Journal of Postgraduate Medicine, Education and Research

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2022 | January-March | Volume 56 | Issue 1

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EDITORIAL

Aditi Kapur, R Tamchos

Building a Healthy Foundation for the Child from Birth: Need for Collaborative Parenting by the Pediatricians and Pediatric Dentists

[Year:2022] [Month:January-March] [Volume:56] [Number:1] [Pages:2] [Pages No:1 - 2]

   DOI: 10.5005/jp-journals-10028-1553  |  Open Access |  How to cite  | 

199

Original Article

Prahbhjot Malhi

Psychosocial Impact of the COVID-19 Pandemic on the Pediatric Population: An Implication for Clinical Practice

[Year:2022] [Month:January-March] [Volume:56] [Number:1] [Pages:4] [Pages No:3 - 6]

Keywords: Children, Emotional and behavioral functioning, Pandemic, Post-traumatic growth

   DOI: 10.5005/jp-journals-10028-1552  |  Open Access |  How to cite  | 

Abstract

The current article briefly reviews the factors that contributed toward risk and resilience experienced by children and families during the pandemic of coronavirus disease-2019 with a focus on the child's behavior and emotional adjustment. The widespread closures of schools for an indefinite period led to a huge slide in academic learning of children at the local and global level, especially from low-income families. Increased time spent indoors, lack of peer interaction and learning remotely on electronic devices led to an exponential increase in time spent using technology and screens, decrease in physical activity, unhealthy eating habits and routines, and poor-quality sleep among children and adolescents during the pandemic. Increase in loneliness was documented in several studies and since loneliness is inextricably linked to mental health outcomes such as increased depression and anxiety these negative emotions are a matter of concern for child health professionals. Several governmental policies and remedial actions were initiated in the education, economic, and social sectors to support the developmental needs of children and pave the way forward. On the positive side, the stay-at-home mandate provided some families a unique opportunity to positively connect, engage in shared family activities, discover new strengths, and develop their interests. The real influence of the pandemic may well extend beyond the infection and profoundly impact children's overall development and quality of life. Effective preventive supports and prioritized targeted measures are therefore needed to ensure the subjective well-being of children during and after the pandemic.

298

Original Article

Puneeth Wadhwa, Ashima Goyal, Krishan Gauba, Harpinder Singh Chawla, Sanjeev Kumar Singh

Risk Factors in Development of Early Childhood Caries in 12–18-month-old Indian Children: A Prospective Study

[Year:2022] [Month:January-March] [Volume:56] [Number:1] [Pages:6] [Pages No:7 - 12]

Keywords: Child, Cohort studies, Deciduous teeth, Dental caries, Oral health, Pediatric dentistry, Preschool, Risk assessment, Risk factors

   DOI: 10.5005/jp-journals-10028-1559  |  Open Access |  How to cite  | 

Abstract

Aims and objectives: To assess the risk factors in the development of early childhood caries (ECC) in 12–18-month-old and also to develop a caries prediction model for the preschool children of Chandigarh and neighboring areas. Materials and methods: Involving 100 children (12–18 months of age) were initially evaluated for various risk factors viz. maternal history, infant feeding pattern, oral hygiene measures, levels of mutans streptococci, developmental defects of enamel, caries activity, and past caries experience. The children were then followed longitudinally for 18 months to investigate the development of ECC. Results: At 18 months, 95 children were available for reexamination, and after bivariate correlation analysis; it was found that approximately 11 variables showed a significant difference between children with and without caries. Logistic regression was also carried out to test the strength of correlation which showed mutans streptococci levels, the history of bottle feeding at night, and the presence of enamel hypoplasia to play a highly significant role in the development of ECC. Conclusion: Recognition of risk factors for ECC and their control and prevention will enable pediatric dentists to improve the oral health of young children.

315

Original Article

Dara Singh, Satinder P Singh, Ashok Utreja, Ashok Jena, Sanjeev Verma, Raj K Verma

Epidemiology of Cleft Lip and Palate among Infants Born in Chandigarh

[Year:2022] [Month:January-March] [Volume:56] [Number:1] [Pages:8] [Pages No:13 - 20]

Keywords: Cleft lip and palate, Epidemiology, Incidence

   DOI: 10.5005/jp-journals-10028-1550  |  Open Access |  How to cite  | 

Abstract

Aim and objective: To determine the incidence of cleft deformity in Chandigarh by monitoring the total live births occurring at different birth facilities. Materials and methods: This cross-sectional study was carried out at all birth facilities of UT, Chandigarh during the period between 1st January 2009 and 31st December 2010. Total 35 birth facilities, 6 government hospitals, and 29 private nursing homes were included in the study. This epidemiological study was based on monitoring of all the live births and recorded the incidence of type of cleft deformity, associated congenital malformations, birth order, family history, detection, and diagnosis with ultrasonography and folic acid intake during pregnancy. Results: Forty eight babies with different types of cleft deformities were born with an incidence of 0.97/1,000 live births. Group- 1, group- 1(A), group- 2, and group- 3 (as per Balakrishnan classification) and miscellaneous group included eight (16.66%), 10 (20.84%), 13 (27.08%), 14 (29.16%) newborns, and three (6.26%) newborns (one with subcutaneous cleft and palate while two with midline cleft deformity of face), respectively. The frequency of cleft deformity was significantly more among males except isolated cleft palate group which showed equal distribution. About 15 (46.87%) newborns had cleft deformity on left side, 10 (31.25%) on right side while seven (21.87%) had bilateral cleft deformity. The overall percentage of subjects of cleft with associated major anomalies or syndromes was 22%. Conclusion: The incidence of cleft deformity in Chandigarh region was found to be 0.97/1,000 live births. The frequency of cleft deformity was more among males as compared to females except isolated cleft palate group which showed equal distribution. The laterality of the cleft deformity was more on left side followed by right side and then bilateral. Improved training to radiologists and gynecologists could increase the detection rates of orofacial clefts during pregnancy.

327

REVIEW ARTICLE

Sanjeev Singh, Mrinalini Rathore, Aditi Kapur

Decrypting the Role of Systemic Illnesses in Developmental Defects of Enamel

[Year:2022] [Month:January-March] [Volume:56] [Number:1] [Pages:8] [Pages No:21 - 28]

Keywords: Dental, Developmental defects, Enamel, Hard tissue, Hypomineralization, Hypoplasia

   DOI: 10.5005/jp-journals-10028-1564  |  Open Access |  How to cite  | 

Abstract

The development of dental hard tissues involves a very intricate mechanism beginning in utero and continuing up to the first few years of life. The developmental processes involved at the cellular level are extremely sensitive to genetic and environmental factors. Any systemic disturbance during this period is thus likely to affect the developing dentition manifesting as a wide spectrum of defects in the enamel, dentin, or overall tooth morphology. Clinically, these often present as discoloration causing aesthetic concerns, tooth sensitivity, increased caries susceptibility, the risk for pulpal involvement, and its sequelae. Various authors have attempted to identify the range of environmental stressors that lead to such defects, but no definite etiology has yet been established. Further research is warranted to better understand these entities, improving their predictability and thus, aiding in timely diagnosis and successful treatment of the defects.

234

REVIEW ARTICLE

Sunaakshi Puri, Aditi Kapur, Preethy J Mathew

General Anesthesia for Dental Procedures in Children: A Comprehensive Review

[Year:2022] [Month:January-March] [Volume:56] [Number:1] [Pages:5] [Pages No:29 - 33]

Keywords: Dental procedures, General anesthesia, Pediatric

   DOI: 10.5005/jp-journals-10028-1555  |  Open Access |  How to cite  | 

Abstract

With the advent of modern and safe anesthesia drugs and equipment, myriad of dental procedures are being safely conducted in children, including those with special needs. General anesthesia facilitates efficient intervention in children who would otherwise be uncooperative to dental interventions. However, providing general anesthesia for these procedures has its own risks and implications. Hence, a focused preanesthesia evaluation emphasizing upon the medical and behavioral comorbidities remains the cornerstone of providing safe anesthesia to these children. The fear of pain and anxiety due to parental separation are common in children which is managed by various pharmacological and non-pharmacological measures to enable a smooth transition onto the dental chair. Another important consideration in dental procedures is the sharing of airway by anesthesiologist and dentist. Airway protection with a definitive airway is therefore mandatory. Since children with special needs constitute a significant cohort undergoing dental procedures under general anesthesia, the anesthetic plan must be tailored for a smooth emergence as well. We hereby discuss the various perioperative concerns in providing anesthesia to children for dental procedures emphasizing the preoperative and intraoperative implications and prerequisites to provide safe anesthesia.

335

CASE REPORT

Suresh K Angurana, Ashish Agarwal, Atit A Gawalkar, Vivek Jaswal, Vishnu Koneru, TK Kavitha, Manoj K Rohit, Goverdhan D Puri, Muralidharan Jayashree

An Infant with Congenital Heart Block and SARS-CoV-2 Infection: Challenges in Diagnosis and Management

[Year:2022] [Month:January-March] [Volume:56] [Number:1] [Pages:3] [Pages No:34 - 36]

Keywords: Congenital heart block, COVID-19, Invasive procedures, Personal protective equipment

   DOI: 10.5005/jp-journals-10028-1557  |  Open Access |  How to cite  | 

Abstract

The coronavirus disease-2019 (COVID-19) pandemic posed a major challenge for delivery of health care services especially for non-COVID-19 related diseases. We present a 1-year-old girl who was symptomatic for last 3 months with recurrent myoclonic jerks, the cause for which could not be evaluated due to lockdown and disruption of healthcare services. She presented to us with complete heart block, cardiogenic shock, and acute kidney injury. The management included mechanical ventilation, placement of an internal jugular venous and peritoneal catheter, insertion of transvenous pacing lead, and later on an epicardial permanent pacemaker implantation.

240

CASE REPORT

Kamaljit Kaur, Aditi Kapur

Bilateral Eruption Cysts in a 15-month-old Child: A Conservative Management Approach

[Year:2022] [Month:January-March] [Volume:56] [Number:1] [Pages:4] [Pages No:37 - 40]

Keywords: Cyst, Eruption, Teething

   DOI: 10.5005/jp-journals-10028-1560  |  Open Access |  How to cite  | 

Abstract

An eruption cyst is a benign, developmental cyst associated with primary or permanent teeth. It usually resolves with the eruption of tooth and is asymptomatic in nature. But if it gets symptomatic or infected, it requires treatment. The present article reports a clinical case with a conservative treatment approach for the management of bilateral eruption cysts in a 15-month-old child.

277

CASE REPORT

Raj K Verma, Satinder P Singh, Sanjeev Verma

Management of Angle's Class II Division 2 Malocclusion with Early Interceptive Orthodontics: A Case Report

[Year:2022] [Month:January-March] [Volume:56] [Number:1] [Pages:6] [Pages No:41 - 46]

Keywords: Class II Division 2, Functional jaw orthopedics, Interceptive orthodontics

   DOI: 10.5005/jp-journals-10028-1556  |  Open Access |  How to cite  | 

Abstract

A case report to illustrate the early interceptive orthodontics for management of developing Class II Division 2 malocclusion is presented. A child with Angle's Class II Division 2 malocclusion was treated with prefunctional orthodontics, functional orthodontics followed by comprehensive orthodontics. Excellent results were achieved.

307

CASE REPORT

Nagarajan S, Sanjeev Singh, Aditi Kapur, Ashima Goyal

Oral Rehabilitation of a Female Child with Vitamin D-dependent Rickets Type II A: A Case Report

[Year:2022] [Month:January-March] [Volume:56] [Number:1] [Pages:4] [Pages No:47 - 50]

Keywords: Child, Hypophosphatemia, Prosthetic rehabilitation, Rickets, Vitamin D

   DOI: 10.5005/jp-journals-10028-1561  |  Open Access |  How to cite  | 

Abstract

Vitamin D-dependent rickets (VDDR) describes a group of genetic disorders that are characterized by early-onset rickets due to the inability to maintain adequate concentrations of active forms of vitamin D or a failure to respond fully to activated vitamin D. The prevalence rate is usually reported to be around 1:20,000. The oral manifestation includes dentin defects, unusually large pulp chambers, and enlarged pulp horns, hypoplastic enamel which is mostly seen in primary teeth than in permanent teeth. The present case report of VDDR in an 8.5-year-old female child highlights the clinical and radiographic features of the oral cavity along with the prosthetic rehabilitation to restore her stomatognathic functions.

172

COMMENTARY

Preethy J Mathew, Anoop Sharma

Pediatric Anesthesia: An Emerging Specialty in India

[Year:2022] [Month:January-March] [Volume:56] [Number:1] [Pages:2] [Pages No:51 - 52]

Keywords: Emerging speciality, Indian healthcare, Pediatric anesthesia

   DOI: 10.5005/jp-journals-10028-1551  |  Open Access |  How to cite  | 

200

Invite Article

Priyanka Madaan, Jitendra K Sahu

Oral Health in Children with Neurological Disorders

[Year:2022] [Month:January-March] [Volume:56] [Number:1] [Pages:4] [Pages No:53 - 56]

Keywords: Children, Dental, Neurological disorders, Oral health

   DOI: 10.5005/jp-journals-10028-1554  |  Open Access |  How to cite  | 

Abstract

Pediatric neurological disorders encompass a wide range of disorders, including neurodevelopmental disorders, epilepsy, immunological disorders, neurometabolic disorders, degenerative disorders, and neuromuscular disorders. Oral health forms an integral part of holistic care in children with neurological disorders. Children with neurological disorders are predisposed to oral health problems because of a multitude of associated impairments, namely cognitive, communication, oro-motor, and behavioral. Children with neurodevelopmental, neurometabolic, neurodegenerative, and movement disorders have an increased risk of dental caries and worse gingival status due to the associated impairments. Children with epilepsy are prone to dental trauma and gingival overgrowth due to antiseizure medications. Children with neuromuscular disorders have limited physical mobility and often have facial or bulbar weakness resulting in drooling, swallowing difficulties, and malocclusion. The management of children with hereditary sensory autonomic neuropathy (associated with self-mutilation and dental concerns) is often challenging. Proper precautions need to be taken along with the involvement of an anesthesiologist during procedural sedation/analgesia for children with neuromuscular disorders.

266

CLINICAL TECHNIQUE

Manoj A Jaiswal, Aditi Kapur, Ashima Goyal, Khushboo Bhalla, Nagarajan S, Bhupendra Babaria

Ankyloglossia in Children and those with Special Healthcare Needs: Diagnosis Management and Implications

[Year:2022] [Month:January-March] [Volume:56] [Number:1] [Pages:4] [Pages No:57 - 60]

Keywords: Ankyloglossia, Feeding difficulty, Frenectomy, Soft tissue laser, Speech difficulty, Tongue-tie

   DOI: 10.5005/jp-journals-10028-1562  |  Open Access |  How to cite  | 

Abstract

Oral ties along with ankyloglossia have been recognized for centuries, but have gained wider interest in the recent years. Tongue-tie refers to a congenital condition characterized by a short lingual frenulum that restricts tongue movement and interferes with tongue function. Recent literature suggests that speech, feeding, oral hygiene, dentition, and sleep difficulties may be linked to this condition. This case series presents evidence on the diagnosis, management using soft tissue laser with the help of pharmacological/nonpharmacological behavior management techniques, use of myofunctional exercises and future implications of short lingual frenulum in young children.

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