A quantitative evaluation of the effects of potassium iodide on the clinical properties of silver diamine fluoride.

Silver diamine fluoride (SDF), an effective topical fluoride agent for arresting caries, has a reputation for staining the teeth. Potassium iodide (KI) has been reported to minimize such staining, but doubts remain over its long-term efficacy and potential adverse influence on the effectiveness of SDF. This in vitro study used quantitative evaluation of color changes and the silver and fluoride release of treated tooth specimens to determine the effect of KI on the staining and caries-arresting properties of SDF. Twenty-one noncarious premolars were sectioned buccolingually to create 42 tooth specimens that were divided into 3 groups for color comparison and ion release measurements. The specimens in the experimental group were treated with a combined SDF + KI product (n = 16), the specimens in the positive control group were treated with SDF (n = 16), and the specimens in the negative control group were untreated (n = 10). Digital color analysis was performed weekly for a month according to the CIE L*a*b* color system of the International Commission on Illumination. Atomic spectrophotometry and ion-selective electrodes were used to measure the quantity of fluoride and silver ions released after 24 and 48 hours. The data from the color measurements were analyzed with the Friedman and Fisher tests, while the data from the ion release measurements were analyzed with the Mann-Whitney U and Wilcoxon signed rank tests. The analysis revealed that KI reduced the dentinal staining caused by SDF, but its effectiveness decreased over time as evidenced by the significantly deteriorating perceptual lightness (L*) values of SDF + KI-treated tooth specimens. The SDF + KI-treated specimens released significantly less silver and fluoride ions than the SDF-treated specimens. Because KI lost its stain-reducing property over time and reduced the effectiveness of SDF, a better "antidote" to SDF staining is needed.

Clinicohistological correlation of etiological spectrum of chronic liver disease diagnosed during noncirrhotic stages in children: Can need of liver biopsy be obviated?

BACKGROUND AND AIM: Limited data exist regarding the etiological spectrum of the subset of chronic liver diseases (CLDs) diagnosed in noncirrhotic states in children. Our primary objective was to study the clinicoetiological profile of CLDs detected in noncirrhotic stages in children younger than 12 years of age. The secondary objective was to find the hepatic histological correlation of provisional diagnosis by different ranks of doctors. METHODS: This was an observational epidemiological study, cross-sectional in design, conducted in a tertiary-care setting over a 2-year period. RESULTS: Thirty-seven cases were enrolled, with a mean ± SD age of 8 ± 4.1 years and a male:female ratio of 1.8:1. Etiologies noted were Wilson disease (n = 8), autoimmune hepatitis (n = 4), secondary hemochromatosis (n = 4), chronic hepatitis B (n = 3), chronic hepatitis C (n = 2), non-alcoholic steatohepatitis (n = 2), progressive familial intrahepatic cholestasis (n = 2), extrahepatic biliary atresia (n = 2), Alagille syndrome (n = 1), galactosemia (n = 1), Gaucher disease (n = 1), Niemann-Pick disease (n = 1), and Budd-Chiari syndrome (n = 1), with an inconclusive diagnosis in five children. Relevant investigations were ordered more frequently by the specialist consultant (SC) and super specialist (SS) combined in comparison with the senior resident (SR) and junior resident (JR) together. (P = 0.0013). Irrelevance of the tests ordered was significantly higher in the junior tier (JR and SR; SR > JR) in contrast to the senior tier of doctors (SC and SS) (P < 0.01). The clinicohistological correlation of an etiological diagnosis significantly differed between the junior and senior ranks of physicians. We noted that an ideal clinical acumen could help to avoid liver biopsy for etiological diagnosis in 78.3% (29/37) of the study population. CONCLUSION: Interpretation of clinical presentation by the senior set of doctors is preferable, which could obviate the need for liver biopsy regarding diagnosis in a proportion of pediatric CLD patients.

A comparative evaluation of dental caries status among hearing-impaired and normal children of Malda, West Bengal, evaluated with the Caries Assessment Spectrum and Treatment.

CONTEXT: Dental caries is one of the major modern-day diseases of dental hard tissue. It may affect both normal and hearing-impaired children. AIMS: This study is aimed to evaluate and compare the prevalence of dental caries in hearing-impaired and normal children of Malda, West Bengal, utilizing the Caries Assessment Spectrum and Treatment (CAST). SETTINGS AND DESIGN: In a cross-sectional, case-control study of dental caries status of 6-12-year-old children was assessed. SUBJECTS AND METHODS: Statistically significant difference was found in studied (hearing-impaired) and control group (normal children). In the present study, caries affected hearing-impaired children found to be about 30.51% compared to 15.81% in normal children, and the result was statistically significant. Regarding individual caries assessment criteria, nearly all subgroups reflect statistically significant difference except sealed tooth structure group, internal caries-related discoloration in dentin, and distinct cavitation into dentine group, and the result is significant at P < 0.05. STATISTICAL ANALYSIS USED: Statistical analysis was carried out utilizing Z-test. RESULTS: Statistically significant difference was found in studied (hearing-impaired) and control group (normal children). In the present study, caries effected hearing-impaired children found about 30.51% instead of 15.81% in normal children, and the result was statistically significant (P < 0.05). Regarding individual caries assessment criteria, nearly all subgroups reflect statistically significant difference except sealed tooth structure group, internal caries-related discoloration in dentin, and distinct cavitation into dentine group. CONCLUSIONS: Dental health of hearing-impaired children was found unsatisfactory than normal children when studied in relation to dental caries status evaluated with CAST.

Assessment of oral health status of Santal (tribal) children of West Bengal.

CONTEXT: Santal is the third largest tribal community of India leading a very poor standard of education and life style. There are, however, few population-based studies evaluating the oral health status among Santal children in West Bengal. AIMS: The aim of the study was to evaluate the oral health status of Santal children of West Bengal by assessing prevalence of dental caries and inflammatory condition of gingival. SETTINGS AND DESIGN: Santal children aged between 2-14 years (N = 1205) were randomly selected from different Santal communities of West Bengal for this study. The children were divided into three different groups according to dentition. MATERIALS AND METHODS: Caries for permanent dentition Decayed Missing Filled Tooth (DMFT), for deciduous dentition decayed extracted filled (def index was used. For mixed dentition DMF and def was measured respectively and then added together. Inflammatory condition of gingival was assessed by papillary marginal attachment (PMA) index. STATISTICAL ANALYSIS USED: the data was analyzed statistically by SPSS software version 11. RESULTS: The study showed there was no significant difference (P > 0.05) between the average decayed extracted filled teeth (deft)/DMFT for boys and girls in deciduous and permanent dentition. But in mixed dentition this value for the boys was significantly higher (P < 0.001) than girls. 'Z' values were found to be non significant when compared mild, moderate and severe gingivitis between boys and girls in each dentition group, but mild gingivitis significantly increases from deciduous dentition to mixed to permanent dentition (P <0.001).

Low-dose acitretin in Papillon-Lefèvre syndrome: treatment and 1-year follow-up.

The Papillon-Lefèvre syndrome (PLS) is a rare, autosomal recessive disease that manifests with palmoplantar keratoderma and destructive periodontitis resulting in early onset periodontal breakdown in deciduous and permanent dentition. Management of this condition is difficult. Here we report one 11-year-old consanguineous Muslim boy suffering from PLS. After failing to get any benefit from methotrexate, three cycles of acitretin, each for 2 months, were given 1 month apart. In each cycle, acitretin (25 mg) was given every other day. At the end of the third cycle, treatment was stopped for 4 months to observe the extent of relapse. Thereafter, acitretin (25 mg) was given twice weekly for 4 months and then the patient was followed up for 1 year. Treatment with acitretin resulted in excellent improvement of periodontitis, increase in the alveolar bone height, and periodontal attachment. Improvement remained stable at the end of 1-year follow-up. There was excellent (>75%) improvement in keratoderma at the end of active therapy. Mild worsening of palmoplantar keratoderma was noticed whenever the drug was stopped. It improved when the drug was restarted. Other areas remained stable. At the end of 1-year follow-up, good improvement (50%) in palmoplantar keratoderma was achieved.

Acute disseminated encephalomyelitis: an uncommon presentation of hyper IgE syndrome.

The hyper-immunoglobulin E (IgE) syndrome (HIES), also known as Job's syndrome is a rare primary immunodeficiency characterized by the clinical triad of recurrent staphylococcal abscesses of skin, recurrent cyst-forming pneumonia, and an elevated serum IgE level of > 2000 IU/ml. Although, most cases are sporadic, families with autosomal dominant (AD-HIES) and recessive (AR-HIES) traits have been reported. Very few articles were published previously on central nervous system abnormalities with definite neurologic manifestations which may vary from partial facial nerve paralysis to hemiplegia in children but Acute Disseminated Encephalomyelitis (ADEM) in a child with HIES hitherto has not been reported. Here we describe a 5-year-old male child with HIES who presented with neurologic manifestations of ADEM.

Prevalence and Distribution of Developmental Defects of Enamel in the Primary Dentition of IVF Children of West Bengal.

INTRODUCTION: Developmental defects of the enamel (D.D.E.) are changes in the deciduous dentition may lead to aesthetic problems, dental sensitivity and may be predictors of dental caries. The aim of this study was to estimate the prevalence and distribution of D.D.E. in the deciduous dentition of IVF children of West Bengal. MATERIALS AND METHODS: A cross-sectional study was carried out with a sample of 153 IVF children aged three to five enrolled in institute of reproductive medicine Kolkata, West Bengal, India. One hundred fifty three spontaneously conceived matched controlled children also examined as control group. All of the teeth were examined and the enamel defects were assessed according to the Modified D.D.E Index. The differences were tested for statistical significance by using the Chi-Square test & z-test. RESULTS: The prevalence of D.D.E. was 7.18% in IVF Children and 8.49% in spontaneously conceived children. Diffuse opacities was the common defect found (2.61%) in both group. The most affected teeth were the deciduous maxillary central incisors (12.82% and 13.63% found in IVF and spontaneously conceived group respectively). Defects were observed more frequently in the maxillary arch than in mandibular arch in both groups. CONCLUSION: There is no significant difference found in IVF & spontaneously conceived children group.

Prevalence of dental attrition in in vitro fertilization children of West Bengal.

CONTEXT: Dental attrition is one of the problems affecting the tooth structure. It may affect both in vitro fertilization (IVF) and spontaneously conceived children. AIMS: This study was aimed to evaluate and to compare the prevalence of dental attrition in deciduous dentition of IVF and spontaneously conceived children. SETTINGS AND DESIGN: In a cross-sectional case control study dental attrition status of 3-5 years old children were assessed. The case group consisted of term, singleton babies who were the outcome of IVF in the studied area in 2009. SUBJECTS AND METHODS: The control group consisted of term, first child, singleton and spontaneously conceived 3-5 years old children who were also resident of the studied area. A sample of 153 IVF and 153 spontaneously conceived children was examined according to Hansson and Nilner classification. STATISTICAL ANALYSIS USED: Statistical analysis was carried out using Chi-square tests (χ(2) ) or Z test. RESULTS: No statistically significant difference found in studied (IVF children) and control group (spontaneously conceived children). CONCLUSIONS: IVF children are considered same as spontaneously conceived children when studied in relation to dental attrition status.

A cross sectional study of dermatoglyphics and dental caries in Bengalee children.

CONTEXT: Dermatoglyphic is the permanent imprint found in hands. Variations of dermatoglyphic patterns among the individuals have been noted. AIMS: To find out the dermatoglyphic pattern variations in dental caries between study group and the control group. SETTINGS AND DESIGN: A cross-sectional study was done on 300 Bengalee children of Kolkata between the age group of 4-14 years. MATERIALS AND METHODS: The samples were divided into two groups; study group and control group. Dental caries were detected clinically using mouth mirror and probe in daylight. Ink was applied on palm and finger by pressure pad. Bilateral palm and finger prints were taken by placing the palm and fingers over glazed paper and applying pressure over palm. Finger and palm prints obtained were inspected by magnifying glass for the study of different dermatoglyphic parameters. STATISTICAL ANALYSIS USED: Analytical statistical method with the help of student's t-test was used to determine mean values and gender differences in the findings using SPSS version 11.0. RESULTS: The characteristic feature which shows significant increase in caries sample group were increased total finger ridge count (TRFC) and absolute finger ridge count (AFRC) on fingers, representing pattern size and types. ab count and tr count were significantly lower in male and female caries sample group compared with the control group. CONCLUSIONS: There was a significant difference between caries and control group in different patterns and number of "tri radii on fingers" in fingers, the percentage of patterns on all palmar areas, total number of triradii on palm and main line index. Perhaps more systematic larger samples consisting of different genetic population are necessary to verify the conclusion.

Double eye brow: a rare case report.

Eye brows are essential for esthetic and functional purposes. Various kinds of eye brows are found in human species. Protective function is one of the important functions of eye brows. Double eye brow is a very rare condition found in human. This case report describes one of the rare cases of double eye brow.