Background. A common site for neonatal intestinal obstruction is the duodenum. Delayed establishment of enteral nutritional autonomy continues to challenge surgeons and, since early institution of nutritional support is critical in postoperative newborns, identification of patients likely to require alternative nutritional support may improve their outcomes. Therefore, we aimed to investigate risk factors leading to delayed establishment of full enteral nutrition in these patients. Methods. 87 patients who were surgically treated for intrinsic duodenal obstructions from 1998 to 2012 were reviewed. Variables were tested as potential risk factors. Median time to full enteral nutrition was estimated using the Kaplan-Meier method. Independent risk factors of delayed transition were identified using the multivariate Cox proportional hazards regression model. Results. Median time to transition to full enteral nutrition was 12 days (interquartile range: 9–17 days). Multivariate Cox analysis identified three significant risk factors for delayed enteral nutrition: gestational age (GA) ≤ 35 weeks (P < .001), congenital heart disease (CHD) (P = .02), and malrotation (P = .03). Conclusions. CHD and Prematurity are most commonly associated with delayed transition to full enteral nutrition. Thus, in these patients, supportive nutrition should strongly be considered pending enteral nutritional autonomy.

OBJECTIVE: The purpose of this split-mouth single-centered, parallel-group, randomized clinical trial was to evaluate the efficiency of corticotomy-facilitated orthodontics in rapid canine retraction. METHODS: The sample consisted of 10 patients (15–25 years old) requiring extraction of the maxillary first premolars with subsequent canine retraction. The patients’ right sides were randomly assigned to either the corticotomy (experimental) or control groups. Corticotomy cuts and perforations were performed and canine retraction was initiated bilaterally with closed-coil nickel-titanium springs that applied 150 g of force. The following variables were examined till the end of canine retraction on both sides: Rate of canine retraction, canine root resorption, and patient perception of the procedure. The rate of canine retraction was assessed every month using study models while root resorption was evaluated using CBCT. Patient`s perception was evaluated using a 100 mm VAS. RESULT: Mean time taken for full completion of canine retraction: 5.7 months (test) and 7.1 months (control). Mean root resorption: 0.53 ± 0.10 (control) and 0.24 mm ± 0.10 (test). Mean VAS scores: 16 ± 3.94 (24 hours) and 2 ± 2.58 (1 week) at control side and 46.50 ± 6.69 (24 hours) and 2 ± 2.58 (1 week) at test. CONCLUSION: There was an overall reduction in the time taken for canine retraction with corticotomy; however, an increase in the rate of canine retraction in the corticotomy-facilitated method was evident only for the first four months, compared to the conventional method. Less root resorption was observed in corticotomy-facilitated method than conventional method. Pain perception was more for corticotomy-facilitated method than conventional method at 24 hours, but similar after one week.

Introduction: Cleft lip and cleft palate (CLCP) affects several systems and functions of the child and result in social and psychological problems.Therefore early repair of CLCP is imperative. Every cleft center follows its own surgical treatment protocol. Before closure of palatal defects, babies with cleft palate have great difficulty in feeding. To overcome this feeding difficulties, use of special bottles, nipples, initial palatal obturator therapy are used. The first exposure of those children are primarily the medical doctors including pediatricians from where they are generally referred to the concerned speciality for repair of CLCP. The aim of this study was to assess the knowledge and practice of orofacial clefts and feeding plate obturator among medical doctors working in Kanti Children’s Hospital (KCH). Method: This was a questionnaire based survey among medical doctors working in KCH. The pretested questionnaire with 7 questions each on the knowledge and practice of feeding plate obturator was distributed among the medical doctors and data was collected. The data collected were subjected to statistical analysis using frequency of responses and percentages. Results: Of the total 57 study participants, 32 (56.1%) were males and 25 (43.9%) were females. Majority i.e. 61.4% belonged to 31-40 years age group. 91.2% study participants faced the cleft lip/ palate related feeding difficulties 0-5 times/month while 5 (8.8%) faced this condition 6-10 times/ month. Majority of the infants who were less than 28 days (43.9%) attended the OPD due to difficultyin feeding/ swallowing (57.9%) followed by regurgitation/ aspiration (22.8%). 49.1% of the participants thought feeding plate oburator as the best way to feed a cleft patient on discharge from hospital. In their clinical practice, three fourth of paticipants (70.2%) had never seen a patient with feeding plate obturator, half of the participants (50.9%) didn’t advise for feeding plate obturator for patients withcleft palate and 89.5% were not aware of the replacement of feeding plate obturator. Conclusion: There is low exposure regarding the feeding plate obturator among medical doctors in KCH which needs to be reinforced through meaningful continuing education and training programs.

Zirconia is a “metastable” ceramic, consisting of monoclinic, tetragonal, and cubic phases. Partially stabilized zirconia is preferred choice for dental use since they offer the opportunity to fabricate prosthesis which is not available with other ceramic materials. Phase transformation in zirconia ceramics represents one of the most remarkable innovations in the ceramic field. This phase transformation can have desirable consequences, increase in crack growth resistance which is referred to as “phase transformation toughening”. However, the phase-induced volumetric transformation can also have disastrous consequences, if not properly controlled. This article provides information on crystallography of zirconia and the main characteristics of the tetragonal to monoclinic transformationand also discusses the positive (transformation toughening) and negative aspects (ageing/LTD) of the tetragonal to monoclinic transformation.

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