Evaluation of RURS elbow guard in the management of thumb-sucking habit in children with and without intellectual disability

BACKGROUND

Digit sucking is a common oral habit among many children, which involves placing the thumb/finger into the mouth, which can cause malocclusion in mixed and permanent dentition.

AIM

To evaluate the efficacy of the RURS elbow guard in the management of thumb-sucking habits in children with intellectual disabilities and those without in terms of the mean duration of appliance therapy. The secondary objective was to compare the RURS elbow guard with an intraoral crib in healthy children (without intellectual disabilities) to manage the habit of thumb-sucking.

DESIGN

Children with intellectual disabilities and those without between the age of 4 and 16 years were included in the study and categorised into three groups, namely group I (50 normal children; intraoral crib appliance), group II (50 normal children; RURS elbow guard) and group III (50 children with intellectual disabilities; RURS elbow guard).

RESULTS

The mean duration of appliance therapy for groups I, II and III were 200.20 ± 20.43 days, 204.34 ± 20.56 days, and 218.43 ± 15.66 days, respectively (p < 0.001). The differences in the mean duration between group I and group II were statistically non-significant, with statistically significant differences between group I and group III (p < 0.001) and between group II and group III (p < 0.05).

CONCLUSION

The RURS elbow guard was found to be an efficient appliance in treating thumb-sucking among children who had mild to moderate intellectual disabilities. RURS elbow guard was equally efficient as an intraoral crib appliance in managing thumb-sucking habits in children without intellectual disabilities.

Needle in a haystack: Intraoperative breakage of pediatric minimal access surgery instruments

The search for tiny bits of broken pediatric minimal access surgery (MAS) instruments in an operative field is akin to the search for a needle in a haystack. With the extension of MAS to the pediatric age group, instruments are becoming smaller and equitably more prone to breakage. When breakages occur, retrieval, especially in the pediatric abdominal cavity, can be challenging. Inability to do so would affect patient safety and also lead to a web of medico legal and ethical issues. We present two cases of intraoperative breakage: An eyeless 3-0 polyamide suture needle and a 2-mm grasper blade both of which were successfully retrieved and fortuitously escaped becoming retained surgical items.

Observational study to evaluate the safety and efficacy of saroglitazar in Indian diabetic dyslipidemia patients

Saroglitazar is a dual PPAR α/γ agonist approved in India for the management of diabetic dyslipidemia.

AIMS

The objective of this study was to evaluate the safety and efficacy of saroglitazar 4 mg once daily in clinical practice.

METHODS

This was an observational, multicenter, single-arm study. Patients with type 2 diabetes (with on-going antidiabetic medication), age above 18 years, and triglycerides ≥200 mg/dL were included.

RESULTS

A total 2804 patients with a mean duration of diabetes 6.29 yrs were included in this analysis. The baseline demographic profile was: mean age of 53 yrs, mean body weight 72.3 kg and mean BMI of 27 kg/m(2). 62.5% patients were male and 57.8% were reported to be on statin therapy at baseline. All 2804 patients were on antidiabetic medications with 15.4% patients on monotherapy and rest were on two or more than two antidiabetic medications at baseline. The baseline triglycerides and HbA1C values were 312.3 mg/dL and 8.3% respectively. At 3 months follow-up, use of saroglitazar 4 mg led to significant reduction in TG (35.8%), LDL-C (16.4%), total cholesterol (19%) and non-HDL-C (23.4%). Addition of saroglitazar to baseline antidiabetic medications showed a significant 0.9% absolute reduction in HbA1c with significant improvement in fasting and post prandial plasma glucose. No serious adverse events, alteration in liver or renal enzymes and edema or weight gain were reported.

CONCLUSION

Saroglitazar is a potential therapeutic option in type 2 diabetic patients with high TG levels, not controlled by statins, for comprehensive control of lipid and glycemic parameters with acceptable safety profile.

Wetting characteristics of addition silicon materials subjected to immersion disinfection--an in-vitro study

An in-vitro study was conducted to assess wetting characteristic of four brands of addition silicon materials subjected to immersion disinfection using four different disinfectants. Among the non-disinfected specimens, the lowest contact angle was recorded for Aquasil ultra (21.63), followed by Imprint II (29.06), Aquasil LV (44.10) and Take 1 (44.55). While 5.25% phenol increased the contact angle of all the silicon materials; 0.05% iodophor increased the angle of Take 1 and Imprint II and 0.5% sodium hypochlorite increased the angle of Imprint II and decreased for Aquasil ultra. However, 2% glutaraldehyde did not significantly change the contact angle of any of the four impression materials.

Orofacial haemangiopericytoma--a rare case

Haemangiopericytoma is an uncommon vascular tumour that originates from small pericapillary spindle-shaped cells. Clinical diagnosis of such a lesion is an extremely challenging task because there are very few detailed reports of such lesions and one would hardly think of a diagnosis such as haemangiopericytoma while examining a lesion. We report here a case of haemangiopericytoma arising from the infratemporal fossa involving the orbit, the lateral wall of the nasal cavity, the maxillary sinus, the maxillary alveolar process and the ethmoidal sinus. The clinical features, radiological findings and differential diagnoses to be considered, and the available treatment options, are discussed in this case report.

Mesocolic hernia: an unusual internal hernia

Internal hernia may be either congenital or acquired. Its incidence has been reported to be 1-2%. Herniation may be persistent or intermittent. Internal hernia is a rare cause of small bowel obstruction with a reported incidence of 0.2-0.9%. The most common type is paraduodenal. Less common types include mesocolic hernia, which occurs following abdominal surgery. We report mesocolic hernias in two young patients, which presented as small bowel obstruction without any prior abdominal surgery.

A comparative study of the efficacy of topical negative pressure moist dressings and conventional moist dressings in chronic wounds

Aim: To assess the efficacy of topical negative pressure moist wound dressing as compared to conventional moist wound dressings in improving the healing process in chronic wounds and to prove that negative pressure dressings can be used as a much better treatment option in the management of chronic wounds. Materials and Methods: This is a prospective comparative study of data from 112 patients with chronic wounds, of which 56 patients underwent topical negative pressure dressings (17 diabetic, 10 pressure sores, nine ischemic, two varicose, 10 post-infective raw areas and eight traumatic - six had bone exposed, two orthopaedic prosthesis exposed). The remaining 56 patients underwent conventional moist dressings (20 diabetic, two ischemic, 15 pressure sores, three varicose, eight post-infective raw areas and eight traumatic - five had bone exposed, three orthopaedic prosthesis exposed). The results were compared after 10 days. The variables compared were, rate of granulation tissue formation as a percentage of ulcer area covered, skin graft take up as the percentage of ulcer surface area and duration of hospital stay. The variables were compared using Unpaired Student′s t test. A " P" value < 0.05 was considered significant. Results: Out of 56 patients who underwent topical negative pressure dressings, six (10.71%) were failures, due to failure in maintaining topical negative pressure due to defective sealing technique; these were included into the study group. After 10 days, the mean rate of granulation tissue formation was 71.43% of ulcer surface area. All these 56 cases underwent split-thickness skin grafting. The mean graft take-up was 79.29%. The mean hospital stay was 32.64 days. In the remaining 56 patients, the mean rate of granulation tissue formation was 52.85% of ulcer surface area. The mean graft take-up was only 60.45% of the total ulcer surface area. The mean hospital stay was 60.45 days. Conclusion: To conclude, topical negative pressure dressings help in faster healing of chronic wounds and better graft take-up and reduce hospital stay of these patients.

Oral habits in children--a prevalence study

This epidemiological study was conducted upon 4,590 school children to find the prevalence of oral habits in Mangalore in relation to their age and sex and to find the correlation, if any, between the habits and the malocclusion status. We noted that 29.7% of the population had habits of which 3. 1% had digit sucking, 4.6% mouth breathing, 3.02% tongue thrusting, 6.2% bruxism, 6% lip/cheek biting, 12.7% nail biting, 9.8% pencil biting and 0. 09% masochistic habits respectively. Digit sucking, pencil biting and tongue thrust were highly prevalent among Group 1 (3-6 years) children. Mouth breathing and bruxism were significant in Group 2 (7-12 years) cases whereas lip/cheek biting and nail biting were more common in Group 3 (13-16 years) cases. Digit sucking, tongue thrust, mouth breathing and bruxism were more prevalent among the boys whereas lip/cheek biting, nail biting and pencil biting were more prevalent among the girls. 28.95% of the children in Group 2 and 3 with habits had malocclusion. There was a significant correlation between class I type 2, class II div 1 and tongue thrust and mouth breathing whereas children with digit sucking showed a high correlation with class I type 2 malocclusion.