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Coronary arterial air embolism is an extremely rare but readily recognizable condition on computed tomography (CT) that may complicate a lung biopsy. We present an incidence of symptomatic air embolism into the right coronary artery during a percutaneous CT-guided lung biopsy that was successfully recognized during the procedure and managed accordingly. An active search for this complication should be made when the patient deteriorates on table and the usual complications (pneumothorax, vasovagal shock, etc.) are ruled out, as immediate resuscitative measures could be life-saving.

Objective: The objective of this study was to evaluate the short-term efficacy and safety of the topical application of amlexanox paste with triamcinolone acetonide paste and tacrolimus paste in the treatment of oral erosive lichen planus. Study Design: This study was a randomized double-blinded placebo-controlled clinical trial. Forty patients aged 18–70 years with erosive oral lichen planus received amlexanox 5% paste (n = 10), triamcinolone acetonide 0.1% paste (n = 10), tacrolimus 0.03% paste (n = 10), and glycerin as placebo (n = 10) for 15 days. Outcome measures included pain using visual analog scale (VAS) scores, and the erosive area in cm2 was evaluated both before (baseline) and during the trial (i.e., days 7 and 15). Results: After 15 days of treatment, all the groups showed significant reductions in erosive areas and VAS scores (P

Burning mouth syndrome is a condition characterized by chronic orofacial pain without any mucosal abnormalities or other organic disease. There are numerous synonyms for this ailment such as stomatodynia, stomatopyrosis, glossodynia, glossopyrosis, sore mouth, sore tongue, oral dysesthesia, and scalding mouth syndrome. Patients usually present with burning, stinging, or numbness on the tongue or other areas of oral mucosa. The complex etiology and lack of characteristic signs and symptoms makes the diagnosis difficult. As a result of which managing such patients become a herculean task. Moreover, lack of understanding of the disease leads to misdiagnosis and unnecessary referral of patients. In this article, the authors have described the etiopathogenesis, diagnostic algorithm and management of this confusing ailment.

Background: Alpha-2 adenoreceptors as an adjuvant to local anesthetic during caudal analgesia in children prolongs the duration of analgesia. This study was designed to compare the analgesic efficacy and adverse effects of dexmedetomidine and clonidine when added to ropivacaine for caudal analgesia in children undergoing lower abdominal surgeries. Methods: In a prospective study, Seventy-eight children received block with either 0.2% ropivacaine 1.5 mg/kg (Group R; n = 26) or 0.2% ropivacaine 1.5 mg/kg + 1 mcg/kg clonidine (Group RC; n = 26) or 0.2% ropivacaine 1.5 mg/kg + dexmedetomidine 1 mcg/kg (Group RD; n = 26). Results: Duration of analgesia was 7.15 ± 1.00 h in Group R, 11.57 ± 1.27 h in Group R + C, and 14.73 ± 1.53 h in Group R + D (P < 0.0001). One patient in Group R + D had vomiting and 1 patient in Group R had urinary retention which was not statistically significant (P > 0.05). Conclusion: Addition of clonidine and dexmedetomidine to caudal ropivacaine significantly prolongs the duration of analgesia without adverse effects.

Background and Aim: Ozone is highly valued for various therapeutic applications such as antimicrobial, antihypoxic, analgesic, and immunostimulating for more than a century in the medical profession. Ozone therapy is now gaining a strong foothold in dentistry. Ozone has bactericidal, fungicidal, and virucidal properties. Oral candidiasis is one of the most common opportunistic fungal infections of the oral cavity. Hence, a study was conducted to evaluate and compare the ability of ozonated water and topical clotrimazole in reducing the Candidal species colony-forming unit (CFU) count in oral candidiasis. Materials and Methods: The study included 40 candidiasis patients of either sex aged between 18 and 60 years attending the Department of Oral Medicine and Radiology. The patients were randomly assigned to either topical ozone therapy or topical clotrimazole groups. Salivary Candidal CFU counts were assessed during and after the treatments. Results and Conclusion: There was gradual but significant reduction in Candidal CFU count in both groups. At the end of the treatment, Candidal CFU count reduction in ozone group (60.5% reduction) was more than the clotrimazole group (32.3% reduction). 14 patients (70%) with candidiasis in ozone group were reduced to 6 (30%) whereas only 8 patients (40%) out of 13 (65%) in clotrimazole group, although intergroup comparison was not statistically significant. Ozone therapy was much more effective in reducing the patients with candidiasis to a state of carriers. These findings suggest that ozonated water might be useful to treat oral candidiasis.

Background: Ionizing radiation is a potent mutagenic agent capable of inducing both mutation and chromosomal aberrations. Non-lethal doses of ionizing radiation may induce genomic instability favoring carcinogenesis. In spite of their mutagenic potential, this kind of radiation is an important tool for diagnosis of the disease and is used in medical and dental practice. It has been believed that the number of micronucleus and increased frequency of other nuclear alterations, including karyorrhexis, condensed chromatin and pyknosis, are related to the increasing effects of carcinogens. Many approaches and techniques have been developed for the monitoring of human populations exposed to various mutagens, but the analysis of micronuclei (MN) has become a standard approach for the assessment of chromosomal damage in human populations. Aim: To assess the effects of radiation exposure from panoramic radiography on the buccal epithelial cells (BECs) of pediatric patients. Materials and Methods: The study included 20 pediatric patients who had to undergo panoramic radiography for further dental treatment. Exfoliated BECs were obtained and examined immediately before and 10 days after radiation exposure. The cells were stained using rapid Papanicolaou (PAP) kit. Evaluation for MN and nuclear alterations was carried out by an oral pathologist and data were statistically analyzed using the "t" test. Results: The mean number of MN in the BECs before exposure of pediatric patients to panoramic radiography was 4.25 and after exposure was 4.40. This difference was not found to be statistically significant (P < 0.0001). However, the mean nuclear alterations of 8.70 and 15.75 before and after exposure were statistically significant (P < 0.0001). Conclusion: Panoramic radiographs can induce cytotoxicity but not genotoxic effects in buccal mucosal cells. Hence, dental radiographs should be prescribed only when deemed indispensable.

Lichen planus is a chronic autoimmune, mucocutaneous disease, which can affect the oral mucosa, skin, genital mucosa, scalp and nails, and commonly seen in adults. Childhood lichen planus is a rare entity, which is characterized by skin lesions with the oral involvement being extremely uncommon. There are only a few reports on this subject in the literature. Early and correct diagnosis with adequate management is very important to avoid further complications as it is a pre-malignant condition. Herewith, we report a seven-year-old girl having erosive oral lichen planus with cutaneous involvement, which responded well to the treatment. This is to add another case of lichen planus in a child and to emphasize its consideration in the differential diagnosis of oral mucosal red and white lesions in children.

Aims: Though use of transcutaneous electrical nerve stimulation (TENS) in dentistry was first described in 1967 by Shane and Kessler, it has yet to gain widespread acceptance in dentistry. This study was designed to evaluate and compare the effectiveness of active and placebo TENS therapies in the treatment of temporomandibular disorder. Methods: Thirty patients received active TENS therapy and 15 received placebo TENS therapy. VAS was used to measure changes in pain and tenderness in the muscles of mastication and TMJS during and after therapy- Also, changes in mouth opening was recorded and analyzed. Results: A significant improvement was observed in both active and placebo TENS therapies regarding orofacial pain, muscles and TMJs tenderness and interincisal distance. None of the parameters except medial pterygoid muscle tenderness revealed any differences between the methods. Conclusion: This study justifies the use of TENS therapy as well as placebo in the management of TMD. TENS therapy appears to be useful in relieving pain, especially muscular and chronic pain Hence, along with TENS therapy, placebo should also be considered as a potent and independent therapeutic modality in its own right.

Central giant cell granuloma is an uncommon, benign, and proliferative lesion whose etiology is not defined. It is considered widely to be a non-neoplastic lesion Although formerly designated as giant cell reparative granuloma these lesions were found to be destructive rather than reparative, the word "reparative" was omitted from the ten and the terminology is central giant cell granuloma Presenting a case report of a female patient of aged 40 years having chief complaint of swelling since t year and pain since 4 to 5 months present at the lower right back region of the jaw. Correlating all clinical features and all investigation we finally diagnosed this case as central giant cell granuloma.

Pachyonychia congenita is a rare, but well-characterized autosomal dominant disorder of keratinization. It usually begins within the first few months of life. Here, we are presenting a rare case, which started at the age of 10 years of life and is known as pachyonychia congenita tarda. The case is being reported for its rarer occurrence as the patient had oral leukokeratosis and angular cheilosis present in the same type of the syndrome (Jadassohn-Lewandowsky syndrome), which is still uncommon.

Abstract Background Global regulatory mechanisms involving chromatin assembly and remodelling in the promoter regions of genes is implicated in eukaryotic transcription control especially for genes subjected to spatial and temporal regulation. The potential to utilise global regulatory mechanisms for controlling gene expression might depend upon the architecture of the chromatin in and around the gene. In-silico analysis can yield important insights into this aspect, facilitating comparison of two or more classes of genes comprising of a large number of genes within each group. Results In the present study, we carried out a comparative analysis of chromatin characteristics in terms of the scaffold/matrix attachment regions, nucleosome formation potential and the occurrence of repetitive sequences, in the upstream regulatory regions of housekeeping and tissue specific genes. Our data show that putative scaffold/matrix attachment regions are more abundant and nucleosome formation potential is higher in the 5' regions of tissue specific genes as compared to the housekeeping genes. Conclusion The differences in the chromatin features between the two groups of genes indicate the involvement of chromatin organisation in the control of gene expression. The presence of global regulatory mechanisms mediated through chromatin organisation can decrease the burden of invoking gene specific regulators for maintenance of the active/silenced state of gene expression. This could partially explain the lower number of genes estimated in the human genome.