Relationship between oral health status and hematological values in pediatric leukemic patients: an evaluative survey.

INTRODUCTION: Leukemia is a malignancy of the bone marrow and constitutes 30% of all childhood cancers. The leukemic condition itself and its therapy cause oral signs and symptoms with significant morbidity. AIMS AND OBJECTIVES: The aim of this study was to review the oral health status in children with leukemia and relate the gingival and periodontal findings to the changes in their hematological values. MATERIALS AND METHOD: The oral health status in 47 pediatric leukemic patients in the age group of 6 to 14 years was assessed using the dmft/DMFT index, OHI(S) index and modified gingival index (MGI). Their hematological reports on the day of examination were obtained. The patients were divided into three groups based on the status of treatment. The relation between the platelet count and the WBC count with the MGI score was checked. RESULTS: The highest dmf and DMF scores were seen in patients who were currently under treatment. Though an inverse relation was seen between the platelet count and the MGI score, a statistically significant value was not obtained. CONCLUSION: A longitudinal follow-up of patients should be carried out in order to establish a relation between the hematological parameters and the gingival inflammation score

ZIF-8 @polycarbonate nanocomposite membranes for improved permeability and selectivity for hydrogen gas.

Through this work, we are reporting high-performance ZIF-8 @polycarbonate nanocomposite membranes with satisfactory structural stability for improving the gas separation performance. ZIF-8 nanoparticles were synthesised using the wet chemical route with cubic morphology and controlled size using CTAB as a surfactant. The membranes were prepared using the solution casting method by adding ZIF-8 filler at various concentrations. The synthesised filler material and MMMs were characterised through X-ray diffraction spectroscopy (XRD), transmission electron microscopy (TEM), scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR), and RAMAN spectroscopy techniques. The gas separation measurements were taken using H2, CO2, and N2 gas in the purest form. The SEM results confirm the formation of spherulite-like morphology with the addition of ZIF-8 due to the crystallisation of the polymer, which increased the membrane's free volume and opened up additional pathways for the transportation of the gas molecules. The gas separation results confirmed that the 15 wt% ZIF-8/PC nanocomposite membrane showed the maximum H2 permeability of 180,970 barrer with an increment of 316.03%, while H2/CO2 and H2/N2 selectivity showed the increments of 89.43% and 103.64%, respectively. Therefore, this PC/ZIF-8 system seems to be a promising approach to developing new H2 selective membranes with high gas permeability and gas selectivity values.

The adverse effects of solid biomass fuel exposure on lung functions in non-smoking female population.

Background: Though, smoking is the leading cause of chronic obstructive pulmonary disease worldwide, the household air pollution due to use of solid biomass fuel is considered as a major risk factor for the development of obstructive lung disease. The aim of the study was to assess the effect of solid biomass fuel exposure on lung functions in non-smoking female population. Methods: A hospital based, descriptive cross sectional study was carried out among 140 non-smoking female patients aged 40 or more and who had been exposed to solid biomass fuel. These patients underwent spirometry to assess their lung function and were classified as obstructive, restrictive or mixed. Modified medical research council (mMRC) dyspnoea scale for symptom assessment, 6-minute walk test (6 MWT) to determine the exercise capacity and Cumulative exposure index to assess the duration of exposure were also done. Results: All 140 (100%) patients having abnormal lung function, 4 (2.86%) had restrictive pattern, 5 (3.57%) had mixed pattern and 131 (93.57%) had obstructive pattern. Of 131 patients having obstructive pattern, 11 had mild obstruction, 49 had moderate obstruction, 39 had severe obstruction and 32 had very severe obstruction. Most commonly used biomass fuel was wood (43.57%). All the patients had shortness of breath, whereas cough was present in only 35.71% cases. 77 (55%) patients presented with a dyspnoea of mMRC grade 3 and above. Conclusion: Cumulative exposure index for solid biomass fuel is directly proportional to the severity of lung impairment as well as the symptom severity.

Pulmonary function in cured pulmonary tuberculosis cases.

BACKGROUND: In clinical practice it has been observed that several patients of cured pulmonary tuberculosis (PTB) suffer with lung dysfunction and these problems are less documented routinely. Prevalence of these abnormalities remains unknown. Aim of this study is to estimate the lung function abnormality and exercise capacity including diffusion capacity of lung for carbon monoxide (DLCO) in cured PTB cases. METHODS: A hospital based observational descriptive study was carried out among 100 patients with PTB, who had been declared cured. These patients were evaluated by spirometry and DLCO to assess their lung function and were classified as normal or abnormal. Modified medical research council (mMRC) dyspnea scale for symptom assessment and 6-minute walk test (6MWT) to determine the exercise capacity was also done. Borg's scale was used for dyspnea assessment in 6MWT. RESULTS: 83 (83%) patients having abnormal spirometry, 17 (17%) had obstructive pattern, 32 (32%) had restrictive pattern and 34 (34%) had mixed pattern. 22 (22%) patients had mild decrease in DLCO, 43 (43%) patients had moderate decrease in DLCO, while only 4 (4%) had severe decrease in DLCO. More than half of the patients having normal spirometry had reduced in DLCO. CONCLUSION: The prevalence of abnormal lung functions is high even after complete anti-tubercular treatment. DLCO could be a better tool for evaluation of lung function in these patients. There is need to strengthen the National Programme to detect and treat TB patient earlier, also there is need to formulate guidelines for pulmonary rehabilitation of cured PTB patient.

Impact of socio-economic inequity in access to maternal health benefits in India: Evidence from Janani Suraksha Yojana using NFHS data.

BACKGROUND: Caste plays a significant role in Indian society and it influences women to health care access in the community. The implementation of the maternal health benefits scheme in India is biased due to caste identity. In this context, the paper investigates access to Janani Suraksha Yojana (JSY) among social groups to establish that caste still plays a pivotal role in Indian society. Also, this paper aims to quantify the discrimination against Scheduled Castes/Scheduled Tribes (SCs/STs) in accessing JSY. METHODS: This paper uses a national-level data set of both NFHS-3 (2005-06) and NFHS-4 (2015-16). Both descriptive statistics and the Fairlie decomposition econometric model have been used to measure the explained and unexplained differences in access to JSY between SCs/STs and non-SCs/STs groups. RESULTS: Overall, the total coverage of JSY in India is still, 36.4%. Further, it is found that 72% of access to JSY is explained by endowment variables. The remaining unexplained percentage (28%) indicates that there is caste discrimination (inequity associated social-discrimination) against SCs/STs in access to JSY. The highest difference (54%) between SCs/STs and non-SCs/STs in access to JSY comes from the wealth quintile, with the positive sign indicating that the gap between the two social groups is widening. DISCUSSION AND CONCLUSION: It is necessary for the government to implement a better way to counter the caste-based discrimination in access to maternal health benefits scheme. In this regard, ASHA and Anganwadi workers must be trained to reduce the influence of dominant caste groups as well as they must be recruited from the same community to identify the right beneficiaries of JSY and in order to reduce inequity associated with social-discrimination.

Emerging mental health issues during the COVID-19 pandemic: An Indian perspective.

The current global health crisis, the COVID-19 pandemic, has posed an unprecedented challenge to our health systems, economy, socio-political organizations, and the infrastructure of most countries and the world. This pandemic has affected physical health as well as mental health adversely. Several recent evidence suggests that health systems across the world have to improve their preparedness in context to infectious pandemics. The research on mental health aspects of COVID-19 and other related pandemics is lacking due to obvious reasons. This narrative review article, along with our personal views, is on various current and future mental health issues in the context of the COVID-19 pandemic focusing on various challenges and suggested solutions. The aim is also to update mental health strategies in the context of such rapidly spreading contagious illness, which can act as a resource for such a situation, currently and in future. We recommend that there is a need to facilitate mental health research to understand the psychiatric aspects of the COVID-19 pandemic, include psychiatrists in the task force, and make available psychotropic and other medications with special attention to the deprived sector of the society.

Rhabdomyosarcoma mimicking as pleural effusion.

Rhabdomyosarcoma (RMS), a malignant neoplasm of skeletal muscle origin, is the most common soft tissue sarcoma caused by infectious disease etiology, especially in nondeveloped countries. Despite being a relatively rare cancer, it accounts for approximately 40% of all recorded soft tissue sarcomas. Alveolar RMSs are seen to occur in children, while around 80% cases occur in the first three decades of life. We present here, a case of a 12-year-old child having alveolar RMS, presenting clinically and radiologically with pleural effusion.

Comparative evaluation of application of different fluoride varnishes on artificial early enamel lesion: An in vitro study.

INTRODUCTION: In an attempt to manage noncavitated carious lesions noninvasively through remineralization, a range of novel fluoride varnishes with additional remineralizing agents have been made available for clinical application. AIM AND OBJECTIVES: The aim of this study was to compare and evaluate the remineralization potential of three commercially available varnishes on artificial enamel lesions. MATERIALS AND METHODS: This in vitro study involves eighty intact enamel specimens prepared from premolars extracted for orthodontic purposes. After specimen preparation, the eighty samples were divided randomly into two groups (n = 40) for measurement of baseline surface Vickers microhardness and baseline calcium/phosphorus ratio (% weight) through EDAX testing. Thereafter, the specimens were subjected to demineralization for 96 h to induce initial enamel lesions and the measurements were repeated. Following demineralization, each of the two groups was divided randomly into four subgroups (n = 10) from which one was used as the control group and the others three were allotted to each of the three test varnishes. After varnish application, all the specimens were subjected to a pH cycling regimen that included alternative demineralization (3 h) and remineralization (21 h) daily, for 5 consecutive days. The Vickers microhardness and EDAX measurements were then repeated. RESULTS: One-way ANOVA and post hoc Tukey's tests were conducted for multiple group comparison. All the three commercially available varnishes were capable of remineralizing initial enamel lesions that were induced artificially. No difference was noted in the remineralizing efficacy of the varnishes despite their different compositions. MI Varnish™ (casein phosphopeptide-amorphous calcium phosphate fluoride varnish) showed slightly better recovery in surface microhardness as compared to the other two varnishes. CONCLUSION: All the varnishes used in this in vitro study are capable of reversing early enamel lesions.

Evaluation of antimicrobial effect of azadirachtin plant extract (Soluneem (™)) on commonly found root canal pathogenic microorganisms (viz. Enterococcus faecalis) in primary teeth: A microbiological study.

AIM: The aim of this study is to evaluate the antimicrobial activity of Soluneem ™ when used as an irrigating solution along with other commonly used irrigating solution sodium hypochlorite (NaOCl) against Enterococcus faecalis. MATERIALS AND METHODS: Microorganism used in this study was E. faecalis (Microbial Type Culture Collection 439). Test substance used was Soluneem ™, which was obtained from Vittal Mallya Scientific Research Foundation (VMSRF), Bengaluru. This study was conducted in a microbiology laboratory (Biocare Research India Pvt., Ltd. Laboratory, Ahmedabad, Gujarat) to evaluate the antimicrobial effect of Soluneem ™ (Azadirachtin) on E. faecalis. Antimicrobial activity testing was performed using the macrobroth dilution method according to the Clinical Laboratory Standards Institute guidelines. All determinations were performed thrice. RESULTS: Minimum bactericidal concentration (MBC) was seen as 2.6% for Soluneem ™ while the same was seen at 0.1% for NaOCl. Independent sample t-test was carried out to compare the MBC of Soluneem ™ and NaOCl, which showed that there was no statistically significant difference between them, i.e., 2.6% Soluneem ™ was as effective as 0.1% NaOCl. CONCLUSION: Soluneem ™ showed antimicrobial activity against E. faecalis at various concentrations. It was also found that the efficacy of Soluneem ™ at 2.6% concentration and above was relatively similar to that of gold standard irrigating solution (NaOCl) on inhibition of E. faecalis.

Erosive potential of commonly used beverages, medicated syrup, and their effects on dental enamel with and without restoration: An in vitro study.

AIM: This study evaluates erosive potential of commonly used beverages, medicated syrup, and their effects on dental enamel with and without restoration in vitro. MATERIALS AND METHODS: Test medias used in this study included carbonated beverage, noncarbonated beverage, high-energy sports drink medicated cough syrup, distilled water as the control. A total of 110 previously extracted human premolar teeth were selected for the study. Teeth were randomly divided into two groups. Test specimens were randomly distributed to five beverages groups and comprised 12 specimens per group. Surface roughness (profilometer) readings were performed at baseline and again, following immersion for 14 days (24 h/day). Microleakage was evaluated. The results obtained were analyzed for statistical significance using SPSS-PC package using the multiple factor ANOVA at a significance level of P < 0.05. Paired t-test, Friedman test ranks, and Wilcoxon signed ranks test. RESULTS: For surface roughness high-energy sports drink and noncarbonated beverage showed the highly significant difference with P values of 0.000 and 0.000, respectively compared to other test media. For microleakage high-energy sports drink had significant difference in comparison to noncarbonated beverage (P = 0.002), medicated syrup (P = 0.000), and distilled water (P = 0.000). CONCLUSION: High-energy sports drink showed highest surface roughness value and microleakage score among all test media and thus greater erosive potential to enamel while medicated syrup showed least surface roughness value and microleakage among all test media.

Comparative evaluation of retention of prefabricated and conventional cast post: An in vitro study.

BACKGROUND AND OBJECTIVES: This study was conducted to evaluate the retention of various prefabricated posts and to compare them with that of the conventional cast post. MATERIALS AND METHODS: A sample of 60 freshly extracted single-rooted human mandibular first premolars were sectioned horizontally, 1 mm coronal to the cemento-enamel junction and randomly divided into four groups consisting of carbon fiber posts, glass fiber posts, stainless steel posts and cast metal posts. Cast metal post was the control group. Each group contained 15 specimen. The post space of 9 mm depth was prepared using specific drill supplied by the manufacturer. Resin patterns of the prepared post spaces were fabricated for 15 specimen and were cast in nickel chromium base metal alloy. All the posts were cemented with self-adhesive resin cement and mounted in acrylic cylinders. The teeth were subjected to tensile pull-out test using a universal testing machine. The force required to dislodge each post from the teeth was recorded. The data was analyzed using one-way analysis of variance and Bonferroni test. RESULTS: The bond strength of all the prefabricated posts was significantly lower than the conventional cast post. Among the prefabricated posts highest bond strength was obtained for prefabricated stainless steel post and lowest for carbon fiber posts. There was no significant difference in the mean bond strength obtained for stainless steel and glass fiber post. CONCLUSION: Though no single prefabricated post could achieve results close to the control group, most retentive among the experimental group were the stainless steel posts. However, conditions where nonmetallic posts are indicated most preferred type of post can be the glass fiber posts.

Applicability of regression equation using widths of mandibular permanent first molars and incisors as a predictor of widths of mandibular canines and premolars in contemporary Indian population.

BACKGROUND: Predicting the size of unerupted teeth during the mixed dentition period is a critical factor in managing the developing occlusion. Different studies found that the combined width of only the four mandibular permanent incisors is not a good predictor of the sum of unerupted mandibular permanent canines and premolars (SPCP). In 2007, Melgaço et al. developed a new method for SPCP by measuring the sum of the mandibular first permanent molars and four mandibular permanent incisors (SMI). AIM: It was aimed to evaluate the accuracy of this new method in comparison with Moyers' mixed dentition analysis table in contemporary Indian population. SETTINGS AND DESIGN: Sixty boys and 60 girls from Gandhinagar district (age ranged from 12 to 14 years) were included. MATERIALS AND METHODS: The mesiodistal crown widths of all fully erupted teeth were measured with digital vernier callipers and the odontometric values obtained were then subjected to statistical and linear regression analysis. RESULTS: Student's unpaired t-test gave statistically significant difference between the original values of teeth and the values obtained by Melgaço's prediction equation as well as Moyers' mixed dentition analysis table (P < 0.001). High values of correlation (r = 0.77) and determination coefficients (r2 = 0.59) were found while considering Melgaço's method. Also, no statistically significant difference was found between the tooth sizes of males and females. CONCLUSION: From this study, it can be evaluated that Melgaço's method gives better prediction and a simplified equation Y = 0.925X can be suggested for the present population.

Efficacy of silver diamine fluoride as an antibacterial as well as antiplaque agent compared to fluoride varnish and acidulated phosphate fluoride gel: an in vivo study.

BACKGROUND: Silver diamine fluoride (SDF) is already proven as an antibacterial agent in vitro. Present study was formulated to compare the efficacy of SDF as an antibacterial as well as antiplaque agent in vivo with fluoride varnish and acidulated phosphate fluoride (APF) gel. STUDY DESIGN: Total 123 children (male = 82, female = 41) were included in the study for a period of 18 months. Children were divided into three different groups-Group 1: SDF; Group 2: fluoride varnish; and Group 3: APF gel. All subjects were evaluated via plaque score at 6 th, 12 th, and 18 th months as well as Streptococcus mutans counts in saliva at 72 h, 6 th, 12 th, and 18 th months of follow-up. RESULTS: Significant reduction was found in plaque score as well as S. mutans counts irrespective of group division. On intergroup comparison, no statistically significant difference was found in plaque score, but significant reduction in S. mutans counts was found in Group 1 as compared with Groups 2 and 3, while no significant difference was found between Groups 2 and 3. CONCLUSION: In vivo application of SDF on enamel significantly decreases S. mutans counts as compared to fluoride varnish and APF gel.

Evaluation of the remineralization potential of amorphous calcium phosphate and fluoride containing pit and fissure sealants using scanning electron microscopy.

AIM: To evaluate the remineralization potential of Amorphous Calcium Phosphate (ACP) and Fluoride containing pit and Fissure Sealants using Scanning Electron Microscopy. MATERIALS AND METHODS: Thirty maxillary first premolars were divided into three groups of ten each and were randomly selected for ACP containing (Aegis- Opaque White, Bosworth Co. Ltd.), Fluoride containing (Teethmate F1 Natural Clear, Kuraray Co. Ltd.), resin based (Concise- Opaque White, 3M ESPE Co. Ltd.) pit and fissure sealant applications. The Concise group served as a control. The teeth weresubjected to the pH-cycling regimen for a period of two weeks. After two weeks, the teeth were sectioned bucco-lingually into 4mm sections and were observed under Scanning Electron Microscope at 50X, 250X, 500X, 1000X and 1500X magnifications. The qualitative changes at the tooth surface and sealant interface were examined and presence of white zone at the interface was considered positive for remineralization. RESULTS: Both ACP containing (Aegis) and Fluoride containing (Teethmate F1) group showed white zone at the tooth surface-sealant interface. The resin based group (Concise) showed regular interface between the sealant and the tooth structure, but no clear cut white zone was observed. CONCLUSION: Both, Aegis and Teethmate F1 have the potential to remineralize. Release of Amorphous Calcium Phosphate molecules in Aegis group and formation of Fluoroapetite in Teethmate F1 group, were probably responsible for the remineralization.