Outcomes of accelerated collagen cross linking in progressive paediatric keratoconus

Purpose: To determine the efficacy and safety of pediatric accelerated cross linking (CXL). Methods: A prospective study on progressive keratoconus (KC) cases under ?18 years of age. Sixty four eyes of thirty nine cases underwent epithelium?off accelerated CXL protocol. Visual acuity (VA), slit?lamp examination, refraction, pentacam reading of keratometry (K), corneal thickness, and thinnest location pachymetry were noted. Cases were followed up on days 1, 5, and at 1st, 3rd, 6th, and 12th?month post procedure. Results: Statistically, significant improvement of the mean aided VA, K, and mean corneal astigmatism (p < 0.0001) was noted. Mean Kmax reading reduced from 55.5 ± 5.64 (47.4–70.4) diopter (D) preoperatively to 54.41 ± 5.51 (46–68.3) D at 12 months postaccelerated CXL. Two cases had progression. Complications encountered were sterile infiltrate and persistent haze. Conclusion: Accelerated CXL is effective and efficacious in pediatric KC.

Effect of Muscle Energy Technique on Piriformis Tightness in Chronic Low Back Pain with Radiation

Low back pain is a common condition in India. 90 % of Indian population experience low back pain at least once in their lifetime. Studies show that 98 % low back pain is because of mechanical disorder of spine. Piriformis tightness is one of the most misdiagnosed causes for low back pain or sacroiliac joint dysfunction. Various manual therapy approaches have been studied for reducing muscle tightness. We wanted to assess the effectiveness of muscle energy technique that is post-isometric relaxation technique on piriformis muscle tightness, its effectiveness in relieving low back pain with radiation, and increasing range of motion. METHODS60 patients were included in the study as per inclusion and exclusion criteria from Ravi Nair Physiotherapy College, Sawangi Meghe, and were randomly assigned in to two groups. The duration of study was 12 days (6 sessions / week) and follow up was taken on 27th day. Subjects in muscle energy technique experimental group were treated with post isometric relaxation technique (PIR), subjects in control group were given simple passive stretching of piriformis. All subjects were educated about proper ergonomics. RESULTSBoth interventions post isometric relaxation and simple stretching techniques were effective in terms of pain reduction, ROM (Range of Motion) improvement, piriformis tightness, disability with p < 0.05 with post isometric relaxation technique superseding simple stretching. Moreover, post isometric relaxation technique in muscle energy technique had sustained effects on follow-up in terms of relieving pain, disability and tightness for longer period of time. CONCLUSIONSMuscle energy technique gives immediate relief of pain improving ROM and decreasing tightness of piriformis and disability and has longer lasting effects.

Wilson’s Disease - A Case Report

Introduction: Wilson's disease (WD) is a disorder of coppermetabolism leading to the accumulation of this metal indifferent organs. Hepatic manifestations tend to occur in thefirst decade and neurological symptoms in the third decade.Neurological manifestations are said to worsen with chelationtherapy.Case report: In our patient however the initial manifestationwas head tremor at the age of 43 years which improved withtreatment. The patient for some reason stopped the therapy for8 years after which he decided to resume it only to precipitatethe liver cirrhosis clinically –something that has not beenreported earlier. The diagnosis was missed initially. Howevertreatment produced good results.Conclusion: The case also serves as a reminder not to dismissthis disease as a rare theoretical possibility but to suspect itin a case of liver cirrhosis of unknown etiology or when thepatient presents with an obscure isolated neurological signsuch as tremor. Delayed recognition of the disease or stoppingtherapy can lead to a progression of the disease. The patienthad many unusual features which are being reported for futurereference by researchers and practioners

Microelements in primary teeth by inductively coupled plasmad Atomic emission spectroscopy

AIM: This study was carried out to estimate the concentrations three microelements in enamel of deciduous normal and carious teeth using atomic emission spectrometry. METHODS: A total of 80 deciduous molar teeth indicated for extraction from children between the age group of 713 yrs. were taken for this study. The specimens were divided into four groups and the samples were prepared using centrifuge flotation technique. They were analyzed for Manganese, Strontium and Zinc using inductively coupled plasma atomic emission spectroscopy. RESULTS: This study shows that sound enamel contains more of strontium when compared to the carious enamel. Carious enamel contains more of manganese, and zinc when compared to the normal enamel. Elements zinc and strontium occur in high concentrations, where as elements manganese occur in low concentrations in enamel. The concentrations of elements manganese, strontium and zinc does not vary in relation to sex of individual. CONCLUSION: The microelements strontium and zinc are present in high concentration. Further studies are necessary to see their potential in mineralization and anticariogenic process.

Odontoameloblastoma: A Diagnostic Dilemma for Maxillofacial Radiologist / Odontoameloblastoma: Un Dilema Diagnóstico para el Radiólogo Maxilofacial

Odontoameloblastoma is a rare neoplasm of odontogenic origin in which there is proliferation of tissue of the odontogenic apparatus in an unrestrained pattern including complete morphodifferentiation, apposition and even calcification. Till date, around 20 cases have fulfilled the histologic criteria of the current World Health Organization histologic classification of odontogenic tumors. Review of literature from 1944 to 2011 reveals only four reported cases in the anterior mandible. Here, we report a case of odontoameloblastoma in the anterior mandible in which plexiform ameloblastoma was associated with compound odontoma forming an unusual combination.

El odontoameloblastoma es una neoplasia rara, de origen odontogénico en el que existe proliferación tisular del aparato odontogénico en un patrón sin restricciones, incluyendo morfodiferenciación completa, aposición e incluso calcificación. Hasta la fecha, alrededor de 20 casos han cumplido todos los criterios histológicos de la actual clasificación de tumores odontogénicos de la OMS. La revisión de la literatura desde 1944 hasta el año 2011 revela sólo cuatro casos reportados en el sector mandibular anterior. Se presenta un caso de odontoameloblastoma en la region anterior mandibular donde un ameloblastoma plexiforme se asoció con un odontoma complejo formando una combinación inusual.

Agenesis of the hemidiaphragm: A rare presentation in an adult.

Unilateral diaphragmatic agenesis is a rare finding in adult patients. We report a case of unilateral agenesis of diaphragm in a 22-year-old male patient to highlight the fact that a rare entity of agenesis of diaphragm can have a misleading presentation in adulthood due to both pulmonary and abdominal symptoms.

A novel deletion cluster at 13q14.2-q21.33 in an 80-year man with late onset leukemia: Clinical and molecular findings.

Chromosomal deletions are among the most common genetic events observed in hematologic malignancies; loss of genetic material is regarded as a hallmark of putative tumor suppressor gene localization. We have identified an unusual cluster of deletions at 13q14.2-13q21.33 in an 80-year-old father of a monozygotic twin pair discordant for schizophrenia, who developed chronic leukemia (CLL) at age 69. MATERIALS AND METHODS: The breakpoints for individual deletions in this cluster was identified by Affymetrix Human Array 6.0 screening. RESULTS: The deleted segments harbours a number of genes, most associated with cancer as well as a high concentration of LINEs, SINEs and related repeats. The derived chromosome represents an intra-chromosomal re-arrangement that quickly overtook blood progenitor cells probably before age 69 as a cause of CLL. CONCLUSIONS: The study highlights the role of ongoing de novo changes at susceptible sites, such as repeat rich regions, in the human genome. Also, it argues for the involvement of genes/deletions in the 13q(14.2-21.33) region in the development of CCL.

Medical Conditions, Medications And Gerodontology.

An increasing percentage of the population is now living longer. The elderly are more likely to have medical conditions which can affect their systemic well-being, their oral health and their ability to undergo dental treatment. This can be compounded by polypharmacy .There are significant physiological changes that occur in old age. These can affect an individual’s ability to process drugs. The General Dental practitioner need to be familiar with the potential influences of systemic diseases and also with the potential for side-effects and interactions associated with a wide range of medications and impact of ageing on pharmacokinetics and pharmacodynamics of any drug taken. The aim of this article is to outline the `must know` facts about most common medical conditions affecting elderly and medications used to treat systemic diseases that impact upon the oral mucosa and principles that should be borne in mind when prescribing medication for this group.

Unusual lung mass: benign or malignant?

Primary adenoid cystic carcinoma of lung is a rare tumour. It is a slowly growing, indolent tumour. Average time that elapses before diagnosis is reported to be two years. We report the case of a patient who remained well inspite of harbouring primary adenoid cystic carcinoma of lung for 15 years.