Phytobezoar: a rare cause of small bowel obstruction.

Phytobezoar is an unusual cause of small bowel obstruction. It accounts for about 0.4%-4% of all mechanical bowel obstruction. However, the symptoms are not very different from those caused by usual aetiologies of small bowel obstruction. The commonest site of obstruction is terminal ileum. Treatment of small bowel obstruction due to Phytobezoar is surgery. Prevention includes avoidance of high fibre diet, prokinetics particularly in patients who have undergone gastric surgery. A 57-year-old male presented with symptoms and signs of small bowel obstruction. On exploratory laparotomy Phytobezoar in the ileum was found to be the cause of obstruction. Diagnosis was confirmed by histopathology.

Intraosseous acinic cell carcinoma.

Acinic cell carcinoma is an uncommon low-grade malignant tumor of salivary glands. It was first described by Nasse in 1892, arising in parotid salivary gland. Salivary gland tumors are also known to develop within jaw bones, arising within the jaw as a primary central lesion, and are extremely rare with only a few cases reported. We present a rare case report of 65-year-old woman with intraosseous acinic cell carcinoma of left side of the mandible.

Surgical management of Stenson's duct injury using epidural catheter: a novel technique.

Stenson's duct of parotid gland is a major duct which drains saliva into the oral cavity. Deep penetrating wound in the form of cut or crush injury to the buccal area carries the risk of parotid duct injury. It is in the form of ductal exposure, laceration, total severing, or crushing of the duct. These conditions are difficult to diagnose because of complex anatomy and variable nature of injury. Successful management of parotid duct injury depends on early diagnosis and appropriate intervention, failing of which may lead to complications like sialocele or salivary fistula. Many techniques have been proposed for diagnosis and management of parotid duct injuries. This article presents an easy and novel technique to diagnose and manage the parotid duct injuries using an "epidural catheter" which is often used for inducing spinal anesthesia. The technique of epidural catheter usage, its advantages, and limitation over other techniques proposed for the management of parotid duct injury are discussed.

Second-generation platelet concentrate (PRF) as a pulpotomy medicament in a permanent molar with pulpitis: a case report.

AIM: To discuss the clinical and radiographic success of a pulpotomy with second-generation platelet concentrate (PRF), in a human mature permanent molar tooth. SUMMARY: A 19-year-old female patient reported to the Department of Conservative Dentistry and Endodontics with established pulpitis in tooth 36. The tooth had a carious pulp exposure, with a history of lingering pain. After isolation, caries removal and pulp exposure, pulpotomy with PRF was performed and a permanent restoration was placed immediately. At the first recall (+1 day), no postoperative pain was reported. At 6, 12, 18 and 22 months recall, the tooth responded positively to pulp sensibility tests, and radiographic examination revealed a normal periodontal ligament space. Positive results of this case imply the need for more studies with larger sample sizes and a longer recall period to justify the use of this novel material for the treatment of pulpitis in human permanent molar teeth. KEY LEARNING POINTS: Pulpotomy with PRF could be an alternate treatment to mineral trioxide aggregate or other materials in mature permanent teeth with pulpitis.

Effect of Ayurvedic herbs on control of plaque and gingivitis: A randomized controlled trial.

Ayurveda had mentioned various procedures for maintaining oral hygiene. These include procedures like gandusha, kavala, dantadhavana, and jivha lekhana (cleaning tongue). Various plants have been mentioned in Ayurveda for dantakashta. Various Ayurvedic dental formulations are available in market in the form of powders, paste, etc. Present study was conducted for evaluating the effect of one of such Ayurvedic toothpowder named UDM, in controlling plaque and reducing gum inflammation in patients of moderate gingivitis. Scaling, root planning, and polishing were done for all the patients participating in the study. Oral hygiene instructions were given that included brushing twice/day with assigned tooth powder using BASS method for tooth brushing and also massage over gum tissue with finger. All the patients were recalled after 15 days. Scores of plaque index and gingival index was recorded on day 1 and day 15 of treatment. Total of 15 patients were recruited in each group. The mean reduction in gingival index was 1.15 (P<0.05) and 1.26 (P<0.05) in positive control and UDM treatment groups, respectively. However, the mean reduction in plaque indices were found to be 2.03 (P<0.05) and 2.16 (P<0.05) in positive control and UDM groups, respectively. No significant difference was seen in both the parameters between the two groups.

Prevalence of torus palatinus and torus mandibularis among Malay population.

The aims of this study were to determine the prevalence, size, shape, and location of torus palatinus (TP) and torus mandibularis (TM), and to assess their sex-related and age-related differences in the Malay population. Sixty-five subjects were assessed for the presence of both tori at the School of Dental Sciences University Sains Malaysia. The prevalence of TP was 38-63% and that of TM was 1-10%. TP was frequently more common in females than males (90.9% versus 9.1%; P < 0.05) and was frequently found in medium sizes, spindle shaped, and was often located at the combined premolar to molar areas. The prevalence of TM was not significantly different in males and females (33.3% versus 66.7%; P = 0.523), occurred most commonly in bilateral multiple form, and was often located at the canine to premolar area.

Audit of thromboprophylaxis following caesarean section.

Venous thromboembolism is the most common cause of death in pregnant women and delivery by caesarean section increases the risk of developing venous thromboembolism. In 1995 the Royal College of Obstetricians and Gynaecologists (RCOG) issued guidelines for thromboprophylaxis following caesarean section. We have performed an audit of compliance with these guidelines in our unit. Of 240 women who were delivered by caesarean section over a six month period, 62.9% and 20.4% fell into moderate and high risk groups for venous thromboembolism according to RCOG guidelines. Overall, 34 (17%) of 200 eligible women received thromboprophylaxis. Women undergoing an emergency caesarean section were just over twice aslikely to have had no thromboprophylaxis compared with those undergoing an elective caesarean section (OR 2.6 (95% CI 1.2 - 5.9).

Case report: primary choriocarcinoma of the stomach.

An 80-year-old man with gastrointestinal hemorrhage was found to have primary choriocarcinoma of the stomach with liver metastases. Review of the literature revealed that this patient had the highest reported level of beta human chorionic gonadotrophin.

A phase II trial of alternating chemotherapy in patients with inoperable non-small cell lung cancer.

We assessed the efficacy and toxicity of alternating non-cross-resistant chemotherapy in the treatment of advanced NSCLC. Cycles of cisplatin, methotrexate, doxorubicin, and cyclophosphamide were alternated monthly with cisplatin and etoposide. Patients had measurable disease, ECOG performance status 0-3, no previous chemotherapy, and stage II (inoperable), III, or IV disease without brain metastases. Between 1988 and 1990, 28 patients were entered in the study: 20 patients (71%) had stage IV disease, 19 (68%) were evaluable for response and toxicity; 4 (21%) responded. There were 3 partial responders (16%) and 1 complete responder (5%). The mean duration of response was 60.5 weeks (range: 32-105+ weeks), and the median time to progression was 12 weeks (range: 8-105+ weeks). The median survival time for all 28 patients was 24 weeks (range: 3-153+ weeks). The most significant toxicity was grade 3-4 leukopenia experienced by 63% of patients, but there were no episodes of sepsis and no treatment-related deaths. This regimen of alternating cycles of cisplatin-containing chemotherapy is safe, but its efficacy is not superior to other combination chemotherapy regimens.

Carcinoid syndrome in the absence of liver metastasis: a case report and review of literature.

A patient with carcinoid tumor of the head of pancreas and carcinoid syndrome presented without liver metastasis. The patient had retroperitoneal lymphadenopathy. He had symptoms of flushing, diarrhea and abdominal pain. 5-Hydroxyindoleacetic acid (5-HIAA) was elevated. Absence of liver metastasis was documented not only by the negative computed tomography (CT) scan and liver/spleen scan, but also by autopsy. Except for carcinoid arising from ovary, testis, or bronchi, the other carcinoid tumors rarely cause carcinoid syndrome without liver metastasis. The literature was reviewed, and the findings are presented.