An assessment of "Organization Culture" in District Program Management Units established under National Health Mission in a western state of India.

Background: State programme management unit and District Programme Management Units (DPMU) are established under National Health Mission with an expectation to strengthen the management structures at the state and district levels, respectively. This is a major initiative to bring change in organisation structure and an effort to embrace change in working culture. The study was undertaken in a western Indian state to assess and compare the organisation culture in DPMUs. Methods: Districts of the state were divided into three strata based on the geographical and demographic features. One district from each stratum was randomly selected for the study. In-depth interview of nine key officials in each sampled DPMU was conducted with the use of standardised questionnaire-openness, confrontation, trust, authenticity, proactiveness, autonomy, collaboration and experimentation (OCTAPACE), developed by Pareek. Results: Values of OCTAPACE were diversely distributed with significant difference in distribution of scores between these domains (p < 0.05). Pro-action and Trust scores were relatively higher and consistent in the study units. Values of experimentation were lower and inconsistent. There was no significant difference in the distribution of scores between three sampled DPMUs for openness, confrontation, trust, authenticity, pro-action, autonomy and experimentation (p > 0.05). However, the distribution of collaboration score was significantly less in DPMU of desert district in comparison to DPMU of plain and tribal district (p < 0.05). Conclusion: The lacuna in values of organisation culture should be addressed to strengthen the existing management structures at the state and district levels.

Severe insulin resistance syndrome - A rare case report and review of literature.

Insulin Resistance syndromes (IR's), are a group of genetic disorders caused due a functional defect in chromosome 19p13. It is an autosomal recessive condition. Donohue Syndrome was initially described by Donohue and Uchida in 1948 and 1954, a case of sisters born to parents with a first-degree consanguineous marriage. Infants presented with typical facial features that resembled the Leprechaun elves of Irish fairy tales. The following is a report of a rare case of dental complications of Severe Insulin Resistance Syndrome. An eight year old female child, with characteristic features of severe insulin resistance syndrome, reported to the Department of Pediatric and Preventive Dentistry, Pravara Institute of Medical Sciences, Loni, presenting with cariously destructed molars and a previous history of dental treatment under local anaesthesia. Given her condition, it was decided to reduce the multiple appointments, to one appointment with all procedures done under general anaesthesia. The following case report discusses the advantages, disadvantages and post operative complications faced when forming a treatment strategy for Severe Insulin Resistance Syndrome.

A comparative evaluation of probiotic formulations in prevention of dental caries: A clinical study.

BACKGROUND: Caries is a multifactorial disease, microbes being an important etiological factor. "Probiotics" are nonpathogenic microbes which can stimulate health-promoting flora and suppress pathogens. It's the era of prevention, clinical approach toward prevention by altering bacterial ecology is the need of the hour. The aim of the study was to evaluate anticariogenic effect of probiotic curd (Amul's Probiotic Dahi) containing Lactobacillus acidophilus (La5) and Bifidobacterium lactis (Bb12) in 6-12 years of age group. MATERIALS AND METHODS: This was a prospective, randomized, nonblinded study conducted on school children aged between 6 and 12 years having Decayed, Missing, and Filled Teeth and/or deft ≥2. Selected subjects were divided into two groups of 31 each, study group received probiotic curd ("Amul's Probiotic Dahi") two times a day in a quantity of 100 g, respectively, for 21 days and control group did not receive any intervention. Salivary Streptococcus mutans count and salivary pH estimation were done at the baseline, after 7 days and at the end after 24 days, for comparison. RESULTS: No statistical difference was seen in salivary S. mutans count between both groups, after intervention of 7 days. However, there was significant difference in salivary S. mutans count at the end of 24 days. There was no statistical difference in salivary pH between both groups. CONCLUSION: The present study concludes that probiotics substitute decreases salivary S. mutans count after continuous consumption for 3 weeks and there is no short-term effect on salivary pH.

Aberrant Location of Low-grade Myofibroblastic Sarcoma of the Gingiva in Posterior Maxilla.

Low-grade myofibroblastic sarcoma is a malignant tumor arising from myofibroblasts, which has only recently become clearly defined. It represents a rare entity developing in the soft tissues of the head and neck. About 20 cases have been reported in the oral cavity, especially in the tongue and bone, while gingiva as the primary site has been described only twice to date. Diagnostic methods include histology and immunohistochemistry. The present report concerns a case of a 13-year-old female child who presented with gingival nonulcerated swelling that was interpreted for a long time as a gingival fibroma. A low-grade myofibroblastic sarcoma was diagnosed and the patient underwent a segmental osteotomy of the right posterior region of the maxilla. There was no sign of recurrence or metastatic disease during the 12-month postoperative period. HOW TO CITE THIS ARTICLE: Padmawar NS, Bhadange S, Mustilwar RG, et al. Aberrant Location of Low-grade Myofibroblastic Sarcoma of the Gingiva in Posterior Maxilla. Int J Clin Pediatr Dent 2021;14(6):816-819.

Clinical Success of Platelet-rich Fibrin and Mineral Trioxide Aggregate (MTA) or MTA-like Agents in Healing of Periapical Lesion in Nonsurgically Treated Pulpless Immature Permanent Teeth: A Systematic Review.

BACKGROUND: The chances of extrusion of mineral trioxide aggregate (MTA) are quite high if apical barrier is not present in immature pulpless permanent teeth. Platelet-rich fibrin (PRF) enriched with platelets and growth factors serves to accelerate the wound healing of periapical lesion in immature pulpless permanent teeth and also serves as internal matrix to condense MTA. AIM: The aim of the present study was to comprehensively review the clinical success of MTA+PRF in healing of periapical lesions in immature pulpless permanent teeth. MATERIALS AND METHODS: An electronic search for systematic review was conducted in Pubmed/Medline (www.ncbi.nlm.nih.gov), Cochrane (www.cochrane.org), Scopus (www.scopus.com) databases upto 15th January 2020 related to the healing of periapical lesions in permanent teeth with immature apices when combination of MTA+PRF was used. A sample of 10 relevant studies and case reports were identified in our search out of 65. The sampling method was simple random technique. The studies and case reports with Randomised Controlled Trials(RCTs), Invitro studies, Case reports and animal studies in healing of periapical lesion were included in our comprehensive systematic review. RESULTS: The search showed that the combination of MTA+PRF showed faster and definite periapical lesion healing in immature permanent teeth. The follow-up period was also recorded in all the relevant studies and case reports. CONCLUSION: Acclerated bone filling was seen in healing of periapical leions when MTA+PRF was used.

Scaffolds--The Ground for Regeneration: A Narrative Review.

AIM: The aim of this study was to comprehensively review the various biomaterials used as scaffolds, rates of biodegradability of natural, artificial and composite hybrid scaffolds, and the role of controlled biodegradability in tissue engineering. MATERIALS AND METHODS: An electronic search for systematic review was conducted in PubMed/MEDLINE (www.ncbi.nlm.nih.gov), Cochrane (www.cochrane.org), Scopus (www.scopus.com) databases, and dental journals related to endodontics and pediatric dentistry to identify the research investigations associated with the degradation profiles, factors relating to degradation, rates of biodegradability and the role of controlled biodegradability of natural, artificial and composite scaffolds. A sample of 17 relevant studies and case reports were identified in our search of 100 using simple random sampling. RESULTS: Naturally derived scaffolds degrade at a much higher rate than artificial and composite scaffolds. The degradation profiles of composite scaffolds can be much better controlled than naturally derived scaffolds. CONCLUSION: Composite scaffolds are more favorable as compared to natural or artificial scaffolds, as it has superior mechanical properties, minimal immune response, and a controlled rate of degradation and consequent tissue regeneration.

A comprehensive oral and dental management of an epileptic and intellectually deteriorated adolescent.

Epilepsy along with intellectual deterioration and other neurological disorders can have social, physical, and psychological consequences, especially, when they begin in childhood. Moreover, the seizure episode along with mental deterioration may compromise the oral and dental care resulting in numerous decayed teeth. This report presents the case history of an adolescent with poor oral hygiene and numerous decayed teeth. This report also presents the comprehensive endodontic, surgical, and prosthodontic management of epileptic mentally challenged patient in the dental office. Epilepsy along with intellectual deterioration and other neurological disorders can have social, physical, and psychological consequences, especially, when they begin in childhood. Moreover, the seizure episode along with mental deterioration may compromise the oral and dental care resulting in numerous decayed teeth. This report presents the case history of an adolescent with poor oral hygiene and numerous decayed teeth. This report also presents the comprehensive endodontic, surgical, and prosthodontic management of epileptic mentally challenged patient in the dental office.

Sturge-Weber syndrome with pyogenic granuloma.

Vascular lesions represent one of the rare disorders affecting overall quality of life of a child. A wide variety of these conditions are known, ranging from a simple nevus to life-threatening hemangiomas. These conditions make the treatment options more complex due to the fear of uncontrollable bleeding. The present case is one of the rare combinations of Sturge-Weber syndrome and pyogenic granuloma. Conditions of importance and treatment options keeping hemangioma in mind are discussed.