Oral manifestations of hospitalized cirrhotic at Shaikh Zayed hospital, Lahore: a pilot study

Background: in Pakistan cirrhosis has reached alarming proportions due to spread of HCV and HBV viruses. Some of the oral manifestations of cirrhosis have been found to exhibit geographically variability. There is no research available on the oral health of these patients in Pakistan and their specific oral problems are not known

Objectives: this study examined a cohort of cirrhotic patients admitted at Shaikh Zayed hospital Lahore to assess their oral health status and needs

Materials and methods: thirty consecutive patients admitted with diagnosis of cirrhosis were examined for oral health status. Extra oral examination included any visible lesions or abnormalities on the face, head or neck region, lymph node enlargement and TMJ dysfunction. Intra oral examination included measurement of caries [DMFT] and periodontal disease level [CPITN], oral mucosal lesions, prosthetic status and prosthetic needs of the patients. All findings were recorded on the standard WHO oral health survey form

Results: the oral health of this cohort was poor compared to the general population. Xerostomia [20%], papillary atrophy [1 00%], oral Melanosis [90%], petechieal hemaorrhages [26%] and glossitis [53%] were found prevalent in the sample. Two females had oral lichen planus and one of the patients had oral ulceration. DMFT score [Mean=5.7] was not different from national average [Mean=8.02]. Periodontal disease was more severe than general population. Less than 21% of the sample wore prostheses and over 50% needed one. TMJ dysfunction was common but fewer patient complained of the condition that the number of patients with clinical signs

Conclusions: oral health of cirrhotic population is worse than general population and they have significant oral health needs. Further research is required to investigate this relationship. Effective oral health educatior of patients' and physicians' is required to reduce the burden of oral disease thus mproving quality of life for these patients

Bronchial carcinoid - case report and review of the subject

Carcinoid tumours are rare entity but carcinoid syndrome is even more uncommon. These tumours arise from neuro-endocrine cells of the fore- mid- and hind-gut and produce a number of substances, the most important is serotonin. Bronchial carcinoid tumours are rare and account for 2.5% of all pulmonary tumours. Two cases of bronchial carcinoid are reported with different presentations and a review of the subject is discussed