Intraoral Scanners (IOS) are devices which are used for capturing direct optical impressions in dentistry. They are handheld devices used to directly create digital impression data of the oral cavity. Light source from the scanner is projected onto the scan objects, such as full dental arches, and then a 3D model processed by the scanning software will be displayed in real-time on a touch screen. Pediatric dental patients requiring dental prostheses is considered the most challenging for dental professionals owing to managing the children’s behavioural problems, gagging reflex, foreign body aspiration, and choking (breathing) concerns. The conventional impression-making procedures in young children are regarded as quite cumbersome and difficult due to several clinical factors in dentistry. Pediatric dentistry is evolving to minimise the disadvantages of traditional techniques by introducing advanced digital intraoral scanners in the field of pediatric dentistry. Thus this paper reviews the application of intraoral scanners in pediatric dentistry.
Introduction: Citrus limon peels essential oil has the potential to be developed as a topical medicine due to its active components. The essential oil has been demonstrated in numerous studies to have anti-inflammatory, anti-microbial, antifungal, and antioxidant properties. A study is required to determine whether Citrus limon peel essential oil can cause a type IV hypersensitivity reaction by examining the expression of the cytokines TNF-, IL-1, and IL-6 as well as the clinical manifestations on an animal skin. In this study, the effect of topically applying the essential oil of Citrus limon peel on the expression of TNF-α, IL-1, and IL-6 as well as on type IV hypersensitivity reaction symptoms was examined. Methods: This study is based on the guinea-pig maximisation test method in NADFC RI Regulation Number 7 of 2014, with two groups (control group and treatment group) for each set of ten samples. Citrus limon peels essential oil was administered to the treatment group, whereas CMC-Na was given to the control group. Animal models were euthanized after which the tissues were prepared as specimens for immunohistochemical staining. The expression of cytokines was computed and examined using a light microscope. Results: There were no clinical signs of type IV hypersensitivity in either group, and the expression of TNF-α, IL-1 and IL-6 in the treatment group was found higher than in the control group. Conclusion: After topical administration of Citrus limon peels essential oil, there was an increase in the expression of TNF-α, IL-1 and IL-6 without any clinical symptoms of type IV hypersensitivity.
Background: Biodentin is a pulp capping material that has perfected the shortcomings of Ca(OH)2, but has low radiopacity and lower washing out resistance, so it is hoped that there will be natural ingredients that can be used as pulp capping materials. The nano brown anchovy has antibacterial content in the form of fluoride. Its nano size can also facilitate penetration better. Purpose: Analyzing the antibacterial potency of nano brown anchovy on mixed bacteria in deep carious dentine. Methods: The research was conducted in an experimental laboratory in vitro with a post-test only control group design. Brown anchovy was converted into nanoparticles then diluted into several concentrations using the broth dilution method. Direct contact method was used between nano anchovy and various concentrations of bacteria. The values of MIC (Minimum Inhibitory Concentration) and MBC (Minimum Bacterial Concentration) were obtained by counting the number of bacterial colonies growing on Mueller Hinton Agar media. Colony growth was calculated manually in Colony Forming Units (CFU). Data were analysed by One Way Anova test followed by a Tukey HSD test. Results: The MIC value at a concentration of 0.781% and the MBC value at a concentration of 1.56%. In positive control, there was an average bacterial death of 0%, a concentration of 0.781% had an average bacterial death of 91%, and at a concentration of 1.56% the average bacterial death was 100%. The results showed that the greater the concentration of nano anchovy, the stronger the antibacterial power. Conclusion: There is antibacterial potency in nano brown anchovy against Mixed Bacteria in deep dentin caries lesions.
Background: Severe Acute Respiratory syndrome Coronavirus–2 (SARS –Cov-2) named COVID-19 (Coronavirus Disease – 2019) pandemic is the biggest public health problem the human mankind is facing today. Objective: Primary objective was to determine in-hospital mortality within 30 days of admission. The secondary objective was to analyze the risk factors leading to deterioration and poor outcome in patients suffering from COVID-19 infections. Material and Methods: This Multicentric, Retrospective Observational cohort study was conducted in confirmed COVID-19 infected patients admitted in three COVID care centers of Jalandhar city during January 2020 to June 2021. The data of admitted Patients was retrospectively analyzed. The study has been approved by Institutional Ethics Committee of Punjab Institute of Medical Sciences, Jalandhar reference number PIMS/IEC/22/10. Results: Total 1139 patients were admitted in three COVID centers of the city during the period of January 2020 to June 2021. The mean age of the patients was 54.96 ±15.43, 706 (62%) were male and 433 (38%) were female, 523 (45.9%) belong to rural area and 616 (54.1%) belong to urban area. 580 (50.9%) have comorbid condition while 559 (49.1%) do not have any comorbidity. The total number of deaths reported was 225 (19.8%). Comorbidities were seen in 580 patients (50.9%) with 126 deaths (21.7%). Out of 1139, 336(29.5%), 211(18.5%), 31(2.7%), 2(0.2%) had one, two, three and four number of comorbidities respectively. The maximum number of deaths i.e. 140 deaths (12.3%) were seen in the age group of 51–75. Conclusion: Maximum mortality rate was seen in the age group of 50-75 years of age, with significant number of deaths in rural population with two comorbidities in patients suffering from Diabetes and hypertension.
Calcifying odontogenic cyst was first described by Gorlin, so the name, Gorlin cyst. Calcifying Odontogenic Cyst (COC) is rare in occurrence and usually asymptomatic in nature. It is an uncommon benign odontogenic neoplasm which may show characteristics of both a cyst and solid neoplasm. Its clinical and radiographic features may mimic other odontogenic cysts or tumors, and a definitive diagnosis can only be arrived on histological examination. We report a classic case of calcifying odontogenic cyst in a 50 year old patient.
Introduction: Mobile Colon is a subtle developmental anomaly, which is due to the failure of the process of peritoneal zygosis. The incidence of this anomaly is estimated to be 10-15% of the population. Evidence Acquisition: During routine cadaveric dissection of the abdomen in the Department of Anatomy, collective anomalies of the caecum, ascending colon and descending colon were found. In these collective anomalies cecum, ascending and descending colon instead of normally being retroperitoneal were suspended from the posterior abdominal wall by a fold of peritoneum called the mesentery. Mobile colon is an uncommon anomaly, which is being reported here. Clinical Implications: Mobile colon is usually asymptomatic but whenever it becomes symptomatic, it leads to mobile colon syndrome. Clinical symptoms associated with mobile colon syndrome mimic other common gastrointestinal disorders such as inflammatory bowel disease, malignancy, appendicitis and volvulus. Complications of this syndrome include intestinal obstruction, torsion of the intestine and gangrenous bowel which needs immediate treatment. Conclusion: Mobile colon syndrome should be considered in the differential diagnosis of chronic abdominal pain of obscure cause. Laparoscopic colopexy and cecopexy are recommended as therapeutic and diagnostic treatments.
Tirzepatide, a glucose-dependent insulinotropic polypeptide receptor and glucagon-like peptide-1 receptor agonist has recently been approved by FDA for type 2 diabetes in adults as a single dose weekly. Tirzepatide is in phase 3 development for adults with obesity or overweight with weight-related comorbidity. Tirzepatide is also under evaluation for treatment of non-alcoholic steatohepatitis, heart faialure and obstructive sleep apnea.
Ophthalmomyiasis refers to larval infestation of the eye. A 75 years old male bedridden since three years was brought to casualty by his neighbour after having noticed worms crawling around both his eyes. Examination revealed a poor general condition and bilateral ophthalmomyiasis with blood stained foul discharge. Surgical intervention was undertaken. More than 200 maggots were removed mechanically and it was noted that there was complete destruction of intraocular contents leaving behind the scleral shell in both eyes. Entomological examination revealed larvae to be of Musca domestica and histopathological examination of the surrounding tissue showed no malignancy. Despite intensive treatment patient died after four days of admission.
Protocolised removal of central venous catheter is of paramount importance, as the procedure is implicated with numerous complications which are witnessed as well as reported in literature. Unprecedented events like bradycardia, arrhythmias, cardiac arrest as a result of air embolism, carotid sinus hypersensitivity, embolisation from the vascular end of the catheter, dislodgment of an atherosclerotic plaque or thrombus in the carotid artery precipitated during central line removal have been highlighted. Following is a brief account of cardiac arrest following Subclavian central line removal in a patient with cervical spine injury. In addition to above factors is pertinent to note that patients with High Spinal Cord Injury, above fourth dorsal vertebra have a decreased sympathetic outflow, leading to parasympathetic dominance, which may have resulted in baroreceptor mediated vagal stimulation and reflex bradycardia which progressed to junctional rhythm and pulseless electrical activity. Being aware of these serious potential complications while removing the central venous catheters and prevention of the same is of vital importance. The trainees and nursing staff should be educated regarding being vigilant and monitoring these patients.
Neurofibromatosis is an autosomal dominant disorder that affects the bone, the nervous system, soft-tissue, and the skin. The expressivity of the disease is extremely variable, with manifestations ranging from mild lesions to several complications and functional impairment. The penetrance, otherwise, is 100%. Approximately 72% of Neurofibromatosis Type1 patients present with oral manifestations. These patients have an estimated 3-15% additional risk of malignant disease in their life-time. The following report presents a 32 year old lady diagnosed with Neurofibromatosis Type 1 in childhood who presented to department with complain of bleeding gums. Radiograph showed shallow sigmoid notch on left side, obtuse and thinned out left angle of mandible which are some additional features. A multidisciplinary approach of dental and medical specialties was taken here for oral rehabilitation and to manage and treat periodontal manifestations and other oral complaints. Case was followed for more than 6 years. Neurofibromatosis has no cure hence when such patients report to dental professionals it is up to them to act as primary care giver and instill positive frame of mind to help reduce stressful life events.
Temporomandibular Joint ankylosis is the adhesion of the condyle of the mandible to the base of the skull. It is the most common cause of hypoplasia of the mandible and eventual facial asymmetry. This case report describes the management of unilateral bony re-ankylosis of temporomandibular joint after the failure of a costochondral graft in an eight-year-old girl. The management of temporomandibular ankylosis presents a major challenge due to its increased reoccurrence rate. In the present case, simultaneous gap arthroplasty and distraction osteogenesis were performed to separate the ankylotic mass and lengthen the ramus-condyle unit. The one year follow-up of the patient showed adequate mouth opening. We recommend concomitant gap arthroplasty and distraction osteogenesis for effectively managing temporomandibular joint bony ankylosis.
Arsenic is a naturally occurring element in the earth's crust. Chronic arsenic poisoning has been regularly reported predominantly due to occupational exposure in the literature. Acute arsenic poisoning is very rare. A 27-year-old gentleman was brought to the hospital with a history of suicide attempt by consumption of arsenic trioxide diluted in water. He initially manifested with gastrointestinal manifestations along with tachycardia. The patient was treated with fluid resuscitation, antidote-Dimercaprol, dialysis, and other supportive treatment. The patient continued to deteriorate with deranged liver and renal function, coagulopathy, and neurological symptoms. The presence of coagulopathy further complicated the scenario, as the antidote which is administered as an intramuscular injection could not be given. The patient continued to deteriorate and eventually succumbed. Acute arsenic poisoning is very rare, and very few reports of suicide are reported. It initially presents with acute gastroenteritis symptoms followed by multi organ involvement. Fatal doses will invariably result in death irrespective of treatment modality. Rapid administration of antidote and supportive treatment might increase the chances of survival. Difficulty in the availability of oral antidote and unavailability of any Intravenous preparations further complicates the scenario.
Background: Superficial fungal infections are one of the commonest human infections. Causative agents of such infections may vary from yeasts like Candida species, Trichosporon species to dermatophytes and non-dermatophyte moulds. Fungal culture therefore, holds importance in identification and characterization of a fungal isolate, so that proper diagnosis can be made and correct treatment is instituted. Our objective was to study the etiology of the superficial fungal infections in patients presenting to the dermatology department in a tertiary care hospital in New Delhi. Materials and Methods: A total of 340 skin and hair samples from patients clinically suspected to have superficial fungal infection of skin and hair were microscopically examined and cultured over a period of 2 years. The percentage and frequency distribution of etiological fungal agents was studied. Also the performance of the culture and microscopy as methods of detecting fungal agents was statistically compared using Kappa and proportions of positive and negative agreement as well as McNemar’s Chi-squared value. Corresponding p-values were also calculated for both kappa and Chi-squared values. The analysis has been done using Epitools. Results: Of these, 57.6% were positive for fungal elements by microscopic examination and the overall positivity of fungal infection was 70%. Out of 238 culture positive samples, 72.7% grew dermatophytes and 27.3% grew non-dermatophytes (including 16.8% yeasts and 10.9% non-dermatophyte moulds. Trichophyton mentagrophytes was the commonest (60.7%) dermatophyte isolated, followed by T. rubrum (17.3%), T. violaceum (7.5%), T. tonsurans (7.5%), T. verucosum (2.9%), Microsporum gypseum (1.2%) and M. canis (0.6%). Among the isolated non-dermatophytes, Candida species was the commonest (50.8%) majority of which were C. albicans, other non-dermatophytes included moulds like Fusarium spp. (6.1%), Aspergillus fumigatus (4.6%), A. flavus (3.1%), Alternaria spp. (3.1%), Acremonium spp. (3.1%), A. niger (3.1%) etc. and yeasts like Trichosporon spp. (10.8%). Conclusion: Dermatophytosis still remains the most common type of fungal infection involving skin and its appendages but non-dermatophytes are also slowly emerging as the causative agents for these infections.
For decades, scholars have debated which mode of education is superior amongst online versus traditional teaching. Some argue in favour of traditional or face to face teaching and others consider online teaching better. Still others suggested hybrid or blended mode of teaching as the most effective and productive method. This shift in strategy for medical education delivery has been driven by external forces beyond the influence of the institutions as well as by their internal dynamic. However, students’ perception towards online teaching as compared to traditional teaching has largely been overlooked. Aims and Objectives: This study or survey in covid pandemic intends to fill this void in the literature, and explore medical students’ perception and obtain their feedback towards online learning or teaching versus traditional teaching (face to face) mode of education in the medical field. Material and Method: Present survey included 1100 medical students from different medical colleges situated under different universities in North India. Survey was developed, which included a total of 14 questions (5 were demographical). After obtaining their responses, statistical analysis of responses was done. Conclusion: The results of present study concluded that medical students preferred traditional teaching over online mode of teaching.
Background: Maxillofacial injuries can be classified according to its anatomical location of the involved bone and by the degree of involvement like simple, compound or comminuted. Regardless of the site of involvement and nature of trauma the fracture can be addressed by closed and open methods of reduction. Objective: The aim of this retrospective study was to record the incidence and factors associated with plate removal in patients with maxillofacial trauma. Materials and Methods: Records of 280 cases managed for maxillofacial trauma in the last (5 years) period from January 2010 to Dec 2014 by open reduction and internal fixation (ORIF) with osteosynthesis plates were analyzed at a tertiary health care facility. Logistic regression analysis was done to find an association between the variables studied and incidence of plate removal. Results: 32 cases (11.42%), 55 number of implants underwent removal of plates due to reasons ranging from infection(50%), Plate exposure(9.375%), treatment failure(15.625%), palpability(12.50%), and persistent pain(12.50%), Zygomatic buttress and Parasymphysis sites had highest incidence of plate removal compared to other sites. Being a female [OR 9.87(4.21–10.72)], age groups of 46-60 [OR 6.39(4.43-9.62)], 31-45 [OR 11.25(6.81-13.77)] and 15-30 [OR 10.01(5.74-12.22)], infra orbital rim among sites [OR 2.03 (1.48-4.67)] significantly increased the odds of incidence of plate removal. Conclusion: In our retrospective analysis, the overall incidence of plate removal was 11.42%. Maximum plate removals were from Zygomatico-Maxillary Buttress and Symphysis and Parasymphysis regions. Infection was found to be the most common cause of plate removal.
