BackgroundDirect sputum smear microscopy for tuberculosis (TB) lacks sensitivity for the detection of acid fast bacilli. Sputum pretreatment procedures may enhance sensitivity. We did a pilot study to compare the diagnostic accuracy and incremental yield of two short-duration (<1 hour) sputum pretreatment procedures to optimize direct smears among patients with suspected TB at a referral hospital in India.Methodology/FindingsBlinded laboratory comparison of bleach and universal sediment processing (USP) pretreated centrifuged auramine smears to direct Ziehl-Neelsen (ZN) and direct auramine smears and to solid (Loweinstein-Jensen (LJ)) and liquid (BACTEC 460) culture. 178 pulmonary and extrapulmonary TB suspects were prospectively recruited during a one year period. Thirty six (20.2%) were positive by either solid or liquid culture. Direct ZN smear detected 22 of 36 cases and direct auramine smears detected 26 of 36 cases. Bleach and USP centrifugation detected 24 cases each, providing no incremental yield beyond direct smears. When compared to combined culture, pretreated smears were not more sensitive than direct smears (66.6% vs 61.1 (ZN) or 72.2 (auramine)), and were not more specific (92.3% vs 93.0 (ZN) or 97.2 (auramine).Conclusions/SignificanceShort duration sputum pretreatment with bleach and USP centrifugation did not increase yield as compared to direct sputum smears. Further work is needed to confirm this in a larger study and also determine if longer duration pre-treatment might be effective in optimizing smear microscopy for TB.

A BSTRACT Introduction: The third molar is the most frequently impacted tooth with a frequency of occurrence generally reported to be from 18 to 32%. It is considered impacted when its eruption into normal functional occlusion has been interfered with by other teeth, overlying bone or soft tissue and when it is not fully erupted by its expected age of around 20 years. Racial differences affect the pattern of impaction. There is a lacunae of literature on the pattern of mandibular third molar impaction in Tamil population. Aim: To investigate the prevalence of pattern of third molar impaction among the population in Madurai. Materials and Methods: A retrospective cohort study was conducted. The first 1000 OPGs (Orthopantamograms) were taken at the Department of Oral Medicine and Radiology, CSI College of Dental Sciences and Research from August to December 2018 of Madurai population aged between 20 and 40 years old. Data include angle, level and position of impaction, proximity to inferior alveolar nerve and dental caries in second molar and/or third molar. Results: The average age of subject with mandibular third molar impaction is 30.5 years. The most common occurring mandibular impaction is mesioanglar (60%), Level A (71%), Class II (50%) without involving the inferior alveolar nerve (33%) and dental caries in 20% of second and/ or third molar. Conclusion: Mandibular third molar impactions are one of the common developmental condition in this modern civilization. Assessing the third molar and prognosis of its eruption is mandatory for better patient management because of numerous complications associated with unerupted third molar.

Introduction:Conventional methods to estimate the time of death are adequate, but a histological method is yet unavailable to assess postmortem interval (PMI). The autolytic changes that occur in an unfixed antemortem gingival tissue which reflects histologically at an early stage are similar to changes that occur in postmortem tissue. These histological changes can be used and applied in a postmortem tissue as a method to assess PMI.Aims:The aim of the study is to assess the histological changes in a gingival tissue left unfixed for various time intervals and to correlate the findings with duration.Materials and Methods:Sixty gingival tissues obtained from patients following therapeutic extractions, impactions, gingivectomy and crown lengthening procedures were used. Each tissue obtained was divided into two pieces and labeled as “A”, the control group and “ B” the study group. Tissues labeled “A” were fixed in 10% formalin immediately and tissues labeled“B” were placed in closed containers and fixed after 15, 30, 45 min, 1, 2, and 4 h time interval. Of the sixty tissues in the study group “ B”, ten tissues were used for each time interval under investigation. All the fixed tissues were processed, stained, assessed, and analyzed statistically using Pearson correlation and regression analysis.Results:Histological changes appear at 15 min in an unfixed antemortem tissue. At 2 h interval, all layers with few cells in basal cell layer are involved. At 4 h interval, loss of stratification and complete homogenization of cells in the superficial layers with prominent changes in basal layer is evident. There was a positive correlation (<1.0) between the time interval and the appearance of the histological changes.Conclusion:Histological changes such as complete homogenization of cells in superficial layers and loss of epithelial architecture at 4 h in unfixed antemortem tissue may be used as a criterion to estimate PMI, after further studies on postmortem tissues.

MODS was found to be a sensitive and rapid alternative method for performing culture and DST to identify MDR-TB in resource poor settings.

A BSTRACT Aim: To determine the preponderance and the distribution of pathological lesions in oral and maxillofacial region reported in and around the Madurai city. Study Design: Retrospective study on the oral and maxillofacial biopsies taken during 11 years period from 2007 to 2018 in a CSI Dental College, Madurai, Tamilnadu. A total of 1000 cases were analyzed and 904 were selected. The parameters recorded were age, sex, area, and the histopathological report obtained. Descriptive statistics was used for analysis. Result: The most common soft tissue lesion was traumatic fibroma (16.1%) and the prevalent hard tissue lesion was periapical cyst (12.7%). The more common oral malignant tumour observed was squamous cell carcinoma (7.3%) and benign tumor was ameloblastoma (5.3%). The frequently affected sites were mandible (36.1%) and buccal mucosa (19.8%). There was more predilection among male than females. The frequency of lesion is common in age group of 31-60 years. A considerable similarity was observed between age, type of lesion and its location. Conclusions: This study evaluated chronic periapical lesions were the most common hard tissue lesions and fibromas in soft tissue category. The idea of this histopathological study concludes on the requirement for biopsy to rule out type of the lesion and its severity to start up the earlier management.