Comparison of changes in endothelial cell count and central corneal thickness after phacoemulsification and small-incision cataract surgery: A prospective observational study at a tertiary care center of eastern Uttar Pradesh

Purpose: Morphological stability and functional integrity of corneal endothelium are necessary to maintain long-term corneal transparency. When the number of endothelial cells drops below 450�0 cells/mm2, corneal edema, irreversible loss of corneal transparency, and decreased vision occur. There is concern regarding manual small-incision cataract surgery (MSICS) being more harmful to the endothelium in comparison to phacoemulsification. Our study aims to determine which technique maintains the corneal parameters closest to the normal physiological state. Methods: A prospective observational study was conducted over a period of 15 months on 100 eyes, out of which 43 patients underwent phacoemulsification surgery and 57 underwent MSICS. TOPCON SP-1P, Version 1.41, 50� Hz frequency, noncontact specular microscope with pachymeter was used to measure endothelial cell count (ECC) and central corneal thickness (CCT) on four occasions: 1 day prior to surgery and on day 1, 3rd week, and 6th week after surgery. Results: In total, 100 eyes of 100 subjects were studied with no dropout during the study period. The age range was 40� years. There was no statistically significant difference between the preoperative mean ECC and mean CCT in phacoemulsification and SICS groups. A statistically significant difference was observed in the postoperative mean ECC (P < 0.01) and mean CCT (P < 0.001) on day 1 and 3rd week between the phacoemulsification and SICS groups, respectively. The mean endothelial cell loss at 6 weeks was less with SICS but comparable with phacoemulsification. Conclusion: SICS is significantly faster, less expensive, less technology dependent, can deal with all types of cataracts, is relatively safe, and is more appropriate for advanced cataracts.

Early childhood caries and oral hygiene practices among preschool children in Mangaluru city

Background: Dental caries in young children is a serious public health problem that is highly underestimated in a country like India as it is not life threatening. The rapid westernization and urbanization in Mangaluru city has led to the inclusion of more refined sugars, frequent snacking habit and intake of more chocolates and candies in children, making them more susceptible to early childhood caries (ECC). This study intends to determine prevalence of ECC.Methods: This cross-sectional study was conducted among 240 preschool children aged 3-6 years studying in private preschools in the North Zone of Mangaluru city, Karnataka, India. Data collection was done using semi-structured and self-administered questionnaire given to the parent; examination of the child’s oral cavity was also done.Results: The prevalence of ECC in preschool children in Mangaluru City was 57.5%. A statistically significant association was seen between oral hygiene practices and father's education level (p=0.033). The oral hygiene practices were found to be satisfactory with the majority (62.1%) of them following good oral hygiene practices.Conclusions: Lack of awareness about ECC has further contributed to the increase in the prevalence and severity of the problem hence revealing the need for effective preventive methods.

Perception of Dental Students towards Infant Oral Health Care and Early Childhood Caries

Early childhood caries can lead to a higher risk of new carious lesions in both primary and permanent dentition, hospitalizations, increased treatment expenditure, risk for delayed physical growth and development, loss of school days with restricted activity, diminished oral health related quality of life and psychological distress to parents. Infant oral health is one of the foundations on which dental care and preventive education must be built to allow a lifetime opportunity free from preventable oral diseases. The purpose of this study was to determine the baseline knowledge and attitude of undergraduate dental students regarding early childhood caries and infant oral health and to propose ways to improve the undergraduate dental curriculum particularly in the prevention of Infant Oral Health diseases. Methods: A cross-sectional study was carried out among third and final year students of Government Dental College and Hospital, Srinagar, India in December 2019. Data was collected using a self-structured questionnaire. The questionnaires were entered into excel worksheet for cleaning and imported into Statistical Package for Social Sciences (SPSS) version 21.0 (SPSS Inc., Chicago, IL, USA) for analysis. Results: About eighty five (85 %) of students had a good knowledge about early childhood caries and infant oral health care. Conclusion: There is still a need to improve the knowledge of graduating dental students through effective strategies. They require adequate training in infant oral health care to be included in their curriculum.

A study to assess the association between early childhood caries and relationship of Streptococcus mutans in saliva of mother, child and sibling pairs

Background: Early childhood caries (ECC) is a specific form of rampant caries that initially affects the primary maxillary anterior teeth of infants and children.' According to American Academy of Pediatric Dentistry (AAPD) 2011, early childhood caries is defined as the presence of one or more decayed (non-cavitated or cavitated lesions), missing (due to caries) or filled tooth surfaces in any primary tooth in a child under the age of six. The objective of this study was to assess the association between early childhood caries and relationship of Streptococcus mutans in saliva of mother, child and sibling pairs.Methods: Group 1 consists of fifty children with early childhood caries along with their mothers and siblings with the child age between 15 months to 5 years and sibling's age between 4 years to 10 years, whereas group 2 consists of fifty caries free children along with their mothers and siblings. For both groups, saliva samples were taken from the child, mother and sibling pairs to estimate the Streptococcus mutans count and to determine pH of saliva in these children. DMFT scores, debris scores checked for child, mother and sibling pairs.Results: Streptococcus mutans count was significantly high in group 1 than that of the group 2. Mothers were more co related to the children in the acquisition of Streptococcus mutans than the siblings. Increased no of meals of the child, pacifier use, low socio-economic status and low maternal education showed significant high correlation with caries prevalence. Low pH score was also significantly correlated with the increase in caries rate.Conclusions: Maternal factors such as high DMFT scores, low education levels, prolonged bottle-feeding with sweetened milk, pacifier use are strong risk indicators for identifying high caries-susceptible children.

Data security and privacy protection of wireless medical sensor network based on hybrid encryption / 医疗卫生装备

Objective To propose a hybrid encryption algorithm involving in elliptic curve cryptography (ECC) and advanced encryption standard (AES) to solve the problems of wiretapping and tampering of medical data in wireless channel transmission.Methods The sender used AES session key for medical data encryption and ECC public key for AES session key,and applied SHA-1 to obtaining the information summary of medical data and ECC public key to gaining information summary signature.The recipient employed ECC private key to verify the signature and then to decrypt AES session key,and finally decrypt medical data with AES session key.Results The proposed security solution gained advantages over the conventional ECC algorithm and hybrid cryptographic algorithm of RSA and AES in encryption and decryption time,safety strength and energy consumption,so that the confidentiality and integrity of medical data could be ensured during transmission.Conclusion The hybrid encryption scheme can meet the requirement of wireless medical sensor network in low time complexity,and realizes the protection of the patient data and privacy.

Ventricular interdependence analysis in patients with congenital heart disease with systolic and diastolic dysfunction of the right ventricle / Análisis de la interdependencia ventricular en pacientes con cardiopatía congénita con disfunción sistólica y diastólica del ventrículo derecho

Ventricular interdependence (VI) is understood as the response of one ventricle to the changes in pressure and volume in the remaining other. At the time, this behavior in congenital heart disease is not clear, specially in those which affect the right ventricle (RV). Objective: To determine and compare the different types of VI in patients with congenital heart disease (CHD) involving RV with systolic and diastolic dysfunction. Methods: A cross-sectional, comparative study was performed in patients with CHD with volume overload mechanism (atrial septal defects, ventricular septal defects, patent ductus arteriosus and total anomalous pulmonary venous connection) as well as patients with overload pressure mechanism (Tetralogy of Fallot, pulmonary atresia with ventricular septal defect and Ebstein's anomaly). An echocardiographic study was performed on every patient and based on each ventricle ejection fraction and tricuspid and mitral annular plane systolic excursion (TAPSE and MAPSE, respectively) interdependence was classified as: A (Preserved measurements on both ventricles), B (changes in RV with preserved measurements of the LV) and C (changes in both ventricles). Comparison was made by dysfunction type, time of evolution, the Tei index of myocardial performance (IMF), pulmonary artery systolic pressure (PASP) and functional class. Results: Out of 86 patients, we found: type A VI in 58%, type B VI in 26% and type C VI in 16% of patients, type C VI was mostly associated with Ebsteins anomaly. The bigger the interdependence, the longer the time of evolution, weight and Tei's Index. Conclusions: Interdependence occurs in CHD where RV is mainly affected. There is an association between type of interdependence and the mechanism of RV dysfunction (systolic or diastolic).

La interdependencia ventricular (IV) se entiende como la respuesta de un ventrículo a los cambios en la presión y el volumen restante en el otro. Hasta hoy, este comportamiento en la enfermedad cardíaca congénita no está claro, especialmente en las que afectan al ventrículo derecho (VD). Objetivo: Determinar y comparar los diferentes tipos de IV en pacientes con enfermedad cardiaca congénita (ECC)) que implica al ventrículo derecho con disfunción sistólica y diastólica. Métodos: Estudio transversal y comparativo que se realizó en pacientes de enfermedad coronaria con mecanismo de sobrecarga de volumen (defectos del tabique auricular, defectos septales ventriculares, ductus arterioso permeable y conexión venosa pulmonar anómala total), así como en pacientes con mecanismo de presión de sobrecarga (tetralogía de Fallot, atresia pulmonar con comunicación interventricular y anomalía de Ebstein). Un estudio ecocardiográfico se realizó en todos los pacientes y con base en cada fracción de eyección del ventrículo y en la excursión sistólica tricúspide y mitral del plano anular (TAPSE y MAPSE, respectivamente) La interdependencia se clasificó como: A (conserva las mediciones en ambos ventrículos), B (cambios en el ventrículo derecho con mediciones conservadas en el ventrículo izquierdo) y C (cambios en ambos ventrículos). Se realizó la comparación por tipo de disfunción, tiempo de evolución, el Índice de Tei de rendimiento miocárdico (IMF), presión sistólica de la arteria pulmonar (PSAP) y clase funcional. Resultados: De los 86 pacientes, se encontró: Tipo A IV en el 58%, el tipo B IV en el 26% y el tipo C IV en 16% de los pacientes, Tipo C IV se asocia sobre todo con la anomalía de Ebstein. Cuanto más grande es la interdependencia, mayor será el tiempo de la evolución, peso e Índice de Tei. Conclusiones: La interdependencia ocurre en las enfermedades del corazón, donde el ventrículo derecho se ve afectado principalmente. Existe una asociación entre el tipo de interdependencia y el mecanismo de la disfunción del ventrículo derecho (sistólica o diastólica).

Hiperlactatemia durante la cirugía cardiaca pediátrica con circulación extracorpórea / The hyperlactacidemia related to pediatric cardiac surgery using extracorporeal circulation

Introducción: El ácido láctico es considerado como un indicador temprano de supervivencia y/o mortalidad en pacientes que necesitan procedimientos quirúrgicos cardiovasculares. Objetivo: Determinar el comportamiento del ácido láctico en sangre arterial durante la cirugía cardiaca pediátrica y el pronóstico de dichos pacientes al egresar de la unidad de cuidados intensivos. Material y Método: Se realizó un estudio prospectivo, analítico y observacional de 55 pacientes pediátricos que recibieron circulación extracorpórea en el Cardiocentro Pediátrico "William Soler". Se tomaron muestras de sangre arterial una vez realizada la inducción anestésica (ácido láctico inicial), precirculación extracorpórea y al final de ella. Se consideró hiperlactatemia cuando el valor de acido láctico en sangre arterial estuvo por encima de 3 mmol/L durante el intraoperatorio y postoperatorio inmediato. Resultados: La cuantificación del ácido láctico en diferentes momentos del proceder quirúrgico fue significativa para el valor al inicio del intraoperatorio y el valor en circulación extracorpórea, no lo fue así para la relación de éste último con el valor al final de la misma. Se demostró que el tipo de cardiopatía no estuvo asociada con el estado al egreso. Conclusiones: la lactatemia perioperatoria constituye un indicador temprano de supervivencia en estos pacientes. Los valores de lactato sérico durante la circulación extracorpórea fueron mayores cuando se emplea ringer lactato en las soluciones de cebado. El tipo de cardiopatía no constituye un factor predictor de supervivencia.

Introduction: Lactic acid is considered as an early indicator of survival and/or mortality in patients with cardiovascular surgical procedures. Objectives: To determine behavior of lactic acid in arterial blood during pediatric cardiac surgery, and the prognosis of such patients when are discharged of intensive care unit. Material and Methods: We made a prospective, analytical and observational study of 55 pediatric patients undergo extracorporeal circulation in "William Soler" Children Cardiac Center. We took samples of arterial blood at the end of anesthesia induction (initial lactic acid), extracorporeal pre-circulation, and at the end of it. We considered the hyperlactacidemia when the lactic acid value in arterial blood was higher 3 mmol/L during the immediate intra- and postoperative period. Results: Lactic acid quantization in different times of surgical procedure was significant for the initial value of intraoperative period, and that of the extracorporeal circulation, but not for its relation with the value at the end of it. It was possible to demonstrate that the type of cardiopathy was not associated with the discharge status. Conclusions: Perioperative lactacidemia is an early indicator of survival in these patients. Serum lactate values during extracorporeal circulation were higher when it is used lactated ringer in primer solutions. The type of cardiopathy is not a predictor factor of survival.

The prevalence and pattern of dental caries in pre-school children.

This study was carried out to determine the prevalence and pattern of early childhood caries and its relevant factors in pre-school children of People’s Public school of Bhopal. One hundred sixty two children aged between 3 to 5 years were selected randomly from the school. They were examined for dental caries on proximal & buccal surfaces of at least two maxillary incisors (WHO, 1987). A questionnaire was used for evaluation of related factors. It was found that 36.42% children were affected by ECC. Thus, substantial efforts by ways of both, early detection & treatment and effective preventive strategies are required to decrease the prevalence of ECC in pre-school children.

Relationship between Scanning Laser Polarimetry with Enhanced Corneal Compensation and with Variable Corneal Compensation

PURPOSE: To evaluate the structure-function relationships between retinal sensitivity measured by Humphrey visual field analyzer (HVFA) and the retinal nerve fiber layer (RNFL) thickness measured by scanning laser polarimetry (SLP) with variable corneal compensation (VCC) and enhanced corneal compensation (ECC) in glaucomatous and healthy eyes. METHODS: Fifty-three eyes with an atypical birefringence pattern (ABP) based on SLP-VCC (28 glaucomatous eyes and 25 normal healthy eyes) were enrolled in this cross-sectional study. RNFL thickness was measured by both VCC and ECC techniques, and the visual field was examined by HVFA with 24-2 full-threshold program. The relationships between RNFL measurements in superior and inferior sectors and corresponding retinal mean sensitivity were sought globally and regionally with linear regression analysis in each group. Coefficients of the determination were calculated and compared between VCC and ECC techniques. RESULTS: In eyes with ABP, R2 values for the association between SLP parameters and retinal sensitivity were 0.06-0.16 with VCC, whereas they were 0.21-0.48 with ECC. The association of RNFL thickness with retinal sensitivity was significantly better with ECC than with VCC in 5 out of 8 regression models between SLP parameters and HVF parameters (P<0.05). CONCLUSIONS: The strength of the structure-function association was higher with ECC than with VCC in eyes with ABP, which suggests that the ECC algorithm is a better approach for evaluating the structure-function relationship in eyes with ABP.

Diagnostic Ability of Scanning Laser Polarimetry with Enhanced Corneal Compensation in the Eye with Typical and Atypical Retadation Pattern

PURPOSE: To investigate the relationship between the SLP-VCC parameters and the SLP-ECC parameters in the eyes with typical retardation pattern (TRP) and atypical retardation pattern (ARP), and the sensitivities and specificities of the SLP-VCC parameters and the SLP-ECC parameters in the eye with TRP and ARP. METHODS: In this prospective study, 72 eyes with TRP images (30 glaucomatous and 42 normal eyes) and 53 eyes with ARP images (28 glaucomatous and 25 normal eyes) were recruited. For each group, we analyzed relationship between each parameters of GDx-VCC and GDx-ECC and the diagnostic ability of GDx-ECC by using the ROC curve. RESULTS: In the eyes with TRP, TSNIT average was significantly lower by GDx-ECC than GDx-VCC in the control group. Inferior average was significantly higher by GDx-ECC than GDx-VCC in both glaucomatous and normal group. TSNIT standard deviation was significantly higher by GDx-ECC than GDx-VCC in both groups. NFI was significantly lower by GDx-ECC than GDx-VCC in both groups. TSS (typical scan score) was significantly higher by GDx-ECC than GDx-VCC in both groups. In the eyes with ARP, TSNIT average was significantly lower by GDx-ECC than GDx-VCC in both groups. Superior and Inferior average was not different between GDx-ECC and GDx-VCC. TSNIT standard deviation was significantly higher by GDx-ECC than GDx-VCC in both groups. NFI was not different between groups. TSS was significantly higher by GDx-ECC than GDx-VCC in both groups. Comparison of ROC curve for the SLP parameters revealed no difference between VCC and ECC. TSNIT standard deviation, however, showed relatively high value in GDx-ECC compared with GDx-VCC. CONCLUSIONS: GDx-ECC has comparable diagnostic ability in discriminating glaucomatous and normal eyes with GDx-VCC and TSNIT standard deviation by the GDx-ECC algorithm could be a useful parameter in discriminating glaucomatous and normal eyes.

Effect of muscle contraction type and speed on tissue oxygen dynamics in the M. vastus medialis during repeated knee extension exercise / 体力科学

The purpose of this study was to analyze the relationship between activity pattern and temporal changes in the oxygen dynamics of human femoral medial vastus muscles. Oxygen dynamics were evaluated from the surface of the body by near-infrared spectroscopy (NIRS) . Arterial occlusion tests were performed in the femoral region at a cuff pressure of 300 mmHg. Exercise type and speed were controlled by CYBEX 6000. The exercise types examined were concentric contraction (CON) and eccentric contraction (ECC) . The 3 angular velocities of 90, 120 and 180 degrees were used as the exercise speeds. Exercise was performed continuously 60 times at maximum effort. The subjects were 7 healthy males with a mean age of 19.6±0.5 years. A transient decrease in oxygen concentration was observed during circulatory occlusion ; and rapid hyperemia occurred immediately after the removal of pressure. Oxygen concentration peaked above the control level and then returned to the initial level. In the CON exercise, the initial decrease in oxygen concentration was the largest at CON 90, and a gradual increase in oxygen concentration was clearly observed during exercise. In the recovery stage, after exercise at CON 90, 120 and 180, oxygen concentration exceeded the control level before exercise, then peaked and returned to the initial level. In the ECC exercise, an initial decrease in oxygen concentration was similar to that in the CON exercise, but a gradual increase in oxygen concentration was not observed during the exercise ; nor did oxygen concentration exceed the control level in the recovery stage after the exercise.<BR>These results indicate that an increase in oxygen level after the removal of arterial occlusion, during and after the CON exercise was much higher than the control level before the exercise, sug-gesting the involvement of reactive hyperemia and exercise hyperemia.