Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"



Dr Mohan Z Mani,
Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Original article / research
Year : 2022 | Month : May | Volume : 16 | Issue : 5 | Page : ZC29 - ZC34 Full Version

Assessment of Knowledge Regarding Infection Control Protocols among Dental Health Professionals during COVID-19 Pandemic: An Observational Cross-sectional Study


Published: May 1, 2022 | DOI: https://doi.org/10.7860/JCDR/2022/54893.16396
Ananya Jalihal, Atrey Pai Khot, Sagar Jalihal, Anil Ankola, Roopali Sankeshwari, Vinuta Hampiholi, Abhra Roy Choudhury, Deepika V Bhat

1. Intern, Department of Public Health Dentistry, KLE Vishwanath Katti Institute of Dental Sciences, KLE Academy of Higher Education and Research (KAHER), Belagavi, Karnataka, India. 2. Postgraduate, Department of Public Health Dentistry, KLE Vishwanath Katti Institute of Dental Sciences, KLE Academy of Higher Education and Research (KAHER), Belagavi, Karnataka, India. 3. Lecturer, Department of Public Health Dentistry, KLE Vishwanath Katti Institute of Dental Sciences, KLE Academy of Higher Education and Research (KAHER), Belagavi, Karnataka, India. 4. Professor and Head, Department of Public Health Dentistry, KLE Vishwanath Katti Institute of Dental Sciences, KLE Academy of Higher Education and Research (KAHER), Belagavi, Karnataka, India. 5. Reader, Department of Public Health Dentistry, KLE Vishwanath Katti Institute of Dental Sciences, KLE Academy of Higher Education and Research (KAHER), Belagavi, Karnataka, India. 6. Reader, Department of Periodontology, KLE Vishwanath

Correspondence Address :
Dr. Atrey Pai Khot,
Postgraduate, Room No. 2, Department of Public Health Dentistry, KLE Vishwanath Katti Institute of Dental Sciences, KAHER University, Jawarharlal Medical College Campus, Nehru Nagar, Belagavi, Karnataka, India.
E-mail: atreypaikhot01@gmail.com

Abstract

Introduction: It is necessary to prioritise occupational welfare, safety of dental students and health professionals to reduce coronavirus transmission, to offer the best benefit for patients.

Aim: To assess knowledge regarding standard operating procedures to be adhered in clinical setting during pandemic amongst undergraduate, postgraduate dental students and dental interns of dental colleges in northwest region, Karnataka, India.

Materials and Methods: This observational cross-sectional study was undertaken in dental colleges in northwest region, Karnataka from January 2021 to February 2021. Sample size was estimated to be 360 based on a pilot study. Participants were selected by the simple random sampling technique and were interviewed using a questionnaire comprising of 20 close-ended questions. The questionnaire was evaluated for reliability with Cronbach’s α value of 0.82, face validity 0.85%, and content validity ratio 0.76. The collected data was entered in MS Excel and analysed using Statistical Package of the Social Science (IBM-SPSS) statistics-version 21.0 using descriptive analysis, Chi-square analysis, Spearman’s correlation coefficient test, and regression.

Results: The mean age of the participants was 24.6±1.35 years with marked gender distribution of 261 (72.5%) females and 99 (27.5%) males. Overall knowledge score for the standard operating procedure to be adhered during the pandemic was found to be 10.92±1.96 (undergraduates), 12.68±1.80 (postgraduates) and 11.55±1.82 (interns). More than half of the respondents 57.78% displayed a moderate level of knowledge. Spearman’s correlation coefficient test revealed a high statistically significant difference between awareness about Coronavirus disease 2019 (COVID-19) among participants and recommended masks during the procedure.

Conclusion: Postgraduate students had higher knowledge regarding standard operating procedures to be adhered in dental clinics compared to undergraduate students and interns. It’s necessary that dental students are aware of latest infection control guidelines and implement them into their practices right from beginning.

Keywords

Coronavirus disease 2019, Cross contamination, Dental health professionals, Dental students, Infection control measures

The World Health Organisation (WHO) proclaimed Severe Acute Respiratory Syndrome (SARS-CoV-2)/COVID-19 epidemic a Public Health Emergency of International Concern (PHEIC) or a pandemic on January 30, 2020 (1). Since then, the viral sickness has spread around the globe at an exponential rate, resulting in a worldwide health disaster. The virus was found in bats and transferred to humans through unidentified intermediary species (1),(2). Human life has been affected in all dimensions, in terms of physical, mental, social and behavioral aspects by putting the world to halt (2),(3).

Coronaviruses are a huge virus family that cause illnesses ranging from the common cold, fever, dry cough, shortness of breath, and fatigue to more severe COVID-19 manifestations such as haemoptysis, diarrhoea, vomiting, Middle East Respiratory Syndrome (MERS), and SARS (1),(2),(4). A high mortality risk has been associated with older adults or patients with a pre-existing chronic illness (2). The first dentist reported to have fallen prey to this virus was on January 23rd, 2020 at Wuhan University hospital in China, a country where the infection is said to be originated, and eventually most of healthcare professionals were tested corona positive (3).

To mitigate the pandemic, countries all across the world have implemented certain standard operating procedures. Pervasive guidelines have been provided by Centre of Disease Control (CDC) and government to limit the virus transmission. Dentists were instructed to postpone elective procedures and limit care to dental emergencies (4),(5). COVID-19 is primarily transmitted through respiratory droplets produced when an infected person coughs or sneezes (6). Recording the temperatures with infrared thermometers and maintaining a distance of minimum one metre according to WHO (CDC recommends two metres) should be followed in every dental setup (7). Uncontrolled bleeding, soft tissue bacterial infection, intraoral or extraoral swelling, and facial bone injuries are all considered dental emergencies by the American Dental Association (ADA) (8). While conducting physical examination of patients, it is mandatory to wear face shield, eye protection, shoe cover, gown, N-95 mask, head cap (9). Aerosolisation during dental procedures can be reduced by using rubber dams and high volume saliva ejectors. Preprocedural mouthwashes should be used in dental offices to minimise viral load and cross infection risk when treating patients during the pandemic (10),(11).

To reduce the danger of transmission to dental students and professionals and to offer the best possible care for patients, occupational health and safety should be prioritised. Therefore, in this study, undergraduates, postgraduates and dental interns in dental college setting were questioned in order to evaluate their knowledge and to eliminate their deficiencies in order to direct patients effectively. This is first kind of study in this region including all budding dental health professionals to keep them aware of the current situation and to inculcate newer infection control guidelines into their routine practice. Objective of this study was to assess and to compare the knowledge of infection control to be adhered during pandemic among undergraduate, postgraduates and interns working in dental colleges of Northwest region, Karnataka, India.

Material and Methods

This observational, cross-sectional study design based on questionnaire regarding infection control was carried out in dental health professionals and interns from dental colleges, northwest Karnataka from January 2021 to February 2021. Ethical approval obtained from Institutional Ethical Committee (Approval no:1407). The research was carried out in compliance with the ethical standards outlined in the 1964 Declaration of Helsinki and its subsequent modifications. Study participants belonged to KLE Vishwanath Katti Institute of Dental Sciences and M.M.N.G.H Institute of Dental Sciences and Research Centre. After describing the study’s aim, the participants signed a written informed consent form. Combined data was collected from participants of dental colleges.

Inclusion criteria: The study only included those healthcare professionals who were present on the day of the study and willing to offer informed consent. Study participants included third year, fourth year undergraduate students, interns, postgraduate students with clinical experience.

Exclusion criteria: Dental students of first and second year undergraduates who are not allowed to treat patients and students unwilling to offer informed consent were excluded from study.

Sample size calculation: The calculation of sample size was done using the formula n=4pq/d2, based on responses observed in the pilot study (p=52%) where, p=prevalence, q=1-p, d=error (10% of p), the sample size was estimated to be 360. Participants were selected by simple random sampling in each of the group for further investigation.

Pretesting (Pilot Study)

The questionnaire was pretested on a small sample of 11 participants to see whether there were any design flaws, such as ambiguous language, inability to know questions, and other issues. Further, these participants were excluded from the main study. Based on the response from the pretest, the questionnaire was further refined by additions and deletions to make it more appropriate and specific to the aim of the study and hence a valid questionnaire was designed. The questionnaire was assessed for reliability with Cronbach’s α value and was found to be 0.82 and questionnaire validity was assessed using face validity which was found to be 0.85% and content validity ratio was found to be 0.76.

Details of Questionnaire

The self-administered questionnaire was in English language comprising of 15 close-ended knowledge based questions which were formulated based on study by Esmaeelinejad et al., and hand distributed to individual participants (14). They were instructed to attempt all the questions in the stipulated time of 15 minutes. Responses were collected from the participants without revealing the identity. Each correct response was given the score of one wherein each participant could obtain minimum score of zero and maximum score 15. Based on quartile derivative, a cut-off knowledge score of ≤8 was set for low knowledge, 9-12 for medium knowledge and 13-15 as high knowledge. The participant’s general socio-demographic information was included in the first section of the questionnaire, which was then used for qualitative analysis.

Statistical Analysis

Collected data was entered in MS Excel and analysed using IBM-SPSS® Statistics-Version 21 (IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 32.0, Armonk, NY, USA: IBM Corp.). Descriptive statistics was applied for the frequency distribution and percentage of students and Chi-square test was applied for the 30association between the study variables and knowledge questions. Consecutively, Kruskal-Wallis test was applied to test significance among the other study variables. Additionally, the correlation between the knowledge scores was evaluated by Spearman’s rank correlation coefficient test whereas, their association with the demographic details of the students was analysed by simple linear regression and multivariate linear regression analysis. The statistical significance was set at p≤0.05 for all the tests.

Results

A total of 360 responses were received out of which 261 (72.5%) females and 99 (27.5%) males based on gender-wise distribution. The mean age of the participants was 24.6±1.35 years. The respondents were equally considered under each grade of dental students. The socio-demographic characteristics of the respondents are depicted in (Table/Fig 1).

More than half of the respondents 208 (57.78%) displayed a moderate level of knowledge, about 122 (33.89%) showed high knowledge, whereas only small proportion of respondents 30 (8.33%) depicted low knowledge about infection control protocols to be adhered in clinics during pandemic (Table/Fig 2). The study demonstrated explicit fact that mean overall knowledge score for standard operating procedure to be adhered during pandemic was 10.92±1.96 (undergraduates), 11.55±1.82 (interns) and 12.68±1.80 (postgraduates).

Chi-square association between grades of students and knowledge about standard operating procedures in dental clinic are depicted in (Table/Fig 3). Kruskal-Wallis test depicted that there was significant difference in the knowledge scores between the students with different educational qualification with p-value=0.003. Also, it was significantly evident that males had slightly higher knowledge about standard operating procedures to be followed in clinical set-up during pandemic with p-value of 0.006 (Table/Fig 4).

A Spearman’s rank correlation coefficient test obtained positive correlation between awareness about transmission of COVID-19 among participants and recommended masks used during procedure with statistically significant p-value=0.003. positive correlation was found between preoperative mouth rinse to be used and aerosol minimization methods to be used for infection control with statistically significant p-value=0.009. There was weak positive correlation obtained between dental chair distancing in clinics and aerosol minimization procedures using Spearman’s rank correlation coefficient test. The field wise correlation data are presented in (Table/Fig 5).

Simple linear regression analysis depicted a significant relationship between knowledge with Education qualification (r=0.233), and with gender (r=0.216). Multiple linear regression analysis revealed that the better knowledge scores were significantly associated with education qualification (0.003) and gender (0.006) with dependence value of (Adjusted R square=0.042) (Table/Fig 6).

Discussion

COVID-19 is a highly infectious disease requiring strict infection control measures. Dentistry involves working directly on the patient mouth and contact with saliva is inevitable. The majority of dental treatments produce aerosols, putting practitioners in the high risk category, according to the ADA, with a risk of 92.3% (10). As a result, it is critical to decrease the impacts of viral dispersal, transmission, and infection by the COVID-19 virus in a dental setting (11). To decrease the spread of the disease among the community and dental healthcare providers, a high level of knowledge is crucial and must be obtained from all the available resources (12).

The current study found that dental students had a moderate level of knowledge about standard operating procedures to adhere during a pandemic, which is in agreement with Shrivastava KC et al., concluding that dental healthcare professionals had an average level of knowledge that could be improved through continuing education programs (13).

The understanding of the detailed mechanisms of transmission have made mandatary wearing of masks in public places (14). Regarding the optimal protection, majority of students 324 (90%) strongly agreed on wearing N95 mask during the procedure to provide sufficient protection against aerosol. Iranian dental student’s perceptions emphasised on wearing N95 mask during dental procedure to avoid infection transmission (14). In contrast to current study findings, Sommerstein R et al., suggested Respirators for certain procedures with higher risk of transmission. Respirator masks are intended to protect the carrier from the inhalation of airborne particles (15).

In the current study, most of the participants 350 (97.2%) were aware of necessity of preprocedural mouth rinse. This was supported by a study by Aboalela A et al., who concluded that hydrogen peroxide is an effective rinse in reducing viral load (16).

In the explicit findings from this study, majority of students 134 (37.2%) emphasised on using high volume saliva ejectors and 115 (32%) of students agreed on rubber dam application for minimising aerosol production during procedure. These findings are supported by Nagraj SK et al., believing use of a high volume evacuator (HVE) may reduce in aerosols less than one foot (~ 30 cm) from a patient’s mouth compared to rubber dam which reduces up to one metre but combining both methods have significant outcome (17). It is recommended to avoid aerosol generating procedures, if not then as many procedures as possible should be carried out under rubber dam isolation and high volume evacuators (18).

Cleaning, disinfecting and sterilising the instruments after every use is a primary protocol to be followed in healthcare set up. Majority of the participants believe that sodium hypochlorite as most effective disinfecting solution to to curtail the spread of infection from inanimate objects supported by Ilangovan et al., stating all instruments used for dental procedures are to be disinfected, cleaned, and sterilised in colour changing sterilisation autoclave pouches and properly stored in the Ultraviolet (UV) chamber (19). Similarly, study by Ghimire B and Chandra S, proposed that 72.6% of participants immerse the used instruments in decontamination solution after treatment (20).

Awareness towards personal protective equipment revealed only 118 (32.8%) of the students were aware of the components of kit. However, contrasting finding by Deogade SC et al., that majority of the undergraduates (96.6%-100%) care about protective barriers such as gloves, face mask and head cap and a less concern was observed regarding the protective eyeglasses (37.2%) and protective gowns (21.1%) (21). Similar findings were obtained in study by MP SK, stated compliance with protective eyewear was very low; only 43% reported using protective eyewear at all times (22). Poor eyewear use might suggest a lack of understanding among students about the risk of disease transmission through aerosols and blood splashes (22).

The majority of dental students were familiar with the early and frequent symptoms of infection; this finding is critical since students should be able to quickly recognise a suspected case and take appropriate action. In the current study, majority of the students were aware of the symptoms associated with COVID-19 infection and history taking in dental operatory before procedures. On the contrary, study by Umeizudike KA et al., stating that the proportion of respondents with adequate knowledge of the diagnosis, case definition, and symptoms were observed to be low (23). This could be due rapidly evolving variants of the virus and its associated symptoms. The attitude toward patients with infectious diseases was generally poor among Egyptian dental students (24). Therefore, it is important to reduce the transmission of diseases by establishing stringent safety measures and increasing trust in them during clinical practice at dental schools (24).

In summary, the study recognises strengths and deficiencies in the knowledge regarding standard operating procedures amongst dental students of Belagavi district in comparison with findings from various studies all over the world (Table/Fig 7) (2),(14),(20),(21),(22),(23),(24),(25).

Dental students during their clinical postings are in direct contact with patients and hence they are more vulnerable to COVID-19 infection. Lack of knowledge among them might lead to cross infection which is a matter of concern. These guidelines may change from time to time depending on the course of the diseases and regional needs. Healthcare facilities and individual dentists must be aware of the changes and adjust their facilities and practices accordingly. As a result, efforts should be made to improve dentistry student’s knowledge through compliance with infection control requirements in training programs. This could be achieved through the collaborative efforts of global health agencies and government.

Limitation(s)

A study with a more extensive parameters would have made the results even more concrete and substantial. Infection control is a desirable behaviour for dental students. Therefore, results may be affected by social desirability bias, underestimating the magnitude of the problem.

Conclusion

Coping with the current situation with rapidly advancing corona variants is a challenge not only for dentists but also for dental students. Postgraduate students had higher knowledge regarding standard operating procedures to be followed in dental set up compared to interns and undergraduate students. Hence proving that educational qualification has direct influence on knowledge of students. It’s necessary that dental students are aware of latest infection control guidelines and implement them into their practices right from beginning. Training sessions and extra educational initiatives are desperately needed to improve dental students’ knowledge of COVID-19 preventative techniques.

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DOI and Others

DOI: 10.7860/JCDR/2022/54893.16396

Date of Submission: Jan 11, 2022
Date of Peer Review: Jan 27, 2022
Date of Acceptance: Mar 06, 2022
Date of Publishing: May 01, 2022

AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Jan 14, 2022
• Manual Googling: Feb 23, 2022
• iThenticate Software: Apr 29, 2022 (16%)

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