8 research outputs found
Pyogenic Granuloma in a Patient of Sturge-Weber Syndrome with Bilateral Port Wine Stain- A Rare Case Report
Sturge-Weber syndrome (SWS) also known as
encephalotrigeminal angiomatosis. It is a
neurocutaneous syndrome, characterized by a
facial vascular birthmark and neurological
abnormalities. An ipsilateral or bilateral facial
cutaneous vascular malformation Port Wine Stain
(PWS) usually affects the upper face. Other
clinical manifestations are seizures, glaucoma,
hemiparesis, mental retardation and delayed
developmental milestones. The main objective of
this case report is to unravel such a rarest syndrome
with bilateral port-wine stain, which has
intraoral manifestation of pyogenic granuloma
involving gingiva in an 11 year old boy
commerciallyClinical study of rhino-orbital-cerebral mucormycosis in COVID-19 patients in a regional institute in South India
BACKGROUND: Rhino-orbital-cerebral mucormycosis (ROCM) is usually seen in immunosuppressed conditions like uncontrolled diabetes mellitus (DM). The pandemic of severe acute respiratory syndrome coronavirus 2 (Sars-CoV-2) and its associated immunosuppression and indiscriminate use of corticosteroids emerged as a new risk factor for ROCM during its’ second wave of coronavirus disease 2019 (COVID-19), especially in India. The lack of standardized management protocol for ROCM needs the attention of the ophthalmic community. COVID-19-associated risk factors have been linked to the pathogenesis of ROCM, which reached epidemic proportions during India’s second wave of the pandemic.
The aim of the present study was to document cases of ROCM and to evaluate risk factors, including co-morbidities, clinical characteristics, diagnosis, management, and outcome at tertiary care centers during the Sars-CoV-2 (2021) pandemic.
MATERIAL AND METHODS: It is a retrospective study of 42 patients of biopsy-proven mucormycosis. These patients’ records were reviewed from hospital data. All patients were subjected to complete ophthalmological, ortorhino laringological examination, and imaging studies. The orbital staging was done. Each case was treated by a multidisciplinary approach with functional endoscopic sinus surgery (FESS) and intravenous (i.v.) amphotericin B (AMB). Retrobulbar liposomal AMB and exenteration were performed whenever indicated. Statistical analysis was done using the Chi square test. A p-value ≤ 0.05 was considered significant.
RESULTS: Total 42 patients of ROCM were documented. The mean age was 50.48 years, with a male preponderance (82.9%). 99.8% of patients had diabetes (39 patients) and all patients were COVID-19-positive. Concurrent steroid use was seen in 83.3% where 73.1% of patients had received oxygen support during COVID-19 infection. The most common ophthalmologic presentation was orbital/facial oedema (33) and pain, diminution of vision (24), and ophthalmoplegia (26). Direct nasal endoscopy and biopsy were done to establish a diagnosis. All patients were treated with FESS and i.v. AMB. Retrobulbar AMB was given to 11 patients. Exenteration was done in (n = 4) 10.5% of cases. 41 patients recovered, and one patient died
CONCLUSION: The most significant predisposing factors for developing COVID-19-associated ROCM are corticosteroids and DM. Patients with COVID-19 must be followed up even after recovery. For a favorable outcome with lower mortality in COVID-19 recovered patients, we must have a high index of clinical suspicion with awareness of red flag signs and make a timely diagnosis
Ulcerative Uremic Stomatitis - Review of the Literature and A Rare Case Report
Uremic Stomatitis (US) represents a comparatively
uncommon intraoral complication seen, mostly, in
cases of end-stage renal disease or undiagnosed or
untreated chronic renal failure. Its frequency has
diminished due to the advent of renal dialysis. Clinically
uremic stomatitis is characterized by the presence
of painful plaques and crusts that are usually
distributed on the buccal and labial mucosa, dorsal or
ventral surface of the tongue, gingiva, and floor of the
mouth. Ultimate treatment consists of improvement of
blood urea concentration and underlying renal failure
is supported by enhancement of oral hygiene with
antiseptic mouthwashes and antimicrobial/antifungal
agents, if necessary. Here we report a rare case of
ulcerative type of uremic stomatitis occurring in a
patient of chronic renal failure due to sudden relapse of
uremia and reviewed the possible pathophysiology of
oral symptoms of chronic renal failure
Role of oxidative stress in the pathogenesis of oral submucous fibrosis: A preliminary prospective study
Background: In the current scenario pathogenesis of majority of the diseases is deeply linked with the oxidative stress, irrespective of its etiology. Enumerable data suggests that reactive oxygen species play a key role in multistage carcinogenesis. Oral submucous fibrosis (OSMF) is considered as a potentially malignant disorder. Its increased incidence over recent years in the Indian subcontinent is a major health concern to oral physicians. However, the role of oxidative stress has not been widely investigated in OSMF.
Aims: Is to evaluate both antioxidant and oxidant status in OSMF and to compare with controls. Settings and Design: Twenty patients and 20 controls of the same age group were enrolled in the study. Subjects and Methods: Five milliliters of blood were collected from each individual and serum was separated. Malondialdehyde (MDA) estimation using thiobarbituric acid (TBA) method, and antioxidant activity (AOA) using principle of TBA reactive substances was done using this serum, with a calorimetric method.
Statistical Analysis Used: Student's t-test and ANOVA test.
Results: The mean serum AOA status was seen to significantly decrease in OSMF patients, as compared to controls (P = 0.013). The increase in mean serum MDA level was highly significant in OSMF patients, as compared to controls (P < 0.001).
Conclusion: The disparity between AOA and MDA levels in the patients clearly demonstrates the role of oxidative stress in the disease process. The results also suggest the use of antioxidants in the management of OSMF
Potential Association of Hypothyroidism and Cardiovascular Disorders among Type II Diabetes Mellitus Patients Visiting for Dental Treatment
Background: Diabetes is a group of etiologically
different metabolic defects characterized by
hyperglycemia resulting from defects in insulin
secretion, insulin action, or both. Aim and Objectives:
The study intended to estimate prevalence of
hypothyroidism among Type 2 Diabetes Mellitus
(T2DM) patients and to substantiate the association of
these two disorders with cardiovascular diseases.
Material and Methods: The study included 208 T2DM
patients; all were evaluated for diabetes mellitus,
hypothyroidism and cardiovascular disorders by
history, clinical examination and investigations. They
were divided as Diabetes Mellitus (DM) and Diabetes
Mellitus Hypothyroidic (DMH) categories. DM
category was further divided as: Diabetic (D) and
Diabetic Cardiovascular (DC) groups, DMH category
as Diabetic Hypothyroidic (DH) and Diabetic
Hypothyroid Cardiovascular (DHC) groups. Intra and
inter category comparison of biochemical and clinical
parameters were done. Results: Out of 208 T2DM
patients, DM category had 102 patients and DMH
category 106 patients, On intracategory comparison of
various biochemical parameters between the two
categories, in DM category, Fasting Blood Sugar
(FBS) (p=0.00), Postprandial Blood Sugar (PPBS)
(p=0.34 and p=0.02), Low Density Lipoprotein (LDL)
(p=0.00 and p=0.20) were significantly higher and
High Density Lipoprotein (HDL) was lower in both D
and DC groups, total cholesterol in DC (p=0.23) group
was significantly higher and triglycerides were within
normal. In DMH category, FBS (p=0.01 and p=0.00),
serum Thyroid Stimulating Hormone (TSH) (p=0.00),
LDL, total cholesterol (p=0.00), LDL (p=0.02 and p=0.00) and triglycerides (p=0.00 and p=0.01) were
significantly higher in both DH and DHC groups, the
HDL was significantly lower in DHC group. There
was no association between DM category with blood
pressure and electrocardiogram parameters, but in
DMH category there was significant association seen,
as p=0.02 and p=0.06 respectively. On inter group
comparison between DM and DMH categories for
biochemical parameters, there was statistical
significance was found with serum TSH (p=0.00), total
cholesterol (p=0.01) and LDL (p=0.007), where as
FBS, PPBS, triglycerides, HDL were not significant.
Conclusion: Dental treatments are stress inducing, so
cardiovascular events are more likely to occur hence
complete evaluation by physician is mandatory
Survey on Awareness and Knowledge about the Effect of Diabetes Mellitus on Systemic and Oral Health in Patients Visiting General Medicine Outpatient Department in Dental Hospital
Objective: This survey was conducted on known
diabetic patients to appraise the awareness and
knowledge about the effect of diabetes mellitus (DM)
on systemic and oral health and to evaluate the source
of the information. Aim: The aim of this study was
to gather baseline information on awareness and
knowledge of diabetic patients regarding their systemic
and oral health with the view of enhancing their oral
health education. Which will help in updating their
knowledge regarding strong association of DM on
oral diseases, also about importance of maintaining
glycemic levels and good oral health. Methodology:
This experimental study was conducted on known
diabetic patients visiting general medicine outpatient
department for fitness to undergo dental treatments.
Patients were evaluated by using a self developed
questionnaire by interview method. The questions
were about awareness regarding effect of DM on
systemic and oral health, sources of information
patients have received and elicit the symptoms of
DM in those diabetics and educate them regarding
importance of glycemic control and maintenance of
oral health. Results: All the participants had Type 2
DM. The knowledge about DM disease was poor and
most of them attended camps related to DM and their
systemic consequences, but none of them attended
DM associated oral health camps. Many patients(47.5%) were educated about the effect of DM on
systemic organs and their prevention, by their treating
physician, but none of the physicians informed about
effect of DM on oral tissues (0%). Surprisingly, only
some dentists (24%) told regarding oral complications
of DM, large number of patients gathered information
by other sources mainly from relatives and friends,
who are diabetics (61.9%). So awareness of diabetic
patients of their increased risk for oral diseases is low
compared to their awareness of systemic diseases.
Conclusion: It is of paramount importance for dental
specialist to raise the attentiveness of diabetic patients
of their increased risk for oral diseases and the impact
of oral health on their general health. Research project
on awareness for diabetic patients of their increased
risk for oral and dental diseases and their approach
to maintain good oral health will significantly impact
their oral health-related quality of lif
Herpetic Recurrent Oral Erythema Multiforme
Erythema multiforme is considered as an immunologic
disease possibly occurring because of predisposition to
certain microorganisms, radiotherapy, systemic
diseases, malignancy, and food or drug allergy. Here
we report a case of herpes-induced recurrent erythema
multiforme primarily manifesting in oral mucosa
during first two episodes and third episode was
characterized by oral lesions followed by skin lesions
and the severity was increased with the subsequent
episodes, during each incident we have successfully
managed the case
Self-Inflicted Intraoral Hematoma in a Cardiac Patient Receiving Oral Anticoagulant Therapy- A Case Report
Intraoral hematoma secondary to systemic
anticoagulant therapy is rare, but it is a potentially fatal
condition requiring immediate medical management.
Case report: Here we report a case of self-inflicted
hematoma in the anterior maxillary gingival region in a
65year old female cardiac patient who was on systemic
anticoagulant therapy with a poor periodontal
condition, manifesting as a periodontal swelling for a
period of one week. Oral anticoagulant therapy is
considerably imperative to prevent thromboembolic
complications in various medical conditions, in such
patients there are chances for spontaneous bleeding or
hematoma by means of minor trauma due to sharp
teeth or dental prosthesis in the mouth leading to life
threatening complications such as partial or complete
airway blockage. Therefore,directives about possible
bleeding complications secondary to anticoagulant
drugs in the oral cavity and the importance of
maintaining oral health hygiene are necessary for the
patient