Evaluating the effect of probiotic containing milk on salivary mutans streptococci levels.

PURPOSE: To evaluate the changes in mutans streptococci counts in saliva after short term probiotic intervention and its delayed effects on salivary mutans streptococci count. METHODS: 40 children in the age group of 12-15 years with medium to high caries activity were randomly divided into Group I Control (plain milk group) and Group II Experimental (probiotic supplemented milk group). Duration of the study was 9 weeks; which was evenly divided into three phases: baseline, intervention and post-treatment period; each phase consisting of three weeks. After baseline period of 3 weeks, children in group I were given plain milk and in group II milk containing probiotic Lactobacillus rhamnosus hct 70 for 3 weeks; followed by a 3 weeks follow up period. After every phase saliva samples were collected to estimate salivary mutans streptococci counts. RESULTS: The difference in the post follow up mutans streptococci count of group I and group II, was highly significant with p value < 0.001. In the control group, the difference in the mean salivary baseline, post treatment and post follow up mutans streptococci counts was not statistically significant (p > 0.001). In the experimental probiotic group, the difference in mean salivary baseline, post treatment and post follow up mutans streptococci counts was statistically highly significant (p = 0.000, p < 0.001). CONCLUSIONS: Statistically significant reduction in salivary mutans streptococci counts immediately after consumption of probiotic Lactobacillus rhamnosus hct 70 containing milk suggest a beneficial effect of probiotic Lactobacillus rhamnosus hct 70 in the prevention of dental caries.

Dental management of PHACE syndrome under general anesthesia.

PHACE syndrome was first described by Dr. Ilonia Frieden and colleagues in 1996. It is an under-recognized rather than a very rare condition among patients with large facial hemangiomas. It is challenging as it has significant neurological, vascular and airway implications. Vascular malformations compromising cerebral blood flow predispose the patient to strokes and seizures. Subglottic hemangiomas, if present, could bleed during intubation. Meticulous neurological monitoring is mandatory in those undergoing repair of the great vessels. We describe the perioperative management of a child with PHACE syndrome subjected to dental treatment under general anesthesia.

Air pollution effect of O3 on crop yield in rural India.

Measurement of surface ozone (O(3)) mixing ratio was made from January 2006 to December 2007 in Ahmednagar (19.1°N, 74.8°E, 657 m above sea level), India. The monthly average of daytime maximum of O(3) mixing ratio ranged from 14 to 57 parts per billion by volume (ppbv) with an annual average of about 20 ppbv. The estimated winter wheat and summer crop yield reduction by 10% and 15%, respectively from present O(3) pollution level associated with AOT40 (accumulation exposure of O(3) concentration over a threshold of 40 ppbv) index values 7370-9150 ppbv h in rural areas.

PET-CT in recurrent head neck cancers: a study to evaluate impact on patient management.

BACKGROUND AND OBJECTIVES: PET-CT has shown promise in the management of head neck cancers. However, there have been only few studies evaluating its impact on management of patients with recurrent cancers in the presence of available clinicoradiologic methods of assessment. We conducted this study to assess the same in patients with suspected recurrent head and neck cancer. METHODS: Case histories were presented to two oncologists, who were blinded to PET-CT reports. Treatment plans were made by these oncologists based on clinical findings and other conventional imaging. These plans were then compared to the actual treatment received by patients after PET-CT. Any change was recorded as "change in management." RESULTS: Forty-nine patients with suspected recurrent head and neck cancer were evaluated in the study. Overall, there was a 38.7% change in management because of the addition of PET-CT to conventional methods of assessment. Eight patients (16.3%) had a major change in therapy while in 11 patients (22.4%), diagnostic procedures like endoscopies, biopsies and examination under anesthesia were avoided. CONCLUSION: In our study, PET-CT had a significant impact on the management of patients with suspected recurrent head neck cancer.

Surface ozone variability over western Maharashtra, India.

We present the simultaneous field measurements of surface ozone (O(3)) made at the five different sites of western Maharashtra, India for the period between 2001 and 2005. Seasonal variation in O(3) shows a pronounced maximum concentration about 40-50 ppbv in the summer and winter season in the urban site and similar concentration of O(3) is also observed in the rural site despite less emission of precursor gases. The increase in O(3) concentration is observed in the sugar factory premises during sugarcane crushing period. Diurnal patterns in O(3) do not show daytime in situ photochemical buildup at high altitude mountain site. The higher O(3) concentration is observed in the morning hours near to the dam than at urban and rural sites. These variations in O(3) indicate that the local pollutants are major contributors to the O(3) concentrations at the urban and rural sites, while regional transport plays a role at high altitude mountains site. Model simulations using a Eulerian photochemical model have also been carried out with the available data. The comparison of model results with observation shows that a diurnal and seasonal pattern is in good agreement.

Investigation of gain enhancement of electrically small antennas using double-negative, single-negative, and double-positive materials.

In this paper, it is shown that a double-negative or a mu-negative shell can be used to achieve a very high gain for an electrically small loop. It is also seen that together with the high gain, the metamaterial shell can be used to achieve a very uniform gain characteristic with respect to the shell dimensions. This is accomplished by a proper choice of the media parameters of the metamaterial shell and the region surrounding the antenna. This significantly eases the fabrication constraints and the close tolerances on the shell which was a major drawback towards the practical realization of the shell. Also, significant power gain can be obtained when the radiated power from the metamaterial shell is compared to the power radiated by a loop of the same radius as the outer radius of the shell. In addition, it is also found that a double-positive shell of the same dimensions as the metamaterial shell can be used to significantly increase the gain of the infinitesimal antenna. The power gain characteristics show distinct resonant peaks in this case. Excellent matching characteristics are observed corresponding to the radiated power gain.

Revision surgery for incidental gallbladder cancer: factors influencing operability and further evidence for T1b tumours.

BACKGROUND AND AIM: There is a need to increase the available data on revision radical surgery for incidental gallbladder cancer and to determine factors influencing operability. We aimed to assess the impact of stage of disease (pT) and the type of primary surgery (laparoscopy versus open) on resectability rates. MATERIAL AND METHODS: The data of 90 consecutive patients referred to the Tata Memorial Hospital between 1 January 2003 and 30 April 2007 for revision radical surgery for incidental gallbladder cancer were reviewed retrospectively. RESULTS: Of the 90 patients who underwent revision surgery, accurate data on T-stage was available in 76, and of these 76 patients, 44 (57.8%) had prior laparoscopic simple cholecystectomy, while 32 (42.2%) had undergone open surgery. The median time interval between the two surgeries was 2 months (range 4 weeks to 11 months). By T-stage, 23 patients had T1b disease, while 33 and 20 patients had T2 and T3 disease, respectively. Successful revision surgery could be undertaken in 71% of patients (54/76) and 29.6% of these had residual disease confirmed by histopathological examination. CONCLUSIONS: T-stage is an important factor in determining operability as confirmed by our study. As the T-stage of the disease increased, the chances of finding residual disease increased, while operability decreased. Furthermore, the case for revision surgery is strengthened because the incidence of lymph nodal disease is high even for pT1b cancers. The type of primary surgery does not affect operability in patients undergoing revision radical surgery for incidental gallbladder cancer.

Depth of invasion is the most significant histological predictor of subclinical cervical lymph node metastasis in early squamous carcinomas of the oral cavity.

AIMS: Cervical node metastasis is the single most important prognostic factor in head and neck squamous carcinomas. Taking a homogenous patient population, applying stringent selection criteria, and standard pathological evaluation methods, this retrospective study aims to establish histological predictors of subclinical cervical node metastasis in early (T1-T2/N0) squamous carcinomas of the oral cavity, thereby identifying a subset of patients who are at an increased risk for cervical node metastasis. METHODS: Forty-eight previously untreated patients with clinically T1 or T2, and N0, squamous carcinomas of the oral cavity who were treated with primary excision of the tumour and elective neck node dissection were selected. Various histological factors including T size, gross and microscopic tumour depth and thickness, grade of differentiation, pattern of invasion, inflammatory response, perineural and lymphovascular invasion were studied. The statistical significance of various parameters as predictors of subclinical node metastasis was determined using logistic regression analysis. RESULTS: Of all the parameters studied, microscopic tumour depth and thickness were the only significant factors (P value=0.026 and 0.046, respectively) which correlated with cervical node metastasis, on univariate analysis. Tumour depth emerged as a single most significant predictor on multivariate analysis. Majority of patients with node metastasis had a tumour depth of more than or equal to 5 mm. CONCLUSION: Depth is the most significant predictor of cervical node metastasis in early squamous carcinomas of the oral cavity. Patients with a tumour depth of more than or equal to 5 mm are at an increased risk of harbouring node metastasis, hence should be taken up for elective node dissection.

Quality of life of head and neck cancer patient: validation of the European organization for research and treatment of cancer QLQ-C30 and European organization for research and treatment of cancer QLQ-H&N 35 in Indian patients.

AIMS: To present the first cross-culture validation of the European organization for research and treatment of cancer (EORTC) quality of life questionnaires, the EORTC-QLQ-C30, and the QLQ-H&N 35 in India. SETTINGS AND DESIGN: These questionnaires were translated into two vernacular languages and pilot test was done on 15 patients. Two hundred head and neck cancer patients completed the QLQ-C30 and the QLQ-H&N 35 at two time points during their treatment. Psychometric evaluation of the structure, reliability, and validity of the questionnaire was undertaken. RESULTS: The data supports the reliability of the scales. Validity was tested by item-scale, scale--scale correlation and by performing known group comparisons. The results demonstrated that the items correlated with their respective scale and no significant correlation was found between scales. The questionnaire was responsive to change over a period of time. SUMMARY: This data suggests that the EORTC QLO-C30 and the QLQ-H&N 35 are reliable and valid questionnaires when applied to a sample of head and neck cancer patients in India.

Multiple supernumerary teeth in the mixed dentition.

Supernumerary or extra teeth result from disturbances during the initiation and proliferation stages of dental development. Teeth formed in excess of the normal number are termed supernumerary teeth. A supernumerary tooth may closely resemble the teeth of the group to which it belongs i.e. molars, premolars or anterior teeth or it may bear little resemblance in size or shape to the teeth with which it is associated. Discussed here are reports of three cases with multiple supernumerary teeth in the mixed dentition and its management.

Combined effect of carbon-dioxide laser and neutral 2% NaF on acid resistance of human tooth enamel.

Specimens of human enamel were treated topically with 2% sodium fluoride solution before and after laser irradiation. The samples were examined using wet chemical analysis and SEM. The results showed that samples treated with neutral 2% NaF after irradiation caused a remarkable increase in acid resistance of the enamel, while samples treated with neutral 2% NaF before irradiation showed a lesser effect. The results were consistent with observations made by using wet chemical analysis and SEM findings.