Dental rehabilitation of a child with early childhood caries using Groper's appliance

The mainstay of pediatric dental practice is the successful esthetic rehabilitation of a preschooler with advanced carious lesions. Loss of masticatory efficiency, compromised esthesis, mispronunciation of labiodentals sounds, and development of abnormal oral habits are compromises arising due to the loss of primary anterior teeth at an early age either due to trauma or due to caries. Parental desire is the most decisive factor for the placement of an anterior esthetic appliance. This unique case report highlights the fabrication of simple, Groper's appliance in a 5-year-old child with early childhood caries.

Surgical management of a large cleft palate in a Pierre Robin sequence: A case report and review of literature

Pierre Robin syndrome or Pierre Robin sequence (PRS) is a congenital etiologically heterogeneous condition presenting with various malformations. Here we are reporting the surgical management of an 18-month-old female baby who was referred from Department of Pediatrics with a complaint of a large cleft palate. She was taken up for palatoplasty with consent for elective tracheostomy. After genetic evaluation, the authors conclude that the presented case was a PRS in isolation with mild cardiac anomalies and an inferiorly placed hypoplastic epiglottis. Patient should be followed up and growth modifications of the jaws should be done.

Enzymatic antioxidants and its role in oral diseases

Antioxidants are substances that when present at very low concentration inhibits the oxidation of a molecule. It has the capacity to nullify the ill effects of oxidation caused by free radicals in the living organisms. The unpaired electrons of these free radicals are highly reactive and neutralize the harmful reactions of human metabolism. Protection of the body against free radicals is provided by some enzymes which come under a distinctive group, concerned solely with the detoxification of these radicals. Superoxide dismutase (SOD), glutathione peroxidase (GPX) and catalase are the key enzymatic antioxidants of this defense system by which the free radicals that are produced during metabolic reactions are removed. This review highlights the mechanism of action of enzymatic antioxidants SOD, GPX and catalase and its role in oral disease.

Ecological risk assessment of silicon dioxide nanoparticles in a freshwater fish Labeo rohita: Hematology, ionoregulation and gill Na(+)/K(+) ATPase activity

The fate and effect of nanomaterials in the environment has raised concern about their environmental risk to aquatic organisms. Silica nanoparticles (SiO2-NPs) find its uses in various fields and are inevitably released into the environment. However, the ecotoxicological effects of SiO2-NPs on the freshwater fish remain poorly understood. The aim of this study was to evaluate the effect of different concentrations (1, 5 and 25mgL(-1)) of SiO2-NPs on certain hematological, ionoregulatory and enzymological profiles of a freshwater teleost fish Labeo rohita. Hematological parameters such as hemoglobin (Hb), hematocrit (Hct), red blood cells (RBC), white blood cells (WBC), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) values were altered in SiO2-NPs treated groups. Likewise, plasma electrolytes such as plasma sodium (Na(+)), potassium (K(+)) and chloride (Cl(-)) levels and Na(+)/K(+) ATPase activity in gill of SiO2-NPs treated groups were altered in all concentrations throughout the study period (96h). The alterations of these parameters were found to be dependent on dose and exposure period. The results of the present study indicate that the alterations of these parameters may relate to physiological stress system to SiO2-NPs toxicity and also demonstrate that manufactured metal oxide NPs in aquatic environment may affect the health condition of the aquatic organisms.

Prevalence and characteristics of MIH in school children residing in an endemic fluorosis area of India: an epidemiological study

AIM

This was to study the prevalence of molar incisor hypomineralisation (MIH) among school children residing in a fluorosis endemic area in Tamilnadu (Salem, India).

METHODS

A target sample of 5000 children of age ranging between 9 and 14 years, comprising 250 children from each of 20 blocks of Salem, participated in this study. The examination was completed in their respective schools by a calibrated examiner using EAPD criteria.

RESULTS

Of 4989 children examined, 384 children had MIH. A prevalence of 7.3 %. The MIH found in girls was 8.9 % compared with 6.1 % in boys. Single-tooth involvement of MIH was seen predominantly in incisors (2.24 %), whereas with molars usually three teeth were involved (1.1 %). MIH with caries involvement was found in 51 % of the teeth.

CONCLUSION

The prevalence of MIH in the endemic fluorosis district was found to be 7.3 %. A gradual increase in MIH was seen with age due to post enamel breakdown. Caries involvement was also seen in more than 50 % of the MIH-involved teeth. This prevalence study for molar incisor hypomineralisation (MIH) is rare in the literature, especially in a fluorosis endemic district in Tamilnadu.

Proliferating Cell Nuclear Antigen in Premalignancy and Oral Squamous Cell Carcinoma

INTRODUCTION

Cancer has multifactorial aetiology and is a multistep process involving initiation, promotion and tumour progression. Cellular proliferation is one of the important indicators for the biologic aggressiveness of a malignant lesion. The dysregulated proliferation may be a significant change to determine the potential prognosis of various malignant tumours.

AIM

The aim of this study was to evaluate the expression of proliferating cell nuclear antigen (PCNA) as an indicator for clinical aggressiveness in oral premalignancy and squamous cell carcinoma.

MATERIALS AND METHODS

A total of 50 blocks were taken from the Department of Oral Pathology which was diagnosed previously histopathologically. It comprised of normal oral mucosa (10), dysplasia (10) and grades of oral squamous cell carcinoma (30) of patients between the age group of 40-60 years. From each block, sections of 4 micro metre thicknesses were prepared and placed on poly- L lysine coated slides. These sections were immunohistochemically stained with monoclonal proliferating cell antibody (PC10). The stained slides were evaluated by a single examiner for cell count.

RESULTS

A comparison between study groups and controls showed a probability value (p-value) < 0.05. Significant increase in the proliferative index from the normal to oral squamous cell carcinoma was noticed. Poorly differentiated squamous cell carcinoma showed maximum proliferative index followed by moderately differentiated, well differentiated squamous cell carcinoma, dysplasia and normal mucosa.

CONCLUSION

Present study concluded that PCNA index can be used to assess the proliferation and aggressiveness in dysplasia and different grades oral squamous cell carcinoma.

Prevalence of early childhood caries and its risk factors in 18-72 month old children in Salem, Tamil Nadu

Background:

Early childhood caries (ECC) is one of the most common dental diseases among the preschoolers, leading to suboptimal health. A study was planned to evaluate the prevalence of ECC in preschool children in the age group between 18 and 72 months and its relationship with parent's education and socioeconomic status of the family.

Materials and Methods:

This cross-sectional study was conducted among 2771 children selected randomly, in the age group 18–72 months and attending playschools and primary schools in urban, semi-urban, and rural areas of Salem, Tamil Nadu. A modified Winter et al. questionnaire and a proforma were used for collecting information on each child. The completed questionnaire and proformas were statistically analyzed and evaluated. The statistical analysis was done using Student's t-test and analysis of variance (ANOVA) to obtain mean values.

Results:

The prevalence of ECC in Salem was 16% with a mean dfs of 5.23 ± 1. Prevalence was high among the children of low socioeconomic status group and the children of working mothers, with a mean dfs of 10.47.

Conclusion:

The prevalence of ECC was 16% in Salem, Tamil Nadu. ECC was seen more in children of working mothers, lower parental education, and lower socioeconomic groups.

Expression of inducible nitric oxide synthase in carcinomas and sarcomas affecting the oral cavity

Context:

Inducible nitric oxide synthase (iNOS) is a cytoplasmic enzyme which plays a crucial role in the pathogenesis of oral carcinomas and sarcomas.

Aims:

The objective of this study was to analyze the immunohistochemical expression of iNOS in carcinomas and sarcomas affecting the oral cavity in order to understand the possible role of iNOS in their biologic behavior and to correlate iNOS expression with lymph node metastasis in carcinomas and sarcomas.

Settings and Design:

Patients, who attended the oral diagnosis department of Vinayaka Missions Sankarachariyar Dental College, were screened, for the purpose of the study. Besides these, paraffin-embedded tissue blocks were also retrieved from archives of the Oral and Maxillofacial Pathology Department. A total of 40 cases (20 carcinomas and 20 sarcomas) were selected for the study.

Subjects and Methods:

A total of 40 cases (20 carcinomas and 20 sarcomas) were selected for the study. Five apparently normal tissues were obtained from the tumor adjacent normal tissue to be used as a control. These were subjected to immunohistochemical staining using antibody to iNOS and evaluated.

Statistical Analysis Used:

The results were analyzed using the Chi-square test.

Results:

Among the 20 carcinomas 19 showed a positive immunoreactivity for iNOS and 1 case was negative. Among the 19 immunopositive iNOS cases of carcinomas, 15 cases showed positive lymph node metastasis. Among the sarcomas, positive immunoreactivity for iNOS was seen in 10 hard tissue sarcomas, while the remaining 10 soft tissue sarcomas were negative for iNOS expression. The results were analyzed using the Chi-square test.

Conclusions:

iNOS is a reliable marker for lymph node metastasis in carcinomas irrespective of the histologic grade. The high expression in carcinomas shows that the carcinomas elaborate more angiogenesis for growth compared with the sarcomas with the exception of hard tissue sarcomas.

Synthesis, characterization and photocatalytic activity of ZnO nanoparticles prepared by biological method

Zinc oxide have been produced via a simple green method from zinc nitrate and leaf extract aqueous solutions. Prepared ZnO nanoparticles (NPs) were investigated by employing through UV-Visible diffuse reflectance spectroscopy (UV-DRS), photoluminescence (PL) spectroscopy, X-ray diffraction (XRD), Fourier transform infrared (FTIR), field emission-scanning electron microscope (FE-SEM), and transmission electron microscope (TEM), respectively. The present investigation, confirmed the estimated band gap 3.51eV and the PL intensity at 402nm in visible region are dependent upon the geometrical shape and size of the ZnO NPs. The TEM micrograph and XRD pattern confirmed the hexagonal wurtzite structure of ZnO NPs. The presence of functional groups and the chemical bonding are confirmed by FTIR spectra. EDS shows that the highly pure ZnO nanostructures. Moreover, the catalytic activity of synthesized ZnO in the reduction of methylene blue was studied by UV-Vis spectroscopy. The effects of process conditions on the morphology and size of ZnO have been found from FE-SEM and TEM analyses, respectively.

Green synthesis of ZnO nanoparticles using Solanum nigrum leaf extract and their antibacterial activity

In the present investigation, we have described the green biosynthesis of ZnO nanoparticles (NPs) by using Solanum nigrum as capping agent. The functionalization of ZnO particles through S. nigrum leaf extract mediated bioreduction of ZnO was investigated through UV-Vis DRS, photoluminescence (PL), X-ray diffraction (XRD), Fourier Transform Infrared (FTIR) spectroscopy, Field Emission Scanning Electron Microscopy (FE-SEM), Transmission Electron Microscopy (TEM), thermal gravimetric-differential thermal analysis (TG-DTA), X-ray photoelectron spectroscopy (XPS) and antibacterial activities. UV-Vis-DRS studies revealed that the indirect band gap 3.38 eV and photoluminescence study reveals the blue emission at 402, 447, 469 and 483 nm and the green emission at 529 nm respectively. In addition, the synthesized NPs are wurtzite hexagonal structure with an average grain size lies between 20 and 30 nm were found from XRD analysis. Further, FT-IR spectra revealed the functional groups and the presence of protein as the stabilizing agent for surrounding the ZnO NPs. The diameter of the NPs in the range of 20-30 nm was found from FE-SEM study. TEM analysis was investigated the ZnO NPs as a quasi-spherical in shape and their diameter at around 29.79 nm. Finally, the current study has clearly demonstrated that the particle size variations and surface area to volume ratios of ZnO NPs are responsible for significant higher antibacterial activities. Further, the present investigation suggests that ZnO NPs has the potential applications for various medical and industrial fields so, that the investigation is so useful and helpful to the scientific communities.

Transmission of infection to liver transplant recipients from donors with infective endocarditis: lessons learned

Donors not meeting standard criteria, such as those with bacteremia, are now being used in response to the increasing need for organs for transplantation. Recommended strategies to prevent the occurrence of donor-derived bacteremia include the use of directed antibiotic prophylaxis. However, this approach does not eliminate the risk of infection transmission. Similarly, the management of organ recipients from donors with infective endocarditis (IE) remains uncharacterized. We report 2 cases of donor-derived bacterial infections in liver transplant recipients despite pathogen-specific antibiotic prophylaxis. In both instances, the donors had documented IE treated with appropriate antimicrobial therapy and clearance of bacteremia. Recipients had very distinctive clinical outcomes likely related to pathogen virulence and the extent of donor infection. Persistent infection in the transplanted liver should be suspected in organ recipients of a liver from donors with IE, despite the absence of bacteremia at the time of death and organ procurement. For eradication, recipients may require prolonged pathogen-directed antimicrobial therapy, such as is used for endovascular infections. Prompt recognition of donors with IE, appropriate notification, and prolonged antibiotic prophylaxis are key to reducing the risk of such donor-derived infections.

Transmission of methicillin-resistant Staphylococcus aureus infection through solid organ transplantation: confirmation via whole genome sequencing

We describe two cases of donor-derived methicillin-resistant Staphylococcus aureus (MRSA) bacteremia that developed after transplantation of organs from a common donor who died from acute MRSA endocarditis. Both recipients developed recurrent MRSA infection despite appropriate antibiotic therapy, and required prolonged hospitalization and hospital readmission. Comparison of S. aureus whole genome sequence of DNA extracted from fixed donor tissue and recipients' isolates confirmed donor-derived transmission. Current guidelines emphasize the risk posed by donors with bacteremia from multidrug-resistant organisms. This investigation suggests that, particularly in the setting of donor endocarditis, even a standard course of prophylactic antibiotics may not be sufficient to prevent donor-derived infection.

Clostridium difficile infection in liver transplant recipients: a retrospective study of rates, risk factors and outcomes

Clostridium difficile infection (CDI) occurs in 3-7% of liver transplant recipients (LTR). However, few data exist on the recent epidemiology, predictors and outcomes of CDI in LTR. A cohort study was performed including LTR from 2000 to 2010 at a tertiary care hospital in Detroit. CDI was defined as diarrhea with a stool C. difficile positive test. Data analyzed included demographics, comorbidities, length of stay (LOS), severity of CDI, rates of recurrence (<12 weeks), relapse (<4 weeks) and overall mortality. Predictors of CDI were calculated using Cox proportional hazard model; 970 LTR were followed for years. Overall prevalence of CDI was 18.9%. Incidence of CDI within 1 year of transplant was 12.4%. Severe CDI occurred in 29.1%. CDI recurrence and relapse rates were 16.9% and 9.7%, respectively. Independent predictors of CDI were year of transplant (hazard ratio [HR] 1.137, 95% confidence interval [CI] 1.06-1.22; p < 0.001), white race (105/162 whites, HR 1.47, 95% CI 1.03-2.1; p = 0.035), Model for End-Stage Liver Disease score (HR 1.03, 95% CI 1.01-1.045, p = 0.003) and LOS (HR 1.01, 95% CI 1.005-1.02, p < 0.001). Significant mortality was observed among LTR with CDI compared to those without CDI (p = 0.003). We concluded that CDI is common among LTR and is associated with higher mortality.

Abstract 215: Principal Components Analysis in a South Asian Population: Cardiovascular Risk Variable Clustering and Obesity

Aim: Western populations demonstrate a strong role of obesity in clustering of cardiovascular (CV) risk factors. We hypothesized that obesity would not have a dominant role in the clustering of CV risk factors in South Asians, who develop CV disease at young ages despite relatively low BMI.

Methods: We selected 6224 South Indians without diabetes from a population-based cross-sectional survey (mean age 42 years; 58% women) for analysis. We used gender-specific principal components analysis (PCA), a multivariate correlation technique, with orthogonal rotation (to produce interpretable factors) to test the hypothesis. The PCA was done using measures of fasting (FPG) and 2 h plasma glucose (2h PG), haemoglobin A1c (A1c), fasting insulin (FIns), triglycerides (TG) and high-density lipoprotein (HDL), diastolic (DBP) and systolic blood pressure (SBP), body mass index (BMI) and waist circumference (WC). We did separate subgroup analyses stratified by various potential modifiers.

Results: The obesity indices correlated positively with CV risk variables (except HDL), regardless of gender. PCA failed to demonstrate a single dominant underlying pathological role (one component was rejected at P < 0.0001), but suggested three non-overlapping factors (physiological domains) underlying the clustering of the risk variables, accounting for 60% of the total variance in the data [Fig]. Obesity indices had significant positive loading (95% confidence interval >0.8) only in Factor 1, which included FIns, TG, and HDL. The FPG, 2hPG and A1C were associated with Factor 2. The SBP and DBP were associated with Factor 3. The factor patterns were virtually identical among all the subgroups with coefficients of congruence close to 1.0.

Conclusions: These findings are consistent with the presence of three distinct physiological domains underlying CV risk variable clustering. Obesity did not have a dominant role in the clustering of CV risk factors in the South Asian population.

Retrospective evaluation of pediatric oral biopsies from a dental and maxillofacial surgery centre in salem, Tamil Nadu, India

AIM

The aim of the study was to evaluate the pediatric oral biopsies received between 2002-2011 from a dental and maxillofacial centre in Salem, Tamilnadu, India retrospectively based on age, sex, site and type of the pathologies.

MATERIALS AND METHODS

The records of dental and maxillofacial surgery centre were taken and a retrospective evaluation of the pediatric lesions biopsied over a period of ten years (2002-2011) was done. Patients aged 15 years and below were considered as pediatric patients and pathologies were grouped into 8 categories, according to age, gender, anatomic location and pathologic diagnosis.

RESULTS

A total of nine hundred twenty five biopsies were studied, of which 97 cases were from pediatric patients. The pathologies were predominant in mandible to maxilla (47:29).The distribution of the pathologies were 44 odontogenic pathologies, 18 connective tissue tumours, 3 salivary gland tumours, 5 fibro osseous lesions and 25 tumour like lesions. Out of this 44 odontogenic pathologies, 39 were odontogenic cysts, and 5 were odontogenic tumours.

CONCLUSION

Unlike other studies, the lesions were more common in the mandible with a female predilection. The majority of oral and maxillofacial lesions detected in pediatric population were benign similar to the previous reports.