Multidisciplinary treatment in a patient with nifedipine induced gingival enlargement

Adult patients have preexisting condition that are not seen in the adolescent population including tooth loss, severe skeletal dysplasias, periodontal disease and various forms of temporomandibular dysfunction[TMD]. Frequently, the preexisting conditions that are present in the adult patient interfere with the achievement of orthodontisc's general idealized goals. Problem-oriented synthesis of the dental needs of each case helps determine specific treatment objectives that one must establish before determining the treatment plan. A 51 years old patient approached the dental clinic to improve her smile esthetics. She was a skeletal class III high angled case with an increased lower facial height and a dentally class I with supraerupted upper right central incisor, mild spacing 4 mm of overall tooth material excess in the lower arch. Ginigival overgrowth associated with nifedipine intake was also recorded. As a more realistic treatment plan with an interdisciplinary approach was considered to be appropriate in terms of treatment efficacy and duration, a team comprising of a periodontist, an orthodontist and a restorative dentist was formed to manage the case. The importance of multidisciplinary approach in managing the case was explained. After gingivectomy, the patient was kept in a maintenance program, including oral hygiene instructions and professional tooth cleaning during the complete orthodontic treatment. Follow-up of the case for a year did not reveal any recurrence of the drug induced gingival enlargement. This case not only emphasizes the role of meticulous oral hygiene maintenance in preventing the recurrence of gingival enragement but also the ease with which adult cases would be managed efficiently with minimal endeavors by a team approach

Electrophoretic analysis of serum proteins in prostate cancer

Objective: This work was undertaken to analyse qualitatively serum proteins separated by SDS-PAGE and stained with Coomassie Brilliant Blue R-250, to detect novel proteins, which could possibly serve as markers for the early detection of prostate cancer

Design: This study [carried out on subjects who were confirmed by biopsy as cancer prostate [CaP] patients] was a preliminary step towards the detection of some new protein markers for CaP

Place and Duration of Study: This study was conducted at the Institute of Biochemistry and Biotechnology University of the Punjab Lahore, from January to March 2003

Subjects and Methods: Serum samples, 36 cases of cap and 36 controls of similar age group were separated by SDS-PAGE on a 12% gel, and then stained using Coomassie Brilliant Blue R-250. Protein fractions were analyzed using the computer software program "GeneGenius Gel Documentation and Analysis System"

Results: The appearance and relative raw volumes of 14 major protein fractions ranging in molecular weight from 0.23-157 kD in each group were studied. It was seen, on the whole, that the raw volume of most of the protein fractions decreased in the CaP cases as compared to the controls. Furthermore, the protein fractions of 1.27, 100, 114, 122 and 140 kD were absent in a significant number of the cases. However, it was seen that the protein fraction of 0.23 kD was absent in all the control samples while it appeared in most of the cases

Conclusion: A number of proteins were found to have been lost during malignant transformation. Further investigations are warranted to identify these novel proteins using 2D-PAGE followed by immunoblotting

Free and total prostate specific antigen in benign prostate hyperplsia and prodtate cancer

To record the levels of PSA in the sera of prostate cancer [CaP] and benign prostatic hyperplasia [BPH] cases. Free PSA/total PSA as percentage was also calculated in order to evaluate its utility in differentially diagnosing BPH and CaP. Design: A cross-sectional, case control study. Place and Duration of Study: Shaikh Zayed Hospital and Mayo Hospital, Lahore from August 2002 to March 2003. Materials and A group of 108 male subjects, including one-third of each of biopsy-confirmed prostate cancer cases, BPH cases and asymptomatic controls of matching age were studied. PSA and Free PSA were determined by ELISA using commercially available assay kits. Mean PSA was found to be highest in CaP cases [41.9 + 38.7 ng/ml], lower in the BPH cases [13.5+10.5 ng/ml], while it was lowest in the control subjects [5.7 + 4.4 ng/ml]. Moreover, it was observed that a majority of the CaP cases had serum PSA >20 ng/ml, 50% of BPH cases had serum PSA in the 'gray zone' [4.1-20 ng/ml], while majority of controls had serum PSA in the 'normal' range [0 - 4 ng/ml]. Using a free-PSA "cut-off" of 18% to differentiate between benign and malignant prostate enlargement, it was found that 80% of the CaP cases had F/T% <18, while 75% of the BPH cases had F/T%>18. The percent free-PSA test to differentially diagnose BPH and CaP in the 'gray zone' was found to have a sensitivity of 86% and a specificity of 94%. Using a cutoff of 18%, the free-PSA test significantly improved the differential diagnosis of BPH and CaP in the 'gray zone' as compared to the use of total PSA alone in the study group