Evaluation and Management of Premature Rupture of Membranes: A Review Article.

Premature rupture of membranes (PROM), now also referred to as "pre-labour rupture of membranes," is the rupture of gestational membranes after 37 weeks but before the process of labour begins. When membrane rupture occurs before 37 weeks of gestation, it is referred to as preterm PROM (PPROM). Prematurity is held accountable for the majority of newborn morbidity and mortality. PROM causes around one-third of all preterm deliveries and complicates 3% of pregnancies. Significant morbidity and mortality rates have been associated with PROM. Preterm (PROM) pregnancies are more difficult to manage. Pre-labour rupture of membranes is characterised by its short latency, higher intrauterine infection risk, and greater umbilical cord compression probability. Women with preterm PROM are more likely to develop chorioamnionitis and placental abruption. Various diagnostic modalities include sterile speculum examination, the nitrazine test, the ferning test, and the latest advances, which are the Amnisure test and the Actim test. Despite all these tests, there is still a need for newer, non-invasive, rapid, and accurate tests. Admission to a hospital, amniocentesis to rule out infection, and, if necessary, prenatal corticosteroids and broad-spectrum antibiotics are all alternatives for treatment. As a result, the clinician managing a pregnant woman whose pregnancy has been affected by PROM plays a crucial role in the management and must be well aware of probable complications and control measures to reduce risks and increase the likelihood of the required outcome. PROM's proclivity for recurrence in later pregnancies provides a chance for prevention. Furthermore, prenatal and neonatal care developments will continue to enhance the outcomes of women and their children. The purpose of this article is to summarise the concepts related to the evaluation and management of PROM.

Nicotine replacement therapy 'gift cards' for hospital inpatients who smoke: a prospective before-and-after controlled pilot evaluation.

INTRODUCTION: A common barrier identified by individuals trying to quit smoking is the cost of cessation pharmacotherapies. The purpose of this evaluation was to: (1) Assess the feasibility of offering nicotine replacement therapy (NRT) 'gift cards' to hospitalised smokers for use posthospitalisation; and, (2) Estimate the effect of providing NRT gift cards on 6-month smoking abstinence. METHODS: A prospective, quasi-experimental, before-and-after controlled cohort design with random sampling was used to compare patients who had received the Ottawa Model for Smoking Cessation (OMSC) intervention ('control') with patients who received the OMSC plus a $C300 Quit Card ('QCI'), which they could use to purchase any brand or form of NRT from any Canadian pharmacy. RESULTS: 750 Quit Cards were distributed to the three participating hospitals of which 707 (94.3%) were distributed to patients. Of the cards received by patients, 532 (75.2%) were used to purchase NRT. A total of 272 participants completed evaluation surveys (148 control; 124 QCI).Point prevalence abstinence rates adjusted for misreporting among survey responders were 15.3% higher in the QCI group, compared with controls (44.4% vs 29.1%; OR 1.95, 1.18-3.21; p=0.009). Satisfaction was high among participants in both groups, and among staff delivering the QCI. QCI participants rated the intervention as high in terms of motivation, ease of use and helpfulness. CONCLUSIONS: The NRT gift card appears to be a feasible and effective smoking cessation tool that removes a primary barrier to the use of evidence-based smoking cessation pharmacotherapies, while motivating both patients and health providers.

Impact of socioeconomic factors on deciduous teeth eruption among infants born after low-risk pregnancy compared to infants diagnosed with intrauterine growth restriction.

Aim: The aim is to assess the impact of socioeconomic factors on deciduous teeth eruption among infants born after low-risk pregnancy and infants diagnosed with intrauterine growth restriction (IUGR). Materials and Methodology: The cross-sectional study included 110 neonates recruited at birth using stratified random sampling based on inclusion and exclusion criteria. Neonates diagnosed without IUGR were allocated to Group I (n = 55) and those diagnosed with IUGR were allocated to Group II (n = 55). The perinatal case history was recorded, followed by intraoral examination at birth, 6 months, and monthly up to 1 year or till first evidence of teeth eruption. Results: The difference between both groups based on socioeconomic status (SES) was found statistically significant (P = 0.043). The first evidence of eruption of deciduous teeth was found delayed in Group II (P = 0.0001). Secondary school education was found statistically significant between both the groups (P = 0.024). The difference between the two groups based on religion (P = 0.353) and gravidity (P = 0.571) was found statistically insignificant. Conclusion: Lower SES and secondary maternal education can be considered statistically significant risk factors of IUGR and delayed deciduous teeth eruption. No correlation of IUGR with religion and gravidity was found.

Knowledge, Attitude and Practice of Eating Disorders among Children and Adolescents Engaged in Sports: A Cross-sectional Study.

Aim and objective: To assess the knowledge, attitude, and practices regarding eating disorders among children and adolescents, engaged in sports. Materials and methods: A total sample of 650 children was recruited and further divided into two groups on the basis of age. Group, I comprised of children and adolescents between 10-14 years of age and Group II between 15-18 years of age. A self-instructed open ended questionnaire was used in English and Hindi. The sports included were Basketball, Yoga, Wrestling, Judo, Cricket, Gymnastics, Boxing, Badminton, Table Tennis and others based on the availability of children in each sport. Result: The mean knowledge, attitude, and practice of Bulimia nervosa in Group I was 0.228 ± 0.41, 2.69 ± 0.586, and 0.000, respectively. The mean knowledge, attitude, and practice of Anorexia nervosa in Group I was 4.76 ± 1.2, 0.22 ± 0.41, and 1.17 ± 0.908. The mean knowledge, attitude, and practice of Binge eating disorders in Group I was 0.22 ± 0.41, 1.65 ± 0.50, and 0.18 ± 0.39, respectively. The mean knowledge, attitude, and practice of Bulimia nervosa in Group II were 3.717 ± 1.21, 0.34 ± 0.56, and 0.145 ± 0.35. The mean knowledge, attitude, and practice of Anorexia nervosa in Group II were 5.26 ± 1.17, 0.34 ± 0.56, and 1.12 ± 0.85. The mean knowledge, attitude, and practice of Binge eating disorders in Group II were 0.34 ± 0.56, 1.76 ± 0.42, and 0.28 ± 0.60. Conclusion: The likely chance of developing an eating disorder and habits practiced related to Bulimia nervosa and Anorexia nervosa was found higher among adolescents between 15-18 years of age. However, these findings were found similar for Binge eating disorders among both age groups. How to cite this article: Goswami M, Kumar G, Garg A, et al. Knowledge, Attitude and Practice of Eating Disorders among Children and Adolescents Engaged in Sports: A Cross-sectional Study. Int J Clin Pediatr Dent 2022;15(2):135-142.

Auricle Schwannoma: Presentation of a Rare Case and Review of Existing Literature.

Schwannomas are extremely rare over auricle. Despite the extensive somatogenic neural innervations of the pinna, schwannomas are never amongst the differentials for a benign auricular mass. Previously published articles have all agreed on the rarity of this lesion occurring over the auricle. However, none of the articles have tackled and extensively reviewed the auricle schwannomas (AS) as an individual entity. The article aim to review previously published cases of AS along with an illustrative case, and provide a better insight regarding demographic, clinicopathological and immunohistochemical features of this neural tumor in a rare site. A systemic review of English literature was performed after using a sensitive search strategy involving three different databases (PubMed, Google Scholar and Embase). A total of nine cases were included. They mostly presented in young adults as a slow growing tumor (mean duration: 3.17 years) and showed a slightly higher male predominance (male/female ratio 1.25:1). They were mostly located over lateral surface (66.67%) with a predilection for left ear (77.78%). Conventional histological variant has only been reported. Complete surgical excision was performed for all the cases without any reports of recurrence or malignant transformation. AS present as a solitary, painless, firm and well-encapsulated lesion, mostly over the lateral auricle surface. Preoperative clinical diagnosis is difficult and radiological investigations do not hold much importance. FNAC is inconclusive and diagnosis mandates histopathologic examination. The nerve of tumor origin is difficult to precisely identify. Complete surgical excision is the treatment of choice. Post-operative prognosis is excellent.

Evaluation of eruption of deciduous teeth among infants born after low risk pregnancy compared to infants diagnosed with Intra Uterine Growth Restriction.

PURPOSE: The impact of IUGR on holistic growth of an infant is established however, limited evidence has been reported regarding its implication on eruption of deciduous dentition. AIM: Comparative evaluation of eruption of deciduous teeth among infants born after low risk pregnancy and infants diagnosed with Intra Uterine Growth Restriction (IUGR). METHODS: The cross-sectional study included 110 neonates recruited at birth using stratified random sampling based on inclusion and exclusion criteria. Neonates diagnosed without IUGR were allocated to Group I (n = 55) and those diagnosed with IUGR were allocated to Group II (n = 55). Perinatal case history was obtained followed by intraoral examination at birth, 6 months and monthly up to 1 year or till first evidence of teeth eruption. RESULTS: The first evidence of eruption of deciduous teeth was found delayed in Group II (p = 0.0001). The mean gestational age at delivery, estimated fetal weight, frequency of NICU admission, birth weight and infant weight at 6 months was found statistically higher (p = 0.001) in Group I. CONCLUSION: First evidence of deciduous teeth eruption was found delayed among IUGR infants therefore, IUGR along with prematurity, LBW, LSCS delivery, NICU admission can be considered as risk factor for delayed eruption.

The INITIATE trial protocol: a randomized controlled trial testing the effectiveness of a "quit card" intervention on long-term abstinence among tobacco smokers presenting to the emergency department.

BACKGROUND: Smoking cessation interventions implemented in emergency department (ED) settings have resulted in limited success, owing to factors such as lack of time, motivation, and incentives. A dynamic yet simple and effective approach that addresses the fast-paced nature of acute-care ED settings is needed. This study proposes a multi-center randomized controlled trial (RCT) to compare the effectiveness of an easy to deliver proactive, multi-component tobacco treatment intervention to usual care in the ED setting. METHODS: This will be a prospective four-site, single-blind, blinded-endpoint (PROBE) RCT. Participants will be recruited directly in the ED and will be approached strictly in order of arrival time. Those randomized to the Quit Card Intervention (QCI) group will receive a "quit kit" which will include: a "Quit Card" worth $300 that can be used at any Canadian pharmacy to purchase any form of nicotine replacement therapy (NRT); a self-help booklet; and proactive enrolment in 6 months of telephone follow-up counseling. The usual care (UC) group will receive a "quit kit" which will include a brochure for a local smoking cessation program. Quit kits for both groups will be delivered in opaque, sealed envelopes, and identical in size and weight so to conceal group allocation from the blinded research coordinator. Randomization will be stratified by site and by the Canadian Triage Acuity Scale (CTAS), a value assigned to each ED patient based on the severity of the condition. An equal number of quit kits will be prepared for each CTAS level. The primary outcome will be bio-chemically verified smoking abstinence at 26 weeks. Secondary outcomes include smoking behavior at weeks 4, 52, and 104 as well as mortality and health care utilization outcomes. Investigators, outcome assessors, and data analysts will be blinded to group allocation until after primary analyses are completed. It is hypothesized that the QCI group will have higher a abstinence rate, improved health outcomes, and decreased healthcare utilization. DISCUSSION: There are few examples of hospital EDs in Canada that systematically initiate tobacco cessation interventions for patients who smoke. Given the high smoking prevalence among ED patients and the relation of tobacco smoking to the majority of ambulatory care sensitive conditions, EDs are a missed opportunity in the initiation of tobacco treatment interventions. We have designed and will test an evidence-based tobacco treatment intervention that is simple and highly scalable. TRIAL REGISTRATION: ClinicalTrials.gov NCT04163081 . Registered on November 14, 2019.

Attitude and practices of parents toward their children's oral health care during COVID-19 pandemic.

RATIONALE: The impact of COVID-19 has affected billions of people affecting nearly all domains of life, including patient's healthcare needs. Due to constrained dental services during lockdown, pediatric dental needs were severely compromised therefore, parental attitude and practices of maintaining child's oral hygiene impose significant impact on child's oral hygiene. AIM: This study aims to assess the attitude and practices of parents toward their children's oral health care during COVID-19 pandemic. METHODOLOGY: The present cross-sectional study was conducted with a sample of 120 parents selected randomly from the outpatient department after obtaining informed consent. A structured questionnaire was used to assess attitude and practice of parents toward their child's oral hygiene during lockdown in COVID-19 pandemic. RESULTS: The overall attitude and practice score of parents in maintaining their child's oral hygiene was low, with mean value of 2.36 ± 1.36 and 2.51 ± 1.50, respectively. 60.8% of parents reported the need of dental treatment for their child during the lockdown period whereas 50.8% parents contacted the dentist during this period; majority (37.5%) of which reported due to toothache. 68.3% of parents would like to visit nearby dental hospital for emergencies during lockdown period. Only 33.3% of parents took extra efforts to maintain their child's oral hygiene while 45% made dietary changes in their child's diet to prevent tooth decay. CONCLUSION: The overall attitude and practices of the parents were poor toward the oral health of their children during the lockdown period in COVID-19 pandemic. There is urgent need of increasing awareness among parents regarding the importance of maintaining their child's oral health. The inability to see the doctor should at least encourage better home practice measures for future. The concept of tele-dentistry is very new and will be the need of the coming modern times.

Inferring metal binding sites in flexible regions of proteins.

Metal ions are central to the molecular function of many proteins. Thus their knowledge in experimentally determined structure is important; however, such structures often lose bound metal ions during sample preparation. Identification of these metal-binding site(s) becomes difficult when the receptor is novel and/or their conformations differ in the bound/unbound states. Locating such sites in theoretical models also poses a challenge due to the uncertainties with side-chain modeling. We address the problem by employing the Geometric Hashing algorithm to create a template library of functionally important binding sites and match query structures with the available templates. The matching is done on the structure ensemble obtained from coarse-grained molecular dynamics simulation, where metal-specific amino acids are screened to infer the true site. Test on 1347 non-redundant monomer protein structures show that Ca2+ , Zn2+ , Mg2+ , Cu2+ , and Fe3+ binding site residues can be classified at 0.92, 0.95, 0.80, 0.90, and 0.92 aggregate performance (out of 1) across all possible thresholds. The performance for Ca2+ and Zn2+ is notably superior in comparison to state-of-the-art methods like IonCom and MIB. Specific case studies show that additionally predicted metal-binding site residues in proteins have features necessary for ion binding. These include new sites not predicted by other methods. The use of coarse-grained dynamics thus provides a generalized approach to improve metal-binding site prediction. The work is expected to contribute to improving our ability to correctly predict protein molecular function where knowledge of metal binding is a key requirement.

Dealing with "Coronavirus Pandemic": A Dental Outlook.

An emergent pneumonia outbreak, denoted as coronavirus disease-2019 (COVID-19) by the World Health Organization (WHO) originated in Wuhan City, in late December 2019 and spread at an alarming rate to become a pandemic affecting more than 200 countries. The COVID-19 is caused by a novel coronavirus (2019-nCoV), which is highly contagious and is associated with a high mortality rate. The current COVID-19 outbreak has created a major havoc among every strata of the society with a detrimental impact on healthcare professionals, including dentists limiting their capabilities at large. The transmission of virus through aerosols produced by high- and low-speed handpieces, ultrasonic scalers, air/water syringes, or an infected patient coughing, and even when taking intraoral radiographs has made it difficult for dental personnel to provide even the most basic services to the needful. The virus survives on environmental surfaces for extended periods of time, including metal and plastic surfaces commonly found in dental offices making it utmost necessary to follow the precautions and recommendations issued by various organizations in order to contain its spread. This article aims to provide the latest knowledge encompassing the various aspects of COVID-19 to pediatric dentists in India. HOW TO CITE THIS ARTICLE: Goswami M, Sharma S, Kumar G, et al. Dealing with "Coronavirus Pandemic": A Dental Outlook. Int J Clin Pediatr Dent 2020;13(3):269-278.

Parent's attitude toward use of internet for child's oral health and treatment.

BACKGROUND: Widespread use of internet in the modern era has allowed increased access to seek medical and dental education by self-education. However, limited evidence is reported regarding the use of internet to gather oral health information by patients reporting to dental hospital in a centrally located institute of New Delhi, India. AIM: The aim of the present cross-sectional study was to evaluate the parental attitude toward the use of internet related to child's oral health and treatment. DESIGN: The data was collected from 500 patients from the Outpatient Department of Pedodontics and Preventive Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi. A self-administered questionnaire with open ended questions assessing parental attitude toward the use of internet for oral health information was designed, and patients willing to participate were included. MATERIALS AND METHODS: The present cross-sectional study was conducted among 500 parents selected randomly from the Out Patient Department. The participants were given the questionnaire which assessed their attitude towards use of internet related to child's oral health and treatment. The data was collected and statistical analysis was performed. RESULTS: 86% reported to have high school education, 7% to have middle school education, 3% to be diploma holders, 2% to be graduates and postgraduates, and only 2% as professionals. 56.1% of the participants use internet to gather information on oral health, whereas only 41.9% reported that they have access to internet but do not use to search information related to oral health and disease. 26.1% of the participants often search information on internet before consulting a doctor, and 29.3% discuss treatment plan after searching from internet with their doctor. CONCLUSION: Since the use of internet by younger adults seeking information on oral health seems to be more prevalent among educated people, less prevalence is reported in this study. Majority of the participants were aware regarding the harmful effects of such information and also reported that treatment or medication searched on internet made their problem worse than before.

Legal and Regulatory Approaches to Rehabilitation Planning: A Concise Overview of Current Laws and Policies Addressing Access to Rehabilitation in Five European Countries.

BACKGROUND: The rising prevalence of disability due to noncommunicable diseases and the aging process in tandem with under-prioritization and underdevelopment of rehabilitation services remains a significant concern for European public health. Over recent years, health system responses to population health needs, including rehabilitation needs, have been increasingly acknowledging the power of law and formal written policies as strategic governance tools to improve population health outcomes. However, the contents and scope of enacted legislation and adopted policies concerning rehabilitation services in Europe has not been synthesized. This paper presents a concise overview of laws and policies addressing rehabilitation in five European countries. METHODS: Publicly available laws, policies, and national action plans addressing rehabilitation issues of Sweden, Italy, Germany, the Netherlands and the United Kingdom were reviewed and descriptive documents analyzed. Actions found in national health policies were also evaluated for compliance with the key recommendations specified in the World Health Organization's Rehabilitation 2030: Call for Action. Results: Across countries, legal and policy approaches to rehabilitation planning varied in scope and reach. While all countries entitle citizens to rehabilitation services, comprehensiveness of coverage varied. Health legislation of Germany and Netherlands recognizes access to rehabilitation as a human right for persons with disabilities, while Sweden and the United Kingdom acknowledge its importance in disability laws for achieving substantive equality for persons with disabilities. Regarding policies, in all countries but Italy, targeted universalism remains the predominant strategy governing rehabilitation services, as demonstrated by the lack of comprehensive, national action plans for rehabilitation addressing the general population. Nevertheless, references found in disease specific policies indicate a solid consensus that rehabilitation remains an integral component of the care continuum for those experiencing disability. CONCLUSION: Although a universal approach to rehabilitation coverage is institutionalized in national legislation of the countries examined, this approach is not expressed in formal policies. Targeted strategies aiming to ensure access to subpopulation groups with higher perceived needs for rehabilitation prevail, indicating a strong political will towards the reduction of health inequalities and the promotion of human rights of people experiencing disability. Results obtained from conducting this descriptive review provide the basis for future appraisals of the situation regarding rehabilitation service and policy development in Europe.

Assessing predictions on fitness effects of missense variants in calmodulin.

This paper reports the evaluation of predictions for the "CALM1" challenge in the fifth round of the Critical Assessment of Genome Interpretation held in 2018. In the challenge, the participants were asked to predict effects on yeast growth caused by missense variants of human calmodulin, a highly conserved protein in eukaryotic cells sensing calcium concentration. The performance of predictors implementing different algorithms and methods is similar. Most predictors are able to identify the deleterious or tolerated variants with modest accuracy, with a baseline predictor based purely on sequence conservation slightly outperforming the submitted predictions. Nevertheless, we think that the accuracy of predictions remains far from satisfactory, and the field awaits substantial improvements. The most poorly predicted variants in this round surround functional CALM1 sites that bind calcium or peptide, which suggests that better incorporation of structural analysis may help improve predictions.

Evaluating the predictions of the protein stability change upon single amino acid substitutions for the FXN CAGI5 challenge.

Frataxin (FXN) is a highly conserved protein found in prokaryotes and eukaryotes that is required for efficient regulation of cellular iron homeostasis. Experimental evidence associates amino acid substitutions of the FXN to Friedreich Ataxia, a neurodegenerative disorder. Recently, new thermodynamic experiments have been performed to study the impact of somatic variations identified in cancer tissues on protein stability. The Critical Assessment of Genome Interpretation (CAGI) data provider at the University of Rome measured the unfolding free energy of a set of variants (FXN challenge data set) with far-UV circular dichroism and intrinsic fluorescence spectra. These values have been used to calculate the change in unfolding free energy between the variant and wild-type proteins at zero concentration of denaturant (ΔΔGH2O) . The FXN challenge data set, composed of eight amino acid substitutions, was used to evaluate the performance of the current computational methods for predicting the ΔΔGH2O value associated with the variants and to classify them as destabilizing and not destabilizing. For the fifth edition of CAGI, six independent research groups from Asia, Australia, Europe, and North America submitted 12 sets of predictions from different approaches. In this paper, we report the results of our assessment and discuss the limitations of the tested algorithms.

Assessing the performance of in silico methods for predicting the pathogenicity of variants in the gene CHEK2, among Hispanic females with breast cancer.

The availability of disease-specific genomic data is critical for developing new computational methods that predict the pathogenicity of human variants and advance the field of precision medicine. However, the lack of gold standards to properly train and benchmark such methods is one of the greatest challenges in the field. In response to this challenge, the scientific community is invited to participate in the Critical Assessment for Genome Interpretation (CAGI), where unpublished disease variants are available for classification by in silico methods. As part of the CAGI-5 challenge, we evaluated the performance of 18 submissions and three additional methods in predicting the pathogenicity of single nucleotide variants (SNVs) in checkpoint kinase 2 (CHEK2) for cases of breast cancer in Hispanic females. As part of the assessment, the efficacy of the analysis method and the setup of the challenge were also considered. The results indicated that though the challenge could benefit from additional participant data, the combined generalized linear model analysis and odds of pathogenicity analysis provided a framework to evaluate the methods submitted for SNV pathogenicity identification and for comparison to other available methods. The outcome of this challenge and the approaches used can help guide further advancements in identifying SNV-disease relationships.

Exploring the use of molecular dynamics in assessing protein variants for phenotypic alterations.

With the advent of rapid sequencing technologies, making sense of all the genomic variations that we see among us has been a major challenge. A plethora of algorithms and methods exist that try to address genome interpretation through genotype-phenotype linkage analysis or evaluating the loss of function/stability mutations in protein. Critical Assessment of Genome Interpretation (CAGI) offers an exceptional platform to blind-test all such algorithms and methods to assess their true ability. We take advantage of this opportunity to explore the use of molecular dynamics simulation as a tool to assess alteration of phenotype, loss of protein function, interaction, and stability. The results show that coarse-grained dynamics based protein flexibility analysis on 34 CHEK2 and 1719 CALM1 single mutants perform reasonably well for class-based predictions for phenotype alteration and two-thirds of the predicted scores return a correlation coefficient of 0.6 or more. When all-atom dynamics is used to predict altered stability due to mutations for Frataxin protein (8 cases), the predictions are comparable to the state-of-the-art methods. The competitive performance of our straightforward approach to phenotype interpretation contrasts with heavily trained machine learning approaches, and open new avenues to rationally improve genome interpretation.

Knowledge, attitude, and practical behavior of parents regarding their child's oral health in New Delhi.

OBJECTIVE: The objective of this study was to determine the knowledge, attitude, and practical behavior of parents regarding their children's oral health in New Delhi. METHODOLOGY: A cross-sectional study was conducted among 500 parents who reported in outpatient department in the Department of General Medicine at Maulana Azad Medical College and in the Department of Pedodontics and Preventive Dentistry at Maulana Azad Institute of Dental Sciences, New Delhi. Data were collected through a self-administered questionnaire. The statistical analysis was performed using the Statistical Package for Social Sciences software (21.0 version; Inc., Chicago IL, USA) for descriptive and multivariate analysis, and the level of statistical significance used in this study was chosen at P < 0.005. RESULTS: The results of this explorative research showed that the sample selected had a relatively good knowledge regarding the importance of the primary teeth, the fact that problems in primary teeth can affect the permanent teeth, brushing frequency on daily basis, and brushing aids. Participants were aware about the effect of prolonged bottle feeding and sticky foods on the dentition. On the other hand, the majority of participants failed to recognize the ideal time of first dental visit. Parents showed positive attitudes regarding the importance of regular dental visit and their role in their children's daily oral hygiene habits. CONCLUSION: In New Delhi, parental awareness and attitudes regarding their children's oral health are relatively good. However, the high dental caries prevalence in children in Central New Delhi contradict the study findings, which prove the fact that changing parental behavior and attitudes toward their children's oral health is far more important than increasing their knowledge only.

Prosthodontic rehabilitation of completely edentulous patient with partial glossectomy.

Oral cancer accounts for about 40% of all cancers inflicting the human beings. Those involving the tongue results in mild to severe deficiencies of phonation, deglutition, mastication, and taste depending upon the degree and extent tissues involved. Often rehabilitation of such patient is a challenge for the prosthodontist and involves a careful observation and evaluation of the residual oral function and ways to restore them. This article presents a case report of prosthodontic rehabilitation completely edentulous patient, who underwent partial glossectomy following surgical resection of the squamous cell carcinoma involving left lateral borders of the tongue. An attempt was made to restore the comfort and function of the patient with the help of palatal augmentation prosthesis, with additional assistance through speech therapy and simple oral exercises.

A comparative evaluation of effect on water sorption and solubility of a temporary soft denture liner material when stored either in distilled water, 5.25% sodium hypochlorite or artificial saliva: An in vitro study.

INTRODUCTION: Soft denture liners have a key role in modern removable prosthodontics since they restore health to inflamed and abused mucosa by redistribution of forces transmitted to the edentulous ridges. The most common problems encountered using soft denture liners are water sorption and solubility when in contact with saliva or storage media. These problems are associated with swelling, distortion, support of Candida albicans growth, and stresses at the liner/denture base interface that reduces the bond strength. OBJECTIVE: To evaluate the water sorption and solubility of commercially available acrylic based self cure soft denture lining material (GC RELINE™ Tissue Conditioner) after immersion in three different storage media (distilled water, Shellis artificial saliva, 5.25% sodium hypochlorite disinfectant solution) at time interval of 4, 7, 11, and 15 days. MATERIAL AND METHODS: The study involved preparation of artificial saliva using Shellis formula. A total 45 standardized samples of the material (GC RELINE™) were prepared in disk form (15 mm in diameter and 2 mm in thickness). The study was divided into three groups with storage in Control (distilled water), Shellis artificial saliva, and 5.25% sodium hypochlorite. Samples were dried in a desiccator and weighed in the analytical balance to measure the initial weight (mg/cm2) of the disks (W1). The first groups (15 samples) were placed in 30 ml distilled water (Group A) at 37ºC, second group 30 ml of artificial saliva (Group B) and third group in 5.25% sodium hypochlorite (Group C). Disks were removed from disinfectant after 5 min and placed in 30 ml distilled water. On days 4, 7, 11, and 15, all samples were removed from their containers and reweighed to measure the weight (mg/cm2) of the disks after sorption (W2). The solubility was measured by placing the disks back in the desiccator after each sorption cycle and drying them to constant weight in the desiccator. These values were weight after desiccation (W3). Water sorption and solubility was calculated: 1. Sorption (mg/cm2) = (W2-W1)/Surface area 2. Solubility (mg/cm2) = (W1-W3)/Surface area. STATISTICAL ANALYSIS: Statistical Analysis was done using one way analysis of variance and the intercomparison between each group was done using Tukey's honestly significance difference (HSD) test. RESULTS: Within the limitations of this study it was concluded that water sorption of the GC RELINE™ soft denture liner material was highest in distilled water followed by 5.25% sodium hypochlorite and least in Shellis artificial saliva at 4, 7, and 11 day interval. However, on the 15th day, the results showed maximum water sorption in 5.25% sodium hypochlorite followed by distilled water and least in artificial saliva. The results on solubility showed highest solubility of GC RELINE soft denture liner in artificial saliva followed by distilled water and least in 5.25% sodium hypochlorite at 4, 7, 11, and 15 day interval. DISCUSSION: The least water uptake of the soft liner in artificial saliva was due to its ionic properties and supports the theory that water uptake of these materials is osmotically driven. However, the solubility was highest in artificial saliva since it is a mix of various salts and other additives, so there is a possibility of interaction with soft denture lining material.

Visual, tactile, and contact force feedback: which one is more important for catheter ablation? Results from an in vitro experimental study.

BACKGROUND: During radiofrequency ablation, effective contact is crucial in determining lesions efficacy. OBJECTIVE: The purpose of this study was to compare operators' ability to assess contact pressure using visual and tactile feedbacks together or alone in an experimental model. METHODS: In a in vitro experimental setup replicating manual catheter manipulation and recording the applied force, evaluators were asked to identify three levels of force (first, ablation, and maximum contact) as the catheter contacted the tissue model using (1) visual feedback only by fluoroscopy, "blinded" to touch; (2) tactile feedback only, blinded to fluoroscopy; and (3) both tactile and visual feedback together. The latter was regarded as reference. The experiment was repeated using a catheter force sensing technology during robotic navigation. RESULTS: During manual navigation, tighter association was shown for the visual method than for the tactile method: median difference with reference: first contact -1 (P = .97) vs -2 (P = .90); ablation contact 2 (P = .1) vs -7 (P = .03); maximum contact 2 (P = .06) vs -28 (P = .02). Bland-Altman plot and Deming regression confirmed for the visual method the good agreement with reference and the absence of bias at any level and showed for the tactile higher values and proportional bias that reached statistical significance at ablation and maximum contact. During robotic navigation, agreement was higher for the tactile than for the visual only method. CONCLUSION: During manual navigation, visual feedback alone is in better agreement with the reference compared to the tactile only approach. During robotic navigation, agreement is looser for the visual only approach. More objective feedback of contact pressure during ablation procedures is desirable.