Knowledge, attitude and awareness among diabetic vs. non-diabetic patients about the association between diabetes and oral health

Background: Global prevalence of diabetes is rapidly increasing with an estimate to affect 593 million worldwide by 2035. Current evidence clearly states an association between oral diseases and diabetes mellitus with manifestations like periodontitis, peri-implantitis, xerostomia, etc. Despite this obvious link, knowledge, awareness and attitude of general population towards this are not fully understood. Aims: To assess public knowledge and awareness on association between diabetes and oral health and assess their attitude towards oral hygiene care and maintenance. Methods and Materials: A three-part structured questionnaire was developed with multiple choice questions and circulated among patients visiting a private dental college. A total of 502 questionnaires were evaluated, and results were statistically analysed. Statistical Analysis Used: Student-t test and Chi-square test using SPSS software. Results: Majority of the participants were male and lived in urban area. 41.8% respondents had diabetes, out of which 86.7% had no awareness of the type. A significant number of non-diabetic individuals had awareness of excessive sugar intake as a cause of diabetes. Greater number of diabetic patients (96.7%) reported dry mouth, whereas only 53.3% had periodontal complications. 90% participants use tooth brush as oral hygiene aid. Only 10.6% participants follow regular dental visits. Majority of subjects (60.6%) listed their friends and family as major source of information. Conclusion: More people are aware of systemic complications of diabetes as compared to oral problems. A better interdisciplinary relationship is required among dentists and physicians to improve knowledge and awareness of general population

Short-term prognostic value of perioperative coronary sinus-derived-serum cardiac troponin-I, creatine kinase-MB, lactate, pyruvate, and lactate-pyruvate ratio in adult patients undergoing open heart surgery

Objectives: To investigate the release pattern of different cardiac metabolites and biomarkers directly from the coronary sinus (CS) and to establish the diagnostic discrimination limits of each marker protein and metabolites to evaluate perioperative myocardial injury in patients undergoing cardiac surgery under cardiopulmonary bypass (CPB). Patients and Methods: Sixty-eight patients undergoing first mitral and/or aortic valve replacements with/without coronary artery bypass grafting and Bentall procedure under CPB and blood cardioplegic arrest were studied. All cardiac metabolites and biomarkers were measured in serial CS-derived blood samples at pre-CPB, immediate post aortic declamping, 10 minutes post-CPB and 12 hrs post-CPB. Results: Receiver operating characteristic curve analysis of cardiac biomarkers indicated lactate-pyruvate ratio as the superior diagnostic discriminator of myocardial injury with an optimal "cut-off" value >10.8 immediately after aortic declamping (AUC, 0.92; 95% CI: 0.85-0.98). Lactate was the second best diagnostic discriminator of myocardial injury with an optimal "cut-off" value >2mmol/l at immediately after aortic declamping (AUC, 0.89; 95% CI: 0.80-0.96). Cardiac troponin-I was the third best diagnostic discriminator of myocardial injury with an optimal "cut-off" value >2.1ng/ml at immediately after aortic declamping (AUC, 0.88; 95% CI: 0.80-0.95). Creatine kinase-MB was the fourth best diagnostic discriminator of myocardial injury with an optimal "cut-off" value >58 log units/ml prior to decanulation (AUC, 0.85; 95% CI: 0.78-0.94). Conclusions: Measurable cardiac damage exists in all patients undergoing cardiac surgery under cardioplegic arrest. The degree of myocardial injury is more in patients with poor ventricular function and those requiring longer aortic clamp time. CS-derived lactate-pyruvate ratio, lactate, cTn-I served as superior diagnostic discriminators of peri-operative myocardial damage