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   2017| January-March  | Volume 6 | Issue 1  
    Online since March 20, 2017

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Evaluation of oral-hygiene awareness and practice among dental students
Darivemula Daya, Ummadisetty Teja, Dhishan Babu Paturu, Bhumanapalli Venkata Ramesh Reddy, Sreenivas Nagarakanti, Vijay Kumar Chava
January-March 2017, 6(1):24-28
Aim: The aim of this study is to compare oral-health knowledge, attitudes, and self-care practice behaviors among dental students. Materials and Methods: A questionnaire was prepared regarding oral-health attitudes and behaviors. The survey was carried out at Narayana Dental College and Hospital, Nellore. Three hundred sixty-seven questionnaires were responded by the dental students (208 clinical and 159 preclinical students). The data were tabulated and analyzed by using Statistical Package for the Social Sciences (SPSS) v.17.0. Chi-square tests were also used. Results: A more significant knowledge (P < 0.001) of oral-hygiene procedures are noticed in clinical students than in preclinical students. The responses varied mainly regarding the type of brush they are using, the brushing technique, motivating people to consult a dentist (clinical — 95.2%, preclinical—78%), and educate people about oral hygiene procedures (clinical — 98.6%, preclinical — 80.5%). oral hygiene practices in different genders were not included in the present study. Conclusion: The outcome of the study is that there is an appreciably high level of knowledge about oral self-care procedures in clinical students than in preclinical undergraduate dental students. There is a need to educate the undergraduate dental students on oral care procedures as soon as they join the BDS course.
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Dermatological manifestations in chronic renal failure patients with and without hemodialysis: A study at a tertiary care centre
Geetha M Chanda, Sudha R Chintagunta, Geetakiran Arakkal
January-March 2017, 6(1):8-14
Background: Skin is an important diagnostic window to many diseases of internal organs including the renal system. Subtle changes in the skin may act as a clue to the underlying renal pathology. The cutaneous manifestations may be caused either by the disease or drugs used in the treatment of chronic kidney disease (CKD). Aim: The aim of this study is to investigate and compare cutaneous manifestations in patients with CKD on hemodialysiswith patients not on dialysis. Materials and Methods: One hundred patients with CKD were recruited, 50 each in maintenance hemodialysis (MHD) and nondialysis group. Detailed cutaneous examination and necessary investigations were done, and cutaneous manifestations were compared among the two groups. Results: Of the 100 patients, 72 were males and 28 were females. Mean duration of disease was 32.4 months in the dialytic group and 11.2 in the nondialytic group. The most common underlying disease that lead to CKD was diabetes mellitus. Specific cutaneous manifestations observed were Kyrles disease 4%, calcinosis cutis 1%, and uremic frost in 1%. The common nonspecific manifestations observed were xerosis in 59% (dialytic 61.03%, nondialytic 38.98%), pallor in 57% (dialytic 49.1%, nondialytic 50.9%), pruritus in 38%, (dialytic 63.16%, nondialytic 36.84%), pigmentation in 32% (dialytic, 65.63%, nondialytic 34.37%), purpura in 8% of dialytics, and none of the nondialytic patients had purpura. Cutaneous infections were found in 28%, of which fungal were 20%, bacterial 7%, and viral infections 2%. Nail changes were observed in 46% (dialytic 62%, nondialytic 30%), hair changes in 16%, and mucosal manifestations in 11% of the patients. Puncture marks were found in 74% of the dialytic patients. Xerosis, pruritus, and pigmentation had significantly higher prevalence in diabetic uremics compared to nondiabetic uremics. Conclusions: There was a significant association with the mean duration of disease, which is higher in dialytic patients compared to the nondialytic group. Xerosis, pruritus, and hyperpigmentation were common in dialytic patients.
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Class II malocclusion treatment using combined twin block and fixed orthodontic appliances: A case report
Sumita Mishra
January-March 2017, 6(1):64-68
Dentofacial orthopedic treatment can significantly alter and improve facial appearance in addition to correcting irregularity of the teeth. Functional appliance therapy can be used successfully in Class II malocclusion, e.g., in a growing patient. Twin blocks are simple bite blocks that interlock at a 70° angle and correct the maxillomandibular relationship through functional mandibular displacement. The twin block appliance was developed by Clark in 1980s. They modify the occlusal inclined plane, guiding the mandible forward into correct occlusion. The use of these appliances is greatly dependent on patient's compliance and they simplify the fixed appliance phase. In this case, a 13-year-old adolescent was treated with twin block appliance followed by fixed appliance to detail the occlusion. The design and treatment effects are demonstrated in this case report.
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Clinicopathological features of oral squamous cell carcinoma: A hospital-based retrospective study
T Smitha, CV Mohan, S Hemavathy
January-March 2017, 6(1):29-34
Background: Oral squamous cell carcinoma (OSCC) is the most common neoplasm representing more than 80% of all oral cancer cases. Squamous cell carcinoma is defined as a “malignant epithelial neoplasm exhibiting squamous differentiation as characterized by the formation of keratin and/or the presence of intercellular bridges.” Most epidemiological studies have revealed that heavy smoking and alcohol intake are the most important risk factors for oral cavity cancer. Occupational exposure to carcinogens, infections with certain papilloma viruses, and nutritional status are additional risk factors that have been associated with an increased cancer risk. Poor dental hygiene, accompanied by tooth loss, is another suspected risk factor. Aim: The purpose of this study was to analyze the incidence and clinicopathological features of patients with OSCC along with information on age, sex, locality, habits, sites, and grade of lesion. Methods: This was a retrospective studies (2007–2014) in which data on 301 oral squamous cell carcinoma were investigated. H&E-stained slides were reviewed by the two authors and classified according to the Broder's grading system. Demographic variables related to oral squamous cell carcinoma were analyzed along with the histopathological findings. Statistical analysis on patients' sample was performed using the MedCalc software (Ostend, Belgium) and visualizations were performed using Tableau Public 9.0 (Seattle, Washington). Results: Significant associations between buccal mucosa (BM) as the tumor site and smokeless tobacco consumption, lip cancer tumor and beedi plus cigarette smoking, tumor of floor of the mouth and alcohol consumption, maxillary alveolus (MA) as the tumor site, and tobacco plus alcohol consumption were observed. Tumor of BM and gingivo-BM was more common in women, whereas tumor of floor of the mouth, hard palate, and MA sites was more common in men. Tumor involving the lip and gingivobuccal sites was more common in patients who were >60 years old, whereas the cancers of the tongue and hard palate sites were more common in patients whose age is <40 years. In our study cohort, well-differentiated tumors were predominantly present. Conclusion: Dentists play a key role in the screening, detection, and treatment of oral cancers and they can educate public, more importantly the youth, to bring out changes in the attitude and awareness about oral cancers.
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An interesting case of systemic lupus erythematosus – Rowell's syndrome
Chandrasekhar Siddhavatam, Vidyasagar Kekathi, Quraishi Sayed Mohammad Saifullah, Saikiran Kakarla
January-March 2017, 6(1):60-63
Rowell's syndrome is a rare disease consisting of systemic lupus erythematosus associated with erythema multiforme-like lesions. Here, we are reporting a patient who presented with a history of erythema multiforme-like eruption with systemic lupus erythematosus in the form of a malar rash with unusual laboratory and immunological findings consistent with Rowell's syndrome.
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Extralobar pulmonary sequestration in adults
Ravikanth Reddy
January-March 2017, 6(1):52-54
Pulmonary sequestration is defined as a nonfunctioning mass composed of dysplastic lung parenchyma, embryologically detached from the tracheobronchial tree and receiving its own blood supply from a systemic artery, usually the thoracic or abdominal aorta. It may be intralobar or extralobar depending on the presence of an independent pleural envelope. Extralobar sequestration is a much rarer entity, and diagnosis is usually made antenatally or in early life. Here, we present a rare case of extralobar pulmonary sequestration in an adult.
  3,475 209 -
Molecular biology of head and neck cancer
Swetha Gudiseva, Kiran K Katappagari, Lalith P. C Kantheti, Chandrashekar Poosarla, Sridhar R Gontu, Venkat R. R Baddam
January-March 2017, 6(1):1-7
The term molecular biology of head and neck cancer includes two terms “molecules” and” biology.” Molecules are made of atoms and biology includes study of life. Hence, the study of molecular biology of cancer is very essential in understanding the atoms involved, their effect on life in cancer, and the factors controlling its growth, extension, and the process of metastasis. Even though it is an old concept, new molecules were being discovered which have been involved actively in the carcinogenesis. It is a complex process to understand because it involves numerous factors, few involved in halting the process of cancer and few involved in progression of cancer. In normal cells, these both are in a balanced state, and any imbalance in these two results in abnormal growth which becomes persistent. Hence, new treatment modalities by targeting atoms, molecules, receptors, and signal transduction pathways, abnormal, or mutated genes can be invented to decrease the mortality rate and increase the prognosis of patients suffering from head and neck cancer. This review mainly focuses on the molecules involved in head and cancer, their clinical implications, and their role in inventing new therapies.
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Clinical profile of patients presenting with acute pulmonary thromboembolism in a tertiary care hospital in India: A retrospective study
Mitchelle Lolly, Bhagyashri B Patil, Ajith Eti, J Sujay, Sujeer Khan, Avya Bansal
January-March 2017, 6(1):15-18
Objective: To study the clinical profile in patients with acute pulmonary embolism. Methods: Retrospective study of clinical profile and management of patients presenting with acute pulmonary embolism from January 2015 to January 2016. Results: 53 patients who were newly diagnosed to have acute pulmonary thromboembolism with a mean age of 47.2 years with 91% being males were included in the study. It was found that majority of the patients had atleast 1 risk factor for embolisation(58.5%) with smoking being the most important risk factor. Dyspnea (71.7%) and syncope (17.0%) were the predominant symptoms. 39.6% patients had tachycardia and 22.6% had hypotension. Echocardiography was done in all patients. 45 patients (84.9%) had pulmonary arterial hypertension, 31 patients (58.4%) had evidence of RA/RV dysfunction and 3 patients (5.7%) had evidence of thrombus in heart. CT pulmonary angiogram was done in all patients. 32(60.3%) patients underwent anticoagulataion with unfractionated heparin, 10(18.7%) patients were thrombolysed and 6(11.3%) patients underwent embolectomy. 5 patients underwent both thrombolysis and anticoagulation. However independent of the mode of treatment, most patients had good treatment outcomes with the mortality rate being only 7.5%. Conclusion: Pulmonary embolism can have multiple presentations in terms of clinical symptoms, signs and investigations. Early diagnosis and aggressive management is the key to successful outcome.
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Collation of chewing efficiency and dentures with diverse occlusal schemes
Vijay Kumar Peddinti, Chiramana Sandeep, Anne Gopinadh, Suresh Babu Muvva, Jyothula Ravi Rakesh Dev, Aiswarya Suggala
January-March 2017, 6(1):45-51
Background: Rehabilitation of an edentulous patient nurtures satisfaction and this lies in the chewing ability provided by the prosthesis. Aim: To evaluate and compare the masticatory efficiencies of complete dentures with different occlusal schemes. Materials and Methods: Fourteen completely edentulous patients from the age group of 50-70 years were selected according to the inclusion criteria followed in this study. The dentures were made with three different occlusal schemes, i.e., anatomic occlusion without balancing, anatomic occlusion with balancing, and lingualized occlusion and stored in water till the date of denture insertion. Post-insertion instructions were given to the patients at the time of delivery of the dentures. Patients were recalled after seven days and then masticatory efficiency was performed. The test was performed using boiled peanuts and Sieve system. Statistical Analysis: One-way analysis of variance (ANOVA) test and unpaired t-test were carried out. Results: The obtained masticatory efficiency values with anatomic occlusion without balancing, anatomic occlusion with balancing, and lingualized occlusion LO were analyzed using one-way ANOVA test and unpaired “t” test. The tests showed that lingualized scheme had highest masticatory efficiency. Conclusion: Within the scope of this study, it can be concluded that the masticatory efficiency will be generally higher in patients provided with complete dentures fabricated using the lingualized occlusal scheme.
  2,506 231 -
Paragangliomas of the head and neck region: A single center experience
Kumudachalam Pindicura, Ramya P Arikeri, Sreedhar R Dandala, Nagarjunachary Rajarikam, Namala Vivekan
January-March 2017, 6(1):19-23
Background: Head and neck paragangliomas are slowly growing, highly vascular, mostly benign tumors that commonly occur at the carotid bifurcation at the jugular bulb, in the tympanic cavity, or as vagal paragangliomas. Unlike the adrenal counterpart, a vast majority of them are nonsecretory. Aims and Objectives: To study the clinicopathological aspects of paragangliomas arising in the head and neck region. Materials and Methods: This study was conducted in a tertiary care centre for head and neck diseases between 2008 and 2016. Clinical data were retrieved from the records. Morphological examination was the mainstay of diagnosis. Results: Twenty-three cases of head and neck paragangliomas were diagnosed by morphological examination. Paragangliomas constituted 0.20% of all head and neck lesions. The age group ranged between 18 and 60 years, with a mean age of 44 years. Most common age at presentation was fourth and fifth decades. Majority of cases occurred in females, with male: female ratio of 1:4. Out of 23 cases, 19 cases (82.60%) involved the jugulotympanic region, 2 cases (8.69%) were laryngeal paragangliomas, and 2 cases (8.69%) were carotid body paragangliomas. Conclusion: Paragangliomas of the head and neck are uncommon lesions. The most common site in the head and neck region was the jugulotympanic region. Most cases of jugulotympanic paraganglioma presented in the fifth decade and later. Laryngeal paraganglioma presented clinically earlier in the second decade. Jugulotympanic and laryngeal paraganglioma showed dominance of tumor vasculature histologically. There was a rare case of laryngeal paraganglioma with lateral neck extension in this study.
  2,498 211 -
Intracranial schwannomas arising from cranial nerves: Case series and review of literature
Rashmeet Kaur, Simmi Aggarwal, Paramdeep Singh, Anshul Dahuja
January-March 2017, 6(1):55-59
Tumors arising from the cranial nerve sheath are common intracranial neoplasms, with only few articles describing their imaging characteristics. In this present study of four cases of schwannomas originating from the cranial nerves in the head region, we are discussing the radiological features on imaging with the clinical presentation and contrasting them with other differentials in their respective locations. Magnetic resonance imaging and computed tomography were done in these cases and correlated with clinical and biopsy findings.
  2,133 132 -
A study on awareness of early detection and screening of potentially malignant oral disorders and oral cancer
M Devi, D Vijayalakshmi, K Dhivya, N Vezhavendhan
January-March 2017, 6(1):35-38
Background: Squamous cell carcinoma accounts for more than 90% of oral malignancies. The incidence of squamous cell carcinoma of oral cavity differs widely in various parts of the world. It is well within the scope of General Dental Practitioners (GDPs) to carry out certain diagnostic investigations such as exfoliative cytology and oral tissue biopsy to determine the nature of the lesion. Aim: The aim of this study was to assess the awareness concerning the early detection and screening of potentially malignant oral disorders and oral cancer among general dental practitioners of Tamil Nadu. Materials and Methods: Questionnaires were sent to 194 general dental practitioners. The completed questionnaire was collected immediately. Confidentiality of the participants was guaranteed. Statistical Analysis: The statistical analysis included the use of descriptive statistics. Results: Approximately 97% of the participants conducted intraoral soft tissue examination; 86.5% recorded the tobacco habits of the patients and approximately 97% said that they counsel the patient to stop tobacco habits. A total of 23% said potentially malignant oral disorders (PMOD) was scrapable in nature and 77% said it was nonscrapable. A total of 69% of the dentists answered that white lesions had more probability to change into oral cancer. In this study, 92% mentioned that if they suspect oral cancer in their patients then they would examine the regional lymph nodes. When questioned about the best technique for early diagnosis of oral cancer, 24% assumed exfoliative cytology, 73% accepted biopsy. A total of 43% revealed that they had performed these diagnostic procedures in their clinics. A total of 75% dentists suggested that they needed a consultant oral pathologist. A total of 78% participants had attended continuing dental education programs related to oral cancer. On confirming the diagnosis of cancer, 75% referred their patients to regional cancer centres. Conclusion: The findings on the awareness concerning the early detection and screening of PMOD and oral cancer among GDPs show the need for clinicopathologic correlation.
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Immunohistochemical expression of Survivin in oral leukoplakia and oral squamous cell carcinoma
Cherukuri Gayathri, Guttikonda V Rao
January-March 2017, 6(1):39-44
Background and Objectives: Survivin is an inhibitor of apoptosis protein. It is involved in the modulation of the cell death and cell division process. Alterations in the expression of Survivin have been reported in several inflammatory, premalignant, and malignant lesions. Hence, the objectives of the present study were to compare the expression of Survivin with respect to the degree of dysplasia in oral leukoplakia (OL) and to evaluate the expression of Survivin with respect to different histopathological grades of oral squamous cell carcinoma (OSCC). Materials and Methods: Neutral-buffered, formalin-fixed and paraffin-embedded biopsy specimens from 30 patients, each with OL and OSCC, were included in this study. The expression of Survivin was detected by immunohistochemistry. The scores obtained were subjected to Chi-square test. Results: Survivin expression was detected in all grades of dysplasia and OSCC. Expression of Survivin was significant when compared with different degrees of dysplasia and different histopathological grades of OSCC (P < 0.05). A significant correlation was not found in immunostaining between dysplasia and OSCC groups. Conclusion: Higher immunohistochemical scores were obtained with increased histopathological grades of OL and OSCC. High expression of Survivin may be related to malignant transformation in OL and poor prognosis in OSCC.
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Bullous urticaria pigmentosa – A rare case report
Sudha R Chintagunta, M Srinivas, Poojari SriShilpa, Sai Krishna Nagula, Rajesh Velgam
January-March 2017, 6(1):69-71
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