Acute Physiology and Chronic Health Evaluation Apache II - An ICU Scoring Tool to Assess Critically Ill.

The Acute Physiology and Chronic Health Evaluation (APACHE II) is the severity score and mortality estimation tool developed for use in ICU’s around the world. It is calculated during the first twenty four hours of admission of the patient to an ICU. An integer score ranges from values 0 to 71. During the stay, the score is not recalculated; and by definition, is an admission score.METHODSThis is a cross sectional study done on 100 patients admitted in the medical ICU in Sri Ramachandra Institute of Higher Education and Research.RESULTSOur results showed an APACHE II score of 16.5 which was significant and values equal to and higher than that correlated with the severity of illness.CONCLUSIONSAPACHE II score is a good predictor of mortality in acute respiratory failure patients. It is a useful audit tool which helps the healthcare professionals to interpret and compare their care performance over time.

A cross sectional study on alcoholism and its comorbidity patterns among urban adult population in Salem Tamil Nadu

Background: Alcohol use is associated with serious public health problems thereby raising the global morbidity and mortality. The main aim of this study is to estimate the prevalence of alcoholism and its co morbidity pattern among urban adult population in Salem district, Tamil Nadu.Methods: A community based cross-sectional study was carried out among urban adult population in Salem district involving 493 participants. Convenient sampling method was used. Informed consent was obtained from each participant and information was collected by using a predesigned structured questionnaire. Microsoft Excel 2007 was used for data entry and SPSS version 24 was used for data analysis.Results: It was found from the study that the prevalence of alcoholism was high. Alcohol use in any form was found in 38% of the study participants. 8% of the participants confessed that alcohol is an eye opener to them. 6% of the participants lost their job and 15% of the participants were hospitalised due to alcohol.Conclusions: The study showed higher prevalence of alcohol use among urban adult population in Salem district. Awareness about the ill effects of alcoholism among the population and necessary rehabilitation will help to reduce alcoholism consumption and its related disorders.

Comparative prospective randomized open label trial of synbiotic (bifilac) as an add on therapy with standard treatment in patients with aphthous ulcer

Background: To trial the safety, efficacy and rapidity of response to a lozenges containing synbiotic in patients with minor aphthous ulcer.Methods: A total of 60 patients were enrolled for the trial after obtaining IEC approval and randomly allocated into two groups. Control “Group A” was administered with conventional treatment i.e., zytee and B complex for 2 weeks and trial “Group B” was administered with Bifilac along with conventional treatment for 2 weeks. The results of this trial were analyzed both subjectively and objectively.Results: Comparing with control group, where standard treatment was used with analgesics and B-complex, the trial group showed a quick relief of pain and helped in reducing mean size of ulcer.Conclusions: This trial was done with synbiotic lozenges in minor aphthous ulcers and it proved to be better alternative for them. Moreover, synbiotics have no adverse effects.

Effect of conventional and microwave glazing on surface roughness of metal ceramics: An atomic force microscopy analysis

This study investigated and compared the surface roughness achieved by glazing porcelain samples in a conventional and a microwave oven. Materials and Methods: Two commercial brands of metal ceramics were used, VITA VMK MASTER and IPS CLASSIC. Sixty samples were fabricated, 30 for each type of ceramic. The samples were sintered in the conventional oven and hand-polished to remove any irregularities. Samples (n = 10) from each type of ceramic were further divided into three groups as follows: hand-polished (Group A), conventional oven glazed (Group B), and microwave glazed (Group C). Each specimen was evaluated for surface roughness by atomic force microscope. Data were statistically analyzed using two-way analysis of variance (ANOVA) and Tukey's post hoc test (a = 0.05). Results: Two-way ANOVA indicated a highly significant difference in surface roughness based on the type of glazing (P < 0.001), there was a significant difference based on the metal ceramics (P = 0.002). There was also a significant interaction between the type of glazing and metal ceramics (P = 0.009). The images obtained from the atomic force microscope corroborated the measured values. Conclusions: All the results indicate that microwave glazing can be a feasible option for glazing porcelain specimens. It was concluded that surface topography is influenced by surface treatment and microwave glazed ceramic is superior to conventional oven glazed ceramic and hand-polishing showed greater surface roughness when compared to glazing. IPS CLASSIC ceramic showed relatively smooth surface when compared to VITA VMK MASTER irrespective of the surface treatment.

Prosthetic rehabilitation of a patient with near total maxillectomy using a hollow bulb obturator: a case report

Aim: To prosthetically rehabilitate maxillary defect in a patient with near total maxillectomy using hollow bulb obturator. Case description: Authors report a case of 64-year-old male patient with near total maxillectomy with respect to the left side who was referred for the prosthetic rehabilitation. Conclusions: The hollow bulb definitive obturator prosthesis rehabilitated the patient in terms of masticatory function, phonetics and esthetics. The hollow bulb design ensured patient comfort due to its decreased weight.

Emerging technology and techniques.

A technique of fabricating feldspathic porcelain pressable ingots was proposed. A 5 ml disposable syringe was used to condense the powder slurry. The condensed porcelain was sintered at 900°C to produce porcelain ingots. The fabricated porcelain ingots were used in pressable ceramic machines. The technological advantages of pressable system improve the properties, and the fabricated ingot enhances the application of feldspathic porcelain.

A comparative evaluation of linear dimensional accuracy of the dies obtained using three conceptually different die systems in the fabrication of implant prosthesis: An in vitro study.

Statement of Problem: Given that meticulous implant prosthodontic procedures are recommended to obtain the best possible intraoral fit, the die systems used for multi implant casts warrant further investigation. Die stone expansion and errors introduced by removable die casts may exceed the accuracy required for the passive fit of implant prosthesis. Purpose: The purpose of the study was to evaluate the linear dimensional accuracy between the implant master die and three conceptually different die systems such as Pindex system, Accu-trac precision die system, and Conventional brass dowel pin system. Materials and Methods: Thirty impressions of implant master die were made with polyether impression material. Ten experimental implant casts were fabricated for each of the three different die systems tested: Accu-trac precision die tray system, Pindex system, and conventional brass dowel pin system. The solid experimental casts were sectioned and then removed from the die system 30 times. Linear distances between all six possible distances were measured from one centre of the transfer coping to the other, using a co-ordinate measuring machine in millimeters up to accuracy of 0.5 microns. Data were tabulated and statistically analyzed by Binomial non parametric test using SPSS version 15. Results: Significant differences were found for distance A-B (P = 0.002), A-C ( P = 0.002), A-D (P value = 0.002), and B-D ( P = 0.021) in Conventional Dowel pin system however for Accu-trac precision die tray system, it was significant only for distance A-D (P = 0.002) but for Pindex system it was non-significant for all the distances measured. Conclusion: Within the limitations of this study, use of Pindex system is recommended when sectioned dies are needed for a multi implant retained prosthesis.

Modern trends in modeling of extra-oral defects.

Maxillofacial prostheses are usually fabricated on the basis of conventional impressions and techniques. The extent to which the prosthesis reproduces normal facial morphology depends on the clinical judgment and skill of the individual fabricating the prosthesis. Recently, as a result of advances in technology, various computer-aided design and manufacturing techniques have been successfully introduced for the automated fabrication of maxillofacial prostheses. These systems are able to provide more consistently accurate reproduction of facial morphology.

Implant crest module: A review of biomechanical considerations.

The success of dental implants has long been established through various studies with a particular emphasis laid on an implant design. Crest module is that portion of a two-piece metal dental implant, designed to hold the prosthetic components in place and to create a transition zone to the load bearing implant body. Its design, position in relation to the alveolar crest, and an abutment implant interface makes us believe that, it has a major role in integration to both hard and soft tissues. Unfortunately, in most clinical conditions, early tissue breakdown leading to soft tissue and hard tissue loss begins at this region. Early crestal bone loss is usually highest during the first year after placement ranging from 0.9 to 1.6mm and averaged 0.05-0.13mm in the subsequent years . Various hypotheses have been stated to reason it however, none has been proved convincingly. In light of this, various attempts have been made to overcome this undesirable bone loss, by varying an implant design, the position, surgical protocol, and the prosthetic options. Irrespective of an implant system and designs that are used, crestal bone loss of up to the first thread is often observed. The purpose of this review is to look into the various designs and treatment modalities, which have been introduced into the crest module of an implant body to achieve the best biomechanical and esthetic result.

Lingual Tuberculosis.

Summary: Oral tuberculosis is very rare and when present they are usually secondary to pulmonary tuberculosis. Tuberculous lesions of the tongue have become so infrequent that they are virtually a forgotten disease entity and may pose a diagnostic problem. The case reported in this paper emphasizes the importance of including tuberculosis in the differential diagnosis of any chronic oral ulcer. The low number of oral infections by M. tuberculosis could be due to underreporting.

Validation of implant stability: A measure of implant permanence.

Implant stability is a requisite characteristic of osseointegration. Without it, long-term success cannot be achieved. Continuous monitoring in a quantitative and objective manner is important to determine the status of implant stability. Measurement of implant stability is a valuable tool for making decisions pertaining to treatment protocol and also improves dentist-patient communication. Owing to the invasive nature of histological analysis, various others methods have been proposed like radiographs, cutting torque resistance, reverse torque, modal analysis, resonance frequency analysis and Implatest® . This review focuses on objectives and various methods to evaluate implant stability.

Overdenture with accesspost system: A clinical report.

A patient presented with an unfavorable distribution of teeth in the arch which precluded treatment with a removable partial denture. The unique pattern of partial edentulism was treated with an overdenture restoration using accesspost system. The final restoration was stable, well retained and esthetic, serving as a conservative approach to root preservation.

Conventional and advanced techniques in prosthodontic preservation and surgical management of residual alveolar ridge - a review

Prevention of alveolar bone loss and maintenance of alveolar bone structure are mandatory for long-term stability of conventional or implant-supported complete dentures. Extraction of teeth may result in 40% to 60% alveolar bone loss in a period of two to three years. Several conditions, including aging, facial lines, unaesthetic dental restorations and loss of vertical dimension, are often accelerated by premature loss of facial bone. Bone maintenance is the procedure of preserving bone after tooth loss. Every attempt should be made at the time of tooth loss to preserve the height and width of the jawbone. An unsatisfactory ridge morphology may result from periodontal disease, trauma or endodontic complications. Consideration must be given, during tooth extraction, to the final shape of the alveolar ridge and overlying soft tissue and to the optimal esthetic and functional result of the final tooth replacement. Soft and hard tissue complications can lead to unsatisfactory results for the patient, including unacceptable tooth morphology, poor phonetics and lack of confidence in denture stability. These problems may be prevented at the diagnosis and consultation stage. This review mainly includes various conventional and advanced prosthodontic and surgical techniques to enhance the residual alveolar ridge preservation