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Latest Paper:
Department of Pedodontics and Preventive Dentistry, Christian Dental College, Ludhiana, India.
Early Childhood Caries (ECC) is a lifestyle disease that begins when the child's teeth erupt in the oral cavity. The distinctive pattern of decay rapidly spreads from one tooth to another and involves the surfaces of teeth that are usually not at risk. Detection of disease is crucial to control the oral condition using preventive and therapeutic regimes. The aim of this study was to determine the prevalence of caries in children of age 3-6 years in Ludhiana and to examine the relationship between age and caries experience. A total of 609 children in the age group of 3-6 years were examined using def index. To determine dental care seeking attitude, 105 caregivers were interviewed. Results revealed that 52.87% of children in the age group of 3-3.11 years, 45.1% of children in the age group of 4-4.11 years and 58.55% of children in 5-5.11 age groups suffered from caries. The mean def index was 1.82, 1.57 and 2.21, respectively. Interview of caregivers of children revealed that out of 105 only 12 (11.4%) children had previously been to a general dentist. None of them knew about Pedodontics as a specialty. The results of the present study can be used mainly for screening child populations in need of treatment, helping public workers and planners to develop dental health programs to aid early intervention and prevention.
Hiroshi Watanabe,
Dawood Darbar,
Daniel W Kaiser,
Kim Jiramongkolchai,
Sameer Chopra,
Brian S Donahue,
Prince J Kannankeril,
Dan M Roden
Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232-0575, USA.
BACKGROUND: We and others have reported mutations in the cardiac predominant sodium channel gene SCN5A in patients with atrial fibrillation (AF). We also have reported that SCN1B is associated with Brugada syndrome and isolated cardiac conduction disease. We tested the hypothesis that mutations in the 4 sodium channel beta-subunit genes SCN1B-SCN4B contribute to AF susceptibility. METHODS AND RESULTS: Screening for mutations in the 4 beta-subunit genes was performed in 480 patients with AF (118 patients with lone AF and 362 patients with AF and cardiovascular disease) and 548 control subjects (188 ethnically defined anonymized subjects and 360 subjects without AF). The effects of mutant beta-subunits on SCN5A mediated currents were studied using electrophysiological studies. We identified 2 nonsynonymous variants in SCN1B (resulting in R85H, D153N) and 2 in SCN2B (R28Q, R28W) in patients with AF. These occur at residues highly conserved across mammals and were absent in control subjects. In 3 of 4 mutation carriers, the ECGs showed saddleback-type ST-segment elevation in the right precordial leads. Transcripts encoding both SCN1B and SCN2B were detected in human atrium and ventricle. In heterologous expression studies using Chinese hamster ovary cells, the mutant beta1- or beta2-subunits reduced SCN5A-mediated current and altered channel gating compared with coexpression of wild-type subunits. CONCLUSIONS: Loss of function mutations in sodium channel beta-subunits were identified in patients with AF and were associated with a distinctive ECG phenotype. These findings further support the hypothesis that decreased sodium current enhances AF susceptibility.
Department of Radiation Oncology, Tata Memorial Hospital, Parel, Mumbai, India.
AIMS: To compare the quality of life of women with early breast cancer treated with either accelerated partial breast irradiation (APBI) or whole breast radiotherapy (WBRT). MATERIALS AND METHODS: After matching for the American Brachytherapy Society criteria, the general European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and the breast cancer-specific BR23 modules were given to 48 women (23 APBI and 25 WBRT) who attended the radiotherapy clinic between May 2006 and December 2006 at Tata Memorial Hospital. RESULTS: The median follow-up of patients in both groups was 3 years. The reliability and validity of the English and translated versions of the questionnaires were tested by Cronbach alpha ( .67- .96) and Pearson's correlation for scale-scale correlation statistic ( .013- .505). The scores for social functioning and financial difficulties in QLQ-C30 showed a trend towards a better outcome in the APBI group (P= .025 and .019, respectively) and body image in BR23 was significantly better in the APBI group as compared with the WBRT group (P= .005). When the analysis was restricted to women receiving chemotherapy in order to eliminate the confounding effect of the heterogeneous use of chemotherapy in the WBRT group, the difference in social functioning was not significant. However, financial difficulties and body image showed a trend towards a worse outcome in the WBRT group. CONCLUSION: Favourable long-term results of APBI in terms of superior body image perception and lesser financial difficulties compared with WBRT need to be confirmed in larger prospective studies investigating the effect of APBI on quality of life and health economics in different ethnic groups and health care set-ups.
F Streitparth,
T Walter,
U Wonneberger,
S Chopra,
F Wichlas,
M Wagner,
K Hermann,
B Hamm,
U Teichgräber
Department of Radiology, Charité, Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany, florian.streitparth@charite.de.
OBJECTIVE: We prospectively evaluated the feasibility and technical features of MR-guided lumbosacral injection procedures in open high-field MRI at 1. T. METHODS: In a CuSO(4).5H(2)O phantom and five human cadaveric spines, fluoroscopy sequences (proton-density-weighted turbo spin-echo (PDw TSE), T1w TSE, T2w TSE; balanced steady-state free precession (bSSFP), T1w gradient echo (GE), T2w GE) were evaluated using two MRI-compatible 20-G Chiba-type needles. Artefacts were analysed by varying needle orientation to B( ), frequency-encoding direction and slice orientation. Image quality was described using the contrast-to-noise ratio (CNR). Subsequently, a total of 183 MR-guided nerve root (107), facet (53) and sacroiliac joint (23) injections were performed in 53 patients. RESULTS: In vitro, PDw TSE sequence yielded the best needle-tissue contrasts (CNR = 45, 18, 15, 9, and 8 for needle vs. fat, muscle, root, bone and sclerosis, respectively) and optimal artefact sizes (width and tip shift less than 5 mm). In vivo, PDw TSE sequence was sufficient in all cases. The acquisition time of 2 s facilitated near-real-time MRI guidance. Drug delivery was technically successful in 100%(107/107), 87%(46/53) and 87%(20/23) of nerve root, facet and sacroiliac joint injections, respectively. No major complications occurred. The mean procedure time was 29 min (range 19-67 min). CONCLUSION: MR-guided spinal injections in open high-field MRI are feasible and accurate using fast TSE sequence designs.
Department of General-, Visceral-, and Transplantation Surgery, Charité Virchow-Clinic, Augustenburger Platz 1, 13353 Berlin, Germany.
INTRODUCTION: Liver tumors should be surgically treated whenever possible. In the case of bilobar disease or coexisting liver cirrhosis, surgical options are limited. Radiofrequency ablation (RFA) has been successfully used for irresectable liver tumors. The combination of hepatic resection and RFA extends the feasibility of open surgical procedures in patients with liver metastases and hepatocellular carcinoma (HCC). PATIENTS AND METHODS: RFA was performed with two different monopolar devices using ultrasound guidance. Intraoperative use of RFA for the treatment of liver metastases or HCC was limited to otherwise irresectable tumors during open surgical procedures including hepatic resections. Irresectability was considered if bilobar disease was treated, the functional hepatic reserve was impaired or appraised marginal for allowing further resection. RESULTS: Ten patients with both liver metastases and HCC, and two patients with cholangiocellular carcinoma were treated. Complete initial tumor clearance was achieved in all patients. Two patients of the metastases group and five patients of the HCC group suffered from local recurrence after a median of 12 months (1-26)(local recurrence rate 32%). Five patients of the metastases group and six patients of the HCC group developed recurrent tumors in different areas of the ablation site after a median time of 4 months (2-18)(distant intrahepatic recurrence in 55%). Survival at 31 months was 36%. CONCLUSION: RFA extends the scope of surgery in some candidates with intraoperatively found irresectability.
Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
OBJECTIVE: To study maternal and perinatal outcome in congenital heart disease (CHD) and to compare outcome between cyanotic and acyanotic CHD. METHOD: A retrospective analysis of 196 cases of CHD was undertaken, and maternal and perinatal outcome of pregnancy was compared in cyanotic and acyanotic cases and between surgically corrected and uncorrected cases. RESULTS: Maternal and perinatal outcome was better in the acyanotic group. Maternal complications included higher incidence of cardiac complications in cyanotic group,(33.3% vs 3.4% in acyanotic group, P = .001), abruption (12.5% vs nil) and pregnancy-induced hypertension (16.6% vs 5.2%). Rate of prematurity (25% vs 11.6%), intrauterine growth retardation (50% vs 15.1%, P = .003) and abortion (4.1% vs 2.1%) was higher in cyanotic group. Mean gestational age at delivery was better in corrected group, 37.13 vs 34.93 weeks in uncorrected group. There was no case of infective endocarditis. There were four cases of maternal mortality in cyanotic group, two of which were in women with Eisenmenger syndrome. In acyanotic heart disease one case died undelivered and one died on first postoperative day. CONCLUSION: Maternal and perinatal outcome is better in acyanotic CHD compared to cyanotic CHD. Surgical correction of cardiac lesions prior to conception improves outcome.
Department of Pedodontics and Preventive Dentistry, Christian Dental College and Hospital C.M.C., Ludhiana, Punjab, India.
OBJECTIVE: To evaluate the reliability of the magnification method for localisation of palatally placed canines. METHODS: Panoramic radiographs were taken of subjects, aged 10 to 12 years, with unerupted upper permanent canines. Two periapical radiographs (horizontal parallax method) were then used to identify 36 sublects with one palatally placed canine. Differences in the sizes of crowns of the canines on the panoramic radiographs were used to identify which tooth was palatally placed. The observer was blinded to the side with the palatally placed canine. The parallax and magnification results were tabulated, and the sensitivity and specificity of the magnification method calculated. RESULTS: The magnification method was found to have a sensitivity of 75 per cent; specificity of 100 per cent; positive predictive value of 100 per cent; negative predictive value of 80 per cent; and an accuracy of 87.5 per cent, in localising palatally placed canines. CONCLUSION: The magnification method, which uses the side-to-side difference in the magnification of the crowns of ectopic canines on panoramic radiographs, is adequate for initial assessment of canine position. The magnification method did, however, accurately identify canines that were not palatally placed. Additional radiographs may be required to accurately localise an ectopic canine.
Department of Gynecology and Obstetrics, Post Graduate Institute of Medical Education and Research, Chandigarh - 160012, India.
Swyer-James-MacLeod (SJM) syndrome is a chronic, progressive lung disease as a result of infection and bronchial obstruction that ultimately leads to emphysema. It is associated with chronic cough, sputum production and recurrent chest infections and is occasionally seen in women of reproductive age. The radiological finding of unilateral hyperlucent lung is considered synonymous with the disease entity.
Clinic for General, Visceral, and Transplantation Surgery, Charité Campus Virchow Clinic, University of Medicine Berlin, Augustenburger Platz 1, 13353, Berlin, Germany, sven.schmidt@charite.de.
BACKGROUND: In recent years, laparoscopic hepatic resection is performed by an increasing number of surgeons. Despite many advantages of the laparoscopic procedure, it is unclear whether the pneumoperitoneum affects the postoperative liver regeneration after liver resection. The current study aimed to investigate the influence of a carbon dioxide (CO(2)) pneumoperitoneum on liver regeneration in a rat model. METHODS: In this study, 60 male Wistar rats were subjected to 70% partial hepatic resection. Of these 60 animals, 30 underwent preoperative pneumoperitoneum at 9 mmHg for 60 min. After hepatic resection, the rats were killed at 12, 24, and 48 h, and on days 4 and 7. The outcome parameters were hepatocellular injury (plasma aminotransferases), oxidative stress (plasma malondialdehyde), interleukin-6 (IL-6), and liver regeneration (mitotic index, KI-67; regenerating liver mass). RESULTS: The mitotic index was significantly lower in the pneumoperitoneum group than in the group without pneumoperitoneum at all time points (p < .05). In the pneumoperitoneum group, KI-67 was significantly lower on day 4 (p < .05). The liver regeneration rate was significantly lower for the animals with pneumoperitoneum on days 2 and 4 (p < .05). The postoperative hepatocellular injury was significantly greater after pneumoperitoneum at 12, 24, and 48 h (p < .05). Plasma malondialdehyde and IL-6 were significantly higher in the pneumoperitoneum group at 24 h and on day 4 (p < .05). CONCLUSION: This study showed that pneumoperitoneum before extended liver resection impaired postoperative liver regeneration. Oxidative stress reaction and hepatocellular damage was markedly higher after pneumoperitoneum. Further investigations, especially with patients that have impaired liver function, are necessary for clinical consequences to be drawn from these results.
Vanita Suri,
Anish Keepanasseril,
Neelam Aggarwal,
Rajesh Vijayvergiya,
Seema Chopra,
Meenakshi Rohilla
Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Aim: Maternal complete heart block (CHB), which manifests for the first time during pregnancy and peurperium, poses a challenge to treating physicians. We present here four cases that were diagnosed during pregnancy and peurperium, and we discuss their management issues. Methods: A retrospective analysis of a 3-year period was carried out in a referral hospital in northern India. The course of pregnancy, disease and perinatal outcome in women with CHB diagnosed during pregnancy was studied. Results: Of the four patients who presented with CHB, only one had a structural cardiac lesion (corrected transposition of great arteries). All of the women had an uneventful delivery. Two women were given prophylactic temporary pacing before labor and three women required subsequent permanent pacing. Intrauterine growth restriction (IUGR) was present in two babies and preterm labor occurred in one patient. None of the neonates had any rhythm disturbances. Conclusion: When a multidisciplinary approach is used, both maternal and neonatal outcomes are good. The incidence of IUGR and preterm birth may be on the increase; hence, clinical vigilance for these conditions is warranted.
