Non communicable diseases (NCDs) affect the life of an individual in terms of mortality, morbidity and financial crises. Main NCDs are diabetes mellitus (DM), cardiovascular diseases (CVD), pulmonary diseases, osteoporosis and chronic kidney diseases (CKD). About 40% of the total deaths can be controlled by eliminating the risk factors for NCDs. Periodontitis have recently been labeled as an important potential risk factor for NCDs. CKD affect the oral health status of patients by inducing gingival hyperplasia, xerostomia, calcification of root canals and delayed eruption of teeth. Periodontitis increases systemic inflammatory burden leading to worsening of CKD which in turn has been has been found to negatively affect CKD of patients on hemodialysis therapy by altering their serum albumin and C-reactive protein levels. As hypoalbuminemia leads to increased mortality in CKD patients, it needs to be avoided by reducing systemic inflammatory burden in patients receiving HD therapy. Treating periodontal disease could be one factor that might decrease the systemic inflammatory burden and thereby improve quality of life of these patients. Sources of Data: Data from descriptive, cross sectional and longitudinal studies published between 2000 and 2012 were included. Data searches based on human studies only. Data Extraction: The key words, periodontitis, chronic kidney disease and hemodialysis, on MEDLINE, approximately 120 studies were identified. 35 of them were relevant to all three keywords. Most of them were cross sectional studies and total 7 clinical trials were identified regarding checking of serum levels after periodontal therapy with variable results. Conclusion: Patients with CKD have higher prevalence of periodontal disease while non-surgical periodontal therapy has been indicated to decrease the systemic inflammatory burden in patients with CKD specially those undergoing HD therapy.

Objective Smoking induces changes in salivary pH and inflammatory biomarker levels associated with oral diseases. This study examined the effect of alkaline oral rinse to modify this effect of smoking on salivary study parameters. Materials and Methods A double-blind randomized controlled trial (RCT) on systemically healthy smokers was conducted. A total of 78 smokers, aged 18 to 40 years, were enrolled as per exclusion/inclusion criteria. An alkaline mouthwash was provided to the intervention group and a placebo to control group. Salivary pH and inflammatory biomarker interleukin (IL)-1β levels were evaluated at baseline and at follow-up (14 ± 2 days). Statistical Analysis Chi-squared test, independaent t-test, and paired t-test were used to observe the changes in parameters among and between groups before and after intervention using SPSS v16 with a significance level of p≤0.050. Results Sixty eight salivary samples were analyzed. All study parameters of the study sample were statistically insignificant between both intervention and control groups at baseline. pH level was 6.56 ± 0.53 at baseline and 6.62 ± 0.45 at follow-up in the intervention group; respective values for control group were 6.70 ± 0.36 and 6.83 ± 0.44 and the changes were not significant (p≥0.071). IL-1β level was 9.39 ± 10.23 pg/µL at baseline and 5.40 ± 6.62 pg/µL at a follow-up in the intervention group and the change was significant (p = 0.001); respective values for the control group were 10.63 ± 11.50, and 9.33 ± 11.73 and the difference was nonsignificant (p = 0.076). Conclusion This randomized trial indicated that sodium bicarbonate mouth rinse is effective in decreasing IL-1β levels and increasing salivary pH favorable for prevention of oral diseases.

Health professionals are expected to support oral health and encourage the patients to follow appropriate dental care. Awareness and practices related to oral-systemic disease connection was assessed among medical and dental practitioners. METHODOLOGY: A cross-sectional study on medical and dental practitioners of city Faisalabad, Pakistan was conducted. Two hundred and forty (n=240) medical and dental practitioners were approached for study, all practitioners rendering a consent were recruited in study and their response was collected on a close-ended questionnaire. RESULTS: Eighty three (n=83%) of respondents knew that a relationship exists between oral and systemic health, but application of this knowledge is limited. 59% medical practitioners were in practice to look for dental conditions in medical patients in comparison to 79% dental practitioners who look into medical conditions while examining dental patients. Medical and dental professionals with postgraduate qualification had better awareness and were applying their knowledge in daily practice. Females were better in status of awareness and practice in this study sample. CONCLUSION: Level of awareness and practice about relationship of oral-systemic disease connections was moderate among the study sample, dentists showed better awareness and practice. A need is felt to improve collaboration between dental and medical profession in order to enhance patient care.

Chronic kidney disease is a worldwide public health problem and a chronic disease that deteriorates the quality of life (QOL). Diabetes is recognized as co-morbidity in patients of end stage renal disease (ESRD). This study evaluated QOL in diabetic and non-diabetic patients on maintenance dialysis therapy. A cross-sectional study was conducted on ESRD with or without diabetes on hemodialysis therapy for at least three months at Kidney Center, Sheikh Zayed Medical Complex, Lahore Pakistan. QOL was assessed using WHOQOL-BREF questionnaire by World Health Organization. One hundred and thirty seven (n=137) hemodialysis patients were observed. 59 (41.8%) were with diabetes mellitus (DM) and 78 (55%) were without DM. 81 (54%) were on hemodialysis for more than 2 years. There was no statistically significant (p≥0.066) difference in QOL scores of hemodialysis patients with or without diabetes; however, a significant (p≤0.025) difference was observed in responses of 'meaningfulness' and "ability to concentrate" by patients of both groups. The scores were divided in two categories of '≤50' and '>50'; a significant (p≤0.047) difference between two groups was observed in physical domain only. The current study on diabetic and non-diabetic hemodialysis patients showed no statistical difference in their QOL except for "meaningfulness of life" and "ability to concentrate".

Objective: To evaluate the knowledge and attitude of dental students towards hepatitis B infection. Study Design: A Cross Sectional Study (survey).