Microbiological evaluation of the disinfection of the root canal system using different irrigation protocol – An interventional study

Aim: The focus of the present research is to analyze the potential role of irrigants along with the activation system in the disinfection of the root canal space. Methods: Ninety root canals were randomly divided into two experimental groups based on the irrigants: Group I (n = 45) – Sodium hypochlorite irrigant and Group II (n = 45) –Chlorhexidine irrigant. The two groups are further subdivided into three subgroups base on the activation devices, i.e., passive ultrasonic irrigation, endoactivator, and laser. The first sample as a baseline, and the second sample was collected after the disinfection procedure. All the samples were streaked in brain − heart infusion agar plate to analyze the bacterial colony growth. The confirmatory analysis for the presence of Enterococcus faecalis was done using gram staining, biochemical analysis, and polymerase chain reaction. The nonparametric analysis was done using Kruskal–Wallis, Mann–Whitney U, and Wilcoxon signed-rank test and P < 0.05 was considered to be statistically significant. Results: The mean colony-forming unit was significantly reduced and there exhibited a statistically significant difference in pretreatment and posttreatment irrigated with sodium hypochlorite and chlorhexidine activated with passive ultrasonic activation with (P = 0.001), endoactivator with (P = 0.001), and laser with (P = 0.001). Conclusion: In consideration with advantage of the properties of both irrigants, the present study concludes a combined use with sodium hypochlorite during instrumentation followed by laser activation and a final rinse with chlorhexidine for a better eradication of the microbes from the root canal system thus preventing re-infection

“Once a smoker, always a smoker: Primary care physicians” views on integrating smoking cessation with antitubercular treatment in primary health centers – A qualitative study

Although smoking and tuberculosis (TB) pose a health threat in low- and middle-income countries, they are less recognized as public health problems. Lack of awareness among smokers about smoking cessation services and health-care professionals not viewing apparently – healthy smokers as the candidates for smoking cessation treatment are some of the significant barriers. This qualitative study explores the opinions and views of primary care physicians (PCPs) on integrating smoking cessation programs with the ongoing antitubercular treatment in primary health-care settings of India. The study employs a deductive qualitative design using a purposive sampling method to recruit physicians to implement the Directly Observed Treatment Short Course for TB patients in primary health-care settings. A semi-structured, open-ended questionnaire was developed based on the Consolidated Framework for Implementation Research to conduct in-depth interviews of eight PCPs. Although smoking cessation intervention is noticeable in the primary health centers, lack of uniformity in service deliverables, nonusage of nicotine replacement therapy, shortage of human resources, and meager readiness of the patients to quit smoking are a few encounters. PCPs advocate early identification of smokers, delegation of responsibilities to grassroots level health-care workers, and collaboration with the nongovernmental organizations and private sector