Assessment of optimal condylar position with cone-beam computed tomography in south Indian female population.

AIM: The purpose of this study was to investigate, the condyle-fossa relationship, in clinically asymptomatic orthodontically untreated south Indian female volunteers, by cone-beam computed tomography (CBCT). MATERIALS AND METHODS: The study population consisted of 13 clinically symptom-free and orthodontically untreated angle's Class I female subjects with the mean age of 18 years (ranges from 17 years to 20 years). The normal disc position of the 13 subjects was confirmed by history, clinical examination and magnetic resonance imaging scan. Then, the images of the temporomandibular joint (TMJ)of the subjects were taken using CBCT to evaluate the optimal condylar position. Posterior joint space (PS), superior joint space (SS) and anterior joint space (AS) were measured, and the values were subjected to statistical analysis. Mean PS, SS and AS of right and left side TMJ ' and AS of right sid 's were calculated. Paired samples t-test were used for each measurement to evaluate the average differences between the right and left side for each element of the sample. RESULTS: The mean value of PS, SS and AS of right side TMJ 's were 2.1385, 2.2769 and 1.7615, respectively. The mean value of PS, SS and AS of left side TMJ 's were 2.1385, 2.5308 and 1.8538, respectively. Statistical analysis with the t-test indicated no significant differences in the AS, SS, or PS values between the right and left side. TMJ 's mean PS, SS, and AS measurements were2.1 mm (standard deviation [SD] ±0.65 mm), 2.4 mm (SD ± 0.58 mm), and 1.8 mm (SD ± 0.52 mm), respectively. The ratios of SS and PS to AS, with AS set to 1.0, were 1.3 and 1.2, respectively. CONCLUSION: These data from optimal joints might serve as norms for the clinical assessment of condylar position obtained by CBCT.

Assessment of a new scoring system for predicting non-sentinel node positivity in sentinel node-positive melanoma patients.

BACKGROUND: When completion lymph node dissection (CLND) is performed in sentinel node (SN)-positive melanoma patients, a positive non-sentinel node (NSN) is found in approximately 20% of them. Recently, Murali et al. proposed a new scoring system (non-sentinel node risk score, N-SNORE) to predict the risk of NSN positivity in SN-positive patients. The objectives of the current study were to identify factors predicting NSN positivity and to assess the validity of the N-SNORE in an independent patient cohort. METHODS: All SN-positive patients who underwent CLND at a single institution between 1995 and 2010 were analyzed. Characteristics of the patient, primary melanoma, and SN(s) were tested for association with NSN positivity. Missing values were reconstructed using multiple imputation to enable multivariable analysis. RESULTS: CLND revealed positive NSNs in 30 (23%) of 130 SN-positive patients. Primary melanoma regression (p = 0.03) was independently associated with NSN positivity. After adjustment because of missing data on perinodal lymphatic invasion, N-SNORE proved to be a significant stratification model in our patient cohort (p = 0.003): 5.9% NSN positivity in the very low risk category and 75.0% NSN positivity in the very high risk category. CONCLUSIONS: Presence of regression in the primary melanoma was independently associated with a higher risk of NSN positivity. The slightly modified N-SNORE scoring system provided useful stratification of the risk for NSN positivity. However, lack of perinodal lymphatic invasion data may have reduced its predictive value.

Systemic lupus erythematosus in Indian patients: prognosis, survival and life expectancy.

BACKGROUND: There have been several studies on survival patterns in Indian patients with systemic lupus erythematosus but it is still not clear as to which factors at diagnosis predict survival outcome. The impact of specific organ involvement, and of disease activity itself, needs to be studied further. METHODS: We conducted a non-concurrent prospective study of 98 lupus patients between 1981 and 1993. The clinical symptoms, signs and investigation results at onset, and at subsequent visits, were abstracted from the case notes. A systemic lupus erythematosus disease activity index (SLEDAI) was constructed at the initial presentation and for each subsequent visit. Patients not attending for at least 6 months were traced by post. The quantitative data from the SLEDAI was used to construct a Markov chain mathematical expression designed to predict life expectancy. RESULTS: The cumulative percentage survival at 1, 5 and 10 years was found to be 89%, 77% and 60%, respectively. The Markov chain predicted a life expectancy of 13.9 years. Central nervous system and renal involvement were poor prognostic factors. Proteinuria (> 0.5 g/day) caused a 50% reduction in life expectancy but increased disease activity at onset did not predispose to a poor outcome. CONCLUSION: The survival of patients with systemic lupus erythematosus continues to be poor. Central nervous system and renal disease indicate a poor outcome. Hence, new treatment strategies must be evolved to improve the survival of such patients.