Publications by authors named "Priyanka Kapoor"

24 Publications

  • Page 1 of 1

MicroRNAs in oral fluids (saliva and gingival crevicular fluid) as biomarkers in orthodontics: systematic review and integrated bioinformatic analysis.

Prog Orthod 2021 Oct 11;22(1):31. Epub 2021 Oct 11.

Department of Bioinformatics, Stella Maris College (Autonomous), Chennai, India.

Background: MicroRNAs (miRNAs) are non-coding short, single-stranded RNA molecules that may serve as biomarkers for various inflammatory and molecular mechanisms underlying bone and tissue remodeling consequent to orthodontic force application.

Methods: A thorough literature search in major databases was conducted in March 2021 to generate evidence for miRNAs in orthodontics, with prior PROSPERO registration. The initial search revealed 920 articles, subjected to strict selection criteria according to PRISMA, and resulted in final inclusion of four studies. Quality assessment by QUADAS-2 classified three studies as unclear risk-of-bias while the applicability was high. Further, bioinformatic analysis was performed to identify the target genes from the miRNA database (miRDB) and TargetScan databases and their protein-protein interaction pathways with the STRING analysis.

Results: Multiple miRNAs in gingival crevicular fluid (GCF) of orthodontic patients were seen, including miRNA-21, 27(a/b), 29(a/b/c), 34,146(a/b), 101, and 214 along with matrix metalloproteinases (MMPs)-1, 2, 3, 8, 9, 14 in one study. A statistically significant increase in expression of miRNA-29a/b/c,101, 21 from pre-treatment (before initiation of retraction) was seen to reach a peak at 4-6 weeks (wk) of retraction. On the contrary, miRNA-34a showed downregulation from the 1 day to 4 wk of retraction and also, negatively correlated with MMPs-2,9,14 levels at the same observation times. The distance of canine movement showed mild correlation with miRNA-27a/b, 214 at 2 wk of retraction. Bioinformatics revealed 1213 mutual target genes which were analyzed for inter-relational pathways using Cytoscape plugin, MCODE. Further, 894 prominent protein interactions were identified from the STRING database and SMAD4, IGF1, ADAMTS6, COL4A1, COL1A1, COL3A1, FGFR1, COL19A1, FBN1, COL5A1, MGAT4A, LTBP1, MSR1, COL11A1, and COL5A3 were recognized as the hub genes. Their interactions were able to isolate multiple miRNAs: hsa-miR-34a-5p, hsa-miR-29b-2-5p, hsa-miR-29b-3p, hsa-miR-34a-3p, hsa-miR-27a-5p, hsa-miR-29a-5p, hsa-miR-29b-1-5p, hsa-miR-29c-3p, hsa-miR-214-5p, hsa-miR-27a-3p, hsa-miR-29a-3p, hsamiR-146-5p, which were found promising as biomarkers for tooth movement.

Conclusions: Our results support using miRNAs as biomarkers in varied orthodontic study designs and for inter-relationships with pathological settings like periodontal disease, pre-malignancies, or conditions like obesity or metabolic irregularities, etc. The identified target genes and their protein interaction pathways can be used to propose precision therapies, focusing on ideal tooth movement with minimal iatrogenic side-effects.
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http://dx.doi.org/10.1186/s40510-021-00377-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8502526PMC
October 2021

Saliva and COVID 19: Current dental perspective.

J Oral Maxillofac Pathol 2021 Jan-Apr;25(1):18-21. Epub 2021 May 14.

Department of Oral Pathology and Microbiology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India.

Oral health care providers are at a higher risk of being infected by novel coronavirus due to close proximity to patient's face and exposure to saliva while working on the patient. Thus, there is an urgent need to interpret the available literature in order to establish safe practices for dental professionals as well as limit the spread of infection through saliva. The study intends to provide up-to-date, compiled evidence-based information related to saliva and its association with COVID-19. It further provides suggestions for safe practices in dentistry in current pandemic times. Oral symptoms may be strongly suggestive of early diagnosis and disease progression in COVID-19 patients. Viral loads in saliva are reported higher than standard nasopharyngeal swabs in few studies, majorly in the 1 week of symptom onset. Besides, salivary diagnostics has many additional advantages of being noninvasive, comfortable to the patients with the possibility of point-of-care testing for diagnosing COVID-19. High-efficiency particulate arrestor filter, rubber dam application and high-volume evacuator can reduce spatter and droplets/aerosol production. Povidone-iodine-based mouthwash maybe mouthwash of choice before any dental examination or procedures due to its ability to decrease severe acute respiratory syndrome- coronavirus 2 viral loads in the mouth. Salivary diagnostics related to COVID-19 should be integral part of dental teaching programs. There is a tremendous scope to study saliva in health and diseases.
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http://dx.doi.org/10.4103/jomfp.jomfp_63_21DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8272509PMC
May 2021

Customized Orthodontic Triage During COVID-19 Pandemic.

J Indian Orthod Soc 2020 Oct;54(4):391-393

Faculty of Dentistry, Department of Orthodontics, Jamia Millia Islamia, New Delhi, Delhi, India.

COVID-19 pandemic necessitates streamlining patient influx in orthodontic office to avoid cross infection between patients, clinicians, and dental health care workers. A customized orthodontic triage has been proposed in this article to schedule patient appointments through priority triaging and, at the same time, provide self-care advice, virtual assistance, and remote monitoring for patient management in elective circumstances.
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http://dx.doi.org/10.1177/0301574220963495DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7899941PMC
October 2020

Impact of Thyroid Dysfunction on Insulin Resistance: A Study from a Tertiary Care Center in India.

J Assoc Physicians India 2021 Feb;69(2):49-53

Resident, Medicine, SMS Medical College and Hospital, Jaipur, Rajasthan.

Introduction: The thyroid hormones perpetuate a fine equilibrium of glucose metabolism. Abnormalities of thyroid function can disrupt this balance leading to glucose metabolism abnormalities and insulin resistance.

Objectives: We studied the correlation between insulin resistance and thyroid status in hyperthyroid, euthyroid, and hypothyroid individuals.

Methods: In this observational comparative analysis conducted at a tertiary care center, the 3 study groups comprised of 35 patients each with newly detected hyperthyroidism, hypothyroidism and euthyroid individuals. Assays were conducted for serum insulin, thyroid profile, blood sugar and routine biochemistry in the fasting state. The homeostasis model assessment for insulin resistance (HOMA-IR) was used to evaluate insulin resistance.

Results: The mean HOMA-IR was highest in patients with hypothyroidism (3.22 ± 2.69) followed by the hyperthyroid group (2.25 ± 1.59). It was lowest in the euthyroid group (0.79 ± 0.58) with the intergroup difference being statistically significant (P<0.001). Hypothyroid patients showed a significant a positive correlation between TSH and HOMA-IR (r=0.945, P=<0.001) whereas hyperthyroid patients showed positive correlation between FT3 and insulin resistance (r=0.706, P<0.001).

Conclusion: Thyroid dysfunction is associated with an increase in insulin resistance and glucose abnormalities validating the resultant higher risk of related cardiovascular and metabolic abnormalities observed in these patients.
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February 2021

Exploring salivary diagnostics in COVID-19: a scoping review and research suggestions.

BDJ Open 2021 Jan 26;7(1). Epub 2021 Jan 26.

Laboratory of Infection Biology and Translational Research, Department of Biotechnology, All India Institute of Medical Sciences, New Delhi, India.

Introduction: Molecular diagnostics for SARS-CoV-2 infection characteristically involves the sampling of the throat or nasopharyngeal swab (NPS). However, these procedures are invasive, require necessary skills for sample collection, cause patient discomfort, and are non-conducive for extensive scale testing. Saliva is increasingly being suggested as an alternate diagnostic sample in SARS-CoV-2 infection.

Objectives: This scoping review was done with the objective of exploring the evidence on the role of saliva as an alternate diagnostic sample in SARS-CoV-2 condition.

Methods: Thorough search of the literature in major databases was undertaken in June 2020 using free text and MESH terms, followed by PRISMA to identify 17 studies for data extraction.

Results And Conclusions: Evidence was summarised for study characteristics, salivary sampling characteristics, viral load, and longevity of virus in saliva. The literature supports that saliva offers a simple sample collection method compared to technique-sensitive NPS and has the advantage of point-of-care testing for initial screening in community or hospital-based set-up. The additional highlights of this review are heterogeneity in the current literature and the gaps in methodology. Therefore, a robust study design to generate higher levels of evidence has been proposed.
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http://dx.doi.org/10.1038/s41405-021-00064-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7836040PMC
January 2021

Screening of obstructive sleep apnea (OSA) risk in adolescent population and study of association with craniofacial and upper airway morphology.

J Oral Biol Craniofac Res 2020 Oct-Dec;10(4):807-813. Epub 2020 Oct 15.

Biostatistician, Dept of Neurology, Christian Medical College & Hospital, Ludhiana, 141008, India.

Background: Obstructive sleep apnea (OSA) is a common form of sleep-disordered breathing with high prevalence and associated co-morbidities. It still goes largely under-reported due to events occurring in sleep and difficulty in identifying predisposing factors.

Aims: To perform questionnaire-based screening of OSA-risk in adolescents and study association of OSA-risk with craniofacial and upper airway morphology.

Material And Methods: Modified STOP-BANG questionnaire was used for screening OSA-risk in adolescent orthodontic patients (10-19 years) in a government dental hospital in India. Patients were categorised into two groups: OSA-risk and non-risk, based on the questionnaire scores, and were subsequently evaluated for craniofacial and upper airway morphology, both on examination and on lateral cephalometric radiographs.

Results: Documented a high prevalence of 14% for OSA-risk in adolescent orthodontic patients. The extra-oral and intra-oral parameters found significantly associated with OSA-risk were convex profile [Odd's ratio (OR) - 3.824], steep mandibular plane angle [MPA] (OR- 79.75), Type 3/4 faucial pillars (OR- 11.227), Class II molar relationship (OR - 4.518), ovoid upper arch form (OR - 13.750). In addition, the cephalometric parameters: ANB (p- 0.025), SN-MP (p- 0.007), BA-SN (p- 0.020), PNS-AD1 (p < 0.001), PNS-AD2 (p - 0.001) also showed highly significant association to OSA-risk. The ROC curves demonstrated high sensitivity and specificity for PNS-AD1 (60%,83.3%), PNS-AD2 (73.3%, 70%) and SN-MP (60%,70%), respectively for OSA-risk.

Conclusions: The study supported applicability of modified STOP-BANG questionnaire for OSA-risk in Indian adolescents. The parameters [extra-oral, intra-oral, cephalometric and upper airway (PNS-AD1, PNS-AD2, SN-MP)] significantly associated with OSA-risk, were identified.
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http://dx.doi.org/10.1016/j.jobcr.2020.10.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7666333PMC
October 2020

Strengthening health care research and academics during and after COVID19 pandemic- an Indian perspective.

J Oral Biol Craniofac Res 2020 Oct-Dec;10(4):343-346. Epub 2020 Jul 3.

Department of Oral Pathology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India.

The world-wide crisis of COVID-19 pandemic has disrupted daily lives, global economies, intra/inter-countries political outlook and educational systems. Schools and colleges in India and abroad are under lock-down to maximize social distancing and minimize the spread of infection amongst students and teaching staff. Health sciences related universities and researchers are forced to adopt non-contact teaching and research. Present article highlights the positive impact and opportunities provided by COVID-19 crisis to health care research and academic set-up. We have compiled ethical, effective and practical guidelines to mitigate the impact on health care related research and academic front during these pandemic times in an Indian perspective. These guidelines and management suggestions can be modified to suit region based cases and can be applied in global perspective also. The suggestions in the current article provide a working collaboration of students and teachers to effectively connect on virtual platforms to strengthen their research output, giving suggestions of data-sharing and rapid review of proposals by online review ethical boards. This time is proposed to be used for generating a positive impact on health and research sector to use each adversity as an opportunity.
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http://dx.doi.org/10.1016/j.jobcr.2020.06.015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7333619PMC
July 2020

Rectal spacing, prostate coverage, and periprocedural outcomes after hydrogel spacer injection during low-dose-rate brachytherapy implantation.

Brachytherapy 2020 Mar - Apr;19(2):228-233. Epub 2020 Feb 19.

Department of Radiation Oncology, Virginia Commonwealth University, Richmond, VA; Hunter Holmes McGuire Veterans Affairs Medical Center, Radiation Oncology Service, Richmond, VA. Electronic address:

Purpose: To analyze the dosimetric impact and periprocedural outcomes with a bioabsorbable hydrogel rectal spacer injected during low-dose-rate (LDR) prostate brachytherapy implants.

Methods And Materials: A consecutive series of 80 patients implanted with stranded I-125 LDR brachytherapy seeds were evaluated, of which 40 underwent a transperineal injection of polyethylene glycol (5 cc) in between the prostate and rectum. Same day CT-based dosimetry was compared between patients with and without hydrogel spacer to evaluate for differences in rectal and prostate dosimetry. Physician-reported toxicities were coded with Common Terminology Criteria for Adverse Events (CTCAE) v4.

Results: Baseline patient and implant characteristics were similar. There were no acute genitourinary or rectal toxicities attributed to the hydrogel spacer. Comparing patients with and without hydrogel, the mean separation between the prostate and rectum was 13.9 ± 5.2 mm vs. 6.5 ± 5.0 mm (p < 0.0001), respectively. The adjusted mean dose to 1 cc, 2 cc, and 5 cc of the rectum relative to prescription dose was decreased by 32% (p < 0.01), 26% (p < 0.01), and 17% (p < 0.01), respectively. There were no statistically significant differences in prostate coverage: mean V (92% vs. 91%), V (45% vs. 48%), and D (106% vs. 106%), respectively. At 1 month followup, grade 1 rectal toxicity was 12.5% vs. 17.5% (p = 0.35). No patients developed Grade ≥2 rectal toxicity with hydrogel, although one did without.

Conclusion: Hydrogel rectal spacers significantly reduced rectal exposure to LDR brachytherapy seeds without an observable impact on prostate coverage or periprocedural side effects. These outcomes reflect only LDR implants that used stranded seeds.
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http://dx.doi.org/10.1016/j.brachy.2019.11.002DOI Listing
December 2020

The impact of a patient-directed activity program on functional outcomes and activity participation after stroke during inpatient rehabilitation-a randomized controlled trial.

Clin Rehabil 2020 Apr 15;34(4):504-514. Epub 2020 Jan 15.

Baylor Scott & White Institute for Rehabilitation, Dallas, TX, USA.

Objective: Individuals post stroke are inactive, even during rehabilitation, contributing to ongoing disability and risk of secondary health conditions. Our aims were to (1) conduct a randomized controlled trial to examine the efficacy of a "Patient-Directed Activity Program" on functional outcomes in people post stroke during inpatient rehabilitation and (2) examine differences three months post inpatient rehabilitation discharge.

Design: Randomized control trial.

Setting: Inpatient rehabilitation facility.

Subjects: Patients admitted to inpatient rehabilitation post stroke.

Interventions: Patient-Directed Activity Program (PDAP) or control (usual care only). Both groups underwent control (three hours of therapy/day), while PDAP participants were prescribed two additional 30-minute activity sessions/day.

Main Measures: Outcomes (Stroke Rehabilitation Assessment of Movement Measure, Functional Independence Measure, balance, physical activity, Stroke Impact Scale) were collected at admission and discharge from inpatient rehabilitation and three-month follow-up.

Results: Seventy-three patients (PDAP ( = 37); control ( = 36)) were included in the primary analysis. Patients in PDAP completed a total of 23.1 ± 16.5 sessions (10.7 ± 8.5 upper extremity; 12.4 ± 8.6 lower extremity) during inpatient rehabilitation. No differences were observed between groups at discharge in functional measures. PDAP completed significantly more steps/day (PDAP = 657.70 ± 655.82, control = 396.17 ± 419.65;  = 0.022). The Stroke Impact Scale showed significantly better memory and thinking (PDAP = 86.2 ± 11.4, control = 80.8 ± 16.7;  = 0.049), communication (PDAP = 93.6 ± 8.3, control = 89.6 ± 12.4;  = 0.042), mobility (PDAP = 62.2 ± 22.5, control = 53.8 ± 21.8;  = 0.038), and overall recovery from stroke (PDAP = 62.1 ± 19.1, control = 52.2 ± 18.7;  = 0.038) for PDAP compared to control. At three months post discharge, PDAP ( = 11) completed significantly greater physical activity ( = 0.014; 3586.5 ± 3468.5 steps/day) compared to control ( = 10; 1760.9 ± 2346.3 steps/day).

Conclusion: Functional outcome improvement was comparable between groups; however, PDAP participants completed more steps and perceived greater recovery.
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http://dx.doi.org/10.1177/0269215519901153DOI Listing
April 2020

Salivary signature in forensic profiling: A scoping review.

J Forensic Dent Sci 2018 Sep-Dec;10(3):123-127

Department of Oral Pathology and Microbiology, Faculty of Dentistry, Jamia Miillia Islamia, New Delhi, India.

Background: Saliva has recently served as a primary investigative tool in forensics in the detection of crime, cases of sexual assaults, human and animal bite marks, poisoning, hormone identification, and alcohol and drug abuse.

Aim: This scoping review aimed to comprehensively identify the role of saliva in comparative and reconstructive identification and propose the concept of salivary signature (SS) in forensics.

Methodology: A literature search was performed on electronic databases, PubMed and Google Scholar with keywords, "salivary," "microbiome," and "forensics," and relevant articles identified along with reference tracking.

Results: SS model was based on salivary microbiome and biomarkers which together provide pertinent information about lifestyle, behavioral patterns, circadian rhythms, geolocation, cohabitation of individuals, postmortem intervals, systemic and oral ailments or cancers besides salivary flow and composition.

Conclusions: This communication highlights the constituents of SS and their significance in forensics. It also enumerates factors altering SS, limitations owing to diversity in microbiome and biomarker status, and possible measures to improve its accuracy and robustness in forensics.
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http://dx.doi.org/10.4103/jfo.jfds_30_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6528535PMC
May 2019

Effect of orthodontic forces on levels of enzymes in gingival crevicular fluid (GCF): A systematic review.

Dental Press J Orthod 2019 May;24(2):40.e1-40.e22

All India Institute of Medical Sciences,Department of Biochemistry (New Delhi, India).

Objective: Orthodontic force application releases multiple enzymes in gingival crevicular fluid (GCF) for activation, resorption, reversal, deposition of osseous elements and extracellular matrix degradation. The current systematic review critically evaluated all existing evidence on enzymes in orthodontic tooth movement.

Methods: Literature was searched with predetermined search strategy on electronic databases (PubMed, Scopus, Embase), along with hand search.

Results: Initial search identified 652 studies, shortlisted to 52 studies based on PRISMA. Quality assessment further led to final inclusion of 48 studies (13 moderately and 35 highly sensitive studies). Primary outcomes are significant upregulation in GCF levels of enzymes-aspartate aminotransferase (AST), alkaline phosphatase (ALP), matrix metalloproteinases (MMPs), lactate dehydrogenase (LDH), β-glucuronidase (βG), tartrate resistant acid phosphatase (TRAP), acid phosphatase (ACP) and down regulation in cathepsin B (Cb). Site specificity is shown by ALP, TRAP, AST, LDH, MMP9 with levels at compression site increasing earlier and in higher quantities compared with tension site. ALP levels are higher at tension site only in retention. A positive correlation of LDH, ALP and AST is also observed with increasing orthodontic force magnitude.

Conclusions: A strong evidence of variation in enzymes (ALP, AST, ACP TRAP, LDH, MMPs, Cb) in GCF is found in association with different magnitude, stages and sites of orthodontic force application.
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http://dx.doi.org/10.1590/2177-6709.24.2.40.e1-22.onlDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6526765PMC
May 2019

A cross-sectional study of knowledge regarding rabies among attendees of anti-rabies clinic of a teaching hospital, Jaipur.

J Family Med Prim Care 2019 Jan;8(1):194-198

Department of Cardiothoracic and Vascular Surgery, S.M.S. Medical College, Jaipur, Rajasthan, India.

Background: Being a fatal and 100% preventable disease, all efforts must be made by the health system to prevent even a single case of rabies. By assessing the knowledge of people regarding rabies prevention, we can make plans and policies for its prevention. The aim of this study was to assess the knowledge regarding rabies among attendees of anti-rabies clinic of a teaching hospital, Jaipur.

Methods: This observational cross-sectional study was conducted among attendees of anti-rabies clinic, Govt. R.D.B.P. Jaipuria hospital, Jaipur from February 2018 to July 2018. A total of 107 participants were included in the study. Data was collected using preformed questionnaire. Continuous data were expressed in mean and standard deviation and count data were expressed in proportion.

Results: In our study population, only 22.5% respondents had good knowledge, 56% had fair, and 21.5% had poor knowledge. Fatality of rabies was known to 68.2% of participants. One fourth of the participants knew that rabies is not curable, however, approximately 83% knew that it is preventable. Fifty-six percent of the participants were aware about washing the bite wound with soap and water. Approximately one-third (36%) of the participants knew that it is an infectious disease, however, only 7.5% knew that saliva, vomitus, tear, and urine of rabies patient may have rabies virus. Approximately 15% of the attendees had a wrong concept that a single injection is sufficient for immunization.

Conclusion: Although this study was done at a teaching hospital, lack of knowledge is still a big issue in urban population as well. This study concludes that knowledge regarding rabies should be highlighted in national programs of India to acknowledge Indian population regarding fatal rabies.
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http://dx.doi.org/10.4103/jfmpc.jfmpc_205_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6396603PMC
January 2019

A cross-sectional study of practices regarding HIV/AIDS among attendees of integrated counseling and testing center at the SMS Medical College, Jaipur.

J Family Med Prim Care 2018 Nov-Dec;7(6):1379-1384

Department of CTVS, Assistant Professor, SMS Medical College, Jaipur, Rajasthan, India.

Introduction: This proposed study was carried out among attendees of integrated counseling and testing center (ICTC) associated with the SMS Medical College, Jaipur which included general population as well as multiple types of high-risk behavior people to determine practices about the human immunodeficiency virus (HIV) and to correlate the socio-demographic profile of attendees with their practice about HIV/AIDS.

Materials And Methods: This cross-sectional study was conducted among 177 attendees at ICTC at the SMS Medical College, Jaipur from May 2015 to October 2015. Data were collected through an anonymous pre-designed semi-structured questionnaire. Continuous variables were summarized as mean and standard deviation while categorical variables as proportion (%). Chi-square test was used for the analysis of categorical variable. Stepwise multiple logistic regression analysis was done to find out predictors of practice. All statistical calculations were done by using the Med Calc. 12.2.1.0 software.

Results: Most participants were male (80.79%), age group 20-29 year (44.07%), married (57.63%), Hindu (92.09%), from OBC caste (36.72%), graduate (22.6%), from urban setting (53.11%), joint family (66.67%), from socio-economic Class 1 (31.07%), and referred by doctor (61.02%). About 22% agreed that they had sexual intercourse with a person other than spouse; 8.47% agreed on having more than one sexual partner; 8.39% male respondents agreed that they had sex with men. Poor practice was prevalent in 16.38%. Gender, age, literacy, mode of referral, socio-economic class, and area of residence were found significantly associated ( < 0.05) with high-risk behavior. Literacy of respondents was found only significant predictor of practice scores in stepwise multivariate regression analysis with following regression equation - Practice score = 2.9821 + 0.3421 (Education).

Conclusion: Literacy of respondents was found only significant predictor of practice scores. Government should strengthen IEC activities and ongoing HIV/AIDS education and prevention programs.
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http://dx.doi.org/10.4103/jfmpc.jfmpc_28_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6293882PMC
January 2019

Comprehensive Chart for Dental Age Estimation (DAEcc8) based on Demirjian 8-teeth method: Simplified for operator ease.

J Forensic Leg Med 2018 Oct 3;59:45-49. Epub 2018 Aug 3.

Intern, Faculty of Dentistry, Jamia Millia Islamia, Maulana Mohammad Ali Jauhar Marg, New Delhi, India.

With an alarming increase in number of juveniles in conflict with the law, in India as well as worldwide, more emphasis lies on radiographic dental age estimation (DAE) methods for different ethnic populations having specific formulas based on large sample databases. Of these, Chaillet and Demirjian modification of original Demirjian method was devised to increase the applicability to 18-year-old individuals. However, this method is cumbersome with multiple tables and difficulty in comprehension, thus deterring its use on a wider scale. The current study was aimed at developing a comprehensive DAE chart "DAEcc8", inclusive of all tables and regression equations of above modification along with improvisation of pictorial representation of stages based on Demirjian and Nolla. The method of filling this chart is explained in this communication along with selection of corresponding scores for each stage for both males and females and final computation of estimated age is done by application of total score in the regression equation. Hence, this study proposes the use of DAEcc8 for age estimation due to ease in comprehension and execution. It suggests a future scope of its use in educational and on field application in forensic dentistry.
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http://dx.doi.org/10.1016/j.jflm.2018.07.014DOI Listing
October 2018

A review of biomarkers in peri-miniscrew implant crevicular fluid (PMICF).

Prog Orthod 2017 Nov 27;18(1):42. Epub 2017 Nov 27.

Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, India.

Background: The temporary anchorage devices (TADs) which include miniscrew implants (MSIs) have evolved as useful armamentarium in the management of severe malocclusions and assist in complex tooth movements. Although a multitude of factors is responsible for the primary and secondary stability of miniscrew implants, contemporary research highlights the importance of biological interface of MSI with bone and soft tissue in augmenting the success of implants. The inflammation and remodeling associated with MSI insertion or loading are reflected through biomarkers in peri-miniscrew implant crevicular fluid (PMICF) which is analogous to the gingival crevicular fluid. Analysis of biomarkers in PMICF provides indicators of inflammation at the implant site, osteoclast differentiation and activation, bone resorption activity and bone turnover. The PMICF for assessment of these biomarkers can be collected non-invasively via paper strips, periopaper or micro capillary pipettes and analysed by enzyme-linked immunosorbent assay (ELISA) or immunoassays. The markers and mediators of inflammation have been previously studied in relation to orthodontic tooth movement include interleukins (IL-1β, IL-2, IL-6 and IL-8), growth factors and other proteins like tumour necrosis factor (TNF-α), receptor activator of nuclear factor kappa-B ligand (RANKL), chondroitin sulphate (CS) and osteoprotegerin (OPG). Studies have indicated that successful and failed MSIs have different concentrations of biomarkers in PMICF. However, there is a lack of comprehensive information on this aspect of MSIs. Therefore, a detailed review was conducted on the subject.

Results: A literature search revealed six relevant studies: two on IL-1β; one on IL-2, IL-6 and IL-8; one on TNF-α; one on CS; and one on RANKL/OPG ratio. One study showed an increase in IL-1β levels upon MSI loading, peak in 24 hours (h), followed by a decrease in 21 days to reach baseline in 300 days. A 6.87% decrease in IL-2 levels was seen before loading and a 5.97% increase post-loading. IL-8 showed a 6.31% increase after loading and IL-6 increased by 3.08% before MSI loading and 15.06% after loading. RANKL/OPG ratio increased in loaded compared to unloaded MSIs.

Conclusions: Cytokines (mainly ILs and TNF-α) and RANKL/OPG ratio showed alteration in PMICF levels upon loading of MSIs as direct or indirect anchorage.
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http://dx.doi.org/10.1186/s40510-017-0195-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5702602PMC
November 2017

Demirjian approach of dental age estimation: Abridged for operator ease.

J Forensic Dent Sci 2016 Sep-Dec;8(3):177

Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India.

Background: Present times have seen an alarming increase in incidence of crimes by juveniles and of mass destruction that Highlight the preponderance of individual age estimation. Of the numerous techniques employed for age assessment, dental age estimation (DAE) and its correlation with chronological age (CA) have been of great significance in the recent past. Demirjian system, considered as gold standard in DAE is a simple and convenient method for DAE, though,, although, referring to multiple tables make it cumbersome and less eco friendly due to excessive paper load.

Aim: The present study was aimed to develop a comprehensive chart (DAEcc) inclusive of all Demirjian tables and developmental stages of teeth and also to as well as to test the operator ease of 50 undergraduate dental students in performing DAE using this chart.

Materials And Methods: The study was performed in two stages, wherein the first stage was aimed at formulation of the comprehensive chart (DAE) which included pictorial representation of calcification stages, the Federation Dentaire Internationale notation of the teeth, and the corresponding scores for each stage with a concluding column at the end to enter the total score. The second stage assessed the applicability of the ease of DAE by DAE, whereby fifty 2 year BDS students were asked to trace the calcification stages of the seven permanent left mandibular teeth on a panorex, identify the correct stage, assign the corresponding score, and to calculate the total score for subsequent dental age assessment.

Results And Conclusions: showed that average time taken by the students for tracing seven mandibular teeth was 5 min and for assessment of dental age was 7 min. The total time taken for DAE was approximately 12 min, thus making the procedure less time consuming. Hence, this study proposes the use of DAEcc for age estimation due to ease in comprehension and execution of Demirjian system.
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http://dx.doi.org/10.4103/0975-1475.195103DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5210113PMC
January 2017

Craniofacial and upper airway morphology in adult obstructive sleep apnea patients: A systematic review and meta-analysis of cephalometric studies.

Sleep Med Rev 2017 02 30;31:79-90. Epub 2016 Jan 30.

Academy of Scientific & Innovative Research (AcSIR), India; CSIR-Central Scientific Instruments Organisation, Chandigarh, 160030, India.

Obstructive sleep apnea (OSA) is one of the common sleep breathing disorders in adults, characterised by frequent episodes of upper airway collapse during sleep. Craniofacial disharmony is an important risk factor for OSA. Overnight polysomnography (PSG) study is considered to be the most reliable confirmatory investigation for OSA diagnosis, whereas the precise localization of site of obstruction to the airflow cannot be detected. Identifying the cause of OSA in a particular ethnic population/individual subject helps to understand the etiological factors and effective management of OSA. The objective of the meta-analysis is to elucidate altered craniofacial anatomy on lateral cephalograms in adult subjects with established OSA. Significant weighted mean difference with insignificant heterogeneity was found for the following parameters: anterior lower facial height (ALFH: 2.48 mm), position of hyoid bone (Go-H: 5.45 mm, S-H: 6.89 mm, GoGn-H: 11.84°, GoGn-H: 7.22 mm, N-S-H: 2.14°), and pharyngeal airway space (PNS-Phw: -1.55 mm, pharyngeal space: -495.74 mm and oro-pharyngeal area: -151.15 mm). Significant weighted mean difference with significant heterogeneity was found for the following parameters: cranial base (SN: -2.25 mm, S-N-Ba: -1.45°), position and length of mandible (SNB: -1.49° and Go-Me: -5.66 mm) respectively, maxillary length (ANS-PNS: -1.76 mm), tongue area (T: 366.51 mm), soft palate area (UV: 125.02 mm), and upper airway length (UAL: 5.39 mm). This meta-analysis supports the relationship between craniofacial disharmony and obstructive sleep apnea. There is a strong evidence for reduced pharyngeal airway space, inferiorly placed hyoid bone and increased anterior facial heights in adult OSA patients compared to control subjects. The cephalometric analysis provides insight into anatomical basis of the etiology of OSA that can influence making a choice of appropriate therapy.
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http://dx.doi.org/10.1016/j.smrv.2016.01.007DOI Listing
February 2017

Improving practice with integration of patient directed activity during inpatient rehabilitation.

Clin Rehabil 2017 Jan 10;31(1):3-10. Epub 2016 Jul 10.

1 Physical Medicine and Rehabilitation, Baylor Institute for Rehabilitation, Dallas, TX, USA.

Background: Early initiation of rehabilitation following stroke promotes better long-term outcomes than delayed onset, emphasizing the importance of inpatient therapy. However, literature indicates that following stroke individuals in inpatient rehabilitation spend the majority of their day in their bedroom and inactive. Consequently, since amount of functional activity is posited to relate to outcomes, the current rehabilitation model needs to be challenged with innovative solutions to maximize recovery.

Rationale: In an attempt to promote greater activity and higher doses of therapy during inpatient rehabilitation, we implemented the "Patient Directed Activity Program" to facilitate specific movement and improve outcomes for patients post stroke. Our interdisciplinary activity program was conceptualized on a theoretical model for stroke recovery and principles of experience-dependent neural plasticity.

Main Features: The "Patient Directed Activity Program" includes distinct activity stations designed to increase repetition, stimulation, attention, and activity of the affected upper extremities, lower extremities, and trunk. Each task-specific activity was easily graded to achieve moderate- to high-intensity. The activity program prescribed individuals up to three additional 30-minute bouts of activities daily that were to be completed independently, and in addition to standard of care. Clinical application: After implementing this program in our facility for one year as a quality improvement project, the intervention has been delivered as an Institutional Review Board approved randomized controlled trial (Clinical Trial #NCT02446197). Challenges with people and facilities have been overcome, resulting in a feasible program that can be delivered in an inpatient setting. High satisfaction has been reported by patients and clinicians.
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http://dx.doi.org/10.1177/0269215515625100DOI Listing
January 2017

Photo-editing in Orthodontics: How Much is Too Much?.

Authors:
Priyanka Kapoor

Int J Orthod Milwaukee 2015 ;26(3):17-23

Digital photography and radiology are the mainstay of orthodontic records but current image editing software programs nave led to increase in instances of digital forgery and scientific misconduct. In the present study, digital image data of orthodontic study casts and photographs were altered using software such as [Microsoft Paint6 1, Picasa3.1, Adobe Photoshop3.6]. Based on ethical guidelines on digital image manipulations, cropping or intensity adjustments in moderation to entire image were considered permissible while cloning or color adjustments were deemed unethical.
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March 2016

Transverse changes in lateral and medial aspects of palatal rugae after mid palatal expansion: A pilot study.

J Forensic Dent Sci 2015 Jan-Apr;7(1):8-13

Department of Orthodontics, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India.

Introduction: Palatal rugae has established role in forensic identification of an individual due to its stability in growth as well as orthodontic treatment. However effect of orthodontic mid-palatal expansion on rugae stability still requires further investigation. Hence, this study was aimed at evaluating the stability of palatal rugae in transverse dimension in adolescent patients of mid-palatal expansion.

Materials And Methods: The study sample consists of 14 subjects (10F,4M, age 12.4 ± 2.0 years) with transverse maxillary constriction, treated with bonded and banded rapid maxillary expansion (RME) appliance. 1(st) to 3(rd) rugae on pre- and post-expansion casts were recorded synchronously. Inter-medial and inter-lateral rugae distance were measured with digital calipers to record the transverse positional rugae changes.

Results: There was a statistically significant (p < 0.05) increase in values after expansion between medial aspects of 2(nd) (p = 0.002) and 3(rd) rugae (p = 0.005) and lateral aspects of 1(st) (p = 0.015), 2(nd) (p = 0.006) and 3(rd) (p = 0.001) rugae. The transverse changes were recorded in the order of 3(rd) rugae >2(nd) rugae >1(st) rugae.

Conclusion: This pilot study does not support stability of medial and lateral ruga points of 2(nd) and 3(rd) primary rugae for forensic identification in individuals treated with mid palatal expansion.
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http://dx.doi.org/10.4103/0975-1475.150294DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4330626PMC
February 2015

Effect of orthodontic forces on cytokine and receptor levels in gingival crevicular fluid: a systematic review.

Prog Orthod 2014 Dec 9;15:65. Epub 2014 Dec 9.

Division of Orthodontics and Dentofacial Deformities, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi 110029, India.

This systematic review aimed to generate evidence on role of potent markers of inflammation [cytokines, chemokines, their associated receptors and antagonists] following the application of orthodontic forces. Subsequent to registration with PROSPERO, literature search followed a predetermined search strategy to key databases along with hand search (HS). Seventy-seven articles from PubMed (P), 637 from Scopus (S), 51 from Embase (E), and 3 from hand search (HS) were identified. A total of 39 articles were shortlisted that met strict inclusion and exclusion criteria and quality assessment. Each study was evaluated for participant characteristics, study design, oral hygiene regimen, and gingival crevicular fluid (GCF) handling. Among these studies, biomarkers in the order of frequency were interleukin (IL)-1β (N=21), tumor necrosis factor (TNF)-α (N=10), IL-8,IL-6(N=8), receptor activator of nuclear factor kappa-B ligand (RANKL) (N=7), monocyte chemoattractant protein (MCP)-1 (N=3), IL-2 (N=4), IL-4, IL-10, RANTES (N=2), IL-1, IL-5, IL-1α, IP-10, osteopontin (OPN) (N=1) and receptors and their antagonists in the order of osteoprotegerin (OPG) (N=8), IL-1RA (N=5), and RANK (N=1). Results revealed an immediate release of inflammatory bone-resorptive mediators, IL-1β and TNF-α, where IL-1β increased as early as 1 min to 1 h reaching peak at 24 h while TNF-α increased at 1 h or 1 day. This was accompanied by a fall in bone-protective mediator (OPG) levels at 1 h and 24 h after orthodontic force application. Continuous forces were accompanied by a decrease in mediator levels after attaining peak levels (most commonly at 24 h) while repeated activations in interrupted force upregulated their secretion. Significant correlations of IL-1β levels with pain intensity, rate of orthodontic tooth movement (OTM) and of activity index (AI) (IL-1β/IL-1RA) with velocity of tooth movement and growth status of individuals have also been deduced. A greater AI and RANKL/OPG ratio was seen in juveniles as compared to adults or non-growers that were associated with faster rate of OTM in juveniles. None of the studies addressed the effect of estrous cycle in female subjects. Lack of homogeneity in several parameters calls for a better controlled research on the biology of OTM.
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http://dx.doi.org/10.1186/s40510-014-0065-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4259981PMC
December 2014

Transposition of bilateral maxillary canine and first premolar.

Authors:
Priyanka Kapoor

Int J Orthod Milwaukee 2010 ;21(4):37-41

Kalka Dental College, India.

The following case report describes the treatment of a 16-year-old female patient with complete transposition of maxillary first premolars and canines. Retained deciduous maxillary canines and buccal eruption of permanent maxillary canines led to non-consonant smile arc of the patient and obliteration of buccal corridors. Mechanics for correction were individualized based on factors such as facial pattern, age, malocclusion, tooth-size discrepancy, stage of eruption, and magnitude of the transposition. Thus an attempt was made to align transposition by maintaining order of transposed canine and first premolar and attain a consonant smile arc with a normal buccal corridor width.
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March 2011

Levels of t-PA and PAI-2 in gingival crevicular fluid during orthodontic tooth movement in adults.

Aust Orthod J 2005 Nov;21(2):151-2; author reply 152-3

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November 2005

STUDIES ON PHARMCOGNOSTICAL FEATURES OF Zizyphus mauritiana LINN. ROOT (FAMILY : RHAMNACEAE).

Anc Sci Life 2004 Oct;24(2):92-6

Department of Pharmaceutical Sciences, Birla Institute of Technology, Mesra, Ranchi - 835215, Jharkhand, India.

Description of the root of the plant, Zizyphus mauritiana Linn. the microscopical characters of the powdered root, its behavior on treatment with different chemical reagents, and the fluorescence character under ultraviolet light after treatment were studied to fix some pharmacognostical parameters. Preliminary phytochemical screening on the various extracts of the root of the plant was also performed. These studies were carried out to identify this plant for further research work.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3330926PMC
October 2004
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