Comparative Evaluation of Different Varnishes and Pit and Fissure Sealants on Streptococcus mutans Count in Saliva of Children.

Aim: This study aims to evaluate and compare the effect of different varnishes: 3M ESPE Clinpro and Voco Profluorid and fissure sealants- 3M ESPE ClinPro and Ivoclar Vivadent Helioseal-F on the S. mutans count in the saliva of children. Materials and methods: Eighty children of 6-12 years of age with no incidence of caries were selected and saliva samples were collected by drooling method after oral prophylaxis. The children were divided randomly into four groups and materials were applied accordingly. Saliva samples were obtained immediately after the procedure as well as 1-month, 3-months and 6-months posttreatment. Saliva samples were inoculated on Mitis salivarius agar and colony counts of S. mutans were obtained. Results: This study showed that both the varnishes and pit and fissure sealants were equally effective in reducing the salivary S. mutans count in children in a time period of 6-months however pit and fissure sealants were more effective in preventing caries. Conclusion: Both varnishes and pit and fissure sealants are equally effective in reducing S. mutans count in saliva. How to cite this article: Sharma R, Ghambir N, Gupta N, et al. Comparative Evaluation of Different Varnishes and Pit and Fissure Sealants on Streptococcus mutans Count in Saliva of Children. Int J Clin Pediatr Dent 2022;15(3):362-365.

COVID-19-associated Multisystem Inflammatory Syndrome in Children: A Multicentric Retrospective Cohort Study.

BACKGROUND: Multisystem inflammatory syndrome in children (MIS-C) associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new entity affecting a small percentage of children during the COVID-19 pandemic. MATERIALS AND METHODS: Demography, clinical, and laboratory variables of children admitted from April to September 2020 with MIS-C were studied retrospectively at eight hospitals in Delhi, India. RESULTS: We identified 120 patients [median age: 7 years (interquartile range (IQR): 4-10)] with male-to-female ratio of 2.3:1. Overall, 73 out of 120 children (60.8%) presented with shock, 63 (52.5%) required inopressor support, and 51 (43%) required respiratory support. We categorized the cohort into three observed clinical phenotypes: MIS-C with shock (n = 63), MIS-C with Kawasaki disease (KD) (n = 23), and MIS-C without shock and KD (n = 34). Atypical presentations were hypothermia, orchitis, meningoencephalitis, demyelination, polyneuropathy, pancreatitis, and appendicitis. Ninety-four percent had laboratory evidence of SARS-CoV-2 (78.3%, seropositive and 15.8%, RT-PCR positive). The median C-reactive protein (CRP) was 136 mg/L (IQR, 63.5-212.5) and ferritin was 543 ng/mL (IQR, 225-1,127). More than 90% received immunomodulatory therapy (intravenous immunoglobulins and/or steroids) with an excellent outcome (96% survived). CRP and absolute neutrophil count (ANC) were correlated statistically with severity. CONCLUSION: MIS-C data from Delhi are presented. Rising CRP and ANC predict the severe MIS-C. HOW TO CITE THIS ARTICLE: Mehra B, Pandey M, Gupta D, Oberoi T, Jerath N, Sharma R, et al. COVID-19-associated Multisystem Inflammatory Syndrome in Children: A Multicentric Retrospective Cohort Study. Indian J Crit Care Med 2021;25(10):1176-1182.

Consensus Guidelines for Pediatric Intensive Care Units in India, 2020.

BACKGROUND: Consensus Guidelines for Pediatric Intensive Care Units (PICUs) were published in Indian Pediatrics in 2002. OBJECTIVE: The current document represents a recent update in the Indian context, regarding unit design, equipment, organization, staffing as well as admission and discharge criteria for different levels of Pediatric Intensive Care and teaching units with PICU training programs, as well as nonteaching units. PROCESS: The Pediatric Intensive Care College Council (PICC), an academic wing of the Indian Academy of Pediatrics (IAP) Intensive Care Chapter took the initiative to update the guidelines with members of the PICU guidelines Committee writing group. After a great deal of discussion at conferences and through mailing and feedback with listed members, as well as with the guidance and feedback of senior PICU guidelines advisory committee members, The consensus is now updated. These guidelines are intended to serve as a reference for health Care institutions wishing to establish a new PICU or to modify an existing PICU. As a resource, experience of those members who have worked extensively in western PICUs was also taken into consideration, in addition to published guidelines in the medical literature. PICUs with teaching programs run by the IAP Intensive Care Chapter must follow these criteria for unit accreditation and teaching curricula as applicable. RECOMMENDATIONS: Unit design, equipment, organization, staffing as well as admission and discharge criteria for different levels of pediatric intensive care are updated.

Tissue Engineering; Current Status & Futuristic Scope.

Almost 30 years have passed since the term 'tissue engineering' was created to represent a new concept that focuses on the regeneration of neotissues from cells with the support of biomaterials and growth factors. This interdisciplinary engineering has attracted much attention as a new therapeutic means that may overcome the drawbacks involved in the current artificial organs and organ transplantation that have also been aiming at replacing lost or severely damaged tissues or organs. However, the tissues regenerated by tissue engineering and widely applied to patients are still minimal, including skin, bone, cartilage, capillary, and periodontal tissues. What are the reasons for such slow advances in clinical applications of tissue engineering? This article gives a brief overview of the current state of tissue engineering, covering the fundamentals and applications. The fundamentals of tissue engineering involve cell sources, scaffolds for cell expansion and differentiation, as well as carriers for growth factors. Animal and human trials are a major part of the applications. Based on these results, some critical problems to be resolved for the advances of tissue engineering are addressed from the engineering point of view, emphasizing the close collaboration between medical doctors and biomaterials scientists.

Intrauterine Copper Device (CuT380A) as a Contraceptive Method in the Indian Context: Acceptability, Safety and Efficacy Depending on the Timing of Insertion.

BACKGROUND: Ideal time of Intrauterine copper device (IUCD) insertion either to space or limit births in Indian women should be known to check fertility effectively and safely. We therefore aimed to compare various IUCD related clinical factors to assess its acceptability, safety and efficacy in immediate postpartum vaginal insertion, intra-caesarean insertion, delayed postpartum insertion and interval insertion at a tertiary-care centre in India. METHODS: It was a retrospective analysis of prospectively collected data from July 2013 to July 2014. Data was reviewed about maternal age, socioeconomic status, education, occupation and parity of a total of 1631 eligible mothers and was compared between postpartum group and interval group. Data about spontaneous expulsion rate of IUCD, proportion of patients not able to feel thread, reasons for removal and failure rate of IUCD up to a follow-up period of 6 months was also collected in these women and compared among immediate vaginal insertion, intra-caesarean insertion, delayed postpartum insertion and interval insertion. RESULTS: Majority of women were between 20 and 35 years of age group, literate, multiparous, unemployed and belonged to middle/lower socio-economic strata in both postpartum and interval groups. Spontaneous expulsion rates were 1.84, 0.84, 2.83 and 1.63%; proportions of patients not able to feel thread were 3.07, 8.73, 4.45 and 1.63%; and removal rates were 7.99, 6.48, 7.69 and 3.47% in immediate vaginal, intra-caesarean, delayed postpartum and interval insertion groups, respectively. Failure was seen in only one case of delayed postpartum insertion. CONCLUSION: IUCD was more acceptable among young, literate and multiparous women as a contraceptive method. Immediate postpartum period was the safest and most efficacious time for IUCD insertion with least expulsion rate, maximum continuation rate and no failure and, therefore, should be encouraged by adequate counseling of mothers.

Natural Killer Cells - Their Role in Tumour Immunosurveillance.

An important component of the innate immune system, the natural killer cells that originate from the lymphoid cell lineage, hold tremendous potential as an effective therapeutic tool to combat a variety of cancers. Their vast capability to kill altered cells such as opsonized cells (antibody coated), tumour cells, genotoxically changed cells without affecting the healthy cells of the body, make them an effective therapeutic agent for various types of cancers. Besides, through interplay and molecular crosstalk via several cytokines, they also augment the adaptive immune response by, promoting the differentiation, activation and recruitment of component cells of the system. With the current advance knowledge of Natural Killer (NK) cells, their receptor-ligand interactions involved in functional regulation, various mechanistic approaches involving the role of cytokines led to desired modulation of NK cell activity in a tailor-made manner, for triggering clinically relevant responces. Several strategies have been adopted by researchers, to augment the efficacy of NK cells. Still many challenges exist for increasing the therapeutic relevance of these cells.

Green dentistry, a metamorphosis towards an eco-friendly dentistry: a short communication.

Dentistry is most importantly and foremost a healing profession. In today's world, it is very necessary to understand the importance of being eco-friendly in every facet of our lives, including dental practice which has a huge impact on the environment due to the large amount of metallic waste generated by various dental procedures along with excessive use of water and electricity, which specifically emphasis the thrust to move towards 'Green dentistry'. Green dentistry is an innovative way of dental practice which is environment friendly and at the same time conserves money and time by reducing waste, conserving energy and decreasing pollution with the use of latest techniques and procedures. Green dentistry therefore, protects the environment and mankind from the hazards of rapid urbanisation in developing countries. The authors wish to emphasize the practice of eco-friendly, green dentistry in a developing country like India which needs to conserve resources and curb environmental pollution.

Orbitocranial complications of acute sinusitis in children.

BACKGROUND: Orbitocranial complications (OCCs) of sinusitis are uncommon but potentially life threatening. OCCs carry high morbidity, mortality, and significant long-term sequelae. Late recognition leads to even worse outcomes. OBJECTIVE: To present four case reports showing that aggressive management of complications of sinusitis-like OCC decreases long-term sequelae and mortality in pediatric patients. CASE REPORTS: Four pediatric patients diagnosed with OCC were treated at our institution from April 2012 to March 2013. Three were boys and one was a girl; ages ranged from 4-14 years. Magnetic resonance imaging and computed tomography were the most useful imaging modalities. All patients received broad-spectrum antibiotics. Additional interventions consisted of endoscopic sinus surgery, subdural empyema drainage, and orbital decompression. CONCLUSION: The difficult complications of acute sinusitis in the pediatric age group should be anticipated, recognized early, and aggressively managed to prevent morbidity and a fatal outcome.

Genetic analysis in Bartter syndrome from India.

Bartter syndrome is a group of inherited, salt-losing tubulopathies presenting as hypokalemic metabolic alkalosis with normotensive hyperreninemia and hyperaldosteronism. Around 150 cases have been reported in literature till now. Mutations leading to salt losing tubulopathies are not routinely tested in Indian population. The authors have done the genetic analysis for the first time in the Bartter syndrome on two cases from India. First case was antenatal Bartter syndrome presenting with massive polyuria and hyperkalemia. Mutational analysis revealed compound heterozygous mutations in KCNJ1(ROMK) gene [p(Leu220Phe), p(Thr191Pro)]. Second case had a phenotypic presentation of classical Bartter syndrome however, genetic analysis revealed only heterozygous novel mutation in SLC12A gene p(Ala232Thr). Bartter syndrome is a clinical diagnosis and genetic analysis is recommended for prognostication and genetic counseling.

Isolated severe bilateral bronchomalacia.

Airway malacia is uncommon condition having symptoms similar to common respiratory illnesses. Any child having persistent wheeze during infancy should be evaluated for airway malacia. The authors report a case of isolated severe bilateral bronchomalacia managed with tracheostomy and continuous positive pressure ventilation.

Emperipolesis - a review.

Emperipolesis is an uncommon biological process, in which a cell penetrates another living cell. Unlike in phagocytosis where the engulfed cell is killed by lysosomal enzymes of the macrophage, the cell exists as viable cell within another in emperipolesis and can exit at any time without any structural or functional abnormalities for either of them. This process can either be physiological or pathological and may be a pathognomonic feature of certain diseases. Histiocytes and Megakaryocytes are involved in Emperipolesis normally but tumour giant cells in Hodgkin's disease and Rosai-Dorfman disease are pathologic conditions in which this process is seen. We report a mini review as this process is rare and not much reported in the literature.

Diagnostic procedures for autoimmune vesiculobullous diseases: A review.

Oral soft tissues are affected by numerous pathologic conditions of variable etiology and hence their appropriate management relies on their accurate diagnosis. Clinical identification of intact vesicle and bulla in the oral cavity is really a challenge due to the regular irritation and the friable nature of oral mucosa. Rupture of these lesions leads to erosions or ulcerations on the surface, hence making the diagnosis of vesiculobullous (VB) lesions is even more difficult due to the fact that the differential diagnosis along with VB lesions will also include ulcerative, immunological-mediated diseases, and neoplasms and systemic diseases. Hence, knowledge of the clinical presentation of these disorders and the relevant diagnostic procedures is important not just for dermatologists, but also for general practitioners and dentists. In this article, the various procedures have been explained that can be used for the diagnostic purpose of VB lesions.

Pachymeningitis in a young child responded to antitubercular therapy: a case report.

Pachymeningitis is a rare disease of diverse etiology mainly affecting the adult population. Only 4 pediatric cases have been reported till now. We report the youngest child with pachymeningitis from India. Our case responded very well to antitubercular therapy with near complete recovery. Antitubercular therapy can be considered in children from endemic countries with hypertrophic pachymeningitis before labeling their condition as idiopathic hypertrophic pachymeningitis.

Artefacts: a diagnostic dilemma - a review.

The significance of proper handling of biopsy specimens is important and obvious for any histopathological diagnosis. Accuracy of tissue diagnosis by the pathologists is heavily dependent upon the competence of histotechnologists. The aim of a good histopathological technique is to produce microscopic preparation of tissues, usually stained, that represents as closely as possible, their structures in life. But this is not always possible and some sort of tissue morphology is bound to be seen. The ability of oral pathologists in interpreting a biopsy correctly is directly proportional not only to the quality, but also to the quantity of the specimen. There are many ways through which the exact interpretation of tissue specimen becomes compromised and the major pitfall is the presence of artefacts. These artefacts may occur during surgical removal, fixation, processing, embedding, microtomy and staining procedures. It is therefore important to identify the common occurring artefacts during interpretation of oral biopsies.

Prevalence and risk factors for neutralizing antibodies to human papillomavirus types 16 and 18 in HIV-positive men who have sex with men.

OBJECTIVE: Human papillomavirus (HPV) vaccination is routinely recommended in HIV-positive men who have sex with men (MSM) aged ≤ 26 years. Levels of previous HPV exposure in older HIV-positive MSM are assumed to be too high to warrant routine HPV vaccination. However, little is known about the prevalence of and risk factors for neutralizing antibody seropositivity to HPV-16 or HPV-18, a key measure of previous exposure to these types. METHODS: Cross-sectional analysis of baseline visit for 296 HIV-positive MSM participating in a prospective cohort study of anal squamous intraepithelial lesions at a university-based research clinic. Participants completed a questionnaire detailing behaviors and medical history. Phlebotomy, anal cytology, HPV DNA testing with quantitation, and high-resolution anoscopy with biopsy were performed. A pseudovirion-based neutralizing antibody assay was used to measure HPV-16 and HPV-18 neutralizing antibodies. RESULTS: One hundred thirty-two of 296 (45%) men were HPV-16 seropositive and 141 of 296 (48%) were HPV-18 seropositive. One hundred seventy-five of 296 (59%) of the men were positive for HPV-16 antibodies or DNA and 167 of 296 (56%) were positive for HPV-18 antibodies or DNA. In multivariable analysis, HPV-16 seropositivity did not correlate with age, years of HIV positivity, CD4 level, or HIV viral load. Significant risk factors included HPV-16 DNA positivity with higher DNA levels (ptrend < 0.001) and higher number of receptive sexual partners in the last year (ptrend = 0.012). CONCLUSIONS: A high proportion of HIV-positive MSM aged >26 years are DNA negative and seronegative to HPV-16 and HPV-18 even when using a sensitive pseudovirion-based neutralizing antibody assay. Prospective studies are needed to determine the clinical- and cost-effectiveness of HPV vaccination in HIV-positive MSM aged >26 years.

Ventriculo-peritoneal shunt: A rare cause of basal ganglia and thalamic abscess.

We report an 18-month-old female child with ventriculo-peritoneal shunt related thalamic abscess treated with stereotactic aspiration. Deep seated abscesses are complex due to difficult access and are associated with an increased risk of intra-ventricular rupture as well as antibiotic resistance, a fact which justifies a more aggressive and immediate neurosurgical management.

Phase control of nanostructured iron oxide for application to biosensor.

We report results of the studies relating to the phase transformation of bare Fe3O4 nanoparticles (NPs) to α-Fe2O3 NPs obtained during electrophoretic film deposition onto indium-tin oxide coated glass plates. The in situ oxidation of NPs during electrophoretic deposition can be circumvented using surface passivation of the Fe3O4 NPs with an organic shell (carbon) as well as an inorganic shell (silica), while retaining the biocompatibility of the Fe3O4 NPs. XRD and XPS studies reveal the transformation of Fe3O4 NPs to α-Fe2O3 NPs upon electrophoretic deposition, and the retention of the phase of the Fe3O4 NPs upon encapsulation with carbon and silica, respectively. The results of SEM studies indicate decreased agglomeration of the Fe3O4 NPs upon encapsulation during film deposition. Attempts have been made to compare the characteristics of cholesterol biosensors fabricated using Fe3O4@C and α-Fe2O3 NPs, respectively. The Fe3O4@C NPs based cholesterol biosensor shows response time of 60 s, a linearity range of 25-500 mg dl-1, a sensitivity of 193 nA mg-1 dl cm-2 and a Michaelis-Menten constant of 1.44 mg dl-1.