Objectives Leukoplakia is a white mucosal thickening and perhaps undermining change in the oral mucosa transcendently found in tobacco users. Since the tobacco utilization is extensively higher with the indigenous groups in the Asia Pacific locale, the current examination implicated the prevalence of tobacco consumption and leukoplakial lesions and the relationship between the two. Methods This cross-sectional study was conducted through six tribal hamlets of Chithalayath Forest range at Wayanad district of Kerala, South India. Leukoplakia screening was led by a senior consultant on the basis of a visual investigation and pathological evaluation was not done. An organized questionnaire was utilized to gather data on demographic details and tobacco usage status and frequency. The prevalence of clinical oral lesions among tobacco users and non users was determined using statistical analysis. Results Clinical oral leukoplakia was diagnosed in 27 (8.5%) subjects among the 317 individuals screened. The prevalence of lesions was considerably higher among tobacco consumers in comparison with non users (11 vs. 3.7%). Also, the tobacco chewers group had a higher percentage of leukoplakia. Another significant finding of this study is that the incidence of provisional leukoplakia was observed to be comparatively high among the most frequent tobacco consumers 15 (65.2%) in comparison with 8 (34.8%) in the frequent and nonfrequent users. Conclusions Prevalence of abusive habits and clinical oral leukoplakial was substantial among the tribes. The cause and effect relationship and dose-response were also shown to have a significant association.

Background Clopidogrel is an adenosine diphosphate receptor antagonist used in patients with atherosclerotic vascular disease to reduce the incidence of ischemic events. Case Presentation A 62-year-old woman developed a spontaneous hemarthrosis of her left knee following clopidogrel treatment. To date, no case of spontaneous hemarthrosis following clopidogrel monotherapy was reported. Prompt aspiration after discontinuing clopidogrel by conservative management can assist early diagnosis and prevent further damage to the joint. The assessment of the causality of the event was carried out via Naranjo Causality Assessment Scale. A score of 5 was reported for this patient, indicating clopidogrel as a probable cause of this reaction. Conclusion We conclude that spontaneous hemarthrosis is a possible complication following clopidogrel therapy and it needs assessment when appropriate clinical symptoms (e.g. intra-articular effusion, pain) are present.

Syringomyelia is a rare neurological disorder generally regarded as chronic, characterized by slowly progressing fluid-filled cyst (syrinx) forms within the spinal cord. Here we describe the historical review of a patient suffering from syringomyelia for the past 16 years and present gastric condition- gall stone induced pancreatitis. A quadriparetic female patient who had previously undergone surgical treatment for syringomyelia with the early signs including muscle weakness and wasting (atrophy), loss of reflexes, loss of sensitivity to pain and temperature and also stiffness in back, shoulders, spinal curvature (scoliosis) presenting complains of multiple episodes of hematemesis and severe constipation since 5 days. Ultrasonography imaging and laboratory investigations revealed gallbladder stone induced acute pancreatitis also associated. The patient underwent multiple surgical interventions for syrinx removal and associated surgical complications were managed adequately. Currently, the pancreatitis was managed by laparoscopic corrections. Postoperatively, there was a prompt resolution of pancreatitis and associated gastric symptoms. In conclusion, early diagnosis of syringomyelia with magnetic resonance imaging is critical in the prophylaxis of spinal cord compression and potential neurologic injury. Surgical interventions are recommended in symptomatic cases. This case report describes clinical manifestations and management of acute pancreatitis in a chronic sufferer of syringomyelia.

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