Teledentistry: Limitation and Challenges

Dentistry is the top listed most risky jobs in this pandemic Covid 19 situation, as dentist contain close face-to-face contact with the patients which increase the potential transmission of the (SARS)-CoV-2 virus from human to human through direct contact via oro-pharyngeal droplets and indirect contacts with fomites where dental professionals are highly vulnerable to get infected from the coronavirus. Thus, dental practice has mostly been suspended during this period. Teledentistry introduces a novel solution to resume dental practice by providing dental treatment, guidance, and education through teleconsultation, telediagnosis and telemonitoring through Information Technology (IT) instead of direct contact with patients. But there are some major challenges like lack of government initiatives, compensation strategy, legal issues, technical base, co-ordination among doctors, along with patients’ co-operation and limitations in telediagnosis. This technical note highlighted these limitations and challenges to make a concern to the dentist as at least teledentistry can accompaniment the existing threaten dental system during this living pandemic

Depression among the Non-Native International Undergraduate Students Studying Dentistry in Bangladesh.

BACKGROUND: Bangladesh has been attracting international students with interests in various subjects recently. Every year students from different parts of the world come to study undergraduate and postgraduate courses, mostly at private universities in Bangladesh. This study evaluates the depression status among international students who are studying dentistry in Bangladesh. METHODS: This cross-sectional survey was conducted among International undergraduate dental students who enrolled in the Bachelor of Dental Surgery program in nine public and private dental colleges in Bangladesh. Participants were selected using a convenience sampling method. A total of 206 students completed the survey where 78.5% of them were female students and 21.5% students were male, and a CES-D 10-item Likert scale questionnaire was used for data collection. The Cronbach alpha for the 10-item CES-D scale for this population is 0.812. RESULTS: The majority of the students (79.5%) are below 24 years of age with a mean age of 23.22 years and standard deviation of 2.3, and are students who cannot communicate well in Bengali (Bangla), about 60% of them have experienced depression. About 77.3% (p < 0.00) of the international students having financial difficulties exhibited depression. The international students who went through financial problems were two times more likely to suffer from depression (OR = 2.38; p-value < 0.01). CONCLUSION: This study tried to highlight the struggles faced by international students in Bangladesh studying dentistry. It is evident from the findings that several factors influence students' mental well-being during demanding dental education years

COVID-19 Vaccination Intent and Willingness to Pay in Bangladesh: A Cross-Sectional Study.

This article reports the intent to receive a SARS-COV-2 vaccine, its predictors and willingness to pay in Bangladesh. We carried out an online cross-sectional survey of 697 adults from the general population of Bangladesh in January 2021. A structured questionnaire was used to assess vaccination intent. The questionnaire included sociodemographic variables and health belief model constructs which may predict vaccination intent. Among the participants, 26% demonstrated a definite intent, 43% probable intent, 24% probable negative, and 7% a definite negative intention. Multivariable logistic regression analyses suggest an association between definite intent and previous COVID-19 infection (OR: 2.86; 95% CI: 1.71-4.78), perceiving COVID-19 as serious (OR: 1.93; 1.04-3.59), the belief that vaccination would make them feel less worried about catching COVID-19 (OR: 4.42; 2.25-8.68), and concerns about vaccine affordability (OR: 1.51; 1.01-2.25). Individuals afraid of the side effects (OR: 0.34; 0.21-0.53) and those who would take the vaccine if the vaccine were taken by many others (OR: 0.44; 0.29-0.67) are less likely to have a definite intent. A definite negative intent is associated with the concern that the vaccine may not be halal (OR: 2.03; 1.04-3.96). Furthermore, 68.4% are willing to pay for the vaccine. The median amount that they are willing to pay is USD 7.08. The study findings reveal that the definite intent to receive the SARS-CoV-2 vaccination among the general population varies depending on their COVID-19-related health beliefs and no significant association was found with sociodemographic variables

Biosynthesis of silver nanoparticles from Cymbopogon citratus leaf extract and evaluation of their antimicrobial properties

Background: Silver nanoparticles (AgNPs) are toxic to microorganisms and can potentially kill multidrug-resistant bacteria. Nanoparticles can be synthesized in many ways, such as physical or chemical methods. Recently, it has been found that plant molecules can perform the same reduction reactions necessary for the production of nanoparticles but in a much more efficient way. Results: Here, green chemistry was employed to synthesize AgNPs using leaf extracts of Cymbopogon citratus. The effects of different parameters such as temperature, pH, and the volume of plant extract were also tested using their absorbance pattern at different wavelengths. The Surface Plasmon Resonance (SPR) changed with the changes in parameters. Changes in temperature from 20 °C to 60 °C have changed the highest absorbance from 0.972 to 3.893 with an SPR of 470 nm. At higher pH (11.1), the particles become highly unstable and have irregular shapes and sizes. The peak shifts to the right at a lower pH level (3.97), indicating a smaller but unstable compound. We have also investigated the effect of the volume of plant extracts on the reaction time. The sample with the highest amount of plant extract showed the most absorbance with a value of 0.963 at λmax, calculated to be 470 nm. The total formation of the AgNPs was observed visually with a color change from yellow to brownish-black. UV-visible spectroscopy was used to monitor the quantitative formation of AgNPs, showing a signature peak in absorbance between 400 and 500 nm. We have estimated the size of the nanoparticles as 47 nm by comparing the experimental data with the theoretical value using Mieplot. The biosynthesized AgNPs showed enhanced antibacterial activity against several multidrug-resistant bacteria, determined based on the minimal inhibitory concentration and zone of inhibition. Conclusion: The findings of this study indicate that an aqueous extract of C. citratus can synthesize AgNPs when silver nitrate is used as a precursor, and AgNPs act as antimicrobial property enhancers, which can be used to treat antibiotic-resistant bacteria. Hence, mass production and green synthesis of AgNPs from C. citratus will be able to increase the overall health of the general population. Moreover, it will enormously reduce the costs for drug development and provide employment options in the remotely located source areas. Finally, our findings will influence further studies in this field to better understand the properties and applications of AgNPs and ultimately contribute to improving planetary health by increasing immunity with high biocompatibility and less drug toxicity

A comparison of four fibrosis indexes in chronic HCV: Development of new fibrosis-cirrhosis index (FCI)

<p>Abstract</p> <p>Background</p> <p>Hepatitis C can lead to liver fibrosis and cirrhosis. We compared readily available non-invasive fibrosis indexes for the fibrosis progression discrimination to find a better combination of existing non-invasive markers.</p> <p>Methods</p> <p>We studied 157 HCV infected patients who underwent liver biopsy. In order to differentiate HCV fibrosis progression, readily available AAR, APRI, FI and FIB-4 serum indexes were tested in the patients. We derived a new fibrosis-cirrhosis index (FCI) comprised of ALP, bilirubin, serum albumin and platelet count. FCI = [(ALP × Bilirubin) / (Albumin × Platelet count)].</p> <p>Results</p> <p>Already established serum indexes AAR, APRI, FI and FIB-4 were able to stage liver fibrosis with correlation coefficient indexes 0.130, 0.444, 0.578 and 0.494, respectively. Our new fibrosis cirrhosis index FCI significantly correlated with the histological fibrosis stages F0-F1, F2-F3 and F4 (r = 0.818, p < 0.05) with AUROCs 0.932 and 0.996, respectively. The sensitivity and PPV of FCI at a cutoff value < 0.130 for predicting fibrosis stage F0-F1 was 81% and 82%, respectively with AUROC 0.932. Corresponding value of FCI at a cutoff value ≥1.25 for the prediction of cirrhosis was 86% and 100%.</p> <p>Conclusions</p> <p>The fibrosis-cirrhosis index (FCI) accurately predicted fibrosis stages in HCV infected patients and seems more efficient than frequently used serum indexes.</p

Oral Healthcare during Pregnancy: Its Importance and Challenges in Lower-Middle-Income Countries (LMICs)

Oral health is essential in general health and well-being to maintain overall quality of life [...

Experience of Bangladeshi Dental Students towards Online Learning during the COVID-19 Pandemic: A Web-Based Cross-Sectional Study.

BACKGROUND: During the COVID-19 pandemic, dental education institutions throughout the world experienced significant challenges, including a quick shift to an online learning paradigm. Since the pandemic has had a considerable impact on dental education, this research evaluated the perspectives and attitudes towards online learning among undergraduate dental students in Bangladesh. METHODS: The research was conducted through a cross-sectional method using self-administered online questionnaires. The questionnaire included information on the students' sociodemographic status, their views, and their attitudes about the changes in the educational system, specifically regarding online learning. The study gathered data from 952 undergraduate students from 14 dental institutions in Bangladesh. RESULTS: The results suggested that 87.5% of all the students were unsatisfied with their online programs. Most of the respondents who expressed dissatisfaction with their online classes were female, did not receive assistance in overcoming barriers to accessing the classes or materials (64.23%), did not have access to the institutional online-learning management system (OLMS) (67.35%), and did not have access to the online course materials (71.43%). The students considered that the shift to online learning failed to provide quality clinical teaching. CONCLUSIONS: The lack of an OLMS was found to be linked with dissatisfaction with online learning among Bangladeshi dental students during the COVID-19 outbreak. Additionally, insufficient time allocation and a lack of support through online training were found to be strongly correlated with the students' discontent. The overall findings highlight the need to develop and implement effective online dentistry educational interventions to promote academic advancement and key practical skills

Depression among the non-native international undergraduate students studying dentistry in Bangladesh

Abstract Background: Bangladesh has been attracting international students with interests in various subjects recently. Every year students from different parts of the world come to study undergraduate and postgraduate courses, mostly at private universities in Bangladesh. This study evaluates the depression status among international students who are studying dentistry in Bangladesh. Methods: This cross-sectional survey was conducted among International undergraduate dental students who enrolled in the Bachelor of Dental Surgery program in nine public and private dental colleges in Bangladesh. Participants were selected using a convenience sampling method. A total of 206 students completed the survey where 78.5% of them were female students and 21.5% students were male, and a CES-D 10-item Likert scale questionnaire was used for data collection. The Cronbach alpha for the 10-item CES-D scale for this population is 0.812. Results: The majority of the students (79.5%) are below 24 years of age with a mean age of 23.22 years and standard deviation of 2.3, and are students who cannot communicate well in Bengali (Bangla), about 60% of them have experienced depression. About 77.3% (p &lt; 0.00) of the international students having financial difficulties exhibited depression. The international students who went through financial problems were two times more likely to suffer from depression (OR = 2.38; p-value &lt; 0.01). Conclusion: This study tried to highlight the struggles faced by international students in Bangladesh studying dentistry. It is evident from the findings that several factors influence students’ mental well-being during demanding dental education years

COVID-19 vaccination intent and willingness to pay in Bangladesh:a cross-sectional study

Abstract This article reports the intent to receive a SARS-COV-2 vaccine, its predictors and willingness to pay in Bangladesh. We carried out an online cross-sectional survey of 697 adults from the general population of Bangladesh in January 2021. A structured questionnaire was used to assess vaccination intent. The questionnaire included sociodemographic variables and health belief model constructs which may predict vaccination intent. Among the participants, 26% demonstrated a definite intent, 43% probable intent, 24% probable negative, and 7% a definite negative intention. Multivariable logistic regression analyses suggest an association between definite intent and previous COVID-19 infection (OR: 2.86; 95% CI: 1.71–4.78), perceiving COVID-19 as serious (OR: 1.93; 1.04–3.59), the belief that vaccination would make them feel less worried about catching COVID-19 (OR: 4.42; 2.25–8.68), and concerns about vaccine affordability (OR: 1.51; 1.01–2.25). Individuals afraid of the side effects (OR: 0.34; 0.21–0.53) and those who would take the vaccine if the vaccine were taken by many others (OR: 0.44; 0.29–0.67) are less likely to have a definite intent. A definite negative intent is associated with the concern that the vaccine may not be halal (OR: 2.03; 1.04–3.96). Furthermore, 68.4% are willing to pay for the vaccine. The median amount that they are willing to pay is USD 7.08. The study findings reveal that the definite intent to receive the SARS-CoV-2 vaccination among the general population varies depending on their COVID-19-related health beliefs and no significant association was found with sociodemographic variables

Efficacy and safety of sparsentan versus irbesartan in patients with IgA nephropathy (PROTECT): 2-year results from a randomised, active-controlled, phase 3 trial

BackgroundSparsentan, a novel, non-immunosuppressive, single-molecule, dual endothelin angiotensin receptor antagonist, significantly reduced proteinuria versus irbesartan, an angiotensin II receptor blocker, at 36 weeks (primary endpoint) in patients with immunoglobulin A nephropathy in the phase 3 PROTECT trial's previously reported interim analysis. Here, we report kidney function and outcomes over 110 weeks from the double-blind final analysis.MethodsPROTECT, a double-blind, randomised, active-controlled, phase 3 study, was done across 134 clinical practice sites in 18 countries throughout the Americas, Asia, and Europe. Patients aged 18 years or older with biopsy-proven primary IgA nephropathy and proteinuria of at least 1·0 g per day despite maximised renin–angiotensin system inhibition for at least 12 weeks were randomly assigned (1:1) to receive sparsentan (target dose 400 mg oral sparsentan once daily) or irbesartan (target dose 300 mg oral irbesartan once daily) based on a permuted-block randomisation method. The primary endpoint was proteinuria change between treatment groups at 36 weeks. Secondary endpoints included rate of change (slope) of the estimated glomerular filtration rate (eGFR), changes in proteinuria, a composite of kidney failure (confirmed 40% eGFR reduction, end-stage kidney disease, or all-cause mortality), and safety and tolerability up to 110 weeks from randomisation. Secondary efficacy outcomes were assessed in the full analysis set and safety was assessed in the safety set, both of which were defined as all patients who were randomly assigned and received at least one dose of randomly assigned study drug. This trial is registered with ClinicalTrials.gov, NCT03762850.FindingsBetween Dec 20, 2018, and May 26, 2021, 203 patients were randomly assigned to the sparsentan group and 203 to the irbesartan group. One patient from each group did not receive the study drug and was excluded from the efficacy and safety analyses (282 [70%] of 404 included patients were male and 272 [67%] were White) . Patients in the sparsentan group had a slower rate of eGFR decline than those in the irbesartan group. eGFR chronic 2-year slope (weeks 6–110) was −2·7 mL/min per 1·73 m2 per year versus −3·8 mL/min per 1·73 m2 per year (difference 1·1 mL/min per 1·73 m2 per year, 95% CI 0·1 to 2·1; p=0·037); total 2-year slope (day 1–week 110) was −2·9 mL/min per 1·73 m2 per year versus −3·9 mL/min per 1·73 m2 per year (difference 1·0 mL/min per 1·73 m2 per year, 95% CI −0·03 to 1·94; p=0·058). The significant reduction in proteinuria at 36 weeks with sparsentan was maintained throughout the study period; at 110 weeks, proteinuria, as determined by the change from baseline in urine protein-to-creatinine ratio, was 40% lower in the sparsentan group than in the irbesartan group (−42·8%, 95% CI −49·8 to −35·0, with sparsentan versus −4·4%, −15·8 to 8·7, with irbesartan; geometric least-squares mean ratio 0·60, 95% CI 0·50 to 0·72). The composite kidney failure endpoint was reached by 18 (9%) of 202 patients in the sparsentan group versus 26 (13%) of 202 patients in the irbesartan group (relative risk 0·7, 95% CI 0·4 to 1·2). Treatment-emergent adverse events were well balanced between sparsentan and irbesartan, with no new safety signals.InterpretationOver 110 weeks, treatment with sparsentan versus maximally titrated irbesartan in patients with IgA nephropathy resulted in significant reductions in proteinuria and preservation of kidney function