammatory modulators, and cartilage degradation product in the urine samples were the secondary efficacy measures. Twenty-seven subjects in each group completed the trial. RESULTS: After the trial, NXT15906F6 and NXT19185 significantly improved (P < 0.05) the WOMAC scores from baseline compared with placebo. In the subgroup analyses, the knee pain and functional scores were significantly improved in the KL-II and KL-III grade KOA subjects. At the end of the study, the NXT15906F6- and NXT19185-supplemented participants showed significant (P < 0.05) improvement in the functional scores, inflammatory status, and collagen breakdown product in the urine samples. Summary. The present study demonstrates that NXT15906F6 and NXT19185 supplementations reduce knee pain and improve the musculoskeletal function of KOA subjects. Moreover, these herbal compositions helped reduce inflammation and inflammation-induced cartilage degeneration in the participants. NXT15906F6 and NXT19185 supplementations are further documented to be tolerable and safe to the participants.

Effect of 0.4% Triphala and 0.12% chlorhexidine mouthwash on dental plaque, gingival inflammation, and microbial growth in 14-15-year-old schoolchildren: A randomized controlled clinical trial.

CONTEXT: A strong correlation exists between plaque and dental caries and periodontal diseases. Ayurvedic drugs have been used since ancient times; oral rinses made from these are used in periodontal therapy. Triphala is one of these with wide spectrum of activity. AIMS: To assess and compare the effect of 0.4% Triphala and 0.12% chlorhexidine (CHX) mouthwash on dental plaque, gingival inflammation, and microbial count of Streptococcus mutans, Streptococcus sanguinis, and Lactobacilli from dental plaque sample of 14-15-year-old schoolchildren of Pune city during 90 days supervised use. SETTINGS AND DESIGN: A randomized, controlled, double-blind, parallel-group clinical trial was conducted among 72 schoolchildren aged 14-15 years. SUBJECTS AND METHODS: Children were divided into two study groups: Group A with 0.4% Triphala mouthwash (n = 36) and Group B with 0.12% CHX mouthwash (n = 36). The plaque Index (Loe H [1967]), gingival index (Loe H and Silness J [1963]), and microbial analysis were recorded at baseline, 30 days, and 90 days interval. STATISTICAL ANALYSIS USED: Statistical analysis was done using unpaired t-test for group-wise comparison and one-way analysis of variance test, followed by Tukey's post hoc test for intragroup comparison. P < 0.05 was considered statistically significant. RESULTS: The results showed that 0.4% Triphala and 0.12% CHX have similar inhibitory effect on plaque accumulation, gingivitis, and growth of S. mutans, S. sanguinis, and Lactobacilli. CONCLUSION: Herbal mouthwash proved to be helpful in reducing plaque microbial counts, plaque, and gingival inflammation and opens new arenas in the field of herbal dentistry and chemical plaque control.

Depression and anxiety in Malaysian population during third wave of the COVID-19 pandemic.

INTRODUCTION: The outbreak of coronavirus posits deleterious consequences on global healthcare system while affecting human life in every aspect. Despite several measures undertaken to limit the socio-economic effect of coronavirus, various challenges remain pervasive, and one such challenge is mental health, particularly depression and anxiety. Therefore, this study examines the prevalence and determinants of depression and anxiety in Malaysian population during third wave of COVID-19. METHODS: A cross-sectional online survey was carried out via social media platforms and 1544 Malaysians were selected. The level of depression was assessed by Patient Health Questionnaires (PHQ-9) and scored accordingly for categorization. Zung's Self-Rating Anxiety Scale (SAS) was used as a self-assessment survey to quantify the level of anxiety of persons experiencing anxiety-related symptoms. Percentage distribution and logistic regression analysis were used in the data analysis. RESULTS: Results showed that one-fourth (25.1%) of the participants had severe depressive symptoms. Almost one-sixth (18.7%) had mild depressive symptoms and one-third (34.1%) had mild to moderate anxiety symptoms. Age, gender, and friends infected with virus were the three important predictors of depression and anxiety. The odds of having depression (OR = 1.44; C·I. = 1.32-1.62) and anxiety (OR = 1.36; C·I. = 1.27-1.47) were significantly higher among females than in males. CONCLUSION: A significant proportion of the study participants were facing mild to severe depression and anxiety symptoms which is very alarming as the pandemic is still now increasing across the country. Immediate interventions including community counselling programmes, TV and social media campaigns are urgently needed to reduce the psychological stress among the Malaysian population.

A preliminary study to quantify the efficacy of 3D data acquisition for human bone replication.

BACKGROUND: Three-dimensional imaging is a rapidly growing technology that has revealed exciting insights in disparate fields of research, especially in medicine, forensics, and archaeology. Recent advancements in this technology have also made a remarkable impact in the field of anthropology and odontology. A major benefit of this technology is that they offer effective methods of creating digital records that can aid in physical documentation and can be digitally stored for later assessment and research. AIM: The aim of the current study is to evaluate the metric accuracy of 3D models generated using three different 3D acquisition techniques for performing metric analytical procedures. MATERIALS AND METHOD: Twenty standard craniometric linear measurements (using both sliding and spreading callipers) were taken on two craniums and eight standard measurements were taken on 2 mandibles (using sliding callipers and a mandibulometer); these measurements were then replicated on 3D digital models. RESULTS: Statistical analysis of these dataset using Analysis of Variance (ANOVA) and post hoc Bonferroni test suggested that the physical and virtual measurements were accurate, comparable, and concordant (p > 0.05). CONCLUSION: These findings open up numerous avenues for future study, especially in the fields of forensics and clinical studies. However, in order to overcome the limitations faced in using the digital method certain standardised protocols and guidelines must be established to record these data.

Effectiveness of oral health educational interventions on oral health of visually impaired school children: A systematic review and meta-analysis.

AIM: To evaluate the effect of newer and traditional oral health education (OHE) methods in improving oral health knowledge, oral hygiene status and practices, plaque, gingival, and dental caries status of visually impaired children. METHODOLOGY: Comprehensive literature search was performed by using PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, Google scholar, and Open Gray from 2010 to 2020 for studies in English language. Two reviewers critically assessed the studies for eligibility criteria, and data extraction was performed. Quality assessment of selected studies was executed according to the study designs. A meta-analysis was carried out using Review Manager 5.3 software. RESULTS: Twenty-four articles were included for qualitative synthesis and out that 11 in meta-analysis. Cumulative standardized mean difference for plaque (Silness and Loe, 1964) and gingival index (Loe and Silness, 1963) was -0.45 (-0.88, -0.02, p = 0.04) and -0.54 (-1.10, 0.03, p = 0.06), respectively favoring newer OHE group as compared to traditional OHE group. Comparison of different newer OHE methods had similar effects on the oral health of visually impaired children. CONCLUSION: The study period of included studies was short-term, so long-term effectiveness could not be assessed, however newer OHE methods were effective in improving plaque and gingival scores over a short period.

Influence of different implant placement techniques to improve primary implant stability in low-density bone: A systematic review.

AIM: The aim of this study is to assess the influence of different implant placement techniques to improve primary implant stability (PIS) in the low-density bone. MATERIALS AND METHODS: Citations published in English and those available in full text were searched from electronic databases (PubMed and Google Scholar) from the year 2000-2017 by which 75 manuscripts were revealed. After applying inclusion and exclusion criteria, seven were selected for the present review. The whole process was conducted by the following preferred reporting items for systematic reviews and meta-analyses guidelines. RESULTS: The measurement of primary stability showed significant correlations with different bone densities and with implant outcome; however, these two parameters have not been investigated at the same time frequently. Of the seven manuscripts, three discussed standard drilling protocol, two used undersized drilling, one used guided drilling, and one compared standard drilling with undersized drilling. Several intraoperative methods of jaw bone-density assessment were reported, and resonance frequency analysis, periotest, and insertion torque values were used to quantify PIS. CONCLUSION: The use of undersized drilling has proven advantageous for increasing initial implant stability in the low-density bone. Although the PIS may be lower, the secondary implant stability is found to be correlated to acceptable values.

Comparative evaluation of two caries detection systems for detecting the prevalence of early childhood caries: A cross-sectional study.

BACKGROUND: The early diagnosis of dental caries is very crucial to prevent tooth loss, which leads to serious consequences in preschool children. The aim of this study is to compare the diagnostic outcome by the World Health Organization (WHO) and WHO and early carious lesions (ECLs) (i.e., WHO + ECL) criteria for assessing early childhood caries (ECC) in preschool children. MATERIALS AND METHODS: A cross-sectional, comparative study was conducted among 3-5 year old children (n = 358). Clinical examination was conducted using WHO and WHO + ECL criteria. The data were assessed using paired "t" test. P < 0.05 was considered as statistically significant. RESULTS: There was statistically significant difference between the mean decayed, missing, or filled teeth recorded by the WHO + ECL and WHO (P < 0.05) method. CONCLUSION: It was concluded that WHO + ECL criteria were significant and more precise in assessing the presence of ECL in preschool children.

Factors Facilitating Academic Success in Dental Students After Initial Failure: A Qualitative Study.

Most previous research on academic failure has sought to understand the reasons students failed. The aim of this study was to identify factors that led to academic success for dental students who had previously failed written examinations, using interviews based on Appreciative Inquiry (AI). The AI approach led the investigators to focus on positive aspects of what helped students overcome failure, rather than the reasons for it. Students in this qualitative study, conducted in 2016 at a dental college in India, completed a questionnaire with six open-ended questions and participated in individual semi-structured interviews. Purposive sampling identified 25 students as possible participants; 21 volunteered to participate; and data saturation was reached after interviews with 15. Four key themes were identified in the data collected. On the theme of learning strategies, participants mentioned modifying their attitude toward studying and making it learning-oriented. On the theme of resources, participants reported strategies for obtaining books, others' notes, and teachers' guides to help with studying. In the third theme, psychological aspects, students reported methods used to motivate themselves to succeed after failing. The fourth theme, environmental factors, concerned the key means of support provided by parents, teachers, and seniors/peers. All the students reported that the failure had been a turning point and that overcoming it had boosted their self-confidence. One student said he learned to "never give up and keep trying till you succeed," and most spoke of continuing the best practices they learned. These findings suggest that knowledge-oriented studying, conceptual learning, appropriate study material, internal motivation, and support of parents, teachers, and peers may help dental students overcome failure.

Risk of Psychiatric Morbidity in Patients with Tobacco Habits: A Cross-Sectional Study.

INTRODUCTION: Tobacco cessation is a challenging arena for healthcare professionals. Many patients seem to be unable to quit tobacco despite of knowing its ill-effects and several efforts. It has been speculated that patients' psychosocial status may be associated with his/her dependence on tobacco and there could be some amount of psychiatric morbidity associated with chronic and compulsive use of tobacco. However, very few studies have been conducted to explore this aspect of tobacco dependence. AIM: To assess psychiatric morbidity in tobacco users as compared to non-users of tobacco. MATERIALS AND METHODS: This cross-sectional study included 200 patients reporting to a Dental College who consented to participate in the study. The study consisted of two groups; first consisting 100 tobacco users and another age and gender matched group of 100 non-users of tobacco. Dependence to tobacco products amongst the study group was assessed using International classification of Diseases-10 (ICD-10) criteria. General Health Questionnaire - 28 (GHQ-28) was used to assess the psychological morbidity amongst both the groups. Statistical analysis was done using SPSS 21.0 version. Chi square test and Pearson's correlation coefficient were used to assess the difference in proportion and correlation between variables respectively. RESULTS: A 79% of tobacco users showed dependence on tobacco according to ICD-10 criteria. GHQ-28 scores analysis revealed that 61% of tobacco users with a score of 24 or above in contrast to only 17% of non-tobacco users. Tobacco users were observed to be 7.63 folds at a higher risk of developing psychiatric morbidity than non-users of tobacco (p-value< 0.001). CONCLUSION: There appears to be a significant risk of psychiatric morbidity prevalent amongst tobacco users. Hence, psychosocial counselling must be considered as a part of tobacco cessation strategy.