Evaluation of hearing impairment in leprosy patients taking multidrug therapy.

Present descriptive study was carried out for the assessment of hearing capability in leprosy patients. After getting approval from Institutional ethical committee, the present descriptive study was carried out on 60 subjects. All the patients were indoor-patients at the Leprosy Rehabilitation Center Maharogi Sewa Samiti Anandvan Warora, and were on multidrug therapy described by World Health Organization from an average period of 6 months. Study Group I consisted of 30 diagnosed Leprosy patients taking multidrug therapy from an average period of 6 months. Group II (Control group) consisted of 30 normal healthy individuals of same age. Patients suffering from acute or chronic ear discharge, Presence of wax in external auditory canal, diabetes mellitus, hypertension, impaired renal function and patients having history of trauma were excluded from the study. All the subjects underwent Pure tone audiometry, Tuning Fork test to check the level of hearing loss and type of hearing loss and detailed clinical examination for cranial nerve function was done in all the patients of study group and control group. Audiometry findings in study group patients showed that 23 patients (76.66%; 45 ears) of the leprosy patients had sensory neural hearing impairment and 7 patients (23.33%) showed normal hearing. Out of these affected patients, 10 patients (43.47%; 19 ears) had mild sensory neural hearing impairment, 10 patients (43.47%; 20 ears) had moderate sensory neural hearing impairment. 2 patients (8.69%; 04 ears) had moderate to severe hearing impairment, 1 patient (4.34%; 02 ears) showed severe sensory neural hearing impairment. In the absence of any local or systemic disease or drugs likely to have side effects on the cochleovestibular function, leprosy affects the cochleovestibular system, and effect on cochlear function is seen more often than effect on the vestibular system. Thus hearing loss which is seen in patients suffering from Hansen's disease is of cochlear origin.

Rugae patterns as an adjunct to sex differentiation in forensic identification.

It is widely acknowledged that in some forensic situations there are limitations to identification of the deceased by fingerprints, DNA and dental records. Palatal rugae pattern of an individual may be considered as a useful adjunct for sex determination for identification purposes. The aim of this study was to identify and compare the rugae pattern in Indian males and females, as an additional method of differentiating the sexes in various postmortem scenarios. Dental stone casts of 120 Indians: 60 males and 60 females were obtained. The method of identification of rugae patterns was that of Thomas and Kotze (1983) and Kapali et al (1997) which includes the number, length, shape and unification of rugae. Our study revealed no significant difference in the total number or various length measurements of rugae between the two sexes which conforms to previous results. However, in terms of the different types of rugae shape, the converging type of rugae were statistically greater in number in females whilst the circular type of rugae were statistically greater in number in males, which contrasts with earlier studies. The use of logistic regression analysis (LRA) enabled highly accurate sex prediction (>99%) when all the rugae shapes were analyzed. It may be concluded that rugae pattern through the use of LRA can be an additional method of differentiation between the Indian male and female and assist with the identification process in conjunction with other methods such as visual, fingerprints and dental characteristics in forensic sciences.

An evaluation of efficacy of ultrasonography in the diagnosis of head and neck swellings.

OBJECTIVE: The aim of this study was to evaluate the efficacy of ultrasonography in the diagnosis of swellings in the head and neck regions. METHODS: For this study, 70 cases with clinically obvious swellings in head and neck regions were selected randomly. The ultrasonographic features considered were shape, boundary, echo intensity, ultrasound architecture of lesion, posterior echoes and ultrasound characteristic of tissues. Intergroup comparisons were made between four different types of swellings: inflammatory; cystic; benign; and malignant. RESULTS: A comparison was made between benign and malignant neoplasms, and the criteria of boundary, echo intensity and ultrasound architecture of lesions are statistically significant as the P-value is <0.05. The comparison of inflammatory swellings and malignant neoplasms shows that criteria of boundary and ultrasound architecture of lesions are statistically significant. The comparison of cystic swellings and benign neoplasms concluded that only the criterion of ultrasound characteristics of tissues is statistically significant. The comparison of inflammatory swellings and benign neoplasms shows that the criteria of boundary and echo intensity are statistically significant. The comparison of inflammatory swellings and cystic swellings concluded that the criteria of boundary, shape, echo intensity, posterior echoes and ultrasound characteristics of tissues are statistically significant. The comparison of cystic swellings and malignant neoplasms concluded that the criteria of ultrasonography, boundary, shape, echo intensity, ultrasound architecture of lesion, posterior echoes and ultrasound characteristics of tissues are statistically significant as the P-value is <0.05. CONCLUSION: It can be concluded that clinical diagnosis had a sensitivity and accuracy of 85.7% and ultrasonographic diagnosis had a sensitivity and accuracy of 98.5%.

Rapidly maturing juvenile ossifying fibroma: a case report.

This report describes an unusual case of juvenile ossifying fibroma (JOF) in a 16-year-old female patient with a clinical presentation of a single large, well-circumscribed swelling on left side of the palate. Ossifying fibromas are normally slow growing benign lesions. Radiographically they can present as radiolucent, mixed or radiopaque lesions depending on the degree of maturity. A period of at least 6 years is required for the lesion to pass from the radiolucent to radiopaque stage. All previously reported cases of JOF have been either radiolucent or mixed density lesions, but our case is unusual because the lesion had shown apparently rapid transformation into an almost complete radiopaque stage at a very early age.

Oral health status and alveolar bone loss in treated leprosy patients of central India.

A descriptive cross sectional study was carried out, in a group of 160 leprosy patients treated with multi drug therapy. The patients with age group of 25 to 60 year were considered. Out of 160 patients 50 patients were selected by simple random sampling technique for radiological assessments. Intra-oral periapical radiographs (6 for each patient) were taken. The paralleling long cone technique was used and radiographs were attached with grids so as to enable measuring the bone height. The grid was spaced in 1 mm marking and placed directly over the film. Clinical examination revealed that Prevalence of dental caries was 76.25% and periodontal disease was 78.75%. Mean DMFT score was 2.26. Mean OHI-S score was 3.50. Score for Gingival index was 1.60 and average loss of gingival attachment was 1.2 mm. Radiographic findings showed mean alveolar bone loss in maxillary anterior region to be 5.05 mm and in maxillary posterior region it was 4.92 mm. Alveolar bone loss in mandibular anterior region was 4.35 mm and in mandibular posterior region was 5.14 mm. Overall Dental Health Status of the leprosy patients was poor and needed more attention for dental care. There was also an increase in the alveolar bone loss, which was generalized. This bone loss could be due to advance stage of the disease or late approach to rehabilitation center, these patients also had peripheral neuropathy leading to hand and feet deformity in the form of claw hand or ulcer on hand, making maintenance of oral hygiene difficult.

Comparative evaluation of gustatory function between postmenopausal women and age-matched men.

OBJECTIVE: The aim of the study was to compare the gustatory function between postmenopausal women and age-matched men. SUBJECTS AND METHODS: During a period of 4 months, 30 postmenopausal women and 30 age-matched men were prospectively evaluated for gustatory function. Each subject was given a symptoms questionnaire for self-assessment of taste function. Then, whole mouth taste test was performed in which the quality identification and intensity ratings of taste solutions were measured. RESULTS: Regarding correct quality identification, the results were statistically non-significant (P > 0.05). As far as the intensity judgments are concerned, significant difference exists between postmenopausal women and age-matched men. Intensity of taste perception for sucrose was significantly lower in postmenopausal women than intensity of taste perception for other tastes (P < 0.05). One of the noticeable findings is that 15 (50%) postmenopausal women reported a change in dietary habits; all expressed liking for sweeter food. CONCLUSION: Postmenopausal women appeared to have a reduced perception of sucrose, which can alter eating habits, such as intake of more sweet foods, whereas no significant difference is observed in taste perception of NaCl, citric acid and quinine hydrochloride between postmenopausal women and age-matched men. Fifteen (50%) postmenopausal women stated fondness for sweet taste.

Evaluation of the efficacy of colour Doppler ultrasound in diagnosis of cervical lymphadenopathy.

OBJECTIVES: The purpose of the study was to evaluate the efficacy of colour Doppler ultrasound (CDUS) to differentiate between benign and malignant cervical lymph nodes. METHODS: During a period of 12 months, 100 untreated patients with clinical evidence of cervical lymphadenopathy (50 patients with clinically suspected malignant/metastatic cervical lymphadenopathy and 50 patients with clinically suspected reactive/benign cervical lymphadenopathy) were prospectively evaluated with CDUS. CDUS was performed for 168 cervical lymph nodes in these 100 patients. Histopathological confirmations were obtained by fine needle aspiration biopsy and/or excisional biopsy. To evaluate the efficacy of CDUS, comparison between clinical features, CDUS features and cytological/histological features of enlarged cervical lymph nodes was then done. RESULTS: Initially, clinical examination evaluated 143 cervical lymph nodes. CDUS evaluation discovered additional 25 lymph nodes (143+25 = 168). Correlation of patterns of colour Doppler flow signals with pathological diagnosis showed that central flow for benign nodes and peripheral flow for malignant nodes were highly significant parameters (P < 0.01). CDUS has a higher specificity than clinical evaluation, being 94.28% and 58.76%, respectively. Accuracy of the CDUS examination was also definitely higher than clinical evaluation at 92.85% and 63.67%, respectively. CONCLUSIONS: Nodal vascularity can be used to differentiate benign from malignant lymphadenopathy. Proper judicious CDUS examination provides an opportunity to eliminate the need for biopsy/FNAC in reactive nodes.