Autoimmune hemolytic anemia due to mediastinal teratoma: A case report and review article.

Key Clinical Massage: Autoimmune hemolytic anemia (AIHA) is a rare disease that is divided into primary and secondary types. In patients with AIHA we should consider mediastinal tumors as a serious cause. If such teratoma was found surgical removal of it is in order. Abstract: Autoimmune hemolytic anemia (AIHA) is a rare disease that is divided into primary and secondary types. The secondary type usually appears as a complication to some diseases such as chronic inflammatory diseases, systemic lupus erythematosus (SLE), and malignancies. A 26 years-old female with a chief complaint of weakness, fatigue, and exertional dyspnea is diagnosed with AIHA. Initially, medical steroid treatment appeared to be successful and the anemia improved, however, by weaning steroid dosage the disease relapsed. Eventually, surgical resection of the mediastinal teratoma lead to the hemolysis being treated successfully. In patients with AIHA we should consider mediastinal tumors as a serious cause. If such teratoma was found surgical removal of it is in order.

An algorithmic approach to sinonasal evaluation preceding bone marrow transplantation.

<b>Introduction:</b> The authors conducted this study to review the available resources and prepare an algorithmic approach to pre-transplantation sinonasal evaluation.</br></br> <b>Materials and methods:</b> The sources of data were PubMed, Cochrane databases, and Google Scholar. We searched the available database for English-language studies using the keywords rhinosinusitis, transplantation, post -transplant sinusitis. Studies of all designs were included.</br></br> <b>Results:</b> Thirty-five relevant studies were retrieved from a total of 182 articles. The review of references guided us to 5more publications.</br></br> <b>Discussion:</b> We have proposed an algorithmic approach to sinonasal evaluation before transplantation which can provide a brief but comprehensive assessment of the patients. The evaluation begins with a thorough history and physical examination, including nasal endoscopy with careful attention to objective evidence of inflammation. CT scan should not be considered in all of the cases.</br></br> <b>Conclusion:</b> We have suggested an algorithm to provide a comprehensive and cost-effective way for the evaluation of sinonasal diseases before planned immunosuppression in order to assist in reducing post-transplantation morbidity and mortality.

Accuracy of digital image enhancement in detection of vertical and horizontal root fracture.

BACKGROUND: Two-dimensional intraoral radiography is the most common tool for recognizing root fractures. Improving the quality of images by means of enhancement tools can increase the recognition power of them. The aim of this study is to evaluate the effect of digital image enhancement on vertical and horizontal root fractures (HRFs) diagnostic accuracy. MATERIALS AND METHODS: In this in vitro study, 100 human extracted teeth, involving 50 mandibular premolars and 50 maxillary incisors, were investigated. In total, 25 premolar teeth were vertically fractured and other 25 sound teeth served as testing group. According to the verified methods, 25 incisor teeth were fractured and other 25 teeth of this group served as testing ones. Following, by using the charge-coupled device sensor, preapical digital images were recorded. The original images were altered using reverse-contrast and colorization enhancement tools. Two different observers independently investigated all of the images. Receiver operating characteristic analysis was used to calculate the area under the curve (AUC) and sensitivity and specificity of all images. Data analyzde using receiver operating characteristic (ROC) analysis. Two-ways variance analysis was used to assess differences in the values (P = 0.05 ). RESULTS: AUC and sensitivity and specificity related to the original, reverse-contrast, and colorized images were calculated (0.84, 0.64, 0.99), (0.84, 0.64, 0.96), and (0.82, 0.64, 0.92) respectively, for vertically root fractured images. AUC and sensitivity and specificity related to the original, reverse-contrast, and colorized images were calculated (0.49, 0.44, 0.56), (0.50, 0.44, 0.60), and (0.48, 0.48, 0.48), respectively, for horizontally root-fractured images. CONCLUSION: The results of the present study revealed that reverse-contrast and colorized enhancement filters cannot be used as critical methods in detecting in vitro vertical and HRF.

An unusual case of tricho-dento-osseous syndrome.

Tricho-dento-osseous (TDO) syndrome is a multisystem congenital disorder that is known by bone, skin, and hair abnormalities. Primitive studies show different varieties of manifestations related to this disorder, which involve sclerotic bones, nail involvement, enamel hypoplasia, mandibular prognathism, and taurodontism. Although exploring different TDO cases revealed genetic mutations in all of them, they have many variations in phenotypic view. In this study, we report a case whose primary diagnosis was alopecia and came for extraction of her third molars, but after clinical and radiographic examination, it was found that the cause of her disease was something different.

Assessment of palatal rugae pattern for sex and ethnicity identification in an iranian population.

BACKGROUND: Palatal rugoscopy is a reliable method in the forensic personal identification and racial group specification. the aim of the present study is to use palatal rugae pattern in sex and ethnicity identification applications. MATERIALS AND METHODS: Four hundred individual dental casts from four different ethnic populations of Iran were randomly selected. The pattern of the palatal rugae (shape, length, and number) investigated and its reliability to classify sex and minor ethnicity for each individual cast was evaluated. (P < 0.05) considered significant. RESULTS: The most common rugae shapes were straight, followed by wavy and curved types. The least frequent shapes were converging and circular types. Palatal rugae patterns were unique to each person. However, they could not differentiate males and females and had low abilities to classify the racial subsets. CONCLUSION: The palatal rugae pattern was unique to each individual and palatal rugoscopy can be considered as a reliable forensic identification tool where utilizing other methods such as DNA profiling, fingerprint, and dental record comparison is impossible or difficult. In this study, palatal rugoscopy was not a reliable method to classify the sex of an individual and to differentiate between different racial subsets.

Bilateral coronoid hyperplasia causing painless limitation of mandibular movement.

The coronoid process is a beaklike process in the ramus of the mandible. Coronoid process hyperplasia (CPH) is a rare possible cause of reduced mouth opening. An overgrown process interferes with mandibular rotation and lateral excursion and hence leads to restricted mouth opening (RMO). Although some factors are suggested, etiology of CPH is not completely known. Prescription of suitable radiography is necessary for an accurate diagnosis. This article reports a 30-year-old man with bilateral CPH and progressive RMO since childhood. This disorder affected his oral hygiene and quality of life. With the help of different types of radiography, CPH was diagnosed and coronoidectomy was the only treatment option. The patient showed normal jaw movements after the surgery and postoperative physiotherapy. General dentists have an important role in noticing RMO and referring the patients to maxillofacial radiologists. Although it is a rare phenomenon, general dentists need to keep CPH in mind as a possible cause. Panoramic imaging accompanied by computed tomography or cone beam computed tomography is the best imaging option in such cases.

Posttraumatic Mandibular Asymmetry Presenting in a Young Adult.

One of the most common sites of injury of the facial skeleton is mandibular condyle. However, it is the least diagnosed site of trauma in the head and neck regions. A trauma to the mandible and specifically condylar zone during childhood, may lead to asymmetry or mandibular bilateral distortion, which is usually manifested in the second decade of life when the etiology is unknown to most people. This report is about an adult male complaining about facial asymmetry with an unknown source. Obvious clicking at the right side and shorter right ramus and condyle's head deviation directed us to a childhood trauma and fracture.