BACKGROUND: Special needs children are at a higher risk of dental trauma because of neurological, physical, mental, and behavioral impairments. They are also at higher risk of developing obesity due to the side effects of medication. OBJECTIVE: Assess the association between traumatic dental injuries (TDIs) and obesity in children with special health care needs. DESIGN: Analytical cross-sectional study. SETTING: Schools for special needs children. STUDY POPULATION AND METHODS: Special needs children with a diagnosis of TDI according to the Andreasen criteria were included in the study. Data on the disability status were obtained from a national demographic survey in 2016. Demographic and dental variables were measured for analysis. Multivariable logistic regression was used to analyse any relationship between TDI prevalence and obesity. MAIN OUTCOME MEASURE: Relationship of body mass index (BMI) to TDI prevalence. SAMPLE SIZE: 350 (131 boys and 219 girls) special needs children with a median (interquartile range) age of 12.0 (2.0) years. RESULTS: Eighty-one (23.1%) children presented with TDIs. The mean (standard deviation) BMI for the entire study population was 24.7 (7.8). Children with obesity had a 30.3% TDI prevalence compared normal-weight children (20.6%) ( P =.035), but BMI category was not statistically significant in the regression analysis ( P =.541), which showed that children with an overjet of >3 mm were 4.82 times (CI: 2.55–9.09, P =.001) more likely to have TDI than children with an overjet of ≤3 mm. Those with inadequate lip coverage were 2.85 times (CI: 1.49–5.44, P =.002) more likely to have TDI. Children with cerebral palsy were 3.18 times (CI: 1.89–11.32, P =.024) more likely to have TDI than children with other disabilities. CONCLUSION: The study showed a significant association between TDI prevalence and increased overjet, inadequate lip coverage, and cerebral palsy. The prevalence of TDI among obese special needs children was statistically significant according to bivariate analysis, but not in a multivariate analysis that adjusted for other variables. LIMITATIONS: Causal relationship cannot be established with cross-sectional study. CONFLICT OF INTEREST: None.

Antibiotic resistance rate is rising worldwide. Silver nanoparticles (AgNPs) are potent for fighting antimicrobial resistance (AMR), independently or synergistically. The purpose of this study was to prepare AgNPs using wild ginger extracts and to evaluate the antibacterial efficacy of these AgNPs against multidrug-resistant (MDR) Staphylococcus aureus, Streptococcus mutans, and Enterococcus faecalis. AgNPs were synthesized using wild ginger extracts at room temperature through different parameters for optimization, i.e., pH and variable molar concentration. Synthesis of AgNPs was confirmed by UV/visible spectroscopy and further characterized by scanning electron microscopy (SEM), X-ray diffraction (XRD), energy-dispersive X-ray spectroscopy analysis (EDXA), and Fourier-transform infrared spectroscopy (FTIR). Disc and agar well diffusion techniques were utilized to determine the in vitro antibacterial activity of plant extracts and AgNPs. The surface plasmon resonance peaks in absorption spectra for silver suspension showed the absorption maxima in the range of 400–420 nm. Functional biomolecules such as N–H, C–H, O–H, C–O, and C–O–C were present in Zingiber zerumbet (Z. zerumbet) (aqueous and organic extracts) responsible for the AgNP formation characterized by FTIR. The crystalline structure of ZZAE-AgCl-NPs and ZZEE-AgCl-NPs was displayed in the XRD analysis. SEM analysis revealed the surface morphology. The EDXA analysis also confirmed the element of silver. It was revealed that AgNPs were seemingly spherical in morphology. The biosynthesized AgNPs exhibited complete antibacterial activity against the tested MDR bacterial strains. This study indicates that AgNPs of wild ginger extracts exhibit potent antibacterial activity against MDR bacterial strains.

In addition to the pathogenesis of SARS-CoV-2, bacterial co-infection plays an essential role in the incidence and progression of SARS-CoV-2 infections by increasing the severity of infection, as well as increasing disease symptoms, death rate and antimicrobial resistance (AMR). The current study was conducted in a tertiary-care hospital in Lahore, Pakistan, among hospitalized COVID-19 patients to see the prevalence of bacterial co-infections and the AMR rates among different isolated bacteria. Clinical samples for the laboratory diagnosis were collected from 1165 hospitalized COVID-19 patients, of which 423 were found to be positive for various bacterial infections. Most of the isolated bacteria were Gram-negative rods (n = 366), followed by Gram-positive cocci (n = 57). A significant association (p < 0.05) was noted between the hospitalized COVID-19 patients and bacterial co-infections. Staphylococcus aureus (S. aureus) showed high resistance against tetracycline (61.7%), Streptococcus pyogenes against penicillin (100%), E. coli against Amp-clavulanic acid (88.72%), Klebsiella pneumoniae against ampicillin (100%), and Pseudomonas aeruginosa against ciprofloxacin (75.40%). Acinetobacter baumannii was 100% resistant to the majority of tested antibiotics. The prevalence of methicillin-resistant S. aureus (MRSA) was 14.7%. The topmost symptoms of > 50% of COVID-19 patients were fever, fatigue, dyspnea and chest pain with a significant association (p < 0.05) in bacterial co-infected patients. The current study results showed a comparatively high prevalence of AMR, which may become a severe health-related issue in the future. Therefore, strict compliance of antibiotic usage and employment of antibiotic stewardship programs at every public or private institutional level are recommended.

Miniscrew-supported appliances are effective in molar distalization with distal movement of premolars with minimal anchorage loss and distal tipping of the molar teeth.

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ObjectivesThis study assessed the association between soft drink consumption, gastric reflux, dental erosion, and obesity among special care children.Materials and methodsA total of 350 special care children (male‐131, female‐219) mean age of 12.6 (± 2.6) years were included. Detection of dental erosion was performed according to the World Health Organization criteria. The medical evaluation assessed body mass index (BMI). With appropriate sample weighting, relationships between dental erosion prevalence and obesity were assessed using multivariable logistic regression.ResultsOverall prevalence of dental erosion was 36%. Mean BMI for entire study population was 24.7 (± 7.8). Regression analysis showed strong association between dental erosion prevalence and consumption of soft drinks (adjusted odds ratio = 1.8; 95% CI = 0.71‐2.92, P < .05), bulimia (adjusted odds ratio = 2.27; 95% CI = 0.99‐4.28, P < .001), and gastric reflux (adjusted odds ratio = 2.24; 95% CI = 0.82‐4.1, P < .001). Bivariate analysis showed high prevalence of dental erosion among obese children compared to children with normal weight (P = .04).ConclusionThe present study demonstrated a significant association between dental erosion prevalence and consumption of soft drinks and gastric reflux among special care children.

Introduction Ginger ( Zingiber officinale ) has been one of the most commonly consumed herbal medicines for a long time to treat several common diseases. Antibacterial activity, antioxidant properties and many bioactive compounds in ginger have been identified previously, which could be used as an alternative method to treat many infectious diseases. Methods The current study evaluates ginger’s biochemical profile using qualitative and quantitative analysis and its bioactive potentials using antioxidant and antimicrobial assays against Streptococcus mutans and selective oral microbes. HPLC analysis was performed for the quantitative analysis. DPPH and disc diffusion assays were used for antioxidant and antimicrobial activities. The antimicrobial activity was checked against Streptococcus mutans, Enterococcus faecalis, Staphylococcus spp., and Lactobacillus spp. All solvents were removed by rotary evaporation before testing the dried extracts. Results The observed IC 50 value showed that distilled water extract exhibited the highest antioxidant activity (43.9), followed by ethanol extract (52.4), and the lowest activity was observed in n -butanol extract (91.2) and n -hexane (90.6). Different plant extracts have shown significant antibacterial activity ( p = 0.001) against each bacterium. The highest antibacterial activity against tested bacteria was observed in n -hexane, chloroform and ethanol extracts. In comparison, the ethyl acetate, n -butanol and water extracts showed low antibacterial activity. Conclusion This study emphasizes that Zingiber officinale ( Z. officinale ) against Gram-positive bacteria is an effective antimicrobial herb. Furthermore, it can be used as a potential natural source of antioxidants. Further studies on the toxicity analysis of ginger are recommended.

In Malaysia, oral cancer is very common and the reported 5-year survival of such patients is nearly 50% after treatment with surgery and radiotherapy, much lower than most of the developed countries. This study aimed to investigate the socio-demographic and clinicopathological parameters that influence the mortality rate of the patients suffering from oral squamous cell carcinoma (OSCC) in the Kelantanse population. In this retrospective study, data regarding socio-demographic, clinicopathological factors, and treatment outcome associated with OSCC were gathered from the archives of the medical records office of Hospital Universiti Sains Malaysia. For statistical analysis, simple and multiple logistic regression were performed. The significance level was set to P < .25. A total of 211 OSCC cases were registered in Hospital Universiti Sains Malaysia from January 1, 2000 to December 31, 2018. Majority of them were male (57.82%), non-smoker (54.97%), non-alcohol consumer (91.94%), and non-betel quid chewer (93.83%) Malay (60.66%) patients. The tongue was the most commonly involved part of the oral cavity (41.52%). Histologically, the majority of the cases had moderately-differentiated OSCC (52.82%). Most of the patients were diagnosed at stage IV at the time of diagnosis (61.61%). When this study was performed, the survival status of the majority of the patients was alive (68.24%). Within the analyzed socio-demographic and clinicopathological parameters, gender, alcohol consumption, T-classification, histological grading, and treatment status have been demonstrated as an independent risk factors for mortality rate in multivariate analysis. Hence, these parameters need to be taken into account for the individualized therapy management of OSCC patients.