Traditionally, obtaining tissue diagnosis from the Temporomandibular Joint (TMJ) has required invasive open techniques. In this case-series, the authors demonstrate a minimally invasive technique using arthroscopy to diagnose and treat Pigmented Villonodular Synovitis (PVNS) and pseudogout of the TMJ, followed by a review of the literature.
Traditionally, obtaining tissue diagnosis from the Temporomandibular Joint (TMJ) has required invasive open techniques. In this case-series, the authors demonstrate a minimally invasive technique using arthroscopy to diagnose and treat Pigmented Villonodular Synovitis (PVNS) and pseudogout of the TMJ, followed by a review of the literature.
An insight into dental evidence as experts witnessLegalSaviour
Kindly Find the presentation presented by Dr. Shanmuganandham, Forensic Odontologist GeneXplore Diagnostics & Research Centre Pvt Ltd, Brazil in the National Webinar conducted on 12.05.2020 by Legal Saviour
Background: The spectrum of pathological bone lesions ranges from inflammatory to neoplastic conditions. Bone tumours are comparatively uncommon among wide array of lesions. The roentgenogram helps in defining exact location of lesion but becomes difficult to differentiate them. They often pose diagnostic problem as they constitute a small portion of diagnostic experience among pathologist.
Objective: To study histopathological spectrum of bone lesions & correlate them with age, gender and site of occurrence.
Results: All bone biopsies from January 2011 to December 2015 received at department of pathology, S.Nijalingappa Medical College, India. Total 121 cases of bone biopsies were analysed. They were decalcified & processed routinely. Out of 121 bone biopsies, 35 (28.9%) cases are non- neoplastic, 77 (63.6%) are neoplastic and 9 (7.4%) were inadequate for evaluation. The incidence of benign lesions are more than malignant with 51(66.2%) and 26(33.7%) cases respectively. Chronic osteomyelitis is the most common non-neoplastic lesion. Giant cell tumor and osteosarcoma are common benign and malignant lesions respectively. Femur is the common bone involved and metaphysis, the commonest site. The maximum numbers of cases are in the age group between 11-30 years with male preponderance.
Conclusion: Though bone lesions are less common, if viewed in perspective of clinico-radiology and histopathology, correct diagnosis can be reached.
Key-words- Bone lesions, Chronic osteomyelitis, Osteosarcoma, Giant cell tumor, Histopathology
Pandey KK, Agrawal AC.Partial Fibulectomy for ununited fracture of the tibia ...Dr K K Pandey
Pandey KK, Agrawal AC.Partial Fibulectomy for ununited fracture of the tibia with nondraining (Quiescent) infection; Orthopaedic Journal of MP Chapter. 2014,Vol-20; Page 69-72.
An Unusual Presentation of Squamous Cell Carcinoma of Bilateral Temporal Bones by Titas Kar in Experiments in Rhinology & Otolaryngology
Squamous cell carcinoma of temporal bone is a rare entity, comprising of a very small percentage of all head neck tumours, mostly occurring in aged population. Bilateral presentation of tumours in both temporal bones is extremely rare and only a few cases have been reported. We report a case of bilateral squamous cell carcinoma of both temporal bones in a young adult male patient who presented very late.
https://crimsonpublishers.com/ero/fulltext/ERO.000510.php
This presentation explains the various controversies in different topics in periodontics. Discusses the controversies in Classification of periodontal diseases,
Diagnosis of periodontal diseases,
Prognosis,
Tooth mobility & splinting,
Gingival curettage one stage full-mouth disinfection versus quadrant SRP,
Systemic antimicrobials in periodontal therapy, Non-surgical versus surgical periodontal therapy,
Postsurgical antimicrobial medication,
Periodontal pack,
Periodontal-endodontic relationship,
Periodontal and systemic diseases,
Implant therapy in periodontally compromised patients.
Craniofacial growth in untreated skeletal class i subjects with low, average,...EdwardHAngle
The dental measurements showed few changes with growth in all groups. In terms of skeletal measurements from ages 9 to 18, similar growth changes were found between the sexes in most angular measurements, but males had larger values in linear measurements than females.
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Gingival recession—can orthodontics be a cure? evidence from a case presentationEdwardHAngle
Does orthodontic treatment help or hinder a patient’s periodontal status? What factors affect the
periodontium? Can those factors be managed in a way that remedies existing periodontal issues?
A 35-year-old woman presented with severe gingival recession and a unilateral Class II
malocclusion. The treatment plan was to correct the malocclusion in a way that torques the roots
more onto bone and to change her dental hygiene methods. With an extensive review of the
literature, this case review attempts to make sense of the enigma of gingival recession and
demonstrates an excellent treatment solution to concomitant orthodontic and periodontal
problems.
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
36.Kesharwani P, Hussain SA, Sharma N, Karpathak S, Bhanot R, Kothari S, Tiwari RVC. Massive radicular cyst involving multiple teeth in pediatric mandible- A case report. J Family Med Prim Care. 2020 Feb;9(2):1253-1256. doi: 10.4103/jfmpc.jfmpc_1059_19. eCollection 2020 Feb. PubMed PMID: 32318508; PubMed Central PMCID: PMC7113959.
An insight into dental evidence as experts witnessLegalSaviour
Kindly Find the presentation presented by Dr. Shanmuganandham, Forensic Odontologist GeneXplore Diagnostics & Research Centre Pvt Ltd, Brazil in the National Webinar conducted on 12.05.2020 by Legal Saviour
Background: The spectrum of pathological bone lesions ranges from inflammatory to neoplastic conditions. Bone tumours are comparatively uncommon among wide array of lesions. The roentgenogram helps in defining exact location of lesion but becomes difficult to differentiate them. They often pose diagnostic problem as they constitute a small portion of diagnostic experience among pathologist.
Objective: To study histopathological spectrum of bone lesions & correlate them with age, gender and site of occurrence.
Results: All bone biopsies from January 2011 to December 2015 received at department of pathology, S.Nijalingappa Medical College, India. Total 121 cases of bone biopsies were analysed. They were decalcified & processed routinely. Out of 121 bone biopsies, 35 (28.9%) cases are non- neoplastic, 77 (63.6%) are neoplastic and 9 (7.4%) were inadequate for evaluation. The incidence of benign lesions are more than malignant with 51(66.2%) and 26(33.7%) cases respectively. Chronic osteomyelitis is the most common non-neoplastic lesion. Giant cell tumor and osteosarcoma are common benign and malignant lesions respectively. Femur is the common bone involved and metaphysis, the commonest site. The maximum numbers of cases are in the age group between 11-30 years with male preponderance.
Conclusion: Though bone lesions are less common, if viewed in perspective of clinico-radiology and histopathology, correct diagnosis can be reached.
Key-words- Bone lesions, Chronic osteomyelitis, Osteosarcoma, Giant cell tumor, Histopathology
Pandey KK, Agrawal AC.Partial Fibulectomy for ununited fracture of the tibia ...Dr K K Pandey
Pandey KK, Agrawal AC.Partial Fibulectomy for ununited fracture of the tibia with nondraining (Quiescent) infection; Orthopaedic Journal of MP Chapter. 2014,Vol-20; Page 69-72.
An Unusual Presentation of Squamous Cell Carcinoma of Bilateral Temporal Bones by Titas Kar in Experiments in Rhinology & Otolaryngology
Squamous cell carcinoma of temporal bone is a rare entity, comprising of a very small percentage of all head neck tumours, mostly occurring in aged population. Bilateral presentation of tumours in both temporal bones is extremely rare and only a few cases have been reported. We report a case of bilateral squamous cell carcinoma of both temporal bones in a young adult male patient who presented very late.
https://crimsonpublishers.com/ero/fulltext/ERO.000510.php
This presentation explains the various controversies in different topics in periodontics. Discusses the controversies in Classification of periodontal diseases,
Diagnosis of periodontal diseases,
Prognosis,
Tooth mobility & splinting,
Gingival curettage one stage full-mouth disinfection versus quadrant SRP,
Systemic antimicrobials in periodontal therapy, Non-surgical versus surgical periodontal therapy,
Postsurgical antimicrobial medication,
Periodontal pack,
Periodontal-endodontic relationship,
Periodontal and systemic diseases,
Implant therapy in periodontally compromised patients.
Craniofacial growth in untreated skeletal class i subjects with low, average,...EdwardHAngle
The dental measurements showed few changes with growth in all groups. In terms of skeletal measurements from ages 9 to 18, similar growth changes were found between the sexes in most angular measurements, but males had larger values in linear measurements than females.
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Gingival recession—can orthodontics be a cure? evidence from a case presentationEdwardHAngle
Does orthodontic treatment help or hinder a patient’s periodontal status? What factors affect the
periodontium? Can those factors be managed in a way that remedies existing periodontal issues?
A 35-year-old woman presented with severe gingival recession and a unilateral Class II
malocclusion. The treatment plan was to correct the malocclusion in a way that torques the roots
more onto bone and to change her dental hygiene methods. With an extensive review of the
literature, this case review attempts to make sense of the enigma of gingival recession and
demonstrates an excellent treatment solution to concomitant orthodontic and periodontal
problems.
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
36.Kesharwani P, Hussain SA, Sharma N, Karpathak S, Bhanot R, Kothari S, Tiwari RVC. Massive radicular cyst involving multiple teeth in pediatric mandible- A case report. J Family Med Prim Care. 2020 Feb;9(2):1253-1256. doi: 10.4103/jfmpc.jfmpc_1059_19. eCollection 2020 Feb. PubMed PMID: 32318508; PubMed Central PMCID: PMC7113959.
Primary hydatidosis of the tibia is a rare disease. In an endemic area, it should be considered in the differential diagnosis of a
hypolucent osteolytic lesion on x-ray. If not properly managed, anaphylactic shock may occur intraoperatively, as well as increased recurrence of the disease. This is a case report of a primary tibial hydatid cyst, treated fi rst with curettage and phenolizaton, and then after recurrence, with total knee arthroplasty. We will review the literature of the diagnosis and the treatment of a tibial hydatid cyst.
Abstract—This study was aimed to present a case report of a case of peripheral ossifying fibroma which is a rare case. This case was a 30 years non smoker male with the chief complaint of growth of gum tissue, moderately large in the mandibular posterior region. On intraoral examination, a peduncalated growth of 17 x 12 x 6 mm on marginal and attached gingiva with respect to tooth number 47 considerably hard in consistency and movable was seen. The lesion was erythmatous having a smooth non ulcerated surface. It was asymptomatic with no sign of pain. Intra oral periapical radiograph was taken which revealed slight erosion of crest of bone which was later confirmed during surgical excision. The possible reason of crestal bone erosion may be constant pressure of the growth. Differential diagnosis of irritation fibroma, pyogenic granuloma and peripheral giant cell granuloma was considered. However, clinical appearance and consistency was of a hard fibrous growth, which therefore led to a provisional diagnosis of peripheral ossifying fibroma or peripheral odontogenic fibroma.
A case of childhood Burkitt's lymphoma with gingival swelling as the first sy...komalicarol
Burkitt's lymphoma (BL) is a highly infiltrative malignant lymphoma caused by germinal B-cell differentiation. There are several oral symptoms of BL, including tooth mobility, pain, gingival swelling, maxillofacial swelling and pain, and facial sensory
disturbances. In this paper, we report a case of BL in a 4-year-old
child who initially presented with gingival swelling. The diagnosis of BL/leukemia (stage IV) was confirmed by the bone marrow
examination, bone marrow flow cytometry, and B lymphocytoma
mutation gene screening test. After chemotherapy, the general
condition improved, and then there was swelling and pain in the
right cheek. Considering the recurrence of the disease, the patient
died half a year later. This case is characterized by BL with oral
symptoms as the first symptom, emphasizing the important role of
physicians in early detection of systemic disease
Choroidal Neovascular Membrane Association with Tumoral Calcinosis, a Case Re...CrimsonpublishersMSOR
To report a case of Choroidal neovascular membrane in a tumoral calcinosis patient, 2 eyes from 1 patient with choroidal neovascular membrane in one eye, a 40-year-old male with a history of Tumoral calcinosis presented with a choroidal neovascular membrane in his right eye, with his medical work up consisting of elevated levels of phosphorus and normal levels of calcium, with radiological imaging consistent with the diagnosis of tumoral calcinosis. We describe a case of choroidal neovascular membrane in tumoral calcinosis, and its response to Intravitreal anti-VEGF injections.
Journal of Pathology & Microbiology is an open access, peer reviewed, scholarly journal dedicated to publish articles covering all areas of Pathology & Microbiology.
The journal aims to promote research communications and provide a forum for doctors, researchers, physicians and healthcare professionals to find most recent advances in all areas of Pathology & Microbiology. Journal of Pathology & Microbiology accepts original research articles, reviews, mini reviews, case reports and rapid communication covering all aspects of pathology & microbiology.
Journal of Pathology & Microbiology strongly supports the scientific up gradation and fortification in related scientific research community by enhancing access to peer reviewed scientific literary works. Austin Publishing Group also brings universally peer reviewed journals under one roof thereby promoting knowledge sharing, mutual promotion of multidisciplinary science.
Dr. Rahul VC Tiwari - Fellowship In Orthognathic Surgery - Jubilee Mission Medical College Hospital and Research Center, Thrissur, Kerala - 31st publication IJAR 1st name
Fibro osseous lesions of jaws/oral surgery courses by indian dental academyIndian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
60.Srinivasan S, Velusamy G, Munshi MAI, Radhakrishnan K, Tiwari RVC. Comparative Study of Antifungal Efficacy of Various Endodontic Irrigants with and without Clotrimazole in Extracted Teeth Inoculated with Candida albicans. J Contemp Dent Pract. 2020 Dec 1;21(12):1325-1330. PubMed PMID: 33893253.
Mathew P, Kattimani VS, Tiwari RV, Iqbal MS, Tabassum A, Syed KG. New Classification System for Cleft Alveolus: A Computed Tomography-based Appraisal. J Contemp Dent Pract. 2020 Aug 1;21(8):942-948. PubMed PMID: 33568619
Sahu S, Patley A, Kharsan V, Madan RS, Manjula V, Tiwari RVC. Comparative evaluation of efficacy and latency of twin mix vs 2% lignocaine HCL with 1:80000 epinephrine in surgical removal of impacted mandibular third molar. J Family Med Prim Care. 2020 Feb;9(2):904-908. doi: 10.4103/jfmpc.jfmpc_998_19. eCollection 2020 Feb. PubMed PMID: 32318443; PubMed Central PMCID: PMC7113948.
65.Izna, Sasank Kuntamukkula VK, Khanna SS, Salokhe O, Chandra Tiwari RV, Tiwari H. Knowledge and Apprehension of Dental Health Professionals Pertaining to COVID in Southern India: A Questionnaire Study. J Pharm Bioallied Sci. 2021 Jun;13(Suppl 1):S448-S451. doi: 10.4103/jpbs.JPBS_551_20. Epub 2021 Jun 5. PubMed PMID: 34447131; PubMed Central PMCID: PMC8375944.
Vohra P, Belkhode V, Nimonkar S, Potdar S, Bhanot R, Izna, Tiwari RVC. Evaluation and diagnostic usefulness of saliva for detection of HIV antibodies: A cross-sectional study. J Family Med Prim Care. 2020 May;9(5):2437-2441. doi: 10.4103/jfmpc.jfmpc_138_20. eCollection 2020 May. PubMed PMID: 32754516; PubMed Central PMCID: PMC7380795
Mittal S, Hussain SA, Tiwari RVC, Poovathingal AB, Priya BP, Bhanot R, Tiwari H. Extensive pelvic and abdominal lymphadenopathy with hepatosplenomegaly treated with radiotherapy-A case report. J Family Med Prim Care. 2020 Feb;9(2):1215-1218. doi: 10.4103/jfmpc.jfmpc_1125_19. eCollection 2020 Feb. PubMed PMID: 32318498; PubMed Central PMCID: PMC7113973.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Are There Any Natural Remedies To Treat Syphilis.pdf
61st publication sjmps - 2nd name
1. Available online: http://scholarsmepub.com/sjmps/ 1053
Saudi Journal of Medical and Pharmaceutical Sciences ISSN 2413-4929 (Print)
Scholars Middle East Publishers ISSN 2413-4910 (Online)
Dubai, United Arab Emirates
Website: http://scholarsmepub.com/
Fibrous Dysplasia of Maxilla with Port Wine Stain: A Case Report
Dr. Raja Satish Prathigudupu1
, Dr. Rahul VC Tiwari2
, Dr. Philip Mathew3*
, Dr. Arun Ramaiah4
, Dr. Heena
Tiwari5
, Dr. Jisha David6
1
Senior Registrar, Ministry of Health, Amiri Dental Casuality, Kuwait
2
FOGS, MDS, OMFS & Dentistry, JMMCH & RI, Thrissur, Kerala, India
3
HOD, OMFS& Dentistry, JMMCH & RI, Thrissur, Kerala, India
4
Senior Fellow, Cleft & Craniofacial Centre, St. Thomas Hospital, Malakkara, Pathanamthitta, Chengannur, Kerala, India
5
BDS, PGDHHM, Government Dental Surgeon, CHC Makdi, Kondagaon, C.G. India
6
Registrar, Dept of Dentistry, JMMCH & RI, Thrissur, Kerala, India
Case Report
*Corresponding author
Dr. Philip Mathew
Article History
Received: 14.09.2018
Accepted: 26.09.2018
Published: 30.09.2018
DOI:
10.21276/sjmps.2018.4.9.11
Abstract: Fibrous dysplasia (FD) is an uncommon skeletal disorder in which normal
bone is replaced by abnormal fibro osseous tissue. Mainly, Fibrous Dysplasia is found
in children, and by adulthood it usually becomes quiescent. Our case showed Fibrous
dysplasia of 9-year-old female child with port wine stain on the right side of mid face
since birth. Our evaluation was that growth in childhood had achieved the progressive
stage. We presented all radiographic and clinical images of this case that emphasized
the diagnosis of the disease.
Keywords: Fibrous Dysplasia, Maxilla, Monostotic, Polyostotic, Recontouring.
INTRODUCTION
Fibrous dysplasia (FD) is an idiopathic skeletal disorder in which the
trabecular bone is replaced and distorted by poorly organized, structurally unsound
fibro-osseous tissue. The lesion is classified into two forms: Monostotic (75-80%) and
polyostotic. A distinct form of Polyostotic FD, known as McCune-Albright Syndrome,
is accompanied by cutaneous pigmentation and sexual precocity, and this occurs
almost exclusively in women. Typical radiographic appearance shows an expanded
osseous lesion having poorly defined margins covered by a thin “eggshell” cortex and
lacking periosteal new bone formation. Here, we are presenting two case reports of FD
involving the maxilla. Fibrous dysplasia (FD) is a non-malignant condition caused by
post-zygotic, activating mutations of the GNAS gene that result in inhibition of the
differentiation and proliferation of bone-forming stromal cells and leads to the
replacement of normal bone and marrow by fibrous tissue and woven bone [1].
The disease may present in a monostotic or
polyostotic form, affecting one or multiple bones,
respectively. Mainly, FD is found in children, and it
usually becomes dormant by adulthood [2]. The age
range of patients with FD has been reported to be
between 20 and 70, with the majority diagnosed in their
30s [3]. Despite recent advances in the understanding of
the natural history and molecular abnormalities of FD,
many questions remain regarding its progression and
management [4]. Although most cases of FD are self-
limiting [5] and hamartomatous, some cases of FD do
not go into dormancy at the end of adolescence [6] and
may be activated or reactivated in adulthood in
response to a life event, such as pregnancy [7, 8].
Because some cases of FD in elderly people have also
been reported [9-11], we directed attention to the
question of whether a long-term case could show
continuous progress or would cease in the quiescent
stage. We also examined the incidence of FD
transformation into malignancy. Our case showed
Fibrous dysplasia of 9-year-old female child with port
wine stain on the right side of mid face since birth. Our
evaluation was that growth in childhood had achieved
the progressive stage. We presented all radiographic
and clinical images of this case that emphasized the
diagnosis of the disease.
CASE REPORT
A 9-year-old female patient reported with her
parents with the chief complaint of painless swelling
and discoloration on the right side of face with
excessive upper teeth and gum show on the right side
since childhood. the disease progressed slowly as time
advanced which started with a pea size and gradually
increased to attain the present size. There was no
history of trauma, paresthesia, and difficulty in chewing
food, and it was not associated with any other
symptoms. Extra orally (Figure-1), a diffuse swelling (4
× 5 cm approximately) was seen, superioinferiorly
starting from 2 cm below the infraorbital margin to the
line joining the commissure and the ear lobe, and
mediolaterally starting from the left side of nasal
2. Raja Satish Prathigudupu et al., Saudi J. Med. Pharm. Sci., Vol-4, Iss-9 (Sept, 2018): 1053-1058
Available online: http://scholarsmepub.com/sjmps/ 1054
septum, causing obliteration of left nasolabial fold, to
maxilla on the right side, which was bony hard and
nontender in nature. Intraorally, the swelling started
form the central Incisor region on the left side crossing
the midline extending from 21 to 18 tooth region with
palatal extensions and ectopically erupted tooth in the
involved region, with expansion of the buccal cortical
plate and obliteration of vestibule. Overlying mucosa
was smooth and it was bony hard and nontender
(Figure-2). Presence of port wine stain on the right
region of face (Figure-3). Provisional diagnosis of
fibro-osseous lesion of right maxillary region was
made. Teeth in the vicinity of the lesion were vital.
Complete hemogram showed all the parameters were
within normal limits. Serological investigations
including serum calcium, serum phosphorus, and
alkaline phosphatase (ALP) were also within normal
range. Orthopantomogram (OPG) (Figure-4) and PNS
X ray (Figure-5) revealed and a homogeneous ground-
glass radio-opaque pattern in the periapical areas
involving the maxillary sinus and excessive radiopacity
and increase in size of maxilla. Higher radiographic
investigations (CT Scan) with axial coronal and sagittal
sections were done to rule out the extensions (Figure-6)
which revealed homogeneous, granular radiopacity of
right maxillary alveolar bone with expansion of buccal
cortical plate extending from 21 to 18 region, giving a
granular or ground-glass appearance. On the palatal
side, homogeneous radio-opacity partially covered the
greater palatine foramen. Margins of the lesion blended
with adjacent areas. Angiogram was taken of the
involved area to rule out any vascular malformations
which was negative (Figure-7) Chest X ray was taken
as patient was planned to be operated under General
anesthesia which was clear (Figure-8). Surgical
recontouring of maxilla was done and histopathological
examination revealed a connective stroma which was
cellular and fibrous with plump cells. It was intermixed
with bone of varying sizes and shapes confirming
Fibrous dysplasia. The histologic features were
suggestive of a fibro-osseous lesion. After the clinical
features and radiological features were correlated, it
was diagnosed as Fibrous dysplasia. Patient was
discharged after 3 days and recalled after 2 weeks for
follow up. On follow up she was happy with her
appearance in the post-operative follow up after 2
weeks (Figure-9).
Fig-1: Clinical Picture of Patient
Fig-2: Intra-oral Pictures
3. Raja Satish Prathigudupu et al., Saudi J. Med. Pharm. Sci., Vol-4, Iss-9 (Sept, 2018): 1053-1058
Available online: http://scholarsmepub.com/sjmps/ 1055
Fig-3: Picture showing Port wine stain on right side of face
Fig-4: OPG X ray
Fig-5: PNS X ray
4. Raja Satish Prathigudupu et al., Saudi J. Med. Pharm. Sci., Vol-4, Iss-9 (Sept, 2018): 1053-1058
Available online: http://scholarsmepub.com/sjmps/ 1056
Fig-6: CT Scan
Fig-7: Angiogram
5. Raja Satish Prathigudupu et al., Saudi J. Med. Pharm. Sci., Vol-4, Iss-9 (Sept, 2018): 1053-1058
Available online: http://scholarsmepub.com/sjmps/ 1057
Fig-8: Chest X ray
Fig-9: Post-operative follow up clinical picture after 2 weeks
CONCLUSION
Fibrous dysplasia (FD) is a disturbance of
bone metabolism that is classified as a benign fibro-
osseous lesion. The fibrous connective tissue containing
abnormal bone replaces normal bone. FD is a benign
intramedullary fibro-osseous lesion. It is a sporadic
benign skeletal disorder that can affect one or multiple
bones, and the latter may form part of syndromes. FD is
also attributed to gene mutation. Knowing all these
features of FD it is very important to diagnose and treat
such case promptly to increase the quality of life of
patients.
DECLARATION OF PATIENT CONSENT
The authors certify that they have obtained all
appropriate patient consent forms. In the form the
patient(s) has/have given his/her/their consent for
his/her/their images and other clinical information to be
reported in the journal. The patients understand that
their names and initials will not be published and due
efforts will be made to conceal their identity, but
anonymity cannot be guaranteed.
FINANCIAL SUPPORT AND SPONSORSHIP: Nil
CONFLICTS OF INTEREST
There are no conflicts of interest.
REFERENCES
1. Lee, J. S., FitzGibbon, E. J., Chen, Y. R., Kim, H.
J., Lustig, L. R., Akintoye, S. O., ... & Kaban, L. B.
(2012, June). Clinical guidelines for the
management of craniofacial fibrous dysplasia.
In Orphanet journal of rare diseases (Vol. 7, No. 1,
p. S2). BioMed Central.
2. Mardekian, S. K., & Tuluc, M. (2015). Malignant
sarcomatous transformation of fibrous
dysplasia. Head and neck pathology, 9(1), 100-103.
3. Tehranzadeh, J., Fung, Y., Donohue, M., Anavim,
A., & Pribram, H. W. (1998). Computed
tomography of Paget disease of the skull versus
fibrous dysplasia. Skeletal radiology, 27(12), 664-
672.
4. Ricalde, P., Magliocca, K. R., & Lee, J. S. (2012).
Craniofacial fibrous dysplasia. Oral and
Maxillofacial Surgery Clinics, 24(3), 427-441.
5. Kramer, I. R., Pindborg, J. J., & Shear, M. (1992).
The WHO histological typing of odontogenic
tumours. A commentary on the second
edition. Cancer, 70(12), 2988-2994.
6. Davies, M. L., & Macpherson, P. (1991). Fibrous
dysplasia of the skull: disease activity in relation to
age. The British journal of radiology, 64(763), 576-
579.
7. MacDonald-Jankowski, D. (2009). Fibrous
dysplasia: a systematic review. Dentomaxillofacial
Radiology, 38(4), 196-215.
6. Raja Satish Prathigudupu et al., Saudi J. Med. Pharm. Sci., Vol-4, Iss-9 (Sept, 2018): 1053-1058
Available online: http://scholarsmepub.com/sjmps/ 1058
8. Nityasri, V., Haris, P. S., Bose, T., & Balan, A.
(2011). Fibrous dysplasia—a 13-year retrospective
radiographic analysis in a south Indian
population. Dentomaxillofacial Radiology, 40(5),
282-289.
9. Proschek, D., Orler, R., Stauffer, E., & Heini, P.
(2007). Monostotic fibrous dysplasia of the spine:
report of a case involving a cervical
vertebra. Archives of orthopaedic and trauma
surgery, 127(2), 75-79.
10. Lee, S. H., Han, I. H., Kang, D. W., & Choi, B. K.
(2011). Cervical fibrous dysplasia presenting as a
pathologic fracture in an older patient. Journal of
Korean Neurosurgical Society, 50(2), 139.
11. Sachdeva, S. K. (2015). Craniofacial fibrous
dysplasia in an elderly patient: a case report with a
review of literature. Acta stomatologica
Croatica, 49(1), 60.