Criminal activities involving human life always puts lives at stake. Newer advances in other fields especially medicine and dentistry is essential in solving the mysteries of death. Different disciplines insert a part of the puzzle until it is complete. Fingerprints, DNA profiling, Forensic anthropology are commonly employed in personnel identification, mass disasters and others. Investigators may also rely on lip prints to identify possible suspects or to support evidence gained in specific investigations. A lip print at scene of crime can be the basis for inference as to the number of people involved, gender, habits, occupational traits, and others, based on the pathological changes present. This review deals with lip prints and their possible acquisition and usage.

Aims: Epidermophyton, Microsporum and Trichophyton are the genera of dermatophytes causing superficial mycoses. These infections are on rise due to increase in immunocompromised patients and favorable environmental conditions in countries like India. The present study was undertaken to identify dermatophytes causing superficial fungal infection by microscopy and culture techniques which helps in accurate diagnosis and appropriate treatment of cases. Methodology and results: Samples were collected from affected sites after cleaning the affected surface with 70% alcohol. All samples were microscopically examined for presence of hyphal structures by digesting in 10% to 40% KOH solution. All samples were inoculated into Sabouraud dextrose agar with chloramphenicol and Sabouraud dextrose agar with cycloheximide and chloramphenicol and incubated at room temperature for four weeks. Tease mount technique and slide culture technique were used for identification of dermatophytes. One hundred and ten samples from clinically suspected dermatophytoses which includes 77(70%) from male and 33(30%) from female patients were processed for identification of dermatophytes. Samples were subjected to microscopy and culture. In 61 samples (54.54%) fungal hyphae were seen by direct microscopic examination (KOH). Fifty six samples (50%) yielded dermatophyte growth in culture. Trichophyton rubrum was the predominant species isolated followed by T. violaceum and T. mentagrophytes. Conclusion, significance and impact of study: Accurate and rapid diagnosis of superficial fungal infection is essential for proper management of cases. Direct microscopy is very good method for routine diagnosis, however culture remains gold standard.
Arthrodermataceae

Pulp chamber is considered as a very important and integral part of the tooth. Pulp chamber undergoes different types of morphological and pathological alterations. Calcified canals are one amongst other pathological alterations. Calcified root canals have been a challenge to the diagnostician and the dental physician before diagnosis and after diagnosis respectively. It is considered that the impact of an irritant to the tooth, like trauma, caries, infection and age changes can precipitate calcification. Calcification makes a dentist to negotiate with his treatment planning and at times it can be a surprise element.

Agenesis of teeth and ankyloglossia are common human developmental anomalies. Terms like Oligodontia, Anodontia and Hypodontia are used to describe agenesis of teeth. Oligodontia is a rare condition generally defined as agenesis of six or more teeth excluding the third molars. The condition is not frequently documented in Indian children. There is no much documentation on oligodontia with ankylogossia. Ankyloglossia can adversely affect the development of the surrounding structures including the alveolar process, teeth and can impair functions such as mastication, speech, and swallowing. The present article reports a rare case of non-syndromic oligodontia associated with ankyloglossia in an 8-year old male patient. Oligodontia is a relatively rare condition affecting 0.1-0.2% of the population. Our present case is even rare because of its association with ankyloglossia

BACKGROUND: Bilateral superficial cervical plexus block (BSCPB) provides good postoperative analgesia, but its effect on anesthetic consumption is unknown. This study evaluated the effects of BSCPB on sevoflurane consumption during thyroid surgery. METHODS: Fifty patients were randomly allocated into groups A and B of 25 each in this prospective double-blind study. Group A received BSCPB with 20 ml 0.25% bupivacaine, whereas group B received 20 ml saline immediately before entropy-guided general anesthesia. Intraoperative hemodynamic parameters, end-tidal sevoflurane concentration, minimum alveolar concentration, and sevoflurane consumption were recorded. Postoperative pain was assessed using a visual analog scale, and the time of the first request for analgesia was noted. All side effects were recorded. RESULTS: Demographics were comparable. Mean sevoflurane consumption [for 30 min: group A = 7.2 (1.1) ml, group B = 8.8 (2.0) ml, P = 0.001; for 60 min: group A = 13.5 (1.7) ml, group B = 16.5 (3.9) ml, P = 0.002] and mean end-tidal sevoflurane concentration [for 30 min: group A = 1.2% (0.2%), group B = 1.4% (0.2%), P = 0.008; for 60 min: group A = 1.2% (0.1%), group B = 1.4% (0.2%), P = 0.010] were significantly lower in group A. Patients in group A had a longer duration of analgesia [361.6 (79.5) min vs. 151.0 (60.2) min, P < 0.001] compared to those in group B. CONCLUSIONS: Preinduction BSCPB during thyroid surgery significantly reduced sevoflurane consumption and increased the duration of postoperative analgesia.
Analgesia ; Anesthesia, General* ; Bupivacaine ; Cervical Plexus Block* ; Cervical Plexus* ; Demography ; Double-Blind Method ; Entropy ; Hemodynamics ; Humans ; Nerve Block ; Pain, Postoperative ; Prospective Studies* ; Thyroid Gland* ; Thyroidectomy ; Visual Analog Scale

BACKGROUND: Neutrophil to lymphocyte ratio (NLR) is a simple marker in peripheral blood and is used to assess inflammatory response and physiological stress during the peri-operative period. Anesthetic technique may influence NLR, thereby modulating the inflammatory response and surgical outcomes. The study aimed to evaluate the relationship between blood NLR and anesthetic techniques in patients undergoing infraumbilical surgeries. METHODS: Institutional ethical committee approval and patient consent were obtained. A prospective randomized double- blinded study was conducted between July 2017 and November 2017, involving 80 patients classified as the American Society of Anesthesiologists grade 1 and 2, aged 18–60 years, and scheduled for elective infraumbilical surgeries. Unwilling and those with infections were excluded. The patients were randomly divided into two groups: Group G (general anesthesia) and Group S (spinal anesthesia) as per the standardized protocol. Differential counts of leukocytes and NLR in the peripheral blood were obtained pre-operatively on the morning of surgery and at 2 h and 24 h after surgery in both the groups. The data were analyzed using appropriate statistical tests. RESULTS: The demographic parameters, basal total leukocyte count (TLC), and NLR were comparable between the groups. TLC and NLR were significantly higher in Group G as compared to that in Group S post-operatively. The post-operative rise in TLC and NLR from the basal values was significantly higher in Group G as compared to that in Group S. CONCLUSIONS: General anesthesia was associated with a greater increase in TLC and NLR when compared with spinal anesthesia.
Anesthesia, General ; Anesthesia, Spinal ; Humans ; Leukocyte Count ; Leukocytes ; Lymphocytes ; Neutrophils ; Prospective Studies ; Stress, Physiological

BACKGROUND: Neutrophil to lymphocyte ratio (NLR) is a simple marker in peripheral blood and is used to assess inflammatory response and physiological stress during the peri-operative period. Anesthetic technique may influence NLR, thereby modulating the inflammatory response and surgical outcomes. The study aimed to evaluate the relationship between blood NLR and anesthetic techniques in patients undergoing infraumbilical surgeries. METHODS: Institutional ethical committee approval and patient consent were obtained. A prospective randomized double- blinded study was conducted between July 2017 and November 2017, involving 80 patients classified as the American Society of Anesthesiologists grade 1 and 2, aged 18–60 years, and scheduled for elective infraumbilical surgeries. Unwilling and those with infections were excluded. The patients were randomly divided into two groups: Group G (general anesthesia) and Group S (spinal anesthesia) as per the standardized protocol. Differential counts of leukocytes and NLR in the peripheral blood were obtained pre-operatively on the morning of surgery and at 2 h and 24 h after surgery in both the groups. The data were analyzed using appropriate statistical tests. RESULTS: The demographic parameters, basal total leukocyte count (TLC), and NLR were comparable between the groups. TLC and NLR were significantly higher in Group G as compared to that in Group S post-operatively. The post-operative rise in TLC and NLR from the basal values was significantly higher in Group G as compared to that in Group S. CONCLUSIONS General anesthesia was associated with a greater increase in TLC and NLR when compared with spinal anesthesia.

Objective: To determine the relationship between C-reactive protein (CRP) level and the severity of dengue and the potential use of CRP in predicting acute dengue infection. Methods: A prospective observational study was performed on dengue patients admitted to a tertiary care hospital in southern India. All patients of age above 18 years, diagnosed with dengue were included in the study. The detailed laboratory parameters pertaining to dengue were recorded. CRP levels were estimated and compared between groups i.e. severe and non-severe dengue. CRP cut-off value was detected using the receiver-operator curve. Results: Totally 98 patients with a mean age of 40 years were included. Among them, 11.2% of the patients suffered from severe dengue, 54.1% of the cases had non-severe dengue without warning signs, and 34.7% had non-severe dengue with warning signs. The median CRP was significantly higher in patients with severe dengue compared to patients with non-severe dengue (96.2 mg/dL vs. 5.3 mg/dL). Univariate logistic regression analysis showed that the odd's ratio (OR) of CRP was 1.053 (P≤0.001, 95% CI=1.029-1.078). CRP at a cutoff value of 21.6 mg/L (0.929 AUC) had excellent sensitivity (100%) and specificity (81.6%) in predicting severe dengue infection. Multivariate logistic regression analysis showed that CRP (OR=1.089, P=0.013) and ALT (OR=1.010, P=0.034) were statistically significant independent predictors of dengue severity. Conclusions: CRP level could be used as a potential biomarker to predict severity of dengue in adults.

Background: In the field of dentistry, topical anesthetics play an important role in reducing pain during needle pricks. The anesthetic property of betel leaves remain unexplored, even though they have been widely used for the treatment of various ailments. The purpose of this study was to compare and evaluate pain perception following topical application of lignocaine gel, clove gel, ice, and newly developed betel leaf extract gel during intraoral injection in children. Methods: Sixty children aged 6-10 years who met the inclusion criteria were divided into four groups. Topical anesthetic agents, 2% lignocaine (Lox-2% Jelly, Neon, Mumbai, India), 4.7% clove gel (Pain Out Dental Gel, Colgate Palmolive India Ltd, Solan, India), 10% betel leaf extract gel, and ice were applied to each group for one min, followed by administration of infiltration anesthesia. Pain perception was analyzed during needle insertion.The Wong Bakers FACES pain rating scale (WBFPRS) was used for subjective assessment and the Sound, Eye, Motor (SEM) scale for objective assessment. Recorded values were tabulated and subjected to appropriate statistical analysis using SPSS software with a P value set at 0.05. Results: The clove oil and betel leaf groups demonstrated the highest WBFPRS scores, followed by the ice and lignocaine groups. The clove, betel leaf extract, and ice groups showed equal and highest SEM scores, followed by the lignocaine group. The mean WBFPRS and mean SEM scores were statistically significant. Conclusion Betel leaf extract gel is effective in reducing pain and can act as an alternative topical anesthetic agent.

Background: In the field of dentistry, topical anesthetics play an important role in reducing pain during needle pricks. The anesthetic property of betel leaves remain unexplored, even though they have been widely used for the treatment of various ailments. The purpose of this study was to compare and evaluate pain perception following topical application of lignocaine gel, clove gel, ice, and newly developed betel leaf extract gel during intraoral injection in children. Methods: Sixty children aged 6-10 years who met the inclusion criteria were divided into four groups. Topical anesthetic agents, 2% lignocaine (Lox-2% Jelly, Neon, Mumbai, India), 4.7% clove gel (Pain Out Dental Gel, Colgate Palmolive India Ltd, Solan, India), 10% betel leaf extract gel, and ice were applied to each group for one min, followed by administration of infiltration anesthesia. Pain perception was analyzed during needle insertion.The Wong Bakers FACES pain rating scale (WBFPRS) was used for subjective assessment and the Sound, Eye, Motor (SEM) scale for objective assessment. Recorded values were tabulated and subjected to appropriate statistical analysis using SPSS software with a P value set at 0.05. Results: The clove oil and betel leaf groups demonstrated the highest WBFPRS scores, followed by the ice and lignocaine groups. The clove, betel leaf extract, and ice groups showed equal and highest SEM scores, followed by the lignocaine group. The mean WBFPRS and mean SEM scores were statistically significant. Conclusion Betel leaf extract gel is effective in reducing pain and can act as an alternative topical anesthetic agent.