Compromised Patients Research Articles

A small molecule that targets the processivity factor of molluscum contagiosum virus has therapeutic potential

Molluscum contagiosum (MC) is an infectious disease that occurs only in humans with a tropism that is narrowly restricted to the outermost epidermal layer of the skin. Molluscum contagiosum virus (MCV) is the causative agent of MC which produces skin lesions that can persist for months to several years. MCV is efficiently transmitted by direct physical contact or by indirect contact with fomites. MC is most prevalent in children and immune compromised patients. The failure to develop a drug that targets MCV replication has been hampered for decades by the inability to propagate MCV in cell culture. To address this dilemma, we recently engineered a surrogate poxvirus expressing the MCV processivity factor (mD4) as the drug target. The mD4 protein is essential for viral replication by keeping the viral polymerase tethered to the DNA template. In this study we have designed and synthesized a lead compound (7269) that is able to prevent mD4 dependent processive DNA synthesis in vitro (IC50 = 6.8 μM) and effectively inhibit propagation of the mD4-VV surrogate virus in BSC-1 cells (EC50 = 13.2 μM) with negligible cytotoxicity. In human liver microsomes, 7269 was shown to be stable for almost 2 h. When tested for penetration into human cadaver skin in a formulated gel, the level of 7269 in the epidermal layer was nearly 100 times the concentration (EC50) needed to inhibit propagation of the mD4-VV surrogate virus in BSC-1 cells. The gel formulated 7269 was scored as a non-irritant on skin and shown to have a shelf-life that was completely stable after several months. In summary, 7269 is a potential Lead for becoming the first MCV anti-viral compound to treat MC and thereby, addresses this unmet medical need that has persisted for many decades.

Updates on Intraoperative Neurophysiology During Surgery for Spinal Dysraphism.

Spinal dysraphism is a group of disorders resulting from an embryologic failure of spinal cord development which can lead to a radicular-medullary mechanical stretch that generates vascular compromise and hypoxic-ischemic damage to the nervous structures of the conus-cauda region.Thus, the clinical relevance of the different types of spinal dysraphism is related to the possible neurologic deficits resulting from spinal cord tethering. The clinical presentation is heterogenous: from asymptomatic to very compromised patients. The indications and the time of a detethering surgery are still subject of debate, although there is an agreement on the high standards of treatment that have to be offered by the surgery. Intraoperative neurophysiology (ION) contributes to the safety of tethered cord surgery in reducing the risks of iatrogenic neurological damages.

The Correlation between Mechanobiology and Fracture Healing; Osteosynthesis, Biomaterial Optimization and TRIZ Design Principles to Develop Ameliorative Implants for Reconstruction of Median Osteochondrotomy of the Sternum.

The application of stainless-steel wire is still the "standard of care" and is believed to be the "gold standard" after trans-sternal thoracotomy. To overcome postoperative instability and surgical wound infection there had been the development of a variety of circumferential, Hemi-circular, and surface on-lay implant designs to enhance bone healing of the sternum particularly in compromised patients. This fundamental descriptive theoretical research study probes into biology and effects of mechanical environment on fracture healing in general and various types of ossifications that may occur during healing of the sternum. Following surgical anatomy of the sternum, the biology of fracture (osteotomy) healing, an update on the conventional and newer biomaterials, and role of 3D printing in custom additive manufacturing of the surgical implants have been discussed in detail. There is discussion on design principles and structural optimization in-line with patient-specific and patient-appropriate osteosynthesis. In support, the Teorija Rezhenija Izobretatelskikh Zadatch engineering principles have been applied to improve implant design in the face of the current strategies to relieve some of the recalcitrant deficiencies underlying the mechanics of the most favored implant for the reconstruction of the sternum. Several scientific domains of the engineering design principles and fracture healing processes have been connected leading to four newly conceptualized prototype designs for the reconstruction of the sternum. In conclusion, despite increased knowledge of the fracture healing process there are limited means to mitigate the adverse mechanical environment experienced by the healing sternum. There are uncertainties how to transfer the well-known facts of tissue strain during healing from the experimental platform to the operating table at the time of fracture fixation and reconstruction of the sternum for its optimal healing.

Oral health related-quality of life before and during the COVID-19 pandemic in patients with non-alcoholic fatty liver disease.

Since the beginning of the COVID-19 pandemic, the number of medical appointments and the offer and use of oral health services have decreased sharply with the lockdown period. Restriction to regular dental care can increase the risk of oral diseases, capable of affecting general health and oral health-related quality of life, particularly among medically compromised patients. This study aimed to assess health-related quality of life (HRQoL) and oral health-related quality of life (OHRQoL) of patients with non-alcoholic liver disease (NAFLD) before and during the COVID-19 pandemic. Prospective cohort of 58 patients with NAFLD followed up from March 2020 (before the pandemic) to December 2021 (during the pandemic). RAND 36-Item Health Survey and Oral Health Impact Profile 14 (OHIP-14) questionnaires were used to assess HRQoL and OHRQoL, respectively, in the two points of time. The scores of all scales HRQoL and of the question about health change in the last year decreased substantially with the advent of the pandemic. Large (>0.50) effect sizes were estimated for the scales Role functioning/physical, Pain, General health, and Energy/fatigue. Patients who had COVID-19 presented better HRQoL and OHIP-14 mean scores than those who did not have the disease. The OHIP-14 total score increased 3.6 points with the advent of the pandemic, representing a large effect size (0.62). Patients presented high probability (84.3%) of increasing OHIP14 score during the pandemic. The HRQoL and the OHRQoL scores of NAFLD patients decreased substantially with the advent of the pandemic. However, these decreases were not associated with the COVID-19 disease by itself, but probably to other factors related to the deep social changes brought by the social isolation measures to combat the pandemic.

Mucormycosis in immuno compromised patients: Findings from an Indian case series

Mucormycosis in immuno compromised patients: Findings from an Indian case series

To Refer or Not to Refer Periodontally Compromised Patients- What Does Literature Suggest?

Periodontal disease is one of the most common diseases worldwide. Hence, regular and thorough periodontal screening and care is imperative and should be a basis of all oral examinations. General dental practitioners often being the first to diagnose periodontal disease, might play a significant role in the management of periodontally affected patients. It is also necessary to focus on management of the risk factors and modifying factors which might affect periodontal disease and its treatment plan. Irrespective of the treatment being administered by a specialist or general practitioner, it should be ensured that the patients receive the same and best quality treatment. The level of speciality education being limited in the curriculum for undergraduates, general dentists need to be well acquainted with the criteria of timely and appropriate referrals to periodontists. The speciality of periodontology is growing in diverse aspects and various advancements in this field of dentistry have given success predictability level to previously considered unsalvageable periodontal issues. The present article provides useful guidelines for periodontal referral. It elaborates the levels of complexity associated with periodontal treatment and care of periodontally compromised patients in a secondary care setting.

Pneumocytosis: An Emerging Opportunistic Mycosis of Public Health Importance

Opportunistic mycoses have become a significant causee of morbidity and mortality in both sexes and in all age groups throughout the world. Pneumocytosis caused by Pneumocystis jiroveciiis, a potentially fatal fungal disease, is significant for public health. Pneumocytosis is often the AIDS-defining disease in HIV-infected patients, usually occurring when CD4 count drops below 200 cells/μL. However, the disease is a growing concern to immune compromised patients without HIV infection, such as those who are undergoing organ transplantation, receiving novel immunosuppressive therapeutics or those who have connective tissue diseases. Pneumocytosis is recognized to affect patients all over the world, and is transmitted from person to person through the airborne route. Patients with and without HIV infections have substantially distinct clinical presentations of Pneumocytosis. Disease has a bad prognosis in individuals who are HIV-negative, rapidly progresses, is challenging to correctly diagnose, and produces severe respiratory failure. Interstitial pneumonia in immune compromised patient a patient is the most common clinical symptom. Due to non-specific signs and symptoms, diagnosis of disease poses a problem. Since chest radiographs are not pathognomonic for disease and the organism cannot be cultivated routinely, a definitive diagnosis must be made using histopathology or cytopathology evidence of organisms in tissue, bronchoalveolar lavage (BAL) fluid, or artificial sputum samples. Trimethoprim-sulfamethoxazole (TMP-SMX) is the treatment of choice. Intravenous pentamidine, clindamycin-primaquine, daps one, atovaquone, and echinocandins are among the second-line treatment options in Pneumocytosis.

Serial Application of Meshed Collagen-chondroitin Silicone Bilayer Matrix to Obtain Full Coverage over Bone and Tendon in Challenging Situations and Medically Compromised Patients: A Small Case Series

Introduction. Soft tissue defects in medically compromised patients present significant challenges to the reconstructive surgeon, particularly when vital structures are exposed. This case series reports clinical outcomes of 5 adult patients with challenging medical problems whose wounds were managed using a meshed collagen-chondroitin silicone bilayer matrix to obtain coverage over bone and tendon. Materials and Methods. Patient 1 had significant degloving of the scalp. Patient 2, who had a giant neglected tumor, had a defect comprising the entire occipital skull. Patients 3 and 4 had necrotizing infection in a lower extremity open wound and a pretibial wound (patient 3). Patient 5 sustained a severe crush injury of his forearm and had a large open wound. All the wounds had exposed structures. Results. The incorporation rate of the dermal matrix in the wound bed was 100% in patients 1 and 5, 75% in patient 2, and 90% in patients 3 and 4. Patients 2 and 4 received a second application of dermal matrix to obtain full coverage of the wounds. Each patient achieved stable soft tissue coverage and successful reconstruction. Conclusions. These 5 cases highlight the capacity and capability of this dermal matrix to allow coverage over exposed bone and tendon, as well as the clinical utility of the serial application of this matrix.

Impact of pending dental treatments on patient's oral health during COVID-19 pandemic in the United Arab Emirates

Background: Untreated dental problems can have a negative impact on the health and well-being of affected individuals, and delayed treatment would lead to serious oral problems. The outbreak of COVID-19 has shut down many dental care services, and this has deferred dental treatment for many. Assessing the effect of pending dental treatment will clarify the role and importance of dental services in maintaining and controlling oral health. Aims and Objectives: This study was carried out to explore the impact of COVID-19 on pending dental treatment among United Arab Emirates (UAE) residents. Assessing the importance of dental services, studying patients' self-management of symptoms, comparing the most affected categories, and determining the demand of developing a forward strategy in case of a future pandemic. Methodology: A cross-sectional study was designed using a pre-tested questionnaire published in an online survey among UAE residents that included participants from all seven emirates. Consent was conducted from each participant after ensuring anonymity and confidentiality. The collected responses were tabulated and subjected to statistical analysis. Appropriate tests of significance were used, and a P< 0.05 was considered statistically significant. Results: The analysis showed about 34.2% of the participants had pending dental treatment due to COVID-19. The most deferred treatment was orthodontic treatment by 18.6% of participants. The commonly affected oral region was the teeth, where toothache was the most reported oral symptom. Conclusion: The findings showed that the pandemic had a significant impact on the dental health of UAE residents due to postponed treatment. It is suggested to raise the level of awareness and the shifting of the dental care paradigm to preventive strategies has to be developed according to the new guidelines focusing on reducing the risk factors of oral cancer. The new strategies emphasise dental health promotion, topical fluorides and nutritious diet. Oral health messaging and actions should be incorporated in pediatric offices and primary health-care facilities. Moreover, allocate mandatory periodic dental checkups for compromised patients. Dentists should consider alternative strategies to address these deferred treatments during such pandemics.

Soft-Tissue Augmentation in Periodontally Compromised Patients during Immediate Placement and Immediate Loading Dental Implant Surgery - A Retrospective Study.

The purpose of this article is to describe a soft-tissue augmentation procedure for multiple tooth extraction sites during immediate placement and immediate loading (IPIL) dental implant surgery in periodontally compromised patients and to present follow-up results of its effectiveness. A retrospective study was conducted on data from patients who underwent IPIL dental implant surgery between 2018 and 2021 at an oral implant centre in Bulgaria. Based on inclusion and exclusion criteria, 103 patients were included, 53 of whom had pre-operative indications for connective tissue grafts (CTGs) and 50 of whom did not. The post-operative incidence of gum recession was evaluated in the two patient groups. The majority of the 53 patients (56.60%) had six, seven or eight tooth sites grafted. A significant proportion (87%) needed CTGs at the canine teeth (13 and 23), P < 0.001. The post-operative data showed a low incidence of gum recessions in both the patient groups, with a lower rate in the CTG group at tooth no: 13 (2.20% vs. 18%, P = 0.016) and in the total sum of 10 tooth sites with CTGs (P = 0.001). A reduction in gum problems and increased satisfaction with gum health and aesthetics were reported by 100% of the CTG patients. Soft-tissue augmentation at multiple tooth extraction sites during IPIL dental implant treatment may benefit periodontally compromised patients through an improved prosthesis-tissue interface in the aesthetic area and a reduction in gum infections, swelling, bleeding and pain.

Ocular disease amongst patients visiting ophthalmology department

Background: The presentation of eye diseases distribution varies globally. Specific ocular diseases are related to age, races and occupations. Early diagnosis is drawn in most eye morbidities to prevent diminution of sight and to have better prognosis. Eye sight is essential for daily activities and any visual impairment is serious and devastating disability. While some eye morbidities are easily cured and wells if not prevented or treated quickly can lead to diminution of vision and permanent blindness, therefore it is importance to determine the frequency of ocular diseases in patients. Objective: To determine the ocular disease amongst patient’s visiting ophthalmology department. Methodology: This Descriptive cross-sectional study was conducted at department of ophthalmology DHQ hospital Bannu from April 2022 to November 2022 by accessing the patient’s ocular diseases. All patients from 18 years to 80 years of age irrespective of their sex, suffering from some eye problem were included in the study while those who presented for follow-up, Immune- compromised patients, getting anti-cancer treatment were excluded from the study. The data was analyzed by SPSS version 24. Results: A total of 380 patients were examined. Out of 380 patients, 156 (41.1%) were Male and 224 (58.9%) were Female.

Nasal reconstruction after skin cancer surgery; presentation of treatment modalities for medically compromised patients.

Nasal reconstruction after surgical excision of non-melanoma skin cancer defects can be a challeng- ing condition for every head and neck surgeon. There are certain technical difficulties that may arise from the tissue deficit and the area that a locoregional flap could cover. What is more, patients with a compromised medical history cannot always receive surgical manage- ment under general anaesthesia, limiting even more the defect reconstruction options. The aim of the present study is to present two patients that were treated under local anaesthesia for advanced basal cell carcinomas of the nose, with modifications of paramedian and hemi- nasal flaps that provided excellent surgical and aesthetic outcomes, despite the limits of the surgical modality.

Two murine cytomegalovirus microRNAs target the major viral immediate early 3 gene.

Human cytomegalovirus is responsible for morbidity and mortality in immune compromised patients and is the leading viral cause of congenital infection. Virus-encoded microRNAs (miRNAs) represent interesting targets for novel antiviral agents. While many cellular targets that augment productive infection have been identified in recent years, regulation of viral genes such as the major viral immediate early protein 72 (IE72) by hcmv-miR-UL112-1 may contribute to both the establishment and the maintenance of latent infection. We employed photoactivated ribonucleotide-enhanced individual nucleotide resolution crosslinking (PAR-iCLIP) to identify murine cytomegalovirus (MCMV) miRNA targets during lytic infection. While the PAR-iCLIP data were of insufficient quality to obtain a comprehensive list of cellular and viral miRNA targets, the most prominent PAR-iCLIP peak in the MCMV genome mapped to the 3' untranslated region of the major viral immediate early 3 (ie3) transcript. We show that this results from two closely positioned binding sites for the abundant MCMV miRNAs miR-M23-2-3p and miR-m01-2-3p. Their pre-expression significantly impaired viral plaque formation. However, mutation of the respective binding sites did not alter viral fitness during acute or subacute infection in vivo. Furthermore, no differences in the induction of virus-specific CD8+ T cells were observed. Future studies will probably need to go beyond studying immunocompetent laboratory mice housed in pathogen-free conditions to reveal the functional relevance of viral miRNA-mediated regulation of key viral immediate early genes.

Higher Rates of Severe Infection and Persistent Cytopenias in Long-Term CAR19 Responders Than after Autologous HCT: A Single Institution Study of 139 Subjects

Introduction: Chimeric antigen receptor (CAR) T-cell therapy is a leading treatment for relapsed or refractory aggressive and indolent lymphomas. One major adverse effect of CAR T-cell therapy is prolonged risk for infection. To quantify infectious risk after CAR, we performed a single center analysis of patients after anti-CD19 CAR T-cell therapy axicabtagene ciloleucel (axi-cel, n=78) and compared these with chemo-responsive lymphoma patients concurrently undergoing autologous hematopoietic cell transplant (HCT) with cyclophosphamide, carmustine, and etoposide conditioning (n=61). Methods: All 139 patients were treated between 09/2017 and 10/2021, with 37/78 CAR and 32/61 HCT patients treated after the first report of COVID-19 in California (02/2020). Median follow up was 718 days (range 175-1650 days). We included only patients without documented relapse of their lymphoma to avoid the confounding impact of lymphoma relapse on study endpoints. There was no significant difference in age or sex between groups. The CAR-treated cohort had fewer non-CAR prior lines of therapy (mean 3.0 vs mean 3.6, p=0.014, Wilcoxon rank sum test). Nearly all patients in the CAR group (76/78) were treated for large B-cell lymphoma (LBCL) entities, with 2/78 having follicular lymphoma with a prior LBCL history. Similarly, a minority of patients in the HCT group were treated for mantle cell lymphoma (4/61) and follicular lymphoma (5/61). Of the CAR patients 19/78 had an HCT prior to CAR, and 1/61 HCT patients had prior CAR treatment. For each patient we catalogued and graded post-treatment infections after day +30 (D+30) to focus on post-discharge events. Endpoints analyzed were any infection as well as severe infections (grade ≥3). Death and treatment for a second malignancy were considered competing events. We additionally catalogued blood count measurements including hemoglobin, platelets, white blood cell count (WBC), absolute neutrophil count (ANC) and absolute lymphocyte count (ALC) at regular intervals from pre-treatment through D+800. There was no difference in baseline WBC or ANC between groups. CAR-treated patients had a higher baseline ALC and hemoglobin while HCT-treated patients had higher baseline platelets (p<0.05 for all values, Wilcoxon rank sum test). Results: There was no difference in overall survival between groups (p=0.18, log-rank test). We performed cumulative risk regression considering infections for 1200 days starting at D+30. When considering all infections there was no significant difference in the total incidence of infections between the CAR and HCT group. However, there was increased risk in CAR-treated patients for severe (grade >= 3) infections (Figure 1A, HR 2.4, CI 1.2-4.78, Gray's p=0.013). The increased risk for severe infection was sustained when considering only infections that occurred greater than one-year post-transplant (HR 3.06, CI 1.14-8.21, Gray's p=0.021). The increased risk for severe infection in the CAR-treated cohort remained if patients with prior HCT were excluded, or if COVID-19 cases were excluded. We used linear mixed effects modeling to assess cytopenic risk longitudinally from D+28 to D+800. Age, sex, and non-CAR lines of therapy were also included in the multivariate model. CAR-treated patients demonstrated significantly reduced WBC, ANC, and ALC relative to patients treated with HCT (Figure 1B, p-value <5E-7, <0.05, and <5E-5 respectively, restricted maximum likelihood with t-test using Satterthwaite's approximation). These values remained significant if CAR patients with prior HCT were excluded from analysis. WBC and ANC were significantly reduced relative to pre-lymphodepletion baseline through D+365 (p<0.05, Wilcoxon signed-rank test). There was no difference in hemoglobin level in CAR-treated vs HCT patients using the same methods. Platelet counts in CAR-treated patients resolved to the same level as following HCT by the end of the follow up period. Conclusion: Lymphoma patients without relapse after axi-cel CAR T-cell therapy have greater risk for severe infections than a concurrent group of patients treated with autologous HCT. This risk is associated with prolonged reduction in WBC, ANC, and ALC but not platelets or hemoglobin. Clinical surveillance for infections in these immune compromised CAR-treated patients therefore remains critical, with role of additional prophylaxis strategies needing further investigation. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Cardiomyopathy and dentistry

This article considers the clinical implications of cardiomyopathy and how it impacts on the provision of oral care. Consideration is given to the management of pain and anxiety in this patient group and the provision of safe, effective care. CPD/Clinical Relevance: With an increasingly ageing population, dentists should have the knowledge to safely assess and treat medically compromised patients.

Histomorphometric Analysis of Flaplessly Placed and Early Loaded One-Piece Mini Dental Implants in Overdenture Patients.

Mini dental implants (MDIs) are an affordable alternative for overdentures in medically compromised patients with reduced bone volume. This human study reports the histomorphometric analysis of early loaded and flaplessly placed tapered, one-piece MDIs (ILZ, Southern Implants; Sa: 1.5 μm) after 7 to 11 months in function. Patients agreed to have an additional MDI placed and removed for evaluation. MDI stability was assessed via Periotest prior to implant removal. Histologic sections of four mandibular and three maxillary MDIs with surrounding bone were processed, and the bone-to-implant contact (BIC) was analyzed. At retrieval, the MDIs were in function for more than 6 months, were clinically healthy, and had mean probing pocket depths of 1.4 mm and 1.6 mm in the maxilla and mandible, respectively. Periotest values were < 5.5, indicating clinical stability. Most of the screw threads were filled with bone and revealed an intimate BIC, without any signs of intervening fibrous tissue layer. In both arches, the mean BIC was 68.5%. Large osteocytes could be identified in the calcified tissue, indicative of mature peri-implant bone. It can be concluded that MDIs, when loaded within 2 weeks in either arch, provide proper clinical stability and high BIC after 6 months.

Patient-Factors Influencing the 2-Year Trajectory of Mental and Physical Health in Prostate Cancer Patients.

This study aimed to examine the physical and mental Quality of Life (QoL) trajectories in prostate cancer (PCa) patients participating in the Pros-IT CNR study. QoL was assessed using the Physical (PCS) and Mental Component Score (MCS) of Short-Form Health Survey upon diagnosis and two years later. Growth mixture models were applied on 1158 patients and 3 trajectories over time were identified for MCS: 75% of patients had constantly high scores, 13% had permanently low scores and 12% starting with low scores had a recovery; the predictors that differentiated the trajectories were age, comorbidities, a family history of PCa, and the bowel, urinary and sexual functional scores at diagnosis. In the physical domain, 2 trajectories were defined: 85% of patients had constantly high scores, while 15% started with low scores and had a further slight decrease. Two years after diagnosis, the psychological and physical status was moderately compromised in more than 10% of PCa patients. For mental health, the trajectory analysis suggested that following the compromised patients at diagnosis until treatment could allow identification of those more vulnerable, for which a level 2 intervention with support from a non-oncology team supervised by a clinical psychologist could be of help.

Oxygen Saturation During Dental Surgery with Local Anesthesia Alone and in Combination with Sedation in Medically Compromised Patients

Objective. The aim of this study was to determine which specific operative events are associated with change in SaO2 and blood pressure and heart rate in patients undergoing exodontia or minor oral surgery with local anaesthetic Medically compromised patients with Local anaesthesia alone or in combination with sedation. Methods. Arterial oxygen saturation (SaO2) with Heart rate and blood pressure was measured in 60 patients divided into two equal groups. Group I consisted of 30 patients receiving LA alone and undergoing simple extraction minor oral surgery, group II 30 patients receiving LA with oral midazolam and undergoing simple extraction or minor oral surgery. Results. There was a decrease in SaO2 from the baseline in 10% of group I patients, represented in 3 patients, 2 of them asthmatic and one anxious patient who the BP and HR raised slightly during LA admiration. There was a fall in SaO2 from the baseline in 53% of patients in group II, represented in 16 patients, the majority of them asthmatic and anxious patients, 6 patients with history of ischemic heart disease. The majority of these decreases in SaO2 or raining in BP or HR were associated with breath holding, in response to fear or emotional stress, during administration of LA due to vasoconstrictor effect or during elevation of teeth. The patients in group II showed a significantly (P&lt;0. 001) greater maximum decrease in SaO2 from the baseline value compared to group I. The length of the operating time was longer in group II than that in group I, and the patients of group II were more anxious than the patients in group I. Conclusion. It was concluded that during simple extraction and minor oral surgery under LA alone or in combination with sedation procedures such as elevation of the tooth or administration of the LA may as a result of Breath holding cause reduction in SaO2 or raising in BP or HR. In fit patients this may be of little consequence, however patients with existing airway disease or Medically compromised patients may suffer significant falls in SaO2 or alter the Blood Pressure and Heart Rate. Therefor Monitoring of vital signs and oxygen saturation recommended during simple extraction dental surgery procedure and sedation as premedication for cardiac patients would be recommended.

A COMPREHENSIVE REVIEW OF CANDIDIASIS

Candidiasis is a fungal infection caused by the genus Candida. It is otherwise called moniliasis, thrush, and candidosis. Candida albicans is the most one to cause an infection in humans and other species such as Candida auris, Candida tropicalis, Candida glabrata, Candida parapsilosis, C. parapsilosis, and Candida lusitaniae. It is categorized into oral candidiasis, invasive candidiasis, vulvovaginal, and genital candidiasis. In general, Candida yeasts are present in the human body and their growth is limited by the human immune system. When an imbalance, colonization of Candida occurs finally leads to an infection. It is mainly affected in immune compromised patients followed by risk factors such as diabetes, stem cell transplantation, organ transplantation, and prolonged use of antibiotics, and steroids. It can be diagnosed to overcome this infection by direct examination of smear, culture, and biopsy. Fluconazole is the first line drug to treat candidiasis and Amphotericin-B, Caspofungin, Voriconazole also used.

Evaluation of dental implants failure rate in medically compromised patients: A randomized case control study

Aim: The present research was done to evaluate dental implant failure in medically compromised patients compared to control group.Materials and Method: This randomized control study comprised of 50 medically compromised patients of both genders who underwent dental implants 7 years ago (Group I). Equal number of healthy subjects was taken as control (Group II). Amount of bone loss around the implant over 1mm of bone loss in the first year and over 0.3 mm bone loss every subsequent year were considered as failures.Results: The most commonly seen medically compromised patients were diabetes (20) with 24 dental implants followed by Hypothyroidism (12) with 12 implants, osteoporosis (8) with 15 dental implants, organ transplant (7) with 8 dental implants and CVD (3) with 3 dental implants. There was statistically significant difference (p&lt; 0.05). The implant failure was 15 (30%) in group I, and 3 (6%) in group II. At first year, in group I, mean bone loss around implant was 1.18 mm and 0.4 mm in group II. Up to 5 years, in group I, mean bone loss around implant was 2.8 mm and 1.3 mm in group II.Conclusion: Among medically compromised conditions, higher failure rate was found in diabetes.