Rare Variant of Adult Rhabdomyosarcoma Presenting as a Palatal Swelling.

A 26-year-old male was referred to the Department of Oral and Maxillofacial Surgery of a tertiary care hospital in Lahore with chief complaint of painless swelling on the right palate of 40 days duration. Clinical differential diagnosis included squamous cell carcinoma, Ewing sarcoma, fibrosarcoma, neuroblastoma and rhabdomyosarcoma. Computed tomography scan revealed hypodense mass with necrotic changes. Histological examination of the excised tumor revealed malignant neoplasm arranged in fascicles and bundles comprising of spindle cells with pleomorphic, hyperchromatic nuclei and increased atypical mitosis. Immunohistochemical analysis showed negative staining with Cytokeratin, S100, CD34, Stat6, h-Caldesmon and EMA while the tumour cells were positive for desmin, myogenin, smooth muscle actin, CD-99 and MyoD1 thus confirming the diagnosis of spindle cell rhabdomyosarcoma.

Effect on blood pressure and pulse rate after administration of an epinephrine containing dental local anaesthetic in hypertensive patients.

OBJECTIVE: To document safety for use, through recording changes in blood pressure and pulse rate, after administering 3.6 ml of a 2% lignocaine with 1:100,000 epinephrine dental local anaesthetic in a group of hypertensive patients. METHODOLOGY: The present study was conducted at Shaikh Zayed Medical Complex, Lahore, from May to December 2008, using a convenience sampling technique. The first 60 walk-in patients in the dental outpatient department planned for tooth extraction were enrolled in the study. Out of these 60 patients, 10 had pre-hypertension (BP = 130/90), 10 had stage 1 hypertension (BP =140-159/90-99) and 10 study subjects were suffering from stage 2 hypertension (BP = 160-179/100-109). Thirty age and sex matched normo-tensive patients requiring tooth extraction acted as the control group. All patients were administered two cartridges each of 1.8 ml of dental local anaesthesia containing 2% Lignocaine with 1:100,000 epinephrine. Blood pressure and pulse rate (PR) were the risk indicators that were measured thrice; pre-injection, 2 minutes and 5 minutes after injection. RESULTS: A decrease in systolic in stage 2 hypertension patients after 2 and 5 minutes of injections was noted. The diastolic BP (DBP) fell in all the groups after injections. Mean pulse rate increased from three to four beats per minute in all groups except in stage 2 hypertension patients where it slightly decreased. CONCLUSION: Epinephrine containing dental local anaesthesia decreased systolic blood pressure in stage 2 hypertension patients included in this study. There was an observed decrease of 21 mm Hg in systolic blood pressure hypertension patients but with no adverse effects.

Helicobacter pylori in dental plaque; is it related to brushing frequency, plaque load and oral health status?

OBJECTIVE: To determine the relation between presence of H. pylori in supra-gingival dental plaque with oral hygiene habits and oral health status of patients suffering from symptomatic dyspepsia. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: The Department of Oral Health Sciences, Shaikh Zayed FPGMI, Lahore, from September 2008 to August 2009. METHODOLOGY: One hundred and fifty dyspeptic subjects with dental plaque were enrolled. After recording brushing frequency, oral health status and plaque load, the supra-gingival dental plaque samples were collected by sterile curettes. Helicobacter pylori were detected in dental plaque samples through PCR assay. RESULTS: Presence of H. pylori in dental plaque was found to be 37.5% in the sample. Most of the subjects brushed once daily, had plaque index score of 1 and had fair to poor oral hygiene status. Approximately 35% of the individuals who brushed once or twice a day harbored the bacterium in their dental plaque. There was no difference between bacterial detection rates among different categories of plaque index and oral health status of the study subjects. CONCLUSION: Presence of H. pylori in dental plaque was found to be associated with neither brushing frequency nor with the plaque load nor with the oral health status of individuals suffering from symptomatic dyspepsia.

Choice of operative method for management of isolated zygomatic bone fractures; evidence based study.

OBJECTIVE: To evaluate the treatment outcome of different methods for reduction and fixation of isolated zygomatic bone fractures using degree of displacement as a guide to classify patients into closed and open reduction groups. METHODS: This Clinical Trial was conducted at de' Montmorency College of Dentistry/Punjab Dental Hospital, Lahore between 21st July 2000 and 30th June 2003. Sixty patients with isolated zygomatic bone fractures were assigned to open and closed reduction groups of treatment depending on the degree of fracture displacement. Adequacy of reduction was evaluated by comparing pre and post operative radiographs. Aesthetic outcome was assessed by biometric evaluation. RESULTS: Reduction was adequate in all patients except four. In two of four no facial deformity was apparent. No patient showed post surgical change in position of reduced zygomatic bone. Biometric evaluation revealed acceptable aesthetics and adequate mouth opening in all except two patients. CONCLUSION: Our study indicates that displacement of 2 mm at any of the fractured site on occipitomental radiographs can be successfully used as a criterion to assign patients into open and closed reduction groups, for treatment of isolated zygomatic bone fractures.

Estimating the burden of head and neck cancers in the public health sector of Pakistan.

This study was designed to establish the burden of head and neck cancers (HNCA) in public sector based cancer centres of Pakistan. Data were obtained from the central body governing all the cancer centres in the country. The frequency of treated HNCAs out of the total body cancers treated across Pakistan was found to be 14.5%. Highest prevalence rates amongst all cancers were noted in Sind, notably in Karachi and Jamshoro, followed by Multan in Punjab and a much lower frequency in Peshawar in the North West Frontier Province. This variation presumably reflects levels of betel quid consumption but more data are needed to be gathered in a comprehensive way if the findings are to be applicable for improvement of the national cancer control program.

Helicobacter pylori in dental plaque and gastric mucosa: correlation revisited.

Helicobacter pylori (H. pylori) related gastric infection is highly prevalent in developing countries. Prevalence of bacterium in dental plaque from these regions is also reported to be high, but association between simultaneous colonization of H. pylori in both these sites has not been established yet. Aim of this paper is to review possible association between simultaneous oral and gastric H. pylori colonization in dyspeptic patients. Pertinent literature was reviewed and all available evidence collected from Medline and PakMedinet. Studies conducted in the developing world show conflicting results. Some report a positive relation between oral and gastric H. pylori colonization while others deny any association. This may be due to the population sampled or methodology applied. Further studies are recommended to confirm the association between concurrent presence of H. pylori in dental plaque and gastric mucosa of dyspeptic patients using sensitive and specific tests for detection of bacterium in oral samples.