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

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On Sep 2018




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Prof. Somashekhar Nimbalkar
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Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
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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."



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Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
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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.
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Professor and Head
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Saraswati Dental College
Lucknow
On Sep 2018




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Calcutta National Medical College & Hospital , Kolkata




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Best regards,
C.S. Ramesh Babu,
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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 : October | Volume : 16 | Issue : 10 | Page : ZC25 - ZC30 Full Version

Effect of Mobile Phone Radiation on Parotid and Submandibular Salivary Glands- An Ultrasonographic Study


Published: October 1, 2022 | DOI: https://doi.org/10.7860/JCDR/2022/56667.17035
Mercy Sravanthi Yendluru, Priyanka Rana, M Chandra Sekhar, G David Chakra Varthi, D Suresh, P Nagajyothi, Gandham Meghana, Soni Solanke

1. Assistant Professor, Department of Oral Medicine and Radiology, Government Dental College and Hospital, Kadapa, Andhra Pradesh, India. 2. Postgraduate, Department of Oral Medicine and Radiology, Government Dental College and Hospital, Kadapa, Andhra Pradesh, India. 3. Professor and Head, Department of Oral Medicine and Radiology, Government Dental College and Hospital, Kadapa, Andhra Pradesh, India. 4. Assistant Professor, Department of Radiology, Government Dental College and Hospital, Kadapa, Andhra Pradesh, India. 5. Assistant Professor, Department of Oral Medicine and Radiology, Government Dental College and Hospital, Kadapa, Andhra Pradesh, India. 6. Senior Lecturer, Department of Oral Medicine and Radiology, Government Dental College and Hospital, Kadapa, Andhra Pradesh, India. 7. Postgraduate, Department of Oral Medicine and Radiology, Government Dental College and Hospital, Kadapa, Andhra Pradesh, India. 8. Postgraduate, Department of Oral Medicine and Radiology, Gove

Correspondence Address :
Dr. Priyanka Rana,
Postgraduate, Department of Oral Medicine and Radiology, Government Dental College and Hospital, Kadapa, Andhra Pradesh, India.
E-mail: priyankarana65@gmail.com

Abstract

Introduction: In this era of digitalism, mobile phones have become a cultural accessory. Frequent smartphone usage results in possible adverse effects from low radiofrequency radiation and thermal effect emitted by these devices. One of the major concerns is salivary glands as the mobile phones are held against the side of face in close proximity to these glands.

Aim: To assess the effect of cell phone radiation on the volume, systolic velocity, salivary flow rate of parotid and submandibular gland between the dominant and non dominant side of mobile phone users.

Materials and Methods: A cross-sectional study was conducted in the Department of Oral Medicine and Radiology, Government Dental College and Hospital, Kadapa, Andhra Pradesh, India, from September to November 2021. The sample size of 100 (50 males and 50 females). Inclusion criteria were based on the frequency of mobile phone usage of more than two hours per day. Mobile phone usage was determined based on patient’s answer to the questionnaire. Ultrasonography (USG) of both parotid and submandibular gland was done bilaterally to measure the volume of the glands and colour doppler of external carotid artery to measure systolic velocity. Modified Schirmer tear strips were used bilaterally to measure unstimulated salivary flow rate. The data was entered into MS excel and significance was calculated using independent sample t-test.

Results: In parotid gland, mean volume, mean systolic velocity and mean salivary flow rate were of higher value in the dominant side (14.22±2.17 mL; 15.14±3.74 cm/s; 0.37±0.26 mm/5 mins) compared to the non dominant side (13.76±2.14 mL; 14.53±3.39 cm/s; 0.24±0.2 mm/5 mins). In submandibular gland, mean volume, mean systolic velocity and mean salivary flow rate were of higher value in the dominant side (9.60±1.96 mL; 15.70±6.44 cm/s; 0.30±0.22 mm/5 mins) compared to the non dominant side (8.88±2.17 mL; 13.87±4.83 cm/s; 0.26±0.21 mm/5 mins).

Conclusion: The volume, systolic velocity of blood flow, the salivary flow rate, of the parotid gland and submandibular gland were significantly more on the dominant side than the non dominant side of mobile phone usage. The study emphasised that prolonged mobile phone usage causes biological changes in salivary glands and its flow rate.

Keywords

Colour doppler, Salivary flow rate, Systolic velocity

As the world is becoming more and more digital, smartphones have become a common place as well as a cultural accessory. More than six billion people are smartphone users today and this number is expected to rise within a few years. With this, the number and length of phone calls have also increased considerably (1). Mobile phones works both as receiver and transmitter where it emits heat and Radiofrequency Radiation (RFR) within the frequency range of 800-2200 MHz (1),(2). The RFR can access subcellular structures in this frequency range since the outer membranes of mammalian cells are no longer barriers to electric fields (3).

The salivary glands are one of the concerns as the mobile phones are typically held up against the side of the face where these glands are located. Due to long-term use and proximity to the adjacent tissues, heat and RFR emitted can be absorbed by the tissues resulting in elevated temperature and modified cutaneous blood flow (4),(5).

The literature demonstrates the potential health risks associated with mobile phone use. Mobile phones influence the heart rate. The sympathetic tone increase and parasympathetic tone decrease during mobile phone use. This suggests that the electromagnetic field generated may affect the autonomic nervous system by modulating the function of the circulatory system (4). Multiple studies have examined links of mobile phone use with salivary gland malignancies (6),(7),(8),(9),(10). There are conflicting studies on whether mobile phone emissions (heat and radiation effects) might induce significant physiologic, anatomical, functional, or even carcinogenic alterations in the human body (1),(2),(11).

The present study was conducted with the aim to evaluate any possible changes in the salivary glands that may happen due to the long-term usage of mobile phones by determining gland volume, its systolic velocity and salivary flow rate and comparing it between dominant and non dominant side of same individuals. Although, studies have been done to know the effect of mobile phone radiation on parotid gland, very little research has been conducted to evaluate the effect of mobile phone usage on submandibular salivary glands (4),(6). This study was conducted keeping in mind that because of the increasing size of mobile phones and dual sim properties of recent mobile phone there is increased radiation due to dual receiver-transmission properties. Only the parotid and submandibular glands were evaluated using Ultrasonography (USG) as they are in easier accessible areas for imaging than the sublingual and minor salivary glands (12).

Material and Methods

A cross-sectional study was conducted in the Department of Oral Medicine and Radiology, Government Dental College and Hospital, Kadapa, Andhra Pradesh, India, from September to November 2021. Ethical clearance was not taken as no therapeutic intervention was undertaken. A total of 100 students who use only smartphones (50 males and 50 females) were selected based on the inclusion and exclusion criteria.

Sample size calculation: All the samples were taken from undergraduates of the dental college based on convenience sampling method. The sample size was calculated based on data from previous similar study using the formula (4):



Inclusion criteria: Individuals who belonged to the age range of 19-29 years, had a history of smartphone usage of more than two years, used smartphone for an average of at least two hours per day and prominently used smartphones on one side were included.

Exclusion criteria: Participants with any history of trauma, systemic disease, salivary gland disorders, metabolic disorders, long-term drug history, adverse habits or drug abuse or recent exposure to medical investigatory radiation, or frequent usage of handsfree devices like microphones or bluetooth devices for voice calls were excluded. The handsfree devices are a confounding factor and its usage has been kept in exclusion criteria as they do not affect the salivary glands.

After taking informed consent, each individual was asked to fill a preformed questionnaire about his/her mobile phone usage habit, followed by a detailed intraoral examination (13). The questionnaire was devised by the authors based on data from previous study (13). Intraoral examination was conducted to rule out any trauma, diseases or disorders that could have an effect on salivary flow rate. The questionnaire collected subjective data which was not used for analysis.

The dominant side was determined as the side more frequently used while talking on the phone and the less frequently used side was considered as the non dominant side.

Ultrasonography (USG) of both superior lobe of parotid gland and submandibular gland was performed bilaterally for all the 100 participants using Toshiba USG machine using a 4 cm imaging linear probe of 5-10 MHz and volume of the glands were recorded in millilitre (mL).

Study Procedure

The patients were examined in a supine position with neck extended and head slightly turned to the side opposite to the gland when examining parotid gland and with a mild tilt of the head upwards when examining the submandibular glands (14).

The glands were examined for the echogenicity and the biplane volume of the glands were calculated after measuring the Length (L), antero-posterior length (AP) and width (W) (Table/Fig 1),(Table/Fig 2). Colour doppler was used to evaluate the blood flow through the transverse facial artery (branch of superficial temporal artery) to the parotid gland and through the facial artery (branch of external carotid artery) to the submandibular gland (15). The systolic velocity of blood flow through the glands was measured in cm/sec (Table/Fig 3).

As the USG process is operator dependent, all the imaging was done on the same machine by the same radiologist who was blinded to dominant side to avoid observer expectancy bias.

The salivary flow rate was measured in between 9-12 AM and all the participants were asked not to brush, eat or drink an hour before the procedure. The Modified Schirmer Test (MST) strip was used to measure the salivary flow rate. The MST is a 4 cm strip of filter paper that is calibrated at 1 mm intervals throughout its length from 5-35 mm. (tear touch- Madhu Instruments Pvt Limited, New Delhi, India) (4).

The participants were asked to relax for five minutes before the procedure. They were made to sit upright on the dental chair and asked to swallow all the saliva. After proper isolation using cotton pellets, rounded end of the strip was kept at the opening of Stenson’s duct for a period of five minutes using tweezers (Table/Fig 4). The strip was removed and graduated scale on the strip was referred to record the salivary flow rate as mm/5 mins. The same process was then done on the other side and for the wharton’s duct at the floor of the mouth beside the lingual frenum for the submandibular glands (Table/Fig 5). The salivary flow rate measured was unstimulated rather than stimulated as the glands are in their resting phase during most of the day and to record their activity in this phase only (Table/Fig 6).

Statistical Analysis

All the data was recorded and entered into MS excel for statistical analysis and independent sample t-test was used. The level of significance was set at a p-value of less than or equal to 0.05.

Results

A total of 100 volunteers participated in the study (50 male and 50 female) with age range between 19-29 years with mean age being 22.4±1.4 years. Around 49% of these had a history of mobile phone usage of five years or more and 51% have been using it for less than five years but more than three years. The average usage of smartphone by all the participants was 17.73±6.56 hours per week (Table/Fig 7). Out of the total, 18 (18%) used left side as their dominant side and 82 (82%) used right as their dominant side.

In parotid gland, higher mean volume was recorded on dominant side 14.22±2.17 mL compared to non dominant side (13.76±2.14 mL) but the difference between them was not statistically significant (p>0.05). In parotid gland, higher mean systolic velocity was recorded on dominant side as compared to non dominant side but the difference between them was also not statistically significant p=0.014 (Table/Fig 8).

In submandibular gland, higher mean volume was recorded on dominant side compared to non dominant side and the difference between them was statistically significant (p<0.05). In submandibular gland, higher mean systolic velocity was recorded on dominant side (15.70±6.44 cm/s) compared to non dominant side (13.87±4.83 cm/s) and the difference between them was statistically significant p=0.024.

In parotid gland, significantly higher mean salivary flow rate was recorded on dominant side as compared to non dominant side (p<0.001). however, non significant higher mean salivary flow rate was recorded on dominant side (0.30±0.22 mm/5 mins) compared to non dominant side (p>0.05) in submandibular gland (Table/Fig 8).

Submandibular volume on the dominant side was found to be a significant factor in predicting the submandibular salivary flow (p<0.01). Submandibular volume can be used to explain up to 41.7% of the variation in predicting submandibular salivary flow. Using linear regression analysis r2 adjusted value was calculated. None of the other parameters were found to be significant in predicting the salivary flow rate (Table/Fig 9).

In parotid gland, on the dominant side, both mean volume and systolic velocity were higher in females than males. Similarly, on the non dominant side, females had a higher mean systolic velocity when compared to males, but both were found to be statistically non significant (Table/Fig 10). In submandibular gland, a higher mean volume was seen in males than females which was statistically significant on the dominant side as well as on the non dominant side. The mean systolic velocity on the both dominant and non dominant sides was also higher in males and was statistically non significant (Table/Fig 10),(Table/Fig 11).

Salivary flow rate of parotid and submandibular gland had a higher mean in males than females on both dominant and non dominant sides (Table/Fig 10),(Table/Fig 11).

There was an overall increase in salivary gland volume, salivary flow rate and systolic velocity on the side where mobile phone is frequently used and statistically significant difference was found between salivary flow rate and volume of parotid gland on the non dominant side with the subsequent increase in the number of years of usage. (Table/Fig 12),(Table/Fig 13). Statistically significant difference was also found between salivary flow rate of parotid gland and volume of parotid and submandibular gland on the dominant side with the subsequent increase in the number of hours of usage (Table/Fig 14). Statistically significant difference was also found between salivary flow rate of parotid gland and volume of parotid gland on the non dominant side with the subsequent increase in the number of hours of usage (Table/Fig 15).

Discussion

The aim of the present study was to find the association between the effect of mobile phone radiation on salivary glands between the dominant and non dominant side of mobile phone users. USG which has been established as the first choice of imaging modality for salivary gland imaging was used as it is non invasive, uses high frequency pulsed ultrasound beam rather than ionising radiation to give high resolution images of superficial structures rather than Computed Tomography (CT) or Magnetic Resonance Imaging (MRI). The colour doppler feature which allows the blood flow to be detected at the same time is an added benefit (16),(17).

Furthermore, it is easier to evaluate the parotid and submandibular glands using USG because of the encapsulation than the sublingual and minor salivary glands (12). Results of similar studies have been tabulated in (Table/Fig 16) (4),(18),(19),(20).

There are two means in which mobile phone usage can affect the human tissues due to radiofrequency field. One is due to prolonged conversations as the mobile phone heats up leading to increased temperature of the tissue in contact. This increase in temperature can lead to parenchymal changes like expansion which in turn could be the cause of altered volume of salivary glands (18). This was similar to results of present study where there was increased volume on the dominant side when compared to the non dominant side in both parotid glands as well as submandibular glands. The second way could be the RFR influencing the autonomic nervous system by affecting the circulatory system leading to changes in the heart rate and hence the altered blood flow to the salivary glands (18),(21).

Handsfree devices such as earphones, headphones and earpods are a confounding factor and its usage has been kept in exclusion criteria as they do not affect the salivary glands.

There was a difference in mean volume of both the parotid and submandibular salivary glands which could be attributed to the physiological difference in male and female salivary glands.

The present study showed that both the volume and salivary flow rate were seen higher in the parotid gland than the submandibular gland.This could be attributed to the fact that the direct heating effect of mobile phone radiation is seen more on parotid gland than the submandibular gland which could lead to increase in size as well as volume especially on the dominant side (4).

Monfrecola G et al., also described that cell phone radiations can change cutaneous blood flow and cause increase in skin perfusion when the gadget is placed near to the skin (5). Similar results were seen in present study where systolic blood velocity was increased on dominant side when compared to the non dominant side.

In the present study, there was an overall increase in salivary gland volume, salivary flow rate and systolic velocity on the dominant side and statistically significant difference was found between salivary flow rate and volume of parotid gland on the non dominant side with the subsequent increase in the number of years of usage. Statistically significant difference was also found between salivary flow rate of parotid gland and volume of parotid and submandibular gland on the dominant side with the subsequent increase in the number of hours of usage. Statistically significant difference was also found between salivary flow rate of parotid gland and volume of parotid gland on the non dominant side with the subsequent increase in the number of hours of usage. An increase in the washing out of acids (and sugars) and concentration of bicarbonate buffer and of remineralising ions occurred as a result of stimulation of saliva flow (22).

Mobile phones were classified as group 2B agents, potentially carcinogenic to humans, by the World Health Organisation and the International Association for Research on Cancer on June 1, 2011, and many nations have suggested measures to reduce mobile radiation exposure (3). Use of handsfree to reduce radiation to the head, keeping the mobile phone away from the body, not using the phone in a car without an external antenna and moderate use of mobile phones for youngsters are just a few examples of such measures.

Limitation(s)

The limitations of this study are that the sample size is small and factors like the frequency of phone usage, geographic location, location of towers etc. were not considered.

Conclusion

In the present study, there is an overall increase in salivary gland volume, salivary flow rate and systolic velocity on the side where mobile phone was frequently used and statistically significant difference has been found between salivary flow rate and volume with the subsequent increase in the number of hours and years of usage.

More long term studies are needed to be done along with other parameters like oxidative stress and free radicals with keeping in mind the frequency of phone usage, geographic location, location of towers etc.

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DOI and Others

DOI: 10.7860/JCDR/2022/56667.17035

Date of Submission: Mar 26, 2022
Date of Peer Review: Apr 25, 2022
Date of Acceptance: Jul 25, 2022
Date of Publishing: Oct 01, 2022

AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? No
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Apr 01, 2022
• Manual Googling: Jul 21, 2022
• iThenticate Software: Jul 23, 2022 (16%)

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