The Risk and Impact of COVID-19 Pandemic on Immunosuppressed Patients: Cancer, HIV, and Solid Organ Transplant Recipients.

Toward the end of the year 2019, there was the eruption of an acute respiratory syndrome, which is widely referred as coronavirus disease (COVID-19) from Wuhan, Hubei Province. The disease causes a range of respiratory illnesses, which are fatal. The COVID-19 disease has spread globally and has significantly impacted the health delivery systems, travel regulations, and economic activities and has posed and upsurge of responsibilities for the frontline healthcare workers. Due to the nature of the COVID-19 disease, it has typically caused complications which include pneumonia, multiple organ dysfunction together with renal failure, and acute respiratory distress syndrome. As of date, there is no approved vaccine or treatment for COVID-19 though there are ongoing research studies to formulate a treatment. COVID-19 is highly contagious, and the risk of infection is higher for patients with immunesuppressed patients than regular patients. The immunesuppressed conditions include cancer, HIV, and patients with solid organ transplants (SOT). This paper aims to review the risk and impact of COVID-19 on immunesuppressed patients, with a focus on cancer, HIV, and patients with SOT and the essence of special parameters for their care and management. Despite the fatal effects of this global pandemic, the findings of this study indicate the high risk which immunosuppressed patients have to contract the disease; thus, the governments and health delivery systems have to offer them extra support and treatment.

Odontogenic myxoma: a clinicopathological study in a South African population.

BACKGROUND: Odontogenic myxoma is a benign, locally aggressive neoplasm of the jaws. Prevalence rates range between 0.5% and 17.7% of odontogenic tumours. There are few reports in the literature on this lesion in African populations, and therefore, this study aimed to report on odontogenic myxoma in a South African population over a 40-year period. METHODS: The clinical records and orthopantomograms of 29 histopathologically diagnosed odontogenic myxoma were retrospectively analysed. Details of age, gender, ethnic origin and clinical, histological as well as radiological features were recorded. RESULTS: The ages of patients ranged from 7 to 44 years with a mean of 21.3 years. The male-to-female ratio was 1:2.6 with the majority of patients being of mixed race and Africans. Clinically, 31% complained of pain while 58.6% had a history of swelling. The majority of odongenic myxomas (62.1%) were located in the mandible with the posterior region being most commonly affected. Multilocular lesions (69.2%) were more common and were significantly larger than unilocular lesions (P < 0.05). The outline of these tumours was mostly well-defined (84.6%) with different degrees of cortication. Only one tumour caused tooth resorption, while 20 cases (76.9%) caused tooth displacement. Six tumours expanded into the maxillary sinus, and 14 tumours caused expansion of the mandible. CONCLUSIONS: Odontogenic myxomas have variable clinical, radiological and histological features. Most of these features in this population were similar to other populations. It is mandatory to use conventional radiographs along with histopathological examination to aid in arriving at an accurate diagnosis.

Reliability of periapical radiographs and orthopantomograms in detection of tooth root protrusion in the maxillary sinus: correlation results with cone beam computed tomography.

OBJECTIVES: The purpose of the present study was to investigate the reliability of both periapical radiographs and orthopantomograms for exact detection of tooth root protrusion in the maxillary sinus by correlating the results with cone beam computed tomography. MATERIAL AND METHODS: A database of 1400 patients scanned with cone beam computed tomography (CBCT) was searched for matching periapical (PA) radiographs and orthopantogram (OPG) images of maxillary premolars and molars. Matching OPG images datasets of 101 patients with 628 teeth and PA radiographs datasets of 93 patients with 359 teeth were identified. Four observers assessed the relationship between the apex of tooth root and the maxillary sinus per tooth on PA radiographs, OPG and CBCT images using the following classification: root tip is in the sinus (class 1), root tip is against the sinus wall (class 2) and root tip is not in the sinus (class 3). RESULTS: Overall correlation between OPG and CBCT images scores was 50%, 26% and 56.1% for class 1, class 2 and class 3, respectively (Cohen's kappa [weighted] = 0.1). Overall correlation between PA radiographs and CBCT images was 75.8%, 15.8% and 56.9% for class 1, class 2 and class 3, respectively (Cohen's kappa [weighted]  = 0.24). In both the OPG images and the PA radiographs datasets, class 1 correlation was most frequently observed with the first and second molars. CONCLUSIONS: The results demonstrated that both periapical radiographs and orthopantomograms are not reliable in determination of exact relationship between the apex of tooth root and the maxillary sinus floor. Periapical radiography is slightly more reliable than orthopantomography in determining this relationship.