Spatial analysis has been vital in mapping the spread of diseases and assisting in policy making. Targeting diarrhea transmission hotspots is one of the potential strategies for reducing diarrhea cases. This study aimed to examine the spatial-temporal variations and to identify the modifiable determinants of diarrhea while controlling for the spatial dependence in the data. An ecological study on diarrhea data from DLHS-3 and NFHS- 4 in India. Moran’s I and LISA were used to detect the spatial clustering of diarrhea cases and to test for clustering in the data. Spatial regression was used to identify the modifiable factors associated with the prevalence of diarrhea. The study comprised of the prevalence of diarrhea among the children below the age of five years (U-5 s) across different states in India. The determinants of diarrhea were obtained using spatial lag models. The software used were GeoDa 1.6.6 and QGIS 2.0. The presence of spatial autocorrelation in DLHS-3 and NFHS-4 (Moron’s I = 0.577 and 0.369 respectively) enforces the usage of geographical properties while modeling the diarrhea data. The geographic clustering of high-prevalence districts was observed in the state of UP consistently. The spatial pattern of the percentage of children with diarrhea was persistently associated with the household with a sanitation facility (%) (p = 0.023 and p = 0.011). Compared to the diarrhea cases in the period 2007–2008, no much reduction was observed in the period 2015–2016. The prevalence of diarrhea and percentage of household with sanitation were ranging between 0.1–33.8% and 1.3–96.1% in the period 2007–2008 and 0.6–29.1% and 10.4–92.0% in the period 2015–2016 respectively. The least and highest prevalence of diarrhea being consistently from Assam and UP respectively. Despite improvements in controlling spread of diarrheal disease, the burden remains high. Focus on widespread diarrheal disease control strategy by addressing the social determinants of health like basic sanitation is crucial to reduce the burden of diarrhea among U-5 s in India. The identification of hotspots will aid in the planning of control strategies for goal setting in the targeted regions.

Background: Accidental ingestion of a dental bur during the dental procedure is a rare, but a potentially serious complication. Early recognition and foreign body retrieval is essential to prevent adverse patient outcomes. Case presentation: A 76-year old male patient, presented to the department with a chief complaint of sensitivity in his upper right back tooth due to attrition. After assessing the pulp status, root canal therapy was planned for the tooth. During the procedure, it was noticed that the dental bur slipped out of the hand piece and the patient had accidentally ingested it. The patient was conscious and had no trouble while breathing at the time of ingestion of the bur although he had mild cough which lasted for a short duration. The dental procedure was aborted immediately and the patient was taken to the hospital for emergency care. The presence and location of the dental bur was confirmed using chest and abdominal x-rays and it was subsequently retrieved by esophagogastroduodenoscopy (EGD) procedure under general anaesthesia on the same day as a part of the emergency procedure. The analysis of this case reaffirms the importance of the use of physical barriers such as rubber dams and gauze screens as precautionary measures to prevent such incidents from occurring. Conclusion: Ingestion of instruments are uncertain and hazardous complications to encounter during a dental procedure. The need for physical barrier like rubber dam is mandatory for all dental procedures. However, the dentist should be well trained to handle such medical emergencies and reassure the patient by taking them into confidence. Each incident encountered should be thoroughly documented to supply adequate guidance for treatment aspects. This would fulfil the professional responsibilities of the dentist/ clinician and may help avoid possible legal and ethical issues. This case report emphasizes on the need for the usage of physical barriers during dental procedures in order to avoid medical emergencies.

Background: There have been numerous cone-beam computed tomography (CBCT) studies done over the years to analyze the canal configurations among various racial and ethnic population groups. Several of these studies have highlighted a certain consistency in the incidence of particular features within these population subsets. Aim: The study aimed to analyze the root morphology and canal configurations of the maxillary first premolar (Mx1PM) in the Indian Dravidian subpopulation using CBCT. Setting and Design: This study involved a retrospective analysis of 200 CBCT scans, which included 400 Mx1PM. Methods: The CBCT images were evaluated, and the number of roots and canal configurations was recorded as per the Vertucci's classification. Statistical Analysis: Variations in the number of roots and canal anatomies were statistically interpreted using the Chi-square test of association with the significance level set at P < 0.05. Results: Among the 400 Mx1PM studied, 116 (29%) teeth displayed single roots and 284 (71%) showed the presence of two roots. The single-rooted premolars revealed a varied canal configuration with a predominance of Vertucci's Type II configuration in around 53.4% of the Mx1PM. The two-rooted premolars revealed 100% Type I canal configuration. Conclusion: The Mx1PM studied predominantly showed the two-rooted morphology with independent canals in each root. There was no significant difference between the teeth on either side of the same arch. The CBCT is an excellent nondestructive modality that can help us study the internal anatomy of pulp space accurately.

The occurrence of morphological deviations in root canal anatomy is challenging and can influence treatment outcomes. While mandibular second molars typically have 2 roots and 3 canals, a unique case emerged in a 23-year-old Indian male with a symptomatic permanent left mandibular second molar showing three distal, two mesial canals, and two roots. The tooth presented as non-mobile but tender on percussion. The patient was diagnosed with symptomatic irreversible pulpitis with symptomatic apical periodontitis. The presence of mid distal canal was radiographically and visually confirmed with the aid of limited FOV cone-beam computed tomography and the dental operating microscope. Successful nonsurgical root canal treatment with 6-month follow-up has been documented in this case report.

The maxillary deciduous molar periapical radiograph often presents a diagnostic challenge for the clinician due to the overlapping of their roots with the developing premolar tooth bud. Clear and distortion free images are necessary for decision making while planning the treatment. However, the practical anatomical difficulties discourage the clinician from using the paralleling technique in children. While looking for an alternative technique, it was hypothesized in the literature that the 20 degree paralleling compromise technique suggested by Van Aken (1969), could override the anatomic challenges in children and provide images that are superior compared to those recorded with the bisecting angle technique. To compare the image quality of maxillary deciduous molar IOPAR taken using the “20 degree paralleling compromise technique” with that taken using the “bisecting angle technique”. Parallel double blinded randomized clinical trial. Sixty children who fulfilled the inclusion criteria were randomly split into two groups. In group A, the bisecting angle technique was used and in Group B the 20 degree paralleling compromise technique was used. The radiographs were categorized into three groups according to the quality of the image (1: Foreshortened image of the roots, 2: Elongated Image of the roots, 3: Undistorted well-defined image) by two independent observers who were blinded to the study and then compared. The obtained data was analysed for inter and intra observer agreements using Kappa statistics and analyzed for significance using the Chi square test. The p values obtained for category 1 and 2 were 0.21 and 0.99 for observer 1 and 0.16 and 0.33 for observer 2 respectively. Under the conditions of the study, there was no difference in the image quality of maxillary deciduous molar roots on IOPAR recorded using either the “bisecting angle” or the “20 degree paralleling compromise” techniques.

Aim: The present study evaluated the tissue-dissolution ability of 3% sodium hypochlorite (NaOCl) and two other irrigants, namely, 10% calcium hypochlorite and 13.8% chlorine dioxide (ClO₂) at different temperatures, keeping isotonic saline as control. Materials and Methods: The bovine muscle tissue specimens which were prepared for the study, were weight adjusted (50 ± 5 mg). One hundred and twenty frozen tissue samples were distributed equitably between the four groups. The experiments were conducted at three different temperature slabs, that is, room temperature, 37°C and 45°C, respectively. The 30 tissue samples in each group were immersed in 5 mL of the allocated test solution at the desired temperature for a total of 20 min, with change of solution done every 2 min. At the end of the 20-min experiment period, the tissues were carefully removed, blotted dry on absorbent paper, and weighed on a precision balance. The percentage weight loss of the specimens was then recorded for the experiment period. Results: The results of this study showed that at room temperature, the 3% NaOCl solution presented maximum tissue dissolution, whereas at 37°C, 13.8% ClO₂solution was most effective in dissolving the tissue. However, when the temperature was raised to 45°C, all the three test solutions were equally effective in their tissue-dissolving capacity. Conclusion: The present study showed that heating the solutions enhances their ability to dissolve organic material.