Fetal breathing movements in late diabetic pregnancy: relationship to fetal heart rate patterns and Braxton Hicks' contractions

Evaluation of Dentin-Pulp Complex Response after Conservative Clinical Procedures in Primary Teeth

Introduction

Although selective caries tissue removal decreases the number and diversity of bacteria, stops the caries process, and reduces the risk of pulp exposure, the studies on the minimally removal of caries tissue are limited and further clinical research is necessary in this field.

Aim

This study aimed to evaluate through clinical and radiographic assessments the in vivo response of the dentin-pulp complex of human deciduous teeth after either partial or total caries removal (TCR).

Materials and methods

A total of 49 deciduous molars of children aged between 5 and 9 years were carefully selected. The teeth were divided into two groups: Group I: Partial removal of caries; group II: Total removal of caries. Clinical and radiographic evaluations were performed during the period of 4 to 6 months after the procedure. The intraexam-iner reproducibility was determined by Kappa test. Fisher’s exact test was used to determine the statistical difference between groups.

Results

All teeth showed clinical success during the 4- to 6-month evaluation period. The radiographic evaluation showed 94.2 and 89.6% of success rate in groups I and II respectively. Radiographic results did not show statistically significant differences between the studied groups (p > 0.05).

Conclusion

The partial caries removal (PCR) showed satisfactory clinical and radiographic outcomes, suggesting that this minimally invasive approach might replace the TCR when correctly indicated.

How to cite this article: Mello B, Stafuzza TC, Vitor L, Rios D, Silva T, Machado M, Oliveira TM. Evaluation of Dentin-Pulp Complex Response after Conservative Clinical Procedures in Primary Teeth. Int J Clin Pediatr Dent 2018;11(3):188-192.

Body Mass Index and Dental Caries: A Systematic Review

Introduction

This review was undertaken to analyze the relationship between body mass index (BMI) and dental caries with the available literature evidence.

Materials and methods

The articles were searched from Medline/PubMed and Journal of Web published between 2005 and 2016.

Results

Out of the 146 references obtained, 16 articles in English language were read in full, which fulfilled the inclusion criteria after assessing by Down and Black criteria.

Conclusion

No consensus was reached in the relationship between BMI and dental caries in the present review due to varied associations

How to cite this article: Shivakumar S, Srivastava A, Shivakumar GC. Body Mass Index and Dental Caries: A Systematic Review. Int J Clin Pediatr Dent 2018;11(3):228-232.

Management of Hepatocellular Carcinoma: Bangladesh Perspective

Bangladesh is one of the countries facing huge burden of hepatocellular carcinoma (HCC). Hepatocellular carcinoma is the third commonest cancer in the country and it is just behind to cancer of the lung and cancer of the stomach. Hepatitis B virus (HBV) is responsible for 66% of HCC in Bangladesh. Presumptive prevalence of HBV and hepatitis C virus (HCV) may be as high as 5.4 and 0.84%, respectively, in Bangladesh, and liver diseases occupied 8 to 12% of admission in medicine wards of Public Medical College. In this mini review, I would like to highlight the impact of HBV and HCV in the development of HCC and the management of HCC from a Bangladesh perspective.

How to cite this article: Noor-E-Alam SM. Management of Hepatocellular Carcinoma: Bangladesh Perspective. Euroasian J Hepato-Gastroenterol 2018;8(1):52-53.

Comparison of Vitamin D Level of Children with Severe Early Childhood Caries and Children with No Caries

AIM

To compare the levels of vitamin D in children with severe early childhood caries (SECC) and children without caries and to determine the association of vitamin D deficiency and SECC.

MATERIALS AND METHODS

A total of 30 children each from case (with caries) and control group (without caries) of age between 3 and 6 years were selected from the Department of Pedo-dontics and Preventive Dentistry, Faculty of Dental Sciences, SGT University, Gurugram. Caries status of the children was recorded using decayed, extracted, and filled teeth (deft) index. Blood samples for serum 25(OH) vitamin D were taken from each child. All the data collected were compiled and subjected to appropriate statistical analysis.

RESULTS

Case group has mean serum 25(OH) vitamin D level of 12.19 ng/mL [4.37 standard deviation (SD), 95% confidence interval of 10.5-13.8] and control group has mean serum 25(OH) vitamin D level of 20.11 ng/mL (4.12 SD, 95% confidence interval of 18.56-21.65). When the mean levels of serum 25(OH) vitamin D were compared between case and control groups, there was a statistically significant difference (p-value <0.0001). Simple linear regression in case group shows statistically significant inverse correlation between vitamin D levels and SECC (p-value<0.0001).

CONCLUSION

Our results showed that vitamin D deficiency is risk factor both for incidence of dental caries and for its severity in children.

CLINICAL SIGNIFICANCE

Vitamin D deficiency is an important modifiable risk factor for dental caries in children. Hence, by supplementing vitamin D in children and preventing the deficiency of vitamin D, dental caries can be prevented.How to cite this article: Chhonkar A, Gupta A, Arya V. Comparison of Vitamin D Level of Children with Severe Early Childhood Caries and Children with No Caries. Int J Clin Pediatr Dent 2018;11(3):199-204.

Nonalcoholic Fatty Liver Disease: Time to Take the Bull by the Horns

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the world affecting almost one-fourth of the population. It may progress to nonalcoholic steatohepatitis (NASH), cirrhosis, end-stage liver disease, and liver cancer in the long run. Besides, it may make the natural history in other chronic liver diseases worse too. Furthermore, patients of NAFLD more often suffer from metabolic syndrome, ischemic heart disease, and extrahepatic malignancies than others, leading to a lower overall survival than the general population. Obesity and sedentary lifestyle are among the most important risk factors for NAFLD apart from increasing age, male sex, and certain genetic factors. Due to the rising incidence, possible adverse consequences, and the futile available treatment options, prevention is the key to tackle this health menace. Spreading awareness, adopting a healthy lifestyle with appropriate dietary modifications, regular physical activity are the cornerstones for challenging this unfolding monster.

How to cite this article: Nath P, Singh SP. Nonalcoholic Fatty Liver Disease: Time to Take the Bull by the Horns. Euroasian J Hepato-Gastroenterol 2018;8(1):47-51.

Hepatitis B Virus Infection among Health Care Workers in Indonesia

Hepatitis B virus (HBV) infection is a global health problem with an estimated 257 million chronically infected people. Indonesia is a moderately hepatitis B-endemic country with 7.1% prevalence of hepatitis surface antigen (HBsAg). This infection is considered as an important occupational hazard among health care workers (HCWs), who may become further transmitters of this infection. The extent of hepatitis B among HCWs and specific control strategy are not available in Indonesia. A study was done on 644 HCWs, who were categorized into administration, nonintervention, and intervention groups. The prevalence of HBsAg, antibody to HBV core antigen (anti-HBc), and antibody to HBsAg (anti-HBs) was 4.7, 18.5, and 36.7% respectively, while 57.3% were negative for all seromarkers, indicating susceptibility to this infection. Increasing trend with age was observed in the exposure to infection (anti-HBc) (p <0.001) and the marker of resolved infection (HBsAg-, anti-HBc+, anti-HBs+) (p = 0.004), suggesting accumulated exposure to HBV infection by increasing age. Rising trend of exposure rate was also observed across the administration, nonintervention, and intervention groups (p < 0.001). By length of service period, significant escalation of exposure (p = 0.010) and resolved infection (p < 0.001) were also observed, suggesting increasing occupational risk to HBV infection. There is an urgent need to safeguard the HCWs with hepatitis B vaccination and provide continuing education at various health care setups. The establishment of a national policy and a roadmap for effective and efficient intervention is required for the prevention, diagnosis, postexposure management, and treatment of HBV infection in this special population.

How to cite this article: Muljono DH, Wijayadi T, Sjahril R. Hepatitis B Virus Infection among Health Care Workers in Indonesia. Euroasian J Hepato-Gastroenterol 2018;8(1):88-92.

Squamous Papilloma on Hard Palate: Case Report and Literature Review

Most of the lesions in the oral cavity have papillary appearance. Oral squamous papilloma (SP) is one such type, which is a benign proliferation of the stratified squamous epithelium and presents as papillary or verrucous exophytic mass induced by human papillomavirus (HPV). Most of the oral mucosal lesions are often asymptomatic and have small progression. The common sites of occurrence include tongue, soft palate, and uvula. Squamous papilloma arising on hard palate is described in this article. Surgical excision of the lesion was done and sent for histopathological analyses that confirmed the clinical diagnosis. In larynx and trachea, malignant transformation of papillomas has been reported. The potentially malignant nature of SP if present needs to be explored. How to cite this article: Chaitanya P, Martha S, Punithvathy R, Reddy M. Squamous Papilloma on Hard Palate: Case Report and Literature Review. Int J Clin Pediatr Dent 2018;11(3):244-246.

Prevalence and Risk Factors for Dental Caries among Preschool Children: A Cross-sectional Study in Eastern India

INTRODUCTION

Dental caries is one of the major widespread health issues that continue to negatively affect the oral health of children globally.

AIM

To estimate the prevalence of dental caries and its risk factors among preschool children of Bhubaneswar, Odisha, India.

MATERIALS AND METHODS

The study was a community-based cross-sectional one among preschool children with (N = 425) participants recruited from the Anganwadi centers (AWCs) of Bhubaneswar, Odisha, India. By using a cross-sectional study design, dental caries was assessed using the World Health Organization (WHO) guidelines, and other socioeconomic and risk factors data were collected through parental interview using questionnaires. Caries was identified at both tooth and surface levels through visual dental examinations by trained and calibrated dentists. Logistic regression analyses were used to identify associations among variables and caries.

RESULTS

The proportion of preschool children suffering from dental caries was found to be 47.29%. The multivariable-adjusted model depicted that longer duration of breastfeeding was a significant predictor as follows: Those who had breastfed for more than 36 months [adjusted odds ratio (AOR): 5.41; 95% confidence interval (CI): 2.97-9.85; p = 0.001], 12 to 24 months (AOR: 2.1; 95% CI: 1.04-4.36; p = 0.037), followed by increase in age 61 to 72 months (AOR: 5.39; 95% CI: 2.72-10.67; p = 0.001), 49 to 60 months (AOR: 2.53; 95% CI: 1.41-4.52; p = 0.002), more than two children in the family (AOR: 2.70; 95% CI: 1.55-4.69; p = 0.001), and children who did not brush the teeth under the parent's supervision (AOR: 2.70; 95% CI: 1.55-4.69; p = 0.001).

CONCLUSION

The study highlights the need to increase awareness about the oral health and hygiene among parents of preschool children in India.How to cite this article: Chugh VK, Sahu KK, Chugh A. Prevalence and Risk Factors for Dental Caries among Preschool Children: A Cross-sectional Study in Eastern India. Int J Clin Pediatr Dent 2018;11(3):238-243.

F-18 Fluorodeoxyglucose Positron Emission Tomography/ Computed Tomography Findings of Isolated Gastric Tuberculosis mimicking Gastric Cancer and Lymphoma

Introduction

Tuberculosis (TB) infection is still a challenging health issue, especially in developing countries. Diagnosing extrapulmonary infections, especially isolated organ involvement, is difficult in most cases even with the radiological, endoscopic, and histopathological examinations done for accurate diagnosis. Here we describe a case of isolated gastric TB with specific F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) findings mimicking gastric cancer/ lymphoma.

Case report

A 20-year-old male patient was admitted to our hospital with abdominal pain in the epigastric region, weight loss, and fever especially at nights for 2 months. Physical examination was normal. Hemoglobin was 9.6 gm/dL; the patient had iron deficiency anemia. Upper gastrointestinal (GI) endoscopy was suggestive of gastric ulcer mimicking malignancy. F-18 FDG PET/CT revealed multiple hypermetabolic malignant lymphadenopathies in the abdomen and diffuse gastric wall thickening as linitis plastica and multiple hypermetabolic peritoneal implants in the omentum. Exploratory laparotomy was done for tissue diagnosis and exploration of the peritoneum for TB infection, lymphoma, and Crohn’s disease to make differential diagnosis. Histopathology revealed granulomatous lymphadenitis with granulomas including giant cells, suspecting TB. Patient was put on antituberculosis treatment (ATT). After treatment, the complaints resolved, and he gained weight. Fusion PET/CT exhibited a complete response to ATT with no residual disease.

Conclusion

According to our knowledge, this is the first report about F-18 FDG PET/CT findings in the diagnosis of isolated gastric TB. F-18 FDG PET/CT may provide help in the diagnosis and follow-up of isolated gastric TB in challenging cases.

How to cite this article: Akdogan RA, Rakici H, Güngör S, Bedir R, Akdogan E. F-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Findings of Isolated Gastric Tuberculosis mimicking Gastric Cancer and Lymphoma. Euroasian J Hepato-Gastroenterol 2018;8(1):93-96.

Burden of Alcoholic Liver Disease: Bhutan Scenario

Alcoholic liver disease (ALD) is one of the major public health problems in Bhutan. The incidence of alcohol liver diseases (per 10,000 populations) in the year 2016 was 46.

The burden of mortality associated with it is alarming, going by the size of the population of the country. It is one of the all-time top five killer diseases in the country. In 2016, the mortality attributable to alcohol liver disease was 184 corresponding to 97% of deaths due to reported liver diseases. The ALD is responsible for 15% of all deaths on an average in the last 3 years.

How to cite this article: Wangchuk P. Burden of Alcoholic Liver Disease: Bhutan Scenario. Euroasian J Hepato-Gastroenterol 2018;8(1):81-82.

Primary Gastric Lymphoma: Clinicopathological Profile

Introduction

Gastrointestinal tract (GIT) is the most common site of involvement of extranodal non-Hodgkin’s lymphoma (NHL). There is regional variation in anatomical distribution of extranodal NHL, stomach being the most common site followed by small intestine. Primary gastric lymphoma (PGL) predominantly involves the antrum and corpus of the stomach. It arises from mucosa-associated lymphoid tissue (MALT) and is of B-cell lineage and often associated with Helicobacter pylori infection. Primary gastric lymphoma often presents with nonspecific symptoms. The present study was undertaken to ascertain the clinicopathological characteristics of PGL at a tertiary care center in South India.

Materials and methods

It is a retrospective study from 2006 to 2016. Patient’s data were obtained from institutional medical records. The histopathology slides were reviewed. The relevant immunohistochemistry (IHC) markers done were leukocyte common antigen (LCA), CD3, CD20, CD79a, CD10, Bcl-2, Bcl-6, CD5, Cyclin D1, CD138, and Ki-67. Correlating with the immunoprofile, further subtyping was done.

Results

A total of 405 patients of NHL were seen during the study period, out of which 43 patients were PGL. There were 32 males and 11 females, with M:F of 2.9:1. The mean age at diagnosis was 58 years. Abdominal pain and new-onset dyspepsia were the commonly observed presenting symptoms. The common site of involvement was antrum (20). Diffuse large B-cell lymphoma (DLBCL) was the most common histological subtype. Helicobacter pylori infection was seen in 18 (41%) patients. Majority of the patients were in stages II and III.

Conclusion

In our study, the initial presentation of PGL was with nonspecific symptoms like abdominal pain and new-onset dyspepsia. High degree of suspicion of such symptoms and biopsy of all suspicious lesions is essential for early detection. Diffuse large B-cell lymphoma was the most common histological subtype seen in our study.

How to cite this article: Malipatel R, Patil M, Rout P, Correa M, Devarbhavi H. Primary Gastric Lymphoma: Clinicopathological Profile. Euroasian J Hepato-Gastroenterol 2018;8(1):6-10.

Trichobezoar: Ravenous for Hair

Trichophagia is the habit of chewing hair. On an average, only 1% patients with trichophagia develop trichobezoar. They are usually symptomless until they reach a large size. It is common in young females usually with an underlying psychiatric disorder. The gold standard for diagnosis is upper gastrointestinal endoscopy (UGIE). Here we present a case of trichobezoar in an 11-year-old girl who presented in the emergency with complaint of pain abdomen and symptoms of obstruction.

Nature of Host Immunity during Hepatitis B Virus Infection and designing Immune Therapy

Hepatitis B virus (HBV) infections represent one of the major public health problems in global context. More than 2 billion people in the world have been infected with this virus at some point of time in their life and millions are chronically infected, indicating that chronic HBV-infected subjects remain as a living source of HBV transmission. The public health impact of this is tremendous. Considerable numbers of chronic HBV-infected individuals would eventually develop progressive liver diseases and their complications like hepatic failure, liver cirrhosis (LC), and hepatocellular carcinoma (HCC). Epidemiological studies have suggested that about 0.6 to 1.2 million people die annually from HBV-related liver diseases. These figures about death due to HBV and sufferings from HBV-related diseases indicate a notion of medical emergencies about HBV. In addition to these, the impact of HBV on health care delivery system moves beyond these numbers of HBV-related patients and HB-related deaths. This is because significant insights have already been developed about epidemiology, virology, and pathogenesis of HBV. Also, an effective and widely used preventive vaccine is available against HBV. In addition to these, antiviral drugs against HBV have been developed from early 1980s and several such drugs are now available commercially in the open market around the worldwide. Unfortunately, the ongoing therapeutic regimens could not stand the test of time and new insights about HBV pathogenesis are required for the development of new, novel, and evidence-based therapies for chronic HBV infections.

How to cite this article: Akbar SMF, Al-Mahtab M, Khan SI. Nature of Host Immunity during Hepatitis B Virus Infection and designing Immune Therapy. Euroasian J Hepato-Gastroenterol 2018;8(1):42-46.

Hepatocellular Carcinoma in Malaysia and Its Changing Trend

Hepatocellular carcinoma (HCC) is one of the leading causes of death globally. In Malaysia liver cancer is the eighth most common cause of cancer for both gender and fifth most common cause of cancer for males. Liver cancer is a cause of premature death in Malaysia: The trend from 1990 to 2010 was observed upward. Since 1990, the annual years of life lost (YLLs) from liver cancer have increased by 31.5%. Older persons are at higher risk and there is male predominance observed. Curative surgical resection, liver transplantation, and supportive symptomatic care, including percutaneous ethanol injection and radiofrequency ablation (RFA), and noncurative transarterial chemoembolization (TACE) are among available treatment facilities. Yet the survival rate is very poor as majority of patients present at very advanced stage. Hepatitis B virus (HBV) remained the leading cause of HCC in Malaysia. Several studies showed cryptogenic causes, which are mainly nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) among the predominant causes of HCC in Malaysia than hepatitis C virus (HCV), alcohol, or any other reason. This mainly correlates with the increasing incidence of diabetes and obesity in Malaysia.

How to cite this article: Raihan R, Azzeri A, Shabaruddin FH, Mohamed R. Hepatocellular Carcinoma in Malaysia and Its Changing Trend. Euroasian J Hepato-Gastroenterol 2018;8(1):54-56.

Epidemiology of Chronic Hepatitis B in Turkey

Hepatitis B virus (HBV) infection is a global public health problem and it is also a major health concern of Turkey. The estimated number of HBV carriers in Turkey is about 3.3 million, with an overall HBV prevalence of 4.57%. Thus, both prevention and therapy of HBV-infected patients are urgent medical need of Turkey. A total of 1,533 among 37,637 patients who were examined at the Department of Gastroenterology, Ankara University School of Medicine were found to be hepatitis B surface antigen (HBsAg) positive (4%). Viral hepatitis treatment is fully reimbursed in Turkey through the national insurance system, which covers all residents across Turkey. How to cite this article: Özkan H. Epidemiology of Chronic Hepatitis B in Turkey. Euroasian J Hepato-Gastroenterol 2018;8(1):73-74.

Changing Etiology in Liver Cirrhosis in Sapporo, Japan

In Japan, preventive measures and antiviral therapy against acute or chronic viral infection had achieved remarkable progress in the 1980s or later. On the contrary, metabolic syndrome complicated with fatty liver has emerged as a public health concern to date. In the current study, we attempted to clarify etiological changes in liver cirrhosis treated in a single tertiary institute in Sapporo, Japan, from 1998 to 2016. Medical records of 1,166 patients (787 males, with mean of 64.9 ± 11.7 years), diagnosed as having liver cirrhosis for 19 years, were retrospectively reviewed to analyze etiology and clinical features. During the past 10 years, annual numbers of cirrhotic patients with chronic infection of hepatitis B virus (HBV) or hepatitis C virus (HCV) decreased from 50 or more to 20 or less, and alcoholic liver disease or cryptogenic liver injury emerged as major cause of liver cirrhosis. Among 100 cirrhotic patients of unknown cause, nonalcoholic fatty liver disease (NAFLD) occupied almost 50% in 19 observational years. In order to control the rising trend in NAFLD related with metabolic syndrome, preventive measures including education in society would be required in Japan. How to cite this article: Kang J-H, Matsui T. Changing Etiology in Liver Cirrhosis in Sapporo, Japan. Euroasian J Hepato-Gastroenterol 2018;8(1):77-80.

Hepatocellular Carcinoma Surveillance: Benefit of Serum Alfa-fetoprotein in Real-world Practice

Introduction

Better treatment outcome of early-stage hepatocellular carcinoma (HCC) warrants employment of screening programs, in which ultrasonography (US) and serum alfa-fetoprotein (AFP) have been recommended. Considering cost-effectiveness, serum AFP has recently been withdrawn from several guidelines for HCC surveillance. However, there were limited studies on benefits of AFP for HCC surveillance in Thailand.

Materials and methods

This is a retrospective study of a proportion of HCC cases in which a diagnostic study was triggered by high serum AFP levels, but US failed to detect the lesion. Patients who received diagnostic imaging for HCC at Siriraj Hospital between January 1, 2012 and December 31, 2014 were included. All the patients must fulfill criteria for HCC surveillance according to American Association for the Study of Liver Diseases (AASLD) practice guidelines on the management of HCC 2010 or European Association for the Study of the Liver-European Organisation for Research and Treatment of Cancer (EASL-EORTC) Clinical Practice Guidelines: Management of HCC 2012. Previous diagnosis of any liver malignancy was excluded. Demographic data, underlying liver diseases, screening of AFP and US results, and definite diagnosis of HCC were recorded.

Results

Of the 452 cases who fulfilled inclusion and exclusion criteria, chronic hepatitis B, C, and alcoholic cirrhosis were accountable for 53.8, 25.9, and 7.3% respectively. Totally, 150 cases were diagnosed with HCC. Additional HCC detection rate by high serum AFP but failed US of 15.3% was demonstrated. Subgroup analysis revealed significant benefit of AFP in cirrhotic patients with chronic hepatitis B and C (p-value 0.004 and 0.002). No significant benefit was observed in cirrhosis of other causes and in noncirrhotic chronic hepatitis B.

Conclusion

We reported a 15.3% additional benefit of serum AFP for HCC surveillance in conjunction with US of liver. Chronic hepatitis B and C with cirrhosis significantly derived the benefit from serum AFP screening.How to cite this article: Lersritwimanmaen P, Nimanong S. Hepatocellular Carcinoma Surveillance: Benefit of Serum Alfa-fetoprotein in Real-world Practice. Euroasian J Hepato-Gastroenterol 2018;8(1):83-87.

Diagnostic and Prognostic Role of Serum Interleukin-6 in Malignant Transformation of Liver Cirrhosis

Aim

Alpha-fetoprotein (AFP) is still the most commonly used and the single most recommended marker in the diagnosis of hepatocellular carcinoma (HCC). Interleukin (IL)-6 is a circular cytokine and its role on carcinogenesis in various hematological and solid tumors is clearly documented. A combination of serum IL-6 and AFP may provide beneficial information regarding early diagnosis of HCC. In this study, the effect of plasma IL-6 level in the diagnosis of HCC was investigated.

Materials and methods

A total of 130 patients with liver cirrhosis, together with 30 control cases were enrolled in the trial. A diagnosis of HCC was present in 75 patients (57.6%) in the liver cirrhosis group. Blood samples were obtained from the enrolled study and control cases. Alpha-fetoprotein was quantified by chemiluminescent method. Plasma IL-6 levels of samples obtained at -80°C were quantified by human IL-6 BMS213/2 BMS213/2TEN kit.

Results

The HCC patients were older than the patients in the cirrhosis group (p = 0.016). On comparison of the HCC patients with the control group, AFP (p < 0.001) and IL-6 (p < 0.001) were significantly higher among the HCC patients. Comparison of HCC patients with liver cirrhosis cases with no diagnosis of HCC revealed significantly high AFP (p < 0.001) and IL-6 levels (p < 0.001) in HCC group. Cutoff value for IL-6 was calculated as 5.73 (pg/mL). No difference was detected in AFP (p = 0.600) and IL-6 (0.344) in all three subgroups. A total of 17 patients died during a mean follow-up period of 32.9 months. No correlation was found between mean AFP values and IL-6 values and survival rates.

Conclusion

Plasma IL-6 level was found to be significant in the diagnosis of HCC. Alpha-fetoprotein and IL-6 provided no advantage in terms of early diagnosis of HCC and no correlation was observed between these markers and survival.

How to cite this article: Yakut M, Özkan H, Karakaya MF, Erdal H. Diagnostic and Prognostic Role of Serum Interleukin-6 in Malignant Transformation of Liver Cirrhosis. Euroasian J Hepato-Gastroenterol 2018;8(1):23-30.

Management of Autistic Patients in Dental Office: A Clinical Update

Autism is an intellectual developmental disorder characterized by insidious disability in communication, social interaction, and using language and abstract concepts. This organic disorder is known to have deformities in brain, i.e., cerebellum and limbic system, showing wide spectrum of systemic and behavioral symptoms. The oral health care of such patients can be complicated as they cannot verbalize complaints about any dental problems they may be experiencing and can display a variety of behaviors and reactions to small changes also. This study summarizes etiology and diagnosis of this disorder with the special emphasis on the issues encountered while coping with children with autistic spectrum. How to cite this article: Chandrashekhar S, Bommangoudar JS. Management of Autistic Patients in Dental Office: A Clinical Update. Int J Clin Pediatr Dent 2018;11(3):219-227.

Clinical Evaluation of Preventive Effect of Fissure Sealants on Initial Carious Lesion of Permanent Mandibular Molars Pretreated with and without Fluoride Varnish by Fluorescence Camera

The important armamentarium in the present day scenario against caries prevention is considered to be a combination of preventive methods. The present study was conducted to evaluate the preventive effect of pit and fissure sealant pretreated with fluoride varnish on initial carious lesion by fluorescence camera (FC).

How to cite this article: Lakshmi MS, Srilatha KT, Nandlal B, Deshmukh S. Clinical Evaluation of Preventive Effect of Fissure Sealants on Initial Carious Lesion of Permanent Mandibular Molars Pretreated with and without Fluoride Varnish by Fluorescence Camera. Int J Clin Pediatr Dent 2018;11(2):89-93.

Influence of Storage Media and Duration of Fragment in the Media on the Bond Strength of the Reattached Tooth Fragment

Introduction

Fracture of anterior teeth is the most frequent type of injury in the permanent dentition. Composite materials have made possible the use of adhesive materials and techniques, but storage of fragment in the media can enhance the bond strength. The purpose was to evaluate the influence of storage media and duration of the fragment in the media on the bond strength of the reattached fragment of teeth.

Materials and methods

A total of 104 permanent maxillary central incisors were included. Samples were divided into four groups of 26 teeth each, further divided into eight groups of 13 teeth each and sectioned 3 mm apical to the incisal edge and stored in four storage media—tap water, artificial saliva, sodium fluoride, and Tooth Mousse at 12 and 24 hours. The bond strength was measured by universal strength testing machine.

Results

Tooth Mousse showed statistically significant difference (p-value 0.001) compared with sodium fluoride, artificial saliva, and tap water when stored in both 12 and 24 hours’ duration.

Conclusion

Tooth Mousse was a better storage media when compared with sodium fluoride, artificial saliva, and tap water.

Clinical significance

Tooth Mousse can be considered as a best storage media for fragment reattachment.

How to cite this article: Jalannavar P, Tavargeri A. Influence of Storage Media and Duration of Fragment in the Media on the Bond Strength of the Reattached Tooth Fragment. Int J Clin Pediatr Dent 2018;11(2):83-88.

A Survey on the Use of Antibiotics among the Dentists of Kolkata, West Bengal, India

Introduction

Dental infections are multimicrobial in origin with their etiological factors involving a combination of Gram-positive, Gram-negative, facultative anaerobes, and obligate anaerobic bacteria. Thus, antibiotics and analgesics account for a great majority of medicines prescribed by the dental surgeons. Inappropriate prescription of antibiotics by health care professionals has become a worldwide issue nowadays.

Aim

The purpose of the present study was to:

• Determine the pattern of antibiotic prescription among dentists of Kolkata.

• Assess the attitude of dentists toward antibiotic resistance.

Materials and methods

An electronic version of the questionnaire of cross-sectional survey regarding antibiotic use and attitude toward growing antibiotic resistance was constructed using Qualtrics (Qualtrics Pvt. Limited Provo, Utah), an internet online survey tool that was e-mailed to dental surgeons of Kolkata registered with Indian Dental Association (IDA), West Bengal. A reminder e-mail was given after 1 month to recollect the responses from them.

Results

The survey was e-mailed to 300 dental surgeons, out of which 115 dental surgeons completed the survey, thereby achieving a response rate of 38.33%. Majority of the respondents (60%) chose amoxicillin in nonallergic patients. Average minimum duration of antibiotic therapy was 5 days. The drug of first choice for patients with an allergy to penicillin was erythromycin. The prime determinant of antibiotic use was facial swelling (68%). The prime determinant to select a particular brand of antibiotics was affordability of that brand (61%). Almost all (99%) dental surgeons were aware of antibiotic resistance being a growing concern. As per their views, there was overprescription of antibiotics.

How to cite this article: Kaul R, Angrish P, Jain P, Saha S, Sengupta AV, Mukherjee S. A Survey on the Use of Antibiotics among the Dentists of Kolkata, West Bengal, India. Int J Clin Pediatr Dent 2018;11(2):122-127.

Estimation of Salivary Glucose, Calcium, Phosphorus, Alkaline Phosphatase, and Immunoglobulin A among Diabetic and Nondiabetic Children: A Case-Control Study

Introduction

Saliva is vital for oral health and helps to maintain oral homeostasis. It may show qualitative and quantitative variations owing to any changes in the systemic health. Diabetes mellitus (DM) is a metabolic disease and the individuals may be at higher risk for oral health problems.

Objective

The study was aimed to estimate the levels of various salivary components among diabetic and nondiabetic children with similar caries status and also to analyze possible association between caries status and possible caries determinants in the saliva of diabetic children.

Materials and methods

A total of 70 children in the age group of 6 to 13 years with minimal dental caries (Decayed, Missing and Filled Teeth index (DMFT/dmft >1 and <5)) were selected. Group I comprised of type I diabetic children and on medication for diabetes and group II included healthy nondiabetic children. Salivary samples were collected from the participants by passive drool method and estimation of all salivary parameters was done using autoanalyzer.

Results

Statistical analyses were done using Student’s t-test and results are presented as mean ± standard deviation (SD). There was a highly significant difference in mean glucose value between diabetic and nondiabetic children. Levels of salivary calcium, phosphorus, and salivary immunoglobulin A (s-IgA) did not show any significant difference between the two groups. There was also a statistically significant difference in the alkaline phosphatase (AP) levels, which was found to be higher in diabetics.

Conclusion

An elevation in the levels of salivary glucose and AP was evident in diabetic children, which can be a risk marker for dental caries. There was no correlation in the levels of salivary calcium, phosphorus, and s-IgA levels among diabetic and healthy children.

Clinical significance

The salivary factors evaluated in the study may prove to be useful measures of caries experience in diabetic children.

How to cite this article: Uppu K, Sahana S, Madu GP, Vasa AAK, Nalluri S, Raghavendra KJ. Estimation of Salivary Glucose, Calcium, Phosphorus, Alkaline Phosphatase, and Immunoglobulin A among Diabetic and Nondiabetic Children: A Case-Control Study. Int J Clin Pediatr Dent 2018;11(2):71-78.

Evaluation of Antimicrobial Activity of Two Endodontic Sealers: Zinc Oxide with Thyme Oil and Zinc Oxide Eugenol against Root Canal Microorganisms- An in vitro Study

Aim

The present study was aimed to find out and compare the antimicrobial effect of the paste containing zinc oxide cement mixed with thyme oil (ZO + Th oil) with that of the paste containing zinc oxide and eugenol (ZO + E) against Staphylococcus aureus, Escherichia coli, Enterococcus faecalis, and Pseudomonas aeruginosa, common root canal pathogens of deciduous teeth.

Materials and methods

An in vitro antimicrobial effect was carried out by the agar diffusion method. The ZO + Th oil paste was filled in the punched holes of Mueller Hinton agar at two equidistant points. The same was followed for ZO + E paste. For 24 hours, all the plates were incubated at a temperature of 37°C. The inhibition zones in millimeters around the wells were calculated. There were 6 times repetitions of the test for each microorganism. Data were tabulated and analyzed statistically using one-way analysis of variance (ANOVA) and Tukey's post hoc comparison test. Level of significance for the tests was 5%.

Results

Zones of bacterial inhibition were highest for ZO + Th oil paste against the pathogenic microorganisms S.aureus, followed by E. coli, E. faecalis, P. aeruginosa while for ZO + E paste, the decreasing order against pathogenic microorganisms was E. coli, S. aureus, E. faecalis, and P. aeruginosa. Statistically significant difference was found in both the pastes, ZO + Th oil paste and ZO + E paste.

Conclusion

ZO + Th oil paste showed higher levels of antimicrobial effect against the root canal pathogens.How to cite this article: Thosar NR, Chandak M, Bhat M, Basak S. Evaluation of Antimicrobial Activity of Two Endodontic Sealers: Zinc Oxide with Thyme Oil and Zinc Oxide Eugenol against Root Canal Microorganisms-An in vitro Study. Int J Clin Pediatr Dent 2018;11(2):79-82.

Comparison of the Effectiveness of Probiotic, Chlorhexidine-based Mouthwashes, and Oil Pulling Therapy on Plaque Accumulation and Gingival Inflammation in 10- to 12-year-old Schoolchildren: A Randomized Controlled Trial

Introduction

The use of a mouthwash augments mechanical removal of plaque by brushing and flossing and helps maintain oral health through its antiplaque and antibacterial chemical properties.

Aim

To evaluate the effectiveness of a probiotic mouthwash, sesame oil pulling therapy, and chlorhexidine-based mouth-wash on plaque accumulation and gingival inflammation in schoolchildren aged 10 to 12 years.

Materials and methods

The randomized controlled trial included 45 healthy schoolchildren aged 10 to 12 years and studying in Government High School, Tiruchengode, Tamil Nadu, India. The participants were randomly divided into three groups, I, II, and III, with 15 children in each group as follows: group I: probiotic mouthwash; group II: chlorhexidine mouthwash; and group III: sesame oil. Baseline scores of plaque index (PI) and modified gingival index (GI) were recorded followed by a full mouth oral prophylaxis. The designated mouth rinses were distributed to the respective groups and they were instructed to rinse once daily. Their parents supervised the children during the use of mouthwash. On the 15th and 30th day, the children were subjected to the same clinical measurements. Children’s acceptance of their plaque control method was assessed using a modified facial image scale.

Results

Intragroup comparisons for both the GI and PI scores were statistically significant (p ≤ 0.001) in all the three groups. Difference in the GI scores between the 15th and 30th day was statistically significant for chlorhexidine group alone (p = 0.024). Intergroup comparisons between the three groups were not statistically significant.

Conclusion

Probiotic mouthwash, chlorhexidine mouthwash, and sesame oil were equally effective in reducing plaque and in improving the gingival status of children. The difference between the gingival scores on the 15th and 30th day was statistically significant in the chlorhexidine group.

How to cite this article: Kandaswamy SK, Sharath A, Priya PRG. Comparison of the Effectiveness of Probiotic, Chlorhexidine-based Mouthwashes, and Oil Pulling Therapy on Plaque Accumulation and Gingival Inflammation in 10- to 12-year-old Schoolchildren: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2018;11(2):66-70.

Impact of Diabetes Mellitus Type 1 on Lebanese Families' Quality of Life

Introduction

Diabetes mellitus type 1 (DM1) markedly alters the lives of individuals and their families. Family members can be affected by diabetes and its treatment, causing burden, distress, and reduced quality of life (QOL).

Objective

The aim of this research is to study the relationship between the diabetic child and the family members, to evaluate the stress and emotional issues between siblings, and to weigh in on the psychological, affective, and financial burden that parents have to deal with in their daily life.

Materials and methods

A total of 37 diabetic Lebanese families recruited from the Chronic Care Center (CCC) answered two questionnaires, one about general information and the other related to psychological and financial impact of DM1 and its oral complications on the families.

Results

About 56.8% have monthly income below $1,000; 16.2% of parents have an educational upper limit of college degree; 83.8% of the mothers are housewives; 75.7% of parents feel guilty about their child’s condition; 89.2% feel that their diabetic child is frustrated with their diet. For 78.4%, the siblings are jealous of the diabetic child; 13.5% of parents are well aware of the oral complications of diabetes and 86.5% think that treating the diabetic child’s teeth is more important than the siblings’ ones; 91.9% assist their diabetic child’s toothbrushing, but 81.1% of family members do not visit the dentist regularly. A total of 100% allocate special budget for the diabetic child’s diet and 59.4% have an additional budget dedicated to the diabetic child’s treatment; 81.1% declared that their career is affected by their child’s illness.

Conclusion

The diabetic child expressed frustration with their diet. The child’s siblings are jealous as they feel left behind. The parents experienced guilt feeling and psychological stress. They have social restriction and financial problems. The QOL of families living with a diabetic child is altered negatively.

How to cite this article: Noueiri B, Nassif N. Impact of Diabetes Mellitus Type 1 on Lebanese Families’ Quality of Life. Int J Clin Pediatr Dent 2018;11(2):61-65.

Mandibular Regional Odontodysplasia in an 8-year-old Boy showing Teeth Disorders, Gubernaculum Tracts, and Altered Bone Fractal Pattern

Regional odontodysplasia (RO) is a rare nonhereditary developmental condition usually affecting maxilla and female patients. A few number of articles have used the cone beam computed tomography (CBCT) to describe imaging findings in RO. Thus, this article aims to report unusual imaging findings in a Brazilian child who presented with mandibular RO. A healthy 8-year-old boy was referred for evaluation of an anterior mandibular gingival enlargement. Radiographically, all right mandibular teeth showed wide pulp chambers and shortened roots with thin dentinal walls and open apices, featuring a “ghost teeth“ appearance, which indicated a diagnosis of RO. Missing teeth and altered radiopacity were observed. Cone beam computed tomography provided great insight into RO, allowing to identify gubernaculum tracts (GTs) associated with RO teeth. Fractal analysis of the bone surrounding RO teeth revealed an altered trabecular pattern.

Validating the Usage of Cariogram in 5- and 12-year-old School-going Children in Paonta Sahib, Himachal Pradesh, India: A 12-month Prospective Study

Aim

To validate the caries risk profiles in 5- and 12-year-old school-going children and to single out main contributing factor, if any, using cariogram over a period of 1 year.

Materials and methods

A cariogram model was used to create caries risk profiles on 499 children aged 5 and 12 years ±6 months. They were divided into 2 groups. The group I and group II consisted of 250 and 249 children respectively. Re-examination was done after 1 year and caries increment was recorded. The caries risk profiles generated by the cariogram software were compared with caries increment.

Results

Percentage of subject having caries increment in groups I and II in high-, medium-, and low-risk group after 1 year was 66.2, 39.5, and 13%, and 48.5, 27.3, and 13.9% respectively. The mean caries increment after 1 year in groups I and II in high-, medium-, and low-risk patients was 0.96, 0.49, and 0.13, and 0.7, 0.36, and 0.11 respectively. Linear regression analysis showed dental caries, diet content, diet frequency, plaque index, Streptococcus mutans count, fluoride, salivary flow rate, and buffer capacity are significantly associated with actual chance to avoid caries.

Conclusion

The risk of developing new carious lesions consistently reduced from high-risk category to low-risk category, reflecting the cariogram ability in accurately estimating future caries. Hence, cariogram can be said to be a useful tool for caries prediction. Initial dental caries came out to be the strongest predictor of future caries.

How to cite this article: Garg A, Madan M, Dua P, Saini S, Mangla R, Singhal P, Dupper A. Validating the Usage of Car-iogram in 5- and 12-year-old School-going Children in Paonta Sahib, Himachal Pradesh, India: A 12-month Prospective Study. Int J Clin Pediatr Dent 2018;11(2):110-115.

Comparison of Short-term Postoperative Hypotony Rates of 23-gauge vs 25-gauge Needles in Formation of the Scleral Tract for Baerveldt Tube Insertion into the Anterior Chamber

Introduction

To compare the early postoperative hypotony rates and intraocular pressure (IOP) in two groups of eyes using either 23-gauge (23G) or 25-gauge (25G) needle in the creation of the anterior chamber entry tract for Baerveldt tube. The primary outcome measure was incidence of hypotony, and secondary outcome measures included comparison of mean IOP and other early complications.

Materials and methods

Ours was a retrospective case review of consecutive patients who underwent 350 mm² Baerveldt implantation in two units over a 2-year period. Data including IOP and complications were collected at 1 day, 1 week, and 1 month following surgery from patients’ notes. Statistical analysis between groups was determined using the unpaired 2-tailed f-test for continuous variables and chi-squared test for categorical variables. Statistical significance was defined at the 0.05 level.

Results

A total of 58 eyes of 58 patients were included in this study. Preoperative mean IOP in the 25G group was significantly higher (26.4 ± 6.8 mm Hg) when compared with the 23G group (21.6 ± 4.0 mm Hg) (p = 0.002). The mean postoperative IOP remained significantly higher in the 25G group at day 1 (p=0.004), week 1 (p = 0.008), but not at month 1 (p = 0.744). Four patients in the 23G group had hypotony within 1 month postsurgery compared with no cases in the 25G group (chi-squared test p = 0.038).

Conclusion

There was a significantly higher risk of early hypotony and lower IOP in the larger 23G group at days 1 and 7, although the IOP was similar in both groups by 1 month.

Clinical significance

After all glaucoma drainage device (GDD) tube implantation, regardless of which needle is used to create the tract, the entry site should always be checked with 2% fluorescein drop and 10.0 nylon suture is used with or without autologous Tenon’s tissue to close any leakage.

How to cite this article: Lim KS, Garg A, Cheng J, Muthusamy K, Beltran-Agullo L, Barton K. Comparison of Short-term Postoperative Hypotony Rates of 23-gauge vs 25-gauge Needles in Formation of the Scleral Tract for Baerveldt Tube Insertion into the Anterior Chamber. J Curr Glaucoma Pract 2018;12(1):36-39.

Determination of ABO Blood Groups and Rh Typing from Dry Salivary Samples

INTRODUCTION

A unique blood group is a characteristic every individual possesses. Blood group antigens like A, B, D, H, etc., are found to be present on the cell surfaces of red blood cells (RBCs). Besides blood, these are also secreted in various body secretions like semen, sweat, amniotic fluid, and saliva. Blood grouping has several applications in forensic sciences and is also a major part of routine medical investigations. Presence of these antigens in saliva is dependent on the secretor status of an individual. Saliva samples at the crime scene are very crucial, as they help in deoxyribonucleic acid typing, sex determination, bite mark analysis, and blood grouping. Dried salivary samples are often obtained in more number of cases as compared with the wet form, due to the variable time lapse between the occurrence of the crime and the start of the investigation. Blood grouping from these samples proves to be very efficient. Thus, the present study aims at evaluating the accuracy of ABO blood group determination and Rh typing from dried salivary samples. Also, the study would establish the use of saliva as a noninvasive technique in routine blood examinations, especially in children who have needle phobia.

MATERIALS AND METHODS

Blood grouping and Rh typing were performed on the dry salivary samples obtained from the 47 subjects using the absorption-inhibition technique. This was then compared with the results obtained using extraction socket blood and evaluated.

RESULTS

The present study showed a 100% positive correlation for ABO blood grouping, but a mere 14.81% positive correlation for Rh typing between the dried salivary samples and the extraction socket blood.

CONCLUSION

Dried salivary samples can thus be put to immense use in several areas of forensic investigations. It could also help in developing alternate methods for routine blood investigations in children and adults.How to cite this article: Velani PR, Shah P, Lakade L. Determination of ABO Blood Groups and Rh Typing from Dry Salivary Samples. Int J Clin Pediatr Dent 2018;11(2):100-104.

Association of Diopsys® Short-duration Transient Visual Evoked Potential Latency with Visual Field Progression in Chronic Glaucoma

Aim

To determine the association of Diopsys® NOVA-LX amplitude and latency abnormality scores with perimetric staging of chronic glaucoma, and to explore potential single-visit short-duration transient visual evoked potential (SD-tVEP) trend detection ability utilizing Humphrey 30-2 field progression data.

Materials and methods

Setting: Glaucoma subspecialty clinic. Participants: Treated adult chronic glaucoma patients undergoing SD-tVEP evaluation. Main outcome measures: (1) Proportion of eyes designated as suspect or abnormal by the NOVA-LX multifactorial algorithm were determined as a function of glaucoma severity using the most recent Humphrey visual field analyzer (HVFA) 30-2 field. (2) Association between long-term HVFA-guided progression analysis (GPA) annual slopes and SD-tVEP abnormality was assessed to determine whether a single VEP test might help to identify eyes more prone to progressive visual field (VF) loss.

Results

One hundred and thirty-three eyes of 84 patients (mean age 68 years) were analyzed. The SD-tVEP abnormality increased proportionately with severity of VF loss under high-contrast (Hc) test conditions for both latency (p = 0.001) and amplitude (p < 0.01). The HVFA progression analysis printouts existed for 91 eyes (mean 12.3 fields per eye/range 5-18). Nearly three-quarters (72.5%) of eyes with mean annual HVFA progression >0.7 dB/year (n = 29) had single-visit VEP latency abnormalities. Fewer than half (46.7%) of the remainder (n = 62) showed latency abnormality. Mean progression for eyes with abnormal vs normal VEP latency was -0.87 ± 0.3 dB/year vs -0.32 ± 0.4 dB/year.

Conclusion

Diopsys NOVA-LX Hc latency abnormality shows strong association with VF loss among a diverse population of clinical patients undergoing active treatment for chronic glaucoma, and appears likely to afford clinically useful trend-detecting test.

Clinical significance

The SD-tVEP has the potential to serve as a single-visit clinical indicator to identify glaucoma patients at high risk for VF progression.

How to cite this article: Trevino R, Sponsel WE, Majcher CE, Allen J, Rabin J. Association of Diopsys® Short-duration Transient Visual Evoked Potential Latency with Visual Field Progression in Chronic Glaucoma. J Curr Glaucoma Pract 2018;12(1):29-35.

Pre-emptive Intracoronal Radiolucency in First Permanent Molar

Pre-eruptive intracoronal radiolucency (PECR) is characterized by the existence of a radiographic radiolucent area inside the coronal dentin prior to dental eruption. It is a rare clinical entity of unknown etiology, usually asymptomatic and diagnosed through routine radiographs. The aim of this article is to report the treatment of a PECR in an 8-year-old girl. Surgical procedure to expose the crown was conducted; upon tooth eruption, the radiolucent lesion was accessed and the tooth was restored. The case has an 18-month follow-up and emphasis on aspects linked to diagnosis and clinical approach was discussed. How to cite this article: Ilha MC, Kramer PF, Ferreira SH, Ruschel HC. Pre-eruptive Intracoronal Radiolucency in First Permanent Molar. Int J Clin Pediatr Dent 2018;11(2):151-154.

Application of Optical Coherence Tomography in the Detection and Classification of Cognitive Decline

Aim

This review aims to critically analyze the current literature on the relationship of optical coherence tomography (OCT) measures to cognition and dementia.

Background

Optical coherence tomography, a noninvasive method of imaging neuroretinal layers, and OCT angiography, a highly precise method of examining retinal vasculature, have widely been used to aid in the diagnosis and monitoring of a variety of ocular diseases. There is now an increasing body of evidence relating the structural and microvascular changes of the retina to cognitive impairment.

Review results

In general, several studies have found decreased retinal nerve fiber layer (RNFL) thickness in Alzheimer’s disease (AD) and mild cognitive impairment (MCI) and an association between RNFL thickness and continuous measures of cognitive ability, though findings were inconsistent across studies. In many studies, associations were found for specific regions of the RNFL but not with overall thickness. Studies linking OCT measures to non-Alzheimer’s dementia were lacking, and limited work has been done on persons with past cognitive decline but who remain cognitively normal (the ideal stage at which to target treatment). Common limitations of prior studies include a failure to account for intraocular pressure (IOP) and axial length.

Conclusion

Current research suggests a potential association between retinal findings observed on OCT and cognitive impairment. Methodologically robust research accounting for important covariates and looking at changes in OCT and/ or cognition is needed to better characterize the association between OCT and cognitive ability.

Clinical significance

Further research is warranted to determine whether OCT findings can help identify the etiology of cognitive decline and/or serve as objective markers of AD. If this is the case, OCT may also help identify the presence of disease processes in cognitively normal individuals.

How to cite this article: Lee MJ, Abraham AG, Swenor BK, Sharrett AR, Ramulu PY. Application of Optical Coherence Tomography in the Detection and Classification of Cognitive Decline. J Curr Glaucoma Pract 2018;12(1):10-18.

Epidemiology, Genotype Distribution, Prognosis, Control, and Management of Viral Hepatitis B, C, D, and Hepatocellular Carcinoma in Mongolia

Mongolia is located between Russia and China. The total population of Mongolia as of December 2017 is estimated to be 3.2 million people. According to our previous study results, the prevalence of HBV was 11.8%, and anti-HDV was detected in 4.8% among the HBsAg-positive subjects. Interestingly, most HCV infection is caused by genotype 1b. Among all HBV DNA-positive samples, 98.5% were classified into genotype D, and regarding HDV genotypes, all HDV RNA-positive samples, 100%, were classified into genotype I. The second study is the baseline survey of a Nationwide Cancer Cohort Study. Prevalence of HBsAg was 10.6%. Additionally, HCV infection was observed in 9.9%, and 0.8% were coinfected with HBV and HCV among the general population aged from 10 to 64 years. The third study investigated the population-based prevalence of hepatitis B and C virus in apparently healthy population of Ulaanbaatar city, Mongolia. The anti-HCV prevalence was 9.0%. In addition, the prevalence of HBV was 8.0%. The fourth study is on the prevalence of HCV and coinfections among nurses in a tertiary hospital in Mongolia. The prevalence of HCV was 18.9%. Additionally, HBV infection was observed in 23.1%, and 1.2% were coinfected with HCV and HBV. Mongolia has the highest HCC incidence in the world (78.1/100,000, 3.5* higher than China). As a result, the Mongolia government has launched The National Viral Hepatitis Program, which is a comprehensive program that involves all aspects from prevention to care and disease control to meet a reduction goal for morbidity and mortality due to HBV, HCV, and HDV. Consequently, access to antiviral therapies is now improving in Mongolia. How to cite this article: Baatarkhuu O, Gerelchimeg T, Munkh-Orshikh D, Batsukh B, Sarangua G, Amarsanaa J. Epidemiology, Genotype Distribution, Prognosis, Control, and Management of Viral Hepatitis B, C, D, and Hepatocellular Carcinoma in Mongolia. Euroasian J Hepato-Gastroenterol 2018;8(1):57-62.

Vision Restoration in Glaucoma by Activating Residual Vision with a Holistic, Clinical Approach: A Review

How to cite this article: Sabel BA, Cárdenas-Morales L, Gao Y. Vision Restoration in Glaucoma by activating Residual Vision with a Holistic, Clinical Approach: A Review. J Curr Glaucoma Pract 2018;12(1):1-9.

Intake of Bifidobacterium longum and Fructo-oligosaccharides prevents Colorectal Carcinogenesis

INTRODUCTION

We aimed to investigate the effects of intake of yogurt containing Bifidobacterium longum (BB536-y) and fructo-oligosaccharides (FOS) in preventing colorectal carcinogenesis in healthy subjects, and the preventive effects of short-chain fatty acids (SCFA), whose production was enhanced by the intake of BB536-y and FOS, in human colon cancer cell lines.

MATERIALS AND METHODS

The subjects were 27 healthy persons who were divided into a group taking yogurt containing BB536 (BB536-y group; n = 14) and a group taking yogurt containing BB536 and FOS (BB536-y with FOS group; n = 13) once a day for 5 weeks. The feces were sampled before and after the intake to analyze the amount of SCFA in the feces and the profile of intestinal flora, such as putrefactive bacteria and Bacteroides fragilis enterotoxin (ETBF). Subsequently, human colon cancer cell lines (DLD-1 cells, WirDr cells) were cultured in the presence of SCFA (butyric acid, isobutyric acid, acetic acid) in order to evaluate the cell growth-inhibitory activity of SCFA (WST-8 assay) by calculating the IC50 value from the dose-response curve.

RESULTS

Intake of BB536-y increased the total amount of SCFA in the feces and significantly suppressed the detection rate of ETBF and growth of putrefactive bacteria. Intake of BB536-y with FOS was associated with a higher Bifidobacterium detection rate than that of BB536-y alone. The contents of butyric acid, isobutyric acid, and acetic acid, namely, of SCFA, were also decreased. Analysis of the results of culture of DLD-1 cells and WirDr cells in the presence of butyric acid, isobutyric acid, and acetic acid revealed that each of the substances showed significant cell growth-inhibitory activity, with the activity being the highest for butyric acid, followed by that for isobutyric acid and acetic acid.

CONCLUSION

These findings suggest that intake of both BB536-y and BB536-y with FOS prevents colorectal carcinogenesis.How to cite this article: Ohara T, Suzutani T. Intake of Bifidobacterium longum and Fructo-oligosaccharides prevents Colorectal Carcinogenesis. Euroasian J Hepato-Gastroenterol 2018;8(1):11-17.

Improving Glaucoma Surgical Outcomes with Adjunct Tools

Conventional glaucoma surgeries, such as trabeculectomy and glaucoma drainage device (GDD) surgery, have been enhanced by surgeons to improve outcome and decrease complications. Over the last two decades, adjuncts, such as collagen matrix implants, fibrin adhesives, and amniotic membrane transplantation (AMT) have been found to be effective in modulating fibrosis and scarring during the wound-healing process, reducing postoperative inflammation, and repairing bleb leakage or conjunctival erosion. The use of these tools provides several advantages when used in trabeculectomy, GDD surgery, and surface reconstruction associated with glaucoma surgery complications. Their use will be discussed in this review. How to cite this article: Lu LJ, Hall L, Liu J. Improving Glaucoma Surgical Outcomes with Adjunct Tools. J Curr Glaucoma Pract 2018;12(1):19-28.

Screening of Esophageal Varices by Noninvasive Means in Chronic Liver Disease

Introduction

Noninvasive assessment of esophageal varices (EV) decreases the medical and financial burden related to screening and helps in the management of patients with chronic liver diseases (CLDs). In this study, our aim was to assess the utility of the platelet count/spleen diameter index for the noninvasive evaluation of EV.

Materials and methods

In this cross-sectional observational study, a total of 100 CLD patients underwent screening endoscopy for EV in Medicine and Gastroenterology Department, Sylhet MAG Osmani Medical College Hospital, Sylhet, Bangladesh. Platelet count/spleen diameter ratio was assessed in all patients and its diagnostic implication was calculated.

Results

Upper gastrointestinal endoscopy revealed that 45 (45.0%) patients had medium EV followed by 27 (27.0%) that had small EV and 19 (19.0%) patients had large EV. Receiver operator characteristic (ROC) curve was constructed using platelet count/spleen index, which gave a cut-off value of >905. The validity of platelet count/spleen index evaluation of CLD was: Sensitivity 92.3%, specificity 66.7%, accuracy 90.0%, positive predictive value (PPV) and negative predictive value (NPV) were 96.6 and 46.2% respectively. True positive was 84 cases, false positive 3 cases, false negative 7 cases, and true negative 6 cases. If we consider cut-off value as 909 in the evaluation of EV in CLD, then true positive was 85 cases, false positive 3 cases, false negative 6 cases, and true negative 6 cases. From this, by calculation, sensitivity was 93.4%, specificity 66.7%, accuracy 91%, PPV 96.6%, and NPV 50%.

Conclusion

The platelet count/spleen index may be proposed to be a safe and reliable mean of screening of EV in CLD patients; however, case-control study would be required to validate this.

How to cite this article: Hossain E, Ahammed F, Saha SK, Foez SA, Rahim MA, Noor-e-Alam SM, Abdullah AS. Screening of Esophageal Varices by Noninvasive Means in Chronic Liver Disease. Euroasian J Hepato-Gastroenterol 2018;8(1):18-22.

Liver Disease in Singapore

Liver disease is a significant health issue in Singapore. In the Singapore Burden of Disease Survey, liver cancer and liver cirrhosis contributed 3.2 and 0.9% of years of life lost (YLL) out of 182,753 YLL respectively. Liver cancer was ranked 8th and liver cirrhosis was ranked 20th in YLL. Liver cancer is the 5th most common cancer in males, and has an age-adjusted rate of 17.6 per 100,000 population. The underlying etiology of liver cirrhosis is chronic hepatitis B (CHB) in 63.3%, alcohol in 11.2%, cryptogenic in 9%, and chronic hepatitis C (CHC) in 6.9%. The overall seroprevalence rate of CHB is 3.6%, while CHC is approximately 0.1%. The trend in prevalence of liver cancer is gradually reducing as is CHB. However, less is known about alcoholic liver disease and fatty liver disease and there is some evidence that the latter is increasing. Singapore has a multilayered health care system designed to provide basic health care needs to the population. There are various schemes available that provide subsidized and assisted health care for treatment of hepatitis B and C as well as liver transplantation. Health policy with regard to a national action plan has not yet been developed and there is room for health care specialists, government and nongovernment agencies to work together to tackle liver disease in Singapore. How to cite this article: Muthiah M, Chong CH, Lim SG. Liver Disease in Singapore. Euroasian J Hepato-Gastroenterol 2018;8(1):66-68.