Prevalence Of Parafunctional Habits And Temporomandibular Disorder Symptoms In Young Individuals Reporting To Watim Dental Hospital

Objective: This study aims to identify the prevalence of parafunctional habits and common symptoms of temporomandibular disorders in young individuals reporting to the Watim Dental College Materials and methods: This cross-sectional study was carried out by a survey and clinical examination over a period of six months from September 2021 to February 2022. Data from 103 patients, who fulfilled the inclusion criteria, were collected using a structured questionnaire and clinical examination regarding their parafunctional habits and temporomandibular joint symptoms. Informed consent was filled out by all the participants. Data were analyzed using SPSS version 23. A descriptive analysis was calculated for both quantitative and qualitative variables. Results: The prevalence of oral parafunctional habits among the study sample was quantified on a binary scale (yes/no) where nail-biting was observed to be highly prevalent (38%), followed by mouth breathing (27%). The most frequently reported temporomandibular joint symptom was noise (clicking or crepitation)  which was 66%. Difficulty in mouth opening was the least common (20%) of all the symptoms noted. Conclusion: It may be concluded from our study that amongst parafunctional habits nail biting is the most common habit amongst young individuals and amongst the temporomandibular joint disorder clicking and crepitation is the most common symptom persistent with the condition. Keywords: clicking, nail-biting, parafunctional habits, temporomandibular joint symptom

Periodontal Treatment Needs of Patients Undergoing Orthodontic Treatment in Comparison To Non-Orthodontic Treatment Patients: A Comparative Study

OBJECTIVES To determine the periodontal treatment needs of patients undergoing orthodontic treatment compared to those not undergoing the treatment.   METHODOLOGY A cross-sectional comparative study was conducted on 100 patients visiting the Dental OPD of Sharif Medical and Dental College, Lahore, from June 2019 to July 2020. Clinical examination was done using the Community Periodontal index for treatment needs (CPITN) to assess the participants' periodontal health and treatment needs. RESULTS There was a statistically significant difference in the scores of CPITN across the treatment and control groups (≤0.001). The patients requiring scaling and prophylaxis and Oral hygiene instructions (TN 2) were more (94%) in the orthodontic treatment group in comparison to the non-orthodontic treatment group (62%). A higher percentage of patients (6%) requiring complex treatment (deep scaling, root planning and complex surgical procedures), scaling and prophylaxis and Oral hygiene instructions (TN3) belonged to the non-orthodontic treatment group, while only 4% required it from the orthodontic treatment group. CONCLUSION All orthodontic and non-orthodontic treatment group participants required oral hygiene instructions and had periodontal treatment needs (TN1). The patients requiring scaling and prophylaxis and Oral hygiene instructions (TN 2) were more in the orthodontic treatment group than the non-orthodontic treatment group. A higher percentage of patients requiring complex treatment (deep scaling, root planning and complex surgical procedures), scaling and prophylaxis and Oral hygiene instructions (TN3) belonged to the non-orthodontic treatment group

Impact of Virtual Reality Goggles as a Distraction Technique on the Pain Perception and Heart Rate of Pediatric Dental Patients

Objective: To assess the impact of virtual reality (VR) glasses on pain perception and heart rate during inferior alveolar nerve block in pediatric patients. Methods: This quasi-experimental investigation was conducted at a dental hospital (University College of Dentistry), Lahore, Pakistan from June to February 2022. The study included healthy children aged four to twelve years who needed dental treatment involving an inferior alveolar nerve block. The distraction was done using VR glasses. Participants were arbitrarily divided into two groups, one with VR and the other without VR. The patients' behavior was recorded during the nerve block using the face, legs, activity, cry, and consolability (FLACC) behavioral pain assessment scale. The Pulse rate was monitored before, during, and after the procedure. Results:Of the total 68 participants, the median age was 8 (7 – 9) years. There were 36 (52.9%) patients in the nonVR group and 32 (47.1%) patients in the VR group. The median FLAACC score was found to be significantly lower in the VR group as compared to the non-VR group i.e., 1.0 (1.0 - 2.0) vs. 5.0 (4.0 - 5.0) (p-value <0.001) respectively. Both groups showed significant median differences in face (p-value 0.008), legs (p-value <0.001), activity (p-value <0.001), crying (p-value <0.001), and consolability (p-value <0.001) scores. During treatment, the heart rate of VR participants was found to be significantly lower than the non-VR group i.e., 93.0 (90.0 – 96.0) vs. 100.0 (87.7 – 104.0) (p-value 0.044) respectively. Conclusion: The study revealed that the use of VR goggles as a distraction method demonstrated a significant reduction in pain perception and heart rate

Impact of Virtual Reality Goggles as a Distraction Technique on the Pain Perception and Heart Rate of Pediatric Dental Patients

Objective: To assess the impact of virtual reality (VR) glasses on pain perception and heart rate during inferior alveolar nerve block in pediatric patients. Methods: This quasi-experimental investigation was conducted at a dental hospital (University College of Dentistry), Lahore, Pakistan from June to February 2022. The study included healthy children aged four to twelve years who needed dental treatment involving an inferior alveolar nerve block. The distraction was done using VR glasses. Participants were arbitrarily divided into two groups, one with VR and the other without VR. The patients' behavior was recorded during the nerve block using the face, legs, activity, cry, and consolability (FLACC) behavioral pain assessment scale. The Pulse rate was monitored before, during, and after the procedure. Results:Of the total 68 participants, the median age was 8 (7 – 9) years. There were 36 (52.9%) patients in the nonVR group and 32 (47.1%) patients in the VR group. The median FLAACC score was found to be significantly lower in the VR group as compared to the non-VR group i.e., 1.0 (1.0 - 2.0) vs. 5.0 (4.0 - 5.0) (p-value <0.001) respectively. Both groups showed significant median differences in face (p-value 0.008), legs (p-value <0.001), activity (p-value <0.001), crying (p-value <0.001), and consolability (p-value <0.001) scores. During treatment, the heart rate of VR participants was found to be significantly lower than the non-VR group i.e., 93.0 (90.0 – 96.0) vs. 100.0 (87.7 – 104.0) (p-value 0.044) respectively. Conclusion: The study revealed that the use of VR goggles as a distraction method demonstrated a significant reduction in pain perception and heart rate

Impact of Virtual Reality Goggles as a Distraction Technique on the Pain Perception and Heart Rate of Pediatric Dental Patients

Objectives: To assess the impact of virtual reality (VR) glasses on pain perception and heart rate during inferior alveolar nerve block in pediatric patients. Methods: This quasi-experimental investigation was conducted at a dental hospital (University College of Dentistry), Lahore, Pakistan from June to February 2022. The study included healthy children aged four to twelve years who needed dental treatment involving an inferior alveolar nerve block. The distraction was done using VR glasses. Participants were arbitrarily divided into two groups, one with VR and the other without VR. The patients' behavior was recorded during the nerve block using the face, legs, activity, cry, and consolability (FLACC) behavioral pain assessment scale. The Pulse rate was monitored before, during, and after the procedure. Results: Of the total 68 participants, the median age was 8 (7 – 9) years. There were 36 (52.9%) patients in the non-VR group and 32 (47.1%) patients in the VR group. The median FLAACC score was found to be significantly lower in the VR group as compared to non-VR group i.e., 1.0 (1.0 - 2.0) vs. 5.0 (4.0 - 5.0) (p-value <0.001) respectively. Both groups showed significant median differences in face (p-value 0.008), legs (p-value <0.001), activity (p-value <0.001), crying (p-value <0.001), and consolability (p-value <0.001) scores. During treatment, the heart rate of VR participants was found to be significantly lower than the non-VR group i.e., 93.0 (90.0 – 96.0) vs. 100.0 (87.7 – 104.0) (p-value 0.044) respectively

Global Retinoblastoma Presentation and Analysis by National Income Level.

Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs

The global retinoblastoma outcome study : a prospective, cluster-based analysis of 4064 patients from 149 countries

DATA SHARING : The study data will become available online once all analyses are complete.BACKGROUND : Retinoblastoma is the most common intraocular cancer worldwide. There is some evidence to suggest that major differences exist in treatment outcomes for children with retinoblastoma from different regions, but these differences have not been assessed on a global scale. We aimed to report 3-year outcomes for children with retinoblastoma globally and to investigate factors associated with survival. METHODS : We did a prospective cluster-based analysis of treatment-naive patients with retinoblastoma who were diagnosed between Jan 1, 2017, and Dec 31, 2017, then treated and followed up for 3 years. Patients were recruited from 260 specialised treatment centres worldwide. Data were obtained from participating centres on primary and additional treatments, duration of follow-up, metastasis, eye globe salvage, and survival outcome. We analysed time to death and time to enucleation with Cox regression models. FINDINGS : The cohort included 4064 children from 149 countries. The median age at diagnosis was 23·2 months (IQR 11·0–36·5). Extraocular tumour spread (cT4 of the cTNMH classification) at diagnosis was reported in five (0·8%) of 636 children from high-income countries, 55 (5·4%) of 1027 children from upper-middle-income countries, 342 (19·7%) of 1738 children from lower-middle-income countries, and 196 (42·9%) of 457 children from low-income countries. Enucleation surgery was available for all children and intravenous chemotherapy was available for 4014 (98·8%) of 4064 children. The 3-year survival rate was 99·5% (95% CI 98·8–100·0) for children from high-income countries, 91·2% (89·5–93·0) for children from upper-middle-income countries, 80·3% (78·3–82·3) for children from lower-middle-income countries, and 57·3% (52·1-63·0) for children from low-income countries. On analysis, independent factors for worse survival were residence in low-income countries compared to high-income countries (hazard ratio 16·67; 95% CI 4·76–50·00), cT4 advanced tumour compared to cT1 (8·98; 4·44–18·18), and older age at diagnosis in children up to 3 years (1·38 per year; 1·23–1·56). For children aged 3–7 years, the mortality risk decreased slightly (p=0·0104 for the change in slope). INTERPRETATION : This study, estimated to include approximately half of all new retinoblastoma cases worldwide in 2017, shows profound inequity in survival of children depending on the national income level of their country of residence. In high-income countries, death from retinoblastoma is rare, whereas in low-income countries estimated 3-year survival is just over 50%. Although essential treatments are available in nearly all countries, early diagnosis and treatment in low-income countries are key to improving survival outcomes.The Queen Elizabeth Diamond Jubilee Trust and the Wellcome Trust.https://www.thelancet.com/journals/langlo/homeam2023Paediatrics and Child Healt

Dental Anxiety and Influencing Factors in Adults

Dental anxiety is one of the most common conditions present amongst the masses globally. It is this fear that makes individuals avoid seeking dental treatment which results in a deteriorated oral health-related quality of life (OHRQoL). Discrepancies exist in the prevalence of dental anxiety based on gender, education levels, level of deprivation of a society and its socioeconomic status. In this study, a sample size of 522 respondents was collected. Kuppuswamy’s socioeconomic status scale and modified dental anxiety scales were used to collect the necessary data. These data were analyzed by cross tabbing and chi-square test of significance was applied to assess the association between dental anxiety and other factors. Female gender was significantly associated with dental anxiety with p-value = 0.03. Higher education levels and dental anxiety also displayed significant associations with each other, with a p-value of 0.048. Seventy-six percent of the individuals of lower socioeconomic status were prone to be more dentally anxious. Dental anxiety was more significant in individuals with higher levels of education in our study. Respondents who were part of a lower socioeconomic class were also more prone to being anxious while receiving dental treatment. Knowing the factors that cause dental anxiety can help dentists effectively manage and treat their patients

Strain features of pneumococcal isolates in the pre- and post-PCV10 era in Pakistan

Pakistan is amongst the four countries with the highest number of pneumococcal deaths. While the PCV10 vaccine was introduced in Pakistan in October 2012, data regarding the impact of the vaccine on the population dynamics of Streptococcus pneumoniae in Pakistan remain obscure. Using whole genome sequencing of 190 isolates (nasopharyngeal carriage=75, disease=113, unknown sites=2) collected between 2002 and 2020, this study presents characteristics of pneumococcal strains in Pakistan in the pre- and post-vaccine era. The isolates were characterized on the basis of serotype distribution, genetic lineages (or Global Pneumococcal Sequence Cluster, GPSC) and antibiotic resistance. A high level of diversity in serotype and genetic lineages of pneumococci was observed in Pakistan. Among 190 isolates, we identified 54 serotypes, 67 GPSCs and 116 sequence types (STs) including 23 new STs. The most prevalent GPSCs and their associated serotypes in nasopharyngeal carriage were GPSC54 (expressing serotype 9V), GPSC5 (15A and 7B, and serogroup 24), GPSC25 (15B/15C), GPSC67 (18C) and GPSC376 (6A and 6D). Similarly, among 113 disease-causing isolates, the most prevalent GPSC/serotype combinations were GPSC2 (serotype 1), GPSC10 (serotypes 14, 10A, 19A and 19F), GPSC43 (serotypes 13, 11A, 23B, 35A and 9V), GPSC67 (serotypes 18A and 18C) and GPSC642 (serotype 11A). Of the 190 isolates, the highest levels of resistance were observed against penicillin (58.9 %, n=122), erythromycin (29.5 %, n=56), clindamycin (13.2 %, n=25), co-trimoxazole (94.2 %, n=179) and tetracycline/doxycycline (53.2 %, n=101). A higher proportion of disease-causing isolates were multidrug resistant as compared to carriage isolates (54 % vs 25 %). Our data suggest limited coverage of PCV10 in nasopharyngeal (21.6 %, 16/74) as well as disease-causing (38.1 %, 16/42) isolates among children ≤5 years old; however, higher valent vaccine PCV13 would increase the coverage rates to 33.8 % in nasopharyngeal and 54.8 % in disease-causing isolates, whereas PCV24/25 would offer the highest coverage rates. Owing to the diversity of serotypes observed during the post-vaccine period, the suggested inclusion of serotype in future vaccine formulations will require investigations with larger data sets with an extended temporal window. This article contains data hosted by Microreact

Synthesis and Application of Egg Shell Biochar for As(V) Removal from Aqueous Solutions

Arsenic in water bodies has increased to toxic levels and become a major issue worldwide. Among various treatment methods, the removal of As from polluted water with low-cost and environmental-friendly sorbents such as biochar is considered a promising technique nowadays. In a recent experiment, the treatment of As-contaminated water using egg shell biochar was studied. Various parameters affecting the sorption, such as pH, contact time, sorbent dose, As(V) concentration and the effects of anions, were also examined. The results revealed that at a pH of 4.5, a maximum sorption of 6.3 mg g−1 was observed, and the As(V) removal was 96% with an As concentration of 0.6 mg L−1 and a sorbent dose of 0.9 g L−1. At a contact time of 2 h (120 min), a maximum sorption of 6.3 mg g−1 was noted with a removal percentage of 96%. The sorption of As(V) was obtained at an optimal sorbent dose of 0.9 g L−1. The SEM-EDS data illustrated that biochar consisted of a large number of active sites for As(V) adsorption, and As appeared on the biochar surface after the sorption experiments. Moreover, XPS analyses also confirmed the presence of As(V) on the biochar surface after treatment with As-contaminated water. In a nutshell, the results of this study demonstrate that egg shell biochar has notable efficiency in the removal of As(V) from aqueous solution and that egg shell biochar could be a cost-effective and environmental-friendly sorbent for the treatment of As(V)-contaminated water, specifically in developing countries