Screw-worm myiasis of prolapsed rectum

Background

Wound myiasis in the Indian subcontinent is most commonly caused by old world screw-worm (Chrysomya bezziana).

Case Report and management

A 4-yearold malnourished girl presented with full thickness rectal prolapse following acute diarrhea with a large wound and screwworm myiasis of the rectum. Turpentine oil was applied to immobilize the maggots followed by manual extraction. Prolapse was successfully treated by manual reduction followed by strapping of the buttocks.

Outcome

Child was thriving well and gained 2 kg weight in follow up after two weeks.

Message

Parents should be educated about taking care of prolapsed rectum.     

Enhanced anti-psoriatic efficacy and regulation of oxidative stress of a novel topical babchi oil (Psoralea corylifolia) cyclodextrin-based nanogel in a mouse tail model

Psoriasis is a proliferative inflammatory skin disorder with relapsing episodes. Herein, the efficacy of babchi oil (BO) loaded nanostructure gel was evaluated for antipsoriatic activity and oxidative stress biomarkers assessment using mouse tail model. BO was entrapped into cyclodextrin-based nanocarriers (360.9?±?19.55?nm), followed by incorporation into Carbopol gel and characterised for viscosity, spreadability, and texture analysis. The gels were topically applied on mouse-tails once daily for fourteen days. Evaluation of antipsoriatic activity as determined by histopathological observations of orthokeratotic epidermis revealed two times higher efficacy of BO nanogel in comparison to the native BO gel. Further, significantly enhanced superoxide dismutase (SOD) and reduced glutathione (GSH) levels, and diminished malondialdehyde (MDA) and nitrite (NO) levels revealed that prepared nanogels played a major role in the management of reactive oxygen species (ROS) associated in psoriasis pathogenesis. Hence, this study provides strong evidence for use of cyclodextrin-based nanogels as a safe and better delivery carrier of BO for management of psoriasis.     

Oral Health-Related Quality of Life (OHQoL) among Adolescents Seeking Orthodontic Treatment

Aim: The aim of this study was to assess the effect of different orthodontic treatment needs on the OHQoL of adolescents. Materials and methods: 200 subjects (100 males and 100 females), 11 to 15 years of age were recruited for the study. OHQoL was assessed with the short form of the oral health impact profile (OHIP-14), and malocclusion severity was assessed with the index of orthodontic treatment need (IOTN). The Chi-square test was used to analyse the qualitative data. The level of significance was 0.05. Results: The more severe the malocclusion the worse was the impact on the OHQoL. Orthodontic treatment need had almost similar impact on the daily activities of both males and females. Pronunciation and taste was not significantly affected by the need for orthodontic treatment in either males or females. The proportions of orthodontic patients who found it uncomfortable to eat any food and had to interrupt their meals were significantly correlated with orthodontic treatment needs in both males and females. Conclusion: Orthodontic treatment need had an impact on OHQoL of adolescents with no significant difference between males and females. Clinical significance: Orthodontists should be aware of the impact caused by malocclusion and orthodontic treatment on the quality of life of the patients and should provide regular positive reinforcements to them. Keywords: Oral health-related qualtiy of life, Orthodontic treatment need, Malocclusion. How to cite this article: Manjith CM, Karnam SK, Manglam S, Praveen MN, Mathur A. Oral Health-Related Quality of Life (OHQoL) among Adolescents Seeking Orthodontic Treatment. J Contemp Dent Pract 2012;13(3):294-298. Source of support: Nil Conflict of interest: None declared.     

Prosthetic Rehabilitation of a Hemisected Maxillary Molar: A Rare Entity

Gingival recession beyond grade III and grade IV level involving furcation defects can lead to tooth loss if not intervened at appropriate time. The treatment options include scaling and root planing, Furcation-plasty, Tunnel preparation, Root separation and resection. The chief complaint of the patient was pain in the upper left first molar because of grade III furcation involvement. Since it was a four rooted molar, the treatment of choice was hemisection of the tooth and extraction of the distal half following endodontic treatment. As the second molar was mesially tilted the prosthodontic rehabilitation was done with a hybrid prosthesis involving a full coverage conventional porcelain fused to metal retainer on the hemisected molar and a resin bonded partial coverage retainer on the tilted second molar. The resultant prosthesis is termed as "Hybrid prosthesis".     

Characterisation of bone following ultrasonic cutting

Objectives

Ultrasonic surgery is an increasingly popular technique for cutting bone, but little research has investigated how the ultrasonic tip oscillations may affect the cuts they produce in bone. The aim of this investigation was to evaluate the oscillation and cutting characteristics of an ultrasonic surgical device.

Materials and methods

A Piezosurgery 3 (Mectron, Carasco, Italy) ultrasonic cutting system was utilised with an OP3 style tip. The system was operated with the tip in contact with porcine bone samples (loads of 50 to 200 g) mounted at 45° to the vertical insert tip and with a water flow of 57 ml/min. Tip oscillation amplitude was determined using scanning laser vibrometry. Bone surfaces defects were characterised using laser profilometry and scanning electron microscopy.

Results

A positive relationship was observed between the magnitude of tip oscillations and the dimensions of defects cut into the bone surface. Overloading the tip led to a reduction in oscillation and hence in the defect produced. A contact load of 150 g provided the greatest depth of cut. Defects produced in the bone came from two clear phases of cutting.

Conclusions

The structure of the bone was found to be an important factor in the cut characteristics following piezosurgery.

Clinical relevance

Cutting of bone with ultrasonics is influenced by the load applied and the setting used. Care must be used to prevent the tip from sliding over the bone at low loadings.     

Buccal Injection of 2% Lidocaine With Epinephrine for the Removal of Maxillary Third Molars

The aim of the study was to demonstrate if 2% lidocaine hydrochloride with 1 : 200,000 epinephrine could provide palatal anesthesia in maxillary tooth removal with a single buccal injection. The subjects included in the clinical study were those requiring extraction of the maxillary third molar of either side. For the purpose of comparison, the sample was randomly divided into 2 main groups: group 1 (study group) included 100 subjects who were to receive a single injection before extraction, and group 2 (control group) included 100 subjects who were to receive a single buccal injection and a single palatal injection before extraction. After 5 minutes the extraction was performed. All patients were observed for Faces Pain Scale during extraction and asked for the same on a 100-mm visual analog scale after extraction. According to visual analog scale and Faces Pain Scale scores, when maxillary third molar removal without palatal injection (study group) and with palatal injection (control group) were compared the difference was not statistically significant (P > .05). Removal of maxillary third molars without palatal injection is possible by depositing 2 mL of 2% lidocaine hydrochloride with 1 : 200,000 epinephrine to the buccal vestibule of the tooth.Key Words: Maxillary third molar, Lidocaine hydrochloride with 1 : 200,000 epinephrine single buccal injection, Local anesthesiaAchieving excellent local anesthesia is the key to many dental treatments. Pain-free operating is an added benefit to the patient but also helps the operator to treat the patient in a calm, unhurried fashion.¹ The removal of maxillary third molars is one of the most frequently performed procedures by dental surgeons. Indications for removal include common pathological conditions such as caries, buccal eruption with food impaction or cheek biting, and recurrent pericoronitis.²According to the literature, for the removal of maxillary third molars, anesthetic solution should be administered as either a greater palatine nerve block or local palatal infiltration plus either a posterior alveolar nerve block or a buccal infiltration.³ Palatal injections are frequently associated with some level of discomfort due to strong attachment of palatal mucosa to the bone and dense innervation of the palatal mucosa. Many studies reported that palatal injections are poorly tolerated by the majority of patients.^3–5Initially there was inadequate evidence in the literature to support maxillary third molar removal with only buccal infiltration of local anesthesia,⁶ but now more studies have evaluated the bucco-palatal diffusion of local anesthesia in extractions with only buccal vestibular anesthesia, without palatal complementation.^7,8Many techniques have been tried to reduce the discomfort of intraoral injections, including transcutaneous electronic nerve stimulation, topical anesthetic application, topical cooling of the palate, computerized injection systems, pressure administration, and eutectic mixture of local anesthetics. Some claim that articaine has a higher potential of diffusibility through soft and hard tissues, precluding palatal injection when maxillary third molars are extracted.^7,9 In a comparative study between articaine and lidocaine, both solutions presented similar behavior and properties.¹⁰The aim of our study was to find out if lidocaine hydrochloride with epinephrine could provide palatal anesthesia in maxillary third molar removal without the need for a palatal injection.