Endodontic Management of Variants of C-Shaped Canal: Case Series

A thorough knowledge of the root canal morphology is required for successful endodontic therapy. One of the most important anatomic variations is the C-shaped configuration of the root canal system. The presence of high incidence of transverse anastomoses, lateral canals, and apical deltas makes it difficult to clean and seal the root canal system in these teeth and may complicate endodontic interventions. Meticulous mechanical and chemical debridement of the canal space with additional efforts is essential for complete elimination of pulpal pathology in the anatomical irregularities. Obturation of the canal space also requires special attention as obtaining a three dimensional fill of a C-shaped canal may prove to be a problem due to the various intricacies present within the root canal system. Hence, this case series presents various types of C-shaped canal morphologies of mandibular second molars and their management.

Management of Immature Teeth - A Paradigm Shift From Apexification To Apexogenesis.

Apexification has been a routine procedure for treating immature non-vital teeth with apical pathosis. Even with the advent of single visit apexification procedure using MTA as an apical barrier, no apexification method can produce the outcome that apexogenesis can achieve. Two new clinical concepts have emerged recently. A revascularization procedure is one approach, in which new vital tissue is expected to form in the cleaned canal space, allowing continued root development in terms of both length and thickness. The other approach is the tissue engineering technology to implant or regenerate the pulp tissue. This article will review the recent concepts in the treatment of immature teeth with non-vital pulps.

Removal of phosphates from polluted waters using bio-adsosrbents.

Increasing interest is being envisaged by environmental researchers in controlling the phosphates pollution in natural waters by evoking the surface sorption characteristics of bio-waste materials of flora origin. In the present work, a thorough investigation has been made to find powders of leaves or their ashes of different classes of plants, having the affinity towards phosphate ions. 10 plant leaves and their ashes have been found to have sensitivity towards Phosphate ion. Investigations have been made in optimizing the various physico-chemical parameters such as equilibration time, pH and sorption dosage for the maximum removal of phosphates. The % of removal is found to be increasing with the increase in pH and equilibration time. The ashes of leaves shows more sorption towards phosphates than powders of leaves.79% to 90% removal of phosphate from polluted waters are found at optimum conditions with the sorbents investigated in this work. The interference of foreign ions on the % of extraction of phosphate reveals that some divalent cations are found be synergizing the extraction and thereby % of removal of Phosphate is increased even in the presence of 500 ppm of the said ions.

Influence of galactose cataract on erythrocytic and lenticular glutathione metabolism in albino rats.

Context: Glutathione depletion has been postulated to be the prime reason for galactose cataract. The current research seeks the prospect of targeting erythrocytes to pursue the lens metabolism by studying the glutathione system. Aims: To study the activity of the glutathione-linked scavenger enzyme system in the erythrocyte and lens of rats with cataract. Materials and Methods: Experiments were conducted in 36 male albino rats weighing 80 ± 20 g of 28 days of age. The rats were divided into two major groups, viz. experimental and control. Six rats in each group were sacrificed every 10 days, for 30 days. Cataract was induced in the experimental group by feeding the rats 30% galactose (w/w). The involvement of reduced glutathione (GSH) and the linked enzymes was studied in the erythrocytes and lens of cataractous as well as control rats. Statistical Analysis: Parametric tests like one-way ANOVA and Student's ‘t’ test were used for comparison. Correlation linear plot was used to compare the erythrocyte and lens metabolism. Results: Theconcentration of GSH and the activity of linked enzymes were found decreased with the progression of cataract, and also in comparison to the control. The same linear fashion was also observed in the erythrocytes. Conclusion: Depletion of GSH was the prime factor for initiating galactose cataract in the rat model. This depletion may in turn result in enzyme inactivation leading to cross-linking of protein and glycation. The correlation analysis specifies that the biochemical mechanism in the erythrocytes and lens is similar in the rat model.

Parental awareness regarding childhood injuries.

OBJECTIVE: To assess parental awareness regarding common childhood injuries and to focus on preventive issues. METHODS: Two hundred parents of children each grouped into 2 attending OPD of government hospital and private clinic respectively were enrolled, interviewed and responses analyzed. RESULTS: The commonest potential mode of injuries identified in both groups was falls (53% vs 84%). None of the households in group 1 and less than 2/3rd in group 2 had provision of restraints at stairs. Awareness was found to be greater in the group with higher educational background and socioeconomic status. CONCLUSION: Awareness regarding common childhood injuries and their prevention was lacking. There was a felt need that the pediatricians must counsel the parents on this aspect during visits. Since the sample size is small, a larger community based study is needed.

Maternal and neonatal profile and immediate outcome in ELBW babies.

The present study was designed to ascertain the maternal and neonatal profile and immediate outcome of extremely low birth weight (ELBW) babies at a Level III neonatal intensive care unit (NICU). Case records of ELBW inborn babies delivered between August 2000 and August 2001 were analyzed by using a preset proforma. A total of 52 ELBW babies were admitted in NICU in the relevant period, out of which 30 (57%) survived. Maternal anemia and previous pre-term (PT) delivery were the common predisposing factors for PT delivery. Mean gestational age was 27.8 weeks and mean birth weight was 831 grams. Mortality was highest in babies less than 28 weeks gestation. Neonatal hyper-bilirubinemia (78%) and HMD/RDS (65%) were the commonest morbidity. Retinopathy of Prematurity (ROP) screening could be done in 35 babies (68%), out of which 22 were found to be normal.

Changes in glutathione, glutathione-linked enzymes and hexose monophosphate shunt enzymes in senile cataract.

Changes in glucose-6-phosphate dehydrogenase (G-6-PD), glutathione reductase (GSH-R), reduced glutathione (GSH), glutathione peroxidase (GSH-PO), transketolase (TK) and transaldolase (TA) were studied in lens and red blood cells (RBCs) to understand the possible biochemical mechanisms responsible for the development of senile cataract. The activity of G-6-PD was increased in lens, though not so in erythrocytes during cataractogenesis. A marked decrease was observed in GSH level and GSH-R activity in the lens and RBCs of the cataractous group. The activity of GSH-PO was remarkably high in lens but not in the erythrocytes during the maturity of cataract. The activity of TK decreased gradually in both the lens and erythrocytes. The activity of TA decreased in erythrocytes but increased in the lens with maturation of cataract.

Antioxidant enzymes and peroxidation in galactogenic cataract.

The antioxidant enzymes like catalase and superoxide dismutase (SOD) were studied in erythrocytes and lens at various stages of cataractogenesis in albino rats. The rate of peroxidation was measured by assessing the malondiadehyde (MDA) in lens and plasma. The insoluble and soluble protein fractions were measured in lens to study the protein crosslinkings in relation to the above said parameters. Cataract was induced in albino rats by feeding it with 30% galactose as part of the normal diet (w/w) for 30 days. The results show a decrease of SOD and catalase with concomitant increase of MDA and insoluble protein with the advancement of cataract.

Comparison of tympanic and rectal temperatures in febrile children.

The present study was designed to assess the accuracy of tympanic membrane temperature (TMT) in predicting "core" body temperature and to compare rectal temperature (RT) and TMT in febrile pediatric patients with and without meningitis. Sixty children diagnosed as having meningitis by cerebro-spinal fluid (CDF) analysis formed the cases and 60 non-meningitic febrile patients, chosen as continuous enrollment, formed the controls. Rectal and ear temperatures were assessed in both groups. Ear temperature was significantly higher in cases as compared to controls. The difference between reading of ear temperature and rectal temperature was also significantly higher in cases as compared to controls. Significant correlations were seen between ear temperature and various parameters of CSF profile.

Comparison of tympanic and rectal temperature in febrile patients.

OBJECTIVE: To compare tympanic membrane temperature and rectal temperature in febrile pediatric patients. METHODS: Sixty febrile children were enrolled as continuous enrollment at initial triage. Two readings of ear temperature were taken in each child with Thermoscan infrared thermometer. Rectal temperature was recorded by a digital electronic thermometer. Comparison of both the techniques was done and co-relation co-efficients calculated. Parental preference for both techniques was assessed. RESULTS: It was observed that mean ear temperature was 38.9+/-0.90 C and that for rectal temperature was 38.8+/-0.80 degrees C. The correlation coefficient between the two was 0.994 (p < 0.01). Coefficients for both sites were comparable over a wide age range. The difference between readings taken from two ears was not significant. Temperature ranges over which readings were recorded were quite wide for both techniques. Parental preference for tympanic thermometry over rectal thermometry was noticed. Tympanic thermometry utilizes pyro-electric sensors, to detect infra-red rays emitted from the surface of tympanic membrane. Ear temperatures correlates well with rectal temperatures which have long been considered as "core" temperatures. Parents prefer the technique of ear thermometry which is quick (2 sec), safe and non-invasive and patient resistance for this is also less. CONCLUSION: A non-invasive, non-mucous device which is accurate over a wide range of temperature could be very useful.