Journal of Advanced Clinical and Research Insights

Vol. 2 | No.3 | May-June 2015 Issue

1.EDITORIAL

Why case reports need to have better evidence value

Ravi Prakash

Year:2015 | Month:May-June | Volume:2 | Number:3 | Pages No:105–106 | No. of Hits: 341


ABSTRACT

The history of case reports as a form of evidence in clinical researches has been somewhat non-linear. Before the modern statistical analysis of medical researches came into existence, case reports were the only methods of identifying a particular clinical picture. Hence the diseases were observed closely by a clinician and were given his/her name as a form of honor to the clinician.

How to cite this article: Prakash R. Why case reports need to have better evidence value. J Adv Clin Res Insights 2015;2:105-106.


2.ORIGINAL ARTICLE

Fine-needle aspiration cytology in soft tissue tumors: How far did we go??

K. R. Chatura, Akshi Katyal, S. S. Hiremath

Year:2015 | Month:May-June | Volume:2 | Number:3 | Pages No:107–111 | No. of Hits: 259 [No. of Citation: 5]


ABSTRACT

Objective: Assignment of the tumors into various cytological categories and to determine specific sub-typing in individual cases. To correlate the cytological features observed with histological parameters and analyse the reasons for discordant diagnosis.

Materials and Methods: 27 cases, with both cytological and histopathological details, diagnosed as soft tissue tumors (STT) were included. The lesions were classified into 6 cytological categories.

Results: On fine-needle aspiration cytology (FNAC), 14 cases were reported positive for malignant cells and 13 were reported as benign. On histological follow up discordant lesions were further characterized. Discordance was attributable largely to sampling in lipomatous lesions and interpretation errors due to inattention to clinical history, low volume of these lesions in practice, and overlapping cytomorphologic features with other entities. Sensitivity and specificity was 84.61% and 85.71% respectively and overall diagnostic accuracy was 85.18%.

Conclusion: Soft tissue tumors are rare neoplasms that pose a significant challenge as a result of their morphologic overlap and biological heterogeneity. ‘Time-honored’ histopathology is recognized as the ‘gold standard’ for evaluation of STT. FNAC can be used as a diagnostic modality in soft tissue lesions due to its lesser cost, ease of performance, safety, along with reasonable specificity and sensitivity. In the current era, where ‘needle is preceding the scalpel’ and the biopsy material is getting limited, our study highlights the role and scope, diagnostic difficulties and pitfalls to be aware of when interpreting these challenging FNACs.

Keywords Cytohisto-correlation, errors, soft tissue tumors

How to cite this article: Chatura KR, Katyal A, Hiremath SS. Fine-needle aspiration cytology in soft tissue tumors: How far did we go?? J Adv Clin Res Insights 2015;2:107-111.

Received 02 February 2015;
Accepted 10 April 2015


3.ORIGINAL ARTICLE

Evaluation of salivary levels of Streptococcus mutans pre- and post-probiotics use

Priya Nimish Deo, Revati Deshmukh

Year:2015 | Month:May-June | Volume:2 | Number:3 | Pages No:112–115 | No. of Hits: 4395 [No. of Citation: 3]


ABSTRACT

Background: Probiotics are “live microorganisms which when administered in adequate amounts confer a health benefit to the host.” They are thought to play a role in the maintenance of oral health.

Aim: The aim was to evaluate the effect of probiotics on the salivary levels of Streptococcus mutans.

Materials and Methods: Fifty subjects within the age group of 18-30 years were selected for study. 2 ml of unstimulated saliva was collected before and after 7 days of administration of probiotic (65 ml once daily) to the participant. Mitis salivarius bacitracin agar was used as culture media. Yakult probiotic, fermented milk containing over 6.5 billion Lactobacilli casei strain was used. The colony forming unit of S. mutans was calculated by surface count method, and the total colony count was calculated by consideration of the dilution factor. The mean salivary levels of S. mutans pre- and post-probiotics use were calculated. Paired sample t-test was used for statistical analysis.

Results: The study revealed a statistically significant reduction in the salivary levels of S. mutans after the use of probiotics.

Conclusion: This bacterio-therapy, which is a novel concept, is a non-invasive method for combating infection and dental caries. More research is needed to evaluate the effect of Probiotics on oral health.

Keywords: Dental caries, probiotics, Streptococcus mutans

How to cite this article: Deo PN, Deshmukh R. Evaluation of salivary levels of Streptococcus mutans pre- and post-probiotics use. J Adv Clin Res Insights 2015;2:112-115.

Received 18 January 2015;
Accepted 27 February 2015


4.ORIGINAL ARTICLE

Inter-channel variations in P300 amplitudes-an advocacy for multichannel recording

J. Anupriya, Ravi Prakash, Arun Kumar, M. S. Roopakala

Year:2015 | Month:May-June | Volume:2 | Number:3 | Pages No:116–119 | No. of Hits: 511


ABSTRACT

Introduction and Background: For long, the controversy has prevailed regarding the number of channels that should be involved in recording the P300 waveform or other long-latency event-related potentials (ERPs). There are several theoretical reasons which favor the technique of using multiple channels for ERP over a single channel. Most important is the possibility of, asymmetries in generator activity of a particular waveform. If there are asymmetries of the generator activity, it will result in topographical deviations of the P300 peak from the midline. Here, we provide support for multiple channel recording on the basis of our study results.

Methodlogy: This was a cross-sectional case-control study. 17 normal individuals were recruited for the study. The auditory ERP data were collected using the auditory oddball P300 paradigm. The peak amplitudes obtained in CZ was compared with independent samples t-test with the peak amplitudes in all other electrodes.

Results: There were significant differences between the amplitudes of P300 as recorded from CZ compared to the amplitudes of other electrodes. In line with the idea popular in literature, the maximum amplitude was found in the midline region which was however located at the parietal regions rather than the central region.

Discussion: Our results show two important findings which should be taken into account while interpreting the active electrode as the major source of P300 recording. The first and foremost seems to be that the standard deviations and variances of the amplitude values that we observed were very high, sometimes even more than the mean values. Second, there are irregularities in the localizations of maximum amplitudes in between individuals. On the basis of these findings, we recommend multiple channel recording for P300 ERPs.

Keywords Auditory evoked potentials, frontal, multiple channel recording, P300, single channel recording, temporal

How to cite this article: Anupriya J, Prakash R, Kumar A, Roopakala MS. Inter-channel variations in P300 amplitudes-an advocacy for multichannel recording. J Adv Clin Res Insights 2015;2:116-119.

Received 25 February 2015;
Accepted 03 April 2015


5.ORIGINAL ARTICLE

A comparative assessment of periodontal status and treatment needs among population in Tumkur district using CPITN: An epidemiological study

T. D. Nethravathi, Vaibhavi Joshipura, Sanjay Venugopal, Shobha Krishna Subbaiah, K. N. Jagadeesh, Vijay Apparaju

Year:2015 | Month:May-June | Volume:2 | Number:3 | Pages No:120–123 | No. of Hits: 485


ABSTRACT

Background: Evaluation of existing oral health services showed that it is predominantly urban oriented, mostly curative in nature and accessible mainly to small a part of population, i.e., privileged few. Periodontal diseases are more prevalent in a rural population than the urban population. The socio demographic profile is highly contrasting between the urban and rural population. It is essential to know whether these sociodemographic factors influence periodontal disease by comparing periodontal status of urban and rural population.

Objective: The objective of the study is to assess and compare the periodontal status and treatment needs of rural and urban population in Tumkur district.

Materials and Methods: A cross-sectional study based on the World Health Organization (WHO) guidelines. The sample consisted of 1500 subjects among which 750 subjects were selected from the rural population and 750 from urban population of Tumkur district. The data was collected by modified WHO oral health assessment form and clinical examination was conducted by using CPITN C probe.

Results: It was found that the urban population had better periodontal health than rural population and this relationship was statistically significant (P < 0.05).

Conclusion: India is a country with a population having diverse culture, life style and religious beliefs which might influence the health status of the individuals significantly. Hence, it is necessary to conduct such surveys in different parts of the country and develop a strategy to improve the periodontal status of the population as a whole.

Keywords: Community periodontal index of treatment needs, epidemiological study, prevalence of periodontal disease, urban and rural population of Tumkur district

How to cite this article: Nethravathi TD, Joshipura V, Venugopal S, Subbaiah SK, Jagadeesh KN, Apparaju V. A comparative assessment of periodontal status and treatment needs among population in Tumkur district using CPITN: An epidemiological study. J Adv Clin Res Insights 2015;2:120-123.

Received 02 January 2015;
Accepted 06 February 2015


6.ORIGINAL ARTICLE

Knowledge, attitude and practice of tooth morphology among dental students

Shankargouda Patil, S. V. Sowmya, Roopa S. Rao, Thirumal Raj

Year:2015 | Month:May-June | Volume:2 | Number:3 | Pages No:124–130 | No. of Hits: 536 [No. of Citation: 1]


ABSTRACT

Background: Dental anatomy is one of the basic subjects of dental schools in India while dealt as a specialty on its own abroad. The training imparted to hone the manual skills has paved way to meet the clinical challenges. However, different schools of thought arise whether to retain or ban the dental anatomy subject for future graduates.

Aim: To assess the comprehensive skills and application of tooth morphology among dental students.

Objectives: (1) To assess the knowledge, attitude and practice of tooth morphology in undergraduates (UGs), interns and postgraduates (PGs), (2) to evaluate the differences if any, in the knowledge, attitude and practice of tooth morphology between UGs, interns and PG.

Methodology: A descriptive cross-sectional study was undertaken using an 18 item self-administered questionnaire among UGs, interns and PGs of dental colleges in Bengaluru. A total of 303 student responses were received. Analysis of data was done using SPSS (version 20) software.

Results: There was a statistically significant difference in the knowledge (P = 0.005) and practice (P = 0.003) of tooth morphology between the three groups, i.e., PG, interns and UGs. The difference in the knowledge (P = 0.001) and practice (P = 0.001) of tooth morphology between PGs and UGs was observed. A significant difference was obtained only in the knowledge (P = 0.038) of tooth morphology between interns and UGs.

Conclusion: We recommend that tooth morphology should remain as a fundamental subject in the dental curriculum in combination with web-based learning aids to improve the learning experience. The curriculum may be revised incorporating research in the fundamental subject to give broader career options to the young graduates.

Keywords Dental anatomy, dental curriculum, tooth carving, tooth morphology

How to cite this article: Patil S, Sowmya SV, Rao RS, Raj T. Knowledge, attitude and practice of tooth morphology among dental students. J Adv Clin Res Insights 2015;2:124-130.

Received 03 February 2015;
Accepted 28 April 2015


7.ORIGINAL ARTICLE

Age estimation of adults using dental pulp: A cross-sectional radiographic study

A. P. Indira, R. Shashikala, Tejavathi Nagaraj, H. N. Santosh

Year:2015 | Month:May-June | Volume:2 | Number:3 | Pages No:131–134 | No. of Hits: 1102 [No. of Citation: 2]


ABSTRACT

Background: Age estimation from teeth is frequently used because teeth may be preserved for a long time after all tissues have disintegrated. Dental pulp is a well.protected structure. With progressing age, the size of the dental pulp chamber is reduced vertically and horizontally as a result of secondary dentin deposition. Thus, assessment of these radiographic measurements can be used as an indicator of age estimation.

Aim: Estimation of the chronological age of an adult from dental pulp size using conventional intraoral periapical radiograph.

Materials and Methods: The study group consisted of 100 subjects inclusive of both the genders aged between 16 and 50 years. The tooth selected was maxillary left central incisor. Intraoral periapical radiographs were taken by following paralleling cone technique. Total pulp length and cervical pulp width of the root canal were measured. To compensate for the differences in magnification and angulation on the radiograph, ratio between total pulp length, and cervical pulp width was calculated (P/A).

Results: A gradual reduction in pulp size was observed with respect total pulp length and cervical pulp width with an increase in age and this showed a significant correlation with the chronological age.

Conclusion: Dental age prediction is useful in routine and mass fatalities as teeth can be preserved for a long time. The clinical significance is that, it can be used in anthropology, forensic science, on both living and dead. The results confirm that there is horizontal and vertical reduction in pulp size with an increase in age due to secondary dentin formation. This radiographic morphometric pulp reduction can be used to estimate the nearest chronological age of an adult.

Keywords Age estimation, dental pulp, pulp cavity, pulp measurements

How to cite this article: Indira AP, Shashikala, Nagaraj T, Santosh HN. Age estimation of adults using dental pulp: A cross-sectional radiographic study. J Adv Clin Res Insights 2015;2:131-134.

Received 02 January 2015;
Accepted 19 April 2015


8.ORIGINAL ARTICLE

Assessment of preferred learning modalities of undergraduate medical students using the visual-aural-read/write-kinesthetic questionnaire and the impact of gender

Vaibhav Nayak Jansale, Indudhara Pyati Balappa, Girish Huchhakklla Odappa, Yenni Veerabhadrappa Veerappa

Year:2015 | Month:May-June | Volume:2 | Number:3 | Pages No:135–139 | No. of Hits: 1329


ABSTRACT

Background: Among the several tools available to assess learning styles of students, the visual-aural-read/write-kinesthetic (VARK) questionnaire is a simple, easy to administer, freely available tool that facilitates students to understand their learning behavior in a way that they can relate with and accept.

Aims and Objectives: The objective was to understand the preferred learning modality (or modalities) of medical students and assess the impact of gender on learning preferences.

Materials and Methods: Three hundred and twenty-eight undergraduate students undergoing medical training at our medical college were approached to participate in the exercise. 273 (83.2%) students consented and were provided version 7.8 of the VARK questionnaire in printed format. Along with the questionnaire, we also collected demographic data.

Results: The majority of students in our study preferred more than one learning modality (64.3%). The predominant modalities of learning were visual (65.6%) and aural (63%). The learning modality preference was not influenced by gender.

Conclusions: Despite the fact that we use a multitude of teaching methodologies, there has not been an ardent effort to ascertain whether these sufficiently address the needs of different types of learners. While teachers can utilize this information to facilitate and improve student learning, students can use the knowledge of their learning preferences to change their learning habits. We hope these results will help us better our teaching-learning activities.

Keywords Gender, learning style, visual-aural-read/write-kinesthetic

How to cite this article: Nayak VJ, Indudhara PB, Girish HO, Yenni VV. Assessment of preferred learning modalities of undergraduate medical students using the visual-aural-read/ write-kinesthetic questionnaire and the impact of gender. J Adv Clin Res Insights 2015;2:135-139.

Received 02 March 2015;
Accepted 10 May 2015


9.CASE REPORT

Recurrent epulis granulomatosa: A second look

B. Manovijay, P. Rajathi, Saramma Mathew Fenn, B. Sekar

Year:2015 | Month:May-June | Volume:2 | Number:3 | Pages No:140–142 | No. of Hits: 442 [No. of Citation: 1]


ABSTRACT

Epulis granulomatosa is a benign tumor-like proliferation arising from a poorly healing extraction socket, a complication as a result of bony spicules or tooth fragments within the socket. The remnants act as inciting agents to precipitate an inflammatory reaction to the fibrovascular connective tissue core replacing the defect previously occupied by the tooth. Recurrence of such lesions is rare as excision eliminate the stimulus for inflammation suggesting an indefinite underlying pathology. The following is a case report of recurrent epulis granulomatosa in a 64-year-old patient, detailing the clinical features, diagnosis, and management with emphasis on the differential diagnosis, both clinical and histopathological.

Keywords Epulis granulomatosa, extraction socket, granulation tissue

How to cite this article: Manovijay B, Rajathi P, Fenn SM, Sekar B. Recurrent epulis granulomatosa: A second look. J Adv Clin Res Insights 2015;2:140-142.

Received 05 February 2015;
Accepted 10 March 2015


10.CASE REPORT

A rare case of Ehler–Danlos syndrome with literature review

N. R. Diwakar, Pragyan Das

Year:2015 | Month:May-June | Volume:2 | Number:3 | Pages No:143–146 | No. of Hits: 3376


ABSTRACT

The Ehlers?Danlos syndrome (EDS), “rubber man disease” comprises of a group of generalized connective tissue disorders, which is characterized by fragile skin, skin hyper extensibility, and joint hypermobility. More than 10 types of EDS have been identified based on genetic and biochemical studies. In the majority of patients with molecularly characterized as classic EDS (Type I and Type II), the disease is caused by a mutation leading to a non-functional COL5A1 allele and resulting in haplo-insufficiency of Type V collagen. Most mutations identified so far result in a reduced amount of the Type V collagen in the connective tissues available for collagen fibrillogenesis. Inter and intra-familial phenotypic variability are observed, but no specific genotype-phenotype correlations have been observed. No specific treatment protocol for the underlying defect is presently available for EDS. However, there are a series of preventive guidelines applicable. Periodontal disorders, increased bleeding tendency, delayed eruption of teeth and joint subluxation are few concerns during dental management of such patients. This case report discusses the features of classic EDS presented in a 7-year-old female patient and reviews the recent literature.

Keywords Classic type, Ehler-Danlose syndrome, Rubber man disease

How to cite this article: Diwakar NR, Das P. A rare case of Ehler.Danlos syndrome with literature review. J Adv Clin Res Insights 2015;2:143.146.

Received 11 April 2015;
Accepted 04 June 2015


11.REVIEW ARTICLE

Implications of genomics in oral health

Poornima Govindraju, Poornima Chandra

Year:2015 | Month:May-June | Volume:2 | Number:3 | Pages No:147–150 | No. of Hits: 1553 [No. of Citation: 1]


ABSTRACT

In the last 10 years, there is a rapid improvement in the field of medicine. Scientific advances have made us understand the genetic basis of the diseases giving us the profound difference in the quality of life. Genetics is playing an important role in the diagnosis and management of diseases. Human genome project was the major step, which led to many discoveries in the field of genetics and genomics. This has opened us vast opportunities for translation of basic science research to oral health care. The present article reviews the role of genomics in oral health.

Keywords Cancer, gene, genomics, human genome, oral diseases

How to cite this article: Govindraju P, Chandra P. Implications of genomics in oral health. J Adv Clin Res Insights 2015;2:147.150.

Received 08 February 2015;
Accepted 20 April 2015


12.SHORT COMMUNICATION

TeethBioForm: Device for bacterial biofilms formation

Thaís M. Silva, Flávio R. F. Alves, Márcia T. S. Lutterbach, Maurício M. Paiva

Year:2015 | Month:May-June | Volume:2 | Number:3 | Pages No:151–152 | No. of Hits: 334


ABSTRACT

In order to efficiently treat and prevent biofilm infections, the understanding of bacterial attachment and development in solid substrates as human tooth, for example, has received a lot of attention in recent research. Nowadays several in vitro models have been proposed for biofilms formation. The TeethBioFormTM, developed by the authors, allows the growing of a mature biofilm within shorter periods of time.

Keywords Biofilm, Enterococcus faecalis, teeth

How to cite this article: Silva TM, Alves FRF, Lutterbach NTS, Paiva MM. TeethBioForm: Device for bacterial biofilms formation. J Adv Clin Res Insights 2015;2: 151-152.

Received 02 May 2015;
Accepted 05 June 2015