Evaluation of the mother's anxiety and child's fear in two different age groups in the child's first and second dental visit

The anxiety of the mother influences the child’s behaviour in a dental setting. Objectives: The study aimed at evaluating the mother’s anxiety and a child’s fear of first and second dental visits in two different age groups. Study Design: The cross?sectional study design consisted of a total of 100 mother?child pairs attending Pediatric Dental clinics was included in the study. Group I consisted of 50 mother?child pairs of 6?8 years of age. Group II consisted of another 50 mother?child pairs between 12?15 years of age. Short Form of the Dental Subscale of the Children’s Fear Survey Schedule (DFSS?SF) was administered to the child. Corah’s Dental anxiety scale was administered to the mother. The Tell?Show?Do (TSD) technique was used in all children before the treatment. Statistical Analysis Used: SPSS software 21 was used for descriptive and inferential statistics. Pearson’s correlation coefficient was used for bivariate correlation between variables in the study. Results: The anxiety level of mothers on both appointment days in both age groups was found to be highly significant. The correlation of maternal anxiety to the gender of the child in both groups was found to be highly significant. Conclusion: The fear of dental treatment was commonly found in children irrespective of gender in both age groups. The TSD technique was found to reduce fear in the subsequent appointment.

A prospective and retrospective study on conservative management of hepatic and splenic injury following blunt abdominal trauma

Background: worldwide road traffic accidents accounts as the leading cause of death of young people. For a very long time most of the intra-abdominal injuries following blunt abdominal trauma were managed operatively. Conservative management is becoming more acceptable and effective management option for blunt abdominal trauma during the last few decades.Methods: This study was conducted in Government Medical College, Kottayam during September 2007 to December 2008. All conservatively managed blunt abdominal trauma patients during the study period were included in the study.Results: Out of 22 patients, 4 patients failed conservative management. Success rate was 81%. Most commonly injured solid organ in the study group was liver (77%). Maximum cases were of age group 10 to 20 (31.81%) years. 81% of patients were males. Motor vehicle accident was the most common cause of trauma (77%). Mean stay in intensive care unit was 4.2 days and mean hospital stay was 15.7 days. Mean systolic blood pressure was 110 mmHg ranging from 70 to 130 mmHg. 50% of patients had moderate hemoperitoneum and non-had massive hemoperitoneum.Conclusions: Non operative management is safe and effective approach in blunt spleen and liver injuries. Non operative management should be treatment of choice for all hemodynamically stable patients with blunt liver and splenic trauma.

Gross and Histopathological Findings in Fatalities Caused by Pulmonary Disease: An Autopsy Study

Respiratory pathologies are some of the common causes of deaths and it has been reported that in almost 1/3rd cases of sudden deaths the primary pathology may be attributable to pulmonary pathology. One of the important aspect of respiratory pathologies is that they can progress rapidly over a short period of time and in many cases these pathologies may prove to be fatal. In such cases gross and histopathological examination of lung tissue can give valuable insights into the cause of death. We conducted this prospective study to study the pathological findings in the lungs of such cases. Methods: The present study was conducted in the department of forensic medicine and toxicology of a tertiary care medical college situated in an urban area. The duration of study was 2 years. All cases of natural deaths brought for medico-legal autopsy were included in this study on the basis of a predefined inclusion and exclusion criteria. Virchow’s technique for dissection was followed in all the cases. The demographic details, gross and histopathological examination of lungs was done and findings were noted. Statistical analysis was done using SSPS 21.0 software. P value less than 0.05 was taken as statistically significant. Results: The study consisted of a total 54 patients out of which there were 34 males and 20 females with a M:F ratio of 1:0.58. The most common affected age group was found to be between 30-40 years (22.22%). The mean age of males and females were found to be comparable with no statistically significant difference (P>0.05). Most people died within 3-7 days from time of admission (25.92%). Pneumonia was found to be leading cause of deaths in lung pathology which contributed to 74.7% cases. On gross pathology consolidation and pulmonary edema were most common findings whereas on gross as well as histopathological examination. Conclusion: Gross and histopathological examination of lung tissue in individuals dying due to natural causes can give valuable insights into the cause of death.

Peripheral giant cell granuloma manifestation in pregnancy

The peripheral giant cell granuloma (PGCG) is a benign oral lesion occurring on the gingiva and alveolar ridge. It is the most common oral lesion and occurs at an average age of 30 years. The upsurge in the levels of estrogen and progesterone in pregnancy leads to a plethora of changes in various parts of human body, including the oral cavity. In the oral cavity, changes are commonly seen on the gingiva. These include pyogenic granuloma, PGCG and also peripheral ossifying fibroma, etc., The etiology of PGCG in our case might be related to hormonal alterations during the gestation period.

Estimation of serum lactate dehydrogenase in smokeless tobacco consumers.

Statement of Problem: Salivary and serum lactate dehydrogenase (LDH) levels have been correlated with potentially malignant lesions. Salivary LDH levels require special testing and can be expensive. The need for a simple and cost‑effective analysis tool is essential to detect the oral malignant lesions to benefit rural populations. Aim: The aim of this study is to estimate the serum LDH in patients with oral lesions due to the consumption of smokeless tobacco. Materials and Methods: Thirty‑five patients with lesions were selected for this study while twenty patients served as a control. Levels of serum LDH were assessed. Age‑ and sex‑matched controls (n = 10) with no smokeless consumption habit and with the habit but without lesion (n = 10) also had their blood drawn to assess the basal level of LDH. The results were then analyzed through the two‑tailed t‑test and Chi‑square analysis using the SPSS statistics software. Results: The mean LDH value of patients with habit and lesion is 446.8 U/L; the mean LDH value for patients with habit but without the presence of a lesion is 421.2 U/L, and the mean LDH value for patients without a habit or lesion is 269.4 U/L. The patients having the habit of using smokeless tobacco had higher LDH values compared to the other two groups, and it is found to be statistically significant (p < 0.05). Conclusion: Serum LDH values increased in patients with the habit of chewing smokeless tobacco.

Infectious keratitis – a review.

Infectious keratitis is an important problem in the Indian context, and epidemiological studies suggest a higher prevalence of disease as compared to the developed world. Various aspects of the problem, including the host defence, ocular and systemic risk factors and microbial mechanisms that enhance pathogenesis have been discussed. The clinical and microbiological approach to the infected eye and patient and the relevant tests have been outlined. The major classes of medications that are used the methods of delivery are specified. Finally, the approach to patients with non-responsive keratitis that requires surgical manoeuvres is also highlighted. Clinical experience is important in distinguishing an infective from an inflammatory corneal pathology. The role of an experienced microbiologist is inevitable, for good clinical outcome. Therapeutic keratoplasty has to be done at the right time for better clinical outcomes.

Intermediate uveitis – a review.

Intermediate Uveitis (IU) is an inflammatory disease, primarily involving the vitreous and peripheral retina. It accounts for around 8% of cases of uveitis and affects primarily children and young adults. The etiology is unknown but, found as an isolated and idiopathic condition or in association with systemic disorders such as multiple sclerosis and sarcoidosis and infectious diseases. Symptoms include painless blurring of vision, floaters and deterioration of vision. Clinical features seen are anterior segment affection with keratic precipitates and anterior chamber cells, vitritis, vasculitis in the peripheral retina, vitreal snow banks and cystoid macular edema (CME). CME was the major threat for deterioration of vision; other complications include vitreous haemorrhage, periphlebitis, cataract and glaucoma. Treatment of intermediate uveitis is based on periocular and oral corticosteroids. Cryotherapy or laser photocoagulations of the peripheral retina are options in patients when there is an insufficient response to periocular or systemic corticosteroids. Immunomodulatory therapy is used when other therapies fail. Pars plana vitrectomy (PPV) is indicated in patients with chronic significant inflammation, non-responsive cystoid macular edema, non-clearing vitreous haemorrhage, tractional retinal detachment and epiretinal membranes. IU is an intraocular inflammation involving the anterior vitreous, peripheral retina and pars plana. It usually affects patients from 5 to 30 years old, without gender or racial preferences. The etiology is unknown but there are several associated diseases. The long-term prognosis of intermediate uveitis is usually good, particularly with strict control of inflammation and with proper management of complications.

Conjuctivochalasis - a review.

Conjunctivochalasis is an ocular condition that is usually missed, unless specifically looked for. It is defined as a redundant loose non edematous inferior bulbar conjunctiva. Though generally asymptomatic, It may also present as dryness and foreign body sensation. Various grading systems like Mirmura ((based on Lid-parallel conjunctival folds), Mellers (based on lid-parallel conjunctival folds, punctual occlusion and conjunctival fold changes during down gaze and digital pressure) and Zhang’s based on conjunctival folds, dryness, foreign body sensations, epiphora symptoms, punctual occlusion, tear meniscus height, tear film break-up time (BUT), and conjunctival fold changes during down gaze) system has been outlined. Various etiological aspects like dissolution of the Tenon’s Capsule and role of expression of matrix metalloproteinase-1 (MMP-1) and matrix metalloproteinase-3 (MMP-3) has been dealt in detail. Different surgical approaches like pastepinch- cut conjunctivoplasty and their steps are specified. Conjunctivochalasis has to be understood in a wider depth and more research work is required to understand CCh in better detail so that preventive steps can be implemented with regard to secondary causes.

Dry eye - a review.

Of the myriad reasons for visits to an ophthalmologist, one of the most common maladies afflicting patients is Dry Eye Disease (DED), which can cause mild discomfort in the early stages and endstage ocular surface damage in its more severe forms. Dry eye is a problem of utmost importance, more in the developed rather than developing nations. Various aspects of the manifestation, including the tear osmolarity, ocular surface homeostasis and the role of ocular surface epithelial stem cells in maintaining the ocular surface homeostasis have been discussed. The objective tests to assess and grade dry eye have been noted. A systematic approach to the affected eye and the patient has also been outlined. The major categories of medications used along with the methods of delivery are specified in this review. A systematic approach in understanding the type and grade of Dry Eye Disease is mandatory for good clinical response. Along with clinical management the doctor should also stress on environmental changes that exaggerates dryness.

Correlation between macular thickness and volume with visual acuity in diabetic macular edema by using domain optical coherence tomography.

Introduction: To investigate the correlation between Macular thickness and Volume with Bestcorrected visual acuity (BCVA) in eyes with Diabetic macular edema and Type 2 diabetes. Materials and Methods: A retrospective study including 60 eyes of 60 patients evaluating Retinal thickness and macular volume measured with Spectral Domain Optical Coherence Tomography and best corrected visual acuity was measured with the Snellens Chart. Results: There is significant increase in the macular thickness and macular volume with decrease in the best corrected visual acuity. Conclusion: Diabetic macular edema causes decrease in visual acuity due increase in macular thickness and volume.