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Tuesday, December 18, 2018
Evaluation of lung transplant perfusion using iodine maps from novel spectral detector computed tomography
p. 436
Nils Große Hokamp, Amit Gupta
DOI:10.4103/ijri.IJRI_35_18
We report the case of a 51-year-old patient who underwent bilateral lung transplantation and presented with an unstable condition and sepsis 6 days after transplantation. The performed contrast enhanced spectral detector computed tomography (CT) using a dual-layer detector showed absence of perfusion in the left lung on iodine maps, although branches of the pulmonary artery were patent. This prompted retrospective evaluation of CT images and total venous occlusion of the left pulmonary veins was found. Here, iodine maps helped in raising conspicuity of loss of lung perfusion.
http://www.ijri.org/currentissue.asp?sabs=y
Nils Große Hokamp, Amit Gupta
DOI:10.4103/ijri.IJRI_35_18
We report the case of a 51-year-old patient who underwent bilateral lung transplantation and presented with an unstable condition and sepsis 6 days after transplantation. The performed contrast enhanced spectral detector computed tomography (CT) using a dual-layer detector showed absence of perfusion in the left lung on iodine maps, although branches of the pulmonary artery were patent. This prompted retrospective evaluation of CT images and total venous occlusion of the left pulmonary veins was found. Here, iodine maps helped in raising conspicuity of loss of lung perfusion.
http://www.ijri.org/currentissue.asp?sabs=y
Pulmonary atresia and ventricular septal defect,Coronary artery as the primary source of pulmonary blood flow
Collateral or fistula? Coronary artery as the primary source of pulmonary blood flow in a patient with pulmonary atresia and ventricular septal defect p. 433
Anurag Yadav, Salil Bhargava, T B S Buxi, Krishna Sirvi
DOI:10.4103/ijri.IJRI_489_17
In patients with pulmonary atresia and ventricular septal defect (PA/VSD), a coronary artery being the primary source of pulmonary blood flow is a rare entity. We describe two cases of PA/VSD with coronary-to-pulmonary artery fistula with emphasis on the role of Computed Tomographic Angiography (CTA) in depicting all the sources of pulmonary blood supply, to predict surgical management and need for unifocalization of Major Aortopulmonary Collateral Arteries (MAPCA's).
http://www.ijri.org/currentissue.asp?sabs=y
Anurag Yadav, Salil Bhargava, T B S Buxi, Krishna Sirvi
DOI:10.4103/ijri.IJRI_489_17
In patients with pulmonary atresia and ventricular septal defect (PA/VSD), a coronary artery being the primary source of pulmonary blood flow is a rare entity. We describe two cases of PA/VSD with coronary-to-pulmonary artery fistula with emphasis on the role of Computed Tomographic Angiography (CTA) in depicting all the sources of pulmonary blood supply, to predict surgical management and need for unifocalization of Major Aortopulmonary Collateral Arteries (MAPCA's).
http://www.ijri.org/currentissue.asp?sabs=y
An accurate tool to detect cardiac amyloidosis
Myocardial nulling pattern in cardiac amyloidosis on time of inversion scout magnetic resonance imaging sequence – A new observation of temporal variability p. 427
Harshavardhan Mahalingam, Binita Riya Chacko, Aparna Irodi, Elizabeth Joseph, Leena R Vimala, Viji Samuel Thomson
DOI:10.4103/ijri.IJRI_84_18
Context: The pattern of myocardial nulling in the inversion scout sequence [time of inversion scout (TIS)] of cardiac magnetic resonance imaging (MRI) is an accurate tool to detect cardiac amyloidosis. The pattern of nulling of myocardium and blood at varying times post gadolinium injection and its relationship with left ventricular mass (LVM) in amyloidosis have not been described previously. Aims: The aim is to study the nulling pattern of myocardium and blood at varying times in TIS and assess its relationship with LVM and late gadolinium enhancement (LGE) in amyloidosis. Materials and Methods: This was a retrospective study of 109 patients with clinical suspicion of cardiac amyloidosis who underwent MRI. Of these, 30 had MRI features of amyloidosis. The nulling pattern was assessed at 5 (TIS5min) and 10 (TIS10min) minutes (min) post contrast injection. Nulling pattern was also assessed at 3min (TIS3min) in four patients and 7min (TIS7min) in five patients. Myocardial mass index was calculated. Mann-Whitney U test was done to assess statistical difference in the myocardial mass index between patients with and without reversed nulling pattern (RNP) at TIS5min. Results: RNP was observed in 58% at TIS5minand 89.6% at TIS10min. Myocardial mass index was significantly higher in patients with RNP at TIS5min[mean = 94.87 g/m2; standard deviation (SD) =17.63) when compared with patients with normal pattern (mean = 77.61 g/m2; SD = 17.21) (U = 18; P = 0.0351). Conclusion: In cardiac amyloidosis, TIS sequence shows temporal variability in nulling pattern. Earlier onset of reverse nulling pattern shows a trend toward more LVM and possibly more severe amyloid load.
http://www.ijri.org/currentissue.asp?sabs=y
Harshavardhan Mahalingam, Binita Riya Chacko, Aparna Irodi, Elizabeth Joseph, Leena R Vimala, Viji Samuel Thomson
DOI:10.4103/ijri.IJRI_84_18
Context: The pattern of myocardial nulling in the inversion scout sequence [time of inversion scout (TIS)] of cardiac magnetic resonance imaging (MRI) is an accurate tool to detect cardiac amyloidosis. The pattern of nulling of myocardium and blood at varying times post gadolinium injection and its relationship with left ventricular mass (LVM) in amyloidosis have not been described previously. Aims: The aim is to study the nulling pattern of myocardium and blood at varying times in TIS and assess its relationship with LVM and late gadolinium enhancement (LGE) in amyloidosis. Materials and Methods: This was a retrospective study of 109 patients with clinical suspicion of cardiac amyloidosis who underwent MRI. Of these, 30 had MRI features of amyloidosis. The nulling pattern was assessed at 5 (TIS5min) and 10 (TIS10min) minutes (min) post contrast injection. Nulling pattern was also assessed at 3min (TIS3min) in four patients and 7min (TIS7min) in five patients. Myocardial mass index was calculated. Mann-Whitney U test was done to assess statistical difference in the myocardial mass index between patients with and without reversed nulling pattern (RNP) at TIS5min. Results: RNP was observed in 58% at TIS5minand 89.6% at TIS10min. Myocardial mass index was significantly higher in patients with RNP at TIS5min[mean = 94.87 g/m2; standard deviation (SD) =17.63) when compared with patients with normal pattern (mean = 77.61 g/m2; SD = 17.21) (U = 18; P = 0.0351). Conclusion: In cardiac amyloidosis, TIS sequence shows temporal variability in nulling pattern. Earlier onset of reverse nulling pattern shows a trend toward more LVM and possibly more severe amyloid load.
http://www.ijri.org/currentissue.asp?sabs=y
Gujarati hypertensives
: A cross-sectional study p. 153
Jayesh Dalpatbhai Solanki, Hemant B Mehta, Sunil J Panjwani, Hirava B Munshi, Chinmay J Shah
DOI:10.4103/jpp.JPP_59_18
Objective: To study the effect of different classes and combinations of antihypertensive agents on arterial stiffness and central hemodynamic parameters. Materials and Methods: A cross-sectional study was conducted in 446 treated apparently healthy hypertensives. Oscillometric PWA was performed by Mobil-o-Graph (IEM, Germany) to derive cardiovascular parameters that were further analyzed in groups stratified by antihypertensive used. Study parameters were brachial hemodynamics (blood pressure (BP), heart rate, and rate pressure product); arterial stiffness (augmentation pressure, augmentation index, pulse wave velocity, total arterial stiffness, and pulse pressure amplification); and central hemodynamics (central BP, cardiac output, and stroke work). Statistical significance was kept at P < 0.05. Results: All groups were selected by matching of age, gender, and body mass index. They were comparable with major confounding factors. There was no difference between study parameters in hypertensives taking exclusive angiotensin-converting enzyme inhibitor (ACEI), calcium channel blocker (CCB), or angiotensin II receptor blocker. Multitherapy showed better hemodynamics and monotherapy showed better stiffness parameters. Addition of CCB to ACEI did not make a difference except with diastolic BP. For most comparisons, most of the results lacked statistical significance. Conclusion: Discrete PWA parameters showed no class difference in hypertensives, treated by conventional monotherapy or combination, ACEI appears to be the best drug. This also indicates that early diagnosis and blood pressure control are more important than antihypertensive used.
http://www.jpharmacol.com/currentissue.asp?sabs=y
Jayesh Dalpatbhai Solanki, Hemant B Mehta, Sunil J Panjwani, Hirava B Munshi, Chinmay J Shah
DOI:10.4103/jpp.JPP_59_18
Objective: To study the effect of different classes and combinations of antihypertensive agents on arterial stiffness and central hemodynamic parameters. Materials and Methods: A cross-sectional study was conducted in 446 treated apparently healthy hypertensives. Oscillometric PWA was performed by Mobil-o-Graph (IEM, Germany) to derive cardiovascular parameters that were further analyzed in groups stratified by antihypertensive used. Study parameters were brachial hemodynamics (blood pressure (BP), heart rate, and rate pressure product); arterial stiffness (augmentation pressure, augmentation index, pulse wave velocity, total arterial stiffness, and pulse pressure amplification); and central hemodynamics (central BP, cardiac output, and stroke work). Statistical significance was kept at P < 0.05. Results: All groups were selected by matching of age, gender, and body mass index. They were comparable with major confounding factors. There was no difference between study parameters in hypertensives taking exclusive angiotensin-converting enzyme inhibitor (ACEI), calcium channel blocker (CCB), or angiotensin II receptor blocker. Multitherapy showed better hemodynamics and monotherapy showed better stiffness parameters. Addition of CCB to ACEI did not make a difference except with diastolic BP. For most comparisons, most of the results lacked statistical significance. Conclusion: Discrete PWA parameters showed no class difference in hypertensives, treated by conventional monotherapy or combination, ACEI appears to be the best drug. This also indicates that early diagnosis and blood pressure control are more important than antihypertensive used.
http://www.jpharmacol.com/currentissue.asp?sabs=y
contrast media-induced nonrenal adverse drug reactions
contrast media-induced nonrenal adverse drug reactions over the last three decades: A systematic review p. 131
Maurizio Sessa, Claudia Rossi, Annamaria Mascolo, Antonella Scafuro, Rosanna Ruggiero, Gabriella di Mauro, Salvatore Cappabianca, Roberto Grassi, Liberata Sportiello, Concetta Rafaniello
DOI:10.4103/jpp.JPP_92_18
The aim of this study was to investigate the scientific contribution of Italian clinical research for contrast media-induced nonrenal adverse drug reactions over the last three decades. Ovid Embase, Ovid MEDLINE, Web of Science, and Cochrane Methodology Register were used as data sources to identify Italian descriptive studies, observational studies, meta-analyses, and clinical trials assessing contrast media-induced nonrenal adverse drug reactions as a safety outcome. The population of interest was men and women exposed to a contrast medium. Between 1990 and 2017, 24 original articles investigating contrast-induced nonrenal adverse drug reactions were identified. The cohort study was the most representative study design (10/24; 41.7%). The 24 studies were conducted mainly as monocenter studies (14/24; 58.3%) and without receiving funding (17/24; 70.8%). Seventeen out of 24 studies provided a level of evidence ranging from III-2 (11/24; 45.8%) to IV (6/24; 25.0%) on a Merlin scale. In total, 14 of 24 (58.3%) studies were published in a scientific journal ranked in the first quartile of their subject area. The 24 original articles mainly focused on adverse drug reactions already observed during clinical trials (i.e., idiosyncratic systemic reactions). In conclusion, during the last three decades and a burst was not observed in the Italian clinical research investigating contrast-induced nonrenal adverse drug reactions. High-quality clinical research is needed especially for procedures to prevent the onset of the aforementioned events, to identify risk factors, to minimize the risk of their occurrence, and to optimize their related prognosis.
http://www.jpharmacol.com/currentissue.asp?sabs=y
Maurizio Sessa, Claudia Rossi, Annamaria Mascolo, Antonella Scafuro, Rosanna Ruggiero, Gabriella di Mauro, Salvatore Cappabianca, Roberto Grassi, Liberata Sportiello, Concetta Rafaniello
DOI:10.4103/jpp.JPP_92_18
The aim of this study was to investigate the scientific contribution of Italian clinical research for contrast media-induced nonrenal adverse drug reactions over the last three decades. Ovid Embase, Ovid MEDLINE, Web of Science, and Cochrane Methodology Register were used as data sources to identify Italian descriptive studies, observational studies, meta-analyses, and clinical trials assessing contrast media-induced nonrenal adverse drug reactions as a safety outcome. The population of interest was men and women exposed to a contrast medium. Between 1990 and 2017, 24 original articles investigating contrast-induced nonrenal adverse drug reactions were identified. The cohort study was the most representative study design (10/24; 41.7%). The 24 studies were conducted mainly as monocenter studies (14/24; 58.3%) and without receiving funding (17/24; 70.8%). Seventeen out of 24 studies provided a level of evidence ranging from III-2 (11/24; 45.8%) to IV (6/24; 25.0%) on a Merlin scale. In total, 14 of 24 (58.3%) studies were published in a scientific journal ranked in the first quartile of their subject area. The 24 original articles mainly focused on adverse drug reactions already observed during clinical trials (i.e., idiosyncratic systemic reactions). In conclusion, during the last three decades and a burst was not observed in the Italian clinical research investigating contrast-induced nonrenal adverse drug reactions. High-quality clinical research is needed especially for procedures to prevent the onset of the aforementioned events, to identify risk factors, to minimize the risk of their occurrence, and to optimize their related prognosis.
http://www.jpharmacol.com/currentissue.asp?sabs=y
Phosphodiesterase 7B1 as therapeutic target for treatment of cognitive dysfunctions in multiple sclerosis
p. 126
Arthi Balsundaram, Darling Chellathai
DOI:10.4103/jpp.JPP_77_18
Multiple sclerosis (MS) is an autoimmune, chronic degenerative neuroinflammatory disorder affecting younger age groups of the United States of America and Europe. MS prevalence studies in India have shown that India is no longer a low-risk zone. Many studies have shown the seriousness of cognitive impairments (CIs) and its types caused in MS. In this review, the pathological basis for CI in various stages of MS was reviewed and revealed to provide a basis for the treatment. Role of phosphodiesterase 7B1 (PDE7B1) inhibitors in treating CI related to MS were also stated in this review. The literature for this review was collected from PubMed and Embase.
http://www.jpharmacol.com/currentissue.asp?sabs=y
DOI:10.4103/jpp.JPP_77_18
Multiple sclerosis (MS) is an autoimmune, chronic degenerative neuroinflammatory disorder affecting younger age groups of the United States of America and Europe. MS prevalence studies in India have shown that India is no longer a low-risk zone. Many studies have shown the seriousness of cognitive impairments (CIs) and its types caused in MS. In this review, the pathological basis for CI in various stages of MS was reviewed and revealed to provide a basis for the treatment. Role of phosphodiesterase 7B1 (PDE7B1) inhibitors in treating CI related to MS were also stated in this review. The literature for this review was collected from PubMed and Embase.
http://www.jpharmacol.com/currentissue.asp?sabs=y
Evaluation of tooth wear and associated risk factors: A matched case–Control study p. 1607 C Atalay, G Ozgunaltay DOI:10.4103/njcp.njcp_203_18 Aim: The aim of this case–control study was to compare the associated risk factors between adults with tooth wear (TW) and age- and sex-matched controls without TW. Methods: Fifty participants with TW and 50 age- and sex-matched controls participated in this study. A questionnaire was prepared to assess oral healthcare and consumption of erosive food and drinks. All participants completed the diet analysis forms. Saliva characteristics were evaluated with GC Saliva-Check BUFFER test. Examiners measured the TW of case patients, using the TW index. Data were statistically analyzed using Chi-square and Mann–Whitney U-tests (P < 0.05). Results: Individuals in the case group brush their teeth more often (P < 0.05). The difference in erosive food consumption between the case and control groups was significant (P < 0.05). There was no erosive
C Atalay, G Ozgunaltay
DOI:10.4103/njcp.njcp_203_18
Aim: The aim of this case–control study was to compare the associated risk factors between adults with tooth wear (TW) and age- and sex-matched controls without TW. Methods: Fifty participants with TW and 50 age- and sex-matched controls participated in this study. A questionnaire was prepared to assess oral healthcare and consumption of erosive food and drinks. All participants completed the diet analysis forms. Saliva characteristics were evaluated with GC Saliva-Check BUFFER test. Examiners measured the TW of case patients, using the TW index. Data were statistically analyzed using Chi-square and Mann–Whitney U-tests (P < 0.05). Results: Individuals in the case group brush their teeth more often (P < 0.05). The difference in erosive food consumption between the case and control groups was significant (P < 0.05). There was no erosive effect of acidic food when consumed as a main meal or a snack (P > 0.05). Although there was no difference between stimulated saliva flow rate and buffering capacity between groups, the difference between the resting saliva flow rates and pH values was significant (P < 0.05). Although some wear was seen on buccal/labial surfaces of teeth, cervical and occlusal/incisal surfaces were scored higher. No TW was observed on palatal/lingual surfaces. The cervical surfaces of mandibular premolars and incisal surfaces of anterior teeth were most affected. Conclusion: Of the factors investigated, TW in the case group was correlated with consumption of acidic foods, lower salivary flow rate, and pH.
http://www.njcponline.com/currentissue.asp?sabs=y
Anal melanoma: Outcomes of current surgical approaches p. 1622 S Kaya, M Kement, YE Altuntas, O Altin, A Seker, S Mazmanoglu, L Kaptanoglu, N Bildik, HF Kucuk DOI:10.4103/njcp.njcp_254_18 Aim: In this study, we aimed to evaluate the clinical characteristics and outcomes of the patients with anal melanoma (AM), who underwent surgical treatment. Materials and Methods: This study was conducted in Kartal Training and Research Hospital between January 2010 and December 2017. All patients, who underwent surgical resection with a diagnosis of AM, were enrolled. Results: A total of 10 patients were examined, 8 of them were females, and their average age was 69.2 years (range, 47–85 years). Abdominoperineal resection (APR) was performed in five (50%) patients, and local excision (LE) was performed in other five (50%) patients. Three patients (30%) had stage I disease, two (20%) had stage II disease, and five (50%) had stage III disease. All five patients in APR group had stage III disease
S Kaya, M Kement, YE Altuntas, O Altin, A Seker, S Mazmanoglu, L Kaptanoglu, N Bildik, HF Kucuk
DOI:10.4103/njcp.njcp_254_18
Aim: In this study, we aimed to evaluate the clinical characteristics and outcomes of the patients with anal melanoma (AM), who underwent surgical treatment. Materials and Methods: This study was conducted in Kartal Training and Research Hospital between January 2010 and December 2017. All patients, who underwent surgical resection with a diagnosis of AM, were enrolled. Results: A total of 10 patients were examined, 8 of them were females, and their average age was 69.2 years (range, 47–85 years). Abdominoperineal resection (APR) was performed in five (50%) patients, and local excision (LE) was performed in other five (50%) patients. Three patients (30%) had stage I disease, two (20%) had stage II disease, and five (50%) had stage III disease. All five patients in APR group had stage III disease. In the comparison of the survival period after surgery, the mean survival period of the APR group was 6.2 months (range, 1–16 months) while that of the LE group was 19.6 months (range, 7–43 months). Conclusion: LE with adjuvant radiation seems to offer good locoregional control without reducing the survival and may be an option of treatment for patients with small, superficial AM. However, APR should be offered for patients with locally advanced disease or as a salvage following recurrence.
http://www.njcponline.com/currentissue.asp?sabs=y
Rhabdomyoblastic differentiation in rosai dorfman disease of the orbit in a 12-year-old male p. 1670 E Ezeanosike, OB Ezeanosike, SI Akpan, CN Ezisi DOI:10.4103/njcp.njcp_262_17 Extranodal Rosai–Dorfman disease involving the orbit has been reported severally with extensive discourse on management strategies. However, rhabdomyoblastic differentiation coexisting with the disease is yet unreported. We present the clinical and histopathological features of a 12-year-old boy presenting with both. A 12-year-old boy was referred to our Ophthalmic Plastic Surgical Service with a 5-year history of bilateral, progressively enlarging eyelid, orbital masses causing proptosis, and severe cosmetic blemish. He had suffered vision loss to the right eye following trauma 2 years prior to the onset of the disease. Computed tomography of the orbits revealed preseptal and intraorbital components of well-defined multi-lobulated masses in both orbits. No significant nodal involvement was noted. He unde
E Ezeanosike, OB Ezeanosike, SI Akpan, CN Ezisi
DOI:10.4103/njcp.njcp_262_17
Extranodal Rosai–Dorfman disease involving the orbit has been reported severally with extensive discourse on management strategies. However, rhabdomyoblastic differentiation coexisting with the disease is yet unreported. We present the clinical and histopathological features of a 12-year-old boy presenting with both. A 12-year-old boy was referred to our Ophthalmic Plastic Surgical Service with a 5-year history of bilateral, progressively enlarging eyelid, orbital masses causing proptosis, and severe cosmetic blemish. He had suffered vision loss to the right eye following trauma 2 years prior to the onset of the disease. Computed tomography of the orbits revealed preseptal and intraorbital components of well-defined multi-lobulated masses in both orbits. No significant nodal involvement was noted. He underwent excision biopsy of the tumor in both eyes performed 1 month apart. A histopathologic diagnosis of the Rosai–Dorfman disease with focal areas of rhabdomyoblastic differentiation was made. He was treated postoperatively with a course of oral steroids with close observation for the rhabdomyoblastic differentiation. Rosai–Dorfman disease is an uncommon disease and has been reported to coexist with other pathologies. We highlight focal myoblastic differentiation within the excised tissues which may not necessarily warrant a diagnosis of rhabdomyosarcoma. Long-term follow-up of this patient is required to establish the safety of observation.
http://www.njcponline.com/currentissue.asp?sabs=y
Recurrent oral squamous papilloma in a pediatric patient: Case report and review of the literature p. 1674 OO Orenuga, Oluwo A, RT Oluwakuyide, AB Olawuyi DOI:10.4103/njcp.njcp_407_17 Squamous papillomas are common lesions of the oral mucosa. They are benign proliferating lesions often painless, slow growing and with a cauliflower appearance. However, its clinical appearance which sometimes mimics exophytic carcinoma, verrucous carcinoma or condyloma acuminatum raises concern when it occurs in the oral cavity. Squamous papilloma occurs predominantly in 30- to 50-year old's. However, they may be seen in children <10 years and accounted for 8% of all oral tumors in children. There is no sex predilection. It has a predilection for the tongue and soft palate, but may occur on any other surface of the oral cavity. Oral squamous papillomas have been associated with infection by the human papilloma virus (HPV). The present report is a case of a recurrent squamous papilloma of the hard pal
OO Orenuga, Oluwo A, RT Oluwakuyide, AB Olawuyi
DOI:10.4103/njcp.njcp_407_17
Squamous papillomas are common lesions of the oral mucosa. They are benign proliferating lesions often painless, slow growing and with a cauliflower appearance. However, its clinical appearance which sometimes mimics exophytic carcinoma, verrucous carcinoma or condyloma acuminatum raises concern when it occurs in the oral cavity. Squamous papilloma occurs predominantly in 30- to 50-year old's. However, they may be seen in children <10 years and accounted for 8% of all oral tumors in children. There is no sex predilection. It has a predilection for the tongue and soft palate, but may occur on any other surface of the oral cavity. Oral squamous papillomas have been associated with infection by the human papilloma virus (HPV). The present report is a case of a recurrent squamous papilloma of the hard palate in a 5-year-old patient with a review of the literature.
http://www.njcponline.com/currentissue.asp?sabs=y
severe skeletal open bite using temporary anchorage devices p. 1678 WX Lv, S Chen, TM Xu, B Han DOI:10.4103/njcp.njcp_223_18 This case report presents the treatment and long-term follow-up of a patient with severe skeletal hyperdivergent open bite, Class II malocclusion, and a severely retruded chin. After failure of early treatment using high-pull headgear with a bite block during the early permanent dentition stage due to an unfavorable growth pattern, orthognathic surgery was proposed but rejected by the patient. Then, temporary anchorage devices were used to correct the occlusion and establish an acceptable overbite and overjet. The overall observation time was 8.5 years; the treatment time using fixed appliances was 3 years and 4 months. The achieved tooth position and occlusal relationship remained stable 2.5 years later without recurrence of the open bite.
WX Lv, S Chen, TM Xu, B Han
DOI:10.4103/njcp.njcp_223_18
This case report presents the treatment and long-term follow-up of a patient with severe skeletal hyperdivergent open bite, Class II malocclusion, and a severely retruded chin. After failure of early treatment using high-pull headgear with a bite block during the early permanent dentition stage due to an unfavorable growth pattern, orthognathic surgery was proposed but rejected by the patient. Then, temporary anchorage devices were used to correct the occlusion and establish an acceptable overbite and overjet. The overall observation time was 8.5 years; the treatment time using fixed appliances was 3 years and 4 months. The achieved tooth position and occlusal relationship remained stable 2.5 years later without recurrence of the open bite.
http://www.njcponline.com/currentissue.asp?sabs=y
Feulgen stain as a special stain for mitotic figures and apoptotic bodies in oral squamous cell carcinoma p. 164 Sankari Radhakrishnan, Ramesh Venkatapathy, PD Balamurali, Karthik Shree V Prashad, B Premalatha, Saikat Chakraborty DOI:10.4103/srmjrds.srmjrds_49_18 Background: Oral cancer is one of the most prevalent cancers worldwide. The oral squamous cell carcinoma (OSCC) is graded for the proper treatment planning, and it has been a subjective phenomenon. This grading depends on several features, of which the presence of mitotic figures and apoptotic bodies is one of the important criteria. The routine hematoxylin and eosin (H and E) staining may help in identifying the mitotic figures and apoptotic bodies, but it is difficult to identify accurately. Thus, an attempt was made to evaluate the efficacy of crystal violet and Feulgen stain in identifying the mitotic figures and apoptotic bodies and to observe any variation in different grades of carcinoma. Aims: This study was aimed
Sankari Radhakrishnan, Ramesh Venkatapathy, PD Balamurali, Karthik Shree V Prashad, B Premalatha, Saikat Chakraborty
DOI:10.4103/srmjrds.srmjrds_49_18
Background: Oral cancer is one of the most prevalent cancers worldwide. The oral squamous cell carcinoma (OSCC) is graded for the proper treatment planning, and it has been a subjective phenomenon. This grading depends on several features, of which the presence of mitotic figures and apoptotic bodies is one of the important criteria. The routine hematoxylin and eosin (H and E) staining may help in identifying the mitotic figures and apoptotic bodies, but it is difficult to identify accurately. Thus, an attempt was made to evaluate the efficacy of crystal violet and Feulgen stain in identifying the mitotic figures and apoptotic bodies and to observe any variation in different grades of carcinoma. Aims: This study was aimed at using crystal violet and Feulgen stain in identifying mitotic figures and apoptotic bodies in different grades of OSCC. Materials and Methods: Fifteen diagnosed cases of OSCC were retrieved and stained with routine H and E, crystal violet stain, and Feulgen stain. All the sections were scanned for mitotic figures and apoptotic bodies. Apoptotic index (AI) and mitotic index (MI) were calculated. AI and MI were expressed as the average of a total number of apoptotic and mitotic cells counted in ten high-power fields. Results: A significant increase in MI and AI was found in Feulgen stain than crystal violet and H and E stain. Conclusion: Feulgen stain can be considered as the best, cost-effective, relatively cheap stain to visualize mitotic figures and apoptotic bodies.
http://www.srmjrds.in/currentissue.asp?sabs=y
Regenerative periodontics in restoring oral functions: A power to regenerate what's lost p. 168 Hunny Sharma, Swati Verma DOI:10.4103/srmjrds.srmjrds_24_18 Although human oral cavity benefits from remarkable mechanical and functional properties, still it faces continuous insult and damage resulting from exposure to microbial attacks. In the past where conventional dentistry was only focused on evaluating, restoration, and replacement of the diseased oral structures. The recent era of advancement in the field of materials science, molecular biology, tissue engineering, and stem cell research's had let to the path of development of new era of periodontal engineering known as regenerative periodontics. The ultimate goal of regenerative periodontics is the regeneration of the lost periodontium due to advanced periodontal disease. Currently, scientists are working on a wide range of biomaterials and scaffolds, genes, stem cells, and growth factors in the hope of achieving more predictab
Regenerative periodontics in restoring oral functions: A power to regenerate what's lost p. 168
Hunny Sharma, Swati Verma
DOI:10.4103/srmjrds.srmjrds_24_18
Although human oral cavity benefits from remarkable mechanical and functional properties, still it faces continuous insult and damage resulting from exposure to microbial attacks. In the past where conventional dentistry was only focused on evaluating, restoration, and replacement of the diseased oral structures. The recent era of advancement in the field of materials science, molecular biology, tissue engineering, and stem cell research's had let to the path of development of new era of periodontal engineering known as regenerative periodontics. The ultimate goal of regenerative periodontics is the regeneration of the lost periodontium due to advanced periodontal disease. Currently, scientists are working on a wide range of biomaterials and scaffolds, genes, stem cells, and growth factors in the hope of achieving more predictable outcomes in regenerative periodontics. Future research areas in regenerative periodontics include three-dimensional printing, tissue engineering, and gene therapy strategies which give more positive and predictable outcomes of regenerative periodontics. This review provides an overview of current on-going technique and researches in the field of regenerative periodontics and also will show a glimpse of what the future holds.
http://www.srmjrds.in/currentissue.asp?sabs=y
Hunny Sharma, Swati Verma
DOI:10.4103/srmjrds.srmjrds_24_18
Although human oral cavity benefits from remarkable mechanical and functional properties, still it faces continuous insult and damage resulting from exposure to microbial attacks. In the past where conventional dentistry was only focused on evaluating, restoration, and replacement of the diseased oral structures. The recent era of advancement in the field of materials science, molecular biology, tissue engineering, and stem cell research's had let to the path of development of new era of periodontal engineering known as regenerative periodontics. The ultimate goal of regenerative periodontics is the regeneration of the lost periodontium due to advanced periodontal disease. Currently, scientists are working on a wide range of biomaterials and scaffolds, genes, stem cells, and growth factors in the hope of achieving more predictable outcomes in regenerative periodontics. Future research areas in regenerative periodontics include three-dimensional printing, tissue engineering, and gene therapy strategies which give more positive and predictable outcomes of regenerative periodontics. This review provides an overview of current on-going technique and researches in the field of regenerative periodontics and also will show a glimpse of what the future holds.
http://www.srmjrds.in/currentissue.asp?sabs=y
Importance of cone-beam computed tomography in dentistry: An update p. 186 Shruthi Hegde, Vidya Ajila, Jasmine Shanti Kamath, Subhas Babu, Devika S Pillai, S Mithula Nair DOI:10.4103/srmjrds.srmjrds_26_18 In this era of advanced technology, cone-beam computed tomography (CBCT) has gained popularity in the field of oral radiology due to its advantages over conventional radiography. The use of CBCT is profoundly increasing for diagnosis and treatment planning in different specialties of dentistry. The incorporation of cone-beam technology into clinical practice is taking place because of the progress in image acquisition and three-dimensional (3D) imaging. The equipment design is easier to use, image distortion is minimal, and the images are compatible with other planning and simulation software. The 3D imaging has made the complex craniofacial structures more accessible for examination. Early and accurate diagnosis of deep-seated lesions is possible. CBCT provides a high-spatial res
Shruthi Hegde, Vidya Ajila, Jasmine Shanti Kamath, Subhas Babu, Devika S Pillai, S Mithula Nair
DOI:10.4103/srmjrds.srmjrds_26_18
In this era of advanced technology, cone-beam computed tomography (CBCT) has gained popularity in the field of oral radiology due to its advantages over conventional radiography. The use of CBCT is profoundly increasing for diagnosis and treatment planning in different specialties of dentistry. The incorporation of cone-beam technology into clinical practice is taking place because of the progress in image acquisition and three-dimensional (3D) imaging. The equipment design is easier to use, image distortion is minimal, and the images are compatible with other planning and simulation software. The 3D imaging has made the complex craniofacial structures more accessible for examination. Early and accurate diagnosis of deep-seated lesions is possible. CBCT provides a high-spatial resolution of bone and teeth which allows accurate understanding of the relationship of the adjacent structures. CBCT has helped in detecting a variety of cysts, tumors, infections, developmental anomalies, and traumatic injuries involving the maxillofacial structures. It has been used extensively for evaluating dental and osseous disease in the jaws. This paper reviews current advances in CBCT and their uses in dentistry.
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Chemical burns of gingiva and its management p. 174 MM Dayakar, Prakash G Pai, Radhika Priyadarshini M Sooranagi, Vintu Vijayan, Abdul Waheed DOI:10.4103/srmjrds.srmjrds_16_18 Chemical burns on the gingiva can be caused by the use of certain pharmaceutical and nonpharmaceutical products by patients or by injudicious use of caustics by the dental clinician. These lesions in the oral cavity, however, are rarely reported. Hence, information about the product and needful instructions is necessary to be given to the patients for prevention of the same. These burns can be caused by the way of self-infliction, allergic tendency toward certain products, or it may be iatrogenic. A detailed history is the key to diagnosing and managing these cases. Chemical burns are usually treated by eliminating the etiology and managed by palliative therapy.
MM Dayakar, Prakash G Pai, Radhika Priyadarshini M Sooranagi, Vintu Vijayan, Abdul Waheed
DOI:10.4103/srmjrds.srmjrds_16_18
Chemical burns on the gingiva can be caused by the use of certain pharmaceutical and nonpharmaceutical products by patients or by injudicious use of caustics by the dental clinician. These lesions in the oral cavity, however, are rarely reported. Hence, information about the product and needful instructions is necessary to be given to the patients for prevention of the same. These burns can be caused by the way of self-infliction, allergic tendency toward certain products, or it may be iatrogenic. A detailed history is the key to diagnosing and managing these cases. Chemical burns are usually treated by eliminating the etiology and managed by palliative therapy.
http://www.srmjrds.in/currentissue.asp?sabs=y
Mucormycosis – Can the diagnosis be challenging at times?? p. 191 Vandana Raghunath, K Hanna Rose Priyanka, C Geetha Kiran, R Manasa Deepthi DOI:10.4103/srmjrds.srmjrds_53_18 Mucormycosis is an aggressive and often rapidly progressing fatal form of fungal infection mainly affecting the immunocompromised patients and characterized by destruction and necrosis. The paranasal sinuses get affected commonly in the rhinocerebral type with or without oral cavity involvement. At times, even in the setting of immunosuppression, it presents as a subtle clinical infection posing both as a diagnostic and therapeutic challenge to the clinicians. Further, in such immunocompromised cases, early diagnosis and prompt treatment become utmost demanding to prevent the ensuing morbidity and mortality. We present one such indolent case which presented as a sinus infection in a 50-year-old diabetic woman. Further, the granulomatous presentation on hematoxylin and eosin-stained sections led to an erroneo
Vandana Raghunath, K Hanna Rose Priyanka, C Geetha Kiran, R Manasa Deepthi
DOI:10.4103/srmjrds.srmjrds_53_18
Mucormycosis is an aggressive and often rapidly progressing fatal form of fungal infection mainly affecting the immunocompromised patients and characterized by destruction and necrosis. The paranasal sinuses get affected commonly in the rhinocerebral type with or without oral cavity involvement. At times, even in the setting of immunosuppression, it presents as a subtle clinical infection posing both as a diagnostic and therapeutic challenge to the clinicians. Further, in such immunocompromised cases, early diagnosis and prompt treatment become utmost demanding to prevent the ensuing morbidity and mortality. We present one such indolent case which presented as a sinus infection in a 50-year-old diabetic woman. Further, the granulomatous presentation on hematoxylin and eosin-stained sections led to an erroneous initial diagnosis, which later upon Grocott's methenamine silver staining was diagnosed as mucormycosis-rhinocerebral type. Thus, both clinical and histopathological presentations were defying.
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This is the fourth in a series of posts based upon Jordan Peterson's book Maps of Meaning, published in 1999 after 17 years of researc...
