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Ocular tear film and the ocular surface together represent a dynamic playground of various protective factors against environmental influencers. Surrounding environment and geoclimatic milieu are the pertinent and continuous influencing factors. Prevalence study of Dry eye disease (DED) in various climatic conditions and professions provides an insight into this peculiar aspect of DED and human geography. This was a hospital based, cross-sectional, comparative, analytical observational study. 1840 young soldiers between 25 and 45 years of age were studied. Divided in five climate groups based on Köppen–Geiger climate classification system the subjects were sub-grouped into professions exposed to known aggravating environmental factors. The ocular surface was examined for signs and symptoms of DED and its prevalence and risk ratio for different climates and professions were calculated. Highest prevalence of DED was found in cold desert climate and among visual display unit (VDU) users. Least prevalence was seen in highland type of climate and among people involved in professional exposed to high temperature. Prevalence of DED based upon the signs and ocular surface disease index (OSDI) was calculated and stratified with risk ratio for climatic conditions and professions. Different climatic conditions and professions had different prevalence of signs, symptoms of OSD and DED which indicated its influence on prevalence of the disease. [ABSTRACT FROM AUTHOR]

Background: Sugar-sweetened beverages (SSB) are an independent risk factor for obesity and other non-communicable diseases. Socioeconomic status (SES) is one of the key drivers for the purchase and consumption of SSBs among children and adults; however, there is a lack of strong evidence. This study aims to determine the association between SES and consumption patterns of SSBs across populations. Results: The review was conducted according to PRISMA guidelines. PubMed, MEDLINE, Scopus, EMBASE, LILACS, Web of Science, Cochrane, and CINHAL databases were searched for relevant articles until 2022. Participants included children, adolescents, and adults who consumed different SSBs and were assessed based on their SES. The random-effects model was used to obtain the pooled odds ratio (OR). Twenty-one studies (152,070 participants) met the inclusion criteria. The risk of bias was assessed using the Newcastle-Ottawa tool, with the majority of the studies indicating medium to high quality. Eight ORs from four studies (34,454 participants) were considered for meta-analysis. Results showed those belonging to high SES had 48% lower odds of consuming the SSBs (OR 0.52; 95% CI: 0.42–0.61; p = 0.017). The overall quality of evidence was ascertained using GRADE criteria, illustrating a moderate certainty of evidence between SSB consumption and SES. Conclusion: Meta-analysis suggests that SES influences the consumption pattern of SSBs, with high SES having lower odds of SSB consumption. [ABSTRACT FROM AUTHOR]

The scaffolds used in regenerative endodontic therapy (RET) provide structural support for cells so that they can adhere to the scaffolds and also are crucial for cellular proliferation and differentiation. The objective of this network meta-analysis was to compare effects of different intracanal scaffolds on success outcomes of RET. PubMed/Medline, EMBASE, Cochrane, CINAHL, Scopus, and Web of Science databases were searched. Studies evaluating and/or comparing clinical and/or radiographic success of RET using different scaffolds with a minimum of 12 months follow-up were included. The Cochrane Collaboration risk of bias (ROB) tool and appropriate tools from Joanna Briggs Institute were used for the assessment of ROB. A network meta-analysis was performed to compare the primary outcome (clinical success) and other success outcomes (root maturation, and pulpal sensibility) using different scaffolds. Twenty-seven studies fulfilled the desired inclusion criteria of which 25 had a low ROB whereas 2 had a moderate ROB. Clinical success of RET using platelet-rich plasma (PRP), blood clot (BC), and platelet-rich fibrin (PRF) scaffolds ranged between 91.66%–100%, 84.61%–100%, and 77%–100% respectively. The different scaffolds did not show any statistically significant difference in clinical success (PRF vs BC [ P = 1.000], PRP vs BC [ P = 1.000], and PRF vs PRP [ P =.999]), apical root closure (PRF vs BC [ P = 1.000], PRP vs BC [ P =.835], PRF vs PRP [ P =.956]), and pulp sensibility (PRF vs BC [ P =.980], PRP versus BC [ P =.520], and PRF vs PRP [ P =.990]). The intracanal scaffolds used during RET did not result in significant differences in regard to clinical success, root maturation, and pulpal sensibility. [ABSTRACT FROM AUTHOR]

This is the first randomized controlled trial of trabeculectomy with Ex-Press Shunt versus Ologen implant in primary open-angle glaucoma (POAG) in Indian eyes. A prospective randomized controlled trial of patients of POAG treated with two different methods of augmented trabeculectomy. Group A with Ex-PRESS shunt (P50 model) and Group B with Ologen implant. Surgical success was defined as intraocular pressure of 21 mm Hg or lower at 6 months postoperative. N = 40 eyes of 33 patients. Baseline IOP in Group A was 23.70 ± 4.6 mm Hg (Range 22–36 mm Hg), and Group B was 26.00 ± 4.0 mm Hg (Range 23–36 mm Hg). Surgical success was achieved in 85% of patients in both Groups. Change in IOP from baseline was statistically significant in both groups at 1, 4, 8, 12 weeks, and 6 months postoperative. No statistically significant difference in the change in IOP between the two groups. Postoperative complications were lesser in Group A compared to Group B, in both early (35% vs 50%) and late stage (20% vs 30%). The drop in visual acuity became statistically insignificant at 4 weeks in Group A and 8 weeks in Group B. There is no difference between the surgical success rates of trabeculectomy with Ex-PRESS Shunt versus Ologen. However, the Ex-PRESS shunt fares better with lower complication rates and faster visual recovery than the Ologen group. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the efficacy of Ahmed glaucoma valve (AGV) drainage devices in cases of adult refractory glaucoma in Indian eyes. Settings and Design: Retrospective interventional case series study. Materials and Methods : Fifty two eyes of 32 patients of refractory glaucoma in the age group of 35 to 60 years who underwent AGV implantation with or without concomitant procedures from January 2003 to Jan 2007 were studied. Of these, 46 eyes (88%) had undergone filtering surgery earlier whereas remaining eyes underwent primary AGV implantation following failure of maximal medical therapy. The follow up ranged between 12 months to 48 months Results: Eighteen eyes (35%) had undergone phacoemulsification with AGV implantation, penetrating keratoplasty (PK) with AGV and intraocular lens (IOL) implantation in 13 eyes (25%), AGV over preexisting IOL in eight eyes (15%). AGV implantation alone was done in six (11%) eyes. Anterior chamber (AC) reconstruction with secondary IOL and AGV was performed in the remaining eyes. The mean intra ocular pressure (IOP) decreased from 36.3 ± 15.7 mm Hg to 19.6 ± 9.2 mm Hg. Complete success as per criteria was achieved in 46 eyes (88%). None of the eyes had failure to maintain IOP control following AGV. Conclusion: The AGV resulted in effective and sustained control of IOP in cases of adult refractory glaucoma in intermediate follow up.

The impact factor of journals has been widely used as glory quotients. Despite its limitations, this citation metric is widely used to reflect scientific merit and standing in one′s field. Apart from the impact factor, other bibliometric indicators are also available but are not as popular among decision makers. These indicators are the immediacy index and cited half-life. The impact factor itself is affected by a wide range of sociological and statistical factors. This paper discusses the limitations of the impact factor with suggestions of how it can be used and how it should not be used. It also discusses how other bibliometric indicators can be used to assess the quality of publications.

Background: Dental caries remains the most important dental health problem in developing countries. In India the prevalence of dental caries is reported to be about 50-60%. Most of the Indian studies have been carried out in school children and very few in adults. This study aimed to estimate the prevalence of dental caries in the adult population (aged 35-44 years) and in the elderly (60 years and above) in an urban resettlement colony in New Delhi. Methodology: A community-based cross-sectional study was carried out in Dakshinpuri, New Delhi, from January to February 2007. A local adaptation of the WHO questionnaire was used. Oral examination was done and dentition status was recorded by trained investigators and according to the standard procedures. Results: A total of 452 participants were enrolled in the study. The prevalence of dental caries in the 35-44 years age-group was 82.4% and it was 91.9% in those ≥60 years. The DMF index was 5.7 ± 4.7 in the 35-44 years age-group and 13.8 ± 9.6 in the ≥60 years age-group. Of the participants, 27.9% were currently using tobacco. A statistically significant association was found between tobacco consumption and dental caries ( P = 0.026). The awareness about good and bad dental practices was found to be low among the study participants. One-fifth of the individuals with dental problems relied on home remedies. Conclusion: The prevalence of dental caries among adults is high in this population. There is a need to generate awareness about oral health and the prevention of dental caries and to institute measures for the provision of dental care services at the primary level.

Identifies sources of ambiguity in economics textbooks' discussion of the condition for efficient output mix. Points out that diverse statements without accompanying explanations create confusion among students. Argues that conflicting views concerning the concept of Pareto optimality as one source of ambiguity. Suggests clarifying additions to the discussions. (SG)

Objectives: To evaluate the root and canal morphology of primary maxillary and mandibular molars in an Indian population using cone-beam computed tomography (CBCT).Methods: A retrospective cross-sectional study was performed, where CBCT scans of children less than 10 years of age taken for valid diagnostic purposes previously were considered and images were analyzed. The number of roots, root canals, and variations in morphology were recorded. Left-right symmetry was also noted.Results: A total of 433 deciduous maxillary and mandibular primary molars were studied. It was observed that two separate roots with three separate canals were common in primary mandibular first molars, whereas two separate roots with two canals in each root were common in mandibular second primary molars. In primary maxillary molars, three separate roots with one canal each were the most common. Maxillary first molars (17.21%) and 17.35% second molars had fused distobuccal and palatal roots. It was observed that primary maxillary molars showed more left-right symmetry (86.7% in first molars and 82.7% in second molars) compared to primary mandibular molars (54.05% in first molars and 68% in second molars).Conclusions: It was concluded that in both primary maxillary first and second molars, three separate roots, a mesiobuccal root, a distobuccal root, and a palatal root with one canal in each root, were the most common. Two separate roots with three separate canals were the most common in primary mandibular first molars, whereas two separate roots with two canals each in both roots were more common in mandibular second primary molars. [ABSTRACT FROM AUTHOR]

The changing paradigm of dental education in India has led its way to the development of Competency-Based Curriculum (CBC). This article describes the process of developing CBC in the specialty of Pediatric Dentistry under the initiative of Dental Council of India. Rationale behind CBC development is to bring uniform system of education for improving oral health outcomes of the society in long term. The process of CBC development was a collaborative teamwork, planned meticulously with predefined outline, tasks and timelines. Workflow involved identification of curricular content, defining program goals, outlining competencies, assigning them domains / levels of clinical competence, priority, educational strategies, assessment practices, integration and numbers needed for certification in selected competencies. Early clinical exposure was introduced in CBC. The final content was validated and submitted to the Council. CBC output can be summarized as competencies with fair share of all domains, levels, prioritization and integration. It is characterized by flexibility for choosing educational strategies and assessment practices. It opens up ways for global competition. However, it still has some inherent weaknesses like diverging learning paths, time constraints and number chasing. CBC can further have more academic flexibility and develop toward an outcome-based approach. Faculty preparedness and acceptability shall be the biggest challenges in CBC implementation besides resources' availability, support from leadership and acceptability from our primary stakeholders, our learners. CBC is the beginning of evidence-based delivery of education in dentistry. An effective implementation of CBC in current form would result in increased numbers of competent oral healthcare professionals for the society. [ABSTRACT FROM AUTHOR]

Introduction: The wire composite splint as a general rule is placed on the middle third of labial surface of the tooth. This is due to ease of application, better isolation, and fewer chances of contamination. However, these assumptions are opinion-based, with no scientific evidence to support them. In addition, to best of our knowledge no research has been carried out to evaluate the effect of position of wire splints on the mobility of the affected tooth and anchor teeth.Aim: The aim of this study was to evaluate the effect of the cervico-incisal position of splinting wire on the mobility of a replanted tooth and anchor teeth in a cadaveric model.Methodology: Three cadavers (one female, 45 years old and two males, each 40 years old) were included in the study. periotest S was used to assess physiologic-tooth-mobility in three cadavers at baseline and after "extraction-replantation-wire-composite" splinting-protocol.Results: Greatest splint effect for horizontal-mobility was found to be 9.33 ± 0.57 for Cadaver-I (incisal-third), whereas it was highest (3.66 ± 2.51) for vertical-mobility in Cadaver-II (cervical third).Conclusion: Middle third position of wire composite splint have lowest splint effect on both horizontal and vertical mobility of replanted teeth, thus rendering the most favorable position for the establishment of physiologic mobility. [ABSTRACT FROM AUTHOR]

Background and Aims: Although Streptococcus mutans has been implicated as the major etiologic agent in the development of dental caries, however, this organism has not been found to be present in all children with caries. Thus it remains to be elucidated whether a single or specific consortium of bacteria is responsible for the caries process. The aim of this study is to evaluate the oral microflora of Indian children suffering from dental caries and to compare the same in children with no caries.Methods: The study was carried out on 67 out-patient 2-14 years old children who reported to the department of Paediatric Dentistry. Dental plaque samples from superficial and deep carious lesions and caries free surfaces in caries active children (n = 35) were collected using a sterile excavator in storage vials and subjected to various conventional and molecular microbial techniques. Caries free children (n = 32), who did not have any carious lesion served as controls. The data obtained was subjected to Pearson's Chi Square/Fischer's Exact tests to determine the statistical difference between the microflora of groups.Results: Main organisms isolated were: Streptococcal species mainly S anginosus, S salivarius, S gordonii: Lactobacilli spp; Coagulase negative Staphylococci, Staph epidermidis, Staph aureus. Other organisms such as Klebsiella spp, Acinetobacter, Enterococcus, E coli could also be found. There was a statistical difference in the frequency of isolation of non-mutans Streptococcal species (P = 0.008) and Lactobacilli species (P = 0.0001) in the two groups.Conclusions: The study suggests that caries activity in this population of children is associated with a diverse microbial flora without detectable S mutans. Main organisms associated with dental caries in this population are: Gram-positive cocci and bacilli mainly the non-mutans Streptococcus and Lactobacilli. Frequent consumption of sugar containing food promotes the presence and growth of cariogenic organisms. [ABSTRACT FROM AUTHOR]

Traumatic dental injuries (TDI) have emerged as a significant global public health concern. One major problem which is developing and yet unreported is the incidence of traumatic dental injuries and soft tissue facial trauma due to the inadvertent falling of smartphones on to the face during their use in rest time. This is related to the weight of the smartphones and their excessive use in all parts of the world. This paper aims to highlight this phenomenon as an emerging aetiological factor for dental and facial injuries in children. [ABSTRACT FROM AUTHOR]

Resumo Justificativa e objetivos Pé caído no período pós‐operatório é muito raro após a anestesia espinhal. Avaliação clínica e intervenções diagnósticas precoces são de primordial importância para estabelecer a etiologia e iniciar o tratamento adequado. Um acompanhamento atento é justificado no pós‐operatório imediato nos casos em que o paciente se queixa de parestesia ou dor durante a inserção da agulha ou da injeção de fármacos. Relato de caso Paciente do sexo masculino, 22 anos, submetido a cirurgia ortopédica de membros inferiores sob anestesia espinhal. Durante a transferência para a sala de recuperação pós‐operatória, houve suspeita de pé caído durante a avaliação rotineira da regressão do nível espinhal. O paciente foi imediatamente enviado ao neurologista e uma ressonância magnética foi feita, mas não foi conclusiva. O manejo conservador foi iniciado e o estudo de condução nervosa foi feito no 4° dia de pós‐operatório, o que confirmou a neuropatia motora pura do nervo fibular direito. O paciente foi dispensado com imobilizador de tornozelo e fisioterapia após ligeira melhoria da força motora (2/5). Conclusões Pé caído é muito raro após a anestesia espinhal. Qualquer paciente suspeito deve ser submetido à consulta neurológica de emergência e ressonância magnética para excluir o principal achado e a necessidade de intervenção cirúrgica precoce. Background and objectives Foot drop in postoperative period is very rare after spinal anesthesia. Early clinical assessment and diagnostic interventions is of prime importance to establish the etiology and to start appropriate management. Close follow‐up is warranted in early postoperative period in cases when patient complain paresthesia or pain during needle insertion or drug injection. Case report A 22‐year‐old male was undergone lower limb orthopedic surgery in spinal anesthesia. During shifting from postoperative ward footdrop was suspected during routine assessment of regression of spinal level. Immediately the patient was referred to a neurologist and magnetic resonance imaging was done, which was inconclusive. Conservative management was started and nerve conduction study was done on the 4 th postoperative day that confirmed pure motor neuropathy of right peroneal nerve. Patient was discharged with ankle splint and physiotherapy after slight improvement in motor power (2/5). Conclusions Foot drop is very rare after spinal anesthesia. Any suspected patient must undergo emergent neurological consultation and magnetic resonance imaging to exclude major finding and need for early surgical intervention. [ABSTRACT FROM AUTHOR]