Exploring the practice of common oral diseases among the patients visiting in the selected dental college and hospital in Bangladesh

Background:Having the ability to identify potential health risk factors such as lifestyle,ethnicity,health status,and social determinants associated with oral health status risk,health care providers can take an active role in health screening to discover any need for clinical preventive services,including dental preventive services,and can detect health problems.Methods:A descriptive type of cross-sectional study was conducted to explore the practice of common oral diseases among the patients visiting in the selected dental college and hospital in Bangladesh from October 2019 to December 2019.About 100 patients were interviewed through a semi-structured questionnaire,followed by an oral examination through a checklist and a face-to-face interview.A systematically random sampling technique was employed to select the study population.Results:Among them,the(21-30)year age group shows a maximum 20%,whereas the(71-80)year age group represents the minority with only 2%.Among them,56%were male and 44%were female.Students represent the majority of 26%,whereas others(day laborers)represent only 4%.Decayed teeth remained in 72%of cases,teeth were missing in 31%of cases,and filled teeth were present in 24%of cases.A majority of 71%clean teeth once daily,whereas only 29%clean teeth twice daily.Again,only 30%brush teeth at night and a maximum of 95%brush teeth in the morning.Moreover,a maximum of 68%use toothpaste and brushes,while only 4%use meswak for cleaning their teeth.About 4%of cases with no debris,51%of cases with less than 1/3rd of the tooth with debris,32%of cases with 1/3rd-2/3rd of the tooth with debris,and 13%of cases with more than 2/3rd of the tooth with debris were present.Again,about 30%had no calculus,52%less than 1/3rd of tooth,16%in between 1/3rd and 2/3rd of tooth,and 2%more than 2/3rd of the calculus was present.About 47%of mild,22%of moderate,6%of severe and 25%had no inflammation.Furthermore,for treatment purposes,20.69%was advised for scaling,19.66%for filling,16.90%for root canal treatment,17.59%for extraction,17.24%for prosthodontic treatment,1.03%for orthodontic treatment,2.07%for pulpotomy,2.41%for pulpectomy,and 2.41%for minor surgery.Overall,about 72%of the respondents,mostly the students,are suffering from decayed teeth,which may be due to a lack of frequency of brushing,indicating 95%that it is once daily.In addition,the most alarming situation among them is about 20.69%required scaling,which may be due to improper and inadequate brushing maintenance.Conclusion:to some extent,the above scenario may reflect the negative hallmark for our country’s younger generation in terms of oral health practice.Therefore,the establishment of a preventive oral health policy by our policymakers for the general population,mostly school-going students,on an emergency basis.

Dental pulp stem cells and banking of teeth as a lifesaving therapeutic vista

Exfoliated deciduous or an extracted healthy adult tooth can be used to harvest,process,and cryogenically preserve dental pulp stem cells.Future stem cell-based regenerative medicine methods could benefit significantly from these mesenchymal stem cells.Teeth serve as a substantial source of mesenchymal stem cells,otherwise disposed of as medical waste.Care should be taken to store this treasure trove of stem cells.Collective responsibility of patients,dentists,and physicians is necessary to ensure that this valuable resource is not wasted and that every possible dental pulp stem cell is available for use in the future.The dental pulp stem cells(DPSC)inside teeth represent a significant future source of stem cells for regenerative medicine procedures.This review describes the ontogeny,the laboratory processing and collection,and isolation methods of DPSC.This review also discusses currently available stem cell banking facilities and their potential use in regenerative medicine procedures in dental and general medical applications in the future.

Synoptic review on existing and potential sources for bias in dental research methodology with methods on their prevention and remedies

The results of years of dental study serve as the foundation for the practise of medicine and,for that matter,dentistry.Doctors may have their own preferences for techniques and materials,but whether directly or indirectly,their decisions are influenced by systematic reviews and meta-analyses.However,due to poorly conducted or presented research,this very basic foundation may not be reliable.Bias in research is one of several factors that might make study results or research itself unreliable.Bias can be introduced into research at many stages,deliberately or unknowingly.Bias can appear at any point during the research process,even before the study itself begins.There are many biases in research,but some of them are more relevant to dentistry research than others.Because it is said that“eyes see what the mind knows”,it is essential to have a complete understanding of the different types of bias,how and when they get entrenched,and what steps may be taken to prevent or lessen them if they do occur.This comprehensive summary of bias in dentistry research is provided by this synoptic review.The goal is to identify gaps and measures that have been taken-or that should have been taken-by providing both descriptive and evaluative summaries,as well as examples from the literature,when needed.

Patient-centric periodontal research:A pioneering application of patient-reported outcome measures

Conventional dentistry or periodontal research often ignores the human component in favor of clinical outcomes and biological causes.Clinical research is driven by the statistical significance of outcome parameters rather than the satisfaction level of the patient.In this context,patient-centric periodontal research(PCPR)is an approach that considers the patient´s feedback concerning their functional status,experience,clinical outcomes,and accessibility to their treatments.It is argued that data self-reported by the patient might have low reliability owing to the confounding effect of their personal belief,cultural background,and social and economic factors.However,literature has shown that the incorporation of“patient-centric outcome”components considerably enhances the validity and applicability of research findings.Variations in the results of different studies might be due to the use of different and non-standardized assessment tools.To overcome this problem,this editorial enlists various reliable tools available in the literature.In conclusion,we advocate that the focus of researchers should shift from mere periodontal research to PCPR so that the results can be effectively applied in clinical settings and the therapeutic strategy can also change from mere periodontal therapy to patient-centric periodontal therapy.

Carbamazepine in osteoarthritis treatment:A novel approach targeting Nav1.7 channels

Osteoarthritis(OA)presents a growing health concern,with substantial societal and healthcare burdens.Current management focuses on symptom relief,lacking disease-modifying options.Emerging research suggests the sodium channel Nav1.7 as a pivotal target in OA treatment.Preclinical studies demonstrate carbamazepine's efficacy in Nav1.7 blockade,offering significant joint protection in animal models.However,human trials are needed to validate these findings.Carbamazepine's repurposing holds promise for OA management,potentially revolutionizing treatment paradigms.Further research is essential to bridge the gap between preclinical evidence and clinical application,offering hope for improved OA management and enhanced patient quality of life.

Promotion of sexual and reproductive health in Pakistan-The role of technology and online awareness

Digital health innovations such as online webinars,websites,blogs,and health apps have been associated with increased sexual and reproductive health(SRH)among the general population.Many studies have been conducted in developed countries in the West;however,little research has been conducted in low-income countries,especially in Pakistan.The socioeconomic instability and the government's lack of awareness and knowledge have resulted in no regulations being placed to incorporate telehealth in medicine.The healthcare departments must take into consideration the lifechanging impact of telehealth and the barriers that prevent it in becoming known,to reduce the incidence of unsafe abortions and sexual health practices that prove to be a stigma in society.

Correlation of tumor-associated macrophage density and proportion of M2 subtypes with the pathological stage of colorectal cancer

BACKGROUND Colorectal cancer(CRC)is a prevalent global malignancy with complex prognostic factors.Tumor-associated macrophages(TAMs)have shown paradoxical associations with CRC survival,particularly concerning the M2 subset.AIM We aimed to establish a simplified protocol for quantifying M2-like TAMs and explore their correlation with clinicopathological factors.METHODS A cross-sectional study included histopathological assessment of paraffinembedded tissue blocks obtained from 43 CRC patients.Using CD68 and CD163 immunohistochemistry,we quantified TAMs in tumor stroma and front,focusing on M2 proportion.Demographic,histopathological,and clinical parameters were collected.RESULTS TAM density was significantly higher at the tumor front,with the M2 proportion three times greater in both zones.The tumor front had a higher M2 proportion,which correlated significantly with advanced tumor stage(P=0.04),pathological nodal involvement(P=0.04),and lymphovascular invasion(LVI,P=0.01).However,no significant association was found between the M2 proportion in the tumor stroma and clinicopathological factors.CONCLUSION Our study introduces a simplified protocol for quantifying M2-like TAMs in CRC tissue samples.We demonstrated a significant correlation between an increased M2 proportion at the tumor front and advanced tumor stage,nodal involvement,and LVI.This suggests that M2-like TAMs might serve as potential indicators of disease progression in CRC,warranting further investigation and potential clinical application.

Correlation of periodontal inflamed surface area with glycated hemoglobin,interleukin-6 and lipoprotein(a)in type 2 diabetes with retinopathy

BACKGROUND The two-way relationship between periodontitis and type 2 diabetes mellitus(T2DM)is well established.Prolonged hyperglycemia contributes to increased periodontal destruction and severe periodontitis,accentuating diabetic complications.An inflammatory link exists between diabetic retinopathy(DR)and periodontitis,but the studies regarding this association and the role of lipoprotein(a)[Lp(a)]and interleukin-6(IL-6)in these conditions are scarce in the literature.AIM To determine the correlation of periodontal inflamed surface area(PISA)with glycated Hb(HbA1c),serum IL-6 and Lp(a)in T2DM subjects with retinopathy.METHODS This cross-sectional study comprised 40 T2DM subjects with DR and 40 T2DM subjects without DR.All subjects were assessed for periodontal parameters[bleeding on probing(BOP),probing pocket depth,clinical attachment loss(CAL),oral hygiene index-simplified,plaque index(PI)and PISA],and systemic parameters[HbA1c,fasting plasma glucose and postprandial plasma glucose,fasting lipid profile,serum IL-6 and serum Lp(a)].RESULTS The proportion of periodontitis in T2DM with and without DR was 47.5%and 27.5%respectively.Severity of periodontitis,CAL,PISA,IL-6 and Lp(a)were higher in T2DM with DR group compared to T2DM without DR group.Significant difference was observed in the mean percentage of sites with BOP between T2DM with DR(69%)and T2DM without DR(41%),but there was no significant difference in PI(P>0.05).HbA1c was positively correlated with CAL(r=0.351,P=0.001),and PISA(r=0.393,P≤0.001)in study subjects.A positive correlation was found between PISA and IL-6(r=0.651,P<0.0001);PISA and Lp(a)(r=0.59,P<0.001);CAL and IL-6(r=0.527,P<0.0001)and CAL and Lp(a)(r=0.631,P<0.001)among study subjects.CONCLUSION Despite both groups having poor glycemic control and comparable plaque scores,the periodontal parameters were higher in DR as compared to T2DM without DR.Since a bidirectional link exists between periodontitis and DM,the presence of DR may have contributed to the severity of periodontal destruction and periodontitis may have influenced the progression of DR.

Disease clearance in ulcerative colitis:A new therapeutic target for the future

Advancements in murine modeling systems for ulcerative colitis have diversified our understanding of the pathophysiological factors involved in disease onset and progression.This has fueled the identification of molecular targets,resulting in a rapidly expanding therapeutic armamentarium.Subsequently,management strategies have evolved from symptomatic resolution to well-defined objective endpoints,including clinical remission,endoscopic remission and mucosal healing.While the incorporation of these assessment modalities has permitted targeted intervention in the context of a natural disease history and the prevention of complications,studies have consistently depicted discrepancies associated with ascertaining disease status through clinical and endoscopic measures.Current recommendations lack consideration of histological healing.The simultaneous achievement of clinical,endoscopic,and histologic remission has not been fully investigated.This has laid the groundwork for a novel therapeutic outcome termed disease clearance(DC).This article summarizes the concept of DC and its current evidence.

Interorgan communication in neurogenic heterotopic ossification: the role of brain-derived extracellular vesicles

Brain-derived extracellular vesicles participate in interorgan communication after traumatic brain injury by transporting pathogens to initiate secondary injury.Inflammasome-related proteins encapsulated in brain-derived extracellular vesicles can cross the blood‒brain barrier to reach distal tissues.These proteins initiate inflammatory dysfunction,such as neurogenic heterotopic ossification.This recurrent condition is highly debilitating to patients because of its relatively unknown pathogenesis and the lack of effective prophylactic intervention strategies.Accordingly,a rat model of neurogenic heterotopic ossification induced by combined traumatic brain injury and achillotenotomy was developed to address these two issues.Histological examination of the injured tendon revealed the coexistence of ectopic calcification and fibroblast pyroptosis.The relationships among brain-derived extracellular vesicles,fibroblast pyroptosis and ectopic calcification were further investigated in vitro and in vivo.Intravenous injection of the pyroptosis inhibitor Ac-YVAD-cmk reversed the development of neurogenic heterotopic ossification in vivo.The present work highlights the role of brain-derived extracellular vesicles in the pathogenesis of neurogenic heterotopic ossification and offers a potential strategy for preventing neurogenic heterotopic ossification after traumatic brain injury.

The neutrophil–osteogenic cell axis promotes bone destruction in periodontitis

The immune-stromal cell interactions play a key role in health and diseases. In periodontitis, the most prevalent infectious disease in humans, immune cells accumulate in the oral mucosa and promote bone destruction by inducing receptor activator of nuclear factor-κB ligand (RANKL) expression in osteogenic cells such as osteoblasts and periodontal ligament cells. However, the detailed mechanism underlying immune–bone cell interactions in periodontitis is not fully understood. Here, we performed single-cell RNAsequencing analysis on mouse periodontal lesions and showed that neutrophil–osteogenic cell crosstalk is involved in periodontitis-induced bone loss. The periodontal lesions displayed marked infiltration of neutrophils, and in silico analyses suggested that the neutrophils interacted with osteogenic cells through cytokine production. Among the cytokines expressed in the periodontal neutrophils, oncostatin M (OSM) potently induced RANKL expression in the primary osteoblasts, and deletion of the OSM receptor in osteogenic cells significantly ameliorated periodontitis-induced bone loss. Epigenomic data analyses identified the OSM-regulated RANKL enhancer region in osteogenic cells, and mice lacking this enhancer showed decreased periodontal bone loss while maintaining physiological bone metabolism. These findings shed light on the role of neutrophils in bone regulation during bacterial infection, highlighting the novel mechanism underlying osteoimmune crosstalk.

Depression and anxiety among cancer patients visiting a tertiary care cancer hospital

BACKGROUND Cancer patients frequently experience psychological problems related to reactions to cancer diagnosis,cancer type and stage,treatment effects,recurrence,fear of end-of-life,survivorship,and financial burden.Depression and anxiety are both psychological and physiological disturbances among cancer patients.AIM To assess the prevalence of depression and anxiety among cancer patients attending a tertiary care cancer hospital.METHODS A cross-sectional study was conducted at Bhaktapur Cancer Hospital in Kathmandu Valley among 220 cancer patients aged from 18 years to 70 years.Ethical approval was taken from the Institutional Review Committee of CiST College.Convenient sampling was used to interview patients with the standardized Patient-Health Questionnaire(PHQ-9)for Depression and Hospital Anxiety and Depression sub-scale(HADS-A)for anxiety.Epi-Data was used for data entry and transferred to SPSS Version 25 for analysis.RESULTS The study revealed that of 220 patients,most of the respondents belonged to the age group 51-60 years.More than half 131(59.6%)of the respondents were female,most of them had depression,and one-third had anxiety.Among the respondents,124(56.4%)had mild depression,70(31.8%)had moderate depression,and 3(1.3%)had severe depression;79(35.9%)had mild anxiety,64(29.1%)had moderate anxiety,and 4(1.8%)had severe anxiety.CONCLUSION Most respondents were depressed and one-third had anxiety.More than half and nearly one-third had mild and moderate depression,respectively,and nearly one-third had mild and moderate anxiety,which is higher than other studies.

Fentanyl and xylazine crisis:Crafting coherent strategies for opioid overdose prevention

The United States is in the throes of a severe opioid overdose epidemic,primarily fueled by the pervasive use of fentanyl and the emerging threat of xylazine,a veterinary sedative often mixed with fentanyl.The high potency and long duration of fentanyl is compounded by the added risks from xylazine,heightening the lethal danger faced by opioid users.Measures such as enhanced surveillance,public awareness campaigns,and the distribution of fentanylxylazine test kits,and naloxone have been undertaken to mitigate this crisis.Fentanyl-related overdose deaths persist despite these efforts,partly due to inconsistent policies across states and resistance towards adopting harm reduction strategies.A multifaceted approach is imperative in effectively combating the opioid overdose epidemic.This approach should include expansion of treatment access,broadening the availability of medications for opioid use disorder,implementation of harm reduction strategies,and enaction of legislative reforms and diminishing stigma associated with opioid use disorder.

Nipah Virus Unveiled: A Review Article

Nipah virus (NiV) is a highly infectious zoonotic pathogen that poses a significant threat to human and animal health. First identified in Malaysia in 1998, NiV has since caused several outbreaks in Southeast Asia, with sporadic cases reported in Bangladesh and India. The virus is primarily transmitted to humans through direct contact with infected animals, primarily fruit bats, or through the consumption of contaminated fruits and their juices. NiV infection presents a wide spectrum of clinical features, ranging from mild respiratory illness to severe encephalitis, with a high case fatality rate. The incubation period typically ranges from 4 to 14 days, during which patients develop fever, headache, myalgia, and respiratory symptoms such as cough and sore throat. As the disease progresses, neurological signs become prominent, including altered consciousness, seizures, and focal deficits. Severe cases may exhibit acute respiratory distress syndrome and multi organ failure. Laboratory findings often include lymphocytopenia, thrombocytopenia, and elevated liver enzymes. Diagnosis of NiV infection requires specialized laboratory testing, including reverse transcription-polymerase chain reaction (RT-PCR) and serological assays. Currently, no specific antiviral treatment exists for NiV infection, and management primarily focuses on supportive care. Prevention and control strategies encompass public health interventions, surveillance, and raising awareness among healthcare providers and the general population. The emergence and re-emergence of NiV highlight the urgent need for continued research, improved diagnostic capabilities, and the development of effective vaccines and therapeutics to mitigate the impact of this deadly virus.

Advances in Zika virus vaccines and therapeutics:A systematic review

Zika virus(ZIKV)is the causative agent of a viral infection that causes neurological complications in newborns and adults worldwide.Its wide transmission route and alarming spread rates are of great concern to the scientific community.Numerous trials have been conducted to develop treatment options for ZIKV infection.This review highlights the latest developments in the fields of vaccinology and pharmaceuticals developments for ZIKV infection.A systematic and comprehensive approach was used to gather relevant and up-to-date data so that inferences could be made about the gaps in therapeutic development.The results indicate that several therapeutic interventions are being tested against ZIKV infection,such as DNA vaccines,subunit vaccines,live-attenuated vaccines,virus-vector-based vaccines,inactivated vaccines,virus-like particles,and mRNA-based vaccines.In addition,approved anti-ZIKV drugs that can reduce the global burden are discussed.Although many vaccine candidates for ZIKV are at different stages of development,none of them have received Food and Drug Authority approval for use up to now.The issue of side effects associated with these drugs in vulnerable newborns and pregnant women is a major obstacle in the therapeutic pathway.

Relationship of Periodontal Status and Dental Caries Status with Oral Health Knowledge, Attitude and Behavior among Professional Students in India

Aim To find the relationship of periodontal status and dental caries status with oral health knowledge, attitude, behavior, among professional students in India. Methodology In a cross sectional study, a total of 825 students （males： 577, females： 248） fi＇om six professions were surveyed using a self administered structured questionnaire including 41 multiple choice questions and the WHO Oral Health Assessment Form （1997）. The data was analyzed using the SPSS version 13.0 to perform the Student＇s t-test, ANOVA test, Scheffe＇s test and Chi-square test, linear regression analysis. Results The mean percentage scores of the students for knowledge were 53.25 ±15.05; for attitude 74.97±20.48; and for behavior 59.09 ±18.77. The percentage of students with calculus score was found to be significantly high （43.8%）. The percentage of professional students with DMFT〉4 was 14.1% and the percentage of students with decayed teeth was 46.2%. The regression analysis showed that the oral health behavior of the students was dependent on the attitude （P〈0.001）, but showed no significant linear relation with the knowledge. Also, that the mean DMFT score was dependent on the oral health behavior （P〈0.05）, but showed no significant relationship with the knowledge and attitude of the students. The periodontal status was independent on the knowledge, but showed a significant relationship with attitude and behavior of the students. Conclusion A positive attitude and adherence to good oral hygiene behaviors is associated with better oral health.

Corrosion aspect of dental implants—An overview and literature review

The use of metals and their alloys in restorative and implant dentistry dates back to centuries. Titanium (Ti) is one of the most widely used biomaterial for medical implants because of its excellent mechanical properties and exceptional biocompatibility. The good biocompatibility of Ti is related to the thin oxide layer formed on Ti surface. TiO2 is inactive with the surrounding biological environment and quite compatible with living tissues. However, TiO2 layer can be destroyed during movements between implant and bone tissue under loading condition. The localized destruction causes corrosion of the implant, thus, weakening it;and can induce the leak of small metallic particles or ions into living tissues. This article highlights a review of the various aspects of corrosion and biocompatibility of dental titanium implants as well as suprastructures, and the methods to prevent it.

Accidental Entry of Foreign Body in Maxillary Sinus—A Case Report

Extraction of the first molar or premolar is the commonest cause of oro-antral fistula. Management involves identification of the same, removal of any foreign body from the maxillary sinus, if present, followed by appropriate flap for closer. A case is presented when a gutta percha (GP) point was accidentally dislodged into the right maxillary sinus during preliminary diagnosis of the oro-antral fistula. The surgical management of the case is described and is the appropriate treatment plan.

Knowledge,attitude and anxiety pertaining to basic life support and medical emergencies among dental interns in Mangalore City,India

BACKGROUND: This cross-sectional study aimed to assess the knowledge, attitude and anxiety pertaining to basic life support(BLS) and medical emergencies among interns in dental colleges of Mangalore city, Karnataka, India.METHODS: The study subjects comprised of interns who volunteered from the four dental colleges. The knowledge and attitude of interns were assessed using a 30-item questionnaire prepared based on the Basic Life Support Manual from American Heart Association and the anxiety of interns pertaining to BLS and medical emergencies were assessed using a State-Trait Anxiety Inventory(STAI) Questionnaire. Chi-square test was performed on SPSS 21.0(IBM Statistics, 2012) to determine statistically signifi cant differences(P<0.05) between assessed knowledge and anxiety.RESULTS: Out of 183 interns, 39.89% had below average knowledge. A total of 123(67.21%) reported unavailability of professional training. The majority(180, 98.36%) felt the urgent need of training in basic life support procedures. Assessment of stress showed a total of 27.1% participants to be above highstress level. Comparison of assessed knowledge and stress was found to be insignifi cant(P=0.983).CONCLUSION: There was an evident lack of knowledge pertaining to the management of medical emergencies among the interns. As oral health care providers moving out to the society, a focus should be placed on the training of dental interns with respect to Basic Life Support procedures.

Dental knowledge and awareness among grandparents

AIM: To investigate grandparent's knowledge and awareness about the oral health of their grandchildren. METHODS: Grandparents accompanying patients aged 4-8 years, who were living with their grandchildren and caring for them for a major part of the day, when both their parents were at work were included in the study. A 20-item questionnaire covering socio-demographic characteristics, dietary and oral hygiene practices was distributed to them. The sample comprised of 200 grandparents(59 males, 141 females). χ2 analysis and Gamma test of symmetrical measures were applied to assess responses across respondent gender and level of education.RESULTS: Oral health related awareness was found to be low among grandparents. In most questions asked, grandparents with a higher level of education exhibited a better knowledge about children's oral health. Level of awareness was not related to their gender. CONCLUSION: Oral hygiene and dietary habits are established during childhood. There is a great need for dental education of grandparents as they serve as role models for young children.