The use of denture adhesives (DA) and their role in prosthodontics has been a conflicted topic both in clinical practice and dental education. The use of adhesives, are viewed as poor reflection of their clinical skills and prosthetic expertise or to provide retention to an ill-fitting prosthesis by many dentists. These conflicting views have raised many doubts among practicising dentists on the use of DAs in their clinical practice. The aim of this study was to assess the knowledge, attitudes and practices of DA use among private dental practitioners' of Jabalpur city, Madhya Pradesh. This descriptive, cross-sectional survey was conducted using a self-administered questionnaire involving private dental practitioners of Jabalpur city. A total of 172 private dental practitioners of Jabalpur made up the sample of the study. A comprehensive, closed-ended, self-administered questionnaire was employed which was designed to collect the sociodemographic details and to assess the knowledge, attitudes and practices of DA use among private dental practitioners'. The institutional review committee approved the study. Data were imported to the SPSS 13.01 program to draw the means and percentages. Majority of the dentists were males (55 %), preponderance (68 %) of the dentists were in the 21-30 years age-group. Greater part of the study population comprised of general dental practitioners (GDPs) (81 %). When the subjects were questioned if DA were soluble in saliva, 32 % of the GDPs replied wrongly. Similarly 25 % of the GDPs didn't know that using DA with incompletely removed old DA affected tissue health. Zinc containing DA are recently held responsible for causing neurological diseases on their prolonged usage, 71 % of the GDPs and 74 % of other specialists were unaware in this context. A total of 115 (83 %) GDPs, 6 (100 %) prosthodontists and 22 (81 %) other specialist's used DA as a beneficial adjunct in their clinical practice. DA being used frequently by the dentists, unfortunately they did not have sufficient knowledge regarding the material. The attitude is a reflection of an individual's knowledge, which was also not homogeneous. By pursuing continuing education courses, the practitioners can update themselves regarding new technology and materials, thus improving the standard of care for prosthodontic patients.
Idiopathic normal pressure hydrocephalus (iNPH) is the most common cause of hydrocephalus in adults. The diagnosis may be challenging, requiring collaborative efforts between different specialists. According to the International Society for Hydrocephalus and Cerebrospinal Fluid Disorders, iNPH should be considered in the differential of any unexplained gait failure with insidious onset. Recognizing iNPH can be even more difficult in the presence of comorbid neurologic disorders. Among these, idiopathic Parkinson's disease (PD) is one of the major neurologic causes of gait dysfunction in the elderly. Both conditions have their peak prevalence between the 6th and the 7th decade. Importantly, postural instability and gait dysfunction are core clinical features in both iNPH and PD. Therefore, diagnosing iNPH where diagnostic criteria of PD have been met represents an additional clinical challenge. Here, we report a patient with parkinsonism initially consistent with PD who subsequently displayed rapidly progressive postural instability and gait dysfunction leading to the diagnosis of concomitant iNPH. In the following sections, we will review the clinical features of iNPH, as well as the overlapping and discriminating features when degenerative parkinsonism is in the differential diagnosis. Understanding and recognizing the potential for concomitant disease are critical when treating both conditions.
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