Introduction: Oral candidiasis is one of the most common opportunistic oral fungal infections. Oral candidal carriage in schoolchildren is a subject of increasing interest worldwide and has recently been associated with increased caries incidence in children. Aims: This study was carried out to identify association between oral candidal carriage in children and dental caries. Subjects and Methods: One hundred subjects with an age range between 6 and 12 years were included in this study. The subjects were distributed equally into two groups, i.e., study (caries-positive) and control (caries-free) groups. Oral hygiene index and DMFT/dmft scores were recorded for each subject. Sampling for Candida was carried out using intraoral swabs and concentrated oral rinse. Sabouraud dextrose agar containing 0.1 mg/ml of chloramphenicol was used as the primary culture medium. Candida was identified by employing API-20C AUX and germ tube formation tests. Results: The subjects in the caries-positive group showed a high frequency of oral candidal carriage compared to the caries-free subjects and the results were statistically very significant (p < 0.01). The odds ratio was 67.37, implying a high caries risk with positive oral candidal carriage (95% CI 14–323). Discussion: The findings of this study underscore the possible association of Candida with dental caries. Conclusions: The occurrence of dental caries in children with mixed dentition is positively correlated with the frequency of oral candidal carriage.
Following a single blind, cross-over and non-randomized design we investigated the effect of 7-day use of chlorhexidine (CHX) mouthwash on the salivary microbiome as well as several saliva and plasma biomarkers in 36 healthy individuals. They rinsed their mouth (for 1 min) twice a day for seven days with a placebo mouthwash and then repeated this protocol with CHX mouthwash for a further seven days. Saliva and blood samples were taken at the end of each treatment to analyse the abundance and diversity of oral bacteria, and pH, lactate, glucose, nitrate and nitrite concentrations. CHX significantly increased the abundance of Firmicutes and Proteobacteria, and reduced the content of Bacteroidetes, TM7, SR1 and Fusobacteria. This shift was associated with a significant decrease in saliva pH and buffering capacity, accompanied by an increase in saliva lactate and glucose levels. Lower saliva and plasma nitrite concentrations were found after using CHX, followed by a trend of increased systolic blood pressure. Overall, this study demonstrates that mouthwash containing CHX is associated with a major shift in the salivary microbiome, leading to more acidic conditions and lower nitrite availability in healthy individuals.
The signiicance of the educational environment in health professions academic institutions, increasingly recognized on a global scale, is fundamental to effective student learning. This study was carried out to evaluate students' perceptions of the educational environment in ive undergraduate dental institutions in Pakistan. This non-interventional study used a postal questionnaire based on the Dundee Ready Educational Environment Measure (DREEM). The subjects were dental students taking the inal professional B.D.S. examination at ive dental institutions afiliated with the University of Health Sciences, Lahore, Pakistan. A total of 197 students participated in the study (response rate of 83.82 percent). The overall DREEM score was 115.06 (Cronbach's alpha 0.87). Nine items recorded scores <2 and were lagged for remediation. Signiicant differences were observed between students' perceptions of learning and of teachers (p<0.05). Many issues challenge the quality and delivery of dental education in Pakistan, and dental institutions need to develop robust mechanisms to incorporate contemporary international trends in dental education in order to improve the educational environment.
Data sources Experimental investigation.Study design A retrospective review to evaluate the use of a negative-pressure otolaryngology viral isolation drape (NOVID) system to reduce cross-infection through aerosol. The apparatus consists of a plastic drape suspended over the surgical field in the head and neck region with a smoke evacuator suction placed inside the chamber with an ultra-low penetrating air (ULPA) efficiency rating and a fluid suction high-efficiency particulate air (HEPA) filter compartment. Spread of patient secretions and droplet formation was evaluated using 1% fluorescein dye in 10 ml of normal saline and ultraviolet light.
Background This study aimed to determine the impact of pulmonary complications on death after surgery both before and during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Methods This was a patient-level, comparative analysis of two, international prospective cohort studies: one before the pandemic (January–October 2019) and the second during the SARS-CoV-2 pandemic (local emergence of COVID-19 up to 19 April 2020). Both included patients undergoing elective resection of an intra-abdominal cancer with curative intent across five surgical oncology disciplines. Patient selection and rates of 30-day postoperative pulmonary complications were compared. The primary outcome was 30-day postoperative mortality. Mediation analysis using a natural-effects model was used to estimate the proportion of deaths during the pandemic attributable to SARS-CoV-2 infection. Results This study included 7402 patients from 50 countries; 3031 (40.9 per cent) underwent surgery before and 4371 (59.1 per cent) during the pandemic. Overall, 4.3 per cent (187 of 4371) developed postoperative SARS-CoV-2 in the pandemic cohort. The pulmonary complication rate was similar (7.1 per cent (216 of 3031) versus 6.3 per cent (274 of 4371); P = 0.158) but the mortality rate was significantly higher (0.7 per cent (20 of 3031) versus 2.0 per cent (87 of 4371); P < 0.001) among patients who had surgery during the pandemic. The adjusted odds of death were higher during than before the pandemic (odds ratio (OR) 2.72, 95 per cent c.i. 1.58 to 4.67; P < 0.001). In mediation analysis, 54.8 per cent of excess postoperative deaths during the pandemic were estimated to be attributable to SARS-CoV-2 (OR 1.73, 1.40 to 2.13; P < 0.001). Conclusion Although providers may have selected patients with a lower risk profile for surgery during the pandemic, this did not mitigate the likelihood of death through SARS-CoV-2 infection. Care providers must act urgently to protect surgical patients from SARS-CoV-2 infection.
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