Indian Journal of Mednodent and Allied Sciences

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SEM Evaluation of the effect of root conditioning with citric acid: An In-Vitro study
(Association of Medical Dental and Allied Sciences, 2018-02) Vidya, N.; Pujari, Ravi Kumar
Background Root conditioning agents reveal the orifices of dentinal tubules and the dentin collagen matrix and provide a substrate which plays a role chemotaxis migration and proliferation of cells involved in periodontal healing and formation of new connective tissue attachment. Materials and methods A total of 15 extracted teeth which were periodontally involved were utilised for the study. All the teeth received 25% citric acid application. The samples were subjected to scanning electron microscope evaluation. The photomicrographs were analysed by image software analyser to assess its surface area. Results Group II showed better results for mean surface area. Conclusion: These results show that citric acid could be a better healing biomaterial in periodontal regeneration by increasing surface area.
Role of haematological parameters in oral potentially malignant disorders and oral squamous cell carcinoma-A comparative study
(Association of Medical Dental and Allied Sciences, 2018-06) P, Preethi; N.D.V.N, Shyam; N, Vaishali; R, Poornima; R, Shravani; M, Priyanka
Context Oral squamous cell carcinoma (OSCC) is one of the most common cancers in human population and has a multifactorial aetiology. It is often preceded by oral potentially Malignant Disorders (OPMDs). Studies have shown that OSCC and OPMDs cause significant variations in various haematological parameters. Aim and objectives To assess the role of haematological parameters like haemoglobin, erythrocyte sedimentation rate, red blood cell count, white blood cell count and differential leukocyte count in OPMDs and OSCC and also to compare these parameters among OPMDs, OSCC and controls. Materials and methods Study comprises 30 diagnosed cases each of OPMDs and OSCC and 10 normal healthy age and sex-related individuals. Blood sample was collected from the patients and was evaluated for various haematological parameters by Sahli's acid haematin method, Westergren method and Coulter Counter ZF-6. Results There was a statistically significant difference in haemoglobin, red blood cell count, erythrocyte sedimentation rate, differential leukocyte count between OSCC, OPMDs and controls. Conclusion In the present study, haematological parameters were significantly altered in OPMDs and OSCC, and these variations may be useful in the prediction of malignant transformation and prognosis.
Giant-Cell Fibroma of Oral Cavity- A Case Report
(Association of Medical Dental and Allied Sciences, 2018-11) Prakesh, A. Ravi; Kanth, M. Rajini; Simha, A. Vikram; Sreenath, G.; Radhika, B.
Giant-cell fibroma is a benign fibrotic soft tissue lesion with several unique features, separating it from other oral fibrous hyperplasias. Giant cell fibromas are most commonly seen in younger adults. It is often mistaken with fibroma because of due to its clinical resemblance. Its peculiar histopathological features help to distinguish giant-cell fibroma from them. The presence of stellate fibroblasts and multi-nucleated giant cells makes this lesion a different pathological entity. This article presents a case report of giant-cell fibroma in a 65-year-old female patient, this late manifestation of the lesion makes the case unusual.
Free gingival graft: An effective technique to create healthy keratinised gingiva
(Association of Medical Dental and Allied Sciences, 2018-02) Nettem, Sowmya; Nettemu, Sunil Kumar; Singh, Vijendra P.; Nayak, Sangeeta Umesh
The high labial frenal attachment in mandibular anterior segment is most commonly associated with inadequate width of attached gingiva. Insufficient attached gingiva contributed to the difficulty in oral hygiene maintenance and ultimately poor gingival health. Frenectomy, vestibular extension and gingival augmentation procedures either alone or in combination are often required to maintain adequate health of the gingiva. Clinical relevance Inadequate width of keratinised gingiva contributed to the difficulty in oral hygiene maintenance and ultimately poor gingival health. Frenotomy with free gingival graft (FGG) technique is most predictable in these situations. Objective To highlight the importance of keratinised gingiva and overview of the FGG technique.
MRI on rotator cuff and shoulder joint pathologies
(Association of Medical Dental and Allied Sciences, 2018-06) Baru, Ramakrishna Rao; Ketepalli, Neeharika
The shoulder joint is an elegant anatomic structure formed by the humerus, clavicle and the scapula; its range of motion exceeds all other joints, yet under most circumstances, it is stable. The shoulder complex comprises of three joints namely the sternoclavicular, acromioclavicular, and glenohumeral joints. The factors which aid on to this progress including age, occupation, trauma, acromion type, slope and position, acromioclavicular joint degeneration, proximal migration of the humeral head, bony spurs compressing on the tendons. The most commonly affected rotator cuff tendon being the supraspinatus. The tears are further classified as complete/full thickness and partial tears depending on the involvement of the whole or part of the tendon. Being one of the most important stabiliser of the shoulder joint, rotator cuff pathologies can cause major joint dysfunction, like stiffness, restricted/painful joint movements even to the extent of restricting daily activities our study aims to describe MRI characteristics of shoulder and rotator cuff pathologies. And to describe the distribution of rotator cuff pathologies in terms of age, gender, symptomatology and secondary changes/sequelae study, the rotator cuff abnormalities were common in the sixth and seventh decades of life. The incidence of predisposing factors for rotator cuff tears was also found to increase with age as seen in our study, type II and III acromions, acromioclavicular joint arthropathies, osteophytosis/spurs are common in the sixth and seventh decades of life. We noticed in our patients that pain followed by stiffness resulting in reduced range of movement across the shoulder joint is very common. MRI imaging was useful in effectively ruling out the other causes of shoulder pain, overall features conclude that magnetic resonance imaging is very useful in depicting rotator cuff disease diagnosis along with the predisposing factors like the acromion type and orientation, reduction in coracohumeral distance, reduced acromioclavicular distance and other associated features like effusion, bursitis and bone changes. Further research with a larger sample size for a longer study period is suggested to draw broader conclusions and to strengthen the findings of the present study.
Evaluation of ABO blood groups in oral potentially malignant disorders and oral squamous cell carcinoma-a retrospective study in South Indian population
(Association of Medical Dental and Allied Sciences, 2018-06) R, Poornima; N.D.V.N, Shyam; G, Kiran; N, Vaishali; P, Preethi; K.C, Shobhita
Context Oral squamous cell carcinoma (OSCC) has a multifactorial aetiology. Risk factors such as individual's lifestyle like chronic use of tobacco, spicy food, alcohol and smoking are associated with cancer. Recent studies have revealed the possibility of ABO blood group antigens role in development of cancer. Aims and objectives To detect and correlate ABO blood group type in oral potentially malignant disorders (OPMDs) and OSCC and to compare the ABO blood group type among controls, OPMDs and OSCC. Materials and methods Study included 100 subjects, 35 cases each of OPMDs and OSCC and 30 controls. ABO blood grouping was carried out by standard agglutination method (Spanclone ARKRAY Health Care Private Limited) based on the principle of haemagglutination reaction. Results We found that OPMDs and OSCC subjects to be more prevalent among cases with B blood group. There was a significant variation in age (P=0.004), sex (P=0.004) and blood group (P= 0.003) among controls, OPMDs and OSCC. Conclusion ABO blood grouping may be used as one of the diagnostic marker for OPMDs and OSCC.
Hodgkins Lymphoma in a Child with Sickle Cell Anaemia: A Case Report
(Association of Medical Dental and Allied Sciences, 2018-11) K. Sree, Laxmi; Triveni, Bhopal; Sai Mallik, Arjun; V.S. Aparna, Akella
To study the co existence of Hodgkins lymphoma in sickle cell disease in a 10-year-old boy who is also a known case of sickle cell anaemia presented to out centre with symptoms of fever, weight loss. History of previous blood transfusions was given. On clinical examination, he was found to have pallor, generalised lymphadenopathy, splenomegaly. Complete blood picture revealed haemoglobin of 9 g/dl, white blood cell count of 12,000/cu mm, platelet count of 2 lakhs. Biopsy from the cervical lymph node revealed effacement of lymph nodal architecture with replacement by scattered atypical mononuclear and binucleate Reed–Sternberg cells with moderate cytoplasm, large vesicular nucleus and prominent eosinophilic nucleoli against a background of, mixed population of small lymphocytes, plasma cells and few eosinophils. Immuno histochemistry revealed positive expression of CD15, CD30, Pax-5 in the atypical cells and thus proved to be Hodgkins lymphoma.
Clinical study of sexually transmitted viral infections in HIV seropositive patients
(Association of Medical Dental and Allied Sciences, 2018-06) Metta, Parvathi; Gunta, Divya Lekha; Lakshmi, S. Jhansi
Human immunodeficiency virus disease (HIV) and sexually transmitted viral infections (STIs) are important cause of increasing morbidity and mortality in sexually active individuals, In our study we the incidence, age, sex distribution, risk factors and prevalence of viral STIs among HIV positive and negative patients who attended the tertiary care hospital and study we found that Herpes Genitalis to be the most common viral infection in HIV seropositive patients. Condylomaaccuminata are second most common viral infection in seropositive HIV patients. Social factors, lack of awareness, multiple sexual partners, poverty also contributed to the spread of HIV. HPV vaccine-based prevention and education programs need to be implemented in this high-risk community and centres providing voluntary counselling and testing (VCT) services for HIV. Introduction Human immunodeficiency virus (HIV) disease and sexually transmitted viral infections (STIs) are important cause of increasing morbidity and mortality in sexually active individuals. Patients suffering with viral STI are more vulnerable to acquire HIV infection in comparison with individuals without STI. HIV-seropositive patients are more vulnerable to acquire viral STI in comparison with HIVseronegative patients. Objectives of the Study To study the incidence, age, sex distribution, risk factors and prevalence of viral STI among HIV-positive and negative patients who attended the tertiary-care hospital. Materials and Methods This is a prospective and descriptive study conducted in STI clinic, Andhra Medical College, Department of Dermatology Venereology and Leprosy, King George Hospital, Visakhapatnam, Andhra Pradesh, for a period of 1 year from February 2017 to January 2018. The study includes 150 HIV-seropositive patients suffering with viral STI like genital herpes, molluscum contagiosum, genital warts, viral hepatitis and 150 HIV-seronegative patients. Results In our observation of 150 HIV-seropositive patients, herpes genitalis 57 cases (38%) was found to be the most common viral STI followed by condyloma accuminata 34 cases (22.7%). The most common age group involved was 20–29 years 68 cases (45.4%) with males most commonly effected 108 (72%) than females 42 (28%). Social factors like illiteracy, multiple sex partners and unprotected sex contributed to the risk of viral STI and HIV. Conclusion In our study, we found that herpes genitalis to be the most common viral infection in HIV-seropositive patients. Warts are second most common viral infection in seropositive HIV patients. Social factors, lack of awareness, multiple sexual practises, poverty also contribute to the spread of HIV.
Correlative cytohistologic study of breast carcinoma with special reference to oestrogen and progesterone receptor status
(Association of Medical Dental and Allied Sciences, 2018-02) Vasireddy, Guvera; Maley, Sai Kumar
Breast carcinoma is the second major killer next to lung carcinoma in female population, and the incidence is on rise. The current study is undertaken to underscore the importance of a low-cost and easy technique like fine-needle aspiration to identify and to grade carcinoma cytologically using Robinson's grading system and Fisher's modification of Black's nuclear grading system and compare with standard Scarff-Bloom-Richardson (SBR) histologic grading system and hormonal receptor status, as these are an important prognostic factor determining the therapy and outcome. The study found that Robinson's cytological grading system is superior to Fischer's modification of Black's nuclear grading, and the former system lined in congruence with the SBR histologic grade of tumour.
Efficacy of Transcutaneous Electrical Nerve Stimulation (TENS) and Pharmacotherapies in Myofacial Pain: A Randomised Study
(Association of Medical Dental and Allied Sciences, 2018-11) Venepally, Sailaxmi; Balmuri, Praveen Kumar; Reddy, Shantan; Sravanthi, Sai
Background Temporomandibular disorder (TMD) is a collective term for the disorders involving the temporomandibular joint, the soft-tissue structures within the joint and the muscles of mastication. Myofascial pain is the most common type of painful TMD, characterised by pain in the muscles of mastication, frequently along with muscle dysfunction and tightness. Objectives To evaluate and compare the effectiveness of transcutaneous electrical nerve stimulation (TENS) with pharmacotherapy in the management of myofacial pain. Methodology A total of 40 patients with myofacial pain are divided into two groups, in which 20 patients (Group A) were treated with pharmacotherapy and other 20 patients (Group B) were treated with TENS. Results In Group B, all the patients were responded well for therapy, and there was significant reduction in myofacial pain as compared with patients in Group A. Conclusion Our study revealed a positive result towards TENS therapy and concluded that it can be given as first line of therapy.
Folic acid and vitamin B12 levels in smokers as compared with healthy Controls
(Association of Medical Dental and Allied Sciences, 2018-02) Pujari, Ravi Kumar; Vidya, N.; Motupalli, Naveenkumar
Background Smoking is one factor which can alter the folic acid, vitamin B12 and blood cell parameters. The aim of this study was to compare the levels of folic acid, vitamin B12 parameters in smokers as compared with healthy controls. Materials and Methods Totally, 50 patients between the age group 25 and 65 years were recruited for the present study. They were grouped as group I-healthy subjects-and group II-subjects who smoke. Five millilitres of venous blood were collected from all the subjects and submitted for haematological analysis. Results Significant lower levels of folic acid and vitamin B12 levels were noticed in smokers’ subjects. Conclusion The result of the present study signifies that folic acid and vitamin B12 levels are significantly lower in smokers. Smoking has an impact on the folic acid and vitamin B12 levels.
Solitary fibrous tumour of the kidney: A case report
(Association of Medical Dental and Allied Sciences, 2018-02) Madhuri, M.; Sreelakshmi, K.; Mallikarjun, Sai; Triveni, B.; Ezhil, Arasi
A solitary fibrous tumour (SFT) is an unusual spindle cell neoplasm that usually occurs in the pleura but has recently been described in diverse extrapleural sites. Urogenital localisation is rare, and to our knowledge, only 82 cases of SFT of the kidney have been described. Although SFT of the kidney is extremely rare, this tumour must be included in the differential diagnosis, whenever a renal tumour consisting of mesenchymal elements is encountered. We report a case of a large SFT of the left kidney which was clinically and radiologically thought to be a renal cell carcinoma, and a final diagnosis was made after immunohistochemical study.
Metastatic papillary serous carcinoma of testis: A rare case
(Association of Medical Dental and Allied Sciences, 2018-02) Kasula, Siddartha; Mallikarjuna, S. Sai; Triveni, B.; Sreelakshmi, K.
Papillary serous carcinomas of testis are very rare, and only case reports have been reported in the literature. These neoplasms are characterised histologically by papillary fronds and numerous psammoma bodies and exhibit immunoreactivity for markers of ovarian serous carcinomas. These are very aggressive and are both chemo and radioresistant with surgery remained the main stay of management.
Immunocytochemistry Study on Pulmonary Cytology Samples in Lung Cancer
(Association of Medical Dental and Allied Sciences, 2018-11) Durga; Kumar, Sai; Reddy, Smita
There is an increasing need to subtype non-small cell lung carcinoma (NSCLC) into squamous cell carcinoma and adenocarcinoma of lung, and this subtyping guides the treatment with the advent of targeted therapies that are available for cases of adenocarcinoma of lung, by which prognosis can be improved. In cases of lung cancer, many a times, cytology may be the only material available to render a diagnosis; cases that are poorly differentiated on morphology are challenging to subtype and the immunocytochemical markers can be applied on these cytosmears for further subtyping of NSCLC. Aims and Objectives This study was carried out to check the expression of p63 and TTF-1 in diagnostically difficult cases, such as NSCLC, poorly differentiated lung carcinomas on pulmonary cytology samples, and to further subtype them into squamous cell and adenocarcinoma. Materials and Methods The study period was from 1 September 2013 to 31 August 2015; during this span, the total number of malignancies that were diagnosed on cytology was 585 cases. Prestained slides (haematoxylin and eosin or H&E, Papanicolaou or Pap) were collected over a span of these two years and these were destained using 1% acid alcohol with intermittent washing followed by running of p63 and TTF-1 as the immunocytochemical markers. Observations and Results The smears that are positive for p63 are labelled as squamous cell carcinoma and those that are positive for TTF-1 are labelled as adenocarcinoma, as these markers are highly sensitive and specific for the diagnosis of squamous cell and adenocarcinoma, respectively; neuroendocrine markers were used in the cases that were positive for TTF-1 to rule out small cell carcinoma. Conclusion: By the positive expression of p63 and TTF-1, the cases were labelled as squamous cell carcinoma and primary adenocarcinoma of lung, with due considerations given to the clinical and radiological parameters.
Reduction and Fixation of Zygomatic Complex Fractures with Miniplates at the Fronto-zygomatic Suture and Zygomatic Buttress Area-A Clinical Study
(Association of Medical Dental and Allied Sciences, 2017-11) Pushpanjali; Dayanandam, M.; Sultana, Juweria; Tatineni, Kalyani
Background Zygomatico-maxillary complex fractures are one of the most frequently occurring injuries of the facial skeleton due to its position and also the facial contour. The principal aetiologic factors that may result in zygomatic bone fracture include assaults, road traffic accidents and also falls. There are many methods of fixation that have been applied for treatment of zygomatic arch fractures. Aim To reduce and fix the zygomatic complex fracture using miniplates at the fronto-zygomatic suture and zygomatic buttress area. Material and method The present study includes five cases of zygomatic complex fractures who visited the Department of Oral and Maxillofacial Surgery in Government Dental College and Hospital, Hyderabad. The operative procedure adopted was the lateral bow incision for exposure of fronto-zygomatic suture, the Gillie temporal approach for reducing the zygoma and intra-oral incision for exposure of zygomatic buttress fracture. Fixation was done with miniplates at the fronto-zygomatic suture and the zygomatic maxillary buttress suture. Result All the cases were successfully treated without any post-operative complications and with uneventful restoration of aesthetics and function.
Levamisole Monotherapy in Treatment of Oral Lichen Planus-A Clinical Study
(Association of Medical Dental and Allied Sciences, 2017-11) Pushpanjali; Dayanandam; Sultana, Juweria
Background Oral lichen planus is a chronic inflammatory disease of oral mucosa which rarely undergoes spontaneous remission and has potential for malignant transformation. There are several different kinds of treatment that have been used to treat chronic oral lichen planus. Most commonly advised treatment is steroid therapy to treat oral lichen planus either in topical form or systemically. As steroid therapy has various underlying adverse effects other alternative drug has to be used in the treatment of oral lichen planus. Objective The aim of the study is to evaluate the efficacy of levamisole monotherapy in oral lichen planus. Methods Seven patients who had oral lichen planus were treated with levamisole 50 mg thrice daily for 3 consecutive days and not administered for the following 4 days. Result After 2 weeks of treatment, four patients reported with partial response, three patients had no response and no patients showed clearance of the lesion. Furthermore, after 2 months of treatment, five patients showed clearance of lesion, one patient showed partial response and one patient had no response to therapy. There were no significant side effects noted. Conclusion Levamisole therapy can be a substitute to steroid therapy in treating oral lichen planus in patients who can't take steroids.
Illusions of a Common Man in Dental Perspective: A Time for Eradication
(Association of Medical Dental and Allied Sciences, 2017-11) Ambati, Madhavi; Pushpanjali; Tatineni, Kalyani
Aim To assess the most common myths prevailing in the society and the reason behind the innocent beliefs. To compare the dental myths in population with various educational backgrounds and in medical graduates. To formulate the steps and educate the common man to come into the limelight for maintenance of oral health for better overall health. Methodology A total of 194 individuals aged above 18 years were randomly included in the study and their response to the given questionnaire was obtained and analysed statistically by using SPSS version 21. Results Most of the individuals believe that root canal treatment is a painful procedure (59.3%), whereas 56.2% believe that dental treatment should be avoided during pregnancy. 54.6% gave a positive response that worms cause tooth decay. 54.4% of the respondents believe that children do not need cleaning of the milk teeth, whereas 42.3% thought that diseased milk teeth don't need any treatment. More than 40% of the subjects believe extraction of the upper tooth affects vision and application of Zandu Balm or hot fermentation reduces swelling. Conclusion Some of the dental myths are still persisting in all the participants of various educational backgrounds and even in medical respondents.
MRI in Evaluation of Avascular Necrosis of Head of Femur
(Association of Medical Dental and Allied Sciences, 2017-11) Baru, Ramakrishna Rao; Kantala, Santhosh Reddy
The purpose of the study was to describe the role of Magnetic Resonance Imaging in evaluation of Avascular necrosis of femoral head and study the age, gender, symptoms among the study group. MRI examination of 48 patients who were clinically suspected with Avascular necrosis of femoral head and referred to department of Radiology, Osmania general hospital, Hyderabad were studied. All patients were imaged using a 1.5 tesla MRI scanner (SignaHDxt; GE Medicalsystems). MRI is the most sensitive means of diagnosing avascular necrosis (AVN). This imaging modality provides the criterion standard of noninvasive diagnostic evaluation and is more sensitive than CT scanning or planar scintigraphy. In addition, MRI is much more sensitive than plain film radiography for detecting avascular necrosis (AVN). MRI is indispensable for the accurate staging of avascular necrosis (AVN), because images clearly depict the size of the lesion, and gross estimates of the stage of disease can be made. MRI does not employ ionizing radiation and both hip joints can be imaged simultaneously. 48 patients were evaluated in our study. MRI helps in accurate staging of Avascular necrosis of femoral head. Screening of asymptomatic contralateral hips is important as most of the times the disease is bilateral and early core decompression can prevent progression of the disease.
A Case Report on Marfan Syndrome
(Association of Medical Dental and Allied Sciences, 2017-11) Dayanandam, M.; Sriram; Sultana, Juweria; Kumar, Pavan
Marfan syndrome (MS) is a disorder of the connective tissues characterised by various phenotypical and genetic manifestations. About 75% of the time, the condition is inherited from a parent, whereas 25% of the time, it is a new mutation. It involves a mutation to the gene that makes fibrillin. People with Marfan tend to be tall and thin, with long arms, legs, fingers and toes. They also typically have long face, prognathic maxilla, high arched palate, irregularly aligned teeth, flexible joints and scoliosis. The most serious complications involve the heart and aorta with an increased risk of mitral valve prolapse and aortic aneurysm. Other commonly affected areas include the lungs, eyes, bones and the covering of the spinal cord. Here, we report a case of Marfans syndrome with focus on oral manifestations to increase the awareness among dental practitioners to avoid complications due to infective carditis and cardiac defects.
Revisiting the Efficacy of Immunomodulatory Effect of Hydroxychloroquine in Oral Lichen Planus: A Case Series
(Association of Medical Dental and Allied Sciences, 2017-11) Dayanandam, Mala; Pushpanjali; Pasupuleti, Pravallika; Satya, Neeharika; Jyothi, Seelam Divya; Sree, M. Satya
Oral lichen planus (OLP) is a common inflammatory, autoimmune disorder that affects stratified squamous epithelium. The exact etiopathogenesis of this mucocutaneous disease is still uncertain. Although OLP has been associated with altered Quality of Life and considerable morbidity, with important note for erosive type of OLP, its treatment is often disappointing and controversial. Though corticosteroids remained the first line of treatment for OLP, the associated adverse effects of corticosteroids are not acceptable. Hence, there is a need of drugs with steroid sparing effect. Use of immunomodulators is systemic pathologies is widely encountered. However, their use in oral lesions is not frequently seen. Use of hydroxychloroquine (HCQ), an age-old disease-modifyinganti-rheumatic-drug, has been widely used in various autoimmune diseases; however, it received little attention in treatment of OLP. This article presents a case series of three patients with erosive OLP which were managed with HCQ. The results presented allow the authors to consider systemic HCQ as a newer therapy for atrophicerosive lichen planus.

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