Publications by authors named "Shruthi Acharya"

13 Publications

  • Page 1 of 1

Nicotine dependence and its association with health utility ratings among a sample of Indian dental patients.

Community Dent Oral Epidemiol 2021 Feb 27. Epub 2021 Feb 27.

Dental Epidemiology and Public Health, Faculty of Dentistry, WHO Collaborating Centre for Dental Epidemiology and Public Health, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand.

Objectives: To measure utility ratings and quality-adjusted life-years(QALYs) for nicotine dependence-related health states using the standard gamble approach among a sample of dental patients; investigate the possible associations of nicotine dependence, and study the influences on tobacco-related health state utilities estimates among patients.

Methods: A sample of 200 adult outpatients who were current or former consumers of tobacco were included in the cross-sectional study. Demographic, oral health self-rating and tobacco-related data (Fagerstrom scale for nicotine dependence, type of tobacco consumed, frequency and duration of the habit) were collected. A standard gamble method of utility valuation was also carried out.

Results: Older age, lower educational attainment, higher frequency of consumption, increased duration of the habit, consumption of chewing tobacco, as opposed to smoking tobacco, and poor oral health were associated with higher nicotine dependence. Lower nicotine dependence, better oral health and quitting the habit were associated with better health utility estimates. QALYs lost due to the habit among the 'low to moderate' and 'significant' nicotine dependence groups were 2.7 (sd, 3.7) and 6.7 (sd, 8.0) years, respectively.

Conclusions: Higher health utility ratings were seen among patients with 'low to moderate' nicotine dependence, better oral health status and quitters of the tobacco habit. Quality of life weights generated through this method could be used for cost-utility analyses of tobacco cessation/prevention interventions in different settings and cultures.
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http://dx.doi.org/10.1111/cdoe.12629DOI Listing
February 2021

Bilateral Bell's palsy in a young female: a rare case report.

Med Pharm Rep 2021 Jan 29;94(1):118-120. Epub 2021 Jan 29.

Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.

Bell's palsy is described as a type of facial paralysis, which is unilateral in 70% of the cases. Bell's palsy accounts for about 23% of bilateral facial paralysis. Here, we present a rare case of bilateral Bell's palsy in a 15-year-old female who developed sudden facial weakness with no associated symptoms. The patient was subjected to thorough clinical, laboratory, and necessary radiological investigations. As there was no conclusive evidence from any of the investigations, this could be a case of idiopathic bilateral Bell's palsy. This is the first ever case of bilateral Bell's palsy in a young female which has been reported in the Indian population.
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http://dx.doi.org/10.15386/mpr-1389DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7880067PMC
January 2021

Risk assessment for osteoradionecrosis of the jaws in patients with head and neck cancer.

Med Pharm Rep 2020 Apr 22;93(2):195-199. Epub 2020 Apr 22.

Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Karnataka, India.

Objectives: To identify the potential risk factors for the occurrence of osteoradionecrosis (ORN) of the jaws among patients who have been treated with radiotherapy for head and neck malignancy.

Methods: The study comprised of 231 patients treated with radiotherapy for head and neck malignancy at a tertiary referral center. The following details were recorded for each patient: age, gender, histopathological diagnosis, clinical staging, tumor site, treatment modality, radiation dose, radiation field, number of fractions, type of accelerator used, radiation area and duration of follow-up. Patient's tobacco, alcohol habit history, and history of extraction of teeth before/during/after radiotherapy were also noted.

Results: Thirteen patients had osteoradionecrosis (frequency 5.62%). Among the radiotherapy variables assessed, increased radiation area was found to be significantly associated with the occurrence of osteoradionecrosis. Among the 13 ORN cases, 10 (76.9%) had a history of tobacco consumption, 8 (61.5%) had a time interval between radiotherapy and occurrence of ORN of less than 1-year duration.

Conclusions: We found a low cumulative incidence of osteoradionecrosis and a tendency to occur within a year of starting radiotherapy. Patients of older age, those with a prior tobacco habit may be considered more liable to develop osteoradionecrosis. A larger radiation field may also put patients at hazard for developing osteoradionecrosis.
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http://dx.doi.org/10.15386/mpr-1418DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7243884PMC
April 2020

Prophylactic extraction of non-impacted third molars: is it necessary?

Minerva Stomatol 2019 Dec;68(6):297-302

Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, India.

Background: The decision of removing a non-impacted 3rd molar, unlike extraction of an impacted 3rd molar, is challenging for dentists as well as patients. This study investigates the pathologies affecting second molars situated adjacent to asymptomatic non-impacted 3rd molars.

Methods: This retrospective study included digital radiographs of 749 patients taken between April to October 2015. Panoramic radiographs were evaluated for the presence of erupted asymptomatic non-impacted 3rd molars and pathologies on adjacent second molars. The patients were reviewed according to age and gender.

Results: A total of 2342 asymptomatic 3rd molars were assessed in the study based on the inclusion and exclusion criteria, and 2112 of them were found to be non-impacted. The second molars adjacent to non-impacted 3rd molars were shown to be significantly associated with distal caries (25.2%), mesial bone loss (10.5%) and total bone loss (37.2%), i.e., mesial as well as distal bone loss.

Conclusions: Pathologies of the 3rd molars and teeth adjacent to 3rd molars can occur as a result of multiple factors. Caries and periodontal disease may also occur due to the inaccessibility to maintain oral hygiene. With a regular follow-up schedule, reinforced by the dentist and good oral hygiene, several pathologies that are significantly associated with non-impacted 3rd molars can be prevented and may not require prophylactic extraction.
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http://dx.doi.org/10.23736/S0026-4970.19.04273-0DOI Listing
December 2019

Awareness About Medication-Related Osteonecrosis of the Jaw Among Dental Professionals: A Multicentre Study.

Oral Health Prev Dent 2020;18(1):505-509

Purpose: Bisphosphonates and non-bisphosphonate antiangiogenic and antiresorptive agents are widely used in the management of bone diseases and cancer. A subset of patients receiving these drugs can manifest with medication-related osteonecrosis of the jaw (MRONJ) and it is one of the major complications faced in dental practice. Dentoalveolar and periodontal surgery are the major risk factors associated with it. Therefore, a dentist must have adequate knowledge to promptly identify patients at risk and efficiently manage the condition. This multicentre study was designed with an aim to assess the level of knowledge and awareness regarding MRONJ among dentists from six dental schools.

Methods And Materials: An online self-administered questionnaire was sent to all the dentists from six dental schools through Google forms. The results obtained were statistically analysed. The Kolmogorov-Smirnov test was performed to check for normality of data, while the Mann-Whitney U-test and chi-square test were used to compare the responses to each question.

Results: The questionnaire was sent to 570 dentists, out of which 234 responses were obtained. The majority of participants were aware of the term 'MRONJ' (83.3%), clinical indications of bisphosphonates (61.5%) and its mechanism of action (72.2%). However, 68.4% and 61.5% of dentists had no knowledge about the 'drug holiday' concept and risk factors associated with MRONJ, respectively.

Conclusion: Although most of the participants had knowledge regarding certain aspects of MRONJ, such as mechanism of action and clinical indications of bisphosphonates, there was a lack of awareness about the drug holiday concept and drug-associated risk factors. This emphasises the need to spread awareness among the dental community, not only in tertiary healthcare centres, but also among private dentists and dental interns to prevent cases of MRONJ.
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http://dx.doi.org/10.3290/j.ohpd.a43361DOI Listing
June 2020

Efficacy of a remote screening model for oral potentially malignant disorders using a free messaging application: A diagnostic test for accuracy study.

Aust J Rural Health 2019 Apr 3;27(2):170-176. Epub 2019 Apr 3.

Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India.

Objective: To assess the feasibility of using a remote sensing model as a free messaging application tool in the preventive screening of oral potentially malignant disorders in a rural area of India.

Design: An observational cross-sectional study.

Setting: Primary care setting in Udupi District, Karnataka, South India.

Participants: One-hundred and thirty-one individuals with a mean (SD) age of 37.34 (11.31) years, of whom 64.1% and 35.9% were men and women, respectively.

Interventions: Clinical oral examination followed by photo capture of five areas of the patients' mouth.

Main Outcome Measures: Reliability measures for the use of a photo messaging service in diagnosing oral potentially malignant disorders, as compared to the clinical examination.

Results: When lesions were categorised as normal and abnormal, the reliability (kappa) between the diagnoses, based on photo messaging and clinical oral examination, was 0.68 and 0.67 for Examiners 1 and 2, respectively. The sensitivity values for Examiners 1 and 2 were 98.5% and 99.04%, respectively, whereas the specificity was 72% and 64%, respectively. When the agreement between photo messaging and clinical oral examination for an exact diagnostic match was assessed, the reliability (kappa) was 0.59 and 0.55 for Examiners 1 and 2, respectively. The sensitivity values for Examiners 1 and 2 were 98.1% and 98.7%, respectively, whereas the specificity was 64% and 52% respectively.

Conclusion: There was a substantial agreement between the diagnosis based on clinical examination and WhatsApp image for both the examiners, when the lesions were dichotomised as normal and abnormal, but slightly reduced when assessed for the exact diagnostic match. Screening for oral potentially malignant disorders using photo messaging can serve as an effective adjunct and a potential cost-effective tool in a low-resource setting.
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http://dx.doi.org/10.1111/ajr.12496DOI Listing
April 2019

Dental health state utilities among dental patients.

J Public Health Dent 2019 03 31;79(2):147-153. Epub 2019 Jan 31.

Faculty of Dentistry, Department of Oral Sciences, Dental Epidemiology and Public Health, WHO Collaborating Centre for Dental Epidemiology and Public Health, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand.

Objectives: To test the efficacy of a dental health state utility measure among a sample of dental patients using the standard gamble (SG) method and to examine its association with two quality of life constructs, namely the Oral Health Impact Profile-14 questionnaire and the global oral health item.

Methods: A cross-sectional study was conducted with a sample of 202 adult dental patients. Demographic and clinical data were collected. The 14 item oral health impact profile (OHIP-14) and Locker's global rating scale for oral health were administered and a SG utility valuation was carried out.

Results: The mean age of the patients was 38.6 ± 14.1 years. The mean SG score was 0.2 ± 0.2. Bivariate and negative binomial regression using the SG score as the outcome variable showed significant associations between SG scores and the OHIP-14 summary scores, global oral health rating values, as well as with age, gender, and nature/severity of the oral problem.

Conclusion: The SG method was effective in assessing dental health state utilities in the patient population. Determining patients' risk tolerance through the SG method may lead to greater awareness about factors that could influence their choice of treatment and could help in planning treatment regimens.
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http://dx.doi.org/10.1111/jphd.12306DOI Listing
March 2019

Oral changes in patients undergoing chemotherapy for breast cancer.

Indian J Dent Res 2017 May-Jun;28(3):261-268

Department of Community Dentistry, Manipal College of Dental Sciences, Manipal University, Manipal, Karnataka, India.

Background: Breast cancer is one of the most common cancers in India. Most of the patients with breast cancer are treated with chemotherapy which has multiple oral complications.

Aims: The objectives of this study were to describe the occurrence of taste disturbances, xerostomia, oral mucositis, oral pigmentation, and candidal and salivary changes among patients receiving chemotherapy for breast cancer.

Methods: Fifty-two women with newly diagnosed breast cancer (without distant metastasis), eligible for adjuvant/neoadjuvant chemotherapy (cyclophosphamide and adriamycin, 4 cycles × 3 weeks), were included in this study. All the observations were noted before, during (after 6 weeks of starting chemotherapy), and after the completion of chemotherapy (after 12 weeks of starting chemotherapy).

Statistical Analysis Used: Variables such as mucositis, salivary flow rate, salivary pH, and candidal carriage rate were compared at baseline, and at 1st and 2nd follow-ups using Wilcoxon signed-rank test (P value corrected for α for pair-wise comparisons).

Results: Mean unstimulated whole salivary flow rate reduced from 0.5 ml/min to 0.3 ml/min, and the mean colony-forming units of Candida reduced from 32.3 × 103 cells/ml to 13.1 × 103 cells/ml at the end of the study period. Xerostomia, taste disturbances, and oral mucosal pigmentation increased from 28.8% to 50%.

Conclusions: There was a discernible change in oral mucosal, salivary, and candidal status during the course of the study.
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http://dx.doi.org/10.4103/ijdr.IJDR_379_16DOI Listing
May 2018

Unusual neoplasm on the hard palate of a child: a case report.

J Med Case Rep 2017 Jun 2;11(1):149. Epub 2017 Jun 2.

Department of Pediatric Surgery, Kasturba Medical College, Manipal University, Manipal, 576104, Karnataka, India.

Background: Myoepitheliomas account for less than 1% of salivary gland tumors. They mostly affect the parotid glands of adults during the third to fifth decades.

Case Presentation: A 10-year-old Indian boy reported a small swelling in the roof of his mouth of 10 days' duration. History revealed that the lesion was painless and not associated with bleeding or pus discharge. On examination, a purplish well-circumscribed growth was noted on his posterior hard palate. Magnetic resonance imaging was suggestive of a well-encapsulated hemangioma. An excisional biopsy was performed and histopathology along with immunohistochemistry analysis showed that the lesion was a spindle cell variant of benign myoepithelioma.

Conclusion: Palatal myoepitheliomas are rare and their occurrence in young individuals is rarer.
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http://dx.doi.org/10.1186/s13256-017-1321-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5457591PMC
June 2017

Maxillary pseudotumor as initial manifestation of von Willebrand disease, type 2: report of a rare case and literature review-a commentary.

Oral Surg Oral Med Oral Pathol Oral Radiol 2016 Aug 24;122(2):259-60. Epub 2016 May 24.

Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal University, Manipal, Karnataka, India.

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http://dx.doi.org/10.1016/j.oooo.2016.05.011DOI Listing
August 2016

Hybrid ameloblastoma: An amalgam of rare and conventional ameloblastoma.

Contemp Clin Dent 2016 Jan-Mar;7(1):90-4

Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal University, Manipal, Karnataka, India.

Ameloblastoma is a common benign odontogenic tumor with multiple histologic types. This case report describes an unusual type of ameloblastoma called "Hybrid Ameloblastoma" with features of both follicular and desmoplastic ameloblastoma in a 50-year-old female. This is a very rare form of ameloblastoma as <30 cases have been reported so far in literature. Though this rare form of ameloblastoma is only a histologic variant, it poses a great challenge to diagnosticians and thus to surgeons as there will be mismatch of biopsy reports at different sites in the same tumor thereby changing the treatment plan. This case report is one such example of diverse presentation of this ameloblastoma with conflicting histopathological diagnosis at initial biopsy and on surgical excision.
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http://dx.doi.org/10.4103/0976-237X.177089DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4792065PMC
April 2016

Repeat film analysis and its implications for quality assurance in dental radiology: An institutional case study.

Contemp Clin Dent 2015 Jul-Sep;6(3):392-5

Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal University, Manipal, Karnataka, India.

Context: The goal of any radiologist is to produce the highest quality diagnostic radiographs, while keeping patient exposure as low as reasonably achievable (ALARA).

Aims: The aim of this study was to describe the reasons for radiograph rejections through a repeat film analysis in an Indian dental school.

Settings And Design: An observational study conducted in the Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal.

Materials And Methods: During a 6-month study period, a total of 9,495 intra-oral radiographs and 2339 extraoral radiographs taken in the Radiology Department were subjected to repeat film analysis.

Statistical Analysis Used: SPSS Version 16. Descriptive analysis used.

Results: The results showed that the repeat rates were 7.1% and 5.86% for intraoral and extraoral radiographs, respectively. Among the causes for errors reported, positioning error (38.7%) was the most common, followed by improper angulations (26.1%), and improper film placement (11.2%) for intra-oral radiographs. The study found that the maximum frequency of repeats among extraoral radiographs was for panoramic radiographs (49%) followed by lateral cephalogram (33%), and paranasal sinus view (14%). It was also observed that repeat rate of intraoral radiographs was highest for internees (44.7%), and undergraduate students (28.2%).

Conclusions: The study pointed to a need for more targeted interventions to achieve the goal of keeping patient exposure ALARA in a dental school setting.
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http://dx.doi.org/10.4103/0976-237X.161898DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4549993PMC
August 2015

Socioeconomic mobility and tobacco consumption patterns in fish industry workers in Udupi District of coastal Karnataka.

Indian J Dent Res 2014 Sep-Oct;25(5):653-6

Department of Public Health Dentistry, Manipal University, Manipal College of Dental Sciences, Manipal, Karnataka, India.

Aim: The aim of this study was to understand the tobacco consumption patterns and their relationship with life course socioeconomic mobility among fish industry workers as this could provide important information in dealing with the tobacco problem in this very vulnerable population.

Materials And Methods: Socioeconomic life course data and information about tobacco habits was collected from 102 fish industry workers. A subject was considered to be upwardly mobile if the family head's educational attainment and the number of earning members increased and the number of children and dependents decreased since childhood in his or her household. Oral examination was also done for malignant/premalignant lesions.

Results: Of the 102 subjects, 64 regularly consumed tobacco either in smoking or smokeless forms and the common reasons for the habit were the co-workers' influence and to keep awake at work. Fourteen subjects had premalignant lesions in the oral cavity and all them were in the buccal mucosa. The prevalence of the tobacco habit was much lesser (25%) among the upwardly mobile group when compared to the minimal or no improvement group (75%). A majority of those free from the habit (73.7%) were belonging to the group, which showed improved educational attainment. Among those with good social mobility, the percentage of workers with high frequency of tobacco consumption and those with a longer duration of the tobacco habit was low when compared to the minimal social mobility group.

Conclusion: A holistic approach consisting of efforts to improve the overall socioeconomic conditions can be more effective than piecemeal solutions in dealing with the tobacco menace.
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http://dx.doi.org/10.4103/0970-9290.147116DOI Listing
December 2016