Tuberculous meningitis can lead to precocious puberty. Central nervous system (CNS) hamartomas are common etiological factors but association of tuberculomas with precocious puberty is very unusual. Here, we are reporting a 6-year-old male child who developed precocious puberty secondary to tuberculoma.

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Atherosclerosis is a chronic inflammatory condition and infectious diseases are believed to contribute to its pathophysiology. Periodontitis is a chronic infectious disease of the supporting tissues of the teeth, and the epidemiological association with atherosclerosis is now beyond doubt. However causal mechanisms are still lacking; research suggests that bacteria from the periodontal lesions may enter atherosclerotic plaques. Alternatively, elevated CRP and a prothrombotic state in periodontitis contribute to exacerbation of atherosclerosis. Finally, the link may also be explained by polymorphisms in the ANRIL gene, which has been associated with both atherosclerosis and periodontitis. Previous studies used surrogate biomarkers to investigate the association between atherosclerosis and periodontitis, and to evaluate the effects of periodontal intervention. Unfortunately, more definitive cardiovascular parameters are still lacking, because of methodological difficulties in study design and ethical considerations.

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Context: Lingula is a sharp tongue-shaped bony projection located on the medial aspect of mandibular ramus and knowledge regarding its shape, size, and location is clinically significant in oral and maxillofacial surgeries. Aim: The present study aims to study shape, height, and precise location of lingula in dry adult human mandibles. Materials and Methods: The material for this study comprised of sixty (120 sides) dry adult human mandibles of North Indian origin to determine the morphological features and location of lingula. Student's t-test was used for statistical analysis. Results: Triangular (61.6%) shape of lingula was most commonly found followed by truncated (46.6%), nodular (31.6%), and assimilated (11.6%) types. Each type of lingula was more often unilateral than bilateral. The mean height of the lingula was 5.5 ? 2.02 mm. The mean distance of lingula from the anterior and posterior borders of mandibular ramus was 20.0 ? 2.4 mm and 15.0 ? 2.7 mm, respectively. The lingula was located at 15.4 ? 2.7 mm from the mandibular notch and 30.4 ? 3.5 mm from the distal side of alveolar socket of mandibular second molar tooth. The mean lingula ratio was 0.567 ? 0.005. Conclusion: The information regarding shape, height, and precise location of lingula in relation to various mandibular ramal landmarks could be of immense help in performing surgical procedures such as bilateral sagittal split ramus osteotomy (BSSRO), intraoral ventral ramus osteotomy (IVRO), and inferior alveolar nerve block.

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Objectives: In the present study, we reviewed our experience with full-length low- and medium-pressure peritoneal shunts and recorded any additional complications/benefits caused by using these shunts. Materials and Methods: This study was conducted from May 2005 to December 2006 in the Department of Surgery, Government Medical College Hospital, Jammu. Over the study period, all the children who underwent ventriculoperitoneal shunt for hydrocephalus were included. Ventriculoperitoneal shunt was placed in all the cases by using the Chhabra 'Slit n spring' hydrocephalus shunt system. In all the cases, the shunt was placed on the right side with a common technique of insertion. In the present study, the full length of the distal catheter was placed in the peritoneal cavity in all the cases. Before placing the peritoneal catheter into the abdomen, the length of the inserted peritoneal tube was measured. All patients were followed up on a fortnightly basis for the first three months and thereafter on a three-monthly basis. Results: A total of 30 children underwent right ventriculoperitoneal shunt for congenital hydrocephalus during the study period. Mean age of the patients was 11.1 months (range: 1-36 months, SD: 11.0963, median: 7 months). There were 16 male and 14 female patients and 75% children were less than 17 months of age. In the present study, the full length of the distal catheter was placed into the peritoneal cavity and it was observed that the minimum length of the distal catheter placed inside was 44 cm and the maximum length was 52 cm. Twenty-five children (83.3%) had normal shunt functioning with no clinical or radiological evidence of shunt complications at a follow-up at one year. Five children (16.6%) had features of shunt malfunction and were evaluated further. Conclusion: In accordance with the literature, we find that the length of the peritoneal catheter of the shunt tube does not increase the distal complication rate; however, the use of adequate length of the peritoneal catheter does eliminate the need to lengthen the peritoneal catheter as the child grows.

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Unicystic ameloblastoma (UA) refers to those cystic lesions that show clinical and radiologic characteristics of an odontogenic cyst but in histologic examination show a typical ameloblastomatous epithelium lining part of the cyst cavity, with or without luminal and/or mural tumor proliferation. These tumors characteristically expand within the jaw and displace the bone, the teeth and their roots. Occasionally, infiltrating tumors may erode through the bone and extend into the soft tissue. The tumor is most commonly seen in the posterior mandible, but may also arise in the maxilla and the anterior aspect of the jaws. The unicystic type of ameloblastoma is one of the least encountered variant of the ameloblastoma. We report a case of UA of maxilla in a 32-year-old male patient.

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The presence of a solitary, firm, progressive or rapidly growing mass in the orofacial region has a long list of differential diagnoses, ranging from benign lesions to more fatal malignant ones. Nodular fasciitis (NF) is a benign, reactive proliferation of fibroblasts and myofibroblasts, which typically arises in the subcutaneous fascia, most probably in response to a local injury. Although commonly seen in the upper extremities (50%), orofacial NF is less common, with an incidence of less than 20%, primarily affecting adults in the fourth and fifth decades of their life. In this report, we describe a unique case of oronasal nodular fasciitis, aggravated by trauma, in a six-year-old female child. To the best of our knowledge, this is the first case report in the literature of nodular fasciitis arising in this anatomic location.

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Herpes zoster (HZ) presents as cutaneous vesicular eruptions in the areas innervated by the affected sensory nerves and is usually associated with severe pain. Oral manifestations of HZ appear when the maxillary or mandibular divisions of the trigeminal nerve are involved. Infection commonly occurs unilaterally and affects mostly middle-aged or the elderly persons. Multiple complications have been reported following HZ of the trigeminal nerve. The most common among them is the neuralgia. There are only a few reports of bony and dental complications following HZ infection. The aim of this article is to present a case of a 44-year-old male patient affected by HZ infection involving trigeminal nerve which led to necrosis of bone and exfoliation of teeth.

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Background: Application of resorbable materials in craniofacial surgery offers many advantages compared with conventional materials such as titanium which is used in the reduction of incidence of complications like extrusion, intracranial migration or translocations of the implant, also there is no restriction on the skeletal growth as well as no distortion in plain radiographic and CAT scan studies. Materials and Methods: It was a prospective, sequential, comparative and open study carried out between October of 2002 and February of 2004 among patients of the Clinic of Craniofacial Surgery at ISSEMYM Medical Center in Metepec, Mexico. The patients were sequentially assigned either to group I in which LactoSorb^? (Biomet microfixation) resorbable screws and miniplates of 1.5 mm, 2.0 mm and 2.5 mm sizes (made up of 82% PLLA and 18% PGA) were used; and to group II in which titanium screws and miniplates of the same sizes were used. All patients were preoperatively documented with clinical examination, clinical photographs and CAT scan. Results: A total of 100 patients were included with 50 patients in each group. In group I, 40 patients (80%) with facial fractures were operated, of which 18 were simple maxillary fractures, 11 were fractures of orbitomalar complex, 7 panfacial fractures, 2 fractures of frontal sinus and 2 mandibular fractures; in 5 patients (10%) with malocclusion, some kind of orthognathic surgery was performed, 4 maxillary osteotomies and one maxillo-mandibular osteotomy were performed; and the remaining 5 patients (10%) were subjected to some advanced craniofacial surgery procedure, in one patient with Apert's syndrome a fronto-orbital advancement was performed, there were 3 patients with hypertelorism in whom orbital medialization was undertaken in two cases and facial bipartition in one; the remaining case was a Treacher Collins patient in which a orbital reconstruction using monocortical parietal bone was performed. In the age range of 6-55 years with an average of 30.5-year-old in these procedures, a total of 196 miniplates were placed. Conclusions: The results of our study confirm data reported by previous descriptive studies about the systems for resorbable fixation. We consider that the present method of resorbable fixation is a viable and safe option for the management of patients who require some type of fixation of the craniofacial skeleton.

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Odontogenic keratocyst (OKC) has been the subject of great interest since Philipsen introduced the term in 1956. Investigations continue into the lesion's pathologic classification, diagnosis and biologic behavior. OKCs are one of the most frequent features of nevoid basal cell carcinoma syndrome (Gorlin Goltz syndrome/Bifid rib syndrome). We report a rare case of multiple OKCs in a nonsyndromic patient in a 16-year-old male patient, with emphasis on its diagnosis, radiographic features and management.

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The risk of local and systemic complications are ever present during the administration of nerve blocks in the field of dentistry, but the knowledge and timely steps taken by the clinician can decrease the incidence of this event in his/her practice. Here the author presents a case of transient blurring of vision in one eye following the administration of posterior superior alveolar nerve block prior to a dental surgical procedure. To explain the possible mechanism of this rare complication and to make aware of such complications of local anesthetic in dental practice.

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