Effect of alcohol on Glasgow Coma score in traumatic brain injury: a single, center, cross-sectional study

Background: To study the effect of blood alcohol levels on GCS in Traumatic brain injury patients (TBI) and relate the findings to brain injury severity based on the admission CT scan. Methods: This cross-sectional study with a comparison group is conducted in Emergency Department (ED) of Pushpagiri Institute of Medical Sciences and Research Centre, Central Travancore, Kerala, India from April 2016 to September 2017 including all patients of 18 - 70 years of age presenting with head injury. 200 participants, 100 each of alcohol intoxicated and non- intoxicated were selected by consecutive sampling. GCS, Blood alcohol concentration-BAC (derived from the reading of alcohol breath analyzer) and admission CT Rotterdam Score are collected and analyzed at the end of study. Results: When CT Rotterdam Score is 1-3, GCS was found to decrease with increase in BAC (Chi-square test p value=0.011; Spearman’s Rank Correlation coefficient rs=-0.326). Independent t –test showed that at BAC 1-100 mg/dl, mean GCS decrease by 1.6 while only same decrease is found when the BAC levels ranges from 100-400 mg/dl. When the CT Rotterdam score is 4-6, no significant correlation was found between GCS and BAC (p value=0.092; rs=0.214). In the presence of alcohol, GCS had sensitivity 87.5% and specificity 70% in comparison to alcohol absent TBI patients (sensitivity 98.5%, specificity 69.7%). When features of hypoxia and shock are present, GCS have good agreement with actual CT findings of TBI. (Kappa coefficient: K 0.659, sensitivity 76%, specificity 100% in alcoholics and K 0.756, sensitivity 100%, specificity 80.6% in nonalcoholic). Conclusions: Even in the setting of alcohol intoxicated TBI patient, Glasgow coma score is a useful tool for quick decision making in emergency department

Prosthodontic perspective of laser application: A review

Background: A laser works primarily through stimulated emission which is responsible for the biological effects produced by the lasers. With the development of the ruby laser by Maiman in 1960, various studies on applications of lasers in dentistry have been conducted. Various wavelengths of dental lasers have been discovered so far but not all of them are used in prosthetic rehabilitation. Advent of diff erent laser systems has a considerable spectrum of applications in removable prosthodontics and fixed prosthodontics. Aim: When compared to traditional methods, laser treatments are less invasive and painful. Various studies have documented the capacity of laser wavelength and laser parameters used in prosthetic dentistry. Moreover, it is important to study the diff erent reactions; they can produce on the soft and hard tissues. Therefore, proper knowledge of properties of lasers and its mode of action are also important for its advantageous use. The aim of this article is to debrief the application of lasers in a prosthodontic perspective. Conclusion: The knowledge and ideas of pioneers in the field of laser are being developed and expanded into clinical practice that can enhance the quality of dental care and make the patient comfortable. The unique features and vast potential of dental lasers allow the overall success rate of any procedures. Thus, lasers have become an inexorable clinical tool in a dental armamentarium. Despite the benefits, laser energy also poses some risks. Hence, the clinician must understand the principles of lasers to take full advantage of its benefits and to provide safe and effective treatment. Clinical Significance: Recently, computer-aided design and rapid prototyping technology, surface treatment of base metal alloys, and study of occlusion in complete dentures using three-dimensional laser scanner have been developed. Thus, laser seems to be very helpful in reducing the complexity and thus provides a better platform and easier accomplishment of the task