Use of eradication therapy in adjunction to periodontal therapy versus alone for treatment of Helicobacter pylori infections: a mini review.

Approximately 50% of the human population on the Earth is estimated to be affected by the bacterium Helicobacter pylori. which causes disease manifestations ranging from peptic ulcer disease to chronic gastritis to gastric cancer. It has been a struggle to contain this bacterium using conventional antibiotics due to rising antimicrobial resistance, which has made its eradication an even bigger challenge. Due to this major issue, scientists have ventured to use alternative approaches to bring about the eradication of H. pylori colonization. Aim: The main aim of this review was to update previous studies that investigated periodontal therapy's effect on H. pylori eradication. Method: A systematic electronic search of the currently available research was conducted to identify all the relevant trials and original studies that compared the clinical effect of periodontal therapy in conjunction with eradication therapy. Results: The newly updated review of the literature did not change the conclusion previously reached and instead reinforced the fact with more power and more recent studies that the addition of periodontal therapy to eradication therapy for H. pylori is superior to the use of eradication therapy alone for H. pylori. Core Tip: The addition of periodontal therapy to the standard eradication therapy may be a clinically viable option and pave the way for tackling the H. pylori burden as well as aiding in the prevention of antimicrobial resistance to an extent, along with immensely increasing the efficacy of the standard eradication therapy for H. pylori that is currently in use around the world.

Case of maxillary actinomycotic osteomyelitis, a rare post COVID complication-case report.

Introduction: and Importance: Maxillary actinomycosis is a persistent, very rare disease produced by Actinomyces species which may include only soft tissue or bone or the two together. Actinomycotic osteomyelitis of maxilla is very infrequent when compared to mandible. Case presentation: Here we are conferring a case of an elderly male patient who had history of COVID-19 infection 4 months ago, with constant complaint of non-remitting vague pain in the region of maxilla with tooth loosening and extractions. He was given a provisional diagnosis of chronic osteomyelitis of maxilla which was later on proved by histopathology as actinomycotic osteomyelitis. Clinical discussion: A saprophytic fungus causes mucor mycosis, and it is quite unusual. Strawberry gingivitis is one of the signs and symptoms. Mucormycosis and post-covid oral maxillofacial problems can be improved with early diagnosis. Oral Mucormycosis should be suspected in individuals with weakened immune systems, uncontrolled diabetes or post-covid instances. Surgery and adequate antibiotic treatment are necessary to treat actinomycosis. Infection may return after a period of inactivity, so long-term follow-up is necessary. Conclusion: We conclude a positive causal association between COVID-19 and actinomycosis. Maxillary osteomyelitis, a very rare infection, and in our case, the causative organism was Actinomyces Patients who have been infected should be tested for Actinomycin, which may masquerade as a head and neck illness.

A prospective, single-centered, cohort study comparing the treatment of renal stones by following PCNL types: Standard, tubeless & totally tubeless.

Introduction: Renal stones are a frequent cause of morbidity globally. The number of lumbotomies performed for benign lithiasis has been greatly decreased with the usage of Percutaneous Nephrolithotomy (PCNL). Further development is aimed at reducing tract size, leading to numerous advanced minimally invasive PCNL procedures like mini-PERC, ultra-mini-PERC, and micro-PERC. The aim of this study was to evaluate whether tubeless or totally tubeless PCNL is the safest and most efficient, less morbid management technique for renal stones compared to the standard PCNL with a nephrostomy tube. Methodology: This is a comparative, prospective, single-centered, cohort study that took place between August 2015 and January 2018 in the Urology department of Benazir Bhutto Hospital in Rawalpindi, Pakistan. 218 patients having single/multiple stones of variable sizes were enrolled in the study. Participants were stratified into three groups; Group A: Standard PCNL treatment; Group B: Tubeless PCNL treatment; Group C Totally Tubeless treatment. Mean operation time (±SD) and stone-free rates were our primary outcomes. The rate of complications during and post-operative complications were our secondary outcomes. Results: A total of 181 patients were included in our study. A decreasing trend can be seen in mean operation time as we move from Group A to Group C (p = 0.000). The rate of problems during operation in each group was highest (45.8%) in Group A, much lesser problems in Group C (13.3%), and least problems in Group B (8.1%) (p = 0.000). The postoperative complication rate was again the highest in Group A (30.5%), low in Group C (8.3%), and extremely low in Group B (1.6%). Conclusion: Tubeless PCNL proved to be the safest and most effective when compared to standard and totally tubeless PCNL procedures. It also showed the highest stone-free rates and least 'unsatisfactory' results amongst all the groups. Conclusively, it should be performed in routine preferably.