Atharva Scientific Publications (E-Jounals)
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TRAP Intrusion Arch-Modification of Transpalatal Arch for an effective Intrusion of Molars and Premolars
Full text linkThe aim of the present clinic paper is to demonstrate an innovative design for the effective molar intrusion using TRAP appliance. Since its inception, Transpalatal Arch (TPA) has been modified to meet the various needs of orthodontic tooth movement and marathon of the modification continues still now. The applications of the transpalatal arch involve the three-dimensional control of the molar to active tooth movement of the molar as well. The design involves the usage of the properties of Niti open coil spring along with acrylic pad in TPA to bring about the effective molar intrusion
Orthodontic treatment of transposition of bilateral maxillary canine and 1st premolar by maintaining the transposed position: A case report
Full text linkBilateral tooth transposition between maxillary canine and 1st premolar is a rare finding and poses a challenge to any orthodontist to treat. In definitive treatment plan, one of the treatment alternatives can be finishing the case with alignment of involved teeth in their transposed position whereas the other option is to correct the transposition orthodontically and establishing the natural tooth order. Here a case is presented where transposed positions were maintained with the philosophy to treat by minimizing the negative factors
Evaluation of the Efficacy of a Conventional Bristle Brush and Cross-action Brush in Routine Oral Hygiene Practice: A Comparative Study
Full text linkBackground: Toothbrush filament configuration can vary to a large extent with a considerable emphasis on the design and texture of bristle of a toothbrush in order to enhance effective removal of plaque. Aims: The aim of the study was to compare the plaque removing efficiency of two branded toothbrushes with different brush head design and bristle arrangement in routine oral hygiene practice. Materials and methods: The study was randomized single blind, involving 100 healthy individuals, 50 samples in each group. At the time of initial examination the subjects randomly picked toothbrushes (Oral B fresh-clean and Oral B crossaction) and common toothpaste by lottery method along with the printed instructions to use the assigned brush for next 28 days. Plaque and gingival indices were recorded at appointed time every 0, 7th, 14th, 21st and 28th day. Finally, the resultswere subjected to student’s unpaired ‘t test’. Results: Plaque and gingival scores showed a significant decrease in all parameters at all time intervals. Plaque and gingival scores were found to be significantly reduced in 3rd and 4th week time interval with respect to both the brushes though the cross-action brush showed better result with mean reduction of gingival index score from 1.812 at baseline to 1.5733 at 4th week as compared to fresh-clean brush which showed mean reduction of gingival index score from 1.4161 at baseline to 1.4016 at 4th week. Conclusion: Among the two toothbrushes it was Oral-B crossaction toothbrush which showed the maximum reduction in plaque and gingival index scores followed by Oral-B fresh-clean toothbrush. It can be concluded that the arrangement of bristles plays a convincing role in reduction of plaque besides the manual dexterity of an individual
Review on the role of pidotimod in recurrent respiratory infections in children
Full text linkBackground: Physiological immaturity of the immune system is the most common cause of recurrent respiratory infections (RRIs) in children. Drugs acting on the immunological pathways such as immunostimulants can be a very useful approach in the management of RRIs in children. Pidotimod (PDT) is an immunostimulant that acts on both innate and adaptive immunity. The immunostimulant activity of PDT has been firmly established in the management of RRIs in children with or without asthma. Objectives: This review was performed to summarize the available literature on the correlation of immunity and RRIs and current evidence of PDT in RRIs and pneumonia in children. Methodology: The literature search was performed in PubMed and Google Scholar databases using search terms such as pidotimod, children, RRIs, and pneumonia. Results: A total of 18 clinical studies with 10,704 children were included in this review. This includes 13 randomized controlled trials, two meta-analysis, and two observational studies. This review of current clinical evidence demonstrates that when added to the standard of care, PDT significantly reduces the number of recurrences of RRIs, severity, and duration of acute episodes in children and is safe in its prevention and treatment. This ultimately results in reduced visits to pediatric clinics and lesser absenteeism from school. It is also effective in improving the clinical outcomes in pneumonia patients. Conclusion: Pidotimod is effective and safe in the prevention and treatment of RRIs in children
A renal biopsy-based clinicopathological study of primary tubulointerstitial nephritis in children
Full text linkBackground: Inflammation of the tubular and interstitial compartment without involving the glomeruli and vessels is called as primary tubulointerstitial nephritis (TIN), which may be due to varied etiologies. This is relatively uncommon in children as compared to primary glomerular disorders. Infections and drugs are the most common causes of primary TIN worldwide. Objectives: The objectives of the study were to assess primary TIN in pediatric patients using findings from renal biopsies at a tertiary care center of Western India. Materials and Methods: All biopsy-proven cases of primary TIN in pediatric patients over a period of 10 years were included in the study. All cases with glomerular or vascular diseases, or where data were inadequate were excluded from the study. The cases were reviewed in detail for epidemiological data, clinical presentation, etiology, and histomorphological features. Depending on their clinical and morphological features, the cases were categorized into acute, chronic, and granulomatous TIN. Results: A total of 30 cases of primary TIN were assessed with a mean age of 12.4 years and range of 6–18 years. Pedal edema and facial puffiness were the most common symptoms followed by oliguria. The common causes of TIN were drugs, namely antibiotics and non-steroidal anti-inflammatory drugs and infections. Acute TIN was more common than chronic TIN. Conclusion: Primary TIN is an uncommon renal disease in pediatric patients with varied presentations and etiologies. However, early diagnosis by renal biopsy, detailed history, and withdrawal of the offending agent along with prompt treatment helps in recovery and avoids chronic renal damage
Hidden hazard in appendix in children: Carcinoid tumors
Full text linkIntroduction: Carcinoid tumors (CT) are the most common tumors of the appendix. The incidence of CT of the appendix is generally 1–2 in every 1000 appendectomy material. Objectives: The objectives of the study were to discuss the follow-up and treatment of CT of the appendix in the specimen of patients who underwent an appendectomy. Materials and Methods: This retrospective study enrolled the patients who were diagnosed with CT of the appendix as a result of an examination of the appendix specimen after the patients underwent an appendectomy. All the patients, who underwent appendectomy in the pediatric surgery clinic of our hospital between November 2015 and November 2018, were included in the study. Patients’ demographic characteristics, clinical findings, pre-operative laboratory and imaging results, location, diameter and size of the tumor, mesoappendix invasion status, mitotic index and Ki-67 elevation, hospital stay duration, surgical types and complications, and results of laboratory and imaging tests were evaluated. Findings: Eight of the 621 patients (1.2%) who underwent an appendectomy were diagnosed with CT of the appendix. The median age of the patients was 13 years (range, 11–16 years). Of the eight patients, five (62.5%) were female and three (37.5%) were male. All patients presented to our clinic with abdominal pain. No surgical complications were observed during the operation and in the early post-operative period. The mean hospital stay was 2.7 days (2–5 days). In all the patients, the tumor size was <2 cm, the surgical margins were clean, the mitotic index was <2%, the Ki-67 index was below 1%, and the tumor had not spread to the mesoappendix. Only in one of the patients, the CT was located in the appendix radix; in the other seven patients, the tumor was in the middle and end of the appendix. Conclusion: CT of the appendix are clinically similar to acute appendicitis but may be found incidentally during other surgical procedures other than an appendectomy. Diagnosis is made after the pathological specimen diagnosed with CT is histopathologically evaluated. The size, diameter, and depth of the tumor, mesoappendix invasion, mitotic index, and Ki-67 elevation are used in the evaluation and treatment of the tumor
Assessment of knowledge of mothers from migrant population regarding use of oral rehydration solution in diarrheal illness in under-five children from rural Pune
Full text linkBackground: Diarrhea is one of the important causes of morbidity and mortality among under-five children in India. Lack of knowledge of mothers about the management of diarrheal diseases is a common problem in many developing countries. Use of oral rehydration solution (ORS) largely depends, on the level of mother’s knowledge. Objective: The objective of the study was to assess the knowledge of the mothers, from rural migrant population regarding the use of ORS in under-five children with diarrhea. Materials and Methods: A cross-sectional study was carried out from December 2016 to March 2017, among mothers of the migrant population residing and working at brick kilns and construction site in the field practice area of the rural health training center, Lavale, Pune. We included the mothers whose children were under five years of age. Those mothers, who had serious illness and had hearing and speech problems, were excluded from the study. Data were collected by interview method from mothers with the help of a pre-structured and pre-tested questionnaire. Results: A total of 54 (93.1%) mothers from brick kiln sites were included among whom, 43.10% were aware of ORS. Only 37.93% of mothers knew the use of homemade sugar salt solution for diarrhea in children. In this study, 25 (43.10%) mothers were illiterate and the study showed that knowledge regarding ORS was lower in illiterate mothers. Conclusion: Majority of the mothers were not aware regarding ORS, and as per the study, knowledge regarding ORS was lower in less educated mothers. Government schemes would help these mothers to increase the awareness which will result in a decrease in mortality rate
Endovascular management of pediatric neurovascular malformations – A single‑center experience from South India
Full text linkBackground: Neurovascular malformations (NVMs) in pediatric population are highly challenging to manage and treatment options include open surgery, endovascular therapy, and radiosurgery or combined. Recently, there has been a gradual shift from conventional surgical approach toward endovascular therapies with increasing availability of technical expertise and gadgetry. Objective: We aimed to study the clinical profile and immediate outcome of children with NVMs, who underwent endovascular therapy. Materials and Methods: This retrospective observational study was conducted in a tertiary care center in South India between February 2017 and August 2018. We included children admitted in pediatric intensive care unit (PICU) with NVM and needed neuroradiological intervention. Children with thromboembolism or other NVMs who did not require intervention were excluded from the study. Data on clinical profile, endovascular procedure done, supportive therapy given, and immediate outcome were collected and analyzed. Results: Of 1615 children admitted in PICU, 13 had NVM (0.8%), of which five had arteriovenous malformation (AVM), three had vein of Galen arteriovenous malformation (VGAM), one had VGAM with dural AVM, one had acquired carotid-cavernous fistula, two had berry aneurysm, and one had mycotic aneurysm. VGAM presented as hydrocephalus, whereas AVM and aneurysm as intracranial hemorrhage. Endovascular embolization was done using platinum detachable coils, onyx, N-butyl cyanoacrylate glue, and coil assist stents. One child needed decompressive craniectomy and another child needed extraventricular drainage. Four children needed pre-procedure ventilation and seven children needed prolonged post-procedure ventilation. Mortality was 15%; and among the survivors, 72% had an uneventful recovery. One child had seizures and two had hemiparesis at discharge. Conclusion: Endovascular management is an effective intervention for pediatric NVM. Multidisciplinary team approach and good pediatric intensive care are important for successful outcome. Further studies with long-term follow-up are needed to assess the durability of endovascular therapy
A case of Dentigerous Cyst in Association of Impacted Mandibular Canine
Full text linkDentigerous cyst being the second most common odontogenic cyst which constitutes around 20-24% of all the odontogenic cysts involving the jaws. Usually, these cysts remain asymptomatic and rarely cause enlargement and displacement of associated tooth. It develops by an accumulation of fluid between reduced enamel epithelium and the tooth crown of an unerupted tooth. This case report presents conservative treatment modality for 17-year-old female patient, diagnosed with a dentigerous cyst in association of impacted mandibular canine. The patient was treated with a minimal invasive approach, enucleation followed by marsupialization under local anesthesia, preserving all the teeth in occlusion