Zinc-Oxide Eugenol Paste, Antimicrobial Gel, and Ayurvedic Medicament in the Management of Alveolar Osteitis: A Prospective and Comparative Study

Objectives: The objective of this study was to compare the three treatment strategies of zinc oxide eugenol (ZOE), metronidazole gel, and Aloe vera gel in the management of dry socket with respect to pain relief and mucosal healing. Methods: This was a comparative study in which 90 patients were recruited and randomly divided into three groups of 30. ZOE dressings were applied in Group A, Metronidazole gel in Group B, and Aloe vera gel was applied in Group C patients on the day of reporting. Patients were followed up for seven consecutive days. Day-wise pain and mucosal healing were assessed in each patient using the visual analog scale and mucosal healing index, respectively. Results: The mean age for the 90 patients recruited in the study was 44.02 (9.9). Male: Female ratio was 37:53. Higher values of pain were reported in Group A from day 1 to 6 (P < 0.01). However, the difference was not significant among the three groups (P > 0.05) on the 7th day. Significant differences were seen among groups (P < 0.01) for mucosal healing on days 2–6 with higher mean values in Group A. On day 1 and day 7, a non-significant difference was seen for the values across all three groups (P > 0.05). Conclusion: Metronidazole and Aloe vera gels were found effective in early pain relief while producing a similar amount of mucosal healing. These gels offer the potential to be used as alternative home remedies, thus reducing the number of dental appointments required in the case of ZOE dressings. However, further randomized and clinical studies are required to evaluate the three strategies for their potential adverse effects

A study of Extended Spectrum ß-Lactamases in Gram-negative Bacterial Isolates in a Tertiary Care Hospital in Mumbai

Background: Injudicious use of antimicrobials for any infection causes microbes to undergo changes through selective pressure and ultimately leads to the development of antimicrobial resistance. The production of ß-Lactamase is one of the most important mechanisms adopted by bacteria to evade action by penicillins and cephalosporins. Materials and Methods: This prospective in vitro study was conducted in a tertiary care hospital in Mumbai over a 6-month period with the aim of identifying extended spectrum b-lactamases (ESBLs) in Gram-negative bacteria in clinical isolates, by double disk diffusion test and E test. Results: Five thousand five hundred and forty-eight g-negative bacilli were isolated of which 2354 (42.42%) were ESBL producers. Maximum numbers of ESBL production were seen in isolates from the blood sample (53.91%) followed by pus (47%) and urine samples (42.27%). Conclusion: ESBL-producing organisms are increasing in the community; therefore, restricted and judicious use of the third generation cephalosporins is to be followed to prevent and control such types of resistance

An Innovative App (ExoDont) for Postoperative Care of Patients After Tooth Extraction: Prototype Development and Testing Study

BackgroundThe postoperative period is crucial for the initiation of healing and prevention of complications after any surgical procedure. Due to factors such as poor compliance, comprehension, and retention of instructions, and other unaccounted factors, the objectives of postoperative care are not always achieved. Therefore, an Android-based mobile health app (ExoDont) was developed to ensure a smooth postoperative period for patients after a dental extraction. The ExoDont app delivers reminders for postoperative instructions and drug intake at defined intervals, thus fostering self-reliance among patients in taking their prescribed dose of medication. ObjectiveThe aim of this study is to design, develop, and validate ExoDont, an innovative app for improved adherence to postoperative instructions after tooth extraction. MethodsA postoperative treatment protocol was developed by a team of oral and maxillofacial surgeons and general dentists, following which the clinical and technological requirements of the app were determined along with the software engineers, graphic designers, and applications architect in the team. ExoDont was developed to provide timely reminders for medication and postoperative care. The app was field tested and validated using the User Version of the Mobile Application Rating Scale. ResultsThe ExoDont software design was divided into a 3-level architecture comprising a user interface application, logical layer, and database layer. The software architecture consists of an Android-based ExoDont app for patients and a web version of the admin panel. The testing and validation of the ExoDont app revealed that Perceived Impact received the highest mean score of all rated components (mean 4.6, SD 0.5), while Engagement received the lowest mean score (mean 3.5, SD 0.8). ConclusionsThe testing and validation of the app support its usability and functionality, as well as its impact on users. The ExoDont app has been designed, keeping the welfare of patients in view, in a user-friendly manner that will help patients adhere to the prescribed drug regimen and ensure easy and efficient dissemination of postoperative instructions. It could play an instrumental role in fostering compliance among patients and significantly decrease the complication rate following dental extractions

Innovative App (ExoDont) and Other Conventional Methods to Improve Patient Compliance After Minor Oral Surgical Procedures: Pilot, Nonrandomized, and Prospective Comparative Study

BackgroundPostoperative care is influenced by various factors such as compliance, comprehension, retention of instructions, and other unaccounted elements. It is imperative that patients adhere to the instructions and prescribed regimen for smooth and placid healing. ExoDont, an Android-based mobile health app, was designed to ensure a smooth postoperative period for patients after a dental extraction. Besides providing postoperative instructions at defined intervals, the app also sends drug reminders as an added advantage over other available, conventional methods. ObjectiveThe aim of this study was to compare the compliance rate of individuals with respect to the prescribed regimen and postoperative instructions. Additionally, we aimed to assess any changes in the postoperative complication rate of patients assigned to 3 categories: the verbal, verbal plus written, and ExoDont app-based delivery groups. MethodsWe conducted a pilot, nonrandomized, and prospective comparative study in which patients after tooth extraction were assigned to 3 groups—verbal (Group A), verbal plus written (Group B), and ExoDont app-based delivery (Group C)—based on the eligibility criteria, and a 1-week follow-up was planned to obtain the responses regarding compliance and postoperative complications from the participants. ResultsIn total, 90 patients were recruited and equally divided into 3 groups. Compliance to prescribed drug was found to be the highest in Group C, where of the 30 participants, 25 (83%) and 28 (93%) followed the entire course of antibiotics and analgesics, respectively. For postoperative instructions, higher compliance was observed in Group C in relation to compliance to diet restrictions (P=.001), not rinsing for 24 hours (P<.001), and warm saline rinses after 24 hours (P=.001). However, the difference was not significant for smoking restrictions (P=.07) and avoiding alcohol (P=.16). Moreover, the difference in postoperative complication rate was not statistically significant among the 3 groups (P=.31). ConclusionsAs evident from the results, it is anticipated that the ExoDont app will be helpful in circumventing the unaccounted possibilities of missing the prescribed dosage and postoperative instructions and ensuring the smooth recovery of patients after dental extraction. However, future studies are required to establish this app-based method of delivery of postoperative instructions as a viable option in routine clinical practice

Quaternary Ammonium Compounds: Usage in Households during COVID-19 Pandemic, Boon, or Bane?

Quaternary ammonium compounds (QACs) have been used as disinfectants and as components in various household items since long. The furore and panic created during the COVID-19 pandemic triggered an unprecedented increase in their usage in health-care facilities as well as in households. This narrative attempts to explore the usage of various QACs in households during the pandemic and delve into the increased exposure and consequent health outcomes. A comprehensive literature search was performed on various databases to include the studies conducted on QACs since 2019. Multiple studies reported an increase in the exposure to QACs during the pandemic and this surge was reflected as adverse effects in human beings as well as the environment – cytological aberrations, intoxication, and damage to aquatic life being the main-stays