Current Trends of Leprosy in a Tertiary Care Centre in North Kerala: A 10 Year Observational Retrospective Study

After the declaration of elimination of leprosy as a public health problem, leprosy services in India have been integrated with General Health-Care System, possibly resulting in readuced focus. This study was conducted to analyze the trends in the disease over a 10-year period in a tertiary care hospital in North Kerala in post elimination era. Of the 133 Hansen’s disease (HD) cases, HD-BT (borderline tuberculoid) was the most common type, followed by, HD-LL (lepromatous lepromatous). Leprosy reactions were seen in 37.59% cases, and deformities were noticed in 19 (13.53%) cases, of which 13 (66.67%) had grade 2 disability. While analyzing slit skin smear results, 25.56% were AFB (Acid Fast Bacilli) positive. On histopathological evaluation of 129 biopsied cases, 115 (89.13%) cases were consistent with clinical diagnosis. The presence of a significant number of smear-positive cases in a post elimination era, particularly lepromatous spectrum, is a matter of serious concern. Community based studies will be necessary to understand the reality at population level and for devising appropriate strategy to break the chain in transmission.

Inflammatory myofibroblastic tumor of the oral cavity: A case report and literature review

Inflammatory myofibroblastic tumor (IMT) is a rare tumor of unknown etiology and pathogenesis. The lesion has been recognized to occur at various sites but rarely affects the head and neck region. A 29-year-old male presented with a 13 months' history of a slow growing, painless growth in maxillary left posterior gingiva. An excisional biopsy was performed under local anesthesia. Microscopic examination revealed a compact cellular spindle cell proliferation with collagenous stroma having storiform architecture. Immunohistochemistry revealed that the tumor cells were positive for smooth muscle actin, CD-68 and negative for anaplastic lymphoma kinase. Oral IMT should be included in the differential diagnosis of localized gingival enlargement mimicking oral hyperplastic/reactive lesions

JuRoLap: A resilient and economical home-made specimen retrieval bag

OBJECTIVE@#Specimen retrieval bags were used to remove cysts and masses in minimally invasiveurologic surgeries for more than 3 decades. This study aims to describe the steps in making a home-made specimen retrieval bag named JuRoLap and its safety and resiliency.@*MATERIALS AND METHODS@#The bag’s name was taken from the initials of the institution combined withthe department's short-name (uro) and laparoscopy (Lap). The bag is composed of a non-toxicpolyvinyl chloride (PVC) urine bag custom fitted according to the expected specimen size. The sideswere sealed using an impulse sealer leaving one side open. The bag ways rolled and introducedintracorporeally via the 12mm port. It was opened followed by specimen placement using standardlaparoscopic instruments. Purse-string suture at the one-side opening was tightened and extractedthrough the umbilical port extending the incision as necessary.@*RESULTS@#JuRoLap was used in 33 cases removing various organs such as adrenals, kidney, ureter,bladder and prostate. It was easily prepared, safe, resilient and economical costing approximatelyUSD 0.68. It was essential to routinely check its durability by doing a leak test prior to sterilization.Proper rolling, transparent plastic component of the bag and the use of two laparoscopic graspersprovided ease in bag deployment and specimen entrapment. It was also observed that smaller incisionon extraction site as compared to the specimen size was needed due to the resiliency of the bag.Despite the required learning curve in organ entrapment and extraction, there were no complicationsand specimen leakage noted.@*CONCLUSION@#JuRoLap specimen retrieval bag is organ size specific, safe, resilient and low cost specimenretrieval bag innovation.

Oral findings in West syndrome ­ A Case Report / Achados bucais na síndrome de West- Relato de um caso

West syndrome is a severe form of epilepsy syndrome which is characterized by a triad of infantile spasms, characteristic EEG findings (Hypsarrhythmia) and developmental delay. Minimal literature is available on dental findings of West syndrome. This case report presents an eight year old male child with cryptogenic form of West syndrome having a history of multiple clusters of infantile spasms. Orodental manifestations of west syndrome have been described and its dental management has been discussed in this report. (AU)

A síndrome de West é uma forma severa da síndrome de epilepsia que é caracterizada pela tríade de espasmos infantil, achados EEG (hipsarritimia) e atraso no desenvolvimento. A literatura disponível é escassa a respeito dos achados dentais e manejo da síndrome de West. Este caso relata uma criança de 8 anos de idade, masculino com a forma criptogênica da síndrome de West com história de múltiplos episódios de espasmos infantis e achados dentais típicos. O tratamento odontológico do caso é discutido e mediadas preventivas e tratamento da síndrome de West é descrito. (AU)

Accidental separation and lodgment of rotary endodontic file into the dentist’s thumb.

Separation of the endodontic instrument within the root canal system and sharp injuries to the dentist is not an uncommon event in endodontic practice. Although root canal instruments can fracture at any stage of endodontic treatment, its fracture within the dentist’s hand is a very rare event. An unusual case of accidental separation and lodgment of rotary endodontic file in the dentist’s thumb is presented along with its management. A 33‑year‑old dentist reported with an accidental lodgment of rotary endodontic file into his thumb. The fractured instrument was removed successfully by a surgeon. The present case describes a rare event of occupational risk in endodontic practice.

Toxic epidermal necrolysis in a 5-year-old boy - case report / Necrólise epidérmica tóxica em um relato de caso de um menino de 5 anos de idade

Necrose epidérmica tóxica ( NET ) e síndrome de Stevens - Johnson ( SSJ ) são considerados um espectro de reação mucocutânea aguda com risco de vida , que diferem apenas em termos de gravidade, muitas vezes induzidos por drogas. Vírus varicelazoster tem sido raramente relatada como agente etiológico em casos de NET. O nosso relato de caso destaca a associação do vírus varicela- zoster e TEN em um menino de 5 anos de idade.

Toxic epidermal necrolysis (TEN) and StevensJohnson syndrome (SJS) are considered a spectrum of acute life-threatening mucocutaneous reaction that differ only in severity, often induced by drugs. Varicella-zoster virus has been rarely reported as an etiological agent in TEN. Our case report highlights the association of varicella-zoster virus and TEN in a 5-year-old boy.

A new occlusive patch test system comparable to IQ and Finn chambers.

Background: A good patch test system should have good adhesion and contact, and minimal leakage; Finn and IQ patch test system have these properties but are expensive. Aims: To develop a new cost‑effective occlusive patch test system that had good contact with the skin and was non‑irritant. Methods: The system (designated Chamber X) was fabricated using a semi‑permeable tape and a flexible virgin plastic chamber. Chamber X was developed by (i) selecting adhesive tape based on its non irritancy and adhesive potential (ii) testing plastic chamber material for its skin irritancy (iii) testing the assembled system against Finn, IQ and locally available chambers for irritancy, contact, leakage and occlusivity. Results: Chamber X showed better occlusion than IQ, Finn and locally available chambers and was comparable to, (P > 0.05) IQ and Finn in terms of irritancy, contact and leakage. Conclusions: The results demonstrate that the Chamber X offers a cost effective patch test system comparable to IQ and Finn chambers in terms of safety, adhesion, leakage and occlusivity.

Van der woude syndrome with an unusual intraoral finding.

Orofacial manifestations of Van der Woude syndrome (VWS) include cleft lip or palate, lower lip pits, hypodontia, hypernasal voice, cleft or bifid uvula, syngnathia, narrow high arched palate, and ankyloglossia. Extraoral manifestations include limb anomalies, popliteal webs, accessory nipples, congenital heart defects, and Hirschsprung disease. We report an interesting case of VWS with characteristic orofacial features along with an unusual additional finding of fusion of primary mandibular left lateral incisor and canine in a 7-year-old boy.

Squamous papilloma: case report and review of literature / 国际口腔科学杂志·英文版

Squamous papillomas are common lesions of the oral mucosa with a predilection for the mucosa of the hard and soft palate. As an oral lesion, it raises concern because of its clinical appearance, which may mimic exophytic carcinoma, verrucous carcinoma or condyloma acuminatum. Its pathogenesis is related to human papilloma virus but there is controversy regarding its viral origin. We present a case of squamous papilloma presenting as oral lesion along with a review of the literature.

Ichthyosis bullosa of Siemens: response to topical tazarotene.

In 1937, Siemens described a Dutch family with superficial blistering, flexural hyperkeratosis, and characteristic mauserung appearance. Since then, less than 20 kindreds with this condition have been described in the English dermatologic literature. A 14-year-old boy presented with history of recurrent blistering and peeling of skin since the age of 1 month, predominantly seen over limbs and trunk, often associated with secondary infection. His mother also had similar symptoms from childhood. On examination, the child had typical mauserung peeling of the skin and dirty gray hyperkeratosis in a rippled pattern over flexures. Skin biopsy from the boy showed intracorneal blistering with epidermolytic hyperkeratosis in the upper spinous layers. The typical history and clinical features along with characteristic histological findings confirmed our diagnosis of ichthyosis bullosa of Siemens. It must be differentiated from other conditions with epidermolytic hyperkeratosis and skin peeling, such as bullous ichthyosiform erythroderma of Brocq and peeling skin syndrome. Our patient responded well to 0.05% topical tazarotene gel over four weeks.