Specialty dentistry for the hemophiliac: is there a protocol in place?

Restorative dental care for the hemophiliac patient is of paramount importance for the fact that advanced dental conditions and subsequent treatments prove to be more complicated and risky. Quite often, dental health is neglected by hemophiliacs for fear of bleeding during procedures. Surprisingly, even dental specialists avoid these candidates and contribute to the conversion ofa simple dental patient to an oral surgical patient. The complexities involved in diagnosing a bleeding disorder and the rarity of a standardized protocol to handle such patients contribute to this problem. This article prescribes a simple protocol to diagnose bleeding disorders and a modified scheme for endodontic and periodontal therapy in a hemophiliac patient.

Interaction of potassium phosphonate fungicide in laterite soil.

Potassium phosphonate is a fungicide widely used to control Phytophthora fungi species in many crops all over the world. In this paper, an attempt has been made to study the interaction of potassium phosphonate with soil under varying pH and calcium level. Several reports available in literature indicate that the phosphonate in organic form adsorb strongly on almost all mineral surfaces and natural materials like soil and sediments. The present study conducted on laterite soil of Kerala using 2 mm sieved sample indicated that phosphonate obeys Freundlich adsorption isotherm. Though at lower concentrations, Langmuir model equally fits well, deviation was observed at higher concentrations. pH and calcium content of the soil had striking influence on the interaction of the chemical with the soil. The calcium source also appeared to influence the adsorption phenomenon. Since potassium phosphonate is extensively used to control Phytophthora fungi species in black pepper (Piper nigrum) plantations in India and liming is a standard practice followed as soil amendment in acid soils to increase the soil pH, this study may help to maintain good soil quality.

Tilt table testing in the diagnostic evaluation of presyncope and syncope: a case-series report.

Tilt table testing has long been used as a standard tool in the diagnostic evaluation of syncope. However, differences of opinion exist with regard to its utility in the evaluation of patients with only presyncopal attacks. We present the results of drug-free, 70-degree head-up tilt table tests (maximum duration of 45 minutes), conducted between May 2002 and May 2003 in the Department of Physiology at JIPMER. This series consisted of both male and female patients (age 6-79 yr) with presyncope (n = 43), unexplained syncope (n = 43) and asymptomatic healthy volunteers without a history of syncope (n = 14). 28 out of 43 patients with unexplained syncope had a history of recurrent syncope while the remaining 15 had only 1 episode. 2 out of 43 patients (4.6%) with a history of only presyncopal attacks had a positive test (induction of intense presyncope and/or syncope accompanied by hypotension and/or a relative bradycardia). 21 out of 43 patients (49%) with a history of syncope had a positive test. 7 had vasodepressor syncope due to hypotension, 6 had cardioinhibitory syncope characterized by asystole and 10 had a mixed form of the vasovagal syndrome characterized by hypotension as well as bradycardia. 18 out of 28 patients (64%) with recurrent unexplained syncope had a positive test. All fourteen healthy volunteers had a negative test. We conclude that tilt table testing is useful in the diagnostic evaluation of patients with unexplained syncope, especially those with recurrent syncope, but not in the evaluation of patients with presyncope alone.