ABSTRACT
Background: The mainstay of acute and long-term Management of Acute coronary syndrome includes aspirin and a P2Y12 inhibitor, such as clopidogrel or ticagrelor. Aspirin is a drug that has proved its efficacy in the treatment of various diseases in last 120 years and has stood the test of time. The challenge posed today is the variability in response to anti-platelet therapy which has been documented by many studies. The prevalence of resistance to aspirin is around 5%-45% worldwide. Hence, a study was planned to evaluate the factors causing aspirin resistance among the patients of acute coronary syndromes who were receiving of aspirin as anti-platelet drug therapy in our setting. Methods: A cross sectional, observational study was conducted in a tertiary care rural hospital in central India. Patients of acute coronary syndrome or follow up cases of acute coronary syndrome, who were prescribed aspirin for at least 7 days as antiplatelet therapy, were included in the study. The aspirin resistance was documented in 46 (45.09%) patients by a test based on the plateletworks kit. The factors causing aspirin resistance were evaluated. Statistical analysis was done by using descriptive and inferential statistics using chi square test and z-test. The statistical software used in the analysis was graph pad prism 5.0 and SPSS 17.0.Results and conclusion: The patients receiving 150 mg of aspirin, hypertension, concurrent intake of beta-blockers or ARB, elevated level of LDL cholesterol had a trend to be more inclined towards aspirin responders while patients receiving 75 mg of aspirin, diabetes and addiction to tobacco or alcohol had a trend to be more aspirin resistant. Other parameters tested namely age, gender, BMI, Duration of treatment, smoking, concurrent intake of statins, calcium channel blockers, ACE inhibitors, diuretics or PPI, blood glucose level or cholesterol levels (except LDL) did not show any statistically significant difference among the aspirin responders or

ABSTRACT
Sutton's disease is a major recurrent aphthous stomatitis. It is an inflammatory pathology, characterized by the recurrent eruption of ulcerations. Although the etiopathogenesis of sutton's disease is still imperfectly known, it is nevertheless probable that the main phenomenon results from the cytotoxic action of CD4 + and CD8 + T lymphocytes and monocyte-macrophages with respect to the oral epithelium. We report the case of a 22- year-old patient who came to see for recurrent ulcerations of the oral cavity. The endobuccal examination showed giant ulcers of the lower lip, tongue and uvula. The suggested diagnostic for this clinical picture were: aphtosis oral recurrent, cyclic neutropenia and vitamin B12 deficiency. The combination of low cyanocobalamin, megaloblastic anemia, and histopathological characteristics, confirmed the diagnosis of Sutton disease secondary to vitamin B12 deficiency. Several treatments have been tried, but can not prevent recurrence. However, taking colchicine combined with vitamin B12 replacement therapy reduced the frequency and severity of the lesions. Keywords: inflammatory pathology, cytotoxic action, CD4 + and CD8 + T lymphocytes and monocyte-macrophages.

ABSTRACT
Ameloblastic carcinoma is a tumor which combines histological characteristics of ameloblastoma and the cytological features of malignity. According to the evolution, it can be primary or secondary. The treatment is not yet well defined. Surgery which remains the main treatment modality should be more aggressive than in a usual ameloblastoma. This article reports a case of a secondary ameloblastic carcinoma and its treatment in our context. The patient was a woman, age 45 years, treated four times before by conservative surgery method on the mandible for ameloblastoma, each followed by recurrences. A panoramic radiography exam showed a destruction of the corpus of the mandible. From a biopsy, the histological analysis concluded to an ameloblastic carcinoma. The treatment was a radical surgery resection of the whole corpus of the mandible far from the ends of lesion. This corpus was immediately rebuild by two metallic plaques disposed one over the other, fixed on the two ramus. Post operative period was simple and five years after, there is no recurrence.