Does salvage and tranexamic acid reduce the need for blood transfusion in revision hip surgery?

We carried out a retrospective case-control study in 80 patients who underwent a revision total hip replacement. Group A (40 patients) received tranexamic acid and intra-operative cell salvage. Group B (40 patients) was a matched control group and did not receive this management. Each group was divided into four subgroups: revision of both components, revision of both components with bone grafting, revision of the acetabular component with or without bone graft, and revision of the femoral component with or without bone graft. In group A the total number of units transfused was 52, compared with 139 in group B, representing a reduction in blood usage of 62.5%. The mean amount of blood transfused from cell salvage in each group was 858 ml (113 to 2100), 477 ml (0 to 2680), 228 ml (75 to 315) and 464 ml (120 to 1125), respectively. There was a significant difference in the amount of blood returned between the groups (p < 0.0001). In group A, 22 patients needed transfusion and in group B, 37 (p < 0.0001). A cost analysis calculation showed a total revenue saving of pounds sterling 70 000 and a potential saving throughout our facility of pounds sterling 318 288 per year. Our results show that a significant reduction in blood transfusion can be made using combined cell salvage and tranexamic acid in revision surgery of the hip.

Expression of CCL20 and granulocyte-macrophage colony-stimulating factor, but not Flt3-L, from modified vaccinia virus ankara enhances antiviral cellular and humoral immune responses

While modified vaccinia virus Ankara (MVA) is currently in clinical development as a safe vaccine against smallpox and heterologous infectious diseases, its immunogenicity is likely limited due to the inability of the virus to replicate productively in mammalian hosts. In light of recent data demonstrating that vaccinia viruses, including MVA, preferentially infect antigen-presenting cells (APCs) that play crucial roles in generating antiviral immunity, we hypothesized that expression of specific cytokines and chemokines that mediate APC recruitment and activation from recombinant MVA (rMVA) vectors would enhance the immunogenicity of these vectors. To test this hypothesis, we generated rMVAs that express murine granulocyte-macrophage colony-stimulating factor (mGM-CSF), human CCL20/human macrophage inflammatory protein 3alpha (hCCL20/hMIP-3alpha), or human fms-like tyrosine kinase 3 ligand (hFlt3-L), factors predicted to increase levels of dendritic cells (DCs), to recruit DCs to sites of immunization, or to promote maturation of DCs in vivo, respectively. These rMVAs also coexpress the well-characterized, immunodominant lymphocytic choriomeningitis virus nucleoprotein (NP) antigen that enabled sensitive and quantitative assessment of antigen-specific CD8(+) T-cell responses following immunization of BALB/c mice. Our results demonstrate that immunization of mice with rMVAs expressing mGM-CSF or hCCL20, but not hFlt3-L, results in two- to fourfold increases of cellular immune responses directed against vector-encoded antigens and 6- to 17-fold enhancements of MVA-specific antibody titers, compared to those responses elicited by nonadjuvanted rMVA. Of note, cytokine augmentation of cellular immune responses occurs when rMVAs are given as primary immunizations but not when they are used as booster immunizations, suggesting that these APC-modulating proteins, when used as poxvirus-encoded adjuvants, are more effective at stimulating naïve T-cell responses than in promoting recall of preexisting memory T-cell responses. Our results demonstrate that a strategy to express specific genetic adjuvants from rMVA vectors can be successfully applied to enhance the immunogenicity of MVA-based vaccines.

Steady-state fully noninductive current driven by electron cyclotron waves in a magnetically confined plasma

A steady-state, fully noninductive plasma current has been sustained for the first time in a tokamak using electron cyclotron current drive only. In this discharge, 123 kA of current have been sustained for the entire gyrotron pulse duration of 2 s. Careful distribution across the plasma minor radius of the power deposited from three 0. 5-MW gyrotrons was essential for reaching steady-state conditions. With central current drive, up to 153 kA of current have been fully replaced transiently for 100 ms. The noninductive scenario is confirmed by the ability to recharge the Ohmic transformer. The dependence of the current drive efficiency on the minor radius is also demonstrated.

Is it necessary to use three mandatory loading doses when commencing therapy for neovascular age-related macular degeneration using bevacizumab? (BeMOc Trial)

PURPOSE

To determine whether a Pro Re Nata (PRN) regimen with three initial mandatory loading doses results in better functional and anatomical outcome compared with a PRN regimen without initial loading when using intravitreal bevacizumab in patients with minimal classic or occult choroidal neovascularisation secondary to age-related macular degeneration.

METHODS

Patients were randomised (1 : 1) to Loading (LD group) or No Loading (NLD group) and treated with open label intravitreal bevacizumab. In the LD group, patients received two mandatory doses after the baseline dose before entering the PRN phase and in the NLD group, patients did not receive mandatory doses after the baseline dose. Six-weekly evaluations were performed up to week 54 and retreatment was done based on OCT criteria. Visual stability and reduction in central retinal thickness were compared between groups.

RESULTS

49 patients were in the NLD group and 50 patients were in the LD group. At the 12-month end point, 84% of the patients in the LD group achieved visual stability (<15 letter loss) compared with 67% of the patients in the NLD group (P<0.05). The mean reduction in central macular thickness was 105.35 μm in the LD group and 81.45 μm in the NLD group (P>0.05). There was no significant difference in scores of VFQ-25 questionnaire testing between the two groups and no serious ocular or systemic side effects were observed.

CONCLUSION

The results supported our hypothesis that a loading dose leads to slightly better visual stability in terms of proportions of patients experiencing moderate visual loss, but did not support the hypothesised difference in anatomical outcome.

Efficacy and timing of adjunctive therapy in the anti-VEGF treatment regimen for macular oedema in retinal vein occlusion: 12-month real-world result

Purpose

Various combination treatment regimens have been tried to improve the short-term efficacy of intravitreal monotherapy for the treatment of macular oedema (MO) secondary to retinal vein occlusion (RVO). Our study introduces the RandOL protocol (Ranibizumab and Ozurdex with Laser photocoagulation) of initial anti-VEGF therapy, controlling recurrent non-ischaemic MO with an intravitreal steroid and applying laser therapy to non-perfused retina. We describe our 12-month follow-up experience on timing for adjunctive therapy and real-world effectiveness and safety data.

Methods

A retrospective analysis was carried out on 66 consecutive treatment-naive RVO patients with MO who received our RandOL treatment regimen. Baseline visual acuity (VA) and central retinal thickness (CRT) were compared with 12-month result.

Results

At 12 months, 77% had significant VA improvement, 52% had ≥3-line improvement, and 15% were worse. Significant improvements in CRT were observed in 97% (baseline median CRT=531 μm (IQR 435–622) reduced to 245 μm (IQR 221–351, P<0.001) at 12 months); 76% achieved a dry fovea at 1 year. Mean number of total injections required was 5.5 (range 2–11) and 6% required ≥9 injections in 1 year. Although 70% received additional Ozurdex, 82% received ≥1 sessions of laser therapy. The BRVO subgroup achieved better VA and CRT improvement at 1 year, but small numbers limit definitive statistical conclusions.

Conclusions

Our real-world results using a combination treatment protocol for RVO-related MO achieved similar desirable anatomical and visual outcomes as with a single-agent therapy with less intravitreal re-treatment rates at first year. Randomised controlled studies are needed to evaluate the role of laser and the ideal timing of combination therapy.

Disappearing saccular intracranial aneurysms: do they really disappear?

SUMMARY

Evolution and natural history of cerebral aneurysms is a dynamic process. Spontaneous regression in size or complete disappearance of an aneurysm is a known phenomenon, more commonly noted in giant intracranial aneurysms. However, reappearance or regrowth of such aneurysms is rare with few anecdotal reports. We report a series of four cases including one giant aneurysm, which either disappeared or regressed on sequential angiograms. Regrowth or reappearance of two of these previously disappeared or regressed aneurysms was noted and endovascularly treated while the other two cases are being followed up. The decision to follow up was crucial considering the nature of the aneurysms to change in morphology under the influence of various hemodynamic factors.

Simple liquid chromatography–tandem mass spectrometry method for determination of novel anti-methicillin-resistant Staphylococcus aureus fluoroquinolone WCK 771 in human serum

A simple, rapid, specific, precise, accurate and sensitive method for determination of WCK 771 in human serum has been developed. The method uses high performance liquid chromatography with tandem mass spectrometric detection. Sample preparation involves protein precipitation method by addition of acetonitrile. Gatifloxacin was used as internal standard. The response was found to be linear from 0.312 to 40 microg/ml of serum with correlation coefficient greater than 0.99. Limit of detection and lower limit of quantification for WCK 771 was found to be 0.078 microg/ml and 0.312 microg/ml, respectively. The intra-day precision and accuracy from analysis of quality control (QC) samples at four concentrations was in the range of 2.36-2.58% and from 96.71 to 103.2%, respectively. The inter-day precision and accuracy from analysis of quality control samples at four concentrations was in the range of 3.14-6.82% and from 96.84 to 105.76%, respectively. WCK 771 was found to be stable for 24 h at auto-injector environment. WCK 771 was also found to be stable for 2h in serum at 25+/-3 degrees C and for 3 months at -20 degrees C. Mean absolute recovery at four different concentrations was 86.92% with standard deviation of 1.79. Throughput of the method is approximately one sample every 4 min. The method was also reproduced with monkey serum. The method was employed for estimation of drug serum levels during pre-clinical and clinical trials.

A molecular insight into the role of inflammation in the behavior and pathogenesis of odontogenic cysts

Background:

Although, odontogenickeratocyst (OKC) and dentigerous cyst (DC) are considered asdevelopmental cysts inflammation has been seen in its connective tissue wall. Inflammation is seen to alter the epithelial lining of both OKC and DC butwhether it plays in altering the behavior of these cysts is not fully understood.

Aim:

The present study is conducted with the help of molecular marker proliferating cellular nuclear antigen (PCNA) to assess the proliferative activity of OKC and DC and to further evaluate and correlate the effect of inflammation on the proliferative activity and hence on biological behavior of these cysts.

Materials and Methods:

Immunohistochemicalstaining was performed using anti-PCNA antibody in 10 cases each of classical OKC, inflamed OKC, classical DC, and inflamed DC. The resulting data was tabulated on Microsoft excel and subjected to statistical analysis using two-way analysis of variance test, t test and post-hoc test followed by Bonferroni test with the application of statistical package for social sciences (SPSS) (SPSS, Chicago, IL, USA) and Epi-Info 6.04 d, Atlanta, Georgia (USA).

Results:

Total mean PCNA expression is statistically higher in inflamed OKC than classical OKC and inflamed DC also showed significantly higher PCNA expression than classical DC (P < 0.001). Correlation between inflammation and PCNA expression was not statistically significant (P ≥ 0.05).

Conclusion:

Inflammation is responsible for change in behavior of neoplastic epithelium of OKC, whereas in dentigerous it is responsible for changes in epithelial lining and hence should be treated meticulously.

Mucormycosis in COVID-19 pandemic: study at tertiary hospital in India

Aim

During the second wave of COVID-19, cases of mucormycosis were increased suddenly over a period of 3 months in Maharashtra, India. An attempt was made to study the clinical profile and risk factors associated with mucormycosis.

Materials and methods

A retrospective descriptive study was carried out at a tertiary hospital during May 2021–July 2021. After obtaining informed written consent from the participants, various details of all participants, such as diabetes mellitus, use of steroids in COVID-19 treatment, use of immunosuppressant drugs, oxygen therapy, use of ventilators, complications that occurred during treatment, etc., were noted. All mucormycosis patients were treated with amphotericin B and aggressive surgical treatment.

Results

In the present study, 74.7% of mucormycosis patients were male. 77.4% of mucormycosis patients were above 40 years of age. 6.7% of mucormycosis patients were partially vaccinated. Among risk factors, 86.6% had diabetes mellitus, 84% had COVID-19 infection, 44% had received steroids, and 54.7% had received oxygen. 80% of patients were present during and within 1 month of COVID-19 infection. 52% of patients were presented in stage III and 41.3% were presented in stage II. Despite aggressive surgical debridement along with amphotericin B, mortality was 25.33%. 5.3% of patients had brain abscesses, 8% of patients had cavernous sinus thrombosis, 4% of patients had facial nerve palsy and 1.3% of patients had meningitis.

Conclusion

Mucormycosis was predominantly seen in male above the age of 40 years COVID-19 infection and diabetes mellitus was common risk factor for mucormycosis.

Langmuir probe electronics upgrade on the tokamak à configuration variable

A detailed description of the Langmuir probe electronics upgrade for TCV (Tokamak à Configuration Variable) is presented. The number of amplifiers and corresponding electronics has been increased from 48 to 120 in order to simultaneously connect all of the 114 Langmuir probes currently mounted in the TCV divertor and main-wall tiles. Another set of 108 amplifiers is ready to be installed in order to connect 80 new probes, built in the frame of the TCV divertor upgrade. Technical details of the amplifier circuitry are discussed as well as improvements over the first generation of amplifiers developed at SPC (formerly CRPP) in 1993/1994 and over the second generation developed in 2012/2013. While the new amplifiers have been operated successfully for over a year, it was found that their silicon power transistors can be damaged during some off-normal plasma events. Possible solutions are discussed.

Mosaic variant in ATP2C1 presenting as relapsing linear acantholytic dermatosis

Relapsing linear acantholytic dermatosis (RLAD) is a rare disease that manifests as recurring episodes of crusted and vesicular lesions distributed in a Blaschkoid pattern with histology resembling Hailey-Hailey disease. RLAD, in the presence of generalized disease, has been shown to be a type 2 mosaic form of Hailey-Hailey disease. RLAD, without systemic disease, has been hypothesized to be type 1 mosaic Hailey-Hailey disease, but this assertion has lacked genetic conformation. To determine the genetic abnormalities causing RLAD, we performed exome sequencing of affected tissue and blood in one patient. Exome sequencing of a punch biopsy revealed a c.238A>T, p.(Lys80*) variant in ATP2C1 found in 26% of the reads from lesional skin but absent in germline DNA. This somatic variant causes a truncated protein that would likely result in loss of function. Our findings indicate that, in this patient, RLAD is a clinical presentation of type 1 segmental Hailey-Hailey disease. What's already known about this topic? Relapsing linear acantholytic dermatosis (RLAD) is postulated to be a mosaic form of Hailey-Hailey disease. This hypothesis has remained unproven for type 1 disease and the putative gene and driving genetic variants have remained unknown. What does this study add? Exome sequencing, performed on lesional skin and matched blood, found RLAD lesions to be mosaic for variants causing a premature stop codon in ATP2C1. Our findings support the hypothesis that RLAD is a type 1 segmental form of Hailey-Hailey disease caused by postzygotic variants in ATP2C1.

Comparison of cough of 2 and 3 weeks to improve detection of smear-positive tuberculosis cases among out-patients in India

SETTING

Governmental health facilities in six districts of India.

OBJECTIVE

To estimate the prevalence of cough and to compare the detection of smear-positive tuberculosis (TB) among out-patients with cough of > or =2 or > or =3 weeks.

DESIGN

Trained health workers questioned each out-patient for presence of cough. Those with cough > or =2 weeks underwent sputum microscopy.

RESULTS

Of 55561 out-patients interviewed, 2210 (4%) had cough > or =2 weeks, of whom 267 had sputum-positive TB, compared to 182/1370 with cough > or =3 weeks. The 31% who did not spontaneously complain of cough were less likely to be sputum-positive than those who did (45/680 [7%] vs. 222/1530 [15%], P < 0.001), but they accounted for 45/267 smear-positive cases. Using cough > or =2 weeks as the screening criterion, the estimated number of smears performed per day at each primary and secondary health care facility was respectively 8 and 19, compared to 5 and 12 using cough > or =3 weeks.

CONCLUSION

The detection of smear-positive TB cases can be substantially improved by actively eliciting history of cough from all out-patients, and by changing the screening criterion for performing sputum microscopy among out-patients from cough > or =3 weeks to > or =2 weeks. Before implementing this change nationally, its programmatic feasibility should be assessed.

Plasma radiation dynamics with the upgraded Absolute Extreme Ultraviolet tomographical system in the Tokamak à Configuration Variable

We introduce an upgraded version of a tomographical system which is built up from Absolute Extreme Ultraviolet-type (AXUV) detectors and has been installed on the Tokamak à Configuration Variable (TCV). The system is suitable for the investigation of fast radiative processes usually observed in magnetically confined high-temperature plasmas. The upgrade consists in the detector protection by movable shutters, some modifications to correct original design errors and the improvement in the data evaluation techniques. The short-term sensitivity degradation of the detectors, which is caused by the plasma radiation itself, has been monitored and found to be severe. The results provided by the system are consistent with the measurements obtained with the usual plasma radiation diagnostics installed on TCV. Additionally, the coupling between core plasma radiation and plasma-wall interaction is revealed. This was impossible with other available diagnostics on TCV.

Efficacy and Safety of a Novel Broad-Spectrum Anti-MRSA Agent Levonadifloxacin Compared with Linezolid for Acute Bacterial Skin and Skin Structure Infections: A Phase 3, Openlabel, Randomized Study

BACKGROUND

Levonadifloxacin is a novel broad-spectrum anti-MRSA agents belonging to the benzoquinolizine subclass of quinolone. It is developed for oral or intravenous administration for the treatment of infections caused by Gram-positive organisms including methicillin-resistant Staphylococcus aureus (MRSA).

OBJECTIVES

To establish the non-inferiority of levonadifloxacin compared with linezolid for the treatment of acute bacterial skin and skin structure infections (ABSSSI) and to compare the safety of the two antimicrobials.

SUBJECTS AND METHODS

This was a Phase 3, multicentre, randomized, open-label, active- comparator study with 500 subjects. Oral levonadifloxacin 1000 mg was compared with oral linezolid 600 mg whereas IV levonadifloxacin 800mg was compared with IV linezolid 600 mg, each treatment was administered twice daily for 7-10 days. Non-inferiority was evaluated by comparing oral levonadifloxacin to oral linezolid and IV levonadifloxacin to IV linezolid for overall clinical response at TOC (Test of Cure) Visit.

RESULTS

The clinical cure rates observed at the TOC in the mITT (modified Intent to treat) populations for levonadifloxacin was numerically higher compared to linezolid in the IV sub-group [(91.0% verses 87.8%); treatment difference of 3.2% (95%CI, -4.5 to 10.9)] and in the oral sub-group (95.2% versus 93.6%); treatment difference of 1.6 % [95%CI, -4.2 to 7.3]). As the lowerbound of the 95% CI around the treatment difference was greater than -15% for both subgroups, the primary objective of the study was met. Therefore, both IV levonadifloxacin and oral levonadifloxacin were non-inferior to IV linezolid and oral linezolid, respectively. The majority of subjects in the micro-ITT population had a baseline infection caused by S. aureus with approximately 30% of subjects having MRSA. Levonadifloxacin (IV and oral) had a higher clinical cure rate at TOC for MRSA patients compared with linezolid (IV and oral), (95.0% vs. 89.3% respectively). Levonadifloxacin showed evidence of favourable clinical and microbiological efficacy in subjects with concurrent bacteraemia as well as in subjects with diabetes including diabetic foot infections caused by Gram-positive pathogens including MRSA. Pharmacokinetic analysis showed that bioavailability of oral levonadifloxacin was 90% and similar pharmacokinetic profile of levonadifloxacin by both routes provide an option for IV to oral switch for the treatment of subjects. Incidences of treatment-emergent adverse events (TEAEs) were similar between treatment groups and between IV (20.8% vs. 22.4%, for levonadifloxacin and linezolid, respectively) and oral therapy (16.0% vs. 13.5%, respectively), There were no SAEs or deaths related to study drug and the majority of the AEs observed were mild in nature. Overall, the administration of both IV and oral levonadifloxacin was well-tolerated in subjects with ABSSSI.

CONCLUSIONS

The results demonstrate that IV and oral levonadifloxacin therapy has excellent clinical activity against MRSA and offers advantage compared to other quinolones which generally lack MRSA coverage. Levonadifloxacin is safe and well tolerated in the treatment of ABSSSI caused by Gram -positive pathogens including MRSA as well as non-inferior to IV and oral linezolid, respectively. Similar pharmacokinetic profile of IV and oral levonadifloxacin provides an option for IV to oral switch for the treatment of subjects. Both oral and IV levonadifloxacin have recently been granted approval in India for the treatment of ABSSSI including diabetic foot infections and concurrent bacteraemia in adults (18 years of age or older). ClinicalTrials.gov Registration: NCT03405064. CTRI No.: CTRI/2017/06/008843.

Single Topical Application of 1% Clotrimazole Cream in Otomycosis

Aim: To assess the clinical improvement after single dose topical application of 1% clotrimazole cream in otomycosis and follow up for recurrence at the end of first and the third month. Materials and Methods: A prospective observational study was carried out at Government Medical college hospital. Patients with KOH diagnosed fungal infection of external auditory canal were included in the study. After obtaining informed written consent from the participating patients, a detail clinical history was taken. Single topical application of 1% clotrimazole cream in otomycosis. The fungal debris was removed with the help of suction aspiration and dry mopping. A single topical application of 1% clotrimazole cream was applied under all aseptic precautions. On the 3rd day the applied cream was cleaned with help of suction under ear microscope. Patients were advised to follow up after one month and three months. During each follow up patients were assessed clinically and examined for residual fungal debris. Result: Otomycosis was seen predominantly in middle aged females, housewives and laborers by occupation. Earache was most common symptom seen in 65.2%. Unilateral involvement was seen in 89.3% cases. The most common organism isolated in otomycosis was Aspergillus niger. At the end of one month of treatment with a single dose of 1% clotrimazole cream, 102 (91.0%) patients were recovered and 10 (9.0%) patients were with persistence or recurrence of the symptoms. At the end of third month, the recovery rate was 84.8% and recurrence rate was 6.3%. Conclusion: Single topical application of 1% clotrimazole cream is effective in treating otomycosis.

Comparative Study of Serum Lipid Profile in Tobacco Addicts, Tobacco Non-addicts and Head-Neck Malignancy

The present study was undertaken to evaluate lipid profile in tobacco consumers with and without head and neck malignancy and to see whether tobacco consumption causes same degree of alteration in lipid profile. Prospective study of serum lipid profile in 90 patients was done at Govt. Medical College Hospital. Various details of all participants such as age and sex of patients, detailed history of tobacco consumption were taken. Patients were divided into group I, II and III. Serum lipid profile was studied in 30 patients with tobacco addicts for more than 5 years in the form of tobacco chewing and smoking without head-neck malignancy (Group I), 30 patients with tobacco addicts for more than 5 yrs in the form of tobacco chewing and smoking with head-neck malignancy (Group II) and 30 controls i.e., non-smokers and non-tobacco chewers (Group III). Statistical analysis was done to compare the serum lipid profile (Total Cholesterol, HDL, Ratio, Sr. triglyceride, VLDL, LDL) among the tobacco chewers with head and neck malignancy, non-tobacco consumers and tobacco consumers without malignancy and controls i.e., non-smokers and non-tobacco chewers. There was no significant change in total cholesterol, LDL, VLDL, HDL in patients with tobacco addicts and tobacco non-addicts. Serum triglycerides are significantly decreased in tobacco addicts and in malignancy. Total cholesterol, HDL, and LDL are significantly increased in malignancy as compared to tobacco addicts and tobacco non-addicts. There was no significant change in total cholesterol, LDL, VLDL, HDL in patients with tobacco addicts and tobacco non-addicts. Serum triglycerides are significantly decreased in tobacco addicts and in malignancy.

Assessment of Deafness in Term Infants with Birth Asphyxia with Otoacoustic Emission and Brain Stem Evoked Response Audiometry: A Prospective Observational Study

To assess deafness in term infant with birth asphyxia by otoacoustic emission and brain stem evoked response audiometry. A Prospective observational study was done at Tertiary care government hospital from 15/02/2021 to 15/10/2022.Total 130 patients were included in the study by consecutive sampling method. All the patients fulfilling the inclusion criteria during the study period were included. After explaining the aims, objectives and methods of study, written informed consent was obtained from the parents to undergo Otoacoustic Emission (OAE) and Brain Stem Evoked Response Audiometry Test (BERA). Data was entered in case record form. Collected data was analysed by appropriate statistical methods. Hearing impairment was present in eight (6.15%) asphyxiated term infants. A mild degree of hearing loss was seen in three (37.5%), a moderate degree of hearing loss was seen in four (50%), severe degree of hearing loss was seen in one (12.5%) asphyxiated term infant. In asphyxiated term infants, no significant difference in hearing loss was seen with respect to gender, Obstetrics history, and type of delivery. Significant difference in hearing loss was seen in antenatal Diabetes mellitus, hypertension, family history of SNHL and APGAR Score less than 6. Severe degree of hearing loss was seen in prolonged labour and HTN mother. Significant difference in hearing loss was seen in antenatal Diabetes mellitus, hypertension, family history of SNHL and APGAR Score less than 4 and 6 in one and five minutes respectively. Severe degree of hearing loss was seen in prolonged labour and HTN mother.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12070-024-04736-2.

A Case Series of Dentigerous Cyst in Paediatric Patients at Our Tertiary Institution

Dentigerous cysts involves erupted or developing teeth in decreasing order of frequency as mandibular third molars, the maxillary canines, the maxillary third molars with rare involvement of the central incisors & are usually asymptomatic but becomes symptomatic with symptoms such as swelling, mild sensitivity, tooth mobility and displacement when it reaches size > 2 cm in diameter. Dentigerous cysts are seen most commonly in 20-30 years age group with relative low frequency in children with proportion of 4-9% of these cysts occur in the first 10 years after birth. Hospital based study conducted in the Department of ENT at Ashwini Rural medical college & Hospital, Solapur in which we have reported a series of three cases of dentigerous cyst in paediatric patients. Dentigerous Cysts in our study were associated with maxillary permanent lateral incisor, mandibular permanent premolar, Mandibular second molar tooth in pediatric age group. Provisional diagnosis of Dentigerous cyst based on clinical, radiological & biochemical study but Histopathological examination confirms the diagnosis. Dental orthopentamogram aids in diagnosing and localizing the Dentigerous cyst and ct face in all views helps to see bony effects and complications due to expansion of Dentigerous cyst. Enucleation of the cystic lesion followed by extraction of the offending teeth is a suitable treatment modality for Dentigerous cyst associated with maxilla and mandible giving adequate balance between complete removal of cyst & giving chance for eruption of unerupted teeth.