Clinical, radiographic, and histological findings of chronic inflammatory periapical lesions - A clinical study.

AIM: The present study aimed at comparing clinical, radiographical, and histological findings in chronic periapical lesions such as cysts, granuloma, and abscess. METHODOLOGY: The present study was conducted on 148 teeth having chronic inflammatory periapical lesions with or without nonsurgical endodontic treatment. Endodontic surgery was performed by single trained endodontist. After surgical endodontic treatment, biopsy sections of teeth were assessed histologically. All slides stained with hematoxylin/eosin and Gomori trichrome for light microscopy assessment. RESULTS: Out of 148 teeth, 41 had chronic inflammatory lesions, 34 had inflammatory cysts, and 25 had indefinite lesions. Chronic inflammatory lesions assessed histologically found chronic apical periodontitis in 86 cases and inflammatory cysts in 62 cases. The difference was significant (P < 0.05). Out of 86 cases of chronic apical periodontitis confirmed clinical radiographically, 64% found positive, whereas 36% were not histologically. Out of 62 cases of inflammatory cysts confirmed clinically and radiographically, 78% found positive while 36% were not histologically. Out of 25 indefinite lesions, 56% found chronic inflammatory lesions while 44% found inflammatory cyst. CONCLUSION: There was significant disagreement in clinical radiographic as well as histological diagnosis.

Clinico-mycological study of onychomycosis in a tertiary care hospital-A cross-sectional study.

Onychomycosis (OM), has a worldwide prevalence of 5% and 0.5%-5% in India. Trichophyton. rubrum (T rubrum) and T mentagrophytes are the most commonly isolated fungi. As the clinical and mycological characteristics change with time and geographical region; it is important to study the temporal and topographic patterns periodically. The study was conducted to identify the epidemiological and clinico-mycological characteristics of patients with OM attending a tertiary care hospital in Delhi. Hundred patients with clinical diagnosis of OM were recruited. Among these, 88 patients who tested positive for OM on direct microscopy with KOH, culture and/or histopathology with periodic acid-Schiff were included in the study. The clinico-mycological characteristics and risk factors associated with OM were evaluated. OM was more common in males (M:F = 2.5:1). The mean age of patients with OM was 39 ± 15.3 years (SE 1.52) with mean disease duration of 27.6 ± 46.1 months (SE 4.9). Seventeen (19.3%) patients had concomitant diabetes mellitus. The patients displayed mean body mass index (BMI) of 25.67 ± 1.35 kg/sq m. Concurrent dermatophytosis of skin was present in 35 (39.77%) patients. Two feet-one hand syndrome was present in 5 patients. Fingernail involvement without toenail involvement was more common than toenail involvement alone. (43.18% vs 38.63%). Distal and lateral subungual OM (DLSO) was the commonest clinical variant (81.8%). Mycological culture showed growth in 47 (53.40%) patients. Dermatophytes were isolated in majority, that is in 30 (63.82%) patients followed by non-dermatophytic moulds (NDM) in 7 (14.8%) and Candida spp. in the remaining 10 (21.27%) patients.

The chik sign in dengue.

The "chik sign" is considered to be one of the most common cutaneous features of chikungunya fever and has been considered unique to this disorder. It consists of brownish hyperpigmentation involving the nose. We report a case of a 3-year-old boy with dengue infection who presented with macular hyperpigmentation of nose simulating the chik sign. Hyperpigmentation is an unusual cutaneous manifestation in cases of dengue.

Status of free radicals and antioxidants in leprosy patients.

Oxidative stress is a condition associated with an increased rate of cellular damage induced by the oxygen derived oxidants commonly known as reactive oxygen species (ROS). ROS are capable of damaging cellular constituents generated in excess during the chronic, inflammatory, neurodegenerative disease process of leprosy. Severe oxidative stress has been reported in leprosy patients because of malnutrition and poor immunity. The decreased levels of SOD, glutathione and total antioxidant status in leprosy patients may indicate a degradation of these antioxidant enzymes by free radicals during detoxification processes. The subjects for this study comprises of Normal human volunteers (NHV, n = 20) and treated MB patients (MB, n = 20). The levels of lipid peroxidation products are increased in MB Patients (*P < 0.001). SOD (**P < 0.0001) and glutathione levels (***P < 0.0001) decreased in MB Patients in comparision with normal human volunteers. The present study of estimation of antioxidants conclude that the free radical activity was increased and the total antioxidant status was decreased in all MB patients, indicating that there was an oxidative stress even after the treatment with MDT. The decreased levels of SOD, glutathione indicate a link between oxidative stress and leprosy. Since the MB patients are unable to produce sufficient amount of antioxidant to cope up with the increased oxidative stress in them. Providing nutritional supplementation may present a novel approach for fast recovery. Administration of exogenous antioxidants like vitamin C, tocopherols would prevent tissue damage and make the patient therapeutically benefited.

Effect of irrigants using ultrasonics on intracanal calcium hydroxide removal – an in vitro comparative evaluation

Aim: To evaluate the efficacy of various irrigating solutions on calcium hydroxide (Apex cal andRC cal) removal with the use of ultrasonics. Methods: The root canals of 120 single-rootedmaxillary central incisors were prepared using the stepback technique. The teeth were decoronatedand split longitudinally. After filling, the two halves of roots were reassembled with sticky wax andeach group was further divided into four subgroups according to the irrigating solution: SmearClear, 10% citric acid, 5% EDTA and 3% NaOCl. Evaluation for cleanliness was done under amicroscope with ×12.5 magnification. Statistical analysis was done with Kruskal Wallis and MannWhitney tests at 5% level of significance. Results: There was no statistically significant difference(p>0.05) for calcium hydroxide (Apex Cal and RC Cal) removal by different irrigants. There weremore residues in the apical groove than in the coronal groove (p<0.05). Conclusions: Whenthe different irrigants were compared at coronal and apical levels, Smear Clear and citric acidwere more effective in calcium hydroxide removal than EDTA and NaOCl.