International Journal of Medical and Dental Sciences

Journal Information
ISSN / EISSN : 2454-8952 / 2320-1118
Published by: Informatics Publishing Limited (10.18311)
Total articles ≅ 400
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Somnath Pralhad Pachrupe, Mangesh Phadnaik, Pooja Gupta
International Journal of Medical and Dental Sciences, Volume 10, pp 1956-1960; https://doi.org/10.18311/ijmds/2021/26284

Abstract:
Neurofibromatosis is an autosomal dominant disorder that affects the bone, the nervous system, soft-tissue, and the skin. The expressivity of the disease is extremely variable, with manifestations ranging from mild lesions to several complications and functional impairment. The penetrance, otherwise, is 100%. Approximately 72% of Neurofibromatosis Type1 patients present with oral manifestations. These patients have an estimated 3-15% additional risk of malignant disease in their life-time. The following report presents a 32 year old lady diagnosed with Neurofibromatosis Type 1 in childhood who presented to department with complain of bleeding gums. Radiograph showed shallow sigmoid notch on left side, obtuse and thinned out left angle of mandible which are some additional features. A multidisciplinary approach of dental and medical specialties was taken here for oral rehabilitation and to manage and treat periodontal manifestations and other oral complaints. Case was followed for more than 6 years. Neurofibromatosis has no cure hence when such patients report to dental professionals it is up to them to act as primary care giver and instill positive frame of mind to help reduce stressful life events.
Shivani Tyagi, Aroma Oberoi
International Journal of Medical and Dental Sciences, Volume 10, pp 1919-1924; https://doi.org/10.18311/ijmds/2021/25742

Abstract:
Background: Staphylococcus aureus (S. aureus) is a well recognized nosocomial and community acquired pathogen which is implicated in causing a wide spectrum of superficial, deep pyogenic infections and toxin mediated illnesses. Localized infections sometimes progress to systemic infections, while ‘spontaneous’ bacteraemia also occur without an evident septic focus, particularly in chronic debilitated immunocompromised patients. Emergence of drug resistance to penicillins and penicillinase-resistant penicillins (i.e., oxacillin and methicillin) is a globally recognized problem. Methicillin Resistant Staphylococcus aureus isolates are also important with respect to the range of nosocomial infections it causes, leading to an increase in the hospital expenditure and mortality or morbidity rate. The increased prevalence of such resistant strains has narrowed down the list of available therapeutic options. Therefore, information regarding the prevalence of S. aureus infections in a health care setting and determining its current antibiotic resistance profile becomes crucial in selecting appropriate treatment regime. Therefore, the current study was done in the department of Microbiology to determine the prevalence of S. aureus infections and the antibiotic resistance pattern of S. aureus isolates from various clinical specimens at our tertiary care hospital in North India. Materials and Methods: A one year prospective study was carried out in the Department of Microbiology, at a tertiary care hospital in North India where non-duplicate strains of S. aureus isolated from various clinical specimens received in the Microbiology laboratory were studied. All S. aureus isolates were subjected to Antibiotic Susceptibility Testing using Kirby Bauer’s disk diffusion method on Mueller Hinton Agar plates in accordance to CLSI guidelines. The antibiotics tested included Penicillin (10U), Amoxicillin-clavulanic acid (20/10μg), Sulphamethoxazole-trimethoprim (1.25/23.75μg), Ciprofloxacin (5μg), Erythromycin (15μg), Clindamycin (2μg), Vancomycin (30μg), Teicoplanin (30μg) and Linezolid (30μg). Results: A total of 23,699 clinical specimens were processed in the laboratory while conducting this study, from which 1233 clinical isolates of S. aureus were identified and processed further. Among all clinical specimens, pyogenic samples (63.1%) yielded maximum number of S. aureus strains followed by blood samples (29.9%) and urine samples (4.8%). S. aureus infection was more evident in hospitalized 71.2% patients than in OPD patients 28.8%. Seasonal variation was also seen in isolation of S. aureus, with a higher percentage of isolates obtained during summer season than during winter season. On antibiotic susceptibility testing, 49.6% strains were Methicillin Resistant. Majority of the isolates were found resistant to Penicillin (92.1%), followed by Erythromycin (59%). Almost half of the total isolates were resistant to Sulphamethoxazole-Trimethoprim (49.3%) followed by Amoxicillin- Clavulanic acid (47.8%), Ciprofloxacin (43.4%) and Clindamycin (18.4%). Antibiotics to which all isolates showed 100% susceptibility included Vancomycin, Teicoplanin, Linezolid. Conclusion: Given the high prevalence of resistance to antibiotics seen in this study, effective treatment of infections caused by multidrug resistant Staphylococcal strains may become challenging. Drugs like Vancomycin, Teicoplanin and Linezolid promise to work as miracle drugs against the multidrug resistant MRSA strains but we need to warrant judicious use of these wonder drugs to conserve them for future use.
Shivani Tyagi, Ravinder Kaur, Deepti Rawat
International Journal of Medical and Dental Sciences, Volume 10, pp 1925-1931; https://doi.org/10.18311/ijmds/2021/25828

Abstract:
Background: Superficial fungal infections are one of the commonest human infections. Causative agents of such infections may vary from yeasts like Candida species, Trichosporon species to dermatophytes and non-dermatophyte moulds. Fungal culture therefore, holds importance in identification and characterization of a fungal isolate, so that proper diagnosis can be made and correct treatment is instituted. Our objective was to study the etiology of the superficial fungal infections in patients presenting to the dermatology department in a tertiary care hospital in New Delhi. Materials and Methods: A total of 340 skin and hair samples from patients clinically suspected to have superficial fungal infection of skin and hair were microscopically examined and cultured over a period of 2 years. The percentage and frequency distribution of etiological fungal agents was studied. Also the performance of the culture and microscopy as methods of detecting fungal agents was statistically compared using Kappa and proportions of positive and negative agreement as well as McNemar’s Chi-squared value. Corresponding p-values were also calculated for both kappa and Chi-squared values. The analysis has been done using Epitools. Results: Of these, 57.6% were positive for fungal elements by microscopic examination and the overall positivity of fungal infection was 70%. Out of 238 culture positive samples, 72.7% grew dermatophytes and 27.3% grew non-dermatophytes (including 16.8% yeasts and 10.9% non-dermatophyte moulds. Trichophyton mentagrophytes was the commonest (60.7%) dermatophyte isolated, followed by T. rubrum (17.3%), T. violaceum (7.5%), T. tonsurans (7.5%), T. verucosum (2.9%), Microsporum gypseum (1.2%) and M. canis (0.6%). Among the isolated non-dermatophytes, Candida species was the commonest (50.8%) majority of which were C. albicans, other non-dermatophytes included moulds like Fusarium spp. (6.1%), Aspergillus fumigatus (4.6%), A. flavus (3.1%), Alternaria spp. (3.1%), Acremonium spp. (3.1%), A. niger (3.1%) etc. and yeasts like Trichosporon spp. (10.8%). Conclusion: Dermatophytosis still remains the most common type of fungal infection involving skin and its appendages but non-dermatophytes are also slowly emerging as the causative agents for these infections.
R. Rajavardhan, Anand Mamadapur, N. Shyamala
International Journal of Medical and Dental Sciences, Volume 10, pp 1961-1965; https://doi.org/10.18311/ijmds/2021/26466

Abstract:
Arsenic is a naturally occurring element in the earth's crust. Chronic arsenic poisoning has been regularly reported predominantly due to occupational exposure in the literature. Acute arsenic poisoning is very rare. A 27-year-old gentleman was brought to the hospital with a history of suicide attempt by consumption of arsenic trioxide diluted in water. He initially manifested with gastrointestinal manifestations along with tachycardia. The patient was treated with fluid resuscitation, antidote-Dimercaprol, dialysis, and other supportive treatment. The patient continued to deteriorate with deranged liver and renal function, coagulopathy, and neurological symptoms. The presence of coagulopathy further complicated the scenario, as the antidote which is administered as an intramuscular injection could not be given. The patient continued to deteriorate and eventually succumbed. Acute arsenic poisoning is very rare, and very few reports of suicide are reported. It initially presents with acute gastroenteritis symptoms followed by multi organ involvement. Fatal doses will invariably result in death irrespective of treatment modality. Rapid administration of antidote and supportive treatment might increase the chances of survival. Difficulty in the availability of oral antidote and unavailability of any Intravenous preparations further complicates the scenario.
Rudra Kaul, Sukhbir Kaur, Ashish Choudhary, Vibhuti Kaul, Rahat Saleem, General Dentistry Private Practitioner
International Journal of Medical and Dental Sciences, Volume 10, pp 1938-1944; https://doi.org/10.18311/ijmds/2021/26669

Abstract:
Background: There has been a paradigm shift in the restorative dentistry practiced in the clinics with an increased share of resin-composites in contrast to dental amalgam due to various factors, however, this has not found its way into the Indian dental school curriculum. Aim: To evaluate the self-perceived competence of contemporary restorative practices of dental students in North India. Materials and Methods: 232 dental students from 4 colleges in North India completed a survey comprising 11 polar questions about their perception of contemporary restorative dental practice and their curriculum update regarding the same. Further, the collected data was tabulated and finally extracted data was subjected to descriptive analysis using Chi-square test. Results: All 11 questions showed statistically significant responses. Only 15.5% of students thought that the current curriculum of restorative dentistry was adequate. Moreover, only 20.7% of the respondents were confident about using rubber dam for isolation. About 93.1% felt that the quality of their composite restorations was not at par with those seen on social media. A clear majority of 91.4% felt that the maximum uploads of restorative dentistry involved composite restorations. A huge number of 91.45% did not use rubber dam for isolation in composite restorations. 79.3% students felt that the current curriculum is not teaching them about the various instruments, and developing their skills about instrumentation and operative procedures of composite restorations matching the trending composite practices. Conclusion: Considering the results of this study as the student’s mandate will help shape the guidelines for possibly a new curriculum of conservative dentistry in India.
Gulbahar Singh Sidhu, Rakesh Kumar, Doaba Hospital Consultant Psychiatrist
International Journal of Medical and Dental Sciences, Volume 10, pp 1-2; https://doi.org/10.18311/ijmds/2021/26800

Somnath Pralhad Pachrupe, Mangesh Phadnaik, Pooja Gupta
International Journal of Medical and Dental Sciences, Volume 10, pp 1952-1955; https://doi.org/10.18311/ijmds/2021/26282

Abstract:
Acute Myeloid Leukemia (AML) is a neoplastic disease of bone marrow. AML M3 variant frequently develops swiftly and if not intervened immediately may prove fatal. This report presents a 32-year-old female who reported to dental OPD with complaint of bleeding gums and no previous medical history. On examination suspicious lesions were seen and patients was advised for full blood workup and Peripheral Blood Smear (PBS) investigations which revealed features suggestive of AML M3. The significant findings of this case are just presentation of oral manifestations, quick progression from initial symptoms to end stage and mild increase in WBC count which is uncommon for AML M3 variant. For many types of cancer, finding it early might make it uncomplicated to treat. This report outlines how a periodontist proved to be an asset in diagnosing a case of AML.
Vasantha Kumar Vanmathi, Varalakshmi Parasuraman, Ramya Vanmathi, Vallalar Dental Clinic Private Practitioner
International Journal of Medical and Dental Sciences, Volume 10, pp 1945-1951; https://doi.org/10.18311/ijmds/2021/25916

Abstract:
Temporomandibular Joint ankylosis is the adhesion of the condyle of the mandible to the base of the skull. It is the most common cause of hypoplasia of the mandible and eventual facial asymmetry. This case report describes the management of unilateral bony re-ankylosis of temporomandibular joint after the failure of a costochondral graft in an eight-year-old girl. The management of temporomandibular ankylosis presents a major challenge due to its increased reoccurrence rate. In the present case, simultaneous gap arthroplasty and distraction osteogenesis were performed to separate the ankylotic mass and lengthen the ramus-condyle unit. The one year follow-up of the patient showed adequate mouth opening. We recommend concomitant gap arthroplasty and distraction osteogenesis for effectively managing temporomandibular joint bony ankylosis.
Prakash Parajuli, Pramita Suwal, Rajkumar Singh
International Journal of Medical and Dental Sciences, Volume 10, pp 1932-1937; https://doi.org/10.18311/ijmds/2021/26378

Abstract:
Background & Objectives: Inter-Condylar Distance (ICD) has been used as a reliable and fixed parameter for selection of mandibular anterior teeth and their arrangement. The objectives of this study were to determine the relationship of inter-condylar distance with maxillary inter-canine distance and maxillary inter-molar distance. Methods: This crosssectional study was conducted in the Department of Prosthodontics & Crown-Bridge, B.P. Koirala Institute of Health Sciences (BPKIHS) enrolling 120 dentate subjects those fulfilled the inclusion criteria. Maxillary casts were prepared and the distance between bilateral canine tips were measured using a Vernier caliper. The mesiobuccal cusp tips of maxillary first molars were marked and the distance was measured using the caliper. Inter-condylar distance was measured using arbritary face bow. The distance between the two condylar rods was measured in millimeters using Vernier caliper. Every distance was measured three times to assure the accuracy and mean taken. Data were recorded on the proforma for statistical analysis. Results: The ratio of intercondylar distance to the maxillary inter-canine distance was found to be 3.6:1 whereas that to intermolar distance was 2.6:1. Pearson correlation coefficients (r) for the ICD showed positive and significant correlation to both the inter-dental distances. (r - 0.33, (p<0.001) for Maxillary Inter-Canine distance (MIC) and r – 0.59, (p<0.001) for Maxillary Inter-Molar distance (MIM). Conclusion: Inter-condylar distance provides significant measurements and hence can be used as a guide for maxillary denture teeth arrangement.
G Gulbahar, Gulbahar S. Sidhu, Doaba Hospital Consultant Psychiatrist
International Journal of Medical and Dental Sciences, Volume 9, pp 1874-1875; https://doi.org/10.18311/ijmds/2020/25699

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