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Aims: To determine demographic details, clinical profile, and underlying causes of limbal stem cell deficiency. Settings and Design: Descriptive cross-sectional study. Methods and Material: Patients visiting tertiary referral hospitals between January 2019 and December 2022 who satisfy the criteria for labeling limbal stem cell deficiency (LSCD) were enrolled. Parameters such as age, gender, region, duration, aetiology, and clinical features were noted. Descriptive statistics was applied. The student t-test was used. Results: A total of 731 eyes of 489 patients with LSCD were included in our study, with age ranging from 5 to 85 years (35.0 ± 19.4 years). The most common presenting complaints were a decrease in vision 473 (96.7%), most of them 342 (69.7%) are having history of gradual progression (>3 months), and 245 (50.1%) have bilateral involvement of eyes. Average corneal clarity was found to be grade 1.6 ± 1.2 and average corneal superficial neovascularization was found to be 7.9 ± 4.3 quadrants. Clinically, we found LSCD of about up to 90° in 57 eyes, 90 to 180° in 71 eyes, 215 eyes with 180 to 270°, and the rest of 388 eyes were having more than 270° of LSCD involvement. Out of 489 patients, 142 (29.0%) patients were of chemical injury, 125 (25.6%) patients were of Steven Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN), followed by 61 (12.5%) patients of vernal keratoconjunctivitis (VKC). Conclusions: The majority of patients were young males presented with more than 270° LSCD and vision <2/60. In our study, chemical injury was most common in unilateral LSCD and SJS/TEN in bilateral LSCD. [ABSTRACT FROM AUTHOR]

The pediatric age group with massive hydrocephalus posted for ventriculoperitoneal (VP) shunt presents a lot of confrontation to anesthesiologists due to macrocephalus and associated congenital anomalies. Here, we presented a case report with massive hydrocephalus with aqueduct stenosis, posted for VP shunt placement, and retained a difficult airway. [ABSTRACT FROM AUTHOR]

Purpose: To determine the demography, risk factors, and causative organisms of microbial keratitis (MK) in Bihar, an eastern state of India. Design: Retrospective study. Methods: We reviewed the demographic, clinical, and microbiological data of 2303 patients with MK (non-viral) presenting between January 2019 and December 2022. Results: This study revealed a predominance of males (65.0%) compared to females (34.9%), with a mean age of 48.4 ± 16.5 years. The majority of patients (63.1%) presented after 2 weeks from the onset of symptoms. The most common risk factor observed was corneal injury (58.1%), followed by ocular surface diseases (13.6%) and diabetes mellitus (13.3%). The majority of patients (73.16%) were involved in agriculture. Prior to presentation, almost all patients (92%) had received topical antibiotics. Unsupervised use of topical corticosteroids was observed in 29.2% of the patients for the median duration of 3 days (odds ratio, 0.17). At presentation, the median size of corneal ulcers was 5 mm, the best-corrected visual acuity was less than 20/400 in 51.4% of patients, and corneal perforation was in 14% of patients. The smear and culture positivity rate were 75.4% and 47.9%, respectively. The common causative organism was fungus (48.8%), followed by bacteria (17.4%). Aspergillus spp. and Staphylococcus spp. were the most commonly identified organisms; a quarter of the patients (24.5%) remained unidentified. All bacteria showed good sensitivity to vancomycin. Conclusion: MK is a significant cause of ocular morbidity in Bihar. The knowledge of epidemiology, risk factors, and microbiological profiles of MK can provide a valuable approach to disease prevention, diagnosis, and management. [ABSTRACT FROM AUTHOR]

Background: This randomized controlled trial aimed to assess and compare postoperative swelling and pain in patients undergoing alveolar ridge preservation using RidgeMax Pro and AlveoGraft Plus. Methods: A total of 20 patients requiring tooth extraction were enrolled in this study and randomly assigned to two groups: Group A received alveolar ridge preservation with RidgeMax Pro and Group B with AlveoGraft Plus. Postoperative swelling was evaluated by measuring facial dimensions using standardized facial photographs at baseline and at 24, 48, and 72 hours postoperatively. Pain was assessed using a visual analog scale (VAS) at the same time points. Statistical analysis was performed using t-tests and repeated measures ANOVA. Results: Both RidgeMax Pro and AlveoGraft Plus demonstrated effective alveolar ridge preservation without any reported complications. In terms of postoperative swelling, Group A (RidgeMax Pro) exhibited significantly lower facial swelling compared to Group B (AlveoGraft Plus) at all time points (P < 0.05). The mean pain scores on the VAS were consistently lower in Group A than in Group B across the assessment time points (P < 0.05). The trend of reduced swelling and pain in Group A persisted throughout the 72-hour follow-up period. Conclusion: Alveolar ridge preservation with RidgeMax Pro (Trade Name: RidgeMax Pro) resulted in significantly reduced postoperative swelling and pain compared to AlveoGraft Plus (Trade Name: AlveoGraft Plus). [ABSTRACT FROM AUTHOR]

Background: Secretory carcinoma (SC) is a newly described entity which has been often misdiagnosed earlier as acinic cell carcinoma on cytology. Diagnosing SC was initially based upon identifying the ETV6:NTRK3 fusion gene with the help of fluorescence in situ hybridization (FISH). Lately, with more knowledge of the reliable histomorphology, cytology, and immunohistochemistry features, definitive diagnosis can be confidently made without the help of FISH in almost every case. Materials and Methods: Six histologically confirmed cases of SC were studied. The cytology slides of all the six cases were retrieved and reviewed to identify the characteristic features which could have helped in raising the possibility of SC on fine needle aspiration cytology itself. Cell blocks were also studied, wherever available. Results: Patients were all male with average age of 35.2 years. The six cases in the current study demonstrated at least focal cytoplasmic vacuolization of varying sizes, papillae formations, and bland nuclear features on fine needle aspirate smears. It was also seen that S-100 and mammaglobin immunohistochemistry (IHC) are very helpful in confirming the diagnosis. Conclusions: The results of the current study highlight the cytomorphological features which may help in clinching the diagnosis SC on cytology itself. They also highlight certain cytological features which help to rule out the other differential diagnoses. [ABSTRACT FROM AUTHOR]

Aim: Chewable toothbrushes were compared to traditional manual toothbrushes in terms of their ability to remove plaque and their impact on salivary pH in a sample of school-aged children. Materials and Methods: The sample size for this research was 200 youngsters aged 10-12. Saliva was collected by spitting into a clean container, and the pH levels were measured using color-coded pH strips to determine where the person was starting from. The plaque score was measured using the OHI-S index after the application of the disclosing agent. The pH and plaque scores were also recalculated after brushing to see how they had changed after surgery. Results: Results indicated that both manual and chewable brushes significantly improved post-brushing pH ratings (P = 0.001), and that plaque scores decreased (P = 0.001). When compared to conventional manual toothbrushes, the chewable brush was much more successful in reducing plaque and elevating salivary pH (P = 0.001). Conclusion: As a result, parents may offer their kids a chewable toothbrush to help them maintain good oral hygiene after lunch and on lengthy car trips, when they would not have time to wash their teeth properly. [ABSTRACT FROM AUTHOR]

Background: Forensic identifications have utilized the height or stature of an individual in their field. Teeth and dentition can act as reliable tools to estimate the stature in cases where the only skull is presented as evidence. The Carrea's index assesses the stature in a subject from the lower anterior teeth dimensions. Aim: The present study was aimed to judge the reliability of Carrea's index in Indian subjects. Materials and Methods: From 80 subjects who were undergraduate students, plaster models were made and each was assessed individually making 160 hemiarches. These hemiarches were divided based on the teeth alignment into normal, diastema, and crowded forms. This was followed by measurement with a vernier caliper into chord and arch. Results: In both genders, the difference seen was statistically significant between dental arch types concerning various alignments with 95.23% and 83.75% success for males and females in normal dentition and 92.30% and 85.71% in crowded dentition. Also, a significant difference was seen for the type of arch with P ≤ 0.001 and 0.003, respectively. Lesser success was seen for spacing in both the genders and arches. Conclusion: The present study concludes that Carrea's index is a dependable and efficient tool for estimating height in subjects having arches with crowded and normal dentition which is functional for both the gender on the left and right side of the dental arches. However, in hemiarches with diastema, this method is not reliable. [ABSTRACT FROM AUTHOR]

Purpose: The objective of the study was to compare the efficacy and safety of two concentration of autologous serum (AS) 20% vs 50% in recalcitrant moderate‑to‑severe dry eye patients. Methods: A double‑blind prospective, interventional, and randomized study was done on 44 patients (80 eyes) clinically diagnosed with moderate‑to‑severe dry eye disease (DED) that was refractory to conventional treatment, and all patients were treated with AS20% or AS50% for 12 weeks. We documented Ocular Surface Disease Index (OSDI), tear film breakup time (TBUT), OXFORD corneal staining score (OSS), and Schirmer test (ST) at baseline, 2,4,8, and 12 weeks. These parameters were compared in both groups and between the groups by using Student’s t‑test. The study included 11 males and 33 females. Results: Out of 80 eyes, 33 eyes had moderate and 47 had severe DED. The age of patients in AS20% was 44.73 ± 14.37 years, and in AS50% was 46.41 ± 14.47 years. The most common etiology associated with DED was secondary Sjogren syndrome. In moderate DED, both the groups showed significant improvement in both subjective and objective parameters. But in severe DED, the AS20% group failed to show any significant improvement objectively, though subjective improvement was present. Conclusion: In refractory severe DED patients, AS50% is better option for treatment and in moderate DED both concentrations of autologous serum are effective. [ABSTRACT FROM AUTHOR]

Background: Iris cyst can lead to iridocyclitis, angle closure, secondary glaucoma, corneal decompensation, band keratopathy, cataract, subluxation of the lens, or visual disturbance leading to amblyopia or strabismus. Incomplete removal of cyst can lead to recurrence. Recurrent surgeries are more complicated and compromise prognosis. So, complete removal of cyst with minimal anatomical disturbances is essential for better outcomes. Purpose: To define a new technique of triple treatment therapy for iris cyst management. Synopsis: Iris cyst was treated in three steps. In the first step, iris cyst aspiration followed by cyst cavity treatment with mitomycin-C was done. After that, cyst cavity was irrigated with balanced salt solution (BSS). In the second step, the anterior cyst wall was removed with a vitrectomy cutter. In the third step, the posterior cyst wall was cauterized with diathermy. Highlights: In this technique, we chose a minimally invasive approach utilizing two 1-mm incisions leading to less astigmatism. Iridectomy was not performed, which led to a small iris defect postoperatively, and pupilloplasty was not required. Injection of mitomycin-C led to destruction of the cyst wall, and diathermy further reduced the chance of recurrence by destroying the cyst base. Postoperatively, mild corneal edema was noted, which resolved in 1 week. Topical steroids were given to control postoperative inflammation. No recurrence has been noted till 6 months of follow-up. The more conservative approach seemed to result in better visual outcomes. Discussion: Wide varieties of approaches are available for iris cysts, like laser cystotomy, aspiration, diathermy, cryotherapy, injection of sclerosing agents, and surgery.[ 1 ] Yu et al.[ 2 ] treated iris cyst in a 60-year-old female with cyst content aspiration using 30G needle, followed by injection of 0.0002 mg/ml mitomycin-C in the cavity for 5 min. BSS wash was given five times at the end. They noted a decrease of 13.3% in endothelial cell count following the procedure. They speculate that transient application of MMC can cause permanent damage to the epithelial and goblet cells that secrete cyst fluid, hence resulting in regression of the cyst. Similarly, Kawaguchi et al.[ 3 ] aspirated cyst fluid with a 30G needle and left 0.3 ml of 10−3 mg/ml mitomycin-C for 5 min in the cavity, followed by BSS wash in a 32-year-old female with recurrent iris cyst. They reported a decrease of 4% in endothelial cell count postprocedure. Shen et al.[ 4 ] used micro diathermy to treat residual cyst wall attached to the endothelium and base of cyst in four cases. In our case, we have combined cyst aspiration, mitomycin-C, excision using vitrectomy cutter, and diathermy. No recurrence has been observed at the longest follow-up of 3 years. However, a small sample size and less duration of follow-up are the limitations to call it the best approach. Video Link: https://youtu.be/EC6WA2TiaAE [ABSTRACT FROM AUTHOR]

Background: To endure the orthodontic forces used throughout treatment, the bond strength of bonded orthodontic brackets must be enough with assessment of shear bond strength when bonding orthodontic brackets with various adhesives. Materials and Methods: Overall, forty extracted premolars due to orthodontic treatment were included. They were split into four equal cohorts with various primers. With both adhesives, shear bond strength had been assessed with and without salivary contamination. SPSS software was used to assess the outcomes. Consideration was given to statistical significance of P value of less than 0.05. Results: Several groups' average bond strengths in MPa were assessed in both dry and contaminated saliva conditions. When it was dry, Transbond Plus demonstrated greater shear bond strength. Conclusion: Hydrophilic Transbond Plus resin outperformed hydrophobic Transbond XT resin in terms of shear bond strength under both situations. [ABSTRACT FROM AUTHOR]

A case study of 13-year-old female child born of non-consanguineous marriage presented to the dermatology outpatient services with dark-red discolouration over the face. Topics include Cutaneous examination revealed reddish-blue hyperpigmentation over the bilateral cheek and periocular region; and multiple linear and dotted vessels with an additional detection of homogenous greyish-black pigmentary area.

Background: Endobronchial ultrasound (EBUS)-guided fine-needle aspiration cytology (FNAC) is recommended for diagnosing bronchial neoplasms and evaluating mediastinal lymph nodes. However, it may not be possible to subtype or definitely categorize many bronchial neoplasms on FNAC smears alone. Obtaining adequate diagnostic material is often a problem. In such cases, cell blocks made from FNAC material may serve as a useful adjunct. Aim: To study the value and limitations of cell blocks in adding diagnostic information to EBUS guided FNAC smears. Material and Methods: One hundred and eighty-five cases of EBUS guided FNAC having concomitant cell blocks were reviewed. The cases were evaluated for the extent of adequacy, of definite benign/malignant categorization and of definite subtyping in malignant tumors in these cases. The proportion of cases in which cell blocks added information to FNAC smears alone for the above parameters were calculated. Results: Cell blocks provided additional information in 31 out of 185 cases. Cell blocks were necessary for subtyping 24/59 malignant tumors, definite categorization into benign and malignant in 10/140 adequate samples, and increasing adequacy in 6/185 total samples. A total of 45 samples were inadequate in spite of adding information from cell blocks to smears. Conclusion: Cell blocks added clinically significant information to EBUS guided FNAC and should be used routinely. To make it more useful, alternative methods of cell block preparation (including proprietary methods) may be evaluated. [ABSTRACT FROM AUTHOR]

With substantial improvement in survival in cancer patients, the risk of radiation-induced malignancy in previously irradiated areas is increasingly possible. Both radiation-induced sarcomas and papillary thyroid carcinomas (PTCs) are well documented in literature. However, radiation-induced synchronous malignancies are rare, are often misdiagnosed, and presents with diagnostic and therapeutic challenges due to paucity of literature and lack of available guidelines. Here, we report a case of radiation-induced synchronous mandibular osteosarcoma and PTC in a previously treated carcinoma of base tongue with concurrent chemoradiation. He initially presented with an oral cavity mass, and during the course of the treatment was incidentally diagnosed with a synchronous PTC. It also establishes the indolent course of PTC, which often goes undiagnosed till the presentation with regional nodal metastasis. This report, to the best of our knowledge, is the first reported case of synchronous radiation-induced OSM and PTC. [ABSTRACT FROM AUTHOR]

Background: The practical solution to handle increasing awareness toward dental treatment and cost of the dental treatment is integration of dental auxiliary into dental healthcare delivery system, and hence the objective of this study was to assess the perception of dental professionals regarding integration of dental auxiliaries into dental health delivery system in India. Materials and Methods: This cross-sectional study of Indian dentists was conducted using self-administered closed-ended questionnaire. Questions were asked to assess the opinions of the dentists on expanding the roles of dental auxiliaries and its consequences on dental services. The data were analyzed using Statistical Package for the Social Sciences version 22.0. The level of significance was kept at P < 0.05. Results: Of 230 dentists who participated in the study, 155 (67.39%) reported unfavorable opinion toward expanded duty dental auxiliaries. Among the studied consequences of expanding the functions of dental auxiliaries, cost-effectiveness of treatment had the highest mean score, followed by redundancy of dentists. Undergraduates reported that expanded function dental auxiliaries would lead to redundancy of dentists. Conclusion: It is recommended to train the auxiliaries to meet the expectations of patients, but this should be considered keeping in mind the existing situation of dental professionals in the country. Nonetheless, this study gives us information necessary to tailor health policies and improve the standards of the existing oral healthcare delivery in India. [ABSTRACT FROM AUTHOR]