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Bekheit M, Kamera B, Colacino L, Dropmann A, Delibegovic M, Almadhoob F, Hanafy N, Bermano G, Hammad S. Mechanisms underpinning the effect of exercise on the non-alcoholic fatty liver disease: review. EXCLI JOURNAL 2025; 24:238-266. [PMID: 40071029 PMCID: PMC11895063 DOI: 10.17179/excli2024-7718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2024] [Accepted: 01/27/2025] [Indexed: 03/14/2025]
Abstract
Non-alcoholic Fatty Liver Disease (NAFLD) - whose terminology was recently replaced by metabolic liver disease (MAFLD) - is an accumulation of triglycerides in the liver of >5 % of its weight. Epidemiological studies indicated an association between NAFLD and reduced physical activity. In addition, exercise has been shown to improve NAFLD independently of weight loss. In this paper, we aim to systematically review molecular changes in sedentary experimental NAFLD models vs. those subjected to exercise. We utilized the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist and standard review techniques. Studies were considered for inclusion if they addressed the primary question: the mechanisms by which exercise influenced NAFLD. This review summarized experimental evidence of improvements in NAFLD with exercise in the absence of weight loss. The pathways involved appeared to have AMPK as a common denominator. See also the graphical abstract(Fig. 1).
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Affiliation(s)
- Mohamed Bekheit
- Department of Surgery, NHS Grampian, Foresterhill Health Campus, Ashgrove Road, AB252ZN Aberdeen, UK
- Institute of Medical Sciences, Medical School, Foresterhill Health Campus, Ashgrove Road, AB252ZN Aberdeen, UK
| | - Blessed Kamera
- Department of Surgery, NHS Grampian, Foresterhill Health Campus, Ashgrove Road, AB252ZN Aberdeen, UK
- Institute of Medical Sciences, Medical School, Foresterhill Health Campus, Ashgrove Road, AB252ZN Aberdeen, UK
| | - Laura Colacino
- Department of Surgery, NHS Grampian, Foresterhill Health Campus, Ashgrove Road, AB252ZN Aberdeen, UK
- Institute of Medical Sciences, Medical School, Foresterhill Health Campus, Ashgrove Road, AB252ZN Aberdeen, UK
| | - Anne Dropmann
- Molecular Hepatology Section, Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Mirela Delibegovic
- Department of Surgery, NHS Grampian, Foresterhill Health Campus, Ashgrove Road, AB252ZN Aberdeen, UK
- Institute of Medical Sciences, Medical School, Foresterhill Health Campus, Ashgrove Road, AB252ZN Aberdeen, UK
| | - Fatema Almadhoob
- St. Helens and Knowsley Teaching Hospitals NHS Trust, Prescot, Prescot, UK
| | - Nemany Hanafy
- Group of Bionanotechnology and Molecular Cell Biology, Nanomedicine Department, Institute of Nanoscience and Nanotechnology, Kafrelsheikh University, 33516 Kafrelsheikh, Egypt
| | - Giovanna Bermano
- Centre for Obesity Research and Education (CORE), School of Pharmacy and Life Sciences, Robert Gordon University, Sir Ian Wood Building, Garthdee Road, Aberdeen AB10 7GJ, UK
| | - Seddik Hammad
- Molecular Hepatology Section, Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
- Department of Forensic Medicine and Veterinary Toxicology, Faculty of Veterinary Medicine, South Valley University, 83523 Qena, Egypt
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Xuan C, Li J, Liu RH, Guo JJ, Zhao C, Zhou TT, Wang Y, He GW, Lun LM. Association between serum gamma-glutamyltransferase and early-onset coronary artery disease: a retrospective case-control study. Ann Med 2023; 55:2289606. [PMID: 38061693 PMCID: PMC10836269 DOI: 10.1080/07853890.2023.2289606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 11/27/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Serum gamma-glutamyltransferase (GGT) activity has been proposed as a promising predictor of atherosclerosis-related complications and a prognostic marker for cardiovascular diseases. The objective of this study was to investigate the potential correlation between serum levels of GGT and early-onset coronary artery disease (EOCAD). METHODS A retrospective, hospital-based case-control study was conducted, which included 860 patients with EOCAD and gender- and age-matched controls. Serum levels of GGT were measured using the reference measurement procedure on an automatic biochemistry analyser. RESULTS The serum GGT levels of patients with EOCAD (34.90 ± 31.44 U/L) were significantly higher than those of the control group (21.57 ± 16.44 U/L, p < .001). Elevated serum levels of GGT were found to be an independent risk factor for EOCAD, with an odds ratio (OR) of 1.021 (95% confidence interval (CI): 1.014-1.029). Additionally, for every quartile increase in serum GGT levels, the risk of developing EOCAD increased by 1.6-fold. Moreover, serum GGT levels were significantly associated with disease severity, with lower GGT levels observed in patients without significant vascular disease (31.74 ± 24.06 U/L) compared to those with two-vessel disease (33.06 ± 25.00 U/L, p = .002) and three-vessel disease (37.75 ± 36.76 U/L, p = .001). CONCLUSIONS The results of this study suggest that elevated serum GGT levels are associated with the development of EOCAD, and GGT may be implicated in the pathogenesis of the disease. Further large-scale prospective studies are needed to explore the potential relationship between serum GGT levels and the dynamic development of EOCAD.
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Affiliation(s)
- Chao Xuan
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jing Li
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Ru-Hua Liu
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jun-Jie Guo
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Cong Zhao
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Ting-Ting Zhou
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yan Wang
- Health Management Institute, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Guo-Wei He
- Department of Cardiovascular Surgery, TEDA International Cardiovascular Hospital, Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Department of Surgery, Oregon Health and Science University, Portland, OR, USA
| | - Li-Min Lun
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, China
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Niemelä O, Bloigu A, Bloigu R, Aalto M, Laatikainen T. Associations between Liver Enzymes, Lifestyle Risk Factors and Pre-Existing Medical Conditions in a Population-Based Cross-Sectional Sample. J Clin Med 2023; 12:4276. [PMID: 37445311 DOI: 10.3390/jcm12134276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/20/2023] [Accepted: 06/24/2023] [Indexed: 07/15/2023] Open
Abstract
While alanine aminotransferase (ALT) and gamma-glutamyltransferase (GGT) enzymes are commonly used indicators of liver dysfunction recent studies have suggested that these may also serve as predictive biomarkers in the assessment of extrahepatic morbidity. In order to shed further light on the interactions between serum liver enzyme abnormalities, factors of lifestyle and health status we examined ALT and GGT activities in a population-based sample of 8743 adult individuals (4048 men, 4695 women from the National FINRISK 2002 Study, mean age 48.1 ± 13.1 years) with different levels of alcohol drinking, smoking, physical activity, body weight and the presence or absence of various pre-existing medical conditions. The assessments also included laboratory tests for inflammation, lipid status and fatty liver index (FLI), a proxy for fatty liver. The prevalence of ALT and GGT abnormalities were significantly influenced by alcohol use (ALT: p < 0.0005 for men; GGT: p <0.0005 for both genders), smoking (GGT: p <0.0005 for men, p =0.002 for women), adiposity (p < 0.0005 for all comparisons), physical inactivity (GGT: p <0.0005; ALT: p <0.0005 for men, p <0.05 for women) and coffee consumption (p <0.0005 for GGT in both genders; p <0.001 for ALT in men). The total sum of lifestyle risk factor scores (LRFS) influenced the occurrence of liver enzyme abnormalities in a rather linear manner. Significantly higher LRFS were observed in the subgroups of individuals with pre-existing medical conditions when compared with those having no morbidities (p <0.0005). In logistic regression analyses adjusted for the lifestyle factors, both ALT and GGT associated significantly with fatty liver, diabetes and hypertension. GGT levels also associated with coronary heart disease, angina pectoris, cardiac insufficiency, cerebrovascular disease, asthma and depression. Combinations of abnormal ALT and GGT activities significantly increased the odds for hypertension coinciding with abnormalities in biomarkers of inflammation, lipid status and FLI. The data indicates that ALT and GGT activities readily respond to unfavorable factors of lifestyle associating also with a wide array of pre-existing medical conditions. The data supports close links between both hepatic and extrahepatic morbidities and lifestyle risk factors and may open new insights on a more comprehensive use of liver enzymes in predictive algorithms for assessing mechanistically anchored disease conditions.
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Affiliation(s)
- Onni Niemelä
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital and Tampere University, 60220 Seinäjoki, Finland
| | - Aini Bloigu
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, 90014 Oulu, Finland
| | - Risto Bloigu
- Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, 90014 Oulu, Finland
| | - Mauri Aalto
- Department of Psychiatry, Seinäjoki Central Hospital and Tampere University, 33100 Tampere, Finland
| | - Tiina Laatikainen
- Department of Public Health and Social Welfare, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, 70211 Kuopio, Finland
- Joint Municipal Authority for North Karelia Social and Health Services, 80210 Joensuu, Finland
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Abstract
The medical disorders of alcoholism rank among the leading public health problems worldwide and the need for predictive and prognostic risk markers for assessing alcohol use disorders (AUD) has been widely acknowledged. Early-phase detection of problem drinking and associated tissue toxicity are important prerequisites for timely initiations of appropriate treatments and improving patient's committing to the objective of reducing drinking. Recent advances in clinical chemistry have provided novel approaches for a specific detection of heavy drinking through assays of unique ethanol metabolites, phosphatidylethanol (PEth) or ethyl glucuronide (EtG). Carbohydrate-deficient transferrin (CDT) measurements can be used to indicate severe alcohol problems. Hazardous drinking frequently manifests as heavy episodic drinking or in combinations with other unfavorable lifestyle factors, such as smoking, physical inactivity, poor diet or adiposity, which aggravate the metabolic consequences of alcohol intake in a supra-additive manner. Such interactions are also reflected in multiple disease outcomes and distinct abnormalities in biomarkers of liver function, inflammation and oxidative stress. Use of predictive biomarkers either alone or as part of specifically designed biological algorithms helps to predict both hepatic and extrahepatic morbidity in individuals with such risk factors. Novel approaches for assessing progression of fibrosis, a major determinant of prognosis in AUD, have also been made available. Predictive algorithms based on the combined use of biomarkers and clinical observations may prove to have a major impact on clinical decisions to detect AUD in early pre-symptomatic stages, stratify patients according to their substantially different disease risks and predict individual responses to treatment.
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Affiliation(s)
- Onni Niemelä
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital and Tampere University, Seinäjoki, Finland.
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5
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Asgari S, Molavizadeh D, Tohidi M, Momenan AA, Azizi F, Hadaegh F. Prevalence and metabolic determinants of abnormal alanine aminotransferase: A cross-sectional study of Iranian adults, 2018-2022. J Clin Lab Anal 2023; 37:e24937. [PMID: 37403787 PMCID: PMC10431421 DOI: 10.1002/jcla.24937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 05/19/2023] [Accepted: 06/15/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND Alanine aminotransferase (ALT) is an enzyme whose activity became the principal biomarker for liver disease. In the current study, we aimed to determine the prevalence of abnormal ALT, as a surrogate of nonalcoholic fatty liver disease (NAFLD) and its associated determinants using different criteria among Tehranian subjects between 2018 and 2022. METHODS This is a cross-sectional study on 5676 Tehranian individuals aged 20-70 years. The weighted prevalence of abnormal ALT was calculated using both the National Health and Nutrition Examination Survey in the United States (US-NHANCE; ALT ≥30 U/L for females and ≥40 U/L for males) and the American College of Gastroenterology (ACG) guideline (ALT >25 U/L for females, and >33 U/L for males) thresholds. Moreover, uni/multivariable logistic regression analysis was performed to find the determinants of abnormal ALT. RESULTS The weighted prevalence of abnormal ALT was 12.8% (7.6% females and 18% males) and 22.5% (17.7% females and 27.3% males) based on US-NHANCE and ACG criteria, respectively. Our results showed every decade increase in age decreased the risk of abnormal ALT by 32%. We also found that generally male gender, being overweight/obese, central adiposity, TG ≥6.9 mmol/L, non-HDL-C ≥3.37 mmol/L, lipid-lowering medications, pre-diabetes/T2DM were associated with abnormal ALT using different cutoff points. Moreover, among men resting tachycardia (≥90 beats per min), hypertension, and females past-smoker were also found as other determinants of abnormal ALT. CONCLUSION High prevalence of abnormal ALT among non-elderly Iranian adults, especially among men, necessitates immediate multifaceted strategies by policymakers to prevent potential complications caused by NAFLD.
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Affiliation(s)
- Samaneh Asgari
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine SciencesShahid Beheshti University of Medical SciencesTehranIran
| | | | - Maryam Tohidi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine SciencesShahid Beheshti University of Medical SciencesTehranIran
| | - Amir Abbas Momenan
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine SciencesShahid Beheshti University of Medical SciencesTehranIran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine SciencesShahid Beheshti University of Medical SciencesTehranIran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine SciencesShahid Beheshti University of Medical SciencesTehranIran
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Balali P, Nasserinejad M, Azadnajafabad S, Ahmadi N, Delavari F, Rashidian L, Ghasemi E, Dilmaghani-Marand A, Fateh SM, Ebrahimi N, Kazemi A, Derouei AA, Djalalinia S, Rezaei N, Delavari A. Is elevated ALT associated with lifestyle risk factors? A population-based survey. J Diabetes Metab Disord 2022; 21:1743-1751. [PMID: 36404851 PMCID: PMC9672187 DOI: 10.1007/s40200-022-01137-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 09/19/2022] [Indexed: 11/27/2022]
Abstract
Purpose Given the high prevalence of non-alcoholic fatty liver disease (NAFLD) and the role of Alanine aminotransferase (ALT) in diagnosing liver injury along with the increasing prevalence of lifestyle risk factors, we aimed to evaluate the association between serum ALT level and lifestyle risk factors in a population-based survey. Methods This was a population-based study conducted in rural and urban areas of Iran in 2016. Cluster sampling method was applied to enroll a total of 31,050 participants aged ≥ 18. Demographic data, anthropometric measures, and laboratory samples were gathered. Multivariate logistic regression analyses were performed using three different cut-off levels for elevated ALT to assess the relationship between elevated ALT and lifestyle risk factors. Results The prevalence of elevated ALT was significantly higher in men with elevated body mass index (BMI), waist-to-hip ratio (WTH), hip circumference, and salt consumption, likewise, in women with higher BMI and WTH. In the multivariate logistic model adjusted for age and sex, high WTH (adjusted odds ratio: 1.73; 95% CI 1.52-1.96), BMI > 25 (1.51; 95% CI 1.29-1.76), hip circumference (1.26; 95% CI 1-1.58), and current smoking (0.67; 95% CI 0.56-0.8) were associated with elevated ALT levels using American cut-off (ALT > 33U/L for male and ALT > 25U/L for female). Only physical measurements (BMI, WTH) but not lifestyle risk factors were related to the increased ALT regardless of the selected cut-offs. Conclusion As elevated ALT was associated with several lifestyle risk factors, stewardship programs should be established to modify lifestyle risk factors, such as abdominal obesity and physical inactivity. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-022-01137-6.
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Affiliation(s)
- Pargol Balali
- Non-Communicable Diseases Research Center,, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Nasserinejad
- Non-Communicable Diseases Research Center,, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sina Azadnajafabad
- Non-Communicable Diseases Research Center,, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Naser Ahmadi
- Non-Communicable Diseases Research Center,, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Erfan Ghasemi
- Non-Communicable Diseases Research Center,, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Arezou Dilmaghani-Marand
- Non-Communicable Diseases Research Center,, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Mohammadi Fateh
- Non-Communicable Diseases Research Center,, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Exndocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Narges Ebrahimi
- Non-Communicable Diseases Research Center,, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ameneh Kazemi
- Non-Communicable Diseases Research Center,, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Arefeh Alipour Derouei
- Non-Communicable Diseases Research Center,, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Djalalinia
- Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Negar Rezaei
- Non-Communicable Diseases Research Center,, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Exndocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Delavari
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Niemelä O, Bloigu A, Bloigu R, Halkola AS, Niemelä M, Aalto M, Laatikainen T. Impact of Physical Activity on the Characteristics and Metabolic Consequences of Alcohol Consumption: A Cross-Sectional Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15048. [PMID: 36429766 PMCID: PMC9690068 DOI: 10.3390/ijerph192215048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 06/16/2023]
Abstract
Sedentary lifestyle and excessive alcohol drinking are major modifiable risk factors of health. In order to shed further light on the relationships between physical activity and health consequences of alcohol intake, we measured biomarkers of liver function, inflammation, lipid status and fatty liver index tests in a large population-based sample of individuals with different levels of physical activity, alcohol drinking and other lifestyle risk factors. The study included 21,050 adult participants (9940 men, 11,110 women) (mean age 48.2 ± 13.3 years) of the National FINRISK Study. Data on physical activity, alcohol drinking, smoking and body weight were recorded. The participants were classified to subgroups according to gender, levels of physical activity (sedentary, low, moderate, vigorous, extreme), alcohol drinking levels (abstainers, moderate drinkers, heavy drinkers) and patterns (regular or binge, types of beverages preferred in consumption). Serum liver enzymes (GGT, ALT), C-reactive protein (CRP) and lipid profiles were measured using standard laboratory techniques. Physical activity was linearly and inversely related with the amount of alcohol consumption, with the lowest alcohol drinking levels being observed in those with vigorous or extreme activity (p < 0.0005). Physically active individuals were less frequently binge-type drinkers, cigarette smokers or heavy coffee drinkers than those with sedentary activity (p < 0.0005 for linear trend in all comparisons). In the General Linear Model to assess the main and interaction effects of physical activity and alcohol consumption on biomarker status, as adjusted for anthropometric measures, smoking and coffee consumption, increasing levels of physical activity were found to be associated with more favorable findings on serum GGT (p < 0.0005), ALT (p < 0.0005 for men), cholesterol (p = 0.025 for men; p < 0.0005 for women), HDL-cholesterol (p < 0.0005 for men, p = 0.001 for women), LDL-cholesterol (p < 0.03 for men), triglycerides (p < 0.0005 for men, p < 0.03 for women), CRP (p < 0.0005 for men, p = 0.006 for women) and fatty liver index (p < 0.0005). The data support the view that regular moderate to vigorous physical activity may counteract adverse metabolic consequences of alcohol consumption on liver function, inflammation and lipid status. The role of physical activity should be further emphasized in interventions aimed at reducing health problems related to unfavorable risk factors of lifestyle.
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Affiliation(s)
- Onni Niemelä
- Department of Laboratory Medicine, Medical Research Unit, Seinäjoki Central Hospital and Tampere University, 60220 Seinäjoki, Finland
| | - Aini Bloigu
- Center for Life Course Health Research, University of Oulu, 90570 Oulu, Finland
| | - Risto Bloigu
- Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, 90570 Oulu, Finland
| | - Anni S. Halkola
- Department of Laboratory Medicine, Medical Research Unit, Seinäjoki Central Hospital and Tampere University, 60220 Seinäjoki, Finland
| | - Markus Niemelä
- Department of Laboratory Medicine, Medical Research Unit, Seinäjoki Central Hospital and Tampere University, 60220 Seinäjoki, Finland
- Department of Anesthesiology, Oulu University Hospital, 90220 Oulu, Finland
| | - Mauri Aalto
- Department of Psychiatry, Seinäjoki Central Hospital and Tampere University, 33100 Tampere, Finland
| | - Tiina Laatikainen
- Department of Public Health and Social Welfare, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, 70210 Kuopio, Finland
- Joint Municipal Authority for North Karelia Social and Health Services, 80210 Joensuu, Finland
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Badiei S, Hashemi SJ, Masjedizadeh A, Sayyah J, Mohammadi Z, Hariri S, Hashemi F, Rahimi Z, Danehchin L, Abolnezhadian F, Malihi R, Paridar Y, Mard SA, Cheraghian B, Poustchi H, Shayesteh AA. Association between physical activity and serum liver aminotransferases in Southwestern Iran: A Cross-sectional study. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2022; 27:79. [PMID: 36438076 PMCID: PMC9693751 DOI: 10.4103/jrms.jrms_835_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 05/24/2022] [Accepted: 06/13/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND The main aim of the present study is to investigate the independent association objectively measured level of physical activity (PA) and serum concentration of liver aminotransferases (alanine aminotransferase [ALT] and aspartate aminotransferase [AST]) among seemingly healthy individuals. MATERIALS AND METHODS The current secondary study was conducted in the framework of Khuzestan Comprehensive Health Study, a large population-based multicentric cross-sectional study, conducted between 2016 and 2019 on 18,966 individuals living in Khuzestan province, southwestern Iran. International PA Questionnaire was used for evaluating PA levels, and participants were divided into three groups: low, moderate, and high PA, and ALT and AST were compared between these groups. RESULTS The mean ± standard deviation age of participants was 38.65 ± 11.40 years. The majority of participants were female (71%). The mean concentration of ALT in total sample was 18.22 ± 13.06 (male: 23.65 ± 16.26 and female: 15.57 ± 10.06), while the mean concentration of ALT in total sample was 19.61 ± 8.40 (male: 22.44 ± 10.03 and female: 18.23 ± 7.08). A statistically significant inverse correlation was found between AST (r = -0.08, P = 0.02) and ALT (r = -0.038, P < 0.001) with total PA score. The mean concentration of ALT was 19.96 ± 13.63 in people with low PA, 17.62 ± 12.31 with moderate PA, and 18.12 ± 13.47 with high PA (P < 0.001). The mean concentration of AST in total sample was 20.37 ± 8.85 in people with low PA, 19.21 ± 8.83 with moderate PA, and 19.75 ± 8.85 with high PA (P < 0.001). The difference between people in different levels of PA in terms of mean concentration of AST was remained significant (P = 0.003); however, the difference for ALT was not remained significant after adjusting potential confounders. CONCLUSION The current study based on large sample showed that PA had a statistically negative association with the concentration of liver aminotransferases in the seemingly healthy individuals; however, the observed associations were weak. People in the lowest levels of PA had the highest levels of ALT and AST.
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Affiliation(s)
- Sajad Badiei
- Alimentary Tract Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed Jalal Hashemi
- Alimentary Tract Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Abdolrahim Masjedizadeh
- Alimentary Tract Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Jalal Sayyah
- Alimentary Tract Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zahra Mohammadi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Tehran, Iran
| | - Sanam Hariri
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Tehran, Iran
| | - Farnaz Hashemi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Tehran, Iran
| | - Zahra Rahimi
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Leila Danehchin
- Department of Medicine, Faculty of Medicine, Behbahan Faculty of Medical Sciences, Behbahan, Iran
| | - Farhad Abolnezhadian
- Department of Pediatrics, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Reza Malihi
- Department of Basic Sciences, School of Medicine, Abadan University of Medical Sciences, Abadan, Iran
| | - Yousef Paridar
- Department of Internal Medicine, School of Medicine, Dezful University of Medical Sciences, Dezful, Iran
| | - Seyyed Ali Mard
- Alimentary Tract Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Bahman Cheraghian
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Tehran, Iran
| | - Ali Akbar Shayesteh
- Alimentary Tract Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Christakoudi S, Riboli E, Evangelou E, Tsilidis KK. Associations of body shape index (ABSI) and hip index with liver, metabolic, and inflammatory biomarkers in the UK Biobank cohort. Sci Rep 2022; 12:8812. [PMID: 35614088 PMCID: PMC9133113 DOI: 10.1038/s41598-022-12284-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 05/05/2022] [Indexed: 12/13/2022] Open
Abstract
Associations of liver, metabolic, and inflammatory biomarkers in blood with body shape are unclear, because waist circumference (WC) and hip circumference (HC) are dependent on overall body size, resulting in bias. We have used the allometric "a body shape index" (ABSI = WC(mm)[Formula: see text]Weight(kg)-2/3[Formula: see text]Height(m)5/6) and hip index (HIwomen = HC(cm)[Formula: see text]Weight(kg)-0.482[Formula: see text]Height(cm)0.310, HImen = HC(cm)[Formula: see text]Weight(kg)-2/5[Formula: see text]Height(cm)1/5), which are independent of body mass index (BMI) by design, in multivariable linear regression models for 121,879 UK Biobank men and 135,559 women. Glucose, glycated haemoglobin (HbA1c), triglycerides, low-density-lipoprotein cholesterol, apolipoprotein-B, alanine aminotransferase (ALT), gamma-glutamyltransferase, and lymphocytes were associated positively with BMI and ABSI but inversely with HI. High-density-lipoprotein cholesterol and apolipoprotein-A1 were associated inversely with BMI and ABSI but positively with HI. Lipid-related biomarkers and ALT were associated only with HI in obese men. C-reactive protein, neutrophils, monocytes, and alkaline phosphatase were associated positively, while bilirubin was associated inversely, with BMI and ABSI but not with HI. Associations were consistent within the clinical reference ranges but were lost or changed direction for low or high biomarker levels. Our study confirms associations with waist and hip size, independent of BMI, for metabolic biomarkers but only with waist size for inflammatory biomarkers, suggesting different contribution of the mechanistic pathways related to body shape.
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Affiliation(s)
- Sofia Christakoudi
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk place, London, W2 1PG, UK. .,Department of Inflammation Biology, School of Immunology and Microbial Sciences, King's College London, London, UK.
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk place, London, W2 1PG, UK
| | - Evangelos Evangelou
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk place, London, W2 1PG, UK.,Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Konstantinos K Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk place, London, W2 1PG, UK.,Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
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10
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Reimann B, Vrijens K, Roels HA, Wang C, Cosemans C, Van Overmeire I, Nawrot TS, Plusquin M. In utero exposure to parabens and early childhood BMI z-scores - Associations between placental ethyl paraben, longitudinal BMI trajectories and cord blood metabolic biomarkers. ENVIRONMENT INTERNATIONAL 2021; 157:106845. [PMID: 34474324 PMCID: PMC8484768 DOI: 10.1016/j.envint.2021.106845] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/21/2021] [Accepted: 08/20/2021] [Indexed: 05/06/2023]
Abstract
BACKGROUND Parabens are used as antimicrobial preservatives in personal care products. Few studies have dealt with adverse health outcomes, transplacental transfer, and obesogenic effects of prenatal exposure to parabens. We examined the association between placental paraben levels and cord blood metabolic biomarkers, considering modulating effects of maternal pre-pregnancy BMI and underlying epigenetic mechanisms, and investigated longitudinal effects of in utero paraben exposure on early childhood trajectories of BMI z-scores. METHODS Placental concentrations of four parabens [methyl (MeP), ethyl (EtP), propyl (PrP), and butyl (BuP)] were measured by ultra-performance liquid chromatography/tandem mass spectrometry in 229 placentas of the ENVIRONAGE birth cohort. The association with cord blood metabolic biomarkers [glucose, insulin, γ-glutamyltransferase (GGT), high-density and low-density lipoprotein (HDL and LDL)] was analyzed in multiple regression models with two different sets of, a priori selected potential confounders, additionally stratified for different maternal BMI groups and assessed by causal mediation analysis. The association between placental paraben concentration and differential DNA methylation of CpGs annotated to GGT and longitudinal measurements of BMI z-scores were investigated with adjusted linear mixed models. RESULTS The geometric means of placental MeP, EtP, PrP, and BuP levels above the limit of detection (LOD) were 4.42, 1.32, 1.51, and 0.35 ng/g respectively, with only EtP showing sufficient (88%) measurements above LOD for further analyses. An interquartile ratio (IQR) increase in placental EtP was associated with an increase of 12.61 % (95% CI: 1.80 24.57) in the geometric mean of cord GGT activity, and with a decrease of -3.64 % (95% CI: -6.80 to -0.39) in the geometric mean of cord glucose. Placental EtP levels were significantly associated with hypermethylation of cg08612779 annotated to GGT7 after correcting for multiple testing (ß = 0.0017, p = 0.049). An interquartile ratio (IQR) increment in placental EtP was associated with a decrease in longitudinal BMI z-score of 0.27 points (95% CI: -0.46 to -0.088). CONCLUSION Prenatal EtP exposure may affect early childhood BMI. The association of placental EtP with cord blood GGT and glucose levels provides a starting point for further research on mechanisms of paraben-related metabolic processes in utero.
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Affiliation(s)
- Brigitte Reimann
- Centre for Environmental Sciences, Hasselt University, Agoralaan Gebouw D, 3590 Diepenbeek, Belgium
| | - Karen Vrijens
- Centre for Environmental Sciences, Hasselt University, Agoralaan Gebouw D, 3590 Diepenbeek, Belgium
| | - Harry A Roels
- Centre for Environmental Sciences, Hasselt University, Agoralaan Gebouw D, 3590 Diepenbeek, Belgium
| | - Congrong Wang
- Centre for Environmental Sciences, Hasselt University, Agoralaan Gebouw D, 3590 Diepenbeek, Belgium
| | - Charlotte Cosemans
- Centre for Environmental Sciences, Hasselt University, Agoralaan Gebouw D, 3590 Diepenbeek, Belgium
| | - Ilse Van Overmeire
- Sciensano, Chemical and Physical Health Risks, J. Wytsmanstraat 14, 1050 Brussels, Belgium
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Agoralaan Gebouw D, 3590 Diepenbeek, Belgium; Department of Public Health, Environment & Health Unit, Leuven University (KU Leuven), Kapucijnenvoer 35, 3000 Leuven, Belgium
| | - Michelle Plusquin
- Centre for Environmental Sciences, Hasselt University, Agoralaan Gebouw D, 3590 Diepenbeek, Belgium.
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11
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Sedliak M, Sedliak P, Vaara JP. Effects of 6-Month Military Deployment on Physical Fitness, Body Composition, and Selected Health-Related Biomarkers. J Strength Cond Res 2021; 35:1074-1081. [PMID: 30829983 DOI: 10.1519/jsc.0000000000002885] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Sedliak, M, Sedliak, P, and Vaara, JP. Effects of 6-month military deployment on physical fitness, body composition, and selected health-related biomarkers. J Strength Cond Res 35(4): 1074-1081, 2021-The purpose was to study the effects of 6-month deployment to Afghanistan on physical performance, anthropometrical, and health-related biochemical parameters in soldiers with sedentary to light physical workload shifts. Twenty-five male soldiers (30 ± 4 years) volunteered and were measured before and after the 6-month deployment. Another 25 home-land-based male soldiers (30 ± 6 years) served as controls. Total body fat percentage decreased in deployed soldiers (Pre: 23.2 ± 5.3 vs. Post: 20.8 ± 5.5%, p < 0.05), whereas no change was observed in control (20.2 ± 6.9 vs. 20.5 ± 7.0%). Physical performance improved in deployed soldiers in 4 × 10-m shuttle run (10.86 ± 0.90 vs. 10.49 ± 0.63 seconds) and pull-up test to failure (4.7 ± 3.7 vs. 7.5 ± 6.7 rep.) (p < 0.05) but not in the controls for the respective tests (10.28 ± 0.74 vs. 10.40 ± 0.76 seconds and 10.2 ± 7.8 vs. 10.2 ± 7.5 rep.). Deployed soldiers also improved 5-km run with a simulated combat gear time (29.2 ± 3.1 vs. 27.4 ± 3.0 minutes), whereas in control the time increased (26.4 ± 2.9 vs. 27.8 ± 2.6 minutes, p < 0.05). Load at maximum power output in bench press was improved in deployed soldiers (51.6 ± 11.3 vs. 56.2 ± 12.6 kg, p < 0.05). Serum glucose and creatinine decreased (5.46 ± 0.53 vs. 4.87 ± 0.74 mmol·L-1 and 87.4 ± 10.7 vs. 80.9 ± 10.2 μmmol·L-1, respectively), and hemoglobin and hematocrite increased (15.13 ± 0.82 vs. 16.75 ± 0.85 g·dl-1 and 45.3 ± 1.5 vs. 48.1 ± 2.4%, respectively, p < 0.05) in the deployment group. In conclusion, after 6-month deployment consisting of sedentary and low physical occupational load, soldiers were able to increase their physical fitness and decrease their body fat content and improve selected health-related biochemical parameters. Therefore, the adoption and promotion of leisure-time physical activity in soldiers during deployments is essential to maintain combat readiness.
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Affiliation(s)
- Milan Sedliak
- Department of Sports Kinanthropology, Faculty of Physical Education and Sport, Comenius University in Bratislava, Bratislava, Slovakia
- Aging and Lifestyle Diseases Research Center, Faculty of Physical Education and Sport, Comenius University in Bratislava, Bratislava, Slovakia
| | - Peter Sedliak
- Operations Department, Multiple Rocket Launcher System Battalion, Land Forces Headquarters, Armed Forces of the Slovak Republic, Rožňava, Slovakia; and
| | - Jani P Vaara
- Department of Leadership and Military Pedagogy, National Defence University, Helsinki, Finland
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12
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Jia J, Yang Y, Liu F, Zhang M, Xu Q, Guo T, Wang L, Peng Z, He Y, Wang Y, Zhang Y, Zhang H, Shen H, Zhang Y, Yan D, Ma X, Zhang P. The association between serum alanine aminotransferase and hypertension: A national based cross-sectional analysis among over 21 million Chinese adults. BMC Cardiovasc Disord 2021; 21:145. [PMID: 33740888 PMCID: PMC7980597 DOI: 10.1186/s12872-021-01948-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 03/08/2021] [Indexed: 12/11/2022] Open
Abstract
Background Inconsistent results were found in the association between serum alanine aminotransferase (ALT) and hypertension among population-based studies. This study evaluated the association between ALT and hypertension among Chinese reproductive-age population by utilizing registration data from National Free Pre-pregnancy Checkups Project in 2016–2017. Methods The 21,103,790 registered participants were eligible for analysis, including women who were 20–49 years old and men who were 20–59 years old with available data for ALT and blood pressure (BP). Logistic regression was conducted to estimate odds ratio (OR) for the association between ALT and hypertension as a binary outcome. Linear regression was used to examine the association between ALT and BP as a continuous outcome. Results In total, 4.21% of the participants were hypertensive, and 11.67% had elevated ALT (> 40 U/L). Hypertension prevalence was 3.63% and 8.56% among participants with normal and elevated ALT levels. A strong linear relationship was found between serum ALT levels and the odds of hypertension after adjustment for potential confounders. The multivariable-adjusted ORs for hypertension were 1, 1.22 (1.21, 1.22), 1.67 (1.65 1.68), 1.78 (1.76, 1.80), and 1.92 (1.90, 1.94) in participants with ALT levels of ≤ 20, 20.01–40, 40.01–60, 60.01–80, and > 80 U/L, respectively. Systolic and diastolic BPs rose by 1.83 and 1.20 mmHg on average, for each 20 U/L increase in ALT (P for trend < 0.001). The association was consistent among subgroups and tended to be stronger among populations who are overweight (body mass index ≥ 24 kg/m2) (χ2 = 52,228, P < 0.001), alcohol drinking (χ2 = 100,730, P < 0.001) and cigarette smoking (χ2 = 105,347, P < 0.001). Conclusions Our cross-sectional analysis suggested a linear association between serum ALT and hypertension or BP, which indicated that abnormal liver metabolism marked by elevated serum ALT could play a role in hypertension or elevated BP condition.
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Affiliation(s)
- Jiajing Jia
- Graduate School of Peking, Union Medical College, Beijing, People's Republic of China.,National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China.,National Human Genetic Resources Center, Beijing, People's Republic of China
| | - Ying Yang
- Graduate School of Peking, Union Medical College, Beijing, People's Republic of China. .,National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China. .,National Human Genetic Resources Center, Beijing, People's Republic of China. .,China DOHaD Research Center, Beijing, People's Republic of China.
| | - Fangchao Liu
- Department of Epidemiology, Fuwai Hospital, Beijing, People's Republic of China.,National Center for Cardiovascular Disease, Beijing, People's Republic of China.,China Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Minjin Zhang
- National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China.,National Human Genetic Resources Center, Beijing, People's Republic of China
| | - Qin Xu
- Graduate School of Peking, Union Medical College, Beijing, People's Republic of China.,National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China.,National Human Genetic Resources Center, Beijing, People's Republic of China
| | - Tonglei Guo
- National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China.,National Human Genetic Resources Center, Beijing, People's Republic of China
| | - Long Wang
- National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China.,School of Public Health, Institute of Epidemiology and Statistics, Lanzhou University, Lanzhou, People's Republic of China
| | - Zuoqi Peng
- National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China.,National Human Genetic Resources Center, Beijing, People's Republic of China
| | - Yuan He
- Graduate School of Peking, Union Medical College, Beijing, People's Republic of China.,National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China.,National Human Genetic Resources Center, Beijing, People's Republic of China
| | - Yuanyuan Wang
- National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China.,National Human Genetic Resources Center, Beijing, People's Republic of China.,China DOHaD Research Center, Beijing, People's Republic of China
| | - Ya Zhang
- National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China.,National Human Genetic Resources Center, Beijing, People's Republic of China
| | - Hongguang Zhang
- National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China.,National Human Genetic Resources Center, Beijing, People's Republic of China
| | - Haiping Shen
- Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing, People's Republic of China
| | - Yiping Zhang
- Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing, People's Republic of China
| | - Donghai Yan
- Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing, People's Republic of China
| | - Xu Ma
- Graduate School of Peking, Union Medical College, Beijing, People's Republic of China. .,National Research Institute for Family Planning, Da Huisi Road, 12#, Beijing, People's Republic of China. .,National Human Genetic Resources Center, Beijing, People's Republic of China.
| | - Puhong Zhang
- Diabetes Research Program, The George Institute for Global Health At Peking University Health Science Center, Zhi Chun Road, 6#, Beijing, People's Republic of China.
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13
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Chen Y, Chen Y, Geng B, Zhang Y, Qin R, Cai Y, Bai F, Yu D. Physical activity and liver health among urban and rural Chinese adults: results from two independent surveys. J Exerc Sci Fit 2021; 19:8-12. [PMID: 32904178 PMCID: PMC7452301 DOI: 10.1016/j.jesf.2020.07.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 07/20/2020] [Accepted: 07/21/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Increased physical activity has been associated with reduced risks of various physical and mental conditions. However, the association between physical activity and liver health in the Chinese general adult population is not clear. This study investigated whether physical activity, stratified by intensity (i.e. walking (light), moderate-to-vigorous), was associated with alanine aminotransferase (ALT) level in middle-aged and older Chinese adults. METHODS Two independent surveys of urban (n = 5,824, males 44%, mean (standard deviation) age 52 (10) years) and rural populations (n = 20,269, males 41%, mean (standard deviation) age 51 (10) years) were undertaken. Physical activity was measured using the International Physical Activity Questionnaire, and in metabolic equivalents of task (MET) × minutes. Elevated serum level of ALT, a clinical surrogate of abnormal liver function, was defined as >40 IU/L (males) and >30 IU/L (females). Multivariable regression models were used. RESULTS Amount of moderate-to-vigorous activity was inversely associated with serum level of ALT (β = -0.147 per 1k MET-minutes, p < 0.001), whereas walking was not associated. People who reached the lower limit of WHO recommendation (≥600 MET-minutes per week) had a reduced odds of ALT elevation, compared to those who did not (adjusted odds ratio: 0.85 95%CI (0.76, 0.95)). CONCLUSIONS Meeting the moderate-to-vigorous recommendations for physical activity in adults may be associated with decreased likelihood of abnormal liver function both in Chinese urban and rural populations. Promoting such activities could be a low-cost strategy in maintaining liver health as well as providing many other health-related benefits.
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Affiliation(s)
- Yan Chen
- Department of Endocrinology, The Affiliated Huai’an Hospital of Xuzhou Medical University and the Second People’s Hospital of Huai’an, No.62 Huaihai Road, Huai’an, 223002, China
| | - Ying Chen
- Department of Health and Environmental Sciences, Xi’an Jiaotong - Liverpool University, Suzhou, 215213, China
| | - Baohua Geng
- Department of Endocrinology, The Affiliated Huai’an Hospital of Xuzhou Medical University and the Second People’s Hospital of Huai’an, No.62 Huaihai Road, Huai’an, 223002, China
| | - Yong Zhang
- Department of Endocrinology, The Affiliated Huai’an Hospital of Xuzhou Medical University and the Second People’s Hospital of Huai’an, No.62 Huaihai Road, Huai’an, 223002, China
| | - Rui Qin
- Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, 210028, China
| | - Yamei Cai
- Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, 210028, China
| | - Feng Bai
- Department of Endocrinology, The Affiliated Huai’an Hospital of Xuzhou Medical University and the Second People’s Hospital of Huai’an, No.62 Huaihai Road, Huai’an, 223002, China
| | - Dahai Yu
- Primary Care Centre Versus Arthritis, Research Institute for Primary Care & Health Sciences, Keele University, Keele, ST5 5BG, UK
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14
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Klinedinst BS, Meier NF, Larsen B, Wang Y, Yu S, Mochel JP, Le S, Wolf T, Pollpeter A, Pappas C, Wang Q, Allenspach K, Wang L, Russell D, Bennett DA, Willette AA. Walking in the Light: How History of Physical Activity, Sunlight, and Vitamin D Account for Body Fat-A UK Biobank Study. Obesity (Silver Spring) 2020; 28:1428-1437. [PMID: 32573118 PMCID: PMC7501143 DOI: 10.1002/oby.22852] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 04/03/2020] [Accepted: 04/10/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The high prevalence of vitamin D deficiency and obesity drives the need for successful strategies that elevate vitamin D levels, prevent adipogenesis, and stimulate lipolysis. This study provides a theoretical model to evaluate how physical activity (PA) and sunlight exposure influence serum vitamin D levels and regional adiposity. This study hypothesized a posteriori that sunlight is associated with undifferentiated visceral adiposity by increasing the ratio of brown to white adipose tissue. METHODS Using 10-year longitudinal data, accelerometry, a sun-exposure questionnaire, and regional adiposity quantified by dual-energy x-ray absorptiometry imaging, a structural-equation mediation model of growth curves was constructed with a data-driven methodology. RESULTS Sunlight and PA conjointly increased serum vitamin D. Changes in vitamin D levels partially mediated how sunlight and PA impacted adiposity in visceral and subcutaneous regions within a subjective PA model. In an objective PA model, vitamin D was a mediator for subcutaneous regions only. Interestingly, sunlight was associated with less adiposity in subcutaneous regions but greater adiposity in visceral regions. CONCLUSIONS Sunlight and PA may increase vitamin D levels. For the first time, this study characterizes a positive association between sunlight and visceral adiposity. Further investigation and experimentation are necessary to clarify the physiological role of sunlight exposure on adipose tissue.
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Affiliation(s)
- Brandon S. Klinedinst
- Department of Food Science and Human Nutrition, Iowa State
University, Ames, IA
- Neuroscience Program, Iowa State University, Ames, IA
| | | | - Brittany Larsen
- Neuroscience Program, Iowa State University, Ames, IA
- Department of Biomedical Sciences, College of Veterinary
Medicine, Iowa State University, Ames, IA
| | - Yueying Wang
- Department of Statistics, Iowa State University, Ames,
IA
| | - Shan Yu
- Department of Statistics, Iowa State University, Ames,
IA
| | - Jonathan P. Mochel
- Department of Biomedical Sciences, College of Veterinary
Medicine, Iowa State University, Ames, IA
| | - Scott Le
- Department of Food Science and Human Nutrition, Iowa State
University, Ames, IA
| | - Tovah Wolf
- Department of Nutrition & Dietetics, Western Carolina
University, Cullowhee, NC
| | - Amy Pollpeter
- Bioinformatics & Computational Biology Program, Iowa
State University, Ames, IA
| | - Colleen Pappas
- Department of Food Science and Human Nutrition, Iowa State
University, Ames, IA
| | - Qian Wang
- Department of Food Science and Human Nutrition, Iowa State
University, Ames, IA
| | - Karin Allenspach
- Department of Veterinary Clinical Sciences, Iowa State
University, Ames, IA
| | - Li Wang
- Department of Statistics, Iowa State University, Ames,
IA
| | - Daniel Russell
- Department of Human Development & Family Studies, Iowa
State University, Ames, IA
| | - David A. Bennett
- Rush Alzheimer’s Disease Center, Rush University
Medical Center, Chicago, IL
| | - Auriel A. Willette
- Department of Food Science and Human Nutrition, Iowa State
University, Ames, IA
- Neuroscience Program, Iowa State University, Ames, IA
- Bioinformatics & Computational Biology Program, Iowa
State University, Ames, IA
- Department of Neurology, University of Iowa, Iowa City,
IA
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15
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Nivukoski U, Niemelä M, Bloigu A, Bloigu R, Aalto M, Laatikainen T, Niemelä O. Combined effects of lifestyle risk factors on fatty liver index. BMC Gastroenterol 2020; 20:109. [PMID: 32293287 PMCID: PMC7157978 DOI: 10.1186/s12876-020-01270-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 04/05/2020] [Indexed: 02/07/2023] Open
Abstract
Background Factors of lifestyle may have a major impact on liver-related morbidity and mortality. We examined independent and joint effects of lifestyle risk factors on fatty liver index (FLI), a biomarker of hepatic steatosis, in a population-based cross-sectional national health survey. Methods The study included 12,368 participants (5784 men, 6584 women) aged 25–74 years. Quantitative estimates of alcohol use, smoking, adiposity and physical activity were used to establish a total score of risk factors, with higher scores indicating an unhealthier lifestyle. FLI was calculated based on an algorithm including body mass index, waist circumference, serum gamma-glutamyltransferase and triglycerides. Results The occurrence of FLI ≥ 60% indicating fatty liver increased from 2.4% in men with zero risk factors to 81.9% in those with a total risk score of 7–8 (p < 0.0005 for linear trend) and in women from 0 to 73.5% (p < 0.0005). The most striking individual impacts on the likelihood for FLI above 60% were observed for physical inactivity (p < 0.0005 for both genders) and alcohol consumption (p < 0.0005 for men). Interestingly, coffee consumption was also found to increase with increasing risk factor scores (p < 0.0005 for linear trend in both genders). Conclusions The data indicates that unfavorable combinations of lifestyle risk factors lead to a high likelihood of hepatic steatosis. Use of FLI as a diagnostic tool may benefit the assessment of interventions aimed at maintaining a healthy lifestyle and prevention of liver-related morbidity.
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Affiliation(s)
- Ulla Nivukoski
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital and Tampere University, Hanneksenrinne 7, 60220, Seinäjoki, Finland
| | - Markus Niemelä
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital and Tampere University, Hanneksenrinne 7, 60220, Seinäjoki, Finland.,Faculty of Medicine, University of Oulu, 90014, Oulu, Finland
| | - Aini Bloigu
- Center for Life Course Health Research, University of Oulu, 90014, Oulu, Finland
| | - Risto Bloigu
- Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, 90014, Oulu, Finland
| | - Mauri Aalto
- Department of Psychiatry, Seinäjoki Central Hospital and Tampere University, 33014, Tampere, Finland
| | - Tiina Laatikainen
- National Institute for Health and Welfare (THL), 00271, Helsinki, Finland.,The Institute of Public Health and Clinical Nutrition, University of Eastern Finland, 70210, Kuopio, Finland.,Joint Municipal Authority for North Karelia Social and Health Services, 80100, Joensuu, Finland
| | - Onni Niemelä
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital and Tampere University, Hanneksenrinne 7, 60220, Seinäjoki, Finland.
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16
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Ding Z, Zhang J, Deng CY, You YB, Zhou H. Association of body mass index with serum alanine aminotransferase in Chinese adolescents: a school-based cross-sectional study. Gastroenterol Rep (Oxf) 2020; 8:119-124. [PMID: 32280471 PMCID: PMC7136703 DOI: 10.1093/gastro/goz039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 07/30/2019] [Accepted: 07/30/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Numerous studies have consistently demonstrated that high body mass index (BMI) is related to elevated serum alanine aminotransferase (ALT) among adults, but little is known about the association regarding adolescents, especially in China. In this study, we aimed to investigate the association between BMI and ALT activity among Chinese adolescents. METHODS A school-based cross-sectional study was performed among nine high schools in Shenzhen, China between February 2017 and June 2018. A generalized linear-regression model adjusting for age and gender was conducted, and bivariate correlation analysis between ALT and BMI was also performed. RESULTS A total of 7,271 adolescents aged from 9 years to 17 years were enrolled. Height, weight, BMI, and ALT were higher among boys than among girls (all P < 0.001). The mean (standard deviation) of serum ALT levels was 14.26 (14.77) U/L. In the entire BMI range, the BMI-ALT correlation was stronger for boys (Spearman's r = 0.396, P < 0.001) and adolescents of 14 years-17 years (r = 0.356, P < 0.001) than for girls (r = 0.203, P < 0.001) and adolescents of 9 years-13 years (r = 0.221, P < 0.001), respectively. Serum ALT increased rapidly and followed a linear pattern from the point of BMI ≥20.5 kg/m2, and each increase of 1 kg/m2 in BMI range above 20.5 kg/m2 was averagely correlated with an increase of 2.71 U/L in ALT levels (P < 0.001). CONCLUSIONS We found a significant BMI-ALT relationship. BMI at 20.5 kg/m2 may be a cut-off for evaluating serum ALT. BMIs ≥27.1 kg/m2 for boys and ≥24.9 kg/m2 for girls were linked to an elevated ALT activity for Shenzhen adolescents.
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Affiliation(s)
- Zan Ding
- Institute of Low Carb Medicine, Baoan Central Hospital of Shenzhen, the Fifth Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, P. R. China
| | - Jing Zhang
- Department of Nursing, Baoan Central Hospital of Shenzhen, the Fifth Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, P. R. China
| | - Chang-Yu Deng
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong, P. R. China
| | - Ying-Bin You
- Institute of Low Carb Medicine, Baoan Central Hospital of Shenzhen, the Fifth Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, P. R. China
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong, P. R. China
| | - Hua Zhou
- Institute of Low Carb Medicine, Baoan Central Hospital of Shenzhen, the Fifth Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, P. R. China
- Corresponding author. Baoan Central Hospital of Shenzhen, the Fifth Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, P. R. China. Tel: +86-755-27956977; Fax: +86-755-27956977;
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Keshani P, Bagheri Lankarani K, Honarvar B, Raeisi Shahraki H. Regression of Nonalcoholic Fatty Liver Disease Detected by Sonography: Results of a Four Years Prospective Adult Population-based Study. HEPATITIS MONTHLY 2019; In Press. [DOI: 10.5812/hepatmon.95646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Khoudari G, Singh A, Noureddin M, Fritze D, Lopez R, Asaad I, Lawitz E, Poordad F, Kowdley KV, Alkhouri N. Characterization of patients with both alcoholic and nonalcoholic fatty liver disease in a large United States cohort. World J Hepatol 2019; 11:710-718. [PMID: 31749901 PMCID: PMC6856017 DOI: 10.4254/wjh.v11.i10.710] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 08/03/2019] [Accepted: 10/15/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) is the hepatic manifestation of the metabolic syndrome (MetS) and is characterized by steatosis in the absence of significant alcohol consumption. However, MetS and significant alcohol intake coexist in certain individuals which may lead to the development of BAFLD.
AIM To assess the clinical characteristics of patients with both alcoholic and NAFLD (BAFLD) in a large cohort in the United States.
METHODS Adults from the National Health and Nutrition Examination Survey between 2003-2014 were included. NAFLD was diagnosed based on elevated alanine aminotransferase (ALT) and being overweight or obese in the absence of other liver diseases. BAFLD patients met the criteria for NAFLD but also had either MetS or type 2 diabetes and consumed excessive amounts of alcohol. Univariable and multivariable analysis were performed to assess differences between NAFLD and BAFLD and to compare severity based on a validated fibrosis score (FIB4 index).
RESULTS The prevalence of NAFLD was at 25.9% (95%CI; 25.1-26.8) and that of BAFLD was 0.84% (0.67, 1.02) which corresponds to an estimated 1.24 million Americans affected by BAFLD. Compared to NAFLD, patients with BAFLD were more likely to be male, smokers, have higher ALT, aspartate aminotransferase, triglycerides, and lower platelets; P < 0.01 for all. More importantly, after adjusting for MetS components, BAFLD patients were significantly more likely to have advanced fibrosis [adjusted OR (95%CI) based on FIB4 index > 2.67 was 3.2 (1.4, 7.0), P = 0.004].
CONCLUSION A significant percentage of the American general population is afflicted by BAFLD and these patients tend to have more advanced liver fibrosis.
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Affiliation(s)
- George Khoudari
- Department of Hospital Medicine, Cleveland Clinic Foundation, Cleveland, OH 44195, United States
| | - Amandeep Singh
- Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH 44195, United States
| | - Mazen Noureddin
- Department of Gastroenterology and Hepatology, Cedars Sinai Medical Center, Los Angeles, CA 90048, United States
| | - Danielle Fritze
- Department of General Surgery, Texas Liver Institute and University of Texas Health, San Antonio, TX 78215, United States
| | - Rocio Lopez
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH 44195, United States
| | - Imad Asaad
- Department of Gastroenterology, Metro Health System, Cleveland, OH 44109, United States
| | - Eric Lawitz
- Texas Liver Institute and University of Texas Health, San Antonio, TX 78215, United States
| | - Fred Poordad
- Texas Liver Institute and University of Texas Health, San Antonio, TX 78215, United States
| | - Kris V Kowdley
- Swedish Liver Care Network, Swedish Medical Center, Seattle, WA 98122, United States
| | - Naim Alkhouri
- Texas Liver Institute and University of Texas Health, San Antonio, TX 78215, United States
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Nivukoski U, Niemelä M, Bloigu A, Bloigu R, Aalto M, Laatikainen T, Niemelä O. Impacts of unfavourable lifestyle factors on biomarkers of liver function, inflammation and lipid status. PLoS One 2019; 14:e0218463. [PMID: 31220128 PMCID: PMC6586311 DOI: 10.1371/journal.pone.0218463] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 06/03/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Adopting a healthy lifestyle is associated with prolonged life expectancy. The main modifiable lifestyle-related risk factors are hazardous alcohol drinking, smoking, excess body weight and lack of physical activity. Our aim was to estimate the impact of unfavourable lifestyle factors on abnormalities in laboratory tests reflecting liver status, inflammation and lipid metabolism in a population-based cross-sectional study. METHODS The study included 22,273 participants (10,561 men, 11,712 women) aged 25-74 years from the National FINRISK Study. Data on alcohol use, smoking, body weight, and physical activity were recorded from structured interviews. The risk scores for the various life style factors were established on a 0-8 scale and used to stratify the population in classes to allow estimates of their joint effects. Serum liver enzymes (GGT, ALT), C-reactive protein (CRP) and lipid profiles were measured using standard laboratory techniques. RESULTS Consistent dose-response relationships were observed between the number of unfavourable risk factors and serum levels of GGT, ALT, CRP, cholesterol, HDL, LDL and triglycerides (p < 0.0005 for linear trend in all comparisons). When compared with those with zero risk factors, the multivariable-adjusted odds ratios (ORs) for abnormalities in all biomarkers were significantly higher in those with a sum of risk score two or more. The most striking increases in ORs in the group with the highest numbers of risk factors were observed among men in serum GGT: 26.6 (12.4-57.0), ALT: 40.3 (5.3-307.8), CRP: 16.2 (7.8-33.7) and serum triglycerides: 14.4 (8.6-24.0). CONCLUSIONS The data support the view that the presence of unfavourable life style risk factors is associated with distinct abnormalities in laboratory tests for liver function, inflammation and lipid status. Such biomarkers may prove to be of value in the assessment of interventions aimed at reducing unfavourable risk factors and in helping individuals in long-term maintenance of lifestyle modifications.
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Affiliation(s)
- Ulla Nivukoski
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital and Tampere University, Seinäjoki, Finland
| | - Markus Niemelä
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital and Tampere University, Seinäjoki, Finland
- Department of Medicine, University of Oulu, Oulu, Finland
| | - Aini Bloigu
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Risto Bloigu
- Infrastructure for Population studies, University of Oulu, Oulu, Finland
| | - Mauri Aalto
- Department of Psychiatry, Seinäjoki Central Hospital and Tampere University, Tampere, Finland
| | - Tiina Laatikainen
- National Institute for Health and Welfare (THL), Helsinki, Finland
- The Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Joint Municipal Authority for North Karelia Social and Health Services, Joensuu, Finland
| | - Onni Niemelä
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital and Tampere University, Seinäjoki, Finland
- * E-mail:
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Lamrabat S, Lyagoubi A, Bouayadi O, Elmalki J, Elkouche K, Bensalah M, Choukri M. Comparison between Roche Integra 400 plus and Abbott Architect ci8200 in Alanine aminotransferase assay. Pract Lab Med 2019; 15:e00121. [PMID: 31011608 PMCID: PMC6462767 DOI: 10.1016/j.plabm.2019.e00121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 03/18/2019] [Indexed: 11/21/2022] Open
Abstract
Background The aim of this work is to present the results of a comparative study between the ALT assay on Integra 400 plus Roche Diagnostic versus Architect ci8200 of Abbott Diagnostic. Methods A total of 200 patients hospitalized in the various departments of the university hospital Mohammed VI of Oujda were prospectively tested on two systems: Abbott Architect ci8200 and Roche Integra 400 plus. Both analyzers use the spectrophotometric technique by coupling the transamination reaction to the oxidation-reduction reaction at NAD. The agreement of the results between the different techniques was evaluated using the Bland-Altman difference diagram and the Passing-Bablok and Deming regression line. Results There was a high concordance between the two assays: the equation of the Passing-Bablok line is YArchitect = −0,5625 + 0,9917 XIntegra with a correlation coefficient r2 = 0.999. The Bland-Altman diagram shows that the mean bias between the two methods is of the order of 1.1 IU/L and the difference between the ALT measurements by Architect and Integra is in the range of −1.4 to 3.6. Conclusion Our study shows a high correlation of the ALT assay results between the architect ci8200 and Integra 400 plus.
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Patnana AK, Narasimha Rao VV, Chandrabhatla SK, Rajasekhar VR. Comparative Evaluation of the Fracture Resistance of Two Different Fiber-reinforced Composite Restorations with Particulate Filler Composite Restorations. Int J Clin Pediatr Dent 2018; 11:277-282. [PMID: 30397370 PMCID: PMC6212671 DOI: 10.5005/jp-journals-10005-1526] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 05/16/2018] [Indexed: 11/23/2022] Open
Abstract
Uncomplicated crown fractures are the most common form of traumatic dental injuries (TDIs) in children affecting their personal and social well-being.
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Affiliation(s)
- Arun K Patnana
- Resident Doctor, Department of Dentistry, All India Institute of Medical Sciences Jodhpur, Rajasthan, India
| | - Vanga V Narasimha Rao
- Professor, Department of Pedodontics and Preventive Dentistry, GITAM Dental College & Hospital, Visakhapatnam, Andhra Pradesh India
| | - Srinivas K Chandrabhatla
- Professor, Department of Pedodontics and Preventive Dentistry, GITAM Dental College & Hospital, Visakhapatnam, Andhra Pradesh India
| | - Vabbala R Rajasekhar
- Professor, Department of Pedodontics and Preventive Dentistry, GITAM Dental College & Hospital, Visakhapatnam, Andhra Pradesh India
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Maddalone M, Rota E, Amosso E, Porcaro G, Mirabelli L. Evaluation of Surgical Options for Supernumerary Teeth in the Anterior Maxilla. Int J Clin Pediatr Dent 2018; 11:294-298. [PMID: 30397373 PMCID: PMC6212659 DOI: 10.5005/jp-journals-10005-1529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 07/23/2018] [Indexed: 11/23/2022] Open
Abstract
Aim The purpose of this study was to evaluate the surgical options for supernumerary teeth (SNT) in the premaxillary region of children. Materials and methods A total of 69 patients with 82 partially or completely formed SNT in the anterior maxillary region were identified over a 3-year period. All selected patients were assessed for the number, location, and family history of SNT, damage to adjacent roots, and associated symptoms. The surgical approaches used for removal were recorded. Postoperative clinical sequelae (loss of vitality, periodontal problems, pain, bleeding, and enanthema) were evaluated. Results A total of 43, 30, and 9 SNT were extracted with palatal, buccal, and bicortical approaches respectively. Peri-odontal and vitality assessments revealed no problems in adjacent teeth at 6 months after surgery. Postoperative pain was within acceptable levels in all patients and subsided within 3 to 7 days. Mild postoperative bleeding occurred in eight patients. Enanthema subsided within 10 days in all patients. Conclusion Our results suggest that early diagnosis and appropriate surgical treatment of SNT are important to decrease the risk of clinical complications. How to cite this article: Maddalone M, Rota E, Amosso E, Porcaro G, Mirabelli L. Evaluation of Surgical Options for Supernumerary Teeth in the Anterior Maxilla. Int J Clin Pediatr Dent 2018;11(4):294-298.
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Affiliation(s)
- Marcello Maddalone
- Deputy Chief, Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Elisa Rota
- Specialist, Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Ernesto Amosso
- House Officer, Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Gianluca Porcaro
- Adjunct Professor, Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Luca Mirabelli
- House Officer, Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
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Nair S, R Nadig R, S Pai V, Gowda Y. Effect of a Papain-based Chemomechanical Agent on Structure of Dentin and Bond Strength: An in vitro Study. Int J Clin Pediatr Dent 2018; 11:161-166. [PMID: 30131634 PMCID: PMC6102437 DOI: 10.5005/jp-journals-10005-1504] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 03/18/2018] [Indexed: 11/24/2022] Open
Abstract
Aim To evaluate the microtensile bond strength of teeth restored with packable composite after removing caries with three chemomechanical caries removal agents (Carisolv, Papacarie and Carie-care) and also to analyze its effect on chemical composition of dentin using energy-dispersive X-ray (EDX) analysis. Design A total of 40 carious molars with 1 to 1.5 mm of remaining dentin were selected and divided into four groups of 20 each. Group I (control)—bur, group II—Carisolv, group III—Papacarie, group IV—Carie-care. A total of 15 samples from each group were restored with composite; 1 mm thick sections were made and were debonded under tensile load. Remaining five samples from each group were subjected to EDX for elemental analysis of dentin surface. Results No statistically significant difference in the bond strength values and Ca/P ratio was observed between control group and three chemomechanical agents tested in the study. Conclusion None of the chemomechanical agents tested in the study adversely affected the bond strength of composite resin to caries-affected dentin. Therefore, newer papain-based chemomechanical agent Carie-care can be considered as an equally effective economical alternative to commonly used agents Carisolv and Papacarie. How to cite this article: Nair S, Nadig RR, Pai VS, Gowda Y. Effect of a Papain-based Chemomechanical Agent on Structure of Dentin and Bond Strength: An in vitro Study. Int J Clin Pediatr Dent 2018;11(3):161-166.
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Affiliation(s)
- Sruthi Nair
- Postgraduate Student, Department of Conservative Dentistry and Endodontics Dayananda Sagar College of Dental Sciences, Bengaluru Karnataka, India
| | - Roopa R Nadig
- Professor and Head, Department of Conservative Dentistry and Endodontics Dayananda Sagar College of Dental Sciences, Bengaluru Karnataka, India
| | - Veena S Pai
- Reader, Department of Conservative Dentistry and Endodontics Dayananda Sagar College of Dental Sciences, Bengaluru Karnataka, India
| | - Yashwanth Gowda
- Senior Lecturer, Department of Conservative Dentistry and Endodontics Dayananda Sagar College of Dental Sciences, Bengaluru Karnataka, India
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S Dhull K, Verma T, Dutta B. Prevalence of Deleterious Oral Habits among 3- to 5-year-old Preschool Children in Bhubaneswar, Odisha, India. Int J Clin Pediatr Dent 2018; 11:210-213. [PMID: 30131643 PMCID: PMC6102427 DOI: 10.5005/jp-journals-10005-1513] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Accepted: 04/01/2018] [Indexed: 11/23/2022] Open
Abstract
Aim Oral habits during and beyond preschool age are one of the important etiological factors in developing malocclusion and other ill effects on orofacial structures. The objective of the present study was to know the prevalence of deleterious oral habits among 3- to 5-year-old preschool children in Bhubaneswar, Odisha, India. Materials and methods This cross-sectional study was conducted among preschool children, in the age group of 3 to 5 years in the city of Bhubaneswar, Odisha, India. To carry out this study, six private schools, two from each of the three electoral constituency, were selected using cluster sampling technique. A total of 500 students, studying in LKG and UKG and their respective mothers/caregivers were selected for the study as per the inclusion/exclusion criteria. Prevalence of different oral habits in children was calculated from the data obtained. Using Statistical Package for the Social Sciences (SPSS), version 17.0 software, Chi-square test was applied to compare the differences present between boys and girls and their significant values (p < 0.05). Results The result of this study showed a high prevalence of oral habits (36%) among preschool children in Bhubaneswar, Odisha, India. Lip biting was found to be the most prevalent habit (13.4%), followed closely by thumb sucking (12.8%), bruxism (12.8%), and mouth breathing (11%). Conclusion The study revealed a great dearth of a well-established dental education program for preschool children as well as their parents, caretakers, teachers, and pediatricians in order to provide an effective and timely care to the children. How to cite this article: Dhull KS, Verma T, Dutta B. Prevalence of Deleterious Oral Habits among 3- to 5-year-old Preschool Children in Bhubaneswar, Odisha, India. Int J Clin Pediatr Dent 2018;11(3):210-213.
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Affiliation(s)
- Kanika S Dhull
- Reader, Department of Pedodontics and Preventive Dentistry, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar Odisha, India
| | - Tulika Verma
- Postgraduate Student, Department of Pedodontics and Preventive Dentistry, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar Odisha, India
| | - Brahmananda Dutta
- Professor and Head, Department of Pedodontics and Preventive Dentistry, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar Odisha, India
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Moda A, Singla R, M Agrawal P. Foreign Body causing Displacement of Immature Fractured Apical Root Fragment: An Unusual Case Report. Int J Clin Pediatr Dent 2018; 11:247-249. [PMID: 30131650 PMCID: PMC6102433 DOI: 10.5005/jp-journals-10005-1520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Accepted: 04/17/2018] [Indexed: 11/23/2022] Open
Abstract
Trauma is a common cause of fractured teeth with exposed canals in growing children. These children use foreign bodies like stapler pin, lead pencil, nail, etc., to explore the canal of fractured tooth. Sometimes, these foreign objects may get stuck in the canal, which the children do not reveal to their parents because of fear. These foreign objects may act as a potential source of infection. We herewith present a case of a 12-year-old boy who presented with a stick lodged in the root canal of maxillary right lateral incisor along with the displaced fractured tooth segment at the apex and the associated management. How to cite this article: Moda A, Singla R, Agrawal PM. Foreign Body causing Displacement of Immature Fractured Apical Root Fragment: An Unusual Case Report. Int J Clin Pediatr Dent 2018;11(3):247-249.
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Affiliation(s)
- Aman Moda
- Ex-Professor, Department of Pedodontics and Preventive Dentistry, Goenka Research Institute of Dental Science, Gandhinagar, Gujarat India
| | - Rajesh Singla
- Ex-Postgraduate Student, Department of Pedodontics and Preventive Dentistry Government Dental College, Rohtak, Haryana, India
| | - Preeti M Agrawal
- Professor and Head, Department of Periodontics, Triveni Institute of Dental Sciences Hospital & Research Centre, Bilaspur, Chhattisgarh, India
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Malhotra R, Gandhi K, Kumar D, Ahuja S, Kapoor R, Sahni A. A Comparative Study to evaluate Parent's Ability to assess Dental Fear in their 6- to 10-year-old Children using Children's Fear Survey Schedule-Dental Subscale. Int J Clin Pediatr Dent 2018; 11:205-209. [PMID: 30131642 PMCID: PMC6102428 DOI: 10.5005/jp-journals-10005-1512] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 02/26/2018] [Indexed: 11/23/2022] Open
Abstract
Aim Parental presence often provides unique challenge in dental operatory and is directly related to the quality dental treatment. The present study was done to investigate parent's ability to assess dental anxiety of their 6- to 10-year-old child and to determine how parent's and children's fear assessments correlate with each other. Materials and methods Prior to dental treatment, 94 child-parent combinations were included to complete Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) questionnaire, and Frankl score was assigned to children during treatment by operator. Results Mean dental anxiety score reported by the children was 27.74, whereas by their parents was 39.64. There was a poor consistency of parents to predict their child dental fear (p < 0.05). Parents reported higher dental fear for their children. Conclusion Parents assessment of their child's fear may vary in accordance to factors, including their own dental fear. Such input may prevent dentists from establishing an accurate association with the child's patient.How to cite this article: Malhotra R, Gandhi K, Kumar D, Ahuja S, Kapoor R, Sahni A. A Comparative Study to evaluate Parent's Ability to assess Dental Fear in their 6- to 10-year-old Children using Children's Fear Survey Schedule-Dental Subscale. Int J Clin Pediatr Dent 2018;11(3):205-209.
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Affiliation(s)
- Ritika Malhotra
- Reader, Department of Pedodontics, Inderprastha Dental College & Hospital, Ghaziabad, Uttar Pradesh, India
| | - Kapil Gandhi
- Professor and Head, Department of Pedodontics, Inderprastha Dental College & Hospital, Ghaziabad, Uttar Pradesh, India
| | - Dipanshu Kumar
- Reader, Department of Pedodontics, Inderprastha Dental College & Hospital, Ghaziabad, Uttar Pradesh, India
| | - Shilpa Ahuja
- Senior Lecturer, Department of Pedodontics, Inderprastha Dental College & Hospital, Ghaziabad, Uttar Pradesh, India
| | - Rishabh Kapoor
- Senior Lecturer, Department of Pedodontics, Inderprastha Dental College & Hospital, Ghaziabad, Uttar Pradesh, India
| | - Anchal Sahni
- Postgraduate Student, Department of Pedodontics, Inderprastha Dental College & Hospital, Ghaziabad, Uttar Pradesh, India
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Sarma A, Nagar P. A Comparative Evaluation of Time-dependent Changes on the Surface Hardness of Bulk Cure Composites: An in vitro Study. Int J Clin Pediatr Dent 2018; 11:183-187. [PMID: 30131638 PMCID: PMC6102429 DOI: 10.5005/jp-journals-10005-1508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 04/09/2018] [Indexed: 11/25/2022] Open
Abstract
Objectives The objective of this in vitro study was to assess the surface hardness through Vickers hardness (VH) test of one conventional hybrid resin composites (Filtek Z350), compared with that of two bulk cure resin composites (SDR™, Tetric N Ceram®). Materials and methods Twenty specimens of each material were prepared in cylindrical aluminum molds with an internal diameter of 5 mm and depth of 4 mm, 10 (incremental curing) and 10 (bulk curing). The surface of each specimen was covered with a transparent plastic matrix strip before light curing with conventional visible light for 40 seconds. The specimens thus obtained were stored in deionized water and transferred to an incubator at 37°C for 24 hours to simulate clinical conditions. After 24 hours, the microhardness of each specimen was measured using a Vickers indenter, with a load of 100 gm and dwell time of 15 seconds (HV 0.2/40). The specimens were further subjected to VH test in an interval of 7, 30, and 90 days. The data were subjected to statistical analysis—Student’s t test, analysis of variance, and post hoc Tukey’s test. Results The present study showed that SDR™ in bulk curing showed consistently greater value of hardness and was comparable to traditional incremental cured Filtek Z350, highlighting the advantages of the new SDR technology. How to cite this article: Sarma A, Nagar P. A Comparative Evaluation of Time-dependent Changes on the Surface Hardness of Bulk Cure Composites: An in vitro Study. Int J Clin Pediatr Dent 2018;11(3):183-187.
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Affiliation(s)
- Anindita Sarma
- Postgraduate Student, Department of Pedodontics and Preventive Dentistry Krishnadevaraya College of Dental Sciences & Hospital Bengaluru, Karnataka, India
| | - Priya Nagar
- Head, Department of Pedodontics and Preventive Dentistry Krishnadevaraya College of Dental Sciences & Hospital Bengaluru, Karnataka, India
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Kumar P, Mandanna DC, Londhe SM, Sharma M. Validity and Reliability of the Hindi Version of the Modified Child Perceptions Questionnaire 11 to 14. Int J Clin Pediatr Dent 2018; 11:271-276. [PMID: 30397369 PMCID: PMC6212661 DOI: 10.5005/jp-journals-10005-1525] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 07/29/2018] [Indexed: 11/23/2022] Open
Abstract
Introduction The study was conceived to formulate a tool to evaluate child perceptions related to oral health in 11- to 14-year-olds tailor-made for Indian children in Hindi. The original child perceptions questionnaire (CPQ11-14) was translated into Hindi and it was tested for validity and reliability. Materials and methods The original CPQ11-14 was translated into Hindi and some questions were rephrased to suit the sociocultural situation in India. The domains of self-esteem and psychological well-being were added to the questionnaire to broaden the scope of parameters to thoroughly assess the impact on child perceptions toward oral health. The English and Hindi versions of the CPQ11-14 were administered during the first visit to test for validity and the children were recalled after 1 week and administered the Hindi questionnaire again after 1 week to check for reliability. Results The results showed significant positive correlation between oral symptoms, decayed, missing and filled teeth (DMFT) functional limitation and malocclusion. The mean functional limitation score was found to be higher in subjects with malocclusion in both the English and Hindi questionnaires. The test-retest samples were evaluated using the paired t-test and showed no significant difference between the first and second administration which suggested good reliability. Conclusion The translated and modified Hindi CPQ11-14 was found to be valid and highly reliable for use in India. The adaptation of the original questionnaire by modifying certain questions to suit the Indian condition was found to be culturally relevant. How to cite this article: Kumar P, Mandanna DCM, Londhe SM, Sharma M. Validity and Reliability of the Hindi Version of the Modified Child Perceptions Questionnaire 11 to 14. Int J Clin Pediatr Dent 2018;11(4):271-276.
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Affiliation(s)
- Prasanna Kumar
- Professor, Department of Dental Surgery and Oral Health Sciences, Armed Forces Medical College, Pune, Maharashtra, India
| | - Dempsy Cm Mandanna
- Assistant Professor, Department of Pedodontics, Armed Dental Centre (R&R), New Delhi, India
| | - Sanjay M Londhe
- Professor, Department of Orthodontics, Armed Forces Medical College Pune, Maharashtra, India
| | - Mohit Sharma
- Associate Professor, Department of Orthodontics, Armed Forces Medical College Pune, Maharashtra, India
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Padiyar B, Marwah N, Gupta S, Padiyar N. Comparative Evaluation of Effects of Triphala, Garlic Extracts, and Chlorhexidine Mouthwashes on Salivary Streptococcus mutans Counts and Oral Hygiene Status. Int J Clin Pediatr Dent 2018; 11:299-306. [PMID: 30397374 PMCID: PMC6212670 DOI: 10.5005/jp-journals-10005-1530] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 03/28/2018] [Indexed: 11/23/2022] Open
Abstract
Aims and objectives To determine and compare the effect of triphala, chlorhexidine gluconate, and garlic extract mouthwash on salivary Streptococcus mutans count and the oral hygiene status. Materials and methods Sixty children aged 9 to 12 years were randomly allocated into the study groups of triphala mouthwash, chlorhexidine mouthwash, garlic extracts mouth-wash, and distilled water mouthwash. Examination included decayed, missing, and filled teeth (dmft)/decayed, missing, filled surface (dmfs) and DMFT/DMFS, plaque index, and S. mutans count on days 1, 15, and 30. Results The results were statistically analyzed using Friedman test, Wilcoxon signed rank, repeated-measures analysis of variance (ANOVA), paired t-test, one-way ANOVA, post hoc Tukey’s honestly significant different (HSD), Kruskal–Wallis test, and Mann-Whitney test; all calculations were done by MEDCALC software 14.0.0 version. Discussion Streptococcus mutans count had significant reductions using different mouthwashes at 15 days, but the chlorhexidine group showed significant difference from the remaining three groups. Intergroup comparison for plaque index scores of triphala, chlorhexidine, and garlic groups was similar in preventing plaque build-up during the 15 days of mouthwash use. Conclusion All the three mouthwashes containing triphala, chlorhexidine gluconate, and garlic were comparably efficient in reducing the salivary S. mutans count as well as in limiting plaque score; however, chlorhexidine was the most effective in this aspect. In comparison of the two natural ingredients, Triphala is more effective in its antimicrobial effect. How to cite this article: Padiyar B, Marwah N, Gupta S, Padiyar N. Comparative Evaluation of Effects of Triphala, Garlic Extracts, and Chlorhexidine Mouthwashes on Salivary Streptococcus mutans Counts and Oral Hygiene Status. Int J Clin Pediatr Dent 2018;11(4):299-306.
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Affiliation(s)
- Bharathi Padiyar
- Reader, Department of Pedodontics, Mahatma Gandhi Dental College & Hospital, Jaipur, Rajasthan, India
| | - Nikhil Marwah
- Professor and Head, Department of Pedodontics, Mahatma Gandhi Dental College & Hospital, Jaipur, Rajasthan, India
| | - Shweta Gupta
- Professor and Head, Department of Microbiology, Mahatma Gandhi Dental College & Hospital, Jaipur, Rajasthan, India
| | - Narendra Padiyar
- Principal, Professor and Head, Department of Prosthodontics, Mahatma Gandhi Dental College & Hospital, Jaipur, Rajasthan, India
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Tandon S, Kalia G, Sharma M, Mathur R, Rathore K, Gandhi M. Comparative Evaluation of Mucosal Vibrator with Topical Anesthetic Gel to reduce Pain during Administration of Local Anesthesia in Pediatric Patients: An in vivo Study. Int J Clin Pediatr Dent 2018; 11:261-265. [PMID: 30397367 PMCID: PMC6212667 DOI: 10.5005/jp-journals-10005-1523] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 07/29/2018] [Indexed: 12/01/2022] Open
Abstract
Introduction Usually discomfort and pain are associated with dental work, especially for young patients. Pain control can be achieved by using anesthesia. Sight of injection can terrify any patient and if the patient is a child it is really difficult to convince them for injections. Alternatives to injections have been explored. Pediatric dentists are using anesthesia in the form of jelly and patch. Recently, the concept of mucosal vibration has been put forward to enhance the effectiveness of local anesthesia. Aim The aim of the present study was to compare and evaluate the effectiveness of lignocaine jelly and mucosal vibration in reducing pain during administration of local anesthesia in pediatric dental patients. Materials and methods Thirty children in the age group 6 to 11 years who required bilateral anesthesia for dental treatment in mandible were selected for this study. Pain was compared using Wilcoxon signed-rank test at the time of injection using Sound, Eye, Motor (SEM) scale as objective criteria and facial pain rating (FPR) scale as subjective criteria after administration of injection by a trained assistant who was blinded to the procedure. Results Local anesthetic injection along with mucosal vibration resulted in significantly less pain (p = 0.001) in comparison with the injections without the use of mucosal vibration. Conclusion The result shows that mucosal vibration can be used as an effective means to reduce the intensity of pain during local anesthetic injection in dentistry. How to cite this article: Tandon S, Kalia G, Sharma M, Mathur R, Rathore K, Gandhi M. Comparative Evaluation of Mucosal Vibrator with Topical Anesthetic Gel to reduce Pain during Administration of Local Anesthesia in Pediatric Patients: An in vivo Study. Int J Clin Pediatr Dent 2018;11(4):261-265.
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Affiliation(s)
- Sandeep Tandon
- Senior Professor and Head, Department of Pedodontics and Preventive Dentistry Government Dental College, Jaipur, Rajasthan, India
| | - Garima Kalia
- Postgraduate Student, Department of Pedodontics and Preventive Dentistry Government Dental College, Jaipur, Rajasthan, India
| | - Meenakshi Sharma
- Assistant Professor, Department of Pedodontics and Preventive Dentistry Government Dental College, Jaipur, Rajasthan, India
| | - Rinku Mathur
- Assistant Professor, Department of Pedodontics and Preventive Dentistry Government Dental College, Jaipur, Rajasthan, India
| | - Khushboo Rathore
- Postgraduate Student, Department of Pedodontics and Preventive Dentistry Government Dental College, Jaipur, Rajasthan, India
| | - Mahima Gandhi
- Postgraduate Student, Department of Pedodontics and Preventive Dentistry Government Dental College, Jaipur, Rajasthan, India
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Pattanaik S, Puvvula N, Mohammad N. Accelerating Treatment of Skeletal Class II Malocclusion using Fixed Twin Block Appliances. Int J Clin Pediatr Dent 2018; 11:146-150. [PMID: 29991869 PMCID: PMC6034051 DOI: 10.5005/jp-journals-10005-1501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 01/25/2018] [Indexed: 11/30/2022] Open
Abstract
Background Patients with class II malocclusion generally seek orthodontic treatment for esthetic concern. Various myo-functionl appliances can be used for the treatment of skeletal as well as the dental malocclusion in a growing patient. Among various functional appliances, twin block appliance is most commonly used due to better patient compliances. It redirects the mandibular growth to correct the maxillomandibular relationship, enhancing facial esthet ics. This article presents a modified design of the twin block appliance which is less bulky, more esthetic, can be used concurrently with fixed orthodontic appliance, and is easily accepted by uncooperative patients. Case summary An 11-year-old-boy, who presented himself with a skeletal class II malocclusion, was treated with simultaneous use of fixed twin block along with fixed orthodontic appliance to correct both the skeletal and dental malocclusion. The twin block design was modified to have a better compatibility with the fixed orthodontic appliance. How to cite this article: Pattanaik S, Puvvula N, Mohammad N. Accelerating Treatment of Skeletal Class II Malocclusion using Fixed Twin Block Appliances. Int J Clin Pediatr Dent 2018;11(2):146-150.
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Affiliation(s)
- Snigdha Pattanaik
- Reader, Department of Orthodontics & Dentofacial Orthopedics Institute of Dental Sciences, Siksha O Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
| | - Navya Puvvula
- Reader, Department of Orthodontics, Gitam Dental College & Hospital Visakhapatnam, Andhra Pradesh, India
| | - Noorjahan Mohammad
- Reader, Department of Pedodontics, Mamata Dental College Khammam, Telangana, India
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A Suyash I, Bhatia R. A Case of Painless Excision. Int J Clin Pediatr Dent 2018; 11:135-140. [PMID: 29991867 PMCID: PMC6034050 DOI: 10.5005/jp-journals-10005-1499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 02/05/2018] [Indexed: 11/23/2022] Open
Abstract
Soft tissue lesions of the oral cavity are seen in children at the dental office. This case report aims to showcase the ability of laser to treat recurrent soft tissue lesions in the oral cavity in a painless manner. This painless procedure provides relief to the child and parent who suffer from anxiety toward dental treatment. How to cite this article: Suyash IA, Bhatia R. A Case of Painless Excision. Int J Clin Pediatr Dent 2018;11(2):135-140.
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Affiliation(s)
- Ipshita A Suyash
- Postgraduate Student, Department of Pediatric and Preventive Dentistry, D Y Patil School of Dentistry, Navi Mumbai, Maharashtra, India
| | - Rupinder Bhatia
- Professor, Department of Pediatric and Preventive Dentistry, D Y Patil School of Dentistry, Navi Mumbai, Maharashtra, India
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Sharma M, Pandit IK, Srivastava N, Gugnani N, Gupta M. A Comparative Evaluation of Efficacy of Streptococcus mutans Counts in Saliva: An in vivo Study. Int J Clin Pediatr Dent 2018; 11:94-99. [PMID: 29991860 PMCID: PMC6034049 DOI: 10.5005/jp-journals-10005-1492] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 01/13/2018] [Indexed: 11/23/2022] Open
Abstract
Dental caries is a disease of multifactorial origin and Streptococcus mutans is considered as the chief pathogen responsible for its development. However, reduction in the number of pathogenic bacteria, particularly S. mutans, with the use of various preventive measures, can reduce dental caries to a significant level. Therefore, the present clinical study was undertaken to evaluate and compare the efficacy of toothbrushing, fluoride varnish, chlorhexidine mouthwash, and a probiotic (Yakult) in reducing the S. mutans counts in the saliva using Dentocult SM Strip Mutans kit in children. A total of 40 school students between the age group of 4 and 8 years were selected for the study and S. mutans count was taken on the first dental visit using Dentocult SM Strip Mutans test kit. After the initial scores of S. mutans were obtained, the children were divided into four groups and provided with different caries preventive regimen for 2 weeks. After 2 weeks, the scores of S. mutans were reevaluated for reduction in their counts, if any. The data thus collected were tabulated and statistically analyzed. All the groups showed a significant reduction in S. mutans counts with the highest reduction from the Fluor Protector varnish followed by chlorhexidine mouthwash, probiotic (Yakult), and toothbrushing. How to cite this article: Sharma M, Pandit IK, Srivastava N, Gugnani N, Gupta M. A Comparative Evaluation of Efficacy of Streptococcus mutans Counts in Saliva: An in vivo Study. Int J Clin Pediatr Dent 2018;11(2):94-99.
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Affiliation(s)
- Megha Sharma
- Senior Resident, Department of Dental Surgery, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Inder K Pandit
- Principal, Professor and Head, Department of Pedodontics and Preventive Dentistry, D.A.V. (C) Dental College & Hospital, Yamunanagar, Haryana, India
| | - Nikhil Srivastava
- Principal, Professor and Head, Department of Pedodontics and Preventive Dentistry, Subharti Dental College, Meerut, Uttar Pradesh, India
| | - Neeraj Gugnani
- Professor, Department of Pedodontics and Preventive Dentistry, D.A.V. (C) Dental College & Hospital, Yamunanagar, Haryana, India
| | - Monika Gupta
- Professor, Department of Pedodontics and Preventive Dentistry, D.A.V. (C) Dental College & Hospital, Yamunanagar, Haryana, India
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Beena JP, Sahoo P, Konde S, Raj NS, Kumar NC, Agarwal M. Manuka Honey: A Potent Cariostatic Agent- An in vitro Study. Int J Clin Pediatr Dent 2018; 11:105-109. [PMID: 29991862 PMCID: PMC6034044 DOI: 10.5005/jp-journals-10005-1494] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 01/31/2018] [Indexed: 11/23/2022] Open
Abstract
Aim The aim of the study was to test the antibacterial activity of manuka honey and compare its efficacy with another commercially available honey (Dabur honey) on the cariogenic bacteria on Streptococcus mutans and Lactobacillus. Materials and methods An in vitro study was carried out on 40 agar specimens; the samples were divided into two groups of 20 samples consisting of S. mutans and Lactobacil-lus respectively. The 20 samples in each group were further subdivided into four groups of five each, which were tested with 25% manuka honey, 100% manuka honey, 25% Dabur honey, and 100% Dabur honey for both Lactobacillus and S. mutans groups. The antibacterial activity was tested using the agar well diffusion method against S. mutans and Lacto-bacillus. Antibacterial activity was assessed by measuring the diameter of inhibition of zones surrounding the wells. The results obtained were statistically analyzed (one-way analysis of variance test, p-value). Results The results showed that 25% of manuka honey has statistically significant (p ≤ 0.001) antibacterial effect than 25% of Dabur honey on both Streptococcus and Lactobacillus species, and manuka honey with 100% concentration showed a statistically significant (p ≤ 0.001) antibacterial effect than 100% Dabur honey on the same species of bacteria. 100% of both the honeys showed statistically significant (p ≤ 0.001) antibacterial effect than 25% concentrations of the same on S. mutans and Lactobacillus. Conclusion Manuka honey had more antibacterial activity than Dabur honey on S. mutans and Lactobacillus bacteria in the in vitro study. This effect was dependent on the concentration of honey used. How to cite this article: Beena JP, Sahoo P, Konde S, Raj SN, Kumar NC, Agarwal M. Manuka Honey: A Potent Cariostatic Agent—An in vitro Study. Int J Clin Pediatr Dent 2018;11(2):105-109.
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Affiliation(s)
- Javaregowda P Beena
- Reader, Department of Pedodontics and Preventive Dentistry, AECS Maaruti College of Dental Sciences & Research Center Bengaluru, Karnataka, India
| | - Punyatoya Sahoo
- Postgraduate Student, Department of Pedodontics and Preventive Dentistry, AECS Maaruti College of Dental Sciences & Research Center Bengaluru, Karnataka, India
| | - Sapna Konde
- Professor and Head, Department of Pedodontics and Preventive Dentistry, AECS Maaruti College of Dental Sciences & Research Center Bengaluru, Karnataka, India
| | - N Sunil Raj
- Professor, Department of Pedodontics and Preventive Dentistry, AECS Maaruti College of Dental Sciences & Research Center Bengaluru, Karnataka, India
| | - Narayana C Kumar
- Professor, Department of Pedodontics and Preventive Dentistry, AECS Maaruti College of Dental Sciences & Research Center Bengaluru, Karnataka, India
| | - Manisha Agarwal
- Reader, Department of Pedodontics and Preventive Dentistry, AECS Maaruti College of Dental Sciences & Research Center Bengaluru, Karnataka, India
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Upadhyay S, Kumar G, Dhillon JK, Gill NC. Perception of Indian Dental Surgeons regarding Molar Incisor Hypomineralization. Int J Clin Pediatr Dent 2018; 11:116-121. [PMID: 29991864 PMCID: PMC6034059 DOI: 10.5005/jp-journals-10005-1496] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 02/01/2018] [Indexed: 11/23/2022] Open
Abstract
Aim To determine the perception of Indian dental professionals about prevalence, severity, and etiological factors of molar incisor hypomineralization (MIH). Materials and methods An online survey was mailed to dental professionals encompassing various questions regarding etiology, diagnosis, prevalence, and management of MIH. Results More than 90% of the respondents encounter teeth with hypomineralization in their practice, with less than half of them encountering such teeth on a monthly basis. Among these more than one-third find it difficult to manage one or the other aspect of MIH. The etiology was found to be varying as per the respondents. Conclusion Molar incisor hypomineralization is a common condition encountered by dental professionals with no apparent consensus regarding the anticipated prevalence, severity, and etiology of this condition. Knowledge of clinicians' level of perception could be an incentive for pediatric dentists to become more acquainted with MIH by conducting research into its different aspects.How to cite this article: Upadhyay S, Kumar G, Dhillon JK, Gill NC. Perception of Indian Dental Surgeons regarding Molar Incisor Hypomineralization. Int J Clin Pediatr Dent 2018;11(2):116-121.
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Affiliation(s)
- Sumita Upadhyay
- Assistant Professor, Department of Pediatric Dentistry, Kathmandu University School of Medical Sciences, Dhulikhel Hospital, Dhulikhel, Nepal
| | - Gyanendra Kumar
- Associate Professor, Department of Pedodontics and Preventive Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Jatinder K Dhillon
- Assistant Professor, Department of Pedodontics and Preventive Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Namrata C Gill
- Assistant Professor, Department of Pedodontics and Preventive Dentistry Dr. Harvansh Singh Judge Institute of Dental Sciences & Hospital, Panjab University, Chandigarh, India
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Mohammad Z, Bagalkotkar A, Mishra A, Veerala G. Customized Hybrid Bluegrass Appliance: An Innovative Technique. Int J Clin Pediatr Dent 2018; 11:141-145. [PMID: 29991868 PMCID: PMC6034056 DOI: 10.5005/jp-journals-10005-1500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 02/26/2018] [Indexed: 11/23/2022] Open
Abstract
Oral habits in the form of thumb sucking and tongue thrusting are commonly learned patterns of behavior seen in preschool children and they are associated with anxiety, fear, hunger, oral pressure, and sleep. Chronic practice can cause dentoalveolar, perioral problems, and atypical root resorption (ARR) of anterior primary teeth. The ARR is provoked by the thumb sucking habit, and leads to early loss of anterior primary teeth. The early loss of anterior tooth may result in speech and masticatory problems, and psychological disturbance to the child. Hence, pediatric dentists play a crucial role in giving necessary information to parents and guardians. Starting from counseling to appliance therapy, various treatment modalities have been reported in the literature. One of them is bluegrass appliance; it is a nonpunitive habit reminder therapy. The present case report describes a customized hybrid bluegrass appliance designed to eliminate thumb sucking and tongue thrusting habit, and to perform as an esthetic functional space maintainer. How to cite this article: Mohammad Z, Bagalkotkar A, Mishra A, Veerala G. Customized Hybrid Bluegrass Appliance: An Innovative Technique. Int J Clin Pediatr Dent 2018;11(2):141-145.
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Affiliation(s)
- Ziauddin Mohammad
- Associate Professor, Department of Pedodontics and Preventive Dentistry, Sri Sai College of Dental Surgery, Hyderabad, Telangana, India
| | - Apeksha Bagalkotkar
- Associate Professor, Department of Pedodontics and Preventive Dentistry, Sri Sai College of Dental Surgery, Hyderabad, Telangana, India
| | - Ashank Mishra
- Associate Professor, Department of Periodontics, Sri Sai College of Dental Surgery Hyderabad, Telangana, India
| | - Gopi Veerala
- Consultant, Department of Orthodontist, Sree Anjaneya Institute of Dental Sciences, Modakkallur, Kerala, India
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Abstract
Hepatocellular carcinoma (HCC) is highly incidental in South Asian countries. Nepal, however, has low incidence for HCC owing to low prevalence for hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. Nepal lacked national cancer registry until 2003. Though there has been some effort in having one, the current registry incorporates twelve centers and may not properly represent the total cancer burden in the country. Serology for HBV and HCV is seen to be positive in nearly 25 to 30% and 5 to 10% of HCCs respectively. Clinical characteristics of HCCs in Nepal have been discussed in this mini-review and it features poor performance status and advanced stage at presentation, making only a small fraction of these subjects eligible for curative treatment options. Most of the standard treatment modalities are available in Nepal and appear to be reasonably affordable as compared with other developed nations. How to cite this article: Shrestha A. Liver Cancer in Nepal. Euroasian J Hepato-Gastroenterol 2018;8(1):63-65.
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Affiliation(s)
- Ananta Shrestha
- Department of Hepatology, Liver Foundation Nepal, Kathmandu, Nepal
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Ounavong A. Reviewing of Research Finding of Hepatitis B Virus Infection in Lao People's Democratic Republic. Euroasian J Hepatogastroenterol 2018; 8:75-76. [PMID: 29963469 PMCID: PMC6024056 DOI: 10.5005/jp-journals-10018-1265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 03/02/2018] [Indexed: 11/23/2022] Open
Abstract
The seroprevalence of hepatitis B virus (HBV) surface antigen (HBsAg)-positive blood donors was 8.7%. The prevalence among males (9.7%) was higher than among females (6.2%). The prevalence of antihepatitis C virus (HCV)-positive blood donors was 1.1%, with no significant differences between males (1.1%) and females (1.0%). Annual positive rates for HBsAg and anti-HCV donors during the years 2003 to 2005 did not differ significantly. In Lao People’s Democratic Republic (PDR), HBV is highly endemic. However, blood donations are only screened for HBsAg, leaving a risk of transmission by HBsAg-negative occult infected donors. Here, we characterized first-time blood donors to assess prevalence of HBV infections and occult infected donors. Despite hepatitis B vaccination at birth and at 6, 10, and 14 weeks of age, HBV infection continues to be endemic in Lao PDR. We carried a cross-sectional serological study in infants, preschool children, school pupils, and pregnant women to determine their burden of disease, risk of infection, and vaccination status. The prevalence of HBsAg carriage in pregnant women is a relevant marker for the risk of mother-to-child HBV transmission. This study aimed to assess the changes in prevalence of HBV infection among pregnant women attending Mahosot Prenatal Clinic (Vientiane). How to cite this article: Ounavong A. Reviewing of Research Finding of Hepatitis B Virus Infection in Lao People’s Democratic Republic. Euroasian J Hepato-Gastroenterol 2018;8(1):75-76.
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Affiliation(s)
- Angkham Ounavong
- Department of Basic Health Sciences, Faculty of Medical Sciences, University of Health Sciences, Vientiane, Lao People's Democrati Republic
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Dassanayake AS. Nonalcoholic Fatty Liver Disease: Identifying the Disease Burden in Sri Lanka. Euroasian J Hepatogastroenterol 2018; 8:69-72. [PMID: 29963467 PMCID: PMC6024049 DOI: 10.5005/jp-journals-10018-1263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 02/20/2018] [Indexed: 12/19/2022] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is becoming one of the most important causes for chronic liver disease and also hepatocellular carcinoma (HCC) in Sri Lanka. This tendency is also recognized worldwide. More than half of the middle-aged and elderly adults in urban Sri Lanka have ultrasonic evidence of NAFLD. The NAFLD is also identified in population from rural areas of Sri Lanka and also in children. Nonalcoholic steatohepatitis (NASH) cirrhosis is the most common cause of referral for liver transplantation in Sri Lankans. The NASH is also the most common cause for rejecting potential donors for liver transplantation in Sri Lanka. Patients who underwent liver transplantation for cryptogenic cirrhosis developed evidence of NASH following liver transplantation. Recent evidence suggests that there is a genetic component to NAFLD. PNPLA3, a single gene polymorphism linked to the short arm of chromosome 22, is associated with the severity of NAFLD. The presence of this genetic polymorphism appears to carry higher risk of patients with NAFLD developing NASH with fibrosis cirrhosis and hepatocellular carcinoma. In a large population-based study from Sri Lanka, there was a tendency to develop NAFLD associated with this genetic polymorphism. In a population-based study, NAFLD was identified as an independent risk factor for development of diabetes. This association is recognized worldwide now. Most patients with HHC in Sri Lanka developed it on a back ground of cryptogenic cirrhosis. At the same time, the prevalence of the markers for hepatitis B and C was rare in Sri Lankan patients with HCC. How to cite this article: Dassanayake AS. Nonalcoholic Fatty Liver Disease: Identifying the Disease Burden in Sri Lanka. Euroasian J Hepato-Gastroenterol 2018;8(1):69-72.
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Ezer A, Parlakgumus A. Postobstructive Cyst Formation in Pancreatic Duct affecting Surgical Approach. Euroasian J Hepatogastroenterol 2018; 8:99-100. [PMID: 29963476 PMCID: PMC6024057 DOI: 10.5005/jp-journals-10018-1272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Accepted: 01/24/2018] [Indexed: 11/23/2022] Open
Abstract
How to cite this article: Ezer A, Parlakgumus A. Postobstructive Cyst Formation in Pancreatic Duct affecting Surgical Approach. Euroasian J Hepato-Gastroenterol 2018;8(1):99-100.
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Affiliation(s)
- Ali Ezer
- Department of General Surgery, Baskent University, Adana, Seyhan, Turkey
| | - Alper Parlakgumus
- Department of General Surgery, Baskent University, Adana, Seyhan, Turkey
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Konyala HR, Mareddy AR, Puppala N, Venugopal Reddy N, Mallela MK, Susheela KP. Clinical, Radiological, and Histological Assessment of Magnetic Nanoparticles as Pulpotomy Medicament in Primary Molars. Int J Clin Pediatr Dent 2018; 11:283-287. [PMID: 30397371 PMCID: PMC6212663 DOI: 10.5005/jp-journals-10005-1527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 07/17/2018] [Indexed: 11/23/2022] Open
Abstract
AIM AND OBJECTIVES Aim of the study was to evaluate the success of magnetic nanoparticles (MNPs) as pulpotomy medicament by clinical, radiologic, and histological assessment in primary molars. MATERIALS AND METHODS The sample included 30 primary molars from 25 children aged between 3 and 9 years requiring pulpotomy treatment. Pulpotomy was carried out with MNPs. The teeth were evaluated after a period of 3, 6, and 12 months clinically and with the aid of radiographs. After 1 year, 10 teeth were extracted for histological evaluation under field emission scanning electron microscope (FE-SEM; ZEISS, Model No. Supra 55vp). RESULTS Of the samples, 98% showed clinical success rate with absence of pain, swelling, mobility, and abscess formation. After 3 months, 98% radiological success with absence of periodontal ligament widening, root resorption, and inter-radicular radiolucency was noted. Histological examination carried out under FE-SEM revealed a zone of odontoblastic proliferation at the interface between MNPs and odontoblastic layer of pulp and viable pulpal cells from the canal orifice till apical foramen. CONCLUSION Magnetic nanoparticles can be recommended as an effective pulpotomy medicament with hard tissue barrier formation and preservation of vitality of remaining radicular pulp.How to cite this article: Konyala HR, Mareddy AR, Puppala N, Reddy NV, Mallela MK, Susheela KP. Clinical, Radiological, and Histological Assessment of Magnetic Nanoparticles as Pulpotomy Medicament in Primary Molars. Int J Clin Pediatr Dent 2018;11(4):283-287.
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Affiliation(s)
- Harivinder R Konyala
- Reader, Department of Pedodontics, Mamata Dental College Khammam, Telangana, India
| | - Ajay R Mareddy
- Reader, Department of Pedodontics, Mamata Dental College Khammam, Telangana, India
| | - Niharika Puppala
- Senior Lecturer,Department of Pedodontics, Mamata Dental College Khammam, Telangana, India
| | - N Venugopal Reddy
- Professor, Department of Pedodontics, Mamata Dental College Khammam, Telangana, India
| | - Manoj K Mallela
- Professor, Department of Pedodontics, SVS Institute of Dental Sciences Mahabubnagar, Telangana, India
| | - Keerthi P Susheela
- Senior Lecturer,Department of Pedodontics, Malla Reddy Institute of Dental Sciences, Hyderabad, Telangana, India
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Reddy VK, Kommineni NK, Padakandla P, Togaru H, Indupalli JP, Nanga SP. Evaluation of Chemokines in the Gingival Crevicular Fluid of Children with Down Syndrome. Int J Clin Pediatr Dent 2018; 11:288-293. [PMID: 30397372 PMCID: PMC6212665 DOI: 10.5005/jp-journals-10005-1528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 05/19/2018] [Indexed: 11/23/2022] Open
Abstract
AIM The goal of the study was to detect the presence of macrophage inflammatory protein (MIP)-1α and MIP-1β and to estimate their levels in gingival crevicular fluid (GCF) of children with Down syndrome. MATERIALS AND METHODS MIP-1α and MIP-1β levels were estimated in GCF samples of 20 healthy and 20 Down syndrome individuals. Gingival status was assessed by measuring the gingival index (GI), plaque index (PI), clinical attachment level (CAL), and probing pocket depth (PPD).The GCF samples were obtained from the subjects and MIP-1α and MIP-1β levels were quantified by enzyme-linked immunosorbent assay (ELISA). RESULTS The mean MIP-1α concentrations in healthy and Down syndrome individuals were 209 and 1411 pg/μL respectively, and MIP-1α levels were 342 and 1404 pg/μL respectively.The levels of MIP-1α and MIP-1β in the GCF of subjects with Down syndrome were significantly higher than in the healthy individual, and statistically significant differences were present among the two groups. CONCLUSION The GCF showed dynamic changes according to the severity of periodontal disease, and the levels of MIP-1α and MIP-1β had a strong relationship with clinical parameters. The MIP-1α and MIP-1β can therefore be considered as novel biomarkers in the biological mechanism underlying the patho-genesis of periodontal disease.How to cite this article: Reddy VK, Kommineni NK, Padakandla P, Togaru H, Indupalli JP, Nanga SP. Evaluation of Chemokines in the Gingival Crevicular Fluid of Children with Down Syndrome. Int J Clin Pediatr Dent 2018;11(4):288-293.
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Affiliation(s)
- Veerakishore K Reddy
- Reader, Department of Pedodontics, CKS Teja Institute of Dental Sciences & Research, Tirupati, Andhra Pradesh, India
| | - Naveen K Kommineni
- Reader, Department of Pedodontics, CKS Teja Institute of Dental Sciences & Research, Tirupati, Andhra Pradesh, India
| | - Prathyusha Padakandla
- Head, Department of Pedodontics, CKS Teja Institute of Dental Sciences & Research, Tirupati, Andhra Pradesh, India
| | - Harshini Togaru
- Senior Lecturer, Department of Pedodontics, CKS Teja Institute of Dental Sciences & Research, Tirupati, Andhra Pradesh, India
| | - John P Indupalli
- Postgraduate Student, Department of Pedodontics, CKS Teja Institute of Dental Sciences & Research, Tirupati, Andhra Pradesh, India
| | - Swapna P Nanga
- Assistant Professor, Department of Dental Surgery, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
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Garg S, Goel M, Verma S, Mahajan N, Kaul B, Garg V. Use of "Surface Analyzer" to evaluate the Effect of Two Polishing Systems on Surface Texture of Four Newer Composites. Int J Clin Pediatr Dent 2018; 11:266-270. [PMID: 30397368 PMCID: PMC6212672 DOI: 10.5005/jp-journals-10005-1524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 06/28/2018] [Indexed: 11/23/2022] Open
Abstract
Composites polymerized with a clear matrix on the surface will leave a resin-rich surface layer that is easily abraded in the oral environment, exposing unpolished, rough, inorganic filler material. The purpose of this study was to evaluate the polishing effect of two different polishing systems: One-step (PoGo) system and Sof-Lex (multistep) system on four different resin composites: Synergy D6, Clearfil APX Esthetics, Filtek Z 350 XT, Ceram X Mono. After polishing, the specimens were analyzed for average surface roughness using a two-dimensional surface profilometer. How to cite this article: Garg S, Goel M, Verma S, Mahajan N, Kaul B, Garg V. Use of "Surface Analyzer" to evaluate the Effect of Two Polishing Systems on Surface Texture of Four Newer Composites. Int J Clin Pediatr Dent 2018;11(4):266-270.
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Affiliation(s)
- Shefally Garg
- Senior Lecturer, Department of Conservative Dentistry and Endodontics Himachal Dental College, Sundernagar, Himachal Pradesh, India
| | - Munish Goel
- Professor and Head, Department of Conservative Dentistry and Endodontics Himachal Dental College, Sundernagar, Himachal Pradesh, India
| | - Shweta Verma
- Reader, Department of Conservative Dentistry and Endodontics Himachal Dental College, Sundernagar, Himachal Pradesh, India
| | - Nanika Mahajan
- Registrar, Department of Pedodontics, Indira Gandhi Government Dental College & Hospital, Jammu, India
| | - Bhawna Kaul
- Registrar, Department of Pedodontics, Indira Gandhi Government Dental College & Hospital, Jammu, India
| | - Vikas Garg
- Senior Lecturer, Department of Orthodontics and Dentofacial Orthopedics Surendera Dental College & Research Institute, Sri Ganganagar Rajasthan, India
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Sinha S, Praveen P, Prathibha Rani S, Anantharaj A. Pedodontic Considerations in a Child with Attention Deficit Hyperactivity Disorder: Literature Review and a Case Report. Int J Clin Pediatr Dent 2018; 11:254-259. [PMID: 30131652 PMCID: PMC6102438 DOI: 10.5005/jp-journals-10005-1522] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 05/17/2018] [Indexed: 11/27/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is a common psychiatric disorder, characterized by extremely short attention span, impulsivity with resultant behavioral problems. They are prone to trauma and frequent dental injuries. The behavioral issues, cognitive deficits, and short attention span pose a challenge to the dental health team. Management of these children requires several modifications in approach at all levels of prevention and treatment. This study reviews all the pertinent oral health issues in these children and also presents the case report of a 14-year-old boy diagnosed with ADHD. How to cite this article: Sinha S, Praveen P, Rani SP, Anantharaj A. Pedodontic Considerations in a Child with Attention Deficit Hyperactivity Disorder: Literature Review and a Case Report. Int J Clin Pediatr Dent 2018;11(3):254-259.
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Affiliation(s)
- Siddhi Sinha
- Postgraduate Student, Department of Pedodontics and Preventive Dentistry, DA Pandu Memorial RV Dental College and Hospital, Bengaluru Karnataka, India
| | - Prasanna Praveen
- Professor and Head, Department of Pedodontics and Preventive Dentistry, DA Pandu Memorial RV Dental College and Hospital, Bengaluru Karnataka, India
| | - S Prathibha Rani
- Reader, Department of Pedodontics and Preventive Dentistry, DA Pandu Memorial RV Dental College and Hospital, Bengaluru Karnataka, India
| | - Athimuthu Anantharaj
- Professor, Department of Pedodontics and Preventive Dentistry, DA Pandu Memorial RV Dental College and Hospital, Bengaluru Karnataka, India
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Chaturvedi Y, Chaturvedy S, Marwah N, Chaturvedi S, Agarwal S, Agarwal N. Salivary Cortisol and Alpha-amylase-Biomarkers of Stress in Children undergoing Extraction: An in vivo Study. Int J Clin Pediatr Dent 2018; 11:214-218. [PMID: 30131644 PMCID: PMC6102441 DOI: 10.5005/jp-journals-10005-1514] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 02/02/2018] [Indexed: 12/23/2022] Open
Abstract
Aim The anxiety of dental procedure evokes physiological response in the human body similar to fear. The level of cortisol and alpha-amylase in saliva can be considered as one of the major biomarkers of stress and anxiety. Our study was aimed to correlate the stress and anxiety with the levels of salivary cortisol (SC) and salivary alpha-amylase (SAA) in patients undergoing routine dental extraction. Materials and methods The levels of SC and SAA were assessed pre- and postextraction in the salivary samples of 20 children. Results The values of cortisol and alpha-amylase showed a significant increase postextraction. Conclusion Salivary cortisol and SAA can be considered an important and noninvasive tool for assessment of anxiety, such as dental extraction, in children. Clinical significance Increase in the stress levels of a child in the dental operatory procedures like tooth extraction suggests the use of some behavior modification and shaping techniques by dentists to overcome the anxiety of the child before commencement of the procedure. This can aid in better cooperation of the child during treatment as well as helps in internal motivation toward future dental treatment. How to cite this article: Chaturvedi Y, Chaturvedy S, Marwah N, Chaturvedi S, Agarwal S, Agarwal N. Salivary Cortisol and Alpha-amylase—Biomarkers of Stress in Children undergoing Extraction: An in vivo Study. Int J Clin Pediatr Dent 2018; 11(3):214-218.
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Affiliation(s)
- Yogita Chaturvedi
- Postgraduate Student, Department of Pedodontics and Preventive Dentistry Mahatma Gandhi Dental College & Hospital, Jaipur, Rajasthan India
| | - Shefali Chaturvedy
- Reader, Department of Pedodontics and Preventive Dentistry Mahatma Gandhi Dental College & Hospital, Jaipur, Rajasthan India
| | - Nikhil Marwah
- Professor and Head, Department of Pedodontics and Preventive Dentistry Mahatma Gandhi Dental College & Hospital, Jaipur, Rajasthan India
| | - Saurabh Chaturvedi
- Reader, Department of Orthodontics and Dentofacial Orthopedics Government Dental College, Jaipur, Rajasthan, India
| | - Swati Agarwal
- Postgraduate Student, Department of Pedodontics and Preventive Dentistry Mahatma Gandhi Dental College & Hospital, Jaipur, Rajasthan India
| | - Neha Agarwal
- Postgraduate Student, Department of Pedodontics and Preventive Dentistry Mahatma Gandhi Dental College & Hospital, Jaipur, Rajasthan India
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Srivastava B, N Devi N, Gupta N, Singh R. Comparative Evaluation of Various Temperature Changes on Stress Distribution in Class II Mesial-occlusal-distal Preparation restored with Different Restorative Materials: A Finite Element Analysis. Int J Clin Pediatr Dent 2018; 11:167-170. [PMID: 30131635 PMCID: PMC6102440 DOI: 10.5005/jp-journals-10005-1505] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Accepted: 05/19/2018] [Indexed: 11/23/2022] Open
Abstract
Introduction The principal goal of dentistry is to maintain and improve the quality of life of the dental patients. As many of these objectives require the replacement or alterations of the existing tooth structure, the main challenge for centuries has been the development and selection of biocompatible materials that can withstand the unique conditions of the oral environment. Finite element analysis (FEA) is a modern technique of numerical stress analysis that has become a solution to the task of predicting failure due to unknown stresses by showing problem areas in a material and allowing designers to see all of theoretical stresses within. Aims and objectives To evaluate and compare the effect of various temperature changes on the stress distribution, in class II mesial-occlusal-distal (MOD) cavity when restored with different restorative materials, using the finite element method (FEM). Materials and methods Using FEA, various thermal stresses generated in class II MOD lesion using different restorative materials were studied. Results The computer-generated models of intact tooth and teeth restored with the different restorative materials were designed, and thermal stress at different temperatures was observed when subjected to the thermal loads of 5°C, 20°C, 36°C, and 55°C. From the results of the study, it can be concluded that glass ionomer cement (GIC) performed best, followed by intact tooth, composite resin, silver amalgam, and zinc oxide eugenol cement. Conclusion Restoration of class II MOD lesions with materials of lower modulus of elasticity and lower coefficient of thermal expansion will enable better stress distribution. How to cite this article: Srivastava B, Devi NN, Gupta N, Singh R. Comparative Evaluation of Various Temperature Changes on Stress Distribution in Class II Mesial-occlusal-distal Preparation restored with Different Restorative Materials: A Finite Element Analysis. Int J Clin Pediatr Dent 2018;11(3):167-170.
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Affiliation(s)
- Binita Srivastava
- Professor and Head, Department of Pedodontics and Preventive Dentistry, Santosh Dental College and Hospital, Ghaziabad, Uttar Pradesh, India
| | - Neorem N Devi
- Postgraduate Student, Department of Pedodontics and Preventive Dentistry, Santosh Dental College and Hospital, Ghaziabad, Uttar Pradesh, India
| | - Nidhi Gupta
- Reader, Department of Pedodontics and Preventive Dentistry, Santosh Dental College and Hospital, Ghaziabad, Uttar Pradesh, India
| | - Rashi Singh
- Senior Lecturer, Department of Pedodontics and Preventive Dentistry, Santosh Dental College and Hospital, Ghaziabad, Uttar Pradesh, India
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Pachori A, Kambalimath H, Maran S, Niranjan B, Bhambhani G, Malhotra G. Evaluation of Changes in Salivary pH after Intake of Different Eatables and Beverages in Children at Different Time Intervals. Int J Clin Pediatr Dent 2018; 11:177-182. [PMID: 30131637 PMCID: PMC6102436 DOI: 10.5005/jp-journals-10005-1507] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Accepted: 04/17/2018] [Indexed: 11/23/2022] Open
Abstract
Introduction Dissolution of the enamel in the form of erosion has increased due to shift in eating habits toward carbonated drinks like soft drink and chocolates. Aim The purpose of this study was to evaluate changes in the salivary pH after intake of different eatables and beverages in children at different time intervals. Study design Using standard salivary tests, this study was conducted as a case-control study. Fifty children between ages of 8 and 12 years having strict vegetarian diet were included in the study. Materials and methods Oral prophylaxis was done and salivary buffer capacity for stimulated saliva was measured. Before the saliva collection, each of the children was informed not to eat or drink anything for up to 2 hours just before the appointment. Results On pairwise evaluation, all the differences were found to be significant statistically except between baseline vs 30 minutes. Maximum mean difference was calculated and observed between baseline and immediately after intake of fruit juice and immediate after 30 minutes, 0.953 and 0.963 respectively, while minimum difference was calculated and observed between baseline and 30 minutes after intake of fruit juice (0.010). Conclusion Maximum drop was seen in cold drink when compared with fruit juice. The maximum pH increase was observed in cream biscuits with 7.63 ± 0.20. It was observed that in all the groups, the pH gradually got back to near normal levels due to the buffering mechanism of saliva.How to cite this article: Pachori A, Kambalimath H, Maran S, Niranjan B, Bhambhani G, Malhotra G. Evaluation of Changes in Salivary pH after Intake of Different Eatables and Beverages in Children at Different Time Intervals. Int J Clin Pediatr Dent 2018;11(3):177-182.
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Affiliation(s)
- Ankit Pachori
- Postgraduate Student (Final Year), Department of Pedodontics and Preventive Dentistry, Rishiraj College of Dental Sciences and Research Centre, Bhopal Madhya Pradesh, India
| | - Haalaswamy Kambalimath
- Professor and Head, Department of Pedodontics and Preventive Dentistry, Rishiraj College of Dental Sciences and Research Centre, Bhopal Madhya Pradesh, India
| | - Satish Maran
- Senior Lecturer, Department of Pedodontics and Preventive Dentistry, Rishiraj College of Dental Sciences and Research Centre, Bhopal Madhya Pradesh, India
| | - Babita Niranjan
- Senior Lecturer, Department of Pedodontics and Preventive Dentistry, Rishiraj College of Dental Sciences and Research Centre, Bhopal Madhya Pradesh, India
| | - Garima Bhambhani
- Senior Lecturer, Department of Public Health Dentistry, Peoples College of Dental Sciences, Bhopal, Madhya Pradesh, India
| | - Garima Malhotra
- Senior Lecturer, Department of Pedodontics and Preventive Dentistry, Maharana Pratap College of Dental Sciences, Gwalior, Madhya Pradesh India
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Halder S, Kaul R, Angrish P, Saha S, Bhattacharya B, Mitra M. Association between Obesity and Oral Health Status in Schoolchildren: A Survey in Five Districts of West Bengal, India. Int J Clin Pediatr Dent 2018; 11:233-237. [PMID: 30131647 PMCID: PMC6102435 DOI: 10.5005/jp-journals-10005-1517] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 03/16/2018] [Indexed: 11/23/2022] Open
Abstract
Introduction Childhood obesity, dental caries, and periodontal disease are major public health problems due to their adverse impact on the growth and development of children. Obesity and oral health are associated as both share some common risk factors. Aim The specific aim of the study was to determine the correlation, if there is any, between obesity and oral health in children. Materials and methods A cross-sectional survey was conducted in five districts of West Bengal, India. A total of 1,227 school-going children of 6 to 12 years were examined from the districts of Howrah, Hooghly, West Midnapore, South 24-parganas, and North 24-parganas. Following indices were analyzed: Decayed-missing-filled teeth (DMFT), decayed, extracted, filled teeth (deft), simplified oral hygiene index (OHI-S). Depending on their nutritional status, subjects were categorized as being normal weight, overweight, and obese. Logistic regression analysis were applied to the study to find out the association between the above-mentioned dental indices and independent variables: Gender and nutritional status. Result A positive association was found between obesity and oral health status in children. Conclusion Considering the results of this study, it was concluded that obesity is related to oral hygiene status of children. In order to improve oral hygiene status in children, dietary modifications need to be done. How to cite this article: Halder S, Kaul R, Angrish P, Saha S, Bhattacharya B, Mitra M. Association between Obesity and Oral Health Status in Schoolchildren: A Survey in Five Districts of West Bengal, India. Int J Clin Pediatr Dent 2018;11(3):233-237.
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Affiliation(s)
- Sonali Halder
- Assistant Professor, Department of Pedodontics and Preventive Dentistry Dr R Ahmed Dental College and Hospital, Kolkata, West Bengal India
| | - Rahul Kaul
- Postgraduate Student, Department of Pedodontics and Preventive Dentistry Dr R Ahmed Dental College and Hospital, Kolkata, West Bengal India
| | - Paras Angrish
- Postgraduate Student, Department of Pedodontics and Preventive Dentistry Dr R Ahmed Dental College and Hospital, Kolkata, West Bengal India
| | - Subrata Saha
- Professorm Department of Pedodontics and Preventive Dentistry Dr R Ahmed Dental College and Hospital, Kolkata, West Bengal India
| | - Bhaswar Bhattacharya
- Associate Professor, Department of Pedodontics and Preventive Dentistry Dr R Ahmed Dental College and Hospital, Kolkata, West Bengal India
| | - Malay Mitra
- Professor and Head, Department of Pedodontics and Preventive Dentistry Dr R Ahmed Dental College and Hospital, Kolkata, West Bengal India
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Bhatia R, C Vora E, Panda A. Pediatric Dental Appointments No-show: Rates and Reasons. Int J Clin Pediatr Dent 2018; 11:171-176. [PMID: 30131636 PMCID: PMC6102432 DOI: 10.5005/jp-journals-10005-1506] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 05/06/2018] [Indexed: 11/23/2022] Open
Abstract
Aim To determine the frequency and reasons of missed and canceled pediatric dental appointments and identifying the factors associated with it among the patients visiting the pediatric dental clinic of the dental college in Navi Mumbai, Maharashtra, India. To assess the parents' perception regarding the treatment of their children and to explore the merit of different management strategies regarding the missed appointments. Materials and methods Self-administered questionnaires were handed over to the parents in the waiting area, whose children were undergoing treatment in the pediatric dental clinic. Questionnaire included questions pertaining to the sociodemo-graphic characteristics, methods of remembering appointments, and satisfaction with the overall past clinic experience. Results Of the 294 surveyed sample, 52.0% stated that they have missed an appointment. Highest percentage of the patients had missed due to parents' forgetfulness and patient's exams; 52.0% relied on their memory to remember their appointments, and 44.5% used their diaries and mobiles as a means of reminders. For canceling an appointment, most of them stated that patient was unwell and parents' commitments toward other work led to an increase in rates of no-shows. Socioeconomic status and the methods of remembering the appointment date were found to be significantly correlated with missing an appointment among the surveyed sample (p < 0.05); 48.3% said that they would want a call from the dentist a day prior to their appointment as a reminder. Conclusion Around one half of the patients attending the pediatric dental clinic missed their appointments. Patients most likely to fail to keep an appointment was the one who was young, remembered appointment via memory, came from a high socioeconomic class, most of them were males, and had previously broken appointments, while patients preferred receiving a call from the dentist as a reminder aide. Clinical significance Missing appointment creates a series of problems. Firstly, it deprives another patient the opportunity of getting treated. Secondly, it contributes to the development of long waiting list for dental services. Thirdly, it affects the patient's treatment time and may cause increase in the dental emergencies leading to a disruption in the doctor-patient relationship and behavioral management problems.How to cite this article: Bhatia R, Vora EC, Panda A. Pediatric Dental Appointments No-show: Rates and Reasons. Int J Clin Pediatr Dent 2018;11(3):171-176.
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Affiliation(s)
- Rupinder Bhatia
- Professor and Head, Department of Pediatric and Preventive Dentistry, D. Y. Patil School of Dentistry, Navi Mumbai, Maharashtra, India
| | - Esha C Vora
- Postgraduate Student, Department of Pediatric and Preventive Dentistry, D. Y. Patil School of Dentistry, Navi Mumbai, Maharashtra, India
| | - Anup Panda
- Professor, Department of Pediatric and Preventive Dentistry, D. Y. Patil School of Dentistry, Navi Mumbai, Maharashtra, India
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Aggarwal A, M Pai K. Orofacial Manifestations of Leukemic Children on Treatment: A Descriptive Study. Int J Clin Pediatr Dent 2018; 11:193-198. [PMID: 30131640 PMCID: PMC6102430 DOI: 10.5005/jp-journals-10005-1510] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 03/28/2018] [Indexed: 11/23/2022] Open
Abstract
Aim To study the prevalence of orofacial manifestations in leukemic children undergoing treatment and to correlate these manifestations with various stages of chemotherapy. Materials and methods A prospective noninvasive study comprising 43 acute lymphocytic leukemic pediatric patients at various stages of therapy. They were examined on day of their each blood examination, and lesions were recorded on a self-designed pro forma. A total of 133 observations were recorded by a single observer. The treatment was divided into the phase of induction, consolidation, maintenance, and relapse. Results The data were analyzed using Statistical Package for the Social Sciences (SPSS) version 10.1. There were 24 males and 19 females in this study, aged between 3 and 13 years. The common oral lesions seen were dental caries, lymphadenopathy (86.04%), pallor (65.11%), ulcers (13.95%), mucositis (16.27%), gingival enlargement, hemorrhages (20.93%), candidiasis, herpes simplex virus (HSV) infection, xerostomia (44.18%), paresthesia, and tooth mobility. Herpes simplex virus infection was seen only during induction and consolidation phases. Ulcers were seen during all phases of therapy. Clinical significance Orofacial manifestations may be seen as the first sign of leukemia and a dentist may play a significant role in the diagnosis of the disease per se. This study highlights not only about commonly occurring lesions but also their variation during various phases of therapy. To the best of our knowledge, no study has such an extensive reporting of orofacial manifestations of acute lymphocytic leukemia (ALL) patients under treatment. How to cite this article: Aggarwal A, Pai KM. Orofacial Manifestations of Leukemic Children on Treatment: A Descriptive Study. Int J Clin Pediatr Dent 2018;11(3):193-198.
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Affiliation(s)
- Aparna Aggarwal
- Reader, Department of Oral Medicine and Radiology, Maharaja Ganga Singh Dental College and Research Centre, Sri Ganganagar Rajasthan, India
| | - Keerthilatha M Pai
- Professor and Dean, Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Karnataka, India
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