"Bone Mapping/Sketching" in Management of Anterior Table Frontal Sinus Fracture

PURPOSE

The aim of this present article was to know the efficacy of bone mapping/sketching in management of anterior table frontal sinus fracture.

MATERIAL AND METHODS

This prospective clinical study includes 10 patients who reported to department of dentistry, AIIMS Bhopal with anterior table frontal sinus fracture. Sterile plain white paper or a glove cover was used for mapping/sketching. The patients were evaluated for post-operative contour of the fractured frontal sinus defect and any mucocele formation.

RESULTS

All the 10 patients had no infection or post-operative mucocele formation and all have excellent aesthetic of the anterior table of the frontal sinus.

CONCLUSION

Bone mapping/sketching should be done in all comminuted fractures of cranio-maxillofacial region.

P14: DOXYCYCLINE: A RARE CAUSE OF DRUG INDUCED PANCREATITIS

Purpose of Study

Drug-induced pancreatitis (DIP) is a rare clinicopathologic entity. We report a 58-year-old female who developed DIP secondary to administration of doxycycline.

Methods Used

A 48 year old female with a history of hypertension presented to the hospital with complains of nausea/vomiting, right upper-quadrant gnawing abdominal pain, 8/10 in intensity with radiation to the back. She denied exacerbating factors, use of alcohol, tobacco and drug. Patient also denied diarrhea, constipation and changes in skin or stool color. On examination patient was hypertensive (155/95) with a heart rate of 102. She had epigastric/right upper quadrant tenderness on superficial palpation, hypoactive bowel sounds without any palpable organs, rebound tenderness or rigidity. Serum lipase was elevated at 2508 IU/L, negative pregnancy and insignificant urinalysis findings. Liver function tests, lipid panel, chemistry panel and hematologic panel were within normal limits. Radiologic investigations with abdominal ultrasound depicted mild proximal dilatation of the common bile duct with smooth tapering of the duct distally indicating status post-cholecystectomy. Contrast enhanced computed tomography scan revealed mild enlargement of the body of the pancreas with adjacent peripancreatic fatty infiltration consistent with acute pancreatitis. Upon further questioning patient explains recent diagnosis (7 days) of tibial orthopedic hardware infection as she was prescribed doxycycline 200 mg twice a day in anticipation of irrigation of infected site. After confirmation, and discontinuation of doxycycline, our patient recovered and has been disease-free for over a month.

Summary of Results

Drug-induced pancreatitis is uncommon etiology of acute pancreatitis, which is responsible for 0.1%–2% of all the acute pancreatitis cases. Among adverse drug reactions, pancreatitis is often-ignored because of the difficulty in implicating a drug as its cause.

Conclusions

In our vastly evolving pharmacotherapy world, DIP should be included in the differential of idiopathic pancreatitis, especially after other common causes have been ruled out.

Transoral removal of ectopic maxillary third molar situated superiorly to maxillary antrum and posteroinferiorly to the floor of orbit

Only few cases of ectopic third molar in relation to the roof of maxillary sinus and posteroinferior to the floor of the orbit have been reported in the literature. The diagnosis is usually done by plain-film radiography. "Caldwell-Luc" operation or endoscopic procedures have been used for the removal of such type of ectopic tooth. We report a case of 46-year-old female patient who presented with pain, swelling and watering of eye due to the ectopic tooth. The trans oral removal (via "Caldwell-Luc" operation) of the ectopic maxillary third molar situated superior to maxillary antrum and posteroinferior to the floor of orbit has been described in this case without any complication.

Risk Factors and Outcome of Neonates Born through Meconium Stained Amniotic Fluid in a Tertiary Hospital of Nepal

Introduction: The incidence of meconium aspiration syndrome is still high in the developing world contributing significantly to the neonatal mortality. The study was aimed to know the risk factors contributing to meconium aspiration syndrome and neonatal outcome in a tertiary government hospital of the country.Materials and Methods: It was a hospital based cross sectional study done over a period of three months. All live newborns born through meconium stained liquor were enrolled and all the details regarding mother, neonate were recorded. Odd’s ratio and bivariate analysis was done to assess the risk factors for meconium aspiration syndrome.Result: Out of all the deliveries 14.6% were meconium stained amniotic fluid and meconium aspiration syndrome developed in 6.6% of the neonates. Low Apgar score and premature rupture of membranes was significantly associated with the risk of occurrence of meconium aspiration syndrome. Neonates who developed meconium aspiration syndrome had mortality of 11.3%.Conclusion: Perinatal asphyxia and premature rupture of membranes were significantly associated with the development of meconium aspiration syndrome and neonates who developed meconium aspiration syndrome had high mortality.J Nepal Paediatr Soc 2015;35(1):44-48

Use of a single miniplate to achieve intra operative intermaxillary fixation

There are different treatment modalities mentioned in the literature for achieving intermaxillary fixation (IMF). Arch bars are time consuming, can cause damage to the periodontium, maintenance of oral hygiene is poor. Eyelets are not suitable for dentitions that carry extensive crown and bridge work. IMF screw causes root damage. To avoid all these complications we recommended the use of single miniplate for achieving IMF.

Alterations in lipid and fatty acid composition of the cyanobacterium Scytonema geitleri bharadwaja under water stress

The composition of the glycerolipids [monogalactosyl diacylglycerol (MGDG), digalactosyl diacylglycerol (DGDG), sulfoquinovosyl diacylglycerol (SQDG) and phosphatidylglycerol (PG)] and alterations in their saturation and unsaturation levels in response to osmotic and matric water potential have been investigated in the cyanobacterium Scytonema geitleri Bharadwaja. The level of MGDG in S. geitleri was high followed by PG, DGDG and SQDG. Whereas, the amount of fatty acids namely palmitic, stearic, oleic, linoleic and linolenic acid were high, arachidic and behenic acid were, however, present in traces in the four glycerolipids. A significant reduction in the level of total lipid as well as individual class lipid was observed in S. geitleri in response to matric water potential to that of its total lipid and individual class lipid in response to osmotic water potential. The levels of polyunsaturated and unsaturated fatty acids also increased in response to matric water potential to that of osmotic water potential.

Locus minimization in breed prediction using artificial neural network approach

Molecular markers, viz. microsatellites and single nucleotide polymorphisms, have revolutionized breed identification through the use of small samples of biological tissue or germplasm, such as blood, carcass samples, embryos, ova and semen, that show no evident phenotype. Classical tools of molecular data analysis for breed identification have limitations, such as the unavailability of referral breed data, causing increased cost of collection each time, compromised computational accuracy and complexity of the methodology used. We report here the successful use of an artificial neural network (ANN) in background to decrease the cost of genotyping by locus minimization. The webserver is freely accessible (http://nabg.iasri.res.in/bisgoat) to the research community. We demonstrate that the machine learning (ANN) approach for breed identification is capable of multifold advantages such as locus minimization, leading to a drastic reduction in cost, and web availability of reference breed data, alleviating the need for repeated genotyping each time one investigates the identity of an unknown breed. To develop this model web implementation based on ANN, we used 51,850 samples of allelic data of microsatellite-marker-based DNA fingerprinting on 25 loci covering 22 registered goat breeds of India for training. Minimizing loci to up to nine loci through the use of a multilayer perceptron model, we achieved 96.63% training accuracy. This server can be an indispensable tool for identification of existing breeds and new synthetic commercial breeds, leading to protection of intellectual property in case of sovereignty and bio-piracy disputes. This server can be widely used as a model for cost reduction by locus minimization for various other flora and fauna in terms of variety, breed and/or line identification, especially in conservation and improvement programs.

Assessment of the oral health status of healthcare-seeking adults living with HIV in Kathmandu Valley, Nepal

AIMS

This study looks to assess the oral health status in the study subjects and to quantify the prevalence of WHO defined HIV-related oral stage 3 and 4 lesions (HIV-OL) as those conditions are indicating need for treatment independently of CD4 count.

METHODS

This quantitative screening study used both structured questionnaire and clinical examination to determine the prevalence of HIV-OL in 83 adults living with HIV randomly selected from a list of service users at a community based HIV organization.

RESULTS

The screening revealed a 40 % (95%-CI: 30-51%) prevalence of HIV-OL in this population where 71 are under Antiretroviral Therapy (ART). Most frequent HIV-OL found were persistent oral candidiasis (19% prevalence), and acute necrotizing gingivitis/stomatitis (18% prevalence) Prevalence of HIV-OL was correlating with CD4 count. Patients with multiple HIV-OL have a mean of 133 CD4 cells/μl, patients with a single HIV-OL have 327 CD4 cells/μl and patients without HIV-OL do have a mean of 457CD4 cells/μl (ANOVA-p=0.002). 6 of 12 patients not taking ART yet were found to have stage 3 or 4 HIV-OL. 46 (55%) of the study population had poor or very poor oral hygiene and 29 (35%) had never had an oral examination, 36 (43%) had attended only for extraction. Only 4 of 54 patients who had previously accessed oral health care have revealed their HIV status to the dentist at that time.

CONCLUSIONS

Wider access to oral healthcare is required for people living with HIV in Kathmandu Valley/Nepal. In this setting HIV-OL are still an important consideration in assessing patients living with HIV, which can have decisive therapeutic implications. Stage 3 and 4 conditions are, independently of CD4 count, indication to start ART without delay in people living with HIV.

Use of anteriolateral wall of maxilla for reconstruction of orbital floor fracture: A clinical study

Purpose:

The aim of the present study was to assess the utility of anterolateral wall of maxilla as a bone graft to reconstruct the continuity of orbital floor.

Materials and Methods

This study was carried out at Datarkar Institute of Maxillofacial Surgery, Pratap Nagar, Nagpur. Out of five patients selected, three were male and two were female. All the patients had intact anterolateral wall of maxilla on contralateral side. In all the patients the reduction of the zygomatic complex fracture was done by Keen's approach. The fractures were stabilized by miniplates. From the contralateral sides,bone graft of 1.5 × 2 cm size was harvested from which were intact in all the patients. All the patients were reviewed at regular interval, initially once every week for 1 month, followed by once in every month for next 6 months postoperatively.

Results:

Five patients with orbital floor defects of medium size average 1.16 cm size (range 0.8-1.5 cm) were grafted by using autogenous bone graft harvested from anterolateral wall of maxilla. All the patients were successfully reconstructed with restoration of the orbital wall continuity. We have not come across any complications like infection, exposure, and extrusion of the graft. Only one patient did not show much improvement in enopthalmous where the size of the defect was large.

Conclusions:

The use of harvested bone graft from the anterolateral wall of the maxilla is better option for the reconstruction of orbital floor defects.