Types of colorectal cancer and dysplasia associated with inflammatory bowel disease

Ulcerative colitis (UC) and Crohn’s disease (CD) are two major inflammatory disorders of the intestinal wall collectively known as inflammatory bowel disease (IBD). Colorectal carcinoma (CRC) is the most significant and grave consequence of IBD and is preceded by dysplasia in majority of the cases. In this review we aim to discuss the various types of dysplasia found in patients with CRC due to IBD. A thorough literature search was conducted in online databases such as PubMed, Google Scholar, from which all studies published in the last ten years were included in this review. The major development in diagnostic procedures and visualization modalities have aided our understanding of dysplasia, which is now known to be the strongest predictor and marker for CRC development. However, the unpredictable behavior and progression of dysplasia still warrants vigilant surveillance. Dysplasia has been classified on histological characteristics using grades of dysplasia from ‘negative for dysplasia’ to ‘high grade dysplasia’. On visibility via an endoscope from ‘visible dysplasia’ to ‘invisible dysplasia’ and macroscopic features of ‘conventional dysplasia’ and ‘non-conventional dysplasia’. No single classification can be utilized to define the stage of dysplasia and more importantly predict its progression and outcome of CRC. Using evidence-based medicine an integrated classification expanding on a management algorithm must be formulated by a panel of experts to steer management of the disease. A multidisciplinary, tailored approach with a strong emphasis on regular and timely surveillance to ensure early detection of CRC can enhance quality of life and patient outcomes.

Mechanical Properties and Clinical Significance of Orthodontic Wires

Orthodontic treatment is usually conducted by applying forces to certain teeth to move them into a targeted position. Orthodontic wires have been reported to be the primary modalities used in fixed-appliances-based orthodontic treatment to induce favorable tooth movement events. Accordingly, acquiring adequate knowledge about these approaches' clinical applications and biochemical behavior is essential when planning for a successful orthodontic treatment. Orthodontic wires are widely used and are mainly composed of composites, polymers, alloys and metals. Accordingly, the physical properties and clinical application of orthodontic wires vary based on their composition. In this context, it was recommended that achieving favorable outcomes of orthodontic treatment obliges clinicians to decide the best orthodontic wire and treatment plan based on the chemical properties and related clinical applications of each wire. Therefore, wires that tend to produce increasing stiffness gradually are generally used. However, it should be noted that no ideal wire exists. Therefore, favoring the application of a wire over the other should be based on the intended outcomes and stage of the treatment process.

Role of impacted teeth in dental arch crowding

Estimates show that the prevalence of mandibular dental anterior crowding is high and might be up to 40%. The etiology of the condition has been multifactorial and evidence regarding the impact of mandibular third molars is still controversial. We discussed the potential role that impacted teeth (particularly mandibular third molars) might have in developing dental arch crowding. Evidence from different original studies and reviews regarding the impact of lower third molars on dental crowding was controversial. However, most of these studies showed that the correlation between these events was insignificant and additional studies might be needed for further validation. We have also identified many factors that can lead to dental arch crowding among the relevant studies in the literature. These factors might include general factors (including gender and age), skeletal factors (including malocclusion and growth of jaws) and dental factors (including primary tooth loss and tooth crown size), all of which were extensively discussed in the current study. Accordingly, further attention should also be paid to studying these factors.

Etiology, staging, and management of cystocele

A cystocele is usually found to protrude the urinary bladder through the vaginal wall. Various causes have been reported in the literature for the pathogenesis and development of cystocele. These can cumulatively lead to a remarkable weakness in the muscular and connective tissue layers related to the urinary bladder and anterior vaginal wall. The present study discusses the etiology, staging, and management of patients with cystocele. Evidence indicates that a defect within the pelvic-floor supporting system can significantly lead to the development of cystocele. Parity, increasing age, and obesity are the main associated risk factors for developing these events. Staging is important to decide the most suitable treatment plan, which might be conservative or surgical. Some patients do not require any management approach, being asymptomatic, and refuse the current treatment modalities. Surgery has been associated with enhanced outcomes and can be conducted via two different approaches, including anterior colporrhaphy and sacral colpopexy.

Stages, risk factors and prevention of early childhood caries

Early childhood caries is a common condition that affects children and young infants. In addition to the effect of the condition on the child's oral health, it has been furtherly shown that many systemic consequences are usually associated. Therefore, it has been reported that these conditions can significantly impair the quality of life of corresponding families based on economic and health-related burdens. Affected children usually present with variable degrees of the condition, and some complications might be associated. Many risk factors have been reported in the literature for developing the condition in children. These include the presence of certain bacterial pathogens (especially through vertical transmission), dietary habits, and poor oral hygiene. Evidence indicates that these risk factors significantly contribute to the development of early childhood caries and the importance of the child's socioeconomic status and his caregivers. Targeting these factors would significantly reduce the risk of developing the condition, in addition to fluoridation as suggested by various relevant investigations.

Instruments used to assess oral health-related quality of life of children

To evaluate oral health-related quality of life (OHRQoL) in children, both the clinical indices and parenteral reporting can be used to achieve this effect. The present review provides evidence regarding the currently available instruments to assess the OHRQoL in children. Many instruments were reported, and some were designated for preschoolers. In contrast, others for schoolchildren and adolescents, and some researchers reported that some tools could be used to assess OHRQoL in different age groups. Moreover, some tools can also be used to assess the OHRQoL of children based on their parent's perspectives. The POQL, FIS, PedsQL™ oral health scale™, and P-CPQ are the only modalities that can effectively assess OHRQoL in all adolescents and all childhood cycles. Moreover, the OHRQoL hypodontia questionnaire, MIQ, IFAQ, DFTO, CPQ11-14, CPQ8-10, child-OIDP, child-OHIP, and child-DPQ are the currently available tools that can be used to assess OHRQoL in adolescents and schoolchildren. Regarding the assessment of OHRQoL in preschoolers, it has been shown that the only available tools for this context include the SOHO-5, OH-ECQOL, Michigan-OHRQoL, ECOHIS, and DDQ questionnaires.

The study about mindset of COVID-19 vaccination among health care employees and general population at tertiary care hospital

Background: Definitive treatment and vaccination are basic necessity to bring down the burden of COVID-19 disease. Due to rapid development of vaccine against COVID-19, associated anxiety and mistrust raises hesitancy for vaccination. We aim to study about the mindset of COVID-19 vaccination among health care employees (HCE) and general population at tertiary care hospital in north east India.Methods: This was a cross sectional and observational study; questionnaires were distributed among 200 HCE and 400 general populations visiting at different OPD regarding their mindset for vaccination. Questionnaires consisted of parameter such as history of previous COVID-19 infection or hospitalization, co-morbidities, job status during pandemic and educational qualification and contained specific questions for causes of vaccine hesitancy.Results: In the survey participants from general population were more hesitant for vaccination as compared to HCE (p<0.001). Most common cause for hesitancy among HCE was pregnancy/lactation followed by concern regarding adverse effects. Doubted efficiency and adverse effects were leading concerns (67%) for vaccine hesitancy among general population. Past history of infection or hospitalization due to COVID-19 did not affect the attitude for getting vaccinated (p>0.05). Among general population, 25% had their job affected during pandemic of which 78% were in favour of vaccination.Conclusions: Increased awareness and high risk of getting infected with COVID-19 makes HCE less hesitant for vaccination. It is important to increase awareness among the general population to bring down the concerns regarding adverse effect and potency of vaccine to reduce the hesitancy for vaccination.

Study to assess the feedback of COVID-19 patients to nutritional services provided in dedicated COVID hospital

Background: In patients’ overall perception of their hospital experience it is widely recognized that food and other aspects of foodservice delivery are important elements and health care teams have committed to deliver appropriate food to their patients on daily basis. The provision of hospital foodservice should not only meet, but, also exceed patients’ expectations so as to gain the patients’ confidence in hospital food. Nutrition is an important element of care. A balanced nutrition is extremely important for patients who have been infected with COVID-19.Methods: To see the feedbacks of COVID-19 patients admitted in dedicated COVID hospital, the present hospital based cross sectional study was undertaken in various wards of dedicated COVID hospital of metropolitan city of western Maharashtra.Results: Mean age of participants was 41 years. Mean duration of hospital stay was 9.1 days. 60% patients were in age group between 31 to 60 whereas only 3% participants were above 80 years of age. 59% were male, 85% were from urban area. 55% participants were taking mix diet. 54% participants stayed for 8 to 10 days. 58% participants were presented with different co morbidities. 73.07% participants had normal diet during their stay in the hospital. Variables like age, gender and hospital stay had significant association with the feedback to nutritional services (p<0.05).Conclusions: Participants were satisfied towards nutrition and nutritional services provided in dedicated COVID hospital.

Clinical and economic benefits of continuous blood glucose monitoring devices

The main intervention to reduce the macro-and microvascular complications of diabetes mellitus (DM) remains to achieve better long-term glycemic control. We have discussed the clinical and economic advantages of using continuous glucose monitoring (CGM) devices for type 1 DM and type 2 DM (T1DM and T2DM) based on data from relevant studies in the literature. Our findings show that using these modalities is associated with remarkable outcomes, including reduced HbA1c levels and enhanced glycemic control among patients with T1DM and T2DM. This can enhance the quality of care and life for diabetic patients and intervene against the development of serious complications and hypoglycemia-related adverse events. The cost of routinely using these devices might seem relatively high. However, the estimated cost benefits are usually higher as they can significantly reduce hospitalization rates due to hypoglycemia and the frequency of diabetic therapy malpractices, which are frequently encountered. However, not many studies have reported these outcomes, indicating the need to conduct future relevant studies.

Application of 3D printing and its various technologies in dentistry

Many applications for these technologies have been reported in multiple fields, including dentistry, within the last three decades. It can be used in periodontology, endodontics, orthodontics, oral implantology, maxillofacial and oral surgery, and prosthodontics. In the present literature review, we have discussed the different clinical applications of various 3D printing technologies in dentistry. Evidence indicates that 3D printing approaches are usually associated with favorable outcomes based on the continuous development and production of novel approaches, enabling clinicians to develop complex equipment in different clinical and surgical aspects. Developing work models to facilitate diagnostic and surgical settings is the commonest application of these modalities in dentistry. Besides, they can also be used to manufacture various implantable devices. Accordingly, they significantly help enhance the treatment process, reducing costs and less invasive procedures with favorable outcomes. Finally, 3D printing technologies can design complex devices in a facilitated and more accurate way than conventional methods. Therefore, 3D printing should be encouraged in clinical settings for its various advantages over conventional maneuvers.