Neural tumours of the head and neck

Objective: To document the pattern of occurrence of all primary neural tumours arising in the neck and craniofacial region over the period 1982 to 1991.Design: A retrospective study.Setting: Cancer Registry, Nairobi, Kenya.Results: Out of the 289 cases who were identified to have had whole body neural tumours, 225(77.8%) had the lesions distributed in the neck and craniofacial area. While 80% of the neoplasms located in this region were retinoblastomas (mainly occurring in the age group 0to 4 years), other lesion types occurred in small numbers thus: neurofibromas comprised 12.4%, Schwannomas four per cent, neuroblastomas and neuromas each 0.4%; and extracranial gliomas 2.7%. Overall, the male to female ratio was 1:1 and the site distributionrevealed that over 90% of the lesions afflicted the upper face.Conclusion: Neural tumours of the neck and craniofacial region appear generally rare in this population as has been shown elsewhere

Ipsilateral Synchronous Manifestation of an HIV-Infection Associated Plunging Ranula and Sublingual Salivary Gland Sialocoele: A Review and Case Report

Plunging ranula is a rare lesion and even more in HIV-infected patients. There has been only one case documented in a 15-year old that had the vertical form HIV-infection. We report a plunging ranula occurring simultaneously with a sublingual salivary gland sialocoele as two separate lesions in an HIV-infected female patient.Keywords: Ranula, salivary glands  

Massive Cervico-Lingual Cystic Hygroma

Cystic Hygroma (CH) is an aberrant proliferation of lymphatic vessels  creating fluid-filled sacs that result from blockage in the abnormal lymphatic system. These benign lesions are characteristic in their capability to grow to an enormously huge size has potential pressure effects on the neighboring structures. The massive expansion can also lead to gross disfigurement of the neck and face. In this paper, we present a rare case of cervico-lingual CH in a 17-year old Rwandese boy. Though the lesion had caused massive expansion of the tongue (12cm x 10cm) and led to gross deformity of the mandible, the boy had no signs of respiratory distress. His main concerns were inability to eat solid foods and compromised speech. The management challenges and literature review on cystic hygroma of the head and neck region are discussed.Key Words: Cystic Hygroma, Cervico-Lingua

Antibiotic Sensitivity Patterns of Aerobic Bacterial Agents in Post-Surgical Orofacial Infections

Background: There is no data on the bacteriology of postsurgical orofacial infections at our institutions. Uncontrolled use of antibiotics may lead to development of resistance with the resultant increase in morbidity and cost of treatment. We aimed to determine the aerobic bacterial agents and antibiotic sensitivity of post-surgical infections in the orofacial region. Methodology: Patients were evaluated for post-surgical wound infection from the 5th to 30th post-operative day. In cases where a surgical implantwas placed the period of review was extended for up twelve months. The specimens were collected using sterile swabs and transported to the  microbiology laboratory within two hours of collection. The specimens were then analyzed for bacteriology according to the standard bacteriological  techniques. A wide range of antibiotics including those commonly used to treat orofacial infections were tested for sensitivity against the isolates obtained using the disk diffusion test (Kirby-Bauer procedure, using CLSI protocols). Results: Staphylococcus aureus accounted for 40% of the isolates followedby Klebsiella species (23%) and the Pseudomonas species (19%).  Amoxycillin/clavulinic acid, the 2nd and 3rd generation cephalosporins were effective against most of the bacterial infections from the orofacial region. Conclusion: Staphylococcus aureus, Klebsiella, and Pseudomonas species arethe commonest isolates from the oral facial region. Antibiotics which showed adequate efficacy against them were the augmented Penicillins and newer generations Cephalosporins.Key Words: Oro-facial infection, Post-surgical, Antibiotic

Q-Curves with Complex Multiplication

The Hecke character of an abelian variety A/F is an isogeny invariant and the Galois action is such that A is isogenous to its Galois conjugate A^σ if and only if the corresponding Hecke character is fixed by σ. The quadratic twist of A by an extension L/F corresponds to multiplication of the associated Hecke characters. This leads us to investigate the Galois groups of families of quadratic extensions L/F with restricted ramification which are normal over a given subfield k of F. Our most detailed results are given for the case where k is the field of rational numbers and F is a field of definition for an elliptic curve with complex multiplication by K. In this case the groups which occur as Gal(L/K) are closely related to the 4-torsion of the class group of K. We analyze the structure of the local unit groups of quadratic fields to find conditions for the existence of curves with good reduction everywhere. After discussing the question of finding models for curves of a given Hecke character, we use twists by 3-torsion points to give an algorithm for constructing models of curves with known Hecke character and good reduction outside 3. The endomorphism algebra of the Weil restriction of an abelian variety A may be determined from the Grössencharacter of A. We describe the computation of these algebras and give examples in which A has dimension 1 or 2 and its Weil restriction has simple abelian subvarieties of dimension ranging between 2 and 24

Antimicrobial efficacy of Hibiscus Fuscus garcke aqueous and ethanol extracts on tooth root canal microorganisms

Objective: To determine the antimicrobial efficacy of Hibiscus fucus extracts against six root canal microorganisms. Design: In-vitro analytical study. Setting: Department of Medical Microbiology, University of Nairobi. Material and Methods: Hibiscus fuscus twigs were collected, dried and ground into coarse powder which was macerated in sterile distilled water and 80% ethanol. The aqueous filtrates were lipolyzed, while the ethanol filtrates were reduced, and oven dried into powder. Tenfold liquid microdilution of 50 mg/ml Hibiscus fuscus extracts against pure strains of Enterococcus faecalis, Streptococcus mutans, Staphylococcus aureus, Fusobacterium nucleatum, Lactobacillus acidophilus and Candida albicans were incubated for 24 and 48 hours. Sodium hypochlorite 5.25% and 2% Chlorhexidine gluconate were the controls. Outcome measures: Percentage growth inhibition measured by changes in growth of microorganism cultures exposed to Hibiscus fuscus extracts. One-way analysis of variance and Tukey’s HSD test were used to test for any differences. Results: Fifty mg/ml Hibiscus fuscus aqueous extracts attained 122.01% ± 22.89, at 95% CI [108.79, 135] and (105.73% ± 7.64, at 95% CI [101.32,110.14] growth inhibition against Enterococcus faecalis and Fusobacterium nucleatum for 24 hours incubation similar to those obtained with 5.25% Sodium hypochlorite, and 2% Chlorhexidine gluconate at p=0.899947 (Tukey’s HSD). Other bacteria tested and Candida albicans showed resistance Conclusion: Fifty mg/ml Hibiscus fuscus aqueous extract showed bactericidal efficacy against E. faecalis (ATCC® 29212 ™), and F. nucleatum (ATCC® 25586™) comparable to 5.25% Sodium hypochlorite and 2% Chlorhexidine gluconate. Investigation to test pure Hibiscus fuscus extracts as a potential source of root canal irrigant is needed