Clinical Profile, Risk Factors and Outcomes in Patients with Cerebral Venous Sinus Thrombosis: A Study from Western India.

AIM: Study of cause and clinical profile of venous sinus thrombosis in Western India. SETTINGS AND DESIGN: A retrospective study was conducted to ascertain the clinical profile, etiology, and follow up of patients with venous sinus thrombosis. METHODS AND MATERIAL: Hospital database of patients suffering from venous sinus thrombosis from two tertiary care hospitals in West India were studied. A telephonic follow up was taken for assessment of outcome. Inclusion criteria were a) Age more than 15 years of age b) clinically symptomatic patients c) Diagnosis confirmed by Magnetic resonance Venography (MRV) or CT Venography (CT Venography) Exclusion criteria: Patients with infarct in arterial territory, hypertensive hemorrhage, metabolic encephalopathy and eclampsia were excluded from the study. STATISTICAL ANALYSIS USED: Descriptive statistic was performed as frequency, mean and standard deviation or percentages. Difference in continuous variables was evaluated by using independent t-test while chi-square test was performed in categorical variables. Statistical P<0.05 was considered statistically significant. RESULTS: We conducted a retrospective study of patients with venous sinus thrombosis in Rajasthan in western India. Out of 71 patients in our study group the mean age of presentation was 36.64 years. 42 patients were male (59.2%) and 29 were female (40.8%). Only 9 patients (12.6%) had pregnancy or puerperium related venous sinus thrombosis. The most common presenting feature was headache 47/71(66.2), followed by seizures 33 (46.5%), paresis 20/71 (28.16%) and coma 15/71(21.1%). MRI Brain recorded infarcts in 32/71 patients and predominant hemorrhage was recorded in 34/71. 4 cases were associated with malignancy (one CNS, one outside CNS and 2 hematological). Raised homocysteine level was found in 26/35 (74.3%) patients in whom they were measured. 9 patients had moderately elevated homocysteine levels (15-30), another 9 had intermediate values (31-64) and 5 patients had elevated homocysteine level >65. Hyperhomocysteinemia was the commonest causative factor and was far more common in men (21/25) than in women (5/10). (p value 0.019). 24 out of 71 patients were found to be anemic (33.8%). Anemia was far more common in women than in men. (p value .002). Protein C level was found abnormal in 5/27 patients, Protein S in 6/27 patients and Anti thrombin III in 1/23 patient studied respectively. History of oral contraceptive intake was recorded in only a minority of women with venous sinus thrombosis 7(24.1%) compared to the western data where most of the venous sinus thrombosis are related to the contraceptive pills. CONCLUSION: The clinical presentation of venous sinus thrombosis in tertiary care centers is changing outside the traditional peurperium / pregnancy related venous sinus thrombosis. Common risk factors include hyperhomocysteinemia, anemia, coagulopathy, pregnancy related, vasculitis, malignancy and oral contraceptive usage. Male involvement was far more common than females and was usually associated with a higher level of homocysteine.

Marginal Bone Level Measurements of Unsplinted Implants Used for Mandibular Overdentures: A Six-Month Randomized Prospective Clinical Study Comparing Early and Delayed Loading Protocols.

Background and purpose Implant-supported mandibular overdentures are a good alternative for patients having poor retention of mandibular conventional dentures. The aim of this prospective study was to evaluate and compare the results between early loading and delayed loading of mandibular overdentures on two unsplinted implants. Materials and methods  A total of 14 completely edentulous male patients in the age group of 50-60 years were selected for the study. Two 3.5×13 mm implants were placed in the mandibular interforaminal region. The patients were divided into two groups: (i) the test group in which the overdenture was connected after one week of surgery, and (ii) the control group, in which the overdenture was connected three months after surgery. Marginal bone levels were evaluated at baseline (during loading), three months, and six months post loading. Unpaired 't' test was used for the comparison of intergroup measurements.  Results No implants were lost. Marginal bone resorptions showed no statistically significant differences between the two groups over six months period after loading. Conclusion The results of this prospective clinical study suggested that there was no significant difference in the clinical and radiographic state of patients treated with implant-supported mandibular overdentures loaded either one week or three months after implant surgery.

Effect of Monopoly-coating Agent on the Surface Roughness of a Tissue Conditioner Subjected to Cleansing and Disinfection: A Contact Profilometric In vitro Study.

INTRODUCTION: Tissue conditioners are used to improve the health of the soft tissues of denture-bearing areas. However, leaching of plasticizers from tissue conditioners results in deterioration, which necessitates frequent replacement. The life of these liners varies, but it can be extended by the use of a coating material. AIM: To evaluate the surface roughness of a tissue conditioner with monopoly coating, subjected to denture cleanser and disinfectant. MATERIALS AND METHODS: Sixty disk-shaped specimens of Visco-gel were made and divided into six groups of 10 each (control 1 [C1], control 2 [C2], control 3 [C3], group 1 [M1], group 2 [M2], and group 3 [M3]). Specimens of the control group were not coated with monopoly, while the specimens of the groups 1, 2, and 3 were coated with monopoly. Specimens of C1 and M1 were immersed in distilled water. Specimens of C2, C3, M2, and M3 were immersed into solution of denture cleanser for 8 h at room temperature and immersed in distilled water for the remainder of the 24-h period. C3 and M3 specimens were treated with disinfectant for 10 min before testing the surface roughness. The surface roughness was measured on 1st, 3rd, 5th, 7th, and 14th day, using a contact profilometer. Student's paired t-test was used to compare the mean Ra values within each group. In the present study, P < 0.05 was considered as the level of significance. RESULTS: The mean surface roughness values of M1, M2, and M3 groups were less than C1, C2, and C3, respectively. Among all the groups, M1 showed the least surface roughness values. CONCLUSION: Monopoly-coating agent prevents the deterioration and reduces the surface roughness of the tissue conditioner.

Giant cell fibroma of tongue: understanding the nature of an unusual histopathological entity.

Giant cell fibroma (GCF) is a rare case with unique histopathology. It belongs to the broad category of fibrous hyperplastic lesions of the oral cavity. It is often mistaken with fibroma and papilloma due to its clinical resemblance. Only its peculiar histopathological features help us to distinguish it from them. The origin of the giant cell is still controversial. Data available is very sparse to predict the exact behavior. Hence, we report a case of GCF of tongue in a 19-year-old male. Special emphasis is given to understand the basic process of development of the lesion, nature of giant cells, and also the need for formation of these peculiar cells. Briefly, the differential diagnosis for GCF is tabulated.

A direct investment method of closed two-piece hollow bulb obturator.

Maxillary defects occur due to surgical treatment of benign and malignant tumors, congenital malformation, and trauma. Prosthetic rehabilitation in such patients is influenced by the size and location of the defect. The most common of all intraoral defects are seen in the maxilla, in the form of an opening into the maxillary sinus and nasopharynx. These defects create disabilities in speech, deglutition, and mastication. The prosthesis which closes such an opening and recreates the functional separation of the oral cavity and sinus and nasal cavities is referred to as an obturator. Numerous techniques of hollow bulb fabrication have been mentioned in the literature from time to time. But there are only a few methods for bulb fabrication in two-piece obturator. This technique describes a direct investment method of waxed-up closed hollow bulb two-piece obturator.