[Psychological assessment of patients with recurrent aphthous ulcers]

Recurrent aphthous stomatitis [RAS] is among the most common oral conditions and psychological disorders are among its predisposing factors. The purpose of this study was to determine the frequency and type of psychological disorders in patients with RAS. Seventy-five patients referred to Mashhad Dental School were enrolled in this cross-sectional study: 35 patients with RAS [15 males and 20 females] constituted the study group and 40 healthy patients [15 males and 25 females] comprised the control group. The SCL-90 questionnaire consisting of 90 multiple choice questions was completed by all subjects and a psychologist scored and analyzed the results in order to evaluate the psychological status of patients. The overall frequency of psychological disorders was 44%; this rate was 68.6% in the RAS patients and 22.5% in the control group [P<0.0001]. The frequency of anxiety disorder was 42.9% in RAS patients and 7.5% in the control group [P<0.0001]. The frequency of somatization disorder was 17.1% in RAS patients and 0% in the control group [P=0.008]. The frequency of depression was 28.6% in RAS patients and 15% in the control group [P=0.004]. All these differences were statistically significant. There was no statistically significant difference between the two groups in other psychological disorders. The results showed that psychological disorders were generally more frequent among RAS patients compared to the control group. The most common psychological disorder was anxiety disorder and the frequency of anxiety, depression and somatization was higher in RAS patients

Rhinocerebral mucormycosis in a diabetic patient with cranial nerve involvement

We report a case of 50- year-old diabetic edentulous woman [FBS=396mg/dl] with chief complain of left side facial pain treated by her physician with corticoid and antibiotic for 15 days without any improvement. With pain exacerbation and skin paresthesia she was referred to oral medicine department of Mashhad school of dentistry by a neurologist with diagnosis of dental infection. On examination, she had left side facial palsy, ptosis, and a mass which was anterior to her left ear. Left eye had loss of vision and was fixed. Due to involvement of II, III, IV, V, VI, VII cranial nerves, maxillary sinus, orbit and base of the skull we referred her to neurosurgery department with clinical diagnosis of mucormycosis. Left maxillectomy along with enucleation of left eye was carried out. Histopathology confirmed the diagnosis. Patient was put on amphotericin B under medical care in hospital. Follow up showed the patient is responding and in good health. Early diagnosis and prompt treatment can reduce the mortality and morbidity of this lethal fungal infection

[ evaluation on patterns and causes of referring patients to oral diseases and diagnosis department of Mashhad dental faculty from September to December 2000]

Background and aim: successful treatment and health could be achieved by on time referring and rapid and accurate diagnosis. It sound necessary to study the reasons underlying patients7 delay in their referral to specialists. Therefore, the aim of the present study was to determine the main reasons of patients' attendance, sources and causes of their referral to oral medical center of Mashhad Dental Faculty

Materials and Methods: all subjects referring to this center, from September to December 2000, were examined and questionnaires were filled out for them. Sampling method was consecutive using Poisson's method the study was of cross-sectional type that performed descriptively. The subjects included 1310, 501 [35.2%] males and 809 [61.8%] females with the mean age of 75.21+/-14.59 ranging from 1 to 78 year

Results: out of the total patients, only 76 [5.80%] of them had oral lesion or symptom complaint and other referred for dental problems. The most common chief complaints were ranked as: dental filling [14.4%], denture [21.7%], toothache [19.4%] and periodontal diseases [13.4%]. Patients with oral lesion or symptom were referred by dentists [73.3%], medical practitioners [11.53%], others [8.9%] and by themselves [8.9%]. Each patient was examined, [on] average, by 2.35+/-1.56 clinicians [ranging from 1 to 7 ones]. Mean period from the onset of oral-facial lesions as noticed by the patients, until they referred to clinic was 17.07+/-35.17 months [ranging from 1 day to 192 months]. The most prevalent causes for patients' referral to oral medical center consisted of: inflammatory hyperplasia [11.8%], jaw 9-sts [10.52%], lichen planus [9.2%], abcess [5.26%], recurrent aphthous stomatitis [5.26%] and pain [6.5796]

Conclusion: patients with oral lesions, for different reasons such as improper examinations by non-specialists, do not refer to oral medical center on time. Therefore, intercommunication between oral specialists and other practitioners and also the improvement of general health knowledge, should be considered as a priority in any health system