Junaid Ahmed

Serious hyperkalemia is common in patients with end‐stage renal disease (ESRD) and accounts for considerable morbidity and death. Mechanisms of extrarenal disposal of potassium (gastrointestinal excretion and cellular uptake) play a crucial role in the defense against hyperkalemia in this population. In this article we review extrarenal potassium homeostasis and its alteration in patients with ESRD. We pay particular attention to the factors that influence the movement of potassium across cell membranes. With that background we discuss the emergency treatment of hyperkalemia in patients with ESRD. We conclude with a review of strategies to reduce the risk of hyperkalemia in this population of patients.

CONTEXT: A validated discipline-specific questionnaire has been developed recently to assess the quality of life (QOL) in patients with chronic oral mucosal diseases. OBJECTIVE: Use the Chronic Oral Mucosal Diseases Questionnaire for evaluating a diverse group of patients with chronic oral mucosal disease after therapy. DESIGN: Prospective convenience sample. MAIN OUTCOME MEASURE: Quality of life. METHODS: Seventy patients seen in the Department of Oral Medicine and Radiology with oral lichen planus, recurrent aphthous ulcers, pemphigus, and other chronic oral mucosal diseases were included in the study. Patients completed the questionnaire after undergoing treatment of their oral mucosal disease to assess their QOL. RESULTS: Patients older than age 35 years reported significantly lower QOL (p = 0.015) in the domain of social and emotional status. Significant age-related differences in QOL were not observed in other domains. Older individuals also reported a significantly lower overall QOL. Men reported significantly better oral health-related QOL than women did in pain and functional limitation: 16.14 ± 8.94 vs 21.44 ± 7.696, respectively (p = 0.010). Significant differences were not observed between sexes for other domains. Significant differences were observed between the disease groups only for recurrent aphthous ulcers and pemphigus (p = 0.005). Patients with pemphigus had the worst overall QOL (73.6 ± 5.6). CONCLUSION: Even after treatment, chronic oral mucosal diseases negatively affect patients’ QOL. Use of the Chronic Oral Mucosal Diseases Questionnaire may allow physicians to more effectively care for their patients with these diseases.

Introduction: Students, like anybody else differ from each other. As students they differ in their preferred mode of learning, i.e. their preferred modes in gathering, organizing and thinking about information. A recent classification proposed by Neil Fleming and associates state that students learning styles can be divided into Visual/graphic, Aural, Read/write and Kinesthetic types, VARK. Aim: The aim of the recent study is to investigate learning styles among dental students in two different dental colleges of India. Method: The VARK-questionnaire contains 15 multiple-choice- questions with four possibilities to select an answer. Each possibility represents one of the four modes of perception. But, one can select more than one answer to each question, which is necessary for the identification of poly modal modes of perception and learning. This is also a psychometric problem when trying to state a measure of the reliability of the questionnaire. The VARK-questionnaire was distributed among 200 students and was collected back. This sample size represents 100% response rate from the students in the class and is markedly above the level required to make conclusions about student preferences for receiving and processing information. The students spent about 10 minutes in an ordinary lesson to fill in the questionnaire. Students register number and name were used in the study and there was no blinding practiced. Study Design: Questionnaire based clinical study Results: The responses from the students in our University where classified into multi-modal (VARK), tri-modal (VRK, VAK, VAR, ARK), bi-modal (VR, VA, VK, RK) and uni-modal (V, A, R.K) categories. Results showed that subjects had a higher preference for multimodal learning. Conclusion: We conclude that students in our set up prefer multimodal and more of Kinesthetic of learning. To meet their needs, a variation in teaching, learning and examination must be implemented. If not, these students with a high kinesthetic preference for perception and learning may be at the losing end.

Osteosarcoma is a bone tumor and can occur in any bone, usually in the extremities of long bones near metaphyseal growth plates. The most common sites are the femur (42%), tibia (19%), and humerus (10%). Other signifi cant locations are the skull and jaw (8%), pelvis (8%), other bones (13%). Osteosarcoma of the jaw differs from osteosarcoma of the long bones in its biological behavior even though they have the same histologic appearance. Its radiographic appearance varies, though the presence of radial spicules and Codman's triangle are highly suggestive of Osteosarcoma. Early diagnosis and radical surgery are the keys to high survival rates. This article presents a case of osteosarcoma of mandible in a 20 year old male patient. Figure 1a: Extraoral photograph: A diffuse swelling over left body and ramus of the mandible.