A Study of Cognitive Impairment in Patients with Type 2 Diabetes Mellitus – A Prospective Observational Study

Introduction: Type 2 diabetes mellitus (DM) is the most lifestyle risk factor for cognition. Regular treatment and managementof Type 2 DM could prevent the onset and progression of cognitive impairment. Cognitive decline associated with DM mayinfluence one’s ability to perform self-care and affect glycemic control.Aim: Our prospective observational study aimed to analyze the cognitive impairment using a mini-mental status examination(MMSE) in patients with Type 2 DM.Materials and Methods: This prospective observational study was conducted to analyze the cognitive impairment using MMSEin patients with Type 2 DM. A total of 50 patients diagnosed with Type 2 diabetes were included in the study. All the demographicand laboratory investigation data so obtained was tabulated and was analyzed statistically, and results were discussed.Results: Of 50 patients, 26 patients were male and 24 patients were female. Based on the age group, 11 patients were in theage group below 40 years, 21 patients between 40 and 50 years, 16 patients between 51 and 60 years, and 2 patients >60years. Based on the duration of Type 2 diabetes, 16 patients had <5 years and MMSE score of 24.28 and 34 patients had >5years and MMSE score of 22.14. Based on cognitive impairment, 44 patients had mild cognitive impairment and 6 patientshad moderate cognitive impairment.Conclusion: From this study, we concluded that the duration of Type 2 DM and level of HbA1c affect the cognitive status ofthe individuals. A greater understanding of the mechanisms linking Type 2 DM and cognitive impairment may facilitate thedevelopment of new ways for the treatment of cognitive impairment.

Liquid Fire In The Stomach A Minimally Invasive Approach

Corrosive injuries are common in developing countries. Acid ingestion is more common in developing countries when compared to alkali ingestion in developed countries. Ingestion may be accidental or suicidal. The nature of the corrosive ingested determines the extent of injury caused. Acidic injury commonly affects stomach than alkalis and it ranges from acute to chronic gastric injuries. In this article we discuss about the management of corrosive stricture of pylorus of stomach which was dealt by laparoscopy.

Pyogenic Granuloma Mimicking Fibroma: A Case Report.

Soft tissue swellings of the oral cavity frequently present a diagnostic challenge because a diverse group of pathologic processes can produce such lesions. Among these lesions are a group of reactive hyperplasia, which develop in response to a chronic, recurring tissue injury that stimulates an exuberant or excessive tissue repair response, and pyogenic granuloma is one of them. It is a reactional response to constant minor trauma or may be related to hormonal changes. It preferentially affects the gingiva followed by lips, tongue, buccal mucosa, and palate. It is commonly seen in young adults. The treatment is excision of the lesion. This case report describes the clinical and histopathological features of a pyogenic granuloma, in a 20-year-old male patient.

Review of management of pruritus in palliative care

Pruritus or itch is an uncommon symptom observed in palliative care, even more uncommon in cancer patients. However, if a patient experiences pruritus, the 'itch?scratch' cycle can damage the skin integrity and can increase the susceptibility of patients to infection owing to their frail immune system. The outcome can be very distressing, dramatically impacting the quality-of-life of the patient. Moreover, since severe pruritus seen in patients with advanced disease can be associated with failure of different organ systems, pruritus must be assessed based on the underlying organ systems and the pathophysiology involved. Regardless of the cause of pruritus, general skin care is important. Depending on the origin of pruritus, specific approach and medications must be considered. Caution must be taken during management of pruritus since most cancer patients take pain medications that interact with some antipruritic medications. In addition to the complex and unclear nature of cutaneous and central pathogenesis of pruritus, treatment of pruritus is challenging

Oral Squamous Cell Carcinoma in Background of Oral Submucous Fibrosis: A Case Report.

Oral submucous fibrosis (OSMF) is a well-recognized, potentially malignant disorder of the oral cavity that can affect any part of the oral mucosa, characterized by mucosal rigidity of varying intensity caused by fibro elastic transformation of the juxta epithelial layer of connective tissue. OSMF occurs in Indians and other population of the Indian subcontinent with certain oral habits. Betel quid chewing is a popular oral habit with potential links to the occurrence of oral cancer. In patients with submucous fibrosis, the oral epithelium becomes atrophic and thereby becomes more vulnerable to carcinogens. Since the ingredients of betel quid, tobacco are crucial for tumor initiation, promotion and progression, exposure to these toxicants simultaneously has been shown to markedly potentiate the oral cancer incidence in OSMF patients. The rate of malignant transformation of OSMF has been estimated to be 2-10%. Most cases with malignant transformation in OSMF have occurred gradually over a long period of time. This paper presents a case of oral submucous fibrosis turning into malignancy in a 34-year-old male patient.

Adenomatoid Odontogenic Tumor: A Case Report.

Adenomatoid odontogenic tumor (AOT) is a very rare odontogenic tumor with an incidence of 1%. Overall it accounts for 9% of all odontogenic tumors. In most of the cases, AOT is misdiagnosed as an odontogenic cyst. Younger individuals are commonly affected and particularly in females. AOT is seen predominantly in the maxillary anterior region in association with an unerupted tooth. Permanent dentition is affected more than the deciduous dentition. Intraoral periapical radiographs play a major role in the diagnosis compared to orthopantomogram because of its increased contrast but for the better assessment of the extension of larger lesions orthopantomogram is must. AOT resembles benign odontogenic lesions like dentigerous cyst and tumors like ameloblastoma. The lesions are managed conservatively by surgical excision along with the removal of the affected tooth and have an excellent prognosis.With this background, we report an unusual case of AOT involving maxillary anterior region in 15-year-old male patient. The present article reviews the etiology, clinical features, histopathological features, and treatment modalities of AOT.

Non‑syndromic bilateral condylar aplasia: A rare case.

The temporomandibular joint is one of the most complex joints of the human body. It consists of the mandibular condyle, glenoid fossa and the articular eminence of the temporal bone. Aplasia of the condyle is usually seen as part of a syndrome otherwise it is rare. We report a case of bilateral condylar aplasia in a 20‑year‑old male not associated with any syndrome. The patient reported to the department with a chief complaint of the underdeveloped lower jaw. Clinical examination, conventional radiographs, and 3D computer tomography images revealed a complete absence of condyle on the right and left sides.

Multiple Talon Cusps: A Rare Case Report.

Talon cusp is a very rare developmental anomaly, arising as a cusp like elevation on the lingual aspect of maxillary or mandibular anterior teeth, usually projects from the cemento-enamel junction or cingulum. It can involve single tooth, either primary or permanent dentition, usually unilateral in occurrence and seen bilaterally in 1/5th of the cases. It can result in a host of clinical problems like occlusal interference, irritation of the tongue, pulpal necrosis, caries, TMJ disorders and periodontal problems. The prevalence of multiple, bilateral talon cusp occurrence is rare, we report a case of Multiple Talon cusps involving all maxillary anterior teeth.

Intrauterine retention of foetal bone: an IUCD effect.

Intrauterine retention of foetal bone is a rare complication of abortion. These patients may present with irregular bleeding per vaginum, dysmenorrheal, pelvic pain and secondary infertility. A 27 year old female (G2, P1, L1, A1) referred by a general practitioner to our OPD as a case of secondary infertility. Patient was asymptomatic and had a second trimester abortion three years back. USG showed a foreign body in the uterine cavity. There was no history of IUCD insertion. On the advice of general practitioner, CT scan was done, which showed similar finding. Then this case was referred to us for further clinical evaluation. On hysteroscopy, we found foetal bones impacted between two Ostia which were removed with difficulty in the same setting. Dye test for patency of tubes was negative, probably due to edema. After that, patient conceived naturally within four months and delivered a healthy baby. Retained foetal bone in the uterine cavity was causing secondary infertility by its IUCD effect. Hysteroscopy is the gold standard method for diagnosis and treatment of foreign body in the uterine cavity.

Cysticercosis of the masseter.

Cysticercosis of the oral cavity is a very rare soft tissue lesion and very few cases have been reported worldwide. Here we report a case of a cysticercous cellulosae within the masseter muscle which was diagnosed with the help of high resolution ultrasonography (USG) and ultrasound guided fine needle aspiration cytology (FNAC) and managed conservatively using oral antiparasitic medication. Cysticercosis is not commonly considered in the diagnosis of swellings of the head and neck and this is the reason why they are of utmost interest to the practitioner and have to be studied.

Aerobic heterotrophic bacterial diversity in sediments of Rajakkamangalam estuary, south west coast of India.

The abundance of aerobic heterotrophic bacterial population in the sediment sample of six experimental stations (S1 to S6) at Rajakkamangalam estuary was studied for a period of one year from March, 1998 to February, 1999. The important bacterial genera encountered were Pseudomonas, Bacillus, Vibrio, Escherichia, Micrococcus, Enterobacter, Salmonella, Aeromonas, Shigella, Klebsiella, Proteus, Alkaligenes, Staphylococcus, Citrobacter and Flavobacterium. The bacterial population based on numerical counts showed wide fluctuations in their distribution at different stations. Among the bacterial genera Pseuaomonas was found to be the dominant genus during the experimental period. The qualitative and quantitative distribution of microflora in the sediment samples are discussed.

Juvenile aggressive cemento-ossifying fibroma. A case report.

Juvenile Aggressive Cemento-Ossifying Fibroma is a benign, fibro osseous neoplasm commonly affected maxilla but also other bones including mandible, arising in children. It is considered to be a locally aggressive and quickly expansile lesion. Because of its aggressive nature and high recurrence rate, an early detection and a complete surgical excision is essential. A case of Juvenile Aggressive Cemento-Ossifying Fibroma in a 9 year old male child who visited the Department of Oral Medicine and Radiology, J.S.S. Dental college and Hospital, Mysore is being reported and discussed.

Juvenile aggressive cemento-ossifying fibroma. A case report.

Juvenile Aggressive Cemento-Ossifying Fibroma is a benign, fibro osseous neoplasm commonly affecting maxilla but also other bones including mandible, arising in children. It is considered to be a locally aggressive and quickly expansile lesion. Because of its aggressive nature and high recurrence rate, an early detection and a complete surgical excision is essential. A case of Juvenile Aggressive Cemento-Ossifying Fibroma in a 9 year old male child who visited the Department of Oral Medicine and Radiology, J.S.S. Dental College and Hospital, Mysore is being reported and discussed.

Computer modelling studies of ribonuclease T1-2'-deoxy-2'-fluoroguanylyl- (3',5')-cytidine complex.

The mode of binding of the substrate analog 2'-deoxy-2'-fluoroguanylyl- (3',5')-cytidine (GfpC) to RNase T1 was determined by computer modelling studies. The results obtained are in good agreement with the observations of 1H-nmr studies. The modes of binding of the substrate analog GfpC and the substrate GpC to the enzyme RNase T1 have been compared. Though the guanine base favours to occupy the same site of the enzyme in both the complexes, significant differences are observed in the local environment around the 2'-substituent group of guanosine ribose moiety. In the RNase T1-GpC complex, the 2'-OH group is in close proximity to the side chain carboxylic acid of Glu58 which leads to the formation of a hydrogen bond. However, in the RNase T1-GfpC complex, 2'-fluorine is positioned away from Glu58 due to electrostatic repulsion and instead forms a hydrogen bond with His40 imidazolium group. The results obtained rule out the possibility of His40 serving as the base group in catalysis as suggested by 1H-nmr studies and further support the primary role assigned to Glu58 as the general base group by earlier computer modelling and the recent site directed mutagenesis studies. This study also implies that the 2'-deoxy-2'-fluoro substrate analog may not serve as a good model for determining the amino acid residue which serves as the general base group in ribonuclease catalysed reactions.