Nifedipine induced gingival enlargement in an edentulous patient: a case report with one year follow up

Background

Gingival enlargement due to calcium channel blockers is a common complaint reported by patients. It can be localized or generalized and can range from mild to severe, affecting patients appearance and function. Nifedipine induced gingival enlargement is noticed only in 10 % of patients and very few cases of Nifedipine induced gingival enlargement in an edentulous patient have been documented in the literature.

Case presentation

Here in, we report a case of gingival enlargement in a 70?year old hypertensive edentulous patient who was on low dose Nifedipine therapy. Patient wanted complete dentures. We planned to excise the overgrowth and followed up for 1 year.

Conclusion

Nifedipine induced gingival enlargement noticed only in 10 % of patients. Hence, there is a need for physicians and dentist to make a coordinated treatment plan and practice care while prescribing these drugs which are associated with gingival overgrowth.

     

Bilateral loss of light reflex and accommodation following 360° peripheral retinal laser therapy

We report a case of bilateral loss of pupillary light reflex and accommodation following 360° peripheral retinal laser therapy. A 24 years old male underwent prophylactic laser barrage for peripheral retinal lattice degenerations. Soon after the procedure, he developed bilateral loss of pupillary light reflex and accommodation. The patient faced difficulty while doing near work. On instillation of 0.125% pilocarpine, both pupils demonstrated the phenomenon of denervation supersensitivity. Damage to the short ciliary nerves was the most likely mechanism responsible for this adverse outcome.     

A comparison of the presence of Theileria ovis by PCR amplification of their SSU rRNA gene in small ruminants from two provinces of Pakistan

ObjectiveTo compare the presence of Theileria ovis in small ruminants from two provinces of Pakistan and to determine the risk factors associated with the spread of theileriosis.MethodsIn present study, a total of 210 blood samples were collected from sheep (n=99) and goats (n=111) from 5 sampling sites in Punjab (Dera Ghazi Khan, Layyah, Multan and Rahim Yar Khan districts) and Khyber Pukhtoon Khwa (district Kohat) provinces, in Pakistan, from randomly selected herds. Data on the characteristics of the animals (species, gender, age, tick presence or absence, prior treatment for babesiosis) and the herd (location, size, species of animals, dogs associated with the herds, tick burden of dogs associated with the herds) was collected through questionnaires.ResultsTwelve blood samples (6% of total), 11 from district Kohat, produced the 520 base pairs DNA fragment specific for small subunit ribosomal RNA (ssu rRNA) gene of Theileria ovis, by PCR amplification, of which 11 were sheep and 1 was goat indicating that sheep are more significantly (P=0.001) prone to this parasite. On the other hand parasite was detected only in 2 out of 210 samples (1%) by blood smear screening confirming PCR as the reliable detection tool.ConclusionsPCR is more sensitive and reliable diagnostic tool for detection of Theileria sp. as compared to blood smear screening. Incidence of Theileria ovis is very high in Khyber Pukhtoon Khwa as compared to Punjab province. It was also observed that presence of ticks on animals was the only significant risk factor associated with the theileriosis in small ruminants.     

Phototherapeutic keratectomy versus mechanical epithelial removal followed by corneal collagen crosslinking for keratoconus

ObjectiveTo compare the visual outcomes of patients with keratoconus treated with either phototherapeutic keratectomy (PTK) or mechanical epithelial removal prior to corneal collagen crosslinking (CXL).DesignComparative study.ParticipantsThe records of 34 patients (34 eyes) who had PTK (17 eyes) or mechanical (17 eyes) epithelial removal prior to CXL for keratoconus were reviewed retrospectively.MethodsCXL was performed by 1 of 3 surgeons (G.M., W.B.J., or K.B.). Of the eyes, 17 had undergone mechanical epithelial removal prior to CXL and were consecutively selected, after matching with the 17 eyes in the PTK group, for the variables of procedure date, average keratometry, and pachymetry. All eyes had central cones. Manifest refraction spherical equivalent, sphere, cylinder, best-corrected distance visual acuity, and pachymetry were measured and compared preoperatively and in follow-up.ResultsThe mean change between the pre- and postoperative manifest refraction spherical equivalent for the PTK and mechanical groups was 1.68 ± 0.80 and 0.26 ± 0.90, respectively (p < 0.05). The mean change between pre- and postoperative cylinder for the PTK and mechanical groups was 0.53 ± 0.28 and 0 ± 0.18, respectively (p < 0.05). The mean number of lines of improvement in the PTK and mechanical groups were 0.33 ± 0.82 and ?0.58 ± 0.45 lines, respectively (p > 0.05).ConclusionsEarly results suggest that CXL with laser epithelial removal is superior to CXL with mechanical epithelial removal because it reduces refractive error in qualified patients. Although not statistically significant, there was also a trend for PTK CXL patients to have better visual outcomes.