Phaco-handpiece used as a Fragmatome for managing nucleus drop

Background: Nucleus drop during cataract surgery is a dreaded complication and requires urgent vitreo?retinal intervention which is managed commonly using a fragmatome. However, a fragmatome is not readily available in routine ophthalmology set?ups because its use is very limited. On the other hand, a phaco?probe is commonly available with all surgeons and makes it cost?effective. Purpose: The purpose is to demonstrate the utility of a phaco?probe as an alternative to a fragmatome in managing nucleus drop during cataract surgery, making it cost?effective and less time?consuming and simple. Synopsis: The video shows two cases of complicated cataract surgery in which a nucleus is dropped in the vitreous cavity. The sleeve of the phaco?probe was removed, and infusion was disconnected to make it function as a fragmatome. We noted reduced lenticular repulsion from the phaco?handpiece tip as compared to the fragmatome, and no scleral burns were observed. The cases were completed by secondary placement of an intra?ocular lens in the sulcus in the same sitting. Thus, the phaco?probe can be considered to manage nucleus drop in the absence of a fragmatome. Highlights: A phaco?probe can be used as an alternative to a framgamtome, which is a cost?effective and simple technique.

Psychosocial and quality of life assessment in cancer patients: a pilot study in Indian set up

Background: Routine screening for distress is internationally recommended as a standard of care among cancer patients. This study was conducted to assess the level of stress and determine the association between quality of life (QOL) with demographic, socio-economic status, treatment phase, cancer stage, etc.Methods: An observational study, performed in the department of Clinical Oncology, Nayati Multi Super Speciality Hospital, Mathura, India. Data of 62 histopathologically proven cancer patients between Nov 2016 and July 2018, were analyzed. This pilot study was conducted to assess the QOL and stress levels of cancer patients by using scales of WHOQOL-BREF, QSC-R23 and Hamilton scale. Results: Among 62 cancer patients, high distress along with poor QOL was seen maximum in males, 40-60 year age group and educated. In majority of domains, high distress was found in middle class, whereas poor QOL was found in Lower class in Environmental domain (p<0.01). We found higher distress in nuclear families (p<0.05). High distress was seen in cancer patients who were aware of illness and was found to statistically significant. Poor QOL in stage 4 was found to be statistically significant in Psychological domain of WHOQOL-BREF. High distress was found in patients undergoing treatment in all patients as compared to Pre-treatment phase and Post-treatment phase (p<0.05).Conclusion: To assess psychological stress in cancer patients using all three scales we could not obtain a conclusive result covering all dimensions of QOL. So, in our next study authors plan to develop one indigenous new scale.

Study of serum calcium, phosphorus and vitamin D status in multitransfused ?-thalassemia major children and adolescents of Jharkhand, India

Background: The pattern of levels of calcium, phosphorous and vitamin D levels among the patients with thalassemia major undergoing repeated blood transfusions remain unexplored. Only very few studies have been undertaken among Indian population. The present study was an attempt to determine the levels of calcium, phosphorous and vitamin D levels among thalassemia major patients undergoing repeated multiple transfusions.Methods: In a prospective observational study, 65 patients suffering from ?-thalassemia major, aged 2-18 years, having undergone regular blood transfusion and chelation therapy, were evaluated for the levels of serum calcium, phosphorus and vitamin D and the values were compared to the standard values of the same.Results: The mean values of serum calcium (6.72'0.66), phosphorous (5.51'1.07) and vitamin D (13.12'2.9) were significantly lower in our patients as compared to that of standard population values, the difference in each being statistically significant (p<0.05).Conclusions: It is evident from the present study that the levels of calcium, phosphorous and vitamin D are deficient among ?-thalassemia major patients on repeated blood transfusion. The deficiencies may be due to iron overload or due to nutritional deficiency. Frequent monitoring and supplementation in deficient states is recommended.

Fertility Outcomes after Tubal Recanalisation - A Prospective Study

Background:To study the fertility outcome after tubal recanalisation done for sterilisation reversal and various factors affecting successful recanalisation. Methods: It is a perspective study of 30 cases who undergone tubal recanalisation for reversal of sterilisation in SCB Medical and hospital, Cuttack from October 2015-october 2017. Result: Loss of child was the commonest reason for seeking reversal of sterilisation. Out of 30 patients, the conception rate was 19(63.3%), 18 were intrauterine, one was ectopic, 15 live birth, 1 aborted and 2 are ongoing pregnancies. The conception rate was high when the age of the patient was less than thirty years (78.8%), interval between sterilisation and its reversal was less than 4 years (83.3%), when it was following laparoscopic sterilisation (68.4%), when the site of anastomosis was isthmo-isthmic (63.1%) and when the remaining tubal length was more than 6 cm (83.3%). Conclusion: Recanalization procedure being simple and effective method in respect to IVF is increasing in demand for sterilisation reversal. Successful fertility outcome after tubal recanalisation depends on age of the patient.type of previous sterilisation,site of sterilisation and anastomosis and final length after tubal recalisation. During sterilisation gynaecologist should remember laproscopic sterisation is preferred and site of occlusion is isthmus so that every sterilised women can undergo recanalization operation if circumstances arises later in life.

Levamisole Monotherapy in Treatment of Oral Lichen Planus-A Clinical Study

Background Oral lichen planus is a chronic inflammatory disease of oral mucosa which rarely undergoes spontaneous remission and has potential for malignant transformation. There are several different kinds of treatment that have been used to treat chronic oral lichen planus. Most commonly advised treatment is steroid therapy to treat oral lichen planus either in topical form or systemically. As steroid therapy has various underlying adverse effects other alternative drug has to be used in the treatment of oral lichen planus. Objective The aim of the study is to evaluate the efficacy of levamisole monotherapy in oral lichen planus. Methods Seven patients who had oral lichen planus were treated with levamisole 50 mg thrice daily for 3 consecutive days and not administered for the following 4 days. Result After 2 weeks of treatment, four patients reported with partial response, three patients had no response and no patients showed clearance of the lesion. Furthermore, after 2 months of treatment, five patients showed clearance of lesion, one patient showed partial response and one patient had no response to therapy. There were no significant side effects noted. Conclusion Levamisole therapy can be a substitute to steroid therapy in treating oral lichen planus in patients who can't take steroids.

Reduction and Fixation of Zygomatic Complex Fractures with Miniplates at the Fronto-zygomatic Suture and Zygomatic Buttress Area-A Clinical Study

Background Zygomatico-maxillary complex fractures are one of the most frequently occurring injuries of the facial skeleton due to its position and also the facial contour. The principal aetiologic factors that may result in zygomatic bone fracture include assaults, road traffic accidents and also falls. There are many methods of fixation that have been applied for treatment of zygomatic arch fractures. Aim To reduce and fix the zygomatic complex fracture using miniplates at the fronto-zygomatic suture and zygomatic buttress area. Material and method The present study includes five cases of zygomatic complex fractures who visited the Department of Oral and Maxillofacial Surgery in Government Dental College and Hospital, Hyderabad. The operative procedure adopted was the lateral bow incision for exposure of fronto-zygomatic suture, the Gillie temporal approach for reducing the zygoma and intra-oral incision for exposure of zygomatic buttress fracture. Fixation was done with miniplates at the fronto-zygomatic suture and the zygomatic maxillary buttress suture. Result All the cases were successfully treated without any post-operative complications and with uneventful restoration of aesthetics and function.

Comparison of Efficacy of Pentoxifyllin with Standard Regimens Dexamethasone and Hyaluronidase in Patients with Oral Submucous Fibrosis

Aims and objectives The purpose of the study was to clinically evaluate the efficacy of oral pentoxifylline 400mg tablets in comparison to intra-lesional injections of dexamethasone (4 mg/ml), hyaluronidase 1, 500 IU and 0.5 ml of lignocaine 2% and a combination of the two in the management of oral sub-mucous fibrosis (OSF) patients. Materials and methods The study population consisted of randomly selected 75 patients with OSF. Patients were divided into three groups. A total of 25 patients were allocated each in dexamethasone group, dexamethasone and pentoxifylline group and pentoxifylline group. Dexamethasone group received weekly intra-lesional injections of dexamethasone (4 mg/ml), hyaluronidase 1, 500 IU and 0.5 ml of lignocaine 2% for a period of 12 weeks. Pentoxifylline group received oral pentoxifylline 400-mg tablets thrice daily for 12 weeks. Dexamethasone and pentoxifylline group received both the drugs. Parameters taken in the study were burning sensation and mouth opening. Results In the present study, improvement in the patients symptomatic parameters were statistically significant (p < 0.001) within groups (intra-group comparison), but not significant (p > 0.001) when compared between the groups (inter-group comparison). Conclusion Study found that the parameters like burning sensation and mouth opening showed statistically significant improvement for all the drug groups. The drug pentoxifylline showed similar improvement in the clinical parameters as that of dexona. For this reason, pentoxifylline can be indicated as a good alternative treatment for OSF in patients in whom dexamethasone is contraindicated, or those who cannot make frequent visits for intra-lesional injections.

Papillon-Lefevre Syndrome-A Report of Two Cases

Papillon-Lefevre syndrome is a rare autosomal recessive trait characterised by palmoplantar hyperkeratosis and precocious loss of both deciduous and permanent teeth. The aetiology is multifactorial with genetic, immunological, microbiological factors being considered a main etiopathogenic factors. We present here two cases of two siblings affected with Papillon-Lefevre syndrome.

Revisiting the Efficacy of Immunomodulatory Effect of Hydroxychloroquine in Oral Lichen Planus: A Case Series

Oral lichen planus (OLP) is a common inflammatory, autoimmune disorder that affects stratified squamous epithelium. The exact etiopathogenesis of this mucocutaneous disease is still uncertain. Although OLP has been associated with altered Quality of Life and considerable morbidity, with important note for erosive type of OLP, its treatment is often disappointing and controversial. Though corticosteroids remained the first line of treatment for OLP, the associated adverse effects of corticosteroids are not acceptable. Hence, there is a need of drugs with steroid sparing effect. Use of immunomodulators is systemic pathologies is widely encountered. However, their use in oral lesions is not frequently seen. Use of hydroxychloroquine (HCQ), an age-old disease-modifyinganti-rheumatic-drug, has been widely used in various autoimmune diseases; however, it received little attention in treatment of OLP. This article presents a case series of three patients with erosive OLP which were managed with HCQ. The results presented allow the authors to consider systemic HCQ as a newer therapy for atrophicerosive lichen planus.

Illusions of a Common Man in Dental Perspective: A Time for Eradication

Aim To assess the most common myths prevailing in the society and the reason behind the innocent beliefs. To compare the dental myths in population with various educational backgrounds and in medical graduates. To formulate the steps and educate the common man to come into the limelight for maintenance of oral health for better overall health. Methodology A total of 194 individuals aged above 18 years were randomly included in the study and their response to the given questionnaire was obtained and analysed statistically by using SPSS version 21. Results Most of the individuals believe that root canal treatment is a painful procedure (59.3%), whereas 56.2% believe that dental treatment should be avoided during pregnancy. 54.6% gave a positive response that worms cause tooth decay. 54.4% of the respondents believe that children do not need cleaning of the milk teeth, whereas 42.3% thought that diseased milk teeth don't need any treatment. More than 40% of the subjects believe extraction of the upper tooth affects vision and application of Zandu Balm or hot fermentation reduces swelling. Conclusion Some of the dental myths are still persisting in all the participants of various educational backgrounds and even in medical respondents.

Evaluation of Plasma Fibrinogen Degradation Products and Total Serum Protein Concentration in Oral Submucous Fibrosis

Background Oral submucous fibrosis (OSF), a potentially malignant disorder, is a chronic, inflammatory, progressive debilitating disease of the oral cavity with a multifactorial etiology. As an inflammatory response, more fibrinogen and its degradation products are produced by the body in OSF patients. Detection of these plasma fibrinogen degradation products (FDP) in OSF patients has contributed a new direction to enlighten the etiopathogenesis of OSF. Objectives To ascertain the role of FDP of OSF patients in betel nut chewers and in control subjects and also to estimate serum levels of proteins in the patients. Materials & Methods The study included 25 clinically diagnosed oral submucous fibrosis patients with betel nut chewing habit & 25 healthy controls without any deleterious habits. All the patients were evaluated for fibrinogen degradation productions and total serum protein concentration (TSP) by agglutination and Biuret method respectively. The results were analysed using unpared ttest and Pearson chi square test. Results The study revealed an increased FDP level in all the betel nut chewers with OSF when compared with the healthy individuals. There was a marginal increase in Total serum Protein concentration levels in OSF patients, thus inferring to a positive correlation between FDP and TSP in all OSF cases. Conclusion This study validates the relationship of plasma FDPs in the etiology of OSF and can be used to measure the prognosis of the disease. Plasma FDP may also be useful as a nonsurgical diagnostic tool in suspected OSF cases without necessitating a histopathological confirmation. However, further studies with a larger sample size may be required to elucidate the precise role of plasma FDP levels and detailed fractional analysis of protein in OSF, thus facilitating to obtain more conclusive results. It can be suggested that biochemical assessment of patients with areca nut chewing habit may help in the earlier diagnosis of OSMF and thus may lead to a better prognosis of these lesions.

A Comparative Study of Micronuclei in Oral Exfoliated Epithelial Cells in Potentially Malignant and Oral Squamous Cell Carcinoma

Background Micronuclei are small, additional nuclei formed as a result of exclusion of chromosome fragments or the whole-chromosome lagging at mitosis. Micronuclei indirectly reflect the chromosomal breakage or impairment of mitotic apparatus. Micronuclei in exfoliated oral epithelial cells are widely used as biomarkers of chromosomal damage, genome instability and cancer risk in humans. Micronuclei scoring can be used as a biomarker to identify different preneoplastic conditions much earlier than manifestations of clinical features and might specifically be exploited in screening of high-risk population for a specific cancer. Aim To correlate frequency of micronuclei in oral exfoliated cells in clinically diagnosed cases of potentially malignant disorders (PMDs) and oral squamous cell carcinoma. Material and Methods The study subjects consisted of clinically and histopathologically diagnosed cases of oral squamous cell carcinoma, oral sub mucous fibrosis and leucoplakia. Healthy subjects without any tobacco consumption habits formed the control group. The cytosmear from all the four groups were stained with Papanicolaou stain. Micronuclei were identified according to the criteria given by Tolbert et al. (1992). Result The frequency of micronuclei was higher in patients with oral squamous cell carcinoma as compared to the other subject groups and the difference was found to be highly significant. Conclusion This study concluded that there is gradual increase in micronuclei counts from normal oral mucosa to PMDs to oral carcinoma.

Estimation of Serum Folate and Homocysteine Levels in Oral Submucous Fibrosis-A Prospective Study

Aim & Objective The aim of the study was to evaluate the levels of serum folate and homocysteine in clinical stages of Oral submucous fibrosis (OSF) patients. Methodology The study sample comprised of 40 clinically and histopathologically diagnosed OSF patients those who are not undergoing treatment and 10 healthy controls. OSF was categorised by clinical staging. Serum foliate and homocysteine levels estimation was done by reverse phase high performance liquid chromatography analysis unit and chemiluminescence immuno assay, respectively. Results were statistically analysed using one-way ANOVA [Analysis of variance]. Results Irrespective of age and gender, serum folate deficiency and high levels of homocysteine were noted in OSF patients when compared with healthy controls. Conclusion Serum hyper homocysteinemia and folate deficiency were noted with the progression of the disease. Folate supplements can be given to decrease the levels of homocysteine, to arrest the progression of the disease. However, further longitudinal studies are needed to establish an association between serum homocysteine and serum folate.

Modified Bisecting Angle Technique: A Novel Method to Eliminate Zygomatic Superimposition over the Apices of Maxillary Molars

Objectives Intra oral radiographic imaging is the most widely used method for obtaining information about root canal anatomy and working length determination. Measuring exact working length is the most essential step for the success of root canal treatment. Bisecting angle technique (BAT) is the most widely used technique for this purpose. However, zygomatic superimposition over the apices of maxillary molars makes it difficult for the dentist to estimate exact working length. The present study made certain modifications in BAT to overcome these undiagnostic shadows. The aim of the study is to compare three techniques, namely paralleling cone technique (PCT), BAT and modified bisecting angle technique (MBAT) to prevent such superimposition over molar apices. Materials and Methods A total of 53 patients requiring endodontic treatment for maxillary molars were included in the study. Three radiographs one with each PCT, BAT, MBAT were made. Each radiographic image was recorded acceptable or unacceptable based on the zygomatic superimposition. The data thus collected was subjected to statistical analysis using chi-square test. Results The percentage of acceptability in MBAT was 56.6% (n = 30) when compared with BAT which was only 28.3% (n = 15) and PCT was 58.3% (n = 31) indicating statistically significant difference between BAT and MBAT. But no statistically significant difference was found between MBAT and PCT. Conclusion In the present study, MBAT was found to be more accurate than BAT, and it was relatively as accurate as PCT in eliminating zygomatic superimposition over the apices of maxillary molars.

Pregnancy luteoma in ectopic pregnancy: a case report

Background: Pregnancy luteoma is a rare non neoplastic condition of the ovary. It is usually asymptomatic and found incidentally during imaging in pregnancy or during cesarean section. Pregnancy luteoma can also occur after ectopic pregnancy

Case Presentation: A 30 year old female presented to G.B. Pant Hospital, Andaman and Nicobar Islands institute of Medical Sciences, Port Blair in October 2015 with abdominal pain. After initial investigations, exploratory laporotomy was done for ruptured ectopic pregnancy. Enlarged ovary was removed along with the ruptured portion of fallopian tube. Histopathological examination revealed solid aggregates of large cells with abundant eosinophilic cytoplasm; diagnosis of pregnancy luteoma was given

Conclusion: It must be considered in the differential diagnosis of ovarian masses in pregnant females that early diagnosis of this entity may avoid unnecessary radical surgery

Epithelial ovarian tumors in a premenarchal girl: a rare case report

Ovarian tumors are relatively uncommon in paediatric age group and mostly occur in the period after menarche and are extremely rare prior to menarche. However, in children and adolescent, the epithelial ovarian tumors account approximately 10% to 28% of all ovarian tumors. In the present case, the patient was presented with abdominal pain for 1 day and no mass was felt on physical examination. Contrast-enhance computed tomography abdomen and pelvis showed a left ovarian cystic mass measuring 7.3×5.1 cm in size and unilateral oophorectomy was done. Tumor shows multiloculated cysts of varying sizes filled with mucinous fluid. Cysts were lined by tall columnar epithelial cells and show predominantly periodic acid-Schiff positive neutral mucin favouring benign nature of lesion. We present this case due to its uncommon age of presentation and the patient was premenarchal girl.

Incidence of chikungunya fever in ghatampur municipality, kanpur nagar district, uttar pradesh, India

Objectives: [I] To estimate the magnitude, compare the results of two wards [Shivpuri and Achhimohal] and [ii] to formulate recommendations for prevention and control. STUDY DESIGN: Experimental study

Place And Duration: 1st October to 16th November 2006 in residents of Shivpuri and Achhimohal ward

Methodology: We selected and compared two wards; Shivpuri ward with high attack rate and the other Achhimohal one-low attack rate. We defined a case as the occurrence of fever with joint pain with or without skin rashes during the period of 1st October to 16th November 2006 in residents of Shivpuri and Achhimohal ward. We collected information on age, sex, residence, date of onset, symptomatology, history of treatment, deaths in the family. We described outbreak in time, place and person characteristics. We collected 14 random blood samples from shivpuri and 7 blood samples from Achhimohal ward for serological investigation. We conducted entomological survey for species identification

Results: We identified total 384 case-patients among 2,202 residents [overall attack rate [AR: 384/2202 [17%]; Median age: 31 year] in both the wards. [343/1173 [29%] in Shivpuri ward vs 41/1029 [4%]]; sex specific AR was 52% for females. The major symptoms were fever 384/384 [100%], arthralgia 380//384 [99%]. Severity of disease and oedema were less prevalent in children of age group 1-15 year as compared to older age group 31-45 years [109/239 [46%], 13/183 [7%]]. The attack rate was highest 88/239 [37%] and statistically significant [P<0.03] in Shivpuri ward adjacent to pond. Both wards, Shivpuri-141 of 343 [41%] and Achhimohal-23 of 41 [56%] reported consulting with unqualified private practitioners. 19/21 were positive for anti Chikungunya IgM antibodies. 38/43 households [88%] in Shivpuri ward and 6/43 households [13%] in Achhimohal ward identified three species of Aedes mosquitoes

Conclusion: Chikungunya is mosquito born and laboratory confirmed; severely debilitating disease. Recommended for aggressive Information, Education and Communication [IEC] for emptying the storage of water once in a week and rational use of drugs

Antibacterial efficacy of triphala against oral streptococci: An in vivo study.

Background: Triphala is a botanical preparation consisting of equal parts of three herbal fruits. Much revered in Ayurveda, triphala has been proven to have antibacterial, antiviral, antifungal actions. Aims and Objectives: The objective of this study was to investigate the effect of 6% triphala in a mouthwash formulation on the salivary streptococci levels at the end of 48 h and 7 days, of twice a day usage, and to compare the same with 0.2% chlorhexidine. Materials and Methods: Sixty undergraduate student volunteers aged between 18 and 25 years were randomly allocated into three study groups. (a) 6% triphala mouthwash, 15 ml twice a day; (b) 0.2% chlorhexidine mouthwash, 15 ml twice a day (active control group); (c) passive control group asked to rinse with plain water, twice a day. The oral streptococci colony forming units/ml (CFUs/ml) was assessed by inoculating blood agar with saliva samples at the end of 48 h and at 7 days. Results: The triphala group showed a 17% and 44% reduction, while the chlorhexidine group showed 16% and 45% reduction at the end of 48 h and 7 days (P < 0.001). The reduction in CFUs/ml seen in triphala group closely paralleled that of chlorhexidine group. Conclusion: Triphala has been used in Ayurveda from time immemorial and has many potential systemic benefits. The promising results shown by Triphala call for further investigations of its antimicrobial effects against the numerous oral microorganisms.

Tobacco cessation in India: A contemporary issue in public health dentistry.

In India, tobacco use is incredibly linked to poverty and accounts for the high public health costs of treating tobacco-related diseases. Dental public health programs aid in detecting the tobacco-related periodontal diseases, oral cancers, etc., where the majority belongs to the submerged portion of iceberg, which otherwise leads to substantial morbidity and mortality. Moreover, public health dentists plays a key role in identifying both clinical and subclinical cases and aid in tobacco use cessation through various modes of health education and counseling. Therefore, the community-based measures are deemed to be the most cost-effective tool for tobacco cessation.

Self-assessed and clinically diagnosed periodontal health status among patients visiting the outpatient department of a dental school in Bangalore, India.

BACKGROUND: The purpose of the present cross-sectional study was to assess the extent of agreement between clinical and self-assessed periodontal health status among patients visiting the outpatient department of M.S. Ramaiah Dental College, Bangalore, India. MATERIALS AND METHODS: The study population included 216 patients aged between 20 and 44 years who attended the outpatient department of the M.S. Ramaiah Dental College, Bangalore. The study population was subjected to a self-administered questionnaire (questions regarding bleeding gums, deposits on teeth, receding gums, swelling of gums, loose teeth), which was followed by periodontal examination. The clinical examination included an assessment of the periodontal condition, using the criteria of Loe and Silness Gingival Index, the Community Periodontal Index, and Mobility, respectively. CONCLUSION: The present study showed that the perceived periodontal health status was low and the discrepancy between the subjectively and objectively assessed needs was very distinct. The awareness of the periodontal problems has been reported to increase with increasing severity of the disease due to the destructive changes that set in.