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Background: Diagnostic accuracy of intra-operative frozen section (FS) depends largely on quality of tissue sections backed by good clinical communication and experience of reporting pathologist. Periodic audit of this consultation in surgical pathology help in assessing the efficiency of procedure and addressing the pitfalls. In this study authors have analysed the spectrum, indications and assessed the accuracy of FS consultation in their institution.Methods: A retrospective study of 212 consequent tissue specimens submitted for FS over two years in study centre was conducted. The FS and corresponding formalin fixed paraffin embedded (FFPE) tissue section with their final histopathological examination (HPE) reports were studied and analyzed. The results were classified in concordant, discordant and deferred categories. Accuracy rates and discordant frequencies were calculated and comparison with other similar studies was done. Reasons for inaccuracies were deduced.Results: A total of 212 tissue specimens for FS were reported over two years in this study institute, six of which showed discordant results. Most common site of FS in this study centre was from central nervous system (CNS) lesions (28.77%). Indications for intra-operative consultation were mainly for establishment of tumor diagnosis (66.51%) and status of margins (29.25%). The accuracy rate was found to be 97.17% with error rate of 2.83%. On analysis of discordant cases; the reason for inaccuracy was mainly due to interpretation error (83.33%).Conclusions: The audit of FS consultation established that accuracy rates of this study institution are comparable with most international quality control statistics for FS. The discordant cases were mostly false positive hence emphasising that a variable degree of reservation is required while interpreting and communicating the FS results. The closest possible diagnosis should be communicated on FS and definitive diagnosis should be deferred to HPE in case of doubt.
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Introduction: Laryngoscopy and tracheal intubation cause significant changes in the hemodynamics of patients. Manypharmacological methods have been devised to reduce the extent of hemodynamic events. This study compares the efficacyof two such agents, dexmedetomidine and esmolol, for the attenuation of response to extubation.Materials and Methods: This study was carried out on 100 patients aged 18–60 years, belonging to the American Society ofAnesthesiologists Grades I and II, having no major systemic comorbidities, and undergoing abdominal or lower-limb surgeriesunder general anesthesia. They were randomly divided into two groups: Group D (dexmedetomidine) and Group E (esmolol).Pre-operative, intraoperative, and post-operative vitals and side effects were monitored.Results: Both the groups were comparable in terms of demographic variables, physical attributes, and baseline vitalparameters. It was observed that dexmedetomidine is better at controlling heart rate and systolic, diastolic, and mean bloodpressures during extubation than esmolol. There was no significant respiratory depression. No significant side effects wereobserved.Conclusion: Dexmedetomidine is an effective and safe drug to provide stable hemodynamics and protects against the stressresponse to extubation in patients undergoing abdominal and lower-limb surgeries under general anesthesia.
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Orthodontic patients experience pain and discomfort to a varying degree during the course of treatment. Since pain is one of the important reasons for not seeking the orthodontic treatment, pain control is important both for patient and clinician. In the present article we made an attempt to highlight the various orthodontic procedures which cause pain and discomfort, mechanism of pain and the methods of evaluating the pain. There are various methods of managing pain but analgesics are still the main treatment modality to reduce orthodontic pain despite their side effects. There are some reports suggesting the use of Tens (transcutaneous electrical nerve stimulation) and low level lasers for the control of pain, further convincing research is required to use them as a main treatment modality.
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This article reviews the various methods of three-dimensional (3D) imaging in orthodontics including the origin and history. Various technologies of 3D imaging applicable to the field of orthodontics such as Structured light ,Stereophotogrammetry, 3D Facial Morphometry, Dynamic stereometry, Laser scanning,Magnetic resonance imaging, Computed tomograghy, Cone beam computerized tomography.Present and future perspectives of 3D imaging in orthodontics
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The aims of this investigation were to define the modified location of CRES and CROT in a maxillary central incisor with different alveolar bone heights. A three dimensional finite element model of the upper central incisor with its supporting structures was created using ANSYS software on a PIII computer. Five three dimensional models of an upper central incisor with 1 to 6.5 mm of alveolar bone loss were formulated and used by the author. Center of resistance and center of rotation were located for the various stages of alveolar bone loss. The results revealed that the moment/force ratio (at the bracket level) required to produce bodily movement increases in association with alveolar bone loss. Bone loss causes center of resistance movement towards the apex, but its relative distance to the alveolar crest decreases at the same time. Greater amounts of displacements of incisal edge and apex were observed with increased alveolar bone loss for a constant applied force. Center of rotation of the tipping movement also shifted towards the cervical line. Among the many differences between orthodontic treatment of an adolescent and an adult patient is the presence of alveolar bone loss in the adult cases. Alveolar bone loss causes change in center of resistance as a result of alteration in bone support. This necessitates modifications in the applied force system to produce the same movement as in a tooth with a healthy supporting structure.
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Aim and objectives: To determine the shear bond strength of laser cured composite resin and compare with that of visible light cure resin and evaluate it’s clinical usefulness. Materials and methods: An argon laser with a wavelength of 488-500nm and a power density of 2.104 mW/cm2 and an optical diameter of 6mm with a curing time of 10 seconds was employed as against the visible light cure with a wave length of 450-500nm of the same optical diameter and curing time of 40 seconds and tested using a universal instron testing machine. Results: The bond strength between laser cured and visible light composite resin was not statistically significant. However the lesser curing time of laser reduces the chair side time. Conclusion: Laser curing of orthodontic brackets may not be a viable procedure due to the cost factor as the bond strength is clinically insignificant.
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The potential challenge at the fag end of orthodontic treatment is to restore the tooth structure as was prior to the beginning of the treatment. The aim of the article is to give a proper insight into the methodology of debonding not only from the orthodontist’s point of view but also keeping in mind the general practitioners who follow the procedure. At times, cases which are very well treated end up with enamel fractures or tears during debonding. Among the several methods recommended, the simplest and most effective and popular method has been discussed in this article as a clinical tip.
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AIM: This study assesses the utility of a Buddemeyer type radiorespirometric (RR) assay in detecting viable Mycobacterium leprae in clinical samples taking the mouse foot pad (MFP) test as gold standard. METHODS: A total of 131 skin biopsy specimens comprising of 56 untreated, smear-positive, borderline lepromatous and lepromatous leprosy (BL-LL) and 75 untreated, smear-negative, borderline tuberculoid and mid-borderline (BT-BB) specimens were processed by both the methods. The cut-off value (in counts per minute, cpm) for test samples in the RR assay was determined using nonleprous (normal) skin biopsy specimens. RESULTS: In the untreated BL-LL and BT-BB groups, 86 and 56% of the cases tested positive in the RR assay respectively, which was comparable to the results of the MFP test (80 and 45% respectively). The overall concordance between the two tests was 74.79%, whereas the sensitivity and specificity were 75 and 74.3% respectively. A Kappa value of 0.459 indicated a fairly good agreement between the two methods. There was no linear relationship observed between the bacteriological index (BI) and the morphological index (MI) with the counts per minute (cpm) output. CONCLUSION: The results indicate the ability of this RR assay to detect viability; however a comparison with another sensitive method would further validate the assay system.