Bio-medical Waste Management

The biomedical waste management in India should be the burning and worrisome topic for the public as well as hospitals and health care service providers. Bio-Medical Waste (Management and Handling) Rules 2016 and further amendments in 2018 and 2019 have made enough provisions to handle all the biomedical wastes by any entity involved in anything related with health care provision. This includes, hospitals with only OPD facilities, hospitals with indoor facilities, blood donation camps, free health camps, medical services being provided in the field excluding the active war zones as well as the ships in the international water with Indian registration. 

The categorization of all biomedical wastes into four color categories namely yellow, red, white, and blue made the segregation easy and practical. It does not specifically say anything about the rules and regulations to be followed in reference to COVID-19. But when, the proper biomedical waste management protocols, standard precautions also known as universal precautions and the latest guidelines issued for the control of spread of Covid-19 by MoHFW are put together; we find ourselves equipped with enough tools to deal with all types of wastes and infections. 

We shall read more about the Bio-medical Waste (Management & Handling) rules 2016 and further amendments in 2018 & 2019 in further articles. 

Role of Zinc in Silver Amalgam

Role of Zinc in Silver Amalgam 

Zinc as such does not participate in the amalgamation process or in the setting reaction of silver amalgam alloy with mercury during and after the completion of the restoration process. 

CBI Books Head of Dental Department AIIMS-Patna for Corruption Charges

The Central Bureau of Investigation (CBI) has filed an FIR against former Head of the Dental Department of All India Institute of Medical Sciences (AIIMS)-Patna, Dr. Shailesh Kumar Mukul. He is accused of resorting to “unlawful means in conspiracy with others” during the 2013 and 2019 period.  

Coronavirus Disease: Seven Essential Norms You Should Follow to Help Yourself during Home Quarantine Period

Coronavirus Disease-COVID-19: Seven Essential Norms You Should Follow to Help Yourself during Quarantine Period

The following category of people should stay at home under home quarantine status. This category includes a person with suspected coronavirus infection, those under investigation but not needing hospitalization. Also, the one who had had confirmed coronavirus infection was hospitalized earlier but now has been discharged and medically stable. These people should stay at home under quarantine conditions.

Dental Amalgam Alloys

Dental Amalgam 

In this section, we shall discuss the composition, type and properties of the dental amalgams alloys used for restoration purpose in posterior teeth as per following format. The source of these notes, MCQs and explanation is Phillips’ Science of Dental Materials, 12th Ed and Sturtevant’s Art and Science of Operative Dentistry.

Why is Zinc Not Added to Dental Amalgam?

Why is Zinc Not Added to Dental Amalgam?

Zinc as such does not participate in the amalgamation process or in the setting reaction of silver amalgam alloy with mercury during and after the completion of the restoration process.

Covid 19: Test Yourself-How Much Do You Think, You Know Coronavirus?

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Indian Prosthodontic Society holds its 46th conference in Mangalore

Indian Prosthodontic Society (IPS) holds its 46th conference in Mangalore on 15th November 18.

19th National PG Student Convention of Indian Prosthodontic Society will be held in Gujarat

The 19th National PG Student Convention of Indian Prosthodontic Society is scheduled to be held from 5-7 April 2019 at Gandhinagar, jointly by Gujarat IPS State branch and Narsinhbhai Patel Dental College & Hospital, Sankalchand Patel University, Visnagar, Gujarat.

 

Local Anaesthesia

Local anaesthesia means a no pain sensation in a particular area supplied by a specific nerve. The correct term is local analgesia but commonly not used? It is given with the help of 2 ml or 5 ml single use disposable syringes. 
The anaesthesia is an inseparable part of surgery. It provides maximum patient comfort and cooperation. Without anaesthesia, the advancement in surgeries could not have been achieved. In 3rd molar surgery a patient may opt for general anaesthesia or local anaesthesia. The local anaesthesia may be supplemented with sedation for increased comfort. 
 

Advantages of Local Anaesthesia 

 
Local anaesthesia has the following advantages over general anaesthesia. 

1. It is safe, efficient and predictably effective in almost all patients. 
2. It is inexpensive. 
3. It is easy to administer. 
4. For healthy patient, no monitoring is needed by equipment 
5. The patient does not lose consciousness with an intact gag reflex during anaesthesia. 
6. Procedures under local anaesthesia, hospitalization is not needed, therefore, for patients’, it is convenient. 
7. To administer local anaesthesia, no preoperative fasting is required. 
8. A patient can be discharged immediately without waiting for recovery or an escort. 

 

Limitations of Local Anaesthesia 

 
Despite the huge number of advantages, the local anaesthesia does have certain disadvantages. They are as follows. 

1. It cannot be used in a non-cooperative patient; for example, younger children. 
2. It cannot be used in a patient with fear of needles. 
3. It cannot be used in an anxious or nervous patient. 
4. It is only suitable for short procedures which are of less than 30-minute duration. 
5. It cannot anesthetize the locally inflamed tissues. 

 

Composition of Local Anaesthesia 

 
The local anaesthetic solutions mainly contain the following contents. 

1. Local anaesthesia base. 
2. Hydrochloride salt for solubility and stability. 
3. Buffering agents. 
4. Preservatives; e.g., Methyl Paraben 

 

How does local anaesthetics prevent the conduction of dental pain? 

 
Local anaesthetics inhibit the generation of electrical impulses and their conduction along the neuronal axon membrane, by reversible blockade of sodium ion channels. 
There is a continuous imbalance of sodium and potassium ions between the cytoplasm of neurons and the intercellular fluid. This is maintained at about 25 times more potassium intracellularly and 15 times more sodium in interstitial space. 
 

Mechanism of action 

 
The molecule of local anaesthetic agent enters the neural cell through neurilemmoma from interstitial fluid by a simple diffusion process. Then in the acidic environment of a neural cell, it breaks itself in its components and acts on the sodium influx gate and blocks it, thus blocking the generation of action potential, thus blocking signal conduction along the nerve cell membrane. The local anaesthesia cannot act on sodium influx gates from outside the nerve cell. It must enter the nerve cell. 

Question: What happens when the area surrounding the nerve gets inflamed?  

Once the tissue is inflamed, the interstitial fluid becomes acidic in nature. In an acidic environment, the local anaesthetic molecule breaks down. A broken local anaesthetic molecule cannot pass through the cell membrane by a simple diffusion process and thus cannot produce its effect.

 
This is the reason a local anaesthetic cannot produce its effect in an inflamed tissue or is not so effective in an inflamed area. 

Question: Why does LA not function efficiently in an inflamed environment?   

Answer: The molecule of local anaesthetic agent enters the neural cell through myelin sheath from interstitial fluid by a simple diffusion process. Then in the acidic environment of a neural cell, it breaks itself in its components and acts on the sodium influx gate and blocks it, thus blocking the generation of action potential, thus blocking signal conduction along the nerve cell membrane. The local anaesthesia cannot act on sodium influx gates from outside the nerve cell. It must enter the nerve cell.

    
Question: What happens when the area surrounding the nerve gets inflamed? 

  
Once the tissue is inflamed, the interstitial fluid becomes acidic in nature. In an acidic environment, the local anaesthetic molecule breaks down. A broken local anaesthetic molecule cannot pass through the cell membrane by a simple diffusion process and thus cannot produce its effect.

  
This is the reason a local anaesthetic cannot produce its effect in an inflamed tissue or is not so effective in an inflamed area.