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Lyme diseaseIt is a metazoonoses caused by a spirochaete, Borrelia burgdorferi. The disease based on the specific symptoms, is also known as erythema migrans (ECM) or lyme arthritis.
Epidemiology: The disease is widely prevalent in parts of the world including Asia. These spirochaetes are transmitted by the infected ticks of genus Ixodes, mainly I. ricinus, I. dammini and I. pacificus. Besides human, the infection has been reported from dog, equine and rodents.
Clinical symptoms: The clinical symptoms include fever, malaise, arthralgia,headache and myalgia. Eerythema, macule, papule appear along with complaints of stiff neck and arthritis. There may be lymphadenopathy, meningoencephalitis and myocarditis.
Diagnosis: A tentative diagnosis can be made on the basis of clinical symptoms along with history of patient. B. burgdorferi can be isolated using Kelley’s medium and can be observed under dark field microscopy or the organisms can also be confirmed by fluorescence antibody technique. ELISA and immunoflurescence assay is used for serodiagnosis. Nucleic acid based diagnosis like PCR may be used for rapid and accurate diagnosis.
Carrier Based Gutta percha Removal “therma-fill” If the cone the carrier is metal and has cutting flutes that are engaging lateral dentin the instrument retrieval system (IRS)
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Results : In critical pulmonary stenosis in infancy, surgical mortality is 6 per cent. For children and adults with isolated pulmonary valve stenosis, the mortality approaches 0
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