A hospital-based observational study on clinical and radiographic findings in COVID-19 associated rhinomaxillary mucormycosis: revealing the pandora box

Mucormycosis is a rare, rapidly spreading, fulminant, opportunistic infection that is caused by a group of filamentous molds. During the second wave of COVID-19 India reported most of the cases of mucormycosis which is termed as COVID-19-associated mucormycosis (CAM). Aim: The purpose of this study is to describe and understand the clinical and radiographic findings related to COVID-19 associated rhinomaxillary mucormycosis. Methods: In this observational study 76 individuals with proven rhinomaxillary mucormycosis were included. The demographic profile, predisposing factors, anatomic structures involved, oral manifestations, radiographic findings management, and 90-day mortality were recorded and analyzed. Results: Among 76 individuals with COVID-19-associated rhinomaxillary mucormycosis diabetes mellitus was present in 93.42% of cases. Almost all patients received corticosteroids during COVID-19 treatment. The maxilla was most commonly involved in around 98.6% of cases. Interestingly 1 case involving the mandible was noted and the maxillary sinus was the most commonly involved. Mortality occurred in 1.31% (n=1) of cases. Conclusion: Diabetes was the most common predisposing factor. Administration of corticosteroids was evident. A considerable number of patients developed diabetes during the treatment of COVID-19. Early signs and oral manifestations of rhinomaxillary mucormycosis play a pivotal role in the early diagnosis and prompt treatment to reduce mortality and morbidity in COVID-19 associatedrhinomaxillary mucormycosis patients

COVID-19 associated rhinomaxillary mucormycosis: a case series and review of literature

During COVID-19 pandemic, fulminant deep fungal infection started emerging in India, known as Mucormycosis. This type of mucormycosis was termed as COVID-19 associated mucormycosis (CAM). These patients had previous history of COVID-19 infection. Such cases were mainly reported in immunocompromised patients such as patients with poorly controlled diabetes and chronic renal diseases etc. Rhinomaxillary mucormycosis is an aggressive, fulminant, fatal deep fungal infection of head and neck region. Early diagnosis and prompt treatment can reduce the mortality and morbidity associated with the disease; hence we present case series of rhinomaxillary mucormycosis to create awareness amongst dental surgeons

Superoxide dismutase, glutathione peroxidase, and catalase antioxidant enzymes in chronic tobacco smokers and chewers: A case–control study

Objective: Tobacco has a time dependent effect on the antioxidant system of the body. This study was designed to determine and compare alteration in levels of erythrocyte superoxide dismutase (SOD), glutathione peroxidase (GPx) and catalase (CAT) in blood subgroups of tobacco smokers and chewers with controls. Materials and Methods: Blood samples were collected from 30 tobacco smokers (> 20 cigarettes daily), 30 tobacco chewers (> 10 packets gutka daily) and 30 controls. These groups were further divided into three subgroups (n=10) based on duration of habit (<5 yrs, 5-10 yrs, >10 yrs). The level of erythrocyte SOD, GPx and CAT were measured using standard procedures. Results: The SOD and CAT levels were significantly decreased in all subgroups of smokers and chewers whereas GPx level was significantly increased. Positive correlation was observed between SOD, GPx and CAT levels with change in duration of habit in all subgroups. No significant difference observed in SOD and CAT activity between tobacco smokers and chewers. Conclusions: The findings suggested that antioxidative enzyme activities have significant correlation with change in the duration of tobacco use. Measurement of markers of free radical activity might be useful for estimating the level of oxidative stress caused by tobacco use.

Bilateral Fusion of Permanent Mandibular Incisors: A Rare Developmental Anomaly.

Fusion is a rare developmental anomaly. Th e prevalence ranges from 0.5% to 5% based on geographic, racial, or genetic factors, which occur as a result of physical force or pressure leading to prolonged contact of the adjacent tooth follicles thus resulting in the fusion of tooth buds. Bilateral fusion of teeth has been reported to be very rare as compared to unilateral fusion which is around 0.05%. Although asymptomatic, they can be a predisposing factor for caries and cause periodontal problems due to malalignment in the arch. Th e aim of this article is to present a rare case of bilateral fusion of mandibular anterior teeth and discuss the possible histogenetic mechanism and future treatment prospectives.

Epithelioid hemangioma (angiolymphoid hyperplasia with eosinophilia) in the oral mucosa.

Angiolymphoid hyperplasia with an eosinophilia (ALHE) is a rare benign entity whose etiology and pathogenesis is under debate. Clinically, it is characterised by cutaneous papules or nodules on the head and neck. Literature reveals very few cases of this entity in the oral mucosa. Here, we report a case of ALHE in a 25 year-old woman, who presented with a painless, 5mm x 5mm, sub mucosal erythematous nodule on left angle of mouth at lower lip. Histological examination of lip biopsy specimens revealed an increase in small vessels. The vascular walls consist of prominent endothelial cells with a histiocytoid appearance, which protruded into the lumen. Many eosinophils and lymphocytes were also seen around the vessels. The diagnosis of ALHE was made from the above findings.

Prevalence of oral mucosal lesions and variations in Indian public school children

Aim: To study the nature and distribution of oral mucosal lesions and variations in children.Methods: This investigation was a cross-sectional study. All the study subjects were taken fromgovernment primary school. Children were in the age group of 4-14years. The children whowere attending the Department of Pediatric Dentistry for dental check up were examined. Results:A total of 1,003 children were included in the present study,. The mucosal lesions were observedin 643 (64.11%) children, developmental variations of mucosa were evident in 220 (21.93%)children and normal mucosal variations were present in 391 (38.98%) children. The mostcommonly observed mucosal lesions were gingivitis, gingival abscess and traumatic ulcers. Themost frequent developmental mucosal variations were ankyloglossia and high frenal attachment.Normal mucosal variations noted were linea alba buccalis and fordyce’s spots. Distribution ofmucosal lesions/variations were same among both the gender except fordyce’s spots (p=0.018).Parotid papillae and pigmented spots had positive relation with age. Conclusions: Mucosallesions/variations were present in more than half of the children in this study. Only few oralmucosal lesions had gender differences and vary with age.