DocumentsDate added
Review article
Navnita Singh1*,S. Savita2,K. Rithesh3,Shilpa Shivanand1
1Post Graduate Student, Department of Periodontology, Rajarajeshwari Dental College and Hospital, Bangalore, India
2Professor and HOD, Department of Periodontology, Rajarajeshwari Dental College and Hospital, Bangalore, India
3Reader, Department of Periodontology, Rajarajeshwari Dental College and Hospital, Bangalore, India
Address reprint requests to
*Dr Navnita Singh, Post Graduate Student, Department of Periodontology, Rajarajeshwari Dental College and Hospital, #14, Ramohalli Cross, Kumbalgodu, Mysore Road, Bangalore, 560074, India
Article citation: Singh N, Savita S, Rithesh K, Shivanand S. Phytotherapy: a novel approach for treating periodontal disease. J Pharm Biomed Sci 2016;06(03):205–210.Available at www.jpbms.info
ABSTRACT
Over the years, periodontal therapy has been influenced by the trends of the times, and consequently treatment approaches have been modified. Our understanding of the etiology and diagnosis of the periodontal diseases is continuously evolving. Periodontitis caused by various microorganisms is often treated with common antibiotics. But antibiotic resistance is a growing problem. Thus, the global need for an alternative prevention and treatment options arises which is safe, effective and economical. So, researchers are in pursuit for new therapeutic agents from natural sources. There is a long and venerable history of the use of plants to improve dental health and promote oral hygiene. Plants contain phytochemicals such as alkaloids, tannins, essential oils and flavonoids which have pronounced antimicrobial activity. Because of its good antimicrobial activity and safety profile, it proves its use in the treatment of periodontal diseases. This suggests a potentially valuable role for phytotherapy in assisting with the management of this serious disease. The evidence and research which supports such a role for plants (or plant products) are reviewed in this study.
KEYWORDS periodontitis, antibiotic resistance, plant extracts
REFERENCES
1. Praveen NC, Rajesh A, Madan M, Chaurasia VR, Hiremath NV,Sharma AM. Antibacterial efficacy of pineapple extract on periodontal pathogens. J Int Oral Health. 2014;6(5):96–98.
2.Palombo EA. Traditional medicinal plant extracts and natural products with activity against oral bacteria: potential application in the prevention and treatment of oral diseases. Evid Based Complement Alternat Med. 2009;10:1–15.
3.http://www.scienceinafrica.co.za/2004/june/phytotherapy.htm
4.Moeintaghavi A. Berberine gel in periodontal inflammation:clinical and histological effects. J Periodontol Implant Dent.2012;4(1):7–11.
5.Cohan RP, Jacobsen PL. Herbal supplements: considerations in dental practice. J Calif Dent Assoc. 2000;28:600–610.
6.Kerry B. Phytotherapy for periodontal disease and improved oral hygiene. Phytother Rev Comm. 2005;54:1–5.
7.Kaweckyj N. Eastern medicine meets dentistry: the use of herbal supplements in dentistry today. American Dental Assistants Association; 2006. p. 19.
8.Kelly K. History of Medicine. New York: Facts on file; 2009.pp. 29–50.
9.Tucakov J. Healing with plants: phytotherapy. Beograd: Culture;1971. pp. 180–190.
10.Glesinger L. Medicine through centuries. Zagreb: Zora; 1954.pp. 21–38.
11.Bojadzievski P. The health services in Bitola through the centuries. Bitola: Society of Science and Art; 1992. pp. 15–27.
12.Gorunovic M, Lukic P. Pharmacognosy. Beograd: Gorunovic M;2001. pp. 1–5.
13.Pelagic V. Pelagic folk teacher. Beograd: Freedom; 1970.pp.500–502.
14.Katic R. La medicine en Serbie au moyen age. Beograd: Scientific work; 1958. pp. 7–36.
15.Bazala V. The historical development of medicine in the Croatian lands. Zagreb: Croation publishing bibliographic institute; 1943.pp. 9–20.
16.Nikolovski B. Essays on the history of health culture in Macedonia.Skopje: Macedonian Pharmaceutical Association; 1995.pp. 17–27.
17.Tucakov J. Pharmacognosy. Beograd: Academic books; 1948.pp. 8–21.
18.Botelho MA, Filho JGB, Correa LL, Fonseca SG, Montenegro D,Gapski R, et al. Effect of novel essential mouth rinse without alchohol on gingivitis: a double blinded randomized controlled trial. J Appl Oral Sci. 2007;15:175–180.
19.Kalemba D, Kunicka A. Antibacterial and antifungal properties of essential oils. Curr Med Chem. 2000;10(10):813–829.
20.Labrecque J, Bodet C, Chandad F, Grenier D. Effects of a high-molecular-weight cranberry fraction on growth, biofilm formation and adherence of Porphyromonas gingivalis. J Antimicrob Chemother. 2006;58:439–443.
21.Yamanaka A, Kimizuka R, Kato T, Okuda K. Inhibitory effects of cranberry juice on attachment of oral streptococci and biofilm formation. Oral Microbiol Immunol. 2004;19(3):150–154.
22.Yamanaka A, Kouchi T, Kasai K, Kato T, Ishihara K, Okuda K.Inhibitory effect of cranberry polyphenol on biofilm formation and cysteine proteases of Porphyromonas gingivalis. J Periodont Res. 2007;42:589–592.
23.Fleming TF. Periodontitis. Ann Periodontal. 1999;4:32–37.
24.Pramod K, Shahid AH, Javed A. Herbal remedies for the treatment of periodontal disease - a patent review. Recent Patents on Drug Delivery & Formulation. 2009;3(1):221–228.
25.Slots J, Chen C. The oral micro flora and human periodontal disease. In: Tannock GW, (ed.): Medical Importance of the Normal Microflora. London: Kluwer Academic Publishers; 1999.pp.101–127.
26.Neelufar SS, Prasanna KR, Thamizhvanan K. Anti microbial evaluation of polyherbal extract in the treatment of periodontitis. Int J Phytother. 2014;4(1):27–31.
27.Gaetti-Jardim E, Landucci LF, Arafat OKK, Ranieri RV, Ramos MMB, Ciesielski FIN, et al. Antimicrobial activity of six plant extracts from the Brazilian Savanna on periodontal pathogens. Int J Odontostomat. 2011;5(3):249–256.
28. Bhat G, Kudva P, Dodwad V. Aloe vera: nature’s soothing healer to periodontal disease. J Ind Soc Periodontol. 2011;15(3):205–209.
29.Grindlay D, Reynolds T. The aloe vera phenomenon: a review of the properties and modern uses of leaf parenchyma gel.J Ethnopharmacol. 1986;16:117–151.
30.Mandeville FB. Aloe vera in the treatment of radiation ulcers of mucous menbranes. Radiology. 1939;32:598–599.
31.Poor MR, Hall JE, Poor AS. Reduction in the incidence of alveolar osteitis in patients treated with the salicept patch containing Acemannan hydrogel. J Oral Maxillofac Surg. 2002;60:374–379.
32.Sudworth R. The use of aloe vera in dentistry. Philadelphia:Positive Health Publications Ltd; 2002.
33.Hahn G. Garlic: the science and therapeutic application of Allium sativum L. and related species, 2nd ed. In: Koch HP,Lawson LD, (eds.): History, folk medicine and legendary uses of garlic. Baltimore: Williams and Wilkins; 1996. pp. 1–24.
34.Yilmaz HH, Gormez O, Hastar E, Yildirim D, Aksoy MC. Garlic burn in a patient with trigeminal neuralgia: a case report. Eur J Dent.2010;4(1):88–90.
35.Lawson LD. Garlic: the science and therapeutic application of Allium sativum L. and related species, 2nd ed. In: HP Koch, LD Lawson, (eds): The composition and chemistry of garlic cloves and processed garlic. Baltimore: Williams and Wilkins; 1996.pp. 38–39.
36.Darout IA, Albandar JM, Skaug N. Periodontal status of adult Sudanese habitual users of miswak chewing sticks or toothbrushes.Acta Odontol Scand. 2000;58(1):25–30.
37.Eid MA, Selim HA, ai-Shammery AR. The relationship between chewing sticks (Miswak) and periodontal health 3, relationship to gingival recession. Quintessence Int. 1991;22(1):61–64.
38.Cinco M, Banfi E, Tubaro A. A microbiological survey on the activity of a hydroalcoholic extract of chamomile. Int J Drug Res. 1983;21:145–151.
39.Aggag ME, Yousef RT. Study of antimicrobial activity of chamomile oil. Planta Med. 1972;22:140–144.
40.Isaac O. Pharmacological investigations with compounds of chamomile i. on the pharmacology of (-)-alpha-bisabolol and bisabolol oxides (review). Planta Med. 1979;35:118–124.
41.Isaac O, Thiemer K. Biochemical studies on chamomile components/III: in vitro studies about the antipeptic activity of (-)-alpha-bisabolol. Arzneimittelforschung. 1975;25:1352–1354.
42.Pereira SL, de Oliveira JW, Angelo KK, da Costa AM, Costa F.Clinical effect of a mouth rinse containing Ocimum gratissimum on plaque and gingivitis control. J Contemp Dent Pract.2011;12:350–355.
43.Gupta GD, Gaud RS. Anti-inflammatory activity of Tenoxicam gel on carrageenan induced paw oedema in rats. Indian J Pharm Sci. 2006;68:356–359.
44.Rajesh RH, Sudarshan NR, Rejeesh E, Jobin J, Narayana CR, Moidin S, Shashidhara R. Evaluation of the efficacy of 2% Ocimum sanctum gel in the treatment of experimental periodontitis. Int J Pharm Investig. 2015;5(1):35–42.
45.Chou CC, Lin LL, Chung KT. Antimicrobial activity of tea as affected by the degree of fermentation and manufacturing season. Int J Food Microbiol. 1999;48:125–130.
46.Yam TS, Shah S, Hamilton-Miller JM. Microbiological activity of whole and fractionated crude extracts of tea (Camellia sinensis) and of tea components. FEMS Microbiol Lett. 1997;152(11):169–174.
47.Melcher AH. On the repair potential of periodontal tissues.J Periodontol.1976;47:256–270.
48.Rhyu IC, Lee YM, Ku Y, Bae KW, Chung CP. The biologic effects of safflower extract and Dipsasi radix extract on periodontal ligament cells and osteoblastic cells. J Korean Acad Periodontol.1997;27:867–882.
49.Monika B, Jaya D, Dhan PT. Safflower seed extract in the treatment of human periodontal osseous defects. JIDA J Indian Dent Assoc. 2014;8(2):8–17.
50.Huh JS, Kang JH, Yoo YJ, Kim CS, Cho KS, Choi SH. The effect of safflower seed human periodontal ligament fibroblast and MC3T3-E1 cell in vitro. J Korean Acad Periodontol. 2001;31:833–846.
51.Jang HO, Eom HS, Roh SB, Yue I. Effect of extracts from safflower seeds on osteoblastic differentiation and intracellular free calcium concentration in MC3T3-E1 cells. Korean J Physiol Pharmacol. 2005;9:55–62.
52.Monagas M, Gomez-Cordoves C, Bartolome B, Laureano O. Ricardo da Silva JM. Monomeric, oligomeric, and polymeric flavan-3-ol composition of wines and grapes from Vitis vinifera L. cv. Graciano, Tempranillo, and Cabernet Sauvignon. J Agric Food Chem. 2003;51:6475–6481.
53.Ross JA, Kasum CM. Dietary flavonoids: bioavailability, metabolic effects, and safety. Annu Rev Nutr. 2002;22:19–34.
54.Pataki T, Bak I, Kovacs P, Bagchi D, Das DK, Tosaki A. Grape seed proanthocyanidins improved cardiac recovery during reperfusion after ischemia in isolated rat hearts. Am J Clin Nutr.2002;75:894–899.
55.Melhus H, Michaelsson K, Holmberg L, Wolk A, Ljunghall S.Smoking, antioxidant vitamins, and the risk of hip fracture.J Bone Miner Res. 1999;14:129–135.
56.Vasange M, Liu B, Welch CJ, Rolfsen W, Bohlin L. The flavonoid constituents of two Polypodium species (Calaguala) and their effect on the elastase release in human neutrophils. Planta Med.1997;63:511–517.
57.Holliday LS, Welgus HG, Fliszar CJ, Veith GM, Jeffrey JJ, Gluck SL.Initiation of osteoclast bone resorption by interstitial collagenase.J Biol Chem. 1997;272:22053–22058.
58.Pavan R, Jain S, Shraddha, Kumar A. Properties and therapeutic application of bromelain: a review. Biotechnol Res Int. 2012;2012:976203.
59.Cohen RP, Jaconson PL. Herbal supplements: considerations in dental practice. J California Den Assoc. 2000;28:600–601.
60.Jagan NR, Subhash KR, Sandeep KK. Role of phytotherapy in gingivitis. Int J Pharmacol. 2000;8(1):1–5.
Statement of originality of work: The manuscript has been read and approved by all the authors, the requirements for authorship have been met, and that each author believes that the manuscript represents honest and original work.
Sources of funding: None.
Competing interest / Conflict of interest: The author(s) have no competing interests for financial support, publication of this research, patents, and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Disclaimer: Any views expressed in this paper are those of the authors and do not reflect the official policy or position of the Department of Defense.
ORIGINAL ARTICLE
Shanmugasamy K1*,Bhavani K1,Anandraj Vaithy K1,Narashiman R2,Dhananjay S Kotasthane3
1 MD, Assistant Professor, Department of Pathology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidhyapeeth University, Puducherry, India
2 MD, Emeritus Professor, Department of Pathology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidhyapeeth University, Puducherry, India
3 MD, Professor and HOD, Department of Pathology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidhyapeeth University, Puducherry, India
Address reprint requests to
*Dr. Shanmugasamy K, MD, Assistant Professor, Department of Pathology, Mahatma Gandhi Medical College and Research Institute, SBV University,Pillaiyarkuppam, Puducherry, 607402, India
Article citation: Shanmugasamy K,Bhavani K, Vaithy AK, Narashiman R,Kotasthane DS. Clinical correlation of upper gastrointestinal endoscopic biopsies with histopathological findings and to study the histopathological profile of various neoplastic and non-neoplastic lesions.
J Pharm Biomed Sci 2016;06(03):220–224.Available at www.jpbms.info
ABSTRACT
Background The pathological conditions of upper gastrointestinal tract (GIT) are responsible for a wide range of morbidity and mortality and are also most commonly encountered disorder in routine clinical practice. Endoscopic visualisation helps in clinical diagnosis, however,it often warrants histopathological correlation of biopsy specimen for accurate final diagnosis.
Aim and Objectives To determine the profile of histopathological lesions of upper GIT and to correlate the various histopathological lesions of upper GIT with age, sex and clinical presentation.
Materials and Methods The study was conducted in the Department of Pathology in Mahatma Gandhi Medical College and Research Institute, Puducherry on 115 upper gastrointestinal
endoscopic biopsies during the period of 1 year from January 2014 to December 2014. Brief clinical data were documented. The biopsies were examined for various inflammatory and neoplastic lesions. The findings were then correlated with the clinical parameters.
Results and Conclusion Among 115 cases studied, non-neoplastic lesions were more common in gastrointestinal pathological lesions. The prevalence of gastrointestinal pathology is more common among males around the fourth and fifth decades of life. Dyspepsia and dysphagia were the most significant presenting clinical features. Helicobacter pylori association was demonstrable in nearly one-fourth of chronic gastritis cases. In gastric region, adenocarcinoma was the commonest neoplastic conditions, whereas in the oesophagus, squamous cell carcinoma is the predominant. In duodenum, inflammatory lesions are more common than malignancy.
KEYWORDS endoscopy, histopathology, chronic gastritis, adenocarcinoma
REFERENCES
1.Sheikh BA, Hamdani SM, Malik R. Histopathological spectrum of lesions of upper gastrointestinal tract: a study of endoscopic biopsies. Global J Med Public Health. 2015;4(4):1–8.
2.Duduyemi BM, Ojo BA, Olaomi OO, Atiba AS. Histopathological pattern of endoscopic gastric biopsy in a district hospital in Nigeria: a review of 118 consecutive cases. Am J Med Biol Res.2014;2(3):83–86.
3.Godkhindi VM, Meshram DP, Deshpande SA, Kadam PN, Chavan YH. The histopathological study of various gastro-duodenal lesions and their association with Helicobacter pylori infection.IOSR J Dent Med Sci (IOSR-JDMS). 2013;2(3):51–55.
4.Poudel A, Regmi S. Poudel S, Joshi P. Correlation between endoscopic and histopathological findings in gastric lesions. J Univ College Med Sci. 2013;1(3):37–41.
5.Hussain SI, Reshi R, Akhter G, Beigh A. Clinico histopathlogical study of upper gastrointestinal tract endoscopic biopsies. Int J Cur Res Rev. 2015;7(16):78–85.
6.Venugopal LS, Rao BS. Endoscopic biopsies of lower 1/3rd oesophagus and gastric lesions and its clinic-pathological correlation with Helicobacter pylori. IJRRMS. 2013;3(3):42–44.
7.Rashmi K, Horakerappa MS, Karar A, Mangala G. A study on histopathological spectrum of upper gastrointestinal tract endoscopic biopsies. Int J Med Res Health Sci. 2013;2(3):418–424.
8.Rumana M, Khan AR, Khurshid N. The changing pattern of oesophago-gastric cancer in Kashmir. JK Pract. 2005;12(4):189–192.
9.Marson BC, Dawson IMP. Gastrointestinal pathology, 2nd ed.London: Black Well Scientific Publications; 1998. pp. 148–151.
10.Mills SE, Carter D, Greenson JK, Oberman HA, Reuter V, Stoler MH. Sternberg’s diagnostic surgical pathology, 4th ed. Philadelphia: Lippincott Williams and Wilkins; 2004. pp. 1562–73.
Statement of originality of work: The manuscript has been read and approved by all the authors, the requirements for authorship have been met, and that each author believes that the manuscript represents honest and original work.
Sources of funding: None.
Competing interest / Conflict of interest: The author(s) have no competing interests for financial support, publication of this research, patents, and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Disclaimer: Any views expressed in this paper are those of the authors and do not reflect the official policy or position of the Department of Defense.
Original article
Gulab Kanwar1,Kshetrapal Singh Shekhawat2*,Shalini Rathore3,Kusum Bala Jain2
1MD, Professor and HOD, Department of Biochemistry, Government Medical College,Kota, Rajasthan, India
2PG Resident, Department of Biochemistry,Government Medical College, Kota,Rajasthan, India
3 MD, Goverment Jaipuria Hospital, Jaipur,Rajasthan, India
ABSTRACT
India is being called the diabetic capital of the world, with over 30 million diabetic individuals. Anthropometric parameters have evolved into reliable indicators for predicting the incidence of diabetes mellitus.
Materials and Methods A total of 100 patients collected from New Medical Hospital, Kota (Rajasthan), India. Weight, height, waist circumference (WC) and hip circumference were measured. Waist–hip ratio (WHR) was calculated. Samples were analysed on autoanalyser.
Results and Discussion In the present study, we found that the WHR is not significantly associated with lipid parameters in male patients except for TG and high-density lipoprotein (HDL). Non-significant correlation was obtained in female patients. Statistically negative significant correlation was found in serum for HDL between fifth and sixth decade of life. No significant correlation was found in any other age groups.
Summary and Conclusion WC and WHR are the important indicators of obesity and can be used to predict incidence of obesity in Indian population. Further broad study is advised.
Keywords lipid profile, waist–hip ratio, diabetes mellitus
References:
1.Powers AC. Diabetes mellitus in: Harrison’s principles of internal medicine,17th ed., In: Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, et al. (eds). New Delhi: Mc Graw Hill; 2008. p. 2275–3002.
2.Visscher TL, Kromhout D, Seidell JC. Long-term and recent time trends in the prevalence of obesity among Dutch men and women. Int J Obes Relat Metab Disord. 2002;26:1218–24.
3.Ho SC, Chen YM, Woo JL, Leung SS, Lam TH, Janus ED. Association between simple anthropometric indices and cardiovascular risk factors. Int J Obes Relat Metab Disord. 2001;25:1689–97.
4.Han TS, McNeill G, Seidell JC, Lean ME. Predicting intra-abdominal fatness from anthropometric measures: the influence of stature. Int J Obes Relat Metab Disord. 1997;21:587–93.
5.Lemieux S, Prud’homme D, Bouchard C, Tremblay A, Despres JP.A single threshold value of waist girth identifies normal-weight and overweight subjects with excess visceral adipose tissue. Am J Clin Nutr. 1996;64:685–93.
6.Hartz A, Rupley D, Rimm A. The association of girth measurements with disease in 32,856 women. Am J Epidemiol. 1984;119:71–80.
7.Ohlson LO, Larsson B, Svardsudd K, Welin L, Eriksson H, Wilhelmsen L, et al. The influence of body fat distribution on the incidence of diabetes mellitus: 13.5 years of follow-up of the participants in the study of men born in 1913. Diabetes. 1985;35:1055–8.
8.Berber A, Gómez-Santos R, Fanghänel G, Sánchez-Reyes L.Anthropometric indexes in the prediction of type 2 diabetes mellitus, hypertension and dyslipidemia in a Mexican population.Int J Obes Relat Metab Disord. 2001;25:1794–9.
9.Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults. Executive summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA. 2001;285:2486–97.
10.Despres JP, Allard C, Tremblay A, Talbot J, Bouchard C. Evidence for a regional component of body fatness in the association with serum lipids in men and women. Metabolism. 1985;34:967–973.
11.Denke MA, Sempos CT, Grundy SM. Excess body weight: an under-contributor to high blood cholesterol in White American men. Arch Int Med. 1993;153:1093–1103.
12.Hu D, Hannah J, Gray RS, Jablonski KA, Henderson JA, Robbins DC, et al. Effects of obesity and body fat distribution on lipids and lipoproteins in nondiabetic American Indians: the strong heart study. Obes Res. 2000;8:411–421.
13.Pihl E, Jurimae T. Relationship between body weight change and cardiovascular risk factors in male former athletes. Int J Obes Relat Metab Disord. 2001;25(7):1057–1062.
14.Baynes C, Henderson AD, Anyaoku V, Richmond W, Johnston DG, Elkeles RS. The influence of regional adiposity on atherogenic risk factors in men and women with type 2 diabetes. Diabet Med. 1991;8(5):458–463.
15.Al-Mukhtar SB, Al-Hamdani RY, Al-Naemi AH. Obesity and lipid profile in type 2 diabetics. Tikrit Med J. 2006;12(1):15–21.
16.Himabindu Y, Sriharibabu M, Alekhya K, Saisumanth K,Lakshmanrao N, Komali K. Correlations between anthropometry and lipid profile in type 2 diabetics. Indian J Endocr Metab2013;17:727–9.
17.Glover SJ, Burgess PI, Harding SP, Hof land HW, Zijlstra EE, et al. Prevalence of diabetic retinopathy, cataract and visual impairment in patients with diabetes in sub-Saharan Africa. Br J Ophthalmol. 2012,96: 156–161.
18.Chandni R, Ramamoorthy KP. Lipoprotein(a) in type 2 diabetic subjects and its relationship to diabetic microvascular complications. World J Diabetes. 2012;3(5):105–109.
Statement of originality of work: The manuscript has been read and approved by all the authors, the requirements for authorship have been met, and that each author believes that the manuscript represents honest and original work.
Sources of funding: None.
Competing interest / Conflict of interest: The author(s) have no competing interests for financial support, publication of this research, patents, and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Disclaimer: Any views expressed in this paper are those of the authors and do not reflect the
official policy or position of the Department of Defense.
Case report
Samruddhi S. Metha1,Amit A. Mhapuskar2,Darshan Hiremutt3,Vidhya D. Kamble4,Shams Ul Nisa3*
1 PG Student, Department of Oral Medicine and Radiology, Bharati Vidyapeeth Deemed University Dental College and Hospital,Pune, India
2 Professor and HOD, Department of Oral Medicine and Radiology, Bharati Vidyapeeth Deemed University Dental College and Hospital, Pune, India
3 Assistant Professor, Department of Oral Medicine and Radiology, Bharati Vidyapeeth Deemed University Dental College and Hospital, Pune, India
4 PG Student, Department of Periodontology, Bharati Vidyapeeth Deemed University Dental College and Hospital, Pune, India
Address reprint request to
*Dr. Samruddhi S Metha, Postgraduate Student, Department of Oral Medicine and Radiology, Bharati Vidyapeeth Deemed University Dental College and Hospital,Katraj, Pune, 411043, India
Article citation: Metha SS, Mhapuskar AA,Hiremutt D, Kamble VD, Nisa SU. Chronic parotid sialadenitis with sialectasis: diagnosis of case through CT sialography.J Pharm Biomed Sci 2016;06(03): 234–237.
ABSTRACT
Sialadenitis is an inflammation of the salivary glands commonly affecting the parotid gland. It may be subdivided into acute, chronic and recurrent forms. Inflammatory changes in the ducts of the salivary glands are referred to as sialadenitis. Salivary gland examination plays an important role in oral diagnosis as most of the systemic diseases involve salivary glands. Sialography is one of the oldest imaging procedures, as it is a simple chair side procedure, easy to perform and cost worthy. The symptoms of chronic sialadenitis include intermittent, often painful, unilateral parotid swelling that may or may not be associated with eating. Intra-oral examination shows pus emanating from the Stenson’s duct orifice by gently massaging the gland. Sialectasis is the sialographic appearance of dots or blobs of contrast medium within the gland caused by inflammation of the glandular tissue producing saccular dilatation of the acini. We here report a case of chronic parotid sialadenitis and role of sialography through computed tomography as an adjuvant in the diagnosis of sialectasis and also as a diagnostic and therapeutic aid. Glandular lavage was performed after 1 week with 60 ml of normal saline and ductal dilatation with saline pressure which helped to clear the mucus plug that formed in acute phase.
KEYWORDS sialadenitis, sialectasis, CT sialography.
REFERENCES
1.McQuone SJ. Acute viral and bacterial infections of the salivary glands. Otolaryngol Clin North Am. 1999;32:793–811.
2.Shafer WG, Hine MK, Levy BM. A textbook of oral pathology, 3rd ed. Philadelphia: WB Saunders Company; 1983.
3.Bhatty MA, Piggot TA, Soames JV, McLean NR. Chronic non-specific parotid sialadenitis. Br J Plast Surg. 1998;51:517–521.
4.Rzymska-Grala I, Stopa Z, Grala B, Gołębiowski M, Wanyura H,Zuchowska A, et al. Salivary gland calculi: contemporary methods of imaging. Pol J Radiol. 2010;75:25–37.
5.Greenberg MS, Glick M. Burket’s oral medicine, 10th ed. Elsevier publication; 2003. p. 238–239.
6.Shojaku H, Shojaku H, Shimizu M, Seto H, Watanabe Y. MR sialographic evaluation of sialoctasia of Stensen’s duct: comparison with X-ray sialography and ultrasonography. Radiat Med.2000;1:143–145.
7.Whaites E. Essentials of dental radiography and radiology. Churchill Livingstone; 1992. p. 325–334.
8.Hasson O. Sialoendoscopy and sialography: strategies for assessment and treatment of salivary gland obstructions. J Oral Maxillofac Surg. 2007;65:300–304.
9.Chitre VV, Premchandra DJ. Recurrent parotitis. Arch Dis Child.1997;77:359–63.
10.Khalil MR. Role of CT sialogram in the diagnosis of parotid region swellings. Egypt J Surg. 2002;21(21):1097–1102.
11.Nahlieli O, Shacham R, Shlesinger M, Eliav E. Juvenile recurrent parotitis: a new method of diagnosis and treatment. Pediatrics.2004;114:9–12.
12.Reddy SS, Rakesh N, Raghav N, Devaraju D, Bijjal SG. Sialography:report of 3 cases. Indian J Dent Res. 2009;20:499–502.
13.Mancuso AA, Hanafee WN. Head and neck radiology. Philadelphia:Lippincott Williams & Wilkins; 2011. pp. 1504–1505.
14.Abdel-Wahed N, Amer ME, Abo-Taleb NS. Assessment of the role of cone beam computed sialography in diagnosing salivary gland lesions. Imaging Sci Dent. 2013;43:17–23. Available at www.jpbms.info
Statement of originality of work: The manuscript has been read and approved by all the authors, the requirements for authorship have been met, and that each author believes that the manuscript represents honest and original work.
Sources of funding: None.
Competing interest / Conflict of interest: The author(s) have no competing interests for financial support, publication of this research, patents,
and royalties through this collaborative research.
All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Disclaimer: Any views expressed in this paper are those of the authors and do not reflect the
official policy or position of the Department of Defense.
ORIGINAL ARTICLE
Rajeev Kumar1*,Bandana Sharma2,Swati Trivedi3,Ranbeer Kumar Mehta4
1 Associate Professor, Department of Anaesthesiology, Rama Medical College, Kanpur, Uttar Pradesh, India
2 Department of Obstetrics and Gynecology, G.S.V.M. Medical College, Kanpur,Uttar pradesh, India
3 Assistant Professor, Department of Anaesthesiology, Rama Medical College, Kanpur, Uttar Pradesh, India
4 Professor and HOD, Department of Anaesthesiology, Rama Medical College, Kanpur, Uttar Pradesh, India
Address reprint requests to
*Dr. Rajeev Kumar, Associate Professor, Department of Anaesthesiology, Rama Medical College, Kanpur, Uttar Pradesh, India
Article citation: Kumar R, Sharma B,Trivedi S, Mehta RK. The effect of dexmedetomidine on haemodynamic changes, extubation time and sedation during laparoscopic hysterectomy. J Pharm Biomed Sci 2016;06(03):225–229.Available at www.jpbms.info
ABSTRACT
Background and Aim Suppression of deleterious effect of pneumoperitoneum is a very important goal of laparoscopic surgeries. Dexmedetomidine is a highly selective α2-adrenoreceptor agonist that causes centrally mediated reduction of sympathetic nervous system activity and lead to sedation and analgesia. The aim of our study was to evaluate the effect of dexmedetomidine on haemodynamic response of intraoperative events like laryngoscopy, endotracheal intubation, pneumoperitoneum and extubation time, and sedation during and after laproscopic hysterectomy.
Methods A prospective, randomised and double blind study was done on 50 female patients, undergoing laparoscopic total hysterectomy. All patients were randomly allocated into two groups; group D (dexmedetomidine) and group C (normal saline). Group D
received inj dexmedetomidine 1 μg/kg, diluted in 50 ml of normal saline over 15 min of duration and 0.4 μg/kg/h infusion was started till the pneumoperitoneum continues. Group C patients receive normal saline infusion. Parameter recorded was heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MAP), SPO2 and ETCO2. Assessment of sedation was done at extubation than every 15 min for 2 h by Ramsay sedation score (RSS).
Results Among haemodynamic profile, mean arterial pressure and HR after drug administration were significantly lower in perioperative period, particularly at intubation and extubation time in dexmedetomidine (group D) as compared with controls (group C). The extubation time was significantly lower in the dexmedetomidine groups than in the control group. No significant change was seen in the sedation score in both the groups.
Conclusion Dexmedetomidine use during laparoscopic hysterectomy leads to attenuation of hemodynamic response to pneumoperitonium and decrease in extubation time with no change in sedation level of the patients.
KEYWORDS dexmedetomidine, laproscopic hysterectomy, pneumoperitonium
REFERENCES
1.Larsen JF, Svendsen FM, Pedersen V. Randomized clinical trial of the effect of pneumoperitoneum on cardiac function and haemodynamics during laparoscopic cholecystectomy. Br J Surg.2004;91(7):848–854.
2.Myre K, Rostrup M, Buanes T, Stokland O. Plasma catecholamines and haemodynamic changes during pneumoperitoneum.Acta Anaesthesiol Scand. 1998;42(3):343–347.
3.Mann C, Boccara G, Pouzeratte Y, Eliet J, Serradel-Le Gal C,Vergnes C, et al. The relationship among carbon dioxide pneumoperitoneum, vasopressin release, and hemodynamic changes. Anesth Analg. 1999;89(2):278–283.
4.Gutt CN, Oniu T, Mehrabi A, Schemmer P, Kashfi A, Kraus T,et al. Circulatory and respiratory complications of carbon dioxide insufflation. Dig Surg. 2004;21:95–105.
5.Mahdavi A, Peiretti M, Dennis S, Nezhat F. Comparison of laparoscopic hysterectomy morbidity for gynecologic, oncologic, and benign gynecologic conditions. JSLS 2006;10:439–442.
6.Toyoyama H, Kariya N, Hase I, Toyoda Y. The use of intravenous nitroglycerin in a case of spasm of the sphincter of Oddi during laparoscopic cholecystectomy. Anesthesiology.2001;94(4):708–709.
7.Koivusalo AM, Scheinin M, Tikkanen I, Yli-Suomu T, Ristkari S,Laakso J, et al. Effects of esmolol on haemodynamic response to CO2 pneumoperitoneum for laparoscopic surgery. Acta Anaesthesiol Scand. 1998;42(5):510–517.
8.Damen SL, Nieuwenhuijs VB, Joosten W, Houweling PL, Clevers GJ. The effects of remifentanil and sufentanil on the quality of recovery after day case laparoscopic cholecystectomy: a randomized blinded trial. J Laparoendosc Adv Surg Tech A. 2004;14(2):87–92.
9.Pandey CK, Priye S, Ambesh SP, Singh S, Singh U, Singh PK. Prophylactic gabapentin for prevention of postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy:a randomized, double-blind, placebo-controlled study.J Postgrad Med. 2006;52(2):97–100.
10.Peng PW, Li C, Farcas E, Haley A, Wong W, Bender J, et al. Use of low-dose pregabalin in patients undergoing laparoscopic cholecystectomy. Br J Anaesth. 2010;105(2):155–161.
11.Jee D, Lee D, Yun S, Lee C. Magnesium sulphate attenuates arterial pressure increase during laparoscopic cholecystectomy. Br J Anaesth. 2009;103(4):484–489.
12.Singh M, Choudhury A, Kaur M, Liddle D, Verghese M,Balakrishnan I. The comparative evaluation of intravenous with intramuscular clonidine for suppression of hemodynamic changes in laparoscopic cholecystectomy. Saudi J Anaesth.2013;7(2):181–186.
13.Khanduja S, Ohri A, Panwar M. Dexmedetomidine decreases requirement of thiopentone sodium and pentazocine followed with improved recovery in patients undergoing laparoscopic cholecystectomy. J Anaesthesiol Clin Pharmacol.2014;30(2):208–212.
14.Hall JE, Uhrich TD, Barney JA, Arain SR, Ebert TJ. Sedative, amnestic and analgesic properties of smalldose Dex infusions. Anesth Analg. 2000;90:699–705.
15.Carollo DS, Nossaman BD, Ramadhyani U. Dexmedetomidine:a review of clinical applications. Curr Opin Anaesthesiol. 2008;21:457–461.
16.Bloor BC, Ward DS, Belleville JP, Maze M. Effects of intravenous dexmedetomidine in humans. II. Hemodynamic changes.Anesthesiology. 1992;77:1134–1142.
17.Isik B, Arslan M, Özsoylar O, Akçabay M. The effects of α2‑adrenergic receptor agonist exmedetomidine on hemodynamic response in direct laryngoscopy. Open Otorhinolaryngol J. 2007;1:5–11.
18.Gurbet A, Basagan‑Mogol E, Turker G, Ugun F, Kaya FN, Ozcan B. Intraoperative infusion of dexmedetomidine reduces perioperative analgesic requirements. Can J Anaesth. 2006;53:646–652.
19.Talke P, Lobo E, Brown R. Systemically administered alpha2-agonist-induced peripheral vasoconstriction in humans. Anesthesiology. 2003;99:65–70.
20.Piascik MT, Soltis EE, Piascik MM, Macmillan LB. Alpha-adrenoceptors and vascular regulation: Molecular, pharmacologic and clinical correlates. Pharmacol Ther. 1996;72:215–241.
21.Grewal A. Dexmedetomidine: New avenues. J Anaesthesiol Clin Pharmacol. 2011;27(3):297–302.
22.Ishii H, Kohno T, Yamakura T, Ikoma M, Baba H. Action of dexmedetomidine on the substantia gelatinosa neurons of the rat spinal cord. Eur J Neurosci. 2008;27(12):3182–3190.
23.Roudet C, Mouchet P, Feuerstein C, Savasta M. Normal distribution of alpha 2-adrenoceptors in the rat spinal cord and its modification after noradrenergic denervation: a quantitative autoradiographic study. J Neurosci Res. 1994;39(3):319–329.
24.Stone LS, Broberger C, Vulchanova L, Wilcox GL, Hökfelt T, Riedl MS, et al. Differential distribution of alpha2A and alpha2C adrenergic receptor immunoreactivity in the rat spinal cord. J Neurosci. 1998;18(15):5928–5937.
25.Arain SR, Ebert TJ. The efficacy, side effects, and recovery characteristics of dexmedetomidine versus propofol when used for intraoperative sedation. Anesth Analg. 2002;95(2):461–466.
26.Candiotti KA, Bergese SD, Bokesch PM, Feldman MA, Wisemandle W, Bekker AY; MAC Study Group. Monitored anesthesia care with dexmedetomidine: a prospective, randomized, double-blind, multicenter trial. Anesth Analg. 2010;110(1):47–56.
27.Alex Bekker, Mary K Sturaitis. Dexmedetomidine for neurological surgery. Neurosurgery. 2005;57(1):1–10.
28.Aho M, Erkola O, Kallio A, Scheinin H, Korttila K. Dexmedetomidine for maintenance of anesthesia in patients undergoing abdominal hysterectomy. Anesth Analg. 1992;75:940–946.
29.Parikh DA, Kolli SN, Karnik HS, Lele SS, Tendolkar BA. A prospective randomized double‑blind study comparing dexmedetomidine vs. combination of midazolam–fentanyl for tympanoplasty surgery under monitored anesthesia care. J Anaesthesiol Clin Pharmacol. 2013;29:173–178.
Statement of originality of work: The manuscript has been read and approved by all the authors, the requirements for authorship have been met, and that each author believes that the manuscript represents honest and original work.
Sources of funding: None.
Competing interest / Conflict of interest: The author(s) have no competing interests for financial support, publication of this research, patents, and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Disclaimer: Any views expressed in this paper are those of the authors and do not reflect the official policy or position of the Department of Defense.