Relationship of obesity with periodontitis among patients attending a dental college in Chennai: A cross-sectional survey

Introduction: Periodontal disease is a global public health issue, and it has been suggested to be an associated risk factor for obesity. However, the studies addressing these relationships were sparse. Aim: This study aims to determine whether there was a relationship between body mass index (BMI) and periodontal disease. Materials and Methods: This cross-sectional study was carried out on 400 individuals who were randomly selected from the outpatient department of a dental college in Chennai. The community periodontal index (CPI) was used to assess periodontal status. Participants with a CPI score (CPI 0–2) were considered as nonperiodontitis group and those with a CPI score (CPI 3–4) were considered to have periodontitis. Statistical analysis was performed using Chi-square test and logistic regression analysis was used to estimate the association between BMI and periodontitis. P < 0.05 was considered as statistically significant. Results: The prevalence of periodontitis was 29.2% with a mean BMI score of 22.45 ± 05.27. Logistic regression analysis revealed a 30% increased risk for periodontitis per 1-kg/m2 increase in BMI (adjusted odds ratio, 1.30; 95% confidence interval, 1.08–1.27; P < 0.05). Conclusion: Periodontal disease was associated with increased BMI establishing a link between obesity and periodontitis

Relationship between the sense of coherence and quality of life among institutionalized elders in Bengaluru city India: A questionnaire study

Introduction: Aged people living in residential homes have a higher prevalence of depression and stress which cause oral health-related problems, contributing to excessive morbidity, than do those who live in communities. Aim: To find the relationship between senses of coherence (SOC) and quality of life (QoL) using Geriatric Oral Health Assessment Index (GOHAI) among elderly residents of old age homes in Bengaluru city, India. Materials and Methods: A cross-sectional study was conducted among elderly residents of Bengaluru city, India. Data were collected using a validated questionnaire which record demographic details, oral hygiene practices, and oral health habits. SOC and oral health-related QoL was measured using 13-item short version of the SOC scale and 12-item GOHAI scale. Chi-square test and Pearson's correlation coefficient test were used for statistical analysis. All variables showing significant association (P < 0.05) were entered into a regression model to identify predictors of low GOHAI and SOC. Results: A total of 376 elderly residents participated in the study and completed the questionnaire. Among them 150 (39.9%) were men and 226 (60.1%) were women. SOC was statistically significant with gender (P = 0.008), marital status (P = 0.003), dentition status (P = 0.000), smoking (P = 0.043), and alcohol consumption (P = 0.043). Age (P = 0.036), gender (P = 0.045), dentition status (P < 0.019), and smoking (P = 0.042) were found to be associated with GOHAI, there also exist a strong Pearson's correlation (r = 0.712) between SOC and GOHAI scores. Conclusions: A strong positive correlation was found between SOC and GOHAI scores indicating elder's with low SOC had low GOHAI scores and vice versa. The elders in residential homes were found to have more self-reported oral health-related functional problems, so dental health education must be focused on the special needs of the disabled, dependant and socio – economically deprived geriatric population to improve their QoL

Bonding interactions and stability assessment of biopolymer material prepared using type III collagen of avian intestine and anionic polysaccharides

The present study demonstrate bonding interactions between anionic polysaccharides, alginic acid (AA) and type III collagen extracted from avian intestine used for the preparation of thermally stable and biodegradable biopolymer material. Further the study describes, optimum conditions (pH, temperature and NaCl concentration) required for the formation of fibrils in type III collagen, assessment on degree of cross-linking, nature of bonding patterns, biocompatibility and biodegradability of the cross-linked biomaterial. Results revealed, the resultant biopolymer material exhibit high thermal stability with 5-6 fold increase in tensile strength compared to the plain AA and collagen materials. The degree of cross-linking was calculated as 75%. No cytotoxicity was observed for the cross-linked biopolymer material when tested with skin fibroblast cells and the material was biodegradable when treated with enzyme collagenase. With reference to bonding pattern analysis we found, AA cross-linked with type III collagen via (i) formation of covalent amide linkage between -COOH group of AA and ε-NH2 group of type-III collagen as well as (ii) intermolecular multiple hydrogen bonding between alginic acid -OH group with various amino acid functional group of type-III collagen. Comparisons were made with other cross-linking agents also. For better understanding of bonding pattern, bioinformatics analysis was carried out and discussed in detail. The results of the study emphasize, AA acts as a suitable natural crosslinker for the preparation of wound dressing biopolymer material using collagen. The tensile strength and the thermal stability further added value to the resultant biopolymer

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London