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Klebsiella pneumoniae has become a health care concern due to its production of extended-spectrum beta-lactamase (ESBL) and its resistance to carbapenem. In February 2022, a 28-year-old female patient was admitted to the CCU private ward at Anil Bhagi Hospital in Firozpur, Punjab, India. The urine sample was inoculated with CLED agar medium for microbiological investigation. B D Phoenix sophisticated automated microbiology system was utilised for identification and sensitivity of bacteria for 24 hours for confirmation of bacteria and antibiotic sensitivity. Fosfomycin, teigocyclin and colistin were sensitive whereas other antibiotics were resistant. The observed radiuses were 13mm, 12mm, and 8mm, respectively. A urine culture revealed a highly resistant K. pneumoniae strain with over 1100,000 colony-forming units (cfu) per mL. In February 2022, a 38-year-old female patient was admitted to the CCU private ward. The 7-8 ml blood sample was collected in blood culture bottles for microbiological examination and cultured for 5 days in the B D Phoenix sophisticated automated microbiology equipment. Fosfomycin, teigocyclin and colistin were sensitive while other antibiotics were resistant. The radius observed was 9mm, 4 mm and 8 mm respectively.

Anti-asthmatic medication makes the oral habitat susceptible to opportunistic infections like

Background: Psychiatric patients or mentally ill patients conform a substantial section of the community deserving special attention. This study aimed to assess the oral health status and treatment needs of psychiatric patients attending District Civil Hospital, Raichur, Karnataka. Materials and Methods: The study group comprised 150 outpatients aged 18–64 years, attending the Department of Psychiatry, District Civil Hospital, Raichur. A specific questionnaire was drawn up and was used to record the demographic and medical data and oral hygiene practices. Type III clinical examination was carried out. The WHO Assessment Form 1997 was used to assess the oral health status of the study population. Results: Of the 150 patients examined, 90 (60%) were male and 60 (40%) were female. The mean age of the patients was 33.79 ± 10.57 years. The majority (52%) were diagnosed with epilepsy and 18% had anxiety disorder. The prevalence of caries was 87.3%. Periodontal status, according to the Community Periodontal Index scores, was as follows: 54% of the patients had shallow pocket (4 mm–5 mm) and 32% of the patients had 6-mm or more deep pocket. Conclusion: This study highlights a substantial need for prevention and treatment of oral health needs among psychiatric patients, and to increase awareness toward oral health.

Introduction: The relationship between chronic periodontitis and type 2 diabetes mellitus (DM) is bidirectional. Halitosis or oral malodor has an effect on psychological and social life of persons, and is seen in individuals with diabetes. Aims and Objectives: The aim of this study was to find out the effect of phase I therapy on the clinical parameters, volatile sulfur compound (VSC) levels, and random blood sugar (RBS) levels in chronic periodontitis patients with diagnosed DM. Materials and Methods: Our study included 80 patients with diabetes and chronic periodontitis. We collected subgingival plaque samples at 1 week and 1 month after scaling and root planing. The parameters measured were probing pocket depth and clinical attachment level for all the teeth at four sites per each tooth. RBS levels were recorded for all the patients. Malodor was measured with Tanita Breath Checker (Tanita India Private Limited, Mumbai, Maharashtra, India). Results: We found a statistically significant reduction in clinical parameter levels, VSC levels, and N-benzoyl-DL-arginine-2-naphthylamide (BANA) levels in both the groups from baseline to 4 weeks with highest levels in diabetic chronic generalized periodontitis (CGP) and lowest in nondiabetic CGP at baseline. The mean intergroup comparison of BANA levels was statistically significant at all intervals of time between the two the groups. Conclusion: There is a significant correlation observed between oral malodor levels, RBS, and clinical parameters in the diabetic group.

Early childhood caries is a condition that impacts oral health-related quality of life of children’s development and well being and also affects parents’ work hours and poses a financial burden on them. Our objective was to study and compare the impact of early childhood caries on the quality of life of preschool children aged 22–70 months and their caregivers in an urban and rural population using the early childhood oral health impact scale. The study was conducted on children of the Rangareddy district, Telangana state, aged between 22 –70 months affected by early childhood caries and their parents/guardians. The subjects were given a questionnaire to measure the early childhood oral health impact scale, and the filled questionnaires were analyzed and tabulated. The mean early childhood oral health impact scale and domain scores for the rural population were significantly higher than that of the urban population signifying a more mediocre quality of life. There was a weak positive and insignificant relationship between early childhood caries and the early childhood oral health impact scale in the rural population, whereas there was a moderately strong, significant positive relationship between the two in the urban population. Oral health-related quality of life of young children enables parents and caregivers to implement positive dental care practices.

Background: Systemic disorder like diabetes mellitus is on the rise in developing countries like India and in many parts of the world. Early diagnosis of this disease will help to prevent the complications due to uncontrolled diabetes mellitus. Dentist helps in the early diagnosis of this disease as patients manifest several oral manifestations. Aims and Objectives: The aim of this study was to study the cytological and cytomorphometric changes of exfoliated cells of oral mucosa in diabetic patients. Materials and Methods: Thirty diabetic patients and 15 healthy controls were included in the study. From the buccal mucosa, smears were collected and Papanicolaou stain was used for staining. Cytological and cytomorphometric study was carried out. The cell diameter and nuclear diameter were measured on these smears and were compared with the control group with the help of “unpaired Student t test.” Results: Buccal mucosa exfoliated cells’ mean nuclear diameter of diabetic group and control group was 11.198 and 9.494 µm, respectively and the difference was highly significant. Conclusion: Our study suggests significant cellular changes in the diabetic patients, which may aid us in early detection of diabetes.

The aim of the study is to assess the hematological profile in oral submucous fibrosis (OSMF) patients.The study's participants (100) were divided into two groups. Group I consisted of fifty areca nut chewers with complaints of burning sensations, blanching, and stiffness of the oral mucosa. Group II consisted of fifty healthy patients as controls. A hematological profile was estimated in all subjects.The control group had a mean hemoglobin (Hb) of 13.87±1.26 g/dL, while the OSMF group had a mean Hb of 11.03±2.16 g/dL (P=0.001). The mean serum iron level in the control group was 120.36±41.22 g/dL, while it was 44.97±13.45 g/dL in the OSMF group (P=0.001). The control group's mean serum vitamin B12 values were 424.77±110.95 g/dL, while the OSMF group's was 210.11±44.88 g/dL (P=0.001). In the research population, 47 patients had iron deficiency. The odds ratio (OR) was 28.11, which meant that the high prevalence of iron deficiency was predicted 28.11 times more often than in the control group.As part of a biochemical assessment, iron status is assessed as part of a prevention mechanism for people who are at high risk. Biochemical testing has been suggested as a potential tool for mass screening OSMF patients.

Background: Though various biological markers are available for improving the diagnostic accuracy early detection of disease progression remains a challenging task mainly due to lack of adequate early prognostic marker. Aim and Objectives: To evaluate the immunohistochemical expression of MUC4 in oral epithelial dysplasia and to compare the immuno histochemical expression of MUC4 in Oral Epithelia Dysplasia (OED) and its expression in the normal tissue specimens. Materials and Methods: The present retrospective study was undertaken to compare and evaluate the expression of MUC4 in oral epithelial dysplasia and normal. The study comprised of 45 cases of oral epithelial dysplasia and 10 controls. Control specimens were obtained from healthy oral mucosa of individuals undergoing oral surgery for disimpaction of third molars and orthodontic extractions. Serial sections of 3-4 microns thickness were made from the tissue blocks and were stained using immunohistochemical marker MUC4, using an immunoperoxidase technique (ABC method). The semi quantitative analysis of the stained sections was done by light microscopy according to the Immunoreactive Score (IRS) by Remmele and Stegner which evaluated percentage of positive cells and the staining intensity. Results: Less than 10% of positive cells were seen in 9 cases of mild dysplasia out of 15 cases and 3 cases showed 10 to 50% of positive cells. Whereas less than 10% of positive cells were seen in 6 cases of moderate dysplasia out of 15 cases and other 9 cases showed 16% and 42% of positive cells respectively. However, in severe dysplasia positive cells percentage increased to 10 to 50% in 10 cases and other cases showed less than 10% respectively. Conclusion: In the OED group a gradual increase in the staining pattern was observed from mild to moderate to severe dysplasia. Severe dysplasia cases exhibited the staining of entire thickness of epithelium. Thus, it may be concluded that MUC4 plays a very important role and can be reckoned as a handy tool or marker for diagnosis of OED.

Background: Garlic has been recommended by many ancient medicines such as the Chinese and the Indian medicine to cure respiratory and digestive issues along with treating microbial infestation and leprosy. The therapeutic effects encompass many advantages in the field of cardiovascular system, antibiotics, anticancer, anti-inflammatory, and hormone-like effects. Aims and Objective: The present study was carried out to evaluate the garlic antibacterial effect against clinical isolates of Staphylococcus aureus, Escherichia coli, and Pneumoniae from patients attending referral hospital. Materials and Methods: The isolation of bacteria was done from pus sample collected from referral hospital, Bedar, Karnataka, with sterile swabs. The study samples were inoculated under aseptic conditions on culture media such as nutrient agar, blood agar, and MacConkey agar plates and isolated the pathogen bacteria such as E. coli, Klebsiella pneumoniae, and S. aureus. The garlic bulbs were peeled off and then ligated using pestle simultaneously with addition of minor quantity of H2O for preparation of plant extract and study the antimicrobial effect of garlic on these bacteria. Results: The result showed that garlic extracts have a high range of antibacterial effect against both Gram-negative (E. coli and K. pneumoniae) and Gram-positive bacteria Staphylococcus. Conclusion: The present study observations revealed that garlic makes large clear zones in comparison to the currently available antibiotics used in the study. The potentiality of the garlic can be utilized in the field of antibacterial agents. It can be prepared in the form of tablets in the best concentrations and affordable dosages so that it can be used as medicine against these pathogenic organisms.

Background: Bidi smoking is a serious health hazard which is common throughout South Asia and parts of the Middle East. It has been strongly implicated to various benign and malignant lesions of oral cavity and oropharynx. These tobacco-filled leaves deliver more than three times the amount of nicotine, carbon monoxide, and tar as cigarettes which exert injurious effects on cells reflected in terms of accelerated proliferative activity in normal oral mucosal cells. Aim: This study aimed to compare the exfoliated cells from the oral mucosa of bidi smokers and nonsmokers, with emphasis on proliferative activity. Materials and Methods: Exfoliative smears were obtained from the oral mucosa of forty participants (twenty nonsmokers and twenty smokers) with age group ranging from 30-80 years, in and around Barwala (Haryana). The cytologic smears were evaluated using Papanicolaou (PAP) stain and AgNOR in order to evaluate the presence of cytological alterations suggestive of inflammation, dysplasia, keratinization, and proliferative activity of epithelial cells. Only PAP Class I and Class II smears were observed. Results: Comparison of the mean number of AgNORs showed a significant difference between nonsmokers and smokers. Inflammatory alterations were found in 70% of smokers and 55% of nonsmokers. A significant difference in proliferative activity was observed between smokers and nonsmokers classified as PAP Class II. Conclusion: A significant difference of AgNORs/nucleus was observed between bidi smokers and nonsmokers.

Aim The aim of present study was to assess the role of E-cadherin in oral carcinogenesis by comparing their expressions in normal oral mucosa, oral epithelial dysplasia (OED), and oral squamous cell carcinoma (OSCC). Materials and methods To elucidate the pattern of E-cadherin expression in oral carcinogenesis, 21 archival cases of formalin-fixed paraffin-embedded sections of OSCC, 21 OED, and 7 normal oral mucosa samples as control were used for the study. Results We observed reduction/loss of E-cadherin in membranous expression pattern and staining intensity with progression from dysplasia to oral cancer. Conclusion A decrease in staining intensity and loss of E-cadherin membranous expression were noted from dysplasia to carcinoma, suggesting its role as a tumor suppressor gene. Clinical significance E-cadherin can be used as a biomarker to assess and evaluate the progression and prognosis of oral dysplastic lesions and OSCC.

Context: Cheiloscopy and dactyloscopy, both are well-established forensic tools used in individual identification in any scenario be it a crime scene or civil cause. Like finger prints, lip prints are unique and distinguishable for every individual. But their relationship to personality types has not been established excepting the hypothesis stating that finger prints could explain these personality patterns. Aims: The study was aimed to record and correlate the lip and finger prints with that of character/personality of a person. Settings and Design: The lip and finger prints and character of a person were recorded and the data obtained was subjected for statistical analysis, especially for Pearson's Chi-square test and correlation/association between the groups was also studied. Materials and Methods: The study sample comprised of 200 subjects, 100 males and 100 females, aged between 18 and 30 years. For recording lip prints, brown/pink-colored lipstick was applied on the lips and the subjects were asked to spread uniformly over the lips. Lip prints were traced in the normal rest position on a plain white bond paper. For recording the finger prints, imprints of the fingers were taken on a plain white bond paper using ink pad. The collected prints were visualized using magnifying lens. To record the character of person, a pro forma manual for multivariable personality inventory by Dr. BC Muthayya was used. Statistical Analysis Used: Data obtained was subjected for statistical analysis, especially for Pearson's Chi-square test and correlation/association between the groups was also studied. Results: In males, predominant lip pattern recorded was Type I with whorls-type finger pattern and the character being ego ideal, pessimism, introvert, and dogmatic; whereas in females, predominant lip pattern recorded was Type II with loops-type finger pattern and the character being neurotic, need achievers, and dominant. Conclusion: Many studies on lip pattern, finger pattern, palatal rugae, etc., for individual identification and gender determination exist, but correlative studies are scanty. This is the first study done on correlating patterns, that is, lip and finger pattern with the character of a person. With this study we conclude that this correlation can be used as an adjunct in the investigatory process in forensic sciences.

Lesions in the floor of the mouth pose a challengin g situation both clinically & surgically because th is area exhibits tightly netted vital structures. Any infection/lesi on could lead to its spread to mediastinum making t he surgeons treatments modalities difficult. The lesion in this region ranges from most benign ranula to sinister carcinomas. Ranula is type of mucocele occurring in the lateral side of the floor of the mouth which is closely re lated to vital structures like the sublingual gland & lingual nerv e. The terminology ranula represents the swelling w hich resembles a frog’s translucent underbelly. Ranulas are characteristically large, appears as translucen t bluish fluctuant dome shaped swelling. While diagnosing, careful dif ferential diagnosis should be carried out to rule o ut the other lesions occurring in the floor of the mouth like th e lipoma, dermoid cyst, abscess, salivary gland les ions and vascular lesions. This paper highlights the clinical paramet ers, radiographic methods helping in differential d iagnosis of ranula & treatment options available. Here we prese nt a case of ranula occurring in lateral of floor o f the mouth & its successful treatment by excision of the lesion.

Background: Recently, oral and maxillofacial surgeons are favoring three-dimensional (3D) miniplates to treat mandibular fractures. Aims: The aim of the study is to evaluate the efficacy of 3D-miniplates over standard miniplates in the management of mandibular parasymphysis fracture. Materials and Methods: Forty patients with mandibular parasymphysis fractures were divided into two groups of 20 patients each. Group I patients underwent osteosynthesis of mandibular fracture by noncompression, unicortical, and stainless steel 3D miniplates, and Group II patients underwent osteosynthesis by noncompression, unicortical, and stainless steel Champy's miniplates. All the patients were followed up 6 months’ postoperatively, evaluating occlusion, mobility of fracture segment, pain, wound dehiscence, neurological deficit, and infection. Statistical Analysis Used: The data were analyzed by SPSS for windows (version 17) statistical package (SPSS Inc., Chicago, IL, USA). Chi-square test was carried out to determine the statistical difference between the groups. Results: Mobility of the fractured site was evaluated postoperatively after 2 weeks, and it was found that mobility was absent in all the cases of Group I and 36 (80%) cases in Group II. There was significant difference in the mean visual analog scale scores among the Group I and II when compared from preoperative to 4-week follow-up. In Group II, two patients showed wound dehiscence. After 2 weeks, infection was seen in two patients of Group II. Conclusion: 3D plates in mandibular parasymphysis fractures give dimensional stability and carry low morbidity and infection rates.

Background: Clinical scenarios of oral potentially malignant disorders (OPMDs) and oral squamous cell carcinoma (OSCC) vary between geographical districts within the same country. This could be attributed to common habits and other cultural factors, such as excessive consumption of tobacco products, leading to higher prevalence of tobacco-related lesions of the oral cavity. A better understanding of their pattern and behavior in each particular region may help in devising strategies for prevention and treatment. Aims and Objectives: The aim of the study is to assess the epidemiological profile and clinical characteristics of OPMD and OSCC among population in and around Bidar and Gulbarga districts of Karnataka, India. Materials and Methods: This was a retrospective, chart review study in the districts of Bidar and Gulbarga, Karnataka, India. Medical records of patients with clinical and histopathological diagnosis of OPMD or OSCC who attended a private dental school in Bidar and 20 private dental clinics in the districts of Bidar and Gulbarga between 2010 and 2017 were included in the study. Collected data were analyzed using Statistical Package Social Sciences software, version 20.0. Results: There were a total of 630 patients, with males representing 69.52% (n = 438; ratio of 2.28:1) of cases and mean age of 42.64 years. 375 (59.52%) patients had a diagnosis of OPMD with the most common subtype of oral submucous fibrosis (185/375; 49.33%) followed by leukoplakia (110/375; 29.33%) and lichen planus (80/375; 21.33%). Buccal mucosa was the most commonly affected site (33.01%). Of 630 patients, 255 (40.48%) had OSCC, with tongue being the most common site (36.86%). Conclusion: This study revealed for the first time that OPMD and OSCC are widespread in the districts of Bidar and Gulbarga. The available knowledge on the prevalence of these lesions could help in educating patients and implementing preventive measures by health-care providers to improve overall survival. Long-term follow-up studies are needed to better understand the disease pattern.

Introduction: White, non scrapable lesions are commonly seen in the oral cavity. Based on their history and clinical appearance, most of these lesions can be easily diagnosed, but sometimes diagnosis may go wrong. In order to arrive to a confirmative diagnosis, histopathological assessment is needed in many cases, if not all. Aims: 1) To find out the prevalence of clinically diagnosed oral white, non scrapable lesions. 2) To find out the prevalence of histopathologically diagnosed oral white, non scrapable lesions. 3) To correlate the clinical and histopathological diagnosis in the above lesions. Materials and Methods: A total of 100 cases of oral white, non scrapable lesions were included in the study. Based on their history and clinical presentation, clinical provisional diagnosis was made. Then biopsy was done and confirmatory histopathological diagnosis was given and both were correlated. In order to correlate clinical and histopathological diagnosis Discrepancy Index (DI) was calculated for all the cases. Results: Based on clinical diagnosis, there were 59 cases (59%) of leukoplakia, 29 cases (29%) of lichen planus and six cases (6%) of lichenoid reaction; whereas, based on histopathological diagnosis, there were 66 cases (66%) of leukoplakia epithelial hyperplasia and hyperkeratosis (leukoplakia) and 30 cases (30%) of lichen planus. Seventy eight clinically diagnosed cases (78%) correlated with the histopathological diagnosis and 22 cases (22%) did not correlate. The total discrepancy index was 22%. Conclusion: A clinician needs to be aware of oral white, non scrapable lesions. Due to the overlapping of many clinical features in some of these lesions and also due to their malignant potential, a histopathological confirmative diagnosis is recommended.

The term nevi constitute a hamartomatous growth of either skin or mucosa that is generally found at birth or shortly after birth. An epidermal nevus consisting chiefly of sebaceous glands is called as nevus sebaceous. Typically this entity is seen as a solitary bald patch over the scalp at birth. We report a case of exophytic lesion following blaschko’s lines at birth. We find this case as peculiar because of the multiplicity of lesions, their pattern of distribution, as well as their atypical morphology.

Leukoplakias are oral white lesions that have not been diagnosed as any other specific disease. They are grouped under premalignant lesions, now redesignated as potentially malignant disorders. Their significance lies in the fact that they have propensity for malignant transformation at a higher rate when compared to other oral lesions. This article reviews aetiology, epidemiology, clinical characteristics, histopathologic features, malignant potential and treatment of oral leukoplakia.