Associations of Comorbid Anxiety With Medication Adherence and Psychiatric Symptomatology in a Population of Nonadherent Bipolar Disorder Subjects.

This analysis was conducted on baseline data from 178 nonadherent bipolar disorder subjects in a randomized controlled trial. Medication adherence was measured with Tablets Routine Questionnaire as percentage of days with missed doses. Inclusion criteria required at least 20% nonadherence. Medication adherence, symptomatology, and functioning in individuals with and without a comorbid anxiety disorder were compared. There were 78.9% of subjects who had at least one or more current anxiety disorder, with the most common being posttraumatic stress disorder, panic disorder, and generalized anxiety disorder. The percentage of days with missed doses over the past month was significantly lower in those with anxiety disorders compared with those without (40.1% vs 50.5%, p = 0.03). Those with comorbid anxiety disorders and those with greater number of anxiety disorder diagnoses had significantly worse mean scores on the Montgomery-Åsberg Depression Rating Scale, Brief Psychiatric Rating Scale, Clinical Global Impression-Bipolar Version, and Global Assessment of Functioning.

Associations among comorbid anxiety, psychiatric symptomatology, and diabetic control in a population with serious mental illness and diabetes: Findings from an interventional randomized controlled trial.

Objective Serious mental illness and type II diabetes mellitus have a high comorbidity, and both have a higher prevalence of anxiety disorders compared to the general population. Targeted Training in Illness Management is a group-based self-management training approach which targets serious mental illness and type II diabetes mellitus concurrently. This analysis examines data from a randomized controlled trial of Targeted Training in Illness Management intervention to examine the impact of comorbid anxiety on baseline psychiatric symptomatology and diabetic control, and on longitudinal treatment outcomes. Methods We conducted secondary analyses on data from a prospective, 60-week, randomized controlled trial testing Targeted Training in Illness Management versus treatment as usual in 200 individuals with serious mental illness and diabetes. Primary outcomes included measures related to serious mental illness symptoms, functional status, general health status, and diabetes control. Measures were compared between those participants with anxiety disorders versus those without anxiety at baseline as well as over time using linear mixed effects analyses. Results Forty seven percent of the participants had one or more anxiety disorders. At baseline, those with an anxiety diagnosis had higher illness severity, depressive, and other psychiatric symptomatology and disability. Diabetic control (HbA1c) was not significantly different at baseline. In the longitudinal analyses, no significant mean slope differences over time (group-by-time interaction effect) between those with anxiety diagnoses and those without in treatment as usual group were found for primary outcomes. Within the Targeted Training in Illness Management arm, those with anxiety disorders had significantly greater improvement in mental health functioning. Those with anxiety comorbidity in the Targeted Training in Illness Management group demonstrated significantly lower HbA1c levels compared to no anxiety comorbidity and also demonstrated a greater improvement in HbA1c over the first 30 weeks compared to those without anxiety comorbidity. Conclusion Comorbid anxiety in serious mental illness and type II diabetes mellitus population is associated with increased psychiatric symptomatology and greater disability. Individuals from this population appear to experience greater improvement in functioning from baseline with the Targeted Training in Illness Management intervention. Anxiety comorbidity in the serious mental illness and type II diabetes mellitus population does not appear to have a negative impact on diabetic control. These complex relationships need further study. Clinical Trials Registration ClinicalTrials.gov: Improving outcomes for individuals with serious mental illness and diabetes (NCT01410357).

Effect of three different core materials on the fracture resistance of endodontically treated deciduous mandibular second molars: an in vitro study.

Endodontic treatment makes the tooth brittle due to loss of bulk of tooth structure, decrease in the moisture content of dentin and dentin elasticity. The following study was carried out to evaluate the effect of endodontic treatment on the fracture resistance of the tooth and reinforcing ability of three different core materials. The following study comprised of sample size of 30 deciduous second molars divided into control group (6) and test group (24). Access opening was done in 24 and 18th teeth with access opening were restored with three different core materials namely IRM (6), silver amalgam (6), GIC (6). All the 30 were subjected to fracture test using UTM (Universal testing machine)- Instron 95. Result showed a drastic reduction in the fracture resistance of the tooth on access opening (1/3rd) and out of the three core materials glass ionomer was shown to be the best core material giving the highest fracture registrance followed by silver amalgam and IRM.

Efficacy of microwaves and chlorhexidine for disinfection of pacifiers and toothbrushes: an in vitro study.

PURPOSE: The purpose of this study was to evaluate, in vitro, the contamination of toothbrushes and pacifiers by Streptococcus mutans, and the efficacy of microwave and chlorhexidine for their disinfection. MATERIALS AND METHODS: Sixty pacifiers and 60 toothbrushes were contaminated with S. mutans and then divided into groups according to the disinfection protocol: Group 1-chlorhexidine solution; group 2-microwave sterilization; and group 3-sterile tap water. The devices were evaluated microbiologically after disinfection for the survival of S. mutans colonies and were examined. The results were analyzed statistically by ANOVA and Turkey test. RESULTS: The results of both types of evaluation showed a large number of S. mutans colonies after spraying with sterile tap water, and chlorhexidine spraying and microwaving were effective in eliminating colonies. Groups 1 and 2 were statistically similar to each other (p > 0.05) and differed significantly from group 3 (p < 0.05). CONCLUSION: The 0.12% chlorhexidine solution spray and 7 minutes of microwave irradiation were almost equally effective for disinfection of pacifiers and toothbrushes.

Congenital epulis in newborn. Case report.

Congenital granular cell lesion, or congenital epulis, is a rare lesion of the newborn. The sight of a newborn infant with congenital epulis can be startling for both parents and healthcare professionals. The lesion appears most commonly in the maxillary alveolar ridge, with predominance in females. The etiology and histogenesis of the lesion remain obscure. This lesion can pose a risk of airway obstruction or can interfere with feeding. The report presented here describes a case of congenital granular cell lesion in the left maxillary region. The lesion was causing a feeding problem and, hence, was excised under local anesthesia.

Comparative Evaluation of Water Sorption, Solubility, and Microhardness of Zirconia-reinforced Glass Ionomer, Resin-modified Glass Ionomer, and Type IX Glass Ionomer Restorative Materials: An In Vitro Study.

The challenge that practicing dentists face every day is to decide which dental material is best suited for each dental treatment. New glass-ionomer cement (GIC) formulations have been introduced in order to overcome the drawbacks of conventional ones thereby catering to the needs of the pediatric population. Aim and objective: The study aimed to evaluate and compare water sorption, solubility, and microhardness of zirconia-reinforced glass ionomer, resin-modified glass ionomer, type IX glass ionomer cements. Materials and methods: 90 specimens were prepared in total of which 45 cylindrical specimens with dimensions of (6 × 4) mm and 45 disks with (10 × 2) mm were prepared from Zirconomer, RMGIC, and Type IX GIC restorative materials, each material having 30 specimens (15 disks, 15 cylinders). After taking the initial weight (W1), the 45 cylinders (15 of each material) were immersed in artificial saliva at 37°C for 28 days after which the weights W2 and W3 were weighed. The other 45 disks (15 of each material) were subjected to microhardness test under microhardness tester. Results were subjected to ANOVA and Tuckey's post hoc test. Results: Zirconomer showed the maximum resistance to water sorption and solubility followed by RMGIC and type IX GIC with a significant p value of < 0.001 difference. For microhardness, Zirconomer showed the highest value with a significant p value of < 0.001 difference. But, there was no significant difference between RMGIC and Type IX GIC depicting almost equal strength. Conclusion: Water sorption, solubility, and microhardness of Zirconomer were significantly high in comparison to the other groups and it can be used as a posterior restorative material for stress-bearing areas. Clinical Significance: As pediatric dentistry demands restorations to be completed frequently in less than ideal conditions, Zirconomer has shown to be better than RMGIC and conventional GIC probably because of the improvisation in the GIC properties. How to cite this article: Bethapudy DR, Bhat C, Lakade L, et al. Comparative Evaluation of Water Sorption, Solubility, and Microhardness of Zirconia-reinforced Glass Ionomer, Resin-modified Glass Ionomer, and Type IX Glass Ionomer Restorative Materials: An In Vitro Study. Int J Clin Pediatr Dent 2022;15(2):175-181.

Caries prevention effect of intensive application of sodium fluoride varnish in molars in children between age 6 and 7 years.

BACKGROUND: The aim of this study was to evaluate the efficacy of intensive application of sodium fluoride varnish in prevention of caries in molars in children between 6 and 7 years and to evaluate the caries status in molars before and after application of fluoride varnish (Cavity Shield). MATERIALS AND METHODS: Two hundred fifty children (6-7 years) randomized into varnish and control groups. Children in varnish group received fluoride varnish (Cavity Shield) three times during one week (once every 2 days). Clinical and radiographical examinations of all children were performed prior to the first application of varnish and 1 year later. For evaluation and comparison, all the collected data were subjected to statistical analysis. RESULTS: At the end of 1 year period, varnish group had 27.7% caries reversal in deciduous dentition which was statistically significant. Though there was a decrease in the caries increment in the permanent dentition, it was not statistically significant. CONCLUSION: Application of fluoride varnish Cavity Shield three times once a week, once a year either in permanent or in deciduous dentition, is associated with substantial reduction in caries increment. CLINICAL SIGNIFICANCE: Fluoride varnish can prove to be an effective tool in prevention of dental caries in both primary and permanent dentitions.

Immunogenicity of human and bovine insulin in type 1 diabetes mellitus patients.

BACKGROUND: The advantages of synthetic insulin (human insulin) over bovine insulin in the treatment of type 1 diabetes mellitus (DM) are much debated in terms of potency and purity. Immunogenicity is one of several factors that determine potency and safety. This study was designed to investigate and study the difference in immunogenicity of human and bovine insulin. We investigated anti-insulin antibody (AIAB) status in 69 type 1 DM patients receiving insulin therapy. Group 1 had 33 patients treated with bovine insulin, and group 2 had 32 patients treated with human insulin. All patients had received their respective insulin therapy for a minimum period of 1 year and had no history of change in insulin type. Forty-three subjects from the normal population were the control group. METHODS: AIABs were assayed in serum samples of all subjects using a semiquantitative radioimmunoassay kit. The Kruskal-Wallis non-parametric and Mann-Whitney U tests were used to study the difference in immunogenicity of human and bovine insulins. RESULTS: The Kruskal-Wallis test showed that antibody titers in the three groups significantly differed (P<0.001). The Mann-Whitney U test showed no significant difference in AIAB titer between the treatment groups. AIAB titers in the two treatment groups differed significantly from that of the control group, independently (P<0.001). High titers of AIABs are present in patients receiving bovine and human insulin compared to that of the normal population. CONCLUSIONS: Bovine and human insulins are antigenic, and there is no significant difference in AIAB titer. Prospective studies are required to determine the long-term clinical significance of these antibodies.

Comparison of the Laryngeal Mask Airways: Laryngeal Mask Airway-classic and Laryngeal Mask Airway-proseal in Children.

INTRODUCTION: In the past 25 years with the development of various supraglottic airway devices, the armamentarium for airway management has increased. In our study, the laryngeal mask airway (LMA)-ProSeal is compared with the LMA-Classic with respect to as follows: (a) Ease of insertion and number of insertion attempts, (b) Device positional stability and possible oropharyngeal leak, (c) Airway trauma, and (d) Hemodynamic changes; in children aged 3-15 years undergoing elective surgery under general anesthesia, hypothesizing that these would be different. MATERIALS AND METHODS: Sixty consecutive American Society of Anesthesiologists Physical Status Classes I and II children aged 3-15 years and weighing 5-45 kg undergoing elective surgery in the supine position were randomized for airway management with the LMA-Classic or LMA-ProSeal. RESULTS: Size of the LMA used in both LMA-Classic and LMA-ProSeal was 1.5, 2, and 2.5 and was statistically nonsignificant. There was no difference between LMA-Classic and LMA-ProSeal with regard to ease of insertion, number of attempts for insertion, device positional stability, airway trauma and hemodynamic changes. CONCLUSIONS: The complications of usage of the LMA are minimal and similar in both the devices. The LMA-ProSeal has advantages over LMA-classic such as the placement of gastric tube, adequate ventilation, and oxygenation without any gastric distension.

Mode of Delivery and Its Influence on the Acquisition of Streptococcus mutans in Infants.

INTRODUCTION: Dental caries pose distinct challenges when it comes to determining their microbial etymology. Streptococcus mutans play an important role in dental caries. The aim of the present study was to compare oral microbiota in infants delivered by these different routes. A study was conducted on 40 infants. Swab sample collection was done for the detection of S. mutans. Our study indicated no differences in oral microbiota in infants due to mode of delivery. AIM: To assess whether infants born through cesarean section delivery or infants born through normal delivery influence the initial acquisition of S. mutans in infants. SETTINGS AND DESIGN: The study was carried out on the premises of Bharati Hospital, Pune, wherein 40 infants (3-36 months) were enrolled for the study. Two groups were designed. Group I: Infants born with cesarean section delivery Group II: Infants born with normal section delivery. MATERIALS AND METHODS: Bacterial swab sampling was done in the participants for the detection of S. mutans. Colony-forming units on each plate were determined for the estimation of S. mutans level in oral cavity. STATISTICAL ANALYSIS USED: Bar diagram analysis and chi-square test were performed to derive p-value. RESULTS: The p value derived at the end of the study was 0.52. Hence, analysis of data demonstrates no significant influence of cesarean section delivery and normal delivery on oral microbiota development in infants. CONCLUSION: Initial acquisition of oral S. mutans in infants is not dependent on the mode of delivery. KEY MESSAGES: Initial acquisition of S. mutans, Mode of delivery. HOW TO CITE THIS ARTICLE: Ubeja RG, Bhat C. Mode of Delivery and Its Influence on the Acquisition of Streptococcus mutans in Infants. Int J Clin Pediatr Dent 2016;9(4):326-329.

Bilateral nephrocalcinosis and amelogenesis imperfecta: A case report.

Amelogenesis imperfecta (AI) is a group of hereditary disorders that affect the quality and/or quantity of dental enamel. This paper describes the clinicopathological features of a patient who was born of nonconsanguineous parents and who presented with oral alterations, including yellow and misshapen teeth, intrapulpal calcifications, delayed tooth eruption, and gum enlargement. Scanning electron microscopy of the teeth revealed hypoplastic enamel, and a renal ultrasound detected bilateral nephrocalcinosis, leading to a diagnosis of AI and nephrocalcinosis syndrome. Since nephrocalcinosis is often asymptomatic and can be associated with impaired renal function, dentists who see children with a generalized and thin hypoplastic AI should consider a renal ultrasound scan and referral to a Nephrologist. Children with nephrocalcinosis should also be considered for a dental check.

Electronic transport properties of BN sheet on adsorption of ammonia (NH3) gas.

We report the detection of ammonia gas through electronic and transport properties analysis of boron nitride sheet. The density functional theory (DFT) based ab initio approach has been used to calculate the electronic and transport properties of BN sheet in presence of ammonia gas. Analysis confirms that the band gap of the sheet increases due to presence of ammonia. Out of different positions, the bridge site is the most favorable position for adsorption of ammonia and the mechanism of interaction falls between weak electrostatic interaction and chemisorption. On relaxation, change in the bond angles of the ammonia molecule in various configurations has been reported with the distance between NH3 and the sheet. An increase in the transmission of electrons has been observed on increasing the bias voltage and I-V relationship. This confirms that, the current increases on applying the bias when ammonia is introduced while a very small current flows for pure BN sheet.

In vivo evidence of IGF-I-estrogen crosstalk in mediating the cortical bone response to mechanical strain.

Although insulin-like growth factor-I (IGF-I) and estrogen signaling pathways have been shown to be involved in mediating the bone anabolic response to mechanical loading, it is not known whether these two signaling pathways crosstalk with each other in producing a skeletal response to mechanical loading. To test this, at 5 weeks of age, partial ovariectomy (pOVX) or a sham operation was performed on heterozygous IGF-I conditional knockout (H IGF-I KO) and control mice generated using a Cre-loxP approach. At 10 weeks of age, a 10 N axial load was applied on the right tibia of these mice for a period of 2 weeks and the left tibia was used as an internal non-non-loaded control. At the cortical site, partial estrogen loss reduced total volumetric bone mineral density (BMD) by 5% in control pOVX mice (P=0.05, one-way ANOVA), but not in the H IGF-I KO pOVX mice. At the trabecular site, bone volume/total volume (BV/TV) was reduced by 5%-6% in both control pOVX (P<0.05) and H IGF-I KO pOVX (P=0.05) mice. Two weeks of mechanical loading caused a 7%-8% and an 11%-13% (P<0.05 vs. non-loaded bones) increase in cortical BMD and cortical thickness (Ct.Th), respectively, in the control sham, control pOVX and H IGF-I KO sham groups. By contrast, the magnitude of cortical BMD (4%, P=0.13) and Ct.Th (6%, P<0.05) responses were reduced by 50% in the H IGF-I KO pOVX mice compared to the other three groups. The interaction between genotype and estrogen deficiency on the mechanical loading-induced cortical bone response was significant (P<0.05) by two-way ANOVA. Two weeks of axial loading caused similar increases in trabecular BV/TV (13%-17%) and thickness (17%-23%) in all four groups of mice. In conclusion, partial loss of both estrogen and IGF-I significantly reduced cortical but not the trabecular bone response to mechanical loading, providing in vivo evidence of the above crosstalk in mediating the bone response to loading.

Evaluation and comparison of biological cleaning efficacy of two endofiles and irrigants as judged by microbial quantification in primary teeth - an in vivo study.

The endodontic triad comprises of cleaning and shaping, disinfection and obturation. Success of root canal therapy is majorly achieved by proper cleaning and shaping. However, elimination of bacterial contaminants as well as necrotic debris of the canals requires the adjunctive use of irrigants. To achieve a satisfactory biological and mechanical preparation proper selection of endodontic instruments and irrigants is necessary. In this study we are comparing and evaluating cleaning efficacy of endofiles (K-files and handprotapers ) and root canal irrigants (sodium hypochlorite and chlorhexidine) by microbial quantification. Root canal samples were collected in autoclavable bottles containing transport media (nutrient broth) and samples were cultured in tryptose soya agar at incubation temperature of 37°C for 24-48 hours and colonies were counted with digital colony counter. The significance of this study is to help the clinician select proper instrument and irrigant which minimize the failure rate of root canal treatment for the benefit of patients.

Reattachment of a vertical complicated subgingival crown root fracture in a 10-year old child: a case report.

Functional, esthetic and biologic restoration of a fractured incisor often presents a daunting clinical challenge. The outcome of conventional composites, prosthodontic restorations in a young patients result in an uncertain longevity of the same. Reattachment of the fractured fragment of a tooth helps in maintaining both morphology and esthetics in a growing child until the permanent long lasting solution is sought after the complete development of the dentition and the jaws. Since fractured fragment exhibited no caries, not even negligible loss of tooth structure and was adapting well to the remaining tooth structure when tried in, the reattachment of fractured fragment was considered as a viable treatment option. This treatment option for complicated subgingival crown-root fracture depicts the involvement of periodontal surgical exposure, endodontic management and ultimately the fragment reattachment.

Endo-esthetic Management of Permanent Maxillary Lateral Incisor with Severe Root Dilaceration in a 12-year-old Child.

Functional, esthetic and endodontic restoration of a pulpally involved permanent incisor with root dilaceration often presents a daunting clinical challenge. The outcome of conventional treatment modalities like surgical removal of the tooth followed by orthodontic closure of the space is time consuming and esthetically compromising. Even the prosthetic and implantalogical rehabilitation after extraction is not possible until the patient reaches certain age; while the compliance is a problem with the use of removable partial denture in young children. Autoalloplastic anterior tooth transplantation can lead to physical and psychological trauma in a young individual. Thus endo-esthetic management of such teeth helps in maintaining both morphology and esthetics in a growing child until the permanent long lasting prosthetic solution is sought after the complete development of the dentition and jaws. This treatment option for a pulpally involved permanent incisor with root dilaceration involves completing the endodontic treatment in a partially calcified and aberrantly located root canal followed by the use of light transmitting fiber post and core build up using composite resin.