Background:India has the third largest number of people living with human immunodeficiency virus (HIV) and thus, dental practitioners are more likely to encounter such patients for dental management.Aim:The aim of the following study is to evaluate the knowledge, attitude and practice regarding post-exposure prophylaxis (PEP) for HIV among dental interns and post graduate (PG) students of a dental institution in India.Subjects and Methods:A cross-sectional study was conducted among 128 dental students (64 interns and 64 PG students). Data related to HIV PEP was collected by pre-designed, pre-tested, self-administered questionnaire and difference in responses by education level was assessed by Chi-square test and Z-test (significance level was set at P ≤ 0.05). For statistical analysis, Statistical Package for Social Sciences (SPSS version 16, Chicago IL, USA) was used.Results:Difference in responses between dental interns and PG students was not statistically significant for majority of questions. All participants had positive attitude toward HIV patients (98.4% [63/64] interns vs. 100% [64/64] PG students). Interns (68.8%, 44/64) and PG students (68.8%, 44/64) were equally aware of the concept of HIV PEP. PG students had better knowledge than dental interns on few questions but overall both of them lacked knowledge about the best timing for commencement of HIV PEP (20.4% [13/64] interns vs. 42.2% [27/64] PG students) (P < 0.01), the antiretroviral drug regimen (48.4% [31/64] interns vs. 43.7% [28/64] PG students) and its duration (23.4% [15/64] interns vs. 25.0% [16/64] PG students), timing of antibody testing to rule out infection to health care worker (23.4% [15/64] interns vs. 35.9% [23/64] PG students) (P = 0.04).Conclusion:As knowledge regarding HIV PEP is found to be inadequate, well-designed educational programs need to be conducted to increase the understanding of dental professionals on this issue.
AIM: To share clinical pattern of presentation, the modalities of surgical intervention and the one month post-surgical outcome of rhino-orbito-mucormycosis (ROCM) cases.
METHODS: All COVID associated mucormycosis (CAM) patients underwent comprehensive multidisciplinary examination by ophthalmologist, otorhinolaryngologist and physician. Patients with clinical and radiological evidence of orbital apex involvement were included in the study. Appropriate medical and surgical intervention were done to each patient. Patients were followed up one-month post intervention.
RESULTS: Out of 89 CAM patients, 31 (34.8%) had orbital apex syndrome. Sixty-six (74.2%) of such patients had pre-existing diabetes mellitus, 18 (58%) patients had prior documented use of steroid use, and 55 (61.8%) had no light perception (LP) presenting vision. Blepharoptosis, proptosis, complete ophthalmoplegia were common clinical findings. Seventeen (19.1%) of such patients had variable amount of cavernous sinus involvement. Endoscopic debridement of paranasal sinuses and orbit with or without eyelid sparing limited orbital exenteration was done in most cases, 34 (38.2%) patients could retain vision in the affected eye.
CONCLUSION: Orbital apex involvement in CAM patients occur very fast. It not only leads to loss of vision but also sacrifice of the eyeball, orbital contents and eyelids. Early diagnosis and prompt intervention can preserve life, vision and spare mutilating surgeries.
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