A Multidisciplinary Outlook in Prosthodontics

Prosthodontic research needs to cover all aspects that can contribute to the clinical outcomes. Without a strong interdisciplinaryrelationship between other disciplines of dentistry and prosthodontics, the esthetic, functional, and/or biological outcome may becompromised and necessitate extensive and expensive retreatment. Through this paper, we would like to review the outline of theareas that overlap between prosthodontics and other branches of modern dentistry that dictates the interdisciplinary treatment.

Evaluation of clinico: Pathologic findings of breast carcinoma in a general hospital in Southern India.

Background and Objectives: Breast cancer is the second most common cancer in the Indian female population. As per our hospital data, breast cancer is also found to be the second leading malignancy in women. Hence, we undertook this study to evaluate the clinical profile, histopathologic types, grade, stage and the prognosis of the disease in our patients. Majority of our patients are from rural areas. Materials and Methods: This study was undertaken over a period of three years comprising of 178 patients who underwent modified radical mastectomy following preliminary diagnosis of carcinoma on fine needle aspiration cytology or histopathological examination of the lumpectomy or trucut biopsy specimens. Clinico-pathological evaluation was done in all of these cases following standard protocols. Result: The study comprised of 175 female patients and 3 male patients in the age range of 28 to 76 years. Majority (111/62.3%) of the cases were within the age range of 31-50 years of age with mean age of 48.7 years. Two females had bilateral breast cancer and one female had synchronous papillary serous cystadenocarcinoma of the ovary. Invasive ductal carcinoma no special type was the most common histopathologic pattern, and was seen in 172 (95.5%) cases. Most tumors were Scarff Bloom Richardson grade II and American Joint Committee on Cancer pathologic stage II. Prognostically, majority of tumors (49.5%) was assessed as 'good' as per the Nottingham prognostic index score. Conclusions: This study gave an insight to the clinico-pathological profile of breast cancer in our area. Long term study with follow up of the patient is needed for better understanding of the case.

Low grade mucoepidermoid carcinoma in a setting of Warthin's tumor.

Warthin's tumor also known as papillary cystadenoma lymphomatosum is a common benign salivary gland neoplasm that occurs exclusively in parotid gland. Rarely, the tumor can undergo carcinomatous or lymphomatous transformation of epithelial or lymphoid component, respectively. Herein, we describe a case of 55-year-old female who had undergone parotidectomy for a rapidly growing tumor in the right parotid gland. The case was diagnosed as mucoepidermoid carcinoma developed in a setting of Warthin's tumor based on the histomorphology, special staining characters, and immunohistochemical findings. The pathogenesis and differential diagnoses of such rare malignancy has been discussed briefly.

Nootropic activity of tuber extract of Pueraria tuberosa (Roxb).

Nootropic effect of alcoholic (ALE; 50, 75, 100 mg/kg) and aqueous (AQE; 100, 200, 400 mg/kg) extracts of P. tuberosa was evaluated by using Elevated Plus Maze (EPM), scopolamine-induced amnesia (SIA), diazepam-induced amnesia (DIA), clonidine-induced (NA-mediated) hypothermia (CIH), lithium-induced (5-HT mediated) head twitches (LIH) and haloperidol-induced (DA- mediated) catalepsy (HIC) models. Piracetam was used as the standard drug. A significant increase in inflexion ratio (IR) was recorded in EPM, SIA and DIA models. A significant reversal effect was observed on rectal temperature in CIH model, reduction of head twitches in LIH models. However no significant reduction in catalepsy scores in HIC models were observed with test extracts and standard piracetam. The results indicate that nootropic activity observed with ALE and AQE of tuber extracts of P. tuberosa could be through improved learning and memory either by augmenting the noradrenaline (NA) transmission or by interfering with 5-hydroxytryptamine (5-HT) release. Further, the extracts neither facilitated nor blocked release of the dopamine (DA). Thus ALE and AQE elicited significant nootropic effect in mice and rats by interacting with cholinergic, GABAnergic, adrenergic and serotonergic systems. Phytoconstituents like flavonoids have been reported for their nootropic effect and these are present in both ALE and AQE extracts of tubers of P. tuberosa (Roxb) and these active principles may be responsible for nootropic activity.

Evaluation of the Blood-Glucose Reducing Effects of Aqueous Extracts of the Selected Umbelliferous Fruits used in Culinary Practices

PURPOSE: Oxidative stress in diabetes coexists with a reduction in the antioxidant status; which can increase the deleterious effects of free radicals. Many plant extracts and plant products have been shown to have significant antioxidant activity. The role of antioxidant plants in diabetes has not been studied. Food additives like spices; which have free radical scavenging activity; may also be useful in maintaining normal glucose levels in diabetic patients. The objective of the study is to evaluate the aqueous extracts of selected umbelliferous fruits for hypoglycaemic and antidiabetic activities in normal and diabetic rats respectively. METHODS: All the aqueous extracts of (Caraway) CA; (Coriander) CO; (Cumin) CU; (Dill) DI and (Fennel) FE were administered at dose levels of 300 mg/kg body weight orally to different groups each containing 5 animals. A control group was also maintained simultaneously and received distilled water orally.Blood samples were collected from retro-orbital plexus of each rat before and at 2; 4; 6 and 8 h after extract administration and were analyzed for glucose content by using glucose oxidase peroxidase (GOD-POD) method using a visible spectrophotometer at 505 nm. RESULTS: In normal rats only caraway extract produced significant hypoglycaemic action. The rest of the extracts produced hypoglycaemia; which was not significant different from that of control animals. In diabetic rats also the caraway was found to be the best among the extracts. CONCLUSION: The study indicates that since the umbelliferous fruits are used in the preparation of foods; they may be useful in the control of postprandial rise of blood glucose particularly in diabetic condition. Additionally; their daily use may help in reducing complications associated with chronic diabetes

Role of cyclooxygenase-2 in lipopolysaccharide-induced hyperalgesia in formalin test.

Lipopolysaccharide (LPS)-induced hyperalgesia and the role of cyclooxygenase (COX) isoforms in acute and chronic nociceptive assays have been well established. However, the role of COX isoforms in LPS-induced hyperalgesia in the formalin test is not clear. Thus, the present study was undertaken to characterize the time course of formalin-induced nociceptive response in LPS-pretreated mice and to investigate possible effects of COX inhibitors to address the potential role of COX isoforms in LPS-induced hyperalgesia in the formalin test. All the animals showed typical biphasic response to formalin challenge. At 0 hr (immediately) and 4 hr after LPS pretreatment, animals did not show any alteration in formalin-induced tonic pain. However, 12 and 16 hr after LPS pretreatment, there was a significant increase in the late phase of formalin-induced nocifensive response as compared to control mice. Treatment with intravenously administered ketorolac (a nonselective COX inhibitor) significantly and dose-dependently inhibited the late phase of formalin-induced nociceptive behaviour in saline and LPS-pretreated mice. In contrast, parecoxib (prodrug of valdecoxib, a selective COX-2 inhibitor) or dexamethasone (COX-2 transcription inhibitor), when administered intravenously or intraperitoneally, respectively, did not show antinociceptive effect in the formalin test in saline-pretreated mice. However, both the agents significantly and dose-dependently decreased the late phase nociceptive behaviour of the formalin test in LPS-pretreated mice to the level of the animals that received saline pretreatment. These results suggest that induction of COX-2 by proinflammatory mediators and subsequent release of prostaglandins could be responsible for LPS enhancement of formalin-induced nocifensive behaviour and supports an important role of COX-2 in LPS-induced hyperalgesia in the formalin test.

Antithrombin III assay using thrombin in disseminated intravascular coagulation (DIC), other thromboembolic disorders and hepatic diseases.

Fifty cases comprising 11 cases of disseminated intravascular coagulation (DIC), 16 cases of venous thromboses and 23 cases of hepatic diseases were studied for AT III levels using clotting assay. Twelve samples were subjected to ATIII estimation by the commercially available synthetic chromogenic assay. Twenty age and sex matched controls were also analysed to find out the reference value for the techniques. Low AT III levels, if present, were correlated with other markers of DIC, viz FDP and D-dimer assays. There was a decrease in the AT III levels in all the three disease categories with a significant difference between the AT III levels of the three disease categories. In DIC, lowest levels were observed which correlated well with FDP and D-dimer levels. There was no significant difference between the average AT III levels measured by both the clotting and synthetic chromogenic assay with the former procedure being relatively inexpensive.

Needle necropsy in AIDS.

The value of autopsy in understanding the natural course of any disease is beyond any argument. The reluctance of pathologists to perform autopsy in HIV infected cadavers is justified due to the risks involved to the prosector and the morgue attendants. A relative low risk needle necropsy protocol is proposed using fine needle aspiration cytology, tru-cut biopsies and microbiological examination. Diagnosis could be offered in all the forty-four needle necropsies performed. Disseminated tuberculosis in 18/44 (40.9%) cases, disseminated cryptococcosis in 12/44 (27.2%) cases, poly-microbial infections in 27.2% cases and non-Hodgkin's lymphoma in 9% cases were detected in the study. Infectious agents like Histoplasma capsulatum, Isospora belli, tachyzoites of Toxoplasma gondii, Candida sp and Cryptococcus sp could be demonstrated in the samples obtained in the study. Lack of material for study of gross pathology, inaccessibility of deep-seated lesions and risk of needle stick injury to the prosector though low are the limitations of this procedure.

Atypical mycobcterial injection abscess.

Other than suppurative organisms, atypical mycobacteria are also known to cause injection abscesses following vaccinations, injections, tattooing and even after implants. Though the usage of disposable needles is practised universally, sporadic cases do occur. The disease entity should be considered, while dealing with injection abscesses, to institute specific therapy. Acid-fast bacilli should be looked for in the pus and mycobacterial culture of the material from injection abscesses should be done for a definitive diagnosis.

Tracheal lymphoepithelioma-like carcinoma: a case report.

Lymphoepithelioma like carcinoma is rare in locations other than nasopharynx. We report the second case of this tumour in trachea, in a young female patient, who was managed with concomitent surgery, radiotherapy and chemotherapy. The patient is disease free in the one-year follow up. The tumour presented difficulties during intubation for general anaesthesia and during surgery. Association with Epstein-Barr virus was not found in our case.

Myxoid leiomyoma of tunica vaginalis testis.

Myxoid leiomyoma is an extremely rare tumor, presenting as a scrotal mass. We report a case of 60 years male, who presented with a painless scrotal mass and operated as secondary hydrocoele. This lesion should be differentiated from other myxoid tumors and tumors with myxoid degeneration.

Ovarian granulosa cell 'tumorlet' and mature follicles with ectopic decidua in pregnancy--a case report.

Non-neoplastic, tumor like lesions are encountered in the ovaries during pregnancy. Of these pregnancy luteoma is the most common lesion mimicking an ovarian neoplasm. Ovarian granulosa cell proliferations are also reported in the ovaries removed during pregnancy as an incidental finding. The granulosa cell proliferation occurs due to the follicular stimulating hormone (FSH) like activity of human chorionic gonadotropin (hCG). We report a case of second gravida who developed uterine atonia, necessitating emergency hysterectomy. Right ovary showed extensive ectopic decidua, numerous well-formed follicles and granulosa cell tumor-like proliferation. Usually follicles are not formed in the ovaries during pregnancy. The same FSH like activity of hCG might have been responsible for the formation and maturation of follicles in this case.

Hypoglycaemic activity of extracts from soft corals of Andaman and Nicobar coasts in rats.

The ethylacetate extract of soft corals collected from Andaman and Nicobar Coasts were screened for hypoglycaemic activity in fasting rats. Rats were divided into 5 groups. Group I received 0.5 ml of 5% gum acacia suspension (control). Group II received the extract of Cladiella australis (CAS), at a dose of 250 mg/kg. Group III received the extract of Sinularia new species (SNS), at a dose of 75 mg/kg. Group IV received the extract of Lamnalia new species (LNS), at a dose of 400 mg/kg and Group V received the extract of 250MF-CBR-13 at a dose of 250 mg/kg. All extracts were administered orally. Blood samples, collected before the administration of test extracts and also at 2, 4, 6, and 8 hr after treatment, were analysed for glucose content. The percentage blood glucose reduction from that of control was also calculated. A very promising hypoglycaemic activity was observed in rats with CAS at 8 hr (42.3%), with SNS at 4 hr (28.34%) and 6 hr (40.6%), with LNS at 6 hr (32.38%) and with MF-CBR-13 at 6 hr (20.25%).

Involvement of nitric oxide (NO) in hypoglycaemic activity of tolbutamide.

The study was conducted to find the involvement of Nitric Oxide (NO) using L-arginine, a NO precursor and NG-methyl L-arginine a nitric oxide synthase inhibitor on tolbutamide activity in normal rabbits. L-arginine (25-300 mg/kg, body weight, oral) produced transient and dose dependent hypoglycaemia. When combined with tolbutamide (40 mg/kg, oral) it produced early and prolonged action. The effect of tolbutamide was blocked by NG-methyl L-arginine (5 mg/kg, body weight, oral). The results confirm the involvement of NO in tolbutamide activity and the possibility of using L-arginine as a supplement to antidiabetic drugs in blood glucose control.