[Influence of primary and secondary closure of surgical wound after impacted mandibular third molar removal on postoperative pain and swelling]

The purpose of the present study was to compare the influence of primary and secondary closure of the surgical wound on postoperative pain and swelling after removal of impacted mandibular third molars. This is randomized clinical trial study 10 patients with bilaterally impacted mandibular third molars were included in the present study. All the patients underwent surgical removal of the bilaterally impacted teeth at the same appointment. Primary closure [group I] was performed on one side and secondary closure [group II] was performed on the other side. All the patients were assessed for pain, trismus and swelling using the visual analog scale, and the data were collected and analyzed with the paired t test after 2 and 7 days. The swelling and pain in group I was greater than that in group II, with a statistically significant difference [P<0.005]. The trismus in group I was greater than that in group II, with a statistically significant difference after 7 days [P=0.03]. Our results have shown that the patients in the secondary closure group experienced a significantly lesser amount of pain, trismus and swelling postoperatively compared the primary closure group

[ effect of Aspirin on bleeding on probing in patients with gingivitis]

Statement of Problems: Bleeding on probing is widely used for diagnosis and screening of periodontal diseases, evaluation of treatment outcome, and determination of the development of the disease. The presence of bleeding on probing [BOP] is considered as the sign of gingival inflammation, and lack of bleeding is the sign of the gingival health. Aspirin has been suggested as an effective factor on increasing the amount of BOP that may result in inappropriate clinical diagnosis

Purpose: The aim of this study was to evaluate the effect of aspirin on BOP in patients with gingivitis

Materials and Method: An experimental, double blind cross-over clinical trial was performed on 50 patients. The patients were divided into case and control groups. The amount of BOP was recorded on the first day in both groups. Coded capsules containing aspirin [100mg] or placebo were randomly given to the patients to be used one per day for one week. A wash out period of 7 days was allocated between the use of aspirin and placebo. The amount of BOP was recorded at the end of days 7 and 14 in each group

Results: The amount of BOP in the case and control groups at the base line was 49% +/- 17 and 47% +/- 15, [ p =0.3] and on the 7th day, it was 49% +/- 18 and 50% +/- 21[ p =0.7], respectively. On the 14th day the BOP in the case and control groups showed to be 46 +/- 19 and 49 +/- 17 [ p = 0.9 ] receptively. No statistically difference was found to be in different periods of the study

Conclusion: Intake of low dose aspirin [100mg] for 7 days in individuals with gingivitis does not increase the amount of BOP as compared with placebo

[Evaluation of correlation between severity of dry eye syndrome and retinopathy in patients with diabetes mellitus]

Diabetes is one of the most common systemic diseases. Dry eye syndrome is one of the eye involvements in diabetic patient. Evaluation of correlation between dry eye syndrome and diabetic retinopathy in patients with insipidus diabetes was the aim of this study. In this study two hundred eyes from 100 diabetic patients [non-insulin dependent] were selected and evaluated for dry eye syndrome. The patients then were divided into four groups: group 1: patients without diabetic retinopathy group 2: patients with non-proliferative diabetic retinopathy; group 3: patients with proliferative diabetic retinopathy; group 4: patients with proliferative diabetic retinopathy undergone PRPAll. The patients were examined for Schirmer test, BUT, painting cornea with flourecein and then allocated in different group based on the severity of dry eye. Collected data were analyzed by X2 and Kendle-taue tests using SPSS software. Prevalence of dry eye syndrome in patients in group 1 was 48% and in patients in group 2, 3 and 4 was 52%, 60% and 80% respectively. Dry eye syndrome is a complication of diabetes mellitus and its severity correlates with severity of diabetic retinopathy

[Candida interface keratitis after deep anterior lamellar keratoplasty: clinical, microbiologic, histopathologic and confocal microscopic reports]

To report the clinical, histopathologic, microbiologic and confocal microscopic features of Candida keratitis after deep anterior lamellar keratoplasty [DALK]. The first patient presented with asymptomatic white to cream-colored interface deposits two months after DALK. Confocal scan disclosed clusters of hyper-reflective fine granular deposits in the interface with no evidence of inflammation or hypha-like structures. With a presumptive clinical diagnosis of progressive epithelial down-growth, irrigation of the interface was performed. Finally, penetrating keratoplasty was performed due to rupture in the Descemet's membrane. Histopathologic examination of the cornea disclosed yeast-like structures at the interface area. Microbiologic results of the irrigation fluid demonstrated Candida glabrata. The second patient presented with symptomatic infiltration of the inferior interface close to the suture site 2.5 months after DALK. Confocal scan disclosed foci of inflammation with clusters of hyper-reflective roundshaped structures that resembled epithelial cells. With a clinical diagnosis of epithelial down growth and progression of the lesion, penetrating keratoplasty was performed. Histopathologic examination of the cornea revealed acute and chronic granulomatous keratitis due to yeast-like structures. The microbiologic results demonstrated infection with Candida albicans. Clinical and confocal features of interface Candida keratitis may resemble those of epithelial down-growth, which may postpone correct diagnosis and treatment. Candida keratitis should be considered in cases of interface deposits after any form of lamellar keratoplasty

Accuracy of ultrasound in detection of gross prenatal central nervous system anomalies after the eighteenth week of gestation

Ultrasound [US] detection of prenatal central nervous system [CNS] anatomic anomalies is very important in making decision about therapeutic termination. In the present study, the accuracy of US in detection of gross prenatal CNS anatomic anomalies has been investigated. 3012 pregnant women were scanned after 18 weeks of gestation by an expert operator in a referring center. All delivered fetuses were followed after birth through clinical examination and sonography. In this study, the accuracy of US in detection of gross CNS anatomic anomalies of fetuses after 18 weeks gestation was found to be 100%. The sensitivity, specificity, positive and negative predictive values of US were 100%. In sonographic examination of these 3012 pregnant women, 36 fetuses were detected with CNS anomalies, some of whom had more than one anomaly. Gross CNS anomalies observed included microcephaly, hydrocephaly, anencephaly, holoprosencephaly, ventriculomegaly, meningocele, encephalocele, lissencephaly, agenesis of corpus callosum, bilateral choroid plexus cysts and hypoplastic cerebellum. US is highly operator dependent and operator experience may be the most determinant affecting the results. Sonographic scanning after 18 weeks of gestation is associated with the best results