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   Table of Contents - Current issue
Coverpage
January - June 2018
Volume 1 | Issue 1
Page Nos. 1-35

Online since Thursday, November 29, 2018

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REVIEW ARTICLE  

Diagnostic issue and caveats of immunoreactivity for Ki67 in hyalinizing trabecular neoplasm with review of literature: A study of one case p. 1
Veer Karuna, Priya Gupta, Mamta Gupta, Kriti Grover
DOI:10.4103/JHNP.JHNP_6_18  
Few benign and malignant thyroid lesions share many histological features including papillary and trabecular pattern, hyalinized stroma, calcification, nuclear grooving and nuclear inclusion. Well formalin fixed right lobe hemithyroidectomy specimen was received. After processing, H and E stain was done. Immunohistochemical studies (TTF, Thyroglobuline, MIB-1) and special stain (Congo red) were done to make a definite diagnosis. The present case describes a relatively rare thyroid tumour – Hyalinizing trabecular tumour with its varied morphological features creating diagnostic difficulties and role of IHC in formulating definitive diagnosis.
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ORIGINAL ARTICLES Top

Prevalence of pathologic findings in maxillary sinuses in asymptomatic patients using cone beam computed tomography p. 5
Abhishek Singh Nayyar
DOI:10.4103/JHNP.JHNP_8_18  
Context and Aim: Complications related to maxillary sinuses are often related to their anatomic and pathologic variations and their close approximation to the tooth roots. It, thus, becomes important to study these sinuses even in situations when the patients reporting for dental complaints are asymptomatic for the sinuses. In the present scenario, cone beam computed tomography (CBCT) has emerged as the standard imaging modality for bone and soft tissue abnormalities offering multiple views with thin sectioning. The aim of the present study was to detect the prevalence of pathologic findings in maxillary sinuses in patients who were asymptomatic for the sinuses using cone beam computed tomography (CBCT). Materials and Methods: CBCT scans of 150 patients between the ages of 18 and 70 years reporting for routine dental complaints were analyzed for detecting pathologic findings in the maxillary sinuses. Statistical Analysis Used: The data was analyzed using SPSS version 15.0 (SPSS Inc., Chicago, IL, USA). Distribution of the overall prevalence of pathologic findings according to age and sex were calculated using Chi-Square test while P value <0.05 was considered to be statistically significant. Results: Overall prevalence of pathologic findings was found to be 58% with the prevalence of mucosal thickening being 29.3%, polypoidal mucosal thickening, 36.7%, partial opacification with liquid accumulation, 2%, complete opacification, 0.7% and miscellaneous findings as 0.7%. Conclusion: The present study highlighted the clinical implications, dental pathologies might have, in relation to the maxillary sinuses underlying the significance of their accurate assessment in the perspective of dental and maxillofacial and ENT problems with a multi-disciplinary approach of treatment for the successful treatment of chronic sinus pathoses.
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Cone beam computed tomography and detection of periodontal bone defects in patients with advanced periodontal disease indicated for periodontal surgeries p. 12
Abhishek Singh Nayyar
DOI:10.4103/JHNP.JHNP_9_18  
Context and Aim: Radiographs play an important role in periodontal diagnosis; however, one of the major limitations of the conventional radiological procedures is the presence of considerable overlapping of the overlying anatomical structures and lack of a clear three-dimensional information. Surgical exposure, although being able to evaluate the type and depth of the defect during surgery, provides very little time to the surgeon to plan for the type of procedure required for periodontal regeneration based on the information obtained during surgery. Recently, cone beam computed tomography (CBCT) has emerged as a lower cost alternative to the computed tomography (CT) with high-quality images and lower radiation exposure to the patients, though, in vivo studies, in this regard, are still scarce. The aim of the present study was to assess the efficacy of CBCT in the detection of periodontal bone defects in patients with advanced periodontal disease indicated for periodontal surgeries. Materials and Methods: The present cross-sectional study included patients with advanced periodontal disease indicated for periodontal surgeries. Bone defects were measured first with the help of CBCT software and then, during a surgical intervention using the standardized UNC-15 periodontal probe and compared. Statistical Analysis: Statistical analysis was done using SPSS version 18.0 (SPSS Inc., Chicago, IL, USA). Both the measurements were compared with the help of Student's t-test. P < 0.05 was considered statistically significant while P < 0.001 was considered highly statistically significant. Results: The palatal/lingual sites in anterior teeth which showed a mean CBCT value of 4.0444 mm and mean surgical value of 4.1822 mm revealed the mean difference to be statistically significant along with the distal sites which showed a mean CBCT value of 3.3667 mm and mean surgical value of 3.5217 mm (P = 0.001). The values, although in case of posterior teeth, were not found to be statistically significant. Conclusion: From the observations made from the present study, it could be concluded that CBCT provided good accessibility to visualize sites which were otherwise difficult to access during surgery. Furthermore, the bone density/volume could be detected precisely with the CBCT software which was otherwise not possible with the conventional methods.
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CASE REPORTS Top

Dumb bell shaped conchal dermoid: Unique presentation p. 21
Garima Arora, Neena Kasliwal
DOI:10.4103/JHNP.JHNP_2_18  
Dermoid are common skin tumours. They are found commonly in head and neck areas. Dermoid cyst in region of auricle is extremely rare, we report a rare case of dumbbell shaped dermoid cyst located at the concha of auricle in a 2 year old female child. The child had presented with a mass both on external and internal aspect of concha which later turned out to be a dermoid.
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Fibroepithelial polyps of the head and neck p. 24
Ramiya Ramachandran Kaipuzha, Davis Thomas Pulimoottil, Satvinder Singh Bakshi, Suriyanarayanan Gopalakrishnan
DOI:10.4103/JHNP.JHNP_4_18  
Fibroepithelial polyps are benign polypoid lesions arising from the mesodermal tissue and are one of the most common cutaneous lesions, but are rare in the oral cavity and upper airway. Two cases are discussed here. A 40 year old male presented with cough of five months duration associated with an intermittent foreign body sensation in the throat. Examination revealed single smooth pinkish pedunculated mass hanging freely from the superior pole of the left tonsil. The patient underwent tonsillectomy and histopathological examination revealed features of fibroepithelial polyp. A 65 year old male chronic smoker presented with swelling in the mouth behind the upper teeth since two months. Examination of the oral cavity revealed a single, non-tender, firm, smooth pedunculated pink swelling just behind the upper incisor on the right side of hard palate; the mass was excised and found to be a fibroepithelial polyp. The diagnosis of fibroepithelial polyps is primarily by histopathological examination of the excised mass. The key to preventing the recurrence of that lesion is its surgical excision in toto along with elimination of the source of irritation that led to the lesion.
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A rare case of isolated retro-orbital fungal granuloma p. 28
Ramiya Ramachandran Kaipuzha, Davis Thomas Pulimoottil, Satvinder Singh Bakshi, Suriyanarayanan Gopalakrishnan
DOI:10.4103/JHNP.JHNP_5_18  
Aspergillus versicolor has been rarely associated with endophthalmitis and epicorneal aspergilloma. We report here the first case of retro-orbital fungal granuloma caused by Aspergillus versicolor. A 52 year old male presented with protrusion associated with pain and watering of the left eye for six months duration. Left eye examination showed axial proptosis and fundus examination revealed blurring of the nasal disc margin. Plain CT of orbits showed a retrobulbar intraconal lesion in the left orbit. The patient was taken up for endoscopic orbital and optic nerve decompression with debulking or retro-orbital mass under general anaesthesia. Culture on Sabaraoud's dextrose agar grew Aspergillus species. The postoperative period was uneventful and the patient was started on Oral itraconazole 100mg twice daily and over the course of two months the left eye proptosis reduced significantly. Successful treatment of aspergillosis requires prompt diagnosis and rapid institution of therapy. Endoscopic clearance of the disease combined with oral antigfungals is the appropriate modality of therapy.
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Gorlin cyst in maxilla: A clinical and histological rarity p. 31
Abhishek Singh Nayyar
DOI:10.4103/JHNP.JHNP_7_18  
Gorlin cyst which is, also, recognised by the synonyms calcifying odontogenic cyst (COC), calcifying ghost cell odontogenic cyst, calcifying cystic odontogenic tumor (CCOT) and dentogenic ghost cell tumor, is a rare developmental lesion was first reported by Gorlin et al. in 1962. It was, later, renamed as calcifying cystic odontogenic tumor (CCOT) in the WHO classification devised in 2005 due to its histological complexity, morphological diversity and aggressive proliferation. Gorlin cyst was, later, re-named several times including Gorlin cyst, calcifying odontogenic cyst (COC), calcifying ghost cell odontogenic cyst, calcifying cystic odontogenic tumor (CCOT) and dentogenic ghost cell tumor. The present case report briefs a case of Gorlin cyst in a 21 year old female which was diagnosed during the diagnostic work-up.
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