Maxillofacial Injuries in Children: A 10 year Retrospective Study

Objectives

Fractures of facial bones in children are relatively uncommon although both children and adults are subjected to similar types of injuries. This study aims to evaluate the epidemiology of facial bone fractures among children under 14 years, their management and outcome.

Materials and Methods

This retrospective study included maxillofacial injuries treated in 112 children under 14 years admitted due to maxillofacial injuries during the period from 2001 to 2011.

Results

Of them ten (8.93 %) were below 5 years, 44 (39.29 %) between 6 and 10 years and 58 (51.78 %) between 11 and 14 years of age. Male to female ratio was 1.8:1. Fall from a height was the most common etiology. The most common jaw involved in the fracture was the mandible. Conservative management was done in 83.04 % of cases and open reduction and internal fixation was performed in 16.96 % of cases. Five (4.46 %) cases accounted for post-operative wound infection.

Conclusion

Fracture of the mandible is the most common maxillofacial injury in children, most often caused by fall from a height. The osteogenic potential of the mandible in children leads to conservative management of these fractures. Opportunities for prevention of maxillofacial trauma should be taken into consideration by parents and care takers.     

Management of Odontogenic Space Infection with Microbiology Study

Introduction

Dental infection has plagued humankind for as long as our civilization has been a fight against microorganisms by man dates back to ancient civilization. The discoveries of antibiotics are encouraging trends towards conquest of the microbial infection.

Materials and Methods

This study emphasizes the detection of pathogenic microorganisms by microbiological examination and culture of specimens representative of the infection, importance of early and correct diagnosis of infections, prompt treatment and supportive care.

Results

The age group most commonly involved was in the third and fourth decades of life. Extraction followed by incision and drainage was done. The most commonly involved space was submandibular followed by buccal space. Thirty isolates were obtained. 43 % of the strains were strict anaerobes and 39 % were aerobes, with mixed growth was seen in 18.52 %. Amongst aerobes alpha hemolytic Streptococcus aureus and Peptostreptococcus as anaerobes were the most predominant followed by Bacteroides and Prevotella. Mixed aerobic and anaerobic isolates were obtained from 18.52 % of total cases. Overall resistance to Penicillin was 22 %, amongst aerobes.

Conclusion

Amoxicillin and Clavulanic acid combination performed better, as 100 % strains were sensitive to it. The results of this study saw a changing trend in terms of predominance of anaerobic bacteria over aerobic ones.     

A Modified Temporal Incision: An Alternative Approach to the Zygomatic Arch

Zygomatic arch fractures occur due to a direct injury to the lateral aspect of the head. When there are multiple fractures of the arch, open reduction and internal fixation is indicated. Conventionally hemi-coronal and pre-auricular incisions are placed to approach the arch. A modified temporal incision has been described. Open reduction and internal fixation of zygomatic arch fractures has been done.     

The preproliferative stage in type 2 macular telangiectasia (MacTel type 2)

Graefe's Archive for Clinical and Experimental Ophthalmology - To study clinical and imaging features of various stages of macular telangiectasia (MacTel type 2). In this retrospective study,...     

Absence of congruency sequence effects reveals neurocognitive inflexibility in Parkinson's disease

The effects of Parkinson's disease (PD) on action selection in conflictual situations were examined in an experiment using the flanker task in combination with event-related brain potentials (ERPs). More specifically, we investigated the effects of PD on behavioral and neuronal indicators of both instantaneous (within-trial flanker congruency effects) and sequence-dependent (between-trial congruency sequence effects) distractor interference. Consistent with the existing literature, congruency-sensitive ERP components (i.e., fronto-central N2 and positive ‘dips’ of the lateralized readiness potential, LRP) were observed over medial-frontal and lateral–central regions, respectively. For situations requiring instantaneous action control, patients with PD and healthy controls showed similar congruency effects on reaction time, as well as on N2 and LRP ‘dip’ amplitudes. As expected, controls showed reliable congruency sequence effects on reaction time, as well as on N2 and LRP ‘dip’ amplitudes. However, patients with PD were completely unaffected by the congruence sequence across consecutive trials, as revealed by reaction time, as well as by N2 and LRP ‘dip’ amplitudes. The data imply that the effects of PD on action selection are largely restricted to a lack of adaptive modulation in time which we refer to as neurocognitive inflexibility, in the context of relatively spared abilities to instantaneously exert control over action selection. The findings are discussed in terms of basal ganglia dysfunction induced by PD which results primarily either in executive function deficits or in aberrant habit formation.     

Peripheral Neurectomy: A Minimally Invasive Treatment for Trigeminal Neuralgia. A Retrospective Study

Aim  

Investigate the efficacy of peripheral neurectomy as a surgical procedure in the treatment of trigeminal neuralgia and to evaluate the results obtained by this procedure and their recurrences in a period of three years followup.     

Randomised Comparative Study on Propofol and Diazepam as a Sedating Agent in Day Care Surgery

Objective

The study was conducted to assess the usefulness by qualitative comparison between the two intravenous sedative drugs, Diazepam and Propofol and to provide sedation in apprehensive and uncooperative patients undergoing day care oral surgical procedures.

Methods

The present study was conducted on 20 adult patients, 10 in each group (Propofol and Diazepam) irrespective of age and sex. Intravenous sedation of Propofol compared with Diazepam in terms of onset of action, recovery, and anterograde amnesia, patient co-operation, surgeon’s convenience and side effects and other parameters.

Results

Propofol was found to be the superior sedating agent compared to Diazepam, having rapid onset and predictability of action, profoundness of amnesia and a faster recovery period, offering advantages of early patient discharge and better patient compliance.

Conclusion

Propofol was found to be an ideal sedating agent in day care oral surgical procedures.     

Efficacy of 4 % Articaine and 2 % Lidocaine: A clinical study

Objectives

This study was undertaken to compare the anesthetic properties of 4 % Articaine hydrochloride and 2 % Lidocaine both with 1:100,000 epinephrine for mandibular inferior alveolar nerve anesthesia.

Materials and Methods

Thirty healthy patients were included in this randomized double-blind clinical cross over study. Each subject received each test solution at different times. Inferior alveolar nerve block anesthesia was used for extraction of bilateral impacted mandibular third molar on different occassions. The time of onset of action, duration of anesthesia, efficacy of anesthesia, hemodynamic parameters and oxygen saturation were monitored during the procedure. A visual analog scale was used to assess pain during surgery, and thus subjectively evaluate the anesthetic efficacy of the two solutions.

Results

No statistically significant differences were seen in the onset and duration of anesthesia between the Articaine and Lidocaine solutions.

Conclusions

4 % Articaine offers better clinical performance than 2 % Lidocaine, particularly in terms of latency and duration of the anesthetic effect. However, no statistically significant differences in anesthetic efficacy were recorded between the two solutions.