Abhishek Dubey

A cross-sectional study on predictors and significance of eating behavior of adolescent girls

Adolescent growth and development depend on multifactorial correlates such as socioeconomic status, dietary intake, nutritional knowledge, and quality of the food with special reference to eating behavior. Undernutrition status of adolescent girls is associated with inferior health and risk of obstetric complications in future. A cross-sectional study was carried out on 576 girls to assess the nutritional status and nutritional knowledge of adolescent girls (10–19 years) residing in rural, urban, and slum localities of Lucknow, India. Nutrient intake and eating behavior were assessed by 24-hour dietary recall method and eating behavior schedule, respectively. The results revealed that the eating pattern of adolescent girls was significantly different in three locality living population. Significant difference in nutritional knowledge score was also observed in girls of three localities. Association of eating with family and eating pattern was found to be significant in all three groups. Stunting was found significantly associated with eating behavior of the girls. Nutritional knowledge and eating behavior were significantly affected by each other; therefore, it can be concluded that eating behavior is associated with nutritional status and nutritional knowledge.

Effect of mandibular advancement device on sleep bruxism score and sleep quality.

Statement of problem. The use of mandibular advancement devices (MADs) in the treatment of sleep bruxism is gaining widespread importance. However, the effects of MADs on sleep bruxism scores, sleep quality, and occlusal force are not clear. Purpose. The purpose of this clinical study was to analyze the effect of MADs on sleep bruxism scores, sleep quality, and occlusal force. Material and methods. This uncontrolled before and after study enrolled 30 participants with sleep bruxism. Outcomes assessed were sleep quality, sleep bruxism scores (sleep bruxism bursts and sleep bruxism episodes/hour), and occlusal force before and after 15 and 30 days of using a MAD. Sleep bruxism scores were assessed by ambulatory polysomnography and sleep quality by using the Pittsburgh sleep quality index (PSQI). Occlusal force was recorded by using a digital gnathodynamometer in the first molar region on both sides. Statistical analysis was done by 1‐factor repeated measures ANOVA (&agr;=.05). Results. Statistically significant reductions in sleep bruxism bursts/h, sleep bruxism episodes/h, and PSQI scores were found after 15 and 30 days of using a MAD (P<.001). Statistically significant reduction in occlusal force on both sides was found only after 15 days (P<.001) but not after 30 days of using a MAD (P=.292 on left side, and P=.575 on the right side). Conclusions. The study showed a short‐term improvement in sleep bruxism scores, sleep quality, and reduction in occlusal force in sleep bruxism participants after using MADs.

Comparative evaluation of craniofacial anthropometric measurements in Indian adult patients with and without obstructive sleep apnea: A pilot study.

Aims: The study aimed to compare the craniofacial features of North Indian patients suffering from obstructive sleep apnea (OSA) to that of normal North Indian population. Materials and Methods: Selected 25 North Indian subjects (age: 18–65 years) were divided into two groups (OSA group [n = 14] and non-OSA group [n = 9]) according to the results of full night polysomnographic sleep study. Body mass index (BMI), neck circumference (NC), and lateral cephalograms were recorded for each subject in both groups and total 22 parameters of craniofacial anthropometric features were measured on lateral cephalograms for each subject. The differences in BMI, NC, and craniofacial features between the OSA and non-OSA groups were compared statistically. Results: Independent sample t-test was used to compare the differences between OSA group and non-OSA group. The results showed that the BMI, NC, bulk of tongue (tongue length, tongue height, and tongue area) and length of the soft palate (PNS-U) were significantly higher in OSA group. OSA group was also found to have inferior positioning of hyoid bone (MP-H, ANS-H, PNS-H, ANS-Eb), narrower superior and middle airway space (SPAS and MAS), antero-inferior positioning of mandible (Gn-C3, ANS-Me, SNB, N-Me) and lower cranial base flexure angle (N-S-Ba). Conclusion: Craniofacial features, which play an important role in the pathophysiology of OSA, differ significantly between North Indian patients suffering from OSA and normal North Indian population.

Association of Serum CRP level with Lung Cancer and Healthy Control of North Indian Population

BackgroundLung cancer is the major cause of cancer-related mortality worldwide. Chronic inflammation of the airway plays an important role in the alternations of bronchial epithelium and lung microenvironment, therefore provoking the pulmonary carcinogenesis and progression of lung cancer. The results may suggest that high inflammation level can be associated with the higher risk of lung cancer. CRP is an acute-phase protein produced in the liver in response to elevated cytokine levels after an inflammatory stimulus. C-reactive protein (CRP) a systemic marker of chronic inflammation is associated with increased lung cancer risk. Material and MethodologyThis case-control study was conducted on 40 lung cancer patients and 30 healthy controls. CRP level was measured in serum by ELISA kits. ResultsElevated serum CRP level was found in lung cancer patients as comparison to healthy controls. This study shows significant association between the serum CRP level of lung cancer patients and healthy controls (p<0.0001) and also showed significant association between smoker, ex-smoker and non-smokers lung cancer patients as well as in healthy controls (p<0.0001). ConclusionHigher CRP levels were found in lung cancer patients as compared to healthy controls. The higher CRP level was also observed in Smoker, Ex-smoker as compared to non-smoker in lung cancer patients and healthy control. Key-wordsLung Cancer, CRP, Inflammatory Stimulus, Cardiovascular disease, Biomarker INTRODUCTION Lung cancer is the major cause of cancer-related mortality in both men and women worldwide [1] . Chronic inflammation in airway plays an important role in the alternations of bronchial epithelium and lung microenvironment provoking the pulmonary carcinogenesis and progression of lung cancer. The results may suggest that high inflammation level can be associated with the higher risk of lung cancer. It is known that pro-inflammatory cytokines such as interleukin 1, interleukin 2, tumor necrosis factor alpha and tumor growth factor are able to stimulate the production of C-reactive protein (CRP) as well as influence survival, growth, mutation, proliferation, differentiation, and migration of tumor cells [2] . C-reactive protein (CRP) a Access this article online Quick Response Code Website:

A Pilot Study to Determine the Effect of Three Months of Oral Appliance Therapy using a Mandibular Advancement Device on HbA1c in Subjects with Type 2 Diabetes Mellitus and Obstructive Sleep Apnea: OSA with Type II Diabetes Mellitus

PURPOSE Continuous positive air pressure (CPAP) is recommended for obstructive sleep apnea (OSA) with type 2 diabetes mellitus (T2DM) but cost and compliance are major barriers. A mandibular advancement device (MAD) may be an economical, feasible alternative to CPAP. Various studies have been published to recommend MAD as an alternative to CPAP for OSA, but not regarding its efficacy for patients having OSA as well as T2DM. This study aims to objectively and subjectively evaluate oral appliance therapy using a MAD in patients having OSA as well as T2DM. MATERIALS AND METHODS Patients who visited the hospital clinic having OSA as well as T2DM were recruited. After giving informed consent, participants were divided into three equally sized groups of three grades of OSA (mild, moderate, severe) on the basis of a polysomnography report and were given intervention of MAD at 50% of maximum mandibular protrusion and 20% of maximum interincisal opening. Objective outcomes were HbA1c level and apnea hypopnea index score (AHI). Subjective outcomes were Epworth Sleepiness Scale (ESS) and the Berlin Questionnaire. All outcomes were assessed before and after 3 months of intervention. RESULTS A statistically significant difference was seen in all outcomes after intervention with MAD (p < 0.01) in all groups except HbA1c level in participants having severe OSA. CONCLUSION MAD may be recommended in patients having OSA as well as T2DM. This study provides evidence to inform health care workers about possible use of MAD in OSA with T2DM.

Incidental case of left lung hypoplasia in a postabortal young female

Congenital malformations of the lung are extremely rare with an incidence of pulmonary hypoplasia around 1–2/12,000 births. Boyden has categorized three degrees of malformation including (i) agenesis in which there is complete absence of the lung and bronchus and no vascular supply to the affected side, (ii) aplasia in which there is the presence of rudimentary bronchus with the absence of pulmonary parenchyma, and (iii) hypoplasia in which there are variable amounts of bronchial tree, pulmonary parenchyma, and supporting vasculature. Here, we present an incidental case of pulmonary hypoplasia in a young female.

Obstructive sleep apnea risk for driving license applicants in India – A community based study

OBJECTIVES To determine the risk of obstructive sleep apnea (OSA) for male permanent driving license (DL) applicants of Lucknow, India. MATERIAL AND METHODS In this cross-sectional community based, study body mass index, waist-hip ratio, blood pressure of each subject were determined as an anthropometric parameter along with the history of habit of smoking, tobacco chewing, alcohol consumption. STOP-Bang (Snoring, Tired or sleepy, Observed apnea, high blood Pressure, Body mass index, Age, Neck, Gender) Questionnaire - a scoring risk assessment tool - was applied for assessment of OSA risk (high OSA risk defined by score ≥ 3) for 542 male DL recipients at 2 Regional Transport Office (RTO) centers in Lucknow, India. The statistical software SPSS 17.0 was applied to the testing. RESULTS In total 23% (N = 125) of participants were found with the risk of OSA. High blood pressure (≥ 140/90 mm Hg) was found for the maximum number of participants (40.5%) followed by neck circumference > 40 cm (17.1%), age (> 50 years old) (15.3%), snoring (12.3%) and tired/sleepy (10.5%). Mean values of age, anthropometric measurements and blood pressure were observed significantly higher (p < 0.001) for participants with the OSA risk. In this population the risk of OSA risk (STOP-Bang score ≥ 3) was observed for 6.7% of young (< 35 years old), 34% of middle (35-45 years old) and 73% of elder age adults (> 45 years old). CONCLUSIONS In view of findings of this study a high number of male driving license applicants were observed with the risk of OSA. Therefore efforts should be made to develop a national screening guideline/protocol for the OSA risk assessment for driving license applicants in India. This may reduce the possibility of road traffic accidents due to the OSA-associated fatigue and drowsiness behind the wheels. Int J Occup Med Environ Health 2018;31(1):25-36.

Prospects of mandibular advancement device (MAD) as a preferred treatment of obstructive sleep apnea in India: a systematic review

Obstructive sleep apnea (OSA) is an independent risk factor for increased cardiovascular and cerebro-vascular morbidity and mortality. OSA leads to loss of human life and huge economical burden to our Society worldwide. The adults prevalence of OSA ranges between 9.3-13.5% in India. India is the second largest populated country of the world and by the end of 2030 it may become the most populated nation. This developing nation is already known as the worlds capital of T2 DM, and other non-communicable diseases like Obesity, Hypertension, Stroke, Ischemic heart diseases (IHD), Hypercholesterolemia congestive heart failure are on a rising trend. These cardiovascular disorders were found to be associated with OSA. OSA treatment may improve these co-morbid conditions. Continuous positive airway pressure (CPAP) is a preferred choice for OSA treatment in western and developed countries. In India, where CPAP is out of the reach of most of the OSA affected population due to high cost and other socio-economic and cultural factors, MAD may become a preferred treatment option. MAD is cheaper than CPAP and generally equally effective. The patients suffering from sleep-related breathing disorder (SBD) may have an alternative to CPAP or surgery for their disease management. Mandibular Advancement Device (MAD) may become an additional standard treatment of OSA in India, and has great potential for reducing associated undesirable cardiovascular co-morbidities and mortalities. This review highlights the prospects of MAD as a preferred treatment of Obstructive Sleep Apnea in India by extensively researching scientific literature, PubMed, Google Scholar, scientific, and academic web portals.

Management of severe obstructive sleep apnea using mandibular advancement devices with auto continuous positive airway pressures.

The use of continuous positive airway pressures (CPAP) is considered standard treatment of moderate to severe obstructive sleep apnea (OSA). Treatment of the disease poses a great challenge not only for its diagnostic purpose but also for its treatment part. In about 29-83% of the patients, treatment is difficult because of non-compliance resulting due to high pressures, air leaks and other related issues. In such situations, alternative methods of treatment need to be looked for so as to ascertain better management. Mandibular advancement devices along with CPAP may show better treatment outcome in specific situations.