Tongue Depressor Research Articles

Does plain radiography still have a role in cases of fish bone ingestion in emergency rooms? A retrospective analysis

BackgroundFish bones are the most common aerodigestive foreign bodies found in adults. Most cases of fish bone impaction improve after primary management by emergency physicians with a mirror laryngoscopy using a tongue depressor, before otolaryngologists perform a fiberoptic nasendoscopy. A computed tomography scan usually follows to determine the next step. Studies have recently been concerned about overdoses of radiation from computed tomography. However, clear algorithms remain unavailable for fish bone ingestion management to date.MethodsA retrospective review was conducted on 180 patients who visited the emergency department with complaints of fish bone impaction between January 2017 and January 2019.ResultsA total of 81.6% of patients with fish bone impaction got symptomatic relief after primary management by emergency physicians and otolaryngologists. Out of 180 patients, 33 (18.3%) needed an endoscopic procedure due to persistent symptoms. Only one (0.56%) required an operation due to perforation. In the group failing primary management, the plain radiography of eight patients showed a positive finding and an esophagogastroscopy was done to remove the fish bones.ConclusionLateral neck radiography is still beneficial to patients with fish bone ingestion failure from primary management. Positive lateral soft tissue radiography in cases with persistent symptoms post primary management may directly suggest esophagogastroscopy without confirmation from a computed tomography, unless complications are suspected. For patients aged below 40, following up on their conditions after post management radiography shows negative results may increase their safety.

Fibula Jaw-in-a-Day with Minimal Computer-Aided Design and Manufacturing: Maximizing Efficiency, Cost-Effectiveness, Intraoperative Flexibility, and Quality.

The vascularized fibular flap has been the mainstay for mandibular reconstruction for over 30 years. Its latest evolutionary step is the jaw-in-a-day operation, during which the fibula flap and dental prosthesis restoration are performed in a single stage. Computer-aided design and manufacturing technology in mandibular reconstruction has gained popularity, as it simplifies the procedure and produces excellent outcomes. However, it is costly, time-consuming, and limited in cases that involve complex defects, including bone and soft-tissue coverage. Moreover, it does not allow for intraoperative changes in the surgical plan, including defect size and recipient vessel selection.The authors describe their approach, including a conventional technique for fibula osteoseptocutaneous flap harvest without the need for a premanufactured cutting guide, using bundled wooden tongue spatulas instead, a stereolithographic model to customize commercially ready-made reconstruction plates, and two pieces of resin to maintain occlusive alignment of the remaining jaw segments during mandibular osteotomy. Dental implants are inserted free-hand. Vector guides are then connected to the implants following insertion into the fibula to confirm acceptable alignment and subsequently replaced with scan sensors. An intraoperative digital scan is used to design and to produce a dental prosthesis by in-house milling of a polymethylmethacrylate block. From our 10-case experience over the past 3 years, we have found that our approach offers a reliable method that matches the excellent outcomes seen using full computer-assisted design and manufacturing technology. It is time- and cost-effective, not limited to relatively simple jaw defects, and can readily accommodate intraoperative changes of surgical plan.

A more secure and effective method for throat swab collection: The importance of adequate exposure of oral cavity in COVID-19 specimen collection

ObjectivesThis study aims to propose a novel and effective throat swab collection method for coronavirus disease 2019 (COVID-19). MethodsThe subjects were randomly divided into two groups. The subjects were asked to open their mouth to make “ah” sound (traditional method) or simulate yawn (improved method) for throat swab collection. The usage of tongue depressor, collection time, adverse reactions and subjective discomfort (VAS score) were compared. The collection time, comprehensive indicators of adverse reactions and VAS score were also compared among three collectors. ResultsThe tongue depressor was less used in the improved group (χ2 = 40.186, P < 0.01). The average collection time of the traditional group was 5.44 ± 2.97 and that of the improved group was 4.00 ± 2.31 (P < 0.01). The subjects in the improved group had fewer and milder adverse reactions. The VAS score of subjects in the improved group was lower than that in the traditional group (P < 0.01). Among different collectors, the collection time, comprehensive indicators of adverse reactions and VAS were the same as the overall trend. ConclusionSimulating yawn is a safer and faster throat swab collection method.

Fiber Microdissection Technique for Demonstrating the Deep Cerebellar Nuclei and Cerebellar Peduncles.

The cerebellum is one of the most primitive and complex parts of the human brain. The fiber microdissection technique can be extremely useful for neurosurgeons to understand the topographical organization of the cerebellum's important contents, such as the deep cerebellar nuclei and the cerebellar peduncles, and their relationship with the brain stem. To dissect the deep cerebellar nuclei and the cerebellar peduncles using the fiber microdissection technique. Under the operating microscope, 5 previously frozen, formalin-fixed human cerebellums and brain stems were dissected from the superior surface, and 5 were dissected from the inferior surface. Each stage of the process is described. The primary dissection tools were handmade, thin, wooden spatulas with tips of various sizes, toothpicks, and a fine regulated suction. In 15 simplified dissection steps (6 for the superior surface and 9 for the inferior surface), the deep cerebellar nuclei (dentate, interpositus, and fastigial) and the cerebellar peduncles (inferior, middle, and superior) are delineated. Their anatomical relationships with each other and other neighboring structures are demonstrated. The anatomy of the deep cerebellar nuclei and the cerebellar peduncles are clearly defined and understood through the use of the fiber microdissection technique. These stepwise dissections will guide the neurosurgeon in acquiring a topographical understanding of these complex and deep structures of the cerebellum. This knowledge, along with radiological information, can help in planning the most appropriate surgical strategy for various lesions of the cerebellum.

USO DE PROTETORES BUCAIS EM PACIENTES INTUBADOS NA UNIDADE DE TERAPIA INTENSIVA: UMA REVISÃO DE LITERATURA

Intubation is a medical technique that consists of placing a tube inside the trachea, orally or nasally, with the aim of maintaining definitive control of the airway. However, there may be complications such as laceration of the lips and gums, vocal fold avulsion, fracture and tooth avulsion. This literature review therefore aims to report the damage that is caused to dental structures, the factors that increase the risk of trauma in the intubation process and the methods that are used to prevent them. A literature review was performed through a search for articles in the Medline/PubMed database including 10 articles. Based on the analysis of the articles included, it can concluded that the use of mouthguards, whether they are 3M tape, wooden spatulas, or mouthguards molded by dentists, can significantly reduce the forces that act on the teeth, minimizing the risks of dental trauma. Thermoplastics have their effectiveness discussed in different studies, but the most recent one discusses that they are effective, in addition to being easy to handle and cost-effective, but it is not the most recommended method of protection.

A Bioimpedance-Based Device to Assess the Volume Conduction Properties of the Tongue in Neurological Disorders Affecting Bulbar function.

Goal: Current instruments for bulbar assessment exhibit technical limitations that hinder the execution of clinical studies. The volume conduction properties (VCP) of the tongue reflect ionic content and myofiber integrity and they can serve as a new biomarker for evaluating neurological disorders with bulbar dysfunction. Methods: We designed a standalone bioimpedance measurement system that enables accurate, multi-frequency measurement of tongue anisotropic VCP including conductivity and relative permittivity. The system includes a tongue depressor with 16 non-invasive surface sensors for electrical contact with the tongue at directions 0n}{}^{circ }, 45n}{}^{circ }, 90n}{}^{circ } and 150n}{}^{circ }. The depressor is interfaced with the tongue electronic system with Bluetooth connectivity, and a smartphone application. De-identified patient data is sent by email. Results: We first determined the accuracy of the hardware performing phantom measurements mimicking a broad range of tongue values and determined the error to be n}{}< 1%. We then validated our new technology measuring a cohort of 7 healthy human subjects under Institutional Review Board approval. Conclusions: None of the subjects who participated suffered discomfort or gag reflexes. The novel technique presented for intra-oral assessment of tongue VCP provides standard, objective and quantitative data potentially sensitive to alterations in tongue internal structure and composition.

Assessment of tongue depressor-related tongue swelling in pediatric patients with ultrasonography: A prospective, case-controlled observational study

Adenoidectomy is one of the most common surgeries performed in children. The tongue depressor is being routinely used during adenoidectomy exerts high mechanical pressure on the tongue. We aimed to discover tongue swelling created by the compression of tongue depressor by using ultrasonography (USG) in pediatric patients who were undertaken adenoidectomy. Thirty-four patients who were undertaken adenoidectomy were involved in the study group. In the control group, 33 patients who were undertaken pediatric surgery were involved. The tongue surface area (TSA) measurement was achieved for two times. In the study group, TSA1 was performed immediately following intubation, prior to the installment of the tongue depressor, TSA2 was performed following the removal of the tongue depressor however prior to extubation. In the control group, TSA1 was performed immediately following intubation, TSA2 was performed prior to extubation. An important correlation was noticed among the severity of tongue swelling (defined as TSA2 - TSA1 ) (P = 0.000) and tongue depressor. Tongue depressor may provoke tongue swelling in adenoidectomy procedures that can be shown with USG. This tongue swelling seems to be a result of the pressure applied by the tongue depressor. Tongue depressor related tongue swelling may cause respiratory complications in patients with already restricted airway passage even if the patients are fully awake. The tongue swelling in pediatric patients under adenoidectomy surgeries was demonstrated for the first time in the literature by USG.

Micronucleus assay in formalin exposed individuals

Introduction: The aim of the study was to find out the nuclear abnormalities like Micronuclei in the oral mucosa of the formalin exposed individuals in the department of anatomy. This MN Aaasy is an inexpensive method. Materials and Methods: Faculties and staffs working in the department of anatomy and the first-year students were included in this study. Study sample consists of 50 subjects and was divided into 5 groups according the years of exposure. By scraping with the wooden spatula in the buccal mucosa Oral squamous cells were collected and smeared on the slides. The smeared slides were fixed with methanol glutaraldehyde fixative and stained with giemsa, maygrunwald stain. After airdrying 1000 cells were screened for Micronucleus (MN). Results: Micronuclei frequency was more in the group who had more than 15 years of formalin exposure. The mean MN count was 9.60 and it was statistically significant when compared to other groups. Conclusion: Micronucleus Assay is the most simple, feasible, inexpensive method to find out the nuclear abnormalities at an early stage in the formalin exposed individuals. Keywords: Formalin, Buccal Mucosa, Micronucleus.

In vivo muscle conduction study of the tongue using a multi-electrode tongue depressor

ObjectiveTo test a novel technology for assessment of the volume conduction properties (VCPs) of the tongue. These properties are electrophysiological data that might reflect alterations in patients with tongue involvement. MethodsSeven healthy individuals were self-measured. The depressor was placed on the surface of the anterior tongue. Directional differences of VCPs were determined with standard descriptive statistics. ResultsConductivity in longitudinal direction was larger than in transverse direction at 16 (p < 0.05), 32 (p < 0.05), 64 (p < 0.01), and 128 kHz (p < 0.01). No differences were found in relative permittivity. The intraclass correlation was 0.778 and 0.771, respectively. ConclusionsOur technology provides, for the first time, VCPs of the healthy human tongue. SignificanceTongue VCPs are standard electrophysiological, quantitative and objective data reflecting ionic content and membrane integrity which could find value for diagnostic purposes and treatment monitoring.

Sequence and Date of Eruption of Permanent Teeth in A Group of Children in El-Gharbia Governorate

Introduction: Teeth eruption is a dynamic, genetically process which is a part of the odontogenesis and comprises all the tooth movement from the bone crypt until reaching the occlusal plane and starting its function. Objectives: The present study was carried out to determine the eruption dates of permanent teeth, also to study bilateral and maxillo-mandibular differences in the eruption of teeth and finally to assess sequence of permanent teeth eruption among a group of children in El Gharbia governorate. Methods: The study sample consisted of 1000 healthy Egyptian children of both sexes aged from (5- 12 years) were selected from different urban and rural primary schools. They were examined by tongue depressors in the day light, mouth mirrors and light torch for recording presence or absence of teeth. Results: The first permanent tooth to erupt was the lower first molar, erupted at 7.30, 7.41 years in girls and boys respectively and the last tooth to erupt was the maxillary second molar, erupted at 11.23, 11.26 years in girls and boys respectively. Also there were no statistically significant gender differences in mean eruption ages of permanent teeth except lower canine and no significant jaw differences except incisors in both girls and boys &canines and lower second molar in girls. Finally there were insignificant differences between right and left sides in permanent dentition. Conclusion: The eruption dates of permanent teeth are delayed in EL-Gharbia governorate compared to other studies. Girls preceded boys only in lower canine

A retrospective study on the oral health of patients in the intesive care unit

&lt;p&gt;&lt;strong&gt;Introduction&lt;/strong&gt;: the oral condition of patients in the Intensive Care Unit (ICU) is extremely important for clinical status monitoring,&lt;br /&gt;as lesions in the oral mucosa may imply complications and worsening of the health status of these patients. A higher probability&lt;br /&gt;of adherence, colonization, and bacterial infection in the oral cavity of patients in the ICU has also been reported. The poor oral&lt;br /&gt;hygiene conditions of these patients may be related to the reduction of salivary flow and difficulties in maintaining oral hygiene in a&lt;br /&gt;hospital environment, which rarely employs dentists on staff. &lt;strong&gt;Objective&lt;/strong&gt;: to analyze the dental condition of patients admitted to the&lt;br /&gt;ICU of Roberto Santos General Hospital, Salvador, Bahia, Brazil. &lt;strong&gt;Methodology&lt;/strong&gt;: a total of 73 patients were evaluated through an oral&lt;br /&gt;examination performed with a wooden spatula and sterile gauze under natural light, and data were collected and analyzed. &lt;strong&gt;Results&lt;/strong&gt;:&lt;br /&gt;The most commom oral lesions were tongue-coating (41%) and ulcerations in the oral mucosa caused by trauma or dehydration&lt;br /&gt;(19.1%). The occurrence of pseudomembranous candidiasis (8.2%), dehydration of the lips and mucosa (26%), and angular cheilitis&lt;br /&gt;(9.5%) was additionally recorded. It was observed that 31.5% patients had more than 10 days of hospitalization and of these, 26%&lt;br /&gt;presented pseudomembranous candidiasis. This clinical condition was not seen in patients with a shorter hospital stay. &lt;strong&gt;Conclusions&lt;/strong&gt;:&lt;br /&gt;this study suggest a possible association between the length of stay of these patients and the clinical conditions presented. Thus, the&lt;br /&gt;results of this study may guide preventive and curative measures implemented by dental surgeons who may, in the future, be part&lt;br /&gt;of the multidisciplinary team of professionals working in the hospital environment, especially in ICUs.&lt;/p&gt;

Assessment Hormonal Disorders of Women in Oral and Vaginal Changes

Hormonal deficiencies may contribute to the development of abnormalities of oral and vaginal tissues, such&#x0D; as pain, desquamation, recurrent oral, vaginal ulceration and delayed post-surgical healing .This study was&#x0D; done to determine the differences of cell activity in oral and vaginal mucosa .&#x0D; A total of 200 females of different age groups were used in this study Oral smears were obtained from the&#x0D; buccal mucosa by scraping the area gently using a wooden tongue depressor while vaginal smears were&#x0D; obtained from the proximal portion of the lateral wall of the vagina using Ayre’s spatula by scraping the area&#x0D; gently . In order to find to change in mucosa during different phases of menstrual cycle .&#x0D; In two groups the present results revealed that vaginal cytological patterns of each group is similar to the&#x0D; oral cytological pattern with some differences .&#x0D; In conclusion significant correlation between the hormonal fluctuations in woman and the degree of&#x0D; maturation of their oral epithelium was revealed in this study .

Mouth Injuries in Hospitalized Patients of an Intensive Care Unit

Oral health conditions of patients in intensive care units (ICU) is often very precarious. This study was conducted in the ICU to identify oral changes of this population. Material and Methods this was an exploratory, descriptive and cross-sectional study. The data collected included age, gender, oral hygiene condition, reasons for hospitalization, oral changes and management. Two trained dentists performed the clinical oral examinations using wooden spatulas and sterile gauze. 104 patients between 19 and 92 years of age (56.82 ± 18.23 years) were analyzed, comprising 26 women and 78 men. Most of the patients presented good hygiene. The most common reason for admission was traumatic severe brain injury. Fifty-nine patients (56.7%) had at least one oral lesion. Most frequent lesions were lip dryness (26.3%), traumatic ulcers (TU) (20.0%) and tongue coating (20.0%). According to our results, traumatic ulcers represent a challenge for physicians, the participation of a dentist and a dental hygienist would help to manage and prevent infections of these lesions, making a truly interdisciplinary team essential for the quick recovery of ICU patients.

Utility Of A Custom Accomodation Convergence Ruler For Measuring Near Point Convergence On The Voms

The Vestibular/Ocular Motor Screening (VOMS) tool is a common assessment that was specifically designed to evaluate vestibular and/or oculomotor control deficits following sport-related concussion. The only objective component of the VOMS is near point convergence (NPC) distance. This distance is commonly measured from the tip of the nose to the instrument (typically a 14-point font “X” on a tongue depressor) which is brought towards the patient’s nose. Unfortunately, without the use of an accommodation convergence ruler, it is possible that NPC may be measured incorrectly. PURPOSE: The purpose of this study was to investigate the use of a custom-made accommodation convergence ruler as compared to conventional methods for measuring NPC on the VOMS in a healthy population. METHODS: 12 healthy collegiate female students (average age = 22 years) all with lower than 20/20 vision (corrected and not corrected) and no diagnosed concussion history participated in this study. All participants completed 3 trials of NPC using standardized instructions and 1) traditional tongue depressor with a 14-point font “X” (TRAD) and 2) a custom made NPC accommodation convergence ruler (RULER). The custom ruler was attached to a series of supports that were connected to the ground and leveled prior to each trial. The ruler is placed at the tip of the nose and participants bring a 14-point font dot on a slide toward the bridge of their nose. Between each trial and condition, participants were given 2-mins of rest as needed to reduce ocular fatigue. Each NPC distance were measured by a highly trained rater and averaged for further analysis using a paired t-test. RESULTS: The results indicate no significant differences between using the TRAD (average=2.79cm ± 2.05cm) and the RULER (average=2.12cm ± 1.64cm; p=0.17; Cohen’s d=0.41). The TRAD had two measurements that were above 5cm, while the RULER measurement had only one above 5cm. CONCLUSIONS: Using a more sophisticated device to measure NPC may not directly influence the measurement of NPC as compared to standard conventional methods in an all-female healthy population. Although NPC distance trended lower and had fewer false negatives using the RULER, trained clinicians using standardized instructions may not need to use an accommodation convergence ruler to obtain sufficient measurements.

Characterization in children aged 4 to 6 years with dental interference from children's daycare institutions

Objective: the objective of characterizing children from 4 to 6 years of age from nursery schools in the health area of the Julian Grimau Garcia Teaching Polyclinic in Santiago de Cuba, according to clinical and epidemiological variables. Materials and methods: An observational, descriptive and cross-sectional study was carried out in children from 4 to 6 years of age belonging to the nursery circles of the health area of the Julian Grimau Garcia Teaching Polyclinic in Santiago de Cuba, in the period of July 2016 to April 2017 .The study was constituted by the 57 children from 4 to 6 years of age belonging to the 2 children's circles of the aforementioned health area, of both sexes and who presented dental interferences. To obtain the data, a structured interview was conducted with parents or guardians, in order to obtain accurate and verified data, using the percentage as a summary measure. The oral examination was performed on children using the tongue depressor and natural or artificial light. Results: the male sex and the period of temporary dentition predominated. Buccal breathing and bottle use were the most practiced deforming habits. Conclusions : Concluding that most of the children examined did not present anomalies of the occlusion. Considering this, we recommend carrying out analytical studies in the area that allow deepening the study of dental interferences in children as a causal factor of malocclusions, elevating health promotion and prevention activities to pregnant women and mothers on the importance of practicing favorable lifestyles for the health and development of the stomatognathic system of their children from an early age.

Serial measurements of facial asymmetry using a wooden tongue depressor in patients with congenital microtia

Congenital microtia may be associated with hemifacial microsomia, but little is known about their correlation and development with aging. Historically, facial asymmetry is easily assessed by observing the occlusal cant using a tongue depressor. We serially measured the occlusal cant in children with microtia to evaluate change in facial asymmetry with growth. Since 2011, frontal photographs of patients with congenital microtia biting a tongue depressor were obtained and reviewed. The occlusal angle was compared between the baseline and final photographs, and the change was compared between cant-positive (>3° at baseline) and cant-negative (<3° at baseline) groups. Multivariate analysis was conducted to determine variables associated with the change in occlusal angle. Overall, 105 patients were enrolled. With a mean age of 5.4 years at baseline and a mean follow-up of 3.9 years, clinically significant aggravation was observed in 15.4% and 24.2% of cant-positive and cant-negative patients, respectively. Hemifacial microsomia (OR, 4.825; p = 0.005) and occlusal angle at baseline (OR, 0.821; p = 0.045) were associated with aggravation, but the severity of microtia showed no significant association. When hemifacial microsomia was present, the occlusal cant seemed to be aggravated in children with microtia at later ages. When the occlusal cant was present without noticeable hemifacial microsomia, some compensation in facial asymmetry was expected. The use of a wooden tongue depressor is a simple, non-invasive, and radiologic hazard-free aid to detect notable change in facial asymmetry in children with microtia.

Measurement of Oral Moisture on Oral Dryness Patients.

Many elderly patients have oral dryness; thus, it is necessary to evaluate the oral moisture in a clinical setting. The aim of this study was to clarify the importance of controlling the measuring pressure of the oral moisture-checking device. The influence of the measuring pressure of the oral moisture-checking device was examined using agar under 10 measuring pressure conditions (Kruskal–Wallis test). Fifty-five oral dryness patients were examined the lingual moisture using the device with and without a tongue depressor. The tongue depressor was placed underneath the tongue to support it during the measurement. The mean value and the coefficient of variation of five measurements was evaluated (paired t-test or Wilcoxon signed-ranks test). The agar moisture values changed according to the measuring pressure (p < 0.05). The lingual moisture value with the tongue depressor was higher than that without the tongue depressor (p < 0.05). The coefficient of variation with the tongue depressor was smaller than that without the tongue depressor (p < 0.01). The results of this study indicated that the measuring pressure of oral moisture-checking device influenced the measurement value, and it is necessary to support the tongue for the measurement of lingual mucosal moisture in a uniform manner.

Correlación entre recuento de micronúcleos y hábito tabáquico: Un estudio hospitalario

Background: Micronucleus is a microscopically visible cyto-plasmic chromatin mass in the extranuclear vicinity, originating from aberrant mitosis, which consists of eccentric chromosomes that have failed to reach spindle poles during mitosis. The present study was designed to evaluate and compare cytogenetic changes in the buccal mucosa of smokers and non-smokers based on the occurrence of micronuclei. The study aimed to determine the correlation between the micronuclei count and the frequency and duration of smoking habit. Materials and Methods: Two groups (smokers and non-smokers) of 34 individuals each were examined. Cytological buccal smears were taken from participants using a moistened wooden spatula and stained with standard Papanicolaou stain. Presence of micronuclei was assessed at 40X magnification using a light microscope and a count per 500 cells was determined. The results of the study were analyzed statistically using Mann-Whitney U test, Spearman's rank correlation coefficient and Student t-test. Result: Smears from smokers showed a significant increase in the total number of micronuclei per 500 cell count compared to non-smokers. There was a strong positive correlation between the occurrence of micronuclei and the frequency and duration of smoking. A age-related increase in older age groups was also observed. Conclusion: The study reveals a strong positive correlation between the occurrence of micronuclei and the frequency and duration of smoking. This observation is vital in the utilization of the micronuclei detection in smears as a prognostic, educational and interventional tool in the management of patients with smoking habits.

Use of a biopsy punch for end-to-side anastomosis in free-tissue transfer

Background: In end-to-side vessel-anastomoses, a side fenestration should be made by a slit incision or partial excision of the vessel wall. However, a slit incision might restrict blood flow across the anastomosis, and a partial vessel wall excision using micro-scissors may be time-consuming and result in irregular edges, which may weaken the vessel wall and cause flow disturbances. We used a biopsy punch for end-to-side anastomosis, and obtained satisfactory results.Methods: Between September 2015 and August 2017, 27 end-to-side anastomoses using punch biopsies were performed. Two vessel clamps were applied to the recipient vessel proximal and distal to the point planned for the side anastomosis. The flap side vessel size was measured, and an appropriately sized punch was selected. The clamped recipient vessel was supported by a wooden tongue depressor and the punch was applied to the vessel wall. An end-to-side anastomosis was performed in the usual manner, and immediate patency was tested with a refill test.Results: The vessel patency rate was 96 percent. The mean arteriotomy or venotomy time was 65 s and entire anastomosis procedure time was 1065 s. Both the vessel preparation and the micro-anastomosis procedure times were shorter than those of the conventional procedure group with statistical significance. (p < .05) There was only one case of venous failure by deep vein thrombosis – and it was resolved with thrombectomy and re-anastomosis.Conclusion: Use of a biopsy punch in end-to-side anastomosis can offer a uniform circular edge and reduce operating time.

Micronucleus Assay of Buccal Mucosa Cells in Waterpipe (Hookah) Smokers: A Cytologic Study

Micronucleus assay of buccal mucosa cells is a simple bio- monitoring method for diagnosing the genetic damages of toxic agents. The aim was to study the genotoxic effect of waterpipe smoking on buccal mucosa cells using micronucleus assay. This was a case control. A total of 30 male waterpipe smokers and 30 non-smokers were included in the study. The exfoliated buccal mucosa cells were scrapped using wooden spatula and were spread over glass slides. The mean number of micronuclei was determined using Feulgen-stained slides. The number of micronuclei per 1000 cells was calculated and compared between the two groups of smokers and non-smokers. The mean number of micronuclei in waterpipe smokers and non-smokers was 1.94±0.39 and 1.68±0.35, respectively. The micronuclei count in waterpipe smokers was significantly higher than non-smokers (P=0). The difference between the number of waterpipe smoking and micronuclei count was significantly different (P=0). The mean number of micronuclei in buccal mucosa cells of waterpipe smokers was significantly higher than non-smokers. The genotoxicity effect of waterpipe was dose-dependent.