Increased risk of type 2 diabetes with ascending social class in urban South Indians is explained by obesity: The Chennai urban rural epidemiology study (CURES-116).

AIM: The aim of this study is to determine the factors responsible for differences in the prevalence of diabetes mellitus (DM) in subjects of different social class in an urban South Indian population. MATERIALS AND METHODS: Analyses were based on the cross-sectional data from the Chennai Urban Rural Epidemiology Study of 1989 individuals, aged ≥20 years. Entered in the analyses were information obtained by self-report on (1) household income; (2) family history of diabetes; (3) physical activity; (4) smoking status; (5) alcohol consumption. Biochemical, clinical and anthropometrical measurements were performed and included in the analyses. Social class was classified based on income as low (Rs. <2000) intermediate (Rs. 2000-5000`) and high (Rs. 5000-20000). RESULTS: The prevalence rates of DM were 12.0%, 18.4% and 21.7% in low, intermediate and high social class, respectively (P < 0.001). A significant increase in the risk of diabetes was found with ascending social class (Intermediate class: Odds ratio [OR], 1.7 [confidence interval [CI], 1.2-2.3]; High class: OR, 2.0 [CI-1.4-2.9]). The multivariable adjusted logistic regression analysis revealed that the effect of social class on the risk of diabetes remained significant (P = 0.016) when age, family history of diabetes and blood pressure were included. However, with the inclusion of abdominal obesity in the model, the significant effect of social class disappeared (P = 0.087). CONCLUSION: An increased prevalence of DM was found in the higher social class in this urban South Indian population, which is explained by obesity

Autosomal dominant polycystic kidney disease with diffuse proliferative glomerulonephritis - an unusual association: a case report and review of the literature

<p>Abstract</p> <p>Introduction</p> <p>Autosomal dominant polycystic kidney disease is an inherited disorder that is characterized by the development and growth of cysts in the kidneys and other organs. Urinary protein excretion is usually less than 1 g/24 hours in autosomal dominant polycystic kidney disease, and an association of nephrotic syndrome with this condition is considered rare. There are only anecdotal case reports of autosomal dominant polycystic kidney disease associated with nephrotic syndrome, with focal segmental glomerulosclerosis being the most commonly reported histopathological diagnosis. Nephrotic-range proteinuria in the presence of autosomal dominant polycystic kidney disease, with or without an accompanying decline in renal function, should be investigated by open renal biopsy to exclude coexisting glomerular disease. To the best of our knowledge, this is the first case of autosomal dominant polycystic kidney disease with histologically proven diffuse proliferative glomerulonephritis presenting with nephrotic-range proteinuria. No other reports of this could be found in a global electronic search of the literature.</p> <p>Case presentation</p> <p>We report the case of a 35-year-old Indo-Aryan man with autosomal dominant polycystic kidney disease associated with nephrotic syndrome and a concomitant decline in his glomerular filtration rate. Open renal biopsy revealed diffuse proliferative glomerulonephritis. An accurate diagnosis enabled us to manage him conservatively with a successful outcome, without the use of corticosteroid which is the standard treatment and the drug most commonly used to treat nephrotic syndrome empirically.</p> <p>Conclusion</p> <p>Despite the reluctance of physicians to carry out a renal biopsy on patients with autosomal dominant polycystic kidney disease, our case supports the idea that renal biopsy is needed in patients with polycystic kidney disease with nephrotic-range proteinuria to make an accurate diagnosis. It also illustrates the importance of open renal biopsy in planning appropriate treatment for patients with autosomal dominant polycystic kidney disease with nephrotic-range proteinuria. The treatment for various histological subtypes leading to nephrotic syndrome is different, and in this modern era we should practice evidence-based medicine and should avoid empirical therapy with its associated adverse effects.</p

Atomic force microscopy and scanning electron microscopy evaluation of efficacy of scaling and root planing using magnification: A randomized controlled clinical study

Aim: A randomized controlled clinical study was undertaken to evaluate the effectiveness of scaling and root planing (SRP) by using Magnifying Loupes (ML) and dental operating microscope (DOM). Materials and Methods: A total of 90 human teeth scheduled for extraction from 18 patients aged between 25 and 65 years suffering from generalized chronic severe periodontitis were randomly assigned to three treatment groups. Group 1 consisted SRP performed without using magnification (unaided), Group 2-SRP with ML and Group 3-SRP with DOM. Following extractions, samples were prepared for (i) evaluation of surface topography by atomic force microscopy, (ii) presence of smear layer, debris by scanning electron microscopy (iii) elemental analysis by energy dispersive X-ray analysis. Data was subjected to statistical analysis using analysis of variance, post-hoc (Tukey-HSD) and Chi-square test. Results: Statistically significant (P < 0.001) difference was found among the different treatment groups. Group 3 was the best while Group 1 was the least effective technique for SRP. Order of efficacy in terms of the surface was found to be - Palatal < Lingual < Distal ≅ Mesial < Buccal. Efficiency in mandibular to maxillary teeth was found to be significant (P < 0.05), also anterior to posterior teeth (P < 0.05). Conclusion: Magnification tools significantly enhance the efficacy of supragingival and subgingival SRP

Efficiency of three different polishing methods on enamel and cementum: A scanning electron microscope study

Background: Tooth polishing is an integral part of clinical dentistry. The main purpose of polishing is to smoothen the surface of the tooth and minimize the deposition of plaque to allow a healthy periodontal maintenance postscaling. Today, polishing by different methods is available to a clinician. Traditional bristle brush and rubber-cup polishing are being widely practiced and gradually getting replaced by novel air polisher. Pros and cons of each method should be weighed before its clinical applications. Aim and Objectives: To evaluate and compare the efficiency of three different polishing systems on enamel as well as on cementum surfaces by scanning electron microscope (SEM). Materials and Methods: A total of 120 samples were divided into three groups randomly – Group 1 (bristle brush), Group 2 (rubber cup), and Group 3 (air polisher) – with 20 samples each of enamel and cementum, which were subdivided into 10 control and 10 test group (subjected to polishing). The samples were analyzed by SEM at ×1000 magnification, and the data obtained were compiled and subjected to statistical analysis. Results: Polishing with bristle brush demonstrated less surface roughness and debris when compared to air polisher at P = 0.58, P = 0.03 for enamel surface and P = 0.003, P = 0.21 for cementum, respectively. The surface roughness was reduced considerably by rubber cup at P = 0.03 for enamel and P = 0.003 for cementum, compared to air polisher at P = 0.99 and P = 0.21 for enamel and cementum, respectively. Conclusion: The results indicate that polishing with rubber cup was more effective and statistically significant when compared to bristle brush polishing and air polisher for the crown and root surface smoothening and debris removal

Proposed classification of medial maxillary labial frenum based on morphology

Objectives: To propose a new classification of median maxillary labial frenum (MMLF) based on the morphology in permanent dentition, conducting a cross-sectional survey. Materials and Methods: Unicentric study was conducted on 2,400 adults (1,414 males, 986 females), aged between 18 and 76 years, with mean age = 38.62, standard deviation (SD) = 12.53. Male mean age = 38.533 years and male SD = 12.498. Female mean age = 38.71 and female SD = 12.5750 for a period of 6 months at Teerthanker Mahaveer University, Moradabad, Northern India. The frenum morphology was determined by using the direct visual method under natural light and categorized. Results: Diverse frenum morphologies were observed. Several variations found in the study have not been documented in the past literature and were named and classified according to their morphology. Discussion: The MMLF presents a diverse array of morphological variations. Several other undocumented types of frena were observed and revised, detailed classification has been proposed based on cross-sectional survey

Application of ultrasound in periodontics: Part I

Ultrasonic is a branch of acoustics concerned with sound vibrations in frequency ranges above audible level. Ultrasound uses the transmission and reflection of acoustic energy. A pulse is propagated and its reflection is received, both by the transducer. For clinical purposes ultrasound is generated by transducers, which converts electrical energy into ultrasonic waves. This is usually achieved by magnetostriction or piezoelectricity. Primary effects of ultrasound are thermal, mechanical (cavitation and microstreaming), and chemical (sonochemicals). Knowledge of the basic and other secondary effects of ultrasound is essential for the development of techniques of application

Bridge flap technique as a single-step solution to mucogingival problems: A case series

Shallow vestibule, gingival recession, inadequate width of attached gingiva (AG) and aberrant frenum pull are an array of mucogingival problems for which several independent and effective surgical solutions are reported in the literature. This case series reports the effectiveness of the bridge flap technique as a single-step surgical entity for increasing the depth of the vestibule, root coverage, increasing the width of the AG and solving the problem of abnormal frenum pull. Eight patients with 18 teeth altogether having Millers class I, II or III recession along with problems of shallow vestibule, inadequate width of AG and with or without frenum pull underwent this surgical procedure and were followed-up till 9 months post-operatively. The mean root coverage obtained was 55% and the mean average gain in width of the AG was 3.5 mm. The mean percentage gain in clinical attachment level was 41%. The bridge flap technique can be an effective single-step solution for the aforementioned mucogingival problems if present simultaneously in any case, and offers considerable advantages over other mucogingival surgical techniques in terms of simplicity, limited chair-time for the patient and the operator, single surgical intervention for manifold mucogingival problems and low morbidity because of the absence of palatal donor tissue

Prevalence of periodontitis in patients with pulmonary disease: A cross-sectional survey in the industrial district of India

Background: Evidence state that periodontitis may have a contributory role in the onset and progression of pulmonary diseases. However, very limited data are available till date, studying the coexistence of both the conditions. Aim and Objective: The aim and objective of this study are to determine the prevalence of periodontitis among patients affected with various pulmonary diseases in Moradabad District, Uttar Pradesh, India. Materials and Methods: A total of 700 patients suffering from pulmonary diseases including tuberculosis (TB), chronic obstructive pulmonary disease, or pneumonia within the age group of 12–70 years were selected for the study. A detailed case-history for both pulmonary and periodontal status was taken. Periodontal Disease Index and Periodontal Index for Risk of Infectiousness were recorded for all patients. The scores were calculated and subjected to statistical analysis. Results: Individuals with pulmonary diseases showed a statistically significant prevalence of periodontal disease with higher values of periodontal disease index (31%) and periodontal index for risk of infectiousness (55%) at P < 0.05. Patients suffering from TB within the age group of 51–60 (42%) showed the highest prevalence of periodontitis with a more number of males (43%) being affected as compared to females at P < 0.01. Conclusion: Most of the study population was diagnosed with periodontitis with a higher proportion categorized under high-risk category as per PIRI scores