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Morbidity pattern and its correlates among adolescent girls residing in rural and urban areas of Haldwani, India.
International Journal of Community Medicine and Public Health. 2018 Nov; 5(11):4889-4895.Background: Adolescent girls are vulnerable to different morbidities as their health is a confluence of diverse factors, with the profile of disease burden varying from early adolescent girls of 10-14 years age, to late adolescent girls of 15-19 years age. Methods: This cross-sectional study was done in rural and urban schools of Haldwani block of district Nainital. Multistage random sampling was used to select adolescent girls of 10 to 19 years of age, who were clinically examined and interviewed. Data was analysed using SPSS v21. Statistically significant association was established by Chi-square test. Results: Common morbidities found among adolescent girls were menstrual problems (54.81%), malnutrition including nutritional deficiencies (54.03%), refractive errors (31.17%), hair problems (28.31%) and dental problems (28.18%). General morbidity was present among 51.69% and 61.47% of rural and urban girls respectively. 123 (15.97%) and 97 (12.60%) were found to suffer from skin diseases and respiratory diseases respectively. Conclusions: This study revealed a high prevalence of various morbid conditions among adolescent girls despite of various ongoing measures addressing them.
Caregivers' perception of oral health-related quality of life in a group of Nigerian children living with human immunodeficiency virus.
Nigerian Journal of Clinical Practice. 2016 May-Jun; 19(3):368-74.AIM: This study examined the caregivers' perception of the effect of dental conditions on general well-being and family life of a group of human immunodeficiency virus (HIV)-infected Nigerian children. A secondary aim was to investigate correlations between the children's sociodemographic and health-related variables and caregivers' global ratings of oral health and well-being. Study Design A cross-sectional questionnaire-based survey was conducted among parents/caregivers of 95 HIV-positive children receiving care at the Lagos State University Teaching Hospital, Nigeria. MATERIALS AND METHODS: The "Parental-Caregivers Perception Questionnaire" which included measures of global ratings of oral health and well-being as well as effects of oral health on domains of oral symptoms, functional limitations, emotional well-being, and family well-being/parental distress was used. Assessment was based on the child's oral health within the preceding 3 months of the study. RESULTS: The most affected subscale of the oral health-related quality of life was functional limitation followed by parental distress and then oral symptoms. Caregivers of older children were 2(1/2) times more likely to view oral health as impacting their child's overall health (P = 0.034). Furthermore, caregivers of children who had not yet commenced antiretroviral therapy were 15% more likely to report oral symptoms (P = 0.024) and 11% were more likely to be distressed. STATISTICS: Data entry, validation, and analysis were done using SPSS version 17.0. Findings were considered to be statistically significant when 95% confidence intervals were not overlapping. CONCLUSIONS: According to caregivers' perceptions, oral symptoms, functional limitations, and parental distress outweighed emotional well-being in impacting a child's oral health quality of life. Oral health programs to improve the knowledge of caregivers on the importance of oral health in HIV-positive children are necessary for improvement in overall quality of life.
Dentists' and dental students' attitudes, knowledge, preparedness, and willingness related to treatment of people living with HIV/AIDS in China.
Journal of Public Health Dentistry. 2017 Dec; 77(1):30-38.OBJECTIVES: This study aims to assess the attitudes, knowledge, preparedness, and willingness of dentists and dental students to treat people-living-with-HIV/AIDS (PLWHA) in China, and to determine the factors associated with willingness to treat. METHODS: We surveyed dentists and dental students in hospitals and dental schools in five regions in China with varying PLWHA prevalence. Survey questions covered demographics, as well as four categories regarding treating PLWHA: knowledge (scaled 0-1), attitude (scaled 1-4), preparedness (scaled 1-4), and willingness to treat (scaled 1-4). Composite scores for each category were calculated as weighted means. Confounder-adjusted regression analysis was performed to determine the factor(s) correlated with willingness to treat. RESULTS: We collected 394 (84 percent) and 462 (90 percent) useable surveys from dentists and dental students respectively. Dentists' mean composite scores were 0.63 (poor knowledge), 2.1 (negative attitude), 2.8 (adequate preparedness), and 2.5 (neutral willingness). Students' mean composite scores were 0.64 (poor knowledge), 2.3 (negative attitude), 2.7 (adequate preparedness), and 2.6 (positive willingness). Forty-five percent of dentists and 59 percent of dental students had scores indicating positive willingness to treat. Attitude was the only factor consistently correlated with willingness to treat. Dentists and dental students scored low in all categories except for preparedness. CONCLUSION: It is imperative that knowledge of HIV/AIDS and attitudes toward PLWHA be further improved during dental training to increase the access to and effectiveness of dental care of PLWHA in China and to enhance their quality of life. (c) 2016 American Association of Public Health Dentistry.
Women and Birth. 2017 Apr; 30(2):e119-e124.BACKGROUND: Knowing the intention of mothers is important to plan actions to improve exclusive breastfeeding rates. AIM: The objective of this retrospective study was to verify the intention to breastfeed and the intended breastfeeding duration of a group of women participating in a public prenatal dental care program in the city of Aracatuba, Brazil. METHODS: The records of 933 childbearing women were analyzed and their intention to breastfeed and intended breastfeeding duration were associated to women's age, ethnicity, marital status, education, employment, number of gestations, previous breastfeeding experience, previous breastfeeding guidance, presence of complications during pregnancy, and systemic diseases. Data were inserted into Epi Info 2000 and analyzed with Biostat, at a 5% level of significance, and confidence interval of 95%. FINDINGS: Participants mean age was 26.1+/-5.9years. The majority of women (96.5%) declared their intention to breastfeed their babies. The main variables to affect the intention to breastfeed were the number of gestations (p=0.001), previous breastfeeding experience (p=0.03), and previous breastfeeding guidance (p=0.01). Intended breastfeeding duration was significantly affected by women's age (p=0.04), employment (0.02), the number of gestations (p=0.001), and previous breastfeeding experience (p=0.04). CONCLUSIONS: Previous positive breastfeeding experience and guidance during prenatal examinations positively affected women's intention to breastfeed; while older, unemployed women in their second or more gestation and previous breastfeeding experience intended to breastfeed their children for longer periods of time. Copyright (c) 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
Pediatrics. 2017 Jul; 140(1)BACKGROUND: Few studies have assessed the effect of breastfeeding, bottle feeding, and sugar consumption on children's dental caries. We investigated whether the duration of breastfeeding is a risk factor for dental caries in the primary dentition, independently of sugar consumption. METHODS: An oral health study (n = 1303) nested in a birth cohort study was carried out in southern Brazil. The average number of decayed, missing, and filled primary tooth surfaces (dmfs) and severe early childhood caries (S-ECC: dmfs >/=6) were investigated at age 5 years. Breastfeeding was the main exposure collected at birth and at 3, 12, and 24 months of age. Data on sugar consumption were collected at 24, 48, and 60 months of age. Marginal structural modeling was used to estimate the controlled direct effect of breastfeeding (0-12, 13-23, and >/=24 months) on dmfs and on S-ECC. RESULTS: The prevalence of S-ECC was 23.9%. The mean number of dmfs was 4.05. Children who were breastfed for >/=24 months had a higher number of dmfs (mean ratio: 1.9; 95% confidence interval: 1.5-2.4) and a 2.4 times higher risk of having S-ECC (risk ratio: 2.4; 95% confidence interval: 1.7-3.3) than those who were breastfed up to 12 months of age. Breastfeeding between 13 and 23 months had no effect on dental caries. CONCLUSIONS: Prolonged breastfeeding increases the risk of having dental caries. Preventive interventions for dental caries should be established as early as possible because breastfeeding is beneficial for children's health. Mechanisms underlying this process should be investigated more deeply. Copyright (c) 2017 by the American Academy of Pediatrics.
Effects of breast-feeding duration, bottle-feeding duration and non-nutritive sucking habits on the occlusal characteristics of primary dentition.
BMC Pediatrics. 2015 Apr; 15:46.Background: Early transition from breastfeeding and non-nutritive sucking habits may be related to occlusofacial abnormalities as environmental factors. Previous studies have not taken into account the potential for interactions between feeding practice, non-nutritive sucking habits and occlusal traits. This study assessed the effects of breast-feeding duration, bottle-feeding duration and non-nutritive sucking habits on the occlusal characteristics of primary dentition in 3–6-year-old children in Peking city. Methods: This cross sectional study was conducted via an examination of the occlusal characteristics of 734 children combined with a questionnaire completed by their parents/guardians. The examination was performed by a single, previously calibrated examiner and the following variables were evaluated: presence or absence of deep overbite, open bite, anterior crossbite, posterior crossbite, deep overjet, terminal plane relationship of the second primary molar, primary canine relationship, crowding and spacing. Univariate analysis and multiple logistic regressions were applied to analyze the associations. Results: It was found that a short duration of breast-feeding (never or =6 months) was directly associated with posterior cross bite (OR = 3.13; 95% CI = 1.11–8.82; P = 0.031) and no maxillary space (OR = 1.63; 95% CI = 1.23–2.98; P = 0.038). In children breast-fed for =6 months, the probability of developing pacifier-sucking habits was 4 times that for those breast-fed for >6 months (OR = 4.21; 95% CI = 1.85–9.60; P = 0.0002). Children who were bottle-fed for over 18 months had a 1.45-fold higher risk of nonmesial step occlusion and a 1.43-fold higher risk of a class II canine relationship compared with those who were bottle-fed for up to 18 months. Non-nutritive sucking habits were also found to affect occlusion: A prolonged digit-sucking habit increased the probability of an anterior open bite, while a pacifier-sucking habit associated with excessive overjet and absence of lower arch developmental space. Conclusion: Breastfeeding duration was shown to be associated with the prevalence of posterior crossbite, no maxillary space in the deciduous dentition and development of a pacifier-sucking habit. Children who had a digit-sucking habit were more likely to develop an open bite.
European Journal of Contraception and Reproductive Health Care. 2017 Aug; 22(4):321-325.AIM: The aim of the study was to investigate the health-related behaviours of pregnant women. Maternal health-related habits, use of psychoactive medicines, diet, prevention of neural tube defects, oral cavity hygiene, chronic diseases and physical activity were analysed in a group of pregnant women attending antenatal classes. METHODS: Hundred pregnant women recruited from various antenatal classes in Poznan, Poland, were investigated using a questionnaire based on the Pregnancy Risk Assessment Monitoring System. RESULTS: The results showed that 29% of pregnancies were unplanned. In women with higher education, 62% reported that they were taking folic acid supplements during pregnancy, in contrast with 35% women with a lower level of education (p = .012). The study showed that 24% of women were exposed to second-hand smoke during pregnancy, and this was more common among younger study participants (p = .038). Nine percentage of women admitted drinking alcohol during pregnancy. Pre-pregnancy alcohol consumption was more frequent among women with higher education (p = .011). Only 46.7% of women informed their dentist about their pregnancy, and these were more often older participants (p = .023). CONCLUSION: The study found low maternal awareness regarding health-related behaviours, which presents a serious challenge to public health care in Poland. Pregnant women and those who wish to conceive need to be educated effectively about preventive measures in order to maintain optimal maternal and reproductive health, as well as normal fetal development.
Oral Candida spp carriage and periodontal diseases in HIV-infected patients in Ribeirao Preto, Brazil.
Revista Do Instituto De Medicina Tropical De Sao Paulo. 2017 Jun 01; 59:e29.The majority of HIV-infected patients develop Candida spp-associated clinical oral lesions. Studies have shown that asymptomatic oral colonization of Candida spp may lead to oral lesions or become a source of disseminated infections. The aim of this study was to verify the effects of periodontal conditions on Candida spp prevalence and Candida spp carriage in the oral cavity of HIV-infected patients compared to non-infected patients. Twenty-five patients not infected with HIV and 48 HIV-infected patients were classified according to periodontal conditions as being periodontal healthy or with periodontal disease. Candida spp carriage and classification were performed in oral rinse samples. Viral load and CD4+ T lymphocyte (CD4+L) counts were performed in blood samples from HIV-infected patients. No differences in Candida spp prevalence related to HIV status or periodontal condition were detected. However, Candida spp carriage was increased in periodontally affected HIV-infected patients when compared to periodontally healthy HIV-infected patients (p= 0.04). Periodontally healthy HIV-infected patients presented Candida spp carriage in similar levels as healthy or periodontally affected non-HIV-infected patients. Candida spp carriage was correlated with CD4+L counting in HIV-infected patients. We concluded that periodontal disease is associated with increased Candida spp carriage in HIV-infected patients and may be a predisposing factor to clinical manifestations of candidiasis.
A survey of HIV-related knowledge and attitude among dental nursing students in South Western Nigeria.
Benin Journal of Postgraduate Medicine. 2007 Dec; 9(1):12 p.Objective: To assess HIV-related knowledge and attitude among dental nursing students in South Western Nigeria. Methods: A descriptive cross-sectional survey of the entire 97 final year dental nursing students from 4 colleges of health technology located in South Western Nigeria was conducted in University of Benin Teaching Hospital during their external clinical posting between June 2006 and June 2007. A self-administered questionnaire elicited information on demography, HIV/AIDS knowledge, source of information, interpersonal communication concerning HIV/AIDS, attitudes towards HIV testing, occupational risk perception and willingness to care for HIV patients. Results: Response rate was 91.8% (89/97). About three quarter (73%) was in 21-25 years age group. Male: Female ratio was approximately 1:12. The respondents’ overall mean HIV/AIDS knowledge score was 13.2+or-1.8 out of 16 points. Level of knowledge was influenced by marital status, state of origin and sources of information (p<0.05). Misconceptions about transmission by mosquito bite (29.2%) and symptomatology (48.3%) existed among respondents. Fifty-five (61.8%) want HIV patients quarantined to prevent spread. The leading source of information was the electronic media 68(76.4%); minor source was the internet 7(7.9%). Interpersonal conversation on HIV/AIDS-related issues was commonly with classmates/friends (62.9%). Majority (86%) favoured compulsory HIV testing for dental nursing students. Over four fifths (88.6%) expressed willingness to render care to HIV infected patient. Fifty-one (57.3%) expressed worry about HIV contagion through occupational exposure. Conclusion: Dental nursing students constitute a useful public HIV education resource but they lack in-depth knowledge of the subject. Comprehensive training to clarify existing misconceptions and reduce discriminatory behaviour is recommended.
Journal of Clinical and Diagnostic Research. 2016 Nov; 10(11):ZE01-ZE06.INTRODUCTION: Oral contraceptives are one of the risk factors for gingival disease. Oral contraceptives can affect the proliferation of cell, growth and differentiation of tissues in the periodontium. Nowadays recent research has suggested that the newer generation oral contraceptives have less influence on gingival diseases. AIM: The purpose of this study was to systematically review the effect of oral contraceptives on periodontium. MATERIALS AND METHODS: A literature review was performed; PubMed, PubMed Central and Cochrane Library, Embase, Google Scholar were searched from 1970 up to December 2015 to identify appropriate studies. RESULTS: Out of the total 94 titles appeared 13 articles fulfilled the criteria and were selected for the review. Two articles which were hand searched and one article which was through e-mail was also included. The hormones progesterone and estrogen have direct impact on immune system of the body and thus, affect the pattern and rate of collagen production in the gingiva. Furthermore, the review also shows that longer duration usage of oral contraceptive could lead to poorer oral hygiene status, gingival inflammation and increased susceptibility to periodontal disease. CONCLUSION: There are relatively few studies evaluating the effect of oral contraceptives on periodontium. It was found that oral contraceptives have a marked effect on periodontium. The gingival changes after use of oral contraceptives are pronounced in the first few months and with the passage of time these changes get enhanced.
Journal of Contemporary Dental Practice. 2015 Mar 01; 16(3):227-33.BACKGROUND: This study had a two objectives to determine the prevalence of domestic violence and to know the impact of the same on the oral health. MATERIALS AND METHODS: An observational cross-sectional study was done in Jodhpur, Rajasthan; among 150 married women of 18 to 60 years of age using a predesigned pretested proforma from 18th January 2014 to 27th February 2014. Pretested semistructured open-ended questionnaire used for collecting the data from the study subjects. Pearson's Chi-square test and p-value were used to calculated the occurrence and impact of domestic violence on oral health among women. RESULTS: The most common form of domestic violence found was physical abuse (54.7%) followed by emotional abuse (20.0%) and financial abuse (14.0%). The most important risk factor was alcoholism followed by literacy status and having a girl child. Study shows that physical abuse is more in graduate than lower level of educational females. Females living in urban area show highest frequency of physical abuse than those living in rural area. Injury to the face were highly reported (38.7%) followed by injury to lip (13.3%) and nose fracture/bleeding nose (9.3%). CONCLUSION: Government has to take stringent action to prevent domestic violence by making women more self-reliant especially by making women more literate and more financially independent.
Forensic Science International. 2015 Dec; 257:510.e1-4.The notification of the Human Immunodeficiency Virus (HIV) in Brazilian children was first reported in 1984. Since that time more than 21 thousand children became infected. Approximately 99.6% of the children aged less than 13 years old are vertically infected. In this context, most of the children are abandoned after birth, or lose their relatives in a near future, growing with uncertain identification. The present study aims to estimate the dental age of Brazilian HIV patients in face of healthy patients paired by age and gender. The sample consisted of 160 panoramic radiographs of male (n: 80) and female (n: 80) patients aged between 4 and 15 years (mean age: 8.88 years), divided into HIV (n: 80) and control (n: 80) groups. The sample was analyzed by three trained examiners, using Willems' method, 2001. Intraclass Correlation Coefficient (ICC) was applied to test intra- and inter-examiner agreement, and Student paired t-test was used to determine the age association between HIV and control groups. Intra-examiner (ICC: from 0.993 to 0.997) and inter-examiner (ICC: from 0.991 to 0.995) agreement tests indicated high reproducibility of the method between the examiners (P<0.01). Willems' method revealed discrete statistical overestimation in HIV (2.86 months; P=0.019) and control (1.90 months; P=0.039) groups. However, stratified analysis by gender indicate that overestimation were only concentrated in male HIV (3.85 months; P=0.001) and control (2.86 months; P=0.022) patients. The significant statistical differences are not clinically relevant once only few months of discrepancy are detected applying Willems' method in a Brazilian HIV sample, making this method highly recommended for dental age estimation of both HIV and healthy children with unknown age. Copyright (c) 2015 Elsevier Ireland Ltd. All rights reserved.
Use of mouth rinse during pregnancy to improve birth and neonatal outcomes: a randomized controlled trial.
BMC Pregnancy and Childbirth. 2015; 15:311.BACKGROUND: Poor oral health, such as periodontal (gum) disease, has been found to be associated with an increased risk of adverse pregnancy outcomes including preterm birth, low birth weight, and neonatal and infant mortality, especially in low-and middle-income countries. However, there is little or no access to preventive dental care in most low-and middle-income countries. We propose to develop and test a "Mouth Rinse Intervention" among pregnant women to prevent the progression of periodontal disease during pregnancy and reduce adverse birth and neonatal outcomes in a rural county of China. METHODS/DESIGN: This is a randomized controlled clinical trial. A sample of 468 (234 in each arm of the study) women in early pregnancy with periodontal disease will be recruited for the study. Periodontal disease will be diagnosed through the methods of Periodontal Screening and Recording. All women diagnosed with periodontal disease will be randomly allocated into the intervention or control group. Women assigned in the intervention group will be provided with non-alcohol antimicrobial mouth rinse containing cetylpyridinium chloride throughout the pregnancy and oral health education. Women in the control group will receive a package of tooth brush and paste, plus oral hygiene education. Women will be followed-up to childbirth until the 42nd day postpartum. The main outcomes include mean birthweight (gram) and mean gestational age (week). DISCUSSION: Compared with conventional mechanical 'scaling and root planning' periodontal treatment during pregnancy, our proposed mouth rinse intervention could be a simple, cost-effective, and sustainable solution to improve both mother's oral health and neonate outcomes. If the mouth rinse is confirmed to be effective, it would demonstrate great potential for the application in other low- or middle-income countries to prevent adverse birth outcomes such as preterm birth and low birth weight and to reduce neonatal and infant mortality. TRIAL REGISTRATION: This trial was registered with Chinese Clinical Trial Registry (ChiCTR): ( #ChiCTR-TRC-13003768 ) on November 06, 2013.
The Relationship Between Maternal Periodontal Status of and Preterm and Low Birth Weight Infants in Iran: A Case Control Study.
Global Journal of Health Science. 2016 May; 8(5):184-8.AIM & BACKGROUND: It has been suggested that periodontitis is associated with systemic alterations such as adverse pregnancy outcomes. However, some conflicting results have been reported. This study was conducted to determine the association between periodontitis and preterm birth (PTB), low birth weight (LBW) to obtain information which is necessary for the planning of preventive programs of periodontal disease for pregnant women in this area. MATERIALS & METHODS: This case-control study was performed on 264 mothers. The index used to determine oral hygiene and periodontal diseases is Community Periodontal Index Treatment Needs (CPITN). RESULTS: The mothers in the sample group with single delivery delivered 8 times low birth weight infants more than the mothers in the control group with single delivery. And also the mothers in the sample group with multiple deliveries; delivered 10 times low birth weight infants and 8 times premature infant more than the mothers in the control group. CONCLUSION: More studies should be carried out in through preventing and treating periodontal diseases, expenses incurred due to preterm labor and low birth weight decrease and the society will witness fewer mental problems suffered by such children as they grow up. So we can emphasize the importance of periodontal care in prenatal health programs. And we may suggest that a special program of periodontal disease prevention for pregnant women is very necessary.
Effects of oral contraceptives on the prevalence of alveolar osteitis after mandibular third molar surgery: a retrospective study.
International Journal of Oral and Maxillofacial Surgery. 2016 Jun 13;The objective of this study was to investigate the influence of oral contraceptives on the incidence rate of alveolar osteitis (AO) following the surgical extraction of both impacted mandibular third molars. This retrospective study reviewed the clinical records of patients who presented to the oral surgery clinic of a university school of dentistry for the extraction of impacted mandibular third molars. Using a database search, all patients were categorized by sex, age, occurrence of AO, and whether the females were taking oral contraceptives at the time of surgery. The patient was considered positive for AO if either one or both sockets developed AO. The incidence of AO among women taking oral contraceptives at the time of impacted mandibular third molar extraction differed significantly from that in the other patient groups. AO occurred in 37.9% (11/29) of females taking oral contraceptives, while only 8.9% (16/179) of females who were not taking oral contraceptives at the time of extraction developed AO. The total incidence of AO among females was 13.0% (27/208). The total incidence of AO among the 363 males and females presenting for mandibular third molar extractions was 13.8%. Females who are taking oral contraceptives at the time of impacted mandibular third molar extraction are at a higher risk of developing AO following extraction. Copyright (c) 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Journal of Dental Sciences. 2016 Mar; 11(1):72-78.Background/purpose Oral care is vital to human immunodeficiency virus (HIV)-positive individuals. As future dentists, it is pertinent that dental students have sufficient knowledge and a positive approach toward this disease. The purpose of this study was to assess HIV/AIDS-related knowledge and attitudes among clinical dental students in central China. Materials and methods This survey was conducted on 103 dental students in the final year of a 5-year program. A structured questionnaire with 50 questions examining their knowledge under various categories and 17 questions examining their attitudes toward the disease was employed. Results The survey was completed by 92.2% (95/103) of the students. The results revealed that more than half of the respondents demonstrated a good level of knowledge, although few exhibited an excellent level. The mean scores on knowledge was 79.41 ± 6.3 out of a maximum possible score of 100, and there was no significant difference regarding sex. Despite their good level of knowledge, the majority (93.68%) displayed a negative attitude (nonprofessional attitude) toward HIV/AIDS. Conclusion These findings might help to define strategies to improve the quality of education among Chinese dental students and suggests that there is a need to address student misconceptions and attitudes toward the disease.
Oral Diseases. 2016 Apr; 22(S1):79-86.The objectives of this study, presented as part of a plenary session at WW7 in Hyderabad, India were to review (i) the epidemiology and current clinical issues of HIV infection with regard to HIV and older populations and (ii) models for increased morbidity and mortality in older HIV-positive individuals with implications for clinical care. HIV infection for those in treatment has become a complex chronic disease in which end-organ injury and resulting morbidity, functional decline, and mortality do not have a single etiology but reflect cumulative loss of organ system reserve from multiple interacting sources leading to functional decline, organ system failure, and death. Emerging guidelines and recommendations suggest a need for increased awareness and treatment of the multifaceted needs of the aging HIV-infected patient.
Bulletin Du Groupement International Pour La Recherche Scientifique En Stomatologie and Odontologie. 2011; 50(2):39-41.Add to my documents.
Pan African Medical Journal. 2015; 20:287.INTRODUCTION: Oral diseases in the HIV infected children though commonly encountered are under researched and often overlooked by physicians in developing countries. The aim of this study is to document the types and frequency of oral lesions in HIV infected children and examine the effects of management with HAART on their rates. METHODS: A cross sectional study designed to identify the oral lesions in consecutive HIV infected children and their distribution at a Paediatric Anti-retroviral clinic. Information on oral disease and clinical features of the subjects were obtained by history and clinical examination and laboratory investigations by the pediatricians and dental surgeons. RESULTS: The 58 children studied consisted of 34 boys and 24 girls with their ages ranging from 3 months to 13 years. Thirty seven (63.8%) of the 58 children had oral diseases. Enamel hypoplasia, candidiasis, caries, angular chelitis, and herpes labialis were the most common oral lesions found in the patients. Oral soft tissue lesions were less frequently encountered among children on HAART. Statistical significance was recorded among those infected with candidiasis. More than 60% of the children diagnosed with oral disease had no knowledge of the state of their oral health before the study. CONCLUSION: Oral diseases are very common amongst the children studied. Awareness of oral disease among the children and their caregivers is low. Administration of HAART may have a preventive effect on the development of oral soft tissue disease. There is a need to integrate dental care into the paediatric HIV care programs.
Effect of Breastfeeding Promotion on Early Childhood Caries and Breastfeeding Duration among 5 Year Old Children in Eastern Uganda: A Cluster Randomized Trial.
PloS One. 2015; 10(5):e0125352.BACKGROUND: Although several studies have shown short term health benefits of exclusive breastfeeding (EBF), its long term consequences have not been studied extensively in low-income contexts. This study assessed the impact of an EBF promotion initiative for 6 months on early childhood caries (ECC) and breastfeeding duration in children aged 5 years in Mbale, Eastern Uganda. METHODS: Participants were recruited from the Ugandan site of the PROMISE- EBF cluster randomised trial (ClinicalTrials.gov no: NCT00397150). A total of 765 pregnant women from 24 clusters were included in the ratio 1:1 to receive peer counselled promotion of EBF as the intervention or standard of care. At the 5 year follow-up, ECC was recorded under field conditions using the World Health Organization's decayed missing filled tooth (dmft) index. Adjusted negative binomial and linear regression were used in the analysis. RESULTS: Mean breastfeeding duration in the intervention and control groups (n=417) were 21.8 (CI 20.7-22.9) and 21.3(CI 20.7-21.9) months, respectively. The mean dmft was 1.5 (standard deviation [SD] 2.9) and 1.7 (SD 2.9) in the intervention and control groups, respectively. Corresponding prevalence estimates of ECC were 38% and 41%. Negative binomial regression analysis adjusted for cluster effects and loss-to-follow-up by inverse probability weights (IPW) showed an incidence-rate ratio (IRR) of 0.91 (95% CI 0.65-1.2). Comparing the effect of the trial arm on breastfeeding duration showed a difference in months of 0.48 (-0.72 to 1.7). CONCLUSION: PROMISE EBF trial did not impact on early childhood caries or breastfeeding duration at 5 years of age. This study contributes to the body of evidence that promotion of exclusive breastfeeding does not raise oral health concerns. However, the high burden of caries calls for efforts to improve the oral health condition in this setting. TRIAL REGISTRATION: ClinicalTrials.gov NCT00397150.
Revista De Saude Publica. 2015; 49OBJECTIVE: To analyze HIV/AIDS positive individual's perception and attitudes regarding dental services. METHODS: One hundred and thirty-four subjects (30.0% of women and 70.0% of men) from Nuevo Leon, Mexico, took part in the study (2014). They filled out structured, analytical, self-administered, anonymous questionnaires. Besides the sociodemographic variables, the perception regarding public and private dental services and related professionals was evaluated, as well as the perceived stigma associated with HIV/AIDS, through a Likert-type scale. The statistical evaluation included a factorial and a non-hierarchical cluster analysis. RESULTS: Social inequalities were found regarding the search for public and private dental professionals and services. Most subjects reported omitting their HIV serodiagnosis and agreed that dentists must be trained and qualified to treat patients with HIV/AIDS. The factorial analysis revealed two elements: experiences of stigma and discrimination in dental appointments and feelings of concern regarding the attitudes of professionals or their teams concerning patients' HIV serodiagnosis. The cluster analysis identified three groups: users who have not experienced stigma or discrimination (85.0%); the ones who have not had those experiences, but feel somewhat concerned (12.7%); and the ones who underwent stigma and discrimination and feel concerned (2.3%). CONCLUSIONS: We observed a low percentage of stigma and discrimination in dental appointments; however, most HIV/AIDS patients do not reveal their serodiagnosis to dentists out of fear of being rejected. Such fact implies a workplace hazard to dental professionals, but especially to the very own health of HIV/AIDS patients, as dentists will not be able to provide them a proper clinical and pharmaceutical treatment.
Odonto - Stomatologie Tropicale. 2015 Dec; 38(152):5-16.OBJECTIVE: To evaluate the association between periodontal disease and pregnancy outcomes like preterm birth and low birth weight. PATIENTS AND METHOD: Interviewer-administered questionnaires were completed by the subjects who attended the antenatal clinic of the Lagos University Teaching Hospital, Lagos. Information obtained included; maternal age, gestational age, marital status, educational status, occupation and expected date of delivery. After delivery, the questionnaire was completed with baby's weight at birth and the actual date of delivery. Clinical assessment of the periodontium was done using Oral Hygiene Index (OHI) and Community Periodontal Index of Treatment Needs (CPITN). Participants were divided into three groups: Test, Control I and Control II groups. Scaling and polishing were done for all patients with periodontal disease before (Test group) and after delivery (Control I). All Control II participants (those without periodontal disease) were given Oral hygiene instructions. Descriptive and comparative analyses were done using Epi info version 2008. RESULTS: Four hundred and fifty women received the questionnaire but the response rate was 94%, giving an actual sample size of 423 participants. Maternal age range was between 18 and 34 years with mean age of 29.67 (+/- 3.37). Gestational age at the point of recruitment was between 10 weeks and 26 weeks with mean of 23.34 (+/- 4.05). The prevalence of periodontal disease among the study group was 33.38%. About 71% of the participants attained tertiary level of education; only 0.7% had no formal education. There was 9.9% use of alcohol among the participants. The mean oral hygiene score for the participants was 1.94 (+/- 1.31). The prevalences for preterm deliveries, low birth weight and spontaneous abortion were 12.5%, 12.1% and 1.42% respectively. CONCLUSION: This study confirms periodontal disease as a probable risk for adverse pregnancy outcomes such as preterm delivery and low birth weight. Therefore, health workers should be encouraged to promote good oral health among women.
Indian Journal of Community Health. 2011 Jul-Dec; 23(2):96-98.Background: India estimates third highest number of HIV infections in the world, with about 2.4 million people currently living with HIV/AIDS. Adequately trained and sensitized healthcare professionals can play a vital role in combating this epidemic. Limited studies have explored knowledge and attitudes of medical students relating to HIV/AIDS, particularly in the eastern part of India. Methods: The present cross sectional study explored knowledge and attitudes of first year MBBS, BDS & BPT students of Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar, Odisha on HIV/AIDS using a self-administered questionnaire. Data thus collected were analyzedand relevant statistics were calculated. Knowledge and attitude scores were determined and analysis of variance (ANOVA) test was used to examine the equality between the groups. Results: All students scored low on the overall knowledge scale (<10/15). Specifically, knowledgewas low on modes of transmission and treatment. Attitudinal scores in the areas of precautions and need for training on HIV was low for all the three streams.The willingness to treat HIV/AIDS patient was found to be high amongst study participants. Conclusion: There is a need and scope to provide correct and detailed information on HIV/AIDS for new entrants in medical and allied health sciences to help them acquire adequate knowledge and develop appropriate attitudes towards HIV/AIDS.
Short-term impact of oral hygiene training package to Anganwadi workers on improving oral hygiene of preschool children in North Indian City.
BMC Oral Health. 2013; 13:67.BACKGROUND: Globally, dental caries is categorized in the list of public health problems in preschool children. In India, lack of availability and affordability of oral health enhances the cost of treatment and care. Empowering community workers like Anganwadi workers (AWWs) in oral health, and providing basic oral health awareness to the mothers through them can be feasible model. So, the present study was conducted to evaluate the short-term impact of Oral Hygiene Training Package (OHTP) to AWWs on improving oral hygiene of preschool children. METHODS: This before and after comparison field trial was done in Anganwadi centres (AWCs) of Chandigarh city, India. 534 children aged 36-72 months attending 21 AWCs were examined before and after imparting trainings to AWWs. OHTP was administered to AWWs, which consisted of power-point presentation and demonstrated the skills like proper brushing technique, plaque disclosure, flossing technique, gum massaging etc. The AWWs later imparted training to mothers in their respective AWCs. Post intervention data was collected after three months.Outcome measures were improvement in oral health status (plaque, debris, gingival health), oral habits (brushing, rinsing) and decrease in caries activity (Snyder test). RESULTS: Prevalence of dental caries was found to be 48.3%. Only 4.1% of the population reported brushing twice which increased significantly to 9.9% post-intervention (p = 0.000). There was a significant decrease in debris (78.3% to 54.1%), and stage-1 plaque (75.5 to 66.5%) in the oral cavity. Caries activity by Snyder's test decreased from 48.2% to 31.2% (p = 0.01) post-intervention. CONCLUSIONS: Controlled trials of using AWWs to improve oral hygiene appear to be justified. TRIAL REGISTRATION: CTRI/2012/07/002786.
International Journal of Dentistry. 2013; 2013:685049.Dental caries is an increasing burden in the developing countries. A proper budgetary allocation for treating dental diseases in an enormous population such as India is impractical, where resources are inadequate for major health challenges such as malnutrition and gastrointestinal and respiratory infections in children. An integrated, directed population approach targeting children is much needed. The existing machinery of successful public health campaigns such as the "Pulse Polio" and the "Mid-Day-Meals Scheme" of the Government of India can be used for oral health promotion for children. India has about 300 dental colleges and countrywide branches of the Indian Dental Association that can provide manpower for the program. An innovative, large-scale "Fit for School" program in Philippines is a model for an integrated approach for children's health and has proved to be cost-effective and viable. A model for oral health promotion in infants and children of India, combining age-specific initiatives for health education, nutrition, hygiene, and fluoride use, is proposed. The model could be implemented to evaluate the oral health status of children, knowledge and knowledge gain of the community health workers, and acceptability and sustainability of the preventive programs (fluoride varnish and preschool and school tooth brushing) pragmatically.