Blessing Nonvital Tooth with Life through Revascularization

In recent times, revascularization has been found to be a better alternative in treatment of immature, nonvital tooth with blunderbuss canal since, it enables formation of root apex radiographically which allows the clinician to get a better hermeatic seal in the apical area. Success of the treatment also dependsgreatly upon the disinfection of the canal, which is achieved not only by the use of intracanal irrigants, but also with the use of intracanal medicaments like triple antibiotic paste, which is followed by getting a good coronal seal to prevent orthograde infection during the procedure. However, long-term prognosisof the treatment and the tissue occupying the canal space requires further investigatio

Role of reradiation in head and neck cancer from limits to option

Locoregional recurrence (LRR) or second primary malignancy in the previously treated area continues to be a major cause of treatment failure with significant morbidity and mortality in head and neck cancer. Prognosis of recurrent disease is dismal. To manage LRR is a therapeutic challenge for multidisciplinary head and neck team and more so if it is in a previously irradiated area. Though surgery is the mainstay of treatment but curative resection is feasible in only minority of patients. Systemic therapy alone has no long-term response rate or survival advantage in the management of inoperable recurrences. Full dose reradiation (RERT) with or without concurrent systemic therapy (CRERT) remains the only viable treatment option offering long-term survival in carefully selected patients. RERT is not a new concept but traditionally been avoided because of concern regarding toxicity due to limitations of conventional radiotherapy techniques. Initial studies were restricted to brachytherapy with its limitations. During the past two decades with the revolution in radiation therapy treatment delivery, more precise treatment techniques such as intensity-modulated radiation therapy, image-guided radiation therapy (IGRT), adaptive radiation therapy, stereotactic body radiotherapy, stereotactic radiosurgery, tomotherapy, intensity modulated proton therapy, image-guided brachytherapy in combination with better imaging modalities to define the target with the concept of biological target volume, offer various options for RERT with improved survival and limited toxicity. Pattern of failure even after full dose RERT is mainly infield, inside recurrent gross tumor volume (r GTV); radioresistance and tumor hypoxia may be the probable explanation. Though RERT has been established as a mainstream treatment option, there is a lack of prospective multi-institutional studies and absence of phase III randomized trial except one in adjuvant setting. Optimum treatment is yet to be defined. We have reviewed the literature and attempt has been made to provide guidance to the priorities on which future investigation should focus. There is a need to reevaluate prognostic factors for survival, selection criteria for patients undergoing RERT, measures to reduce the infield recurrence and morbidity, reradiation tolerance of normal tissue in IGRT era, toxicity antagonist and molecular marker as a diagnostic and prognostic tool. There is a need of multi-institutional prospective randomize trial with uniform data reporting

Understanding the healthcare provider role on post abortion contraception adoption in India using National Family Household Survey-5

Abstract Background Post abortion contraceptive use is an important area in provisioning of services associated with child birth planning. This study examines the factors related to the type and timing of initiation of contraception adoption among women who had undergone induced abortion. Study also tries to identify the role of personnel who provided the abortion service on decision of family planning adoption using complementary log–log model in India. Methodology The study uses the secondary data from the fifth round of the National Family Household Survey conducted during 2019–21. For, the analysis, we have used five-year women’s reproductive calendar to extract information on contraceptive use, post last induced abortion among women. We used complementary log–log regression models, to estimate relative risk ratios and its 95% Confidence intervals (CI). Results According to NFHS-5, out of all the last pregnancies (2,55,549), about three percent resulted in abortion. Most of the abortion occurred in private facilities (55%), with the help of health professionals (71%). From the women’s reproductive calendar, it was found that around 40% of the women adopted modern methods of contraception, with maximum adopting spacing method (33%), and only handful adopted permanent method (7%). It was also found that the likelihood of early adoption of permanent method increased to two times when the abortion is done by health professional compared to others [95% CI (1.25–3.30)]. Conclusion This emphasises a need for quality counselling related to timing and types of family planning as an essential part of the family planning program ensuring client centric approach suited to their needs and contexts that helps in alleviating any apprehensions associated with adverse effects of modern contraceptive methods

Multidisciplinary management of an unusual case of multiple developmental defects in lateral incisor followed by intrusive injury to primary incisors

Dental traumatic injuries occur frequently in children. The close relationship between the apices of primary teeth and germ of the permanent successors can lead to developmental disturbances in the permanent dentition. Developmental disorder can occur in any tooth. One of the most common teeth affected is lateral incisor. These developmental anomalies can cause various clinical problems. Clinical and radiographic characteristics of these anomalies may sometime present confusing picture. Therefore, recognition of this condition, early diagnosis, and treatment are important to avoid complications. High prevalence of dental trauma in young children emphasizes the need of educational and preventive programs in schools. Dentist plays important role in early diagnosis of disturbances in the permanent successor teeth by rigorous clinical and radiographic follow-up examination

Facial talon cusp: A rarity, report of a case with one year follow up and flashback on reported cases

Talon cusp is a relatively uncommon developmental anomaly characterized by cusp-like projections, usually presenting on palatal/lingual surface of the anterior teeth. This cusp resembles an eagle's talon, and hence the name. Normal enamel and dentin covers the cusp, which may or may not contain an extension of pulp. Presence of this anomalous cusp on the facial surface of an anterior tooth is a rare finding and very few cases have been reported in the literature. In most instances, such cusps are associated with clinical problems such as poor esthetics and caries susceptibility. Management of such cases requires a comprehensive knowledge of the clinical entity as well as the problems associated with it. This case report presents a facial talon cusp on the maxillary left central incisor of a 10 year old boy, which was conservatively treated. Vitality of the affected tooth was maintained and followed up for a period of 1 year

Extramedullary plasmacytoma presenting as a mediastinal mass Mediastende kitle ile beliren ilik dışı (ekstramedüller) plazmositom

Abstract Extramedullary plasmacytoma (EMP) is a plasma cell neoplasm without bone marrow involvement or other systemic characteristics of multiple myeloma. Few large-scale clinical studies have been conducted because of the rarity of EMP, especially when it arises from the mediastinum. Herein we report a rare case of solitary mediastinal plasmacytoma with reactive pleural effusion. A 58-year-old female presented with grade 4 dyspnea and dysphagia, with a mediastinal mass observed with on PET. CT-guided biopsy results were suggestive of IgG kappa-type EMP arising from the anterior mediastinum. The patient was treated with local radiotherapy to the mediastinum, and had clinical and radiological response s were good. Radiotherapy is an effective treatment for mediastinal EMP, but a complete workup is mandatory, including PET, as the majority of such masses coexist with multiple myeloma. (Turk J Hematol 2011; 28: 228-31) Key words: Extramedullary, plasmacytoma, mediastinal, radiotherap