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Nevin Manimala Statistics

Factorial validity and internal consistency of a practitioners’ checklist for therapists in rehabilitation

JBI Evid Implement. 2021 Apr 9;19(4):387-393. doi: 10.1097/XEB.0000000000000279.

ABSTRACT

AIMS: The current study aimed to assess the validity and internal consistency of a 20-item checklist to help provide rehabilitation based on effective and clear goal setting.

METHODS: A questionnaire survey was conducted regarding rehabilitation practices followed by physical, occupational, and speech-language therapists over the past month. The questionnaire was based on a checklist covering the following four areas, each comprising five items: goal setting based on patient and family intent and therapist perspective including long-term and short-term goals; therapist’s specialized analysis and focalization of problems using the International Classification of Functioning, Disability and Health to clarify work processes and behaviors that hinder high-priority activities; proposal of plans considering the evidence and environment, which clarifies options for resolution methods (plans) and evidence; and formulation and implementation of plans including patient and family intent, which determines plan frequency and implementation period. The checklist was prepared based on medical records and previous studies by two occupational therapists who had experience in providing hospital and home-visit rehabilitation. To test the factorial validity of the 20-item checklist, confirmatory factor analysis was performed, and Cronbach’s α coefficients were calculated.

RESULTS: The participants’ mean age was 28 (25-75th percentile, range: 25-32) years. Of the 385 participants, 163 were home-visit rehabilitation therapists. Our model revealed a fair fit to data (χ2 statistic = 602.0) and standardized path coefficients ranged from 0.67 to 0.95. Path coefficients were at least 0.41 for all 20 items. Cronbach’s α for goal setting, problem analysis, problem solving method proposals, and formulation and implementation of specific plans were 0.896, 0.890, 0.935, and 0.925, respectively.

CONCLUSION: Based on the assessment of therapists’ practice over 1 month using the developed checklist, the factorial validity and internal consistency of these checklist items were considered acceptable. Education based on these checklist items might support goal setting and planning and improve patient outcomes.

PMID:34810408 | DOI:10.1097/XEB.0000000000000279

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Oral health status and treatment needs of children with sensory deficits in Chennai, India-A cross-sectional study

Indian J Dent Res. 2021 Apr-Jun;32(2):236-242. doi: 10.4103/ijdr.IJDR_809_18.

ABSTRACT

PURPOSE: The negligence of oral health combined with barriers in accessing adequate oral care is more commonly encountered in children with sensory deficits. In a developing country like India, there is a severe lacuna in data regarding the oral health status and treatment needs in this group of population. The purpose of this study is to assess the oral health status and treatment needs of children with sensory deficits, using WHO criteria of Basic Oral Health Survey Methods, 1997.

MATERIALS AND METHODS: A descriptive cross-sectional study was conducted using the WHO criteria (Basic Oral Health Survey, 1997); questionnaire data regarding the demographic profile, oral hygiene status, degree of sensory impairment were recorded and tabulated. The Chi-square test was used to determine whether there existed a significant difference in the oral health status. The confidence interval was set at 95% and alpha error was assumed at 0.05.

RESULTS: Among the 742 sensory deficit children examined, 371 children are visually impaired and 371 are hearing impaired. Gingival bleeding and poor oral hygiene is diagnosed in more than 70% of the visually impaired children. The prevalence of trauma is estimated to be 8% in children, who are visually impaired. In the hearing impairment group, gingival bleeding because of inadequate oral hygiene is seen in 58% of the population examined. There is no statistically significant difference in the dental caries status between visually impaired and hearing impaired children (P > 0.05). There is also no statistically significant difference in the restorative treatment need and trauma status between visually impaired and hearing impaired children (P > 0.05).

CONCLUSION: The present study shows a high prevalence of gingival diseases and dental caries in the special health care group children. The study signifies a wide spread presence of unmet treatment needs among children in this study population.

PMID:34810396 | DOI:10.4103/ijdr.IJDR_809_18

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Relationship between perceived chewing ability, oral health related quality of life and depressive symptoms among completely edentulous individuals

Indian J Dent Res. 2021 Apr-Jun;32(2):211-215. doi: 10.4103/ijdr.ijdr_1141_20.

ABSTRACT

BACKGROUND: Edentulism affects the chewing ability of a person and can engender nutritional deficiencies which can affect the overall quality of life and depression.

AIM: Our aim was to evaluate the association between perceived chewing ability, oral health-related quality of life (OHRQoL) and depressive symptoms among completely edentulous patients with and without dentures.

SETTINGS AND DESIGN: Institutional study and cross-sectional design.

METHODS: A cross-sectional study among 207 completely edentulous persons was conducted in South India. The subjects completed a self-administered questionnaire on demographics, Beck’s depression inventory, oral health impact profile-edentulous (OHIP-EDENT), age when edentate, chewing ability, and denture satisfaction. Further, denture status was clinically evaluated.

STATISTICAL ANALYSIS: Data were summarised and analysed using the Chi-square test and multivariate logistic regression. P < 0.05 was considered significant.

RESULTS: Persons not using complete dentures (odds ratio [OR] =3.5, P < 0.05), who reported impaired chewing ability (OR = 4.6, P < 0.05), those who became edentate before 55 years (OR = 4.6, P < 0.05) and with poor denture status (OR = 6.2, P < 0.05) were more likely to report depressive symptoms. Lesser impact in relation to OHRQoL was found to be protective against depression among completely edentulous (OR = 0.24, P < 0.05).

CONCLUSION: Depressive symptoms were associated with impaired chewing ability, higher impacts on OHIP-EDENT, and edentulous persons not using complete dentures. High priority must be given to enhance awareness towards oral rehabilitation among completely edentulous to reduce the chance of depression occurring due to impaired chewing ability and poor OHRQoL.

PMID:34810391 | DOI:10.4103/ijdr.ijdr_1141_20

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Antimicrobial efficacy of acacia Nilotica (Babul) extract and its effectiveness in disinfecting gutta percha cones – An in vitro study

Indian J Dent Res. 2021 Apr-Jun;32(2):221-225. doi: 10.4103/ijdr.IJDR_233_20.

ABSTRACT

BACKGROUND: Gutta-percha cones used directly from the manufacturer’s sealed packs harbour micro-organisms. During clinical use, the chances of contamination of gutta-percha increases. Hence, disinfection of gutta-percha cones before use is essential to prevent canal recontamination.

AIM: To evaluate the antimicrobial efficacy of babul against chemical disinfectants, and its effectiveness in disinfecting gutta-percha cones.

MATERIALS AND METHODS: The extract of babul was used to assess its antimicrobial activity against E-faecalis, S. aureus and C. albicans using the agar diffusion method. A total of 120 cones acquired from freshly opened manufacturers’ pack were cut into three equal parts and divided into group I which was directly placed into a nutrient broth, group II was clinically contaminated with gloves for 30 s and placed into a nutrient broth, and the third part was clinically contaminated with gloves and decontaminated for 5 min using the experimental disinfectants to check for the presence of turbidity.

STATISTICAL ANALYSIS: The data were analysed by an Unpaired t-test and Chi-square test at a significance level of P < 0.05 using software SPSS 20.

RESULTS: Two percent chlorhexidine showed maximum antibacterial action against E. faecalis and S. aureus followed by babul extract. It was also found more efficacious in decontaminating gutta-percha cones followed by babul and 3% sodium hypochlorite in 5 min.

CONCLUSION: Babul herbal extract is indeed effective in decontaminating gutta-percha cones and is a better alternative to chemical disinfectants.

PMID:34810393 | DOI:10.4103/ijdr.IJDR_233_20

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Comparative analysis of the naso/oropharyngeal swab and oral bio-fluid (whole saliva) samples for the detection of SARS-CoV-2 using RT-qPCR

Indian J Dent Res. 2021 Apr-Jun;32(2):206-210. doi: 10.4103/ijdr.ijdr_483_21.

ABSTRACT

CONTEXT: The Corona Virus Disease 2019 (COVID-19) is a contagious disease caused by the novel Coronavirus (2019-nCoV) and was declared a pandemic disease by the World Health Organization (WHO) in March 2020. The nasopharyngeal and the oropharyngeal swabs are being taken during the screening procedure. However, the virus is also present in the oral bio-fluid and hence it could be a potential tool for screening COVID-19 cases.

AIM: The aim of the present study was to test the accuracy of whole saliva as a diagnostic specimen in COVID-19.

SETTINGS AND DESIGN: This cross-sectional, analytical study was conducted on out-patients visiting the COVID-19 hospital.

METHODS AND MATERIAL: The whole saliva and the nasopharyngeal/oropharyngeal samples from 309 COVID-19 suspected patients were collected and subjected to RT-PCR analysis.

STATISTICAL ANALYSIS USED: The paired t test was used to compare the measured variables (CT values) between the saliva and the swab samples. The positive predictive value (PPV), negative predictive value (NPV), the sensitivity, and the specificity of the tests were calculated for the saliva sample.

RESULTS: The saliva and swab results revealed a similar result (ties) in 86.73% of the samples. The sensitivity and the specificity between the swab and saliva samples were 40% and 96.85%, respectively. The positive predictive value of the saliva sample was 73.3%.

CONCLUSIONS: The sensitivity of whole saliva when compared to the swab samples is low. Large sample studies are needed to validate the role of saliva as a diagnostic tool in COVID-19.

PMID:34810390 | DOI:10.4103/ijdr.ijdr_483_21

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Hydroxychloroquine- A new treatment option for erosive oral lichen planus

Indian J Dent Res. 2021 Apr-Jun;32(2):192-198. doi: 10.4103/ijdr.IJDR_943_20.

ABSTRACT

CONTEXT: Oral Lichen planus (OLP) is a chronic, debilitating, immune-mediated disease whose management is considered a challenge in medical science.

AIMS: To quantitatively evaluate the effect of administration of enteral hydroxychloroquine (HCQS) as a monotherapy for six months on the extent and severity of erosive OLP using reticular score, erythema score and ulcerative score (REU score), and to subjectively evaluate the success of HCQS as a therapeutic drug for OLP-e using Tel Aviv-San Francisco Scale, visual analogue scale (VAS) and severity of burning sensation (BURN score).

SETTINGS AND DESIGN: Prospective clinical trial.

METHODS AND MATERIAL: A total of 45 subjects received 200 mg of HCQS bid for six months. REU, VAS, BURN scores and Tel Aviv-San Francisco Scale readings were taken at the beginning of the study (baseline) and three- and six-month intervals post administration of enteral HCQS. Subjects were examined for any adverse drug outcomes for one year after the cessation of enteric HCQS therapy. Data were analysed with SPSS version 25.

RESULTS: There was a stark reduction in REU, VAS and BURN scores during the study period, with a statistically significant reduction (P < 0.05) seen at three- and six-month time intervals as compared to baseline. Further, the mean of change in R, E and U scores showed a statistically significant difference, with the highest reduction seen at baseline to six-month time interval. The Tel Aviv-San Francisco Scale showed 70%-100% remission in disease in more than 70% of subjects.

CONCLUSIONS: Enteral HCQS can be considered a viable treatment option for the enigma that is erosive OLP.

PMID:34810388 | DOI:10.4103/ijdr.IJDR_943_20

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Evaluating upper lip changes during smiling and at rest in Indian population

Indian J Dent Res. 2021 Apr-Jun;32(2):167-173. doi: 10.4103/ijdr.IJDR_637_18.

ABSTRACT

CONTEXT: Smile aesthetics is one of the major goals to be achieved after orthodontic mechanotherapy as it visibly displays the results of orthodontic treatment. Although orthodontic retainers aid in maintaining post-treatment occlusion, soft tissue function and aesthetics, appropriate knowledge of smile changes with age can help orthodontists to obtain stable and aesthetically appealing treatment results.

AIM: To assess and quantify soft tissue changes in the upper lip in vertical dimension at both repose and maximum smiling and to evaluate changes occurring with the smile index and upper lip with age and sex in subjects of Indian origin.

SETTINGS: Department of Orthodontics and Dentofacial Orthopaedics, Army College of Dental Sciences, Secunderabad, Telangana, India.

DESIGN: Observational study.

METHODS AND MATERIALS: A total of 160 volunteers (80 males and 80 females) selected and were divided into 4 groups according to age and were further divided into 2 sub-groups according to gender. Thirteen measurements of relaxed and smiling upper lip were taken with a calibrated metal ruler and divider directly on the subjects.

STATISTICAL ANALYSIS USED: Analysis of variance (ANOVA) was done followed by post hoc test to determine which groups were significant from others. Levene’s test was done to assess equality of variance and t-test for equality of means was done.

RESULTS: Statistically significant results were obtained in between groups and sub-groups for parameters like smile index, upper lip elevation while smiling and smile pattern in males and females changing with increase in age.

CONCLUSIONS: High smile patterns with more vertical smile are more common among females and low smile patterns are more common among males. With age, the smile tends to be more horizontal in both genders.

PMID:34810384 | DOI:10.4103/ijdr.IJDR_637_18

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A prospective randomized controlled trial on the comparative clinical efficiency and hygiene of a ceramic inter locking retainer and a flexible spiral wire bonded retainer

Indian J Dent Res. 2021 Apr-Jun;32(2):174-180. doi: 10.4103/ijdr.IJDR_1050_20.

ABSTRACT

BACKGROUND: The lower canine to canine retainer is one of the most commonly used retention appliance.

OBJECTIVE: Compare and assess the clinical efficiency and oral hygiene maintenance with 2 retainers: flexible spiral wire and ceramic interlocking bonded.

SETTING AND SAMPLE POPULATION: Orthodontic department of a dental college.

PARTICIPANTS, STUDY DESIGN AND METHODS: Prospective randomized controlled trial that involved 40 patients who had completed orthodontic treatment and were randomly allotted to either group: flexible spiral wire (FSW) or ceramic interlocking retainers. Allocation ratio was 1:1.

ELIGIBILITY CRITERIA: Completed fixed orthodontic treatment with an acceptable treatment result.

MAIN OUTCOMES: Oral hygiene was assessed at 3 (T1) and 6 (T2) months intervals after debonding using Gingival and Plaque index. The contact point displacement was assessed using 3D model superimposition and bonded retainer failure was noted.

RANDOMIZATION AND BLINDING: Computer-generated random allocation, only data analyzer was blinded.

STATISTICS: Data normality was tested using the Shapiro-Wilk and Q-Q plot. Mixed model analysis was used to assess differences between the two groups for the above-mentioned parameters. The failure rate of the retainer was calculated by the Chi-Square test.

RESULTS: Only the plaque index score was significantly greater in the FSW group and showed a statistically significant difference (P < 0.05), rest of the parameters showed no statistically significant difference over the specified time points, although a mild increase in relapse was noted in both groups No serious harms were reported.

CONCLUSION: Both retainers seem to be effective in maintaining the treatment results however the FSW seems to accumulate more plaque over a given period of time thereby mandating proper hygiene maintenance and follow-up.

PMID:34810385 | DOI:10.4103/ijdr.IJDR_1050_20

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Parental issues and concerns for their children treated under general anaesthesia for early childhood caries: A qualitative research approach

Indian J Dent Res. 2021 Apr-Jun;32(2):158-161. doi: 10.4103/ijdr.ijdr_5_21.

ABSTRACT

CONTEXT: Most often, young children with early childhood caries (ECC) may need oral rehabilitation under general anaesthesia (GA) as treatment cannot be done chairside. A procedure under GA can be traumatic and stressful for both the parents and the children. Hence, it becomes necessary to understand the parents’ opinions and address their concerns to provide better treatment. Aims: This qualitative study was conducted to explore the parental issues and concerns for their children treated under GA for ECC. Qualitative research approach was used so that it would enable us to address these issues better and prepare parents by counselling them in advance.

SETTINGS AND DESIGN: An in-depth interview was conducted with the parents of children who underwent oral rehabilitation under GA for ECC in the M.S. Ramaiah Memorial Hospital, admitted under the Department of Pedodontics and Preventive Dentistry.

PARTICIPANTS AND METHODS: Data were audio-recorded and transcribed.

STATISTICAL ANALYSIS USED: Data collected were analysed using thematic analysis. Results: The themes derived were ‘Concerns and Issues of GA Procedures and Improved Oral-health-related Quality of Life’.

CONCLUSIONS: The parents of children who underwent oral rehabilitation under GA initially had a few concerns and were reluctant about the procedure but were happy with the improvement post-operatively.

PMID:34810382 | DOI:10.4103/ijdr.ijdr_5_21

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Applicability of moyer’s probability tables in north indian population of 16-18 years old

Indian J Dent Res. 2021 Apr-Jun;32(2):162-166. doi: 10.4103/ijdr.IJDR_677_19.

ABSTRACT

AIMS: To determine the applicability of Moyer’s probability tables in North Indian population of 16-18 year olds and to formulate a new regression equation for the same group of population.

SETTING AND DESIGN: Evaluative Study.

METHODS AND MATERIAL: 1000 children aged 16-18 years were selected as sample for the measurement of mesiodistal widths of permanent mandibular incisors, maxillary and mandibular canines and premolars using study models. The recorded values were then subjected to statistical analysis.

STATISTICAL ANALYSIS USED: Software Package for Social Sciences (SPSS) software version 22.0.

RESULTS: The actual widths of the canine and premolars showed highly significant differences in maxilla and in mandible (P < 0.001), compared to widths predicted by Moyer’s probability table at 75th percentile.

CONCLUSION: Moyer’s mixed dentition analysis was not an accurate method for prediction in North Indian population as it showed overestimation of tooth sizes. Hence, new regression equation has been formulated for the same.

PMID:34810383 | DOI:10.4103/ijdr.IJDR_677_19