ORAL BIOPSY:
Introduction
Definition
History
Uses of Oral Biopsy
Indication for Oral Biopsy
Contraindication of Oral Biopsy
Precaution in Oral Biopsy
Armamentarium
Types of Oral Biopsy
Special consideration
Biopsy Arifact
Obtaining a Good Oral Biopsy
Complication of Oral Biopsy
Conclusion
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.
ORAL BIOPSY:
Introduction
Definition
History
Uses of Oral Biopsy
Indication for Oral Biopsy
Contraindication of Oral Biopsy
Precaution in Oral Biopsy
Armamentarium
Types of Oral Biopsy
Special consideration
Biopsy Arifact
Obtaining a Good Oral Biopsy
Complication of Oral Biopsy
Conclusion
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.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
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Dr. Ahmed M. Adawy, Professor Emeritus, Dep. Oral & Maxillofacial Surgery. Former Dean, Faculty of Dental Medicine
Al-Azhar University. Oral biopsy; why, when, and how? Biopsy is the removal of the tissue from the living organism for the purpose of microscopic examination and diagnosis. Looking for a definitive diagnosis is the aim of biopsy. Types of Biopsy include incisional, excisional, drill, fine needle and frozen section biopsy.
In the vast landscape of dentistry and oral pathology, the role of oral biopsy emerges as a beacon of diagnostic clarity amidst the complexities of oral lesions.
Suture Materials and Suturing Techniques - Presented by Dr. Prasanjit Das and group as a part of Dhaka Dental College, OMS Department weekly presentation program.
Maxillofacial Trauma and Its Emergency Management - ATLS
Presented by Dr Sabrina and group as a part of Dhaka Dental College OMS Department weekly presentation program
Dental Management of a Medically Compromised Patients - Presented by Dr. Shweta and Parray as a part of Dhaka Dental COllege OMS Department Weekly Presentation Program
Complication of Tooth Extraction and their Management - Presented by Dr. Trisha and group as a part of OMS Department weekly presentation in Dhaka Dental College
- 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
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Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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
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.
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.
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 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
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
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
2. Principles and Techniques ofPrinciples and Techniques of
BiopsyBiopsy
It is important to develop a systematic
approach in evaluating a patient with a
lesion in the Oral and Maxillofacial
region.
3. These steps include :These steps include :
A detailed health history
A history of the specific lesion
A clinical examination
A radiographic examination
Laboratory investigations
Surgical specimens for histopathologic
evaluation
4. Health HistoryHealth History
An accurate health history may disclose predisposing
factors in the disease process or factors that affect the
patients management.
Up to 90% of systemic deseases can be discovered
through history taking.
The same can be true of oral lesions when one is
familiar with the natural progression of the more
common disease processes.
5. Medical conditions thatMedical conditions that
warrant special care include:warrant special care include:
Congenital heart defects
Coagulopathies
Hypertension
Poorly controlled diabetics
Immunocompromised patients
7. Questions to AskQuestions to Ask
Duration of the lesion
Changes in size and rate of change
Changes in the character of the lesion.
– Lump to ulcer, etc
Associated systemic symptoms:
– fever
– nausea
– anorexia
8. More Questions to AskMore Questions to Ask
Pain
Abnormal sensations
Anesthesia
A feeling of swelling
Bad taste or smell
Dysphagia
Swelling or tenderness of adjacent lymph
nodes
Character of the pain if present
9. Historical Reasons for theHistorical Reasons for the
Lesions:Lesions:
Trauma to the area
Recent toothache
Habits
11. Clinical EvaluationClinical Evaluation
The anatomic location of the lesion/mass
The physical character of the lesion/mass
The size and shape of the lesion/mass
Single vs. multiple lesions
The surface of the lesion
The color of the lesion
The sharpness of the boundaries of the lesion
The consistency of the lesion to palpation
Presence of pulsation
Lymph node examination
12. Radiographic ExaminationRadiographic Examination
The radiographic appearance may provide
clues that will help determine the nature of the
lesion.
A radiolucency with sharp borders will often be
a cyst
A ragged radiolucency will often be a more
aggressive lesion
Radiopaque dyes and instruments can help
differentiate normal anatomy
14. These include:These include:
Tumor of hyperparathyroidism
Padgets disease
Multiple myeloma
Determination of serum calcium,
phosphorus, and alkaline phosphatase and
protein can be very useful in excluding
certain pathological processes.
15. Indications for BiopsyIndications for Biopsy
Any lesion that persists for more than 2 weeks
with no apparent etiologic basis
Any inflammatory lesion that does not respond
to local treatment after 10 to 14 days.
Persistent hyperkeratotic changes in surface
tissues.
Any persistent tumescence, either visible or
palpable beneath relatively normal tissue.
16. Indications for BiopsyIndications for Biopsy
Inflammatory changes of unknown cause that
persist for long periods
Lesion that interfere with local function
Bone lesions not specifically identified by
clinical and radiographic findings
Any lesion that has the characteristics of
malignancy
17. Characteristics of lesions that raise theCharacteristics of lesions that raise the
suspicion of malignancy.suspicion of malignancy.
Erythroplasia- lesion is totally red or has a speckled red
appearance.
Ulceration- lesion is ulcerated or presents as an ulcer.
Duration- lesion has persisted for more than two weeks.
Growth rate- lesion exhibits rapid growth
Bleeding- lesion bleeds on gentle manipulation
Induration- lesion and surrounding tissue is firm to the
touch
Fixation- lesion feels attached to adjacent structures
18. What is a Biopsy?What is a Biopsy?
Biopsy is the removal of tissue for the
purpose of diagnostic examination.
19. Types of BiopsyTypes of Biopsy
Oral cytology
Aspiration biopsy
Incisional biopsy
Excisional biopsy
Needle biopsy
20. Oral CytologyOral Cytology
Developed as a diagnostic screening
procedure to monitor large tissue areas
for dysplastic changes.
Most frequently used to screen for
uterine cervix malignancy
May be helpful with monitoring
postradiation changes, herpes,
pemphigus.
21. The Disadvantage of oral cytologicalThe Disadvantage of oral cytological
procedures include:procedures include:
Not very reliable with many false positives.
Expertise in oral cytology is not widely
available
The lesion is repeatedly scraped with a
moistened tongue depressor or spatula type
instrument. The cells obtained are smeared on
a glass slide and immediately fixed with a
fixative spray or solution.
22. Aspiration BiopsyAspiration Biopsy
Aspiration biopsy is the use of a needle and syringe
to penetrate a lesion for aspiration if its contents.
Indications:
– To determine the presents of fluid within a lesion
– To a certain the type of fluid within a lesion
– When exploration of an intraosseous lesion is
indicated
23. AspirationAspiration
An 18 gauge needle on a 5 or 10 ml
syringe is inserted into the area under
investigation after anesthesia is obtained.
The syringe is aspirated and the needle
redirected if necessary to find the fluid
cavity.
24. Incisional BiopsyIncisional Biopsy
An incisional biopsy is a biopsy that
samples only a particular portion or
representative part of a lesion.
If a lesion is large or has different
characteristics in various locations more
than one area may need to be sampled
25. Incisional BiopsyIncisional Biopsy
Indications:
– Size limitations
– Hazardous location of the lesion
– Great suspicion of malignancy
Technique:
– Representative areas are biopsied in a wedge fashion.
– Margins should extend into normal tissue on the deep
surface.
– Necrotic tissue should be avoided.
– A narrow deep specimen is better than a broad shallow
one.
26. Excisional BiopsyExcisional Biopsy
An excisional biposy implies the complete removal of
the lesion.
Indications:
– Should be employed with small lesions. Less than 1cm
– The lesion on clinical exam appears benign.
– When complete excision with a margin of normal tissue is
possible without mutilation.
29. AnesthesiaAnesthesia
Block anesthesia is preferred to
infiltration
When blocks are not possible distant
infiltration may be used
Never inject directly into the lesion
32. IncisionsIncisions
Incisions should be made with a scalpel.
They should be converging
Should extend beyond the suspected depth of the lesion
They should parallel important structures
Margins should include 2 to 3mm of normal appearing
tissue if the lesion is thought to be benign.
5mm or more may be necessary with lesions that appear
malignant, vascular, pigmented, or have diffuse borders.
33. Handling of the TissueHandling of the Tissue
SpecimenSpecimen
Direct handling of the lesion will expose
it to crush injury resulting in alteration
the cellular architecture.
35. Margins of the BiopsyMargins of the Biopsy
Margins of the tissue should be identified
to orient the pathologist. A silk suture is
often adequate. Illustrations are also
very helpful and should be included.
36. Surgical ClosureSurgical Closure
Primary closure of the wound is usually
possible
Mucosal undermining may be necessary
Elliptical incision on the hard palate or
attached gingiva may be left to heal by
secondary intention.
37. Biopsy Data SheetBiopsy Data Sheet
A biopsy data sheet should be completed
and the specimen immediately labeled.
All pertinent history and descriptions of
the lesion must be conveyed.
38. Intraosseous and Hard TissueIntraosseous and Hard Tissue
BiopsyBiopsy
Intraosseous lesions are most often the
result of problems associated with the
dentition.
39. Indications for IntraosseousIndications for Intraosseous
BiopsyBiopsy
Any intraosseous lesion that fails to
respond to routine treatment of the
dentition.
Any intraosseous lesion that appears
unrelated to the dentition.
40. Palpation of the area of the lesion with comparison
to the opposite side.
Any radiolucent lesion should have an aspiration
biopsy performed prior to surgical exploration.
– Information from the aspiration will provide valuable
information about the lesion.
• Solid
• Fluid Filled
• Vascular
• Without Contents
Clinical ExamClinical Exam
41. Principles of SurgeryPrinciples of Surgery
Mucperiosteal flaps should be designed to allow
adequate access for incisional/excisional biopsy.
Incisions should be over sound bone
Cortical perforation must be considered when
designing flaps
Flaps should be full thickness
Major neurovascular structures should be avoided
42. Principles of SurgeryPrinciples of Surgery
Osseous windows should be submitted with the
specimen
Osseous preformations can be enlarged to gain
access
Avoid roots and neurovascular structures
The tissue consistency and nature of the lesion will
determine the ease of removal
43. Principles of SurgeryPrinciples of Surgery
Incisional biopsies only require removal of a
section of tissue
Soft tissue overlying the lesion should be
reapproximated following thorough irrigation
of the operative site.
The specimen should be handled as previously
described
44. Biopsy Results: What If ?Biopsy Results: What If ?
They don’t corroborate your clinical impression
– Repeat the biopsy!!!
– Determine if the tissue was looked at by an Oral
Pathologist
– The results show malignancy
45. When To Refer For BiopsyWhen To Refer For Biopsy
When the health of the patient requires special management
that the dentist feel unprepared to handle
The size and surgical difficulty is beyond the level of skill
that the dentist feels he/she possesses
If the dentist is concerned about the possibility of
malignancy