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   Table of Contents - Current issue
Coverpage
January-March 2023
Volume 8 | Issue 1
Page Nos. 1-24

Online since Thursday, March 30, 2023

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ORIGINAL ARTICLES  

Prevalence of dental fluorosis and dental caries among people consuming water in urban Vadodara: A cross-sectional study p. 1
Sangita Vashrambhai Patel, Rahul D Khokhariya, Jagruti Rathod, Deya G Chatterji, Jesal Patel
DOI:10.4103/ed.ed_22_22  
Introduction: High fluoride concentration in groundwater can result in endemic fluorosis and is a major public health problem in India. Aim: To know the association between prevalence of dental fluorosis and dental caries and fluoride level in the water in urban Vadodara. Methodology: An analytical ecological cross-sectional study was conducted in 4 zones of Vadodara district. Thirty-eight water samples were sent to Gujarat Ecology Society in Vadodara for chemical analysis to test fluoride levels. The data collection was made by house-to-house visit twice during the study involving 2,609 participant interviews. These participants included 449 children belonging to the age group of <15 years. Examination for dental fluorosis and dental caries using Dean's criteria was done. Chi-Square and Mental Hensel Chi-Square were applied for statistical analysis. Results: The prevalence of dental fluorosis was 17.36% in high-fluoride areas and 22.46% in normal-fluoride areas among children (<15 years of age). There was no statistically significant association in dental fluorosis between high-fluoride areas and normal-fluoride areas (P = 0.2533). The prevalence of dental caries was 29.26% in high-fluoride areas and 75.36% in normal-fluoride areas. There was a statistically significant association in dental caries between high-fluoride areas and normal-fluoride areas (P ≤ 0.0001). Conclusions: The risk of dental caries was clearly higher in the areas showing normal-fluoride content compared to places with high fluoride levels in drinking water. The risk of dental fluorosis was higher in area with high-fluoride level but the difference was not statistically significant.
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Prediction of the recurrence risk of Graves' disease after antithyroid drug therapy p. 7
Qiang Zhang, Ying Fu
DOI:10.4103/ed.ed_23_22  
Objective: This study aimed at observing the prognostic factors for Graves' disease (GD) recurrence after treatment with antithyroid drugs. Patients and Methods: Clinical data for 247 patients with primary GD hyperthyroidism diagnosed in the endocrinology department of our hospital between March 2014 and February 2017 were collected. Age, sex, thyroid size, thyroid hormone levels, thyrotropin receptor antibody (TRAb), thyroglobulin antibody, thyroid peroxidase antibody, urinary iodine, and other prognostic factors before and after treatment were analyzed and compared. Results: After ATD treatment, 151 cases were in remission and 96 cases were not. The mean age at diagnosis was 37.3 ± 14.0 years in the remission group and 31.2 ± 12.2 years in the nonremission group (P = 0.032). The levels of free triiodothyronine (FT3) in the nonremission group and remission group were 25.7 ± 8.4 and 18.3 ± 9.1 pmol/L, respectively. The proportion of patients with goiter and thyroid-associated orbitopathy was higher in the nonremission group than the remission group. Similarly, both the FT3/FT4 ratio (4.63 ± 1.08 and 3.72 ± 0.69, P = 0.020) and TRAb level (27.4 ± 10.7% and 18.1 ± 9.8%, P = 0.001) significantly increased. Logistic regression analysis indicated that high thyroid volume (odds ratio [OR] =9.647, P = 0.003), high free T3/free T4 ratio (OR = 1.541, P = 0.019), and TRAb level (OR = 1.317, P = 0.002) were independent factors influencing drug treatment failure and were associated with poor prognosis. After drug withdrawal, patients with distinctly enlarged thyroid glands, thyroid-associated eye disease, and low serum thyroid-stimulating hormone (sTSH) levels were higher in the nonremission group than in the remission group. Conclusion: GD patients with goiter, high TRAb level and high FT3/FT4 ratio had poor poor response to drugs. The recurrence rate was high in patients with thyroid-related eye disease, and sTSH delayed recovery.
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A critical evaluation of anthropological, biochemical, and geo-climatic factors related to chronic kidney disease with unknown etiology in Sri Lanka p. 13
Santhushya Hewapathirange, Ayesha Madagedara, Rohana Chandrajith, Nishantha Nannayakkara
DOI:10.4103/ed.ed_27_22  
Background: Chronic kidney disease of unknown etiology (CKDu) is a critical health issue among farming communities of the dry zone in Sri Lanka. Aims and Objectives: This study was conducted to identify the possible anthropological, biochemical, and geo-environmental characteristics of CKDu, comparing an affected and nonaffected community. Materials and Methods: Serum creatinine (SC) levels were measured and estimated glomerular filtration rate values were calculated in both communities based on a stratified sampling method. Anthropological data, such as population structure, farming behavior, and poverty statistics, were obtained from the respective government officials. Geo-climatic data including elevation, monthly average temperature, rainfall, humidity, ultraviolet intensity, and sunshine hours were obtained for study areas. Results: The most striking difference between the two communities is significantly high SC in male individuals between the age categories of 40–60 in the CKDu endemic area in comparison to nonendemic participants in the same age category from the nonendemic area. Conclusion: Significant differences were observed in migration, drinking water sources, and hot humid environment between the two studied regions.
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SHORT COMMUNICATIONS Top

Sustaining and augmenting the pace of ongoing prevention and control activities to attain the goal of leprosy-free world p. 20
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
DOI:10.4103/ed.ed_29_22  
Leprosy is a chronic infectious disease, predominantly affecting the skin and peripheral nerves, and is completely curable with multidrug therapy. Considering the global estimates, there is no doubt that disease-related control activities have significantly improved in endemic nations due to the campaigns at different levels and the integration of the disease-specific activities with the general health services, as a result of which diagnostic and therapeutic aspects of the disease have improved. A number of global strategies have been launched by the World Health Organization to support all nations to strengthen their routine prevention and control activities. In conclusion, leprosy is a major public health concern in endemic nations and there is an immense need to improve the detection rates and ensure the expansion of the treatment. In addition, there is a great need to empower the affected people, to eventually improve their integration into society.
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Necessity to employ a multifaceted approach to minimize the incidence of burns and associated sequels in low- and middle-income nations p. 22
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
DOI:10.4103/ed.ed_30_22  
The problem of burns has been recognized as one of the major global public health concerns primarily due to the millions of people succumbing to the burn-related complications each year. In addition, nonfatal burns are a predominant cause of morbidity, disability, impaired quality of life, and prolonged hospitalization, which are commonly associated with secondary infections. Acknowledging the fact that the developed nations have made remarkable progress in reducing the death rates through the strengthening of prevention strategies and improvement in medical care to the victims, it is very much possible to minimize the incidence of burns and the associated complications. To conclude, there is an immense need to have a multifaceted approach to minimize the incidence of burns and upgrade the quality of care offered to the victims, especially in low- and middle-income nations. Furthermore, sustained efforts are required to reduce the rates of disability and burn attributed death rates.
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