Search

Background: Contemporary imaging methods and quickly advancing technologies have increased the number of diagnostic tools available in medicine and orthodontics. The current study aimed to determine three-dimensional (3D) space changes that occurred after the extraction of either the maxillary or mandibular primary molars during the mixed dentition period. MATERIALS AND METHODS: The present study was a longitudinal split-mouth study with a study group and a control group. The sample consisted of 20 children aged between 6 and 9 years. Clinical examination, radiological analysis, and 3D digital images of the plaster casts were used sequentially to gather all the data. The dental cast measurements recorded were arch width, arch length, hemi-perimeter, dental space at the extraction site, and angulation of the first permanent molar. The children were recalled for follow-up after 9 months, and all dental cast measurements were repeated using nondestructive 3D computed tomography software. For repeated measurements, the test applied was a paired t-test, and for independent samples, the test was a Student’s t-test. Results: A significant decrease in arch width (P = 0.001), arch length (P < 0.001), hemi-perimeter (P < 0.001), D-space (P < 0.001), and E-space (P = 0.001) was observed following extraction. A significant increase in angulation measurements was observed (P = 0.001). Conclusion: The study revealed a comparative reduction in mandibular arch width, a reduction in arch length in both the maxilla and the mandible, a reduced hemi-perimeter of dental arches, loss of dental extraction space, and a change in angulation of the erupted first permanent molars following premature loss of the primary molar.

Introduction: Laparoscopic sleeve gastrectomy (SG) is the most common bariatric surgical procedure worldwide. Approximately 20%–30% of patients present with weight loss failure or reflux following SG, which might require reoperative surgery. We present the surgical outcomes and complications following reoperative bariatric surgery at a tertiary care centre. Patients and Methods: Prospectively collected data of all patients undergoing reoperative bariatric surgery from 2008 to 2021 were analysed retrospectively. Weight loss, resolution of comorbidities and complications following reoperative surgery were evaluated. Results: Twenty-six patients were included in the study. The mean age was 38.8 (10.8) years. The primary procedure performed was laparoscopic SG in all cases. Nine patients underwent Roux en Y gastric bypass (RYGB) (one banded RYGB) and 14 underwent one anastomosis gastric bypass (OAGB) (three-banded OAGB). Three patients underwent resleeve. The most common indication was weight loss failure (65.3%). Fifteen patients were diagnosed to have hiatal hernia intraoperatively and concomitant repair was performed. The mean body mass index before revision surgery was 42.7 (9.8). It was 32.6 (5.7) kg/m2 and 33.0 (6.1) kg/m2 at 1 and 3 years, respectively. Age and pre-revision surgery excess weight correlated with weight loss (r = −0.79 and r = 0.99, respectively). Leak and bleeding occurred in one and two patients, respectively. There were two band-related complications and one 30-day mortality. Conclusion: Re-operative bariatric surgery following SG has adequate weight loss with acceptable complication rates. Band placement in re-operative surgery might lead to a higher complication rate.

Context : Visual disability in India is categorized based on severity. Sometimes the disabled person does not fit unambiguously into any of the categories. Aims : To identify and quantify disability that does not fit in the current classification, and propose a new classification that includes all levels of vision. Settings and Design : Retrospective chart review of visual disability awarded in a teaching hospital. Materials and Methods : The last hundred records of patients who had been classified as visually disabled were screened for vision in both eyes and percentage disability awarded. Data were handled in accordance with the Helsinki Declaration. Results : Twenty-one patients had been classified as having 30% disability, seven each had 40% and 75%, and 65 had 100% disability. Eleven of them did not fall into any of the current categories, forcing the disability board to use its own judgment. There was a tendency to over-grade the disability (seven of 11; 63.6%). The classification proposed by us is based on the national program for control of blindness′ definition of normal vision (20/20 to 20/60), low vision ( < 20/60 to 20/200), economic blindness ( < 20/200 to 20/400) and social blindness ( < 20/400). It ranges from the mildest disability (normal vision in one eye, low vision in the other) up to the most severe grade (social blindness in both eyes). Conclusions : The current classification of visual disabilities does not include all combinations of vision; some disabled patients cannot be categorized. The classification proposed by us is comprehensive, progresses logically, and follows the definitions of the national program.

A 25-year-old woman was diagnosed to have tubercular meningitis (TBM) with a right parietal infarct. She responded well to four-drug anti-tubercular treatment (ATT), systemic steroids and pyridoxine. Steroids were tapered off in one and a half months; she was put on two-drug ATT after two months. Six months after initial diagnosis she presented with sudden, bilateral visual loss. Vision was 3/200 with afferent pupillary defect and un-recordable field in the right eye; vision was 20/60 in the left eye, pupillary reaction was sluggish and the field showed a temporal hemianopia. On reintroduction of systemic corticosteroids vision improved (20/120 in right eye and 20/30 in left eye) within three days; the field defects improved sequentially to a left homonymous hemianopia, then a left homonymous inferior quadrantonopia. A diagnosis of TBM, on treatment, with bilateral optic neuritis, and right optic radiation involvement was made. Since the patient had been off ethambutol for four months, the optic neuritis and optic radiation lesion were attributed to a paradoxical reaction to tubercular allergen, corroborated by prompt recovery in response to corticosteroids. This is the first report of optic radiation involvement in a paradoxical reaction in neuro-tuberculosis in a young adult.

Background and Aim: Head-and-neck cancers (HNCs) are significant causes of morbidity and mortality in both the developed and developing worlds. One of the most common types of HNC is oral squamous cell carcinoma (OSCC). The rationale behind the present study is to analyze the effectiveness of nuclear proliferative markers in comparison to the various grades of OSCC. This study utilizes Anneroth's histopathological multifactorial grading system for squamous cell carcinoma and further tends to compare this histological grading with nuclear proliferative indices of p53 and argyrophilic nucleolar organizer region (AgNOR). The aim of this study was to establish and develop a correlation between the proliferative markers, AgNOR and p53, and the histologic grade of the tumor (Anneroth's grading). Materials and Methods: A total of 60 cases of oral squamous cell carcinoma were taken from October 2020 to September 2022. The histological grading was done according to Anneroth's grading, and a score was given. P53 expression was graded according to the percentage of cells showing p53-positive immunostaining, and scoring was done from 0 to 3. The AgNOR score was calculated by examining 100 nuclei and calculating the mean AgNOR score per nucleus. Results: A significant linear correlation was obtained between the histological grading of OSCC and the proliferative markers (p53 and AgNOR). Conclusion: The analysis of the NOR count provides invaluable assistance in determining tumor aggressiveness and cellular proliferation rates. They can prove to be efficient tools to procure information on the malignant potential of different premalignant lesions. Elevated p53 expression implies greater clinical severity, a higher histological grade, and a poor prognosis for oral squamous cell carcinoma. Hence, the proliferative markers can be used as adjuncts to the histological grading system of OSCC.

Gingival recession (GR) is considered a public health problem which is highly prevalent across different populations. Accuracy of psychometric properties of prevalence estimates of GR reported in epidemiological studies is important to facilitate setting public health goals, planning of public health programs, implementation of best practices and thereby developing public health policy. However, the reported prevalence estimates are influenced by the methodological variations among different studies, as observed in our recently published systematic review and meta-analysis on the global prevalence of GR. It substantially limits the comparability between studies and inferences about the true global variation in the prevalence of GR are difficult to establish. To address these issues, this commentary suggests to follow the standardized principles related to study design, clinical examination protocol, and characteristics of study subjects in future epidemiological studies on prevalence estimates of GR. Furthermore, the inclusion of additional domains in the reporting data is suggested for a deeper insight into the patterns of GR in different populations. Our suggestions are derived from a pragmatic approach and their consistent implementation would improve the reporting quality and achieve uniformity in future studies, thus benefitting the research in this area.

Background: Coronary artery disease (CAD) is associated with significant mortality and morbidity. Atherosclerosis is the most common pathophysiology behind this condition. This manifests as an increase in arterial wall intima-media thickness and subsequent plaque formation in the asymptomatic phase. Objectives: To measure the carotid intima-media thickness (CIMT) value of carotid arteries in patients with angiographically diagnosed CAD and also asses the carotids for the presence of plaques and if present to characterize them. Materials and Methods: A total of 100 angiographically diagnosed CAD patients were included in the descriptive study and data were analyzed regarding the increased CIMT, and plaques in the carotid arteries in relation to the corresponding coronary disease. Results: Raised CIMT values were found in 47 out of 100 patients. A linear proportional relationship of mean CIMT values with the number of involved coronary arteries was also observed. A total of 62 plaques were demonstrated in 43 patients. Majority of the plaques (65%) had a smooth surface with uniform outlines. Eighteen plaques were found to have irregular surface outlines (29%), whereas four out of 62 plaques (6%) had ulcerated surfaces. Conclusion: There is increased CIMT prevalence and its linear proportional relationship with an increased number of affected coronary vessels in patients with CAD. Furthermore, an increased prevalence of carotid plaques is present in these patients. Hence, the increased CIMT and the presence of carotid plaques may act as surrogate markers for risk stratification in a patient with CAD.

Introduction: Working adults in high-altitude regions (HARs) are at higher risk of developing cerebral venous thrombosis (CVT) due to multiple factors. The clinico-radiological patterns pertaining to the high altitude associated with CVT can be different compared to those without HAR exposure. Objective: We aimed to study the clinico-radiological patterns of CVT in adult males diagnosed with CVT while working in mountainous regions at an altitude higher than 8000 feet above sea level. Methodology: The study population consists of adult males aged >18 years who suffered symptomatic CVT while working in mountains at high altitudes. They were divided into groups according to the altitude at which they were working as high-altitude (8202–11,483 ft), very high-altitude (11,484–19,029 ft), and extremely high-altitude (above 19,030 ft) regions. Meticulous history, clinical examination, imaging with computed tomography, magnetic resonance imaging, and laboratory investigations including procoagulation profile were done. The outcome was classified according to the modified Rankin score at 3-month follow-up. Results: Among the forty patients with CVT, 100% had a headache, 65% had vomiting, and 20% suffered convulsions at presentation. Increasing altitude was associated with higher clot load, increasing extent of involvement within the venous sinuses, and a tendency to involve deep veins in isolation or conjunction with the sinuses. Twenty-three recovered without any deficit and 15 were symptomatic without disability at the 3-month follow-up. Conclusion: In patients of CVT who are exposed to high altitudes in mountains, the increasing altitude is associated with higher clot load, increasing extent of involvement within the venous sinuses, and a tendency to involve deep veins. Polycythemia, smoking, alcohol, and deficiency of protein C are the coexisting factors.

Aim: The present in vitro study was designed to determine the effect of different access cavity designs on intracoronal bleaching of endodontically treated teeth with two different agents. Materials and Methods: Fifty selected permanent maxillary central incisors were stained. Traditional and contracted access cavity designs and two types of bleaching agents, i.e., 35% carbamide peroxide and 35 percent hydrogen peroxide were used for the study. Color measurements were performed with a spectrophotometer: before staining (T1), after staining (T2), at 7 and 14 days (T3 and T4) post bleaching. The values were calculated and subjected to the statistical analysis. Results: The results of our study showed that teeth in which traditional access cavity (TAC) was prepared had statistically significant better bleaching results with both 35% carbamide peroxide and 35% hydrogen peroxide than contracted access cavity design. Carbamide peroxide showed better results than hydrogen peroxide irrespective of the access cavity design, but difference was statistically nonsignificant. Conclusion: The present study concluded that TAC design showed better results than contracted access with both carbamide peroxide and hydrogen peroxide. Whereas, when bleaching agents were compared 35% carbamide peroxide is better than 35% hydrogen peroxide irrespective of access cavity design used.

Introduction: In India, approximately 35,000 new cleft patients are born every year. Many patients receive suboptimum, improper, little, or no treatment. The cumulative burden of cleft care is up to 1 million cases. The spectrum of problems is varied, the caseload is enormous, and the logistics of treatment delivery are complicated. The Indian Council of Medical Research (ICMR) task force project was launched in 2012 to evaluate the status of cleft care in India and develop strategies to provide comprehensive cleft care through a dynamic multidisciplinary and multidimensional tool. ICMR task force project (2012–14) was conducted in Delhi, and the National Capital Region reported that at least 50% of studied cases had complex and multiple treatment needs. The needs identified were related to surgical, orthodontic, dental, ENT and Speech, rehabilitation of mutilated dentition, and various psychological disturbances among patients with Cleft anomalies. Aim: The aim of this study was to develop and test web-based application to create a system for national data of patients with cleft anomalies and digitize the patient records in a standardized preagreed format. Methods and Results: Corresponding to contemporary digital technologies and evolutionary improvements in data collection, web-based data collection instrument, including text, photographs, X-rays, and audio files, was considered the most appropriate. The experts from varied domains in consultation with ICMR and National Informatics Centre evolved a web-based data collection instrument which is named the “IndiCleft tool.” The tool has been tested and used over the years and is presently being upgraded to dynamic version for a national data and patient care registry. Conclusion: The present article describes the process of the development of a “dynamic” web-based data collection instrument. The IndiCleft tool is the national resource on cleft data in India.

Background: Tumor invasion into the orbit by carcinoma is well known and its negative impact on the survival and quality of life has been discussed in the literature. Methods: This article is a narrative review on the preservation of eye in the management of cancers of the nose and paranasal region. Conclusions: The clinical features and modern imaging can help in preoperative planning, aided by the intraoperative assessment in decision-making to preserve the eye or not. Unlike in the past, when even orbital periosteum involvement was considered for orbital sacrifice, more conservative approach has been advocated in recent years in view of anatomic, radiological, and histological studies. Limited involvement of the periorbita or even the small part of intraorbital fat may still be considered for the preservation of the eye in selected patients with frozen section control and without affecting the oncologic outcome.

Aim: This study aims to evaluate the efficacy of the Immediate Donation of Eyes after Life (IDEAL) protocol in establishing and monitoring hospital-based cornea retrieval programs. Methods: Nursing staff was sensitized to the process of cornea donation (CD), contraindications, and counseling by holding workshops and role-plays. All deaths in each of the participating hospitals of the prospective study were reported on WhatsApp “Code Angel Group” in a specific format. Each death was evaluated to rule out any contraindication to CD, the family was approached by the nurse on duty and counseled for donation. In case of negative or equivocal response to counseling for CD, smart phone-based messages were sent by eye bank (EB), followed by a phone call. Cornea retrieval was carried out by the same EB throughout the study period. In case of negative consent to donation, follow-up phone call to the next of kin at 1–2 weeks was done and response recorded. Results: Of 2140 deaths recorded, 1540 (71.9%) were ineligible for donation, largely due to sepsis. Of the remaining 600, counseling was done in 484 (83%). Ninety-nine of 484 (20.5%) families consented to donation. Counseling was carried out by a total of 70 nurses. Of the 45 nurses who counseled 3 or more families, conversion rate for CD was above 50% in 4, 40%–49% in 2, 30%–39% in 5, 20%–29% in 11, and below 20% in 12. Conclusions: Nursing teams on duty, with brief training on CD, can effectively drive the CD program in hospital setting.

Background: Women at menopausal period may frequently develop several oral mucosal disorders. Xerostomia is also a common finding among postmenopausal women. The present study was conducted to assess effect of menopause on saliva and dental health. Materials and Methods: Forty postmenopausal women (Group I) and 40 control (Group II) underwent Oral Hygiene Index Simplified (OHIS), Decayed, Missing and Filled Teeth (DMFT index), Community periodontal index (CPI), and Loss of attachment (LOA), salivary pH and flow measurement. Results: Oral symptoms were normal in 22 and 40, xerostomia in 18 and 0 in Group I and II respectively, salivary pH was normal in 20 and 40, below acidic in 20 and 0, salivary flow was normal in 21 and 40, hyposalivation in 19 and 0 in group I and II, respectively. The difference was significant (P < 0.05). OHI-S was good in 4 and 25, fair in 6 and 10, poor in 30 and 5, DMFT index was decayed was 1.42 and 0.65, missing was 2.84 and 0.26 and filled was 1.06 and 0.52 seen in Group I and II respectively. CPI index mean value was 3.26 in Group I and 1.02 in Group II and mean LOA was 1.42 and 0.46 in Group I and II respectively. The difference was significant (P < 0.05). Conclusion: There was decrease in the salivary pH and flow rate in postmenopausal women which in turn leads to increased OHI-S, DMFT, CPI, and LOA.

Asymmetrical disc edema in idiopathic intracranial hypertension (IIH) is an uncommon finding, with an unclear understanding. This report reinforces the importance of recognizing this entity in IIH diagnosis, and not misdiagnose the condition as unilateral disc edema. In this unique report, the causative association of asymmetric optic disc edema, with optic nerve kink, due to unilateral high myopia, is documented.

Aim: The aim of this in vitro study was to evaluate and compare the push-out bond strength of Adseal and mineral trioxide aggregate (MTA) Fillapex sealer after using various irrigants and Erbium-Yttrium-Aluminum-Garnet (Er:YAG) laser irradiation on radicular dentin surface. Materials and Methods: A total of 80 freshly extracted human permanent maxillary anterior teeth were sectioned transversally below the cemento-enamel junction. The remaining root portion was sectioned to get 4-mm thick dentin disc from coronal end of the root, with straight handpiece, and diamond disc. Root canal of specimens was prepared with bur to create space for sealer placement. Specimens were divided into eight groups of 10 samples each, as per irrigants and sealer used. In Group 1, 3, 5, and 7 specimens irrigated with distilled water, NaOCl, Ethylenediaminetetraacetic acid (EDTA), and Er:YAG laser, respectively, and obturated with Adseal sealer. In Group 2, 4, 6, and 8 irrigated with distilled water, NaOCl, EDTA, and Er:YAG laser, respectively, and obturated with MTA Fillapex sealer. After sealer setting, the force used to remove the sealer was evaluated using universal testing machine. Recorded force used to calculate the push-out bond strength in Megapascals and scanning electron microscopy examination was done for specimens. Results: Adseal sealer had significantly higher bond strength than MTA Fillapex sealer, irrespective of irrigant used. The highest bond strength was seen in specimens irrigated with EDTA and obturated with Adseal sealer and least in specimens irrigated with distilled water and obturated with MTA Fillapex sealer. Conclusion: Adseal sealer had significantly higher bond strength than the MTA Fillapex sealer. EDTA irrigation showed better smear layer removal, followed by Er:YAG laser irradiation, then NaOCl, least by distilled water.

Background: A multidisciplinary approach involving healthcare students for health promotion has been recommended. With this view, the primary phase of the integrated health promotion program (IHPP) was designed and pilot tested. Methods: A pre-post-intervention study was conducted among 55 housewives of two self-help groups in India. The intervention consisted of a motivational interview, interactive session with a nutritionist, group discussion, personal hygiene training, and an illustrative reinforcement leaflet. Interventions were provided by trained dental students. The evaluation was based on outcomes from six tools specifically tailored for the program. These were the health self-regulation self-efficacy scale (HSSS), visual analogue scale (VAS) for self-health perception, oral health knowledge and attitude questionnaire, motivational interview, group discussion, and personal hygiene demonstration test. Results: Statistically significant change in mean pre- and postprogram scores in HSSS (P < 0.001), its two components, metacognitive component, action component, as well as VAS (P = 0.001) indicated a change in health-related perceptions in the participants. Mean oral health knowledge score (6.1), as well as attitude score (3.8), was fair. Most of the participants were able to demonstrate personal hygiene and tooth brushing correctly; take collective decisions about their health, plan changes in their diet, and resolve upon bringing about healthy changes in their lifestyle. Conclusion: The program evaluation indicated successful intervention and may be replicated in a larger population. Healthcare student population may be used in developing countries to bring about an attitude change in the underprivileged population through an IHPP.

Aim: The aim of this study is to evaluate the gutta-percha removal from root canals with diode laser using chloroform and Endosolv E solvents. Materials and Methods: Thirty freshly extracted permanent human maxillary central incisors with single and straight root canals were selected for the study. Teeth were biomechanically prepared and then obturated. Teeth were then stored in 100% humidity at 37°C for 7 days. Then teeth were randomly divided into three groups based on retreatment method used: Group 1-Only diode laser; Group 2-Diode laser along with chloroform as solvent; Group 3-Diode laser along with Endosolv E (Tetrachloroethylene) as solvent. After completion of retreatment, roots were sectioned longitudinally and viewed under stereomicroscope at 10x magnification. The area of the remaining filling material in each half was measured using Image tool for Windows v. 3.00 software. Data were analyzed by using analysis of variance test followed by post hoc test. Results: The results showed that all the laser groups left some filling material inside the root canal. However, the specimens retreated with diode laser along with chloroform (Group 2) left less filling material inside the root canals as compared to other groups. Conclusion: The present study revealed that the diode laser with solvents (Chloroform and Endosolv E) were significantly more effective than only diode laser group in removing gutta-percha during retreatment of the root canal system. Out of these, Group 2 (diode laser along with chloroform as solvent) was more effective than other groups.

Background: The immunization coverage in India is far away from satisfactory with full immunization coverage being only 62% at national level. Targeting the intensive efforts to poor performing areas and addressing the determinants of nonimmunization and dropouts offers a quick solution. In this paper, we assess the inter-district variations in Haryana state, and the association of social determinants with partial and no immunization. Methodology: This analysis is based on data collected as part of a large household survey undertaken in the state of Haryana to measure the extent of Universal Health Coverage. A multistage stratified random sampling design was used to select primary sampling units (i.e., subcenters), villages, and households. A total of 11,594 mothers with a child between 12 and 23 months were interviewed on receipt of immunization services. Determinants of nonimmunization and partial immunization were assessed using multiple logistic regression. Results: About 21% of children aged 12–23 months were partially immunized, while 4.3% children aged 12–23 months had received “no immunization.” While the coverage of full immunization was 74.7% at the state level, it varied from 95% in best performing district to 38% in poorest performing district. Odds of a partially immunized child were significantly higher in urban area (odds ratio [OR] = 1.23; 95% confidence interval [CI] = 1.1–1.38), among Muslim household (OR = 3.52; 95% CI = 3.03–4.11), children of illiterate parents (OR = 1.58; 95% CI = 1.22–2.05), and poorest quintile (OR = 1.61; 95% CI = 1.36–1.89). Conclusions: Wide interdistrict variations call for a need to consider changes in resource allocation and strengthening of the government initiatives to improve routine immunization in these districts.

Purpose: The aim of this study is to survey the management approach, regarding spectacle prescription in children, among Indian ophthalmologists. Methods: A web-based, anonymous questionnaire (multiple choice questions dealing with practical aspects of pediatric refraction), was sent to available database of Indian ophthalmologists. The survey responses (depicted in %) were compared using the amount of pediatric clientele in one's practice (Group A: 0.05, Chi-square test), as to when and how much refractive error to prescribe in children, for a given situation. Conclusion: A wide gap exists between pediatric spectacle prescription patterns of Indian ophthalmologists, as compared to the recommended pediatric ophthalmology protocols. The management approach, for certain situations concerning the pediatric refraction, was better among those with higher pediatric clientele.

Objective: Dysmenorrhea is a widespread medical problem among young females. Hypnosis has been successfully tried for alleviation of different types of pain. In this randomized control trial, we compared it with nonsteroidal anti-inflammatory drug (NSAID), which is a standard treatment, for primary dysmenorrhea. Method: Out of 116 female nursing students, 50 having dysmenorrhea were selected and divided into mild, moderate, and severe pain category based on visual analog scale (VAS) score. Each category was randomly divided into two groups. One group was offered hypnosis and the other was offered Ibuprofen for pain relief in each menstrual cycle, for three consecutive cycles. They were followed for next three cycles (i.e., 4 th , 5 th , and 6 th cycle) without any treatment. Evaluation of pain score was done at the end of each cycle in both the groups. Wilcoxon Signed Rank Test and Mann-Whitney U-test were used for statistical analysis. Results: Compared to baseline, the improvement in pain scores was statistically significant in all six cycles in hypnosis group (P < 0.0001); whereas in NSAID group, the improvement was found during first three cycles only (P < 0.0001). Comparing the VAS scores of the same menstrual cycle in both the groups, it was less in NSAID group than hypnosis group for the first three cycles. This shows the instant effect of NSAID on pain relief. However, for the remaining cycles, pain scores were less in hypnosis group compared to NSAID group. Conclusion: For dysmenorrhea, hypnosis produces lasting pain relief compared to NSAID.

Background: Nowadays, techniques are being developed to guide and instruct the specialized cellular components of the periodontium to participate in the regenerative process. This approach of reconstruction makes use of understanding of the development of the periodontium and the cellular processes that are involved. Hyaluronic acid is a naturally occurring non-sulfated high molecular weight glycosaminoglycan that forms a critical component of the extracellular matrix and contributes significantly to tissue hydrodynamics, cell migration, and proliferation. Hence, its administration to periodontal wound sites could achieve comparable beneficial effects in periodontal tissue regeneration. Hence, the purpose of the present case report was to assess roentgenographically, the regenerative capacity of Gengigel® in conjunction with bioactive amnion guided tissue regeneration (GTR) membrane in a patient with Grade II furcation defect. Case Presentation: A patient complained of bleeding gums from the lower back tooth region, reportedly found Grade II furcation in the lower right mandibular first molar. After Phase, I therapy, Gengigel® along with bioactive amnion membrane was placed in the furcation area during the surgical phase. Roentgenographic assessment was done at 4 months and 6 months postoperatively. It resulted in complete defect-fill and loss of radiolucency at 6 months. Conclusion: Surgical placement of Gengigel® along with amnion membrane in the furcation defect can significantly improve the periodontal defect morphology.

The pathophysiology of nephrolithiasis is not fully understood. The pioneering work of Alexander Randall in the 1940s sought to clarify our understanding of stone formation. This review traces the inception of the theory of Randall′s plaques and the refinement of the hypothesis in the early days of kidney stone research. It then reviews the contemporary findings utilizing sophisticated investigative techniques that shed additional light on the pathophysiology and redefine the seminal findings of Dr. Randall that were made 70 years ago.

Cowden syndrome (CS) or multiple hamartoma syndromes (MHSs) is an uncommon condition and characterized by mucocutaneous lesions which may be associated with the lesions of breast, thyroid, gastrointestinal tract, skin, and often of central nervous system. A thorough evaluation of Cowden′s disease is essential due to increased risk of malignancy in an organ or system of the affected patients. We are reporting a case of female patient who presented with multiple mucocutaneous papilloma associated with involvement of multiple organs and systems. The diagnosis was confirmed by multimodality diagnostic approach. This rare entity has not being reviewed in Indian literature till date. Being a rare case, we are discussing MHS with its clinicoradiological and histopathological correlation along with brief review of literature.

Background: This study was carried out to evaluate the sterility and structural integrity of stored primary teeth in artificial saliva over a storage period of 12 weeks (3 months) in human tooth bank (HTB). Materials and Methods: A total of 80 freshly extracted teeth were taken and were categorized into four groups of 20 each. The samples were stored at 4°C for 12 weeks (3 months) in the refrigerator. During their storage time of 3 months, they were repetitively evaluated for their sterility, enamel hardness, calcium and phosphate solubility and color stability at regular intervals of 3 weeks. Observations and Results: That teeth stored in artificial saliva maintained their sterility throughout the storage time of 12 weeks, but changes in their physical and chemical properties occurred with an increase in storage time. Conclusion: Storage time not more than 9 weeks is recommended for deciduous teeth to be stored in artificial saliva in a HTB.

The epidemiology of kidney stones is evolving - not only is the prevalence increasing, but also the gender gap has narrowed. What drives these changes? Diet, obesity or environmental factors? This article will review the possible explanations for a shift in the epidemiology, with the hope of gaining a better understanding of the extent to which modifiable risk factors play a role on stone formation and what measures may be undertaken for disease prevention in view of these changing trends.

In the last one to two decades, flexible ureteroscopy has rapidly expanded its role in the treatment of urologic stone disease. With the frequent and expanded use of flexible ureteroscopy, other ancillary instruments were developed in order to ease and facilitate this technique, such as ureteral access sheaths (UAS) and a variety of wires and baskets. These developments, along with improved surgeon ureteroscopic competence, have often brought into question the need to implement the "traditional technique" of flexible ureteroscopy. In this review, we discuss a brief history of flexible ureteroscopy, its expanded indications, and the controversy surrounding the use of UAS, wires, and baskets.

Mesiodens is the most common type of supernumerary teeth found in the premaxilla between the two central incisors. Early and proper diagnosis and appropriate treatment plan is critical in eluding the extent of treatment needed. This case report presents the successful orthodontic and esthetic management of an unusual case of Indian origin with twin mesiodens in the maxillary arch causing torsiversion and attrition of mandibular incisors due to occlusal trauma.

The authors present an objective review of what is new in endourology instrumentation, based on up-to-date scientific data gathered from meetings, state-of-art lectures and current literature. The main scope of this review is to highlight the most recommended device options for each step of an ureteroscopy, in order to offer best care to patients.

Objectives : To review the evidence-based literature on the causes, characteristics, and options to manage double J stent-related symptoms. Methods : We performed a Medline database assessment on papers that investigated the prevalence, mechanisms, risk factors, bothersome and management of double-J stent-related symptoms. Articles in English were reviewed and summarized. Results : Stent-related symptoms have a high prevalence and may affect over 80% of patients. They include irritative voiding symptoms including frequency, urgency, dysuria, incomplete emptying; flank and suprapubic pain; incontinence, and hematuria. Assessment tools are important to determine their intensity and allow for comparisons between different points in the timeline. The Urinary Stent Symptom Questionnaire (USSQ) is the most proper tool used for this purpose. Management should be focused on the prevention and management of symptoms. In this sense, research has focused on new materials and stent designs that would be more compatible to the physiologic properties of the urinary tract and medications that can ameliorate the sensitivity and motor response of the bladder. Conclusions : Stent-related symptoms are very common in the Urological clinical setting. It is of major importance for the urologist to understand their physiopathology and to be familiar with ways to avoid or manage them.

Introduction: Technological advances have increased the application of the endoscopic management of upper tract transitional cell carcinoma (TCC) and ureteropelvic junction obstruction (UPJO). Materials and Methods: Published, peer-reviewed articles on endoscopic treatment of upper tract TCC and UPJO were identified using the MEDLINE database. Results: Although nephroureterectomy remains the gold standard for upper tract TCC treatment, low-grade, low-stage and small tumors, especially in patients with solitary kidneys or poor renal function can be managed with encouraging success rates, despite the considerable recurrence rate. Endoscopic alternatives to pyeloplasty for UPJO can be used especially in cases with absence of crossing vessels, stricture length less than 1.5 cm, severe hydronephrosis and renal function less than 30%. Conclusion: Proper patient selection is critical for the successful endoscopic management of treatment of upper tract TCC and UPJO.

Instrumentation is the key to success in endourology. Indeed, endourology could be redefined as "enginurology" as the marriage between engineering and urology to develop instrumentation to improve patient outcomes is the key facilitator in the advancement of minimally invasive techniques. This review article will identify the evidence-base that supports our current recommendations for equipment used during ureteroscopy.

For most dermatologists, the challenge posed by toxic epidermal necrolysis (TEN) lies not in its diagnosis, but in pulling the patient out of this life-threatening condition. However, when a patient presents with a TEN-like picture in the background of lupus erythematosus (LE), it becomes difficult to decide whether the eruption is drug induced or a manifestation of lupus itself.