Manjiri Joshi

Prevalence of Diabetic Retinopathy in Western Indian Type 2 Diabetic Population: A Hospital – based Cross – Sectional Study

CONTEXT Diabetic Retinopathy (DR) can be defined as a damage which is caused to microvasculature in the retina by prolonged hyperglycaemia. Various studies have been conducted in south India, to find out prevalence of DR. It remains a less explored domain among type 2 diabetic patients in western India. OBJECTIVES (1) To assess prevalence of diabetic retinopathy in type 2 DM in western Indian population. and (2) To find out effect of duration of diabetes on severity of DR in this population. STUDY DESIGN A hospital - based, cross - sectional study. MATERIAL AND METHODS A total of 168 patients with type 2 DM underwent detailed opthalmoscopic examinations for DR. The ETDRS classification was followed to categorize retinopathy in different stages. RESULTS We observed that overall, prevalence of DR in type 2 patients of western India was 33.9%. Prevalences of non-proliferative DR and proliferative DR were 25.5% and 8.33% respectively. Statistically significant differences (p value<0.05) were observed between prevalences of DR in each group of patients which was classified, and duration of diabetes. Prevalence of CSME (clinically significant macular oedema) was 6.5%. Associated hypertension showed a statistically significant (p value<0.05%), higher prevalence of DR. CONCLUSION This study concluded that prevalence of DR in type 2 DM patients of western India was 33.9% and that it increased with duration of diabetes. Associated hypertension is a risk factor for development of DR. It was further noted that proliferative DR was prevalent only after having diabetes for 11 years.

Variations in impacted mandibular permanent molars: Report of three rare cases

The impaction of permanent teeth is not uncommon, but few permanent teeth are rarely impacted like mandibular first and second molars. Though third molars are commonly impacted, inversely impacted mandibular third molars are very rare. Here, we report three unusual cases of impacted mandibular molars accidentally diagnosed on conventional radiographs.

Prevalence of commissural lip pits in population of central Gujarat: A hospital-based study

Background: Commissural lip pits (CLPs) fall among the rare congenital deformities recorded. CLP usually follows dominant hereditary pattern and may be associated with other congenital defects. CLP can appear as unilateral depression or bilateral depression. Objective: To assess the prevalence, age distribution, site and gender predilection of CLP in a central Gujarat population. Materials and Methods: Outdoor patients over a period of 6 months were examined for clinical evidence of CLPs. Results: A total of 14,403 patients were examined for the presence of CLP. CLP was identified in 381 patients with a prevalence of 2.65%. The occurrence of CLP was more in male patients. The maximum number of patients was in the age groups of 20–29 years. No significant statistical difference was observed in the distribution of CLP. Unilaterally distributed CLP was more common on the left side. Conclusion: Our study showed 2.65% prevalence of isolated CLPs with a male predilection. There was almost equal distribution of unilateral and bilateral CLP. In unilateral cases, the left side was affected the most. Although literature says lip pits can be an associated feature of certain syndromes, there were no syndromic patients in our study.

Mohr-Claussen Syndrome: A Rare Case

A 22-year-old, female patient reported with complaint of poor esthetics. Her past medical, dental, personal as well as family histories were non-contributory. After performing thorough general and extra oral clinical examination under aseptic precautions, various orofacial abnormalities were noted down which included brachydactyly of a thumb and an index finger of upper extremities on right side [Table/Fig-1] and hypertelorism with frontal bossing and depressed nasal bridge [Table/Fig-2]. Intra oral examination revealed hyperplastic frenula [Table/Fig-3], high lingual frenal attachment with lobed tongue [Table/Fig-4], multiple supernumerary teeth and fused teeth [Table/Fig-5]. Moreover, radiographic investigations were done which showed supernumerary teeth, fusion of two teeth and alveolar clefts in OPG and IOPA [Table/Fig-6,​,7].7]. A hand and wrist radiograph showed defect in phalanges [Table/Fig-8]. Review of literature shows that the diagnosis is based on clinical findings [Table/Fig-9] [1]. There are total 13 types of Oro-Facial Digital Syndrome (OFDS) out of which clinical features of Type 1 and Type 2 must be ruled out properly.

Trigemino-oculomotor synkinesis: Report of a rare case

Trigeminal-oculomotor synkinesis also known as the Marcus Gunn jaw winking phenomenon was first described by the ophthalmologist, Marcus Gunn, in 1883. It is one of the common congenital oculofacial synkinesis, and accounts for approximately 5% of all congenital ptosis. It is characterized by the involuntary winking of eyes during jaw movement, due to an aberrant connection between the mandibular division of the trigeminal nerve and one of the divisions of the occulomotor nerve. Here we report an unusual case of the Marcus Gunn jaw winking phenomenon, which was diagnosed accidentally.

Evaluation and comparison of three most commonly used tests for electrodiagnosis of carpel tunnel syndrome in diabetic patients with or without clinical evidence of neurodeficit

Background and Aim: Electrodiagnosis of carpel tunnel syndrome (CTS) becomes difficult with routine tests when CTS is severe with coexistent polyneuropathy. Diabetes cases often report with symptoms of CTS and peripheral neuropathy. There is lack of literature regarding diagnostic accuracy of electrodiagnostic (EDX) tests, including comparison tests in diabetic patients to diagnose CTS. Therefore, the present study was intended to evaluate and compare the diagnostic sensitivity and specificity of comparison tests in diabetics with or without clinical CTS. Methods: The three commonly used median versus ulnar comparison tests viz., palm-wrist mixed comparison (PWMC), digit4-sensory onset latency comparison (D4SOLC) and 2lumbrical-interossie motor latency comparison (2L-IMLC) were used for diagnosis of CTS in these subjects. Fishers exact test was applied to compare the differences in diagnosis between clinical and different EDX comparison tests. Results: Prevalence of CTS with routine EDX tests and comparison tests was observed as 16% and 24%, respectively. Diagnostic sensitivity for PWMC, D4SOLC and 2L-IMLC was 69.23% 76.92%, and 92.31%, respectively. 2L-IMLC was observed as most sensitive and D4SOLC was observed as most specific comparison tests for EDX of CTS in diabetic patients. Conclusion: Prevalence of CTS in diabetic patients increases with use of comparison tests. Hence, along with routine EDX tests, comparison tests may be included as part of EDX tests to evaluate CTS in these patients. 2L-IMLC test should preferably be adopted for screening CTS in diabetics.

Papillon Lefèvre syndrome: A report of 3 cases with review of literature

Papillon Lefevre syndrome (PLS) is a rare autosomal recessive disorder of keratinisation characterized by palmoplantar hyperkeratosis, periodontopathy and precocious (premature) loss of dentition. Exact mechanism of these clinical events mainly remains speculative. The periodontitis in PLS is usually difficult to control. Effective treatment includes extraction of primary teeth combined with oral antibiotics and professional teeth cleaning. Dentists play a significant role in the diagnosis and management of PLS patients. This paper describes 3 cases of PLS reporting to the out patient department within a span of 2 years with classic clinical features and briefly reviews the literature.