Refractory angiolymphoid hyperplasia with eosinophilia: Complete resolution with low dose thalidomide

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a difficult-to-treat and rare benign vascular proliferative condition which presents as painless, solitary, or multiple vascular papules or nodules in the head and neck area, with predilection for the ear. We report a case of ALHE that failed multiple therapeutic interventions but achieved complete resolution when treated with thalidomide.

Case Report: Chemoradiation with Paclitaxel and Carboplatin Unveiling Leprosy Type 1 Downgrading Reaction

Type 1 lepra reaction (T1R) is a major complication seen in nonpolar forms of leprosy and leads to significant morbidity. The classification of T1R as up and downgrading, based on previously defined histopathological criteria (by Ridley), has therapeutic and prognostic implications. The trigger factors for these reactions are poorly described, especially in case of downgrading T1R and we describe a case of leprosy reaction that was possibly triggered by chemoradiation and elucidate the possible mechanism.

Why Members Dropout? An Evaluation of Factors Affecting Renewal in Micro Health Insurance

Micro health insurance (MHI) is an important mechanism to fight iatrogenic poverty in India. Its sustainability and viability depends, to a greater extent on the renewal of membership. This article evaluates the factors that influence renewal decisions in Sampoorna Suraksha Programme (SSP) in Karnataka. This study shows income class and chronic illness in the family to determine the renewability. The findings indicate adverse selection since low-income low-risk and high-income low-risk families dropout. From the social welfare point of view, renewal from high-risk low-income families is welcome; yet this should not jeopardize resource mobilization of SSP. Sustainable and viable operations of SSP depends on continued membership of insured population that can be achieved through external financial assistance for the poorest, wider network of hospitals and increased awareness on health insurance. Dropout rate in any MHI scheme should be kept very low to achieve deeper penetration and wider coverage especially in India where large percentage of population falls outside the insurance ambit.

Scanning electron microscopic evaluation of the influence of manual and mechanical glide path on the surface of nickel-titanium rotary instruments in moderately curved root canals: An in-vivo study

Aim:

The aim of this study was to evaluate the influence of manual versus mechanical glide path (GP) on the surface changes of two different nickel-titanium rotary instruments used during root canal therapy in a moderately curved root canal.

Materials and Methods:

Sixty systemically healthy controls were selected for the study. Controls were divided randomly into four groups: Group 1: Manual GP followed by RaCe rotary instruments, Group 2: Manual GP followed by HyFlex rotary instruments, Group 3: Mechanical GP followed by RaCe rotary instruments, Group 4: Mechanical GP followed by HyFlex rotary instruments. After access opening, GP was prepared and rotary instruments were used according to manufacturer's instructions. All instruments were evaluated for defects under standard error mean before their use and after a single use. The scorings for the files were given at apical and middle third.

Statistical Analysis Used:

Chi-squared test was used.

Results:

The results showed that there is no statistical difference between any of the groups. Irrespective of the GP and rotary files used, more defects were present in the apical third when compared to middle third of the rotary instrument.

Conclusion:

Within the limitations of this study, it can be concluded that there was no effect of manual or mechanical GP on surface defects of subsequent rotary file system used.

Treating Dehiscence During Implant Placement and Loading on Angled Abutment in Maxillary Lateral Incisor Region: A Case Report

The primary factor causing recession is the morphology and anatomy of the dentition. The facial bony plate overlying the root is usually very thin. The complete absence of bone over the facial root surface is referred to as dehiscence. Such buccal bone defects in case of implant dentistry threaten the survival of dental implant. Many surgical techniques are introduced to enhance alveolar bone volume for placing the dental implants. Guided bone regeneration (GBR) is one such established surgical technique for correcting buccal dehiscence defects, along with the use of various barrier membranes for the same. This case report describes an implant placement in the maxillary left lateral incisor region showing dehiscence on the labial cortical plate, along with bone graft and GTR membrane.

Bacteremia following scaling and root planing: A clinico-microbiological study

BACKGROUND

Bacteremia frequently occurs after treatment procedures such as extractions, scaling, root planing, periodontal surgery. There is currently significant interest in the possibility that bacteremia with oral bacteria may play role in pathogenesis of atherosclerosis. There are well-conducted studies that have determined the frequency of passage of periodontal microorganisms to the bloodstream after periodontal treatment. There is scarce information related to the incidence of periodontopathic microorganisms during bacteremia induced by this procedure.

AIM

The aim of this study was to establish the frequency of passage of periodontopathic microorganisms in peripheric blood after scaling and root planing in patients with periodontitis.

MATERIALS AND METHODS

Forty subjects with chronic periodontitis were included in the study. Blood samples were drawn from each patient at following intervals pre-treatment i.e., before SRP (P1), immediately after SRP (P2), and 30 minutes after SRP (P3). Following SRP, blood samples were analyzed for following microorganisms: Porphyromonasgingivalis, Tannerella. forysthus, Eikenellanella. corrodens, Campylobacter species, Micromonas. micros, and Prevotella. intermedia.

STATISTICAL ANALYSIS USED

Chi-square test.

RESULTS

Bacteremia was found in 70% (28/40) immediately after SRP and after 30 min, it was reduced to 25% (10/40) and 7.5% (3/40) presented bacteremia before SRP.

CONCLUSIONS

It was concluded that bacteremia frequently occurs immediately after SRP with P. gingivalis showing the highest frequency in blood.

Microhealth insurance and the risk coping strategies for the management of illness in Karnataka: a case study

Risk coping strategies adopted by the households in the event of illness depends on the accessibility to healthcare financing mechanisms including health insurance. The empirical evidence on the effect of microhealth insurance (MHI) on the risk coping strategies of the households is scarce. This paper evaluates the impact of Sampoorna Suraksha Program, a nongovernmental organization-initiated MHI scheme and the risk coping strategies of households faced with medical illness in Karnataka state, India. In this descriptive cross-sectional study, we collected data from 416 insured households, 366 newly insured households and 364 uninsured households in randomly selected 10 taluks in three districts of Karnataka state, India. We hypothesized that insured individuals rely less on ex post risk coping strategies (borrowing, use of savings and sale of assets) compared with uninsured and newly insured individuals. Our hypothesis was tested using logistic and linear regression analysis. A significant difference among insured, uninsured and newly insured individuals was found for borrowing but not in the use of savings or sale of assets. A positive impact of MHI on illness-induced borrowing (both incidence and amount) was evident. The evidence from this study reinforces the role of MHI as a pivotal financing alternative to out-of-pocket expenditure in India.

EFFECTIVENESS OF AN INFORMATION BOOKLET ON KNOWLEDGE AMONG STAFF NURSES REGARDING PREVENTION AND MANAGEMENT OF PERINEAL TEAR DURING NORMAL DELIVERY

The study was conducted to evaluate the effectiveness of an information booklet on knowledge among staff nurses regarding the prevention and management of perineal tear during normal delivery. An evaluative approach with one group Pre test Post test design was used for the study. 40 samples were selected using simple random sampling method. The present study was conducted in Justice K. S. Hegde Charitable hospital Mangalore. The collected data were analysed using descriptive and inferential statistics. A significant difference between Pre test and Post test knowledge was found (t = 23.09, p <0.05). The study findings showed that the information booklet was effective in improving knowledge of staff nurses regarding prevention and management of perineal tear during labour. There was no significant association between the level of knowledge and demographic variables.

Decreased alpha1-adrenergic receptor binding in the cerebral cortex and brain stem during pancreatic regeneration in rats

The purpose of this study was to investigate the role of brain alpha1-adrenergic receptor binding in the rat model of pancreatic regeneration using 60-70% pancreatectomy. The alpha1-adrenergic receptors kinetics was studied in the cerebral cortex and brain stem of sham operated, 72 h pancreatectomised and 7 days pancreatectomised rats. Scatchard analysis with [3H]prazosin in cerebral cortex and brain stem showed a significant decrease (P < 0.01), (P < 0.05) in maximal binding (Bmax) with a significant decrease (P < 0.001), (P < 0.01) in the Kd in 72 h pancreatectomised rats compared with sham respectively. Competition analysis in cerebral cortex and brain stem showed a shift in affinity during pancreatic regeneration. The sympathetic activity was decreased as indicated by the significantly decreased norepinephrine level in the plasma (P < 0.001), cerebral cortex (P < 0.01) and brain stem (P < 0.001) of 72 h pancreatectomised rats compared to sham. Thus, from our results it is suggested that the central alpha1-adrenergic receptors have a functional role in the pancreatic regeneration mediated through the sympathetic pathway.

Clinical evaluation of an ionic tooth brush on oral hygiene status, gingival status, and microbial parameter

It has long been recognised that the presence of dental plaque leads to gingivitis and periodontal disease, as well as dental caries. Today tooth brushing is the most widely accepted method of removing plaque. Hence this present clinical study was undertaken to evaluate the effectiveness of an ionic toothbrush on oral hygiene status. For this study, 20 dental students in the age group of 18-20 years were included. All the subjects after undergoing dental prophylaxis were then provided with ionic toothbrushes, either active (equipped with lithium battery) or inactive (without lithium battery). Plaque index and gingival bleeding index were examined at 7th, 14th, and 21st day. Microbial assessment was done for detection of colony forming units (CFU) from the plaque samples which were collected on 0 day and 21st day, both before brushing and after brushing. Results shown a significant reduction in all the parameters and the reduction was more significant in active and inactive ionic toothbrush users. It was concluded that both active and inactive ionic toothbrushes reduced the plaque index and gingival bleeding index scores significantly and active ionic tooth brushes were more effective as compared to inactive ionic toothbrushes. There was no soft tissue trauma following the use of both type of toothbrushes, which showed that ionic toothbrushes were equally safe for regular long-term use.

Thickness of gingiva in association with age, gender and dental arch location

BACKGROUND

It has been long known that the clinical appearance of healthy marginal periodontium differs from subject to subject and even among different tooth types. Many features are genetically determined; others seem to be influenced by tooth size, shape and position and biological phenomena such as gender, growth and age.

AIM

The purpose of this study was to determine the thickness of facial gingiva among Indians and its association with age, gender and dental arch.

METHODS

The study group included 16 males and 16 females with an age range of 16-38 years. Gingival thickness was assessed in the maxillary and mandibular anteriors by transgingival probing.

RESULTS

It was observed that the younger age group had significantly thicker gingiva than that of the older age group. The gingiva was found to be thinner in females than males and, in the mandibular arch than the maxilla.

CONCLUSION

In the present study, it was concluded that gingival thickness varies according to age, gender and dental arch.

Comparative assesment of gingival thickness using transgingival probing and ultrasonographic method

A decided attitude of expectation among many patients has given a new perspective to regenerative and plastic periodonta surgery. With authors emphasizing on the importance of gingival thickness, attempts are being made to obtain necessary information atraumatically and rapidly. Hence in the present study an attempt has been made to compare the two methods of assessing gingival thickness i.e transgingival probing and ultrasonographic method and also assess the gingival thickness in relation to central incisor lateral incisor and canine in Indian population. The gingival thickness was assessed in patients with healthy gingiva by both the methods. It was observed that transgingival probing method significantly over estimated the thickness of gingiva than the ultrasonographic method and the thickness of gingiva varies with morphology of the crown. It was concluded that compared to transgingival probing ultrasonographic method assesses gingiva thickness more accurately, rapidly and atraumatically.

Muscarinic M1 and M3 receptor binding alterations in pancreas during pancreatic regeneration of young rats

The importance of muscarinic receptors in proliferation of different cell types and in insulin secretion from pancreatic beta cells has been extensively studied. However, the role of pancreatic muscarinic receptors during pancreatic regeneration has not yet been studied. For the first time, the functional status of the muscarinic M1 and M3 receptors in regeneration of the pancreas is investigated here. It is observed that the number and affinity of high-affinity muscarinic M3 receptors increased at the time of regeneration. The low-affinity M3 receptors also showed a similar trend. In the case of muscarinic M1 receptors, the receptor number increased with a decrease in affinity. We also observed an increase in the circulating insulin levels at the time of active regeneration. The in vitro studies confirmed that muscarinic receptors are stimulatory to insulin secretion. Our results suggest that the increased muscarinic M1 and M3 receptor subtypes stimulate insulin secretion and islet cell proliferation during the regeneration of pancreas.

An epidemiological study of rabies in Bangalore city

This multicentric study was conducted with the aim of knowing the nature and magnitude of the problem of rabies in Bangalore city. The disease was enzootic and endemic and the principal reservoir of infection was dog. There was stray dog menace due to ineffective dog control measures. Nearly 30% of animal bite victims did not wash their wounds and about 60% of patients started antirabic vaccine late after 24 hours of bite. The antirabies serum (equine) was not available at all. The victims of hydrophobia were both children (37.5%) and adults (62.5%) and the average incubation period ranged from 35-111 days. Pre-exposure antirabic vaccination was not given to dog catching and dog pound staff. Lastly, there was lack of proper laboratory diagnostic facilities for rabies in Bangalore.