Cytological findings of buccal mucosa in megaloblastic anemia

Megaloblastic anemia is a common problem in Pakistan, that can lead to negative health outcomes with increasing age. Apart from the general effect due to the deficiencies of fo late and vitamin B 12 as observed in blood, bone marrow cells and epithelial cell surfaces, similar changes in oral epithelium have also been found. These cellular findings however have been limited to a very few studies and offers a good research scope for more studies to be conducted. Healthcare strategies that consider the impact of laboratory tests on the overall costs and quality of care should consider the advantages of including cytological findings of buccal mucosal scraps for evaluation of these patients and can serve as a prerequisite of diagnosing this disease

Blood glucose level, salivary PH and oral bacterial count in type 1 diabetic children

Laboratory tests and animal studies have shown a relationship between dental caries and high blood glucose level because of reduction in salivary pH level and the subsequent increase in salivary microbial count. If the acidic environment is left unregulated, it would eventually result in greatly disrupted oral microbial and mineral balance resulting in dental caries and subsequent tooth cavitations. Most bacteria have an optimum pH for growth in the range 6.5 - 7.5 with limits somewhere between 5 and 9. Acidophilic bacteria can grow at a low pH, and such organisms are very important in oral microbiology as the causative agents of caries: Lactobacilli and Streptococcus mutans produce acid as end products of metabolism of dietary sugars, are able to survive and grow in acidic conditions and have been found to have tendency toward higher count in diabetic patients. Subjects with juvenile diabetes are more likely to have higher oral bacterial count as compared to those suffering from adult-onset diabetes mellitus, which accounts for more risk in the progression of oral complications in these patients. No studies have so far been conducted in Pakistan that compares the prevalence of dental caries in diabetic children. This review therefore signifies the scope of such analysis especially in relation to the salivary pH level and salivary bacterial count. Hence, prophylaxis and treatment can be targeted more efficiently to the at risk subjects

Rosai Dorfman disease

We report an unusual presentation of sinus histiocytosis with massive lymphadenopathy [SHML], also called Rosai Dorfman disease. The child presented with bilateral proptosis with massive cervical lymphadenopathy. The patient had fair response to steroid therapy but relapsed during the course of the disease