Characteristics of Oral Mucosal Lesions and Their Association with Socioeconomic Status and Systemic Health in A Remote Rural Area in China: A Cross-Sectional Study of 146 Cases

Background: Epidemiological data of oral mucosal lesions (OMLs) are required to develop practical oral care policies. However, limited data are available for rural areas in China. We aimed to estimate the spectrum and prevalence of OMLs and to identify their associated socioeconomic status (SES) and systemic health in a remote rural area in Yunnan, China. Methods: We screened patients for OMLs in an oral medicine clinic in rural Yuannan, China, from August 2020 to February 2021. OMLs were documented. SES, including the highest education level achieved and the previous month’s household income, as well as the patient’s systemic health, including a history of smoking, alcohol use, and chronic disease, were obtained from the Medical History/Health Questionnaire Form and patient medical records. Results: A total of 146 patients were found to have OMLs. The most frequent OML was aphthous ulcer (n = 41, 28.1%), followed by burning mouth syndrome (BMS) (n = 16, 11.0%), viral ulcer (n = 14, 9.6%), and oral lichen planus (OLP) (n = 9, 6.2%). In these patients, the most common chronic diseases were sleep apnea (n = 35, 24.0%), hypertension (n = 23, 15.8%), bronchitis (n = 16, 11.0%), reflux (including gastroesophageal reflux disease) (n = 12, 8.2%), and arthritis (n = 11, 7.5%). On adjusted regression, the patients without chronic diseases had a lower risk of BMS than those with chronic diseases (odds ratio [OR], 0.2; 95% confidence interval [CI], 0.03–0.9). Age was an independent protective factor for viral ulcers (OR, 1.0; 95% CI, 0.9–1.0). Patients with low-income levels had a lower risk of OLP than those with high-income levels (OR, 0.2; 95% CI, 0.05–0.9). Conclusions: In rural Yunnan in China, the most frequent OML was aphthous ulcer, which was followed by BMS, viral ulcer, and OLP. Chronic diseases were associated with BMS. Age was an independent protective factor for oral viral ulcers. A high-income level was associated with the presence of OLP. Oral care policies should be prioritized among patients with aphthous ulcer. Preventive strategy of BMS should be targeted to people with chronic disease for health equalities.

Prosthetic Rehabilitation of an Unusually Self-Obturated Cleft Palate Defect in an Adult Edentulous Patient Living in a Remote Rural Area. A Clinical Report

Patients with unrepaired cleft palate defects still exist within remote rural areas. The prosthodontic rehabilitation of an adult edentulous cleft patient could be very demanding for treating maxillofacial prosthodontist, since most of them are edentulous, challenging the retention and the stability of the maxillary prosthesis. It is therefore highly important that cleft palate patients seek dental and prosthodontic care as early in their life as possible. In this report, an unusual case of a patient self-obturated cleft palate defect is presented. The patient’s self-made prosthesis was replaced by an appropriately fabricated pharyngeal obturator prosthesis in order to improve speech and swallowing.

The multimorbidity of hypertension and osteoarthritis and relation with sleep quality and hyperlipemia/hyperglycemia in China’s rural population

Hypertension (HTN) and osteoarthritis (OA) are frequent in middle-aged and elderly people, and the co-occurrence of these two diseases is common. However, the pathogenesis of the multimorbidity of both diseases and the relation with sleep quality, hyperlipemia, and hyperglycemia is unclear. We conducted a cross-sectional study to make sense of the multimorbidity of HTN and OA and the relation with sleep quality, hyperlipemia, and hyperglycemia. The relation between sleep quality and OA and its joint effect with hyperlipemia or hyperglycemia was evaluated with logistic regression models. The additive interaction was assessed with the relative excess risk due to interaction (REEI), the attributable proportion (AP), and the synergy index (S). According to this research in a remote rural area, approximately 34.2% of HTN patients are accompanied with OA and 49.1% are suffering poor sleep. Both hyperlipemia/hyperglycemia and sleep quality were related to OA prevalence with crude ORs of 1.43 (95% CI 1.014–2.029) and 1.89 (95% CI 1.411–2.519, P < 0.001) respectively. An observed additive effect was found greater than the sum of the effects of sleep quality and hyperlipemia/hyperglycemia posed on OA prevalence alone. This additive interaction was observed in females (OR = 3.19, 95% CI 1.945–5.237) as well as males ≥ 65 years old (OR = 2.78, 95% CI 1.693–4.557), with RERI, AP, and S significant. Therefore, poor sleep and hyperlipemia/hyperglycemia are associated with OA, and further studies on the additive interaction among females and males ≥ 65 are warranted.

Dyslipidaemia among diabetes and hypertensive patients in a remote rural area of South India, in comparison with ICMR-InDiab study

Background: The aim of the study was to find out the prevalence and determinants of dyslipidaemia among DM and HT group in a remote rural area of India and comparing with ICMR-InDiab study. Methods: We screened high risk individuals (hypertension and diabetes patients) for dyslipidemia covering ten villages surrounding a Rural Health Training Centre (RHTC) located in South India, in August-September 2017. Participants were line listed from the electronic data base maintained in RHTC and were screened at their door step by visiting their house.Results: Mean values of all lipids among the high-risk population were increased significantly (p<0.01). Prevalence of hypercholesterolemia was three times more, hypertriglyceridemia was 1.3 times higher, high LDL cholesterol was 3.3 times higher, high cholesterol HDL ratio was 1.5 times higher and isolated hypercholesterolemia was 3.6 times higher among the high-risk population. On the other hand, isolated hypertriglyceridemia has 30% less likely and isolated low HDL was 40% less likely among high risk populations in comparison to ICMR-InDiab study. Female gender [low HDL- aOR 2.1(1.1-4.2)], [high LDL- aOR 2.2(1.3-3.7)] and hypothyroidism [hypercholesterolemia- aOR 10.1(1.1-89)] were directly associated and; underweight [hypercholesterolemia- adjusted Odds ratio (aOR)- 0.4(0.2-0.9)], [hypertriglyceridemia 0.4(0.1-1.0)], and anaemia [hypertriglyceridemia aOR- 0.5(0.3-0.8)] were inversely associated with dyslipidemia.Conclusions: Dyslipedaemia was higher among the DM and HT participants in a remote rural area of South India.

Prevalence and determinants of tobacco use in a remote rural area of South India: a community based cross sectional study

Background: Tobacco use is a major public health problem in India. We intended to study the tobacco use and its risk factors from a rural area of South India.Methods: This study was conducted in 2018, among twenty villages located around a rural health training centre, in South India.Results: Total population surveyed was 14925. Among them 11995 individuals were in the age group of 15 years and above. In this group 739, 6% (5.7-6.6) of tobacco users, 423, 3.5% (3.2-3.9) of smokers and 369, 3% (2.8-3.4) of tobacco chewers were included in the study. Individuals belonging to lower caste were four to five times more likely to be a tobacco user. Tobacco use increases with age. Illiterates were 1.8 times more likely to be a tobacco user, married and Widows were two times more likely to be a tobacco user. Alcoholics were 13 times and hypertensive patients were 1.5 times, non-vegetarians were 1.4 times, individual preferring open defecation were 1.7 times more likely to be a tobacco user. Smoking was more associated with male gender, lower caste, increase in age, married individuals, alcoholics, hypertension and having semi-pucca house. Tobacco chewing was more associated with female, lower caste, increase in age illiteracy, married and widow, alcoholic, hypertension, non-vegetarian diet, open defecation, having kutcha or semi-pucca house.Conclusions: Tobacco use in a remote rural area is high among the socially deprived community who are illiterate, belonging to lower caste and those who prefer open defecation.