Behçet’s Disease: An Enigmatic Malady with Plethoric Expressions

Behçet’s disease (BD) is a chronic, inflammatory, repetitive, debilitating systemic vasculitis with conglomerate system involvement of uncharted aetiology portrayed by the triad of oral ulcers, genital ulcers and cutaneous lesions. Behçet’s disease has a universal distribution with a predominance among populace with higher prevalence of human leukocyte antigen (HLA) B5 and its split, HLA-B51, in the Mediterranean basin, the Middle East and Far East. This ailment is presently acknowledged to be a multisystem disorder with mucocutaneous, ocular, intestinal, articular, vascular, urogenital, musculoskeletal, cardiopulmonary and neurologic systems and hence bears significant organ sinistering morbidity and mortality. The diagnosis of Behçet’s disease relies on scrupulous history, identification of its emblematic clinical countenance as per the diagnostic criteria construed by the International Study Group (ISG) and examination of all pertinent systems and excluding other systemic rheumatic diseases. However, there is a lag in diagnosis because of its plethoric presentations and a dearth of specific biomarkers. The multiple organ and tissue involvement of Behçet’s disease necessitates an interdisciplinary approach from various health specialities since a general and an organ-specific approach is mandatory. Prime concern is to control the active periods of the disease which is achieved by different anti-inflammatory drugs, steroids or immunomodulators

Oral manifestations associated with Novel Coronavirus Disease - 2019 (COVID-19): A questionnaire based hypothetical study [version 2; peer review: 2 approved]

Background: Since the Coronavirus disease 2019 (COVID-19) outbreak in 2019, the virus has evolved drastically, presenting with sets of mutations that influence its properties, including transmissibility and antigenicity. The oral mucosa is postulated as probable portal entry and several oral manifestations have been identified, which places dental professionals in a position to recognize probable COVID-19 patients depending on oral signs and symptoms in the initial phases of the disease itself. As co-existing with COVID-19 seems to be a new reality, greater understanding is required regarding early oral signs and symptoms which can be predictors for timely intervention and prevention of complications in COVID-19 patients. The objective of the study is to identify the distinguishing oral signs and symptoms among COVID-19 patients and to establish possible correlation between severity of COVID-19 infection and oral symptoms. Methods: This study recruited 179 ambulatory, non-hospitalized COVID-19 patients from the Kingdom of Saudi Arabia’s Eastern Province's designated hotels for COVID-19 and home isolated patients from the same region using a convenience sample method. Data was collected by qualified and experienced investigators, including two physicians and three dentists, using a validated comprehensive questionnaire through telephonic interviews with the participants. The X2 was used to assess the categorical variables, and odd's ratio was calculated to determine the strength of the association between general symptoms and oral manifestations. Results: Oral and nasopharyngeal lesions or conditions like loss of smell and taste, xerostomia, sore throat, and burning sensation were predictors of COVID-19-related systemic symptoms such as cough, fatigue, fever, and nasal congestion were identified to be statistically significant (p<0.05). Conclusions: The study reveals the occurrence of olfactory or taste dysfunction, dry mouth, sore throat, and burning sensation along with COVID-19 generic symptoms, should be considered as suggestive yet not conclusive indicators of COVID-19

Periodontal status among tobacco users in Karnataka, India

A cross-sectional study was designed to assess the prevalence of periodontal diseases among tobacco and non-tobacco users. A total of 2,156 dentate subjects were selected in the age group of 35-44 years through multi-stage sampling method. A total of 350 and 175 subjects were selected from household survey from each district in rural and urban areas. Subjects were interviewed for the tobacco usage status, followed by clinical assessment of periodontal status. Prevalence of calculus, periodontal pockets of 4-5 mm depth and loss of attachment of 0-3 mm and 4-5 mm was significantly more frequent among current tobacco users. The subject with smoking and chewing tobacco has an odds ratio (OR) 1.6 (95% confidence intervals [CI] 1.14-2.31) and OR 1.7 (95% CI 1.38-2.28) respectively. The findings contribute to the evidence of smoking as a risk factor for periodontal disease

Validation of dental impact on daily living questionnaire among tribal population of India

Background: Oral conditions are known to affect various aspects of quality of life. Similarly, the social consequence of the quality of life in the day to day living is also equally important. Several studies have quantified the social consequences of diseases through activity limitations in people's daily living. The instruments which cover a broad spectrum of life are proposed to be compared with the clinical oral hygiene status of people from different social classes. Aim: To assess the validity of dental impact on daily living (DIDL) questionnaire measuring subjective dental problems and their impact in the day to day life among tribes of Wayanad. Study Design: Cross-sectional. Materials and Methods: DIDL questionnaire developed by Leao and Sheiham was used. We recorded the clinical oral health status using decayed, missing, filled, simplified oral hygiene index, and community periodontal index indices, to correlate the subjective findings of dental impact tribe to obtain construct validity of the questionnaire. Analysis: Descriptive statistics and Spearman's correlation using IBM SPSS software version 20. Results: In the study population of 250 participants, the majority of the participants were from the age group between 36 and 50 years (40%) and females were in the majority (64%). The clinical status of the participants was poor in the majority while their perceived impact in their day to day living was found to be relatively satisfied. The study results show the DIDL tool had weak validity in relation to the clinical status with relevance to the social status of Indian tribal population. Conclusion: The study result shows that there was insignificant and weak validity between the DIDL tool and the oral health status among these tribes who were from a low social class. This might be because their priority in life which is different from what a person from high social class. So the dental problem is ignored at the level of individual depending on his/her priority and at the community level by the policy makers