Day 1 :
- Clinical Pediatrics | Neonatology | Pediartics Health Care | Pediatrics & Clinical Pediatrics | Pediatrics Critical Care and Emergency Medicine | Pediatrics Nephrology and Urology | Pediatrics Surgery
Bharati Vidyapeeth Deemed University, India
Krishna Patil is Assistant Professor at Bharati Vidyapeeth (Deemed to be) University, Pune, India .He is currently pursuing his PhD in the Pediatric Dentistry. He has presented many National and International Papers at various Conferences. He has many National as well as International Paper a publication to his credit He was chairperson for many conferences as well as in the organizing committee. Currently, he is working on Artificial Intelligence use in Pediatric Dentistry and clinical application of Dental Implants to prevent the malocclusion and as a natural space maintainer. Recently he is been awarded by Maharashtra State Dental council as COVID warrior for his tremendous work during the Pandemic time.
A year spent in artificial intelligence is enough to make one believe in GOD. ‑Alan Perlis.
McElory (1895) has beautifully stated that “Although operative dentistry may be perfect, the appointment is a failure if a child departs in tears”, it stresses the importance of behavior management over technical excellence in pediatric dentistry. Fear and anxiety are often associated with child’s first dental visit and have a negative impact on child’s psychology making the dental appointment an unpleasant one .
Child dental anxiety has been a matter of concern for many years and can be defined as a nonspecific feeling of apprehension, worry, uneasiness or dread, the source of which may be vague or unknown . Hence means of conquering this anxiety in a dental setting has been long sought after  and is essential to identify anxious children at the earliest age possible in order to institute a precocious behavioral treatment .
Sometimes a child may vocalize their fears and anxiety, while others manifest it in behavior such as crying, agitation, and cessation of conversation or play and even attempting to escape from care providers. It may also be accompanied by significant physiological changes such as increase in heart rate, other hemodynamic changes and secretion of stress hormones .
The cornerstone of success in pediatric dentistry is behavior management and the use of these of behavior management techniques enable children to learn appropriate behavior, coping skills, reduce anxiety, and facilitate the delivery of adequate oral health care. Owing to the limitless burden of expectations from parent, society and child there has been a constant evolution in application of behavior management techniques in dental clinics .
Smartphone application intervention reduced anxiety in pediatric patients in a better way as compared to conventional behavior modification techniques. It is an established fact that there is a strong relationship between a child’s dental anxiety and successful dental treatment. More recently, virtual reality immersion is a promising technique of distraction which obstructs the dental environment and allows the child to adapt to dental operatory and allows good communication of child and clinician.
Artificial intelligence (AI) is a technology that utilizes machines to mimic intelligent human behavior. To appreciate human-technology interaction in the clinical setting, augmented intelligence has been proposed as a cognitive extension of AI in health care, emphasizing its assistive and supplementary role to medical professionals. While truly autonomous medical robotic systems are still beyond reach, the virtual component of AI, known as software-type algorithms, is the main component used in dentistry. Because of their powerful capabilities in data analysis, these virtual algorithms are expected to improve the accuracy and efficacy of dental diagnosis, provide visualized anatomic guidance for treatment, simulate and evaluate prospective results, and project the occurrence and prognosis of oral diseases.
Behavior management techniques (BMT’s) have been long sought as a solution for preoperative anxiety. Various behavior management strategies have been proposed to manage anxiety and distress during dental treatment form children. A variety of BMT’s existing in routine pediatric practice however, distraction appears to be the safe and inexpensive. The application of distraction is based on the assumption that pain perception has a large psychological component in that the amount of attention directed to the noxious stimuli modulates the perceived pain .
Anxiety is a human reaction to any unknown situation and this preoperative anxiety produces far reaching effects like increased postoperative pain, poor behavior outcomes for the child and increases the treatment challenges when treating a pediatric patient. The pediatric patients with his/ her first visit to dentist are mostly found anxious and apprehensive because of dental equipment's and the newness of the experience .
The present trend advocates the use of non-aversive behavior management techniques which may be equally effective and more acceptable to parents, patients and practitioners. In distraction, the patient’s attention is diverted from what may be perceived as an unpleasant situation . Audio distraction is a non-aversive distraction technique in which patients listen to music or stories during a stressful procedure. The accomplishment of audio distraction technique has been affirmed in medical setups however scanty literature is available to gauge the potency of this technique in terms of pediatrics population .
Researchers have identified several mechanisms by which music works to reduce anxiety. Music is believed to send enough competing sensory inputs through pathways descending from the brain to cause the brainstem to signal some of the gates shut, thereby reducing the amount of pain that the patient listening to the music perceives .
A second mechanism is distraction. Noguchi defines this as “any technique which diverts attention from a noxious stimulus, such as the sound of the dentist’s hand instrument scraping across a rough tooth surface”. A final mechanism is masking: music is able to “mask” unpleasant sounds such as the noises of the dental drill thereby averting the patient’s anxiety .
Despite major advances in dentistry in terms of techniques, technologies and materials, anxiety related to the dental environment and specific procedures is a significant and common problem faced by child patients worldwide and considered as an obstacle in providing quality dental care.
Various aspects and factors are involved in the acquisition and development of dental anxiety in children. It not only concerns fear of pain or of invasive procedures, but also entails separation from the parents, confrontation with unfamiliar people and surroundings and the experience of loss of control .
Nowadays children from all age groups play countless games on the phone, talking to their friends for long hours, or even browsing the internet. Today, we have many apps available on mobile phones to educate the children about the procedures of their dental treatment which can help to alleviate fear.
Though artificial can’t replace all the traits of human mind, it has made a huge contribution in reducing a dentists efforts and assisting him in decision making. It is of prime importance for a practioner to be alert of the potentials of artificial intelligence to assimilate this technology for a enhancing his practice in forthcoming years.
Importance of Research:
Electronic globalization with such a gigantic technological advancement during last few decades has made a huge impact on our everyday life. Artificial intelligence has been a breakthrough in hi-tech progression and has entranced the brains of scholars worldwide. It is field of technological science dealing with computer science and ability of computers to mimic the function of human brain to perform the tasks readily. Ever since its commencement in the field, dental science has witnessed modernization. From patient data records preservation, diagnosis and treatment planning to robots performing surgeries in supervision of clinician has now become possible because of artificial intelligence. In current scenario, it has become necessary for dental professionals to get oriented with clinical as well as technological advancement to provide easy, quick, relatively cost effective and excellent patient care.
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2) Maryam Ajilian Abbasi, Ali Talaei, Ardeshir Talaei, Ali Rezaei The Use of Appropriate Colors in the Design of Children's Room: A Short Review International Journal of Pediatrics ,Vol.2, N.4-1, Serial No.10, October 2014
3) Khaled Habib, Tarek Soliman Cartoons’ Effect in Changing Children Mental Response and Behavior Khaled Habib, Tarek Soliman Open Journal of Social Sciences, 2015, 3, 248-264
4) Sanjeev B. Khanagar a, Ali Al-ehaideb Prabhadevi C. Maganur et al Developments, application, and performance of artificial intelligence in dentistry e A systematic review Journal of Dental Sciences (2021) 16, 508e522.
5) Naseer Ahmed , Maria Shakoor Abbasi ,Filza Zuberi ,Warisha Qamar, et al Artificial Intelligence Techniques: Analysis, Application, and Outcome in Dentistry—A Systematic Review BioMed Research International Volume 2021, Article ID 9751564,
6) T. Shan, F.R. Tay, and L. Gu Application of Artificial Intelligence in Dentistry Journal of Dental Research 2021, Vol. 100(3) 232–244
7) Zakirulla M., Syed Javed, Nouf Essa H. Assiri, Albatool M. Alqahtani, Rasha H. Alzahrani An Overview of Artificial Neural Network in the Field of Pediatric Dentistry Journal of Dental & Oro-facial Research Vol. 16 Issue 01 Jan. 2020
8 ) Münevver Coruh Kılıc, Ibrahim Sevki Bayrakdar, Özer Çelik, Elif Bilgir, Kaan Orhan Artificial intelligence system for automatic deciduous tooth detection and numbering in panoramic radiographs Dentomaxillofacial Radiology (2021) 50, 20200172
Elena Godoy-Molina is currently working at the Pediatrics Unit at Hospital Regional Universitario in Málaga, Spain. This work is part of a project with doctor of the world trying to improve the medical care for women affected by or at risk of female genital mutilation.
Female Genital Mutilation (FGM) is traditional in multiple cultures. Migratory movements have turned Spain into a destination for population groups where it is still in force. Malaga is the Andalusian province with the highest prevalence of migrants from these regions (33.9% of the total number of migrants in Andalusia are from these countries).
Our objective is to assess the level of knowledge about FGM of health/social work professionals in contact with population at risk. We designed a cross-sectional descriptive study analyzing the results obtained in a survey on basic aspects of FGM. The survey was answered by different professionals in the province who carry out their care work in the framework of Pediatrics, gynaecology, family medicine or social work. So far 150 surveys have been analyzed. 98.6% (148/150) of those interviewed report knowing what FGM is, but only 52% (78/150) correctly recognize its definition. Nigeria is the country most frequently referred to as the place where it is practiced (73.3%). Most of the interviewees (76.6%). No relationship was found between age, sex or area of activity and knowledge regarding legislation or protocols. 6.6% of the interviewees indicated having attended a case of FGM, being mostly gynecologists (33.3%). Those who had attended a case of FGM reported greater knowledge about the existence of protocols (p=0.043) and having received information/training on the subject (p=0.023) compared to those who had not attended. Practically all of the respondents referred to being interested in this problem. We observe a significant lack of knowledge of FGM and how to approach it in professionals in direct contact with the population at risk. Given that our province is an area with a high prevalence of practicing groups, we consider that it is necessary to promote and improve the existing protocols and training the professionals in this field.
- Kaplan A. Prevención y atención de la mutilación genital femenina. Manual para profesionales en Andalucía [Internet]. 2ª ed. Consejería de Justicia e Interior; 2018. Disponible en: https://www.juntadeandalucia.es/export/drupaljda/publicacion/18/05/Manual%20profesionales%20prevenci%C3%B3n%20MGF(1).pdf
- Junta de Andalucía. Guía para la concienciación sobre mutilaciones genitales femeninas [Internet]. Consejería de Igualdad y Políticas Sociales; 2016. Disponible en: https://www.juntadeandalucia.es/sites/default/files/2020-04/Guia_Mutilacion_Genital_Femenina_0.pdf
- Molina-Gallego B, Mordillo-Mateos L, Melgar de Corral G, Gómez-Cantarino S, Polonio-López B, Ugarte-Gurrutxaga. Female Genital Mutilation: Knowledge and Skills of Health Professionals. 2021 Jul 31;9(8):974.
- Dawson A, Assifi A, Turkmani S. Woman and girl-centred care for those affected by female genital mutilation: a scoping review of provider tools and guidelines. Reprod Health. 2022;19:50.
- Ezeoke GG, Adeniran AS, Adesina KT, Fawole AA, Ijaiya MA, Olarinoye AO. Female adolescents and the future of female genital mutilation/cutting: a report from an endemic area. Afr Health Sci. 2021; 21(4)1808-1816.
National University of San Marcos, Spain
Marlene is a pediatrician, Doctor of Medicine, and researcher at the Faculty of Medicine of the Valladolid University. She has a doctorate in "Health Sciences Research", two master's degrees, one in "Clinical Nutrition" and the other in "Biological Aspects of Nutrition." She is a peer reviewer for the MDPI editorial, International Journal of Environmental Research and Public Health and Medicine. She is very interested in food security and food bio fortification and especially in the research that is being carried out on micronutrients in the nutritional status of patients with malnutrition and chronic diseases, especially in childhood and adolescence. She believes in the value of preventive medicine in reducing chronic diseases throughout the life of the human being.
Zinc is one of the essential trace elements in human growth and development. Both zinc deficiency and Chronic Kidney Disease (CKD) are risk factors for morbidity and mortality, recognized as public health problems worldwide. There are few studies on zinc deficiency and its supplementation in children with CKD. Therefore, the goal of this study was to evaluate the effect of two doses of Zinc Sulfate (ZS) on the nutritional status of children with CKD.
Methodology and Theoretical Orientation: In the city of Lima, a single-blind, randomized multicentre study was conducted on 48 patients with CKD (48% women) under 18 years for one year. Randomly, participants took 30 or 15 mg/day of ZS, respectively. We performed anthropometric measurements and biochemical analyses.
Serum Zinc Concentration (SZC) was assessed via atomic absorption spectrophotometry. Increase or decrease in patients' Body Mass Index (BMI), Z-score, serum albumin, zinc, and C- Reactive Protein (CRP) levels were used to assess the effect of supplementation.
Findings: The mean of the SZC and albumin was normal before and after the SZ. Men had a higher mean SZC than women. A positive and significant association was observed between SZC and serum albumin before (p = 0.000) and after (p = 0.007) supplementation. In both groups, at the end of the trial, there was a small but positive and significant change in body mass and normalization of BMI Z-score, albuminemia, serum zinc levels and CRP, especially with doses of 30 mg/day of ZS.
Conclusion and significance: Zinc supplementation may improve the nutritional status of children and adolescents with CKD.
1. Escobedo Monge MF, Barrado E, Alonso Vicente C, Redondo del Río MP, Manuel Marugán de Miguelsanz J. Zinc Nutritional Status in Patients with Cystic Fibrosis. Nutrients. 2019; 11(1):150.
2. Escobedo-Monge, M.F.; Torres-Hinojal, M.C.; Barrado, E.; Escobedo-Monge, M.A.; Marugán-Miguelsanz, J.M. Zinc Nutritional Status in a Series of Children with Chronic Diseases: A Cross-Sectional Study. Nutrients 2021, 13, 1121.
3. Monge, M.F.E.; Barrado, E.; Vicente, C.A.; del Río, M.P.R.; de Miguelsanz, J.M.M. Zinc Nutritional Status in Patients with Cystic Fibrosis. Nutrients 2019, 11, 150.
4. Escobedo, M.F.; Barrado, E.; Alonso, C.; Marugán de Miguelsanz, J.M. Comparison study between colorimetric method and flame atomic absorption spectrophotometry in serum zinc status. Nutr. Clin. Diet. Hosp. 2018, 38, 128–133.
5. Escobedo, M.A.F. Eﬀects of the Zinc Sulphate in a Girl with Chronic Renal Failure. Acad. J. Ped. Neonatol. 2016, 2, 1–3.