Serum lactate dehydrogenase in the prognostic assessment of patients with oral squamous cell carcinoma.

Background: Lactate dehydrogenase (LDH) has been proven to be a diagnostic marker in oral squamous cell carcinoma (OSCC). However, the prognostic value of serum LDH in OSCC is yet to be explored. The purpose of this study is to correlate the level of serum LDH with the degree of OSCC and to evaluate the role of serum LDH as a prognostic marker in OSCC. Methods: The investigators designed and implemented a prospective cohort study composed of patients with OSCC (n = 66) sub-grouped as follows: 2A-well-differentiated (n = 22), 2B-moderately differentiated (n = 22), 2C-poorly differentiated OSCC (n = 22), and normal healthy controls (n = 40). The primary outcome variable was the serum LDH measured at baseline (pre-treatment) and 2 and 12 months post-treatment in OSCC patients. The statistical analysis was performed using the student t-test and analysis of variance, and the P value was set at 0.05. Results: The habit of alcohol consumption alone as a single habit was found only in males (17.5%) (P = 0.3343), whereas betel quid chewing was more common among females (P = 0.0182). A significant difference was observed in the mean serum LDH between OSCC subjects (pre-treatment) (831.56 ± 93.43 IU/L) and controls (188.82 ± 25.53 IU/L), P < 0.00001. The baseline serum LDH was significantly higher in subgroup 2C (933.41 ± 46.1969 IU/L) than in the 2A (742.59 ± 46.5676 IU/L) and 2B (818.68 ± 58.1643 IU/L) subgroups (P = 0). There was a significant decline in the serum LDH within 2 months after treatment, and a further decrement was observed during a 12-month follow-up among the survivors of all three subgroups; P < 0.00001. Conclusion: Serum LDH can play a dual role as a reliable indicator of the degree of OSCC for decision-making in treatment modalities and as a prognostic marker of response to therapy.

Conchal Cartilage in Surgical Reconstruction of Orbital Floor Fracture.

According to Kim and Jeong (2016), isolated orbital fractures are encountered in 4-16% of all facial fractures, and orbital fractures composed approximately 30--55% of the zygomaticomaxillary complex (ZMC) and naso-orbital-ethmoid (NOE) fractures. The ideal material for orbital floor fracture repair is one that is resorbable, osteoconductive, resistant to infection, minimally reactive, does not induce capsule formation, has a half-life that allows significant bone in-growth to occur, and is cheap and readily available. In this article, we report a case of a young female with an orbital floor fracture managed surgically using conchal cartilage and a review of literature.

Comparative Effects of Clonidine and Adrenaline with Lignocaine during Maxillary Infiltration Anaesthesia for Dental Extraction.

INTRODUCTION: Lignocaine is a commonly used local anaesthetic in dental practice. Many practitioners use adrenaline (epinephrine) as additive with lignocaine, and some have used clonidine, instead of adrenaline. Both having benefits and limitations. AIMS: Hence a study was undertaken in our department to evaluate the advantages and disadvantages of using (plain lidocaine local anaesthetic) versus (lidocaine with adrenaline as additive) versus (lidocaine with clonidine as additive). STUDY DESIGN: Randomised, prospective, double blind study. MATERIALS AND METHODS: Seventy five patients requiring extraction of maxillary molar teeth who fall under ASA I category were included and randomly divided into group - I (n=25) (Lignocaine), group - II (n=25) (Lignocaine ± Adrenaline) and group - III (n=25) (Lignocaine ± Clonidine). The observations recorded were, time of onset of anaesthesia, hemodynamic parameters, blood loss during procedure and duration of post operative analgesia. STATISTICAL ANALYSIS: The statistical analysis was carried out using SPSS 16 software. RESULTS: A statistically significant difference was seen in blood loss, being higher in group I and duration of anaesthesia, being shortest in group I. There was no statistical difference between the three groups amongst other parameters. CONCLUSION: Adrenaline at 10 µg/ml and clonidine at 15 µg/ml can be safely used as additives with lignocaine, in maxillary infiltration anaesthesia for dental extraction; with addition of either of these two drugs, having an equal advantage over use of plain lignocaine; in terms of lower blood loss and longer duration of anaesthesia; but, with no difference in the onset of anaesthesia and with no significant hemodynamic changes.

Giant cell fibroma: a case report with immunohistochemical markers.

Giant cell fibroma may mimic fibroma of the gingiva, but have distinctive histopathological difference. Immunohistochemical markers are required to diagnose GCF. It may occur at any age but most often in the third decade of life. It may be often asymptomatic but may not be esthetic if present in the anterior region of the jaw. Surgical excision should be performed, and the prognosis is good. However long term follow-up is required to check for any recurrence. The most common gingival enlargements like fibroma and granuloma may be mistaken for GCF. We present a case report with histopathological markers used to diagnose GCF.