Recurrent black stains and periodontal disease

Objectives: The objective of this study was to identify the anaerobic pigment-forming bacteria present in black stain and correlate its occurrence with dental caries incidence and periodontal destruction. Materials and Methods: A total of 50 healthy subjects with the chief complaint of recurrent black stains were selected based on the inclusion and exclusion criteria. decayed/missing/filled surfaces score, community periodontal index, Gingival Crevicular Fluid (GCF), black stain score, and microbial analysis were done. Results: The data presented indicate that black stain has a constant microflora, dominated by various gram-negative rods, gram-positive cocci and rods (P ≤ 0.1). However, the incidence of gram-positive rods decreased with the increase in plaque score and probing depths and decrease in black stain score. Conclusions: Presence of black stains is predominated by various gram-positive and negative rods, and gram-positive cocci. Increase in the plaque score decreases the severity of black stains, thereby increasing the probability of periodontal destruction and dental caries incidence in adult subjects. Further studies are required to corroborate the results.

Effect of non-surgical periodontal therapy on stress and salivary Chromogranin-A levels: A clinico-biochemical study

Aim: The aim of the study was to compare chromogranin A (CgA) and stress levels before and after non-surgical periodontal therapy (NSPT). Materials and Methods: A sample of 40 patients in the age range 25–60 years were included in the study and were divided into gingivitis (10 subjects), chronic periodontitis (CP) (15 patients) and aggressive periodontitis (AgP) (15 patients). The patients were asked to complete two sets of stress questionnaires, plaque index, gingival index, probing depth and clinical attachment levels (CAL) were recorded. Salivary samples were taken at baseline and were repeated three months post NSPT. Results: CgA was detected in saliva samples of all the groups. A statistically significant correlation was established between levels of CgA and stress parameters, which was shown to be the highest in AgP (P < 0.001), followed by CP group (P < 0.005) at baseline. Following NSPT, an overall reduction was observed in the levels of CgA, which was correlated with the overall reduction in stress levels for AgP group (P < 0.005) followed by CP group (P < 0.037). Amongst the clinical parameters, CAL showed the strongest correlation with CgA both at baseline and after NSPT (P < 0.001). Conclusion: Stress was directly correlated to the levels of salivary CgA levels, which was the highest for aggressive periodontitis at baseline. NSPT showed a marked improvement in all the parameters. Levels of CgA and CAL showed a significant correlation in both the CP and AgP groups.

Gingival crevicular fluid resistin levels in chronic periodontitis with type 2 diabetes before and after non-surgical periodontal therapy: A clinico-biochemical study

Aim: Periodontitis and diabetes mellitus share a bidirectional relationship. Resistin is an adipocytokine shown to be associated with type 2 diabetes mellitus. Hence, the present study aims to estimate the effect of non-surgical periodontal therapy (NSPT) on GCF resistin levels in healthy individuals with gingivitis and well controlled diabetics with periodontitis, and correlate the same with HbA1c levels of the diabetic subjects. Materials and Methods: The present study was a comparative interventional trial set in Department of Periodontics, the Oxford Dental College, Bangalore. Forty subjects participated in the study and were divided into two groups; group I (healthy individuals with gingivitis) and group II (diabetic individuals with mild to moderate periodontitis). Periodontal parameters were assessed and GCF was collected and analysed for resistin before and 3 months after NSPT. Statistical Analysis: All the analysis was done using SPSS version 18. A P value of < 0.05 was considered statistically significant. Results: A significant difference was observed in GCF resistin concentrations between the two groups at baseline, wherein group II had significantly higher values. Following NSPT, there was a significant reduction in GCF resistin concentrations in both the groups, however intergroup comparison showed no difference in the amount of reduction. When all samples were analysed together, no significant correlation could be found between resistin and the parameters assessed. Conclusion: Resistin levels are increased in diabetes related periodontitis. However, post treatment a similar response can be seen between healthy and well controlled diabetics. Hence, resistin can be used as an inflammatory biomarker for diabetes related periodontal disease.

A comparative study between dexmedetomidine and propofol for maintaining depth of anesthesia in elective craniotomy: a prospective randomized double blind study.

Background: The objective of present study was to assess the efficacy of dexmedetomidine over propofol in maintaining depth of anesthesia in patients undergoing elective craniotomy. Methods: Ninety patients of American Society of Anaesthesiologists (ASA) physical status 1 or 2, of either sex, with Glasgow Coma Score (GCS) 14 or 15, scheduled for elective craniotomy, were allocated in two groups, Group D and Group P. Each group consisted of 45 patients. Anesthesia was induced with propofol and maintained with nitrous oxide in oxygen, atracurium and intermittent fentanyl. Patients in Group D received continuous infusion of dexmedetomidine 0.4 μg/kg/hour which was started after induction and stopped after closure of dura in and patients in Group P received continuous infusion of propofol 100 μg/kg/min in same manner. Heart Rate (HR), mean arterial pressure (MAP), and bispectral index (BIS) were recorded and compared at specific time points which are known to have hemodynamic alterations throughout the intraoperative period. Results: Dexmedetomidine was comparable and even better (after intubation p 0.02, head pin fixation p 0.00, opening of dura p <0.00) than propofol in maintaining depth of anesthesia. It also attenuated HR and MAP at intubation, head pin fixation, skin incision, making of burr hole, opening of dura and at extubation (p 0.00). But Ramsay sedation score of patients after extubation in both groups did not differ significantly (p 0.36). No patient had recall. Conclusions: Dexmedetomidine is comparable with propofol in maintaining depth of anesthesia during elective craniotomy. It can be used as a sole anesthetic agent during craniotomy.

Hemothorax--a rare presentation of congenital strangulated diaphragmatic hernia.

We report the case of a 7 years old previously asymptomatic child who initially presented with respiratory distress because of massive left-sided hemothorax but was subsequently diagnosed to be having strangulated small intestine through a diaphragmatic rent on laparotomy. The case is being discussed in detail and the possible causes of hemothorax in such a scenario discussed.