Management of an Epileptic Patient with Intellectual Disability: A Case Report and Clinical Guidelines.

Abstracts: Background: People with epilepsy have compromised livelihood due to the effect of disease and medications on the quality of life. Patients with accompanied intellectual disability have further difficulty to cope up in daily chores. Article highlights holistic management of patient having complex partial seizure with intellectual disability. Control of seizures along with the Psychological therapy was done to ameliorate standard of life. Management of patient consisted of history, oral prophylaxis, patient-parent counselling followed by non pharmacological treatment consisting of cognitive behaviour therapy, promotive autonomy therapy and promotive creativity therapy. She was coached in special school for physiotherapy, speech therapy, music therapy, yoga therapy and special education techniques. Team work between dentist, teachers and psychotherapists gave better accordance with each subsequent appointment. Apart from just teeth oriented approach one should focus on overall care. Timely referral to physician should be done for physical and mental ailments. The article also gives brief clinical guidelines on dental problems and there treatment in such patients along with seizure control of epileptic patients and behaviour management of patients with mental impairment.

Prevalence of tooth wear in patients attending the department of periodontics, Manipal college of dental sciences, Manipal.

Background: Tooth wear is a condition that encompasses attrition, abrasion and erosion and has a multifactorial etiology. Prevalence of tooth wear is reported to be between 5-50%.This wide range probably reflects the various parameters used in assessing of tooth wear and the difficulty in differentiating between the types of tooth wear. Diagnosing tooth wear and eliciting the etiological factors can help in the prevention and treatment of the condition. Aim and objective: To record the prevalence of tooth wear among the patients attending the Department of Periodontics, Manipal College of Dental Sciences, Manipal over a period of 3 months. Materials and methods: Patients attending the Department of Periodontics over a three month period were examined. Patient history was taken according to the proforma shown. All teeth were examined and indexed according to Tooth Wear Index given by Smith and Knight (1984)16.All patients with 20 teeth and above in their dentition were included in the study. Results: In the present study the prevalence of tooth wear was found to be 6.1% and that it was seen more among males and increased with age. Mandibular canines were the most commonly affected teeth and incisal and occlusal surfaces of the teeth being commonly affected.

Allele, genotype, and composite genotype effects of IL-1A +4845 and IL-1B +3954 polymorphisms for chronic periodontitis in an Indian population.

Introduction: The pro-inflammatory cytokine interleukin-1 (IL-1) is a key modulator of host responses to microbial infection and a major modulator of extracellular matrix catabolism and bone resorption, and polymorphisms in the IL-1 gene cluster have been associated with an increased risk of developing severe adult periodontitis. A case control study was performed to determine the role of IL-1A+4845 and IL-1B+3954 polymorphisms in the predisposition to chronic periodontitis. Materials and Methods: The study was conducted with 103 unrelated participants recruited from Manipal College of Dental Sciences, Manipal, which included 51 chronic periodontitis patients and 52 normal periodontally healthy individuals. Extensive clinical data were collected, bone loss was the major outcome variable and smokers and diabetics were excluded from the study to eliminate the influence of these risk factors. Genomic DNA was isolated from the blood samples of participants for genotyping IL-1A+4845 and IL-1B+3954 polymorphisms by polymerase chain reaction-restriction fragment length polymorphism and the data statistically analyzed. Results: Allele 2 of the IL-1A+4845 polymorphism was carried by 38% of all participants; of these only 6 were homozygous for the allele. Allele 2 of the IL-1B+3954 was carried by 21% of the subjects; only 1 was homozygous for allele 2. The composite genotype was carried by 31% of the cases and by 38% of the controls. Overall, 35% participants carried the composite IL-1 genotype. No statistically significant association was found for the distributions. Conclusions: The distribution of the IL-1 positive composite genotype is in concordance with the frequencies reported in the Caucasians. Association was not found for the effect of allele, genotype, composite genotype, and haplotypes of IL-1A+4845 and IL-1B+3954 polymorphisms with periodontitis. Its utility as a risk marker in this population was not borne out by the study.