BACKGROUND In this study, we wanted to evaluate the prevalence and association of impulsivity and psychiatric morbidity in suicide attempters, along with the socio-demographic characteristics of those who attempt suicide. METHODS This was a hospital-based cross-sectional analytical study conducted among 150 patients who presented with a history of suicide attempt to the Department of Psychiatry, Government Medical College, Kannur, Kerala, from 1st May 2021 to 30th April 2022 after obtaining clearance from the institutional ethics committee and written informed consent from the study participants. RESULTS Psychiatric morbidity was seen among 81% of the study participants, and the commonest among them were mood disorders (47%) including (major depression, bipolar, and dysthymia) followed by a general anxiety disorder, phobia, anxiety disorder NOS, obsessive-compulsive disorder, and stress-related disorder (14%). The overall scores were observed to be a mean (SD) of 62.3 (8.9), while the distribution of BIS “Non- Planning”, BIS “Motor Impulsiveness” and BIS “Attentional Impulsiveness” was observed to be 29.6 (7.1), 19.5 (4.9), and 13.1 (3.4) respectively. Also, it was seen that there was a statistically significant difference in the distribution of BIS scores in relation to the overall score, “Non- Planning”, and BIS “Motor Impulsiveness” between the proportion having psychiatric morbidity and without psychiatric morbidity (p-value <0.05). CONCLUSIONS We found that a history of suicide attempts was more common among males. The 4/5th of the participants had some form of psychiatric morbidity and the most common ones seen among the participants were major depression, bipolar, and dysthymia followed by anxiety disorder.
{"title":"Impulsivity and Psychiatric Morbidity in Suicide Attempters - A Cross-Sectional Study in a Tertiary Care Centre in Northern Kerala","authors":"Amrutha Francis, Druhin Adavalath, Padmini Cherukunnath","doi":"10.14260/jemds.v12i5.402","DOIUrl":"https://doi.org/10.14260/jemds.v12i5.402","url":null,"abstract":"BACKGROUND \u0000In this study, we wanted to evaluate the prevalence and association of impulsivity and psychiatric morbidity in suicide attempters, along with the socio-demographic characteristics of those who attempt suicide. \u0000METHODS \u0000This was a hospital-based cross-sectional analytical study conducted among 150 patients who presented with a history of suicide attempt to the Department of Psychiatry, Government Medical College, Kannur, Kerala, from 1st May 2021 to 30th April 2022 after obtaining clearance from the institutional ethics committee and written informed consent from the study participants. \u0000RESULTS \u0000Psychiatric morbidity was seen among 81% of the study participants, and the commonest among them were mood disorders (47%) including (major depression, bipolar, and dysthymia) followed by a general anxiety disorder, phobia, anxiety disorder NOS, obsessive-compulsive disorder, and stress-related disorder (14%). The overall scores were observed to be a mean (SD) of 62.3 (8.9), while the distribution of BIS “Non- Planning”, BIS “Motor Impulsiveness” and BIS “Attentional Impulsiveness” was observed to be 29.6 (7.1), 19.5 (4.9), and 13.1 (3.4) respectively. Also, it was seen that there was a statistically significant difference in the distribution of BIS scores in relation to the overall score, “Non- Planning”, and BIS “Motor Impulsiveness” between the proportion having psychiatric morbidity and without psychiatric morbidity (p-value <0.05). \u0000CONCLUSIONS \u0000We found that a history of suicide attempts was more common among males. The 4/5th of the participants had some form of psychiatric morbidity and the most common ones seen among the participants were major depression, bipolar, and dysthymia followed by anxiety disorder. \u0000 ","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44594692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-30DOI: 10.14260/jemds.v12i5.406
Sanjana A.S., Girishma J.
Sarcoidosis was characterised by Scadding and Mitchell as an idiopathic multisystem disorder characterised by the formation of non-caseating epithelioid cell tubercles in the organs or tissues that are affected by the condition.[1] The disease process is extensive, with varying symptoms and an unpredictability in its progression. Skin manifestations are present in 20–35% of individuals with systemic sarcoidosis, but 25% of patients with cutaneous sarcoidosis do not have any systemic illness.[2] Psychological symptoms are more prevalent in sarcoidosis patients than in the general population. Between 18% and 66% of sarcoidosis patients have depression, while between 31% and 33% have anxiety.[3] When treating these patients, clinicians should look for signs of depression and, if found, consider a therapeutic trial of antidepressants and/or psychosocial interventions. Management of sarcoidosis is done by a multidisciplinary team. The most common forms of treatment for sarcoidosis are immunosuppressive medicine, such as corticosteroids used orally or topically, methotrexate, and the TNF-alpha inhibitors adalimumab and infliximab.[4]
{"title":"Cutaneous Sarcoidosis Encountered in a Patient with Major Depressive Disorder – A Case Report","authors":"Sanjana A.S., Girishma J.","doi":"10.14260/jemds.v12i5.406","DOIUrl":"https://doi.org/10.14260/jemds.v12i5.406","url":null,"abstract":"Sarcoidosis was characterised by Scadding and Mitchell as an idiopathic multisystem disorder characterised by the formation of non-caseating epithelioid cell tubercles in the organs or tissues that are affected by the condition.[1] The disease process is extensive, with varying symptoms and an unpredictability in its progression. Skin manifestations are present in 20–35% of individuals with systemic sarcoidosis, but 25% of patients with cutaneous sarcoidosis do not have any systemic illness.[2] \u0000Psychological symptoms are more prevalent in sarcoidosis patients than in the general population. Between 18% and 66% of sarcoidosis patients have depression, while between 31% and 33% have anxiety.[3] When treating these patients, clinicians should look for signs of depression and, if found, consider a therapeutic trial of antidepressants and/or psychosocial interventions. \u0000Management of sarcoidosis is done by a multidisciplinary team. The most common forms of treatment for sarcoidosis are immunosuppressive medicine, such as corticosteroids used orally or topically, methotrexate, and the TNF-alpha inhibitors adalimumab and infliximab.[4]","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47302407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-30DOI: 10.14260/jemds.v12i5.403
Krishna Deepthi P.P., Bandana Mahanta
BACKGROUND In this study, we wanted to compare the characteristics of subarachnoid block when intrathecal versus intravenous magnesium sulphate was used with 0.5 % hyperbaric bupivacaine spinal anaesthesia in elective infraumbilical surgery. METHODS This was a hospital based prospective randomized clinical parallel arm study double-blinded (patient and observer blinded) single hospital study conducted among 100 patients who presented with elective infraumbilical surgery under spinal anaesthesia to the Department of Anesthesiology and Critical Care, Gauhati Medical College and Hospital, Guwahati, from 1st June 2021 to 31st May 2022 after obtaining clearance from the institutional ethics committee and written informed consent from the study participants. RESULTS The onset of sensory block, and comparison of duration of analgesia with respect to time to first analgesic request was found to be statistically significant. While comparing, duration of analgesia was significantly prolonged in the intravenous group. Magnesium administered intravenously or intrathecally was not linked to any harmful side effects. CONCLUSIONS Infraumbilical procedures that use intravenous magnesium sulphate as an adjuvant to 0.5% hyperbaric bupivacaine spinal anaesthetic extend the time that post-operative analgesia lasts. Intrathecal co-administration of Magnesium sulphate with 0.5% hyperbaric bupicavaine delays the onset of sensory block compared to intravenous MgSO4.
{"title":"A Comparative Study of Intravenous Magnesium Sulphate Versus Intrathecal Magnesium Sulphate in 0.5% Hyperbaric Bupivacaine Spinal Anaesthesia for Elective Infraumbilical Surgery","authors":"Krishna Deepthi P.P., Bandana Mahanta","doi":"10.14260/jemds.v12i5.403","DOIUrl":"https://doi.org/10.14260/jemds.v12i5.403","url":null,"abstract":"BACKGROUND \u0000In this study, we wanted to compare the characteristics of subarachnoid block when intrathecal versus intravenous magnesium sulphate was used with 0.5 % hyperbaric bupivacaine spinal anaesthesia in elective infraumbilical surgery. \u0000METHODS \u0000This was a hospital based prospective randomized clinical parallel arm study double-blinded (patient and observer blinded) single hospital study conducted among 100 patients who presented with elective infraumbilical surgery under spinal anaesthesia to the Department of Anesthesiology and Critical Care, Gauhati Medical College and Hospital, Guwahati, from 1st June 2021 to 31st May 2022 after obtaining clearance from the institutional ethics committee and written informed consent from the study participants. \u0000RESULTS \u0000The onset of sensory block, and comparison of duration of analgesia with respect to time to first analgesic request was found to be statistically significant. While comparing, duration of analgesia was significantly prolonged in the intravenous group. Magnesium administered intravenously or intrathecally was not linked to any harmful side effects. \u0000CONCLUSIONS \u0000Infraumbilical procedures that use intravenous magnesium sulphate as an adjuvant to 0.5% hyperbaric bupivacaine spinal anaesthetic extend the time that post-operative analgesia lasts. Intrathecal co-administration of Magnesium sulphate with 0.5% hyperbaric bupicavaine delays the onset of sensory block compared to intravenous MgSO4.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47124836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-30DOI: 10.14260/jemds.v12i4.387
Sagarika Borah, Bandana Mahanta, Sushmita Borah
BACKGROUND In this study, we wanted to compare the efficacy of two different doses of Labetalol for controlling the hemodynamic responses to laryngoscopy and tracheal intubation under the same anaesthetic techniques in controlled hypertensive patients. METHODS This was a hospital-based prospective, randomized, and double-blinded study conducted among 96 patients who presented for a pre-anaesthetic check-up to the Department of Anaesthesiology and Critical Care, at Gauhati Medical College and Hospital, over a period of 1 year from 1st September 2021 to 31st August 2022 after obtaining clearance from the institutional ethics committee, and written informed consent from the study participants. RESULTS Intragroup comparison of mean SBP in patients receiving IV Labetalol 0. 15 mg/Kg and IV Labetalol 0. 3mg/Kg was statistically significant. In an intragroup comparison of mean DBP in patients receiving IV Labetalol 0. 15 mg/Kg, it was significant at 5 and 10 mins. In a comparison of changes in DBP and MAP at various predetermined time intervals i. e., at intubation, it was statistically significant. In an intragroup comparison of mean RPP in in patients receiving IV Labetalol 0. 3mg/Kg in comparison to the baseline, it was significant at 10 mins. CONCLUSIONS Both doses of IV Labetalol (0. 15 mg/Kg and 0. 3 mg/Kg), given 5 mins before endotracheal intubation are effective in attenuating the hemodynamic response to laryngoscopy and intubation in controlled hypertensive patients. In comparison to the IV Labetalol dose of 0. 15 mg/Kg, attenuation of hemodynamic response to laryngoscopy and endotracheal intubation was more in IV Labetalol 0. 3 mg/Kg.
{"title":"Attenuation of Hemodynamic Response to Laryngoscopy and Endotracheal Intubation with Two Different Doses of Labetalol in Controlled Hypertensive Patients","authors":"Sagarika Borah, Bandana Mahanta, Sushmita Borah","doi":"10.14260/jemds.v12i4.387","DOIUrl":"https://doi.org/10.14260/jemds.v12i4.387","url":null,"abstract":"BACKGROUND \u0000In this study, we wanted to compare the efficacy of two different doses of Labetalol for controlling the hemodynamic responses to laryngoscopy and tracheal intubation under the same anaesthetic techniques in controlled hypertensive patients. \u0000 \u0000METHODS \u0000This was a hospital-based prospective, randomized, and double-blinded study conducted among 96 patients who presented for a pre-anaesthetic check-up to the Department of Anaesthesiology and Critical Care, at Gauhati Medical College and Hospital, over a period of 1 year from 1st September 2021 to 31st August 2022 after obtaining clearance from the institutional ethics committee, and written informed consent from the study participants. \u0000 \u0000RESULTS \u0000Intragroup comparison of mean SBP in patients receiving IV Labetalol 0. 15 mg/Kg and IV Labetalol 0. 3mg/Kg was statistically significant. In an intragroup comparison of mean DBP in patients receiving IV Labetalol 0. 15 mg/Kg, it was significant at 5 and 10 mins. In a comparison of changes in DBP and MAP at various predetermined time intervals i. e., at intubation, it was statistically significant. In an intragroup comparison of mean RPP in in patients receiving IV Labetalol 0. 3mg/Kg in comparison to the baseline, it was significant at 10 mins. \u0000 \u0000CONCLUSIONS \u0000Both doses of IV Labetalol (0. 15 mg/Kg and 0. 3 mg/Kg), given 5 mins before endotracheal intubation are effective in attenuating the hemodynamic response to laryngoscopy and intubation in controlled hypertensive patients. In comparison to the IV Labetalol dose of 0. 15 mg/Kg, attenuation of hemodynamic response to laryngoscopy and endotracheal intubation was more in IV Labetalol 0. 3 mg/Kg.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48371908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-30DOI: 10.14260/jemds.v12i4.388
Mustafa Mohammed Salih, Hussein Talib Mohsin
BACKGROUND A recent upper respiratory tract infection is linked to the development of peri-operative respiratory complications. In this study we wanted to evaluate the effect of salbutamol premedication on the incidence of peri-operative respiratory adverse events in children with a recent upper respiratory tract infection (PRAE). METHODS A randomized clinical trial study that was conducted at the Children Welfare Teaching Hospital for a period of six months. It included 90 children aged ≤ 16 years who underwent a surgical operation under general anesthesia with a laryngeal mask airway or a tracheal tube and were divided into three groups; (had a recent URTI and received preoperative salbutamol, those who had a recent URTI and didn’t receive preoperative salbutamol, and those with no URTI group). The preferred outcome was the difference in the rate of occurrence of PRAE between children who had received salbutamol and those who hadn’t. RESULTS Four children with no URTI (13.3%) developed peri-operative respiratory adverse events. The incidence of bronchospasm and severe cough was significantly higher in patients with URTI and who didn’t receive preoperative salbutamol than in those with URTI who received preoperative salbutamol. CONCLUSIONS Preoperative salbutamol doses 10 – 30 minutes before surgery have been demonstrated to reduce and treat peri-operative respiratory adverse events.
{"title":"Effect of Nebulized Salbutamol Premedication on Perioperative Respiratory Adverse Events in Children with Recent Respiratory Tract Infections","authors":"Mustafa Mohammed Salih, Hussein Talib Mohsin","doi":"10.14260/jemds.v12i4.388","DOIUrl":"https://doi.org/10.14260/jemds.v12i4.388","url":null,"abstract":"BACKGROUND \u0000A recent upper respiratory tract infection is linked to the development of peri-operative respiratory complications. In this study we wanted to evaluate the effect of salbutamol premedication on the incidence of peri-operative respiratory adverse events in children with a recent upper respiratory tract infection (PRAE). \u0000METHODS \u0000A randomized clinical trial study that was conducted at the Children Welfare Teaching Hospital for a period of six months. It included 90 children aged ≤ 16 years who underwent a surgical operation under general anesthesia with a laryngeal mask airway or a tracheal tube and were divided into three groups; (had a recent URTI and received preoperative salbutamol, those who had a recent URTI and didn’t receive preoperative salbutamol, and those with no URTI group). The preferred outcome was the difference in the rate of occurrence of PRAE between children who had received salbutamol and those who hadn’t. \u0000RESULTS \u0000Four children with no URTI (13.3%) developed peri-operative respiratory adverse events. The incidence of bronchospasm and severe cough was significantly higher in patients with URTI and who didn’t receive preoperative salbutamol than in those with URTI who received preoperative salbutamol. \u0000CONCLUSIONS \u0000Preoperative salbutamol doses 10 – 30 minutes before surgery have been demonstrated to reduce and treat peri-operative respiratory adverse events.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49306538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 22-year-old woman of Malay ethnicity presented with severe blurred vision in the right eye and experienced periocular pain with eye movement. She had a visual field defect over the affected eye, while an examination showed clinically normal optic discs. Relative afferent pupillary defect was also present in the right eye, with reduced optic nerve function. Optic nerve imaging revealed the ‘doughnut sign’ and ‘tram track’ signs, which are characteristics of optic perineuritis. The patient was initiated on a steroid regime that was tapered off over four months. Her visual function recovered gradually during the treatment until reaching a satisfactory final visual outcome. This is a unique case where optic perineuritis occurred in a normal fundus and magnetic resonance imaging (MRI) served as an important diagnostic tool for the condition. Optic perineuritis (OPN) is an orbital inflammatory disease that involves the meningeal sheath surrounding the optic nerve.[1] It can be idiopathic or secondary to an underlying systemic autoimmune disorder.[1,2] Visual loss in OPN results from inflammation of the tissue surrounding the optic nerve, resulting in mechanical compression of the nerve and subsequent ischaemia.[1] OPN can be diagnosed using an optic nerve sheath biopsy, while magnetic resonance imaging (MRI) diagnoses OPN through perineural enhancement, making it a useful diagnostic tool.[2] Upon diagnosis, OPN should be treated with corticosteroids for a prolonged period to ensure visual recovery.[3] We report a unique case of unilateral OPN with severe visual loss in a young Malay woman with a normal fundoscopy who was successfully treated with prolonged corticosteroids.
{"title":"Unilateral Idiopathic Optic Perineuritis in a Normal Fundus","authors":"Muhammad Khairul Adha Fuaad, Mazaya Mahmud, Rafidah Md. Saleh, Syamil Salmi","doi":"10.14260/jemds.v12i4.391","DOIUrl":"https://doi.org/10.14260/jemds.v12i4.391","url":null,"abstract":"A 22-year-old woman of Malay ethnicity presented with severe blurred vision in the right eye and experienced periocular pain with eye movement. She had a visual field defect over the affected eye, while an examination showed clinically normal optic discs. Relative afferent pupillary defect was also present in the right eye, with reduced optic nerve function. Optic nerve imaging revealed the ‘doughnut sign’ and ‘tram track’ signs, which are characteristics of optic perineuritis. The patient was initiated on a steroid regime that was tapered off over four months. Her visual function recovered gradually during the treatment until reaching a satisfactory final visual outcome. This is a unique case where optic perineuritis occurred in a normal fundus and magnetic resonance imaging (MRI) served as an important diagnostic tool for the condition. \u0000Optic perineuritis (OPN) is an orbital inflammatory disease that involves the meningeal sheath surrounding the optic nerve.[1] It can be idiopathic or secondary to an underlying systemic autoimmune disorder.[1,2] Visual loss in OPN results from inflammation of the tissue surrounding the optic nerve, resulting in mechanical compression of the nerve and subsequent ischaemia.[1] \u0000OPN can be diagnosed using an optic nerve sheath biopsy, while magnetic resonance imaging (MRI) diagnoses OPN through perineural enhancement, making it a useful diagnostic tool.[2] Upon diagnosis, OPN should be treated with corticosteroids for a prolonged period to ensure visual recovery.[3] \u0000We report a unique case of unilateral OPN with severe visual loss in a young Malay woman with a normal fundoscopy who was successfully treated with prolonged corticosteroids.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42834047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-30DOI: 10.14260/jemds.v12i4.390
Khaidem Monalee Devi, Abhinav Giri
This case report describes a treatment using lithium disilicate in rehabilitating maxillary anterior with midline spacing. This conservative treatment requires fewer clinical sessions along with detailed clinical protocol, precise indications, and laboratory procedures. The result concludes that ceramic veneers not only restore harmony and proportion in a patient’s smile but also prove to be an excellent treatment for an anterior aesthetic zone. Today, with the influence of social media or social technologies, the concern about facial aesthetics and the demand for cosmetic procedures grows rapidly.[1] Hence, the requirement for aesthetic dental treatments and the creation of beautiful smiles has increased for the re-establishment of oral health and function.[2] The presence of anterior spacing or diastema is one of the factors that affect the smile of an individual. This has become the most common aesthetic complaint of patients.[3] According to Keene (1963), a midline diastema is an anterior midline separation between the proximal surfaces of consecutive teeth that is greater than 0.5 mm.[4] There was also a report that states the maxilla has a higher occurrence of midline diastema than the mandible.[5] According to Oquendo et al., the objectives of treating diastemata are to achieve a stable and effective occlusion as well as a tooth form that is harmonious with the surrounding teeth, arch, and facial form. The result needs to be balanced and appealing to the patient.[6] The options to correct midline diastema range from composite resins to ceramics. Time restrictions, the desire for fast aesthetic results, or the perception of the social stigma connected with their age and wearing braces are some of the reasons why patients may choose not to have orthodontics to close diastemas.[7] Due to the preservation of dental structures, reduced price compared to ceramics, reversibility, and straightforward process, the composite resin was once the preferred choice for diastema closure.[8] However, it was shown that secondary caries, loss of repair, pigment impregnation, fracture, marginal flaws, and a high level of colour instability all contribute to their high failure rate.[9] For patients looking for long-lasting therapy and with high aesthetic standards, ceramics have become the material of choice. Although zirconia has greater mechanical strength, lithium disilicate has greater translucency, making the two materials the most popular. Porcelain laminate veneers introduced by Charles Pincus in 1938 are a thin shell of ceramic and these can be bonded to the facial surface of anterior teeth using bonding agents and dual-cure cements.[10] Buonocore in 1955 introduced the acid etch technique. Bowen in 1958 introduced silica resin direct filling material. Furthermore, with the introduction of improved bonding agents in the 1980s when coupled with the silanization of veneers, the results of porcelain laminate veneers have become more predictable.[11] C
{"title":"Aesthetic Management of Anterior Midline Diastema","authors":"Khaidem Monalee Devi, Abhinav Giri","doi":"10.14260/jemds.v12i4.390","DOIUrl":"https://doi.org/10.14260/jemds.v12i4.390","url":null,"abstract":"This case report describes a treatment using lithium disilicate in rehabilitating maxillary anterior with midline spacing. This conservative treatment requires fewer clinical sessions along with detailed clinical protocol, precise indications, and laboratory procedures. The result concludes that ceramic veneers not only restore harmony and proportion in a patient’s smile but also prove to be an excellent treatment for an anterior aesthetic zone. \u0000Today, with the influence of social media or social technologies, the concern about facial aesthetics and the demand for cosmetic procedures grows rapidly.[1] Hence, the requirement for aesthetic dental treatments and the creation of beautiful smiles has increased for the re-establishment of oral health and function.[2] The presence of anterior spacing or diastema is one of the factors that affect the smile of an individual. This has become the most common aesthetic complaint of patients.[3] According to Keene (1963), a midline diastema is an anterior midline separation between the proximal surfaces of consecutive teeth that is greater than 0.5 mm.[4] There was also a report that states the maxilla has a higher occurrence of midline diastema than the mandible.[5] According to Oquendo et al., the objectives of treating diastemata are to achieve a stable and effective occlusion as well as a tooth form that is harmonious with the surrounding teeth, arch, and facial form. The result needs to be balanced and appealing to the patient.[6] \u0000The options to correct midline diastema range from composite resins to ceramics. Time restrictions, the desire for fast aesthetic results, or the perception of the social stigma connected with their age and wearing braces are some of the reasons why patients may choose not to have orthodontics to close diastemas.[7] \u0000Due to the preservation of dental structures, reduced price compared to ceramics, reversibility, and straightforward process, the composite resin was once the preferred choice for diastema closure.[8] However, it was shown that secondary caries, loss of repair, pigment impregnation, fracture, marginal flaws, and a high level of colour instability all contribute to their high failure rate.[9] \u0000For patients looking for long-lasting therapy and with high aesthetic standards, ceramics have become the material of choice. Although zirconia has greater mechanical strength, lithium disilicate has greater translucency, making the two materials the most popular. Porcelain laminate veneers introduced by Charles Pincus in 1938 are a thin shell of ceramic and these can be bonded to the facial surface of anterior teeth using bonding agents and dual-cure cements.[10] Buonocore in 1955 introduced the acid etch technique. Bowen in 1958 introduced silica resin direct filling material. Furthermore, with the introduction of improved bonding agents in the 1980s when coupled with the silanization of veneers, the results of porcelain laminate veneers have become more predictable.[11] C","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43853070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND Suicide attempts in elderly people has higher risk of mortality. The elderly are more vulnerable to depression and other psychological and social factors that may contribute to higher risk of suicide. Studies have suggested that suicide in elderly is strongly associated with depression and lack of social support. Factors that increase risk of suicide are also found to increase the risk for suicide ideation. Suicide ideation is an important predictor of suicide attempts and completed suicide. Aims: Our study aims at estimating the prevalence of suicide ideation among mentally ill geriatric population and identifying potential predictors of suicide ideation among elderly. METHODS A cross-sectional study involving 50 persons with mental illness aged above 60 years and 50 persons with no previous psychiatric history. The was conducted at a tertiary psychiatric hospital. Geriatric Suicide Ideation Scale, Geriatric Depression scale and other psychopathology assessment tools were used. RESULTS The GSIS scores were significantly higher among those elderly persons with mental illness and the scores were higher in our study when compared to the community-dwelling elderly persons without psychiatric illness. It was observed that geriatric depression was an important predictor of suicide ideation followed by previous suicide attempt. The study also finds significant difference in the subscales of GSIS and we constructed an ROC for optimal cut-off point for the Indian population. CONCLUSIONS Geriatric suicide ideation is a less studied area with suicide ideation in elderly person with mental illness having various determinants and risk factors. It is for further research to identify feasible means of assessing suicide ideation among the elderly person receiving care from primary care physicians.
{"title":"Prevalence and Predictors of Suicide Ideation among Elderly Mentally Ill Population in a Tertiary Psychiatric Hospital","authors":"Sudha Srinivasa Ragavan, Saravana Jothi Ramalingam, Vanishree Gunasekaran","doi":"10.14260/jemds.v12i4.386","DOIUrl":"https://doi.org/10.14260/jemds.v12i4.386","url":null,"abstract":"BACKGROUND \u0000Suicide attempts in elderly people has higher risk of mortality. The elderly are more vulnerable to depression and other psychological and social factors that may contribute to higher risk of suicide. Studies have suggested that suicide in elderly is strongly associated with depression and lack of social support. Factors that increase risk of suicide are also found to increase the risk for suicide ideation. Suicide ideation is an important predictor of suicide attempts and completed suicide. \u0000Aims: Our study aims at estimating the prevalence of suicide ideation among mentally ill geriatric population and identifying potential predictors of suicide ideation among elderly. \u0000METHODS \u0000A cross-sectional study involving 50 persons with mental illness aged above 60 years and 50 persons with no previous psychiatric history. The was conducted at a tertiary psychiatric hospital. Geriatric Suicide Ideation Scale, Geriatric Depression scale and other psychopathology assessment tools were used. \u0000RESULTS \u0000The GSIS scores were significantly higher among those elderly persons with mental illness and the scores were higher in our study when compared to the community-dwelling elderly persons without psychiatric illness. It was observed that geriatric depression was an important predictor of suicide ideation followed by previous suicide attempt. The study also finds significant difference in the subscales of GSIS and we constructed an ROC for optimal cut-off point for the Indian population. \u0000CONCLUSIONS \u0000Geriatric suicide ideation is a less studied area with suicide ideation in elderly person with mental illness having various determinants and risk factors. It is for further research to identify feasible means of assessing suicide ideation among the elderly person receiving care from primary care physicians.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46240586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-30DOI: 10.14260/jemds.v12i4.385
Reethika Thatikonda, Sathyanarayana Gorthi, Pranay Baith, Ali Raza Syed, Lakshmi Vara Prasad Gaddam, Vijetha Potru, Adithya Murthy Ponna, Manasa Gaini
BACKGROUND In this study, we wanted to evaluate the role of diagnostic laparoscopy in the management of blunt injury to abdomen in hemodynamically stable patients. METHODS This was a hospital based prospective observational clinical case study conducted among 30 patients who presented with blunt trauma of abdomen to the Department of General Surgery, Kamineni Academy of Medical Sciences and Research Centre, L.B. Nagar, Hyderabad, from September 2019 to September 2021 after obtaining clearance from Institutional Ethics Committee and written informed consent from the study participants. The aim of the study is to assess the role of Diagnostic Laparoscopy in the management of Blunt Injury to Abdomen in Hemodynamically Stable patients. Objective of the study were to assess the incidence of Hollow Viscus Injury not detected by clinical or radiological assessment, incidence of persistent bleed and to assess the incidence of Mesentery injury not detected by clinical or radiological assessment. RESULTS The most common mode of injury was road traffic accidents (23 cases) 76.66 %, followed by fall from height (3 cases) 9.99 %. Then accidents and assaults which were (2 cases) 2.22 % each. Ongoing bleeding from solid organ injuries was seen intra-operatively in 3 cases (9.99 %). P value = 0.0237 was calculated using Fischer’s exact test and was found to be significant P < 0.05. Most common grade of liver injury was Grade 1- 37.75 % followed by grade 3 - 33.33 %, then grade 2 - 20.8 % and grade 4 - 8.33 %. Grade 1 and grade 2 splenic injuries were more common with 36.36 % (4 cases) each. Followed by grade 3 27.27 % (3 cases). Diagnostic laparoscopy ongoing bleed was noted in 9.99 % (3 cases), followed by mesenteric injury in 6.66 % (2 cases) and hollow viscous perforation in 3.33 % (1 case). Total of 6 therapeutic procedures were done after diagnostic laparoscopy. Out of which, 4 were carried out in laparoscopy (66.66 %) and two were converted from laparoscopy to laparotomy (33.33 %). CONCLUSIONS Diagnostic laparoscopy can be carried out in patients of blunt trauma of abdomen, who are hemodynamically stable without any increase in morbidity or mortality. It is a highly useful tool to detect injuries which could not be detected on CT scan. Laparoscopic surgery can be used both as a diagnostic and therapeutic modality. Laparoscopy helps in reducing the negative laparotomies and significant decrease in both morbidity and mortality. With advances in technology and increasing in expertise in laparoscopy, it can be concluded that diagnostic laparoscopy is a valuable modality in the diagnosis and management of patients with blunt trauma to abdomen.
{"title":"Role of Diagnostic Laparoscopy in the Evaluation of Blunt Injury to Abdomen in Hemodynamically Stable Patients","authors":"Reethika Thatikonda, Sathyanarayana Gorthi, Pranay Baith, Ali Raza Syed, Lakshmi Vara Prasad Gaddam, Vijetha Potru, Adithya Murthy Ponna, Manasa Gaini","doi":"10.14260/jemds.v12i4.385","DOIUrl":"https://doi.org/10.14260/jemds.v12i4.385","url":null,"abstract":"BACKGROUND \u0000In this study, we wanted to evaluate the role of diagnostic laparoscopy in the management of blunt injury to abdomen in hemodynamically stable patients. \u0000METHODS \u0000This was a hospital based prospective observational clinical case study conducted among 30 patients who presented with blunt trauma of abdomen to the Department of General Surgery, Kamineni Academy of Medical Sciences and Research Centre, L.B. Nagar, Hyderabad, from September 2019 to September 2021 after obtaining clearance from Institutional Ethics Committee and written informed consent from the study participants. The aim of the study is to assess the role of Diagnostic Laparoscopy in the management of Blunt Injury to Abdomen in Hemodynamically Stable patients. Objective of the study were to assess the incidence of Hollow Viscus Injury not detected by clinical or radiological assessment, incidence of persistent bleed and to assess the incidence of Mesentery injury not detected by clinical or radiological assessment. \u0000RESULTS \u0000The most common mode of injury was road traffic accidents (23 cases) 76.66 %, followed by fall from height (3 cases) 9.99 %. Then accidents and assaults which were (2 cases) 2.22 % each. Ongoing bleeding from solid organ injuries was seen intra-operatively in 3 cases (9.99 %). P value = 0.0237 was calculated using Fischer’s exact test and was found to be significant P < 0.05. Most common grade of liver injury was Grade 1- 37.75 % followed by grade 3 - 33.33 %, then grade 2 - 20.8 % and grade 4 - 8.33 %. Grade 1 and grade 2 splenic injuries were more common with 36.36 % (4 cases) each. Followed by grade 3 27.27 % (3 cases). Diagnostic laparoscopy ongoing bleed was noted in 9.99 % (3 cases), followed by mesenteric injury in 6.66 % (2 cases) and hollow viscous perforation in 3.33 % (1 case). Total of 6 therapeutic procedures were done after diagnostic laparoscopy. Out of which, 4 were carried out in laparoscopy (66.66 %) and two were converted from laparoscopy to laparotomy (33.33 %). \u0000CONCLUSIONS \u0000Diagnostic laparoscopy can be carried out in patients of blunt trauma of abdomen, who are hemodynamically stable without any increase in morbidity or mortality. It is a highly useful tool to detect injuries which could not be detected on CT scan. Laparoscopic surgery can be used both as a diagnostic and therapeutic modality. Laparoscopy helps in reducing the negative laparotomies and significant decrease in both morbidity and mortality. With advances in technology and increasing in expertise in laparoscopy, it can be concluded that diagnostic laparoscopy is a valuable modality in the diagnosis and management of patients with blunt trauma to abdomen.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47607130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-30DOI: 10.14260/jemds.v12i4.389
Elif Çoker, Öznur Sariyilmaz, Raif Alan
BACKGROUND A healthy periodontium forms the basis of an aesthetic and functional dentition. Due to the reciprocal dynamic relationship between restorative dentistry and periodontal health, iatrogenic factors arising from restorative procedures are likely to have a negative effect on the periodontium. Awareness of these factors among dentistry students can lead to more progress in taking precautions and being careful against iatrogenic factors. Thus, the aim of this study was to evaluate failures in restorative treatments using panoramic radiographs as a graduation project. METHODS A total of 2622 PRs were randomly screened. After applying the exclusion criteria, 776 digital images containing at least one iatrogenic factor were analyzed. The measurement of the interrater agreement was calculated using Cohen's kappa coefficient. RESULTS This study included a sample size of 776 patients aged 18-85 years (435 females and 341 males). Most of the patients were in their 40s (27,45%). A total of 1662 treated teeth containing iatrogenic factors that may have possible negative effects on the periodontium were analyzed. Most of the teeth with improper restoration margins were more common in the maxillary molar region and also had bone loss. In addition, among the iatrogenic factors associated with endodontic treatment, inadequate root canal filling was observed the most, while perforation was the least. Interrater agreements were recorded at statistically significant levels of perfect, substantial and fair. CONCLUSIONS It is of great importance for dental students to increase their awareness by evaluating iatrogenic factors clinically and radiographically before graduation. Students also have the opportunity to test their knowledge, attitudes and skills that will be required after graduation, together with the academicians assigned to them as supervisors for the graduation projects.
{"title":"Evaluation of Interrater Agreement in Determining the Prevalence of Iatrogenic Factors as a Graduation Project","authors":"Elif Çoker, Öznur Sariyilmaz, Raif Alan","doi":"10.14260/jemds.v12i4.389","DOIUrl":"https://doi.org/10.14260/jemds.v12i4.389","url":null,"abstract":"BACKGROUND \u0000A healthy periodontium forms the basis of an aesthetic and functional dentition. Due to the reciprocal dynamic relationship between restorative dentistry and periodontal health, iatrogenic factors arising from restorative procedures are likely to have a negative effect on the periodontium. Awareness of these factors among dentistry students can lead to more progress in taking precautions and being careful against iatrogenic factors. Thus, the aim of this study was to evaluate failures in restorative treatments using panoramic radiographs as a graduation project. \u0000METHODS \u0000A total of 2622 PRs were randomly screened. After applying the exclusion criteria, 776 digital images containing at least one iatrogenic factor were analyzed. The measurement of the interrater agreement was calculated using Cohen's kappa coefficient. \u0000RESULTS \u0000This study included a sample size of 776 patients aged 18-85 years (435 females and 341 males). Most of the patients were in their 40s (27,45%). A total of 1662 treated teeth containing iatrogenic factors that may have possible negative effects on the periodontium were analyzed. Most of the teeth with improper restoration margins were more common in the maxillary molar region and also had bone loss. In addition, among the iatrogenic factors associated with endodontic treatment, inadequate root canal filling was observed the most, while perforation was the least. Interrater agreements were recorded at statistically significant levels of perfect, substantial and fair. \u0000CONCLUSIONS \u0000It is of great importance for dental students to increase their awareness by evaluating iatrogenic factors clinically and radiographically before graduation. Students also have the opportunity to test their knowledge, attitudes and skills that will be required after graduation, together with the academicians assigned to them as supervisors for the graduation projects.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43948969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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