Postural Disharmony Causing Myofacial Pain: A Case Report and Review of Literature of the Treatment

Myofacial pain, a chronic painful condition of muscle origin, has numerous precipitating factors, if undiagnosed or left untreated could lead to compromised function and poor quality of life. In this case report, a female patient giving a history of 10 years of pain in the head and neck region was eventually diagnosed with myofacial pain secondary to bowing posture. The patient was successfully treated with combination of treatment modalities (TENS therapy, exercises, occlusal splint, etc.), which resulted in relief from chronic pain and improvement in quality of life.

In silico evaluation of drugs used in treatment of oral lichen planus

BACKGROUND

Oral lichen planus (OLP) is a chronic T cell-mediated, immunological, mucocutaneous disease with a number of genes and inflammatory mediators implicated in its pathogenesis. Heart shock protein 70 and the proinflammatory mediator TNFα have been predominantly involved in the etiopathogenesis of oral lichen planus.

METHODS

In this study, the action of 27 commonly used drugs for treating OLP at HSP70 and TNFα were evaluated by molecular docking using Maestro Schrodinger version 10.1. X-ray crystallographic structures of the target proteins, that is, Heat Shock Protein 70 (PDB Code: 6FDT) and tumor necrosis factor alpha-1 (PDB Code: 1TNF) were obtained from Protein Data Bank (PDB). The structures of the ligands (27 drugs) were obtained from PubChem in.sdf format. Using Ligprep, pre-processing of the ligands was done. Extra-precision docking was performed with the prepared protein and the ligands.

RESULTS

With respect to HSP70, the highest dock score (-4.768) and glide score (-4.818) were seen with hydroxychloroquine (HCQ), followed by epigallocatechin gallate (green tea), methotrexate, and curcumin. The highest dock (-9.525) and glide score (-9.584) in TNFα were seen in with epigallocatechin gallate, followed by HCQ, dapsone, and methotrexate.

CONCLUSION

The results of the study tend to explain the clinical use of HCQ in recalcitrant and severe cases, as well as the anti-inflammatory property of epigallocatechin gallate. The results of the study open ventures for exploring the in silico behavior of drugs for effective pathological management.

Association of OLP and thyroid disorder: Case report and review of literature

Oral lichen planus is a chronic T cell mediated inflammatory condition with multifactorial etiology. Being autoimmune mediated condition, it has been associated with other autoimmune disorders. This case report discusses the possible presentation of oral lichen planus in hypothyroid patients as a marker of severity of the thyroid deficient status and the possible pathogenetic link between both the conditions.

Clinical evaluation of photodynamic therapy for the treatment of refractory oral Lichen planus - A case series

Oral lichen planus (OLP) is a chronic inflammatory, immune mediated mucocutaneous disorder of uncertain etiology. Psychologic stress has been found to be a main contributing factor in onset and progression of lesions. Most erosive OLP patients are refractory to available therapies, even corticosteroids, and report remarkable side effects. As photodynamic therapy (PDT) has proved it to be an effective and safe alternative treatment of abnormal or neoplastic cells we employed PDT for this diagnosis. Due to limited literature on application of this method for treatment of refractory erosive OLP, we present a series of 10 cases of bilateral erosive LP treated by 5 -Aminolevulinic acid mediated PDT. Outcome of our clinical cases showed remarkable improvement in lesions with reduction in Reticulation, Erythema, Ulceration (REU) score (from 5 to 3) and burning sensation as recorded by Visual Analogue Scale (Pretreatment VAS ranged from 5 to 8, posttreatment VAS was 0-1). PDT could be used as a complementary treatment method for symptomatic resistant OLP lesions, although our findings necessitate further research to validate the efficacy of this method for control of resistant oral lichen planus.

A comparison of caudal epidural bupivacaine with adrenaline and bupivacaine with adrenaline and pethidine for operative and postoperative analgesia in infants and children

This study compares the effectiveness of two drug combinations--(a) bupivacaine with adrenaline and (b) bupivacaine with adrenaline and pethidine--on operative and postoperative pain relief when administered by the caudal route in infants and children. A randomised controlled trial was conducted on fifty children below the age of twelve years: 25 children were randomly allocated to each group. Both groups had a significant period of analgesia in the postoperative period. None of the children in either group required parenteral analgesia. Though the group with pethidine had a longer duration of analgesia and sedation, the very high incidence of vomiting and delay in urination observed in this group would preclude the use of pethidine routinely. No respiratory depression was seen in either group.

Rhythmic succinate dehydrogenase activity in the slug, Laevicaulis alte (Ferussac, 1821)

Succinate dehydrogenase (SDH) in central nervous system (CNS) and food muscle (FM) crested at 0400 h while in midgut gland (MG) it was out of phase. The average enzyme level (in per cent) was high during dark h half cycle (data points at 2000, 0000 and 0400 h) in CNS and FM and opposition prevailed for MG. Null hypothesis (Ho) was accepted (Ho = A = O) for CNS and rejected (Ho = A not equal to O) for MG and FM. The characteristics of the rhythm in CNS and FM correspond to motor functions, while in MG to energy source.

Rhythm in acetylcholine-acetylcholinesterase system in the slug, Laevicaulis alte (Ferussac, 1821)

Acetylcholine (ACh) and acetylcholinesterase (AChE) in central nervous system (CNS) and foot muscle (FM) of Laevicaulis alte cresting at 0400 h under LD 12:12 (0600 to 1800 : 1800 to 0600 h) regimen are in phase with each other. Nuli hypothesis (Ho) than for FM AChE, was rejected (A not equal to 0) since F (2,3) (0.05) greater than 9.6 ACh and AChE rhythm phase synchronized motor rhythm of Laevicaulis alte.