Diagnostic efficacy of panoramic mandibular index to identify postmenopausal women with low bone mineral densities

Objectives: The aim of the study was to compare and assess the accuracy of panoramic mandibular index (PMI) and antegonial index (AI) in the panoramic radiographs of postmenopausal women with normal and low skeletal bone mineral densities( BMD) diagnosed by using dual energy x-ray absorptiometry ( DXA). Study Design: In panoramic radiographs obtained from 40 post menopausal women( 20 normal and 20 osteoporo tic) aged between 50-75 who’s BMD has already been assessed by a DXA, the mean was calculated for PMI and AI index values measured in the right and left mandibles. The PMI and AI index values were evaluated using the student’s t test. The correlation between the observers for indices was calculated by Pearson correlation coefficient test. Results: A statistically difference was shown between the PMI values in the osteoporotic group and normal group (t = 13.280, p < 0.001); however, AI showed no significant difference between the groups. For PMI, the area under the receiver operating curve (ROC) analysis in identifying women with low BMD was 0.821 ( Standard error: SE = 0.0676), 95% confidence interval (Cl) = 0.668 to 0.924) which was moderately accurate. Conclusion: PMI values were found to be smaller among female patients with osteoporosis, compared with normal patients in the present study. Our results suggest that PMI has a better efficacy in identifying postmenopausal women with osteoporosis in comparison with AI

Orofacial granulomatosis: a rare case report with review of literature

The term orofacial granulomatosis (OFG) is a descriptive term used for granulomatous disorders affecting the face and oral cavity, which can occur for a variety of reasons resulting in significant morbidity. It is characterised by persistent swelling that may involve one or both the lips and /or recurrent ulcers and a variety of other orofacial features. Medical history is very important in the diagnosis of OFG as medical condition like Crohn’s disease can also present an extra intestinal manifestation of OFG. Exclusion of other entities like sarcoidosis, mycobacterial infections, foreign body reactions and biopsy helps to establish a correct diagnosis. Herein we report a case of OFG in a 55 year old female patient with review of literature

Leukocyte adhesion deficiency type I - a focus on oral disease in a young child

This paper presents a case of the moderate form of Leukocyte adhesion deficiency type 1 (LAD-1) in a 4 year-old boy. LAD-1 is a rare, inherited immunodeficiency that affects 1 in 1 million people yearly. Affected patients are susceptible to recurrent bacterial and fungal infections, impaired pus formation and delayed wound healing. In the oral clinical finding, more important is a generalized prepuberal periodontitis that can affect the primary and permanent dentitions. For this reason cooperation between dentists and pediatricians is essential in these patients. Evaluating immune system in these patients included peripheral blood leukocyte counts, measurement of serum immunoglobulin levels, assessment of complement level and function, flow cytometric analysis of lymphocyte subsets, and tests of phagocytic function (nitrobluetetrazolium test (NBT)). In families with known molecular defect, an earlier prenatal diagnosis is possible by chorionic villi biopsy. The most important focus should be to control infections. Treatment includes systemic antibiotics and in many cases bone marrow transplantation

Personalised Precision Medicine - A Novel Approach for Oral Cancer Management

Oral Cancer is one of the most common malignancies of the head and neck region. Despite technological advancements and improvements in Oral cancer diagnosis and treatment modalities, the 5-year survival rate remains low and is associated with poor prognosis and high mortality rate especially when detected at a later stage. The empirical therapy followed for the treatment of oral cancer includes surgery, radiotherapy and chemotherapy. The treatments are not equally efficacious for all patients, are associated with side effects and poor prognosis. The need of the hour is early diagnosis and tailored treatment therapies for individual patients. With the advent of immunotherapy, the cancer treatment has moved toward personalised precision medicine which tailors’ treatments to each individual. Personalised precision medicine incorporates, molecular profiling of tumours with OMICS technology, biomarkers and companion diagnostics to build databases of patients and devise tailor made treatment approaches for individual patients. This article discusses the role of precision medicine in OSCC prevention, detection, and management by reviewing our understanding of OC from both genetic and OMICS perspectives

Rhino cerebral mucormycosis: a report of two cases and review of literature.

Mucormycosis is caused by fungi of the order Mucorales and is one of the fulminant and fatal mycotic infections known to human beings with a high mortality rate. Rhinocerebral mucormycosis is the most common type and its extension to the orbit and brain is quite usual. It is commonly reported in immunocompromised patients such as poorly controlled diabetes mellitus, blood dyscrasias, malnutrition, neutropenia, iron overload, organ transplant, and immunosuppressive therapy. Mucormycosis is on the rise with an increase in incidence of Diabetes mellitus and HIV infection leading to immunocompromised status of the patient. Here in, reporting two cases of rhinocerebral mucormycosis in two uncontrolled diabetic patients with deep palatal perforation in one case and this is a rare and late occurrence. Both the patients were successfully treated with a combination of surgical debridement and systemic amphotericin B administration. By presenting this case report we would like to point out that mucormycosis should be included in the differential diagnosis of hard palate ulcers and cellulitis

Assessment of knowledge and intake of artificial sweeteners among type II diabetic individuals and perspectives of registered dieticians in India

Background: The beneficial effects of artificial sweeteners (AS) on the prevention of non-communicable diseases have been noticed with various ambiguity outcomes. The knowledge of AS among consumers and healthcare providers can facilitate in making informed decisions about its usage. Therefore, this study, aimed to assess the knowledge, attitude and practice and usage of AS among type II diabetic patients and the conception of registered dieticians on usage of AS, as a sugar substitute. Study design: The study was a cross-sectional, descriptive study. Methods: The data on AS consumption, discomforts, and health consequences of chronic consumption from type-II diabetics (n = 51) and the opinion of dieticians (n = 53) on AS recommendations were gathered using a pretested questionnaire online through email via docs.google.com. The association or correlation between AS consumption, discomforts, and awareness was analysed by chi-square and Spearman correlation tests. Results: The results indicated that study subjects consumed AS in the form of tabletop sweeteners (86.3%), sweets (35.3%), and beverages (31.4%). Saccharin (29.5%), sucralose (27.3%), and aspartame (27.3%) were the major tabletop sweeteners consumed. 77% of subjects consumed AS from 1-3 years, while others from 4-5 years. 59% of participants consumed AS without consultation, and only 5.9% expressed discomfort after consumption. However, a significant association was noticed between discomfort and beverage consumption. 58.8% were unaware of the health consequences, and KAP analysis showed that knowledge was negatively associated with practice and attitude was positively associated with it. The survey among dieticians revealed that 73.6% were not recommending AS, mainly due to less reliable information, particularly regarding safety issues, and ambiguity on the use of AS in dietetic practice. While others consumed AS over natural sugars in glycemic control, weight management, and lifestyle factors. Conclusion: Majority of diabetic patients did not know the side effects of chronic AS consumption, while dieticians had divergent views on AS due to insufficient research regarding the safety and side effects of chronic AS consumption. Therefore, more precise studies are required to understand the consequences of chronic consumption of AS on health benefits

Tumour associated tissue eosinophilia as a predictor of locoregional recurrence in oral squamous cell carcinoma

Objectives: The increasing global burden of oral cancer has driven much of the focus of research to the determina - tion of reliable prognostic markers which may have significant effects on survival and the control of post-treatment morbidity. This study was undertaken to evaluate tumour associated tissue eosinophilia (TATE) quantitatively in oral cancer specimens and observe for its possible association with tumour stage, patterns of locoregional recurren - ce and overall prognosis. Study Design: 14 patients undergoing surgical resection for primary oral squamous cell carcinoma (OSCC) were subjected to grey scale ultrasonography (USG) to assess tumour dimensions. The findings were compared with the cTNM stage initially documented. TATE was evaluated along the invasive tumour front (ITF) using H & E stained sections of histopathological specimens for 10 continuous high power fields (HPF) and graded as mild, moderate or intense. Patients were followed up over 5 years and observed for patterns of recurrence. Results: Loco regional recurrence was significantly associated with intense degree of TATE. ( p <0.001) cTNM stage as well as USG stage did not correlate with the degree of TATE with p =0.419 and 0.772 respectively. None of the patients with mild/ moderate dysplasia developed locoregional recurrence within the period of follow up. Conclusions: Analysis of TATE in OSCC patients may provide an early indication of future locoregional recurren - ce. Identification of an appropriate biopsy site representing the ITF where TATE analysis can be performed may be a simple, inexpensive method of obtaining valuable prognostic information at the time of diagnosis

Efficacy of light based detection systems for early detection of oral cancer and oral potentially malignant disorders: systematic review

Background: Earlier detection of oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMD) is essential for dental professionals to improve patient survival rates. The aim of this systematic review is to to evaluate the effectiveness of devices that utilise the principles of chemiluminescence and tissue autofluorescence as adjuncts in the detection of OSCC and OPMD. Material and Methods: The electronic retrieval systems and databases searched for relevant articles were PubMed [MEDLINE] and Science direct. The search was for limited articles published in English or with an English abstract and articles published during the period from January 2005 to April 2014. Clinical trials utilized ViziLite, Microlux TM/DL and Visual Enhanced Light scope (VELscope) for early detection of OPMD and OSCC. Results: Twenty primary studies published satisfied our criteria for selection - 10 utilised chemiluminescence and 10 tissue autofluorescence. Senstivity of Vizilite for detecting OSCC nad OPMD ranged from 77.1 % to 100% and specificity was low that ranged from 0% to 27.8%.Most have shown that chemiluminescence increases the brightness and margins of oral mucosal white lesions and thus assist in identification of mucosal lesions not considered under Conventional visual examination. However, it preferentially detects leukoplakia and may fail to spot red patches. Clinical trials demonstrated that sensitivity of VELscope in detecting malignancy and OPMD ranged from 22 % to 100 % and specificity ranged from 16 % to 100%. Most studies concluded that VELscope can help the experienced clinician to find oral precursor malignant lesions. But it couldnot differentiate between dysplasia and benign inflammatory conditions. Conclusions: Both devices are simple, non-invasive test of the oral mucosa but are suited for clinicians with sufficient experience and training. More clinical trials in future should be conducted to establish optical imaging as an efficacious adjunct tool in early diagnosis of OSCC and OPMD

Effectiveness of pharmacological interventions for Sjogren syndrome - A systematic review

Sjogren?s Syndrome (SS) is characterized by xeropthalmia and/or xerostomia. Treating the associated salivary gland hypofunction has been challenging to the clinicians. A variety of topical and systemic therapies have been tried to restore/stimulate the g