IntroductionSublingual hematoma secondary to excessive anticoagulation is a rare but potentially fatal condition, and few cases have been documented in the literature.Case presentationWe report the case of a 73-year-old Caucasian woman who attended our Accident and Emergency department with massive sublingual hematoma causing superior displacement of the tongue. The condition was found to be the result of an elevated international normalized ratio, further complicated by a traumatic mandibular denture.ConclusionsIn summary, we recommend the immediate reversal of anticoagulation therapy on admission of patients with severe sublingual hematoma. We further advise surgical decompression/drainage if required and to continue meticulous monitoring. In all cases of early recognition of sublingual hematoma, prompt medical treatment and continuous clinical monitoring is essential, and may prevent the need for a surgical airway procedure.

An audit was conducted within a district general hospital's orthodontic department to improve the quality of digital lateral cephalometric radiographs. The results of the audit show improvements in the quality of lateral cephalometric radiographs, following the introduction of a new picture archiving and communications system and charged coupling device cephalometric machine. Clinical Relevance: A Quality Assurance programme is one of the essential legal requirements of the Ionizing Radiations Regulations 1999 (IRR99). This article demonstrates a simple method to monitor the quality of lateral cephalometric radiographs, based on the Health Protection Agency ratings of radiographic quality.

The formulate and evaluate Niosome drug delivery system for Clindamycin phosphate to increase its effectiveness by increasing penetration through skin and reducing its side effects Sorbitan esters which are Non-ionic surfactants was the key ingredient which forms vesicles upon hydration with aqueous media. Cholesterol was used to make vesicle stable and rigid. Different formulations were preparing by using different sorbitan ester and changing the ratio of surfactant and Cholesterol. Clindamycin Phosphate is an antibiotic widely used for the treatment of acne. The pseudomonas colitis occurs with oral dosage form while in topical dosage forms it has side effects like irritation, skin rash, itching etc. its topical bioavailability is also less. An attempt has been made to overcome these limitations for the preparation to prepare niosomes of clindamycin phosphate as well as for the enhanced delivery through skin by the variation in cholesterol level. Niosome were prepared by reverse phase evaporation method using span 60 as polymer. The compatibility of drug and polymer is analyzed by using FTIR and DSC method. There was no interaction detected by FTIR, DSC study. Further the prepared niosomes were evaluated for drug entrapment efficiency, drug content, and in vitro drug release. Amongst all the formulation batch 3 shows the best release when compared to other batch. SEM (Scanning electron microscopy) revealed that niosomes were spherical and porous. Finally it was concluded that clindamycin phosphate have been found suitable for controlled release formulation due to its bioavailability and biodegradability and thus lead to improved patient compliance.