Osteotomy in lateral sinus augmentation: A comparative study of rotary technique and Lateral Approach Sinus Kit®.

Background: Various sinus lift techniques have been tried to minimize the rate of perforations, especially in Type I and Type II sinus membrane thickness. Aims and Objectives: The aim and objectives of this study was to present our own experience compare and the efficacy of conventional direct sinus lift technique and direct sinus lift using LAS Kit. Material and Methods: Our study included 14 patients in which seven patients in conventional technique and seven patients in Lateral Approach Sinus (LAS) Kit®. Result: The results showed that the sinus membrane perforation rate, using LAS Kit® with specially designed drills, is less than that of the conventional technique, especially in Type I and II sinus membrane with the added benefit of reduced operative time. The mean operative time in conventional technique was 28.29 ± 2.21min and in LAS Kit®, it was 19.43 ± 2.88min which was statistically significantly less than the conventional technique group (P < 0.001). In both the groups, 100% implant integrity was achieved (measured using reverse torque technique) after 6 months of follow-up. It was observed that there was no statistically significant difference between the groups in pain, swelling, flap dehiscence, and infection at different time intervals. Conclusion: We conclude that the use of LAS Kit® for sinus lift procedure in atrophied maxilla with Type I and II sinus membrane is a much safer approach over the conventional technique. Further, the results obtained also showed that blood coagulum gave better gain in bone height over a period of 6 months.

Ameloblastic carcinoma of maxilla.

Ameloblastic carcinoma (AC) is a rare malignant lesion with characteristic histologic features and clinical behavior that dictates a more aggressive surgical approach than that of a simple ameloblastoma. The tumor cells resemble the cells seen in ameloblastoma, but they show cytologic atypia. Direct extension of the tumor, lymph node involvement, and metastasis to various sites (frequently the lung) have been reported. Wide local excision is the treatment of choice. Regional lymph node dissection should be considered and performed selectively. Literature shows that radiotherapy and chemotherapy is of limited value for the treatment of AC. A case of AC of maxillary region is presented here. Clinical/histological characteristics of this tumor and current knowledge on the classification of odontogenic malignancies are also discussed.

Osteopetrosis-A rare entity with osteomyelitis.

Osteopetrosis is a rare genetic disorder that causes generalized sclerosis of the bone due to defect in bone resorption and remodeling. Albergs-Schonberg disease or autosomal dominant osteopetrosis type II is a rare form of osteopetrosis. Osteomyelitis is a well-documented complication of osteopetrosis. Any associated dental abnormality may be attributed to the pathological changes in bone remodeling. This case report discusses a case of osteopetrosis with osteomyelitis as a complication in a 8-year-old boy.

Odontogenic myxoma of the mandible: a case report.

A case of myxoma of mandible in a 23 years old female patient is described. The case was treated with enbloc resection and bone graft from iliac crest. No recurrence is reported after 4 years follow up.

A clinico-radiological review of 62 cases of tropical eosinophilia in Punjab.

A clinico-radiological account of 62 cases of tropical pulmonary eosinophilia (TPE) seen during past seven years among permanent residents of Punjab, a non-filarial endemic state, has been presented. In comparison to reports from filarial states, rhonchi (32.2%), systemic involvement (1.6%) and mottled radiological appearance (8%) was seen less commonly. Possible means of transmission have been discussed. This report should dispel the commonly held view that TPE is prevalent in filarial endemic regions only.

Unilateral hypertransradiancy in a child with recurrent chest infections.

A 3-year-old female child was treated for six recurrent episodes of cough, high grade fever and breathlessness during past one year. Every time total leucocyte counts used to range between 17,000 - 25,000 per mm3 with neutrophils over 80%. Except for diminished breath sounds in left basal region, systemic and chest examinations were normal. Her chest roentgenogram is shown in figure 1. A good quality chest roentgenogram could not be done because of persistent movements of the child.

Allergic bronchopulmonary aspergillosis: review of 20 cases.

An account of clinical, radiological and laboratory findings in 20 cases of allergic bronchopulmonary aspergillosis, seen over a period of 6 years is presented. All patients showed blood eosinophilia (with 30% having an absolute eosinophil count (AEC) of over 2000 mm3) and a positive immediate skin reaction. However, dual skin reaction with Aspergillus fumigatus antigen was observed in 7 (35%) cases. Serum precipitins against A. fumigatus antigen was detected in all cases while culture of sputum yielded A. fumigatus in 15 (75%) cases. Areas of consolidations of various sizes, shapes and number (80%) and irregular infiltrations (60%), either shifting in nature (85%) or recurrent at same site (35%), were the main radiological findings.

Asthma management by private general practitioners of Punjab.

Analysis of information about asthma management, gathered from 106 private general practitioners of Punjab shows a lack of awareness among doctors about recent advances in the treatment of asthma. Improper use of oral steroids, overuse of ephedrine preparations and supportive measures and underuse of inhalers, oxygen therapy, peak flow meter as well as inadequate attention to patient education support this observation. This study highlights the need for continuing education for updating the knowledge of doctors.

Aetiological diagnosis in permanent residents of Punjab presenting with chest complaints and high peripheral blood eosinophilia.

Sixty-six permanent residents of Punjab, presenting with chest complaints and absolute eosinophil counts (AEC) over 2000 per cumm were investigated to find out the cause of high eosinophilia. Tropical pulmonary eosinophilia (TE) was responsible for high eosinophilia in 27 cases (40.9%), even in this region where filariasis is not endemic. Severe asthma (23 cases), allergic bronchopulmonary aspergillosis (ABPA-5 cases), drug reaction (2 cases) and chronic eosinophilic pneumonia (2 cases) in adults and ascariasis (6 cases) in children were other main causes of high eosinophilia. It is emphasized that all cases with high blood eosinophilia should not be labelled as cases of TE simply on the basis of AEC over 2000 per cumm. This is all the more important for non-filarial regions. Only a systematically conducted work up can clinch the correct diagnosis in such cases.

Metronidazole-induced asthma.

A case of metronidazole-induced asthma is being described. To the best of my knowledge, bronchospasm due to this drug has not been reported in medical literature so far.