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The oral cavity inhabits diverse microorganisms with members of all age groups including children being associated with oral infections. Bacteria being the principle component of this resident microflora along with the diverse group of other species reflect the wide range of viscerously derived nutrients, the heterogenous habitats for colonization contributing to the survival of the biofilm. Biofilms constitute surface- adherent communities of microorganisms like Streptococcus mutans along with other bacterial species embedded in an extracellular matrix material. The commensal relationship between the host and the microflora can be disrupted in numerous ways, resulting in compromised oral health causing conditions like dental caries and endodontic infections, gingival and periodontal conditions, oral candidiasis and peri-implantitis. Biofilm-related infections prove to be a major threat from both an economical and health perspective. Innovative treatment options remain limited despite of advancements in understanding the mechanisms of biofilm formation. The concept of nanotechnology is based on controlling atoms on an individual basis and creating structures less than 100 nm (10_7 m) in size thereby greatly influencing the properties. Incorporation of metals and other nanoparticles with polymers and coating of surfaces provide antimicrobial and anti-adhesive benefits within the oral cavity. Therefore, this paper seeks to throw light into the current advancements in nanoparticle mediated treatment approaches of oral biofilms and its future implications in pediatric dentistry. Keywords: Biofilm, Oral Cavity, Metal Oxides, Nanoparticles, Reactive Oxygen Species, Antibiofilm Efficacy

Background: In a developing country like India the cost effectiveness of all polyethylene tibial components is a major boon, without compromising the functional outcome. In this study we have attempted to evaluate the functional outcome of all polyethylene tibial monoblock component in total knee arthroplasty. Methodology: The study was carried out on 86 patients who are operated for total knee arthroplasty with all polyethylene tibial monoblock component. Demographic, surgical and follow up data was collected from case sheets of patients and copied in Performa. The patients were called for five years follow up and examined in the outpatient department. Results: The mean age of study population was 62.8 years (range 50 – 72 years) with mean BMI of 27.6 kg/m2. Statistically significant improvement was seen in the range of movements in all the age groups. Both male and female patients had insignificant difference in knee scoring. Assessment of clinical functional abilities of knee scoring have observed to be higher in patients with lower BMI. Conclusion: Significant improvement in range of motion as well as knee score in all age range, emphasizes the fact that total knee arthroplasty with all polyethylene design in osteoarthritis is an excellent surgery to restore near normal life style.

Dental caries is a common problem in adolescents, leading to permanent loss of teeth or cavitation. Caries is a continuous process wherein demineralization and remineralization occur regularly. Hydroxyapatite (HA) is one of the most biocompatible and bioactive materials, as it closely resembles the mineral composition of teeth. The present study deals with isolating hydroxyapatite from fish bone (Epinephelus chlorostigma) by alkaline hydrolysis and thermal calcination. The isolated nano HA was characterized using FT-IR, XRD, TGA, FE-SEM-EDX, and HR-TEM analysis. The nano HA isolated by alkaline hydrolysis is nontoxic, and the cells are viable. The isolated HA enhances the proliferation of L929 cells. The remineralization potential of the extracted nano HA was evaluated in healthy premolars by DIAGNOdent/laser fluorescence quantification, surface microhardness test, and SEM-EDX analysis. Surface morphological observations in SEM and EDX analyses show that thermally calcined HA and alkali-treated HA can induce mineralization and deposit minerals. Therefore, HA obtained from Epinephelus chlorostigma could be a potential biomaterial for treating early caries.

The absence of a tooth in the oral cavity may be the result of some obstruction with the process of tooth eruption. Physical obstruction can result from many different causes, such as supernumerary teeth, mucosal barrier, scar tissue, and cysts or tumors. Their removal will usually permit the affected tooth to erupt. This case report describes the delayed eruption of the permanent mandibular first molar in a 9-year-old boy due to the dentigerous cyst associated with it. The management was done through a multidisciplinary approach. Surgical removal of cystic sac through marsupialization along with the removal of the barrier was done. As a consequence of delayed eruption of the permanent first molar, the opposing tooth had supraerupted, which was intruded using mini-implants. Following this, the tooth erupted satisfactorily into the oral cavity to establish class I molar relation.

Deepanshu Mallan,1 Sandeep Sharan,2 Sumi Saxena,3 Tapas Kumar Singh,2 Faisal21Department of Anaesthesiology and Critical Care, Saraswati Medical College, Lucknow, India; 2Department of Anaesthesiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India; 3Department of Anaesthesiology and Critical Care, TSM Medical College, Lucknow, Uttar Pradesh, IndiaCorrespondence: Tapas Kumar SinghDepartment of Anaesthesiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh 226014, IndiaEmail singh.tapas1@gmail.comAbstract: Transverse abdominis plane (TAP) blocks, over the past decade, have emerged as a reliable tool in multimodal analgesia. Although they block only the somatic component of pain, studies have still revealed a consistent benefit in the first 24–48 hours after surgery in terms of pain scores and overall opioid consumption. The safety and dependability has increased with ultrasound usage. The aim of this review is to help the reader appreciate the applied anatomy required for a TAP block and its congeners, to standardize its nomenclature, and to help choose between variants of a TAP block and its complications and safety profile.Keywords: tap block, ultrasound, regional anesthesia, truncal block

Monali S Malvankar-Mehta,1,2 Ryan Wilson,3 Erik Leci,3 Kelly Hatch,4 Sapna Sharan1 1Department of Ophthalmology, Ivey Eye Institute, St. Joseph’s Hospital, 2Department of Epidemiology and Biostatistics, 3Schulich School of Medicine and Dentistry, 4Allyn & Betty Taylor Library, Natural Sciences Centre, The University of Western Ontario, London, ON, Canada Background: The objective of this research was to conduct a systematic review and cost analysis to summarize, from the Ministry of Health perspective, the costs families might incur because of their child’s prescription for refractive errors and amblyopia correction.Methods: Databases including MEDLINE, Embase, BIOSIS, CINAHL, HEED, ISI Web of Science, and the Cochrane Library as well as the gray literature were searched. Systematic review was conducted using EPPI-Reviewer 4. Percentage difference in cost of glasses and patches per patient per various diagnoses were computed. The cost of glasses and patches was projected over a 5-year time horizon. Cost-utility analysis was performed.Results: In total, 302 records were retrieved from multiple databases and an additional 48 records were identified through gray literature search. From these, a total of 14 studies (10,388 subjects) were eligible for quantitative analysis. The cost of glasses increased significantly for congenital cataract patients to US$1,820, esotropia patients to US$840, myopes to US$411, amblyopes (mixed) to US$916, anisometropes to US$521, and patients with strabismus to US$728 over a 5-year period making them unaffordable for low-income families. Incremental cost of glasses of congenital cataract patients with delayed treatment was computed to be US$1,690 per health utility gained. Incremental cost of glasses for high refractive error was US$93 per health utility gained in non-compliant children. For amblyopia patients, incremental cost of glasses per quality-adjusted life years gained was US$3,638.Conclusion: Cost of corrective lenses is associated with significant financial burden and thus other means of mitigating costs should be considered. Eyesight problems in children are perceived as low-priority health needs. Thus, educational interventions on substantial visual deficits of not wearing glasses should be offered to families and governmental health agencies. Keywords: systematic review, amblyopia, prescription lens, utility, cost, quality-adjusted life years

Recently, a significant amount of research work has been carried out in the field of feature selection. Although these methods help to increase the accuracy of the machine learning classification, the selected subset of features considers all the classes and may not select recommendable features for a particular class. The main goal of our paper is to propose a new class-specific feature selection algorithm that is capable of selecting an appropriate subset of features for each class. In this regard, we first perform class binarization and then select the best features for each class. During the feature selection process, we deal with class imbalance problems and redundancy elimination. The Weighted Average Voting Ensemble method is used for the final classification. Finally, we carry out experiments to compare our proposed feature selection approach with the existing popular feature selection methods. The results prove that our feature selection method outperforms the existing methods with an accuracy of more than 37%. [ABSTRACT FROM AUTHOR]

Background: Injection of local anesthesia is one of the most important reasons for avoidance behavior in children. Applying a topical anesthetic before injection is the most popular way to control pain; however, topical anesthetics have some shortcomings such as longer duration of action, displeasing taste, and spread of the anesthetic agent to noninjection site areas. Cryoanesthesia using refrigerant as a topical anesthesia is being studied as an alternative to overcome the shortcomings of topical anesthetics and has shown promising results. Materials and Methods: In this split-mouth design study, 50 children of aged 8–10 years who required bilateral mandibular local anesthesia administration were selected. In the first visit, application of topical anesthetic spray (lidocaine) on one side and during the second appointment cryoanesthetic tetrafluorethane on the other side was used before local anesthetic administration. Patients were asked to report their discomfort and pain using visual analog scale (VAS) (subjective method). Patients' pain perception during injection is assessed by sound, eye, and motor (SEM) scale by the dentist (objective method). Results: The results were statistically analyzed using paired Wilcoxon signed-rank test and Mann–Whitney tests. In VAS scale (subjective method), pain scores were significantly lower in tetrafluorethane group when compared with lidocaine group. In SEM scale (objective method), pain scores were lower in tetrafluorethane group when compared with lidocaine group, but it was statistically insignificant. Conclusion: Precooling the injection site using refrigerant tetrafluorethane spray has shown to be effective in eliminating pain before local anesthesia administration in children when compared with topical anesthetic lidocaine spray.