Agartala Government Medical College

ABSTRACTBackground:The surgical extraction of impacted mandibular 3rd molars is a common procedure in oral surgery. Choosing an appropriate incision technique significantly influences postoperative outcomes.Objective:This research evaluates the outcomes of different incision types in terms of postoperative complications, healing, and patient satisfaction.Materials and Methods:A comparative research was conducted involving 120 patients undergoing impacted mandibular 3rd molar extraction. Patients were divided into three groups based on incision type: triangular flap, envelope flap, and modified triangular flap. Postoperative pain, swelling, healing, and complications were assessed over two weeks.Results:The triangular flap showed faster healing and fewer complications, while the envelope flap resulted in less immediate postoperative pain. Modified triangular flaps demonstrated a balance between outcomes.Conclusion:Selecting an incision should be tailored to patient-specific needs and surgeon expertise, considering the nuances of each technique.

The aim of this research was to assess the microleakage of three different implant-abutment interface designs. A total of 60 implants were used in this investigation. These were divided into three groups. i.e., 20 samples in each group as follows: group I-conical hex implant and abutment interface, group II-internal hexagon and abutment interface, and group III-Morse taper implant and abutment interface. Staphylococcus aureus was cultivated and incubated for 24 hours at 37°C to create a bacterial suspension in brain-heart infusion broth. The assembly was taken out after 2 weeks of S. aureus culture broth submersion and allowed to remain submerged in 70% alcohol for 3 minutes. Microbial evaluation was conducted to assess the microleakage of all the samples, and scanning electron microscope with a ×1,000 magnification was used to evaluate and record the microgaps. All data were recorded and statistically analyzed. The least microleakage was found in conical hex implant and abutment interface group, i.e., 6.80 ± 2.58 followed by internal hexagon and abutment interface group (8.56 ± 3.14) and 10.24 ± 2.10 with Morse taper implant and abutment interface group. Statistically significant difference was obtained between different implant-abutment interface designs. The maximum gap was found in Morse taper implant and abutment interface group with a mean of 9.18 ± 1.62 followed by internal hexagon and abutment interface with a mean value of 7.98 ± 2.08 and conical hex implant and abutment interface group with a mean value of 7.30 ± 1.26. Statistically significant difference was obtained between different implant-abutment interface designs. In conclusion, the implant abutment connection is susceptible to microleakage despite the connection design. But, implants with conical hex connections demonstrated less microleakage and microgaps than those with internal hexagon and Morse taper connection design implants. A microgap within the implant and abutment interface might be a source of microorganisms, affect clinical and histological parameters, cause inflammation, and potentially jeopardize osseointegration. As a result, knowing the components that work well together helps overcome treatment planning issues. By altering implant designs, implant-abutment connections, and procedures, several inventions are produced to reduce marginal bone loss. How to cite this article: Mondal U, Bhargava A, Roy AK, et al. Comparative Evaluation of the Microleakage of Various Implant-Abutment Interface Designs: An In Vitro Study. J Contemp Dent Pract 2025;26(8):776-779.

Objectives: Medical education is evolving with the integration of newer approaches alongside traditional pedagogical methods based on didactic lectures. New learner-centred strategies foster a dynamic learning environment and enhance critical thinking amongst students. This study explores the impact of heutagogical teaching strategies compared to andragogical teaching–learning (TL) methods, specifically assessing their effectiveness in improving achievement motivation and academic confidence amongst 1 st -year MBBS students. Materials and Methods: The study employed a two-phase design: First, developing and validating a teaching learning questionnaire (TLQ) to assess and compare students’ perceptions of andragogical and heutagogical teaching methods, and second, assessing learning outcomes using TLQ. About 99 1 st -year MBBS students completed the TL questionnaire using a Likert scale. Teaching sessions were conducted on ‘Exercise Physiology’ using an andragogical approach and ‘Autonomic Nervous System’ using a heutagogical approach. Post-test assessments and student feedback from each session were analysed to determine the effectiveness of both methods. Results: In the first phase of the study, a 13-item TL questionnaire was developed after validation following standard procedures. It showed strong content validity (content validity index = 0.97 and content validity ratio = 0.88) and reliability (Cronbach’s alpha = 0.97 and intra-class correlation coefficient = 0.96). Factor analysis indicated two factors in the TLQ, accounting for 71.79% of the variance, with most items showing strong factor loadings. In the second phase, 1 st -year MBBS students expressed a preference for heutagogical teaching, with 76% favouring it over traditional methods and 98% reporting higher satisfaction with this approach. Students reported increased motivation, problem-solving skills, creativity, and confidence with the heutagogical style. Conclusion: This study highlights the significance of both heutagogical and andragogical TL methods in medical education to foster a dynamic and effective learning environment. The validated TLQ provides a reliable tool for evaluating teaching strategies across medical disciplines. This study also underscores the potential of heutagogical learning in developing achievement motivation and confidence amongst medical students. Further research with larger sample sizes is recommended to confirm these findings and assess the broader applicability of both TL strategies.

Precipitate labor and neonaticide can present with overlapping features, often posing significant challenges in forensic interpretation. Differentiating between these possibilities is essential for reaching accurate medicolegal conclusions. This case report examines the forensic complexities involved in distinguishing precipitate labor from neonaticide. A father brought a deceased neonate to the hospital, alleging that the mother had fatally slit the infant’s throat. In contrast, the mother claimed the injury occurred accidentally during an unexpected bathroom delivery. She stated that while attempting to cut an umbilical cord looped around the baby’s neck with a blade, she unintentionally caused the fatal wound. Autopsy findings revealed a full-term male neonate with multiple incised wounds on the neck, blunt trauma to the scalp, and bilateral subdural and subarachnoid hemorrhages. The combination of sharp and blunt force injuries, along with conflicting parental accounts, raised concerns about the true circumstances surrounding the death. Further complicating the case were the father’s delayed reporting and his claim of being unaware of the pregnancy. This report highlights the critical need for a comprehensive forensic investigation, including careful correlation of injuries with reported events and consideration of medical, psychological, and social factors in suspected cases of neonaticide.

BackgroundHollow viscus perforation is a surgical emergency with variable outcomes. The surgical Apgar score (SAS) offers a simple method for risk stratification, but its utility in the patient population is unclear. This study aimed to evaluate the role of SAS in predicting postoperative complications in patients undergoing surgery for hollow viscus perforation.MethodsThis prospective observational study included 106 patients aged 18 years and above who underwent surgery for hollow viscus perforation at a tertiary care center in Tripura, India, between August 2022 and January 2024. The SAS was calculated intraoperatively based on estimated blood loss, lowest mean arterial pressure, and lowest heart rate. Postoperative complications were graded using the Clavien-Dindo classification. The correlation between SAS and complication severity was analyzed.ResultsThe mean age of the participants was 41.3 ± 15.2 years, with male predominance (87%, 92/106). Gastric perforation was most common (67.9%, 72/106). The most frequently observed SAS was 6, accounting for 39.6% (42/106) of the cases. A strong negative correlation was found between the SAS and Clavien-Dindo grade (Spearman's ρ = -0.664, p < 0.001), indicating that lower SASs were associated with higher grades of complications.ConclusionThe SAS demonstrated a significant inverse correlation with postoperative complication severity in patients who had undergone surgery for hollow viscus perforation. The SAS may serve as a simple yet effective tool for predicting outcomes and informing postoperative management in this setting.

Food choices we make have profound implications on mental well-being, and this is an area that demands detailed investigation. Hence, this systematic review was conducted to synthesize evidence to elucidate if sugar consumption is associated with anxiety and depression. Electronic databases of PubMed, Cochrane, Scopus, Web of Science, Google scholar, and EMBASE were searched for relevant articles. Cross-sectional, cohort, and case-control studies assessing the influence of sugar consumption on anxiety and depression were included. The Newcastle Ottawa Scale was used for assessing the risk of bias. A systematic review was conducted according to PRISMA guidelines. Twenty-six articles were included for systematic review, out of which 14 were cross-sectional, 10 were cohort, and two were case-control studies. Risk of bias was assessed across all included studies. Nineteen studies were rated as high quality, while the remaining seven were of moderate quality. There was a considerable degree of heterogeneity between the studies, with a wide range of age groups and a lack of consistency in tools to measure anxiety and/or depression, and hence a meta-analysis was not conducted. However, an overall positive association was observed between high intake of sugar and increased risk of anxiety and depressive symptoms in different populations across the globe. Reducing sugar intake may serve as a modifiable risk factor for mental disorders, underscoring the need for public health interventions. A further understanding of the causal directions, as well as mediation mechanisms underlying the complex relationship between sugar consumption and mental disorders, is essential.

Cerebral palsy (CP) is a neurodevelopmental disorder characterized by permanent and non-progressive brain injury, typically associated with motor impairments and epilepsy. Psychiatric manifestations, though prevalent, often remain underrecognized and undertreated in patients with CP. Treatment choices in these individuals are particularly challenging due to their complex clinical presentations and increased vulnerability to medication side effects. While long-acting injectable antipsychotics (LAIAs) are established treatment options for various psychiatric conditions, evidence supporting their use in patients with CP is notably scarce. A 24-years-old patient with spastic quadriplegia presented with complaints of increased energy and grandiosity. She is a known case of bipolar disorder which was diagnosed at the age of 15 after overshadowing of symptoms for a long time. Despite these challenges she remains to be a high functioning adult pursuing college degree and continues participating in physical, occupational, language and speech therapy. In spite of trial of different antipsychotics and mood stabilizers, they failed to stop the cycling of moods. She also mentions unique effects of mood on her muscle spasticity and strength. She was started on Risperidone LAI which helped improve her mood and was apparent on the mental status examination after 2 weeks. This case highlights the promising role of LAIA formulations in psychiatric management of individuals with CP and this represents the first documented use of a LAIA in a CP patient with bipolar disorder. Further longitudinal studies are necessary to substantiate the long-term safety and efficacy of LAIAs in this special patient population.

Introduction: The COVID-19 pandemic brought unprecedented changes to human behavior due to widespread lockdowns, which restricted movement and altered daily activities. These disruptions not only affected people’s lifestyles but also had implications for interactions between humans and animals. Animal bite incidents, which pose significant public health concerns, may have been influenced by changes in human presence and activities. Present study investigates the effect of COVID-19 lockdowns on the frequency and characteristics of animal bites, focusing on factors such as gender, Socio-Economic Status (SES), types of animals, category of bites etc. A non-parametric statistical approach has been used to analyze the data and assess the impact of the lockdown. Objectives: The primary objective of this study was to investigate the effect of the COVID-19 lockdown on animal bite incidents by comparing the data recorded before and after the lockdown. The analysis focused on the following some key factors, like: Gender of the individuals affected by animal bites. Socio-economic status (SES) of the individuals. Type of animal responsible for the bite (e.g., dog, cat, wild animal). Category of bite (categorized by severity and treatment required) etc. etc. Methodology: 4246 Data were collected of animal bites cases being reported in the Anti Rabies Vaccination (ARV) clinic at the Agartala Government Medical College (AGMC) and GBP Hospital, Agartala, Tripura, during the year 2018 to 2023. The dataset included variables such as the gender of the victim, their socio-economic status, the type of animal responsible for the bite, the category of bite (mild, moderate, severe) etc. The non-parametric Wilcoxon Signed Rank Test was applied to the dataset, which does not assume a normal distribution, making it suitable for comparing the medians of two related samples: animal bite incidents before and after the Covid-19 Lockdown. Results: The Wilcoxon Signed Rank Test revealed a statistically significant reduction in animal bite incidents during the lockdown compared to the before lockdown period (p &lt; 0.05). Sub-group analyses provided further insights: Gender: Both males and females experienced a reduction in bite incidents, though the decrease was more pronounced among males. Socio-Economic Status: Lower SES groups showed a greater decline in bite cases, possibly due to stricter mobility restrictions in densely populated areas. Type of Animal: Dog bites, which represented the majority of cases, showed the most significant decline. Bites from stray animals also decreased, likely due to reduced human-animal encounters during the lockdown. Category of Bite: The proportion of severe bites remained relatively unchanged, suggesting that while overall bite incidents decreased, the severity of bites in individual cases did not. Discussion: The findings suggest that the COVID-19 lockdown had a significant impact on animal bite incidents, likely due to reduced human movement and interaction with stray or domestic animals. The results align with the hypothesis that fewer people on the streets and public spaces led to fewer opportunities for negative human-animal encounters, particularly with stray animals. Furthermore, the difference in the reduction of bites across SES groups points to how lockdown measures might have differentially affected various population segments, especially in urban versus rural areas. The analysis also highlighted that, while the frequency of bites decreased, the severity of bites in reported cases did not change substantially. This could imply that the nature of high-severity bites is more random or related to specific interactions that were less impacted by the lockdown. Conclusion: This study presents evidence that the COVID-19 lockdown significantly reduced the frequency of animal bite incidents. The Wilcoxon Signed Rank Test confirmed that the differences between before and post-lockdown periods were statistically significant across multiple demographic and socio-economic factors. These findings provide valuable insights into the indirect effects of large-scale public health measures on human-animal interactions. Future research should explore the long-term impacts of such disruptions and examine the role of animal management policies during emergencies to mitigate the risk of animal bites. Keywords: COVID-19, lockdown, animal bites, Wilcoxon Signed Rank Test, non-parametric analysis, socio-economic status, gender, type of animal, bite severity

Background: In 2022, NMC has introduced family adoption program as part Community Medicine Curriculum to sensitize upcoming medical professionals for the health needs of community. Objectives of the study were to assess perception towards FAP among first and second professional medical students of Agartala Government Medical College of Tripura and to determine the challenges encountered by the students during family adoption visits. Methods: A cross-sectional study was conducted among 1st and 2nd Professional MBBS Students of AGMC for a period of one month. All students of 1st and 2nd Professional were included with a sample size of 250. A semi structured questionnaire was used for data collection and data were analysed using SPSS v.29. Perception towards FAP was measured with 1-5-point Likert scale where 1 being lowest and 5 being highest score. Mean score of each item was measured. Study was approved by Institutional Ethics Committee of AGMC. Results: Total 210 students had participated. Regarding perception of students towards FAP, majority agreed that it will create health awareness in community and can understand dynamics of rural setup. Communication and leadership skill can be learned and it provide an early clinical exposure to students. Students had faced multiple challenges like, families expected curative treatment but students were not eligible to provide (47.8%), language barrier (26.8%), difficulty in graining trust (26.3%) and cooperation from the families (18.7%) etc. Conclusions: Family adoption helps the students to learn communication and leadership skill and it will improve health awareness in community.

Mobile genetic elements (MGEs) play a crucial role in the spread of carbapenem resistance. A study was undertaken to characterize MGEs and evaluate their contribution to the spread of carbapenem resistance in Escherichia coli and Klebsiella pneumoniae collected from three intensive care units (ICUs) of a tertiary care hospital in Tripura. Isolates were subjected to susceptibility testing, genotypic detection of carbapenemases and their transmissibility, whole-genome sequencing (WGS), and phylogenomic analysis. E. coli and K. pneumoniae were the dominant Enterobacterales, exhibiting resistance to the majority of antibiotics. WGS of carbapenemase-producing E. coli (n = 15/48,31%) and K. pneumoniae (n = 13/26,50%) revealed the presence of bla NDM-1,5,7 (n = 21), bla KPC-2 (n = 1), and bla OXA-181,232 (n = 8). Isolates were diverse and belonged to different sequence types, including epidemic clones (K. pneumoniae-ST16/101/147/231; E. coli-ST167/410/648). This study has noted the allelic shift of bla NDM-1 to bla NDM-5 similar to global reports. bla NDM-1,5,7-bearing plasmids were conjugative but those carrying bla KPC-2 and bla OXA-181,232 were non-conjugative. bla NDM-1,5,7 were present in diverse replicons: IncF-types (predominant), IncHI1B, IncX3, and IncX4, etc., while bla OXA-181,232 were present in ColKP3, corroborating with global studies. bla NDM-1,5 was associated with intact/truncated ISAba125 in Tn125, bla NDM-7 with IS3000, bla KPC-2 with ISKpn6, and ISKpn7 in Tn4401b, and bla OXA-181,232 with ∆ISEcp1 in Tn2013, depicting an ancestral genetic context noted globally. Study isolates were related to other Indian isolates, primarily from blood. The association with different MGEs noted in the study is similar to those in other parts of India and the globe, signifying that the genetic determinants are part of the global gene pool. These associations can facilitate the spread of carbapenem resistance, leading to outbreaks and treatment failures.