Three point fixation is superior to two point fixation technique for zygomatic complex fracture

Background:Isolated zygomatic or malar bone fractures are second most common fracture among facial skeletal injuries. It has been reported that three point fixation is appropriate for isolated zygomaticbone fracture. The objective of current study was to compare the mean difference in terms of malar height outcome by using different fixation techniques (two point and three point)in patients with zygomatic complex fracture.Methods:This randomized controlled trial was conducted at Department of Oral and Maxillofacial Surgery, MMDC, Multan, during a period of six months from 1st June 2017 to 30th November 2017. A total 182 patients of both genders were included in this study. Two point fixation techniques were used in Group-A patients. While 3 point fixation was used in Group-B patients. After 6 weeks follow-up, patients were assessed for malar height. Outcome was measured by comparing the mean difference of pre and postoperative malar height of both techniques. Data were analyzed using computer program SPSS-21. P≤0.05 was taken as significant in all analysis.Results:Among patients in two pointfixation group, the mean malar height was 67.55±2.98 mm and in three pointfixation group, meansmalar height was 71.55±2.36 mm. The difference of malar height among two treatments was highly significant with p<0.01. Conclusions: Using three point fixation results better as compared to two point fixations in terms of malar height outcome

Frequency of Different Types of Mandibular Third Molar Impactions

Objective: Impacted third molars are a major problem in modern dentistry and the decision of whether to remove an impacted third molar is probably one of the most frequent treatment decisions faced by dentists. Impacted mandibular third molars are often associated with pericoronitis, periodontitis, cystic lesions, neoplasm, and pathological root resorption and can cause detrimental effects on the adjacent tooth. Therefore, the objective of the present study was to determine the frequency of different types of mandibular third molar impactions. Materials and Methods: This cross-sectional study was carried out in the outdoor patient Department of Oral and Maxillofacial Surgery, Multan Medical and Dental College, Multan during a period of 6 months from 15 December 2017 to 14 June 2018. After written informed consent, a total of 200 patients were recruited, diagnosed clinically and radiographically as having impacted mandibular 3rd molar. Angulation of impacted third molar was classified according to the long axis of the adjacent second molar on periapical and OPG radiographs. Statistical analysis was done through SPSS version 20. Results: Out of 200 patients, the frequency of mesioangular, vertical, distoangular, and horizontal impactions were 84 (42%), 60 (30%), 40 (20%), and 16 (8%) respectively. The depths of the impactions were 67 (33.5%) depth A, 92 (46%) depth B, and 41 (20.5%) depth C. Conclusion: Mesioangular impaction was more common followed by vertical. Depth B was the most common.

Histopathological Audit of Thyroid Lesions: A Retrospective Study in a Tertiary Care Hospital

Objectives: The present study aims to determine the pattern of thyroid lesions in thyroidectomy specimens received in the Pathology Department of Ibn-e Sina Hospital, Multan, Pakistan. Materials and methods: In the current research all the thyroidectomy and subtotal thyroidectomy specimen from any age, sex were included. Previously diagnosed cases with any neoplastic lesions were excluded from the research. The biopsy registers were reviewed and different lesions were categorized. Age and sex-wise variations of the lesions were noted. The study proposal was reviewed and accepted by the hospital ethical committee. Statistical analysis was done using the frequency distribution table in the Microsoft Excel Office. Results: A total of 1465 cases presented with thyroid nodule were histopathologically examined. Among these cases 1169 cases were diagnosed as simple goiter, 146 as adenoma and 86 cases were proved to be malignant tumors. These 86 malignant cases were comprised of papillary thyroid carcinoma (n=43) and follicular thyroid carcinoma (n=43). While 64 cases were categorized as “other”. Conclusion: The majority of the thyroid nodules are either non-neoplastic or benign neoplasm. Papillary and follicular thyroid carcinomas share equal prevalence in Pakistani society according to the findings of the present study.

Pulpotomy of Immature Permanent Teeth using Two Different Sealing Materials: A Comparative Study

Objective: To compare the outcome of pulpotomy of immature permanent teeth using calcium hydroxide (CH) and mineral trioxide aggregate (MTA) as sealing materials. Methods: This randomized controlled trial was carried out in the Department of Pediatric Dentistry, Punjab Dental Hospital, Lahore. Duration of the study was 9 months: 6 months data collection (February 01, 2016 to May 31, 2016, and August 01, 2016 to September 09, 2016) and 3 months follow up period (October 01, 2016 to December 31, 2016). Total of 110 patients was included in this study. They were divided into 2 groups; A and B, each comprising of 55 patients. All cases were treated by the same operative team. Conventional access cavity was formed and coronal pulp was removed to the cervical level using a sharp spoon excavator and a sterile round diamond bur. Results: There were 25 males (45.4%) and 30 females (54.6%) in calcium hydroxide group, while in the mineral trioxide aggregate group, there were 26 males (47.2%) and 29 females (52.8%) with a male to female ratios 1:1.2 and 1:1.1 respectively. The mean ± SD ages were 8.93 ± 1.82 and 8.89 ± 1.97 years. Total 44 patients (80%) have success and 11 patients (20%) have a failure in calcium hydroxide group, while in mineral trioxide aggregate group, 48 patients (87.2%) have success and 7 patients (12.8%) have a failure. Statistically, there was no significant difference (p>0.05) between the two groups. Conclusion: Mineral trioxide aggregate showed good clinical and radiographic success as a pulpotomy agent in immature permanent teeth and seems to be a suitable alternative to calcium hydroxide.

Frequency of Post Obturation Pain after Single versus Multiple Visits Endodontic Therapy by using Hybrid Root Canal Preparation Technique

Background/objective: The hybrid root canal preparation technique is better in a single visit as compared to multiple visit endodontic therapy in reducing the incidence of post endodontic pain. Relationship of post obturation pain and canal preparation has been studied in the past for the better outcomes of the treatment and for the patient’s belief in the treatment. The objective of this study was to compare the frequency of post obturation pain after single versus multiple visits endodontic therapy by using hybrid root canal preparation technique. Materials and methods: This randomized clinical trial (RCT) was carried out in the Department of Operative Dentistry, College of Dentistry, BAMDC, Multan, Pakistan, between 15th December 2017 and 14th June 2018. After approval from the Institutional Ethical Review Committee, a total of 140 patients with acute pulpitis and non-vital asymptomatic maxillary central incisor to first molar teeth were divided into 2 equal groups. In both groups, canal preparation was done by following hybrid canal preparation technique. Group A patients were treated in a single visit and Group B patients were treated in 2 visits. Patient’s pain response was recorded after 24 hours of treatment, using a Visual Analogue Scale. Data were analyzed using SPSS version 20.0. Results: After 24 hours, when post-operative pain was compared in two groups, it was found that in one visit Group A post obturative pain was significantly less as compared to the 2 visit Group B. In one visit Group A, 18 (25.7%) patients reported pain as compared to the two visits Group B where 38 (54.3%) patients complained of pain. When both the groups were compared by Chi-square test p-value was found 0.001, which was highly significant. Conclusion: Single visit endodontic therapy is better than multiple visits endodontic, in relation to post obturation pain when hybrid root canal preparation technique was used.

Scrutinizing the patients with breast lump on fine needle aspiration cytology

Background: One of the most common medical problems, women face today, is a lump in the breast. These lumps may range from simple inflammatory to malignant. In case of carcinoma, early and accurate diagnosis can save the patient from metastases thus reducing mortality and morbidity. The aim of the present study is to see the spectrum of lesion in breast lump specimens in Ibn e Sina Hospital, Multan Medical and Dental College, Multan over a period of ten years.Methods: This retrospective study was carried out in the Department of Pathology, Multan Medical and Dental College Multan, Pakistan. Data were gathered from the archives of Pathology laboratory, comprising of years 2007 t0 2017, after approval from Institutional Ethical Review Committee. All the patients presented with complaint of any kind of swelling of breast were included in this study. All the demographic and clinical details of the patients were collected on proforma. Fine needle aspiration technique was used to take sample from the suspected lesional area. Descriptive statistics was used to analyze the data.Results: A total of 2039 patients were presented with complaint of lump/swelling in their breast unilaterally or bilaterally. There were 628 (30.8%) benign lesions, 872 (42.8) malignant lesions, 229 cases with atypical cells. Mastitis/inflammatory lesions were seen in 167 (8.2%) cases and tuberculous granulomas were observed in 83 (4.07%) cases. Twenty cases were of miscellaneous types including lipoma, phylloda, simple cysts etc.Conclusions: Findings of present study show that majority of breast lumps were malignant, benign, inflammatory and tuberculous respectively.

Molecular cloning and subcellular localization of six HDACs and their roles in response to salt and drought stress in kenaf (Hibiscus cannabinus L)

BACKGROUND: Histone acetylation is an important epigenetic modification that regulates gene activity in response to stress. Histone acetylation levels are reversibly regulated by histone acetyltransferases (HATs) and histone deacetylases (HDACs). The imperative roles of HDACs in gene transcription, transcriptional regulation, growth and responses to stressful environment have been widely investigated in Arabidopsis. However, data regarding HDACs in kenaf crop has not been disclosed yet. RESULTS: In this study, six HDACs genes (HcHDA2, HcHDA6, HcHDA8, HcHDA9, HcHDA19, and HcSRT2) were isolated and characterized. Phylogenetic tree revealed that these HcHDACs shared high degree of sequence homology with those of Gossypium arboreum. Subcellular localization analysis showed that GFP-tagged HcHDA2 and HcHDA8 were predominantly localized in the nucleus, HcHDA6 and HcHDA19 in nucleus and cytosol. The HcHDA9 was found in both nucleus and plasma membranes. Real-time quantitative PCR showed that the six HcHDACs genes were expressed with distinct expression patterns across plant tissues. Furthermore, we determined differential accumulation of HcHDACs transcripts under salt and drought treatments, indicating that these enzymes may participate in the biological process under stress in kenaf. Finally, we showed that the levels of histone H3 and H4 acetylation were modulated by salt and drought stress in kenaf. CONCLUSIONS: We have isolated and characterized six HDACs genes from kenaf. These data showed that HDACs are imperative players for growth and development as well abiotic stress responses in kenaf.

Frequency of post obturation pain by using ibuprofen and ibuprofen/dexamethasone infiltration in single visit root canal treatment cases

Background: Pain after root canal treatment is a challenging problem for the operative dentists over the last few years. The development of pain is dependent on the intensity of tissue damage. Inflammation is characterized by a series of vascular events in response to tissue injury. The release of mediators is responsible for much of the pain. The rationale of this study is to use NSAIDs alone or in combination with dexamethasone to reduce post treatment swelling and pain following endodontic therapy. The objective of the study was to compare the frequency of post obturation pain by using ibuprofen or ibuprofen/ dexamethasone infiltration in single visit endodontic cases.Methods: This study was carried out in the Operative Dentistry, Department (AFID), Rawalpindi, Pakistan from December 2015 to May 2016 after approval from the Institutional Ethical Review Board. After an informed consent, 128 patients fulfilling inclusion criteria were divided in to two equal groups. In Group A, after root canal treatment, an additional single shot local infiltration of 0.5 mg dexamethasone was given in periapical area. Both the patient groups were prescribed ibuprofen 400 mg three times a day. Patient’s pain response was recorded after 24 hours of treatment, using visual analogue scale. Data was analyzed using SPSS version 17.Results: After 24 hours, 6 (9.4%) patients showed the pain in group A while 16 (25.0%) patients complained of pain in group B.Conclusions: The results of this study showed, group A showed less postoperative pain as compared to group B where only ibuprofen was given.

An overview of dermatological and cosmeceutical benefits of Diospyros kaki and its phytoconstituents

Abstract Diospyros kaki L.f. belonging to family Ebenaceae, commonly known as persimmon is used as a medicinal plant in Chinese traditional medicine since many years for different ailments including cosmetics and dermatologic applications. Traditionally this plant is used to treat different skin conditions including pimples, skin eruptions and eczema. Present interest has been focused toward use of natural bioactive compounds in various curative and beautifying applications in dermatological and cosmeceutical disciplines. The objective of this article is to present cumulative data on potential use of D. kaki for its possible role in dermatologic and cosmetic applications. Scientific data has revealed an excellent position of D. kaki in both dermatology and cosmetic discipline making it a valuable choice in respective field. Active principles from different plant parts have shown to possess anti-inflammatory, antiallergic, photo-protective, and anti-wrinkle effects with appreciable activities against tyrosinase, elastase, and collagenase enzymes. Promising antioxidant activity and skin whitening potential, augmented by reduction in sebum contents, and reduction in size and number of skin pores make it a suitable choice as cosmetic ingredient. Data has been summarized and presented on available molecular mechanism that can contribute toward phytoconstituents usage in cosmetics and dermatology mediated by different cellular pathways. Crude extracts and some of phytochemical obtained from this plant such as isoquercitrin and hyperin have better reported activities than well-known cosmetic ingredients viz., arbutin, kojic acid and hydroquinone with possibility of having no side effects. Photo protection against degenerative effects of UVA, UVB and gamma radiation can help skin to fight well against oxidative stress and reactive oxygen species. Further investigation need to be directed toward human subjects for evaluation of these reported activities for obtaining optimum commercial and industrial benefits from this valuable plant.

Relationship between percentage of regulatory t-cells and dental amalgam fillings / Relación entre el porcentaje de células t-reguladoras y obturaciones de amalgama

Abstract: introduction: regulatory T-cells are the main component of peripheral tolerance and their level is decreased in autoimmunity. In dental amalgam, a mixture of metals is used as a restorative material. During daily a ctivities, these metals are ingested and affect renal, neurosensory and immune systems. Studies have demonstrated an increased risk of autoimmune diseases in patients with dental amalgam fillings. It was hypothesized that the percentage of regulatory T-cells decreases in individuals with amalgam fillings. Therefore this study was designed to determine and compare the percentage of regulatory T-cells in individuals with and without amalgam fillings. Material and Methods: This was a cross-sectional study. Subjects were divided into two groups with each group consisting of 40 individuals. Group I (study group) comprised individuals with amalgam fillings, and Group II (control group), individuals without amalgam fillings in their teeth. Blood samples of all the participants were collected and tagged with CD4 FITC, CD25 PE and CD127 PerCP-Cy monoclonal antibodies for the detection of regulatory T-cells, FACSCalibur was used for this purpose. Results: The percentage of regulatory T-cells in the control group was high (77.77 +/- 5.54 percent) compared to the study group (76.09 +/- 7.68 percent), however, on comparison, the difference was not statistically significant (p=0.25). Conclusion: Dental amalgam fillings did not show a declining effect on the percentage of regulatory T-cells.

Resumen: introducción: las células T reguladoras son el principal componente de la tolerancia periférica y su nivel se reduce en la autoinmunidad. En las obturaciones de amalgama, una mezcla de metales se utiliza como un material de restauración. Durante las actividades diarias, estos metales se ingieren y afectan el sistema renal, neurosensorial e inmunológico. Los estudios han demostrado un aumento del riesgo de enfermedades autoinmunes en pacientes con amalgamas dentales. Se planteó la hipótesis que el porcentaje de células T reguladoras disminuye en individuos con obturaciones de amalgama. Por tanto, este estudio fue diseñado para determinar y comparar el porcentaje de células T reguladoras en individuos con y sin obturaciones de amalgama. Material y Métodos: Se realizó un estudio de corte transversal. Los sujetos fueron divididos en dos grupos, cada uno con 40 individuos. El grupo I (de estudio) estuvo conformado por individuos con obturaciones de amalgama y el grupo II (de control) por individuos sin obturaciones de amalgma. Se colectaron muestras de sangre, las que fueron marcadas con anticuerpos monoclonales CD4 FITC, CD25 PE y CD127 PerCP-C para detectar las células T reguladoras, se utilizó FACSCalibur para este propósito. Resultados: El porcentaje de células T reguladoras en el grupo control fue alta (77,77 +/- 5,54 por ciento) en comparación con el grupo de estudio (76,09 +/- 7,68 por ciento), pero esta diferencia no fue estadísticamente significativa (p=0,25). Conclusión: Las obturaciones de amalgama no se asociaron con una disminución en el porcentaje de células T reguladoras.

Supernumerary Molars: A Rare Finding.

Panoramic radiographs of a female patients aged twenty one years without any associated syndromic or systemic medical history, revealed the presence of the two supernumerary molars, right upper and left lower fourth molars. Both the teeth were disto-molars. The right upper fourth molar had normal tooth morphology with regard to its crown and root but was slightly smaller than the existing third molars. The left lower disto-molar had somewhat different morphology as compared to adjacent third molar and smaller in size as compared to the fourth right upper disto-molar. Their crowns were tuberculated and both had single root (2D radiographic morphology).