Periodontitis as a manifestation of systemic diseasesDr. vasavi reddy
Describes conditions that show periodontal manifestations inherently and primary cause is the disease itself whereas bacterial plaque acts as a secondary factor.
Periodontitis as a manifestation of systemic diseasesDr. vasavi reddy
Describes conditions that show periodontal manifestations inherently and primary cause is the disease itself whereas bacterial plaque acts as a secondary factor.
Odontogenic keratocyst (OKC) is the cyst arising from the cell rests of dental lamina. It can occur anywhere in the jaw, but commonly seen in the posterior part of the mandible. Radiographically, most OKCs are unilocular when presented at the periapex and can be mistaken for radicular or lateral periodontal cyst.
A Small effort to make this theory topic a little practical!!
The knowledge of this basic structure is actually the first building block towards dentistry.
Proper knowledge leads to correct diagnosis and henceforth desired treatment.
Dentin dysplasia (DD) is a rare hereditary disturbance is inherited as an autosomal dominant trait.
unknown etiology that affects approximately 1 :100,000.
In 1972, Witkop classified it into type I and type II which affect both dentitions.DD Type I
Radicular dentin dysplasia
Characterized by:-
1.Both dentitions are affected.
2.Normal appearing crowns
3.No or only rudimentary root development (rootless teeth)
4.Incomplete or total obliteration of the pulp chamber.
5.Teeth may exhibit extreme mobility and exfoliate prematurely.DD type II
coronal dentin dysplasia
Characterized by:-
1.partial pulpal obliteration.
2.Thistle-tube-or flame-shaped coronal pulp chambers
3. Thread-like root canals
4. Usually the absence of periapical radiolucencies.
5. In this type of anomaly, teeth roots are of normal shape and contour.The enamel and the immediately subjacent dentin appear normal.
Deeper layers of dentin show an atypical tubular pattern with an amorphous, atubular area, and irregular organization.
Normal dentinal tubule formation appears to have been blocked so that new dentine forms around obstacles and takes on the characteristic appearances described as “lava flowing around boulders”The radiograph revealed features of dentine dysplasia type I with normal appearance of crown but no root development Autosomal Dominant Disorder:
Manifested in heterozygous states
At least one parent of index case is usually affected
Both males and females are affected.
Clinical feature can be modified by variation in penetrance and expressivity. Some individual inherit the mutant gene but are phenotpically normal. This is reffered to as “incomplete penetrance”.
In many condition the age of onset is delayed.
Inheritance Pattern:
Typical pattern is a heterozygous affected parent with a homozygous unaffected parent.
Every child has one chance in two of having the disease
Both sexes are affected equally..Autosomal Recessive Disorder
Largest category of Mendelian disorder
Usually does not affect the parent of the affected individual, but sibling may show the disease.
Complete penetrance is common.
Onset is frequently early in life.
Usually affect enzymatic proteins.
Pattern Of Inheritance:
Typical pattern is two heterozygous unaffected (carrier) parent.
The triat does not usually affect the parent, but siblings may show the disease
Siblings have one chance in four of being affected
Both sexes affected equally.
Odontogenic keratocyst (OKC) is the cyst arising from the cell rests of dental lamina. It can occur anywhere in the jaw, but commonly seen in the posterior part of the mandible. Radiographically, most OKCs are unilocular when presented at the periapex and can be mistaken for radicular or lateral periodontal cyst.
A Small effort to make this theory topic a little practical!!
The knowledge of this basic structure is actually the first building block towards dentistry.
Proper knowledge leads to correct diagnosis and henceforth desired treatment.
Dentin dysplasia (DD) is a rare hereditary disturbance is inherited as an autosomal dominant trait.
unknown etiology that affects approximately 1 :100,000.
In 1972, Witkop classified it into type I and type II which affect both dentitions.DD Type I
Radicular dentin dysplasia
Characterized by:-
1.Both dentitions are affected.
2.Normal appearing crowns
3.No or only rudimentary root development (rootless teeth)
4.Incomplete or total obliteration of the pulp chamber.
5.Teeth may exhibit extreme mobility and exfoliate prematurely.DD type II
coronal dentin dysplasia
Characterized by:-
1.partial pulpal obliteration.
2.Thistle-tube-or flame-shaped coronal pulp chambers
3. Thread-like root canals
4. Usually the absence of periapical radiolucencies.
5. In this type of anomaly, teeth roots are of normal shape and contour.The enamel and the immediately subjacent dentin appear normal.
Deeper layers of dentin show an atypical tubular pattern with an amorphous, atubular area, and irregular organization.
Normal dentinal tubule formation appears to have been blocked so that new dentine forms around obstacles and takes on the characteristic appearances described as “lava flowing around boulders”The radiograph revealed features of dentine dysplasia type I with normal appearance of crown but no root development Autosomal Dominant Disorder:
Manifested in heterozygous states
At least one parent of index case is usually affected
Both males and females are affected.
Clinical feature can be modified by variation in penetrance and expressivity. Some individual inherit the mutant gene but are phenotpically normal. This is reffered to as “incomplete penetrance”.
In many condition the age of onset is delayed.
Inheritance Pattern:
Typical pattern is a heterozygous affected parent with a homozygous unaffected parent.
Every child has one chance in two of having the disease
Both sexes are affected equally..Autosomal Recessive Disorder
Largest category of Mendelian disorder
Usually does not affect the parent of the affected individual, but sibling may show the disease.
Complete penetrance is common.
Onset is frequently early in life.
Usually affect enzymatic proteins.
Pattern Of Inheritance:
Typical pattern is two heterozygous unaffected (carrier) parent.
The triat does not usually affect the parent, but siblings may show the disease
Siblings have one chance in four of being affected
Both sexes affected equally.
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.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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
2. - INTRODUCTION
- ALSO KNOWN AS
- CLASSIFICATION
- EPIDIMIOLOGY
- ETIOLOGY
- PATHOGENESIS
- CLINICAL FEATURES
- ORAL MANIFESTATIONS
- HISTOLOGICAL FEATURES
- LABORATORY FINDINGS
- TREATMENT
INDEX
2
3. INTRODUCTION
Agranulocytosis, also known as agranulosis or
granulopenia, is an acute condition involving a severe
and dangerous leukopenia (lowered white blood cell
count), most commonly of neutrophils causing a
neutropenia in the circulating blood.
● IT IS DEEMED A MORE SERIOUS FORM OF NEUTROPENIA.
● NORMAL NEUTROPHIL COUNT OF BLOOD= 2-8 /mcL
● AGRANULOCYTOSIS IS THE TERM WHEN NEUTROPHIL
COUNT IS <2.5 X 10^9/L AND CHILDREN AND < 1.5 X 10^9/L.
● MILD -WHEN THE COUNT IS 1000-1800/MM3.
● MODERATE- WHEN THE COUNT IS 500- 1000/MM3.
● SEVERE -WHEN THE ANC IS BELOW 500/mm3
4. ALSO KNOWN AS
- NEUTROPENIA
- GRANULOPENIA
- GRANULOCYTOPENIA
- A POINT TO BE NOTED IS THAT AGRANULOCYTOSIS IS
NOT TO BE CONFUSED WITH INCREASE IN
AGRANULOCYTES IN BLOOD NAMELY THE LYMPHOCYTES
AND MONOCYTES
- AGRANULOCYTOSIS HERE REFERS TO DECREASE IN
NEUTROPHILS ( GRANULOCYTE ) MUCH BELOW OPTIMUM
LEVELS.
5. CLASSIFICATION
IT CAN BE CLASSIFIED AS
PRIMARY
IDIOPATHIC
CAUSE IS UNKNOWN
SECONDARY
CAUSE IS KNOWN.
IT CAN ALSO BE CLASSIFIED AS
CONGENITAL
ACQUIRED
6. EPIDIMIOLOGY
1) Frequency : • The exact frequency of agranulocytosis is
unknown. • The estimated frequency of agranulocytosis is
1.0 -3.4 cases per million population per year.
2) Race : • Agranulocytosis has no racial predilection.
3) • Sex: • Agranulocytosis occurs slightly more frequent in
women than in men, possibly because of their increased rate
of medication usage.
• Whether this higher frequency is related to the increased
incidence of autoimmune disease in women is unknown.
4) • Age : • Agranulocytosis occurs in all age groups.
• The congenital forms are most common in childhood.
• Acquired agranulocytosis is most common in the elderly
population 6
8. * According to a Survey
8
64.4%
Average US
Population Who Visit
their GP Regularly*
$124B 40-60%
Average Profit
Margin
$175,000
Average Annual
Revenue per Doctor
3%
Market Growth Per
Year
Success
A) DRUG INDUCED
ANTIBACTERIAL
- CHLORAMPHENICOL
- CO- TRIMOXAZOLE
- PENICILLIN
- DOXYCYCLINE
ANTINFLAMMATORY
- PHENYLBUTAZONE
- AMINOPYRINE
- IBUPROFIN
ANTITHYROID
- THIOURACIL
- CARBIMAZOLE
ANTICONVULSANTS
- VALPROIC ACID
- PHENYTOIN
- TRIMETHADIONE
10. PATHOGENESIS
Pathogenesis of neutropenia can be divided into following
categories
1. Inadequate or ineffective formation of granulocytes.
2. Accelerated destruction of neutrophils.
3. Decreased production.
4. Decreased survival
10
11. INADEQUATE OR INEFFECTIVE
FORMATION OF GRANULOCYTES
This can be due to bone marrow failure similar to the kind
that occurs in aplastic anemia, several leukemias and
chemotherapeutic agents.
There can also be isolated neutropenias where only
differentiated granulocyte precursors are affected as in the
case of neoplastic proliferation of cytotoxic T cells or NK
Cells
11
12. ACCELERATED DESTRUCTION OF
NEUTROPHILS
Immune mediated reactions to neutrophils which can be
caused by drugs.
An enlarged spleen can lead to splenic sequestration and
accelerated removal of neutrophils.
Utilization of neutrophils can occur in infection.
12
16. CLINICAL MANIFESTATIONS
The manifestations of neutropenia depend upon the degree of
neutropenia and of compensatory monocytosis. • The
manifestations are generally due to severe bacterial infections.
- ASYMPTOMATIC
- HIGH FEVER, CHILLS, EXHAUSTION
- SUDDEN ONSET OF MALAISE, WEAKNESS,
PHARYNGITIS, DIFFICULTY SWALLOWING
- SKIN:PALE, ANEMIC, JAUNDICE
- ORAL CAVITY, GASTROINTESTINAL TRACT,
RESPIRATORY TRACT AND SKIN AFFECTED
- FAILURE TO TREAT: LIFE THREATENING
GENERALISED SEPSIS
- DEATH IN FEW WEEKS 16
17. ORAL MANIFESTATIONS
- NECROTISING ULCERATIONS OF THE ORAL MUCOSA,
TONSILS AND PHARYNX
- PARTICULARLY INVOLVED PARTS ARE GINGIVA AND
PALATE
- APPEAR AS RAGGED NECROTIC ULCERS COVERED
BY GREY OR EVEN BLACK MEMBRANE
- USUALLY NO PURULENT DISCHARGE
- HEMORRHAGE OCCURS AROUND THE PERIPHERY OF
THE LESIONS ESPECIALLY IN GINGIVA BUT WITH
LITTLE TO NO INFLAMMATORY CELL INFILTRATION.
- PATIENTS ALSO MANIFEST EXCESSIVE SALIVATION
- ALL ORAL PROCEDURES ESPECIALLY TOOTH
EXTRACTION ARE CONTRAINDICATED IN
17
20. HISTOLOGICAL FINDINGS
- MICROSCOPIC APPEARNACE IS PATHOGNOMIC AND MAY
ACCOUNT FOR CERTAIN CLINICAL FEATURES
- SINCE THE ESSENTIAL FAULT IS THE LACK OF DEVELOPMENT OF
THE NORMAL GRANULAR LEAUKOCYTES, THE ULCERATED AREAS
LACK THE TYPICAL POLYMORPHONUCLEAR REACTION TO THE
BACTERIA AND PRESENT WITH RAMPANT NECROSIS
- IT BEGINS AS NECROSIS OF SULCUS
SPREADS TO FREE GINGIVA PERIODONTAL
LIGAMENT
ALVEOLAR BONE.
20
21. LABORATORY FINDINGS
NEUTROPHIL COUNT IS BELOW 2000CELLS/MM3
ALMOST COMPLETE ABSENCE OF GRANULOCYTES OR
POLYMORPHONUCLEAR CELLS
RBC AND PLATELET COUNT USUALLY NORMAL BUT
ANEAMIA MIGHT BE PRESENT OCCASSIONALLY
BONE AMRROW IS NORMAL EXCEPT FOR ABSENCE OF
GRANULOCYTES, METMYLOCYTES,
POLYMORPHONUCLEAR CELLS.
21
22. PERIPHERAL BLOOD EXAMINATION
Complete blood examination is required to rule out various
causes of pancytopenia
- Hb : Normal
- TLC: Decreased
- DLC: Neutropenia with neutrophils being 0-20% .
- ANC: < 0.5 X 109/L
22
23. BONE MARROW EXAMINATION
BM is essential to rule other causes of neutropenia like…….
• sub leukemic • aleukemic leukemia • Megaloblastic anemia
• Aplastic anemia
• Cellularity : Normal
• Erythropoiesis: Normoblastic
• Myelopoiesis: Myelopoiesis in No. of cases manifests
maturation arrest at promyelocytes / myelocyte stage.
• In some cases there is depletion of the cells of myeloid
series.
• Megakaryopoiesis : Normal 23
24. TREATMENT
- FILAGASTRIN OR G-CSF IS STANDARD TREATMENT
FOR ACQUIRED AGRANULOCYTSOIS.
- ESSENTIAL TO IDENTIFY AND DISCONTINUE THE
CAUSATIVE DRUG , CHEMICAL OR ADMISNISTER
APPROPRIATE BROAD SPECTRUM ANTIBIOTIC.
- STEROIDS TO TREAT SHOCK.
- PATIENTS WITH LOW LEVELS OF IMMUNE FACTORS
ARE TO BE TREATED WITH INFUSIONS OF GAMMA
GLOBULIN.
24