Assessment and correlation of anxiety, depression and serum cortisol levels in patients with oral submucous fibrosis and leukoplakia: A clinicohematological study.

Context: Potentially malignant disorders (PMDs) of the oral cavity like oral submucous fibrosis (OSMF) and leukoplakia are known to be caused due to addictive habits, while serum cortisol is accepted to be a stress hormone. Aim: The present study was aimed to assess and correlate the anxiety, depression and serum cortisol levels in habit-associated PMDs such as OSMF and leukoplakia and compare it with healthy subjects. Materials and Methods: Ninety patients were included in the study and were divided into three Groups, namely Group I (OSMF), Group II (leukoplakia) and Group III (control group). Serum cortisol levels and severity of anxiety and depression using the Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HAM-D) were recorded and correlated. Results: A significant correlation existed between serum cortisol level and levels of both anxiety and depression between Group I and II as compared to the control group. Conclusion: There exists a definite correlation between serum cortisol levels and the levels of anxiety and depression in patients with leukoplakia and OSMF, with increasing levels of serum cortisol and higher values in both the HAM-A and HAM-D scales in patients with both OSMF and leukoplakia. PMDs such as leukoplakia and OSMF have an established cancer-causing potential. Anxiety and depression although prevalent are underdiagnosed and poorly understood. Hence, a holistic approach in the treatment of such pathologies including hematological investigations and psychological evaluation should be mandatorily made a part of the workup and treatment plan.

Efficacy of rebamipide and levamisole in the treatment of patients with recurrent aphthous ulcer - a comparative study.

UNLABELLED: Context (Background): Recurrent aphthous stomatitis is an inflammatory condition of unknown aetiology characterized by painful recurrent, single or multiple ulcerations of the oral mucosa. AIMS: To compare the efficacy of rebamipide, a gastro-protective agent and levamisole, an immunomodulating agent in the treatment of recurrent aphthous stomatitis. MATERIALS AND METHODS: Hundred patients diagnosed with recurrent aphthous stomatitis were enrolled in the study. Fifty patients were assigned randomly to each of the two treatment groups. After the clinical diagnosis and ulcer measurement, a subjective evaluation of symptoms was done for each subject. Both the drugs were given orally at specified intervals. Ulcer measurements and subjective evaluations were made at day one. STATISTICAL ANALYSIS: Analysis was done using various test like Mann Whitney and t-test. RESULTS AND CONCLUSION: The overall results showed mean number of episodes whose values were not statistically significant (p=0.43), neither were the mean number of ulcers (p=0.75), or values for mean size of ulcers (p=0.91). However, the overall results suggested that efficacy of rebamipide is almost same as that of the efficacy of previously proved drug levamisole. The current study with a three months follow up, including patients with high scores of pain, aphthae count, ulcer size and frequency of occurrence showed better results in both the study groups. However, rebamipide is suggested to be well tolerated and may therefore be useful in the treatment and prevention of frequently recurrent aphthous ulcers not restricted to Behcet's disease.

An unfamiliar presentation of a lateral periodontal cyst.

Lateral periodontal cyst, developmental in origin, typically is observed in the cuspid-bicuspid region of the mandible and less frequently in the maxilla. It may arise initially as a dentigerous cyst developing by expansion of the follicle along the lateral surface of the crown which eventually comes to lie on the lateral aspect of the root if tooth eruption is normal. Alternatively, it may arise from the cell rests of malassez. The incidence of lateral periodontal cysts has been reported to be less than 1% and these cysts represent nearly 0.8% of all central cysts of the maxillary bone. Here we present one such case with unusual findings.

Management of haemangioma with sclerosing agent: a case report.

The use of multiple weekly intralesional injections of 3% sodium tetradecyl sulfate as a sclerosing agent for the management of facial haemangiomas is a safe treatment with acceptable results. As presented in this case report, this technique offers the patient considerable relief of symptoms with minimal complications. However, the possibility of second-stage surgery to correct residual deformity is still considered. Sclerotherapy with 3% sodium tetradecyl sulfate provides a good preparation for further surgery.