Hypertension-related distress and its associated factors: findings from an urban primary health centre of South Delhi, India.

Background: Living with hypertension (HTN) has been found to cause distress, which adversely affects one's self-care and may lead to elevated blood pressure. There is a paucity of data regarding the prevalence of HTN-related distress. This study was conducted to estimate the prevalence of HTN-related distress among adults with HTN attending an outpatient department in an urban primary health centre and to determine the factors associated with distress. Methods: This was a cross-sectional study conducted at the outpatient department of an urban primary health centre in Delhi, India. The enrolled participants were administered a questionnaire, which included a Distress Scale for patients with diabetes mellitus and/or hypertension (DSDH17 M) (to assess for HTN-related distress) and Health-Related Quality of Life, Healthy Days Measure. A descriptive analysis was performed. Factors associated with HTN-related distress were tested using logistic regression. Results: One hundred forty-one participants were enrolled in this study. Most were women (73.76%) with a mean age of 60.15 years (standard deviation [SD]: 0.78). The prevalence of HTN-related distress (average DSDH17 M score ≥3) was 14% (95% confidence interval [CI]: 9.30-21.03). Patients with HTN-related distress had significantly poor health and reported a greater number of days where they were physically or mentally unhealthy. Patients with uncontrolled blood pressure had six times the odds (95% CI: 1.69-21.77, P value = 0.006) of HTN-related distress compared to those with controlled blood pressure. Conclusions: Hypertension-related distress was present in 14% of adults with HTN. Patients with uncontrolled blood pressure had six times the odds of HTN-related distress.

Estimation and quantification of human DNA in dental calculus: A pilot study.

CONTEXT: Identification using DNA has proved its accuracy multiple times in the field of forensic investigations. Investigators usually rely on either teeth or bone as the DNA reservoirs. However, there are instances where the skeletal or dental remains are not available or not preserved properly. Moreover, due to religious beliefs, the family members of the dead do not allow the investigating team to damage the remains for the sole purpose of identification. AIM: To investigate the presence of human DNA in dental calculus and to quantify the amount, if present. MATERIALS AND METHODS: This prospective single-blinded pilot study included twenty subjects selected from the patients visiting a dental college. The samples of dental calculus were collected from the thickest portion of calculus deposited on the lingual surfaces of mandibular incisors. These samples were decontaminated and subjected to gel electrophoresis for DNA extraction. RESULTS: DNA was found in 85% cases. The amount of DNA varied from 21 to 37 µg/ml of dental calculus. CONCLUSION: Dental calculus is a rich reservoir of human DNA.

Efficacy and Safety of Intralesional Xantinol Nicotinate in the Treatment of Various Stages of Oral Submucous Fibrosis.

INTRODUCTION: Oral Submucous Fibrosis (OSMF) is one of the most prevalent potentially malignant disorders seen in South east population since ages. Despite the extensive amount of research held in this field, its treatment still remains a challenge. In this study, we present our experience in successfully managing OSMF with intralesional injections of a peripheral vasodilator namely xantinol nicotinate. AIM: To determine the efficacy and safety of intralesional xantinol nicotinate in the treatment of various stages of OSMF. MATERIALS AND METHODS: This parallel, prospective, clinical study included 60 patients clinically diagnosed with oral submucous fibrosis divided into two groups. Group I patients were subjected to intralesional xantinol nicotinate injections bi-weekly for a period of four months while Group II patients were given intralesional saline injections biweekly for four months. All the patients were instructed to perform home mouth opening physiotherapy exercises. At each visit, parameters like increase in interincisal distance, cheek flexibility, tongue protrusion and relief from burning sensation and any side effects were measured and recorded. The drop out figure was zero. RESULTS: At the end of four months, in Group I, there was an increase in mean values of interincisal distance, cheek flexibility and tongue protrusion (p<0.001). For burning sensation a significant decrease in mean value was observed (p<0.001). Whereas, in Group 2 the difference between pre-treatment and post-treatment values was not statistically significant (p>0.001). On comparing the results of Group 1 and Group 2, statistically significant difference was observed (p<0.001). CONCLUSION: Xantinol nicotinate, a peripheral vasodilator, when injected intralesionally in OSMF patients not only provides relief from burning sensation but also results in increased mouth opening, tongue protrusion and cheek flexibility.

Supplemental tooth in primary dentition.

An extra tooth causing numerical excess in dentition is described as supernumerary tooth, and the resultant condition is termed as hyperdontia. Hyperdontia is more commonly seen in the permanent dentition than primary one. Supernumerary tooth which resembles tooth shape and supplements for occlusion is called as supplemental tooth. We present a case with supplemental tooth in primary dentition.

Meteorological influences on the incidence of lichen planus in a north Indian population.

Lichen planus is a chronic, autoimmune, mucocutaneous disease that shows differences in clinical presentation at different times of the year. The present retrospective study was conducted to clarify the meteorological factors that influence the incidence of lichen planus, as well as the general features and clinical presentation of this condition during three consecutive years, 2008, 2009, and 2010, in Moradabad district (Western Uttar Pradesh, India). The study group comprised 1,355 patients extracted from the records of the outpatient department of Kothiwal Dental College Research Centre and Hospital, who were clinically diagnosed as having lichen planus during this three-year period. The highest number of patients (735) were recorded in summer, and the lowest (56) in winter. Females were affected more often, and psychosocial influences were also evident. There were significant differences in the incidence of lichen planus in different seasons, and the summer peak was attributable to the intensity of sun exposure (actinic lichen planus and summertime lichen planus).

Non-syndromic hereditary gingival fibromatosis.

Hereditary gingival fibromatosis is a rare condition characterised by severe gingival hyperplasia that can occur as an isolated disease or as part of a syndrome or chromosomal abnormality. In severe cases, the gingival enlargement may cover the crowns of teeth and cause severe aesthetic, emotional and functional impairment. This case report gives an overview of gingival fibromatosis in a 22-year-old male patient who presented with generalised gingival enlargement.

Primary oral tuberculosis.

Persistent oral ulcers and erosions can be the final common manifestation, sometimes clinically distinguishable, of a diverse spectrum of conditions ranging from traumatic lesions, infectious diseases, systemic and local immune-mediated lesions up to neoplasms. A case with oral tuberculosis and absence of any systemic manifestations is reported. The location and clinical presentation of the lesion is unusual and underlines the importance of considering tuberculosis in the differential diagnosis of oral lesions that affect the mucosa and the gingiva.

Gorlin-Goltz syndrome: a rare case report.

Gorlin-Goltz syndrome (GS), also known as nevoid basal cell carcinoma syndrome, is an infrequent multisystem disease inherited in a dominant autosomal way, which shows a high level of penetrance and variable expressiveness. It is characterised by keratocystic odontogenic tumours (KCOT) in the jaw, multiple basal cell nevi carcinomas and skeletal abnormalities. This syndrome may be diagnosed early by a dentist by routine radiographical examinations in the first decade of life, since the KCOTs are usually one of the first manifestations of the syndrome. This article describes an 11-year-old boy with GS.

Florid osseous dysplasia.

Florid osseous dysplasia (FOD) is the most dramatic and rare variant of the cemento-osseous lesions in which the normal cancellous bone is replaced by dense, acellular cemento-osseous tissue in a background of fibrous connective tissue. It appears to be a widespread form of periapical cemental dysplasia (PCD). No clear definition indicates that when the multiple lesions of PCD can be termed as FOD. If PCD is identified in three or four quadrants or is extensive in one jaw, then it is considered as FOD. Here, in this article, we report a case of FOD in 35-year-old woman.

Bilateral macrostomia.

Macrostomia as a rare facial deformity is classified among facial clefts. It is a rare congenital anomaly which affects the aesthetics and function of the oral cavity. It is usually associated with deformities of other structures developed from the first and second branchial arches. Bilateral transverse cleft occurring alone is uncommon. Here we report a case of bilateral macrostomia (bilateral lip cleft) in a 5-year-old girl as a sole entity without other skeletal and facial deformities.

Epulis fissuratum: consequence of ill-fitting prosthesis.

A poorly fitted prosthesis can give rise to a plethora of problems like pain, discomfort in mastication and speech and epulis fissuratum. Epulis fissuratum refers to reactive tissue response to excessive mechanical pressure imparted by the poor fit of prosthesis. In this article, we discuss a case of epulis fissuratum in a 69-year-old male patient.

Cementifying fibroma.

Cementifying fibroma is considered as a benign, osseous tumour, which arises from the periodontal ligament and is composed of varying amounts of cementum, bone and fibrous tissue. It is very closely related to other fibro-osseous lesions like fibrous dysplasia, cemental periapical dysplasia and other calcifying odontogenic cysts and tumour. We report a case of this entity along with differentiating radiographic features that set it apart from other fibro-osseous lesions.

Central giant cell granuloma: a case report.

Central giant cell granuloma (CGCG) is a relatively uncommon benign bony lesion of a variably aggressive nature. Thought to represent a reparative response to intrabony haemorrhage and inflammation, CGCG was once regarded as a reactive lesion. It is actually an asymptomatic lesion which becomes evident during routine radiographic examination or as a result of painless but visible expansion of the affected jaw. This paper presents the case of a 4-year-old boy with  CGCG in the right mandibular region.

Internal resorption.

Internal resorption is a relatively rare resorption of dentine, which starts in the pulpal cavity either in the pulpal chamber or in the root canal and destroys surrounding dental hard tissues. The initiating factor in internal root resorption is thought to be trauma or chronic pulpal inflammation, but other aetiological factors have also been suggested. The prognosis for treatment of small lesions of internal resorption is good. However, if the tooth structure is greatly weakened and perforation has occurred, the prognosis is poor and tooth extraction must be considered. In this article we report a rare case of internal resorption in a 26-year-old male patient.

Acute primary herpetic gingivostomatitis.

Herpes simplex virus (HSV) is a double-stranded virus belonging to human herpes virus family. Although it exists in eight various forms, HSV-1 causes most of the oral infections. Since dentists are more likely to be consulted in the case of oral infections, familiarity with these lesions becomes mandatory. It is more commonly reported in children and rarely in adults. This article presents an acute episode of primary herpetic gingivostomatitis in a 32-year-old male patient.

Herpes zoster.

Herpes zoster (HZ) or 'shingles' is a painful vesicular rash resulting from reactivation of the varicella-zoster virus that also causes chickenpox. The incidence of HZ infection (HZI) increases with age and the degree of immunosuppresssion. Post herpetic neuralgia, the most common complication of HZ, occurs after the zoster rash has resolved. Conventional therapies include antivirals, corticosteroids and analgesics, both oral and topical. Here we report a case of HZ in an 80-year-old woman involving maxillary nerve and the article also reviews various treatment modalities available for the management of HZI.

Treacher Collins syndrome: a case report.

Treacher Collins syndrome is a rare autosomal dominant disorder of craniofacial development. The fully expressed phenotype exhibits characteristic dysmorphic features involving the face, eyes, mandible and ears. We report a case of a 17-year-old woman presenting with the typical orofacial implications of this syndrome.