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Background and Aim of Study: Early childhood caries is a multifactorial disease process affecting children below 71 months of age and continues to be a global health problem. Stainless steel crowns (SSCs) are widely used and are very popular in pediatric dentistry due to its superiority and durability when compared with multisurface amalgam restorations. However, one of the major disadvantages with these crowns is the poor esthetics. Parents often request for a more esthetic alternative to the SSC. Zirconia crowns are one of the tooth-colored full crown restorations currently available for use in primary teeth. These are available as both preformed and custom-made crowns and show excellent esthetics. However, these require extensive tooth preparation with a subgingival finish lines, which would cause gingival trauma and bleeding during the preparation. The present study uses intraoral scanners for making the custom-made zirconia crowns, which will avoid the conventional impressions. Currently, there are no studies available in pediatric dentistry regarding CAD-CAM crowns. Hence, there is a need for the study. Aim: The aim of this study is to clinically evaluate the performance of preformed SSCs and custom-made zirconia crowns in primary molars. To elicit parental and patient satisfaction with respect to preformed SSCs and custom made zirconia crowns and to radiographically compare the interproximal bone height for 1 year. Methods: The patients were selected with purposive sampling. The tooth of interest was prepared according to the crown it would receive. The upper and the lower arch of the tooth receiving custom-made zirconia crown was scanned using an intraoral scanner. The crowns were cemented using Type 1 glass ionomer cement (GIC) (SSC) and resin modified GIC (custom-made zirconia crown). After the crown placement, the patient and the parent's satisfaction was scaled regarding the time taken, comfort, cost of crown, appearance of crown, etc., using a 5-point Likert scale. A baseline radiograph was taken after crown placement. The patient was recalled every 3 months till 1 year for evaluation (loss of retention, loss of proximal contact, gingival inflammation, opposing tooth wear, and marginal integrity). At the end of 1 year, radiographs were taken to check the interproximal bone. Results: After 1 year evaluation of custom-made zirconia crowns and preformed SSCs in primary molars, it was shown that both SSC and zirconia crowns showed good gingival scores but zirconia crown was better than SSC in improving the gingival health. SSCs showed better results with respect to the opposing tooth wear and marginal adaptability. Parents as well as patients preferred a tooth-colored crown as a treatment option. Conclusion: Custom-made zirconia crowns are comparable to the preformed SSCs and they show better gingival scores and excellent color match.
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Background: During the past decade, parental involvement for the selection of full coronal restorations for the primary anterior teeth of their children has been increased. Two most common anterior aesthetic full coronal restorations, the strip crowns and the preformed zirconia crowns, are available options. Aim: The aim of this study is to compare parental satisfaction with strip crowns and preformed primary anterior zirconia crowns over 1 year in 3–5 years old children. Materials and Methods: Forty maxillary primary incisors were restored by either strip crown or zirconia crown in 24 children. Permuted block randomization method was used for the allocation of participants. Twenty-four parents participated were recalled to fill the questionnaire over 1 year. One parent dropped out at the end of 1 year. Data were analyzed using the t-test and Chi-square test. P < 0.05 considered statistically significant. Results: Parents were satisfied with both types of restorations. Statistically significant relationship was found between overall satisfaction and durability (P = 0.004) with strip crowns and with the color (P = 0.043) in the zirconia crowns. The parents with the lower satisfaction levels with the durability of strip crowns and color of zirconia crowns rated high overall satisfaction. Conclusion: Parental overall satisfaction was higher for preformed primary anterior zirconia crowns than strip crowns. Almost equal number of parents was satisfied with all other parameters except for durability, which was more for zirconia crowns.
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Objective: To evaluate the efficacy and safety of Drotaverine hydrochroride in children with recurrent abdominal pain. Design: Double blind, randomized placebo-controlled trial. Setting: Pediatric Gastroenterology clinic of a teaching hospital. Participants: 132 children (age 4-12 y) with recurrent abdominal pain (Apley Criteria) randomized to receivedrotaverine (n=66) or placebo (n=66) orally. Intervention: Children between 4-6 years of age received 10 mL syrup orally (20 mg drotaverine hydrochloride or placebo) thrice daily for 4 weeks while children >6 years of age received one tablet orally (40 mg drotaverine hydrochloride or placebo) thrice daily for 4 weeks. Outcome Measures: Primary: Number of episodes of pain during 4 weeks of use of drug/placebo and number of pain-free days. Secondary: Number of school days missed during the study period, parental satisfaction (on a Likert scale), and occurrence of solicited adverse effects. Results: Reduction in number of episodes of abdominal pain [mean (SD) number of episodes 10.3 (14) vs 21.6 (32.4); P=0.01] and lesser school absence [mean (SD) number of school days missed 0.25 (0.85) vs 0.71 (1.59); P=0.05] was noticed in children receiving drotaverine in comparison to those who received placebo. The number of pain-free days, were comparable in two groups [17.4 (8.2) vs 15.6 (8.7); P=0.23]. Significant improvement in parental satisfaction score was noticed on Likert scale by estimation of mood, activity, alertness, comfort and fluid intake. Frequency of adverse events during follow-up period was comparable between children receiving drotaverine or placebo (46.9% vs 46.7%; P=0.98), Conclusion: Drotaverine hydrochloride is an effective and safe pharmaceutical agent in the management of recurrent abdominal pain in children.
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Objective: To evaluate parental satisfaction with communication provided by health care personnel at Lady Ridgeway Hospital and to determine if differences existed in selected groups. Study design: A prospective descriptive cross-sectional study. Study setting: All six medical wards of Lady Ridgeway Hospital for Children, Colombo Study population: Patients aged 6 months to 14 years with a single hospitalization for a period of five or more days or with two or more hospitalization episodes for the same illness were serially enrolled until the calculated sample size of 458 were recruited. Method: Parental satisfaction with communication provided by doctors, nurses & physiotherapists was evaluated using a pretested questionnaire. Demographic details and parental knowledge about child’s illness were recorded by an interviewer not involved in the care of the child. Richards Scale (a five point scoring system) assessed parental satisfaction regarding ‘establishing rapport’, ‘health advice received’, ‘caring attitude towards patient’ & ‘moral support provided’. Results: Of 458 parents interviewed 95% were mothers. All received care from doctors and nurses but only 49 had met physiotherapists. Forty-one (9%) had more than 5 admissions for chronic illnesses, 53% were first admissions and 38% recurrent admissions. Hospital stay ranged from 5 to 21 days. Mean age of patients was 4.5 years. Male: female ratio was 3:2. Type of illnesses ranged from acute infections to chronic illness and disabilities. Majority of respondents were educated up to GCE O/L and 8% were graduates. Doctors were rated highest for their ability to establish rapport at initial encounter, and lowest for their ability to inform parents of prognosis and follow-up management plans. Time taken by doctors for questions of parents and advice given about the illness were also considered inadequate. There was overall satisfaction regarding a caring attitude by all three categories of personnel but physiotherapists were rated best in this aspect, doctors next and nurses the lowest. There was no significant variation in the demographic variables of ethnicity or gender and communication received. Parental knowledge on illness on the day of discharge was better in recurrent admissions although there was no significance (Mean score in first admissions 24.32, recurrent admissions 25.21). Conclusion: There was overall satisfaction among parents at LRH but we found several aspects of communication that need improvement for delivery of better quality in-door care.
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El objetivo de este estudio es evaluar dimensiones relativas al contexto familiar y laboral, y examinar su contribución al nivel de estrés asociado a la paternidad. Se analizó el papel desempeñado por la percepción de competencia, tanto del padre como de la madre, una vez controladas algunas características de ambos contextos. Se realizaron análisis con la información obtenida de 74 progenitores que, en el momento de la evaluación, disponían de un puesto laboral y cuidaban al menos a un menor en edad escolar. Los resultados indicaron que la dedicaciónlaboral, el número de hijos y la percepción de dificultad en el cuidado del menor, fueron las variables más robustas para explicar el estrés parental. Asimismo, los análisis mostraron que una evaluación positiva y optimista del papel que la persona desempeña en la educación y el cuidado de sus hijos, tendió a atenuar la aparición de estrés parental.
The aim of this study is to explore the role of some dimensions related with labor and family context, and examine their influence to the stress level associated with parenthood. Special attention was given to the perceived competence as a parent after controlling different characteristics from both contexts. Several analyses were performed with the information obtained from 74 active-working parents responsible for at least one school-aged child. The results indicated that the work time, the number of children at home and the perception of difficulty about child caring were the most important variables for explaining the parental stress. Furthermore,analysis showed that a positive and optimistic perception of the parental role and child care helped to mitigate the appearance of parental stress.
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Humans , Stress, Physiological , Family RelationsABSTRACT
BACKGROUND: Potential benefits from parental presence during induction of anesthesia (PPIA) include reducing the need for preoperative sedatives and avoiding fear and anxiety that may occur on separation to the operating room (OR). In addition, the purpose of PPIA includes concern about possible adverse reactions of parents. The purpose of this study was to evaluate parental satisfaction after PPIA. METHODS: Subjects were obtained by approaching all parents of children from 1 to 7 years admitted for elective surgery. Ninety four pediatric patients were accompanied by their parents to the OR and then their anxiety level was checked. For anesthetic induction, intravenous thiopental sodium or sevoflurane with a mask was administrated. A questionnaire was given to parents after anesthesia and the operation to check the satisfaction of their presence. RESULTS: Over eighty eight percent of parents were satisfied with their presence with their children. However, there were no significant differences between parental satisfaction and the anxiety level of children, type of anesthetic induction or attempts of venipuncture. CONCLUSIONS: We concluded that the participation in induction of anesthesia in pediatrics may be effective in not only relieving anxiety of children but also increasing parental satisfaction.