Romesh Nalliah - Academia.edu (original) (raw)

Papers by Romesh Nalliah

Clinical pediatrics, Jan 24, 2015

Outcomes of tonsillectomy (with or without adenoidectomy [w/woA]) in hospitalized children are un... more Outcomes of tonsillectomy (with or without adenoidectomy [w/woA]) in hospitalized children are unclear. We sought, to describe the characteristics of hospitalized children who underwent tonsillectomy (w/woA), to estimate the prevalence of complications and to evaluate the relative impact of different comorbid conditions (CMC) on the risk of occurrence of common complications following these procedures. All patients aged ≤21years who underwent a tonsillectomy (w/woA) were selected from the Nationwide Inpatient Sample (NIS 2001-2010). The associations between several patient/hospital-level factors and occurrence of complications were generated using multivariable logistic regression models. Over a decade, a total of 141 599 hospitalized patients underwent tonsillectomy (w116 319; woA 25 280). A total of 58.1% were males. Majority of the procedures were performed in teaching hospitals (TH, 73.7%), in large (bed-size) hospitals (LH, 57.8%), and in those who were electively admitted (EA,...

Journal of dental education

The aim of this article is to describe the development and implementation of a case completion cu... more The aim of this article is to describe the development and implementation of a case completion curriculum as a new clinical education model for the predoctoral program at Harvard School of Dental Medicine. In this innovative model, students conduct patient-based comprehensive care and complete assigned patient cases on which their performance is assessed, in contrast with a traditional model based on procedural numerical requirements. In our new model, senior tutors, who are full-time faculty members, act as group leaders responsible for patient assignment, treatment planning, monitoring of student performance, and verification of patient care. The number of completed patient cases in this new comprehensive care system increased from a previous average of 12.8 cases per student prior to graduation to 22.8 cases. Additionally, the number of patients who had to be transferred due to outstanding or pending treatment when their student provider graduated or because of students' need to fulfill discipline requirements has decreased from an average of 16.4 to 4.6.

Journal of dental education

The purpose of this study was to evaluate the effects of a new clinical curriculum on dental stud... more The purpose of this study was to evaluate the effects of a new clinical curriculum on dental student productivity as measured by number of procedures performed in the student teaching practice. Harvard School of Dental Medicine adopted a new clinical education model for the predoctoral program in summer 2009 based upon a Case Completion Curriculum (CCC) rather than a discipline-based numeric threshold system. The two study groups (threshold group and case completion group) consisted of students who graduated in 2009 and 2010. Clinical performance was assessed by clinical productivity across five major discipline areas: periodontics, operative dentistry, removable prosthodontics, fixed prosthodontics, and endodontics. The relationships between the two study groups with regard to number of procedures performed by category revealed that the case completion group performed a significantly higher number of operative and removable prosthodontic procedures, but fewer periodontal and endodontic procedures (p≤0.03). No statistically significant difference in number of procedures was observed with fixed prosthodontic procedures between the two groups. Clinical productivity as a result of redesigning the clinical component of the curriculum varied in selected disciplines. The CCC, in which the comprehensive management of the patient was the priority, contributed to achieving a patient-based comprehensive care practice.

... of São Paulo, Ribeirão Preto, Brazil, and SHC SALES-PERES, Pediatric dentistry, Orthodontics ... more ... of São Paulo, Ribeirão Preto, Brazil, and SHC SALES-PERES, Pediatric dentistry, Orthodontics and Public Health, University of São Paulo, Bauru, Brazil ... 1 , S. NICOLEAU 2 , R. BEIL 2 , G. UMANSKI 2 , A. BLANK 2 , A. KARASZ 2 , D. GREEN-HARRIS 1 , A. BOBADILLA 2 , C ...

Progress in Orthodontics, 2015

The objective of this study was to evaluate long-term clinical and bacterial effects of using 6 g... more The objective of this study was to evaluate long-term clinical and bacterial effects of using 6 g of xylitol per day for 3 months on patients with full fixed orthodontic appliances. The study was a pilot clinical trial that included 41 subjects who were undergoing orthodontic treatment. The subjects were randomly divided into three groups. Group A received xylitol chewing gum, group B received xylitol dissolvable chewable tablets, and Group C served as the control group and did not receive xylitol gums or tablets. Clinical examination and the collection of plaque and saliva samples were carried out at baseline and 3, 6, and 12 months. All three groups were given oral hygiene instruction and were put on a 6-month cleaning and topical fluoride schedule. Plaque scores and bacterial counts were used to evaluate the effectiveness of the different approaches at reducing the caries risk. Xylitol groups did not experience any more reduction in plaque score, plaque MS counts, or salivary MS counts than the control group nor did they have lower values at any of the time points. Chewing gum did not significantly increase the incidence of debonded brackets over the other groups. Xylitol does not have a clinical or bacterial benefit in patients with fixed orthodontic appliances. Oral hygiene instructions and 6-month topical fluoride application were effective at reducing plaque scores and bacterial counts in patients with full fixed appliances regardless of whether or not xylitol was used.

Journal of the Massachusetts Dental Society

Access to oral health care is a complex and multifactorial problem. The objective of this article... more Access to oral health care is a complex and multifactorial problem. The objective of this article is to discuss those factors most influenced by the dental care provider. Issues examined include the low participation of dentists in Medicaid, objection of organized dentistry to the introduction of dental therapists into the oral health workforce, increased focus on family and subsequent reduction in work hours by younger dentists, increased participation in the oral health workforce by women (who, research has demonstrated, have shorter careers), and reluctance to treat certain populations (like individuals with special needs and children). There are many things that dentists cannot control, such as patient compliance and insurance reimbursements; however, this article will discuss those factors that the dental profession can influence that may lead to improved access to oral health care.

Clinical pediatrics, Jan 24, 2015

Outcomes of tonsillectomy (with or without adenoidectomy [w/woA]) in hospitalized children are un... more Outcomes of tonsillectomy (with or without adenoidectomy [w/woA]) in hospitalized children are unclear. We sought, to describe the characteristics of hospitalized children who underwent tonsillectomy (w/woA), to estimate the prevalence of complications and to evaluate the relative impact of different comorbid conditions (CMC) on the risk of occurrence of common complications following these procedures. All patients aged ≤21years who underwent a tonsillectomy (w/woA) were selected from the Nationwide Inpatient Sample (NIS 2001-2010). The associations between several patient/hospital-level factors and occurrence of complications were generated using multivariable logistic regression models. Over a decade, a total of 141 599 hospitalized patients underwent tonsillectomy (w116 319; woA 25 280). A total of 58.1% were males. Majority of the procedures were performed in teaching hospitals (TH, 73.7%), in large (bed-size) hospitals (LH, 57.8%), and in those who were electively admitted (EA,...

Journal of dental education

The aim of this article is to describe the development and implementation of a case completion cu... more The aim of this article is to describe the development and implementation of a case completion curriculum as a new clinical education model for the predoctoral program at Harvard School of Dental Medicine. In this innovative model, students conduct patient-based comprehensive care and complete assigned patient cases on which their performance is assessed, in contrast with a traditional model based on procedural numerical requirements. In our new model, senior tutors, who are full-time faculty members, act as group leaders responsible for patient assignment, treatment planning, monitoring of student performance, and verification of patient care. The number of completed patient cases in this new comprehensive care system increased from a previous average of 12.8 cases per student prior to graduation to 22.8 cases. Additionally, the number of patients who had to be transferred due to outstanding or pending treatment when their student provider graduated or because of students' need to fulfill discipline requirements has decreased from an average of 16.4 to 4.6.

Journal of dental education

The purpose of this study was to evaluate the effects of a new clinical curriculum on dental stud... more The purpose of this study was to evaluate the effects of a new clinical curriculum on dental student productivity as measured by number of procedures performed in the student teaching practice. Harvard School of Dental Medicine adopted a new clinical education model for the predoctoral program in summer 2009 based upon a Case Completion Curriculum (CCC) rather than a discipline-based numeric threshold system. The two study groups (threshold group and case completion group) consisted of students who graduated in 2009 and 2010. Clinical performance was assessed by clinical productivity across five major discipline areas: periodontics, operative dentistry, removable prosthodontics, fixed prosthodontics, and endodontics. The relationships between the two study groups with regard to number of procedures performed by category revealed that the case completion group performed a significantly higher number of operative and removable prosthodontic procedures, but fewer periodontal and endodontic procedures (p≤0.03). No statistically significant difference in number of procedures was observed with fixed prosthodontic procedures between the two groups. Clinical productivity as a result of redesigning the clinical component of the curriculum varied in selected disciplines. The CCC, in which the comprehensive management of the patient was the priority, contributed to achieving a patient-based comprehensive care practice.

... of São Paulo, Ribeirão Preto, Brazil, and SHC SALES-PERES, Pediatric dentistry, Orthodontics ... more ... of São Paulo, Ribeirão Preto, Brazil, and SHC SALES-PERES, Pediatric dentistry, Orthodontics and Public Health, University of São Paulo, Bauru, Brazil ... 1 , S. NICOLEAU 2 , R. BEIL 2 , G. UMANSKI 2 , A. BLANK 2 , A. KARASZ 2 , D. GREEN-HARRIS 1 , A. BOBADILLA 2 , C ...

Progress in Orthodontics, 2015

The objective of this study was to evaluate long-term clinical and bacterial effects of using 6 g... more The objective of this study was to evaluate long-term clinical and bacterial effects of using 6 g of xylitol per day for 3 months on patients with full fixed orthodontic appliances. The study was a pilot clinical trial that included 41 subjects who were undergoing orthodontic treatment. The subjects were randomly divided into three groups. Group A received xylitol chewing gum, group B received xylitol dissolvable chewable tablets, and Group C served as the control group and did not receive xylitol gums or tablets. Clinical examination and the collection of plaque and saliva samples were carried out at baseline and 3, 6, and 12 months. All three groups were given oral hygiene instruction and were put on a 6-month cleaning and topical fluoride schedule. Plaque scores and bacterial counts were used to evaluate the effectiveness of the different approaches at reducing the caries risk. Xylitol groups did not experience any more reduction in plaque score, plaque MS counts, or salivary MS counts than the control group nor did they have lower values at any of the time points. Chewing gum did not significantly increase the incidence of debonded brackets over the other groups. Xylitol does not have a clinical or bacterial benefit in patients with fixed orthodontic appliances. Oral hygiene instructions and 6-month topical fluoride application were effective at reducing plaque scores and bacterial counts in patients with full fixed appliances regardless of whether or not xylitol was used.

Journal of the Massachusetts Dental Society

Access to oral health care is a complex and multifactorial problem. The objective of this article... more Access to oral health care is a complex and multifactorial problem. The objective of this article is to discuss those factors most influenced by the dental care provider. Issues examined include the low participation of dentists in Medicaid, objection of organized dentistry to the introduction of dental therapists into the oral health workforce, increased focus on family and subsequent reduction in work hours by younger dentists, increased participation in the oral health workforce by women (who, research has demonstrated, have shorter careers), and reluctance to treat certain populations (like individuals with special needs and children). There are many things that dentists cannot control, such as patient compliance and insurance reimbursements; however, this article will discuss those factors that the dental profession can influence that may lead to improved access to oral health care.