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   Table of Contents - Current issue
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Supplement - October 2021
Volume 11 | Issue 4
Page Nos. 1-124

Online since Saturday, October 16, 2021

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EDITORIAL  

Trauma rehabilitation services in low- and middle-income countries: The challenge to human recovery p. 1
Timothy Craig Hardcastle
DOI:10.4103/aihb.aihb_94_21  
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REVIEW ARTICLES Top

Psychophysiological effects of yoga on stress management among medical and allied health professional students during COVID-19 pandemic: A narrative review p. 3
Sankalan Sarkar, Bidyadhar Sa, Keerti Singh, Uma Gaur, Ambadasu Bharatha, Virginia Victor, Sayeeda Rahman, Md Anwarul Azim Majumder
DOI:10.4103/aihb.aihb_28_21  
The impact of coronavirus disease 2019 (COVID-19) pandemic has raised health concerns worldwide. Medical and allied health professional schools are seeking ways to alleviate stress and improve the quality of life among students. The effects of yoga have proven to be successful against stress. The review aimed to examine the psychophysiological effects of yoga on stress management among medical and allied health professional students during COVID-19 pandemic. The authors reviewed existing literature and official documents, which mostly focussed on the effect of yoga among medical and health professional students. Mental stress among these students is known to be higher than that of the general population. Sudden changes due to the pandemic are likely to have a significant impact on these students. Uncertainties concerning teaching, learning and assessment generate stress and anxiety, and social distancing further contributes to loneliness. Yoga has gained recognition not only in improving mental health and quality of life, but it also helps in improving respiratory and immune health. Although many published studies examined the psychophysiological effects of yoga among health professional students; only a few medical and allied health professional schools have incorporated yoga into an integrated curriculum for a holistic approach. In response to the COVID-19 crisis, the use of yoga for stress reduction and immune modulation should be considered as a complement to other treatments. There is a need to integrate yoga into medical and health science curricula to prepare physically fit and mentally sound prospective healthcare professionals.
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Contraception: What to use after a solid-organ transplant? p. 13
Kunur Nikhilesh Shah, Sumesh Divakant Choudhary, Vineet V Mishra, Rohina S Aggarwal
DOI:10.4103/aihb.aihb_70_21  
Solid-organ transplant increases the physical and mental well-being of women suffering from chronic kidney diseases. It also improves the menstrual and reproductive function of the transplant recipient, putting a woman at risk of unplanned pregnancy. Various contraceptive options are available to such women. According to the World Health Organization Medical Eligibility Criteria, almost all contraceptive methods belong to Category 2 for uncomplicated post-transplant recipients. For complicated renal-transplant patients, intra-uterine devices are Category 3/2, and combined hormonal contraceptives are Category 4. It is of paramount importance to discuss the pros and cons of each method, and this counselling should be included routinely before undergoing transplant surgery.
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ORIGINAL ARTICLES Top

Salivary zinc levels in mixed unstimulated saliva of children and its correlation with dental caries p. 18
Anmol Mathur, Aditi Mathur, Vikram Pal Aggarwal, Ridam Jain
DOI:10.4103/aihb.aihb_154_20  
Introduction: Zinc is the second most abundant trace element in human and animals. It is essential for the growth and development in humans and has diverse roles. While the effects of zinc on calculus and plaque growth have been reviewed extensively, its interaction with dental caries has received less attention. Materials and Methods: This was a cross-sectional study done on 60 children belonging to 4–6 and 12–14 years of age groups (30 children in each age group). After intraoral examination, the patients were categorised into low caries (deft <2) and high caries category (deft more than 5), with 15 children in each group. Saliva samples were collected, and the estimation of salivary zinc was done by Atomic Absorption Spectrophotometer. Statistical analysis used was Student's t-test, applied to test the association between high and low caries group. Results: The mean values of salivary zinc levels are significantly higher in the low caries category of both groups. The difference in mean salivary zinc values computed for Student's t-test among high and low caries category is found to be highly significant for both the age groups. Conclusion: Salivary zinc levels are negatively correlated with dental caries experience in both the dentition. The authors conclude that zinc can be used in toothpaste to reduce the caries prevalence.
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Midterm clinical results of bankart repair, bankart remplissage, and latarjet procedures for treating recurrent anterior shoulder dislocation p. 22
Hossein Saremi, Ali Saneii, Bijan Goodarzi
DOI:10.4103/aihb.aihb_22_21  
Introduction: This study compared the midterm outcomes of pain, apprehension and range of motion in the shoulder after three arthroscopic procedures including Bankart repair, Bankart repair plus remplissage, and Latarjet surgeries, in patients with recurrent anterior shoulder dislocation. Materials and Methods: We evaluated 128 patients who had undergone anterior shoulder instability surgery at least 4 years ago in our centre based on pain, apprehension and range of motion of both shoulders. Pain was assessed with visual analogue scale, apprehension by physical examination and range of motion with goniometer. We divided them into three groups based on their treatment: (1) Bankart repair, (2) Bankart remplissage and (3) Laterjet procedure. Results: There were 34 patients with Bankart repair, 68 with Bankart remplissage and 26 with Latarjet procedure. The mean of follow-up time was 6.2 years. There was only one re-dislocation. Apprehension was positive in two patients of Bankart repair, eight patients of Bankart remplissage and none of Latarjet procedure groups. The movement limitation average of the external rotation was 9.12° in Bankart repair, 7° in Bankart rempilssage and 18.53° in Latarjet procedure groups. The means of visual analogue scales were 0.29, 0.76, and 0.38 in Bankart repair, Bankart remplissage and Latarjet procedure groups. Conclusion: All operations had had satisfactory results. Remplissage does not induce more restriction on the range of motion. However, in case of more bone loss in the humeral head, apprehension seems to be more positive in those who do remplissage. Latarjet procedure seems to be very effective but causes more range of motion restrictions.
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A comparison of homocysteine, troponin, cobalamin and folate status in acute myocardial infarction patients and healthy subjects: A case–control study p. 27
Abbas Ali Niazi, Mansour Karajibani, Keivan Ghassami, Farzaneh Montazerifar, Maryam Iranneghad, Ahmad Bolouri
DOI:10.4103/aihb.aihb_26_21  
Introduction: Homocysteine (HCY), troponin, cardiac markers, folic acid and Vitamin B12 are known as the potential biomarkers for acute myocardial infarction (AMI) diagnosis. This study was designed to evaluate these markers as candidate biomarkers in the diagnosis, prognosis and prevention of AMI. Materials and Methods: This study was carried out on 40 AMI patients and 40 healthy subjects. After taking blood, HCY level was measured by an enzymatic, troponin and Vitamin B12, while the level of folic acid was determined by the radioimmunoassay method. In addition, the cardiac enzyme markers and lipid profile were measured by commercial kits and spectrophotometric method. Results: The results showed that patients' HCY levels were significantly more than the control group. Furthermore, the level of troponin was significantly different in the two groups (P = 0.0001), while serum levels of cardiac enzyme markers were significantly higher in patients (P < 0.01). Moreover, serum folic acid and Vitamin B12 levels differed between the two groups (P > 0.05). A positive correlation was identified between HCY with cholesterol (r = 0.32, P < 0.04) and low-density lipoprotein cholesterol (LDL-C) (r = 0.38, P < 0.02) in the patients. Conclusion: Elevated fasting HCY and troponin concentration are related to the lower circulation of folate and Vitamin B12 levels in the patients. The deficiency of these vitamins plays a role as an independent factor in HCY metabolism. As our findings revealed, despite a decrease in high-density lipoprotein cholesterol, the level of LDL-C increased in the patients. It can be inferred that merging enzymatic and non-enzymatic biomarkers might be more valuable in the diagnosis of AMI.
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Dermatoglyphics findings in intellectual disability children with down syndrome, autism spectrum disorder and attention-deficit hyperactivity disorder: A descriptive cross-sectional study p. 34
Astri Anindya Sariza, Ziske Maristka, Lusia Hayati, Rara Inggarsih, Septi Purnamasari
DOI:10.4103/aihb.aihb_34_21  
Introduction: Intellectual disability is a condition, in which mental development is incomplete or hindered, causing the individuals to encounter difficulties in everyday learning. Some of the conditions with intellectual disability can be seen in dermatoglyphics due to the same period formation between fingerprints and the neocortex. This study aims to evaluate the distribution of dermatoglyphics in intellectual disability individuals with Down syndrome, autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD). Materials and Methods: A descriptive study with a cross-sectional approach on children with intellectual disabilities diagnosed with Down syndrome, ASD and ADHD in a special needs school in Palembang. Results: Of all 86 respondents, 31 (36%) had Down syndrome, 30 (34.88%) had ASD and 25 (29.07%) had ADHD. The most commonly found fingerprint patterns in Down syndrome, ASD and ADHD were ulnar loop patterns (80.96%, 59.67% and 46.8%, respectively). The mean pattern Intensity Index values were 11.03 for Down syndrome, 13.06 for ASD and 14.36 for ADHD. The mean Dankmeijer Index values were 3.57 in Down syndrome, 12.07 in ASD and 16 in ADHD. The mean Furuhata Index values were 18.72 in Down syndrome, 107.29 in ASD and 146.22 in ADHD. The angle of axial triradius digital in Down syndrome, ASD and ADHD was mostly on the right and left palm: 3°–65°. Conclusions: The majority of intellectual disability individuals with Down syndrome, ASD and ADHD shared relatively the same dermatoglyphic findings, especially in the fingerprint pattern, yet show differences in some measurements.
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Incidence of urinary tract injury while performing total laparoscopic hysterectomy and role of cystoscopy p. 40
Sumesh Divakant Choudhary, Vineet V Mishra, Kunur N Shah, Rohina S Aggarwal, Smit B Solanki
DOI:10.4103/aihb.aihb_45_21  
Introduction: Total laparoscopic hysterectomy is a common surgical procedure performed by a gynaecological endoscopic surgeon. Urinary tract injuries, though rare, is a serious complication requiring early detection and management. The aim of this study is to determine the incidence and risk factors for injury to the lower urinary tract during total laparoscopic hysterectomy and the role of cystoscopy in diagnosing the injury. Materials and Methods: All patients who underwent total laparoscopic hysterectomy for benign disease from January 1, 2017, to November 1, 2019, at the Institute of Kidney Diseases and Research Centre were included. Intraoperative cystoscopy with oral Pyridium given before surgery was routinely performed. Relevant data were abstracted to determine the incidence of lower urinary tract injury, predictors of injury and post-operative complications and the role of cystoscopy. Results: Total laparoscopic hysterectomy was performed in 150 consecutive subjects. Out of the encountered 6 cases (4%) of renal injuries in our study, two (1.3%) cystotomies were noted and repaired. An absent ureteral spill of Pyridium was detected in one subject, ureteral injury that was detected and confirmed with retrograde pyelography and managed with percutaneous nephrostomy and ureteric implantation. Three patients had a ureteric injury which was missed initially with a cystoscope. Later on, the patient presented with a urinary leak. The injury was identified and managed surgically. Only 25% (1/4) of injuries were recognised with the use of cystoscopy with Pyridium. All patients recovered with no long-term complications on follow-up. Conclusions: Renal injuries are relatively uncommon during total laparoscopic hysterectomy. Nevertheless, when an injury does occur, quick recognition of the problem and a working knowledge of its location and treatment are essential in providing patients with optimal medical care. Surgeons should consider performing cystoscopy at the time of total laparoscopic hysterectomy.
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An investigation of effect of rigid and nonrigid connector designs on implant as pier abutment in implant tooth-supported fixed dental prosthesis with three-dimensional finite element analysis: An In vitro study p. 45
S Manoj Kumar, J Brintha Jei, Murugesan Krishnan
DOI:10.4103/aihb.aihb_55_21  
Introduction: The effect and stress distribution of rigid and non-rigid connectors were evaluated on a 5-unit fixed partial denture (FPD) with an implant as pier abutment by finite element analysis. Materials and Methods: A three-dimensional (3D) computed tomography with Digital imaging and communications in medicine (DICOM) format output was made for a patient with the implant in the second pre-molar region of the maxilla and missing the first pre-molar and first molar. In the obtained 3D finite element method (FEM) model, the implant in the second pre-molar region acts as a pier abutment. The canine and second molar served as terminal natural teeth abutments. By using CATIA V.05, the features of the implant in the second pre-molar region of 13 mm length and 3.75-mm diameter and 5 unit FPD tooth implant-supported prosthesis with rigid and non-rigid connector FEM models were made with a static vertical occlusal load of 250N. The areas and locations of maximum and minimum concentration of stress were analysed using Von Mises stress values for all the models at 10 Mpa. Results: The analysis of the von mishes stress values exposed the maximum stress concentrations at the load areas of all models. For all models, the highest stress values were located at connectors and cervical regions of abutment teeth, especially at the pier abutment. Conclusion: The area of maximum stress concentration at the pier abutment was decreased using the non-rigid connector at the mesial surface of the pier abutment.
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Comparative study of dietary habits and sedentary lifestyle among the female medical and non-medical students in a Saudi Arabia University p. 51
Norah Alharbi, Rahaf Alshowibi, Norah Aljabri, Fayza Alamri, Fatimah Alali, Nouf Alajmi, Alhanouf Almarshad, Shahad Almasoudi
DOI:10.4103/aihb.aihb_77_21  
Introduction: Risk factors such as dietary habits and physical inactivity for non-communicable diseases are common and preventable. Thus the reduction in risk factors forms the epicentre of the management of non-communicable diseases. This study was carried out with an objective to compare dietary habits and sedentary lifestyle among the female health Sciences College and non-health college students in a Saudi Arabia University. Materials and Methods: The comparative cross-sectional study was carried out among 700 students belonging to both health sciences and non-health colleges at Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia, from October 2019 to December 2019. A self-administrated questionnaire regarding their diet habits and physical activity was shared with the participants. The distributive statistics were analysed and discussed. Results: Among the total 700 students, 363 students were from the college of health sciences, and 337 were from Non-health College students. The majority of students did not have the recommended meals, with most of them eating only two meals in a day, 51.2% in health sciences college students and 48.1% in non-health college students. About 29.9% of the college students were physically inactive, wherein 28.4% were among the college of health sciences, and 31.5% were non-health, college students, respectively. The difference in the two groups regarding primary source of daily food, the quantity of daily fluid intake, number of hours of sedentary life and the activity after food intake was statistically significant (P ≤ 0.05). Conclusion: This study showed that the eating and sedentary lifestyle habits in the two groups were almost the same, but the difference between the type of food, the quantity of fluid intake and time for physical activity did have significance statistically. These findings have to be further studied to understand the impact on health.
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A cross-sectional study on knowledge and attitude of schoolteachers about epilepsy in Saudi Arabia p. 58
Norah Alharbi, Yousef Mohammed Alharbi, Abdulrahman Khalifah Almasaud, Tareq Naseer Alsamarh, Saleh Abdullah Alwasil, Ahmed Hamoud Aldaham, Omar Abdulaziz Alolayan, Abdulrahman Obaid Alharbi
DOI:10.4103/aihb.aihb_78_21  
Introduction: Epilepsy is a chronic brain disease characterised by intermittent nervous system derangement due to sudden excessive cerebral neuron discharge that results in almost instantaneous sensation disruption and loss of consciousness. There is a clear lack of epilepsy information among the general population. This study was carried out with an aim to examine the knowledge, attitude and practice of schoolteachers towards epilepsy. Materials and Methods: This cross-sectional survey was administered to 433 schoolteachers working in the Al-Qassim region of Saudi Arabia from October to December 2020. A 20-item pretested validated questionnaire was distributed as a Google survey link, and the data collected were analysed using SPSS version 22. P < 0.05 was considered statistically significant. The Chi-square test was used to evaluate the categorical variables. Results: Around two-thirds of the teachers (35.2%) gained their information about epilepsy from public resources such as newspapers, television and the internet, and around half of them (53.1%) gained their information about epilepsy from multiple resources, namely from doctors, public resources and parents of students with epilepsy. Almost all teachers (99.3%) acknowledge that epilepsy is not a contagious disease, and more than half of the participants (58.4%) believed that there are multiple causes of epilepsy, including genetics, head trauma, infection, brain tumour and insanity. Conclusion: The study showed that teachers' knowledge of epilepsy was promising, but still, there are gaps in knowledge and attitude towards first aid management. There is a need to address this issue with the training of schoolteachers with the cooperation of local health professionals.
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Comparison of immediate and delayed loading of dental implants in mandibular posterior teeth: Clinical observations and review p. 64
Khadar Vali Shaik, Rakan Menwer Albilasi, Bader Falah Arqoub Albalawi, Faris Alturqi Alruwaili, Sankar Rao Sanaka
DOI:10.4103/aihb.aihb_155_20  
Introduction: The study is aimed to compare the clinical outcome of immediate and delayed loaded single tooth implants in replacement of mandibular posterior tooth in consideration with implant stability quotient, bleeding on probing, probing depth, implant mobility, marginal bone loss and peri-implant radiolucency. Materials and Methods: The study consisted of 20 patients who were divided into two groups and compared: Group A is an immediately loaded group with ten patients who received implants in the mandibular posterior tooth region along with abutment on the same day and acrylic crown placed within 48 h and the second group is a conventionally loaded group of ten patients who received the implant in the mandibular posterior tooth region in which the cover screw was placed and conventionally loaded after 3 months. Implant stability quotient, implant mobility, bone loss and peri-implantitis were assessed at 1st and 6th months after loading. All patients were evaluated for the parameters at 1st, 3rd and 6th months after loading in both the groups. Results: Probing depths obtained for all twenty patients after 1 and 6 months of loading were within the normal range (1–3 mm). In Group A, the mean probing depth after 1-month loading was 1.8 mm with a standard deviation (SD) of 0.63 and after 6 months of loading 1.2 mm with SD 0.42. In Group B, the mean of the probing depth after 1 month of loading is 1.8 mm with SD 0.42 and remained the same post loading after 6 months. Marginal bone loss was measured mesially and distally after 1 month and 6 months in both the groups. The standard intraoral periapical radiograph was used to evaluate peri-implant radiolucency. No patient showed peri-implantitis for 6-month follow-up after loading of implants. Conclusion: Immediate loading of an implant in a single mandibular posterior tooth can be an effective treatment modality and a promising alternative to delayed loading.
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Assessment of inter-rater and intra-rater reliability of index of orthodontic treatment need index by newly trained orthodontic residents p. 69
Khyati Mahida, Ajay Kubavat, Shrish Charan Srivastava, Manish Desai, Harshit Patel, Harsh S Modi
DOI:10.4103/aihb.aihb_27_21  
Introduction: This study aimed to test the reliability of the index of treatment need by newly trained orthodontic residents. Materials and Methods: A total of 100 patients were assessed by the panel of four consultant orthodontists using the index of orthodontic treatment need (IOTN) index, and the agreed category was set as the 'gold standard'. Four residents of the department in the initial stages of formal orthodontic training and lacking the knowledge of using the IOTN index were trained to score the treatment need according to the IOTN index. All four residents were then asked to score the 100 sets of models using both the indexes of IOTN. Results: Kappa scores for inter-rater agreement with the expert panel for the major categories (1–4) demonstrated moderate agreement (kappa: 0.59–0.5623) for all raters. The percentage agreement ranged from 84.03% to 88.10% in all cases. Intra-rater agreement for the major categories was fair to moderate (kappa: 0.53–0.80).Conclusions: The IOTN index is a reliable index to be used for determining the priority of treatment needs in orthodontic treatment. The clarity and simplicity make the index easy to learn and apply with minimal training. The simplicity of the IOTN index makes it easy to learn and apply by novices.
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Impact of lifestyle change plus dental care programme on stress levels and periodontal status in chronic periodontitis patients p. 73
Shilpa Duseja, Hiral Parikh
DOI:10.4103/aihb.aihb_38_21  
Introduction: Periodontitis is a polymicrobial chronic disease modified by numerous factors, with stress and unhealthy lifestyles being associated with the progression of the disease. It is believed that cognitive-behavioural approaches can improve stress and lifestyle patterns which may subsequently improve oral hygiene-related behaviours. Materials and Methods: Hundred systemically healthy patients participated in the study. Patients with chronic periodontitis, stress (Social Readjustment Rating scale) and with unhealthy lifestyles (Abel's criteria) were selected for the study. The selected patients in the test group (n = 50) were provided with Individual lifestyle counselling and oral education programme along with non-surgical periodontal therapy, while the patients in the control group (n = 50) were provided with non-surgical periodontal therapy. Plaque index (PI), modified gingival index (GI) and probing depth were recorded at baseline and 3 months. The self-efficacy scale for self-care (SESS) was also recorded at baseline and 3 months. Means of all parameters were collected and subjected to Student's t-test. Results: Statistically significant (P ≤ 0.05) reductions were observed in both test and control group for PI, modified GI and probing depth. The SESS showed statistically significant improvement (P ≤ 0.01) in the test group as compared to the control group. Conclusion: Self-efficacy is related to numerous health-related practices such as diet and health-promoting lifestyle, and smoking cessation. The approaches applying the social cognition model are useful for the improvement of periodontal status and should be made part of regular treatment and maintenance regimens.
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An evaluation of dental crowding and its relation to the mesiodistal crown widths in Andhra Pradesh Population p. 77
Divya Kumar Jain, Anmol Mathur, Mansoor Saify, Tanmay Sharma, Manish Jain
DOI:10.4103/aihb.aihb_94_20  
Introduction: Crowding of the teeth is one of the most common anomalies which makes an individual seek orthodontic treatment. Dental crowding is more disturbing to the patients when located in the anterior segment of the dental arch because it often affects the quality of the patient's smile and speech, causing social embarrassment to the patient. Materials and Methods: The maxillary and mandibular casts of 100 subjects belonging to the Andhra population between 13 and 21 years of age were selected and divided into 50 subjects crowded and 50 in the noncrowded group further; we divided the crowded and non-crowded group into 25 males and 25 females in each group. Using measurement tool, individual and collective mesiodistal crown widths of canine, first and second premolar and first molar and arch perimeter of both the maxillary and mandibular jaws were measured. Results: When both the gender were considered, the mesiodistal crown widths were statistically significant for dental crowding in both mandibular jaw (P < 0.05 for mesiodistal crown width–P > 0.05 for arch perimeter) and maxillary jaw (P < 0.05 for mesiodistal crown width–P > 0.05 for arch perimeter). When we analysed the gender wise in the non-crowded group, we found there is no significant difference in dental crowding in both mandibular jaw and maxillary jaw (P > 0.05). Mean arch perimeter of the maxillary arch in crowded females (95.56) and mean arch perimeter of the maxillary arch in crowded males (98.79) have significant difference (P < 0.05). Conclusion: This study concluded that it is the cumulative mesiodistal width of the tooth, which contribute more towards crowding, while the arch perimeter contributes much less to crowding. Thus, it is better to undergo extraction orthodontic treatment then to go for arch expansion in orthodontic patients of Andhra Pradesh who are seeking the treatment for relieving crowding.
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Prevalence of glucose-6-phosphate dehydrogenase deficiency among neonates with hyperbillirubinemia in the West of Iran p. 81
Fatemeh Eghbalian, Rojin Aqaie, Nasrin Jiriaee, Ensiyeh Jenabi
DOI:10.4103/aihb.aihb_12_21  
Introduction: Hyperbilirubinemia is a common complication among neonates. The objective of this cross-sectional study was the prevalence of glucose 6-phosphate dehydrogenase (G6PD) deficiency among neonates with hyperbilirubinemia in the west of Iran. Materials and Methods: In this retrospective cross-sectional study, the records of neonates with hyperbilirubinemia who were hospitalised in Hamadan located in the west of Iran, from 2011 to 2016 were reviewed. After reviewing and studying each of the mentioned files, the necessary information was entered in the relevant checklists. Then, the neonates were divided into two groups, including the group with G6PD enzyme deficiency in the case study group and the G6PD enzyme-free group in the control study group. All statistical analyses were conducted in SPSS version 21 software and P < 0.05 was statistically considered significant. Results: A total of 1545 neonates with hyperbilirubinemia was reviewed. Among them, 40 neonates were in the case group and 1505 were in the control group. The prevalence of G6PD deficiency in the present study was 2.58% among neonates with hyperbilirubinemia which has a similar gender distribution. There were statistically significant differences between case and control groups based on total bilirubin, direct bilirubin, reticulocyte count, time of appearance of jaundice, duration of receiving phototherapy and hospitalisation (P < 0.05). Conclusion: We proposed that cord blood G6PD screening be conducted among neonates. This can be affected in identifying G6PD-deficient neonates who might require a longer hospital stay after birth, with monitoring of their serum bilirubin before and after discharge.
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Assessment of alveolar bone loss at mandibular first molar on panoramic radiographs p. 85
Apoorva Mhatre, Devanand Shetty, Arvind Shetty, Suyog Dharmadhikari, Pooja Wadkar
DOI:10.4103/aihb.aihb_32_21  
Introduction: The loss of alveolar bone is one of the important indicators of periodontitis. There is a widespread use of panoramic radiographs for the detection of bone loss due to periodontitis. The present study is aimed to evaluate the severity and prevalence of alveolar bone loss at mandibular first molar sites on randomly selected 250 orthopantomograms. Materials and Methods: The alveolar bone level was assessed by direct measurements from the cemento-enamel junction to the crest of alveolar bone at the mandibular first molar region at the mesial and distal surface with a Hu-Friedy University of North Carolina probe-15 Probe. Bone loss was assessed based on gender and age. Results: The results indicated that the bone loss was statistically higher in the mandibular molar region on the distal surface than the mesial surface. The bone loss notably increased with age. Conclusion: In conclusion, the study is in accordance with the finding that radiographic bone loss can be used as an important tool to identify patients susceptible to periodontitis.
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Impact of reverse transcriptase real-time polymerase chain reaction-cycle threshold values on SARS-CoV-2–positive cancer patients undergoing treatment p. 90
Rashmisnata Barman, Manash Jyoti Taw, Avdhesh Kumar Rai, Manigreeva Krishnatreya, Anupam Sarma, Sawmik Das, Mouchumee Bhattacharyya, Amal Chandra Kataki, Manoj Kalita
DOI:10.4103/aihb.aihb_73_21  
Introduction: Coronavirus disease 2019 (COVID-19) pandemic, being a novel viral infection, has resulted in disruption of health services, including cancer patient's care and treatment. Hence, there was a need for testing and lateral integration of services for cancer patients with COVID-19. Materials and Methods: A total of 1178 samples were collected from cancer patients for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing before undergoing treatment in a tertiary care cancer center. The realtime reverse transcriptase polymerase chain reaction (RTPCR) was done using the E gene for screening, and for the confirmation, any of the three reactions using RdRp, ORF1bnsp14 and RNasePas were run as internal control. Results: Out of the 1178 samples tested, 211 (17.91%) were positive, and of these patients, 863 (73.25%) were men and 342 (29%) were women. Among the 863 men with cancer, 133 (15.41%) were real-time reverse transcriptase PCR (RT-PCR) positive. Of the 342 women with cancer, 78 (22.80%) were positive. Of the 144 SARS-CoV-2–positive cancer patients with cycle threshold (Ct) <25, 112 (84.2%) were asymptomatic and 32 (41.0%) were symptomatic. Sixty-seven patients showed positive results with a Ct >25. Out of them, 21 (31.3%) were asymptomatic and 46 (68.65%) were symptomatic cancer patients (P < 0.001). Of 144 patients with Ct <25, only 4 (2.8%) patients tested negative within 7–9 days, whereas the rest of the 140 (97.22%) became negative in >9 and up to 28 days. In the 67 cancer patients with Ct >25, within 7–9 days, 50 (74.6%) became RT-PCR negative and the remaining 17 patients mostly >60 years age group became RT-PCR negative in >9–28 days. Conclusions: Ct value of qualitative SARS-CoV-2 reverse transcriptase RT-PCR should be an important tool for an oncologist in designing and implementing patient management guidelines for SARS-CoV-2–positive cancer patients without or with symptoms for COVID-19.
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Assessment of epidemiological profile of hip fractures and their risk factors in a Tertiary Care Centre: A case–control study p. 95
Surendra Singh Rathore, Jitendra Singh Rathore, Lokpal Singh Bhati, Devendra Singh Rathore
DOI:10.4103/aihb.aihb_116_20  
Introduction: Hip fractures are common injuries contributing to both morbidity and mortality in the elderly. The present case–control study was conducted to assess the epidemiological profile of hip fractures and their risk factors in a tertiary care centre. Materials and Methods: The present study was a retrospective case–control study carried out in a tertiary care hospital over a period of 1 year. Fifty patients aged 40 years and above who were admitted with radiologically detected fractures of the femur were included as cases. Controls were selected in an equal number of cases. All the physiological parameters were recorded. Other variables were also noted. Data were collected and analyzed using the SPSS software version 21.0. P < 0.05 was considered to be statistically significant. Results: The study population consisted of 50 cases and 50 controls with an equal male-female ratio. Out of 25 cases in males, 68% were extracapsular and 32% were intracapsular fractures. Out of 25 cases in females, 60% were extracapsular and 40% were intracapsular fractures. The extracapsular (24%) and intracapsular (16%) fractures were maximum in the age group of 40–50 years in males. The extracapsular fractures (28%) and intracapsular (16%) were maximum in the age group of 60–70 years in females. Fractures taking place indoors due to loss of balance were higher (38%). Fractures occurring outdoors due to slip higher (22%). The history of weight loss in the past year was more in cases (44%). Cases were more inactive (46%) in the past than controls. Cases were more inactive (34%) in the past than controls. History of chronic diseases such as diabetes was more in cases (14%), and hypertension was more in controls than cases. History of drug uses as some sought of medication was more in cases (52%) than controls, and usage of drugs for hypertension and calcium tablets was more in controls than cases. Addiction to smoking was more in cases, and alcohol was more in controls. Conclusion: Our study concluded that in males, extracapsular fractures were more, and in females, intracapsular fractures were more. The extracapsular and intracapsular fractures were maximum in the age group of 40–50 years in males. The extracapsular fractures and intracapsular were maximum in the age group of 60–70 years in females. Fractures taking place indoors due to loss of balance were higher. Fractures occurring outdoors due to slip was higher.
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The prevalence and severity of dental caries in permanent molars amongst 8–10 years of children in Vadodara, Gujarat: An epidemiological study p. 99
Bhriti Aditya Thaker, Bhavna Haresh Dave, Aditya Thaker, Susmita Shrenik Shah, Deepika Narasimha Chari
DOI:10.4103/aihb.aihb_71_21  
Introduction: Oral diseases and traumatic injuries are serious public health problems, especially when talking about children. Mutilation of the function and reduced quality of life has an influence on individuals and communities. The most widespread oral disease in developing countries has been found to be dental caries. The maintenance of healthy permanent molars is very important. DMFT and PUFA index can be used to determine the caries status and severity in untreated carious teeth of an individual. Materials and Methods: This was a cross-sectional descriptive survey that included 1380 children between the age group 8–10 years from public and private schools of Vadodara, Gujarat. The study population was divided based on their socioeconomic status as upper, middle and low according to the Kuppuswamy scale. The study was conducted 2 days per week for 6 months to examine the participants. Dental caries was assessed using DMFT index, and the severity of caries was evaluated by PUFA index for permanent first molars. Results: The prevalence of first permanent molar caries in Vadodara city was 55.38%; 747 out of 1380 children of 8–10 years of age were affected with caries evaluated using DMFT index. The severity of first permanent molar caries (PUFA index) was found to be 56.22%. That is, 420 out of 747 children had more severe first permanent molar caries. Conclusion: Caries prevalence and severity increase with age. PUFA index is an effective index in evaluating the clinical sequel of untreated carious teeth and helps better treatment plans for a socially deprived group of society.
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Evaluation of efficacy of platelet-rich fibrin for papilla reconstruction p. 106
Yesha Haresh Raval, Monali Amit Shah, Rahul Deepak Dave, Aastha Vishwanath Debnath
DOI:10.4103/aihb.aihb_87_21  
Introduction: Blood clot or platelet concentrates have been used as a scaffold for regeneration of lost tissues. The most difficult case to date is the restoration of missing interdental papillae in the anterior maxillary area. Hence, the aim of the study is to evaluate the efficacy of the use of platelet-rich fibrin (PRF) membrane in the treatment of black triangles and regeneration of interdental papilla. Materials and Methods: A non-randomised, single-arm study was carried out. Each participant had undergone an initial periodontal diagnosis, including oral hygiene instructions, plaque control and scaling and root planing. All clinical recordings were recorded immediately before surgery (baseline), 1 week, 4-week and after 12-week intervals following periodontal surgery. The measurements recorded were triangle height (TH), triangle width (TW), Papilla Presence Index (PPI) and percentage fill. The split-thickness flap was carried via the semilunar incision, creating a pouch. PRF was obtained using a standard protocol, which was inserted into the pouch allowing interdental papillae to be filled. The periodontal dressing was given for 7 days. The observations were recorded after 1 week, 49 weeks and 12 weeks of surgery. For descriptive analysis, mean ± standard deviation SD at baseline, 1 week, 4 weeks and 12 weeks was calculated, and for non-parametric test, Friedman and Chi-square tests were used. Results: Clinical parameters such as TH, TW and PPI (mm) was 3.96, 3.86 and 3.82 at baseline which after 12 weeks got reduced to 1.36, 1.68 and 1.58, respectively. This reduction in TH, TW and PPI(mm) was statistically significant (P< 0.001). Percentage fill in black triangle area was about 85% after 12-week follow-up. Conclusion: PRF membrane is effective in treating black triangles and regeneration of interdental papilla and can be used successfully.
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Evaluation of periodontal health among tobacco chewers, smokers and non-tobacco users: A case–control study p. 111
Anuja Kashyapbhai Dave, Bela Dave, Viral Thakker, Nancy Joshi, Mahendrakumar Katariya, Harsh Patel
DOI:10.4103/aihb.aihb_160_20  
Introduction: Periodontal disease is a multifactorial disease and one of the most common chronic diseases of the oral cavity. Smoking has a long-term chronic effect on many important aspects of the inflammatory and immune responses. Tobacco smoke has been found to affect both cell-mediated immunity and humoral immunity. Oral smokeless tobacco consumption has been considered a major risk factor for oral cancer. Its role as a risk factor for periodontal disease is less well-documented when compared to that of the relationship between smoking and periodontal disease. Materials and Methods: One hundred and eighty participants willing to sign informed consent were selected randomly with no gender bias, and the purpose of the study was explained. The periodontal examination was conducted, and the oral hygiene index-simplified (OHI-S), community periodontal index (CPI) score and loss of attachment (LOA) score were recorded. The collected data were analysed using SPSS 20 software. Results: Sixty participants in each group were examined. OHI-S mean score in Group 1 was 1.77 ± 0.43, in Group 2, it was 1.70 ± 0.65 and in Group 3, it was 1.73 ± 0.55. The mean value of CPI was 3.32 ± 0.47 in Group 1, 2.17 ± 0.46 in Group 2 and 2.67 ± 0.54 in Group 3. In comparison, the mean value of CPI-LOA was 1.35 ± 0.48 in Group 1, 1.65 ± 0.5 in Group 2 and 1.18 ± 0.65 in Group 3. Conclusion: The present survey concluded that tobacco consumption in both the forms caused poor periodontal status, with smokers having more pocket depth than tobacco chewers and non-tobacco users and tobacco chewers having more LOA than smokers and non-tobacco users.
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CASE REPORTS Top

Proximal femoral nail anti-rotation-2 in intertrochanteric fractures: Experience from the Kingdom of Saudi Arabia p. 116
Abdulmalik Baker Albaker
DOI:10.4103/aihb.aihb_44_21  
Proximal femoral nail anti-rotation (PFNA)-2 is an intramedullary implant designed specifically for the Asian population for managing intertrochanteric (IT) fractures among the elderly. We presented this cases series with an objective to use and document the effectiveness of PFNA-2 for the management of unstable IT fracture among patients aged 60 years and above in the Kingdom of Saudi Arabia. Four females were treated above 65 years with severe pain in the hip region after a trivial fall on the ground over a period of 2 years (2018–2020), diagnosed with T3 and T4 unstable IT fracture. All the patients were hypertensive, with two having diabetes. It was decided to manage the fracture site by PFNA-II implant following baseline clinical and biochemical investigations. The duration of surgery took around 70–75 min with a blood loss of 100–150 ml, and there was no intraoperative complication. Early mobilisation and toe touch walking was achieved within 2 days postoperatively. Harris hip score was 'good' for all patients within 3 months, which became 'excellent' after 6 months for all except one. Union was achieved in all the cases with a full weight-bearing period ranging from 9 to 11 weeks. The usage of PFNA-2 for IT fractures among elderly having co-morbidities such diabetes and hypertension is perfectly promising good results for such reason we strongly recommend it. However, future prospective clinical trials using sufficient sample size, comparing PFNA-2 with PFN and dynamic hip screws are needed for better decision-making.
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Removable sectional complete denture for managing oral sub-mucous fibrosis patient with restricted mouth opening: A clinical report Highly accessed article p. 120
Ravi Maheshchandra Joshi, Dipti S Shah, Kalpesh Vaishnav, Komal Shah, Radhika Agnihotri
DOI:10.4103/aihb.aihb_80_21  
Restricted mouth opening (microstomia) can be defined as a reduction in the circumference of the oral cavity, although the intraoral structures may be of normal size. It is observed that the size of the oral opening decreases, the difficulty increases in required dental treatment. Prosthetic rehabilitation of microstomia patients due to oral sub-mucous fibrosis (OSMF) presents difficulties at all stages, right from preliminary impressions to insertion of prostheses, as the maximal oral opening is smaller than the size of a removal intra-oral prosthesis. To rehabilitate this type of patient successfully, the methods and designs incorporated in the fabrication of prosthesis have to be modified to achieve favourable mastication, retention and aesthetics. This article describes modified primary impression procedure without using tray and other techniques used to fabricate maxillary and mandibular custom sectional trays, sectional denture bases and removable sectional complete dentures for completely edentulous patient with limited oral opening caused by OSMF. Fabricating the sectional denture allows the patient to insert and remove the denture with ease.
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