A New Diagnostic Criteria and Grading System of Rhino-Maxillary Mucormycosis based on Cone Beam Computed Tomographic Findings.

Background: Mucormycosis is a rare opportunistic fungal infection, which has a rapidly progressive and fulminant course with fatal outcome. It is the need of the hour to diagnose and treat the increasing cases urgently. Aim: The aim of this article is to study the common radiographic features of rhinomaxillary mucormycosis (RMM), find diagnostic criteria, and grade the disease according to the radiographic features. Settings: This study was conducted at Face Three-Dimensional Cone-Beam Computed Tomography (CBCT) Center, Aurangabad, Maharashtra. Materials and Methods: CBCT scans of 30 patients who were referred for CBCT scanning of suspected RMM were retrospectively evaluated for relevant radiological data. Results: The most common CBCT features of RMM were osteolytic lesions in alveolar bone, palate, nose and nasal cavity, and zygoma along with involvement of paranasal sinuses. About 76.66% of patients had a history of COVID-19 infection. Conclusion: According to the collected data, the scans of probable rhinomaxillary mucormycosis were graded in three groups - mild, moderate, and severe. The goal of this article is to emphasize the most overlook diagnostic entity - CBCT and its significant importance in early diagnosis, treatment, and prognosis of RMM. Early diagnosis of RMM can save the patients from the extent of morbidity and mortality.

Lactate Dehydrogenase: The Beacon of Hope?

Lactate dehydrogenase enzyme (LDH) helps in the conversion of glucose into pyruvic acid during aerobic glycolysis and is found in the cytoplasm of most cells in the human body. When oxidative stress occurs in the body, LDH may be released extracellularly and its level is usually indicative of the severity of tissue damage. LDH has proved to be an inestimably resourceful marker in early prediction of serious diseases involving extensive tissue or cellular damage. This short communication explores the potential of LDH as a salivary biomarker of cell injury and death.

Lactate Dehydrogenase Levels in the Saliva of Cigarette and E-Cigarette Smokers (Vapers): A Comparative Analysis.

BACKGROUND: We examined the lactate dehydrogenase (LDH) enzyme levels in the saliva of vapers (e-cigarette users) and compared the data with cigarette smokers and a control group of non-smokers and non-vapers. METHODS: Subjects were recruited among those responding to a social media announcement or patients attending the SEGi Oral Health Care Centre between May and December 2019, and among some staff at the centre. Five ml of unstimulated   whole saliva was collected and salivary LDH enzyme activity levels were measured with a LDH colorimetric assay kit. Salivary LDH activity level was determined for each group and compared statistically. RESULTS: Eighty-eight subjects were categorized into three groups (control n=30, smokers n=29, and vapers n=29). The mean ± standard deviation (SD) values for salivary LDH activity levels for vapers, smokers, and control groups were 35.15 ± 24.34 mU/ml, 30.82 ± 20.73 mU/ml, and 21.45 ± 15.30 mU/ml, respectively. The salivary LDH activity levels of smoker and vaper groups were significantly higher than in the control group (p = 0.031; 0.017). There was no significant difference of salivary LDH activity level in vapers when compared with smokers (p= 0.234). CONCLUSION: Our findings showed higher LDH levels in the saliva of vapers when compared with controls, confirming cytotoxic and harmful effects of e-cigarettes on the oral mucosa.

Early prediction of mandibular third molar eruption/impaction using linear and angular measurements on digital panoramic radiography: A radiographic study.

BACKGROUND: The impaction rate is higher for the third molars than for any other tooth in modern human population. This study was conducted with the aim to evaluate the validity of linear and angular measurements on the digital panoramic radiograph as a reference for early prediction of mandibular third molar eruption/impaction. MATERIALS AND METHODS: Digital panoramic radiographs of 200 subjects were selected based on their status of eruption of mandibular third molars; fully erupted (Group A), partially erupted (Group B), fully developed but not erupted (Group C) and partially developed groups (Group D). Each group comprised 50 subjects with 25 males and 25 females. Nine variables (linear measurements, angles, and ratios) were determined and measured bilaterally by two observers and values were compared between the study groups and genders. RESULTS: The data thus obtained were analyzed for comparison among all the study groups. It was found that the difference in the mean values of lower eruption space (LES) measurements, α-angle (angle between long axis of the third molar and gonial-symphyseal plane) and ß-angle (angle between long axis of mandibular second and third molars) were significant (P < 0.05). The mean values of mesiodistal width, LES-ramus, LES-Xi point and ß-angle were found more in males than in females. No significant difference was observed between the sides. CONCLUSION: α- and ß-angle together with LES measurements give the accurate information on early prediction of lower third molar eruption or impaction.

Efficacy of Oral Brush Biopsy without Computer-Assisted Analysis in Oral Premalignant and Malignant Lesions: A Study.

BACKGROUND: In the present study, the reliability of oral brush biopsy in identifying dysplasia in clinically diagnosed oral potentially malignant and malignant lesions was evaluated while comparing the findings with scalpel biopsy in terms of sensitivity and specificity. MATERIALS AND METHODS: In our study, a total number of 50 patients that included both premalignant and malignant lesions were included. Oral brush cytology using a cytobrush was done for all patients, which was followed by incisional biopsy. Sensitivity, specificity, positive and negative predictive values were obtained. To see the agreement between two modalities Kappa test of agreement was applied. A P < 0.05 was considered to indicate statistical significance. Proportions were compared using Chi-square or Fisher's exact test. RESULTS: Brush cytology using a cytobrush is a reliable adjunct to histopathology in detecting oral premalignant and malignant oral lesions and can be easily performed with less cost and less discomfort. This technique showed a reasonable sensitivity and specificity thus substantiating its reliability in evaluation of oral premalignant and malignant lesions. CONCLUSION: The oral brush biopsy is a simple and rapid, non-invasive and relatively painless and well accepted by patient. It is suitable in population screening programs and for pre- and post-treatment observation of confirmed premalignant and malignant lesions and has proved applications in incapacitated areas.

Evaluation of serum sialic acid, fucose levels and their ratio in oral squamous cell carcinoma.

BACKGROUND: Detection of cancer at the early stage is of utmost importance to decrease the morbidity and mortality of the disease. Apart from the conventional biopsy, minimally invasive methods like serum evaluation are used for screening large populations. Thus, this study aimed to estimate serum levels of sialic acid and fucose and their ratio in oral cancer patients and in healthy control group to evaluate their role in diagnosis. MATERIALS AND METHODS: Serum samples were collected from 52 healthy controls (group I) and 52 squamous cell carcinoma patients (group II). Estimation of serum levels of sialic acid and fucose and their ratio was performed. This was correlated histopathologically with the grades of carcinoma. Statistical analysis was done by using analysis of variance (ANOVA) test and unpaired "t" test. RESULTS: Results showed that serum levels of sialic acid and fucose were significantly higher in oral cancer patients compared to normal healthy controls (P < 0.001). The sialic acid to fucose ratio was significantly lower in cancer patients than in normal controls (P < 0.01). However, comparison with histological grading, habits, gender, and age group did not show any significant result. CONCLUSION: The mean serum sialic acid and fucose levels showed an increasing trend from controls to malignant group and their corresponding ratio showed decreasing trend from controls to malignant group. The ratio of sialic acid to fucose can be a useful diagnostic aid for oral cancer patients.

Rhinomaxillary mucormycosis: A palatal ulcer.

Rhinocerebral mucormycosis (zygomycosis) is an opportunistic fungal infection caused by saprophytic fungus. It involves several areas of the body, but the rhinocerebral form is most relevant to health care providers. Zygomycosis is associated with medically compromised patients. Our case reports an unhealed ulcer present over the palate of 15 days duration associated with swelling over the maxillary sinus region. This case is a blend of clinical, radiological, and histological manifestations of mucormycosis in a patient.

Risk factors for coronary artery disease in newly diagnosed non insulin dependent diabetes mellitus: Prevalence in Bahraini compared with Asian Indian patients.

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