International Journal of Medical Science and Dental Research

Volume 6 Issue 6 (November-December 2023)

    • The role of Local Government Level in Public Health in Australia
      The focus of public health has traditionally been one of clinical prevention and evidence-based services for health care. Many governments have shifted the focus of public health to innovative practices where services are provided outside the clinical setting within the community, and where interventions and outcomes are designed for community wide health promotion and protection. Local government authority is important in achieving this goal and its role is expanding in this regard. However, there is much to understand in terms of implementation and refinement in terms of the challenges, drivers, outcomes, and performance, particularly the role of local government in providing strategic partnerships with the community as a key stakeholder, in health protection and promotion in improving the numerous social determinants of health. This review examined the role within an Australian context to provide a way forward to more informed and effective responses to public health. This review showed an expanding role of LG in health protection beyond health promotion and community engagement to a shift in power and responsibility. Some of the recommendations made were clarifying the role LG in legislation, greater funding and resources, and greater use of evidence-based interventions through a range of public health issues from obesity, food safety and security, to climate change resilience and emergency preparedness.

      Keywords:: public health, local government, Australia, promotion, protection, lifestyle, community

    • Effect of Periodontal Therapy on Salivary Nitric Oxide Levels in Chronic Periodontitis Patients with and without Hypertension
      Background: Nitric Oxide(NO) is a multifunctional signaling molecule involved in the maintenance of metabolic, cardiovascular homeostasis and a potent endogenous vasodilator that suppresses the formation of vascular lesions in atherosclerosis. Through nitrate-nitrite reduction and some commensal oral bacteria can supply bioactive NO, which is essential for the endothelial cell function and regulation of arterial BP, it is thought that a decreased quantity of oral nitrate-reducing bacteria and an increased quantity of pathogenic bacteria are responsible for a correlation between oral hygiene and chronic periodontitis and at a later stage cardiovascular diseases(CVD).
      Aim: To evaluate the effect of periodontal therapy on salivary NO levels in chronic periodontitis (CP) patients and chronic periodontitis patients with hypertension.
      Materials and methods: A total of 60 subjects with age group of 20-55 years male and female subjects, divided into three groups, 20 each. Group I– control (Healthy), group II–CP (chronic periodontitis) and group III–CP with Hypertension. Subjects underwent clinical examination for Plaque Index, Gingival Bleeding Index, Probing Pocket Depth, Clinical Attachment Level using UNC15 probe and Blood pressure measurement using Sphygmomanometer. Salivary nitric oxide concentration detected using human N Strips developed from University of Texas health science. All the parameters were evaluated at baseline and 4weeks after initial periodontal therapy.
      Result: Four weeks after initial periodontal therapy both groups II and III exhibited improvement in clinical periodontal parameters (OHI-S, GI, PPD, CAL) and at baseline salivary NO levels were depleted in group III and low in group II, after 4 weeks salivary NO was low and adequate respectively however, statistically significant differences were observed only with OHI-(S) and salivary NO values in both groups II and III (p < 0.05). However, when the post-treatment clinical periodontal parameters and salivary NO level of groups II and III were compared, statistically significant differences (p < 0.05) were observed except for PPD and CAL between the groups.
      Conclusions: Study revealed depleted salivary nitric oxide levels in periodontitis with hypertensive group and low levels of nitric oxide levels with chronic periodontitis patients as compared to the control group at baseline and the NO levels were improved after 4 weeks in both the groups II and III improving the blood pressure levels. Salivary Levels NO can be utilized as an indicator for assessment of the periodontitis as well as hypertensive patients. Periodontal therapy is effective in improving salivary levels of NO in both the groups.
      Clinical significance: A co- relationship exists between periodontal disease and hypertension. NO is found to play a significant role in the pathobiology of both CP and hypertyension. Initial periodontal therapy seems to be beneficial in improving salivary NO levels along with periodontal parameters in CP patients with or without hypertension. However further studies are warranted to enhance our knowledge about the role of NO in periodontal diseases in the course of hypertension.

      Keywords: Hypertension, Periodontal Therapy, Periodontitis, Salivary Nitric oxide.

    • Effect Of Erytin Emsa Inhibition Endothelial Dysfunction in Diabetes Mellitus Rats
      This study aims to determine the effect of administering the polyherbal EMSA Eritin on inhibiting endothelial dysfunction which is characterized by a decrease in the production of Endothelial progenitor cells (EPC), circulating endothelial cells (CEC), malondiadedhyde (MDA), and Superoxide dismutase (SOD). This study used a Randomized Post Test Control Group design which was divided into 5 groups (negative control, positive control, EMSA Eritin 1, EMSA Eritin 2, and EMSA Eritin 3). The intervention was provided for 28 days. Data were analyzed using anova with a confidence level of 95%. Data were analyzed using the SPSS version 21.0 program. The results showed that administration of the EMSA Eritin polyherbal had an effect on suppressing the production of EPC, CEC, MDA, and SOD. Polyherbal EMSA Eritin can inhibit endothelial dysfunction involving oxidative stress, endothelial damage which is characterized by a decrease in the production of EPC, CEC, MDA, and SOD.

      Keywords: Endothelial progenitor cells, Circulating endothelial cells, malondiadedhyde, dan Superoxide dismutase.

      Gingival hyperplasia is common in patients with fixed orthodontic appliances who have poor oral hygiene. This gingival enlargement is characterized by a slow, continuous and sometimes asymptomatic development. Clinically, gingival hyperplasia presents as an irregular contour and swelling, making it necessary to adopt a surgical approach to provide regular contouring of the gingival margin, returning esthetics and function to the periodontal tissue. The classification of hyperplasias is defined according to the causal factor, and in this case it is a hyperplasia caused by orthodontic trauma associated with poor hygiene. Objective: The aim of this paper is to report a clinical case of a patient with gingival hyperplasia, with an aesthetic complaint and treated surgically by surgical excision. Case Report: A 22-year-old female patient was wearing an orthodontic appliance and during clinical examination it was found that there was an increase in gingival tissue and extension with the periodontal probe, in addition to the presence of biofilm on the brackets and gingival margin. The treatment of choice was gingivoplasty, in which a surgical excision of the swollen gingiva was performed, respecting the biological space of 3 mm, without any complications. Postoperative recommendations were made, and a satisfactory postoperative period was achieved, reaching the expected results. Conclusion: In addition to surgery, it is necessary that the patient maintain adequate oral hygiene to prevent recurrence of gingival hyperplasia.

      Keywords: Gingival hyperplasia. Fixed orthodontic appliance. Dental biofilm.

    • Assessment of Knowledge, Awareness and Vaccination Compliance of Hepatitis B
      Background: Viral hepatitis refers to a liver infection transmitted through blood, specifically caused by the Hepatitis B virus (HBV). Immunization serves as an effective preventive measure against this particular disease. Medical students face an increased susceptibility to contracting the Hepatitis B virus (HBV) as a result of work exposure. Objective: The objective of this study is to evaluate the level of knowledge and awareness regarding Hepatitis B (Hep B) vaccination, as well as the extent to which students enrolled in health colleges at university adhere to vaccination guidelines. Methods: A cross-sectional quantitative study was conducted, involving the administration of a close-ended survey to 394 medical students at university. The data acquired from the survey was subjected to statistical analysis using the SPSS program. Results: The findings from the descriptive analysis indicate that a higher proportion of participants identified as males (73%) compared to females (26.9%). The majority of the subjects (92%) did not exhibit HBV infection. Approximately half of the participants said that they did not receive the hepatitis B virus (HBV) vaccination. of the level of awareness among the participants, it was found that 43.60% of respondents were uninformed about the specific duration required to attain complete immunity through vaccination doses. Conversely, 57.11% of the participants shown awareness of the protective efficacy of the vaccine against HBV infection. Approximately 71.07% of the participants had the understanding that Hepatitis B is a disease that mostly affects the liver, and they are knowledgeable about the availability of vaccine as a means of prevention. Nevertheless, a notable proportion of participants (44%) exhibited a lack of awareness regarding the presence of asymptomatic hepatitis B virus (HBV) infection. Conclusion: Hepatitis B virus (HBV) is a multifaceted viral illness. The level of vaccine knowledge among students was found to be insufficient. Consequently, it is advisable to enhance the awareness and understanding of medical students, given their elevated susceptibility to HBV infection.

      Keywords: HBV, awareness, knowledge, hepatitis, vaccination.

    • Knowledge and awareness about aesthetic crowns in children among dental Undergraduates, Postgraduates and General dental practitioners
      Aim: To assess the knowledge and awareness about aesthetic crowns in children among dental undergraduates, postgraduates and general dental practitioners.
      Methods: A cross sectional study was conducted on 400 participants who were divided into two groups of 200 each, Group 1- Dental Students (Undergraduates); Group 2- Clinicians (Postgraduates and General Practitioners treating children other than Pediatric Dentists). A questionnaire containing 19 questions regarding the procedures done on the deciduous teeth, different type of crowns available for primary teeth, aesthetic crowns and the procedure for their placement were asked using the computer- generated questionnaire (Google form) which was submitted online. The collected data was subjected to statistical analysis.
      Result: The study comprised of 51.8% undergraduates, 31.6% postgraduates and 16.6% general practitioners (Table 1). Full coverage crowns are necessary after a pulp therapy for primary teeth was a finding among 83.1% of the Group1 participants and 88.1 % of the Group 2 participants. Tooth- coloured crowns to their pediatric patients was recommended by 87.8% of the Group 1 participants and 79.4% of the Group 2 participants (Table 2).
      Conclusion: The study concluded that most of the participants had a fair knowledge about aesthetic crowns used in children.

      Keywords: Aesthetic crowns, General Dental Practitioners, Postgraduates, Undergraduates, Zirconia Crowns,

    • Multiple primary cancers: a case report and literature review
      The fortuitous discovery of synchronous double primary cancers of the lung and stomach is relatively rare, but the discovery of triple primary cancers in one patient remains exceptional. The discovery of triple primary cancers in a single patient remains exceptional. This coexistence corresponds to the syndrome of multiple primary malignancies or multiple primary cancers (MPC). We present a case of synchronous association of squamous cell carcinoma of the lung and gastric adenocarcinoma with a history of mature squamous cell carcinoma of the larynx.

      Keywords: larynx; lung; stomach; adenocarcinoma; squamous cell carcinoma.

      The dawn of ‘minimal invasive dentistry’ has enormously changed the basic idea of cavity preparation. The current cavity preparations depend on the shape and extent of the carious lesion, and leaving the healthy tooth tissue as much as possible. New caries excavation techniques have been introduced like ceramic and polymeric burs, caries disclosing dyes, caries dissolving chemical agents, caries selective air and sonic abrasion, laser ablation and use of enzymes to dissolve caries. All these methods aim at minimal tooth preparation and maximum tooth preservation. All these methods are under constant modification for improvement.

      Keywords: Caries excavation, Chemo-mechanical caries removal, Dental caries, Laser, Tooth preparation

    • Analysis of Patient Satisfaction at Dental and Oral Hospital of Jember University in 2022
      Health providers are required to give high quality health services for patients in order to establish a good patient satisfaction. A measurement with different aspects and methods is needed to describe and analyze patient satisfaction in more details at Dental and Oral Hospital of Jember University in 2022. This study used the Patient Satisfaction Questionnaire 2017 (KKP-2017) as an instrument to conduct the analysis of patient satisfaction. Research was conducted on primary data obtained from 100 respondents. The research consisted of several phase, which are determining research subjects using the purposive sampling method based on inclusion & exclusion criteria, then research subjects filled the KKP-2017 questionnaire consisting of 25 questionnaire items with five Likert scale answer choice. The analysis phase will be carried out based on calculation of average point of each questionnaire item and the final patient satisfaction score will represents the population assessment. The average of patient satisfaction result based on the satisfaction aspect shows a good category except for the physical environment aspect of general patients which are still classified as "Less". The results of calculation based on KKP-2017 shows satisfaction score of BPJS patients namely 82.06 (Moderate), general patients is 83.56. Based on the results of analysis, patient satisfaction at RSGM Jember University is relatively good. The overall average of the satisfaction scores obtained is 84.25 which is included in the “High” satisfaction category according to KKP-2017.

      Keywords: Patient satisfaction, health services, hospital, dental and oral hospital

    • Effectiveness of Reducing Household Waste BOD, COD and TSS with the Ecotech Garden Method
      The main source of household waste water (grey water) is domestic liquid waste, originating from non-latrine activities, namely bathrooms, kitchens, yards, and waste other than feces (black water). This waste poses a burden to water bodies, rivers that pass through densely populated settlements are in very poor condition, are black, murky and smelly, contain soap, fatty oils, detergents and microorganisms. These conditions can disrupt aquatic ecosystems so that the photosynthesis process cannot run smoothly, this causes water productivity to decrease. Waste treatment with the Ecotech Garden (EGA) system or sanitary garden is very appropriate to reduce the level of pollution considering the characteristics of gray water wastewater with relatively low organic load, high nitrogen and phosphate elements. Research objective: to determine the effectiveness of reducing BOD, COD and TSS levels in household waste using the Ecotech Garden method with Echinodorus palaefolius and Typha Angustifolia plants. This research is quasi-experimental, using 6 waste treatment miniatures, made of acrylic with a size of 50x50x50 cm. In Box 1, Box 2: filled with waste and given Typha Angustifolia plants; Box 3, Box 4: filled with waste and given Echinodorus palaefolius and Bak 5, Bak 6 filled with waste as a control. Household liquid waste levels were measured for pH, temperature, TSS, BOD and COD before being treated. The 6 BAK were kept in contact for 6 days (5 days of residence), every day the levels of TSS, BOD and COD were measured. The reduction in TSS, BOD and COD pollutant levels was calculated. Conclusion: Echinodorus palaefolius is more effective than Typha Angustifolia in reducing pollutant levels

      Keywords: Reduction, domestic waste, ecotech garden

    • Comparative Analysis of Healthcare Systems in Australia and India
      While it is true that every individual is responsible for his/her health, what is equally true is the fact that the responsibility of provision of healthcare lies with the government. To quote Winston Churchill: “Healthy citizens are the greatest assets any country can have.” Human beings require varied forms of healthcare at different points in their life cycle. To this effect, the onus is on the regulatory bodies and the concerned authorities to ensure that the requirement is duly met in a qualitative and a quantitative manner to the benefit of all parties concerned. Framework through which healthcare is provided to the population varies from one country to another and is designed bearing in mind the local factors and situations which exist on the ground. Therefore, it is important to understand that no two countries would have the exact same healthcare system, and that each would design one as per the specific requirements of its population (Donabedian, 2005). However, there are certain edicts which the healthcare system of every country must adhere to, regardless of their unique position. Foremost is the consideration that every phase of life projects a different healthcare need, and this is often an outcome of a variety of factors. An individual‟s health is determined as much by personal circumstances, like nutrition, lack of exercise and eating habits, as by external factors which could be social or environmental. On requiring assistance pertaining to health, people normally visit a health practitioner in a clinic or a hospital, and undergo treatment as per the seriousness of their condition. In such a situation, the healthcare framework of the country should be such that it is in a position to provide good-quality services to people in a manner that suits them the best irrespective of their economic background (Freedman, 2005). Efficiency of a country‟s healthcare framework is an outcome of several parameters and is often judged on whether or not it satisfies the requirements of its citizens. The final outcome is based on several aspects, which are referred to as performance indicators, and these also form the basis for comparing healthcare sectors of various countries (Freedman, 2005). This paper takes a close look at the healthcare sectors in Australia and India and reflects on an attempt to compare them through various performance indicators.

      Keywords: public health, Health system comparison, Australia life style, promotion, India health system

    • The Correlation of Diabetes Mellitus Patients Background with Levels of Self-Management Application in At Depok General Hospital
      Diabetes Mellitus is a chronic disease in the form of metabolic disorders indicated by blood sugar levels that exceed normal limits which can cause death worldwide. Self-management in patients with diabetes mellitus is the behavior of individuals with diabetes mellitus to manage their condition, including taking medication, adjusting diet, carrying out physical exercise, monitoring blood glucose independently, and maintaining foot care. Diabetes mellitus was included in the top 10 diseases that caused death in Depok city hospitals in 2019 with 69 new cases (5.2%). Therefore, it is important to know whether or not there is a relationship between the background of people with diabetes mellitus and the level of self-management implemented by people with diabetes mellitus. This study uses descriptive analytic method with a cross sectional approach with a sample of 95 respondents. Data were collected using a questionnaire. The results showed that there was no relationship between age and the level of application of self-management in patients with diabetes mellitus at RSUD Kota Depok with value = 0.299, (ρ > α), there was no relationship between gender and the level of application of self-management in patients with diabetes mellitus. at the Depok City Hospital with value = 0.687, (ρ > α), there is no relationship between the level of education and the level of self-management Application in diabetes mellitus patients at the Depok City Hospital with value = 0.359, (ρ > α), and no there is a relationship between the duration of suffering from diabetes mellitus with the level of self-management Application in diabetes mellitus patients at the Depok City Hospital with value = 0.723, (ρ > α).

      Keywords: diabetes mellitus, background, self-management

    • The efficacy of electronic cigarettes as a smoking cessation tool among medical students
      Background: Several studies have been conducted to assess the efficacy of E-cigarettes in facilitating smoking cessation and to determine their safety and viability as a substitute for conventional tobacco cigarettes. The evaluation of the product necessitates a substantial investment in research in order to conduct a thorough analysis of its usage prevalence, encompassing both its application as a means of smoking cessation and its adoption as a habitual smoking practice. Methods: The present cross-sectional study was carried out in the early months of 2022 at the Faculty of Medicine, King Abdulaziz University. The research encompassed a total of 263 participants, who were students. The researchers in the prior study implemented and verified the use of a standardized and anonymous questionnaire. The idea was evaluated and tested using statistical analysis conducted with "IBM SPSS Statistics version 20.0."Results: The research encompassed a sample of 263 pupils, with 60.9% identified as male and 39.1% identified as female. Out of a total of 133 students, it was found that 49 of them were former smokers, while the remaining 86 were now smoking. In terms of the smoking type employed, it was found that 23 individuals (17.3%) utilized tobacco cigarettes, while 90 individuals (67.7%) engaged in the usage of E-cigarettes/vape. Additionally, 20 individuals (15%) reported the use of other forms of tobacco products. A total of 36.1% of individuals who smoke employ electronic cigarettes (e-cigarettes) as a means to cease tobacco consumption. A statistically significant correlation was observed between the regular use of E-cigarettes/vape and the marital status and academic year of the subjects (P< 0.05).Conclusion:The present study has determined that the utilization of electronic cigarettes (e-cigarettes) or vaping serves as a contributing factor in the cessation of smoking among a cohort of medical students who successfully quit smoking through its implementation. Furthermore, it is regarded as a transitional tool for those seeking to reduce their overall tobacco intake.

      Keywords: E-cigarettes, vape, smoking cessation, medical students, smoking

    • Women's Participation in Mammography Screening, Breast Cancer Risk Levels and Its Relationship with Death Fear and Anxiety
      Aim:This study aimed to evaluate the relationship between women's participation in mammography screening, breast cancer risk levels, and death anxiety. Materials and Methods:This cross-sectional study was held between January and April 2023, to 305 women aged over 40 in to family health centers. A face-to-face survey included sociodemographic characteristics, their breast cancer risk factors, whether they have undergone mammography and their beliefs related to mammography screening was applied to the participants. All of the participants GAIL score calculated and they answered Templer's Death Anxiety Scale (TDAS) .
      Results: The mean age of the participants was 54,14±9,30 years, 66,90% were housewives, 48,90% were obese, and 66,9% were in menopause. According to the Gail model, the mean percentage risk of developing breast cancer at five years was 1.42±0.46%; and the mean percentage of lifetime risk as 10,0±2,02. The mean death anxiety score of the participants was found to be 8.47±2.39. 68.90% of the participants participated in at least one mammography screening while 23.0% of them had regular screens. In a binary logistic regression model in which the dependent variable was being in study group (Participants who had regular mammography screening), age (OR=0,929 %95 CI 0,898-0,960), and positive score of the beliefs about mammography (OR=1,154 %95 CI 1,099-1,211) are found as independent variables for being in the study group.
      Conclusions: The positive beliefs of the participants and age were found as independent variables for regular mammography screening while we failed to find TDAS is ineffective.

      Keywords: Breast cancer, mammography, Death anxiety, Gail model

    • Knowledge, Attitude and Practice of Aromatherapy in Management of Dental Anxiety in Pediatric Patients among Pediatric Dentists and Post Graduates
      BACKGROUND:Dental anxiety is one of the most common obstacles to dental care, especially for children. Hence, dental anxiety in children should not be underestimated because it prevents children from receiving treatment and causes further health problems. Aromatherapy is one such alternative medical approach that includes the inhaled, absorbed, or ingested use of essential oils for prophylactic treatment. Hence, children are likely to accept essential oils that they find pleasant.
      AIM:To assess the knowledge, attitude and practice regarding Aromatherapy in managing dental anxiety in pediatric patients among Pediatric dentists and Post Graduates.
      SETTING AND DESIGN: Descriptive Cross-sectional study conducted among Pediatric dentists and post graduates in Mangalore.
      MATERIALS AND METHOD:This is a questionnaire study which consists of 20 questions and distributed to the participants through online platform as Google forms. 62 participants are included in the study among Pediatric dentists and post graduate students. Prior to the study ethical clearance has been obtained. Informed consent was obtained from the participants.
      STATISTICAL ANALYSIS: Descriptive statistics used for analysis.
      RESULTS: Results were statistically analysed and concluded that awareness among Aromatherapy in managing dental anxiety in children in the Pediatric dentists and post graduates students is satisfactory. But the practical knowledge about the aromatherapy is very scarce.
      CONCLUSION: Aromatherapy for managing Dental anxiety is a excellent alternative technique to reduce and calm the pediatric patients during their dental treatment.

      Keywords: Aromatherapy, dental anxiety, pediatric patients

    • Case Study on 25-Year-Oldmale Patient with Pemphighus Vulgaris
      A 25-year-old male patient came to hospital with IPNO. 55298 in dermatology department and with chief complaints of multiple raised nodular lesions at axilla and perianal region in the past one month with exudative discharge. Patient is having previous history of this dermatological infection which is previously diagnosed as pemphigus vulgaris and on medication with tab prednisolone 25mg dose per oral/once daily. History of present illness after admitted in the hospital patient complaints that he is suffering from headache and rise in body temperature and similar complaints that are in past are positive. Patient is a known case of seizure history and on medication tab phenytoin 200mg per oral/once daily. Patient is having normal stable vitals. On general examination patient is with reddish bumps and raised body lesions. On physical examination patient conscious, coherent and cooperative. Patient was diagnosed with of pemphigus vulgaris one year ago and since then he is using medication related to the itching and lesions and again reoccurrence of skin infection happened for past one month with exudative discharge of lesions, skin irritation and rashes.

    • Case Study on 12-Year-Oldmale Patient with Neurocutaneous Syndrome
      A 12-year-old male child came to the hospital in paediatric department. And he has complaints of one episode of seizure which is a generalized tonic clonic seizures lasts for 15 minutes, pain in abdomen, loss of concentration and history of frothing, portical confusion for 15 minutes and tongue bite was positive. And he has a complaint of hyperpigmented areas distributed over face, back and buttock of right side. Patient had a known case of seizure activity which was occurred at the age of 8 years and the second episode at 11 years. On general examination patient was conscious and coherent. Patient was using anti-convulsant and steroids. Patient vitals were normal. On physical examination hyperpigmented areas over face, back and buttock of right side. Patient was diagnosed as seizure episode one year ago using anti-convulsant includes midazolam and phenytoin. His father-in-law has same complaints with hypopigmentation and seizures.