AIM: The objective of the present prevalence analysis was to study the implications of Down's syndrome on oral health status among patients.
MATERIALS AND METHODS: This was a descriptive and cross-sectional prevalence analysis conducted within a duration of 1 year. A total of 100 children diagnosed with Down syndrome (aged between 5 and 16 years) were selected as the study sample. Inclusion criteria were (a) cytogenetic positive trisomy 21, (b) cooperative behavior, and (c) written informed consent obtained from the legal care-takers. Exclusion criteria were (a) any debilitating form of systemic diseases, (b) any other disability, and (c) extremely uncooperative children. The gingival health status was assessed using gingival index (GI) [Loe and Silness], calculus index (CI) [Ramfjord], and plaque index (PI) [Silness and Loe]. Information involving the practice of oral hygiene maintenance, diet plans, and parental educational status was derived from each parent. Based upon their intelligence quotient (I. Q.) values, the subjects were classified into three groups: a) mild (I. Q. level = 50 to 70), b) moderate (I. Q. level = 35 to 50), and c) severe (I. Q. level ≤35). Statistical analysis was performed using the statistical software tool Statistical Package for Social Sciences (SPSS) version 20.0. Qualitative data were recorded as frequencies, and percentages and quantitative data were recorded as mean and standard deviation values. All categorical outcomes were analyzed by means of the Chi-square test. The quantitative outcomes of Calculus Index, Gingival Index, and Plaque Index were analyzed by either student's t-test or one-way analysis of variance (ANOVA). Significance was set at a cut-off value of P < 0.05.
RESULTS: Down syndromic children between 12 and 16 years were reported to have statistically significant higher Calculus Index, Gingival Index, and Plaque Index values in comparison with younger age syndromic children (P < 0.01). Those with severe mental retardation had significantly higher Plaque Index (P < 0.001) and Gingival Index (P < 0.04) values when compared with those with mild and moderate mental retardation. No significant difference in comparing Calculus Index was noted.
CONCLUSION: Higher age group children with Down syndrome require close monitoring by parents for assisting in maintaining oral hygiene practices just as in younger age group children.
OBJECTIVE: This paper narrates ground experiences gained through the Palm Tocotrienols in Chronic Hemodialysis (PaTCH) project on kidney nutrition care scenarios and some Asian low-to-middle-income countries namely Bangladesh, India, and Malaysia.
METHOD: Core PaTCH investigators from 3 universities (USA and Malaysia) were supported by their postgraduate students (n = 17) with capacity skills in kidney nutrition care methodology and processes. This core team, in turn, built capacity for partnering hospitals as countries differed in their ability to deliver dietitian-related activities for dialysis patients.
RESULTS: We performed a structural component analyses of PaTCH affiliated and nonaffiliated (Myanmar and Indonesia) countries to identify challenges to kidney nutrition care. Deficits in patient-centered care, empowerment processes and moderating factors to nutrition care optimization characterized country comparisons. Underscoring these factors were some countries lacked trained dietitians whilst for others generalist dietitians or nonclinical nutritionists were providing patient care. Resolution of some challenges in low-to-middle-income countries through coalition networking to facilitate interprofessional collaboration and task sharing is described.
CONCLUSIONS: We perceive interprofessional collaboration is the way forward to fill gaps in essential dietitian services and regional-based institutional coalitions will facilitate culture-sensitive capacity in building skills. For the long-term an advanced renal nutrition course such as the Global Renal Internet Course for Dietitians is vital to facilitate sustainable kidney nutrition care.
METHODS: We analyzed the collaborative 2019 Rehabilitation Database of the Global Burden of Disease (GBD) Study and World Health Organization for neurological and mental disorders available for 204 countries and territories. Point prevalence and YLDs with 95% uncertainty intervals (UI) are presented.
RESULTS: Globally, 8.1 million (7.1-9.2) or 1.2% of children under 5 years are estimated to have CP with 16.1 million (11.5-21.0) or 2.4% having intellectual disability. Over 98% resided in low-income and middle-income countries (LMICs). CP and intellectual disability accounted for 6.5% and 4.5% of the aggregate YLDs from all causes of adverse health outcomes respectively. African Region recorded the highest prevalence of CP (1.6%) while South-East Asia Region had the highest prevalence of intellectual disability. The top 10 countries accounted for 57.2% of the global prevalence of CP and 62.0% of the global prevalence of intellectual disability.
CONCLUSION: Based on this Database, CP and intellectual disability are highly prevalent and associated with substantial YLDs among children under 5 years worldwide. Universal early detection and support services are warranted, particularly in LMICs to optimize school readiness for these children toward inclusive education as envisioned by the United Nations' Sustainable Development Goals.