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Aim: During the coronavirus disease, a palliative approach was recommended for the management of endodontic emergencies. This retrospective cohort study was conducted to investigate the effectiveness of dexamethasone or ibuprofen-acetaminophen combination for pain management in endodontic emergencies. Material(s) and Method(s): One hundred and eight records of patients who presented to the emergency department with dental pain were evaluated retrospectively. Since interventional procedures were not performed during the pandemic period, Specific analgesics/antibiotics for the management of pain were preferred. A follow-up protocol with a questionnaire was developed to observe the effectiveness of palliative treatment and make changes if necessary. All participants received a questionnaire to rate the pain levels 6, 12, 18, 24, 48, and 72 hours after taking the drug. All data were collected from the patient file and assessed. After inclusion and exclusion criteria, 32 patients were included (n = 19, ibuprofen + acetaminophen;n = 13, dexamethasone). Data were analyzed using the chi-square test (P = 0.05). Result(s): In both groups, a significant decrease in pain was experienced immediately after medication and at 6, 12, and 18 hours, with no significant difference (P >.05). However, dexamethasone (Group II) resulted in lower pain levels than ibuprofen\acetaminophen (Group I) at 24 and 48 hours (P <.05) Discussion: Both dexamethasone and ibuprofen-acetaminophen can be good palliative choices in endodontic emergencies in pandemic conditions. However, at 24 and 48 hours, dexamethasone resulted in lower pain levels.Copyright © 2022, Derman Medical Publishing. All rights reserved.
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Objetivo: O presente trabalho tem como objetivo relatar um caso de evolucao de sindrome mielodisplasica para leucemia mieloide aguda, diagnosticada atraves de biopsia de lesao intraoral de sarcoma mieloide. Material e Metodos: Trata-se de um estudo descritivo, retrospectivo, do tipo relato de caso. Os dados foram coletados atraves dos registros em prontuarios eletronico e fisico da instituicao. Resultados: O caso apresentado envolveu um paciente do sexo masculino, de 51 anos, melanoderma, matriculado na instituicao devido ao diagnostico de sindrome mielodisplasica, tratado com 19 ciclos de decitabina. Devido a um quadro de odontalgia e abscessos de repeticao o paciente foi encaminhado ao setor de Odontologia onde, durante o exame clinico, foi constatada presenca de lesao eritematosa, amolecida, friavel, de superficie lisa, base sessil, de aproximadamente 3 x 1cm na regiao distopalatina do dente 26. No exame radiografico, foi observada imagem radiopaca associada a raiz mesial do dente 26, com margens definidas. Foi realizada biopsia excisional da lesao em regiao de palato com carater de urgencia e as hipoteses diagnosticas iniciais foram de granuloma piogenico e cisto radicular. O laudo histopatologico foi compativel com quadro de sarcoma mieloide comprometendo mucosa, com imuno-histoquimica positiva para CD34 e CD117 e negativa para CD163 e TdT. Diante do diagnostico previo de sindrome mielodisplasica, associado ao diagnostico de sarcoma mieloide oral, a equipe medica constatou a transformacao da doenca inicial em leucemia mieloide aguda. Foi definido novo protocolo terapeutico e realizado um ciclo de citorreducao com Citarabina (ara-C) subcutaneo e resgate com hidroxiureia + ara-c (HYDAC) + idarrubicina. Durante este ciclo, o paciente foi diagnosticado com Covid-19, evoluindo para obito, nao concluindo portanto, o protocolo terapeutico proposto. Discussao: O diagnostico de sarcoma mieloide oral permitiu que a equipe multiprofissional detectasse a transformacao da doenca primaria em leucemia mieloide aguda, resultando na reformulacao do tratamento e conduta do caso. O prognostico da leucemia mieloide aguda secundaria a sindrome mielodisplasica e pior quando comparado as primarias, bem como, apresenta baixas taxas de remissao apos quimioterapia intensiva e a sobrevida global mediana de 9-12 meses. O diagnostico dessas lesoes por parte do cirurgiao-dentista e considerado um desafio, visto que sao raras em cavidade oral e as apresentacoes clinicas costumam ser variadas e inespecificas. Conclusao: O presente relato de caso evidencia a importancia de uma avaliacao clinica minuciosa e do diagnostico preciso e completo de lesoes orais, que podem implicar diretamente na definicao da doenca de base, tratamento e prognostico do paciente. Alem disso, ratifica a importancia do cirurgiao-dentista na pratica clinica e na atuacao profissional de forma interdisciplinar e integrada com a equipe de saude. Copyright © 2022
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The plant Curcuma longa, a perennial herbaceous member of the Zingiberaceae (ginger family), produces turmeric. Protein, fat, minerals, carbs, and moisture are all included in turmeric. Curcumin (diferuloylmethane), a phenolic diketone that makes up 34 percent of curcumin and is made up of curcumin I, curcumin II, and curcumin III, is what gives turmeric its characteristic yellow colour. Curcumin have versatile pharmacotherapeutic potential and their biological functions have been thoroughly investigated in recent years. As the main bioactive component, curcumin has numerous pharmacological properties including antioxidant, anti-inflammatory, anti-hypertensive, anti-diabetic, hepatoprotective, anti-rheumatoid arthritis and anti-cancer properties. In persons who are active, it improves recuperation and performance. It helps with viral infections and dental issues such as dental pain, gingivitis. Covid also benefits from curcumin. ar-turmerone also possesses antiinflammatory properties. Ar-turmerone is a potentially effective treatment for a number of neurologic conditions like schizophrenia. Multiple health advantages are provided by curcumin when mixed with boosting agents. Copyright © 2022, Global Research Online. All rights reserved.
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Introduction: The infection potential of Coronavirus Disease 2019 (COVID-19) is remarkable due to its airborne transmission through droplets and aerosols. Paediatric dental needs were severely compromised during the COVID-19 lockdown period. Aim: To assess parents' attitudes and concerns towards approaching paediatric dentists during the COVID-19 pandemic. Materials and Methods: This cross-sectional study was conducted in Department of Paediatric and Preventive Dentistry at Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India, from August 2021 to October 2021. The study included 200 parents to assess the attitudes and concerns towards approaching Paediatric dentists during the COVID-19 pandemic. A structured questionnaire was used through Google forms to collect from parents, information regarding precautions, mode of transmission of the virus and type of treatment option. The Chi-square test and Fischer-exact test were used to compare the parameters such as education and occupation with parents' attitude and knowledge. Results: Out of the 200 parents, 37 were males and 163 were females with mean age of the parents was 34.8 years. Out of total 200, 153 (76.5%) of the parents were worried to visit a paediatric dentist. Only 56 (28%) of the children suffered from toothache during the pandemic. About 28 (14%) of parents believed that the virus is transmitted through the air and 70% of the parents preferred teledentistry. A 152 (76%) of them were willing to pay extra costs and 123 (61.5%) of respondents expected to treat the emergency condition alone. A statistically significant difference was not observed between different occupation in the answers given about transmission paths of a virus (p-value=0.39), extra payment (p-value=0.77), and preference of approach (p-value=0.223). Conclusion: Majority parents were worried to visit a Paediatric dentist and preferred teledentistry. They were ready to pay extra costs for the sanitisation.
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Background: Mucormycosis is one such infection which has shown a sudden rise during the second wave in India. (Our present study has been designed to all the confirmed cases of rhino orbital mucormycosis. In our study we have included all the rhinorbital mucormycosis cases that have been confirmed by microscopy and or radiological evidence.Mucormycosis (also called zygomycosis) is a serious fungal infection caused by agroup of molds called mucoromycetes. Materials and Methods: All the patients that have directly attended the ophthalmology OPD. Chief complaint with duration (Look for redness, watering, discharge & pain in the eye, diplopia, eyelid/ periocular swelling) facial swelling, eyelid/perioculay facial discoloration, Worsening headache, sudden drooping of eyelid (or) restricted eye movements, sudden loss of vision, facial parasthesia / anaesthesia, nasal discharge (blakish/ bloody/foul smell nasal stuffiness, dental pain. Results: Out of all 60 cases, 79 there were 47 males and 13 females. In this study 48.33% cases belongs to age group of 50-60 years followed by 36.66% belongs to age group of 60-70 years. Among the 60 patients who presented to hospital within 1 week of onset of symptoms likee pain redness watering et 35 of them got good vision, whereas among the 15 members who presented beyond 2 weeks after the onset of their symptoms only 7 got good vision while 2 of them got poor vision below 6/60 indicating the importance of early diagnosis. 65% cases affected at right eye and 63.33% cases showing symotoms like Redness, treatment under goes with total Restriction 42 members and Painful oculr movement in 43.33% cases. Conclusion: The second wave of COVID-19 in India has led to more deaths than the first. In just a few weeks, the B.1.617.2 (Delta) variant became the dominant strain across India. It has since spread to about 40 nations, which include United Kingdom, Fiji and Singapore.18 the first case of Covid-19-related Mucormycosis has now been found in Chile. It is important to recognise at an early stage this infection, so as to potentially reduce soft and hard tissue necrosis and severe complications and alert colleagues of this mutilating and life threatening infection.
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Background and Aim: When COVID-19 pandemic broke out, there was a need to set up an urgent dental care (UDC) clinic where COVID-19 infected, suspected, exposed, or quarantined patients could be treated safely. The aim of this study is to report UDC clinic's triage and the patient-specific characteristics, reasons to seek for care and the given treatments from March to December 2020 at the UDC clinic in the Hospital District of Helsinki and Uusimaa (HUS), Finland. Methods: The triage and the treatment protocol were based on the existing scientific data. Questionnaire and assessment of the treatment needs were done by dental specialists as gatekeepers. Staff was educated to follow the treatment protocol, which aimed to avoid the transmission of SARS-CoV-2 while providing adequate treatment for the patients. Patient files were evaluated from HUS electronic data base. Modified Total Dental Index and the number of teeth were assessed from the panoramic tomography and used to determine the overall oral health of the patients. Results: There were 1114 consultations and 257 visits at the clinic. Most of the patients (63.2%) were generally healthy with a mean age of 35. The most common reason for seeking for care was toothache (78.6%). Respiratory symptoms were present in 63.4% and 6.8% of the patients had COVID-19 infection. The most frequent given treatment was tooth extraction (65.8%), mostly due to caries (66.5%). Periodontal problems were reason for 4.7% of the visits. Statistically significant differences between COVID-19 infected and other patients occurred in age (45 vs. 34 years-of-age, p = 0.009) and number of teeth (25 vs. 28, p = 0.031). No SARS-CoV-2 infection transmission chains were traced to the clinic. Conclusions: Triage worked well and patients were treated safely and effectively. Patient-specific characteristics revealed no new data on COVID-19 and visits were typical for UDC.
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Background Patients are hesitant to enter a dental hospital because of the significant danger of cross infection and illness transmission due to rapid spread of corona virus. Objective To assess knowledge regarding Covid-19, oral health practices and circumstances on dental treatment during a pandemic. Method Cross sectional study was conducted among patients visiting dental department of Dhulikhel hospital from September to October 2020. Questionnaires were interviewed following safety protocols regarding the pandemic and descriptive analysis was performed. Both verbal and written consent as well as ethical approval was taken before the study. Result A total 411 patients aged 14 to 75 years old from 14 different districts across Nepal participated in the study. All of the patient were free of Covid-19 symptoms and had strong knowledge and awareness about disease transmission. During the crisis 96% of the people maintain good oral hygiene while 25.8% acquire new dental problems where majority experienced oral discomfort and swelling, 93.2% of them did not attend a dental clinic or hospital in the interim owing to fear and inaccessibility. Majority of the participants were impressed by the safety precautions and preparations during treatment and 99.3% strongly suggest or pledge to visit dental department if necessary during the pandemic. Conclusion Dental patient visiting Dhulikhel hospital is highly aware of current health crisis, possible transmission and preventive measures. Proper safe hospital setup can encourage them to seek dental treatment during crisis. Dental pain and swelling in Endodontic department recorded most common dental emergency during this pandemic.
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Background:Mucormycosis has been increasingly described in patients with covid 19 2nd wave (delta variant) which is a highly contagious disease caused by SARS-COV-2 is the leading cause of global pandemic. AIM AND OBJECTIVES: To evaluate etiology, indications, management options and complications in patients managed with endoscopic and external maxillectomy after mucormycosis, to evaluate the incidence and distribution of cases who had extensive mucormycosis and to evaluate the outcome of the management options. Materials and Methods: This is a prospective study done in 30 cases at a tertiary care centre.All the patients were subjected to detailed history taking, clinical examination, endoscopic, radiological, pathological, microbiological investigations after taking informed consent. Patients with age group(30yrs -70yrs) who presented with ROM with extensive maxillary sinus involvement and destruction of different walls of the maxillary sinus were managed with different types of maxillectomies. Results: In this study, 30 cases of post covid rhinoorbital mucormycosis who presented to our hospital were studied, among male 24(80%) & females6 (20%).12 patients (40%) were in 5th to 6th decade and 9 patients (30%) in 4th to 5th decade.Main presenting features were unilateral cheek pain, cheek swelling, nasal obstruction, loosening of teeth, tooth ache, cheek numbness, headache, periorbital edema, visual disturbances being present in 95% of the patients.5% presented with epistaxis, ptosis, diplopia alone.90% patients were known case of diabetes milletus,10% are denovo diabetes.All the patients were subjected to routine blood investigations, microbiological, radiologicalinvestigations.(CT, MRI contrast- PNS, Orbit & Brain).Most commonly seen in males 80%. 1 patient had to undergo orbital exenteration,3 patients underwent palatal resection. Conclusion: Debridement of sinuses is necessary in all cases of mucormycosis so that the fungal reservoir could be removed and the antifungal therapy can reach the viable areas. Therefore the management of mucormycosis is individualised to each patient based on the extension of the disease and overall general conditon of the patient.
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Background: One of the largest outbreaks of rhinosinocerebral mucormycosis (RSCM) occurred in India close to the second wave of the SARS-CoV-2 infection. RSCM is a rare infection caused by several fungal species occurring in immunocompromised subjects. Mucor shows a high propensity to invade the central nervous system. There have been limited studies, mostly isolated case reports, on the neurological manifestations of RSCM. The outbreak of mucormycosis infection was thus the most opportune to study the neurological manifestations and cranial nerve involvement in mucormycosis in greater depths. Aim of the study: The purpose of the study was to investigate and review the involvement of cranial nerves in a series of cases of rhinosinocerebral mucormycosis associated with the novel coronavirus disease caused by SARS-CoV-2. Results: It was a retrospective cross-sectional study of seven patients who were undergoing treatment of RSCM with a recent history of coronavirus disease caused by SARS-CoV-2 infection within the last 3 months. Patients with cranial nerve involvement were identified by magnetic resonance imaging (MRI) at a single institution. Demographic details of the patients, clinical presentation, imaging, microbiological and pathological findings were recorded. All subjects had two or more cranial nerves affected by fungal infection. The most commonly involved cranial nerve was found to be the optic nerve followed by the trigeminal nerve and its branches. We document three cases with extensive involvement of the inferior alveolar branch of the mandibular division of the trigeminal nerve (V3), a previously unreported finding. In one case, in addition to the second and fifth cranial nerves, the third, fourth, sixth, seventh, eighth, and twelfth cranial nerves were involved without any sensory or motor long tract involvement, suggestive of Garcin syndrome secondary to intracranial abscesses and skull base osteomyelitis due to invasive fungal infection. This case is of rare occurrence in the literature, and our study provides one such example. Conclusion: Cranial nerve involvement in patients of mucormycosis tends to have a poor prognosis, both cosmetic and functional. Radical surgeries and aggressive medical management is needed in such cases to improve the outcome.