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   Table of Contents - Current issue
October-December 2020
Volume 16 | Issue 4
Page Nos. 143-184

Online since Wednesday, December 23, 2020

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Development of a new questionnaire to study students' perception toward online classes p. 143
Unnikrishnan K Menon, Suja Gopalakrishnan, C Sumithra N. Unni, Riju Ramachandran, B Poornima, MS Ashika, Anu Sasidharan, Natasha Radhakrishnan
Medical education is going through a new learning experience of its own due to the impossibility of physical classes in the present pandemic situation. This article describes in detail the conceptualization and development of a questionnaire for the specific purpose of studying the perception of undergraduate students of a medical college toward the online education program.
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Review of the correlation between social economic status and oral diseases in India p. 146
Chandrashekar Janakiram, Naveen Jacob Varghese, Joe Joseph
Socioeconomic inequalities in oral health can be defined as the differences in the prevalence or incidence of oral health problems. We assessed the pooled estimate of prevalence of oral diseases among different socioeconomic status (SES) in India by including all articles published up to December 2016 with the prevalence of the oral diseases in SES population using the confined research terms in databases of PubMed and Google Scholar. All articles which had assessed the dental caries, periodontal disease, malocclusion, and oral cancer in different socioeconomic groups were collected. Out of 209 articles retrieved, 19 studies were included. The pooled estimate for mean DMFT for upper, middle, and lower SES status was 3.1 (95% confidence interval [CI] 3–3.1), 2.6 (95% CI 2.6–2.9) and 3.05 (95% CI 3.05–3.04). The prevalence of periodontal disease for (upper SES 12 [95% CI 11–12], middle SES 28 [95% CI 28–29] and lower SES status 60 (95% CI 59–60)] and in (Kuppuswamy scale Upper SES 22 [95% CI 21–22], middle SES 24 (95% CI 23–24] lower SES status 28 [95% CI 27–28]). Our analysis shows that the SES was inversely proportional to the oral diseases. There was a minor variation between DMFT between groups which may be attributed to the lack of large number of studies assessing the SES and dental caries. The pooled estimate of the mean DMFT across the SES status was inconsistent.
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Measuring dental diseases: A critical review of indices in dental practice and research p. 152
Venkitachalam Ramanarayanan, Vineetha Karuveettil, Vinita Sanjeevan, Bobby K Antony, Naveen Jacob Varghese, Heljo Joseph Padamadan, Chandrashekar Janakiram
Dental indices are tools used to quantify dental diseases thereby cross comparisons can be made based on disease burden and treatment efficacy. In dental literature, there exists an ambiguity on selecting the ideal scale or index to measure dental diseases. This is because of the availability of different indices and the lack of standardization among dental associations in measuring diseases. This warrants the need for a critical assessment of available indices commonly used in dental research and clinical practice. The critical appraisal of indices used for measuring oral hygiene, dental caries, gingival disease, periodontal disease, dental fluorosis, malocclusion, enamel defects, and tooth wear is attempted in this study.
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Hearing loss: A neglected and morbid clinical entity in Corona Virus Disease 2019 pandemic p. 159
Santosh Kumar Swain, Somya Ranjan Pani
Hearing loss may be caused by certain viral infections. The hearing loss due to viral infection can be congenital or acquired, bilateral or unilateral. The viral infections typically cause sensorineural hearing loss (SNHL), although conductive or mixed hearing loss can be found. The corona virus disease 2019 (COVID-19) infection has deleterious impact on the cochlear hair cells. The hearing loss will not improve even patient recovered from COVID-19 infections. This is probably a neuro-auditory involvement in COVID-19 infections. The current COVID-19 is caused by severe acute respiratory syndrome corona virus 2. The audiologic and radiologic investigations are helpful for evaluation of the hearing loss in COVID-19 patients. Hearing loss due to COVID-19 infections is rarely reported in medical literature so far. Hearing loss specifically SNHL is often challenging to the clinicians in this current pandemic. The mechanism for this deleterious effect on the cochlear hair cells requires further research. There is a large gap in the understanding of the etiopathogenesis, epidemiology, and clinical presentations such as hearing loss and human transmission of this disease. There should be a continuous monitoring of the hearing loss and tracing of this COVID-19 infection is needed to ensure the detail understanding of this inner ear pathogenesis. This review article provides an overview of COVID-19 infections and its impact on hearing loss.
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Acoustic reflex decay and acoustic reflex latency threshold test findings in patients with cerebellopontine angle tumors: Correlation with tumor type, size, and extent p. 164
Prem G Nair, N Shivashankar, B Indira Devi, SG Srikanth, V Shanmugham, KS Gayathri
Context: This was a comparative prospective study. Aims: (1) To characterize acoustic reflex decay (ARD) and acoustic reflex latency threshold (ARLT) profiles in cerebellopontine angle (CPA) tumors. (2) To correlate ARD and ARLT test results with the type, size, and extent of tumors. Study Design: Comparative prospective study. Setting: Primary versus Tertiary referral center. Subjects: The clinical group comprised 98 patients with CPA tumor and the control group comprised 100 normal hearing subjects. Subjects and Methods: ARD and ARLT were estimated at 500 Hz and 1000 Hz both ipsilaterally and contralaterally for both the groups. Statistical Analysis Used: Statistical analysis for clinical group versus control group was carried out using analysis of covariance for age and gender covariates. For discrete clinical groups, analysis of variance followed by post hoc (Turkey) test was used. An independent sample t-test was used for the statistical analysis of tumor ear versus nontumor ear. Results: Test results indicated that the proportion of ears with abnormal reflex decay (0%–25%) was less compared to those with normal findings (75%–100%) in the patient group reflecting the poor efficacy of ARD to identify the presence of CPA tumors. Statistical analysis for ARLT was possible mainly for nontumor ear stimulation and it did not give any clear indications regarding the presence of brain stem compression. Conclusions: In the present study, an estimation of ARD and ARLT did not appear to be useful indices for CPA tumor identification.
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Deep neck space infection of the pediatric patients: Our experiences at a tertiary care teaching hospital of Eastern India p. 169
Santosh Kumar Swain, Prasenjit Baliarsingh, Swaha Panda
Background: Deep neck space infections are uncommon life-threatening clinical entity. It can cause significant morbidity in the pediatric age group. Objective: This study analyzes the clinical presentations, diagnosis, and management of the deep neck space infection of the pediatric patients. Materials and Methods: A retrospective study was conducted at a tertiary care teaching hospital during May 2015–June 2020. The medical records pediatric patients diagnosed with deep neck space infections with age <16 years were reviewed. Data of demographics, clinical symptoms, hospital course, and management were retrieved. Results: There was the predominance of male children with deep neck space infections (65.38%) and mean age of 8.3 years. The most common symptom was neck swelling (61.53%). The most common deep neck space infection was peritonsillitis (21.15%), followed by parapharyngeal abscess (17.30%). The important life-threatening complications in this study were stridor found in 3 children (5.76%). Conclusion: Deep neck space infections are an uncommon clinical entity in the pediatric age group. Odontogenic infections are the most common etiology for the deep neck space infection. The common clinical presentations are restricted neck movement, fever, neck swelling, and pain in the neck. Imaging like computed tomography scan is helpful to assess the site and extent of the deep neck space infection. Incision and drainage and appropriate antibiotics are important options for treatment.
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Knowledge of nutrition among students in a dental teaching institution in Kerala p. 175
Rohan Yatindra Vaidya, Vibha M R. Shivani, Sachi Santosh, Priyanka Tiruchirapalli Gaupiysunder, Aiswarya Anil, Venkitachalam Ramanarayanan
Introduction: Basic education about nutrition can be extremely beneficial for medical and dental professionals. It is very important that, dental students are taught about nutrition during their course of study as this will help in developing a holistic approach in treating patients. As limited literature is available regarding the nutritional knowledge among dental students, the present study was done to assess the same among students in a dental teaching institution. Materials and Methods: The awareness of dietary recommendations, knowledge of food sources and nutrients and diet–disease relationship was assessed among clinical students of a dental teaching institute in Kerala, through a 13-point self-administered questionnaire. Analysis was done based on two groups (undergraduate [UG] students and post-graduate [PG] students). Results: A total number of 140 responses were obtained. UG students comprised 31.4% while PG students comprised 68.6% of the study population. Majority (>75%) of the participants in both groups (UG and PG) felt that there is a need to consume more vegetables and fibers and less amounts of sugary and fatty foods. Among the PG students, most respondents (36%) opined that sugar contained more calories for the same weight while 34% of PG students and 44% of UG students reported that starchy food contained more calories. While more than 95% of participants associated diabetes to sugar consumption, there was a mixed response for kidney disease (47.7% in PG and 53.1% in UG; P < 0.026) and heart diseases (40.9% in PG and 38.5% in UG), respectively. Conclusion: The knowledge among dental students about dietary recommendations, knowledge of food sources and nutrients and diet–disease relationship was found to be satisfactory.
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Autologous platelet-rich fibrin to treat difficult nonhealing diabetic foot wounds with exposed bone – A case report of this safe, effective, and economical method p. 181
Riju Ramachandran Menon, Anoop Vasudevan Pillai, Veena Shenoy, Sundeep Vijayaraghavan
Diabetic wounds, especially with exposed bones, are notorious to cause complications. Various drugs and substances have been tried by different researchers in their quest for early painless healing. We report our patient with peripheral vascular disease (PVD) and chronic nonhealing wound with exposed bone successfully treated with autologous platelet-rich fibrin (PRF). Our patient with a diabetic foot ulcer and PVD underwent an amputation of the great toe. His wound could not be closed, and there was exposed bone on the floor of the ulcer. Regular treatment may have caused nonhealing, osteomyelitis, and spreading gangrene. His PVD contraindicated a vascular flap cover. Hence, we tried the use of autologous PRF on the wound. The hospital stay was minimized, adjuvant procedures were not needed, and the wound healed well in 4 weeks. PRF is a very economical and safe adjuvant in the fight to treat difficult wounds.
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