Etiological factors and patterns of presentation of radicular cyst :a study

Radicular cysts are the most common odontogenic cysts of inflammatory origin affecting the human jaws. Radicular cysts are usually asymptomatic but can result in slow growth tumefaction and involve many adjacent sound teeth endangering their vitality and prognosis. The objectives of this study were to enumerate and evaluate the etiological factors and the pattern of presentation of radicular cysts in a tertiary care centre in Pakistan. A total of 58 patients were included in this case series study after taking history, clinical examination, radiological findings, aspiration test and histological diagnosis of lesion by biopsy report. It was carried out at the Oral and Maxillofacial Surgery Department, Lahore Medical and Dental College, Lahore from April 2012 to August 2014. The patients in the study included 30 male [51.72%] and 28 female [48.28%]. Most cases were diagnosed in the second decade of life [50.00%] which declined in the later age groups. The most affected region was the anterior maxilla [65.52%, n=38], followed by anterior mandible [18.96%, n=11]. The main etiological factor was dental trauma followed by unrestored nonvital carious teeth. Radicular cyst is the most commonly occurring odontogenic cyst which affects the maxillofacial skeleton with varying frequency. A proper early screening of dental trauma can significantly reduce the incidence of some of these cystic lesions. In addition, patient education with regards to improved oral health and regular dental check ups is important for reducing the caries prevalence in the population

Emergency services [1122]; A ten years data from four largest cities in Punjab 2004- 2014

Emergency services were working all over the world to deal with different types of emergencies and the frequency of emergencies were increased with the passage of time. Many developing countries even don't have such services and it was difficult to estimate the scale of emergencies in those countries. To know about the types of emergencies and to help to plan for their prevention in future. Data was collected from emergency services department 1122 in four big cities of Punjab from Nov.2004-Feb.2014. Descriptive observational study. The road traffic emergencies received were 243481 in Lahore, 92367 in Faisal Abad, 52507 in Multan and33847 in Rawalpindi. Medical emergencies were 247692 in Lahore, 82910 in Faisal Abad, 112531 in Multan and 31069 in Rawalpindi. Fire incidences were 14594 in Lahore, 6369 in Faisal Abad, 3707 in Multan and 3929 in Rawalpindi. Crime incidence related emergencies were 13301 in Lahore, 15051 in Faisal Abad, 5326 in Multan and 1705 in Rawalpindi. Road traffic related emergencies were increased even some times more than medical emergencies. Fake calls were also in higher proportion

Effect of two triangular flap designs for removal of impacted third molar on maximal mouth opening

The aim of this study was to compare the effect of marginal flap and paramarginal flap designs on maximum mouth opening following surgical removal of impacted mandibular third molars. This comparative study consisted of sixty patients which were divided into two groups of thirty each and was carried out at Oral and Maxillofacial Department, Lahore Medical and Dental College, Lahore from June 2012 to October 2013. Maximum mouth opening was recorded preoperatively. A marginal flap was used in one randomly chosen half of the patient's sample, and a paramarginal flap was used in the other half. The effect of these flaps on maximum mouth opening was studied postoperatively. No significant difference was found between marginal and paramarginal flaps on maximum mouth opening at second and seventh days after surgical removal of impacted mandibular third molar [P>0.05]. Therefore, the decision to use a marginal flap or a paramarginal flap may be based on surgeon's preference

Outcome of management of mandibular third molar impaction by comparing two different flap designs

The aim of this study was to compare the outcome of management of mandibular third molar impaction in terms of wound healing and periodontal probing depth of the adjacent second molar in patients treated by marginal flap versus paramarginal flap. This quasi experimental study consisted of sixty patients divided into two groups of thirty each [ages 18 to 30 years], who required surgical removal of impacted mandibular third molars. Periodontal probing depth of the adjacent second molar was recorded preoperatively. A marginal flap was used in one randomly chosen half of the patient's sample, and a paramarginal flap was used in the other half. The influence of these flaps on wound healing and periodontal probing depth of the adjacent second molar was studied postoperatively. No wound dehiscence occurred with the use of marginal flap or the paramarginal flap at 1 and 2 weeks after surgery [P>0.05]. The buccal and distal probing depths of the adjacent second molar showed no significant difference between marginal flap and paramarginal flap before surgery and at 2 weeks and 4 weeks after surgery [P>0.05]. No significant difference was found with the use of paramarginal flap instead of traditional marginal flap in the removal of impacted mandibular third molar

Dengue outbreak; descriptive epidemiological analysis and vector surveillance in District Faisalabad during 2011

This longitudinal study was conducted during August to December 2011 in District Faisalabad to analyze epidemiological pattern of dengue outbreak in the district. Weekly trends of all cases [893] reported through Disease Surveillance System from week No. 33 to 52 were monitored. On the basis of this continuous flow of information, different ongoing vector control measures were adopted simultaneously in different areas of the district and larval indices were calculated. The Surveillance data was used to monitor the trends of the outbreak in terms of time, person and place. Teams of 3102 trained workers were formed to conduct various surveillance activities like vector surveillance, fogging, larviciding, and indoor residual sprays. During indoor and outdoor vector surveillance, teams also calculated the larval indices for vector control. The rural to urban ratio of cases was 1:3. Maximum cases [215] were reported from Jinnah Town in urban area and [102] cases were reported from Tehsil Sadar among the rural areas. Most cases of dengue fever were observed during the 37-46 weeks of the year 2011. Mean age was 29 +/- 14.7 years for rural and 35 +/- 16.5 years for urban. Male to Female ratio was 1.2:1 in urban and 1.8:1 in rural areas. Majority of the cases belonged to the age group 21 -30. The case fatality rate was 6/1000 cases. The house Index was 1.03%, the indoor container index was 0.26% and the breateu index was found 1.21%. Maximum cases occurred during 40th to 44th weeks. Male were affected more as compared to females. Jinnah Town in urban areas and Tehsil Sadar among the rural areas reported maximum number of cases. The different calculated larval indices like house index, indoor/outdoor container index and breateu index showed moderate larval growth and hence, the outbreak was within control

Current concepts in central giant cell granuloma

Central Giant Cell Granuloma is a nonneoplastic intraosseous lesion, and constitutes a common nonodontogenic pathology to occur in the jaws. It is characterized histologically by cellular fibrous tissue containing multiple foci of haemorrhage, aggregations of multinucleated giant cells, and occasionally, trabeculae of woven bone. Various theories brand it from being a 'reactive' to hamartomatous to a neoplastic lesion. It has now been hypothesized that it is the mononuclear spindle shaped cell which controls the proliferative activity of this lesion, as opposed to the more frequently seen giant cell. It has an increased predilection for mandible and females, in younger age groups. Various radiological and histopathological differential diagnoses should be considered in case of giant cell lesions. Some of the lesions are thought to display a markedly 'aggressive' behaviour and a clinically 'aggressive' model of CGCG has been proposed. Smaller, 'nonaggressive' tumours generally respond very well to conservative enucleation or curettage but recurrence is seen to be common with 'aggressive' lesions. Various medical therapies including injections of intra lesional steroids, subcutaneous calcitonin and interferon have been proposed for the treatment of 'aggressive' lesions