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This study aimed to understand the experiences of bereaved family members in view of restrictive COVID guidelines using qualitative approach. 10 Hindu, Gujarati bereaved family members who lost their loved ones during the first wave were interviewed telephonically after a month of their loss. Findings were difficulty in proper communication during hospitalization, disrupted end-of-life and funeral rituals and accepting harsh realities related to the changes imposed by using content analysis. Most of the family members felt that there was a need of staying with the patients. Telephonic mode of communication was not sufficient for them and created doubts related to death. Most of them felt remorseful as they were not able to see or bring their loved one home during their last moments and felt deprived of the traditional rituals. Also, they had to deal with their grief by themselves. [ABSTRACT FROM AUTHOR]

Introduction: The clinical application of the diode laser seems to have beneficial effects in surgery. The laser provides precise and rapid tissue dissection, excellent haemostasis and lessens post-operative inflammation. This study was done to assess the clinical effectiveness of diode laser in the management of different varieties of intraoral soft-tissue lesions. Materials and Methods: After applying exclusion criteria, a total of 50 samples were selected with benign intraoral soft-tissue lesions treated with a diode laser under local anaesthesia between September 2017 and September 2020. Each patient was followed up on the 3rd, 7th and 15th post-operative days for healing, pain, infection and swelling. Results: From all patients, a total of 50 were evaluated in the study; out of all, 60% of patients had no pain on the 2nd follow-up. As per the Landry Index of Healing, 54% of patients had excellent healing. None of the cases had post-operative bleeding, infection was present in 4% at the 1st–2nd follow-up, and in 2% of cases, post-operative swelling was present. The efficacy of diode lasers was tested using the Chi-square test and P < 0.01, which was statistically significant. Discussion: Diode laser seems to be superior over conventional treatment modalities as it provides a bloodless dry field and increases patient comfort during surgery. It also lessens the post-operative pain and swelling. Diode laser can safely and effectively be used as a treatment modality for benign soft-tissue lesions, without any complication and without compromising the health and function of patients. [ABSTRACT FROM AUTHOR]

Hair loss in children is an important cosmetic concern, especially in adolescents where body image matters. Trichotillomania manifests through patchy hair loss which reflects underlying psychiatric conditions. It is a challenge for the dermatologist, who are first contact physicians, to deal with such cases who are secretly struggling with their inner turmoil. Hence, they must be well versed to deal with such patients. The current review aims to facilitate the dermatologist to handle them effectively. We performed PubMed and Google Scholar searches of English literature using the terms "Trichotillomania", "Trichotillosis," "Trichotillomania in Children," "Trichotillomania in pediatrics," "Trichotillomania in adolescents," "Hair pulling disorder," "Obsessive-Compulsive disorders AND Dermatology," "Psychodermatology," and "Psychocutaneous disorders." The selected publications were reviewed for additional resources. Thorough psychological evaluation of the patient along with the cutaneous examination will help the dermatologists in establishing the diagnosis. Dermatologists should be empowered regarding the need of mental health referral and should be able to convey the same to the patient/family members empathetically. They can offer habit reversal therapy, mainstay treatment, as well as pharmacotherapy as and when needed after adequate training. [ABSTRACT FROM AUTHOR]

Schizophrenia is a severe, debilitating disorder that is associated with a significant burden of illness. Antipsychotic medications remain the mainstay of treatment for schizophrenia and related disorders. In recent years, a number of new psychotropic medications have been introduced to the market, with some potential differences in the mechanism of action compared to the previous ones. In this paper, we discuss the issue of lack of access to the newer antipsychotics in Canada, and the discontinuation of some of the older options from the market, leaving clinicians and patients with a limited number of available options. While the aim of this paper is to increase awareness of the current state of availability and accessibility of options, we further discuss some potential solutions. [ABSTRACT FROM AUTHOR]

Introduction: Bovine-derived collagen membrane is usually and regularly used as a temporary cover or dressing for extraoral wounds and burns. It has wide applications because of its usefulness and biocompatibility. This has provoked us to do a study with the use of collagen membrane even for minor intraoral surgical defects. The aim of this evaluative study was to evaluate the clinical efficacy of collagen membrane in intraoral wounds created by removal of various soft tissue lesions. Materials and Methods: A total of 25 healthy patients (16 males and 9 females) were taken for this study. This study was confined to secondary defects of the oral mucosa, which occur after excision of premalignant lesions and other conditions, such as benign lesions, reactive proliferations, and incisional biopsy wounds. Only those lesions that were sufficiently large and could not be closed primarily were included in the study. Results: The results were evaluated on the day of surgery and in the postoperative period. The usefulness of collagen membrane as an intraoral temporary wound dressing material to promote haemostasis, relieve pain, induce granulation, and assist in rapid epithelialization at the wound site and prevent infection, contracture, scarring, and donor-site morbidity was evaluated, and finally, the efficacy of collagen membrane was tested by the use of Chi-square test and P < 0.001, which is a statistically and clinically significant value. Discussion: Collagen membrane was observed as both biological dressing material and drug carrier. It was found to be a suitable alternative to other graft materials mentioned for the repair of defects in the mucous membrane created by surgical excision of lesions. Therefore, when used judiciously in a controlled clinical situation, collagen membrane is biologically acceptable in nature. It is an alternative to autologous grafts rather than a replacement of other grafts used in the oral cavity. [ABSTRACT FROM AUTHOR]

Introduction: The treatment of subcondylar mandible fractures is a topic of debate and can be variable even though these fractures are commonly seen. The present study aimed at evaluation of various treatment modalities for unilateral condylar fracture in adults. Materials and Methods: Thirty patients with unilateral condylar fractures between the age of 18 and 60 years were evaluated. Treatment protocol included closed reduction for 15 patients and open reduction for 15 patients. Results: Assessment was done functionally for maximum interincisal mouth opening, deviation on maximum interincisal mouth opening, occlusion and facial nerve function, and radiologically for ramus height shortening. In general, there were no statistically significant differences between closed and open methods. Discussion: Both the treatment options for condylar fractures of the mandible yielded acceptable results. Closed treatment appears to be a safe and appropriate modality for most unilateral condylar fractures. Although the open group, in general, showed similar outcomes, this treatment should be reserved for limited indications. The present study has confirmed that both treatment options can yield acceptable results. On clinical examination, there was no significant difference in mouth opening measures, the incidence of occlusal disturbances or in the degree of pain perception. [ABSTRACT FROM AUTHOR]

Background: Beginning of the pandemic showed our limitations in our understanding of the spread of the dreaded coronavirus-19 that had sprung from China and spread through thick and thin across the world. The measures to contain the spread of virus in the absence of specific treatment protocol had everyone grope for the solutions in a very short time frame. One such is the knowledge, attitude, and practice in the rural setup. Aim: The aim of the study is to measure the change in knowledge, attitude, and practices (KAP) regarding COVID-19 following an awareness session in rural population. Materials and Methods: A cross-section interventional study was carried out in January 2021. An interactive awareness session was conducted with the help of audiovisual aids following MOHFW guidelines for COVID-19, and the change in KAP about COVID-19 was measured by pre- and posttest standardized questionnaire. Results: Of all the participants, statistically significant change in knowledge was seen from 43% to 52%. The villagers were educated about preventive steps and a positive change was measured in the practice of changing masks regularly (84%–100%), maintaining social distancing (44%–64%), frequent handwashing (52%–64%). No change was seen in wearing of masks (92%) and negative change was seen in avoiding handshakes (32%–28%). The preventive practices regarding COVID-19 pandemic changed significantly from 50% to 58%. Our study measured positive attitude change toward getting vaccinated from 64% to 72%. Conclusion: A single, short awareness session led to significant change in KAP about COVID-19 in rural population. [ABSTRACT FROM AUTHOR]

Adenomatoid odontogenic tumor (AOT) is a relatively rare, benign, hamartomatous, and cystic odontogenic neoplasm that was first described more than a century ago. It accounts for 2-7% of all odontogenic tumors. The lesion still continues to intrigue experts with its varied histomorphology and controversies regarding its development. The present article describes a case of cystic AOT with an unusual histomorphology associated with an impacted 43 in a 15-year-old male. [ABSTRACT FROM AUTHOR]

Leiomyoma is a benign smooth muscle tumor that occurs most frequently in the uterine myometrium, gastrointestinal tract, skin, and lower extremities. Leiomyoma rarely affects the oral cavity. Angioleiomyoma (vascular leiomyoma) is a histological subtype of the leiomyoma. The diagnosis is commonly determined by histopathological studies. This case report shows a 57-year-old male patient with a lesion of the lower lip. After laser excision, hematoxylin and eosin and smooth muscle actin staining confirmed the diagnosis of angioleiomyoma. [ABSTRACT FROM AUTHOR]

Objectives:To assess prevalence and pattern of movement disorders among patients taking antipsychotic medications. Methods:This cross-sectional, intensive monitoring (patient interview, case record form review and clinical examination) study was conducted in patients taking antipsychotic drugs irrespective of duration for the development of movement disorders. The psychiatrist used Modified Simpson-Angus Scale score (10-item scale), Barnes’ rating scale and Abnormal Involuntary Movement Scale to diagnose parkinsonism, akathisia and tardive dyskinesia, respectively. We assessed movement disorders for the preventability and seriousness. Results:The overall prevalence of antipsychotic induced movement disorders was 5.67% (95% CI: 4.19–7.62). The prevalence of parkinsonism, akathisia and tardive dyskinesia was 5.10% (95% CI: 3.71–6.98), 0.85% (95% CI: 0.39–1.84) and 0.57% (95% CI: 0.22–1.45), respectively. There was a trend of high proportions of movement disorders in extreme of age group, female gender, patients treated with conventional antipsychotics, on poly therapy, patients of epilepsy with psychosis, schizophrenia and bipolar mood disorder. The movement disorder was lowest with quetiapine (2.02%). Conclusions:The higher use of atypical antipsychotics had reduced the occurrence of movement disorders in our setup. [ABSTRACT FROM PUBLISHER]

Objectives As pharmacists expand their roles as patient care providers, remuneration must be offered for patient care activities apart from dispensing. Most jurisdictions paying for such services utilize the fee-for-service ( FFS) model, while little is known about the role of pay for performance (P4P) within the pharmacy profession. This study aimed to elicit the experience of pharmacists practicing under both models within the Alberta Clinical Trial in Optimizing Hypertension (Rx ACTION) study in Alberta, Canada. Methods Pharmacist participants in Rx ACTION caring for at least one patient under FFS and under P4P were interviewed about their experiences until data saturation was reached. Interviews were conducted in June-July 2015, with responses audio recorded, transcribed and coded to identify key themes. Key findings Eight pharmacists were interviewed, with three key themes identified: a perceived comfort with the existing FFS model particularly due to its ease related to business planning, the transformative effect of the study on their practices and a preference for future models to consider a blend of both service count- and performance-driven metrics. The degree of influence pharmacists feel they can have on outcomes achieved by patients, the perceptions of patients and other healthcare professionals on outcome-based payment, and concerns with the impact of variable remuneration on the pharmacy business model are concerns raised with P4P in pharmacy practice. Conclusions This study reveals a hesitation to radically transform payment for pharmacists' patient care services towards a P4P model. Efforts to implement P4P should therefore be gradual and accompanied with a robust evaluation plan. [ABSTRACT FROM AUTHOR]

A variety of eruption disturbances arise during the transitional dentition period, which can be broadly classified as disturbances related to time and disturbances related to position. The occurrence of ectopic eruption is relatively common, but ectopically positioned tooth piercing the philtrum is a rare clinical presentation. This is a case report of a 70-year-old female who presented with the chief complaint of an abnormally positioned tooth piercing out from the upper lip to the Department of Oral and Maxillofacial Surgery, Karnavati School of Dentistry, Uvarsad, Gandhinagar, Gujarat, India. As per the patient's history, labially erupted tooth was piercing the philtrum for 60 years and it was visible extraorally from the philtrum and was painful. [ABSTRACT FROM AUTHOR]

Background & Objective: To study the patterns of psychiatric referrals in a newly established tertiary care teaching Hospital has been important for understanding consultation liaison psychiatry and setting up better general hospital psychiatric units. The aim of the present study was to study referral characteristics' of patients of various departments to psychiatric unit at a tertiary care teaching hospital. Methodology: All referrals made to psychiatry department over a period of one year were assessed by psychiatrist based on structured performa including demographic data, referring department, referral note, present complaints, past history of psychiatric illness, family history of psychiatric illness, mental status examination and DSM -IV-TR criteria to diagnose psychiatric illness and analyzed. Results: Out of 400 referred patients to psychiatry unit over a period of one year, majority were from Medicine department (62.75%). Substance use disorder (37.25%) was the most common diagnosis followed by depressive disorders (15.75%) and anxiety disorders (8.25%). 235 (58.75%) references were with statement like 'psychiatry reference' and no reason mentioned for that. Significantly higher proportions of OPD referrals (71.81%) were made with statement like 'psychiatry reference' and no reason mentioned for that as compared IPD referrals (41.62%). Significantly higher proportions of patients (66.75%) with past history of psychiatric illness were referred with statement like 'psychiatry reference' and no reason mentioned for that as compared to patients (52.81%) without past history of psychiatric illness. Conclusion: Study highlights importance of consultation-liaison psychiatry through referral pattern in a tertiary care teaching hospital. More referrals for Substance use disorders suggest emerging need to develop separate deaddiction services in our setting. Past history of psychiatric illness was considered significant factor for referrals from other departments and majority of references were without any details. There is need to sensitize other specialists, especially general physicians who are the common source of referrals regarding common psychiatric conditions and proper referral note to improve consultation liaison psychiatry in general hospital setup. [ABSTRACT FROM AUTHOR]

Spindle Cell Carcinoma (SpCC) also known as sarcomatoid carcinoma, is a rare and peculiar biphasic malignant neoplasm that occurs mainly in the upper aerodigestive tract. It is most frequently encountered in the larynx, and also occurs in the nasal cavity, hypopharynx, oral cavities, esophagus, trachea, skin and breast. It is a variant of squamous cell carcinoma which has spindled or pleomorphic tumor cells which simulate a true sarcoma but are epithelial in origin. It consists of sarcomatoid proliferation of pleomorphic spindle cells and squamous cell carcinoma. Spindle cell carcinoma is an unusual aggressive variant of Squamous Cell Carcinoma (SCC) that frequently recurs and metastasizes, reinforcing the importance of its correct diagnosis.We report a rare case of SpCC, present in unusual locatoion i.e. maxillary alveolar ridge region with immunohistochemical findings as well as review of literature. [ABSTRACT FROM AUTHOR]

Schwannoma (Neurilemmoma) is a benign nerve sheath tumor that is composed entirely of well differentiated Schwann cells. Intraosseous neurilemmomas are rare and they represent less than 1% of all benign primary bone tumors. It is important to highlight that the Schwannoma is usually found in the head and neck, and rarely in the oral cavity. Schwannoma is a benign tumor that originates from the Schwann cells of the peripheral nerves. They are usually asymptomatic, do not recur, and malignant transformation is rare. We report here on an additional case of intraosseous neurilemmoma that was located in unusual lacation i.e. anterior palatal region. [ABSTRACT FROM AUTHOR]