-
Indian Journal of Public Health Oct 2023The Saharia tribe of Madhya Pradesh has a very high tuberculosis (TB) burden. However, there is no report of adverse drug reaction (ADR) available in patients receiving... (Observational Study)
Observational Study
Adverse Drug Reaction Patterns of First-line Anti-tubercular Drugs among Saharia Tuberculosis Patients: An Observational Study in Particularly Vulnerable Tribal Group of Madhya Pradesh, India.
The Saharia tribe of Madhya Pradesh has a very high tuberculosis (TB) burden. However, there is no report of adverse drug reaction (ADR) available in patients receiving anti-TB chemotherapy in the community. Reporting and monitoring of ADRs among TB patients is still rare in marginalized communities. An observational prospective study was performed from November 2019 to June 2020 to assess the patterns of ADRs in 250 Saharia TB patients, who were prescribed Category-I daily DOTS (HRZE) by the physician. Both male and female participants equally experienced ADR during the treatment, but relatively more females (92.6%) than males (88.6%) reported ADR during Phase I. Out of 250 patients, 224 patients (89.6%) experienced one or more ADRs in Phase I. The central nervous system-related (75.6%) ADR was mostly reported followed by any gastrointestinal (74.4%), cardiovascular (49.2%) and any dermatological related (44.4%) ADRs. It is paramount to timely monitor and proactively manages ADRs pertaining to anti-TB drug treatment with minimal alteration in the treatment course.
Topics: Humans; India; Male; Female; Antitubercular Agents; Adult; Prospective Studies; Middle Aged; Tuberculosis; Drug-Related Side Effects and Adverse Reactions; Adolescent; Young Adult; Directly Observed Therapy; Aged
PubMed: 38934815
DOI: 10.4103/ijph.ijph_865_22 -
Indian Journal of Dental Research :... Jan 2024Effective plaque control is essential for improved oral health. Advancements in mechanical plaque removal using toothbrushes still continue. One such sophisticated... (Randomized Controlled Trial)
Randomized Controlled Trial Comparative Study
BACKGROUND
Effective plaque control is essential for improved oral health. Advancements in mechanical plaque removal using toothbrushes still continue. One such sophisticated intervention is the app-based toothbrush, a new innovative technology that helps to track the child's brushing habits.
AIM
The aim of this study is to evaluate the plaque removal efficacy of three different toothbrushes in children aged 6-8 years.
METHODS
A randomized controlled clinical trial was conducted among primary school children with decayed missing filled teeth (dmft) score of ≤2. Baseline plaque score was collected using Turesky modification of the Quigley and Hein Index 1 week after oral prophylaxis. Children were randomly divided into three groups. Group I received conventional toothbrush (n = 25), group II received powered toothbrush (n = 25), and group III received app-based toothbrush (n = 25). Post-intervention plaque score, toothbrush wear and bite mark scores were done at the 15th, 30th, 45th and 90th day. Participant's opinion on their toothbrushes was evaluated using a questionnaire.
RESULTS AND CONCLUSION
App-based toothbrush showed maximum plaque reduction followed by powered and conventional toothbrush. Significant reduction in plaque score was seen at 30th-, 45th- and 90th-day follow-up in group II (<0.001) and group III (<0.001). There was no appreciable difference in the toothbrush wear and bite mark score between the three groups. Children preferred app-based toothbrush in spite of the complex nature of using it.
Topics: Humans; Toothbrushing; Child; Dental Plaque; Female; Male; Dental Plaque Index; Equipment Design
PubMed: 38934752
DOI: 10.4103/ijdr.ijdr_375_23 -
Indian Journal of Dental Research :... Jan 2024Measurement of dental caries is imperative for its prevention and control. The present study was conducted with the aim of developing a dental caries index that is...
INTRODUCTION
Measurement of dental caries is imperative for its prevention and control. The present study was conducted with the aim of developing a dental caries index that is reliable, reversible, and valid. A cross-sectional study was designed and conducted at the outreach dental clinics of a dental school in India.
METHODS AND MATERIAL
A total of 219 patients visiting outreach centres participated in the study. Patients attending outreach dental clinics aged 15 years and above, who were dentate and affected by dental caries, were included. Clinical examination was done under clinical conditions with dental chair lighting. Decayed Missing and Filled Teeth (DMFT) and Index of Caries Experience (ICE) were recorded using the visuo-tactile method according to the index criteria.
RESULTS
The relationship between the DMFT and ICE was determined. Results showed that the DMFT from ICE had good correlation. The decayed teeth index (DTI) score varied from decayed teeth (DT) according to age and sex. DTI was significantly higher for females than for males and higher among younger age groups than older ones, but DT did not exhibit the differences.
CONCLUSIONS
ICE is a new system in which the proviso is to measure the non-cavitated lesions and health of permanent dentition. DMFT and ICE have good correlation. DTI is more sensitive than the DT score.
Topics: Humans; Dental Caries; Female; Male; Cross-Sectional Studies; Adult; Adolescent; DMF Index; Young Adult; Middle Aged; India; Age Factors; Sex Factors; Aged
PubMed: 38934749
DOI: 10.4103/ijdr.ijdr_492_22 -
Indian Journal of Dental Research :... Jan 2024This study aimed to predict oral health behaviour (OHB) using the theory of planned behaviour (TPB) and determine its influence on oral health status and oral...
OBJECTIVES
This study aimed to predict oral health behaviour (OHB) using the theory of planned behaviour (TPB) and determine its influence on oral health status and oral health-related quality of life (OHRQoL) among subjects attending the outpatient department of a tertiary dental hospital in India.
METHODS
A pre-validated questionnaire was used among 240 randomly selected study subjects to record their demographic details, attitudes (Att), subjective norms (SN) and perceived behaviour control (PBC) with regard to dietary habits (DH), oral hygiene habits (OH) and dental attendance (DA) behaviours. OHRQoL and oral health status of study participants were recorded using Oral Health Impact Profile-14 (OHIP-14) and World Health Organization (WHO) Oral Health Assessment Form (2013), respectively. Multivariate analysis was performed after the necessary bivariate comparisons.
RESULTS
Among demographic characteristics, the Socioeconomic status (SES) of the study subjects highly influenced their DH and OH (P < 0.05). DA was largely affected by the age of the study subjects (P < 0.05). While attitude of the study participants greatly affected their DH, PBC largely influenced their OH and DA behaviours (P < 0.05). The OHRQoL and Decayed Missing Filled Teeth (DMFT) levels were strongly influenced by the participants' DA behaviours (P < 0.05).
CONCLUSIONS
DMFT scores and OHRQoL were highly influenced by DA behaviour besides others. DA instead was influenced by PBC. Hence, there needs to be a conscious shift towards strengthening the skills of the population to promote oral health.
Topics: Humans; Quality of Life; Oral Health; Cross-Sectional Studies; Female; Male; Adult; Health Behavior; India; Middle Aged; Outpatients; Surveys and Questionnaires; Oral Hygiene; Young Adult; Health Status; Adolescent
PubMed: 38934746
DOI: 10.4103/ijdr.ijdr_684_22 -
Indian Journal of Dental Research :... Jan 2024Periodontitis and type 2 diabetes are chronic inflammatory diseases that increase inflammatory Interleukin-6 (IL-6) levels that induce the production of advanced...
BACKGROUND
Periodontitis and type 2 diabetes are chronic inflammatory diseases that increase inflammatory Interleukin-6 (IL-6) levels that induce the production of advanced glycation end products (AGEs) causing receptor activator of nuclear factor-kappa B ligand (RANKL) expression on osteoclasts, contributing to further alveolar bone destruction.
AIM
To assess the role and diagnostic potential of salivary IL-6 (SIL-6) in the detection and evaluation of chronic periodontitis (CP) and tooth loss in type 2 diabetes mellitus (T2DM).
MATERIALS AND METHODS
This cross-sectional study comprised 240 subjects aged 30-69 years with minimum of 15 natural teeth. Fasting, unstimulated whole saliva was collected, full-mouth intra-oral examination and periodontal evaluation were performed using PCP-UNC 15 probe and glycaemic (HbA1c) levels were analysed by high-performance liquid chromatography (HPLC) method. Subjects were categorised into four groups of 60 participants each: Group 1 (controls); Group 2 (CP); Group 3 (T2DM with CP); Group 4 (T2DM with CP and tooth loss). Salivary IL-6 levels were quantitatively assessed by enzyme-linked immune sorbent assay method.
RESULTS
Average SIL-6 levels were significantly elevated in Group 4 (T2DM with CP and tooth loss) (P = 0.001) and in severe periodontitis (P = 0.001). Karl Pearson Correlation found a significant association between average SIL-6 and average periodontal pocket depth (APPD) (r = 0.180), average clinical attachment loss ≥3 mm (ACAL3) (r = 0.289) and severity of periodontitis (r = 0.3228). The receiver operating characteristic (ROC) curve depicted an overall sensitivity of 53.3%, specificity of 68.6% and accuracy of 60% in the detection and assessment of CP in T2DM with tooth loss.
CONCLUSION
IL-6 in saliva is a valuable, non-invasive biomarker in the detection and evaluation of CP in T2DM with tooth loss.
Topics: Humans; Chronic Periodontitis; Middle Aged; Interleukin-6; Saliva; Biomarkers; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Female; Tooth Loss; Adult; Male; Aged
PubMed: 38934745
DOI: 10.4103/ijdr.ijdr_112_23 -
Indian Journal of Dental Research :... Jan 2024Expanding knowledge on tobacco use and quitting outcomes in Chhattisgarh, India, is crucial. Limited data hinder the assessment of tobacco use prevalence and quitting...
INTRODUCTION
Expanding knowledge on tobacco use and quitting outcomes in Chhattisgarh, India, is crucial. Limited data hinder the assessment of tobacco use prevalence and quitting outcomes in the region. This household-based cross-sectional study aimed to assess smokeless tobacco (SLT) use and quit behaviour among village dwellers aged 35-44 and 65-74 years in Jamul, Chhattisgarh.
MATERIALS AND METHODS
A survey was conducted among 450 participants, utilising a pretested questionnaire and data analysis using IBM Statistical Package for the Social Sciences (SPSS) v23.
RESULTS
The study revealed that among the survey participants, 61.1% were males and 38.9% were females. The prevalence of SLT use was found to be 67.8%, with 59.1% of current SLT users reporting daily use. Middle-aged individuals predominantly chose gutkha, while khaini was more common among the elderly. Tobacco and paan with tobacco were also commonly used forms. Gudakhu, a popular SLT product for oral hygiene and easy defecation, was reported by 71.34% of participants. Television warnings and SLT packages proved to be successful methods for disseminating information about the dangers of SLT use. However, SLT users who attempted to quit independently reported encountering one or more withdrawal symptoms, which posed significant obstacles to quitting SLT.
CONCLUSION
Community-based awareness programmes are implemented via regional television (TV) channels, coupled with cessation initiatives, including professional counselling, pharmaceutical interventions and support of peer. Changing attitudes against SLT use and promoting tobacco-free environments are prioritized. These strategies will effectively address SLT use and improve quitting outcomes in Jamul, Chhattisgarh, fostering a healthier community.
Topics: Humans; Tobacco, Smokeless; Female; Male; India; Adult; Cross-Sectional Studies; Middle Aged; Aged; Rural Population; Tobacco Use Cessation; Tobacco Use; Surveys and Questionnaires; Prevalence
PubMed: 38934741
DOI: 10.4103/ijdr.ijdr_596_23 -
Hepatology Communications Jul 2024MASH is a common clinical disease that can lead to advanced liver conditions, but no approved pharmacotherapies are available due to an incomplete understanding of its...
BACKGROUND
MASH is a common clinical disease that can lead to advanced liver conditions, but no approved pharmacotherapies are available due to an incomplete understanding of its pathogenesis. Damaged DNA binding protein 1 (DDB1) participates in lipid metabolism. Nevertheless, the function of DDB1 in MASH is unclear.
METHODS
Clinical liver samples were obtained from patients with MASH and control individuals by liver biopsy. Hepatocyte-specific Ddb1-knockout mice and liver Hmgb1 knockdown mice were fed with a methionine-and choline-deficient diet to induce MASH.
RESULTS
We found that the expression of DDB1 in the liver was significantly decreased in MASH models. Hepatocyte-specific ablation of DDB1 markedly alleviated methionine-and choline-deficient diet-induced liver steatosis but unexpectedly exacerbated inflammation and fibrosis. Mechanistically, DDB1 deficiency attenuated hepatic steatosis by downregulating the expression of lipid synthesis and uptake genes. We identified high-mobility group box 1 as a key candidate target for DDB1-mediated liver injury. DDB1 deficiency upregulated the expression and extracellular release of high-mobility group box 1, which further increased macrophage infiltration and activated HSCs, ultimately leading to the exacerbation of liver inflammation and fibrosis.
CONCLUSIONS
These data demonstrate the independent regulation of hepatic steatosis and injury in MASH. These findings have considerable clinical implications for the development of therapeutic strategies for MASH.
Topics: Animals; Mice; Hepatocytes; Liver Cirrhosis; Mice, Knockout; DNA-Binding Proteins; Humans; HMGB1 Protein; Fatty Liver; Male; Choline Deficiency; Disease Models, Animal; Methionine; Liver; Lipid Metabolism
PubMed: 38934719
DOI: 10.1097/HC9.0000000000000474 -
Hepatology Communications Jul 2024Sodium and water retention is a mainstay of the pathophysiology leading to ascites formation in patients with advanced cirrhosis. Refractory ascites denotes the most... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Sodium and water retention is a mainstay of the pathophysiology leading to ascites formation in patients with advanced cirrhosis. Refractory ascites denotes the most severe ascites status with limited treatment options and a poor prognosis. We investigated the efficacy and safety of the natriuretic peptide ularitide in patients with refractory cirrhotic ascites.
METHODS
We conducted a randomized placebo-controlled trial investigating ularitide to manage refractory ascites. Until trial termination after interim analyses, we randomized 17 participants in a 2:1 ratio between ularitide (n=11) and placebo (n=6). While hospitalized, the participants received treatment for up to 48 hours. The primary efficacy endpoint was a change in renal water excretion, and secondary end points included changes in renal sodium excretion rate and body weight. The starting dose was 30 ng/kg/min, though later reduced to 20 for safety reasons.
RESULTS
In contrast to the study hypothesis, the mean urine production decreased after 24 hours of ularitide treatment compared with the baseline level (22.8 vs. 47.5 mL/h, p=0.04) and decreased more in participants randomized to ularitide than placebo (24.7 vs. -6.2 mL/h, p=0.05). Ularitide did not increase the renal sodium excretion rate or reduce the weight gain. The incidence rate ratio of adverse reactions in ularitide versus placebo was 8.5 (95% CI: 2-35, p=0.003). Participants treated with ularitide developed serious blood pressure reductions, impacting their renal responsiveness.
CONCLUSIONS
Ularitide in doses of 20-30 ng/kg/min did not benefit urine production and renal sodium excretion rate in patients with refractory ascites. The participants randomized to ularitide overall developed more adverse reactions than placebo. EudraCT no. 2019-002268-28.
Topics: Humans; Male; Ascites; Liver Cirrhosis; Female; Middle Aged; Treatment Outcome; Double-Blind Method; Aged; Adult; Sodium
PubMed: 38934679
DOI: 10.1097/HC9.0000000000000481 -
Acta Odontologica Scandinavica Jun 2024The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) is part of the undergraduate dental curriculum. Online teaching has nowadays become common also in...
INTRODUCTION
The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) is part of the undergraduate dental curriculum. Online teaching has nowadays become common also in dentistry.
OBJECTIVE
To compare undergraduate students' self-assessed ability and satisfaction with learning DC/TMD Axis I between traditional and online learning and to evaluate the possible gains of online teaching.
MATERIAL AND METHODS
Third-year undergraduate dental students in 2018 (traditional learning, Group 1, n = 43/50) and in 2019 (online learning, Group 2, n = 34/50) at the University of Oulu, Finland evaluated their self-assessed ability and satisfaction with learning DC/TMD clinical examination and diagnostics on a 10-point scale. Additionally, those participating in online courses answered to two open-ended questions; Group 2 (n = 50) and another group from the University of Eastern Finland in 2019 and 2020 (n = 75, Group 3). Total of 105/125 students (84%) responded. Content analysis was used to open-ended responses.
RESULTS
The online course reported significantly higher self-assessed ability in measurements (p = 0.004), identifying referred pain (p = 0.043) and statement for the diagnostics (p = 0.017) and also higher self-assessed satisfaction in measurements (p = 0.046). According to the content analysis, essential gains of online teaching were efficient learning, videos and exercises, and adjustability to own timetable.
CONCLUSION
The online learning course can be considered as a good option for traditional learning of the DC/TMD protocol.
Topics: Humans; Temporomandibular Joint Disorders; Education, Dental; Education, Distance; Finland; Male; Female; Curriculum; Surveys and Questionnaires
PubMed: 38934339
DOI: 10.2340/aos.v83.40984 -
Obesity Facts Jun 2024Non-alcoholic fatty liver disease (NAFLD), now termed metabolic dysfunction-associated steatotic liver disease (MASLD), is an escalating health concern linked to obesity...
INTRODUCTION
Non-alcoholic fatty liver disease (NAFLD), now termed metabolic dysfunction-associated steatotic liver disease (MASLD), is an escalating health concern linked to obesity and type 2 diabetes. Despite liver biopsy being the gold standard, its invasiveness underscores the need for non-invasive diagnostic methods.
METHODS
A cross-sectional study was performed to assess MASLD using the non-invasive OWLiver® serum lipidomics test in a cohort of 117 patients with severe obesity undergoing bariatric surgery, comparing outcomes with liver biopsy. Exclusions (n = 24) included insufficient data, liver disease etiology other than MASLD, corticosteroid treatment, excessive alcohol consumption, low glomerular filtration rate and declination to participate. Comprehensive laboratory tests, demographic assessments and liver biopsies were performed. Serum metabolites were analyzed using OWLiver®, a serum lipidomic test that discriminates between healthy liver, steatosis, metabolic dysfunction-associated steatohepatitis (MASH) and MASH with fibrosis ≥2 by means of three algorithms run sequentially.
RESULTS
Liver biopsy revealed a MASLD prevalence of 95.7%, with MASH present in 28.2% of cases. OWLiver® demonstrated a tendency to diagnose more severe cases. Body mass index (BMI), rather than the presence of type 2 diabetes, emerged as the sole independent factor linked to the probability of concordance. Therefore, the all-population concordance of 63.2% between OWLiver® and liver biopsy notably raised to 77.1% in patients with a BMI <40 kg/m². These findings suggest a potential correlation between lower BMI and enhanced concordance between OWLiver® and biopsy.
CONCLUSION
This study yields valuable insights into the concordance between liver biopsy and the non-invasive serum lipidomic test, OWLiver®, in severe obesity. OWLiver® demonstrated a tendency to amplify MASLD severity, with BMI values influencing concordance. Patients with BMI < 40 kg/m² may derive optimal benefits from this non-invasive diagnostic approach.
PubMed: 38934179
DOI: 10.1159/000538765