Efficacy of normal saline nasal spray and gargle on SARS-CoV-2 for prevention of COVID-19 pneumonia

Background: Role of microaspiration of mucus mixed with SARS-CoV-2 (severe acute respiratory syndrome corona virus 2) causing pneumonia is lacking in searched literature. Recently some authors have emphasized on microaspiration. SARS-CoV-2 primarily replicates in nasal mucosa and sheds in nasal mucus which travels down as microaspiration and causes pneumonia. We aimed to evaluate the efficacy of normal saline nasal spray and gargle (NSNSG) to wash off SARS-CoV-2 from nasal and pharyngeal mucosa to prevent microaspiration and pneumonia. Methods: From RT-PCR (reverse transcriptase polymerase chain reaction) report, we selected 62 patients for study group and 63 patients for control, having higher virion load i.e. cycle threshold (Ct) value 25 or less. Patients in study group were trained with NSNSG. We reviewed HRCT (high resolution computed tomogram) of lung in 56 patients of both groups for severity score (SS) in lung and was compared with initial HRCTResults: Thirty out of 62 (48%) of study group significantly (p=0·01) became RT-PCR negative following NSNSG compared to 16 out of 63 patients (25%) of control. Thirty one out of 34 patients (91%) of study group either improved or inhibited progression of SS in lung HRCT. In control group, 14 out of 22 patients (63%) also showed favourable findings. Nevertheless, study group significantly improved (p=0·028) in SS.Conclusions: NSNSG is significantly efficacious to wash off SARS-CoV-2 from nasal cavity and pharynx, and to break supply chain of SARS-CoV-2 from source to prevent microaspiration in lung alveoli and pneumonia. From that phenomenon we infer that SARS-CoV-2 as a ‘surface virus’ and it seems that vaccine resistant SARS-CoV-2 and different strains of SARS-CoV-2 would be washed off with NSNSG.

Orthokeratinized odontogenic cyst associated with multinucleated giant cell reaction: report of unusual findings

ABSTRACT Orthokeratinized odontogenic cysts are developmental odontogenic cysts, presenting with low frequency, low rate of recurrence and their ethiopathogenesis is unknown. Radiographically, they show a radiolucent area in the mandibular posterior region. The aim of this report is to describe an unusual case of orthokeratinized odontogenic cysts, radiographically exhibiting radiopaque areas with an aspect of calcifications in the lesion. Based on this, the clinical hypothesis of ameloblastic fibro-odontoma was suggested. After incisional biopsy and microscopic analysis, the conclusive diagnosis was orthokeratinized odontogenic cysts. The radiopaque foci were observed to be associated with a foreign body reaction. The patient was submitted to surgery under local anesthesia, with intraoral access for complete excision of the lesion and to re-establish esthetics. After follow-up of 24 months there were no signs of recurrence. Knowledge of this type of reaction is important because of the risk that the lesion may mimic a potentially more aggressive lesion, affecting the choice of treatment.