Anaphylaxis rarely manifests as a vasospastic acute coronary syndrome with or without the presence of underlying coronary artery disease. The variability in the underlying pathogenesis produces a wide clinical spectrum of this syndrome. We present three cases of anaphylactic acute coronary syndrome that display different clinical variants of this phenomenon. The main pathophysiological mechanism of the allergic anginal syndromes is the inflammatory mediators released during a hypersensitivity reaction triggered by food, insect bites, or drugs. It is important to appropriately recognize and treat Kounis syndrome in patients with exposure to a documented allergen.

There are few data on the risk of exercise and the role of exercise stress testing in Brugada syndrome. We sought to address this deficiency using a systematic literature review. We identified 98 English-language articles possibly addressing exercise in Brugada syndrome by searching PubMed and Google Scholar from January 1990 through November 2013 using the keywords ''Brugada syndrome,'' ''exercise,'' ''exercise testing,'' and ''syncope'' alone and in combinations. Abstracts were reviewed, and those articles pertaining to Brugada syndrome and exercise were reviewed in full. We identified 18 articles reporting on Brugada syndrome and exercise. This pool included 2 large studies of 93 and 50 Brugada subjects undergoing exercise testing, plus 16 case reports. There were no reports of exercise-related sudden death, but there were 4 cases of syncope after exercise. We identified 166 Brugada patients who underwent exercise testing. During exercise testing, there were 2 reports of ventricular tachycardia and 1 report of multiple ventricular extrasystoles. ST-segment elevation increased (ST augmentation) during the early recovery phase of exercise in 57% of patients. Exercise unmasked a Brugada electrocardiographic pattern in 5 patients. Exercise is associated with syncope and ST augmentation after exercise and may be helpful in unmasking Brugada syndrome. There are insufficient data on the risks of exercise in Brugada syndrome to make recommendations for exercise, but the observations that exercise can worsen the ST abnormalities in Brugada and produce ventricular arrhythmias suggest that patients with Brugada syndrome should be restricted from vigorous exercise.

Introduction:In the modern competitive society, a pleasing appearance often dictates the difference between success and failure in both our personal and professional lives. Evaluation of gingival biotype is very important from the start of treatment plan to the final restorative placement to provide excellent esthetics.Materials and Methodology:For the study, subjects were divided into 4 groups of different ages, from 20-30, 31-40, 41-50 and 51-60 years. 30 subjects (15 men and 15 women) were selected in each group for the study. Examination of the thickness of Gingival Biotype was done in 3 different ways; - Direct visual, William's Graduated Probe and Using modified wax caliper.Results:The McNemar test showed statistically significant differences in the way gingival biotype was identified when comparing visual assessment with assessment using direct measurement (P < 0.001). And there was no statistically significant difference when assessment using a periodontal probe was compared to direct measurement (P < 0.676). There is no correlation for the Biotype among the different age groups.Conclusion:Gingival biotype identification by visual assessment is statistically significantly different from assessment with direct measurement. Gingival biotype identification by assessment with a periodontal probe is not statistically significantly different from direct measurement.

Introduction:From the point of dental practice, the restoration of endodontically treated teeth has become an important aspect as it involves a range of treatment options of variable complexity. Restoring teeth with insufficient coronal tooth structure, it is always indicated to use the post to retain a core for definitive restoration. Fiber post has a modulus of elasticity in analogs to dentin structure, thus reducing the stress areas at the dowel dentin interface. However, the only material that can substantiate all these properties can be none other than dentin itself.Materials and Methodology:Three-dimensional (3D) models of the maxillary central incisor were developed incorporating all the nonlinearities. Continuum 3D elements were used in three dimensions. Maxillary central incisor was laser scanned, duplicated with the help of reverse engineering into STL format, and it was converted into 3D model for finite element analysis (FEA). For the model, fixed boundary conditions were applied at the outer bone, while 100 N static vertical occlusal loads were prescribed at 135° on the loading component of the simulated tooth. The stress distribution was evaluated using dentin and fiber post with prescribed materials, loading and boundary conditions in endontically treated teeth by 3D FEA.Results:The analysis for von Misses stress for dentin post showed that the stress in the dentin post at the cervical area was 127 MPa. The displacement in the dentin post was <0.025 mm. Von Misses stress for the fiber post at the cervical area was approximately 182 MPa and the displacement was <0.035 mm.Conclusion:The FEA results showed that the stress in the cervical area of the dentin was more for fiber post when compared to dentin post, and maximum displacement values were less for dentin post in comparison to fiber post.