Quantification of oral neutrophil counts in periodontal health and disease utilising a standardised oral rinse.

Background and Objectives: Polymorphonuclear neutrophils are the most abundant leukocytes in humans and are key host cells in defence against invading microorganisms. The oral neutrophil count may be an indicator of the periodontal health status, which correlates with the severity of periodontal disease. This study attempts to quantify orogranulocytes utilising an oral rinse and to assess the usefulness of this method in evaluating the oral inflammatory load much the same way the circulating neutrophils are used to screen for patients with infection in extra-oral sites. Methods: A total of 125 participants were divided into five groups with 25 subjects in each group. The groups consisted of healthy, gingivitis, mild periodontitis, moderate periodontitis, and severe periodontitis. Participants were asked to rinse with 10 mL of 0.9% saline for 30 s and to expectorate. Samples were centrifuged at 2000 RPM for 10 min. The supernatant removed was suspended in 5 mL of Hanks's balanced salt solution. One millilitre of this suspension was mixed with 4 µL of acridine orange. A 10 µL aliquot of this suspension was then assessed on a haemocytometer, and the oral PMNs were counted using fluorescence microscopy. Results: The mean number of oral neutrophils (100,000 cells/mL) was the lowest in the healthy group and increased in ascending order across the different groups with the highest for severe periodontitis group. Conclusion: The oral neutrophil counts increased with the severity of periodontal inflammation. This is an easy, safe, reliable, and non-invasive method of quantification of oral neutrophils.

An Assessment of Correlation between Dermatoglyphic Patterns and Sagittal Skeletal Discrepancies.

INTRODUCTION: Investigators over years have been fascinated by dermatoglyphic patterns which has led to the development of dermatoglyphics as a science with numerous applications in various fields other than being the best and most widely used method for personal identification. AIM: To assess the correlation between dermatoglyphic patterns and sagittal skeletal discrepancies. MATERIALS AND METHODS: A total of 180 patients, aged 18-40 years, were selected from those who attended the outpatient clinic of the Deparment of Orthodontics and Dentofacial Orthopedics, Mar Baselios Dental College, Kothamangalam, Kerala, India. The fingerprints of both hands were taken by ink and stamp method after proper hand washing. The patterns of arches, loops and whorls in fingerprints were assessed. The total ridge count was also evaluated. Data was also sent to the fingerprint experts for expert evaluation. The sagittal jaw relation was determined from the patient's lateral cephalogram. The collected data was then statistically analyzed using Chi-square tests, ANOVA and Post-hoc tests and a Multinomial regression prediction was also done. RESULTS: A significant association was observed between the dermatoglyphic pattern exhibited by eight fingers and the sagittal skeletal discrepancies (p<0.05). An increased distribution of whorl pattern was observed in the skeletal Class II with maxillary excess group and skeletal Class II with mandibular deficiency group while an increased distribution of loop pattern was seen in the skeletal Class III with mandibular excess group and skeletal Class III with maxillary deficiency group. Higher mean of total ridge count was also seen in the groups of skeletal Class II with maxillary excess and skeletal Class II with mandibular deficiency. Multinomial regression predicting skeletal pattern with respect to the fingerprint pattern showed that the left thumb impression fits the best model for predicting the skeletal pattern. CONCLUSION: There was a significant association between dermatoglyphic patterns and sagittal skeletal discrepancies. Dermatoglyphics could serve as a cost effective screening tool of these craniofacial problems.

Histological and Histometrical Evaluation of two Synthetic Hydroxyapatite Based Biomaterials in the Experimental Periodontal Defects in Dogs.

AIM: The present study was to evaluate histologically and histometrically the efficacy of Chitra granules in the regeneration of alveolar bone and to compare it with that of OsteoGenR (HA Resorb)(TM) in iatrogenically created alveolar bone defects in mongrel dogs. MATERIALS AND METHODS: Four dogs (16 sites) were used for this split-mouth study. The animals were divided randomly into two groups of two animals. Same animals were used as control and test. Each dog had four implantation sites. The periodontal defects were prepared by acute defect model. Animals were sacrificed at 3 months (n=2), 6 months (n=2) and histologic and histometric evaluation was carried out. STATISTICAL ANALYSIS: The data was analysed using statistical package Graph pad Software. Comparison of the hard and soft tissue parameters in the two groups was done using the Wilcoxan (Man Whitney), two tailed t-test. A p-value less than 0.05 were considered significant. RESULTS: Maturing bone with immature periodontal ligament fibers were observed at three months and advanced osteogenesis at six months with both the types of bone graft materials. The mean values showed that amount of new bone formed with OsteoGenR (HA Resorb)(TM) was slightly more than that obtained by Chitra granules in histometric evaluation. CONCLUSION: Histological study showed similar healing pattern with both the types of bone graft materials with maturing bone at 3 months and advanced osteogenesis at six months in experimental intraosseous periodontal defects in dogs. However, histological evaluation for longer period is necessary to determine the time taken for complete replacement of the bone graft materials with new bone.

Results of laparoscopic cryoablation in the treatment of small renal masses.

CONTEXT: Study of clinical outcome in renal cryoablation. AIMS: Laparoscopic cryoablation (LCA) is emerging as a reliable treatment option for small renal masses (SRMs) particularly in elderly patients. Our aim was to study the results of cryoablation for small renal masses in our cohort of patients. SETTINGS AND DESIGN: We retrospectively studied all patients who underwent LCA for SRMs between September 2005 and July 2008. MATERIALS AND METHODS: All patients were discussed in our multidisciplinary meeting prior to cryoablation. Our LCA protocol included two freeze-thaw cycles, achieving a core temperature of -70°C and a peripheral temperature of at least -40°C. Follow-up included serum creatinine measurements and pre- and postcontrast CT scans at 3, 6, 12, 18, and 24 months and yearly thereafter. STATISTICAL ANALYSIS USED: Paired samples t-test was used to study statistical difference. RESULTS: Twenty-two patients underwent LCA with a mean (range) age of 68 (39-81 years) years. The mean (range) tumor size was 29 (19-45 mm) mm. Two patients required blood transfusions, one patient developed pneumonia, and another patient developed a small area of skin necrosis at the cryoneedle entry site. The average (range) hospital stay was 4 (2-14 days) days. Twenty-one patients have had CT follow-up at a mean (range) of 24 (4-42 months) months. Three of the 21 tumors showed central enhancement on follow-up CT scans, consistent with treatment failure. CONCLUSIONS: Laparoscopic cryoablation is a safe treatment option for SRM in a selected group of patients.

Urethral catheter induced pseudoaneurysm of the bulbar artery.

Injuries of the urethra due to urethral catheter have been well recognised. We report a case of pseudoaneurysm of the artery to the bulb of the penis which formed due to necrosis of the arterial wall secondary to prolonged pressure due to a wrongly placed urethral catheter. The catheter was inflated in the bulbar urethra and left during surgery for 4 hours. The patient developed intermittent severe urethral bleeding. An angiogram of internal iliac artery showed a pseudo aneurysm involving the bulbar artery with arteriovenous communication. Super selective embolization of the feeding vessel was performed with cessation of the blood fl ow immediately. To our knowledge, pseudoaneurysm of the bulbar artery of penis has not previously been described.

Fine-needle aspiration cytology versus open biopsy for evaluation of chronic epididymal lesions: a prospective study.

OBJECTIVE: To compare the efficacy of fine-needle aspiration cytology (FNAC) with that of open biopsy in the evaluation of chronic epididymal lesions. MATERIAL AND METHODS: Forty men evaluated for chronic epididymal lesions were studied. Men aged >25 years who did not intend to father any more children and had had local symptoms for >6 weeks were included. Of these 40 men, 23 who satisfied the above criteria were subjected to FNAC and open biopsy. The slides were reviewed by two independent pathologists. The sensitivity, specificity and positive predictive value of FNAC were compared with the results of open biopsy. RESULTS: Tuberculous epididymitis was the commonest cause of chronic epididymal lesions, followed by non-specific epididymitis, sperm granuloma, epdidymal cyst and normal epididymis. The sensitivity and specificity of FNAC for the diagnosis of tuberculous epididymitis were 87% and 93%, respectively. For the diagnosis of non-specific epididymitis, FNAC was 100% sensitive and 100% specific. The positive predictive value was 87% for the diagnosis of both tuberculous and non-specific epididymitis. CONCLUSIONS: FNAC has an overall sensitivity and specificity of 90% for diagnosing chronic epididymal lesions, with a positive predictive value of 87.5%. It is a valuable tool for evaluating chronic epididymal lesions. We suggest that FNAC should be the first-choice investigation for establishing the histopathological diagnosis of epididymal lesions.