Aditi Amit Byatnal

Palatoscopy: An adjunct to forensic odontology: A comparative study among five different populations of India

Objectives: This study was conducted to analyze and identify differences in the palatal rugae patterns and to identify gender wise changes in the palatal rugae shapes in populations of five different states of India. Study Design: Study was conducted in five different Indian states. 500 sample subjects from Andhra Pradesh, Tamil Nadu, Karnataka, Madhya Pradesh and Maharashtra were included. Rugae patterns with predominant shapes were analyzed and categorized according to different states and both genders, data was statistically analyzed using SPSS software 15.0 and the results were obtained by Chi-square analysis. Results: “Wavy” type of palatal rugae pattern is the most predominant variant in five different study groups in both the genders. Conclusion: This study could identify variations in distribution of various palatal rugae pattern in five different states and confirmed the “wavy” type of palatal rugae patterns to be the most predominant variant in five different study groups.

Efficacy of rebamipide and levamisole in the treatment of patients with recurrent aphthous ulcer - a comparative study.

UNLABELLED Context (Background): Recurrent aphthous stomatitis is an inflammatory condition of unknown aetiology characterized by painful recurrent, single or multiple ulcerations of the oral mucosa. AIMS To compare the efficacy of rebamipide, a gastro-protective agent and levamisole, an immunomodulating agent in the treatment of recurrent aphthous stomatitis. MATERIALS AND METHODS Hundred patients diagnosed with recurrent aphthous stomatitis were enrolled in the study. Fifty patients were assigned randomly to each of the two treatment groups. After the clinical diagnosis and ulcer measurement, a subjective evaluation of symptoms was done for each subject. Both the drugs were given orally at specified intervals. Ulcer measurements and subjective evaluations were made at day one. STATISTICAL ANALYSIS Analysis was done using various test like Mann Whitney and t-test. RESULTS AND CONCLUSION The overall results showed mean number of episodes whose values were not statistically significant (p=0.43), neither were the mean number of ulcers (p=0.75), or values for mean size of ulcers (p=0.91). However, the overall results suggested that efficacy of rebamipide is almost same as that of the efficacy of previously proved drug levamisole. The current study with a three months follow up, including patients with high scores of pain, aphthae count, ulcer size and frequency of occurrence showed better results in both the study groups. However, rebamipide is suggested to be well tolerated and may therefore be useful in the treatment and prevention of frequently recurrent aphthous ulcers not restricted to Behcets disease.

An Infiltrative Angioarchitectural Variant of Arteriovenous Malformation of Temporalis

Vascular anomalies of the head and neck region pose a certain diagnostic and therapeutic paradox. Management of arteriovenous malformations (AVM) is a challenge owing to the presence of abnormal vascular communications and high recurrence. We report a case of a 19-year-old male patient, who presented with diffuse swelling in the right temporal region. Magnetic Resonance Angiography (MRA) suggested it to be an AVM in the temporalis muscle, having afferents in the ascending pharyngeal artery, with cavernous angioma. Surgical excision of the lesion was carried out under carotid control. Histopathology of the excised specimen utilizing special stains confirmed the presence of AVM. An absence of distinct nidus concomitant along with the exuberant proliferation of capillaries between the muscle fibres suggested it be an infiltrative angioarchitectural variant. The present case highlights significance of diagnosing AVM in temporalis muscle which is a rare occurrence in head and neck region. Also, the importance of ruling out other closely resembling vascular diathesis, both non neoplastic and malignant is discussed.

A guise of osteosarcoma: chondroblastoma-like.

Osteosarcoma (OS) is a rare tumor arising from immature bone forming cells or through neoplastic differentiation of other immature mesenchymal cells into osteoblasts. Chondroblastoma-like OS is one of the rare forms of OS to be seen in jaw bones. Aggressive clinical behavior, osteolytic areas in the radiograph and histological presentation of chondroblastoma such as cells with grooved nuclei, typical chicken-wire calcification along with areas of tumor osteoid, implied the diagnosis as chondroblastoma-like OS. Use of reticulin stain further confirmed the diagnosis. A case of chondroblastoma-like OS is reported, emphasizing the importance of early diagnosis of aggressive jaw lesions with the help of routine radiography, histopathology, and special stains.

Elucidating the role of Cyclooxygenase-2 in the pathogenesis of oral lichen planus – an immunohistochemical study with supportive histochemical analysis

OBJECTIVE Oral lichen planus (OLP) is a chronic, inflammatory disorder that affects the oral mucous membrane. During an inflammatory response, several chemokines and cytokines are released by the cells of the immune system. Activation of MMPs, along with mast cell-derived chymase and tryptase, degrades the basement membrane structural proteins, resulting in basement membrane breaks. AIM To investigate the association between the COX-2 expressions, presence of intact or degranulating mast cells within the connective tissue and the extent of basement membrane discontinuity in OLP cases. METHODS This study included a total of 50 formalin-fixed paraffin-embedded specimens (FFPE) of histologically confirmed cases of idiopathic oral lichen planus. A retrospective cross-sectional analysis was carried out by immunohistochemistry to study the epithelial expression of COX-2 and by the use of special stains such as toluidine blue and periodic acid-Schiff (PAS) to study the mast cell count and basement membrane changes in the oral mucosal tissue, respectively. RESULTS There was a significant (P = 0.03) association between the COX-2 expressions and mast cell count. As the intensity of COX-2 expression increased from mild to moderate or severe, the number of mast cell count almost doubled. CONCLUSION Interaction between upregulation of COX-2, mast cell and basement membrane sets a vicious cycle which relates to the chronic nature of the disease. Inhibitors of COX-2 may reduce the inflammatory process preceding the immune dysregulation in OLP.

β-Thalassemia hijacking ineffective erythropoietin and iron overload: Two case reports and a review of literature.

Thalassemia is a rare, complex disease, representing a group of disorders of hemoglobin synthesis that are characterized by reduced synthesis of either the alpha-globin or β-globin chains of the hemoglobin molecule. Defective synthesis of β-globin resulting from a variety of molecular defects causes β-thalassemia. Thalassemia is an autosomal recessive disorder, which requires prompt diagnosis and an appropriate treatment. Thorough clinical, radiographic and laboratory assessment helps in diagnosing thalassemia and any other hematological disorder. Here, two cases of β-thalassemia showing distinct features are presented and the importance of detailed work-up of the cases has been highlighted.

Orthokeratinized odontogenic cyst: critical appraisal of a distinct entity

The orthokeratinized odontogenic cyst (OOC) is a rare developmental jaw cyst. Recognition of OOC as a unique entity has long been due, yet its inexplicable radiographic presentation resembling dentigerous cyst, histological likeness to odontogenic keratocyst (OKC) and inconsistent cytokeratin expression profiles overlapping with both as well as with the epidermis, makes it rather confounding. Diagnosis of OOC is important as the pathologic behavior, clinical outcome and the surgical management of OOC is disparate. This is the report of a case of OOC in relation to an impacted mandibular third molar and critical review of this entity with an emphasis on its biologic characteristics is highlighted.