BACKGROUND: Halitosis or oral malodor is characterized by unpleasant odor arising from the oral cavity. The prevalence of halitosis however is not studied extensively. METHODOLOGY: A structured questionnaire consisting of 15 questions was administered to 220 undergraduate students of Sharif Medical and Dental College, Lahore. RESULTS: Out of them 212(96.36%) students participated in the study. Among them 90(42.45%) were males and 122(57.55%) were females. Mean age of the students was 20.48±1.63 years. Average age of male was 21.41±1.66 years and of female was19.79±1.22 years. 89(42.0%) reported halitosis (95% C.I 35.3% to 48.9%), 90(42.5%) have no halitosis and 33(15.6%) did not know about It. Halitosis was reported among 30(33.3%) male and 59(48.4%) female. Present study showed that females have more awareness of malodor than the male students. CONCLUSION: The results of this study indicate higher prevalence and awareness of halitosis among this population consisting of dental students. The awareness of halitosis as an individual entity should be promoted to the general population and the therapeutic measures should be made available to all.

Students have unique preferences when it comes to knowledge acquisition, information processing, retention in memory, and recall. This study is aimed at examining the preferred learning styles of medical and dental undergraduate students of Pakistan. It is also aimed at investigating the influence of gender, preclinical or clinical academic year, and academic record on the preferred learning style. A descriptive cross-sectional study was conducted in Pakistan. The learning styles of undergraduate students were identified using visual, aural, read/write, and kinesthetic (VARK) questionnaire. Students were also asked about their satisfaction towards teaching style of their teachers in institute. Descriptive statistics were done to characterize the learning styles of the students. The Fisher test and chi-square test were used to compare the learning preferences between genders and public/private sector students and among preclinical/clinical years. A p value of less than 0.05 was considered significant. A total of 1473 students participated in the study. Among the students, 39.37% preferred unimodal learning style whereas 60.62% preferred multimodal style. Kinesthetic (K) and visual (V) were the most preferred unimodal styles. The preferred learning styles of female students are aural (A), visual (V), and kinesthetic (K), whereas male students preferred visual (V) and kinesthetic more (K). Students with lower academic record chose unimodal styles in comparison to high achievers that chose multimodal styles. Students of clinical year preferred multimodal and quadmodal styles in comparison to preclinical year students. An alarming 78% of students were dissatisfied with their teacher’s instructional style. Majority of students prefer multimodal learning styles over unimodal style. Gender, public/private sector, and academic record have influence on the preference of learning styles. Majority of the students are dissatisfied with their teacher’s instructional style and rely on social media platforms for understanding. Academics need to adapt their teaching methods according to student preferences in order to get better graduates.

Background Polymicrobial biofilms are notorious for causing intraoral tissue destruction. Streptococcus sanguinis and Streptococcus mitis, commensals of oral cavities, have been found co-existing with C. albicans in resistant oral infections. There is an urgent need to find alternative treatment options. This study aims to assess the efficacy of garlic (G) and bakuchiol (Bk) combination against candida virulent genes and their subsequently secreted proteins. Methods In vitro single species biofilms of C. albicans, and mixed species biofilms formed in combination with streptococci were exposed to bakuchiol and garlic extract (Bk+G). Gene expression of agglutinin-like sequence (ALS1), (ALS3), adhesin-like wall proteins (HWP1) and aspartyl proteinases (SAP5) were determined using qPCR and their subsequent proteins were assessed through Western blotting. Results Virulent genes were significantly downregulated in single species biofilms when they were treated with Bk+G combination. However, Bk+G did not have significant effect on ALS1 and HWP1 gene in polymicrobial biofilms. ALS3 and SAP5 were significantly downregulated in Bk+G treated polymicrobial biofilm. Similar results were portrayed in Western blotting. Conclusion Bk+G combination exhibited antimicrobial effects against single and mixed species biofilms. The findings might provide insights for treating resistant candida infections. This combination could potentially serve as an herbal alternative to traditional antifungals following further research.

Objective: Chlorhexidine mouthrinses are considered a gold standard as an adjunct treatment of oral infections. However, owing to its toxicity, discoloration of tooth surface and the emerging prevalence of drug-resistant species, attention is being given to exploring natural alternatives to the drug. Methods: The experiment was carried out in Azra Naheed Center for Research and Development (ANCRD), Superior University, Lahore, Pakistan from September 2018 till May 2019. Biofilms and planktonic cells of C. albicans alone and in combination with streptococci were subjected to chlorhexidine, allium sativum and bakuchiol individually and to allium-bakuchiol combination. Kirby-Bauer test, antifungal susceptibility testing, CFU count and drug synergy assessment was done on planktonic cells. Dynamic biofilms were formed to mimic conditions similar to oral cavity and CFU was determined. Results: MIC of all three agents was higher against mixed species when compared to single species planktonic cells and biofilm. Allium sativum and bakuchiol demonstrated synergistic effects. The decrease in CFU count and minimum biofilm reduction to salivary pellicle caused by allium sativum-bakuchiol was comparable to that of chlorhexidine. Conclusion: Thus, allium sativum-bakuchiol combination demonstrated antimicrobial effects similar to chlorhexidine against planktonic cells and dynamic biofilm. It could serve as a possible natural, economical alternative to chlorhexidine mouthrinses usually recommended in dental clinics. However, in vivo studies are required to determine the correct dosage of these agents. doi: https://doi.org/10.12669/pjms.36.2.1457 How to cite this:Fahim A, Himratul-Aznita WH, Abdul-Rahman PS. Allium-sativum and bakuchiol combination: A natural alternative to Chlorhexidine for oral infections? Pak J Med Sci. 2020;36(2):---------. doi: https://doi.org/10.12669/pjms.36.2.1457 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Interactions between oral microorganisms contribute to formation of polymicrobial communities on surfaces and prosthetics. Since streptococci are early colonizers, the ability of Candida albicans to adhere to streptococci paves the way for an additional surface for candidal colonization and propagation. This study aimed to investigate the molecular response of C. albicans to two species of streptococci, i.e. Streptococcus mitis and Streptococcus sanguinis in in vitro salivary biofilms. Single, dual and mixed species salivary biofilms were formed for 24 h. Biofilm biomass and cellular metabolic activity of microbial species were assessed by crystal violet (CV) staining and XTT reduction assay, respectively, followed by scanning electron microscopy. ALS1, ALS2 and ALS3 genes were screened and quantified using qPCR. CV and XTT analysis showed a significant increase in biofilm biomass and cellular metabolic activity of two dual species and mixed species in comparison to single species biofilm. SEM analysis revealed formation of candidal hyphae under influence of streptococci. ALS1 and ALS3 were significantly overexpressed in a mixed species biofilm, in comparison to dual species and single species biofilms. Presence of S. mitis and S. sanguinis assisted in the proliferation of C. albicans which may augment tissue invasion. This study proposes substantial contribution of bacteria in propagation of C. albicans biofilm. Hence, in oral fungal conditions, promotion of the infection may be contingent upon the bacterial constituent, a prospect which is frequently neglected and requires more research.

The purpose of this meta-analysis was to strengthen the credibility of primary research results by combining open-source scientific material, namely a comparison of craniofacial features (Cfc) between Crouzon's syndrome (CS) patients and non-CS populations. All articles published up to October 7, 2021, were included in the search of PubMed, Google Scholar, Scopus, Medline, and Web of Science. The PRISMA guidelines were followed to conduct this study. PECO framework was applied in the following ways: Those who have CS are denoted by the letter P, those who have been diagnosed with CS via clinical or genetic means by the letter E, those who do not have CS by the letter C, and those who have a Cfc of CS by the letter O. Independent reviewers collected the data and ranked the publications based on their adherence to the Newcastle-Ottawa Quality Assessment Scale. A total of six case-control studies were reviewed for this meta-analysis. Due to the large variation in cephalometric measures, only those published in at least two previous studies were included. This analysis found that CS patients had a smaller skull and mandible volumes than those without CS.in terms of SNA° (MD = −2.33, p = <0.001, I2 = 83.6%) and ANB°(MD = −1.89, p = <0.005, I2 = 93.1%)), as well as ANS (MD = −1.87, p = 0.001, I2 = 96.5%)) and SN/PP (MD = −1.99, p = 0.036, I2 = 77.3%)). In comparison to the general population, people with CS tend to have shorter and flatter cranial bases, smaller orbital volumes, and cleft palates. They differ from the general population in having a shorter skull base and more V-shaped maxillary arches.

Objective: With recent advancement in technology, generation Z has become addicted to gadgets, particularly smartphones. The fear of being separated from mobile phones, is known as Nomophobia. The aim of our study was to ascertain whether nomophobia and/or problematic mobile phone use has any influence on decision-making of undergraduate dental students. Methodology: A descriptive, cross-sectional study was conducted on dental students of Pakistan. The level of nomophobia was determined using the Nomophobia Questionnaire (NMP-Q), Mobile Phone Problematic Use Scale (MP-PU), and the decision-making skills of dental students was determined using the Melbourne Decision Making Questionnaire (MDM-Q). Results: The mean score of the NMP-Q was 102.49 ± 11.07, and the mean score of MP-PU Scale was 83.45 ± 17.82. Positive correlation was present between the measure of mobile phone problematic use scale and nomophobia. Similarly, positive correlations were discovered between nomophobia and the measure of buck-passing, procrastination and hypervigilance in regard to decision-making. As for the MDM-Q scale, the procrastination measure had a high correlation with the decision-making value. Conclusion: The results of our study suggest an increasing prevalence of nomophobia among dental students of Pakistan. Keywords: Smartphone; Nomophobia, Decision making, Dental student

Objective: To evaluate the effect of different preparations of fluoride gels on the salivary pH of albino rats. Material and Methods: This experimental study consisted of 40 Albino rats randomly divided into four equal groups. Group A was the control group and received no intervention. Experimental group B received a topical application of 0.2% sodium fluoride gel. Experimental group C received topical application of stannous fluoride gel 0.4%. Experimental group D received topical application of APF gel (1.23% acidulated phosphate fluoride gel). The different preparations of the gels were applied once daily for 4 minutes on the occlusal surface of the right maxillary molars for 14 days. Salivary pH values were recorded immediately after the application of gels with the help of pH paper on day 1 and day 14. Results: There was a significant difference in the pH level of groups B, C and D after 14 days of fluoride application (p < 0.05). The nonparametric Kruskal Wallis test was applied for the comparison between the groups. Conclusion: This study concluded that all the fluoride gels after administration caused the acidic pH of saliva with the most acidic effect produced by APF gel.