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author:("Jain, hashish")
2.  Perceptions of Indian dental hygiene students toward their profession and its relationship with their explicit self-esteem scores 
Indian Journal of Dentistry  2014;5(4):202-210.
The purpose of this study was to investigate the perceptions toward the profession, the level of explicit self-esteem (ESE) of Indian students pursuing the course of dental hygienists, to evaluate the relationship between the two and to develop educational strategies to positively influence students’ perceptions. We also wished to evaluate the level of satisfaction of the students to the current status of professional employment in the country.
Materials and Methods:
Students in the second year of the dental hygienist 2-year course were asked to participate in a cross-sectional survey study. An instrument was used to obtain students’ perceptions about the profession by estimating the dimensions of “Motivation,” “Expectation” and “Environment”. Their self-esteem was evaluated using the Rosenberg self-esteem scale. Relationship of self esteem scores with perceptions towards profession was then evaluated.
Scores for dimensions including “Motivation,” “Expectation” and “Environment” were significantly high, as were the self-esteem scores. The level of ESE was positively correlated with their perceptions of the profession.
The perception of the Indian dental hygienist students was significantly high and positively correlated to the ESE scores. We also conclude that environmental factors may be more influential than innate cultural factors for the development of self-esteem.
PMCID: PMC4260386  PMID: 25565754
Dental hygiene education; perception; profession; self-esteem
3.  A year that was… 
PMCID: PMC4239738  PMID: 25425810
4.  Repeat Descemetopexy after Descemet's Membrane Detachment following Phacoemulsification 
Case Reports in Ophthalmology  2014;5(2):203-206.
Descemet's membrane detachment (DMD) is an uncommon condition with a wide range of possible etiologies. Probably the commonest cause is a localized detachment occurring after cataract extraction surgery. Descemetopexy gives good anatomic attachment rates and visual outcomes and has become the standard treatment for DMD. However, in cases with failed initial descemetopexy, the next step in the management of such cases remains unclear. Before initiating a complex surgical procedure like keratoplasty, which requires good postoperative care and regular follow-ups, repeat descemetopexy with a long-term tamponade using 14% C3F8 gas for recurrent DMD is definitely a worthwhile attempt.
PMCID: PMC4130814  PMID: 25126074
Repeat descemetopexy; Descemet's membrane detachment; C3F8 gas
5.  Genetically altered fields in head and neck cancer and second field tumor 
South Asian Journal of Cancer  2014;3(3):151-153.
The concept of field cancerization has been ever changing since its first description by Slaughter et al in 1953. Field cancerization explains the mechanisms by which second primary tumors (SPTs) develop. SPTs are the tumors, which develop in the oral cavity in succession to the primary malignant tumors, which might vary in duration ranging from few months to years. Conceivably, a population of daughter cells with early genetic changes (without histopathology) remains in the organ, demonstrating the concept of field cancerization. This review explains the concept of field cancerization and various field theories along with molecular basis of field formation.
PMCID: PMC4134604  PMID: 25136520
Second primary tumor; head and neck squamous cell carcinoma; tumor adjacent mucosa; upper aerodigestive tract
6.  Periodontology: Future of centerstage 
PMCID: PMC4158576
7.  An In vitro Evaluation of Flexural Bond Strength of Indirect Composites Fused to Metal 
With the advent of newer indirect composite resin materials for crown and bridge prosthesis, it has become imperative to evaluate their strength to serve as long term replacements as a substitute to metal ceramic restorations. This study aimed to evaluate and compare the flexural bond strength of three composite resin veneering material to metal, cured by different methods. Specimen were fabricated with pattern resin by duplicating it with machined metal die and divided into three groups. Three composite resin materials were used in this study. Group (A) received Adoro, Group (B) received Targis and Group (C) received Tescera. The bond strength of all specimens was tested with Lloyd’s universal testing machine under three point loading. The highest values for fracture resistance were displayed by light, heat and pressure cured composites followed by composites cured using a temperature of 104 °C and composites with curing temperature of 95 °C. The results indicate that there is a significant difference between the three groups, with the Tescera group specimens exhibiting the highest flexural bond strength. Of the other two groups, Adoro group exhibited higher flexural bond strength than Targis group. The results of this study suggest that Tescera group with curing temperature of 130 °C and pressure of 80 Psi, cured with metal halide unit exhibited the highest flexural bond strength when compared to Adoro and Targis groups.
PMCID: PMC3634948  PMID: 24431721
Flexural bond strength; Indirect composites; Crown and bridge
8.  Sensitive polarographic electrochemical determination of clarithromycin in blood serum 
Clarithromycin is an antibacterial widely used for the treatment of a myriad of infections. Various methods including HPLC have been reported for its drug plasma concentration but they are more complex. In this study, we developed an electrochemical method for estimation of clarithromycin in blood using differential pulse polarography (DPP) after oral administration of pure clarithromycin suspension. The differential pulse polarography of clarithromycin showed peak with peak potential Ep is −1460 mV SCE at pH 6.5 ± 0.1. The developed electrochemical method was standardized and validated for the determination of clarithromycin in blood serum of albino rats. PK analysis included Cmax, Tmax, AUC0-24, elimination rate constant (Kel) and t1/2. Cmax were found to be 1.34 ± 0.16 mg/ml and 1.99 ± 0.22 mg/ml for plain clarithromycin and suspension formulation, respectively. Effects of ammonium tartarate concentration and pH were also studied as specificity parameters. Developed electrochemical method was found to be simple, accurate method for to estimate blood-clarithromycin profile and can also be used similarly for various dosage forms.
PMCID: PMC3758096  PMID: 24023459
Clarithromycin; Polarography; Electrochemical; Serum
9.  Prosthognathic Rehabilitation of A Patient with Underlying Skeletal Discrepancy- A Case Report 
Vertical and anterioposterior maxillary excesses can be treated with a combination of orthopaedic functional appliances, orthodontics and surgery. Treatment varies according to the age, patient reports for treatment. In patients who are treated with either of the above mentioned treatment modalities, if they require prosthetic replacement on a later date, especially of anterior teeth, prosthetic treatment alone does not give an aesthetic outcome. A partially edentulous, elderly patient with underlying skeletal discrepancy (Class II Skeletal deformity) in relation to 12,11,21,22 was treated with a combination of orthognathic surgery and prosthetic rehabilltation. An orthognathic surgery (leforte I osteotomy) was performed to manage vertical maxillary excess, class II skeletal pattern of maxilla and increased lower third facial height. Dental compensations in the mandibular arch were decompensated surgically with lower subapical osteotomy. Prosthetic restorations of missing anterior teeth were done later, such that facial and dental aesthetics. The records showed that the results were stable 12 months after prosthognathic (prosthodontic and orthognathic) treatment. A team approach enabled the female patient in her fifth decade of life, to receive better function, aesthetics and increased quality of life. Doing prosthetic restorations in patients with underlying skeletal discrepancies may become a challenge , which should be achieved without compromising on final outcome, with a calculated risk benefit ratio.
PMCID: PMC4003664  PMID: 24783156
Prosthognathic; Orthognathic surgery; Fixed prosthesis
10.  Funding or the lack of it 
PMCID: PMC4095615
11.  Conference: A place for scientific appetite or gourmet feast 
PMCID: PMC4033871  PMID: 24872613
12.  Piece meal research 
PMCID: PMC3988636  PMID: 24744533
13.  Palatogram revisited 
Contemporary Clinical Dentistry  2014;5(1):138-141.
It is the responsibility of the dentist to fabricate a denture that is fully functional and perfectly esthetic. One prime oral function that has always been overlooked in this regard is speech. It has been thought that speech will follow mere replacement of teeth and that it is the patient's duty to fine tune this function with practice. Phonetics, esthetics, function and comfort form the foundation of a successful prosthodontic treatment. Accurate approximation of palatal contours of a maxillary complete denture to a patient's tongue can improve speech intelligibility, if other factors such as tooth position, occlusal plane and occlusal vertical dimension are satisfactory. Customizing palatal contours of a maxillary complete denture can be accomplished by using tissue-conditioning material, which provides sufficient working time for a patient to pronounce a series of sibilant sounds while recording dynamic impression of the tongue. This article describes a technique of obtaining palatogram and customizing palatal contours of a maxillary complete denture with autopolymerizing acrylic resin to improve the intelligibility of speech.
PMCID: PMC4012109  PMID: 24808716
Complete denture; palate; palatogram; phonetics; sounds; speech
14.  Time to merge boundaries 
PMCID: PMC3917194
15.  Cataract surgery in juvenile xanthogranuloma: Case report and a brief review of literature 
Indian Journal of Ophthalmology  2013;61(11):673-675.
There is limited literature on the management of cataracts in juvenile xanthogranuloma (JXG). A 2-month-old girl presented to us with hyphema, secondary glaucoma OU and skin nodules suggestive of JXG. She developed bilateral cataracts during her follow-up and was treated successfully with cataract surgery and aphakic rehabilitation.
PMCID: PMC3959089  PMID: 24145561
Cataract surgery; juvenile xanthogranuloma; non-langerhans histiocytic proliferation
16.  School based oral health promotional intervention: Effect on knowledge, practices and clinical oral health related parameters 
Contemporary Clinical Dentistry  2013;4(4):493-499.
No organized school oral health program is existent in India.
The aim of this study is to test the feasibility and efficacy of an economical school oral health promotional intervention with educational and preventive components.
Settings and Design:
School oral health promotional intervention carried out in one of the randomly selected school and evaluated through short duration prospective model.
Materials and Methods:
A total of 100 children with an age range of 10-12 years with no previous history of dental intervention were enrolled. Interventions comprised of oral health education (delivered through lecture and demonstrations by an undergraduate dental student) and topical antibacterial therapy (fluoride varnish and povidone iodine). Outcomes consisted of Knowledge and practices (KAP) regarding oral health, clinical oral health related parameters such as plaque index (PI), gingival index (GI) and caries activity as per Modified Snyder's test. These were reported at baseline, 3 weeks and 6 months follow-up examination by a calibrated examiner.
Statistical Analysis:
McNemar Bowker's test, Student's t-test, Pearson Chi-square tests were used.
Highly significant (P < 0.001) improvements in KAP scores, PI scores, GI scores and caries activity were reported at 3 weeks and 6 months follow-up examination.
This small economical school oral health program positively influenced oral health related practices and parameters of oral health such as oral cleanliness, gingival health and caries activity.
PMCID: PMC3883330  PMID: 24403795
Fluoride varnish; oral health education; preventive oral health program; school oral health program; topical povidone iodine
17.  Full mouth rehabilitation of a patient with reduced vertical dimension using multiple metal ce ramic restorations 
Contemporary Clinical Dentistry  2013;4(4):531-535.
Rehabilitation of a patient with severely worn dentition after restoring the vertical dimension is a complex procedure and assessment of the vertical dimension is an important aspect in these cases. This clinical report describes the full mouth rehabilitation of a patient who was clinically monitored to evaluate the adaptation to a removable occlusal splint to restore vertical dimension for a period 1 month and provisional restorations to determine esthetic and functional outcome for a period of 3 months. It is necessary to recognizing that form follows function and that anterior teeth play a vital role in the maintenance of oral health. Confirmation of tolerance to changes in the vertical dimension of occlusion (VDO) is of paramount importance. Articulated study casts and a diagnostic wax-up can provide important information for the evaluation of treatment options. Alteration of the VDO should be conservative and should not be changed without careful consideration.
PMCID: PMC3883339  PMID: 24403804
Crown lengthening; dental prosthesis; full mouth reconstruction; gingivectomy; removable appliance
18.  Congenital miliaria crystallina – A diagnostic dilemma 
Miliaria crystallina is a transient, superficial obstruction of eccrine sweat ducts resulting in rapidly evolving noninflammatory vesicles. The disease is observed frequently in hot, humid, tropical climates and in the neonatal period, most likely due to lack of maturation of the sweat duct during the first few days following birth. It is rarely present at delivery and remains a diagnostic dilemma for the neonatologists. We report a rare case of “Congenital miliaria crystallina” that was present at birth.
PMCID: PMC3862747  PMID: 24532912
Miliaria; Congenital; Vesicular lesion
19.  Predictors of mortality and length of stay in hospitalized cases of 2009 influenza A (H1N1): Experiences of a tertiary care center 
To study the clinical characteristics and outcome of admitted patients of H1N1 (hemagglutinin -H neuraminidase -N) influenza in a tertiary level hospital, from Oct 2009 to Dec 2010.
Materials and Methods:
A retrospective analysis of 77 confirmed patients admitted in this unit with H1N1 infection.
Of the 77 patients studied, 33 (42.8%) were female. Mean age was 40.88 ± 13.45 years, majority (70.13%) being less than 50 years. Thirty eight (49.3%) patients had at least one co-morbidity, diabetes mellitus being the most common (n = 15, 19.5%). The most common presenting symptom was fever in 75 (97.4%) patients, cough in 67 (87%) and dyspnoea in 59 (76.6%) patients. At admission, mean PaO2/FiO2 ratio was 213.16 ± 132.75 mmHg (n = 60) while mean PaCO2 was 40.14 ± 14.86 mmHg. One or more organ failure was present in 45 (58.4%) patients. Nineteen (24.60%) patients required invasive mechanical ventilation. Circulatory failure was observed in 10 (13%) patients while 2 patients required hemodialysis. Overall, 13% mortality (n = 10) was observed. PaCO2 level at admission (OR 1.093; 95% confidence interval: 1.002-1.193; P = 0.044) and number of organ failure (OR 8.089; 95% confidence interval: 1.133-57.778; P = 0.037) were identified as independent risk- factors for mortality.
Increased duration of dyspnoea prior to admission, pneumonia, low PaO2/FiO2 ratio at admission and 24 hours later, higher PaCO2 values on admission, higher O2 requirement, number of organ failures and use of corticosteroids and delay in specialized treatment were associated with a poorer outcome.
PMCID: PMC3841489  PMID: 24339638
2009 influenza A; H1N1; hospitalized; length of stay; mortality; predictors
20.  Clinico – diagnostic and therapeutic relevance of computed tomography scan of brain in children with partial seizures 
Therapeutic relevance of computed tomography (CT) in children with partial seizures is reported to be remarkably low (1-2%). However, in the developing countries where infections involving the nervous system are common, routine CT scan of brain may help in finding treatable causes of seizures.
Aim of this study was to evaluate the significance of CT scan of brain in the management of children with partial seizures.
Materials and Methods:
Children with partial epilepsy, whose predominant seizure type was focal motor seizures, were included in the study. CT scan of brain was done in all children aged between 1 month and 12 years with partial seizures of unknown etiology prospectively. The clinical findings of these children were noted along with the CT findings.
Between August 2001 and July 2002, of the 200 children with seizure disorder 50 children who satisfied the inclusion criteria were included in the study. CT scan of brain was normal in 16 children (32%) and was abnormal in 34 children (68%). Twenty children (~60% of abnormal scan) had potentially correctable lesions: Tuberculoma (n = 13), neurocysticercosis (n = 3), and brain abscess (n = 4). Five children had changes representing static pathology that did not influence patient management. The clinical features correlated with CT findings in 78% children.
Children with partial motor seizures have high probability of having abnormal findings on CT scan of brain, especially, neuro-infections which are potentially treatable. Therefore, CT scan brain should be carried out in all children with partial motor seizures especially, in developing countries.
PMCID: PMC3788279  PMID: 24101815
Children; computed tomography scan; partial seizures
21.  Designed Chemical Intervention with Thiols for Prophylactic Contraception 
PLoS ONE  2013;8(6):e67365.
Unlike somatic cells, sperm have several-fold more available-thiols that are susceptible to redox-active agents. The present study explains the mechanism behind the instant sperm-immobilizing and trichomonacidal activities of pyrrolidinium pyrrolidine-1-carbodithioate (PPC), a novel thiol agent rationally created for prophylactic contraception by minor chemical modifications of some known thiol drugs. PPC, and its three derivatives (with potential active-site blocked by alkylation), were synthesized and evaluated against live human sperm and metronidazole-susceptible and resistant Trichomonas vaginalis, in vitro. Sperm hexokinase activity was evaluated by coupled enzyme assay. PPC irreversibly immobilized 100% human sperm in ∼30 seconds and totally eliminated Trichomonas vaginalis more efficiently than nonoxynol-9 and metronidazole. It significantly inhibited (P<0.001) thiol-sensitive sperm hexokinase. However, the molecule completely lost all its biological activities once its thiol group was blocked by alkylation. PPC was subsequently formulated into a mucoadhesive vaginal film using GRaS excipients and evaluated for spermicidal and microbicidal activities (in vitro), and contraceptive efficacy in rabbits. PPC remained fully active in quick-dissolving, mucoadhesive vaginal-film formulation, and these PPC-films significantly reduced pregnancy and fertility rates in rabbits. The films released ∼90% of PPC in simulated vaginal fluid (pH 4.2) at 37°C in 5 minutes, in vitro. We have thus discovered a common target (reactive thiols) on chiefly-anaerobic, redox-sensitive cells like sperm and Trichomonas, which is susceptible to designed chemical interference for prophylactic contraception. The active thiol in PPC inactivates sperm and Trichomonas via interference with crucial sulfhydryl-disulfide based reactions, e.g. hexokinase activation in human sperm. In comparison to non-specific surfactant action of OTC spermicide nonoxynol-9, the action of thiol-active PPC is apparently much more specific, potent and safe. PPC presents a proof-of-concept for prophylactic contraception via manipulation of thiols in vagina for selective targeting of sperm and Trichomonas, and qualifies as a promising lead for the development of dually protective vaginal-contraceptive.
PMCID: PMC3694959  PMID: 23826278
22.  CD40 agonist antibody mediated improvement of chronic Cryptosporidium infection in patients with X- linked hyper IgM syndrome 
Clinical Immunology (Orlando, Fla.)  2012;143(2):152-161.
X-linked hyper-IgM syndrome (XHM) is a combined immune deficiency disorder caused by mutations in CD40 ligand. We tested CP-870,893, a human CD40 agonist monoclonal antibody, in the treatment of two XHM patients with biliary Cryptosporidiosis. CP-870,893 activated B cells and APCs in vitro, restoring class switch recombination in XHM B cells and inducing cytokine secretion by monocytes. CP-870,893 infusions were well tolerated and showed significant activity in vivo, decreasing leukocyte concentration in peripheral blood. Although specific antibody responses were lacking, frequent dosing in one subject primed T cells to secrete IFN-g and suppressed oocyst shedding in the stool. Nevertheless, relapse occurred after discontinuation of therapy. The CD40 receptor was rapidly internalized following binding with CP-870,893, potentially explaining the limited capacity of CP-870,893 to mediate immune reconstitution. This study demonstrates that CP-870,893 suppressed oocysts shedding in XHM patients with biliary cryptosporidiosis. The continued study of CD40 agonists in XHM is warranted.
PMCID: PMC3365556  PMID: 22459705
X-linked hyper-IgM syndrome; CD40 ligand; CP-870; 893; CD40-R internalization
23.  Effect of four different surface treatments on shear bond strength of three porcelain repair systems: An in vitro study 
Ceramic fracture in metal ceramic restorations are serious and pose an aesthetic and functional dilemma both for the patients and the dentist. This has created a demand for the development of practical repair options which do not necessitate the removal and remake of entire restorations.
To evaluate and compare the effect of four different surface treatments on shear bond strength of metal ceramic specimens with three commercially available porcelain repair systems.
Materials and Methods:
Specimens were fabricated with a base-metal ceramic alloy and divided into three groups, to evaluate three porcelain repair systems. Each group was divided into four subgroups based on surface treatment (A) sandblasting, (B) sandblasting followed by etching with 9% HF (Hydrofluoric acid) on surrounding ceramic, (C) Use of a diamond bur on exposed metal followed by etching with 37% H3PO4 and (D) Control groups (D1, D2, D3 for three groups of porcelain repair system which was not subjected to further treatment after finishing with 240 grit silicon carbide paper grinding. Shear bond strength of each group of specimens based on surface treatment were evaluated with a universal testing machine after storing in distilled water for 7 days. One way ANOVA and Tukey-HSD procedure were used to compare the mean values between and among the groups.
The mean shear bond strength of group III (10.402 ± 1.055) were significantly higher than group I (8.647 ± 0.990) and group II (8.099 ± 0.600) for all surface treatments. However the mean values of shear bond strength of sub-group A were significantly higher than sub-group C and D but were not significantly higher than sub-group B.
The results of this study suggest that in fractured metal ceramic restorations the exposed metal surface treated with sandblasting or sandblasting and etching the surrounding ceramic surface with HF can increase the shear bond strength of the repaired metal ceramic area. Porcelain repair systems which contain hybrid composites and 4-META as primer had increased bond strength.
PMCID: PMC3698582  PMID: 23833452
Ceramic; fracture; intra-oral repair
24.  Full mouth rehabilitation of a patient with mandibular implant screw retained Fp-3 prosthesis opposing maxillary acrylic removable over-denture 
Contemporary Clinical Dentistry  2013;4(2):231-235.
A hybrid denture is one that is fabricated over a metal framework and retained by screws threaded into the implant abutments. The anterior part of a mandibular hybrid denture is fixed on implants while the posterior part of the denture is extended and cantilevered from implants. This article presents the fabrication of a maxillary over-denture opposing mandibular implant retained hybrid prosthesis. A total of four implants were placed in the mandibular arch. Castable abutments were used to produce the optimal angulations. Framework was waxed, cast recovered, and the fit was refined until the framework seated passively on the master cast. The mandibular denture teeth were waxed to the hybrid framework, and a final wax try-in was performed to verify and correct maxillomandibular relations before processing. The prosthesis was inserted after verification of occlusion, retention, and stability. The rehabilitation of edentulous patients with hybrid dentures has been observed to achieve greater masticatory function and psychological satisfaction than with conventional over-dentures. Producing a passive-fitting substructure for a fixed removable screw retained hybrid prosthesis is arguably one of the most technically complex tasks in implant dentistry. The technique presented may not initially produce a perfectly passive framework, but use of disclosing media and adjusting the internal aspect of the casting can result in non-binding, fully seated prostheses.
PMCID: PMC3757889  PMID: 24015016
Hybrid prosthesis; implant occlusion; passive fit
25.  Potentiating Metronidazole Scaffold against Resistant Trichomonas: Design, Synthesis, Biology and 3D–QSAR Analysis† 
Metronidazole (MTZ), the FDA-approved drug against Trichomonas vaginalis (TV), is being challenged seriously by drug resistance, while its inertness to sperm makes it ineffective as a vaginal contraceptive. Thirteen piperidine dithiocarbamate hybrids of 2-(2-methyl-5-nitro-1H-imidazol-1-yl)ethane (8–20) were designed to potentiate the MTZ framework against drug resistance and sperm. New compounds were 1.2–12.1 times more effective against MTZ-susceptible and -resistant strains of TV. All of the compounds exhibited high safety toward cervical (HeLa) cells and Lactobacillus. Thirty-eight compounds were scrutinized by CoMFA and CoMSIA techniques of 3D quantitative structure–activity relationship. Good predictive rpred2 values for CoMFA and CoMSIA models reflected the robustness of the predictive ability. This was validated by designing five new analogues (46–50), which were potently microbicidal (3–10 and 10–20 times against MTZ-susceptible and -resistant TV, respectively) and spermicidal. This in vitro study may have significant clinical relevance, which could become evident in due course.
PMCID: PMC4025769  PMID: 24900434
dithiocarbamate; metronidazole; piperidine; antitrichomonas; microbicidal; contraception

Results 1-25 (52)