Comparative Evaluation of Clinical Efficacy of Diode LASER and Cryosurgery for Gingival Pigmentation: A Split-Mouth Randomized Clinical Study

ABSTRACT Objective: To compare and evaluate the clinical efficacy of diode laser and cryosurgery for treating melanin pigmentation of gingiva. Material and Methods: A total of twenty-five subjects with physiological gingival pigmentation on the facial aspect of both maxillary and mandibular anterior arches (50 sites), both male and female, with an average age ranging from 18-35 years, participated in the study. The sites were randomly divided into Group I: depigmentation by Laser and Group II: depigmentation by Cryosurgery. The following parameters were assessed for the evaluation of treatment results: Melanin Oral Pigmentation Index (PI), Visual Analogue Scale (VAS) for pain evaluation and Healing index (HI). The data collected was statistically evaluated. Results: On intergroup comparison, there was no statistical difference in the score from baseline (p>0.05); however, a statistically significant difference was seen at the end of 1 year (p<0.05). Moreover, 57-60% of arches showed recurrence of pigmentation in the laser group whereas; only 12.7-17% recurrence was seen in the cryosurgery group at the end of the first year. Conclusion: Treatment of gingival hyperpigmentation with laser and cryosurgery shows a marked improvement of gingival pigmentation in both groups, but the cryosurgery depigmentation sites showed more sustainability.

Antibacterial efficacy of manuka honey, ocimum sanctum, curcuma longa and 0.2% chlorhexidine mouthwash on the level of streptococcus mutans and lactobacillus acidophilus - A randomized controlled trial

Objective: To assess the effects of Manuka honey, Ocimum sanctum, Curcuma longa, and 0.2% chlorhexidine mouthwash on Streptococcus mutans and Lactobacillus acidophilus levels. Material and Methods: A randomized controlled trial will be conducted on dental students of Teerthanker Mahaveer Dental College and Research Centre, Moradabad. The study participants will be divided into four groups. Each group will have a total of 20 individuals. By using a lottery system, Group A (Manuka honey mouthrinse), Group B (Ocimum sanctum mouthrinse), Group C (Curcuma longa mouthrinse), and Group D (0.2% chlorhexidine mouthrinse) will be chosen. To match the circadian cycle, saliva will be collected at baseline and again after 2 weeks between 10 and 10.30 a.m. The sterile container will subsequently be delivered to the microbiological laboratory and processed as soon as possible to measure Streptococcus mutans and Lactobacillus acidophilus count. For 2 weeks, participants were told to use 10 mL of mouthrinse twice daily. Results: The mean oral hygiene index?simplified (OHI?S) score of all the four groups showed reduction in their scores from baseline to after the study period. For both S. mutans and L. acidophilus, there was a substantial Percentage Reduction (PR) between the prerinse and postrinse samples in all four groups. Discussion: Because quantitative actions play a crucial part in the caries disease process, the changes in microbial activity before and after administration of experimental mouthwashes were examined. Conclusion: Essential oil aqueous extracts were as efficient antibacterial mouthwashes as chlorhexidine and iodine mouthwashes

Evaluation of POSSUM Score for Outcome Prediction in Patients Undergoing Emergency Laparotomy

Background: Emergency Laparotomy is one of the most common surgical procedures performed in Surgical Emergencies, which leads to significant mortality and morbidity. The aim of this study was to evaluate the patients undergoing emergency midline laparotomy, utilizing POSSUM scoring system to help to predict morbidity and mortality in patients, and assuring improved management in present setup. Methods: Total 104 consecutive patients underwent emergency midline laparotomy over a period of two years were included in this prospective study. Surgical outcome was assessed and compared with POSSUM scoring system. The relevant data was recorded on predesigned proforma and analysed. Results: We studied 104 emergency midline laparotomy patients, which resulted in 15 deaths (14.4% Mortality rate). On applying POSSUM, we found that the expected number of deaths for our study group was 24 (O: E= 0.63), relationship was statistically significant. Observed morbidity was 61 (58.65%). On applying POSSUM we found that the expected number of morbidity for our study group was 65 (O: E= 0.93), relationship was statistically significant. Conclusion: The present study validates that the POSSUM is an accurate scoring system for predicting postoperativeadverse outcome among patients undergoing major general surgeries in present setup.

Evaluation of Role of Alvarado Score in Diagnosis of Acute Appendicitis: A Prospective Study.

Background: The aim and objectives of the study is to validate the role of Alvarado score in diagnosis of acute appendicitis. Methods: A total of 310 patients with clinical diagnosis of acute appendicitis were included in this study. Patients were examined thoroughly, investigated and managed accordingly. The relevant data collected and analysed. Results: Out of 310 patients, surgical procedures were performed in 22.90% of the patients. The overall negative appendicectomy rate was 9.86%, and the percentage of Positive Predictive Value (PPV) for Alvarado score was 90.14%. Conclusion: Our study validates the Alvarado score as fast, simple and reliable diagnostic tool for acute appendicitis.

A Comparative Study between Lichtenstein Hernioplasty and Rutkow-Robbins Method of Hernioplasty for Inguinal Hernia Repair.

Background: To compare the effectiveness of the two different methods of inguinal hernia repairs viz. The Lichtenstein hernioplasty and Rutkow-Robbins method of hernioplasty. To compare the results of these two techniques and complications if any, and to arrive at a conclusion as to the better modality of treatment in the present setup. Methods: Total 50 patients of uncomplicated direct and indirect inguinal hernia were included in the study, they were randomly chosen for two different surgeries–The Lichtenstein hernioplasty and Rutkow-Robbins method of hernioplasty, 25 cases each. The relevant data regarding age/sex incidence, mode of presentation, surgical treatment and postoperative complications were recorded on predesigned proforma and analysed. The patients were followed up after 7 days, 15 days, 1 month, 3 months and 6 months thereafter. Results: The mean operative time for Lichtenstein hernioplasty group was 57 minutes, and 47 minutes for the Rutkow-Robbins hernioplasty group. Rest of the observational findings were comparable without any significant difference. Conclusion: The Rutkow-Robbins method of hernioplasty can be completed easily and more quickly with significant reduction in the operative time than Lichtenstein hernioplasty. Incidences of Intra operative and post operative complications as well as overall results of procedures were all comparable without any significant difference.

Evaluation of 100% rapid rescreening of cervical smears.

Advantage of rapid rescreening (RR) over conventional 10% random rescreening of all negative smears has been the topic of debate. RR of negative smears by cytopathologists/cytotechnologists have yielded good results. We undertook the rapid review of all the reported cervical smears to study its results as a means of strict quality control exercise on 2,500 smears.