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1.
Int J Clin Pediatr Dent ; 17(3): 321-327, 2024 Mar.
Article in English | MEDLINE | ID: mdl-39144508

ABSTRACT

Aim: This study was designed to compare the clinical efficacy of two esthetic restorative materials, nanoceramic (Magma NT®) and giomer (Beautifil II®), as full coronal restoration in primary maxillary incisors. Materials and methods: A total of 15 patients aged 3-5 years presenting with mutilated primary maxillary incisors due to caries or trauma were selected for the study using randomized simple sampling. A total of 40 maxillary incisors were randomly divided into two equal groups, with 20 teeth in each group. Teeth in group I (GP I) were restored with nanoceramic (Magma NT®) and group II (GP II) with giomer (Beautifil II®). The full coronal restorations were done using strip crowns (3M ESPE). The restorations were evaluated for gross fracture, marginal integrity, and secondary caries according to modified Ryge's criteria [United States Public Health Service (USPHS)] at baseline (immediate postoperative), 3, 6, and 9 months. Parental satisfaction with each type of restoration was also evaluated using the Likert 5-point scale. Results: The data obtained was statistically analyzed using the Chi-squared test, and the level of significance, that is, the p-value, was determined. The Chi-squared test showed no significant changes to all modified USPHS criteria for each material at baseline and 3-month evaluation period. The changes recorded were after a 3-month follow-up between the two materials; nanoceramic (Magma NT®) restoration demonstrated marginally better than giomer (Beautifil II®) in terms of gross fracture and marginal integrity; however, there was no statically significant difference between them (p > 0.05), while giomer (Beautifil II®) was better than nanoceramic in terms of secondary caries (p < 0.05). Parental satisfaction for both entities was comparable in terms of color and durability; however, they were cost-ineffective. Conclusion: Nanoceramic restoration demonstrated better results in terms of gross fracture and marginal integrity, while giomer was better in terms of secondary caries. Clinical significance: Nanoceramics and giomers can serve as an alternative to conventional restorative materials in primary anterior teeth because of their improved qualities. How to cite this article: Dhaker KK, Tandon S, Rathore AS, et al. Comparative Evaluation of Two Esthetic Full Coronal Restorative Materials for Primary Incisors. Int J Clin Pediatr Dent 2024;17(3):321-327.

2.
Int J Clin Pediatr Dent ; 17(2): 162-167, 2024 Feb.
Article in English | MEDLINE | ID: mdl-39184888

ABSTRACT

Aim: To evaluate the effectiveness of audiovisual (AV) aids in creating awareness of toothbrush hygiene. Materials and methods: This randomized trial study was conducted on 40 children aged 6-11 years. Children were given soft toothbrushes and then collected after brushing for 14 days. The toothbrushes were collected and sent to the laboratory for microbial culture evaluation. A questionnaire consisting of various questions regarding daily toothbrush hygiene practices was filled by the parents at the same time. After 14 days, brushes were collected, and the parents were shown an AV aid regarding toothbrush decontamination, parental awareness, and supervision. Those children were given new sets of toothbrushes and instructed to decontaminate them with chlorhexidine solution. After 14 days, the same questionnaire was filled out by the parents and toothbrushes were collected and immediately sent to the laboratory for microbial culture evaluation. Results: All the sampled toothbrushes had significant (p < 0.001) bacterial growth after 14 days of use. The use of disinfectant led to a 99.98% reduction in microbial colony counts. Hence, showed a significant result. Questionnaire analysis showed a positive parental approach toward maintaining toothbrush hygiene. Conclusion: Cleaning and disinfection of toothbrushes is crucial to stop the spread of disease since bacterial contamination cannot be 100% eliminated. AV aids can be effective tools for increasing awareness. Clinical significance: Through this study, we want to emphasize toothbrush hygiene and create awareness for the same through AV aid because a healthy toothbrush leads to healthy oral health. How to cite this article: Sharma S, Tandon S, Rai TS, et al. Don't Rush with Your Brush: An In Vitro Study on Toothbrush Hygiene. Int J Clin Pediatr Dent 2024;17(2):162-167.

3.
Int J Clin Pediatr Dent ; 17(Suppl 1): S95-S99, 2024 Apr.
Article in English | MEDLINE | ID: mdl-39185257

ABSTRACT

Aim: This case report aims to describe the management of a maxillary lateral incisor with a palatogingival groove (PGG) associated with a complex lesion. Background: The PGG is a rare developmental anomaly that involves the lingual surface of the maxillary incisors and extends for varying distances and depths on the root surface. This anomaly is usually inconspicuous and funnel-shaped, which forms a niche where bacterial plaque and calculus can accumulate to levels significant for pathological changes resulting in endodontic and periodontal lesions. These grooves are easily overlooked as etiologic factors, as they are concealed by the periodontal tissues. Case description: This paper describes the successful management of a rare case of maxillary lateral incisor with an accessory root, two canals, and a complex or type III PGG with a endodontic-periodontic lesion using a multidisciplinary approach. Conclusion: Recognizing PGG as the initiator of pathology is critical for the successful treatment and favorable prognosis of the affected tooth. Clinical significance: This case report highlights the importance of three-dimensional (3D) imaging using cone beam computed tomography (CBCT) that can provide accurate and sensitive information to assess and plan the treatment of the teeth with PGG. It also emphasizes that with the development of newer materials and diagnostic tools, clinicians need a detailed understanding of the characteristics, treatment, and prognosis of PGG to successfully manage the condition. How to cite this article: Gupta S, Tandon S, Rathore AS, et al. Palatogingival Groove: The Known-unknown Devourer. Int J Clin Pediatr Dent 2024;17(S-1):S95-S99.

4.
JCO Glob Oncol ; 10: e2300292, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38301183

ABSTRACT

PURPOSE: Febrile neutropenia (FN) is a serious complication in hematologic malignancies, and lung infiltrates (LIs) remain a significant concern. An accurate microbiological diagnosis is crucial but difficult to establish. To address this, we analyzed the utility of a standardized method for performing bronchoalveolar lavage (BAL) along with a two-step strategy for the analysis of BAL fluid. PATIENTS AND METHODS: This prospective observational study was conducted at a tertiary cancer center from November 2018 to June 2020. Patients age 15 years and older with confirmed leukemia or lymphomas undergoing chemotherapy, with presence of FN, and LIs observed on imaging were enrolled. RESULTS: Among the 122 enrolled patients, successful BAL was performed in 83.6% of cases. The study used a two-step analysis of BAL fluid, resulting in a diagnostic yield of 74.5%. Furthermore, antimicrobial therapy was modified in 63.9% of patients on the basis of BAL reports, and this population demonstrated a higher response rate (63% v 45%; P = .063). CONCLUSION: Our study demonstrates that a two-step BAL fluid analysis is safe and clinically beneficial to establish an accurate microbiological diagnosis. Given the crucial impact of diagnostic delays on mortality in hematologic malignancy patients with FN, early BAL studies should be performed to enable prompt and specific diagnosis, allowing for appropriate treatment modifications.


Subject(s)
Febrile Neutropenia , Hematologic Neoplasms , Leukemia , Lymphoma , Adolescent , Humans , Bronchoalveolar Lavage Fluid/microbiology , Febrile Neutropenia/diagnosis , Febrile Neutropenia/drug therapy , Febrile Neutropenia/etiology , Hematologic Neoplasms/complications , Hematologic Neoplasms/microbiology , Hematologic Neoplasms/pathology , Leukemia/complications , Leukemia/pathology , Lung/microbiology , Lung/pathology , Lymphoma/complications , Lymphoma/diagnosis , Lymphoma/drug therapy , Prospective Studies
5.
J Cancer Policy ; 36: 100412, 2023 06.
Article in English | MEDLINE | ID: mdl-36805892

ABSTRACT

AIM: Healthcare workers (HCWs) have reported negative social experiences during the COVID-19 pandemic; however, this data is largely from medical personnel. We examined living conditions, social determinants, and experiences during the COVID-19 pandemic among all cadres of employees who had recovered from COVID-19 at a tertiary referral cancer hospital in India. METHODS: We conducted a mixed methods study combining a questionnaire-based survey followed by semi-structured interviews with open-ended questions, among hospital staff who recovered from COVID-19 between April and November 2020. We initially administered a 79-point survey to all participants; based on their responses, we used purposive sampling to identify 60 interview participants. The primary aim of the study was to examine the impact of socio-economic factors on experiences and potential stigma faced by staff during the COVID-19 pandemic. RESULTS: We surveyed 376 participants including doctors (10 %), nurses (20 %), support staff (29 %), administrators (18 %) and scientists/technicians (22 %). Of these, 126 (34 %) participants reported negative social experiences. Stigmatisation was lower among doctors compared to other professions, decreased in the second half of the study period, and was more among those living in less affluent surroundings. Interviews revealed 3 types of negative social experiences: neighbourhood tensions around restrictions of mobility, social distancing, and harassment. CONCLUSIONS: The first phase of the COVID-19 pandemic in India led to considerable negative social experiences among hospital employees, especially those lower in the socio-economic hierarchy, which was fuelled by restrictions imposed by the government and pressure on local neighbourhoods. POLICY SUMMARY: It is important to not just document and count stigma experiences during global pandemics, but also to examine sociologically the conditions under which and the processes through which stigma happens.


Subject(s)
COVID-19 , Neoplasms , Humans , COVID-19/epidemiology , Pandemics , SARS-CoV-2 , Social Conditions , Social Determinants of Health , Referral and Consultation , Neoplasms/epidemiology
6.
Int J Clin Pediatr Dent ; 15(Suppl 2): S212-S220, 2022.
Article in English | MEDLINE | ID: mdl-35645521

ABSTRACT

Aim: The study was designed for evaluation and comparison of the efficacy of Xylitol chewing gum and a combination of IgY + Xylitol chewable tablet (Nodecay TM) against the "salivary Streptococcus mutans " count in children. Materials and methods: About 120 children belonging to 6-12 years age-group were enrolled into this "double-blind randomized control clinical trial" according to the selection criteria. They were randomly assigned to three groups of 40 each: Group I-Xylitol chewing gum, Group II-IgY + Xylitol Chewable tablet (Nodecay TM), and Group III-Control. Children in all the groups had to chew the gum/tablet twice daily for 5 minutes during the 15-day period. The salivary samples at baseline, 15 days, 1, 2, and 3 months were inoculated on mitis salivarius bacitracin agar with potassium tellurite medium and the number of colony-forming units (CFUs) of Streptococcus mutans were determined. The data obtained was subjected to statistical analysis. Result: There was a "significant" difference in the number of "S. mutans CFUs" amongst the three groups at 15 days, 1st month, 2nd month, 3rd month with highest levels of S. mutans CFUs in Group III-Control and least in Group II-IgY + Xylitol (NodecayTM). Conclusion: The combination of IgY + Xylitol (NodecayTM) when administered for 15 days had significant efficacy against "S. mutans" when compared to Xylitol and control group. Clinical significance: Passive immunization with immunoglobulin Y is known not only to decrease the S. mutans count but also confers extended immunity by preventing recolonization of the tooth surface by persistence of the antibodies in saliva. How to cite this article: Jain RL, Tandon S, Rai TS, et al. A Comparative Evaluation of Xylitol Chewing Gum and a Combination of IgY + Xylitol Chewable Tablet on Salivary Streptococcus mutans Count in Children: A Double-blind Randomized Controlled Trial. Int J Clin Pediatr Dent 2022;15(S-2):S212-S220.

8.
Int J Clin Pediatr Dent ; 15(2): 143-148, 2022.
Article in English | MEDLINE | ID: mdl-37457212

ABSTRACT

Aims and objectives: The aims and objectives of this study were to evaluate the oral health status in a group of mentally disabled children, to identify the oral health knowledge of parents and to assess the impact of audiovisual oral health education program. Materials and methods: The study sample comprised of 120 mentally disabled subjects aged 5-16 years and 40 parents attending a vocational institute in Jaipur, India. Caries status and oral hygiene status were assessed by DMFT Index and Simplified Oral Hygiene Index (OHI-S) of Greene and Vermillion, respectively. Twenty pre- and post-structured close-ended questions were designed and a 5-minute video on oral health education was prepared. Data was analyzed by using one way ANOVA test followed by Post hoc Tukeys HSD Test, Wilcoxon Signed Rank Test, and Chi-square test. Effectiveness index was calculated to find the impact of AV Teaching Program. Results: Oral hygiene status deteriorates as the severity of mental retardation increases but it was not found significantly associated with oral hygiene status. An effectiveness index of at least 0.5 indicates that the instructional media was satisfactorily effective. Conclusion: Maximum children with poor oral hygiene were in the category of severe mental retardation and mean OHI-S score decreases from severe-to-mild mental retardation. The newly designed audiovisual aid on complete oral health care was effective at some levels in improving the oral health knowledge of the parents/caregivers of mentally retarded children. How to cite this article: Shah RK, Choudhary S, Tandon S. Oral Health Status in Mentally Disabled Children, Dental Care Knowledge of Parents, and the Impact of Audiovisual Oral Health Education Program. Int J Clin Pediatr Dent 2022;15(2):143-148.

9.
Hepatol Int ; 16(2): 463-472, 2022 Apr.
Article in English | MEDLINE | ID: mdl-34687434

ABSTRACT

BACKGROUND AND AIMS: Hepatic tuberculosis (HTB) is rare and mimics neoplastic liver lesions clinico-radiologically leading to misdiagnosis and even unnecessary surgery. METHODS AND MATERIAL: We analysed 43 cases of HTB diagnosed at a referral cancer centre over 10 years. Clinical details, investigations and treatment received were noted. RESULTS: The median age was 46 years with a female preponderance (58%). HTB was diagnosed incidentally in 28% cases during surveillance imaging for a previous cancer. Constitutional symptoms (31, 72%), abdominal pain (25, 58%), fever (12, 28%), hepatomegaly (22, 51%), elevated alkaline phosphatase (34, 79%), elevated aminotransferases (18, 42%) and hypoalbuminemia (19, 45%) were common features. All cases had negative HIV serology and normal tumor markers. Twenty-two (52.5%) had solitary liver lesion and lesions > 2 cm in 28 (65%). Ultrasound showed hypoechoic lesions in 31 of 33 cases. Computed tomography showed hypodense lesions (43,100%) with mild peripheral enhancement (32, 74%). Calcifications (5, 12%) and capsular retraction (8, 19%) was uncommon. MRI was performed in seven cases commonly showed T1 hypointense, T2 hyperintense lesions with restricted diffusion. Histopathology showed granulomatous inflammation (42, 97.5%), Langhan's giant cells (41, 95%) and caseation necrosis (35, 85%). Acid-fast stain and PCR positivity was uncommon. Extrahepatic organs were involved in 20 (46.5%). HTB mimicked cholangiocarcinoma (25, 58%), liver metastasis (11, 26%) and lymphoma (3, 7%). Six patients underwent liver resection with a presumptive diagnosis of cancer without a preoperative biopsy. All patients received antitubercular therapy, 37 had clinico-radiological response, there were 3 deaths and 3 patients were lost to follow-up. CONCLUSION: HTB is rare and can mimic a malignancy clinico-radiologically. Calcifications and pseudocapsule appearance on multiphase CT scan may help in differentiating HTB from hepatic malignancy. Tumor markers are normal while histopathology is generally diagnostic. A high index of suspicion is required to avoid unnecessary surgery as the patients respond well to ATT. TRIAL REGISTRATION: This is a retrospective and observational study hence clinical trial registration is not applicable.


Subject(s)
Bile Duct Neoplasms , Cholangiocarcinoma , Liver Neoplasms , Tuberculosis, Hepatic , Bile Ducts, Intrahepatic , Biomarkers, Tumor , Female , Humans , Liver Neoplasms/diagnosis , Magnetic Resonance Imaging/methods , Middle Aged , Retrospective Studies , Tuberculosis, Hepatic/diagnosis , Tuberculosis, Hepatic/epidemiology
10.
South Asian J Cancer ; 10(2): 102-106, 2021 Apr.
Article in English | MEDLINE | ID: mdl-34604126

ABSTRACT

Objectives Peritoneal tuberculosis can mimic advanced abdominal malignancy. We describe clinical and laboratory characteristics in a series of female patients with peritoneal tuberculosis who were referred to a tertiary cancer center with a diagnosis of suspected advanced ovarian/primary peritoneal cancer. Materials and Methods Details of clinical features, laboratory results including serum tumor markers, radiological findings, and ascitic fluid evaluation were retrospectively collected from hospital records for patients diagnosed to have peritoneal tuberculosis and reported descriptively. Statistical Analysis Descriptive statistics was performed using SPSS Statistics for Windows software, version 20.0 (SPSS, Chicago, Illinois). Results Between January 2009 and December 2017, 120 patients of peritoneal tuberculosis with a median age 41 years (range, 15-79 years) were identified. Of these 112 (93.3%; 95% CI 88.9-97.8%) patients had ascites and 63 (52.5%; 95% CI 43.6-61.4%) had adnexal mass at presentation. Mean serum cancer antigen 125 (CA-125) level was 666.9 (range, 38-18,554) U/mL. Ascitic fluid was negative for malignant cells in all patients and lymphocyte rich exudate was seen in 103 (91.9%; 86.9-97.0%) patients. Ascitic fluid adenosine deaminase (ADA) level was more than 40 U/L in 107 (95.5%; 95% CI 91.7-99.4%). Ascitic fluid Ziel-Neelsen staining was positive in 4/62 (6.5%; 95% CI 0.3-12.6%) patients while ascitic fluid culture examination for mycobacterium tuberculosis was positive in 7/59 (11.9%; 95% CI 3.6-20.1%) patients. The diagnosis of tuberculosis was based on image-guided biopsy in 44 (36.7%) patients, surgical biopsy in 8 (6.7%) patients, and a combination of clinicoradiological and laboratory features in 68 (56.7%) patients. All patients received standard antitubercular treatment. Conclusions The study results suggest that peritoneal tuberculosis has clinical, radiological, and serological profile which may mimic advanced ovarian/primary peritoneal cancer. Peritoneal tuberculosis should be considered in the differential diagnosis of advanced abdominal malignancy.

11.
Nucl Med Commun ; 42(5): 535-544, 2021 May 01.
Article in English | MEDLINE | ID: mdl-33560716

ABSTRACT

PURPOSE: To determine predictive models (PM) that could improve the accuracy for identifying metastatic regional nodes in non-small cell lung cancer based on both PET and CT findings seen on 18F-FDG PET CT. METHODS: Three hundred thirty-nine biopsy-proven NSCLC patients who underwent surgical resection and had a staging 18F-FDG PET CT were enrolled. PET parameters obtained were (1) presence of visual PET positive nodes, (2) SUVmax of nodes (NSUV), (3) ratio of node to aorta SUVmax (N/A ratio) and (4) ratio of node to primary tumour SUVmax (N/T ratio). CT parameters obtained were (1) short-axis diameter and (2) Hounsfield units (HU) of PET-positive nodes. PET and CT parameters were correlated with nodal histopathology to find out the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and overall accuracy. Different PM combining these parameters were devised and the incremental improvement in accuracy was determined. RESULTS: Visual PET positivity showed sensitivity, specificity, PPV, NPV and accuracy of 72.4, 76.1, 30.1, 95.1 and 75.6, respectively. PM2 which combined visual PET positivity, NSUV and HU appears more clinically relevant and showed sensitivity, specificity, PPV, NPV and accuracy of 53.5, 96.5, 68.9, 93.6 and 91.2, respectively. PM6 which combined visual PET positivity, NSUV, N/A ratio and HU showed the maximum PPV (80.0%), specificity (98.3%) and accuracy of (91.9%). CONCLUSION: PM combining parameters like nodal SUVmax, N/A ratio, N/T ratio and HU values have shown to improve the PPV, specificity and overall accuracy of 18FDG PET CT in the preoperative diagnosis of nodal metastases.


Subject(s)
Carcinoma, Non-Small-Cell Lung/diagnostic imaging , Fluorodeoxyglucose F18 , Lung Neoplasms/diagnostic imaging , Positron Emission Tomography Computed Tomography , Adult , Aged , Female , Humans , Male , Middle Aged , Sensitivity and Specificity
12.
Int J Clin Pediatr Dent ; 13(3): 235-239, 2020.
Article in English | MEDLINE | ID: mdl-32904087

ABSTRACT

BACKGROUND: Correct working length determination is one of the main factors leading to success in root canal treatment. The digital tactile sense technique and conventional radiography (CR) are common techniques for working length determination but both techniques have some limitations. A newer method of working length estimation involves use of the apex locator. The current study was carried out to compare the accuracy of the apex locator with a tactile and conventional radiographic method for working length determination in primary and permanent teeth. MATERIALS AND METHODS: The study was conducted on 60 children selected randomly from the outpatient department of the Department of Pediatric and Preventive Dentistry. The patients were divided into two groups: primary and permanent. An informed consent was obtained. After radiographic confirmation of the presence of more than two-third root length access, opening was done in all the teeth. The pulp was extirpated completely from the chamber and canals. Canals were dried completely using paper points. Working length was determined by all the three methods, i.e., digital tactile method, apex locator, and conventional intraoral periapical radiographic method in both primary and permanent teeth. RESULTS: The data were coded and entered into the Microsoft Excel spreadsheet. The analysis was done using the SPSS version 20 (IBM SPSS Statistics Inc., Chicago, Illinois, USA) Windows software program. The variables were assessed for normality using the one-way ANOVA test. Within the limitations of this study, working lengths obtained by the tactile method, the apex locator, and the radiographic method were comparable. There was no statistically significant difference among the three methods except in mesiolingual and distobuccal canals of permanent teeth. CONCLUSION: The apex locator can serve as a useful guide to determine the working length in permanent as well as primary teeth. HOW TO CITE THIS ARTICLE: Rathore K, Tandon S, Sharma M, et al. Comparison of Accuracy of Apex Locator with Tactile and Conventional Radiographic Method for Working Length Determination in Primary and Permanent Teeth. Int J Clin Pediatr Dent 2020;13(3):235-239.

13.
Int J Clin Pediatr Dent ; 13(3): 306-309, 2020.
Article in English | MEDLINE | ID: mdl-32904090

ABSTRACT

Irritation fibroma is a benign, exophytic reactive oral lesion that develops secondary to injury. Its recurrence rate is rare but may happen in case of repeated trauma at the same site. This case report describes a recurrent fibroma in the anterior region of the hard palate in a 13-year-old male patient, which recurred in less than 1 year of surgical excision of the previous lesion. Through a detailed case history and clinical examination, the etiological factor of the same was found to be trauma from occlusion by the lower incisors. A multidisciplinary treatment approach was, therefore, undertaken, which included surgical excision of the lesion and correction of the underlying deep bite to prevent recurrence of the lesion. Thus, this article highlights the significance of a multidisciplinary approach for holistic dental treatment. HOW TO CITE THIS ARTICLE: Lalchandani CM, Tandon S, Rai TS, et al. Recurrent Irritation Fibroma-"What Lies Beneath": A Multidisciplinary Treatment Approach. Int J Clin Pediatr Dent 2020;13(3):306-309.

14.
Indian J Tuberc ; 67(3): 386-388, 2020 Jul.
Article in English | MEDLINE | ID: mdl-32825875

ABSTRACT

Primary tuberculosis (TB) of tonsil is a rare form of extra-pulmonary tuberculosis. Most tonsillar TB cases present with coexistent pulmonary tuberculosis. It can simulate tonsillar malignancy and poses a diagnostic challenge. Histopathological examination is often needed for confirmation. Herein, we report a case of primary tonsillar tuberculosis in a 55-year-old gentleman mimicking carcinoma of the tonsil.


Subject(s)
Carcinoma/diagnosis , Tonsillar Neoplasms/diagnosis , Tonsillectomy , Tonsillitis/diagnosis , Tuberculosis/diagnosis , Antitubercular Agents/therapeutic use , Diagnosis, Differential , Humans , Male , Middle Aged , Positron Emission Tomography Computed Tomography , Tonsillitis/drug therapy , Tonsillitis/pathology , Tuberculosis/drug therapy , Tuberculosis/pathology
16.
Surg Today ; 50(4): 323-334, 2020 Apr.
Article in English | MEDLINE | ID: mdl-32048046

ABSTRACT

Esophageal cancer surgery, comprising esophagectomy with radical lymphadenectomy, is a complex procedure associated with considerable morbidity and mortality. The enhanced recovery after surgery (ERAS) protocol which aims to improve perioperative care, minimize complications, and accelerate recovery is showing promise for achieving better perioperative outcomes. ERAS is a multimodal approach that has been reported to shorten the length of hospital stay, reduce surgical stress response, decrease morbidity, and expedite recovery. While ERAS components straddle preoperative, intraoperative, and postoperative periods, they need to be seen in continuum and not as isolated elements. In this review, we elaborate on the components of an ERAS protocol after esophagectomy including preoperative nutrition, prehabilitation, counselling, smoking and alcohol cessation, cardiopulmonary evaluation, surgical technique, anaesthetic management, intra- and postoperative fluid management and pain relief, mobilization and physiotherapy, enteral and oral feeding, removal of drains, and several other components. We also share our own institutional protocol for ERAS following esophageal resections.


Subject(s)
Enhanced Recovery After Surgery , Esophageal Neoplasms/physiopathology , Esophageal Neoplasms/surgery , Esophageal Neoplasms/rehabilitation , Esophagectomy/methods , Humans , Lymph Node Excision/methods , Perioperative Care
17.
Indian J Cancer ; 57(1): 18-24, 2020.
Article in English | MEDLINE | ID: mdl-31929233

ABSTRACT

BACKGROUND: Stereotactic body radiotherapy (SBRT) is now considered the standard treatment for medically inoperable early-stage non-small lung cell cancer (ES-NSCLC). PURPOSE: There is a paucity of data related to outcomes with SBRT in ES-NSCLC from the developing countries. We report the early outcomes of ES-NSCLC patients treated with SBRT at our institute. MATERIALS AND METHODS: Between 2007 and 2015, 40 consecutive patients with histologically proven ES-NSCLC were treated with SBRT. Median age was 71 years (range: 46-88 years) and median Charlson comorbidity index (CCI) was 3. The majority had stage I (70%) and 45% of the tumors were centrally located. The median tumor diameter was 3.8 cm (range: 2-7.6 cm). The mean gross tumor volume was 41 cc (range: 4-139 cc) and the mean planning target volume (PTV) was 141 cc (range: 27-251 cc). Varying dose and fraction (fr) sizes were used depending on tumor location, tumor size, and treatment period. The median biologically effective dose (BED) was 77 Gy10 (range: 77-105 Gy10) for the initial cohort (2007-2012) and 105 Gy10 (range: 77-132 Gy10) for the subsequent cohort (2013-2015). RESULTS: After a median follow-up of 16 months (range: 3-99 months), the 2-year local control (LC), overall survival, and cancer-specific survival (CSS) rates were 94%, 41%, and 62%, respectively. The univariate and multivariate analysis determined CCI >3 and PTV >80.6 cc as significant predictors of worse OS and CSS (P< 0.01). The clinical stage, tumor location, BED, and treatment period (2007-2012 vs. 2013-2015) did not significantly predict any of the outcomes. The most common acute toxicities were skin erythema (10%), grade 1 esophagitis (8%), and exacerbation of previous chronic obstructive pulmonary disease (10%). Grade ≥2 late radiation pneumonitis was seen in 17.5%. One patient developed a rib fracture. No neurological or vascular complications were seen. CONCLUSIONS: SBRT results in excellent local control (LC) and acceptable survival in medically inoperable ES-NSCLC with minimal adverse effects. Charlson comorbidity index and target volume are important prognostic factors and may aid in patient selection.


Subject(s)
Carcinoma, Non-Small-Cell Lung/radiotherapy , Lung Neoplasms/radiotherapy , Radiosurgery/methods , Aged , Aged, 80 and over , Carcinoma, Non-Small-Cell Lung/pathology , Female , Hospitals , Humans , India , Lung Neoplasms/pathology , Male , Middle Aged , Neoplasm Staging , Radiotherapy Dosage
18.
Int J Clin Pediatr Dent ; 13(6): 617-621, 2020.
Article in English | MEDLINE | ID: mdl-33976485

ABSTRACT

AIM AND OBJECTIVES: To evaluate clinical and radiographic efficacy of a mix of O. sanctum (tulsi extract) and calcium hydroxide as an obturating material in primary molars and to compare these findings with commercially available iodoform with calcium hydroxide paste (metapex). MATERIALS AND METHODS: The present study was conducted on sixty children age group 4-7 years requiring multiple visit pulpectomy for their primary molars. The teeth selected were randomly divided into two groups. One group received Metapex and other group received Tulsi extract with calcium hydroxide as an obturating material. Clinical and radiographic evaluation were done between both the groups. RESULTS: There was no significant difference in the clinical and radiographic success rate between both the groups. CONCLUSION: Tulsi extract with calcium hydroxide can be used as an obturating material in primary molars. HOW TO CITE THIS ARTICLE: Agarwal S, Gupta S, Tandon S, et al. Comparative Evaluation of Ocimum sanctum and Calcium Hydroxide Mix as an Obturating Material in Deciduous Molars: An In Vivo Study. Int J Clin Pediatr Dent 2020;13(6):617-621.

19.
Int J Clin Pediatr Dent ; 13(5): 437-441, 2020.
Article in English | MEDLINE | ID: mdl-33623325

ABSTRACT

OBJECTIVE: To evaluate the effectiveness of audiovisual (AV) aid in assessing the parental attitude for their child's oral health. MATERIALS AND METHODS: A study (cross-sectional) was conducted in 50 parents of the children between age group of 0 and 14 years. A PowerPoint presentation was given to parents in two batches, and its effectiveness was assessed by comparing results of questionnaire before and after presentation. Data were collected through a questionnaire. STATISTICAL ANALYSIS: All data were compiled using MS Office Excel Sheet, and analysis was performed using the Statistical Package for Social Sciences software for descriptive analysis, and the level of statistical significance used in this study was chosen at p value < 0.005. RESULTS: The results proved that selected sample had lack of knowledge regarding primary teeth and its importance, oral health care of the child from birth, ideal time of first dental visit, and preventive treatments before awareness program. But there was significant difference in attitude of parents regarding their child's oral health care after presentation. CONCLUSION: Within the limitation of the study, the high prevalence dental caries in children showed that change of parental behavior and attitude is much more important rather than focusing on increasing knowledge only. Hence, AV aids can be effective tools for increasing awareness. HOW TO CITE THIS ARTICLE: Kajal A, Tandon S, Rai TS, et al. Efficacy of Audiovisual Aid in Assessing Parental Attitude toward their Child's Oral Health. Int J Clin Pediatr Dent 2020;13(5):437-441.

20.
Int J Clin Pediatr Dent ; 13(Suppl 1): S102-S104, 2020.
Article in English | MEDLINE | ID: mdl-34434023

ABSTRACT

Pediatric dentistry is a speciality of dentistry focusing mainly on oral health care of children. Early diagnosis and prompt treatment is key of a good treatment plan and effective results. Sometimes in infants, it is not possible to make a confirmatory diagnosis due to lack of cooperation, which is the biggest challenge of kids dentistry. In such cases, we need to take into consideration the psychological and physiologic aspect of child to find an alternative treatment plan, which is time saving and painless. Here, we present a unique case management of lingual swelling on the ventral surface of tongue in a 9-month-old girl child with a minimal invasive approach, thus avoiding a time-consuming and invasive surgical treatment plan. How to cite this article: Kajal A, Tandon S, Sharma M, et al. Minimal Invasive Approach for Management of Lingual Swelling on Ventral Surface of Tongue. Int J Clin Pediatr Dent 2020;13(S-1):S102-S105.

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