Clinical Examination Of Children Research Articles

Autoreactive processes in children in the initial period of multisystem inflammatory syndrome associated with SARS-CoV-2 and after rehabilitation

BACKGROUND: The problem of the pathogenesis of the multisystem inflammatory syndrome (MIS-C), associated with SARS-CoV-2, remains relevant, but is still far from being resolved. In this regard.
 AIM: The aim our research was to study and evaluate the levels of autoantibodies to native and denatured DNA in the blood serum of children who underwent MIS-C, associated with SARS-CoV-2, in comparison with the initial period of the pathological process.
 MATERIALS AND METHODS: 101 children aged 2 to 17 years old were examined, 77 of them was with a confirmed diagnosis of MIS-C associated with SARS-CoV-2. We have formed 3 groups: group 1 — children with MIS-C upon admission to the hospital; group 2 — children who underwent MIS-C after a course of rehabilitation; group 3 — comparison group. All children underwent determination of the concentrations of IgG-autoantibodies to native and denatured DNA in blood serum, which was performed by EIA ELISA using commercial test systems of Vector-Best LLC (Russia) according to the manufacturer’s instructions. Statistical processing of the obtained results was carried out using the Statistica v. 10.0 application package. Statistical processing used the Newman–Keuls multiple comparison test.
 RESULTS: It was noted that both in the initial period of MIS-C and after rehabilitation, an increased content of autoantibodies to nDNA and dDNA was determined compared to the control group. At the same time, there was a significant excess of the levels of indicators in the post-rehabilitation period compared with the initial period of MIS-C. During a clinical examination of children who underwent MIS-C, most of them noted the appearance of pain in the joints. The results obtained indicate the persistence of inflammatory reactions with the development of an autoreactive component. This requires both the search for risk markers for the development of MIS-C and further monitoring of children who have undergone MIS-C to prevent autoimmune complications, including arthritis, damage to the vascular endothelium with the possible formation of thrombotic complications.
 CONCLUSIONS: In the acute period of MIS-C and after rehabilitation, increased levels of the average content of autoantibodies to nDNA and dDNA were noted compared to the control. Individual values of autoantibodies to nDNA and dDNA exceeded normative levels of the indicator were found in a significantly larger number of children in the post-rehabilitation period after MIS-C, and this excess was more pronounced compared to the acute period of the process. When assessing the clinical condition of children after MIS-C, most of them showed pain in the joints during exercise, abdominal and neurological disorders, and decreased tolerance to physical activity, which indicates persistent inflammatory reactions.

The state of oral health and its impact on the quality of life of six-year-olds in the city area of Živinice

Background: Oral health is the main indicator of general health, individual well-being, and quality of life. Oral health in children and adolescents is often reflected by the state of their dental hard tissues in a form of their previous caries experience. Poor oral health in children increases the likelihood of more complex dental treatment and emergencies, which can lead to absenteeism from school and reduced learning abilities, causing slowed physical development, and overall reduced oral health-related quality of life.Aim: To determine the state of oral health and its influence on the overall quality of the life in six-year-olds in the city of Živinice.Methods: The study participants were psychophysically healthy six-year-old children of both genders with residences in the urban and rural areas of the city of Živinice. Oral examinations were conducted according to the WHO Oral Health Survey manual. The previous caries experience indexes of primary teeth (dmft, SiC, pufa) were noted during clinical examinations of children, with a simultaneous filling of the POQL questionnaire by children's parents.Results and Conclusion: The state of oral health of six-year-olds in the area of the city of Živinice was not on a satisfactory level. Analyzed oral health indexes were higher worldwide and national findings. High scores of all analyzed indexes indicated that oral health could have an impact on the quality of life and that these values are high in comparison to the given recommendations. KEYWORDS: six-year-old children, dmft, pufa, SiC, POQL

Association of symptomatic upper respiratory tract infections with the alteration of the oropharyngeal microbiome in a cohort of school children in Côte d'Ivoire.

The oropharyngeal microbiome plays an important role in protection against infectious agents when in balance. Despite use of vaccines and antibiotic therapy to prevent respiratory tract infections, they remain one of the major causes of mortality and morbidity in Low- and middle-income countries. Hence the need to explore other approaches to prevention by identifying microbial biomarkers that could be leveraged to modify the microbiota in order to enhance protection against pathogenic bacteria. The aim of this study was to analyze the oropharyngeal microbiome (OPM) of schoolchildren in Côte d'Ivoire presenting symptoms of upper respiratory tract infections (URTI) for better prevention strategy. Primary schools' children in Korhogo (n = 37) and Abidjan (n = 39) were followed for six months with monthly oropharyngeal sampling. Clinical diagnostic of URT infection was performed and nucleic acid extracted from oropharyngeal swabs were used for 16S rRNA metagenomic analysis and RT-PCR. The clinical examination of children's throat in Abidjan and Korhogo identified respectively 17 (43.59%) and 15 (40.54%) participants with visible symptoms of URTIs, with 26 episodes of infection in Abidjan and 24 in Korhogo. Carriage of Haemophilus influenzae (12%), Streptococcus pneumoniae (6%) and SARS-CoV-2 (6%) was confirmed by PCR. A significant difference in alpha diversity was found between children colonized by S. pneumoniae and those that were not (p = 0.022). There was also a significant difference in alpha diversity between children colonised with H. influenzae and those who were not (p = 0.017). No significant difference was found for SARS-CoV-2. Sphingomonas, Ralstonia and Rothia were significantly enriched in non-carriers of S. pneumoniae; Actinobacillus was significantly enriched in non-carriers of H. influenzae; Actinobacillus and Porphyromonas were significantly enriched in non-carriers of SARS-CoV-2 (p < 0.001). Nearly 40% of children showed clinical symptoms of infection not related to geographical location. The OPM showed an imbalance during H. influenzae and S. pneumoniae carriage. This study provides a baseline understanding of microbiome markers in URTIs in children for future research, to develop targeted interventions aimed at restoring the microbial balance and reducing the symptoms associated with RTIs.

Parental oral health knowledge and plaque index of their children in rural communities of Armenia

Abstract Background While the prevalence of oral diseases in high-income countries is decreasing, the opposite is true in low and middle-income countries. Parental awareness about oral health has been shown to be an important contributor to children's oral health. This study evaluated the association between parental oral health knowledge and the oral health status of their children aged 6-10 years in two rural communities of Armenia. Methods This cross-sectional study included two main components: telephone survey among parents measuring sociodemographic, oral health knowledge, and behavioral variables, and clinical examination of children's oral health. Multivariable linear regression was used to identify the adjusted association between parental oral health knowledge score and children's oral health measured by plaque index. Results A total of 400 pairs of parents and children participated in the study. The mean plaque index among children was 3.1 (out of the maximum 5.0), demonstrating abundant coverage of teeth with plaque. The mean parental knowledge score was 6.9 (out of the maximum 9.0), indicating above-average oral health awareness. The items with the lowest proportion of correct responses were the belief that caries is preventable, the importance of daily flossing, and using fluoride-added toothpaste/water for preventing caries, with 75.1%, 60.4%, and 59.9% of correct answers respectively. The multivariable analysis found negative association between parental oral health knowledge score and children's plaque index (B= -0.24, p = 0.039), when controlling for other significant variables. Conclusions The study confirmed the importance of parental oral health knowledge for the oral health of their children and highlighted the knowledge gaps that should be addressed. The high prevalence of dental plaque among the children emphasized the need for complex interventions, including educational activities, preventive clinical procedures, and improved access to dental care. Key messages • In two rural communities of Armenia, there was a clear link between parental oral health knowledge and oral health status of their primary schoolchildren measured by plaque index. • Well-focused educational interventions targeting parents of primary schoolchildren combined with children’s better access to dental care are recommended for improving their oral health.

Parental Knowledge, Attitude, and Practice Regarding Children's Dental Health

Parent-targeted oral health awareness campaigns should place a strong emphasis on issues like the value of deciduous teeth and how to treat them, frequent dental checkups, and dietary habits. The current study's objective is to evaluate parents' knowledge, behaviors, and attitudes regarding their children's oral health and how those factors affect the prevalence of dental caries in 5- to 10-year-old children in Riyadh, Saudi Arabia. Parents of school-aged children aged 5 to 10 who came to our hospital were the subjects of a cross-sectional questionnaire survey. The study included 209 children in all, together with their parents. Utilizing DMFT and the deft index, clinical examinations of children were conducted. Parents were given a self-designed questionnaire to evaluate their understanding, attitudes, and practices about their children's dental health. SPSS version 24 was used for the statistical analysis. A p-value of 0.05 or less was regarded as statistically significant when using the ANOVA test to examine the relationship between dental caries status and KAP. The mean deft and DMFT were 6.46 ± 1.6 and 1.56 ± 2.8, respectively. Most parents (72.2%) demonstrated adequate knowledge, behaviors, and attitudes. Parental KAP and mean DMFT/DEFT did not differ significantly. The study's participants had reasonable KAP for the oral health of their children. The significance of deciduous teeth and their treatment, frequent dental appointments, and dietary behaviors are among the knowledge gaps in oral health.

Knowledge, Attitude, and Practice of Parents toward Their Children's Oral Health and its Influence on the Dental Caries Status of 5-10-year-old Schoolchildren in Nashik, Maharashtra: A Cross-sectional Study.

AimThe aim of the present study is to assess the knowledge, attitude, and practices of parents toward their children's oral health and its influence on the dental caries status of 5-10 years old schoolchildren in Nashik, Maharashtra.Materials and methodsA cross-sectional questionnaire-based study was conducted among parents of 5-10 years old school children who visited our hospital. A total of 504 children and their parents were included in the study. Clinical examination of children was done using DMFT and deft index. A self-designed questionnaire was given to the parents to assess their knowledge, attitude and practices toward their children's oral health. Statistical analysis was performed using EPI INFO version 6.04. ANOVA test was used to test the association between dental caries status and KAP. p -value < 0.05 was considered to be statistically significant.ResultsThe mean DMFT was 1.6 ± 1.5 and mean deft was 6.6 ± 3.4. Majority of the parents (64.9%) showed fair knowledge, attitude, and practices. There was no significant difference between mean DMFT/deft and parental KAP.ConclusionOverall the parents in the present study had reasonable KAP about oral health of their children. Deficient areas of oral health awareness include importance of milk teeth and their treatment, regular dental visits, and dietary practices.Clinical significanceOral health awareness programs should be directed toward parents and should emphasize on topics such as importance of milk teeth and their treatment, regular dental visits, and dietary practices.How to cite this articlePatil AN, Karkare S, Jadhav HS, et al. Knowledge, Attitude, and Practice of Parents toward Their Children's Oral Health and its Influence on the Dental Caries Status of 5-10-year-old School-children in Nashik, Maharashtra: A Cross-sectional Study. Int J Clin Pediatr Dent 2022;15(S-2):S126-S130.

Risk factors and clinical features of the course of recurrent acute otitis media in children

To study the risk factors and the clinical course of RAOM in children. 148 children (81 boys and 67 girls) from 1 to 14 years old were examined with a diagnosis of recurrent otitis media. The work was carried out in the ENT departments of Pediatric Clinical Hospital No. 13 named after N.F. Filatov, Pediatric Clinical Hospital named after Z.A. Bashlyaeva. The average age of the children was 4.1±1.5 years. Our clinical examination of children with RAOM allows us to identify the main risk factors for this pathology. Thus, the most significant risk factors for the development of RAOM in children included in the study were: early visits by children to preschool institutions (50.6%), allergic history (39.1%), pathology during pregnancy (28.3%), mixed (38.5%) or artificial (27.7%) feeding in the first year of life, frequent upper respiratory tract diseases (41.2%), burdened heredity in close relatives according to RAOM (33.7%), smoking in the family of one of the parents (65.5%) presence in the family of one more child (34.4%). It was shown that the absolute number of children (96%) with RAOM is characterized by a reduced level of 25(OH) vitamin D in the blood serum, which can increase the likelihood of developing episodes of acute otitis media in children and requires therapeutic correction.

Effect of dental caries management using 'CAMBRA-kids' mobile application for children under 5years old.

To determine effects of dental caries management using 'CAMBRA-kids' mobile application for children under 5years old for a period of a year. This study was conducted on 119 preschoolers and parents. Parents downloaded 'CAMBRA-kids' mobile application and entered risk factors and protective factors for children. Clinician entered disease indicators after clinical examination of children. Based on the input, the caries risk group was automatically determined by the 'CAMBRA-kids' application. According to the caries risk level, caries management was conducted for 12months according to guidelines. Children's caries risk level changed after conducting caries management for 1year. In the change of CRA (Caries risk assessment) by factor, risk factors decreased in all risk groups, whereas protective factors increased in all risk groups. Disease indicators increased after 12months in the extreme high-risk group and the high-risk group, but decreased in the low-risk group. This study evaluated the effect of systematic dental caries management using 'CAMBRA-kids' mobile application for preschool children. As a result, dental caries management had effects on children, especially for the extreme high-risk group and the high-risk group. Thus, it is expected to be used in a variety of areas for caries management of preschoolers.

Clinical examination and classification systems of congenital clubfoot: a narrative review.

Clinical examination of the newborn’s foot is a complex exercise that requires a lot of sensitivity, practice and deep understanding of normal and pathological anatomy, and the clinical assessment of a child with congenital talipes equinovarus, or congenital clubfoot, must be complete and it should not be limited to a simple orthopedic evaluation of the foot; the search for a cause is a pressing concern. This narrative review article aims to provide the key information about clinical examination of children with congenital clubfoot; classification systems are also described. Clinical examination of children with congenital clubfoot is essential. In particular, it is important to evaluate the mental age of the child (developmental milestones), to rule out the presence of a spinal dysraphism, to eliminate a mild form of neurological disease (congenital myopathy or arthrogryposis), as well as to carefully examine the face and hands of the patient. The examination of the foot and the classification of the clubfoot deformity complete the clinical evaluation. In the end, the pediatric orthopedic surgeon must not underestimate any clinical signs, and must act as a pediatrician. This narrative review summarizes the key points in taking a history and performing a comprehensive clinical examination for patients with congenital clubfoot; the review also briefly describes the normal foot anatomy and growth as to give the reader the opportunity to better understand the morphological and functional modifications secondary to congenital clubfoot.

Prevalence of Hearing Impairment in Neonates of Mothers with Diabetes Mellitus: A Cross Sectional Study.

This study aims to find out the prevalence of hearing impairment in neonates of mothers with diabetes mellitus. The objective is to assess any correlation between the glycemic control and the development of neonatal hearing impairment. A total of 120 neonates of diabetic mothers were included in the study. Data was collected from hospital medical records, direct interview of parent or care taker and clinical examination of child done whenever possible. 120 Neonates were evaluated by OAE soon after birth. Those who failed the test are evaluated with BERA and results were statistically analysed. In our study prevalence of deafness in neonates of mothers with diabetes mellitus was 4.16%. Prevalence of hearing impairment was higher in neonates of mothers with pre gestational diabetes (9.09%) than gestational diabetes mellitus (3.06%). Mean of HbA1c was higher in mothers of neonates with hearing impairment than those without hearing impairment. Prevalence of deafness in neonates of mothers with diabetes mellitus was 4.16%, which is about sevena times higher than the prevalence of deafness in neonates without any risk factors. Prevalence was higher in neonates of mothers with pre gestational diabetes than neonates of mothers with gestational diabetes mellitus.

Prevalence of first permanent molar caries and streptococcusmutans &amp; lactobacillus level among 6- 7 year old School Children in Qassim province Kingdom of Saudi Arabia

Introduction: Dental caries is a bacterial disease of the calcified tissues of the teeth characterized by demineralization of the inorganic portion and destruction of the organic substance of the tooth and the first permanent molar the first victim of getting carious due to its early involvement. Caries has been known that is caused by bacteria fermenting food, producing acids and dissolving tooth mineral. Objective: The first permanent molars are extremely influential dental structures in maxillofacial growth and development, and in the oral health status. Aim: to assess the Prevalence of First Permanent Molar Caries Among 7-year old Children in Al-Qassim Province and its possible relation to the different levels of S. mutans (SM)and Lactobacilli (LB), salivary buffer capacity and salivary Ph. Material &amp; Methods: a cross sectional analytical study design. With a total of 243 children, aged 6-7 year old selected from different schools randomly. Clinical examination of children was conducted to assess dental caries, and saliva was collected to assess S. mutans levels, lactobacilli, salivary PH, and buffering capacity of saliva. Results: Prevalence of carious first permanent molars was high 153 (63%). No statistically significant difference revealed by chi-square test between carious first permanent molars and Ph. A statistical significant difference was found between carious first permanent molars and saliva buffer capacity. Must patients had high buffer capacity. Chi-square test revealed that the relation between caries and SM levels was highly statistically significant at P&lt;0.001 same thing was found in relation with LB. Children with carious first permanent molars tend to have a higher number of SM and LB in saliva than children with sound first permanent molars. Conclusion: The Prevalence of First Permanent Molar Caries Among 7-year old Children in Al-Qassim Province is high. Levels of SM and LB were also higher; this result gives an indication that there is a higher risk for those children to develop more caries in their permanent teeth in the future. Moreover, it emphasizes the importance of early intervention and educational programs, which should be implemented even before the FPMs erupt (4- to 5-year-old children).

Malocclusion and Associated Factors in Early Childhood and Knowledge Level of Mothers from Childcare Groups

Objective: To determine the prevalence of malocclusion and associated factors in children and the level of knowledge of mothers participating in the child care group of a basic health unit . Material and Methods: This is a cross-sectional study conducted in children between 18 and 72 months of a childcare group in Pelotas. Children whose parents or legal guardians signed the informed consent term participated in the study. Data were collected through a questionnaire previously tested and applied to the mothers, and a clinical examination of children's occlusion were performed by examiners after training and calibration. Statistical analysis was descriptive and analytic. In the bivariate analyses, it was used the Pearson, Fisher or Linear Trend Qui-Square tests and, in the multivariate analysis, the Poisson regression. Prevalence ratios and 95% confidence intervals were obtained, and a p-value <0.05 was used. Results: Forty-seven children were included and 41.3% presented malocclusion. The prevalence of malocclusion was associated with a higher number of children in the family (p<0.005) and breastfeeding for more than 12 months (p<0.05). The highest prevalence of open bite was associated with the use of a pacifier and working mothers (p<0.05) . Conclusion: Most mothers reported having knowledge about the time and use of pacifiers in childhood. In this group, the prevalence of malocclusion in children was high and associated with behavioral and social factors.

Profile of sever acute malnutrition children admitted at nutritional rehabilitation centre at tertiary care treatment centre of Gujarat

Background: Sever acute malnutrition (SAM) may be major obstacle for India to achieve targeted Infant Mortality Rate and under five mortality rate. Malnutrition and infection form vicious cycle and contributes towards mortality. So, malnutrition prevention is major objective of government. Study of malnourished children helps to know aetiology and their response to treatment. The objective of study is to understand clinic-demographic profile of SAM children.Methods: It is retrospective secondary data analysis study. For the purpose of this analysis, we retrieved the data of all children with SAM admitted from 1 January, 2018 to 31 December, 2018 to NRC. At the NRC, a physician conducted a clinical examination in children to detect the presence/absence of medical complications during their admission and these data were available in case sheet.Results: A total of 162 children, aged 6-59 months were referred to the NRC. Around fourty seven percentage of children were in age group 6–12 months Majority of children were in age group of 7 months to one year of age. Majority of children were admitted based on weight of height criteria (Z score &lt; 3SD). Mean admission weight is lower in female compare to male children.Conclusions: Faulty weaning practises and delay in weaning in some cases predisposes later half of infancy period to undernutrition. So, proper health education and good IYCF practices prevent children from undernutrition.

Neurophysiological aspects of enuresis in children

Introduction. Enuresis is a pathological condition, manifested by involuntary urination during sleep or in the wakeful state. It is believed that enuresis is associated with unformed or impaired self-control skills for emptying the bladder. The significance of the problem is determined by the widespread prevalence of pathology, social and psychological maladaptation of children with enuresis. An important role in this plays the development of their personality by an accentuated type often, difficult adaptability, and lack of ability to integrate into the team, especially into the semi or closed type. According to modern concepts, enuresis can be caused by the following reasons: delayed maturation of the nervous system, urological pathology and urinary tract infection, impaired activation reaction during sleep, impaired rhythm of secretion of antidiuretic hormone, adverse heredity, psychological factors and stress. The results of Russian and foreign scientists studies revealed the polyetiological character of enuresis and the impossibility, in most cases, of identifying its obvious cause. This explains the relatively wide variability of outcomes: from spontaneous cure to apparent resistance to all existing treatments. The significant prevalence of enuresis, the relative severity of this pathology and the lack of effective treatment methods necessitate the search for alternative methods of therapy or fundamentally new approaches to using existing ones, which is impossible without a thorough study of this disease etiopathogenesis.The goal of research — is to study the neurophysiological characteristics of enuresis in children.Materials and methods. Prospective controlled study was conducted in Kazan State Medical Academy — a branch of the RMACPE (Kazan) in the period 2003–2019 years. To study enuresis mechanisms we carried out a comprehensive clinical-electroneurophysiological examination of 93 children aged 5 to 15 years, suffering from bedwetting. The control group consisted of 40 healthy children who were comparable in age and gender to those in the main group. All patients underwent a comprehensive examination, which included the study of complaints, anamnesis, clinical and electroneurophysiological research.Results. Clinical examination of children with enuresis revealed signs of minimal cerebral dysfunction. An electrophysiological examination made it possible to determine an increase in the refl ex excitability of brain stem structures against the background of a decrease in downward inhibitory control.Conclusion. The predominance of excitation processes over inhibition in the central nervous system is mainly observed in children with enuresis. The weakness of the inhibitory mechanisms due to constitutional factors, pathology of the nervous system that took place earlier, allows making an assumption about the diffuse nature of the disorders of the nervous system in this urination disorder.

ACUTE RESPIRATORY RECURRENT INFECTIONS IN CHILDREN

Introduction. Insufficient research work on the study of local immunity in children with frequent respiratory recurrent diseases has become the basis for this work. Goal. To study the negative impact of various pathogenic factors on the formation of acute respiratory recurrent infections in children. Materials and methods. 201 children under 3 years of age and 219 children from 3 to 7 years old who attended children's preschools in Kyiv were observed in the dynamics. Indices of local immunity, by the content of immunoglobulins in the secretion of the nasal passages, were studied in comparison with the data of the anamnesis and clinical examination of children; with functional condition of the nasal mucosa (presence of catarrhal phenomena); with the presence and excretion of viral and bacterial microflora in the upper respiratory tract; with the presence of chronic foci of infection in the nasopharynx (tonsillitis, adenotonitis); with a period that has elapsed after preventive vaccinations and transferred respiratory diseases. Research results. Based on the obtained data, changes in local immunity in the examined children were detected under the influence of factors of external and internal environment: birth of children from pathological pregnancy and childbirth; presence of hypochromic anemia, exudative diathesis, chronic tonsillitis of staphylococcal etiology, adenotonsillitis, recurrent and asthmatic bronchitis in children; high infection rate of children with viruses, pathogenicity of pathogenic staphylococcus and streptococcus, fungi of the genus Candida. It was found that the lowest frequency of detection of immunoglobulins of all classes was observed in children with streptococcus in pharynx and its associations with staphylococcus. Conclusions. The published data on the value of local immunity in terms of immunoglobulins in children with frequent respiratory recurrent diseases and its tendency to various changes under the influence of external and internal environmental factors indicate the feasibility of improving treatment and prevention measures, which include the use of agents that enhance the effectiveness of local respiratory protection.

Comparison of hand-held spectral domain optical coherence tomography (HH-SDOCT) findings in nonaccidental injury (NAI) and non-NAI

We previously reported the utility of HH-SDOCT in identifying characteristic and unique vitreoretinal abnormalities not detected on clinical examination in children with NAI. The aim of this study was to compare HH-SDOCT findings in retinal haemorrhages of NAI and non-NAI and evaluate their usefulness in differentiating NAI from non-NAI.

Clinical Examination of Children with Cerebral Palsy

Cerebral palsy (CP), a heterogeneous disorder of movement and posture, is one of the most important causes of disability affecting children. With a wide variability in the clinical presentation and a paucity of reliable diagnostic tests, decision-making in CP is fraught with difficulties and challenges. The plethora of musculoskeletal manifestations includes poor muscle function, spasticity, rigidity, muscle weakness, poor selective motor control, soft-tissue and joint contractures, torsional malalignments, and lever arm dysfunctions. Children with CP are at a high risk of further worsening and progression of these musculoskeletal abnormalities with the natural course of the disease. A comprehensive assessment that includes a combination of detailed medical history, functional assessment, clinical examination, analysis of gait, and radiological assessment is required to provide a favorable treatment outcome in these children. A close surveillance is essential so as to identify risk factors for the development and progression of musculoskeletal problems so that early interventions can be carried out to circumvent them. This review article is to highlight the importance of clinical examination in the assessment of children with CP.

Association of passive smoking with dental caries and salivary biomarkers among 5-10 years old children of Muradnagar, Ghaziabad.

Objectives:The purpose of this study is to assess the association of passive smoking (PS) with dental caries and salivary biomarkers among 5–10 years old children of Muradnagar, Ghaziabad.Methods:A case–control study was conducted among 160 children of age group 5–10 years who visited the outdoor patient department of a dental college. Regular smoking households were recognized and children who lived in smoking households were identified as PS subjects. Two categories of children were formed – PS (80 children) and control group (80 children). Parents completed a pretested questionnaire and clinical examination of children was done using dmft index and gingival index. This was followed by collection of stimulated saliva of children which was further subjected to determine salivary buffering capacity and pH. Inoculation on mitis salivarius-bacitracin agar for counting streptococcus colonies and Rogosa SL agar (Difco) for counting lactobacillus colonies was done. Cotinine level was then measured using enzyme-linked immunosorbent assay kit. Student's independent t-test, Mann–Whitney U test, and one-way analysis of variance test were used for analyzing data.Results:The mean streptococcus and lactobacillus colony count was higher in PS case subjects, that is, 348.9 ± 166.509 and 247.3 ± 15.86 in comparison to control group where the mean streptococcus and lactobacillus colony count was 63.03 ± 23.082 and 63.825 ± 12.638, respectively. The mean cotinine level among PS case subjects was 1.08 ± 0.265 which was higher than the control group, that is, 0.00 ± 0.00. The mean cotinine level was directly proportional to streptococcus colonies, lactobacillus colonies, dmft and gingival index (GI) scores, and smoking exposure.Conclusion:PS has deleterious impact on children which was reflected by their increased cotinine levels, streptococcus colonies, lactobacillus colonies, and poor dmft and GI scores in comparison to the control group.

Relationships between the obstructive character of the tonsils and the type of ventilation and lip posture

The role of obstructive tonsils in ventilatory disorders and abnormal lip posture is widely discussed in the literature but remains controversial. The data reported on the probable relationship between obstructive tonsils and an existing breathing disorder or lip incompetence were subjective. The purpose of this study was to evaluate the relationship between the obstructive character of the tonsils and the type of ventilation and lip posture. This is a cross-sectional study performed in children aged from 6 to 12 years old. The subjects were divided into two groups (A and B) according to the obstructive or non-obstructive character of the palatal tonsils. Type of ventilation and lip posture at rest were recorded for each child. The collected data were analysed using the SPSS 20.0 software (for Windows). A Student's t-test and a Chi2 test were respectively used to compare quantitative and qualitative variables according to the obstructive character of the tonsils for each group. The level of significance is fixed at P=0.05. The subjects in group B with obstructive palatal tonsils were significantly more likely to oral breathing and lip incompetence than the subjects with non-obstructive tonsils (group A). The clinical examination of children with ventilatory and postural disorders with lip incompetence must be directed towards the search for associated obstructive palatal tonsils in order to plan an early etiological treatment. This would allow to avoid subsequent problems in the dentofacial structures.

Orthodontic care and dentition status in children

Parents’ knowledge of risk factors of caries and the need to visit a dentist for routine check-ups affect the children’s dentition status in the future. Lack of activities in this field often results in premature loss of deciduous teeth and it adversely affects a position of permanent teeth undergoing eruption. Aim. To compare the dentition status of children under the care of an orthodontist and of children who are not covered by orthodontic care, and to assess the effects of parents’ education on the dentition status of their children. Material and methods. The study included 232 children from primary schools in Lublin (110 boys and 122 girls). The age of subjects was between 6 years to 8 years and 11 months. The study included a survey questionnaire for parents and a clinical examination of children. The number of DMFT and dmft was calculated in each child based on a clinical examination. In the study population the incidence of caries (Fp) and mean numbers of dmft (for deciduous teeth) and DMFT (for permanent teeth) were calculated. Results. In the study group of children 12.93% were receiving orthodontic treatment with removable appliances, 10.78% were supervised by an orthodontist or were orthodontic treatment scheduled, and 75.86% of studied children had never been at an orthodontist’s office. One person (0.43%) did not provide answers to questions asked. Children receiving orthodontic care had significantly lesser carious defects in their deciduous teeth compared to children who were not receiving such care. Conclusions. 1) Providing orthodontic care to children had a beneficial effect on their dentition. 2) It is worth to pay more attention to prophylaxis of caries and to supervise the process of dentition replacement. 3) It is necessary to promote health-promoting education regarding caries and malocclusions among parents. (Cioczek-Studzińska A, Sękowska A, Mielnik-Błaszczak M, Świrski A, Dunin-Wilczyńska I. Orthodontic care and dentition status in children. Orthod Forum 2018; 14: 17-28)