A Clinicoepidemiological Study of Pemphigus in India.

Introduction: Pemphigus is a group of autoimmune bullous disorder affecting skin and mucosa. There are reports of some factors that can provoke the disease in genetically predisposed individuals and some have a protective effect. Aims and Objectives: To study the clinical features of pemphigus and possible epidemiological risk factors. Materials and Methods: Hundred cases with clinical diagnosis of pemphigus and equal number of controls were selected for the study. The clinical features of the disease and possible epidemiological risk factors were studied and compared with controls. Routine blood tests were also advised. Observations: There were 78 cases of pemphigus vulgaris (PV), 21 of foliaceous (PF) and 1 of erythematosus (PE). Ratio of male: female was 0.92:1. Mean age of cases was 40.905 ± 14.011 and of controls 42.64 ± 12.756. History of (h/o) exposure to pesticides in fields, intake of food containing garlic, number of pregnancies and use of cosmetics (Kajal) were significantly high in cases whereas smoking, tobacco chewing, herpes infection and mental stress were high in controls. Exposure to fertilizers, intake of alcohol and oral contraceptives were equal in both. Conclusion: Pemphigus had slight female preponderance in lower socioeconomic strata of rural areas. Exposure to pesticides, garlic intake, use of cosmetics and higher number of pregnancies may be predisposing where as smoking or tobacco chewing was not. Avoiding such risk factors may be helpful in prevention or fast recovery of pemphigus.

Oral Mucosal Amelanotic Melanoma: A Rare Case Report.

Oral cancer is a major global health problem. It is ranked as the third most common cancer in India. More than 95% of oral cavity carcinomas are of squamous cell type. Melanoma is a major health problem and originates from the malignant transformation of melanocytes. Primary mucosal melanomas of the head and neck occur less frequently than their cutaneous counterparts. Among those, oral mucosal melanoma is extremely infrequent with an incidence of 0.5% of oral neoplasms. Less than 2% of all melanomas lack pigmentation, in the oral mucosa, however, up to 75% of cases are amelanotic melanomas. Th ese are extremely rare variants and the most frequent sites in the oral cavity are the hard palate and the gingiva. Lesions that are suspected to be melanomas should be assessed both histologically and by immunohistochemistry, which are helpful in the diagnosis of amelanotic melanoma. Th ey have a poorer prognosis than the pigmented melanomas because of the delay in diagnosis and in the initiation of treatment. Th is presentation is a rare case report of oral mucosal amelanotic melanoma.

randomized clinical trial comparing the efficacy and safety of ramosetron versus ondansetron in patients undergoing abdominal surgery under general anesthesia

Post-operative nausea and vomiting is one of the most common and distressing complications after anesthesia and surgery. It may lead to serious post-operative complications. Ramosetron is a newer 5-HT3 receptor antagonist and has more potent and longer duration of antiemetic effects compared to first generation 5HT3 receptor antagonists. The purpose of this study was to compare the efficacy of Ramosetron for the prevention of post-operative nausea and vomiting with that of Ondansetron in patients undergoing abdominal surgeries under general anesthesia. In this randomized, double-blind study, 60 patients, 18-60 years of both genders falling under ASA I-II category scheduled for abdominal surgery were included. Group I received I.V ramosetron 0.3 mg while group II received I.V Ondansetron 4 mg at the time of extubation. The standard general anesthetic technique was used throughout. Postoperatively the incidences of nausea, vomiting, and safety assessments were performed at 1, 2, 6, and 24 h during the first 24 h after surgery. There were no differences between groups with respect to patient demographics. The percentage of patients who had complete response [no PONV, and no need for another rescue antiemetic] from 0 to 24 h after anesthesia was 56% with ramosetron and 33% with ondansetron. The corresponding rates at 1, 2, 6, and 24 h after anesthesia were 76% and 63%, 76% and 50%, 100 and 83%, 100 and 93%, respectively. Safety profiles of the two drugs were comparable, as no clinically serious adverse effects caused by study drugs were observed in either of the groups. Our study concludes that prophylactic therapy with ramosetron is highly efficacious than ondansetron in preventing PONV in patients undergoing abdominal surgery under general anesthesia

Treatment of severely mutilated incisors: a challenge to the pedodontist.

Dental caries is the single most common chronic childhood disease. In early childhood caries, there is early carious involvement and gross destruction of the maxillary anterior teeth. This leads to difficulty in speech, decreased masticatory efficiency, development of abnormal tongue habits and subsequent malocclusion and psychological problems if esthetics are compromised. The restoration of severely decayed primary incisors is often a difficult procedure that presents a special challenge to pediatric dentists. This case report documents the restoration of severely mutilated lateral incisors in a patient with early childhood caries.