Shows
The Foreign LocalSherin Sabry: Gulfies, Diaspora, and Third Culture Kids [S02 E02]Today’s episode is a little different.
Unlike most other episodes, this one doesn’t dive too deep into Sherin’s story of growing up in the UAE and moving back to Cairo for university. It starts that way, yes; but, in typical Sherin and Monica fashion, the conversation is basically one giant tangent that starts with a very important question: wtf is a Gulfie?
Bringing two very different perspectives to the conversation, Sherin and Monica discuss the word ‘diaspora’ – what it means, who it entails, and the very particular experience it represents – in contrast with the third...2023-10-171h 30
Oral Surgery1. Medical emergencies2022-04-2708 minOral Surgery2. ME- Infection endocarditis2022-04-2705 minOral Surgery3. ME - Anticoagulant therapy2022-04-2704 minOral Surgery4. Extraction2022-04-2702 minOral Surgery5. Complications of extraction2022-04-2707 minOral Surgery6. I & D + Space Inflection2022-04-2703 minOral Surgery7. Impaction2022-04-2702 minOral Surgery8. Sutures2022-04-2703 minOral Surgery9. Instruments2022-04-2706 minOral Surgery10. Muscles of mastication2022-04-2708 minOral Surgery11. Anterior disc displacement2022-04-2702 minOral Surgery12. Biopsy2022-04-2701 minOral Surgery13. Fractures2022-04-2707 minOral Surgery14. Occlusal splint2022-04-2701 minOral Surgery15. Le Forte fractures2022-04-2705 minOral Surgery16. Cleft lip & palate2022-04-2704 minOral Surgery17. Implants2022-04-2707 minOral Surgery18. Local anesthesia2022-04-2703 minOral Surgery19. LA- to byheart2022-04-2703 minOral Surgery20. LA composition2022-04-2702 minOral Surgery21. LA techniques2022-04-2705 minOral Surgery22. Nerve blocks2022-04-2707 minOral Surgery23. NB Gowgates + Vazirani2022-04-2703 minOral Surgery24. LA calculation 12022-04-2703 minOral Surgery25. LA calculation 22022-04-2702 min
Oral Pathology1. Op intro2022-04-2701 minOral Pathology2. Development disordersDEVELOPMENTAL CONDITIONSDevelopmental conditions are soft tissue or hard tissue defects that occur during the development of the individual, either before or after birth. LIP PITS- Depressions or concavities seen on lip- Seen with Van Der Wood syndrome along with cleft lipFORDYCES GRANULES- Ectopic sebaceous glands - On buccal mucosa- Usually seen as Bilaterally symmetricalLEUKOEDEMA- White or whitish grey edematous (fluid) lesion of buccal mucosa- It dissssipiates when cheek is stretchedANGIOMAS- ANGIO...2022-04-2708 minOral Pathology3. Teeth anomaliesTEETH ANOMALIESDUE TO DEFECT IN THE INITIATION AND PROLIFERATIONFUSION AND GEMINATION - Differentiated by radiography onlyDILACERATION - Cause – mild trauma during root formation stage - Bending of crown / rootTAURODONTISM - Bull teeth (elongation of root trunk) - Syndrome – Klinfilter SyndromeDens In Dente / Dense Invagination - R/F – teeth inside the pulp of a tooth - Most common with upper lateral incisorENAMEL PEARL - After extraction a molar you found a hard tissue at the fu...2022-04-2705 minOral Pathology4. Mucosal reactive lesionsMUCOSAL – REACTIVE LESIONS Trauma and chemicals are frequent causes of oral lesions. Some of these lesions have an iatrogenic cause (i.e., caused by the dental practitioner).FRICTIONAL KERATOSIS - BUCCAL MUCOSA, TONGUE, - CAUSES - CHRONIC BITING - A SHARP CUSP - OVER EXTENDED DENTURE - ORTHO APPLIANCELINEA ALBA - White line in the buccal mucosaNICOTINA STOMATITIS - Red dots, which are inflamed minor salivary duct openings - histology of nicotina stomatitis : hyperkeratosis and acanthosis - only premalignant in smokers2022-04-2703 minOral Pathology5. Mucosal viral infectionsMUCOSAL – INFECTIONSOral infections are viral, bacterial, or fungal in nature. The most commonly encountered infections are viral, usually herpes simplex virus (HSV) infections. Clinical presentation of viral infections depends on viral type: herpes causes mucosal ulceration (preceded by vesicles), human papillomavirus (HPV) typically induces a verruciform (warty) lesion, and Epstein-Barr virus (EBV) causes a white lesion (hairy leukoplakia). Most bacterial and fungal infections manifest as chronic ulcers. The fungus Candida albicans can cause either white or red lesions.VIRAL INFECTIONSHERPES SIMPLEX VIRUS– stress /examPRIMARY - Majo...2022-04-2711 minOral Pathology6. Mucosal inf bacterial & fungalBACTERIAL INFECTIONSSYPHILIS - Treponema palladium** (spirochetes), - Sexually transmitted disease (STD) - Primary 🡪secondary 🡪 tertiary 🡪 death - WASSERMANS TESTPRIMARY SYPHILIS - Chancre – infectious ulcer – painless and indurated(not cancerous) - Remember syphilis first appers as ulcer*** - Non contagious - Site – dorsal surface of tongueSECONDARY SYPHILIS - Highly contagious - Mucocutaneous lesion 🡪 split ulcer - Eg: condyloma lacta 🡪 snail track ulcerTERTIARY SYPHILIS - Oral manifestation – gummatous ulcer in palate - CNS involved, CVS also involed 🡪 becomes a systemic problem...2022-04-2708 minOral Pathology7. Mucosal autoimmuneMUCOSAL – IMMUNOLOGICThese conditions are related to autoimmune (when our immune system attacks our own body) or hyperimmune (immune system just over reacts) reactions to some stimuli. Clinical manifestations include vesicles or bullae, ulcers, erythema, and white patchesThey are treated with steroids !!APHTHOUS ULCER - Main cause Is stressSite - Present only in non keratinized tissue (opp to hsv infection) - Ie; soft palate, buccal mucosa, ventral surface of tongue, labial mucosa, Clinical Types of Aphthous Ulcers : MINOR & MAJORMINOR APHTHOUS ULCERS - One to se...2022-04-2712 minOral Pathology8. SteroidsSTEROIDSExamples are (usually taken 1mg/kg/day) - Hydrocortisone - Prednisolone - Betamethasone - DexamethasoneINDICATION – AUTOIMMUNE DISEASES - Sjogren’s syndrome - Lichen planus - Pemphigus + pemphigoid - SLE+DLE - OSMF - Apthous ulcer - Addisons disease – no adrenal glands - Leukoplakia ∴ will be on long term steroid therapyCONTRAINDICATION - Viral infection - D M - Peptic UlcerSTEROID SCENARIOS (long term steroid patients) - QN Patient has adrenal insufficiency come to your...2022-04-2702 minOral Pathology9. Premalignant lesion & conditionMUCOSAL – PREMALIGNANTPRE MALIGNANT LESIONS AND CONDITIONSPre- malignant lesion – the lesion will become cancerous if the cause is not stopped / removed.Pre – malignangt condition – the condition may become cancerous if the cause is not stopped / removedUsually these lesions develop into SQCC.LEUKOPLAKIA - Most common pre – malignant lesion and condition - White lesion - Cause – tobacco - Most common leukoplakia – Homogenous L - Most dangerous leukoplakia – Verrucous L(growth present)Rx - Stop tobacco - Vit .A, Steroids, Vit.E = adjunct therapyERYTHROPLAK...2022-04-2703 minOral Pathology10. Mucosal MalignancyMUCOSAL – MALIGNANCIESThe various types of carcinomas can manifest as non-healing ulcers, red patches, or irregular surface masses. - Carcinoma 🡪 epithelial - Sarcoma 🡪 mesenchymal / Connective tissue - Melanomas manifest as abnormally pigmented surface lesions that start at the junction of the epithelium and submucosa.SQUAMMOUS CELL CARCINOMA - QN - Stage of squamous cell carcinoma T2 N0 M0. - The most common malignant tumor of oral cavity -mostly affecting lateral surface of the tongue, secondarily the hard palate. - Associated with fixed and firm lymph nodes. - Its primary stage is...2022-04-2707 minOral Pathology11. CT benign tumorsCT- BENIGN TUMORSConnective tissue tumors manifest as masses (lumps or bumps) within the submucosa. Overlying epithelium is generally intact, unless ulceration occurs because of trauma to the lesion. These tumors generally fall into one of two groups: reactive or neoplastic.A. REACTIVEFIBROMA - Traumatic fibroma - Most common benign tumor in the oral cavity - There is fibrous hyperplasia of the oral mucosa that is being traumatized - Case picture lesion, patient all fine but he had traumatically bit the area - Case of lesion in inner surface...2022-04-2702 minOral Pathology12. CT malignant tumorsCT – TUMORS – MALIGNANTSarcoma 🡪 mesenchymal / Connective tissueNot asked in gulf exams usually.a. FIBRES - FIBROSARCOMMAb. NERVES - NEUROSARCOMMAc. VASCULAR - KAPOSI’S SARCOMAKAPOSI’S SARCOMA - Malignant proliferation of endothelial cells. - Characteristic Purple lesion - Human herpes virus HHV-8 has etiologic role. - Most commonly seen as a complication of AIDS - May also be seen as endemic African type or classic Mediterranean type – where AIDS ratio is usually high.2022-04-2701 minOral Pathology13. Salivary gland & disordersSALIVARY GLANDSUBMANDIBULAR GLAND - Main contribution to saliva - Salivary gland is functionally more important in swallowing - Main site for sialolithiasis - Predominantly serous(mixed) - Warthons duct - Open into the sublingual caruncle which is present on either side of lingual frenum. - Corda Tympani branch of facial nerve VII PAROTID GLAND - Main site for pleomorphic adenoma - Purely serous (other two are mixed though) - Stensons duct - Opens opp to Max 2nd Molar - Glossopharyngeal nerve...2022-04-2713 minOral Pathology14. SG- reactive+benign+malignant+ALLSALIVARY GLANDS - REACTIVEMUCOCELE - site – minor salivary glands of lower lip - Cause – trauma - C/F - Translucent swelling - Rx – excisionRANULA - Mostly in sublingual gland - Blue dome shaped swelling on the floor of mouth - Rx – Marsupialization - Excision only for recurrent ranulaNECROTISING SIALOMETAPLASIA - Cause – ischemia to minor salivary glands, causing necrosis to it - Common site – hard palate - C/F – necrotized soft tissue due to ill-fitting denture - Rx – correct the denture...2022-04-2706 minOral Pathology15. Tongue PhysiologyTONGUEDEVELOPMENT OF TONGUETongue develops from 1st ,3rd & 4th branchial arch not from 2nd arch Anterior 2/3rd develops from Tuberculum Impar + Lingual swellingBRANCHIAL ARCHES - Mandibular N - Facial N VII - Glossopharyngeal N - Vagus N X - Rudimentary- disappears immediately after formation - Vagus NMuscles: - Muscles of mastication – by arch 1 -Muscles of facial expression – by arch 2MUSCLES OF MASTICATION (picture)MUSCLES OF TONGUE - Genioglossus - Hyoglossus - Styloglossus - Pa...2022-04-2708 minOral Pathology16. Tongue-PathologyPATHOLOGIES OF TONGUEGEOGRAPHIC TONGUE - Erythema migrans / Benign migratory glossitis – other names - Systemic disease associated - Psoriasis - DM**** - Iron deficiency anaemia - Papilla missing - filliform papilla - C/F – fissured (scrotal tongue is seen) - Rx – no Rx requiredFISSURED TONGUE - MELKERSEN – ROSANTHAL SYNDROME - Facial nerve palsy + fissured tongue + chelitis granulomatosum - C/F – - Lip deviates to opp/ unaffected side - Wide opening of eye on normal sideMEDIAN RHOMBOID GLOSSITIS - On the mid...2022-04-2705 minOral Pathology17. Nerve diseases + Infections (1 of 2)NERVE DISEASESTRIGEMINAL NEURALGIA - Lancinating pain unilaterally when trigger zone is stimulated - Nerve involved is the 5th cranial nerve ie. trigeminal nerve - Maxillary division V2 has shown highest involvement - Then mandibular division V3 - Least involvement is seen with ophthalmic nerve V1 - V2> V3> V1Rx + Carbamazepine (antiepileptic) + Beclofen + Maximum dose = 1200mg/ day***** + Starting dose = 50mg/ dayQN - Trigeminal neuralgia treated by carbamazepine, the dose per day divided in doses is:600-1200 mg ...At least once every 3 monthsa...2022-04-2704 minOral Pathology18. Hormonal DiseasesHORMONAL DISEASESThyroid & parathyroid are 2 endocrine glands in our body. Thyroid glands you see the lobes on either side, whereas the parathyroid glands are four tiny glands located behind the thyroid glandThe thyroid gland uses iodine from food to make two thyroid hormones that regulate the way the body uses energy, ie. the metabolism of the body. The parathyroid glands produce a parathyroid hormone that helps control the calcium ion levels in the bloodHYPERTHYROIDISM Hyperthyroidism is excess production of thyroxine hormone thus increasing the metabolism !!C/F are - Weight...2022-04-2707 minOral Pathology19. Odontogenic infectionsODONTOGENIC INFECTIONS LUDWIG’S ANGINA - Often from odontogenic infection that spreads into the facial spaces. - All 3 facial Spaces involved bilaterally + Sub mental + Sub lingual + Sub mandibularC/F - Bilateral swelling of neck – diffuse (BULL NECK) - Tongue raised - Slight opened mouth - Trismus - Grossly decayed mandibular molarsComplication - Respiratory obstruction + dehydrationRx - Incision and Drainage – cricothyroidectomy - Penicillin + gentamycinCELLULITIS - Caused by necrotic primary / permanent tooth. - Swelling of face & neck.2022-04-2703 minOral Pathology20. Odontogenic CystsODONTOGENIC CYSTSRadicular cyst - Most common odontogenic cyst – Radicular / periapical cyst - Periapical cyst or radicular cyst- CELL RESTS OF MALASSEZ - A well-defined, round or ovoid radiolucency is associated with the root apex or, less commonly in the lateral position, of a heavily restored or grossly carious tooth. - A corticated margin is continuous with the lamina dura of the root of the affected tooth. - The appearances are similar to those of an apical granuloma, but lesions with a diameter exceeding 10 mm are more likely to be cysticDE...2022-04-2707 minOral Pathology21. Odontogenic TumorsODONTOGENIC TUMORSAMELOBLASTOMA - R/F – tennis net, honey comb, soap bubble - Site – post body of mandible 🡪 Molar region - Root is not present in the radiolucency because this is a tissue mass, so root is resorbed or displaced - Seen above 40 years age - 1st WHO odontogenic classifies tumor - Most common variant – follicular ameloblastoma - Most aggressive – granular A - Highest recurrence odontogenic tumorOrigin - Reduced enamel epithelium - Arises from walls of dentigerous cyst - Review atleast for 10 years for any recurrence2022-04-2706 minOral Pathology22. Bone lesions- Fibrous+ Giant cellBONE LESIONS- FIBROUSOSSIFYING FIBROMA - Seen around lower molar tooth, it is discovered during check-up & no bone expansion, associated with vital tooth 🡪 curettageFIBROUS DYSPLASIA - During bone formation more collagen fibres are formed rather than mineralization. - Two types – monostotic, polyostotic - Monostotic – one bone affected , maxilla - Polyostotic – multiple bone affected - Coffee brown discolouration – Café au laite spots - Other lesions where these spots are seen: - Neurofibromatosum - Peutz Jegher syndrome - Rx – ground glass radio opaque Syndrome – McCune Albright syndrome...2022-04-2710 minOral Pathology23. Bone- Inflammatory + MalignantBONE – INFLAMMATORYACUTE OSTEOMYLITIS : - moth eaten appearance ., - caused by Staph aureous***CHRONIC OSTEOMYLITIS : - cotton wool appearance or onion peal appearance.CODENSING OSTEITIS OR FOCAL SCLEROSING OSTEOMYELITIS: - Commonly seen in children and young adults - associated with a large carious cavity which is asymptomatic tooth - Radiographic presentation of this process shows localized radiodensity around teeth roots as well as a thickening of the associated periodontal ligament. - The teeth most often affected are the mandibular premolars and molars.BONE - MA...2022-04-2703 minOral Pathology24. Hereditary + miscellaneousHEREDITARY CONDITIONSWHITE SPONGE NEVUS - Familial or hereditarySITES - Buccal mucosa - Ventral surface of tongue - Labial mucosa - Alveolar ridge - Floor of the mouth - Scrapable, no erythema left - No Rx.AMELOGENESIS IMPERFECTA – ectodermal defect - Hereditary autosomal dominant defect - When defect occurs during the histo-differentiation stage.Stages of tooth formation – - Initian/ proliferation – oligodontia - Histo differentiation – DI, AI - Morphodifferentiation – Hutchinson’s incisors ****** - Apposition – enamel hypoplasia - Maturation...2022-04-2707 minOral Pathology25. SyndromesSYNDROMESCLIEDO – CRANIAL DYSPLASIA - No clavicle, so patient can bring his shoulder to midline - Multiple impacted supernumerary teeth** - Permanent tooth roots are mostly short - Wormian bone present - Small cranium - Rare genetic disorder - Delayed closure of fontanelles and open skull sutures and plugging forehead - Sometimes many Dentigerous cysts - the patient looks smaller than his relatives and shorter than his relativesGARDNER’S SYNDROME - Multiple osteoma - Dermoid** tumor - Multiple intestinal polyps - Multiple impa...2022-04-2708 min