A Nine-Item Red Flag Sign Card for Identification of Autism Spectrum Disorder among Toddlers Aged 12 to 18 Months.

There is a dearth of validated red flags measures for early identification of autism spectrum disorder (ASD) among toddlers. Hence, a new screening measure was developed. Item generation was done through literature search. Content validity (CVI) assessment was done. Criterion validity was done using Diagnostic and Statistical Manual 5 (DSM-5) as reference standard, data were collected from the case records of children with ASD diagnosis at 2 y, and evaluated for developmental milestones between 12 and 18 mo in a tertiary care setting. Item reduction of the measure from 18 to 9 was done. The area under the curve in the receiver operating characteristic (ROC) curve for new measure was 0.81 (95% CI = 0.73, 0.87); z = 7.874; p < 0.001 against DSM-5 score of ≥ 2 in the new measure; achieved sensitivity of 93.42% (95% CI = 85.3, 97.8) and specificity of 60% (95% CI = 45.9, 73.0). Thus, new validated red flag sign card (Concern-9) can be used effectively for early screening and identification of ASD among children aged 12-18 mo.

Fracture Resistance of Reattached Hydrated Fragment of Fractured Incisors.

BACKGROUND AND OBJECTIVES: Fragment reattachment procedure provides conservative treatment option when an intact fractured fragment is available. Rewetting of fractured fragment before reattaching has shown better bond strength of attached fragment. Therefore, fracture resistance of reattached fractured fragment with hydration and without hydration was evaluated and compared. MATERIALS AND METHODS: Ellis class II fracture was induced in selected and coded 60 extracted maxillary central incisors using a custom-made-wise and assigned into group I and group II (without hydration and with hydration) and both the groups were further divided into two groups (1 week and 3 months). In group I, fractured fragments were reattached after bench-drying for 24 hours. In group II, fractured fragments were reattached after hydrating for 1 hour following bench-drying for 24 hours. Composite (Filtek Z350 XT, Universal Restorative, 3M ESPE) was used to reattach the fractured fragments. Reattached fractured fragments were stored in artificial saliva for 1 week and 3 months and subjected to fracture resistance test using Universal Testing Machine. The data obtained were tabulated and statistically analyzed. RESULTS: Fracture resistance in hydration samples was higher than without hydration at the end of 1 week and 3 months statistically. Fracture resistance of fractured fragment at the end of 3 months was higher in both with hydration and without hydration but was not significant with hydration. CONCLUSION: Hydration of fractured fragment before reattachment procedure has shown better fracture resistance and improved further after storing in artificial saliva for 3 months. HOW TO CITE THIS ARTICLE: Suresh M, Mallikarjun SB, Babu G, et al. Fracture Resistance of Reattached Hydrated Fragment of Fractured Incisors. Int J Clin Pediatr Dent 2020;13(5):476-480.

In vitro evaluation of milk-based, soy-based, and amino acid-based infant formulas on Streptococcus mutans biofilm formation.

BACKGROUND AND OBJECTIVE: Infant formulas are based on milk, and the addition of simple carbohydrates as a caloric source, for infants. The carbohydrates added in infant formulas can cause a significant increase of Streptococcus mutans in the oral cavity of infants adding to their cariogenicity. AIM: The aim of the study was to assess and compare the biofilm formation in three commercially available infant formulas;which are based on milk, soy and amino acid. SETTINGS AND DESIGN: In vitro microbiological assay of Streptococcus mutans biofilm formation in milk based, soy based and amino acid based infant formulas. MATERIALS AND METHODS: Twenty-four hour-cultured S. mutans and microtiter plates were used for analysis. At microtiter plate, 190 µL of modified TSB broth containing SBF, MBF, amino acid-based infant formulas, and dairy whitener as a positive control in five dilutions (1:05, 1:10, 1:20, 1:40, and 1:80) was added into respective wells. 10 µL of cultured S. mutans was inoculated into the wells and incubated at 37°C for 24 h. Biofilm was washed, fixed, and stained with crystal violet. The absorbance was measured to evaluate biofilm growth, which was read as optical densities in a spectrophotometer at 490 nm and was tabulated. RESULTS: Three infant formulas tested showed S. mutans biofilm growth. Minimal biofilm growth was observed in amino acid-based formula at 1:80 dilution, followed by MBF at 1:10 dilution and SBF at 1:80 dilution. CONCLUSION: Commercially available infant formulas favor S. mutans biofilm growth and can be cariogenic. Amino acid-based infant formula was found to have less S. mutans biofilm growth than MBF and SBF.

Evaluation of C-Reactive Protein and Fibrinogen in Patients with Chronic and Aggressive Periodontitis: A Clinico-Biochemical Study.

INTRODUCTION: Periodontal disease is characterised by chronic infection and inflammation in periodontal tissues leading to destruction of alveolar bone with subsequent tooth loss. Periodontal infections are the result of an interaction between tooth associated microbial biofilms and the host defences. Periodontal pathogens can affect local and systemic immune and inflammatory responses. AIM: The aim of the present study was to evaluate serum C-Reactive Protein (CRP), plasma fibrinogen and peripheral blood levels in healthy subjects, chronic and aggressive periodontitis patients. MATERIALS AND METHODS: A total of 55 subjects, 27 males and 28 females were selected for the study. Blood samples were taken from healthy controls (n=20) and patients with chronic periodontitis (n=20) and aggressive periodontitis (n=15). The periodontal status of each patient was assessed by recording Oral Hygiene Index-Simplified (OHI-S), Bleeding Index (BI), Probing Pocket Depth (PPD) and Clinical Attachment Level (CAL). The levels of serum CRP were measured using high sensitivity Enzyme Linked Immunosorbent Assay (ELISA) and levels of plasma fibrinogen were measured using Quantitative Immunoturbidimetric assay. Data description was done in the form of mean and standard deviation and analysis of data was done using one way ANOVA (Analysis of Variance) and Students t-test to test the statistical significance between groups. RESULTS: The levels of serum CRP and plasma fibrinogen was increased in patients with chronic and aggressive periodontitis when compared to healthy controls (p<0.001). A positive correlation was found to exist between levels of clinical parameters like OHI-S, BI, PPD and CAL when compared with CRP and fibrinogen as well as with the study groups. CONCLUSION: The finding of the present study suggests the role of serum as a diagnostic marker in inflammatory conditions and indicates that levels of CRP and fibrinogen may serve as important biomarkers for evaluating the association between periodontitis and cardiovascular diseases.

Microelements in primary teeth by inductively coupled plasmad Atomic emission spectroscopy

AIM: This study was carried out to estimate the concentrations three microelements in enamel of deciduous normal and carious teeth using atomic emission spectrometry. METHODS: A total of 80 deciduous molar teeth indicated for extraction from children between the age group of 713 yrs. were taken for this study. The specimens were divided into four groups and the samples were prepared using centrifuge flotation technique. They were analyzed for Manganese, Strontium and Zinc using inductively coupled plasma atomic emission spectroscopy. RESULTS: This study shows that sound enamel contains more of strontium when compared to the carious enamel. Carious enamel contains more of manganese, and zinc when compared to the normal enamel. Elements zinc and strontium occur in high concentrations, where as elements manganese occur in low concentrations in enamel. The concentrations of elements manganese, strontium and zinc does not vary in relation to sex of individual. CONCLUSION: The microelements strontium and zinc are present in high concentration. Further studies are necessary to see their potential in mineralization and anticariogenic process.

Attitude of parents and teachers towards adolescent reproductive and sexual health education.

OBJECTIVE: To assess parents' and teachers' attitude towards Adolescent Reproductive Sexual Health Education (ARSHE). METHODS: The study group consisted of a random sample of 795 parents and 115 teachers belonging to three urban schools (one boys only, one girls only and one co-education) and one co-education rural school at Thiruvananthapuram district, Kerala, where an ICMR supported ARSHE intervention programme was done subsequently. A self-administered questionnaire for parents and teachers developed by an ICMR taskforce for ARSHE programme was used to assess their opinion on the need, content and the appropriate person to provide adolescent reproductive sexual health education in a school setting. RESULTS: 65.2% of parents and 40.9% teachers have not discussed growth and development issues with their adolescents. Only 5.2% teachers and 1.1% parents discussed sexual aspects with adolescents. 44% of parents agreed that information on HIV/AIDS/STD should be provided. More than 50% of parents were not sure whether information on topics like masturbation, dating, safe sex, contraceptives, pregnancy, abortion and childcare should be provided to adolescents. CONCLUSIONS: Results pointed out the need for introducing reproductive and sexual education in the school setting. Only 1.1% of parents and 5.2% teachers actually discussed sexual aspects with adolescents which highlights the need for parent and teacher awareness programs before ARSHE is introduced in the schools.