Child Drawing: A Projective Tool for Dental Anxiety Assessment

INTRODUCTION: Assessment of child’s anxiety is important in order to determine the success of dental treatment. Drawing, a nonverbal, self-report, projective and non-invasive technique may prove be helpful and needs to be explored in order to access anxiety in children requiring dental treatment.AIM: To investigate the applicability of children’s drawings as an indicator to measure their level of anxiety.MATERIALS & METHOD: A cross-sectional study was conducted in a total of hundred children between age group of 4-6 years. Children were asked to draw dental operatory on A4 sheet and colour it with basic set of 12 colours. The drawing was scored using Child Drawing: Hospital (projective scale) scale and the results were compared with pulse oximeter readings (physiological parameter) and Venham Picture Test scorings.RESULTS: Child Drawing: Hospital scale scoring had a positive correlation with pulse oximeter reading (involuntary) (p-value = 0.125) and a negative correlation with Venham picture test (p-value = 0.140).CONCLUSION: Drawing may be statistically significant projective tool significant to assess child anxiety in dental setting

Topographic Distribution of Carious Lesion on Young Permanent Mandibular Molars and Its Relation to Periapical Index Score of Apical Periodontitis: A Radiographic Analysis

INTRODUCTION: Caries in young permanent teeth progress rapidly resulting in early pulp involvement which further progresses into loss of mineralized tissue and severe periapical pathologies. The Periapical Index scoring system (PAI) proposed by Ørstavik et al. in 1986 is an invaluable diagnostic tool used to evaluate periapical lesion extent and severity by 2D digital intraoral periapical radiographic analysis with minimal radiation exposure and hence treatment planning.AIM: To evaluate the relationship of the surface distribution of caries in young permanent molars, pulpal involvement and periapical index (PAI) score with respect to individual root forming young permanent mandibular molars. MATERIALS AND METHOD: In this retrospective single-centre study, 100 pulpally involved carious young permanent mandibular molars were included, selected from the departmental records between August 2018-2019. Topographic distribution of caries and radiographic analysis (using PAI) was evaluated to see the effect of anatomical site of caries, individual anatomical form of root, and extent & severity of apical periodontitis developed.RESULT: No significant correlation between the site of caries involvement and PAI score was observed. PAI score for distal roots was higher(PAI> 2) as compared to mesial root for pulpally involved carious young permanent first molars (p-value mesial root-0.576 , distal root-0.591)CONCLUSION: PAI score is independent of the topographic distribution of caries and no correlation was observed. Periapical radiolucency does not depend on caries distribution, either it is mesial, distal or occlusal

Caries Pattern In Primary Molars With Early Pulpal Involvement In Mixed Dentition

INTRODUCTION: Caries in primary dentition may lead to high risk in permanent dentition; it is therefore important to identify those children who are caries affected. Specific and distinct patterns of caries attack might indicate a distinct etiology or are most likely associated with the subsequent development of carious lesions on other surfaces of teeth.AIM: To assess caries susceptibility and prevalence in primary teeth and evaluate the prevalence of caries according to individual molar surfaces in 4-8 year old children.MATERIAL AND METHODS: A cross sectional retrospective study was conducted in the pediatric department of SGT Dental College using convenient sampling with caries in teeth as chief complaint. 70 radiographs were examined in the age group of 4-8 years. Lesions present on mesial, distal and occlusal surfaces were recorded on the chart after radiographic examination.RESULTS: As per results, distal surface of D(45.40%) and mesial surface of E (37.80%) showed maximum caries on adjacent proximal surfaces and significant dependence (p value<0.05) was found between the presence of lesions on adjacent proximal surfaces. The D(76.1% )and E(79.1% )showed significantly higher caries experience on the proximal surfaces in conjunction with occlusal caries but were statistically not significant.CONCLUSION: In the presence of non-proximal caries (occlusal caries), the chances of proximal caries are increased as seen radiographically. Thus need for treatment, are likely being underestimated during visual examinations alone

Minimal information for studies of extracellular vesicles (MISEV2023): From basic to advanced approaches

Extracellular vesicles (EVs), through their complex cargo, can reflect the state of their cell of origin and change the functions and phenotypes of other cells. These features indicate strong biomarker and therapeutic potential and have generated broad interest, as evidenced by the steady year-on-year increase in the numbers of scientific publications about EVs. Important advances have been made in EV metrology and in understanding and applying EV biology. However, hurdles remain to realising the potential of EVs in domains ranging from basic biology to clinical applications due to challenges in EV nomenclature, separation from non-vesicular extracellular particles, characterisation and functional studies. To address the challenges and opportunities in this rapidly evolving field, the International Society for Extracellular Vesicles (ISEV) updates its 'Minimal Information for Studies of Extracellular Vesicles', which was first published in 2014 and then in 2018 as MISEV2014 and MISEV2018, respectively. The goal of the current document, MISEV2023, is to provide researchers with an updated snapshot of available approaches and their advantages and limitations for production, separation and characterisation of EVs from multiple sources, including cell culture, body fluids and solid tissues. In addition to presenting the latest state of the art in basic principles of EV research, this document also covers advanced techniques and approaches that are currently expanding the boundaries of the field. MISEV2023 also includes new sections on EV release and uptake and a brief discussion of in vivo approaches to study EVs. Compiling feedback from ISEV expert task forces and more than 1000 researchers, this document conveys the current state of EV research to facilitate robust scientific discoveries and move the field forward even more rapidly

A Combined Case of Neonatal Teeth, Bohn’s Nodules and Eruption Haematoma in an Infant Presenting as a Diagnostic Dilemma

Abnormalities in the oral cavity of infants are not uncommon, but most are innocuous and resolve with age in the absence of treatment. Some of the most prevalent oral findings are oral inclusion cysts, vascular lesions, natal and neonatal teeth. The American Academy of Paediatric Dentistry (AAPD) recognises that perinatal and infant oral health are the basics upon which preventive education and dental care must be built to enhance the opportunity for a child to have a lifetime free from preventable oral disease This report describes the clinical presentation, diagnosis and suggestive management for a 32-day-old male child patient reported with neonatal teeth, Bohn’s nodules and further at the age of 18 months, with eruption haematoma in the maxillary alveolar region. “Bohn’s nodules” are keratin-filled cysts with prevalence of 47.4% with no gender predilection. Natal and neonatal teeth considered as critically important conditions as their presence can lead to numerous complications such as ulceration on the ventral surface of the tongue caused by the sharp incisal edge of the tooth and condition known as Riga-Fede disease or syndrome. “Eruption haematoma” is circumcoronal cystic cavity which contains blood usually associated with an erupting primary or permanent tooth which is in its soft tissue eruption phase. Therefore, a thorough clinical examination and knowledge of the various lesions is essential for precise diagnosis, management, as well as parental counselling

Emerging role of baricitinib in dermatology practice: All we need to know!

Baricitinib is a competitive inhibitor of the Janus Kinase family of non-receptor protein kinases, predominantly acting against JAK-1 and JAK-2 subtypes. By downregulating transcription of various pro-inflammatory cytokines, this drug has shown efficacy across various dermatoses. Approved for severe cases of alopecia areata and moderate-severe atopic dermatitis in adults, baricitinib is being increasingly tried across many other indications with promising results. It is prudent that dermatologists remain aware of boxed warnings and precautions with the use of this much-discussed molecule, including its infectious, thrombotic, cardiovascular, and malignant ramifications. Long-term data on the use of baricitinib in dermatological conditions are lacking and further research is warranted since most data on safety profile is extrapolated from its use in rheumatology. The present review aims to highlight the immunopathogenic mechanisms of JAK-1/2 blockade, approved and off-label uses in dermatology, along with a concise review of laboratory monitoring and the side-effect profile of baricitinib

Early childhood caries in preschool children of gram panchayat Anoo, Hamirpur, Himachal Pradesh

Aim and Objectives: A study on prevalence and associated etiological factors of ECC. This study aimed to find the prevalence of ECC and the associated factors among preschool children in Anoo village, Hamirpur district (H.P). Materials and Methods: A sample of 65 children of age between 1 to 5 years was selected from anganwadi units of Anoo village. Dental caries was recorded and information regarding risk factors for caries was obtained through a questionnaire given to mothers or caretakers. Result: The prevalence of ECC was 55.38% and there was a strong association of ECC with some of the risk factors studied. Conclusion: The study emphasizes the need of dental health programs in preschool children. Increasing the awareness regarding maintaining good oral hygiene and encouraging the intake of healthy snacks in children can reduce ECC in concerned population

Esthetic improvement of white spot lesions and non-pitted fluorosis using resin infiltration technique: Series of four clinical cases

White opacities have always been a major concern of esthetics for patients and can have varying etiology. In general, white discolorations of enamel might be due to dental fluorosis, early caries (white spot lesions), developmental defects etc. Conventional treatment options available for such opacities include non-invasive and invasive approaches. Recently, a new "micro-invasive" technique has been introduced as an alternative therapeutic approach that improves such opacities esthetically, in a single sitting, is painless and exhibits no complications. This case series illustrates the use of resin infiltration to treat fluorosis stains and WSLs, exhibiting significant improvement in esthetics

Effect of Type of Malocclusion on the Surface Pattern of Caries on Molars and DMFT Index in Primary and Mixed Dentition Period- A Pilot Study

Introduction: Caries pattern is multifactorial in context to the type of diet, tooth structure, time of insult, microflora and salivary contents (salivary pH, buffering action, salivary flow, etc.). Craniofacial relationship may be a contributing factor in the site of occurrence of caries i.e., mesial, distal, occlusal, palatal/lingual and buccal surfaces of primary and permanent molars. Aim: The aim of the study was to find out the effect of the type of malocclusion in primary dentition and mixed dentition period on the surface distribution of caries with respect to their molars along with overall DMFT (decayed, missing and filled teeth index) of the patient. Materials and Methods: A pilot study was conducted in Government and Private schools of district Gurugram, Haryana. Hundred children between 3-5 years of age with primary dentition and 8-10 years of age in mixed dentition period as per inclusion and exclusion criteria were included. Type of terminal plane relationship, according to Baume’s classification, i.e., Flush terminal/mesial step/distal step and affected carious site in all primary molars were examined in 3-5-year-old children. Similarly in 8-10-year-old, type of malocclusion according to Angle’s Classification and its association with carious sites in permanent first molar were examined. Decayed, missing and filled teeth index, DMFT/dmft (i.e., dmft=0-1, 1-2, ≤3 and DMFT+dmft (DMFT+dmft=0-1, 1-2, ≤3) was analysed in both groups, respectively. Results: The mesial step molar relationship was the most common malocclusion (93%) in primary dentition whereas in mixed dentition Angle’s Class I was the most common (84%) malocclusion. Caries occurrence was more in maxillary molars as compared to mandibular molars. The order of caries occurrence in primary and permanent dentition was occlusal surfaces>mesial surfaces>distal surfaces>buccal surfaces>palatal/lingual surfaces. The caries occurrence according to dmft index in primary dentition was not associated with any type of malocclusion, though it was more in mesial step molar relationship. Angle’s Class II malocclusion contributed significantly high DMFT+dmft index with p-value of 0.020. Conclusion: Type of malocclusion does not affect with surface pattern of caries on molars in primary and mixed dentition period. Decayed, missing and filled caries index may be significantly associated with Angle’s Class II malocclusion according to the present study

A cross-sectional survey to assess knowledge, attitude, and practice of Yoga among cancer patients at a tertiary care hospital

Background: Cancer incidence and mortality are rapidly growing worldwide. Cancer affects the overall quality of life of cancer patients. Yoga has its origin in the ancient times. This ancient practice has been used for holistic well-being for ages. Yoga as an alternative therapy might be beneficial for cancer patients too. This study was conducted to assess knowledge, attitudes, and yoga practices among cancer patients. Materials and Methods: For this cross-sectional survey, a self-designed questionnaire was validated and distributed among 25 cancer patients for a pilot study. Then, a full-fledged study was conducted based on the interviews of 1000 cancer patients at a tertiary care oncology unit and the data were analyzed using R 3.6. Results: A total of 1000 participants were enrolled in this cross-sectional survey. Out of 1000 participants, 91 were excluded as they responded that they were not familiar with the term “Yoga” in the first question of the questionnaire. Of 919 participants, 238 strongly agreed and 395 agreed with the question that people who practice yoga are less prone to diseases, showing that 68.87% of cancer patients have a positive attitude toward yoga. However, only 145 (15.77%) of the participants practice yoga regularly. Lack of time was the most common reason for not practicing yoga, and the other reasons were the lack of interest and insufficient facilities. Conclusion: The present study on 1000 patients from the yoga capital of the world, Rishikesh, highlights the fact that the majority of cancer patients are aware of yoga practice's benefits and if given the opportunity to learn appropriate techniques, yoga can further improve the outcome in such patients. There is a need to design the effective yoga programs for cancer patients to promote suitable yoga practices in this population