Prevalence of Dental Caries in Children of Age 5 to 13 Years in District of Vaishali, Bihar, India.

CONTEXT: Dental caries is the most common type of oral health problem globally. It is known to have multifactorial etiology with a number of variables that influence the prevalence of the condition. AIM: The present study was carried out in the district of Vaishali, Bihar, India, with an aim to determine the prevalence of dental caries in children of 5 to 13 years. SETTINGS AND DESIGN: It was a descriptive type of epidemiological study and the design adopted for the study was cross-sectional. No active intervention and follow-up examinations were performed. MATERIALS AND METHODS: A total of 1,000 children of 5 to 13 year age group were examined for the study. The study population was categorized based on age, sex, location, and socioeconomic status. The examination procedure and criteria were those recommended by the World Health Organization (WHO). STATISTICAL ANALYSIS USED: The data obtained from the survey were subjected to statistical evaluation using the Statistical Package for the Social Sciences (SPSS) software. Test for significance was done with the help of analysis of variance (ANOVA) and chi-square test. RESULTS: The difference in the caries prevalence between the age groups and between the socioeconomic level was very highly significant (p = 0.000). There was a statistically significant difference observed in the prevalence of caries between the sexes (p = 0.016) as well as between urban and rural (p = 0.018). CONCLUSION: It is expected that the data obtained with the help of this survey will prove to be very useful to the concerned authorities in handling dental caries which is a biosocial disease rooted in the technology and economy of our society.How to cite this article: Goenka P, Dutta S, Marwah N, Sarawgi A, Nirwan M, Mishra P. Prevalence of Dental Caries in Children of Age 5 to 13 Years in District of Vaishali, Bihar, India. Int J Clin Pediatr Dent 2018;11(5):359-364.

Structure-function relationship of a bio-pesticidal trypsin/chymotrypsin inhibitor from winged bean.

Protease inhibitors are essential bio-molecules that serve as a model system for the study of protein structure and protease-protease inhibitor interaction. We here report a bi-functional serine protease inhibitor from winged bean (WBCTI) that completely retains its inhibitory property against trypsin and chymotrypsin even after heating at 70°C. Detailed circular dichroism and fluorescence studies at different temperatures, 30-90°C, have been performed to understand the reason behind thermal stability of the protein. On the basis of our results it appears that WBCTI maintains its canonical structure up to 70°C. Above that the heat induced conformational change becomes irreversible which causes aggregation followed by precipitation of the protein. Moreover, the activity and stability of the secondary structure are found to decrease drastically in presence of dithiothreitol indicating that the protein acquires additional stability for the occurrence of two disulfide bonds. In addition to the structural characterization, an important property of WBCTI against the polyphagous pest Helicoverpa armigera has been explored in present study. WBCTI has showed reasonable inhibition of the mid-gut proteases of H. armigera. In artificial feeding trial through addition of WBCTI in diet resulted in significant growth retardation, delayed pupae formation and higher mortality of H. armigera larvae.

Oral Cysticercosis in a Pediatric Patient: A Rare Case Report with Review.

Cysticercosis is a condition in which a human acts as the intermediate host of the pork tapeworm Taenia solium. Although cysticercosis is a common disease in some regions of the world and can occur in any body site, oral lesions are rare. In this report, we document the case of oral cysticercosis in a 10-year-old boy who sought treatment for an asymptomatic nodule on the dorsal surface of the tongue. A detailed history, thorough clinical examination, morphological appearance and the histopathologic findings of the excised cyst formed the basis for the diagnosis of the lesion. How to cite this article: Goenka P, Sarawgi A, Asopa K, Gumber P, Dutta S. Oral Cysticercosis in a Pediatric Patient: A Rare Case Report with Review. Int J Clin Pediatr Dent 2016;9(2):156-161.

Proteomic analysis of JAZ interacting proteins under methyl jasmonate treatment in finger millet.

Jasmonic acid (JA) signaling pathway in plants is activated against various developmental processes as well as biotic and abiotic stresses. The Jasmonate ZIM-domain (JAZ) protein family, the key regulator of plant JA signaling pathway, also participates in phytohormone crosstalk. This is the first study revealing the in vivo interactions of finger millet (Eleusine coracana (L.) Gaertn.) JAZ protein (EcJAZ) under methyl jasmonate (MJ) treatment. The aim of the study was to explore not only the JA signaling pathway but also the phytohormone signaling crosstalk of finger millet, a highly important future crop. From the MJ-treated finger millet seedlings, the EcJAZ interacting proteins were purified by affinity chromatography with the EcJAZ-matrix. Twenty-one proteins of varying functionalities were successfully identified by MALDI-TOF-TOF Mass spectrometry. Apart from the previously identified JAZ binding proteins, most prominently, EcJAZ was found to interact with transcription factors like NAC, GATA and also with Cold responsive protein (COR), etc. that might have extended the range of functionalities of JAZ proteins. Moreover, to evaluate the interactions of EcJAZ in the JA-co-receptor complex, we generated ten in-silico models containing the EcJAZ degron and the COI1-SKP1 of five monocot cereals viz., rice, wheat, maize, Sorghum and Setaria with JA-Ile or coronatine. Our results indicated that the EcJAZ protein of finger millet could act as the signaling hub for the JA and other phytohormone signaling pathways, in response to a diverse set of stressors and developmental cues to provide survival fitness to the plant.

A potent bidirectional promoter from the monocot cereal Eleusine coracana.

Ragi bifunctional α-amylase-trypsin inhibitor (RBI) of Eleusine coracana (L.) Gaertn. (finger millet) simultaneously inhibits α-amylase and trypsin. In continuation of previous work on the cloning, expression and characterization of RBI, a bidirectional promoter from finger millet was explored on the basis of experimental observations. Two trypsin inhibitors were identified while purifying RBI from a trypsin-Sepharose column eluent. Using an FPLC gel filtration column, these three inhibitors were purified to homogeneity and subjected to MALDI-TOF-TOF-MS/MS analysis and N-terminal sequencing. Both ragi trypsin inhibitors (RTIs) showed the same N-terminal sequence and considerable sequence similarity to RBI, indicating the presence of a multigene protease inhibitor family in finger millet. To gain insight into the evolution of these genes, the upstream region of RBI was explored by Genome Walking. Interestingly, on sequencing, a genome walking product of ∼1 Kb showed presence of an N-terminal RBI specific primer sequence twice but in opposite directions and leaving an intervening region of ∼0.9 Kb. The intervening region was presumed to represent an E. coracana bidirectional promoter (EcBDP), intuitively having a divergent RBI-RTI gene pair at two sides. For assaying the bidirectionality of promoter activity, a dual reporter GUS-GFP vector construct was made for plant expression containing the reporter genes at two ends of EcBDP, which was used to transform Agrobacterium tumefaciens LBA 4404. Transient plant transformation by recombinant Agrobacterium cells was carried out in onion scale epidermal cells and finger millet seedling leaves. Simultaneous expression of GUS and GFP under EcBDP established it as a potent natural bidirectional promoter from monocot origin, thereby potentially having vast application in cereal gene manipulations. In addition, inducibility of the EcBDP by either abscisic acid or cold treatment, as determined by transient transformation in onion, would substantiate more precise control of gene expression to mitigate the effects of adverse environmental conditions.

Role of metabolic modulator Bet-CA in altering mitochondrial hyperpolarization to suppress cancer associated angiogenesis and metastasis.

Solid tumors characteristically reflect a metabolic switching from glucose oxidation to glycolysis that plays a fundamental role in angiogenesis and metastasis to facilitate aggressive tumor outcomes. Hyperpolarized mitochondrial membrane potential is a manifestation of malignant cells that compromise the intrinsic pathways of apoptosis and confer a suitable niche to promote the cancer associated hallmark traits. We have previously reported that co-drug Bet-CA selectively targets cancer cells by inducing metabolic catastrophe without a manifest in toxicity. Here we report that the same molecule at a relatively lower concentration deregulates the cardinal phenotypes associated with angiogenesis and metastasis. In mice syngeneic 4T1 breast cancer model, Bet-CA exhibited effective abrogation of angiogenesis and concomitantly obliterated lung metastasis consistent with altered mitochondrial bioenergetics. Furthermore, Bet-CA significantly lowered vascular endothelial growth factor (VEGF) levels and obviated matrix metalloproteases (MMP-2/9) production directly to the criterion where abrogation of autocrine VEGF/VEGFR2 signalling loop was documented. In vitro studies anticipatedly documented the role of Bet-CA in inhibiting actin remodeling, lamellipodia formation and cell membrane ruffling to constitutively suppress cell motility and invasion. Results comprehensively postulate that Bet-CA, a mitochondria targeting metabolic modulator may serve as an excellent candidate for combating angiogenesis and metastasis.

'Dual hit' metabolic modulator LDCA selectively kills cancer cells by efficient competitive inhibition of LDH-A.

Herein, we synthesize and elucidate the potential of a novel 'dual hit' molecule, LDCA, to constitutively block lactate dehydrogenase isoform-A (LDH-A) to selectively subvert apoptosis and rigorously attenuate breast tumor progression in a mouse model, comprehensively delineating the therapeutic prospectus of LDCA in the field of cancer metabolics.

Patterns of mandible fracture in children under 12 years in a district trauma center in India.

AIM: This study aims to present the data of mandibular fracture among children in the age group of 0-12 years treated in a district trauma center in India. STUDY DESIGN: Sixty-two children younger than 12 years treated for mandibular fractures over two-and-a-half-year period were studied by age, gender, anatomic site, etiology, socioeconomic status, residing area, interval from trauma to reporting, and treatment performed. The cases were divided into three age groups, and the records of the patients were analyzed. RESULTS: The male to female ratio was 1.58:1. Common fall and fall from bike together was a cause for injury in 50% (31 patients), of total patients. Condylar fractures occurred in 25 patients (40.3%). Multiple fractures were seen in 13% of the patients. In 47 (75.8%) patients, associated injuries other than the mandibular fractures were also present. Most patients with mandibular fractures were treated by closed reduction (36 patients, 58%). Conservative treatment and open reduction were done in 18 (29%) and 8 (13%) patients, respectively. CONCLUSION: In addition to factors such as age, gender, etiology, anatomic site, and treatment of mandibular fracture, this study also reported statistics regarding other factors such as residing area, socioeconomic status, and interval from trauma to reporting in Indian patients. It is hoped that the data presented here will be valuable to the government agencies and healthcare professionals for planning treatment, recommending preventive measures and encouraging research in this area.

Social and Behavioral Determinants for Early Childhood Caries among Preschool Children in India.

Background and aims. Early Childhood Caries (ECC) is a public health problem with biological, social and behavioural determinants and the notion that the principal etiology is inappropriate feeding modalities is no longer tenable. Hence this study was undertaken to assess the relationship between ECC and socio-demographic factors, dietary habits, oral hygiene habits and parental characteristics. Materials and methods. The study involved a dental examination of 1400 children aged 0-71 months, recording caries using Gruebbel's deft index and a structured questionnaire to interview parents or caretakers. The tabulated data was statistically analyzed using t-test and ANOVA at 5% level of significance. Results. The variables significantly associated with ECC were age (P<0.001), geographical location (P<0.05), duration of breast/bottle feeding (P<0.001), use of sweetened pacifiers (P<0.001), frequency of snacking (P<0.05), frequency of tooth brushing (P<0.001), the person responsible for child's oral health care (P<0.05) and education level of parents (P<0.05). However, other variables like child's gender, number of siblings, types of snack the child preferred and age at which tooth brushing was instituted did not have statistically significant relationship with ECC (P>0.05). Conclusion. ECC is preventable and manageable with proper information and skills. It is important for healthcare professionals, family physicians and parents to be cognizant of the involved risk factors as their preventive efforts represent the first line of defense.

A potent tumoricidal co-drug 'Bet-CA'--an ester derivative of betulinic acid and dichloroacetate selectively and synergistically kills cancer cells.

Selective targeting of cancer cells employing multiple combinations as co-drug holds promise for new generation therapeutics. Betulinic acid (BA), a plant secondary metabolite kills cancer cells and Dichloroacetate (DCA) is capable of reversing the Warburg phenotype by inhibiting pyruvate dehydrogenase kinase (PDK). Here, we report synthesis, characterization and tumoricidal potential of a co-drug Bet-CA, where a DCA molecule has been appended on C-3 hydroxyl group of BA to generate an ester derivative for increased solubility and subsequent cleavage by internal esterase(s) to release one unit each of BA and DCA. In vitro studies revealed pronounced synergistic cytotoxicity of Bet-CA against a broad spectrum of cancer cells and it selectively killed them when co-cultured with human fibroblasts. Bet-CA treatment increased reactive oxygen species (ROS) production, significantly altered mitochondrial membrane potential gradient (ΔΨm); followed by the release of cytochrome c (Cyt c) which prompted cells to undergo mitochondria mediated apoptosis. In vivo experimentation expectedly exhibited tumor inhibitory potential of Bet-CA and clinically achievable doses did not produce any apparent toxicity. Taken together, results suggestively raise an important corollary hypothesis stating that Bet-CA selectively and synergistically combats cancer without producing toxic manifestations and emerges to be the prospect for the new generation therapeutics.

Cloning, expression and mutational studies of a trypsin inhibitor that retains activity even after cyanogen bromide digestion.

A winged bean trypsin inhibitor (WbTI-2) of molecular mass ∼20kDa, has been cloned and expressed in Escherichiacoli with full activity like the one from seed protein. It completely inhibits trypsin at an enzyme:inhibitor molar ratio of 1:2. PCR with cDNA and genomic DNA using same primers produced about 550 base pair product, which indicated it to be an intronless gene. Through site-directed mutagenesis, the Arg64 has been confirmed as the P1 residue. For the presence of five methionine residues in WbTI-2, cyanogen bromide (CNBr) digestion was carried out. Out of three fragments the one (about 65% of original size) containing the reactive site loop retained 50% activity.

Simple fixed functional space maintainer.

Premature loss of a primary tooth is one of the most common etiology for malocclusion. Space maintainers are employed to prevent this complication. In anterior region, esthetics is an important concern along with function and space management. Fiber-reinforced composite (FRC) retained space maintainer solves all these purposes ef ficiently and ef fectively. In addition, the technique is simple and the appliance is very comfortable inside the oral cavity. Here is a case of premature loss of anterior primary tooth which was replaced by FRC retained esthetic functional space maintainer. The appliance was found to be functioning satisfactorily inside the oral cavity till the last visit (1 Year). How to cite this article: Goenka P, Sarawgi A, Marwah N, Gumber P, Dutta S. Simple Fixed Functional Space Maintainer. Int J Clin Pediatr Dent 2014;7(3):225-228.

Camellia sinensis (Tea): Implications and role in preventing dental decay.

Tea is one of the most commonly consumed beverages with bioactive compounds like polyphenols-flavonoids-catechins, which are thought to be responsible for the health benefits that have traditionally been attributed to the tea. These compounds have multi-dimensional effects such as antibacterial action, inhibitory action on the bacterial and salivary amylase and inhibition of acid production. This article outlines the possible role of these compounds coupled with the presence of high fluoride content in tea to exhibit an anticariogenic effect.

Concurrent outbreaks of cholera and peripheral neuropathy associated with high mortality among persons internally displaced by a volcanic eruption.

BACKGROUND: In October 2004, Manam Island volcano in Papua New Guinea erupted, causing over 10 000 villagers to flee to internally displaced person (IDP) camps, including 550 from Dugulaba village. Following violence over land access in March 2010, the IDPs fled the camps, and four months later concurrent outbreaks of acute watery diarrhea and unusual neurological complaints were reported in this population. MATERIALS AND METHODS: A retrospective case-control study was conducted to identify the risk factors for peripheral neuropathy. Rectal swabs were collected from cases of acute watery diarrhea. Hair and serum metals and metalloids were analyzed by Inductively Coupled Plasma-Mass Spectrometry (ICP-MS). RESULTS: There were 17 deaths among the 550 village inhabitants during the outbreak period at a crude mortality rate 21-fold that of a humanitarian crisis. Vibrio cholerae O1 El Tor Ogawa was confirmed among the population. Access to community-level rehydration was crucial to mortality. Peripheral neuropathy was diagnosed among cases with neurological symptoms. A balanced diet was significantly protective against neuropathy. A dose-response relationship was seen between peripheral neuropathy and a decreasing number of micronutrient- rich foods in the diet. Deficiencies in copper, iron, selenium and zinc were identified among the cases of peripheral neuropathy. CONCLUSIONS: Cholera likely caused the mostly preventable excess mortality. Peripheral neuropathy was not caused by cholera, but cholera may worsen existing nutritional deficiencies. The peripheral neuropathy was likely caused by complex micronutrient deficiencies linked to non-diversified diets that potentially increased the vulnerability of this population, however a new zinc-associated neuropathy could not be ruled out. Reoccurrence can be prevented by addressing the root cause of displacement and ensuring access to arable land and timely resettlement.

Vibrio cholerae antimicrobial drug resistance, Papua New Guinea, 2009–2011

Cholera is an acute infectious disease caused by Vibrio cholerae . The disease occurs in a variety of forms ranging from sporadic cases to outbreaks that may transition to endemic disease. While cholera case management focuses on early, rapid rehydration, antimicrobial therapy can reduce the volume of diarrhoea, duration of carriage and symptoms and is frequently recommended for patients with severe dehydration.

A biological approach to crown fracture: Fracture reattachment: A report of two cases.

The development of adhesive dentistry has allowed dentists to use the patient's own fragment to restore the fractured tooth, which is considered to be the most conservative method of treatment of crown fracture allowing restoration of original dental anatomy, thus rehabilitating function and esthetics in a short time by preserving dental tissues. The tooth fragment reattachment is preferred over full coverage crowns or composite resin restoration because it conserves sound tooth structure, and is more esthetic, maintaining the original anatomy and translucency, and the rate of incisal wear also matches that of original tooth structure. Presented here is a report of two cases of crown fracture managed by reattachment procedures.

Cholera risk factors, Papua New Guinea, 2010.

BACKGROUND: Cholera is newly emergent in Papua New Guinea but may soon become endemic. Identifying the risk factors for cholera provides evidence for targeted prevention and control measures. METHODS: We conducted a hospital-based case-control study to identify cholera risk factors. Using stool culture as the standard, we evaluated a cholera point of care test in the field. RESULTS: 176 participants were recruited: 54 cases and 122 controls. Independent risk factors for cholera were: being over 20 years of age (aOR 2.5; 95%CI 1.1, 5.4), defecating in the open air (or river) (aOR 4.5; 95% CI 1.4, 14.4) and knowing someone who travelled to a cholera affected area (aOR 4.1; 95%CI 1.6, 10.7); while the availability of soap for handwashing at home was protective (aOR 0.41; 95%CI 0.19, 0.87). Those reporting access to a piped water distribution system in the home were twice as likely to report the availability of soap for handwashing. The sensitivity and specificity of the rapid test were 72% (95% CI 47-90) and 71% (95%CI 44-90%). CONCLUSIONS: Improving population access to the piped water distribution system and sanitation will likely reduce transmission by enabling enhanced hygiene and limiting the contamination of water sources. The One step V. cholerae O1/O139 Antigen Test is of limited utility for clinical decision making in a hospital setting with access to traditional laboratory methods. Settlement dwellers and mobile populations of all age groups should be targeted for interventions in Papua New Guinea.

A conservative approach toward restoration of fractured anterior tooth.

Reattachment of the fractured anterior tooth is a highly conservative and aesthetic treatment that has gained popularity in the recent past. Presented here is one such case in which a combination of external enamel bevel and internal dentinal groove has been used to enhance the bonding between the fractured fragment and the remaining tooth. The treatment was found to be successful both functionally and aesthetically at the 18-month follow-up.

Supernumerary teeth: Report of four unusual cases.

Supernumerary tooth denotes duplication of tooth in the normal series. It is a developmental anomaly and has been argued to arise from multiple etiologies. These teeth may remain embedded in the alveolar bone or can erupt into the oral cavity. The supernumerary tooth might cause esthetic and/or functional problems, especially if it is situated in the maxillary anterior region. Complications reported were delayed or prevented eruption of succedaneous teeth, displacement or rotation, crowding of the affected region, abnormal diastema, dilacerations, cystic formation, and sometime eruption into the nasal cavity. In this case report, four unusual cases of supernumerary teeth that resulted in varying degrees of disturbances in permanent dentition are presented. Conservative surgical intervention and light orthodontic forces were used to bring the teeth into normal position with minimal disturbance to the surrounding oral structures.