Objectives: Type 2 diabetes mellitus is associated with various rheumatological manifestations that are debilitating and affect the quality of life. The present study was conducted to find the prevalence of rheumatological manifestations in type 2 diabetics and to study its correlation with the duration of diabetes. Methods: 100 type 2 diabetics and 50 age and sex matched non diabetics were examined for rheumatological manifestations during the period august 2014 to august 2015 in mamata general hospital, khammam. Apart from routine investigations renal function tests, fasting and postprandial blood glucose, rheumatoid factor, serum uric acid and x-rays of involved joints wherever required were done. Results: Rheumatological manifestations were seen in 31% of patients with type 2 diabetes mellitus compared to 16% in non diabetics. Periarthritis of shoulder was seen in 18% diabetics compared to 4% in nondiabetics and was statistically significant. It was the most common manifestation among type 2 diabetics accounting for 55% of the cases. Diffuse idiopathic skeletal hyperostosis was observed in 3% of diabetics and none of the non diabetics. Osteoarthritis of knee was noted in 8% of diabetics compared to10% of non diabetics. Carpal tunnel syndrome was seen in 3% of diabetics and 2% non diabetics. Dupuytren's contracture, cheiroarthropathy and flexor tenosynovitis was not found in both the groups. The manifestations were more predominant in females 43.6% as compared to males 23%. Majority of the diabetic patients with rheumatological manifestations 32.25% were noted to have 1 to 5 years of duration of the disease which was not statistically significant. Conclusion: Rheumatological manifestations are more prevalent in type 2 diabetics than non diabetics especially periarthritis of shoulder. They are predominantly seen in females and have no correlation to the duration of diabetes mellitus.
he rapid evolution of computer-aided design and computer-aided manufacturing (CAD-CAM) led to the introduction of newer materials that could be precisely milled for the fabrication of dental prostheses. PEEK (PolyEtherEtherKetone) has been explored for a number of applications for clinical dentistry, including removable dental prostheses, fixed dental prostheses, implant-supported prostheses, resin-bonded fixed dental prostheses and implant-retained overdentures. The major beneficial property of PEEK is its lower Young's modulus, and as elastic as bone, providing a cushioning effect and reduction of stress transferred to abutment teeth. It is a material with high biocompatibility, good mechanical properties, high-temperature resistance, chemical stability, polishability, good wear resistance, and high bond strength with luting cements. Further, PEEK is also recommended for a wide range of CAD-CAM fabricated fixed and removable prostheses, fabrication of occlusal splints, intra-radicular posts, implant abutments and provisional restorations. PEEK material shows a property of radiolucency, which is advantageous for the evaluation of both osseointegrationand tissue surrounding the implant on computed tomography. Considering these properties, PEEK is increasingly being used in implantology.
Mucormycosis, an opportunistic fungal infection commonly associated with diabetes, is now intermittent as a result of co-infection with COVID-19 and steroid use, affecting the nose and paranasal sinuses of the head and neck region, with high mortality and morbidity. It is also more common in diabetic ketoacidosis, neutropenia, cancer, organ transplantation, and/or high serum iron levels, burns, acquired immunodeficiency syndrome, indiscriminate usage of steroids, lymphoma, leukemia, poor metabolic status etc. The most common treatment protocol for such conditions is aggressive surgical debridement, which includes resection of involved maxillofacial structures such as the maxilla, orbit, and/or nose.Rehabilitation of such large maxillofacial defects is a Prosthodontic challenge, with many problems encountered such as lack of retention due to dislodging forces exerted by scarred postsurgical soft tissues, lack of bony base, lost structures of the posterior palatal seal area, multiple defect sites, and compromised medical status due to comorbidities, which also affects the defect's healing rate.For patients to survive, early diagnosis and treatment are frequently required. The clinical manifestations, etiopathogenesis, and management of the dreaded fungal infection known as mucormycosis in the head and neck region will be reviewed in this paper.
Mulit-protocol label switching has been a building block in providing WAN connectivity. Traffic from multiple customers can travel over the service provider's shared MPLS network, making it a VPN service. MPLS VPN provides efficiency for very large networks. It lends scalability, security, and high quality of service to a network. This project encompasses the behavior of a MPLS and a Non-MPLS network when various services like web, VoIP, DNS are deployed on it. Our work emphasis on the way MPLS is capable of handling heavy traffic in large scale networks along with better performance based on the parameters -jitter, latency and round trip time.
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