Assessment of paediatric quality of life in temporomandibular joint ankylosis patients after interpositional arthroplasty: a pilot study.

A comprehensive evaluation of treatment outcomes in paediatric temporomandibular joint (TMJ) ankylosis patients should include the assessment of quality of life (QoL) along with the traditional clinical indicators. This longitudinal retrospective descriptive study evaluated the impact on QoL of interpositional arthroplasty for the treatment of TMJ ankylosis in 18 patients between 8 and 10 years of age. The subjects completed the Child Perceptions Questionnaire (CPQ 8-10) while their parents/primary caregivers completed the Parental/Caregiver Perceptions Questionnaire (PCPQ), once before and then at 3 months after the surgery. There was a significant improvement in mean cumulative scores for both questionnaires. Significant improvements were seen in the oral symptoms, functional limitation (P<0.02), and social wellbeing domains (P<0.05) of the CPQ, and in the oral symptoms and functional limitation (P<0.05) domains of the PCPQ. The improvements in the physical domains were considered important for treatment success by both groups. The psychosocial domains were observed to be largely unaffected by the condition. The level of agreement between the two groups was higher for physical domains as compared to psychosocial domains. This study indicates that QoL outcomes in paediatric TMJ ankylosis patients are largely influenced by the physical factors, while the psychosocial factors play a secondary role.

Quality of life assessment in temporomandibular joint ankylosis patients after interpositional arthroplasty: a prospective study.

Temporomandibular joint (TMJ) ankylosis significantly impacts both physical and psychosocial patient wellbeing. A complete evaluation of treatment outcomes necessitates knowing the extent to which a patient's quality of life (QoL) is impacted. This study was performed to evaluate the impact of TMJ ankylosis on QoL in 25 TMJ ankylosis patients treated by interpositional arthroplasty. The patients completed OHIP-14 and UWQoL questionnaires once before and then at 3 months after the surgery. There was a significant improvement in mean cumulative scores for both questionnaires. With the exception of functional limitation, all OHIP domains showed significant improvement. Preoperatively, the worst scores were found in the psychological distress domain, followed by the social handicap, physical pain and physical disability domains. More than half of the subjects (56%) reported having suicidal thoughts. Amongst the individual UWQoL domains, appearance, chewing, anxiety (P < 0.01), recreation and mood (P < 0.05) showed improved scores. Appearance and chewing were the top ranked priority domains before and after surgery. No significant change was found in speech, taste, sleep, or breathing. Psychosocial factors were found to play a much bigger role than previously thought. The physical, psychological, and social factors were intricately related and dynamically interacted with each other. Surgical treatment produced a definitive QoL improvement in the patients.

Progress in understanding ovarian follicular dynamics in cattle.

The study of follicular dynamics began in the mid-20th century, but progress has been particularly rapid in the last two decades through the use of tools that have enabled serial, non-invasive examination. A brief overview of early oogenesis and folliculogenesis is provided as a backdrop to the evolution of our understanding of follicular dynamics during the bovine estrous cycle. Studies to date support the concept that the pair of ovaries acts as a single unit and influences follicular development primarily via systemic endocrine routes involving ovarian and uterine products, the gonadotropins, and their receptors. Dominant and subordinate follicles pass through growing, static and regressing phases that have distinct morphologic and biochemical characteristics; these changes are the basis of efforts focused on diagnosing and manipulating follicular status. An update of research progress highlights recent findings on the repeatability (predictability) within individuals of follicle recruitment and wave pattern (two- versus three-wave cycles), the relationship between oocyte competence and follicular status, and the dynamics of small follicles. Recent studies documented that wave emergence and follicular dominance are apparent earlier than previously reported, and on the basis of periodic endogenous FSH surges and the presence of FSH receptors, the hypothesis that follicles become progressively entrained to waves from the earliest stages of development is introduced. Lastly, recent studies comparing old cows and their young daughters provide a new understanding of the effects of aging on gonadotropins and ovarian steroids, follicular dynamics, ovarian response to synchronization, superstimulation, and oocyte competence.

Adolescent violence exposure, gender issues and impact.

Youth violence is a growing problem worldwide. Research on adolescent violence in India is limited. Fifteen hundred high school students were investigated to study the prevalence and demographic characteristics of witnesses, victims and perpetrators of violence and to see the impact of violence exposure on their psychosocial adjustments. Sixty nine percent of students had witnessed violence in real life and 28% were of serious nature. Media violence exposure was universal. The prevalence of victims and perpetrators was 27% and 13% respectively. Bullying was prevalent. Male sex was the most important predictive risk factor for witnessing and perpetrating violence (P < or = 0.001). Victims were predominantly females. Those having exposure to violence had poorer school performance and adjustment scores (P < or = 0.05). Thus violence exposure is prevalent even in the lives of Indian adolescents and gender differences exist. Its impact on their psychosocial adjustments is detrimental. Early identification and corrective interventions of these adolescents is vital.

Shaken baby syndrome masquerading as apparent life threatening event.

A variety of diseases and disorders can present as an acute life-threatening event among which shaken baby syndrome has been recently recognized. A high index of suspicion along with an ophthalmologic evaluation and cranial imaging helps to identify this form of child abuse, which needs multidisciplinary management.

Evaluation of quality of life in indian children with bronchial asthma using a disease-specific and locally appropriate questionnaire.

AIM: To evaluate quality of life (QOL) in Indian children with bronchial asthma. METHODS: A disease-specific, locally appropriate QOL questionnaire was administered in asthmatic children and compared with FEV1, FVC, PEFR and asthma symptom score, on three occasions. RESULTS: QOL score had strong negative correlation with symptom score and weaker positive correlation with pulmonary function tests. CONCLUSION: Disease-specific QOL score correlates inversely with symptom score in children with bronchial asthma.

Cerebral gigantism with West syndrome.

A case of cerebral gigantism (Sotos syndrome) with West syndrome in a one-year-old male child is reported. The case had a large stature, typical facies and neurodevelopmental delay along with infantile spasms, which were refractory to treatment with valproate and clonazepam.

Follow up of survival and quality of life in children after intensive care.

OBJECTIVE: To evaluate the health related quality of life of children after intensive care and to assess their long term survival. DESIGN: Prospective. SETTING: Tertiary Care Hospital Intensive Care Unit (ICU). SUBJECT AND METHODS: All patients admitted to ICU were enrolled prospectively over a period of 1 year. Children with ICU stay of less than 24 hrs, infants, readmission to ICU were however excluded. Survival was determined at the time of ICU discharge and 1 year later. Health status assessment was done with the help of the multiattribute health status classification (MAHSC), which has 6 domains; sensation, mobility, emotion, cognition, self care and pain. Assessment was done at two points of time - within 48 hours of admission to the ICU and 1 year after discharge. RESULTS: 150 children (mean age 5.68+/- 3.6 years) with a mean duration of ICU stay (5.7 +/- 5.5 days) were included in the study. The cumulative ICU mortality was 12.9%. Fifty-five (36.7% had no overall health impairment (no affected domains) preceding the present illness. There was overall health impairment (?1 affected domain) preceding the present illness in 95 of the 150 patients (63.3%). In the domain specific health status mobility was affected in 74 (49%) followed by pain 61 (41.2%), self care 56 (38.8%), sensation 29 (20%), cognition 21 (14.8%) and emotion 14(9.5%). After 1 year, overall state of health had improved or was equal to the premorbid state in 87 (75%). In domain specific health, the proportion improving or remaining unchanged varied from 75% (emotional) to 80% (cognition), 85.3% (pain) and 88.7% (mobility). The overall state of health had worsened as compared to the premorbid state in 29 (25%) majority with neurological illnesses. CONCLUSION: Quality of life in three-quarters of the patients was preserved and one year survival was favorable. Worsening was noted primarily in-patients with neurological illnesses.

Diagnosis and management of children with attention deficit hyperactivity disorder.

Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent childhood psychiatric disorder which is characterized by three core symptoms of inattention, hyperactivity and impulsivity. It is estimated that 5% to 10% of school aged children suffer from this disorder. This disorder is more common in boys than girls. Comorbidity is a major problem and is present in as many as two thirds of children with ADHD. A multiple modality approach to treatment which combines pharmacotherapy, psycho education, behaviour therapy, environmental changes and social skills training is recommended. The outcome of ADHD is variable and unless properly treated in early years may predispose the child to serious psychopathology in adulthood.

Psychosocial issues in the management and treatment of children and adolescents with asthma.

Asthma is one of the most common chronic childhood illness. Studies have reported higher incidence of psychosocial adaptation problems in children with asthma, particularly severe asthma, than children in the general population. Increased psychosocial problems in children with asthma have been ascribed to adverse developmental impact of having a chronic health problems, increased demands on the family and dysfunctional familial interactional patterns. Treatment models include education and self management training programs, family therapy, relaxation therapy and biofeedback. These programs have been found to produce improved adjustment, increased medication compliance and greater perceived self competence in managing symptoms and decreased use of medical services. It is concluded that children with asthma require a comprehensive management strategy that pays attention not only to physiological control of asthma symptoms but also emotional and behavioural problems of children and their families.

Son preference and reproductive behaviour in rural Punjab.

PIP: This study examines the impact of son preference on desired family size and contraceptive usage among a rural population in Punjab, India. Data are obtained from a sample survey conducted for the Center for Research in Rural and Industrial Development in 1989-90 in 7 rural districts of Punjab. The sample includes 450 currently married women aged 15-44 years. Analysis pertains to mean desired family size, the percentage not desiring additional children, the percentage desiring additional sons and daughters, and current use of contraception by sex, birth order, and number of living children. The estimation of the extent to which contraception would increase and desired family size would decline is based on methods developed by Arnold (1985) that assume no sex preference at any parity. Findings indicate a strong son preference. At every parity, women with sons only desired fewer children and were more likely to use contraception. Among women who desired more children, there was no indication that women with sons only desired a balanced sex composition. None desired a second daughter, and many desired a second son. As the number of living sons increased, so did contraceptive use. Contraception was 20% among couples with no son, 50% among those with one living son, and 81% among those with two living sons. Sterilization acceptors had an average of 2.07 living sons. At parity 2, two times as many couples had boys only compared to girls only. At parity 3, there were 7 times more families with boys only than families with girls only. If sex preferences were completely eliminated in the Punjab, there would be a 9% decline in desired family size from 3.05 children to 2.77 children. Contraceptive use would increase by 14 percentage points from 58% to 72%. The cultural practices of the Jats ethnic group place girls in the position of being an economic liability.^ieng

Genotoxic effects of some organophosphorus pesticides. II. In vivo chromosomal aberration bioassay in bone marrow cells in rat.

The genotoxic effects of 4 organophosphorus pesticides, i.e., ekatin, fenitrothion, methylparathion and phorate, were assessed employing in vivo chromosomal aberration bioassay in bone marrow cells in rat. Methylparathion and phorate were found to be mutagenic while ekatin was weakly mutagenic. The frequency of chromosomal aberrations induced by fenitrothion did not differ significantly from that observed in negative control.

Genotoxic effects of some organophosphorous pesticides. I. Induction of micronuclei in bone marrow cells in rat.

The genotoxic effects of 4 organophosphorous pesticides, i.e. ekatin, fenitrothion, methylparathion and phorate, were examined employing the micronucleus test in bone marrow cells of the rat. Methylparathion and phorate were found to be mutagenic, while ekatin was weakly mutagenic. The frequency of micronuclei induction by fenitrothion did not differ significantly from that noticed in negative control.