Effect of Twin Block Therapy Versus Fixed Functional Appliances on Pharyngeal Airway Space in Skeletal Class II Patients: A Prospective Cephalometric Study.

Background: Class II malocclusion is one of the most common malocclusion with varied prevalence. Functional therapy with appliances like Twin Block or Fixed functional appliances forms the mainstay of treatment in growing Class II patients. These patients might demonstrate narrow airway due to the retrognathic position of the mandible. This study investigated the effects of twin block and fixed functional appliance therapy (Forsus™ FRD) on the pharyngeal airway space in skeletal Class II patients. Methods: Forty patients with Class II malocclusion were selected and divided into two equal groups of 20 patients each for both Twin block and Forsus group. Lateral cephalograms were obtained before and after the functional appliance therapy. Evaluation was done for changes in hyoid bone position, pharyngeal airway dimensions and tongue position. Results: The variables of the study showed better hyoid position in both the groups. In Twin Block group, an increase in hy-apw2 and hy-PoFH suggested anterior positioning of hyoid and a decrease in H-MP and hy-ML indicated superior positioning. In Forsus group an increase in H-H', hy-FH, hy-ML, hy-NL, hy-NSL and hy-OL suggested inferior positioning of hyoid, while an increase in hy-apw2, hy-CVT, hy-PoFH, hy-RL and hy'-tgo indicated anterior positioning of hyoid bone after functional therapy. Conclusion: Both the twin block and Forsus™ FRD improved the position of the hyoid bone after the functional appliance therapy however the changes were not statistically significant. Twin block and Forsus™ had similar effect on the hyoid bone position, pharyngeal dimensions and the tongue position.

Comparative effect of micro-osteoperforation and Photo-biomodulation on the rate of maxillary canine retraction: A split mouth randomized clinical trial.

INTRODUCTION: The lengthy duration of comprehensive orthodontic treatment has always been a major concern. Various modalities have been proposed to accelerate the orthodontic tooth movement (OTM) with varying degree of success. However, there is limited literature, comparing the efficiency of two commonly used modalities which are relatively simple, safe and comfortable chair-side procedures to accelerate orthodontic tooth movement viz. Photo-biomodulation (PBM) being non-invasive and micro-osteoperforations (MOPs) being minimally invasive. The aim was to evaluate the comparative effect of PBM and MOPs on the rate of orthodontic tooth movement (OTM). METHODS: In this split mouth study, thirty patients requiring ma-xillary first premolar extraction were randomly allocated for Photo-biomodulation (PBM) on one side and for micro-osteoperforations (MOPs) on other side of maxilla. Separate canine retraction was performed and movement was measured over a three month period. RESULTS: Micro-osteoperforations (MOPs) significantly increased the rate of maxillary canine retraction by 1.1 fold when compared to the Photo-biomodulation (PBM).The MOPs can successfully reduce the comprehensive fixed orthodontic treatment time by around 9% as compared to PBM. CONCLUSIONS: Micro-osteoperforation is a more efficient modality of accelerating tooth movement as compared to Photo-biomodulation which can be used in routine orthodontic practice.

Egg production performance, egg yolk antioxidant profile and excreta concentration of corticosterone in golden pheasants (Chrysolophus pictus) fed diets containing different levels of green vegetables.

In order to study the effect of feeding graded levels of green vegetables on egg production performance and egg yolk antioxidant status, 27 female golden pheasants (GP) were randomly distributed into three groups of nine each in an experiment based on completely randomized design. The diets of the birds in groups T1 , T2 and T3 contained 1.4%, 2.7% and 5.0% of green vegetables respectively. Feeding of experimental diets started on 12th February (day 1) and was continued till 30 June 2012. Average number of eggs laid and egg mass produced by the hens in group T3 was higher (p < 0.004) than those of T1 and T2 . Hen day egg production was lowest (p < 0.001) in group T1 . Roche yolk colour score was highest (p < 0.01) in T3 followed by T2 and was lowest in T1 . Other external and internal egg quality parameters were similar among the groups. Total antioxidant capacity (TAC) of egg yolk was higher (p < 0.04) in group T3 as compared to other two groups. Egg yolk concentration of total carotenoids, ß-carotene, total sulfhydryl, protein-bound sulfhydryl and non-protein-bound sulfhydryl was higher (p < 0.05), whereas concentration of malondialdehyde was lower (p < 0.024) in group T3 as compared to other two groups. Excreta concentration of corticosterone was highest (p < 0.012) in T1 , followed by T2 , and was lowest in T3 . Egg yolk concentration of TAC and TSH was positively and that of malondialdehyde was negatively correlated with carotenoids intake. Excreta concentration of corticosterone was negatively correlated with carotenoids intake. It was concluded that incorporation of green vegetables in the diet at 5% on dry matter basis would improve egg production, egg yolk antioxidant status and the ability of the captive GP to combat stress.

Rethinking peer support for diabetes in Vancouver's South-Asian community: a feasibility study.

AIM: To examine the feasibility and potential health impact of a diabetes self-management education and support intervention involving peer support on glycaemic control and diabetes distress. METHODS: A total of 41 South-Asian adults with Type 2 diabetes were recruited for a 24-week diabetes self-management education and support pilot intervention involving peer support. The intervention consisted of six weekly education sessions co-facilitated by a certified diabetes educator and two peer leaders, followed by 18 weekly support sessions facilitated by two peer leaders. Education sessions were guided entirely by participants' self-management questions and also emphasized goal setting and action planning. Support sessions were based on empowerment principles and participants discussed self-management challenges, shared emotions, asked self-management questions, problem-solved in a group, set goals, and developed and evaluated action plans. Feasibility outcomes included recruitment and retention. Primary health-related outcomes included HbA1c levels and diabetes distress (measured at baseline, 6 and 24 weeks). Programme satisfaction was also assessed. RESULTS: Pre-established criteria for recruitment and retention were met. Paired t-tests showed no changes in HbA1c and diabetes distress at 6 weeks. At 24 weeks, HbA1c levels deteriorated [54 mmol/mol (7.1%) vs 61 mmol/mol (7.7%)] while diabetes distress scores improved (2.0 vs 1.7). CONCLUSIONS: Although feasible, findings suggest this peer-support model may have a positive impact on diabetes distress, but not on HbA1c levels. Culturally responsive modifications (e.g. intervention location) to the pilot model are needed and could lead to more favourable health outcomes for this community. Such a re-designed peer-support model will require further investigation.

Coincidental diagnosis of tuberculous lymphadenitis: a case report.

The aim of this case report was to present a case of multiple calcified tuberculous lymph nodes found on a panoramic radiograph coincidently diagnosed in an endodontic clinic. A detailed discussion on the differential diagnosis of similar such calcification found in the same region is also presented. A 14-year-old girl was referred to our department with the complaint of painless swelling in the left side of the lower jaw. Clinical and radiographical examinations were performed, leading to the initial diagnosis of chronic periapical abscess. The patient's medical history was re-evaluated. Advanced imaging and excisional biopsy were performed in order to confirm the final diagnosis. Regarding the presenting signs and symptoms of bilateral carious mandibular molars, a periapical inflammatory process was considered in the provisional diagnosis. A thorough examination and investigations were suggestive of cervical tuberculous lymphadenitis (scrofula), and the patient underwent excision of the same. The clinician should consider the possibility of chronic granulomatous inflammatory lesions in the differential diagnosis of radiopaque lesions.

The cross cultural adaptation and validity of the child-OIDP scale among school children in Karnataka, South India.

OBJECTIVE: To carry out a cross-cultural translation and adaptation of the Child-O1DP instrument and to assess its reliability and validity among 11-12 year olds in Karnataka, South India. METHODS: The original Child-OIDP was obtained from the author, cross-culturally adapted to the Kannada language then the translation's content, face criterion and construct validity and internal and external reliability were evaluated. Children recorded their oral health problems and rated their oral health in a cross sectional study of 505, 11-12 year olds selected from a list of Karnataka schools by using simple random sampling (89.7% participation rate). RESULTS: The child OIDP revealed good validity and reliability. In relation to construct validity; an exploratory factor analysis provided two factors with eigenvalues greater than 1, which represented the physical and psychosocial health components. Cronbach's alpha was 0.60 and test-retest reliability, 0.85 (intra-class correlation coefficient). CONCLUSIONS: The Kannada Child-OIDP is a valid and reliable interviewer-administered instrument to measure the impact of the oral conditions on quality of life in children in Karnataka, South India.

Evaluating a diabetes self-management support peer leader training programme for the English- and Punjabi-speaking South-Asian community in Vancouver.

AIMS: The purpose of this single-cohort study was to implement and evaluate a programme that trains peers to deliver a diabetes self-management support programme for South-Asian adults with Type 2 diabetes and to assess the perceived efficacy of and satisfaction with this programme. METHODS: We recruited eight South-Asian adults who completed a 20-h peer-leader training programme conducted over five sessions (4 h per session). The programme used multiple instructional methods (quizzes, group brainstorming, skill building, group sharing, role-play and facilitation simulation) and provided communication, facilitation, and behaviour change skills training. To graduate, participants were required to achieve the pre-established competency criteria in four training domains: active listening, empowerment-based facilitation, five-step behavioural goal-setting, and self-efficacy. Participants were given three attempts to pass each competency domain. RESULTS: On the first attempt six (75%), eight (100%), five (63%) and five (63%) participants passed active listening, empowerment-based facilitation, five-step behavioural goal-setting, and self-efficacy, respectively. Those participants who did not pass a competency domain on the first attempt were successful in passing on the second attempt. As a result, all eight participants graduated from the training programme and became peer leaders. Satisfaction ratings for programme length, balance between content and skills development, and preparation for leading support activities were uniformly high. Ratings for the instructional methods ranged between effective and very effective. CONCLUSION: Findings suggest it is feasible to train and graduate peer leaders with the necessary skills to facilitate a diabetes self-management support intervention.

Influence of sodium selenite on growth, nutrient utilization and selenium uptake in Cavia porcellus.

A 70 day experiment on forty guinea pigs (Cavia porcellus) was conducted to find the influence of different level of sodium selenite (inorganic selenium supplementation) on growth, nutrient utilization and selenium uptake. The sodium selenite was supplemented into a basal diet at 0, 0.1, 0.2 and 0.3 ppm, respectively and the basal diet comprised of 25% ground cowpea (Vigna unguiculata) hay, 30% ground maize (Zea mays) grain, 22% ground gram (Cicer arietinum) grain, 9.5% deoiled rice (Oryza sativa) bran, 6% soybean (Glycine max) meal, 6% fish meal, 1.5% mineral mixture (without Se), ascorbic acid (200 mg kg) and 0.1 ppm Se to meet their nutrient requirements. Daily feed intake and weekly body weights were recorded. Intake and digestibility of dry matter, organic matter, ether extract, crude fiber and nitrogen-free extract as well as uptake of calcium and phosphorus, total body weight and average daily gain were similar (p>0.05) among the four groups. However, there was a trend of increase in Se absorption of the guinea pigs with the increasing levels of Se, in the groups given 0.2 and 0.3 ppm of Se. It can be concluded that requirement of Se in guinea pigs is 0.1 ppm, as supplementation of > or =0.1 ppm sodium selenite in the diet (having 0.1 ppm Se) did not enhanced their growth rate and nutrient utilization.

Sequential therapy (triple drug-based induction chemotherapy followed by concurrent chemoradiotherapy) in locally advanced inoperable head and neck cancer patients - Single institute experience.

CONTEXT: India has a high incidence of head and neck squamous cell carcinoma (HNSCC) mostly presenting in advanced stage. In the majority of inoperable patients a combination of chemotherapy and radiotherapy (CRT) is considered as the treatment of choice. Adding induction chemotherapy (ICT) before CRT has shown to decrease systemic relapse. Incorporation of taxanes to the cisplatin and 5-FU-based ICT has shown increase in response rates. AIMS: To evaluate the efficacy and toxicity of triple drug-based ICT followed by CCRT in locally advanced, inoperable HNSCC in the Indian context. SETTINGS AND DESIGN: Prospective, non-controlled, observational study, a single-institute experience. MATERIALS AND METHODS: Consecutive, locally advanced inoperable HNSCC patients were put on sequential therapy consisting of docetaxel, 5-FU and cisplatin for three cycles followed by concurrent weekly cisplatin and radiotherapy for responding or stable disease patients. RESULTS: Forty-four patients were enrolled with male,female ratio of 33/44(75%) and 11/44(25%). Hypopharynx 16/44(36.36%) was the most common site followed by oral cavity 12/44(27.27%) and oropharynx 12/44(27.27%); 38/44(86.36%) patients could complete the planned treatment. Seven patients required dose reduction in ICT. As per the RECIST criteria, 16 patients had Complete Response (CR) and 15 had partial response (PR), 10 had stable disease (SD) and three had progressive disease (PD) after ICT. Thirty-eight patients received concomitant chemo radiotherapy (CCRT); 28/44 (66.63%) patients achieved CR, 10/44 (22.72 %) had PR. The main toxicity was mucositis 18/44 (40.90%) secondary to ICT. Grade III and IV hematological toxicity was seen in 16/44(36.36%), of which 6/44 (13.63%) had febrile neutropenia. CONCLUSIONS: Triple drug-based sequential therapy is tolerable in our context. In this trial from a single institute the results are very encouraging.

Intake and utilization of sorghum and maize green fodder in spotted deer under captivity.

PURPOSE: The feeding value and nutritional adequacy of two cereal fodder, viz. sorghum (Sorghum vulgare) and maize (Zea mays), were evaluated in spotted deer (Axis axis) and compared with that in sheep in two consecutive feeding trials of 35 days each. METHODS: Four spotted deer (2 years of age, 68.3 kg average body weight) and six sheep (1.5 years of age, 18.0 kg average body weight) were fed on the above two fodder types as sole feed. Nutrient digestibility and evaluations were made through two digestion studies that ended with each feeding period. RESULT: Both sorghum and maize fodder provided 11% CP and 4.4 kcal DE per gram of TDN in the two species studied. A lower intake of DM (40.6 vs 47.5 g/kg(0.75)) and other nutrients was observed in deer during maize feeding period. It was similar but lower in sheep compared to deer. The digestibility of nutrients from both fodder types was higher in deer (66-77%) than sheep (45-62%). Numerically, most of the nutrients from sorghum fodder were better digested than maize except CP and EE. Maize fodder provided a higher percentage of NDF (70.85% vs 67.90%) and ADF (37.22% vs 30.74%) with a digestibility depression of about two units in deer and three to five units in sheep. Deer and sheep lost body weight during both the sorghum (2.0 and 0.7 kg) and the maize (2.5 and 0.4 kg) feeding periods. CONCLUSION: Although the nutritive value of cereal fodder seemed optimum, a lower voluntary feed intake in both deer and sheep contributed to inadequate nutrient intake compared to standard recommendation.

Clinicopathological Spectrum of Renal Biopsies in Children.

BACKGROUND: Renal biopsy has revolutionized the study of glomerular diseases. A retrospective analysis of 104 consecutive renal biopsies performed in children at a tertiary care referral centre over five years is presented. METHODS: All the biopsies were performed non-ultrasound guided by a single consultant nephrologist. Trucut needles were used in the initial few years and a Magnum biopsy gun (Bard) over subsequent three years. There were 66 boys and 38 girls. RESULT: A male predominance occurred in the older and younger patients. The male: female ratio was 2.2:1, 1:1, and 2.7:1 for the age groups below five years, 5-10 years and above 10 years respectively. All patients tolerated the biopsy well and success rate was 94%. There were minimal complications in the form of post biopsy haematuria (33.3%). Haematuria was mild in most of the cases and settled down within 24 hours. None required transfusion. However, 60% patients had mild discomfort in the form of local pain. There was no mortality, infection or renal loss. The most common indication for a kidney biopsy was nephrotic syndrome. Out of 104 biopsies, 85 were in children with nephrotic syndrome. The commonest primary renal pathology was mesangial proliferative glomerulonephritis (38%), minimal change disease (19%), focal segmental glomerulosclerosis (15%) and membranoproliferative glomerulonephritis (7%). CONCLUSION: Renal biopsy is a safe procedure in experienced hands and the commonest indication for a biopsy in children remains nephrotic syndrome.

The studies on nutrient balances in crossbred cattle bulls fed chopped green sugarcane tops supplemented with some agro industrial by- products.

Fifteen adult crossbred cattle bulls, 18-22 months old (mean body weight 286.33 + 9.43) were divided into 3 groups following RBD design and were fed sugarcane tops (SCT) supplemented with some agro-industrial byproducts and concentrate feeds to determine nitrogen, Ca and P in crossbred cattle bull. For this purpose, crossbred cattle bulls were fed for 30 days ad lib SCT supplemented with Wheat bran (WB), Lentil chuni (LC) and WB + LC (50:50) in Group I, II, and III respectively. The balance values were 15.28 + 2.70, 26.85 + 4.35 and 18.00 + 3.17 for nitrogen, 11.77 + 1.34, 12.94 + 2.96 and 15.38 + 1.15 for calcium, 11.74 + 0.64, 11.26 + 1.58 and 11.69 + 0.79 for phosphorus in group I, II and III, respectively. There were no significant differences among the experimental groups in Ca and P balance values but balance of nitrogen was significantly (P < 0.05) higher in group II as compared to group I and III. It may indicated that the rumen fermentation was more appropriate in group III where animals were fed 50% lentil chuni and 50% wheat bran (supplementation of both protein and energy).

Retrospective study of descending cervical mediastinitis.

OBJECTIVE: Descending cervical mediastinitis can occur as a complication of oropharyhgeal and cervical space that spread to the mediastinum vis cervical space. Descending mediastinitis represent a virulent form of mediastinal infection requiring prompt diagnosis and treatment to reduce high morality associated with the disease. Surgical management and a particularly optimal form of mediastinal drainage remain controversial. METHOD: From 1998-2004, eighteen patients were treated in our institution. Surgical treatment consisted more than 2 times. Cervical drainage associated with drainage of the mediastinum through a thoracic approach in 11 patients with pleural drainage in 8 patients. RESULT: The outcome was favorable in eleven patients who had mediastinum drained through thoracotomy. One patient who was not drained died with tracheo-oesophageal fistula. Main culprit neck space is pre and para tracheal space which lead to anterior, superior and posterior mediastinal collection in our series. The tracheostomy is of immense help not only in opening cervical space collections and also to secure a partially compromised airway.

Cervical thymic cyst-A case report.

A case of cervical thymic cyst in a five year old girl is reported. It was found to be extending between the greatvessels of the neck towards the pharynx. This type of presentation is rare which prompted us to document this case.

The use of hydroxyapatite bone cement for sinus floor augmentation with simultaneous implant placement in the atrophic maxilla. A report of 10 cases.

BACKGROUND: Dental implant placement associated with sinus floor augmentation in a severely atrophic maxilla can be performed in a 1- or 2-stage surgical procedure, depending on the height of the residual alveolar bone. A minimum of 4 to 5 mm is recommended for a 1-stage procedure. METHODS: This clinical study describes the use of hydroxyapatite (HA) bone cement to stabilize HA-coated cylindrical implants placed simultaneously during sinus augmentation in 100 patients where insufficient bone volume did not allow primary implant stability. A total of 26 HA-coated dental implants were inserted in 100 grafted sinuses of 10 patients. RESULTS: None of the cases presented any difficulty in achieving initial stabilization and parallelism. No clinical complications of the sinuses were evident. Prior to exposure, radiographic evaluation revealed the implants embedded in a densely homogeneous radiopaque mass. At second-stage surgery, there was no clinical evidence of crestal bone loss around the implants. All implants were clinically osseointegrated. All patients received fixed implant-supported prostheses. Mean follow-up was 18 months (range 12 to 24 months). CONCLUSIONS: According to this preliminary study, the hydroxyapatite bone cement appears to hold great promise as a grafting alloplastic material for sinus floor augmentations. Its main advantage is its ability to provide initial stability required for osseointegration and proper implant location and parallelism. Further clinical and histological studies are required before it can be recommended for routine use in sinus lift procedures.

Maxillary antral mucocele and its relevance for maxillary sinus augmentation grafting: a case report.

Paranasal sinus mucoceles are benign, locally expansile cyst-like masses that are filled with mucus and lined with epithelium. Most occur in the frontal sinus. Maxillary sinus mucoceles are presumably uncommon in the United States and European countries, although they have been frequently reported in Japan, particularly following Caldwell-Luc surgery. Clinical symptoms may not appear for at least 10 years postoperatively. Chronic sinus inflammation and allergic disease are also common causes of paranasal mucoceles. This paper provides an overview of maxillary sinus mucoceles and presents a case study involving a 62-year-old Latin male whose asymptomatic maxillary sinus mucocele was not revealed until he presented for maxillary sinus grafting and implant placement.