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Introduction: To date, the focus on COVID-19 among children, especially in low- and middle-income countries, has been to address key issues including poor vaccination rates. However, the focus is changing with new variants and concerns regarding the development of hyperinflammatory syndromes. There have also been concerns with the overuse of antibiotics to treat patients with COVID-19, with the Indian Government developing guidelines, including those for children, to improve patient care. Consequently, a need to document the current management of children with COVID-19 in India and use the findings for future guidance. Materials and Methods: Pilot study assessing the management of children with COVID-19 among five hospitals in India using purposely developed case report forms, which had been piloted in Bangladesh. Results: Low numbers of children in hospital with COVID-19 (11.9% of in-patient beds). The majority were boys (58.3%) and between 11 and 18 years (55.5%). Reasons for admission were in line with previous studies and included respiratory distress/breathing difficulties. 69.4% of children with COVID-19 were prescribed antibiotics empirically, typically those on the Watch list, and administered parenterally, with only limited switching to oral therapy. A minority were prescribed antimalarials, antivirals and anti-parasitic medicines. There was appreciable prescribing of immune boosters and steroids. Conclusion: It was encouraging to see low hospitalisation rates. However, concerns with high empiric use of antibiotics and limited switching to oral formulations need to be addressed potentially, by instigating antimicrobial stewardship programmes. Similarly, other antimicrobials where these are not recommended.

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Coronavirus disease 2019 (COVID-19) as a severe and rapid spread disease is a global health emergency since December 2019. During the outbreak of COVID-19, infected pregnant women were treated with different pharmacological regimens; however, trial studies are still investigating their safety and effectiveness. In the present study, we reviewed all recently published studies related to the pharmaceutical management of COVID-19 in pregnancy to discuss the rapid evolving pattern of administered medications. A review study was conducted to investigate the pharmacological management of COVID-19 in pregnancy. All types of full English and recent articles through detailed research on Cochrane Library, PubMed, UpToDate, ScienceDirect and Google Scholar databases were collected. Several medical sites were also investigated. The implemented keywords for the search were COVID-19, SARS-CoV-2, coronavirus, pregnancy, management, treatment, medication, drug, antiviral, teratogenicity, possible effect, therapeutic effect, adverse effect and pregnancy outcome. There are no definitely specific approved pharmacological treatments for COVID-19 in pregnancy. Evaluating published literature showed that different treatment options, including chloroquine, favipiravir and ribavirin, convalescent plasma, interferons and remdesivir, have been used to stop or decline viral replication. We reviewed published evidence for drug selection and its safety during pregnancy, but conflicting results associated with numbers of trials show that we need further investigation for newer antiviral drugs for use in pregnancy. It seems that management of COVID-19 needs a multidisciplinary approach, and a consultant medical team should be arranged to decide about medications for the management of COVID-19-infected pregnant women.

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Introduction: Dysbiosis is often used to describe the state where there is a disruption in the balance of organisms in the microbiota. Dysbiosis of gut microbiota has been associated with disorders within and without the gut. This study aimed to identify the microbiota composition and to determine the association between gut microbiota and gestation weight amongst women attending Muhoza health Center. Materials and Methods: A cross-sectional study design was used where ninety stool samples were collected amongst pregnant women attending antenatal click of Muhoza health center. The samples were transported to Ines microbiology laboratory for microbiological analysis. Laboratory techniques including culturing, gram stain, and biochemical tests were performed for gut microbial identification. Analysis of variance was used to test the mean bacterial difference in pregnancy trimesters, a t-test was performed to test for the mean bacterial difference in the gestational weight gain (GWG) and gestational weight loss groups, and Chi-square test was used to test for association with gut bacteria imbalance and the gestational weight variation. Results: Lactobacillus 23.28% was the most predominant observed in the gut. The gut bacterial variation throughout pregnancy trimesters was observed (F = 4.437904575, P = 0.022909599). The gut bacterial mean difference was statistically significant in the weight gain and weight loss (t = 3.45, 95% confidence interval [CI]: 0.1487–0.5154, P = 0.005428) in the GWG and loss. There was statistical association with gut microbiota dysbiosis and gestational weight amongst pregnant women with Escherichia coli (P = 0.030197, 95% CI: 0.0741–0.4611, x² = 7), Pseudomonas (P = 0.018316, 95% CI: 0.0941–0.4781, x² = 8), and Citrobacter (P = 0.00046, 95% CI: 0.7855–0.9014, x² = 15.38). The overall association (P = 0.001869, 95% CI: 0.9697–0.9868, x² = 46.19) was statistically significant. Conclusion: Gut bacterial alteration contributes to gestational either weight gain or loss. During antenatal care, gut bacteria should be tested to maintain the gestational weight.

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The aim of these clinical cases descriptions was to describe the clinical results of barbed polydioxanone (PDO) threads in neck lifting using the Tight Neck Fontana Protocol (TNFP). Three-barbed PDO threads (19G or 18G and 150 mm in length) were implanted bilaterally in six female adult patients with an indication for neck lifting. Two threads were inserted in the sub-dermis of the neck through the diagonal vectors from the angle of the mandible toward the midline and fixed with a knot. The third thread was implanted in parallel and just below the first vector. The post-operative results were evaluated by the occurrence of adverse events, scores attributed on a Visual Numerical Scale, questionnaire inquiring the satisfaction patient about the treatment (QSP), and evaluation of photographic records. The results were quite satisfactory on the procedures performed, suggesting the indication of the TNFP using barbed PDO threads for the neck lifting.

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Introduction: The retention of an extraoral maxillofacial prosthesis poses a big challenge to the prosthodontist due to the complex and varied nature of facial defects. Several methods are available to enhance the retention of this prosthesis. This study was conducted to compare the efficacy of polysiloxane adhesives and n-butyl cyanoacrylate adhesives in providing retention for an extra-oral maxillofacial prosthesis. Materials and Methods: The samples were prepared by bonding silicone sheets with pigskin. These samples to be studied were divided into two groups of 20 samples each depending on the adhesive used for bonding the silicone sheets to the pigskin. Ten samples from each group were subjected to 180° and T-peel tests, respectively. Results: The results showed that the mean peel strength (PS) in the T peel test was higher for polysiloxane adhesive as compared to n-butyl cyanoacrylate adhesive, but the difference was not statistically significant. Whereas the mean PS in the 180° peel test was higher for n-butyl cyanoacrylate adhesive as compared to polysiloxane adhesive and the difference was statistically significant. Conclusion: The cyanoacrylate adhesives proved to be better in terms of PS.

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Introduction: Platelet-rich fibrin (PRF) is a term for autologous platelet concentrates generated from the patient's own blood (PRF). PRF and its derivatives (L-PRF, A-PRF, i-PRF) have been used for delicate tissue restoration in a variety of dental procedures. The quantity of leucocytes and other growth factors in PRF of healthy and post-COVID-19 people differs, according to the literature, and these influence wound tissue healing. Materials and Methods: Thirty healthy volunteers and 30 post-COVID-19 volunteers (age range 24–60 years). For PRF preparation, a REMI PR-23 table centrifuge and a blood collection kit consisting of a 19G needle and 10 ml blood collection tubes were used. The analysis was performed by dividing the subject groups into three test groups (Group 1 – post-COVID-19, 0–30 days; Group 2 – post-COVID-19, 31–90 days; Group 3 – normal patients). Group 1, 2 and 3 consisted of 23, 7 and 30 patients, respectively. Results: The result was statistically significant between the normal and posted COVID-19 patient groups (P = 0.00). Not much statistical significance was found between post-COVID-19 patients from 0–30 days to 31–90 days (P = 0.370). Considering the limitations of the study, our findings imply that typical patients' PRF clots or membranes comprise the majority of platelets and half of the leucocytes present in the first blood collection. Conclusion: Within the fibrin network, platelet growth factors are stuck, but the PRF clot or membrane of the post-COVID-19 patients contains a reduced/negligible number of leucocytes. Thus, the growth factors which is released are also less. Therefore, usage of PRF in post-COVID-19 patients for periodontal regenerative therapies should be avoided, at least for the first 60 days, to replenish the reduced leucocyte count and growth factors in the blood.

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Introduction: Prolonged digit sucking habits can have deleterious effects on facial growth, oral function, occlusion and aesthetics, leading to dental and skeletal deformities. Early identification and intervention can result in a vast difference in treatment outcomes and avoid a complex, expensive, and time-consuming treatment in the future. Pediatricians are in a key position to identify these habits in children. The present study evaluated the knowledge, attitude and practice among pediatricians about digit sucking habits in children in Pune city, India. Materials and Methods: A pre-validated questionnaire was mailed to the study subjects. The filled 303 questionnaires were then statistically analyzed using descriptive statistics. Results: This study showed that although the number of pediatricians performing routine oral examinations was high (92.7%), the referral to dentists was low. 67.5% of pediatricians referred their patients to a dentist only when they had an explicit dental complaint. Only 20.5% of pediatricians referred children with digit sucking habits to a dentist. 95.7% of participants agreed that treatment of digit sucking is important, but only 7% of pediatricians recognized the use of habit-breaking appliances as a treatment modality. Conclusion: We found that although the pediatricians had sufficient knowledge regarding thumb-sucking habits in children, the involvement and collaboration with dentists was very low. The majority of pediatricians felt there was a need for more awareness programs on oral habits. We conclude that more collaborations should be encouraged between medical and dental professionals.

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Hyaluronic acid fillers can be used for the correction of facial soft tissue in orthodontics patients instead of orthognathic surgery. These clinical cases show the aesthetic results of Sattler MedBeauty Seven Protocol (SMSP) in five Class II female patients after having undergone orthodontic treatment. They had the lower third of the face filled with cross-linked hyaluronic acid (e.p.t.q. S500^®), according to the SMSP. All patients were evaluated before and after treatments through an inquiry on adverse events, a Numerical Visual Scale (NVS), a self-assessment questionnaire (SQ) and the analysis of photographic records (PRs). The results showed oedema, pain and haematoma as the most cited adverse events, a score of 10 in the NVS for all patients, and a good aesthetic effect of chin and mandible in SQ and PR. The results suggest that SMSP is favourable in the aesthetic correction of chin and mandible in class II orthodontic patients using e.p.t.q. S500^® for compensatory filling.

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Introduction: Determination of gender and estimation of stature from the skeleton is vital to medicolegal inquiries. CT scan measurements of maxillary and frontal sinuses are thought to be useful for gender determination. The aim of this study is to compare the frontal sinus dimensions and to assess their reliability and accuracy for gender determination using a CT scan. Materials and Methods: A comparative study included cranial Computerized tomography (CT) of 40 patients aged between 18 and 65 years who underwent CT examination of the head and neck for other medical problems that are not related to the frontal sinus. The measurements of the frontal sinus were done in axial and scout images. Results: Our study showed that the maximum depth of frontal sinus in males and females was 10.76 ± 2.12 and 9.23 ± 1.85, respectively, which showed a statistically significant P value (<0.05). The thickness of the anterior wall for males and females was 5.27 ± 1.46 and 5.62 ± 1.60, respectively. There was no statistical significance with respect to the thickness of the anterior wall of the frontal sinus. The maximal anteroposterior length of frontal sinus measured from scout image for males and females were 12.35 ± 3.11 and 10.52 ± 2.15, respectively, which showed a statistically significant P < 0.05. The frontal sinus dimensions were correlated with age subgroups, and there is no statistical significance. Conclusion: We concluded that the dimensions of the frontal sinus could be used for gender dimorphism. This study also proposes the reliability and accuracy of frontal sinus; hence the study proves vital in identifying the gender of a person in forensic anthropology.

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Introduction: Early and correct identification of the betacoronavirus is important for effective isolation treatment and case management. Real-time polymerase chain reaction (PCR) are consider as a gold standard for the diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); however, for that, there are a requirement of skilled workforce and elaborate infrastructure. A rapid point of care test known as Truenat Beta CoV and Truenat SARS COV assay were recommended by the Government of India. The aim of the study was to find out the performance of Truenat assay in comparison to four RT-PCR assay kits. Materials and Methods: The cross sectional study was conducted in a COVID-19 testing laboratory in Central India. Forty known Truenat positive sample with different viral load were analyze in selected rtPCR kits from 4 different manufacturers. Results: Of the total of ten very low viral load samples, BGI kit was able to detect six samples, followed by TruePCR six samples, TaqPath five samples and NIV kit were able to detect three samples. Similarly, in the case of low viral load sample, BGI and TaqPath kit were able to detect all the 10 samples followed by NIV kit five samples and TruePCR nine samples respectably. In the case of medium and high viral load samples, all four reverse transcription-PCR (RT-PCR) kits were shown a 100% detection rate. Conclusions: Based on our findings, we believe truenat RT-PCR is a more reliable technique for the detection of SARC-CoV-2. Hence, it should be installed in the healthcare setup for better control of the pandemic.

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Introduction: Lipoprotein(a) (Lp[a]) synthesised by the liver consists of low-density lipoprotein which contains apoB-100 linked to apolipoprotein(a) (apo[a]) by disulphide bridge. LPA gene codes for highly polymorphic apo(a). The serum Lp(a) levels are highly varied amongst individuals and ethnicities, which could be attributed to the genetic polymorphisms present in LPA gene. Hence, this study aimed to analyse the association between LPA genetic variants, rs6415084 and rs6919346, with serum Lp(a) levels in apparently healthy subjects. Materials and Methods: In this cross-sectional study, 56 apparently healthy subjects were recruited after obtaining informed consent. Serum Lp(a) levels were measured by immunoturbidimetric assay, and the genotyping of the variants was determined by the real-time polymerase chain reaction. Spearman's correlation test was used to find the association between single-nucleotide polymorphism and serum Lp(a). P < 0.05 is considered statistically significant. Results: The median level of serum Lp(a) amongst the study subjects was found to be 26.75 mg/dL, which is higher in males (35.50 mg/dL) when compared to females (21.85 mg/dL). The analysis of LPA gene variant rs6415084 showed 58.9% of the subjects with computed tomography (CT) genotype, 17.85% with CC and 5.3% with TT genotype. In the case of the rs6919346 variant, 80% of the subjects had CC genotype, 8.9% with CT and 5.3% with TT genotype. Conclusion: Overall, a weak significant association was observed between heterozygous alleles of LPA gene variant rs6415084 with increased serum Lp(a) level.

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Introduction: Dental anxiety causes a decrease in population addressability to the dentist with antagonistic consequences for long-term oral health. Assessment of behavioural factors that correlate with dental anxiety is important for the accurate evaluation of dental fear. Its diagnosis in childhood is important for establishing therapeutic management strategies to reduce anxiety and promote oral health. Materials and Methods: A sample of 289 children of ninth and tenth grades from two public and two private schools of Udupi town was drawn. Two-stage sampling was used for the enrolment of students. A pre-tested self-administered questionnaire was used for the collection of data on psychological aspects, socioeconomic background and health behaviours. Dental anxiety was assessed using a translated version of the modified dental anxiety scale (MDAS). Oral examination was done for the assessment of dental caries using the decayed, missing, filled teeth index. Results: Students from public schools showed a significantly high prevalence of dental anxiety and also higher scores. Dental phobia was significantly more in children from public schools. Female gender, lesser brushing frequency, fewer previous dental visits and lower socioeconomic status were significantly associated with higher dental anxiety levels. In addition, the caries experience was significantly higher in children from public schools. Conclusion: Socioeconomic background and social environment in the school play an important role in overcoming dental anxiety and practising healthy behaviour and therefore should be considered to break the vicious cycle of dental anxiety and poor dental health.

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Introduction: Dental undergraduate students and postgraduates do learn conventional denture making as their curriculum but previous studies have found that the final-year undergraduate students lack the confidence which is required in treating completely edentulous patients. This pilot questionnaire survey was done to evaluate patient awareness about dental implants and satisfaction with conventional complete dentures fabricated by undergraduate and postgraduate students in the department of prosthodontics. Materials and Methods: The study was carried out on thirty patients who received complete maxillary and mandibular denture. These 30 patients were divided into two groups, each group consisting of 15 patients on the basis if the denture was fabricated by a postgraduate or undergraduate student. After using the denture for a period of 3 months, the patients rated the functioning of the dentures using the questionnaire survey. The patient was also asked about the knowledge about the implant and their willingness to go for the implant treatment. Results: Patient satisfaction was significantly higher amongst the patients who received complete denture fabricated by postgraduate students as compared to undergraduate students, and the difference was statistically significant (P < 0.05) for six of the seven questions. Most of the patients were not aware of the dental implants, and the cost of the implant is a major factor for not going for implant treatment. Conclusion: The pilot study showed that the patients who received complete denture delivered by the undergraduates were not satisfied with the fit, masticatory efficiency and encountered falling of denture while talking and eating. In contrast, the patients who received complete denture delivered by the postgraduate students were happy with the fit and masticatory efficiency. The present survey found that there is a lack of awareness about implants in patients, and the cost factor is a major hurdle in patients for not taking implants as a treatment option.

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