Παρασκευή, 7 Ιουνίου 2019

Happy Friday everyone! May your weekend be full of adventure and cheer, and may the start of next week be a long ways from here.


Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480

Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,


Persistent perioral papules in a young man Piyush Kumar, Anupam Das, Rizwana Barkat Indian Journal...
Persistent perioral papules in a young manPiyush Kumar, Anupam Das, Rizwana BarkatIndian Journal of Dermatology, Venereology, and Leprology 2019 85(4):407-409Case History A 22-year-old otherwise healthy male presented with asymptomatic persistent 2-4mm sized papules distributed over the perioral region for the preceding 2 years. The lesions were asymptomatic but the patient reported a tendency to pick at the lesions. His medical as well as surgical history was non-contributory. On examination, multiple,...
Αλέξανδρος Γ. Σφακιανάκης
8m
Erythema ab igne Jaime Company-Quiroga, Sergio Alique-García, Alberto Romero-Maté Indian Journal of...
Erythema ab igneJaime Company-Quiroga, Sergio Alique-García, Alberto Romero-MatéIndian Journal of Dermatology, Venereology, and Leprology 2019 85(4):405-406A 43-year-old man with a long history of ankylosing spondylitis had intense pruritus at the application sites of fentanyl transdermal patches used to treat pain of ankylosing spondylitis. To ease the itch, he showered himself with extremely hot water at least 10 times a day for several months. Dermatological examination revealed confluent and...
Αλέξανδρος Γ. Σφακιανάκης
9m
Evaluation of efficacy and safety of intralesional bleomycin in the treatment of common warts: Results...
Evaluation of efficacy and safety of intralesional bleomycin in the treatment of common warts: Results of a pilot studyKaran Inder Singh Mehta, Vikram K Mahajan, Pushpinder Singh Chauhan, Shailja Chauhan, Vikas Sharma, Ritu RawatIndian Journal of Dermatology, Venereology, and Leprology 2019 85(4):397-404Background: This study evaluated the efficacy and safety of intralesional bleomycin in the treatment of common warts in 50 (32 men, 18 women) patients aged between 14 and 80 (mean ± SD, 28.5 ± 13.27)...
Αλέξανδρος Γ. Σφακιανάκης
10m
Multiple adenoid basal cell carcinoma: An uncommon presentation Ajit Agarwal, Anand Raja, Sivakumar...
Multiple adenoid basal cell carcinoma: An uncommon presentationAjit Agarwal, Anand Raja, Sivakumar Mahalingam, Kanchan MurhekarIndian Journal of Dermatology, Venereology, and Leprology 2019 85(4):393-396Basal cell carcinoma (BCC) is the most common malignant skin tumor which occurs more frequently over the sun exposed parts of body. Its adenoid variant is a rare histological subtype. We report a case of multiple adenoid basal cell carcinomas at unusual sites in a middle-aged male patient.Introduction Basal...
Αλέξανδρος Γ. Σφακιανάκης
10m
In vitro susceptibility of dermatophytes to oral antifungal drugs and amphotericin B in Uttar Pradesh,...
In vitro susceptibility of dermatophytes to oral antifungal drugs and amphotericin B in Uttar Pradesh, IndiaSatyendra Kumar Singh, Dheeraj Kumar Patwa, Ragini Tilak, Arghya Das, Tej Bali SinghIndian Journal of Dermatology, Venereology, and Leprology 2019 85(4):388-392Background: Dermatophytosis is a major public health problem in our country. Although resistance to conventional oral and topical antifungal agents is being increasingly encountered, the sensitivity pattern of dermatophytes has not been...
Αλέξανδρος Γ. Σφακιανάκης
11m
Do primary care physicians require training in core clinical dermatology? A cross sectional needs assessment...
Do primary care physicians require training in core clinical dermatology? A cross sectional needs assessment study from Western IndiaSejal H Thakkar, Paragkumar D Chavda, Kedar G MehtaIndian Journal of Dermatology, Venereology, and Leprology 2019 85(4):380-387Background: Primary care physicians play a crucial role in managing patients with common skin disorders who form around one-third of outpatient attendees. Aim: This study aimed to assess the need for dermatology training among primary care physicians...
Αλέξανδρος Γ. Σφακιανάκης
11m
New insights into leukotrichia in nonsegmental vitiligo: A cross-sectional study Rania M Mogawer, Maha...
New insights into leukotrichia in nonsegmental vitiligo: A cross-sectional studyRania M Mogawer, Maha Fathy Elmasry, Wedad Z MostafaIndian Journal of Dermatology, Venereology, and Leprology 2019 85(4):374-379Background: Leukotrichia has been considered a predictor of poor outcome in vitiligo. However, studies considering the different clinical aspects of leukotrichia in vitiligo patients are few. Aim: Our aim was to conduct a detailed clinical study to provide insights into the relevance and associations...
Αλέξανδρος Γ. Σφακιανάκης
11m
Histopathological comparison of lesional and perilesional skin in melasma: A cross-sectional analysis...
Histopathological comparison of lesional and perilesional skin in melasma: A cross-sectional analysisManjyot Gautam, Sharmila Patil, Nitin Nadkarni, Manjit Sandhu, Kiran Godse, Maninder SetiaIndian Journal of Dermatology, Venereology, and Leprology 2019 85(4):367-373Background: Melasma is a common acquired hyperpigmentary disorder of the sun exposed skin, especially the face. The pathogenesis is unclear but interplay between genetic factors, hormones and ultraviolet radiation is important. We have...
Αλέξανδρος Γ. Σφακιανάκης
12m
Dermatology, Venereology, Leprology
Research ethics in the modern eraSayanta Thakur, Sandeep LahiryIndian Journal of Dermatology, Venereology, and Leprology 2019 85(4):351-354A double-blind, randomized controlled trial to compare the effectiveness and safety of purified protein derivative of tuberculin antigen with Mycobacterium w vaccine in the treatment of multiple viral wartsSomodyuti Chandra, Amrita Sil, Adrija Datta, Santasmita Pal, Nilay Kanti DasIndian Journal of Dermatology, Venereology, and Leprology 2019 85(4):355-366Background:...
Αλέξανδρος Γ. Σφακιανάκης
12m
purified protein derivative of tuberculin antigen with Mycobacterium w vaccine in the treatment of multiple...
purified protein derivative of tuberculin antigen with Mycobacterium w vaccine in the treatment of multiple viral wartsSomodyuti Chandra, Amrita Sil, Adrija Datta, Santasmita Pal, Nilay Kanti DasIndian Journal of Dermatology, Venereology, and Leprology 2019 85(4):355-366Background: Present day therapeutic modalities for viral warts are mostly ablative in nature, limited by high recurrence rates and are unsuitable for numerous lesions. Immunotherapy has the potential to overcome these limitations....
Αλέξανδρος Γ. Σφακιανάκης
12m
anti microbial activity of triantibiotic paste, 2% chlorhexidine gel, and calcium hydroxide on microorganisms...
anti microbial activity of triantibiotic paste, 2% chlorhexidine gel, and calcium hydroxide on microorganisms in the root canal of immature teethSumit Sabharwal, Shresth Kumar Bhagat, Kumar Shresth Gami, Abhishek Siddhartha, Kulwant Rai, Yuvika AhluwaliaJournal of International Society of Preventive and Community Dentistry 2019 9(3):263-268Aims and Objectives: Intracanal medication plays an important role in disinfecting the root canal from various microorganisms. There are various intracanal medication...
Αλέξανδρος Γ. Σφακιανάκης
14m
Evaluation of styloid process and its anatomical variations: A digital panoramic study with systematic...
Evaluation of styloid process and its anatomical variations: A digital panoramic study with systematic reviewKoduri Sridevi, N Mahesh, B Krishnaveni, A D N Deepika, V Thejasri, B H David LeninsonJournal of International Society of Preventive and Community Dentistry 2019 9(3):256-262Aims and Objectives: To evaluate the styloid process (SP) and its anatomical variations on digital panoramic radiographs from the database and also to synthesize the current evidence of literature on SP and anatomical...
Αλέξανδρος Γ. Σφακιανάκης
14m
Comparative evaluation of the effect of three polishing agents on staining characteristics of provisional...
Comparative evaluation of the effect of three polishing agents on staining characteristics of provisional restorative material: An in vitro studySeema Sathe, Sneha Karva, Anjali Borle, Mithilesh Dhamande, Tanvi Jaiswal, Sharayu NimonkarJournal of International Society of Preventive and Community Dentistry 2019 9(3):250-255Aim: The present study aimed to evaluate the effect of three various polishing agents on provisional restorative material on immersion in a staining solutions. Objectives: The objective...
Αλέξανδρος Γ. Σφακιανάκης
14m
The densitometric analysis of protein pattern in cleft lip and palate patients Regina Purnama Dewi...
The densitometric analysis of protein pattern in cleft lip and palate patientsRegina Purnama Dewi Iskandar, Annise Proboningrat, Amaq Fadholly, Ida Bagus Narmada, Chairul Anwar Nidom, Sri Agus SudjarwoJournal of International Society of Preventive and Community Dentistry 2019 9(3):240-244Objectives: Cleft lip and palate (CLP) belongs to the congenital anomaly that is clinically seen as cleft in lip, alveolar bone, palate, and nasal septum. The patients suffer from esthetic and various functional...
Αλέξανδρος Γ. Σφακιανάκης
15m
Preventive and Community Dentistry
Efficacy of resin infiltrate in noncavitated proximal carious lesions: A systematic review and meta-analysisAfra Hassan Elrashid, Basmah Sulaiman Alshaiji, Sara Abdulwahab Saleh, Khadijah Ahmed Zada, Mohammad Abdul BaseerJournal of International Society of Preventive and Community Dentistry 2019 9(3):211-218Objectives: Resin infiltration is a minimally invasive technique for treating noncavitated proximal caries. It slows/stops the carious lesion progression rate by creating a diffusion barrier inside...
Αλέξανδρος Γ. Σφακιανάκης
15m
Efficacy of resin infiltrate in noncavitated proximal carious lesions: A systematic review and meta-analysis...
Efficacy of resin infiltrate in noncavitated proximal carious lesions: A systematic review and meta-analysisAfra Hassan Elrashid, Basmah Sulaiman Alshaiji, Sara Abdulwahab Saleh, Khadijah Ahmed Zada, Mohammad Abdul BaseerJournal of International Society of Preventive and Community Dentistry 2019 9(3):211-218Objectives: Resin infiltration is a minimally invasive technique for treating noncavitated proximal caries. It slows/stops the carious lesion progression rate by creating a diffusion barrier inside...
Αλέξανδρος Γ. Σφακιανάκης
15m
Coronectomy: reoperation rates, New global warming model highlights strong impact of social learning, I, you,..
...
Αλέξανδρος Γ. Σφακιανάκης
1h

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480

Dermatology, Venereology, Leprology

Research ethics in the modern era
Sayanta Thakur, Sandeep Lahiry

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(4):351-354



A double-blind, randomized controlled trial to compare the effectiveness and safety of purified protein derivative of tuberculin antigen with Mycobacterium w vaccine in the treatment of multiple viral warts
Somodyuti Chandra, Amrita Sil, Adrija Datta, Santasmita Pal, Nilay Kanti Das

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(4):355-366

Background: Present day therapeutic modalities for viral warts are mostly ablative in nature, limited by high recurrence rates and are unsuitable for numerous lesions. Immunotherapy has the potential to overcome these limitations. Aims: This study aimed at comparing efficacy and safety of and quality of life changes with intradermal purified protein derivative (PPD) of tuberculin antigen and Mycobacterium w (Mw) vaccine in immunotherapy of warts. Methods: Patients with multiple (≥5) warts were randomized (1:1) into two groups (PPDand, Mw vaccine groups). Fortnightly, 0.1 ml of either medicine was injected intradermally over the deltoidregion till complete resolution or a maximum of six doses. Patients were followed-up for another 3 months for recurrence. Results: Sixty-four participants received either PPD or Mw vaccine. The number of warts were comparable at baseline (P = 0.089, Mann–Whitney test), and reduced significantly with treatment in both groups (P < 0.001, Friedman's ANOVA), as seen from the fourth follow-up onwards with Mw and fifth follow-up onwards with PPD (P < 0.05, Post hoc Dunn's test). Intergroup comparison showed significantly more (P < 0.05, Mann–Whitney test) reduction with Mw than PPD at the sixth and seventh follow-up. The size of warts also reduced significantly (P < 0.001) in both groups from the third follow-up onwards. Complete remission was more (P = 0.539, Fischer's exact test) in the Mw group (68.8%) than the PPD group (50%); and was significantly higher (P = 0.049, Mann–Whitney test) in patients having shorter duration of warts. Adverse events were significantly more (P < 0.001) with Mw including ulceration (50%), discharge (15.6%), pain-swelling-induration and scar at the injection site (97% each), whereas some of those receiving PPD noted erythema and scaling at the injection site (18.8%), and post-inflammatory hyperpigmentation (12.5%). No recurrence was seen till the end of the study. Limitation: Unicentric trial. Conclusion: Intradermal injection of Mw vaccine was more effective but had a higher incidence of adverse effects compared to PPD of tuberculin antigen in patients with warts. 


Histopathological comparison of lesional and perilesional skin in melasma: A cross-sectional analysis
Manjyot Gautam, Sharmila Patil, Nitin Nadkarni, Manjit Sandhu, Kiran Godse, Maninder Setia

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(4):367-373

Background: Melasma is a common acquired hyperpigmentary disorder of the sun exposed skin, especially the face. The pathogenesis is unclear but interplay between genetic factors, hormones and ultraviolet radiation is important. We have evaluated the histological characteristics of melasma and compared the findings with adjacent normal skin. Methods: Skin biopsies were taken from both melasma and the surrounding perilesional normal skin in 50 Indian women. The sections were stained with hematoxylin and eosin, Fontana–Masson and Verhoeff–Van Gieson stains. Results: Biopsy from melasma showed significant epidermal atrophy, basal cell hyperpigmentation and solar elastosis when compared with the perilesional skin. We found that the proportion of pendulous melanocytes was significantly higher in the lesional biopsy compared with the perilesional biopsy (76% vs 42%, P < 0.001). Similarly, pigmentary incontinence and features of solar elastosis were significantly higher in the lesional skin compared with the perilesional skin. Conclusion: The characteristic histopathological features such as epidermal atrophy, basal cell hyperpigmentation and solar elastosis suggest the role of chronic sun exposure in the pathogenesis of melasma. Presence of pendulous melanocytes is a characteristic feature of melasma. The presence of pendulous melanocytes may have prognostic implications in melasma. 


New insights into leukotrichia in nonsegmental vitiligo: A cross-sectional study
Rania M Mogawer, Maha Fathy Elmasry, Wedad Z Mostafa

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(4):374-379

Background: Leukotrichia has been considered a predictor of poor outcome in vitiligo. However, studies considering the different clinical aspects of leukotrichia in vitiligo patients are few. Aim: Our aim was to conduct a detailed clinical study to provide insights into the relevance and associations of leukotrichia in non-segmental vitiligo. Methods: In this cross-sectional study, vitiligo patients attending the dermatology outpatient clinic and phototherapy unit at Cairo University Hospital over a period of 6 months (April–September 2016) were included. Family history, clinical details, the Vitiligo Global Issues Consensus Conference classification, the Dermatology Life Quality Index, Vitiligo Area and Severity Index, Vitiligo Extent Score, Vitiligo Disease Activity Score and Vellus Score were determined and these measurements were correlated to leukotrichia. Results: Out of the 101 patients studied, leukotrichia was found in 47 (46.5%) patients, with vellus hair involved in 37 (78.7%), terminal hairs in 30 (63.8%) and both in 20 (42.5%) patients. Vellus hair involvement was significantly higher in generalized bilaterally symmetrical vitiligo than in acrofacial or unclassified vitiligo. The incidence of scalp leukotrichia also was higher in generalized symmetrical vitiligo than in acrofacial vitiligo. The Vellus Score showed significant associations with Vitiligo Area and Severity Index, Vitiligo Extent Score and the Dermatology Life Quality Index. Limitations: This was a short-term study with a small sample size. Prognostic and therapeutic correlations were not studied; prospective longitudinal studies are needed for further evaluation. Conclusion: Leukotrichia was found in almost half of the studied sample and its frequency varied among the different types of vitiligo. 


Do primary care physicians require training in core clinical dermatology? A cross sectional needs assessment study from Western India
Sejal H Thakkar, Paragkumar D Chavda, Kedar G Mehta

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(4):380-387

Background: Primary care physicians play a crucial role in managing patients with common skin disorders who form around one-third of outpatient attendees. Aim: This study aimed to assess the need for dermatology training among primary care physicians by assessing their knowledge, self-perception of ability to diagnose and manage skin disorders, and their difficulties in managing these patients. Methods: A descriptive, cross-sectional, needs assessment study was done among primary care physicians (n = 61) of rural (n = 34) and urban (n = 27) areas of Vadodara district. A pre-validated semi-structured questionnaire (for self-rating of the ability to diagnose/manage skin disorders and difficulties faced in managing patients) was used along with a photo-quiz (for knowledge assessment) while approaching primary care physicians during their monthly review meeting with prior permission. Data were analyzed by Epi InfoTM software and manual content analysis. Results: The mean score on the photo-quiz was 4.1/10. Forty-three (70.5%) participants rated their ability to diagnose/manage skin disorders as 'average' on a five-point Likert scale. Various difficulties (n = 89) narrated by participants were related to their knowledge/skill, disease factors, patients and administrative aspects. Three-fourths of the participants managed difficulties by referring patients to dermatologists. One-third suggested conducting training in common skin disorders. Limitations: The study population included primary care physicians from the government healthcare setup only. Knowledge assessment was done using a short ten-item photo-quiz instead of actual patients. Conclusions: Primary care physicians had poor knowledge of skin disorders, and a majority overrated their own ability for clinical management of these disorders. Most common difficulties faced were related to clinical management. There is a need for training on common skin disorders. 


In vitro susceptibility of dermatophytes to oral antifungal drugs and amphotericin B in Uttar Pradesh, India
Satyendra Kumar Singh, Dheeraj Kumar Patwa, Ragini Tilak, Arghya Das, Tej Bali Singh

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(4):388-392

Background: Dermatophytosis is a major public health problem in our country. Although resistance to conventional oral and topical antifungal agents is being increasingly encountered, the sensitivity pattern of dermatophytes has not been systematically analysed. Aims: We aimed to determine the sensitivity pattern of dermatophyte isolates to amphotericin B and six oral antifungal drugs. Materials and Methods: Patients with dermatophytosis attending the outpatient department of dermatology were enrolled in the study. Samples were collected for mycological examination and in vitro antifungal sensitivity testing was done by broth microdilution as per the Clinical and Laboratory Standard Institute M38-A standards. Results: A total of 804 patients were enrolled. Specimens from 185 patients (23%) were both KOH and culture positive, and 44 of these isolates (41 Trichophyton mentagrophytes and 3 Trichophyton rubrum) were subjected to sensitivity testing. Minimum inhibitory concentrations (MIC) of itraconazole, ketoconazole, voriconazole and amphotericin B were comparable. The median MIC to fluconazole was higher than the other tested drugs. Dermatophytes were most susceptible to ketoconazole and voriconazole, followed by itraconazole, amphotericin B, fluconazole and griseofulvin. A high incidence of resistance was found to terbinafine and the difference was statistically significant in comparison to fluconazole, itraconazole, voriconazole, ketoconazole (P = 0.001) and griseofulvin (P = 0.003). The strains were more sensitive to amphotericin B as compared to griseofulvin (P = 0.02) and terbinafine (P < 0.001). Limitations: This was a hospital-based study and may not reflect the true pattern in the community. Only a few of the isolates were selected for study. The clinical response of patients, whose isolates were studied for in vitro sensitivity of the antifungals, was not studied. Conclusions: The sensitivity pattern of dermatophytes to various antifungals including amphotericin B, ketoconazole, voriconazole and itraconazole were determined. The studied isolates were least susceptible to terbinafine. 


Multiple adenoid basal cell carcinoma: An uncommon presentation
Ajit Agarwal, Anand Raja, Sivakumar Mahalingam, Kanchan Murhekar

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(4):393-396

Basal cell carcinoma (BCC) is the most common malignant skin tumor which occurs more frequently over the sun exposed parts of body. Its adenoid variant is a rare histological subtype. We report a case of multiple adenoid basal cell carcinomas at unusual sites in a middle-aged male patient. 


Evaluation of efficacy and safety of intralesional bleomycin in the treatment of common warts: Results of a pilot study
Karan Inder Singh Mehta, Vikram K Mahajan, Pushpinder Singh Chauhan, Shailja Chauhan, Vikas Sharma, Ritu Rawat

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(4):397-404

Background: This study evaluated the efficacy and safety of intralesional bleomycin in the treatment of common warts in 50 (32 men, 18 women) patients aged between 14 and 80 (mean ± SD, 28.5 ± 13.27) years. Methods: The warts were present over dorsal hands, feet, palms, soles and periungual skin for 1 month to 10 years. They were infiltrated with bleomycin (1 mg/ml) till blanching. The total cumulative dose did not exceed 2 mg in one session. The treatment was repeated after paring of eschar at 2 weeks in case there was no or partial response. The patients were reviewed at 4, 12 and 24 weeks for cure, adverse effects or recurrences and outcome satisfaction levels. Results: Complete cure without recurrence occurred in 40 (80%) patients and partial response occurred in 7 (14%) patients at the end of the 24-week study period. Three patients did not complete follow-up. No major systemic or local adverse effects other than injection site pain for 2–3 days were noted. All cured patients were very satisfied (Likert scale 5). Conclusion: Intralesional bleomycin appears to be an effective and safe treatment for common warts including palmoplantar and periungual warts. It carries the advantage of low dose, no significant adverse effects and high patient satisfaction. Small number of patients, lack of a control group, comparing different bleomycin concentrations and a short follow-up are a few limitations of this study. Better designed studies are warranted for this useful treatment modality. 


Erythema ab igne
Jaime Company-Quiroga, Sergio Alique-García, Alberto Romero-Maté

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(4):405-406



Persistent perioral papules in a young man
Piyush Kumar, Anupam Das, Rizwana Barkat

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(4):407-409



Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480

Preventive and Community Dentistry

Efficacy of resin infiltrate in noncavitated proximal carious lesions: A systematic review and meta-analysis
Afra Hassan Elrashid, Basmah Sulaiman Alshaiji, Sara Abdulwahab Saleh, Khadijah Ahmed Zada, Mohammad Abdul Baseer

Journal of International Society of Preventive and Community Dentistry 2019 9(3):211-218

Objectives: Resin infiltration is a minimally invasive technique for treating noncavitated proximal caries. It slows/stops the carious lesion progression rate by creating a diffusion barrier inside the porous enamel lesion body. The aim was to evaluate the efficacy of resin infiltration on noncavitated proximal carious lesions in primary and permanent teeth. Materials and Methods: The records were obtained using electronic and other sources. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed to ensure transparent reporting. Eligible studies were randomized controlled trials evaluating the efficacy of resin infiltration for noncavitated proximal carious lesions by comparing it with control/placebo. Each included study was assessed concerning the “risk of bias” using the Cochrane Collaboration's “risk-of-bias” assessment tool. High risk-of-bias studies were excluded from the meta-analyses due to selective reporting matters. The statistics were performed by RevMan software (The Cochrane Collaboration, The Nordic Cochrane Centre, Copenhagen, Denmark) utilizing the random effect model. The GRADE approach was implemented for assessing the quality of evidence. Results: From 106 studies identified, 17 were assessed for eligibility. After “risk-of-bias” assessment, two meta-analyses were conducted to eliminate the limitation of the significant heterogeneity between trials inspecting primary teeth (n = 2) and permanent teeth (n = 3). I2 = 0% indicates the absence of statistical heterogeneity. The risk of carious lesions' progression with resin infiltration was significantly lower in primary (risk ratio [RR]; 95% confidence interval [CI]: 0.48; 0.30–0.75, P = 0.001) and in permanent teeth (RR; 95% CI: 0.19; 0.11–0.33, P < 0.00001) compared to that of control/placebo. The GRADE approach revealed high quality of evidence. Conclusion: The available evidence conveys high confidence that proximal resin infiltration has superior efficacy in slowing/arresting the carious lesions' progression rate in comparison to conventional management modalities. 


HIV-related discrimination among senior dental students in Jeddah
Ehab Alshouibi, Faten Alaqil

Journal of International Society of Preventive and Community Dentistry 2019 9(3):219-224

Aims and Objectives: Advances in the medical management of HIV infection have increased life expectancy and reduced the mortality rate of infected individuals. As a result, dental and medical health-care workers have a higher chance to meet HIV-positive patients in their clinics. People living with HIV and AIDS (PLWHA) are frequently experiencing discrimination. That negative attitude toward HIV remains quite common among health-care professionals. The purpose of this study was to assess students' attitudes toward PLWHA. Materials and Methods: The present study was a cross-sectional survey to assess the attitudes of senior dental students toward HIV/AIDS in Jeddah, Saudi Arabia. Data were collected using an online self-administered questionnaire. Data analysis was done using the statistical package of social sciences. Descriptive statistics including means, standard deviations, frequencies, and percentages were calculated and used to present the data. A binary logistic regression model was constructed to estimate the effect of different predictors on the level of HIV-related discrimination. Results: A total of 400 individuals took part in the study. Bivariate analysis of HIV discrimination in relation to other variables showed that those reluctant to treat HIV patients, the majority (82%) showed a negative tendency toward HIV/AIDS patients, while 75% who were willing to treat them exhibited more positive attitudes, which was statistically significant (P < 0.0001). The discrimination was high, almost 87%, among those who feared accidental exposure to HIV patients; however, 73% of those who did not experience fear, felt nondiscriminative, which was also statistically significant (P < 0.0001). Conclusions: Stigmatizing views toward PLWHA exist among senior dental students in Jeddah. The most significant predictors of discrimination included fear of accidental exposure, reluctance to provide treatment to these patients, and self-protective concerns. 


Effectiveness of an oral health promotion program for the elderly in Khiri Mat district, Sukhothai province: A randomized control trial
Eakpong Keyong, Songchai Thitasomakul, Sukanya Tianviwat

Journal of International Society of Preventive and Community Dentistry 2019 9(3):225-231

Objectives: Oral disease is one of the most common health problems among the elderly, which impacts the quality of life. Applying the Health Belief Model (HBM) in oral health promotion is expected to improve the effectiveness of prevention and promotion that restricts oral health problems. The aim of the present study was to determine the effectiveness of an oral health promotion program on oral health behavior and oral status among the elderly in Khiri Mat, Thailand. Materials and Methods: A prospective randomized control trial was carried out among 162 elderly people for 6 months. They were interviewed to gather oral health behaviors and perception information, followed by an oral health examination. The experimental group received oral health education based on the HBM theory and tooth brushing practice in a small group of 4–5 persons, and then they were remotivated to support behavior change at 1 and 3 months. The control group received traditional oral health activity. All the elderly were followed up at 6 months. Data were analyzed using the t-test, Mann–Whitney test, Chi-square, and logistic regression. Results: The elderly in the experimental group had significantly higher oral health perception, lower plaque scores, lower gingival inflammation, and lower clinical attachment loss than those in the control group (P < 0.05). Conclusion: This oral health promotion program improved oral health perception, behavior, and oral health status of the elderly. 


Oral health status among children with Down syndrome in Dubai, United Arab Emirates
Batool Ghaith, Manal Al Halabi, Amar Hassan Khamis, Mawlood Kowash

Journal of International Society of Preventive and Community Dentistry 2019 9(3):232-239

Objectives: The purpose of this study was to assess the oral health status in Down syndrome (DS) children in Dubai, United Arab Emirates. Materials and Methods: A total of 106 DS children (mean age = 9.3 ± 2.8) and 125 healthy children (mean age = 11.7 ± 4.4) were recruited from both special needs centers and private/public schools in Dubai. A dental examination for decayed-missing-filled teeth (DMFT) in deciduous dentition/DMFT in permanent dentition indices, simplified oral hygiene index, calculus index (CI), were carried out. In addition, occlusal, dentofacial, soft-tissue abnormalities, and erosion were assessed. Statistical analysis was conducted using SPSS for Windows, version 20.0 (SPSS Inc., Chicago, IL, USA). Results: The mean number of DMFT in DS children was significantly higher than that in healthy children. DS children in the primary dentition group had higher restorative index and Met Need Index scores than the control group. On the other hand, CI was found to be significantly higher among children with DS compared to healthy controls (P < 0.004). DS children had a significantly higher proportion of open bite and other occlusal problems. Class III molar angle malocclusion was significantly higher in DS (66%) compared to controls (11.2%). Erosion was significantly higher among DS children compared to healthy control (34% vs. 15.3%). Conclusions: DS children in Dubai had higher caries rate compared to healthy children. DS group received more restorations and dental treatment compared to the control group. More to add, DS children had significantly more calculus, erosion, and malocclusion problems. 


The densitometric analysis of protein pattern in cleft lip and palate patients
Regina Purnama Dewi Iskandar, Annise Proboningrat, Amaq Fadholly, Ida Bagus Narmada, Chairul Anwar Nidom, Sri Agus Sudjarwo

Journal of International Society of Preventive and Community Dentistry 2019 9(3):240-244

Objectives: Cleft lip and palate (CLP) belongs to the congenital anomaly that is clinically seen as cleft in lip, alveolar bone, palate, and nasal septum. The patients suffer from esthetic and various functional defects. CLP is resulted from impaired palatogenesis during the embryonic phase. The etiology of CLP is influenced by genetic, environmental, and combination of both. According to the literature, CLP is highly associated with defect in interferon regulatory factor 6 (IRF6) and poliovirus receptor-like (PVRL1) genes. The present study aimed to investigate the total protein profile and to identify protein IRF6 and PVRL1 in plasma of CLP patients. Materials and Methods: Dot-Blot analysis was performed to identify protein target of IRF6 and PVRL1. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis was performed in gel concentration 12% using plasma of CLP patients, their parents, and control population. The gels were stained by Coomassie blue afterward. Gels were analyzed through ImageLab 5.2.1 software. Results: The intensity of major bands in CLP patients was darker than control group, but remains similar to the parents group. The target protein IRF6 and PVRL1 were positively identified through Dot-Blot. Retardation factor value was significantly different in major bands of CLP patients compared to control group. Conclusion: There pattern of protein profile in CLP patients was different compared to non-CLP. 


Shaping ability of 2Shape and WaveOne Gold files using cone-beam computed tomography
Shalini Singh, Nitin Mirdha, PH Shilpa, Rahul V. C. Tiwari, Muqthadir Siddiqui Mohammad Abdul, Shan Sainudeen

Journal of International Society of Preventive and Community Dentistry 2019 9(3):245-249

Aim and Objective: The aim of this study is to evaluate the apical transportation, centering ability, and volume of removed dentin of WaveOne Gold (WOG) and 2Shape with the use of cone-beam computed tomography. Materials and Methods: Freshly extracted mandibular teeth with sample size of thirty were carefully chosen and instrumented using the 2Shape and WOG rotary files. Preoperative and postinstrumentation cone-beam computed tomographic scans were done to accomplish mesial and distal dentin walls' measurements and volume of removed dentin calculations, apical transportation, and centering ratio. Statistical analysis was performed and confirmed by independent t-test. Statistical significance was set at 5%. Results: When shaping ability of 2Shape and WOG was evaluated, it was reported that there was no statistically significant differences noted among the groups in relation to the total volume of removed dentin, apical transportation, and centering ratio. Conclusion: It can be concluded that 2Shape and WOG preserved the original canal anatomy well and did not eliminate excess dentin during shaping and cleaning. Rotary nickel–titanium files which work on the principle of rotary movement attained an outcome analogous to that of the rotary files working on reciprocating motion in relation to alteration in angle. 


"Comparative evaluation of the effect of three polishing agents on staining characteristics of provisional restorative material:" An in vitro study
Seema Sathe, Sneha Karva, Anjali Borle, Mithilesh Dhamande, Tanvi Jaiswal, Sharayu Nimonkar

Journal of International Society of Preventive and Community Dentistry 2019 9(3):250-255

Aim: The present study aimed to evaluate the effect of three various polishing agents on provisional restorative material on immersion in a staining solutions. Objectives: The objective of the study is (1) To evaluate the effect of pumice on staining characteristics of provisional restorative material before and after immersion in chlorhexidine. (2) To evaluate the effect of aluminum oxide paste on staining characteristics of provisional restorative material before and after immersion in chlorhexidine. (3) To evaluate the effect of diamond paste on staining characteristics of provisional restorative material before and after immersion in chlorhexidine. (4) To compare and assess the outcome of three polishing agents on staining characteristics of provisional restorative material. Materials and Methods: Sixty samples (10 mm × 2 mm) were fabricated of bis-acryl composites (Protemp™ 4) by utilizing a metal mold. The samples were grouped into three groups (n = 20), and various polishing agents were used, including pumice, aluminum oxide paste, and diamond polishing paste. The samples that were not exposed to any polishing agent served as the control group. The samples were kept in a water bath for a day at 37°C and were stained with chlorhexidine mouthwash. The color of all specimens was measured with a spectrophotometer before and after polishing, and color changes (ΔE) were calculated. Results: By using one-way ANOVA, significant difference was found in mean color change in three polishing materials (F = 4.44, P = 0.016). By using Tukey test, statistically significant difference was found among pumice and aluminum oxide paste (P = 0.027), among pumice and diamond paste (P = 0.041) and no significant difference was found among aluminum oxide paste and diamond paste (P = 0.985). Conclusion: Pumice exhibited less staining which was statistically significant when compared with aluminum oxide paste and diamond paste. Hence, it can be considered the most efficient polishing agent. 


Evaluation of styloid process and its anatomical variations: A digital panoramic study with systematic review
Koduri Sridevi, N Mahesh, B Krishnaveni, A D N Deepika, V Thejasri, B H David Leninson

Journal of International Society of Preventive and Community Dentistry 2019 9(3):256-262

Aims and Objectives: To evaluate the styloid process (SP) and its anatomical variations on digital panoramic radiographs from the database and also to synthesize the current evidence of literature on SP and anatomical variations along with the systematic review of the relevant studies after making the necessary exclusions. Materials and Methods: A total of 500 panoramic radiographs from the database were examined and evaluated for the length of SP using OmniVue software and for the calcification patterns which were categorized into three types as described by Langlais. The obtained values were analyzed using t-test and Chi-square tests with a significance level of 0.005 and SPSS version 20.0 software. Results and Conclusion: The mean length of the SP in females was found to be 3.7 cm on the right side and 3.8 cm on the left side. The mean length of the SP in males was found to be 3.4 cm on the right side and 3.3 cm on the left side with significant difference between the genders with the P values of 0.0002 and 0.0001, respectively. The length of the SP was significantly longer in females than in males. Type I was the most common SP and was more prevalent in females. The results of the present study along with the wide range of reported incidence of anatomical variations in the form of elongation from the literature extracted through the systematic review suggests the need to reevaluate the range of the normal length of the SP. 


An in vivo study to compare anti microbial activity of triantibiotic paste, 2% chlorhexidine gel, and calcium hydroxide on microorganisms in the root canal of immature teeth
Sumit Sabharwal, Shresth Kumar Bhagat, Kumar Shresth Gami, Abhishek Siddhartha, Kulwant Rai, Yuvika Ahluwalia

Journal of International Society of Preventive and Community Dentistry 2019 9(3):263-268

Aims and Objectives: Intracanal medication plays an important role in disinfecting the root canal from various microorganisms. There are various intracanal medication frequently used by practitioners based on the efficacy of the same, therefore to compare antimicrobial activity of a triple antibiotic paste with chlorhexidine gel and calcium hydroxide against microorganisms in the root canal used as irrigating solution. Materials and Methods: The present study was conducted on 88 single rooted (central and lateral incisors), asymptomatic, nonvital, and necrotic teeth. Individuals included were between the ages of 12–15 years with no systemic complications. Overall, 88 teeth were divided randomly into four groups on the basis of treatment they were given, with each group having 22 teeth. Each group was assigned to one intervention group namely 2% chlorhexidine gel group, calcium hydroxide group, triantibiotic paste group, and the normal saline group. Triantibiotic paste was prepared from ciprofloxacin Hydrochloride 500 mg+ Metronidazole 400 mg+ Tetracycline 500 mg. Two samples were collected from individual tooth to assess the change in the extent of total colony forming units. Results: Mean log10 bacterial count among the triantibiotic paste was 5.222 preirrigation which was decreased to 0.653. Maximum percentage of log10 bacterial count was decreased among triantibiotic paste group of 87.20% while control group of normal saline has recorded a decrease of 54.65% in bacterial count. Among all the four groups, there was a decrease of 73.51% of bacterial count. Conclusion: From the above results, it was concluded that triantibiotic paste demonstrated the highest efficacy against bacterial pathogen when used as irrigating solution. 


Awareness of specialties of dentistry among medical trainees and teaching faculty of medical college in the central West India
Arun P Nagrik, Bhawana A Bhagat, Sushil B Yemle, Sainath Maidapwad

Journal of International Society of Preventive and Community Dentistry 2019 9(3):269-274

Objective: The purpose of this study was, to assess and create awareness of specialties of dentistry among medical trainees and teaching faculty. Materials and Methods: Printed and validated questionnaires were given personally to a total sample of 180 patients, including 60 interns, 40 postgraduate (PG) trainees and 80 teaching staff of Government Medical College. Their responses were collected and the results were tabulated using Micro-Soft Excel 2010. Data obtained was analyzed using the GraphPad Prism 7 statistical software. To compare the responses between the study groups a Pearson's Chi-square test was used. Results: About 96.11% of the sample replied that they are not aware of the different specialties of dentistry and 89.44% of the sample refers their patients to the general dentist without knowing the specialty. About 70% of the interns marked orthodontics as a specialty dealing with fractures of the jaw, whereas 82.5% of the PGs and 95% of the faculty advised referral of the fracture mandible case to the Oral and Maxillofacial Surgeon. Percentage of correct response for interns, PGS and staff, was 53.33%, 78.75%, and 92.34%, respectively (P ≤ 0.05). Conclusion: A large number of interns are not aware of the differences among the branches in Dentistry, specifically between orthodontics, oral-maxillofacial surgery, community dentistry, and Pedodontics. Many medical doctors have misbelief that all of their dental-related issues can be solved by the general dental practitioner. It is the present need to spread the awareness among the medical trainees and doctors about different subspecialties of dentistry to ensure proper referral practices of the dental patients they come across. 


Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480

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