Intake of Artificial Sweeteners by Children: Boon or Bane?

BACKGROUND: Sugar is the main culprit in many health dysfunctions. Excessive sugar intake can negatively affect oral health, precipitate diabetes, and lead to weight gain and obesity. Sucrose is the primary form of sugar, and is strongly correlated with dental caries. Artificial sweeteners are chemically synthesized sugar substitutes that are generally regarded as being low-calorie. OBJECTIVE: This review examines the current evidence in the literature for the need for artificial sweeteners and outlines its implications for the health of children. We briefly outline its adverse effects, and concerns regarding their safety. REVIEW RESULTS: Artificial sweeteners are a widely used food additive. Six main artificial sweeteners are approved by the food and drug administration (FDA). The conflicting results and divergent regulatory norms of each sweetener are a constant cause of concern and debate. However, most studies have spotlighted the beneficial effects of artificial sweeteners. Dental caries diminish with the increase in sweetener intake. An increase in appetite and eventually weight gain is observed in individuals consuming artificial sweeteners. CONCLUSION: Artificial sweeteners are indeed a bane according to present studies, although more research on recently discovered non-nutritive artificial sweeteners is required. It also has a positive effect on overall health disorders. If one curbs the onset of dental caries, then the eventual rise is highly unlikely. CLINICAL SIGNIFICANCE: Artificial sweeteners' effect on lowering dental caries will help to reduce the caries index in general. Oral hygiene is maintained, and the growth of oral bacterium is depressed. Research on novel sweeteners will help to compare their efficacy in caries prevention compared to existing ones. It is necessary to educate people on artificial sweeteners and its implication as one can use them by being aware of their properties.

Mandibular Arteriovenous Malformation in an 8-year-old Child: A Case Report.

Arteriovenous (AV) malformation is a congenital vascular anomaly in which there is an abnormal connection between the arterial and venous system resulting from developmental arrest during embryogenesis. In children, they are rare and potentially life-threatening. In the present case, an 8-year-old male patient presented with a simple gingival swelling associated with mobility of the corresponding teeth, which appeared relatively simple to excise but had an AV malformation associated with it. Timely diagnosis and investigations revealed its presence and hence prevented a catastrophy from occurring. Conventional method of surgical ligation of the external carotid artery was done as an emergency procedure and surgical resection was done without compromising the associated anatomic structures. This procedure helped control the bleeding as well as achieved an uneventful healing. This case report intends to create an awareness among Pediatric Dentists regarding the condition and thereby preventing an uncontrolled and unmanageable hemorrhage occurring in the Dental Office.

Rare finding of a symptomatic epidermoid cyst of the diaphragm - a case report.

Cystic lesions of the diaphragm are rare and accordingly present a diagnostic challenge. Specific radiological features with which to clinch a diagnosis may be elusive. Herein we present the case of a patient who presented with symptoms attributable to a cyst in the left upper abdomen, irritating the diaphragm. Surgery was considered appropriate for diagnostic and symptomatic purposes. Final histology demonstrated an epidermoid cyst. Resolution of symptoms was reported after surgery. Diaphragmatic epidermoid cysts appear to be a rare entity with only three prior cases reported in the literature. Given the rarity of this lesion and the lack of unique features by which they can be characterized, accurately diagnosing epidermoid cysts of the diaphragm is likely to remain difficult without surgery, although they are presumed to have a benign behaviour.

Artificial intelligence: Machine learning approach for screening large database and drug discovery.

Recent research in drug discovery dealing with many faces difficulties, including development of new drugs during disease outbreak and drug resistance due to rapidly accumulating mutations. Virtual screening is the most widely used method in computer aided drug discovery. It has a prominent ability in screening drug targets from large molecular databases. Recently, a number of web servers have developed for quickly screening publicly accessible chemical databases. In a nutshell, deep learning algorithms and artificial neural networks have modernised the field. Several drug discovery processes have used machine learning and deep learning algorithms, including peptide synthesis, structure-based virtual screening, ligand-based virtual screening, toxicity prediction, drug monitoring and release, pharmacophore modelling, quantitative structure-activity relationship, drug repositioning, polypharmacology, and physiochemical activity. Although there are presently a wide variety of data-driven AI/ML tools available, the majority of these tools have, up to this point, been developed in the context of non-communicable diseases like cancer, and a number of obstacles have prevented the translation of these tools to the discovery of treatments against infectious diseases. In this review various aspects of AI and ML in virtual screening of large databases were discussed. Here, with an emphasis on antivirals as well as other disease, offers a perspective on the advantages, drawbacks, and hazards of AI/ML techniques in the search for innovative treatments.

Association of adiponectin levels with polycystic ovary syndrome among Indian women.

Polycystic Ovary Syndrome (PCOS) is a hormonal condition where women reproductive hormones are out of endocrinal balance. Women with PCOS frequently exhibit obesity, which causes irregularities in the levels of adipocytes like adiponectin. It is hypothesized that the altered adiponectin levels also play a role in the endocrine and metabolic abnormalities seen in PCOS women. We aimed to study the association of adiponectin levels with PCOS women. This case control study included 60 PCOS women under 30 age, and BMI matched healthy controls were recruited. For all the subjects Biochemical and serum adiponectin were determined. The serum adiponectin shows significantly decreased in PCOS women when compared to healthy controls (P <0.001**). This levels were inversely associated with BMI and total cholesterol, triglycerides in women with PCOS (P<0.001**). The significantly decreased levels of serum adiponectin can be useful for diagnostic and prognostic tool for PCOS in women and its application can be used for the success of specific emerging treatment modalities where the follow up shows improvement of levels of adiponectin.

Comparative Evaluation of the Effectiveness of Different Pain-alleviating Methods before Local Anesthetic Administration in Children of 6 to 12 Years of Age: A Clinical Study.

BACKGROUND AND AIM OF THE STUDY: Pediatric patients are apprehensive regarding having dental treatment mainly because of painful local anesthetic (LA) injections. Various techniques like transcutaneous electrical nerve stimulation (TENS), topical anesthetic agents, and vibrator device are introduced to reduce discomfort before LA administration. Therefore, the present study aimed to compare and evaluate the effectiveness of TENS, 2% lignocaine gel, eutectic mixture of lignocaine and prilocaine (EMLA), and vibrating device before LA injections in alleviating pain in pediatric patients. MATERIALS AND METHODS: Sixty healthy children aged 6 to 12 years who required LA injections for dental procedures were selected and divided into four groups with 15 patients in each group. Wong-Baker's facial pain rating scale (WBFPRS) and face, legs, activity, cry, and consolability scale (FLACC) are used for pain perception which are tabulated, and statistically analyzed. RESULTS: The test results demonstrated that the TENS group has shown the least mean WBFPRS and FLACC score, followed by vibrator devices, EMLA gel, and lignocaine gel. CONCLUSION: The newly introduced TENS apparatus showed encouraging results, hence can be used as a safe and reliable technique to be used in pediatric dentistry. HOW TO CITE THIS ARTICLE: Patil SB, Popali DD, Bondarde PA, et al. Comparative Evaluation of the Effectiveness of Different Pain-alleviating Methods before Local Anesthetic Administration in Children of 6 to 12 Years of Age: A Clinical Study. Int J Clin Pediatr Dent 2021;14(4):447-453.

Novel biocompatible poly(acrylamide)-grafted-dextran hydrogels: Synthesis, characterization and biomedical applications.

An electro-responsive PAAm-g-Dxt copolymer was synthesized and characterized by 1HNMR & FTIR spectroscopy, neutralization equivalent, elemental and thermogravimetric analysis to ascertain the grafting reaction. Further, we developed an electro-responsive transdermal drug delivery system (ETDS) utilizing PAAm-g-Dxt copolymer for rivastigmine tartarate delivery through skin. The ETDS were developed using drug-loaded PAAm-g-Dxt hydrogel as the reservoir, and cross-linked dextran-poly(vinyl alcohol) blend films as rate controlling membranes (RCM). In the absence of electrical stimuli, a small amount of drug was permeated from the ETDS, while in the presence of electrical stimuli, the drug permeability was increased. On application of electric stimulus, the flux was increased by 1.6 fold; drug permeability was enhanced when the strength of applied electric current was raised to 8 mA from 2 mA. The drug permeability characteristics studied under "on-off" stimuli suggested that there was faster drug permeation when electrical stimuli was 'on' and it decreased when electrical stimuli was 'off.' The histopathology study confirmed the altered skin structural integrity after application of electrical stimuli. Hence, the PAAm-g-Dxt based ETDS are useful for transdermal drug delivery triggered by an electric stimulus to deliver on-demand release of drug into systemic circulation.

Effectiveness of two different behavioral modification techniques among 5-7-year-old children: A randomized controlled trial.

BACKGROUND: Dental fear is a common, essential, and inevitable emotion that appears as a response to the stressful situation, which raises children's anxiety level, resulting in reduced demand for pediatric dental care. AIMS: (1) To compare and evaluate the effectiveness of customized tell-play-do (TPD) technique with live modeling for behavior management of children. (2) To compare the behavioral modification techniques in managing the children during their dental visits. MATERIALS AND METHODS: Ninety-eight children aged 5-7 years were enrolled in the study and randomly allocated into two groups. Phase I: first visit. Group I - children were conditioned to receive various dental procedures using live modeling followed by oral prophylaxis. Group II - TPD technique was introduced with customized playing dental objects followed by oral prophylaxis. Phase II: second visit. After 7 days interval, all the study subjects were subjected to rotary restorative treatment. EVALUATION: Heart rate, Facial Image Scale (FIS), and Venham-6-point index were used before intervention, after intervention, and during dental procedure to quantify the anxious behavior. RESULTS: All 98 children after intervention underwent oral prophylaxis on first visit and rotary restorative treatment on second visit. The average pulse rate, FIS, and Venham scale scores were significantly lower among children who received TPD intervention when compared to those who received live modeling intervention. Unpaired t-test at 5% level of significance was considered as statistical significance. CONCLUSIONS: TPD is effective in reducing children's fear and anxiety about dental treatment, children enjoy playing with customized dental object. Thus, to promote adaptive behavior, TPD could be an alternate behavioral modification technique during pediatric dentistry.

Severe congenital cyclic neutropenia: A case report.

Congenital cyclic neutropenia syndrome is a constitutional genetic disorder which is characterized by very low number of neutrophils (neutropenia). Patients suffering from this disorder clinically present with neutropenia at early age, history of recurrent fever, ulcerations in the oral cavity, gingivitis, and other recurrent infections. This paper describes a case report of a child with recurrent mouth ulcers, fever, and later diagnosed with severe congenital cyclic neutropenia. This also emphasizes the importance of identification of rare causes of immunosuppressive conditions in children presenting with recurrent oral ulcers and poor dental hygiene, to prevent long-term complications of oral cavity and also morbidity and mortality secondary to neutropenic sepsis.

Accidental Ingestion and Uneventful Retrieval of an Endodontic File in a 4 Year Old Child: A Case Report.

The majority of foreign body ingestions occur in the pediatric population, with a peak incidence between the ages of 6 months and 6 years. Safety during dental treatment of children cannot be overemphasized. Uncooperative, mentally and physically handicapped children are more prone to ingestion or aspiration of dental instruments than other populations. In any event, it is recommended that dental practitioners examine their instrument before use, as a safeguard against any slippage, breakage. Treatment with any endodontic device requires the use of proper isolation such as rubber dam.

Oleanolic acid prevents progression of streptozotocin induced diabetic nephropathy and protects renal microstructures in Sprague Dawley rats.

OBJECTIVE: To study the effect of oleanolic acid (OA) on streptozotocin induced diabetic nephropathy in Sprague Dawley rats. MATERIALS AND METHODS: Four weeks after intra-peritoneal injection of streptozotocin (STZ; 55 mg/kg), the rats with proteinuria were grouped as: Control (non-diabetic, treated orally with vehicle), diabetic control (treated orally with vehicle) and three diabetic groups receiving 20, 40 and 60 mg/kg/day oral doses of OA. At the end of 8 weeks, urine and serum samples from the rats were processed for determination of creatinine, BUN and GFR. The kidney samples were processed for determination of weight changes, oxidative stress related parameters like catalase, superoxide dismutase and reduced glutathione levels. A part of one kidney from each rat was used for transmission electron microscopy (TEM). RESULT: As evident in TEM, OA inhibited the nephropathy induced alterations in podocyte integrity, basement membrane thickness and spacing between the podocytes at 60 mg/kg dose. It increased GFR and reduced oxidative stress in the kidneys in a dose dependent manner. These findings conclusively demonstrate the efficacy of OA in diabetic nephropathy. Significant decrease in the oxidative stress in kidneys indicates the role of anti-oxidant mechanisms in the effects of OA. However, OA is known to act through multiple mechanisms like inhibition of the generation of advanced glycation end products and improving the insulin secretion. These mechanisms might have contributed to its efficacy. CONCLUSION: These results conclusively demonstrate the efficacy of OA in diabetic nephropathy through its possible antioxidant activity.

Multiple natal teeth: a rare case report.

A rare case report of multiple natal teeth in both maxillary and mandibular dental arches in a 21-day-old baby and its management is being presented here.

Prevalence of oral mucosal lesions and variations in Indian public school children

Aim: To study the nature and distribution of oral mucosal lesions and variations in children.Methods: This investigation was a cross-sectional study. All the study subjects were taken fromgovernment primary school. Children were in the age group of 4-14years. The children whowere attending the Department of Pediatric Dentistry for dental check up were examined. Results:A total of 1,003 children were included in the present study,. The mucosal lesions were observedin 643 (64.11%) children, developmental variations of mucosa were evident in 220 (21.93%)children and normal mucosal variations were present in 391 (38.98%) children. The mostcommonly observed mucosal lesions were gingivitis, gingival abscess and traumatic ulcers. Themost frequent developmental mucosal variations were ankyloglossia and high frenal attachment.Normal mucosal variations noted were linea alba buccalis and fordyce’s spots. Distribution ofmucosal lesions/variations were same among both the gender except fordyce’s spots (p=0.018).Parotid papillae and pigmented spots had positive relation with age. Conclusions: Mucosallesions/variations were present in more than half of the children in this study. Only few oralmucosal lesions had gender differences and vary with age.