Background:Although mechanical plaque removal is an effective method, powered toothbrushes are specially designed to benefit differently abled. Literature comparing plaque removal efficacy between manual and powered toothbrushes among differently abled is sparse.Study Design and Setting:A cross-over, randomized, double-blind study was conducted in differently abled institution.Materials and Methods:Twenty differently abled participants were randomly assigned to two groups of ten participants. Plaque removal efficacy of battery-operated powered toothbrush was compared with manual toothbrush in a single brushing on the 8th day. After a washout of 1 week, groups were switched. Assessment of plaque scores was done using Turesky's modification of Quigley-Hein plaque index.Statistical Analysis:Difference in plaque score between pre- and post-brushing in each group was compared using paired sample t-test.Results:In the pooled data analysis combining the results of Phase I and II, mean pre- and post-brushing plaque scores with manual toothbrush was 2.26 ± 0.4 and 1.93 ± 0.5, respectively, while with powered toothbrush, it was 2.21 ± 0.4 and 1.96 ± 0.4, respectively. However, difference in mean plaque reduction between manual and powered toothbrushes was not significant.Conclusion:Manual toothbrushes were equally effective compared to powered toothbrushes. Long-term studies precisely documenting cost-effectiveness and participant perception in the ease of use are recommended to validate our results.

Health care expenditure is increasing day by day across the globe. High cost of branded/innovator drug could be one possible reason for this. Policy makers and governments were looking for alternative strategies to reduce cost without compromising quality of care delivered. Generic drugs were found to be one such alternative. Present review was undertaken to enlighten on generic drugs, policies implemented by various governments, and perceptions of physicians and patients worldwide. Literature search was carried out in May 2016 using keywords ''generic drug,'' ''generic medicine,'' ''physicians perception,'' ''patients perception,'' ''policies.'' Full text articles of past decade were retrieved using electronic databases PubMed, Google Scholar. Thirteen studies were included for final analysis. Results were discussed under five themes: history, policies, and ethical considerations, perceptions of patients, and perceptions of physicians. It was noticed that results were mixed in nature. Some countries have well-established policies with good awareness among physicians and patients while some of them were in budding stages. Great variations that exist in health care structure among developed and developing countries reflected on generic drugs also. Long-term randomized trials to establish safety, bioequivalence of generic drugs were recommended. Awareness programs by mass media, health care professionals are need of the hour to increase acceptability of generic drugs.

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