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Introduction: Neoplasms that are derived from odontogenic tissues represent an uncommon and heterogenous group of enti- ties in oral and maxillofacial region comprising about 1% of all jaw tumors. Ameloblastoma received particular attention of oral pathologists due to its local aggressive behavior. Objective: Indian studies, regarding prevalence of ameloblastoma are very few. The present study was done to analyze and compare clinical, radiographic and histopathologic features of 57 cases of ameloblastomas in India retrospectively. Materials and methods: 57 cases of histologically diagnosed ameloblastomas were retrieved from the archives over a five year period to analyze the age, sex, site, clinical presentation, radiographic features and histopathology. Results: In the present study, ameloblastoma accounted for 77% of all odontogenic tumors with a mean age of 37.5 years in males and 42 years in females. About 60% of the cases revealed mandible as most common site predominantly of posterior re- gion with common clinical presentation as painless swelling. Radiographically, multilocular radiolucency was noticed in about 54.3% of cases. Among the histological variants of solid/multicystic ameloblastomas, follicular variant was reported to be the most common (38%) and intraluminal variant (19%) to be the common subtype in unicystic ameloblastomas. Statistical analy- sis was done among the histological variants of ameloblastomas which showed no statistical significance (p<0.05). Conclusion: The findings in the present study were well in accordance with previous reported studies. However, extensive studies with larger samples need to be carried out in the Indian population to evaluate the incidence of ameloblastoma for more definitive results.
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Background: Salivary lactate dehydrogenase (LDH) is catagorized in altered protein markers present in saliva which shows significantly increased level in oral carcinoma. On the other hand salivary alkaline phosphatase (ALP) is one of the sensitive markers for early detection of oral malignancy. As saliva sample collection is simpler, non-invasive and patient friendly, the use of salivary biomarkers for early detection of oral cancer has been increased remarkably in last decade. Aims & Objectives: To analyze the potential diagnostic role of major two biomarkers i.e, salivary LDH & salivary ALP in oral potentially malignant disorders & oral squamous cell carcinoma. Materials & Methods: In depth search of topic on major search engines like pubmed, google scholar, EBSCO, Wiley online pertaining to the enzymes like salivary LDH, salivary ALP with keywords like salivary LDH, salivary ALP, oral potentially malignant disorders, oral squamous cell carcinoma, salivary biomarkers were done. The literature review was done from 2010-2019. The available data is tabulated & presented under various topics of discussion regarding their regulation & functionality in the body harbouring those disorders & conditions. Conclusion: The salivary LDH is found to be more promising salivary biomarker for detection of oral cancer as per this study. Quite a number of studies have been done during the last decade on the same. Whereas, there is paucity of studies on the role of salivary ALP as a biomarker for oral cancer, instead we can say the role of salivary ALP is rather more in periodontitis in comparison to carcinoma.
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Purpose: To analyze the effect of various macular hole indices and postoperative microstructural changes of all retinal layers on postoperative functional outcomes in patients with idiopathic full?thickness macular hole (FTMH). Methods: In this prospective study, pre and post?operative optical coherence tomography (OCT) scans of 36 eyes with idiopathic FTMH were analyzed. Hole indices and microstructural changes of all retinal layers such as ellipsoid zone (EZ), external limiting membrane (ELM) integrity, outer and inner retinal defects, and cystoid resolution were studied on follow?up visits. Results: Out of 36 eyes, type?1 closure was achieved in 23 eyes (65.7%) and type?2 closure in 11 eyes (31.42%), one eye showed persistent hole, and one eye was lost to follow?up. The mean minimum diameter of hole (P = 0.026), mean MHI (P = 0.001), DHI (P = 0.158), THI (P = 0.001), and HFF (P < 0.001) showed statistical significance with the type of hole closure. Postoperatively, eyes with intact ELM and EZ had better BCVA at the final visit. The BCVA was better by logMAR 0.73 ± 0.38 (P < 0.001) in patients with absent outer retinal defects. There was a significant difference in BCVA of 0.52 ± 0.35 at 1 month and 0.64 ± 0.34 at 6 months in eyes without inner retinal defects (P < 0.001). At 6 months, cystoid resolution was observed in 28 (80%) eyes. BCVA was significantly better at 1 month (P < 0.001) and at 6 months (P = 0.001) in eyes with no DONFL. Conclusion: Macular hole indices determine the closure type. Postoperative regeneration of outer retinal layers and resolution of retinal defects significantly influence the final visual outcomes. ELM recovery is seen as a prerequisite for EZ regeneration with no new IRD after a period of 3 months
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Methods@#In total, 100 participants were studied by using their anteroposterior and lateral radiographic images of whole of pelvic and spinal area. Additionally, various spinal and pelvic parameters were also measured. Subsequently, the outcomes were analyzed with respect to age, sex, and body mass index (BMI). The correlation between different parameters and differences in these parameters between Indians and other races/ethnicities along with population groups were also analyzed. @*Results@#There was a significant increase in thoracic kyphosis (TK) from T1–T12 and T4–T12 with increasing age. Lumbar lordosis (LL), sacral translation (sagittal vertical axis), and pelvic tilt were significantly higher among females. Additionally, sacral slope (SS), pelvic incidence, C7 sagittal offset, and T9 sagittal offset were also higher in females. TK (T4–T12 and T1–T12), LL, SS, and pelvic incidence showed a significant correlation with BMI. As compared to European population, TK, segmental LL, and sacral translation were found to be significantly lesser in Indian population. @*Conclusions@#There is a statistically significant difference between Indians and other races/ethnicities and population groups with respect to TK, LL, and sacral translation. The values obtained can be considered as the physiological normal values for Indian population. Importantly, these values can serve as the reference values for future studies.
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The existing coronavirus 2019 (COVID-19) pandemic is challenging healthcare systems at global level. We provide a practical strategy to reform pathways of emergency elective onco-surgery and colorectal surgery in the COVID- 19 pandemic. The novelists, from areas affected by the COVID-19, thought to outline the key-points to be conferred. Responsibilities were allotted, concerning specific characteristics of surgical emergencies, onco-surgery and colorectal surgery during the pandemic, including the administrative management of the catastrophe in India. The endorsements were collected and summarized. During the swift spread of COVID-19, it remains thoughtful to halt non-cancer procedures and prioritize surgical emergencies. Endoscopy, proctological procedures have to be completed selectively. With colorectal emergencies, a conservative approach is recommended. Detailed procedures should be followed when operating on COVID-19 patients, using committed personal protective equipment and adhering to specific rules, containing minimally invasive surgery. These guidelines summarize the strict instruction of entry/ exit into theatres and operating block as well as advice on performing procedures carefully to decrease risk of contracting the virus. It is likely that restructuring of health system is required, at central, state, and district levels. A description of the strategy adopted in Dr. D.Y. Patil Medical College Hospital, Kolhapur is provided. Evidence on the management of patients requiring surgery for surgical emergencies, onco-surgery and colorectal conditions during the COVID-19 pandemic is presently deficient. Healthcare professionals have succeeded with high volumes of surgical patients during the pandemic, could be useful to alleviate some risks and decrease exposure to other patients, public and healthcare staff.
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Umbolith is a relatively rare entity under normal circumstances, especially in the urban scenario. Usually seen in obese individuals with a deep and retracted umbilicus due to constant accumulation of sebum/keratin leading to stone formation. It’s usually covert until complicated by secondary infection (abscess) or ulceration. Sinus was laid open and healthy granulation was seen within 1st week. Pus culture sensitivity suggestive of heavy staph growth and antibiotics were given accordingly. Appendicitis was treated conservatively.
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Objectives: The efficacy of single oral dose KetorolacTromethamine, Tramadol and Placebo was evaluated in paincontrol after periodontal surgery.Materials and Methods: The study design is a split mouthstudy involving three quadrants of the same patient. 20patients requiring flap surgeries in at least three quadrantswere recorded. Patients were randomly divided into threegroups as per the medications given, either 10 mg ketorolac or50 mg tramadol or placebo tablets at least 30 minutes beforeadministration of local anesthesia (LA). The duration of surgeryfrom the time of incision to the placement of the last suture isrecorded. After the completion of the surgery, patients wereasked to rate their subjective operative pain intensity using avisual analog scale.Results: Differences were statistically significant in VAS scorebetween ketorolac and placebo, and tramadol and placebogroup. Comparison of sum of pain intensity showedsignificantly greater pain levels in the placebo than in theketorolac group and tramadol group.Conclusion: The results of this single-dose, parallel-group,and double blind placebo-controlled study showed that 10-mgketorolac and 50-mg tramadol administered immediately beforeperiodontal surgery was effective for better response by thepatient during the procedure. However, ketorolac and tramadolpremedication neither affected delayed pain levels, norpostoperative analgesic consumption.
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Methods@#All cases of cauda equine syndrome secondary to lumbar disc herniation were recruited. Biographical and clinical data, history, examination findings, operative variables, recovery, and SD were noted. Water cystometry and uroflowmetry were done pre- and postoperatively. The International Index of Erectile Function questionnaire and Female Sexual Function Index were used to assess SD among the men and women, respectively. @*Results@#A total of 43 patients with up to 2.94-year follow-up were included. Urodynamic studies were found to correlate significantly with age, days of bladder involvement, perianal numbness, and motor weakness (p<0.01). In step-wise regression analysis, perianal sensation and overall motor weakness were bladder function determinants. Bladder function recovery was directly related to the number of delay days (t=2.30, p<0.05) and with unilateral leg pain (t=2.15, p<0.05). Significant correlation between SD with age and days of bladder involvement before surgery was found (p<0.01). @*Conclusions@#Surgery timing is related to patient’s functional and sexual outcomes. Patients with unilateral leg pain and hypocontractile bladder have better outcomes. SD is a remarkable problem in CES.
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Methods@#All cases of cauda equine syndrome secondary to lumbar disc herniation were recruited. Biographical and clinical data, history, examination findings, operative variables, recovery, and SD were noted. Water cystometry and uroflowmetry were done pre- and postoperatively. The International Index of Erectile Function questionnaire and Female Sexual Function Index were used to assess SD among the men and women, respectively. @*Results@#A total of 43 patients with up to 2.94-year follow-up were included. Urodynamic studies were found to correlate significantly with age, days of bladder involvement, perianal numbness, and motor weakness (p<0.01). In step-wise regression analysis, perianal sensation and overall motor weakness were bladder function determinants. Bladder function recovery was directly related to the number of delay days (t=2.30, p<0.05) and with unilateral leg pain (t=2.15, p<0.05). Significant correlation between SD with age and days of bladder involvement before surgery was found (p<0.01). @*Conclusions@#Surgery timing is related to patient’s functional and sexual outcomes. Patients with unilateral leg pain and hypocontractile bladder have better outcomes. SD is a remarkable problem in CES.
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Introduction:Spinal tuberculosis has been managed with various modalities of treatment ranging from only antituberculous drugs to radical surgical extirpation. Opinion is divided on management of Potts Paraplegia with respect to surgical approach to the lesion. Results are conflicting on anterior verses posterior approaches as well combined approach. There is also confusion on to when to do anterior first or to operate from posterior first, in combined approaches. In the present study we present 10 year follow-up of our results, clinical and radiological outcomes, of Single stage Circumspinal decompression and pedicle screw fixation through lateral extracavitatory approach with anterior and posterior spinal fusion in cases of Pott's paraplegia.Methods:The study was a retrospective and prospective follow up of 30 patients with active tuberculosis of thoracolumbar spine with neurological deficit, who underwent posterior spinal instrumentation with lateral extra cavitatory approach with circumspinal decompression and pedicle screw instrumentation. Diagnosis of spinal tuberculosis was made by laboratory findings such as anaemia, elevated ESR, radiological features with typical MR imaging findings. 8 patients had multilevel involvement. Kyphosis of 250 to 550 was present. Circumspinal decompression, correction of kyphosis, anterior and posterior spinal fusion was performed in a single stage. The average follow up was 7.67 years (92 months).Results:The mean kyphosis angle improved from 320 preoperatively to 80 in early follow up, followed by a minor loss of correction of 30. Neurological recovery occurred in 28 patients out of 30 patients. 15 patients recovered from Asia Ato AIS E. 13 patients recovered to ASIAD. The visual analog scale and ASIA grade improved in all the cases. Implant failure in the form of rod breakage was seen in 1 patient but with no neurological complications.Conclusion: Drainage of abscess, debridement by extracavitatory route constitutes a less demanding, relatively safe, minimally traumatic operative technique with adequate circumspinal decompression of spinal cord, correction and maintenance of sagittal balance with relatively less morbidity is the added advantage.
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Caroli’s disease and Caroli’s syndrome are rare congenital disorders. Caroli’s disease is characterized by multiple sequential cystic or saccular dilatations of the large intrahepatic biliary ducts while Caroli’s syndrome has small bile duct involvement and congenital hepatic fibrosis. The incidence of Caroli’s disease is as low as 1/1,000,000 people. The average age of presentation is early adolescence. Magnetic resonance cholangiopancreatography is a most valuable investigation in diagnosis. Here, we report the case of Caroli’s Type II without renal involvement as late as 6 years of age with severe portal hypertension and hypersplenism. The child had no history of jaundice or recurrent abdominal pain in the past.
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Helicobacter pylori is a vital human pathogen involved as a causative organism in chronic gastritis [1]. Peptic ulceration is a common complication of this infection. Several study shows direct association between H. pylori and gastric carcinoma. The upper Gastrointestinal Endoscopy is investigation of choice for the screening and diagnosis of Helicobacter pylori related chronic gastritis. As field of endoscopy is getting advanced some new techniques like NBI (Narrow Band Imaging) are developed. Due to better visualization of Subendothelial Capillary Network (SECN) by using lights of two different wavelengths NBI method it is more useful in visualization of affected area of gastric mucosa [2]. Total 100 cases of chronic gastritis were diagnosed using upper G.I .Scopy, Biopsies were taken using both NBI and WLE and results were compared using Rapid Urease kit. Narrow band imaging was found more effective than conventional white light endoscopy in the diagnosis of H. Pylori related chronic gastritis [3].
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Squamous cell carcinoma is the second most common skin carcinoma, which most commonly affects sun-exposed areas. However squamous cell carcinoma can rarely involve the anal and perianal region. It has been found in association with human papilloma virus infection, uterine cervix dysplastic changes and high-grade anal intraepithelial neoplasia (AIN). We report a case of extensive carcinoma of the perianal region, vulva and cervix. A 49 years old female came with complaint of swelling in the right inguinal region since one year, pain and swelling in the gluteal region since 7-8 months. Contrast enhanced CT scan and MRI were done which showed a mass involving the perianal region, vulva and cervix with a large inguinal lymph node. Biopsy revealed squamous cell carcinoma.
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We report a fatal case of disseminated strongyloidiasis masquerading clinically as stage IV caecal malignancy diagnosed at post mortem by needle necropsy. The parasite was seen in the smears from CSF, pleural fluid, ascitic fluid, splenic aspirate, lung aspirate and aspirates from caecal area. Enteric organisms like Group D streptococci and candida sp were also associated. We believe that this is the first report of widespread dissemination of S. stercoralis in AIDS from India.