The impact of weight for age on survival in acute lymphoblastic leukemia: Report from a tertiary care center in North India.

BACKGROUND: Undernutrition is considered to have a negative impact on survival in children with malignancies. The objective of this retrospective analysis was to evaluate the morbidity pattern and outcome of therapy in undernourished (UN) children with acute lymphoblastic leukemia. METHODS: A retrospective analysis of impact of weight for age was performed in children treated for ALL. The IAP & CDC criteria for undernutrition were used in the two different time periods of analysis. RESULTS: There were two cohorts in the study: Between 1995 and 2005, 360 children were evaluated where the weight for age was classified using the Indian Academy of Pediatrics criteria for undernourishment (Group A). Group B of the study included 373 children treated from 2007 to 2011, who were graded as per the Centers for Disease Control criteria for weight for age. In Group A, 35% of the children were malnourished at presentation. The morbidity and supportive care needed in the well‑nourished and UN group were similar. The event‑free survival and mortality were similar in both groups. Analysis of Group B showed an overall survival of 62.6% with a greater survival in children with a weight of ≥10th centile for age compared to children at the <10th centile, (P = 0.026) with a higher mortality (P = 0.011) in the UN group. CONCLUSION: Our data have yielded conflicting results. The older cohort did not show a significant difference in survival using malnutrition as a risk factor. However, in the subsequent cohort, a difference in survival was noted. This could be due to the reason that different criteria for classification of undernutrition were applied in the two groups. This analysis lays the foundation for a future prospective analysis to evaluate nutrition as an independent risk factor nutrition as an independent risk factor in the outcome of childhood malignancies.

Serum and salivary sialic acid as a biomarker in oral potentially malignant disorders and oral cancer.

Background: Aberrant glycosylation is the universal feature of cancer and components of various glycoconjugates, such as sialic acid is found to rise in various malignancies. The objective of this study was to evaluate the serum and salivary sialic acid in oral potentially malignant disorders (OPMD) and oral cancer (OC) to investigate the possibility of using this as a diagnostic marker. Materials and Methods: The study included 85 subjects, who were grouped as control (30), OPMD patients (25), and oral cancer patients (30). Serum and unstimulated whole saliva was collected from subjects of all groups and sialic acid estimation was done using spectrophotometry. The results were tabulated and analyzed statistically. Results: The mean serum sialic acid levels in normal, OPMD, and oral cancer group were 7.515, 19.620, and 55.235 mg/dL, respectively, whereas the levels of salivary sialic acid were 1.5113, 2.3302, and 9.0304 mg/dL, respectively. A very highly significant rise (P < 0.005) in serum and salivary sialic acid was observed in the study subjects compared with that of the control. Conclusions: The present study showed a significant and gradual increase in serum and salivary sialic acid from control to oral potentially malignant disorders to oral cancer. From this study we can suggest that sialic acid can be used as a reliable biomarker. As this monosaccharide is observed in saliva in detectable quantity, saliva can be used as a diagnostic medium for screening and early detection of oral cancer.

Calcifying Epithelial Odontogenic Tumor (Ceot).

Calcifying epithelial odontogenic tumor is a rare benign epithelial odontogenic lesion that comprises from 0.2% to 1.1 of all odontogenic tumors. In the past a number of different names have been given to this lesion, such as calcifying ameloblastoma, cystic complex odontoma, uncommon ameloblastoma with calcifications and others. There is a need to study and explore various aspects of this tumour, this article gives a broad idea of the various aspects of this tumor and which aspect of this tumour needs more investigation

Children's behavior pattern and behavior management techniques used in a structured postgraduate dental program.

Background : Anxiety and fear remain the primary emotion of a child entering a dental office. Successful pediatric dentistry depends not only on the dentist's technical skills, but also on his ability to acquire and maintain a child's cooperation. Methods: A retrospective study was done using the case records of 247 children, to evaluate their behavior patterns, based on the Wright's modification of Frankl's behavior rating scale. Various behavior management techniques like the tell-show-do, reinforcements, voice control, and hand over mouth exercise used in the postgraduate section of the Department of Pediatric Dentistry, Meenakshi Ammal Dental College, Chennai, India, were also evaluated in this study. Results: Behavior of the children improved on the subsequent visits. Tell-show-do was the most common behavior management technique used and more aversive management techniques were rarely used in managing children in the dental office. Conclusion: Proper assessment of children's behavior helps the dentist to plan appointments and render effective and efficient dental treatment. Appropriate use of management techniques can improve the child's behavior in subsequent dental visits.

Quantitative assessment of IgA levels in the unstimulated whole saliva of caries-free and caries-active children.

Saliva is commonly referred to as the blood stream of the oral cavity. It has many functions, one of the major functions being protection of teeth against dental caries. There are many components in saliva, each one having a specific role in the prevention of dental caries. The composition of saliva varies from individual to individual and in the same individual it varies between the glands. The composition of whole saliva, especially when unstimulated, has gained much interest, because it is this which constantly bathes the teeth. The aim of this study was to determine the IgA levels in the unstimulated whole saliva of caries-free and caries-active children aged 3-6 years and to correlate its role in protection of the tooth against dental caries.

A comparative clinical trial evaluating efficacy and safety of fixed dose combination of nimesulide (100 mg) and racemethionine (50 mg) (namsafe) versus reference drug (nimesulide) and other NSAIDs in the treatment of osteoarthritis.

Sixty consecutive patients of either sex, above the age of 18 years with symptoms of osteo-arthritis participated in this open, randomised, comparative clinical trial carried out over 3 months. Patients were randomised into 5 groups: Group A (paracetamol 500 mg), group B (ibuprofen 400 mg), group C (nimesulide 100 mg), group D (diclofenac 50 mg), and group E [fixed dose combination of nimesulide (100 mg) and racemethionine (50 mg) (namsafe)]. The efficacy parameters were pain intensity, pain on movement, tenderness and swelling. The liver function tests were carried out to estimate the effect of the drugs on the hepatic profile. The Wilcoxon signed rank test and the Kruskal Wallis (one way ANOVA) test were utilised to evaluate the significance of the change from baseline to the final visit. The treatment with combination of nimesulide and racemethionine gave the best relief from tenderness. With respect to pain intensity and pain movement, combination of nimesulide and racemethionine with nimesulide efficacy was comparable. Theliver function test data at the end of 6 months show that combination of nimesulide and racemethionine treated group showed the least rise in the serum asparatate aminotransferase and alanine aminotransferase levels, whereas in the other treatment groups it was very pronounced. Thereby, combination of nimesulide and racemethionine is found to be better for the long-term treatment of osteo-arthritis in patients. The combination of the two agents, namely nimesulide and racemethionine is expected to augment the safety profile of nimesulide, without influencing the effectiveness of the analgesic agent, i.e., nimesulide.

Effect of oil pulling on Streptococcus mutans count in plaque and saliva using Dentocult SM Strip mutans test: a randomized, controlled, triple-blind study.

BACKGROUND: Oil pulling has been used extensively for many years, without scientific evidence or proof, as a traditional Indian folk remedy to prevent teeth decay, oral malodor, bleeding gums, dryness of throat and cracked lips, and for strengthening the teeth, gums, and jaws. AIMS: The aim of this study was to evaluate the effect of oil pulling with sesame oil on the count of Streptococcus mutans in plaque and saliva of children, using the Dentocult SM Strip mutans test, and to compare its efficacy with that of chlorhexidine mouthwash. MATERIALS AND METHODS: Twenty age-matched adolescent boys were selected based on information obtained through a questionnaire. They were divided randomly into two groups: the control or chlorhexidine group (group I) and the study or oil pulling group (group II); there were ten subjects in each group. Plaque and saliva samples were collected from all the 20 subjects on the strips from the Dentocult SM kit and, after incubation, the presence of S. mutans was evaluated using the manufacturers' chart. The study group practiced oil pulling with sesame oil and the control group used chlorhexidine mouthwash for 10 min every day in the morning before brushing. Samples were collected from both groups after 24 h, 48 h, 1 week, and 2 weeks and the efficacy of oil pulling was compared with that of chlorhexidine mouthwash. RESULTS: There was a reduction in the S. mutans count in the plaque and saliva samples of both the study and the control groups. The reduction in the S. mutans count in the plaque of the study group was statistically significant after 1 and 2 weeks (P=0.01 and P=0.008, respectively); the control group showed significant reduction at all the four time points (P=0.01, P=0.04, P=0.005, and P=0.005, respectively, at 24 h, 48 h, 1 week, and 2 weeks). In the saliva samples, significant reduction in S. mutans count was seen in the control group at 48 h, 1 week, and 2 weeks (P=0.02, P=0.02, P=0.008, respectively). CONCLUSION: Oil pulling can be used as an effective preventive adjunct in maintaining and improving oral health.

Effect of fluoride varnish on Streptococcus mutans counts in plaque of caries-free children using Dentocult SM strip mutans test: a randomized controlled triple blind study.

Dental caries is one of the most prevalent infectious diseases and although of multifactorial origin, Streptococcus mutans is considered the chief pathogen in its development. Fluoride is one of the most effective agents used for the reduction of dental caries apart from oral hygiene maintenance. AIMS: The aim of this study was to estimate the counts of Streptococcus mutans and to evaluate the effect of Fluor Protector fluoride varnish on these counts in the plaque of caries-free children using Dentocult SM Strip Mutans. MATERIALS AND METHODS: Thirty caries-free subjects were selected for the study based on the information obtained from a questionnaire and were randomly assigned to the control group consisting of ten subjects and the study group consisting of twenty subjects. Plaque samples were collected on the strips from the Dentocult SM kit and after incubation, the presence of Streptococcus mutans was evaluated using the manufacturer's chart. The study group was subjected to a Fluor Protector fluoride varnish application following which the samples were collected again after 24 hours. RESULTS: The average Streptococcus mutans counts in the primary dentition of caries-free children before and after the application of Fluor Protector fluoride varnish were 10(4)-10(5) colony forming units (CFU)/ml and <10(4) CFU/ml respectively. CONCLUSION: The results showed that the study group had a statistically significant reduction in the plaque Streptococcus mutans counts than the control group.

Noonan syndrome: a case report.

Noonan syndrome is a developmental disorder characterized by facial dysmorphia, short stature, cardiac defects and skeletal malformations. It may be sporadic or inherited as an autosomal dominant or recessive trait and occurs, one in 1,000-2,500 children. This is a case report of a 13 year-old girl who was referred by a general dental practitioner to a pediatric dentist for management. Full mouth dental rehabilitation was done and the child was brought to a dental institution for correction of orofacial and occlusal defects. Multidisciplinary treatment is the key to success in managing children with Noonan syndrome and the pediatric dentists play an important position to lead the health team.

Spontaneous closure of midline diastema following frenectomy.

Maxillary midline diastema is a common aesthetic problem in mixed and early permanent dentitions. The space can occur either as a transient malocclusion or created by developmental, pathological or iatrogenical factors. Many innovative therapies varying from restorative procedures such as composite build-up to surgery (frenectomies) and orthodontics are available. Although literature says every frenectomy procedure should be preceded by orthodontic treatment, we opted for frenectomy technique without any orthodontic intervention. Presented herewith is a case report of a 9-year-old girl with a high frenal attachment that had caused spacing of the maxillary central incisors. A spontaneous closure of the midline diastema was noted within 2 months following frenectomy. The patient was followed up for 4 months after which the space remained closed and there was no necessity for an orthodontic treatment at a later stage.

A clinical profile to assess the potential risk factors for cleft lip and palate.

Cleft lip and palate is one of the most common malformations in man. Although the subject of a great deal of investigation, etiologic factors contributing to these congenital deformities remain largely unknown. Various factors like race, sex, parental age at the time of conception etc. have been listed as the exogenous factors. This article strives to project any significant relationship of these factors to cleft lip and cleft palate.

Endodermal sinus tumor of vulva (a case report).

An unusual case of endodermal sinus tumor (EST) of the ovary at an extragonadal site-vulva, in an unmarried female of 25 yr is reported. The patient presented only with a vulval swelling on the right side without any other signs or symptoms. The internal genital organs mainly the ovaries were normal.