Utilization of services and referrals through dental outreach programs in rural areas of India. A two year study

Background. Oral health care services are often sparse and inconsistent in India therefore it is often difficult for poor people to get access to the oral health care services. The approach by dental institutions with the help of community outreach programs is a step ahead in overcoming this situation. Objectives. The study was conducted to evaluate the number of patients, disease pattern and the services provided in the outreach programmes and also effectiveness of patient referral. Methods. A retrospective study was conducted and the data were obtained from records of outreach programs conducted, in last 2 years by Pacific Dental College and Hospital. The data were analysed using descriptive statistics for the computation of percentages Chi-square test was applied to know the association of effectiveness of referral with age and gender. Confidence level and level of significance was fixed at 95% and 5% respectively. Results. A total of 22982 individuals in the age group of 4-80 years attended the outreach program. Dental caries (42.3%), periodontal diseases (63.2-69.0%) and dental fluorosis (33.7-35.0%) were commonly observed diseases. Effectiveness of referral was significantly high among the middle age adults and females (P<0.05). The effectiveness of referral was highly improved in 2013 after establishment of certain guidelines and strategies. Conclusion. The approaches by dental institutions with the help of community outreach programs can spread awareness and disseminate treatment and thereby enhancing access to care and eliminating access to care within the rural communities

Antimicrobial effects of Citrus sinensis peel extracts against periodontopathic bacteria: an in vitro study

Background. Use of plant extracts and phytochemicals with known antimicrobial properties may have great significance in therapeutic treatments. Objective. To assess the in vitro antimicrobial potential and also determine the minimum inhibitory concentration (MIC) of Citrus sinensis peel extracts with a view of searching a novel extract as a remedy for periodontal pathogens. Materials and Methods. Aqueous and ethanol (cold and hot) extracts prepared from peel of Citrus sinensis were screened for in vitro antimicrobial activity against Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia, using agar well diffusion method. The lowest concentration of every extract considered as the minimal inhibitory concentration (MIC) values were determined for both test organisms. Confidence level and level of significance were set at 95% and 5% respectively. Results. Prevotella intermedia and Porphyromonas gingivalis were resistant to aqueous extracts while Aggregatibacter actinomycetemcomitans was inhibited at very high cncentrations. Hot ethanolic extracts showed significantly higher zone of inhibition than cold ethanolic extract. Minimum inhibitory concentration of hot and cold ethanolic extracts of Citrus sinensis peel ranged between 12-15 mg/ml against all three periodontal pathogens. Conclusions. Both extracts were found sensitive and contain compounds with therapeutic potential. Nevertheless, clinical trials on the effect of these plants are essential before advocating large-scale therapy

Prevalence of skeletal fluorosis in fishermen from Kutch coast, Gujarat, India

Background. In health terms, consuming fluoride is well recognised to be a double-edged sword. Consumption of optimal amounts is beneficial to health, however an excess constitutes a health hazard. Objectives. To assess the prevalence of skeletal fluorosis in fishermen from the Kutch coast, Gujarat, India. Materials and method. A descriptive cross-sectional survey was conducted on 653 fishermen from the Kutch District, Gujarat, India, from October 2014 to December 2014. Clinical skeletal fluorosis was assessed using three diagnostic tests. Drinking water fluoride concentrations in different regions of the study area were determined. General information regarding age, gender and adverse habits were also collected. The Chi square test was used for comparisons and the confidence level and critical p-value were set at 95% and 5% respectively. Results. Fluoride concentrations in water from the study area ranged between 3.4- 6.9 ppm. The prevalence of skeletal fluorosis was 30.3%, out of which, the majority of the subjects had mild skeletal fluorosis (18.4%). This condition was found to be significantly associated with age and gender along with tobacco and alcohol consumption; depending on the habit’s duration. Conclusion. Being a public health problem in the fishermen community, skeletal fluorosis requires a-priori attention. Measures for preventing this disease should be undertaken on a communitywide basis

Potential of Natural Biomaterials in Nano-scale Drug Delivery

Background: The usage of natural biomaterials or naturally derived materials intended for interface with biological systems has steadily increased in response to the high demand of amenable materials, which are suitable for purpose, biocompatible and biodegradable. There are many naturally derived polymers which overlap in terms of purpose as biomaterials but are equally diverse in their applications. Methods: This review examines the applications of the following naturally derived polymers; hyaluronic acid, silk fibroin, chitosan, collagen and tamarind polysaccharide (TSP); further focusing on the biomedical applications of each as well as emphasising on individual novel applications. Results: Each of the polymer was found to demonstrate a wide variety of successful biomedical applications fabricated as wound dressings, scaffolds, matrices, films, sponges, implants or hydrogels to suit the therapeutic need. Interestingly, blending and amelioration of polymer structures were but two of a selection of strategies to modify the functionality of the polymers to suit the purpose. Further these polymers have shown promise to deliver small molecule drugs, proteins and genes as nano-scale delivery systems. Conclusion: The review highlights the breadth and depth of applications of the aforementioned polymers as biomaterials. Hyaluronic acid, silk fibroin, chitosan, collagen and TSP have been successfully utilised as biomaterials in the subfields of implant enhancement, wound management, drug delivery, tissue engineering and nanotechnology. Whilst there are a number of associated advantages (i.e. biodegradability, biocompatibility, non-toxic, non-antigenic as well as amenability) the select disadvantages of each individual polymer provide significant scope for their further exploration and overcoming challenges like feasibility of mass production at a relatively low cost