Comparative Evaluation of Four Office Reconditioning Methods For Orthodontic Stainless Steel Brackets On Shear Bond Strength - An In Vitro Study.

An invitro study was conducted to determine a simple and effective method for reconditioning stainless steel orthodontic brackets in the orthodontic office. In total, 120 new brackets were direct bonded using light cure composite to extracted human premolar teeth, then debonded and the shear bond strength recorded as a control for the reconditioning process. The debonded brackets were divided into four groups containing 30 brackets each and each group reconditioned using different techniques as follows: (1) roughened with green stone, (2) direct flamed, (3) flamed followed by ultrasonically cleaned, (4) sandblasted. After reconditioning, the brackets were then rebonded to the premolar teeth after the enamel surfaces had been re-prepared, and their bond strengths measured. The results showed that bracket reconditioned by sandblasting had the highest mean shear bond strength among the reconditioning methods tested, indicated that sandblasting was the most effective in removing composite. Brackets that had only been roughened with green stone and direct flamed had the lowest bond strength, followed by that had been flamed followed by ultrasonic cleaning.

Acute respiratory distress syndrome in pediatric intensive care unit.

Objective. To report causes, clinical feature and outcome of children with Acute Respiratory Distress Syndrome (ARDS). Methods. The case records of children admitted with ARDS from June 2003 to June 2006 were retrospectively reviewed and the data collected was analyzed. Results. A total of 17 children were diagnosed as ARDS during study period giving an incidence of 22.7/1,000 admissions. The mean (SD) age was 74.5 (56.32) mo [range 6 -144 mo]. Primary lung pathology contributed to a (53%) cases of ARDS while the rest (47%) had non pulmonary causes.There was not any significant different in mortality between these two groups. Similarly when infections and non infections conditions were considered separately there was no difference in survival. All children were ventilated using Pressure Controlled Ventilation. The mean (SD) duration of ventilation was 5.0 days [range 1-10 days]. The maximum PEEP (SD) used during the course of ventilation was 10 (3.37) cm H2O [range 7- 18], while the maximum PIP (SD) used was 31 (3.75) cm H2O (range 25-36). The overall mortality was 70%; highest in children less than 2 years of age. Majority of the children had shock as the most common comorbid factor and had a high mortality (73.3%). Conclusion. The high incidence and mortality of ARDS and the presence of a large proportion of potentially preventable accidents and poisoning cases in the study group underline the need for health education measures addressing preventive strategies among the rural population.

Electrocardiographic and echocardiographic changes in perinatal asphyxia.

OBJECTIVE: To study the usefulness of cardiac enzymes in evaluating myocardial damage in perinatal asphyxia. METHODS: Thirty term babies with perinatal asphyxia and without any congenital malformations were selected as cases. They were compared with thirty healthy term babies without asphyxia. Myocardial dysfunction was evaluated using clinical, electrocardiography, echocardiography and cardiac enzymes i.e, troponin-T and CK-MB levels. RESULTS: Among the 30 cases 23 had evidence of myocardial involvement while one baby in the control group had ECG evidence compatible with cardiac involvement. Cardiac enzymes were significantly increased in babies with perinatal asphyxia. The mean level of C-troponin-T among cases and controls were 0.22+/-0.28 and 0.003+/-0.018 while CK-MB levels were 121+/-77.4 IU/L and 28.8 +/- 20.2 IU/L respectively. C-troponin-T had higher sensitivity and specificity compared to CK-MB levels. Moreover, C troponin-T levels correlated well with severity and outcome in babies with perinatal asphyxia. CONCLUSION: C-Tropopnin assay is useful in evaluating the severity of myocardial damage and outcome in perinatal asphyxia.

Cardiac enzyme levels in myocardial dysfunction in newborns with perinatal asphyxia.

OBJECTIVE: To study the usefulness of cardiac enzymes in evaluating myocardial damage in perinatal asphyxia. METHODS: Thirty term babies with perinatal asphyxia and without any congenital malformations were selected as cases. They were compared with thirty healthy term babies without asphyxia. Myocardial dysfunction was evaluated using clinical, electrocardiography, echocardiography and cardiac enzymes i.e, troponin-T and CK-MB levels. RESULTS: Among the 30 cases 23 had evidence of myocardial involvement while one baby in the control group had ECG evidence compatible with cardiac involvement. Cardiac enzymes were significantly increased in babies with perinatal asphyxia. The mean level of C-troponin-T among cases and controls were 0.22+/-0.28 and 0.003+/-0.018 while CK-MB levels were 121+/-77.4 IU/L and 28.8 +/- 20.2 IU/L respectively. C-troponin-T had higher sensitivity and specificity compared to CK-MB levels. Moreover, C troponin-T levels correlated well with severity and outcome in babies with perinatal asphyxia. CONCLUSION: C-Tropopnin assay is useful in evaluating the severity of myocardial damage and outcome in perinatal asphyxia.

Multiple organ dysfunction syndrome following single wasp sting.

Wasp stings have been associated with wide variety of reactions from mild local reaction like wheal formation to fatal systemic reactions. Life threatening complications following a single wasp sting are relatively rare and unexpected. We report here the clinical course of a 12 year old child who developed Multiple Organ Dysfunction Syndrome (MODS) and died after a single wasp sting.

Intravenous immunoglobulin therapy of lupus pneumonitis.

Acute lupus pneumonitis in an 11-year-old girl with lupus nephritis is reported. Chest radiograph and arterial blood gas parameters were suggestive of Acute Respiratory Distress Syndrome (ARDS). Definitive pulmonary infection was excluded by investigations and poor clinical response to antibiotics. The respiratory worsening warranted ventilatory support with very high pressures. A trial of intravenous immunoglobulin was given following which there was improvement in the ventilatory requirements by 36 hours. The child was successfully weaned off ventilator and discharged from ICU by day 7. The role of intravenous immunoglobulin during acute life threatening pulmonary emergencies in a case of SLE prompted this clinical brief.

Wilson's disease presenting as respiratory failure.

Wilson's disease in an 11-year-old girl with generalized weakness and respiratory failure is reported. The child succumbed to severe hypokalemia refractory to therapy progressing to acute renal failure and death. This atypical presentation and course prompted this clinical brief.

Triplet repeat polymorphism & fragile X syndrome in the Indian context.

Mental retardation due to fragile X syndrome is one of the genetic disorders caused by triplet repeat expansion. CGG repeat involved in this disease is known to exhibit polymorphism even among normal individuals. Here we describe the development of suitable probes for detection of polymorphism in CGG repeat at FMR1 locus as well as the diagnosis of fragile X syndrome. Using these methods polymorphism at the FMR1 locus has been examined in 161 individuals. Ninety eight patients with unclassified mental retardation were examined, of whom 7 were found to have the expanded (CGG) allele at the FMR1 locus. The hybridization pattern for two patients has been presented as representative data.