Ameloblastic carcinoma of the mandible.

Ameloblastic carcinoma is a highly malignant tumour and requires aggressive treatment. This case report describes an aggressive ameloblastic carcinoma that infiltrated the mandible. Mandibulectomy with right functional radical neck dissection and left supra omohyoid dissection was followed by primary reconstruction with a single free vascularised fibula flap. The post-operative course was uneventful. The 2 year regular follow up revealed no signs of recurrent tumour or metastasis. Future reporting of this rare condition is encouraged in lieu of limited information in its clinical course and prognosis.

Articulation of speech of patients treated with radicular attachment assisted obturator following maxillectomy.

Background: Obturators are used to separate the oro-nasal opening. These improve speech and other oral functions as well as provide psychological support to the patients. Adding radicular attachments in an obturator makes more effective. Objective: To evaluate and compare the effectiveness of obturator with radicular attachment and conventional obturator in articulation of speech. Materials and Methods: Fifty patients, age ranged from 18 to 72 years, with maxillectomy defect were selected as the sample of the study. Among them 25 patients were treated with obturator with radicular attachment and another 25 patients were treated with conventional obturator. After insertion of obturator, data were collected on the basis of articulation of speech. Results: Patients treated with obturator with radicular attachment showed significantly better (P value <0.001) articulation of speech. Conclusion: Obturator with radicular attachment is more effective than conventional obturator.

Photogrammetric Analysis of Nasolabial Angle and Mentolabial Angle norm in Malaysian Adults.

Introduction: While measurement of nasolabial angle and mentolabial angle is an important clinical examination in pre-orthognathic surgery assessment, data on non-western population is limited. This study was therefore conducted to determine the range of nasolabial angle and mentolabial angle in normal Malaysian adult with comparison of males and females. Materials and Methods: A total of 50 Class I males and 52 Class I females aged 19-30 years from three main ethnic groups were randomly selected from dental students, medical students and staffs in dental clinic of Hospital Universiti Sains Malaysia (HUSM). The photographic set-up consisted of a 50mm Nikon DAT camera held in position by a tripod. The photos taken in JPEG format were digitalized and analysed using ProVixwin software. Independent t-test was used to compare any possible gender difference in nasolabial and mentolabial angles. Results: The mean of nasolabial angle and mentolabial angle for male was 92.99? and 130.44? whereas for females it was 95.04? and 130.73? respectively. Gender differences were found to be insignificant for both nasolabial angle and mentolabial angle.Conclusion: Despite having great variation in our population, the nasolabial angle and mentolabial angle are gender independent.

Perception by Laypersons and Healthcare Professionals Towards Oral and Maxillofacial Surgery.

Background: Oral and maxillofacial surgery (OMFS) is a surgical branch of dentistry that deals with the wide spectrum of diseases, injuries and defects in the maxillofacial region. There are plenty of people who have lack of awareness towards the wide surgical scope provided by OMFS as reported by previous study done in Boston in 1996. The purpose of this study was to assess the level of awareness among the general public and healthcare professionals towards Oral and Maxillofacial Surgery specialty in Hospital Universiti Sains Malaysia (HUSM). Materials and Methods: A total of 186 standardized questionnaire was distributed to 6 groups of respondents which include laypersons attending HUSM, 4th year dental and medical students, dental officers, medical officers and paramedical workers from various departments such as Emergency department, Ear, Nose and Throat (ENT) department, medical family clinic and dental clinic of HUSM. Results: The data showed that 100% of students and practitioners had heard of OMFS, whereas only 68.9% of the laypersons have heard of the specialty. Furthermore, only 11.6% of the lay responders had been treated by an OMFS. The full results also suggested that about 50% of laypersons, 35% of medical professionals and 30% of dental professionals had lack of understanding about the range of care provided by OMFS specialty. Conclusion: A thorough education need to be implemented among dental and medical undergraduate students as well as professionals so that they can make a proper referral later on and automatically provide correct information to the laypersons.

Study of Knowledge; Attitude; Practice towards Epilepsy among Relative of Epileptic Patients in Khartoum State

People with epilepsy are suffering from a lot of un tolded negative impacts on their lives; due to misunderstanding of the disease and from the associated stigma. Objectives: The objective of this study is to assess the knowledge; attitude; and practice among relatives of Sudanese epileptic patients seen in Sheik Mohamed Kheir Neurological clinic and Elshaab Teaching Hospital. Methods: This is a descriptive cross- sectional community based study; 313 respondents were included; the duration of the study was from November 2008 to June 2009. Results: Most of the respondents knew the disease; and had witnessed an attack. One third mentioned a brain lesion as the underlying cause of epilepsy. Most of the respondents mentioned loss of consciousness as the major symptom. More than two thirds mentioned that it is not contagious. Most of the respondents claimed that it can be controlled; and two thirds preferred medical treatment. The study revealed that half of the respondents had shown favourable attitudes and practice. Conclusion: The study revealed that the level of knowledge; attitude; and practice towards epilepsy needs community educational programmes to fill the gaps; and minimize the stigma

Effect of the human leukocyte antigen HLA-DRB1 and anti-cyclic citrullinated peptide on the outcome of rheumatoid arthritis patients

Our objective was to determine whether the presence of the human leukocyte antigen HLA-DRB1 locus is associated with production of anti-cyclic citrullinated peptide antibodies (anti-CCP Abs) and to what extent they are associated with increased susceptibility to and severity of rheumatoid arthritis (RA) in Egyptian patients. Twenty-nine RA patients gave informed consent to participate in a case-control study that was approved by the Ain Shams University Medical Ethics Committee. RA disease activity and severity were determined using the simplified disease activity index and Larsen scores, respectively. We used a wide scale national study on the pattern of HLA typing in normal Egyptians as a control study. Anti-CCP Abs and HLA-DRB1 typing were determined for all subjects. The alleles most strongly associated with RA were HLA-DRB1 [*01 , *04 and *06] (41.4 percent). RA patients with serum anti-CCP Ab titers above 60 U/mL had a significantly higher frequency of HLA-DRB1*01 (58.3 percent) and HLA-DRB1*04 alleles (83.3 percent). Significant positive correlations were found between serum and synovial anti-CCP Ab titer, RA disease activity, and severity (r = 0.87, 0.66 and 0.63, respectively; P < 0.05). HLA-DRB1 SE+ alleles [*01 and *04] were highly expressed among Egyptian RA patients. The presence of these alleles was associated with higher anti-CCP Ab titer, active and severe RA disease. Early determination of HLA-DRB1 SE+ alleles and serum anti-CCP Ab could facilitate the prediction of the clinical course and prognosis of RA when first evaluated leading to better disease control.

An assessment of rabies free status of the Island of Andaman, Nicobar and Lakshadweep: results of the WHO sponsored national multicentric rabies survey.

The Islands of Andaman and Nicobar and Lakshadweep have been reported to be rabies free from time immemorial. Recently, a survey of the islands of Andaman and Nicobar & Lakshadweep was done between July and August 2003 to assess their rabies free status. It was revealed that these islands continue to remain rabies free. However, in Andamans the increasing dog population, poor vigil on import of dogs and lack of laboratory surveillance for rabies posed a threat to this status. The Lakshadweep islands, which are free of dogs, however, faced a threat from the lack of vigil on the entry and presence of cats and poor surveillance for rabies in them.

Chronic Caffey's disease: an uncommon entity in children.

Chronic Caffey's disease in an uncommon condition in children is characterized by an acute inflammatory reaction in the periosteum along with systemic disturbances. A 30 months old boy was reported in the pediatric unit of BSMMU, Dhaka about two and half years back with the complaints of multiple painful soft tissue swelling in different parts of the body since birth and delay in growth and development. The child was found well and alert, moderately pale, febrile with hard, tender swelling of mandible on both sides. There were multiple swellings over the right arm, forearm, both thighs and bowing of the lower limbes. Investigations revealed normal serum calcium and phosphate level with mild elevation of alkaline phosphatase. Radiological findings showed periosteal new bone formation in mandible and long bones. There was diaphyseal expansion of the long bones with expansion of the ribs anteriorly. He was diagnosed as a case of chronic caffey's disease on the basis of history, clinical examination and investigation.

Comparison of the incidence of colour blindness between sections of Libyan and Indian populations.

Incidence of Red-Green colour blindness was studied in a Libyan population and was then compared with the same in two samples of Indian population. The incidence of the Red-Green colour defect was found to be 2.209% amongst the males and 0.0% amongst the females in the Libyan study. However, the incidence was only 1.841% amongst the ethnic Libyan males. This incidence was comparable with those reported from other African countries like Congo and Uganda. The incidence of Red-Green colour defect amongst the Indian males was found to be 2.295% while it was 0.840% amongst the Indian females.