Comparative Evaluation of the Efficiency of Polymer Bur, Cera Bur, and Tungsten Carbide Bur in Dentin Caries Excavation of Mandibular Primary Molars: An In vivo Study.

Conservative caries removal has become an integral part of minimally invasive dentistry (MID). Polymer and Cera burs are two feasible MID methods. The aim of the study was to compare the efficiency of Polymer, Cera, and Tungsten carbide bur in dentin caries excavation of mandibular primary molars. 45 children in the age group of 6-8 years with dentin caries, not involving pulp in the second mandibular primary molars, were selected for the study. The three burs compared were polymer bur, Cera bur, and Tungsten Carbide bur. The excavation of carious lesion was performed with each burs using a slow-speed handpiece with 500-1000rpm. Caries removal efficiency was evaluated using the Visual-Tactile method and confirmed Dye detection method. The time taken to complete the caries removal was measured using a stopwatch. The patient's pain perception was assessed using the Wong-Baker Faces Pain Rating Scale. The intergroup comparisons based on time, dye, and Wong-Baker Faces Pain Rating Scale (WBFPRS) were arrived at using Mann-Whitney and Fisher Exact tests at P < 0.0001. A statistical significance between the three groups on the time taken for caries removal at P < 0.0001. No statistical significance was observed between the three groups for caries removal efficiency and pain perception using the dye and WBFPRS scores at P > 0.001. Cera burs had shown high caries removal efficiency, which had taken less time in the excavation, with reduced pain perception followed by Tungsten Carbide bur and the polymer bur in mandibular primary molars.

A Comparative Study to Evaluate the Effects of Probiotic Curd on Streptococcus mutans, Bifidobacterium dentium, and pH of Saliva in Caries-free Children: An In Vivo Study.

BACKGROUND: Dental caries is one of the commonest oral diseases that require early stages of prevention and intervention. The primary organisms related to dental caries are streptococcus mutans and lactobacilli. In the past decades, some of the non-pathogenic bacteria called probiotics have been added to the food products for the beneficial effect of human health. Intake of probiotic food products has been shown to have beneficial effects on the oral tissues. Hence the present study aimed to compare the levels of salivary pH, S. mutans, B. dentium counts in children consuming probiotic and non-probiotic curd. METHODS AND MATERIAL: 40 healthy caries free children were randomly allocated into two groups. First baseline salivary samples were collected from all the participants and tested for salivary pH, salivary B. dentium and S. mutans count. After collecting the baseline values test group of children were provided with probiotic curd whereas the control group were provided with non probiotic curd for 15 days. After 15 days of consumption of these dairy products, salivary samples were collected again and tested for salivary pH, salivary B. dentium and S. mutans count. RESULTS: Probiotic curd was found to be more effective in reducing the colony counts of B.dentium and S.mutans. There was a marginal decrease in pH in both the groups but was well above the critical pH. CONCLUSIONS: Probiotic curd showed considerable level of decrease in colony counts of B.dentium, S.mutans and salivary pH when compared to normal curd.

A Clinical and Radiographic Comparison of Platelet-rich Fibrin and Lyophilized Platelet-derived Preparation as Pulpotomy Agent in Primary Molars.

INTRODUCTION: Vital pulpotomy in primary molar teeth is aimed to retain the tooth in function until it is replaced by its successors. AIM: The aim of this study was to evaluate and compare platelet-rich fibrin (PRF) and lyophilized platelet-derived preparation (LPDP) as a pulpotomy agent in primary molars. MATERIALS AND METHODS: Forty primary molars from 20 healthy children aged 5-9 years requiring pulpotomy in the contralateral side of mandible were randomly selected. In both the groups, pulpotomy was carried out by removing coronal pulp and achieving hemostasis, the radicular part of pulp tissue was packed with PRF preparation in Group I and LPDP (Mothercell Research Centre, Trichy, Tamil Nadu, India) in Group II. The teeth were restored with zinc oxide eugenol and glass ionomer cement (GIC), followed by stainless steel crown in the same visit. Clinical and radiographic evaluation was undertaken at 1, 3, and 6 months interval. RESULTS: The overall success rate was 90% in PRF group and 95% in LPDP group at the end of 6 months. The results were statistically nonsignificant between the groups (P > 0.05). CONCLUSION: The overall outcome of the study suggests that PRF and LPDP are acceptable pulpotomy agents and are promising in the era of new vital pulp therapy procedure.

Is Laparoscopic Roux-en-Y Gastric Bypass Still the Gold Standard Procedure for Indians? Mid- to Long-Term Outcomes from a Tertiary Care Center.

PURPOSE: Laparoscopic Roux-en-Y gastric bypass (RYGB) is the oldest and most widely performed bariatric surgery worldwide. There is, however, a scarcity of mid- to long-term data of RYGB, especially from the Indian subcontinent. MATERIALS AND METHODS: The study was a single-center, retrospective analysis from patients who underwent RYGB between January 2009 and November 2014 from a tertiary care center in India. Percent of total weight loss (%TWL) was taken as the primary outcome of the study. Secondary outcomes included type 2 diabetes mellitus (T2DM) remission, comorbidity resolution, revisional surgeries, and complications related to RYGB at 1 year, at 3 years, and during the long term, following surgery. Postoperative visits took place at 1 and 3 years, while the long-term outcome was at median 8.3 years (range 5.4-11.2 years), with a follow-up of 92.4% (488/528), 80.5% (424/527) and 69.5% (363/522), respectively. RESULTS: Out of 528 patients studied, 56% were females. The mean body mass index (BMI) was 40.6 ± 6.9 kg/m2. The %TWL in the long-term follow-up was 21.8 ± 11.3%. T2DM remission rates at 1 year, at 3 years, and during the long term were 84.5%, 70.0%, and 60.0%, respectively. Preoperative HBA1c (p = 0.002) and insulin usage (p = 0.016) had a significant predictive effect on T2DM remission. Gastroesophageal reflux disease (GERD) improved significantly (p < 0.001). Early (< 30 days) and late (> 30 days) complications were observed in 2.3% and 4.3% of the patients, respectively. CONCLUSION: Weight loss during mid to long-term follow-up was maintained in the majority of the patients after RYGB. However, a small proportion had significant weight regain in the long term. T2DM, GERD, and other comorbidities were well improved after RYGB.

Formation of nanostructures on magnesium alloy by anodization for potential biomedical applications.

In the present work, we have investigated the formation of nanostructures on AZ31 magnesium alloy using electrochemical anodization technique. The formed nanostructures were efficiently showed bone-like apatite formation followed by its gradual increase, when immersed in simulated body fluid (SBF) and it exhibited controlled degradation in 7 days. Cell viability study was performed using MG-63 cells (human osteosarcoma cell lines) and revealed that the nanostructured surface has excellent biocompatibility by enhancing both cell adhesion and cell growth. The detailed characterization of this anodized surface was evaluated by field emission scanning electron microscopy (FESEM) and energy-dispersive X-ray spectroscopy (EDS). Furthermore, surface-corrosion before and after anodization was examined by electrochemical impedance spectroscopy (EIS) and potentiodynamic polarization studies in SBF. The in-depth studies bring out the fact that native oxide in the sample is converted to a biocompatible nanostructure, which is created due to anodization in a particular electrolyte solution containing ethylene glycol and hybrid hydrofluoric acid mixture.

Impact of Bariatric Surgery on Female Reproductive Health and Maternal Outcomes.

INTRODUCTION: Obesity has a derogatory effect on female reproductive health. Obesity contributes to difficulty in natural conception, increased risk of pregnancy-associated complications, miscarriages, congenital anomalies, and also the long-term negative impact on both mother and the child. OBJECTIVES: Our study aimed to analyze and assess the reproductive health-associated outcomes of females who underwent bariatric surgery. METHODS: We performed a retrospective analysis from a prospectively collected database from June 2013 to June2016. Out of 71 females studied, 45 patients (63.5%) had completed 3 years of follow-up. The data were collected from inpatient and outpatient records. Patients were studied under three groups (A, patients with polycystic ovarian disease (PCOD) symptoms; B, patients with primary infertility; and C, patients who conceived after bariatric surgery that were included in groups A and B). RESULTS: Out of 45 patients studied, 40 patients underwent laparoscopic sleeve gastrectomy (LSG), four patients underwent laparoscopic Roux-en-Y gastric bypass (RYGB), and one patient underwent laparoscopic adjustable gastric banding (LAGB). The mean BMI of the patients was 43.64 ± 6.8 kg/m2. PCOD symptoms improved symptomatically (p = 0.001) after surgery in the group. Seven (43.75%) primary infertility patients conceived after surgery. Three (42.9%) patients conceived naturally while 4 (57.1%) conceived with ART in group B. Out of total population of 45 in group C, percentages of patients who delivered baby with short gestational age (SGA), low birth weight (LBW), normal vaginal deliveries (NVD), and maternal anemia were 63.15%,47.3%,73.4%, and26.3%, respectively. CONCLUSION: Obesity is closely associated with primary infertility and PCOD. Menstrual abnormalities associated with PCOD significantly improve after bariatric surgery with significant improvement in fertility along with maternal outcomes.

Long-term outcomes of laparoscopic sleeve gastrectomy from the Indian subcontinent.

BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is the most commonly performed metabolic surgery worldwide. There are few mid- to long-term studies for LSG, especially from the Indian subcontinent. OBJECTIVE: The primary outcome of the study was percent total weight loss (%TWL), and secondary outcomes included type 2 diabetes mellitus remission (T2DM) rates, comorbidity resolution rates, revisional surgeries, and complications related to LSG, 3 and 5 years after surgery. METHOD: The study was a single-center, retrospective analysis from patients who underwent primary as well as revisional LSG between January 2012 and December 2013 from a tertiary care center in India. We included patients who completed a minimum follow-up of 5 years. Details of the patients were collected from outpatient and inpatient case sheet records, during their follow-up. RESULTS: Out of a total of 284 patients, 57% were females. Mean baseline body mass index (BMI) was 44.9 ± 7.9 kg/m2. The diabetic population comprised 14.8% of the total patients. Mean %TWL at 5 years was 26.0 ± 9.9%. T2DM remission at 1, 3, and 5 years were 78.5%, 71.4%, and 66.6%, respectively. Preoperative BMI (p = 0.02), glycosylated hemoglobin (HbA1c) (p = 0.04), duration of diabetes in years (p = 0.04), and preoperative insulin usage (p = 0.04) were the preoperative predictors for T2DM remission. Early (< 30 days) and late (> 30 days) complications were seen in 4.5% and 0.7% of the population, respectively. CONCLUSION: Weight loss after LSG was maintained in the majority of the patients, while a small proportion has significant weight regain at 5 years. T2DM resolution and other comorbidity resolutions were well supported after LSG.

Effect of Dental Health Education on the Knowledge and Attitude Among Expectant Mothers: A Questionnaire Study.

BACKGROUND: Although dental caries levels have declined and stabilized the world over, the problem of early childhood caries has remained persistent in many areas of the world affecting certain segments of society, especially the socially deprived, who remain at high risk to this disease. Parents have an essential role in mediating between their children and environment for which prenatal period is the best time for health interventions. This mediation is done through preventive services they provide to their children such as dietary habits supervision, oral hygiene performance, and other practices that can be enhanced by prenatal dental health education. PURPOSE: The purpose of the study was to evaluate, by means of a questionnaire, the expectant mother's knowledge and attitude toward dental health and to test the effectiveness of the health education tool. MATERIALS AND METHODS: The baseline questionnaire consisted of 27 questions, which was distributed to 138 participants. Subsequently, provision for dental health education was made in batches of 20. After 3 weeks, 10 questions were randomly selected from the first questionnaire for reassessment session. Paired t test was used for statistical analysis. RESULTS: The mean overall knowledge improved from 67.4% to 97.32% and attitude improved from 75.83% to 99.22%. CONCLUSION: Knowledge and attitude of mothers was found to increase on provision of dental health education, which were retained even after a period of 3 weeks.

Effect of cervical priming with misoprostol on cervical entry in women undergoing vaginoscopic hysteroscopy for evaluation of abnormal uterine bleeding: a randomized controlled trial.

OBJECTIVE: To study the effect of cervical priming with misoprostol on cervical entry in women undergoing diagnostic hysteroscopy for evaluation of abnormal uterine bleeding. METHODS: Randomized controlled trial conducted in teaching hospital and tertiary referral center on 122 women requiring diagnostic hysteroscopy for evaluation of abnormal uterine bleeding. Women were randomized into two equal groups (n = 122). Study group received 200-µg vaginal misoprostol, 3 h prior to vaginoscopic hysteroscopy. No drug was used in control group. No analgesia or anesthesia was used in either group. Outcome measure included (i) ease of cervical entry (Likert scale), and (ii) pain scoring (Visual Analog Scale) and procedural entry time. RESULTS: Forty-six (75.41%) patients in the study group and 17 (27.87%) in control group had easy or very easy entry (Likert scale-4 and 5) (p < 0.001). Median pain scoring by VAS and the median procedural entry time was significantly lower in the study group compared to the control group (p < 0.001). CONCLUSION: Use of 200-µg vaginal misoprostol, administered vaginally 3 h before diagnostic vaginoscopic hysteroscopy, was found to be simple and effective method of cervical priming in facilitating cervical entry with minimal side effects. Clinical Trial registry of India (CTRI): (CTRI/2015/04/005666) (website: http://ctri.nic.in ).

Ring chromosome 8 and trisomy 8 in a patient with acute myeloid leukemia.

We describe a child with Acute Myeloid Leukemia (AML M7) with trisomy 8 and ring chromosome 8. Ring chromosome 8 associated with AML is uncommon and is reported to have a poor outcome. The combination of trisomy 8 and ring chromosome 8 has not been previously reported. This 15-month-old girl had presented with a history of fever, weight loss of 1 kg, gum bleeds and pallor. Clinical examinations revealed no nodes or organomegaly. Investigations revealed pancytopenia and elevated serum LDH. Bone marrow aspirate confirmed the presence of myeloid blasts positive only for CD 41 and CD 61 on flow cytometry. Chromosomal analysis from the bone marrow showed 46, XX [13]/ 47, XX, +8[2]/ 47, XX, +r (8) [5]. The child was treated as per UK MRC AML protocol (ADE 10+3+5). Bone marrow on day 21 post-induction was in morphological remission. Repeat karyotyping revealed 46,XX suggesting that the patient was in cytogenetic remission. Cytogenetic sub grouping in AML patients provides guidelines for the choice of optimal treatment strategy. There was no HLA matched family donor and hence an unrelated donor search was commenced as she was in the group with unfavourable cytogenetics. She developed acute myelofibrosis soon after the second cycle of chemotherapy with swinging fever and rapidly enlarging spleen. The marrow showed 11% blasts with intense fibrosis. She went through a stormy period during conditioning for unrelated stem cell transplantation. She passed away on day 11 post transplantation of veno-occlusive disease of liver and multiorgan failure. This case illustrates the poor outcome in paediatric AML with trisomy and ring chromosome 8.