Kapetansky-Juri Technique to Correct the Whistlers Lip in the Multiple Operated Cleft Patient

Purpose

One of the common sequels of a cleft lip repair may be “whistling lip deformity” but other deformities are also seen particularly in failed or multiple resurgery cases. This retrospective study was carried out to evaluate the usefulness of “Kapetansky-Juri” advancement flap technique to correct such deformities.

Methods

Ten patients of bilateral cleft lip with history of minimum five failed cleft lip surgeries and having residual lip deformity were operated using “Kapetansky-Juri” advancement flap technique and were followed up to minimum 36 months.

Results

All patients showed good tissue fullness and complete correction of the deformity. There was no contracture of surrounding skin or vermilion during follow-up period. In eight patients minimal scar formation was seen while two showed midline scar formation.

Conclusion

No tissue loss due to vascular insufficiency was observed. The technique gives good tissue distribution and minimal surface scar formation.     

Ipsilateral keratoconus associated with long-standing primary hydatid cyst of the orbit

Hydatid cyst is a cyclozoonotic infection of the larvae form of a platyhelminthes Echinococcus granulosus. The majority of hydatid cysts appear in the liver (65%) and lungs (25%). Kidneys and brain are other less common sites for this disease. Only 1% to 2% cases are seen in the maxillofacial region. These commonly appear as cystic lesions located in the mandible, maxillary sinus, orbit, infratemporal fossa, pterygopalatine fossa, parapharyngeal space, tongue, and parotid and submandibular salivary gland. Hydatid cysts of the orbit are rare and account for 1% of all hydatid cysts. The article presents hydatid cyst of the orbit in a 10-year-old child. Clinical features, investigations, surgical approaches, and adjuvant medical management have been emphasized. We believe that the lateral orbital route allows excellent exposure and safe removal of an intraorbital hydatid cyst located posteriorly, superiorly, and laterally without damaging the surrounding important orbital structures. Upper blepharoplasty incision results in good cosmetic outcome.     

Lipid based nanocarriers: a translational perspective

Over the recent couple of decades, pharmaceutical field has embarked most phenomenal noteworthy achievements in the field of medications as well as drug delivery. The rise of Nanotechnology in this field has reformed the existing drug delivery for targeting, diagnostic, remedial applications and patient monitoring. The convincing usage of nanotechnology in the conveyance of medications that prompts an extension of novel lipid-based nanocarriers and non-liposomal systems has been discussed. Present review deals with the late advances and updates in lipidic nanocarriers, their formulation strategies, challenging aspects, stability profile, clinical applications alongside commercially available products and products under clinical trials. This exploration may give a complete idea viewing the lipid based nanocarriers as a promising choice for the formulation of pharmaceutical products, the challenges looked by the translational process of lipid-based nanocarriers and the combating methodologies to guarantee the headway of these nanocarriers from bench to bedside.     

Effect of LH-RH peptide antagonist on serum LH, ovulation and menstrual cycle of crab-eating macaque.

The effects of the antagonistic LH-RH analogue, D-(PHE²)-D-(ALA⁶)-LH-RH (Wy-18,185), were studied in the female crab — eating macaque ($\text{Macaca fascicularis}$) with emphasis on length of menstrual cycle, length and intensity of menstrual bleeding, serum LH, quantity and properties of cervical mucus, growth of the follicle and ovulation during the treatment and subsequent control cycles. Prior to the expected ovulation, the compound was administered subcutaneously, 25 mg/kg body weight/day, for 3 or 6 days. Blood was collected daily before, during and after treatment. Cervical mucus characteristics were charted daily. Laparoscopy was performed 2–4 days after presumed ovulation.Neither the length of the menstrual cycle nor the quality of the cervical mucus were dramatically altered during treatment with Wy-18,185. Of the nine macaques that were treated with six doses of Wy-18,185, two had anovulatory cycles associated with premature LH surges and one was devoid of an LH surge. It is possible that the partial anti-ovulatory effectif Wy-18,185 in the monkey may be due to its mildly inherent gonadotropin releasing properties triggering an LH surge at a time when the follicles were incapable of a complete ovulatory response. However, the general lack of effect of the antagonist, coupled with reports on the comparative refractoriness to LH-RH and related agonists, on reproductive parameters in this primate species, in contrast to the rat, rabbit and hamster, indicate that the macaque may be an inappropriate model.     

Nonvascularized bone grafting for mandibular reconstruction: myth or reality?

This retrospective study analyzes the long-term results and complications of mandibular reconstruction with nonvascularized bone grafts (NVBGs) and suggests refinements. A total of 166 patients underwent mandibular ablation and primary reconstruction between June 1990 and August 2009, of which 101 were NVBGs, 27 were vascularized bone grafts, and 38 were with functional plate reconstruction. Eighty-seven of 101 patients undergoing NVBG, having all records and followed up for a minimum of 12 months, were included in this study. The analysis criteria included site of defect, surgical approach, method of graft fixation, bony continuity and stability, presence or absence of infection, aesthetic and functional prosthetic rehabilitation, donor-site morbidity, and clinical and radiological changes in the reconstructed area.The overall success with NVBGs in our study was 77 (88.5%) of 87. We used ilium in 68 cases (78.16%), fibula in 16 cases (18.39%), and rib in 3 cases (3.44%). Ten cases (11.5%) showed complete failure due to infection (7 cases) and resorption (3 cases).Nonvascularized bone grafts could be used judiciously for reconstruction of selective mandibular resection defects where there is not much of soft tissue loss, or where 2-layer watertight closure can be achieved intraorally and extraorally. Where only a single-layer intraoral closure is anticipated, either additional soft tissue should be brought submucosally or there should not be extraoral-intraoral communication even during surgery. Also precise patient selection, surgical planning, and execution with meticulous nursing care are keys to success.     

Effect of dietary restrictions on disease activity in rheumatoid arthritis.

Additions in five steps were made, as a possible therapeutic measure, to the diet of 27 patients with rheumatoid arthritis (RA) after a period of two weeks of a basal isocaloric diet free from pulses, cereals, milk, and non-vegetarian protein foods. Fourteen patients finally took part in the trial, 10 (71%) of whom showed significant clinical improvement. Only three patients (11%) adhered to the diet for a period of 10 months. The others discontinued the diet and were then treated with conventional disease modifying drugs. The study indicates that dietary factors may influence inflammatory response in RA.     

Management of Late Post-traumatic Facial Artery Pseudoaneurysmal Cyst: Review of Literature

Pseudoaneurysms of the branches of the external carotid artery as a result of trauma are rare in oral and maxillofacial surgery practice. The most affected branches are the superficial temporal artery, internal maxillary artery and distal part of facial artery, usually where they pass over the bone. Very few cases of facial artery pseudoaneurysms of proximal parts (from external carotid artery up to the lower border of the mandible) are reported in the literature. We present a review of literature for management of late post-traumatic pseudoaneurysmal cyst and a case report involving proximal part of facial artery in the submandibular region following open reduction and rigid fixation of the condylar fracture in a 25-year-old male. To our knowledge this is the fourth reported case of proximal facial artery pseudoaneurysm.     

Sialic acid concentration in the reproductive organs, pituitary gland and urine of the Indian langur monkey (Presbytis entellus entellus).

The concentration of sialic acid was determined in the reproductive organs, pituitary gland and urine of male and female langur monkeys. In the male, sialic acid concentration was lowest in the testes and highest in the epididymides. Both caput and cauda epididymides contained almost the same concentration. Castration and subsequent androgen administration did not modify the concentration of sialic acid by comparison with intact animals, suggesting that sialic acid is not androgen-dependent in the langur. There was no significant difference in sialic acid concentration in the uterus during the proliferative and luteal phases of the menstrual cycle. After ovariectomy, there was a decrease in the concentration of sialic acid in the uterus, cervix and vagina while oestrogen or oestrogen plus progesterone administration increased its concentration significantly, but not to the control level. However, the difference in concentration between oestrogen-treated and oestrogen plus progesterone-treated monkeys was not significant. There was a peak of sialic acid excretion in the urine on day 8 of the normal 22-day menstrual cycle, i.e. a day before the probable day of ovulation. In pregnant monkeys siliac acid excretion increased significantly 2 days before delivery compared with the values recorded 7 to 3 days before parturition. The part played by sialic acid during the menstrual cycle and pregnancy in the female is not clear.     

Association of IFNG gene polymorphism with asthma in the Indian population

Epidemiologic studies in India show that the prevalence of asthma is increasing, but no genetic studies have been reported on the Indian population thus far. We selected the IFNG locus on 12q21 as a candidate gene for asthma on the basis of its role in pathophysiology and positive linkage demonstrated in other populations. The aim of this study was to investigate association of a CA-repeat marker in this gene with asthma and total serum IgE levels in the North Indian population. The repeat region was PCR-amplified from patients and control subjects and analyzed through use of GeneScan. The distributions of allele sizes were found to be significantly different between patients and control subjects (Kolmogorov-Smirnov test, P < 10(-6)). Alleles 10 and 11 were found to be overrepresented in individuals with asthma, whereas alleles 13 and 15 were less likely in asthmatic individuals. We found that the CA-repeat polymorphism in the IFNG gene was significantly associated with total serum IgE levels (ANOVA, P < 10(-4) for control subjects and P =.0036 for patients). Furthermore, a previously reported promoter polymorphism at the -333 base pair position was not detected in our population. This is the first report on the association of a candidate gene with asthma from the Indian subcontinent.