An insight into dentin desensitizing agents - In vivo study.

Aims: It is widely accepted that dentin hypersensitivity is an uncomfortable condition, which affects the function and quality of life. This study determines the difference in efficacy of four desensitizing agents. Subjects and Methods: An in vivo study was conducted to compare four dentin desensitizing agents on 40 patients. Age, sex, and place of the patient were recorded. Hydroxyapatite containing agent, potassium nitrate containing, sodium fluoride containing, and natural resin containing agents were used for the study. The baseline measurement for pain perceived due to hypersensitivity was recorded by visual analog scale (VAS). Then after application of the respective desensitizing agent, the last score was taken after 7 days. Statistical Analysis Used: The agents were compared in terms of mean differences in their VAS scale readings. Kruskall-Wallis test and Mann-Whitney tests were used to compare the efficacies of the four agents. Results: The four desensitizing agents which contain different active agents were effective in relieving dentin hypersensitivity. Not much significant difference was found among the four. However, propolis (natural resin-containing agent) showed better clinical response in patients among the four, followed by sodium fluoride-containing agent. Conclusions: Propolis proves to be a good natural and nontoxic option for treatment of dentin sensitivity.

Chorioangioma Syndrome: Co-relation of Color Doppler Ultrasound and Pregnancy Outcome

Large chorioangiomas are rare and associated with significant fetal and maternal risks. A case of chorioangioma syndrome is presented with polyhydramnios, pre-eclampsia, preterm labor and fetomaternal hemorrhage. Antenatal diagnosis is possible with ultrasound, and the prognosis for pregnancy outcome can be predicted by evaluating the vascularity of the tumor on color doppler sonography.

Intravaginal Misoprostol Versus Intra-amniotic 15 Methyl PG F2α for Termination of Second Trimester Pregnancy

To compare the efficacy of intravaginal application of misoprostol and intra-amniotic injection of prostaglandin 15-methyl F2 alpha (PG F2α) in terminating second trimester pregnancies, eighty pregnant women at 14-20 weeks of gestation with single live fetuses and requesting for termination of pregnancy were randomised into two groups.Women in group I: received four tablets of vaginal misoprostol (200 mg/tablet) and in group II : intra-amniotic injection of (10 ml) 2.5 mg 15 methyl - PGF2α. Failure to abort within 48 hours after intiation of treatment occurred in one woman (2.5%) in the misoprostol group and 10 women (25%) in the 15 methyl PGF2α group (P = 0.009). Mean induction-to-abortion interval was 16.3±13 hr in the misoprostol group and 21.2±16 hr in the 15 methyl PGF2a group (P=.001). Lower abdominal pain was significantly higher in the misoprostol group than in the 15 methyl PGF2α group (P = 0.001). Intravaginal misoprostol in a dose of 800mg is more effective than intra-amniotic 15-methyl PGF2α for second trimester pregnancy termination.

Invasive Mole Presenting as Acute Haemoperitoneum

We report a case of invasive hydatidiform mole presenting as an acute primary haemoperitoneum. The patient presented with acute abdominal pain and signs of haemoperitoneum. Emergency laparotomy revealed a molar pregnancy perforating through the uterine fundus, resulting in massive haemoperitoneum. The serum beta chorionic gonado-tropin (ß-hCG) levels regressed spontaneously following evacuation of the molar pregnancy.

Sublingual misoprostol before first trimester abortion: a comparative study using two dose regimens.

Various methods have been described for preoperative cervical priming prior to vacuum aspiration (VA) in first trimester pregnancy termination, to facilitate cervical dilatation and shorten the abortion procedure. Recently misoprostol a prostaglandin E1 analogue has been shown to be effective in facilitating cervical dilatation prior to VA. Misoprostol offers several advantages over the other prostagland in analogues including stability at room temperature, ease of administration and minimal side effects. OBJECTIVE: To determine the optimal dosage and dosing interval for the use of misoprostol administered sublingually for pre-abortion cervical dilatation. SETTING & DESIGN: This was a prospective randomised study conducted at Comprehensive Rural Health Project, Ballabgarh the rural health centre under Centre for Community Medicine, AIIMS, New Delhi. MATERIAL AND METHODS: One hundred and twenty pregnant women between 6-11 weeks of gestation opting for voluntary medical termination of pregnancy were (MTP) randomly allocated to either 200 microg or the 400 microg misoprostol group. Vacuum aspiration was performed either two or three hours after administration of sublingual misoprostol. Using Hegar's dilators, degree of cervical dilatation before vacuum aspiration was measured. Other parameters assessed included the amount of additional dilatation required, intra-operative blood loss and associated side effects. STATISTICS: Statistical analysis was conducted using chisquare, the student's t and the Mann-Whitney U tests to examine the difference between the two groups. RESULTS: In the 200 microg misoprostol group 33% achieved a dilatation of > or = 8 mm compared with 71% of women in the 400 microg misoprostol group. The odds ratio was 95.8 (95% CI 10.2-842.9) for 400 microg misoprostol for successful preoperative cervical dilatation of > or = 8 mm. The mean baseline cervical dilatation for 400 microg and 200 microg misoprostol was 8.2 mm and 6.0 mm respectively (P < 0.001). The use of 400 mg misoprostol with an evacuation interval of two hours appears to be the optimal dosage and evacuation interval. Increasing the time interval beyond two hours did not confer any additional advantage on the rate of successful cervical dilatation but was instead associated with an increased incidence of side effects such as preoperative vaginal bleeding, abdominal pain and shivering. CONCLUSION: Our study has shown that Sublingual administration of 400 microg of misoprostol at least two hours before procedure is effective for preoperative cervical dilatation before vacuum aspiration in first trimester pregnancy termination. There is no additional advantages of increasing the dosing interval upto three hours.

Primary Ovarian Abscess in Pregnancy

Primary ovarian abscess is a rare entity, occurrence of ovarian abscess during pregnancy is even rarer. The clinical presentation is variable ranging from asymptomatic abscess to diffuse peritonitis. A delay in diagnosis may be detrimental to both mother and the fetus. We report a case of asymptomatic primary ovarian abscess associated with a term pregnancy.

Primary Tubercular Appendicitis Masquerading as a Twisted Ovarian Cyst

We report a rare case of primary tubercular appendicitis diagnosed incidentally on histopathological examination of a surgically resected appendix in a 28 year old women who underwent laparotomy for a cllnically suspected diagnosis of twisted ovarian cyst.