This study analyzed 66 patients with mandibular fractures to determine patterns and epidemiology in Lucknow, India. The highest percentage of fractures occurred in patients ages 21-30, who were predominantly male. Road traffic accidents were the primary cause, with the parasymphysis as the most common fracture site. The most frequent fracture combination involved the parasymphysis and subcondyle. While most fractures occurred singly, the number of fracture sites correlated with younger and older age groups.
Analytical Study of Clinicopathological Data of Saudi Patients with Osteoarth...Prof. Hesham N. Mustafa
SUMMARY: Knee osteoarthritis (OA) is a common disabling disease. Epidemiological studies have revealed various risk
factors for OA, including sex, aging, obesity, occupational illnesses, and chronic diseases. Here we evaluate the clinical, pathological,
and radiological findings of knee OA in a subset of Saudi patients who were subjected to total knee replacement (TKA). The study
population included 30 Saudi patients with knee OA who were operated by TKA (from June 2014 to December 2015) in the Department
of Orthopedics, Faculty of Medicine, King Abdulaziz University, Saudi Arabia. Patient’s clinical and radiological data were collected
from the hospital files. Pathological examination of the excised superior articular surface of tibia and femoral condyles were done.
Pearson Chi-squared analysis was used to test for differences between the variables in associated risk factors. There were more women
than men. Sixty per cent of patients were older than 60 years [mean age, 59.2 (females) and 61.7 (men) years-old]. All patients exceeded
obesity class 1, with females being more obese than males. Pathological examination of the superior articular surface of tibia and femoral
condyles showed high score lesions, which was more apparent in females than in males. Radiological findings showed that most lesions
were high grade. The findings of this study will help to understand the pathogenesis of OA and improve treatment decision making
relevant to TKA in knee OA in Saudi Arabia and elsewhere.
KEY WORDS: Osteoarthritis; Knee; Arthroplasty.
Background: The spectrum of pathological bone lesions ranges from inflammatory to neoplastic conditions. Bone tumours are comparatively uncommon among wide array of lesions. The roentgenogram helps in defining exact location of lesion but becomes difficult to differentiate them. They often pose diagnostic problem as they constitute a small portion of diagnostic experience among pathologist.
Objective: To study histopathological spectrum of bone lesions & correlate them with age, gender and site of occurrence.
Results: All bone biopsies from January 2011 to December 2015 received at department of pathology, S.Nijalingappa Medical College, India. Total 121 cases of bone biopsies were analysed. They were decalcified & processed routinely. Out of 121 bone biopsies, 35 (28.9%) cases are non- neoplastic, 77 (63.6%) are neoplastic and 9 (7.4%) were inadequate for evaluation. The incidence of benign lesions are more than malignant with 51(66.2%) and 26(33.7%) cases respectively. Chronic osteomyelitis is the most common non-neoplastic lesion. Giant cell tumor and osteosarcoma are common benign and malignant lesions respectively. Femur is the common bone involved and metaphysis, the commonest site. The maximum numbers of cases are in the age group between 11-30 years with male preponderance.
Conclusion: Though bone lesions are less common, if viewed in perspective of clinico-radiology and histopathology, correct diagnosis can be reached.
Key-words- Bone lesions, Chronic osteomyelitis, Osteosarcoma, Giant cell tumor, Histopathology
Effect of Surgery Difficulty According to Impaction Level on the Incidence of...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Demographics, mechanism of injury, injury severity, and associated injury pro...TÀI LIỆU NGÀNH MAY
Để xem full tài liệu Xin vui long liên hệ page để được hỗ trợ
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HOẶC
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https://www.facebook.com/thuvienluanvan01
https://www.facebook.com/thuvienluanvan01
tai lieu tong hop, thu vien luan van, luan van tong hop, do an chuyen nganh
Analytical Study of Clinicopathological Data of Saudi Patients with Osteoarth...Prof. Hesham N. Mustafa
SUMMARY: Knee osteoarthritis (OA) is a common disabling disease. Epidemiological studies have revealed various risk
factors for OA, including sex, aging, obesity, occupational illnesses, and chronic diseases. Here we evaluate the clinical, pathological,
and radiological findings of knee OA in a subset of Saudi patients who were subjected to total knee replacement (TKA). The study
population included 30 Saudi patients with knee OA who were operated by TKA (from June 2014 to December 2015) in the Department
of Orthopedics, Faculty of Medicine, King Abdulaziz University, Saudi Arabia. Patient’s clinical and radiological data were collected
from the hospital files. Pathological examination of the excised superior articular surface of tibia and femoral condyles were done.
Pearson Chi-squared analysis was used to test for differences between the variables in associated risk factors. There were more women
than men. Sixty per cent of patients were older than 60 years [mean age, 59.2 (females) and 61.7 (men) years-old]. All patients exceeded
obesity class 1, with females being more obese than males. Pathological examination of the superior articular surface of tibia and femoral
condyles showed high score lesions, which was more apparent in females than in males. Radiological findings showed that most lesions
were high grade. The findings of this study will help to understand the pathogenesis of OA and improve treatment decision making
relevant to TKA in knee OA in Saudi Arabia and elsewhere.
KEY WORDS: Osteoarthritis; Knee; Arthroplasty.
Background: The spectrum of pathological bone lesions ranges from inflammatory to neoplastic conditions. Bone tumours are comparatively uncommon among wide array of lesions. The roentgenogram helps in defining exact location of lesion but becomes difficult to differentiate them. They often pose diagnostic problem as they constitute a small portion of diagnostic experience among pathologist.
Objective: To study histopathological spectrum of bone lesions & correlate them with age, gender and site of occurrence.
Results: All bone biopsies from January 2011 to December 2015 received at department of pathology, S.Nijalingappa Medical College, India. Total 121 cases of bone biopsies were analysed. They were decalcified & processed routinely. Out of 121 bone biopsies, 35 (28.9%) cases are non- neoplastic, 77 (63.6%) are neoplastic and 9 (7.4%) were inadequate for evaluation. The incidence of benign lesions are more than malignant with 51(66.2%) and 26(33.7%) cases respectively. Chronic osteomyelitis is the most common non-neoplastic lesion. Giant cell tumor and osteosarcoma are common benign and malignant lesions respectively. Femur is the common bone involved and metaphysis, the commonest site. The maximum numbers of cases are in the age group between 11-30 years with male preponderance.
Conclusion: Though bone lesions are less common, if viewed in perspective of clinico-radiology and histopathology, correct diagnosis can be reached.
Key-words- Bone lesions, Chronic osteomyelitis, Osteosarcoma, Giant cell tumor, Histopathology
Effect of Surgery Difficulty According to Impaction Level on the Incidence of...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Demographics, mechanism of injury, injury severity, and associated injury pro...TÀI LIỆU NGÀNH MAY
Để xem full tài liệu Xin vui long liên hệ page để được hỗ trợ
: https://www.facebook.com/thuvienluanvan01
HOẶC
https://www.facebook.com/garmentspace/
https://www.facebook.com/thuvienluanvan01
https://www.facebook.com/thuvienluanvan01
tai lieu tong hop, thu vien luan van, luan van tong hop, do an chuyen nganh
The Perception of Transtibial Amputees Regarding the Use of Prosthesesinventionjournals
International Journal of Humanities and Social Science Invention (IJHSSI) is an international journal intended for professionals and researchers in all fields of Humanities and Social Science. IJHSSI publishes research articles and reviews within the whole field Humanities and Social Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Within a period from January 2010 to January 2016, there were total of 920 surgically treated patients of Orthopaedy and Traumatology Department, Dubrovnik County Hospital, Croatia, which is a single acute hospital in Dubrovacko-neretvanska County where all patients with proximal femoral fracture are treated within the Orthopaedic-Traumatology Department. The aim of this retrospective study is to compare used implants according to type of the proximal femoral region fracture (femoral neck, pertrochanteric , subtrochanteric) and used osteosynthetic implant depending on the type of fracture. A new surgical techniques were used more commonly. Osteoporotic proximal femoral fractures stayed the major and growing problem in the geriatric traumatology and the traumatollogy in general as well.
Objectives: To describe the pattern of clavicle fractures and to evaluate the results of surgical treatment for clavicle fractures. Patients and methods: This retrospective study included 38 cases of clavicle fractures who were treated by open reduction internal fi xation at Hanoi Medical University Hospital between January 2008 and June 2013.
Results: The ratio of male to female was 1.5/1. Average age was 42.0 years. Simple fractures (no intermediate fragments) are most common with 65.8% of patients. Middle third fractures accounted for
92.1% of patients. Bone union rate was 100%. The surgical results were excellent in 94.7% and good in 5.3% of cases according to Constant Score.
2.tahrir n. aldelaimi article the evaluation of impacted third molars using...MohammedAbdulhammed
Tahrir N. Aldelaimi's ( dean of college of dentistry / Anbar University ) Published paper Show plagiarized paragraph (High light ) from article belong to Faiez N. Hattab, Ma'amon A. Rawashdeh and Mourad S. Fahmy
Clinical assessment scoring system for tracheostomy (CASST) criterion: Objec...DrKamini Dadsena
Tracheotomy has been used for many centuries as a means to bypass upper airway obstruction.
Head and neck cancers are often associated with anatomic changes which can create a potentially difficult airway.
A Cytological Study of Osteolytic Bone Lesions with Intact Cortexiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Clinico-Demographic Profile of Traumatic Spinal Injury in a Tertiary HospitalLemuelJohnTonogan
As of today, there has been a limited number of studies about the demographic profile of traumatic spinal injuries in our locality and our country. The objective of this study is to determine the clinico-demographic profile of patients with traumatic spinal injury admitted in our institution for the past 10 years. A chart review of 73 patients who satisfied the inclusion criteria with traumatic spinal injuries were reviewed. Traumatic spinal injury in the locality mostly affects ages 46-60 years with a mean age of 53.5. Males were most commonly affected, married and unemployed secondary to fall and motor vehicular accidents. The cervical spine is the most commonly affected area, resulting to an incomplete paraplegia with ASIA D score in most cases. These patients were mostly managed conservatively and improved upon discharge. Strict implementation of traffic rules and fall prevention should be emphasized by the government and the locality, and also increase the awareness of patients at risk for traumatic spinal injuries and its debilitating consequences.
Background: Distal femur fractures make up 6 to 7% of all femur fractures. Various plating options for distal femur fracture are conventional buttress plates, fixed-angle devices, and locking plates. This study was planned to evaluate and explore locking compression plate fixation in distal end femur fractures which is expected to provide a stable fixation with minimum exposure, early mobilization, less complications and a better quality of life.
Methods: The study was conducted as prospective clinical study in 20 skeletally mature patients with x-ray evidence of distal femur fracture fulfilling inclusion and exclusion criteria, operated with distal femur LCP plating. Patients were assessed radiologically and classified according to distal femur fracture classification and outcome graded as excellent, good, fair and poor based on Lysholm Knee Score.
Results: Out of 15 excellent outcome cases, 3 cases were type A1 fracture, 1 case had type A3, 2 cases had type B1 and B2 each, 5 cases had type C2 and 2 cases had type C3 fracture. 1 case with good outcome was type C3. 1 case with fair outcome was type B2. While 3 cases with poor outcome were type A1, A2 and C3.
Conclusions: The DF-LCP is an ideal implant to use for fractures of the distal femur. However, accurate positioning and fixation are required to produce satisfactory results. We recommend use of this implant in Type A and C, osteoporotic and periprosthetic fractures.
Keywords: Distal femur, DF-LCP, Lysholm score, Periprosthetic fracture
CARNOY’S SOLUTION AS A SURGICAL MEDICAMENT IN THETREATMENT OF KERATOCYSTIC O...DrKamini Dadsena
The term keratocyst was coined by Philipsen in 1956.
Unlike the other cystic lesion KOT, has got strong tendency for recurrence.
Treatment of these lesions remains controversial and has a number of dilemmas about the choice of treatment whether to use carnoys solution as an adjunct therapy after removal of the lesion.
A Mechanistic, Stochastic Model Helps Understand Multiple Sclerosis Course an...Mutiple Sclerosis
Isabella Bordi, Renato Umeton, Vito A. G. Ricigliano, Viviana Annibali, Rosella Mechelli, Giovanni Ristori, Francesca Grassi, Marco Salvetti, and Alfonso Sutera
Heritable and nonheritable factors play a role in multiple sclerosis, but their effect size appears too small, explaining relatively little about disease etiology. Assuming that the factors that trigger the onset of the disease are, to some extent, also those that generate its remissions and relapses, we attempted to model the erratic behaviour of the disease course as observed on a dataset containing the time series of relapses and remissions of 70 patients free of disease-modifying therapies. We show that relapses and remissions follow exponential decaying distributions, excluding periodic recurrences and confirming that relapses manifest randomly in time. It is found that a mechanistic model with a random forcing describes in a satisfactory manner the occurrence of relapses and remissions, and the differences in the length of time spent in each one of the two states. This model may describe how interactions between "soft" etiologic factors occasionally reach the disease threshold thanks to comparably small external random perturbations. The model offers a new context to rethink key problems such as "missing heritability" and "hidden environmental structure" in the etiology of complex traits.
The Perception of Transtibial Amputees Regarding the Use of Prosthesesinventionjournals
International Journal of Humanities and Social Science Invention (IJHSSI) is an international journal intended for professionals and researchers in all fields of Humanities and Social Science. IJHSSI publishes research articles and reviews within the whole field Humanities and Social Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Within a period from January 2010 to January 2016, there were total of 920 surgically treated patients of Orthopaedy and Traumatology Department, Dubrovnik County Hospital, Croatia, which is a single acute hospital in Dubrovacko-neretvanska County where all patients with proximal femoral fracture are treated within the Orthopaedic-Traumatology Department. The aim of this retrospective study is to compare used implants according to type of the proximal femoral region fracture (femoral neck, pertrochanteric , subtrochanteric) and used osteosynthetic implant depending on the type of fracture. A new surgical techniques were used more commonly. Osteoporotic proximal femoral fractures stayed the major and growing problem in the geriatric traumatology and the traumatollogy in general as well.
Objectives: To describe the pattern of clavicle fractures and to evaluate the results of surgical treatment for clavicle fractures. Patients and methods: This retrospective study included 38 cases of clavicle fractures who were treated by open reduction internal fi xation at Hanoi Medical University Hospital between January 2008 and June 2013.
Results: The ratio of male to female was 1.5/1. Average age was 42.0 years. Simple fractures (no intermediate fragments) are most common with 65.8% of patients. Middle third fractures accounted for
92.1% of patients. Bone union rate was 100%. The surgical results were excellent in 94.7% and good in 5.3% of cases according to Constant Score.
2.tahrir n. aldelaimi article the evaluation of impacted third molars using...MohammedAbdulhammed
Tahrir N. Aldelaimi's ( dean of college of dentistry / Anbar University ) Published paper Show plagiarized paragraph (High light ) from article belong to Faiez N. Hattab, Ma'amon A. Rawashdeh and Mourad S. Fahmy
Clinical assessment scoring system for tracheostomy (CASST) criterion: Objec...DrKamini Dadsena
Tracheotomy has been used for many centuries as a means to bypass upper airway obstruction.
Head and neck cancers are often associated with anatomic changes which can create a potentially difficult airway.
A Cytological Study of Osteolytic Bone Lesions with Intact Cortexiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Clinico-Demographic Profile of Traumatic Spinal Injury in a Tertiary HospitalLemuelJohnTonogan
As of today, there has been a limited number of studies about the demographic profile of traumatic spinal injuries in our locality and our country. The objective of this study is to determine the clinico-demographic profile of patients with traumatic spinal injury admitted in our institution for the past 10 years. A chart review of 73 patients who satisfied the inclusion criteria with traumatic spinal injuries were reviewed. Traumatic spinal injury in the locality mostly affects ages 46-60 years with a mean age of 53.5. Males were most commonly affected, married and unemployed secondary to fall and motor vehicular accidents. The cervical spine is the most commonly affected area, resulting to an incomplete paraplegia with ASIA D score in most cases. These patients were mostly managed conservatively and improved upon discharge. Strict implementation of traffic rules and fall prevention should be emphasized by the government and the locality, and also increase the awareness of patients at risk for traumatic spinal injuries and its debilitating consequences.
Background: Distal femur fractures make up 6 to 7% of all femur fractures. Various plating options for distal femur fracture are conventional buttress plates, fixed-angle devices, and locking plates. This study was planned to evaluate and explore locking compression plate fixation in distal end femur fractures which is expected to provide a stable fixation with minimum exposure, early mobilization, less complications and a better quality of life.
Methods: The study was conducted as prospective clinical study in 20 skeletally mature patients with x-ray evidence of distal femur fracture fulfilling inclusion and exclusion criteria, operated with distal femur LCP plating. Patients were assessed radiologically and classified according to distal femur fracture classification and outcome graded as excellent, good, fair and poor based on Lysholm Knee Score.
Results: Out of 15 excellent outcome cases, 3 cases were type A1 fracture, 1 case had type A3, 2 cases had type B1 and B2 each, 5 cases had type C2 and 2 cases had type C3 fracture. 1 case with good outcome was type C3. 1 case with fair outcome was type B2. While 3 cases with poor outcome were type A1, A2 and C3.
Conclusions: The DF-LCP is an ideal implant to use for fractures of the distal femur. However, accurate positioning and fixation are required to produce satisfactory results. We recommend use of this implant in Type A and C, osteoporotic and periprosthetic fractures.
Keywords: Distal femur, DF-LCP, Lysholm score, Periprosthetic fracture
CARNOY’S SOLUTION AS A SURGICAL MEDICAMENT IN THETREATMENT OF KERATOCYSTIC O...DrKamini Dadsena
The term keratocyst was coined by Philipsen in 1956.
Unlike the other cystic lesion KOT, has got strong tendency for recurrence.
Treatment of these lesions remains controversial and has a number of dilemmas about the choice of treatment whether to use carnoys solution as an adjunct therapy after removal of the lesion.
A Mechanistic, Stochastic Model Helps Understand Multiple Sclerosis Course an...Mutiple Sclerosis
Isabella Bordi, Renato Umeton, Vito A. G. Ricigliano, Viviana Annibali, Rosella Mechelli, Giovanni Ristori, Francesca Grassi, Marco Salvetti, and Alfonso Sutera
Heritable and nonheritable factors play a role in multiple sclerosis, but their effect size appears too small, explaining relatively little about disease etiology. Assuming that the factors that trigger the onset of the disease are, to some extent, also those that generate its remissions and relapses, we attempted to model the erratic behaviour of the disease course as observed on a dataset containing the time series of relapses and remissions of 70 patients free of disease-modifying therapies. We show that relapses and remissions follow exponential decaying distributions, excluding periodic recurrences and confirming that relapses manifest randomly in time. It is found that a mechanistic model with a random forcing describes in a satisfactory manner the occurrence of relapses and remissions, and the differences in the length of time spent in each one of the two states. This model may describe how interactions between "soft" etiologic factors occasionally reach the disease threshold thanks to comparably small external random perturbations. The model offers a new context to rethink key problems such as "missing heritability" and "hidden environmental structure" in the etiology of complex traits.
Automated Equation Breaking: Making Equations ResponsiveAhmed Hindawi
MathML provides a standard way to markup mathematical equations using XML and is currently widely used in the scholarly publishing industry. MathML 3.0 provides some basic automatic line breaking functionality and allows the insertion of different breaking and alignment points to break up a long mathematical formula into several lines to suit a particular text or screen width. However, this is not only tedious, time consuming, and subject to human error, but it essentially provides only a single way to break a particular formula to suit a predetermined text or screen width. In order to address the limitations of manually inserted breaking and alignment points in MathML equations, we developed an automatic equation breaker that breaks the same mathematical formula in different ways to suit a range of text or screen widths. We have also developed a tool that uses this automatic equation breaker to make mathematical equations as responsive as other native HTML elements on a truly responsive website.
Protective Effect of Egyptian Propolis Against Rabbit PasteurellosisBee Healthy Farms
Propolis is known for its protective effects on humans and animals, including improving respiratory conditions. It's also documented to be a very complementary adjuvant with other treatment modalities.
Pasteurella multocida is a well known cause of morbidity and mortality in rabbits. The predominant syndrome is upper respiratory disease or "snuffles." P. multocida is often endemic in rabbit colonies and the acquisition of infection in young rabbits is correlated to the prevalence in adult rabbits.
The results of this study revealed that the use of natural bees’ honey has the ability to protect the liver of rats against the toxic effects of melamine.
Melamine contains 66% nitrogen by mass, so it is sometimes illegally added to food products in order to increase the apparent protein content that has recently become a serious concern. The illegal use of melamine as a food ingredient has led to many poisoning incidents of cats and dogs in the United States, as well as renal function failure of Chinese infants.
Pattern of Pediatric Mandibular Fracture in Central Indiaiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
INTRODUCTION: In India maxillofacial injuries are among the common ones that present to emergency department. Maxillofacial injury can be defined as injury to the facial soft tissue, skeleton and other associated structures resulting deformity or destruction of jaw and eyes. MATERIAL & METHOD: The cases were documented as per proforma, noting name, age, sex, education, religion, socioeconomic status, occupations, mode of trauma and clinical history were recorded and also noted the past H/o of different complaints of ear, nose, throat and face. X-rays and CT scan were done to identify fractures of different maxillofacial region. RESULTS: Results of this study showed that among 150 patients, 122 (81.33%) were males, maximum 62 (41.33%) patients were in 21-30 years of age group, the face was the commonest site of maxillofacial injuries (73.33%), followed by nose (67.33). The nasal bleeding (78.67%) was commonest noted symptom and assaults were the most common cause (48%) of facial injury and nasal bone was the commonest fractured bone (32.66%), CONCLUSION: The incidence of maxillofacial injuries were maximum in age group of 21-30 years and male were more prone for maxillofacial trauma. The most common symptom in present series was epistaxis. Nasal bone was the most commonly fractured bone and assault was the commonest cause of facial injury as compared to road traffic accident. This study showed that increase number of interpersonal violence responsible for facial injury.
Mandibular fractures
Dr. Ahmed M. Adawy
Professor Emeritus, Dept. Oral & Maxillofacial Surg.
Former Dean, Faculty of Dental Medicine
Al-Azhar University
Fractures of the mandible are a common form of facial injury in adults and occur most frequently in males during the third decade of life. The main causes of mandibular fractures are road traffic accidents, interpersonal violence, falls and sport injuries. Mandibular fractures are classified according to various criteria. The three main factors to consider are the cause of the fracture, the type of fracture and the site of the fracture. Clinical diagnosis as well as radiographic examinations are presented. Treatment modalities are discussed. Moreover, treatment-related complications are given.
Clinico-demographic trend of Benign Vocal Cord Lesions among Urban Population...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Dr. Ahmed M. Adawy
Professor Emeritus, Dep. Oral & Maxillofacial Surg.
Former Dean, Faculty of Dental Medicine
Al-Azhar UniversityOrthognathic surgery is the art and science of combining orthodontics and maxillofacial surgery to correct dento-facial deformities.The etiology, prevalence,diagnosis and preoperative planning,and Surgical procedures are presented.
Clinical study of impacted maxillary canine in the Arab population in IsraelAbu-Hussein Muhamad
The objective of the present study was to determine the prevalence of impacted maxillary canine in patients in Arabs Community in Israel (ARAB48,Israel) visiting our Center For Dentistry,Research & Aesthetics,Jatt,Almothalath,Israel, 4250 patients . This study comprises data from patients who attended the O.P.D.2200 patients between Jun. 2006 to Dec 2013. Patients were examined in order to detect the impacted maxillary canines by intraoral examination, palpation, dental records and followed by radiographs. It was found that the prevalence of canine impaction was 0,8 % (N=4250), 1,6 (N=2200), 43,9 (N-82) in males and 1,1% (N=4250), 2,1 (N=2200), 56,1 (N-82) in females suggesting that prevalence of impacted maxillary canines is more in females than males and it is statistically significant. The overall prevalence for maxillary impacted canines was found to be 3,7 % (N=2200) which suggested that it is much higher than previous studies. The results of this study were slightly different than other studies, while the dissimilarities may be attributed to the sample selection, method of the study and area of patient selection, which suggest racial and genetic differences.
Background: Traumatic dental injuries are common in children, and they are often associated with facial fractures in road traffic accidents. Boys sustain dental trauma almost twice as much as girls. The aim of this study is to determine the prevalence of traumatic dental injury among 8-12 years old Sudanese children. Materials and Methods: A cross sectional school based study for 813 school children (395 boys and 418 girls) 8-12 years old were selected from private and public primary schools for assessment of traumatic dental injuries according to Ellis classification and the causes of trauma were studied. Data was collected by visual examination and no radiographs were taken. Chi-square test was used to test association between the different variables. P-value < 0.05 was considered statistically significant. Results: High prevalence (27.9%) of traumatic dental injuries was observed in this study. Boys and girls were more or less equally affected (48.6%, 51.4%) respectively. Falling was the most common cause (14.1%) while the least common one was road traffic accidents (0.6%). Tooth fracture was the most frequent type of tooth injury reported in the current study (13.3%). Conclusion: The prevalence, type and most common causal factors of traumatic injuries to the maxillary anterior teeth in Sudanese schoolchildren 8-12years old was approximately the same as that found in other countries.
Clinical study of impacted maxillary canine in the Arab population in IsraelAbu-Hussein Muhamad
The objective of the present study was to determine the prevalence of impacted maxillary canine in patients in Arabs
Community in Israel (ARAB48,Israel) visiting our Center For Dentistry,Research & Aesthetics,Jatt,Almothalath,Israel,
4250 patients . This study comprises data from patients who attended the O.P.D.2200 patients between Jun. 2006 to Dec
2013. Patients were examined in order to detect the impacted maxillary canines by intraoral examination, palpation, dental
records and followed by radiographs. It was found that the prevalence of canine impaction was 0,8 % (N=4250), 1,6
(N=2200), 43,9 (N-82) in males and 1,1% (N=4250), 2,1 (N=2200), 56,1 (N-82) in females suggesting that prevalence of
impacted maxillary canines is more in females than males and it is statistically significant. The overall prevalence for
maxillary impacted canines was found to be 3,7 % (N=2200) which suggested that it is much higher than previous studies.
The results of this study were slightly different than other studies, while the dissimilarities may be attributed to the sample
selection, method of the study and area of patient selection, which suggest racial and genetic differences.
2. 2 Plastic Surgery International
zygoma and about half that for the frontal bone [4–7]. It is
four times as much force is required to fracture maxilla [8].
Bone fractures at site of tensile strain, since their resis-tance
to compressive forces is greater [5]. Areas that exhibit
weakness include the area lateral to the mental protuberance,
mental foramen, mandibular angle, and the condylar neck
[3]. The thickening on the inner aspect of the condylar neck
or crest of the neck apparently acts as a main buttress of the
mandible as it transmits pressure to the TMJ and the base of
the skull.
The main causes of maxillofacial fractures worldwide
are traffic accidents, assaults, fall, and sport-related injuries.
Alcohol consumption is a well-known contributing factor to
mandibular fractures derived from assault.
Hagan and Huelke in their survey showed a clean-cut
pattern of mandibular fractures [9] as follows.
(1) The Condyle region is the most common site of frac-ture.
(2) Angle is the second most common site of fracture.
(3) But if only one fracture is there, then angle is the most
common site of fracture than condyle.
(4) Multiple fractures are more common than single
(ratio, 2 : 1), 4.80% of the patients were dentate.
Clinical examination may be sufficient to make a pro-visional
diagnosis of a fracture, but the presence of edema,
usually prevents an accurate assessment of the underlying
skeletal damage.With maxillofacial radiography, at least two
radiographs at right angles to each other are recommended.
Because indirect fractures of the mandible are common, it
is important to take radiographs at both sides of the jaw in
every trauma case.
This study was undertaken to study various aspects of
mandibular fractures clinically and radiologically with an
aim to:
(1) calculate the incidence of mandibular fractures;
(2) study the pattern of fracture and the commonest site
of fractures, in population in and around Lucknow.
2.Material andMethod
Patients presenting with history of trauma at various centers
of maxillofacial surgery in Lucknow were included in this
study.
Detailed information consisting of age, sex, socioeco-nomic
status, chief complaint, history of present illness, past
medical history, duration of injury, etiology, and associated
injuries was recorded. After recording the history, a thorough
clinical examination as well as radiological interpretation
was done for each patient in this study for establishing the
diagnosis.
Patients with history of trauma irrespective of clinical
diagnosis of fracture were subjected to radiological examina-tion
to determine the diagnosis and to correlate with clinical
examination findings to arrive at a diagnosis.
The data was analyzed in relation to age, sex, etiology
of the fracture, site of fracture line, unilateral or bilateral,
Table 1: Agewise distribution of study subjects (n = 66).
S. no. Age group (years) No. of subjects Percentage
(1) <10 9 13.6
(2) 11–20 17 25.8
(3) 21–30 19 28.8
(4) 31–40 14 21.2
(5) 41–50 4 6.1
(6) 60 and above 3 4.5
13.6%
60 and
above
4.5%
11–20
25.8%
21–30
28.8%
31–40
21.2%
41–50
6.1%
<10
isolated fractures versus mandibular fractures with associ-ated
injuries, commonest combination of fracture site in
mandible, interrelation of incidence of etiology and location
of fracture; type of fracture whether single, double, or
multiple with etiology, gender, and age, respectively.
The statistical analysis was done using SPSS (Statistical
Package for Social Sciences) Version 15.0 Statistical Analysis
Software. The values were represented in frequencies and
percentages.
The following statistical formulas were used:
(1) Chi square test:
χ2 = Σ(O − E)2
E
, (1)
where O is observed frequency and E is expected fre-quency
and
(2) level of significance: “P” is level of significance
P > 0.05 is not significant,
P < 0.05 is significant,
P < 0.01 is highly significant, and
P < 0.001 is very highly significant.
3. Results
3.1. Table 1: Agewise Distribution of Study Subjects. Out of
66 patients, 37 had a unilateral mandibular fracture while
29 had bilateral fractures with maximum number of subjects
were in the age group 21–30 years (28.8%) followed by 11–
20 (25.8%), 31–40 (21.2%), <10 (13.6%), 41–50 (6.1%), and
60 years and above (4.5%). Around three-fourth (75.76%) of
patients were in the age range 11 to 40 years.
3. Plastic Surgery International 3
Table 2: Sexwise distribution of study subjects (n = 66).
S. no. Gender No. of subjects Percentage
(1) Female 12 18.2
(2) Male 54 81.8
Female
18.2%
Male
81.8%
Table 3: Etiologywise distribution of study subjects (n = 66).
S. no. Etiology No. of subjects Percentage
(1) Fall from height 20 30.3
(2) Hit against object 1 1.5
(3) Road traffic accident 45 68.2
Road traffic
accident object
68.2%
Fall from height
30.3%
Hit against
1.5%
Table 4: Incidence of mandibular fractures according to unilateral-ity/
bilaterality (n = 66).
S. no. Site No. of patients %
(1) Unilateral 37 56.1
(2) Bilateral 29 43.9
Bilateral
43.9%
Unilateral
56.1%
3.2. Table 2: Sexwise Distribution of Study Subjects. More
than four-fifth (81.8%) of patients were males. Only 12
(18.2%) patients were female. The male to female ratio of
the patients was 4.5 : 1.
3.3. Table 3: Etiologywise Distribution of Study Subjects.
Road traffic accident (68.2%) was the cause of mandibular
fractures in majority of subjects, followed by fall from height
(30.3%) and hit against object (1.5%).
3.4. Table 4: Incidence of Mandibular Fractures According
to Unilaterality/Bilaterality. 56.1% patients had a unilateral
Table 5: Mandibular fractures and associated injuries (n = 66).
S. no. Site No. of
patients
%
(1) No associated injury 41 62.12
(2) Mandible fracture with associated injuries 25 37.9
Mandible fracture with
associated injuries
37.9%
No associated
injury
62.1%
Table 6: Combinations (n = 32).
S. no. Site Number % Age
(1) Symphysis + subcondyle 2 6.3
(2) Parasymphysis + body 3 9.4
(3) Parasymphysis + angle 4 12.5
(4) Parasymphysis + subcondyle 6 18.8
(5) Parasymphysis + condyle 1 3.1
(6) Parasymphysis + parasymphysis 2 6.3
(7) Body + angle 5 15.6
(8) Body + subcondyle 4 12.5
(9) Body + body 2 6.3
(10) Subcondyle + subcondyle 1 3.1
(11) Ramus + parasymphysis 1 3.1
(12) Dentoalveolar + subcondyle 1 3.1
mandibular fracture while 43.9% patients had bilateral
fractures.
3.5. Table 5: Mandibular Fractures and Associated Injuries. In
37.9% of cases, the mandible fracture was associated with
other injuries while in majority (62.1%) no such associated
injury was observed.
3.6. Table 6: Combinations. Among cases having multiple
injuries (n = 32), fracture parasymphysis + subcondyle was
the commonest (18.8%) followed by fracture body + angle
(15.6%), fracture body + subcondyle (12.5%), and fracture
parasymphysis + angle (12.5%).
3.7. Table 7: Site of Mandibular Fractures. Fracture parasym-physis
(31.4%), body (24.5%), subcondyle (20.6%), and
angle (13.7%) were the most common sites while fracture
condyle (1%), coronoid (1.0%), dentoalveolar (1.0%), and
ramus (1.0%) were the least common fracture sites.
3.8. Table 8: Association of Site of Mandibular Fractures with
Etiology. Fracture parasymphysis was the most common
fracture irrespective of the etiology. It was observed to be
30.6% of fractures with etiology fall from height and 31.8%
of fractures with etiology road traffic accident. Fracture
body was seen in 27.8% of fall from height and 22.7%
4. 4 Plastic Surgery International
Table 7: Site of mandibular fractures.
S. no. Site No. of sites %
(1) Symphysis 4 3.9
(2) Parasymphysis 32 31.4
(3) Body 25 24.5
(4) Angle 14 13.7
(5) Ramus 1 1.0
(6) Subcondyle 21 20.6
(7) Condyle 1 1.0
(8) Coronoid 1 1.0
(9) Dentoalveolar 1 1.0
(10) Comminuted 2 2.0
Total sites 102 100.1
Comminuted
Symphysis
Parasymphysis
31.4%
Body
24.5%
Dentoalveolar
Subcondyle
20.6%
Ramus
1%
Angle
13.7%
1%
Coronoid
1%
Condyle
1%
2%
3.9%
of road traffic accident fractures while fracture subcondyle
was seen in 22.2% and 19.7% fractures of fall from height
and road traffic accident, respectively. Statistically, there was
no significant difference in the site of fracture and type of
etiology (P > 0.05).
3.9. Table 9: Age Group versus Number of Fracture Sites in
Mandible. The patients in lower age group (0–10 years) and
higher age groups (51 and above years) only had greater than
two fracture sites. The number of patients with two fracture
sites was maximum in the age group 21–30 years while it was
proportionately lower in age group 11–20 and 31–40 years.
4. Discussion
The sheer pace of modern life with high-speed travel as well
as an increasingly violent and intolerant society has made
facial trauma a form of social disease from which no one
is immune. Seemingly, divergent shifts in society may be
responsible for recent changes in patterns of facial injuries,
extent, clinical features, and so forth resulting in massive
disfigurement of maxillofacial skeleton. Mandible is the only
mobile bone of facial skeleton, and there has been significant
increase in the number of cases in recent years. Mandible
fractures if not identified or inappropriately treated may lead
to severe consequences both cosmetic and functional.
This study was undertaken with the view to review the
incidence, commonest site, and combination of mandibular
fracture sites; to study corelation of site of fracture with
etiology; to study correlation of number of fracture sites in
mandible with age, sex, and etiology.
The incidence of mandibular fracture in this study
increased with increasing age from0 to 30 years then progres-sively
decreased from31 years of age. This could be explained
as children till the age of 6 years are under parental care
thereby prevented from sustaining severe injuries and the
elasticity of bones makes them less prone to fracture. As the
age progresses, they are more involved in physical activities,
by the time they reach adulthood they are involved in fast and
rash driving, interpersonal violence, alcohol abuse, contact
sports, and so forth, while the people beyond 40 years of age
lead a more calm, peaceful, and disciplined life.
In this study, the incidence was highest in 21 to 30
years of age (28.8%) followed by 11 to 20 years of age
(25.8%); least being in 60 years and above (4.5%). This is in
conformity with Adi et al. [10], Bataineh [11], Dongas and
Hall [12], Ahmed et al. [13], Brasileiro and Passeri [14], but
contradictory to Shapiro et al. [15] who reported 34.1 years
as mean age range, Ogundare et al. [16].
Male are predominating with 81.8% while female con-stitute
a meager percentage of 18.2%, that is, in a ratio of
4.5 : 1. This is in conformity with Adi et al. [10], Bataineh
[11], Dongas and Hall [12], Ahmed et al. [13], Shapiro et al.
[15], Ogundare et al. [16], Sakr et al. [17], and Brasileiro and
Passeri [14] with a slight variation from this study. This is
probably due to higher level of physical activity among men
as they are still the bread winners in this part of the country.
Table 3 shows the etiologic division of study subjects. The
most common etiologic factor in this study is road traffic
accident (68.2%) which is in accordance with Luce et al.
[7], Bataineh [11], Shah et al. [18], Ahmed et al. [13], and
Brasileiro and Passeri [14]. Adi et al. [10], Dongas and Hall
[12], and Olasoji et al. [19] reported assault as the main
cause whereas no such case is reported in this study. In this
study, fall from height is the second common etiologic factor
accounting for 30.3% of the cases. Road traffic accident is
still the major cause probably due to reckless and high-speed
driving, reluctance to use helmets and seat belts, with
inadequate enforcement of traffic safety rules.
In this study, out of 66 subjects 37 (56.1%) were reported
as unilateral while bilateral accounted for 29 cases (43.94%),
62.12% were isolated mandibular fractures and 37.88% of
cases had other associated injuries asmid-face fractures. This
varied from the observations of Sakr et al. [17] who reported
91% cases as isolated mandible fractures and 9% cases with
associated injuries.
Among the 102 fracture sites recorded in this study, the
commonest site is the parasymphysis which accounted for
a total of 32 followed by body (25), subcondyle (21), angle
(14), symphysis (4), comminuted (2), ramus (1), condyle
(1), coronoid (1), and dentoalveolar (1). The parasymphysis
being the commonest in this study is contrary to Ellis et
al. [20], Adi et al. [10], Bataineh [11], and Shah et al. [18]
who reported body as the commonest while Dongas and Hall
[12], Ogundare et al. [16], and Sakr et al. [17] reported angle;
Motamedi [21], Ahmed et al. [13], and Brasileiro and Passeri
[14] stated condyle as the most commonest site of fracture.
5. Plastic Surgery International 5
Table 8: Association of site of mandibular fractures with etiology.
S. no. Site No. of sites
Fall from height Road traffic accident∗ Statistical significance
No. % No. % χ2 P
(1) Symphysis 4 1 2.8 3 4.5 0.193 0.660
(2) Parasymphysis 32 11 30.6 21 31.8 0.017 0.896
(3) Body 25 10 27.8 15 22.7 0.321 0.571
(4) Angle 14 4 11.1 10 15.2 0.321 0.571
(5) Ramus 1 0 0.0 1 1.5 0.551 0.458
(6) Subcondyle 21 8 22.2 13 19.7 0.091 0.763
(7) Condyle 1 0 0 1 1.5 0.551 0.458
(8) Coronoid 1 1 2.8 0 0.0 1.851 0.174
(9) Dentoalveolar 1 1 2.8 0 0.0 1.851 0.174
(10) Comminuted 2 0 0.0 2 3.0 1.113 0.291
Total 102 36 35.293 66 64.7
35
30
25
20
15
10
5
0
(%)
Symphysis
Parasymphysis
Body
Angle
Fall from height
Road traffic accident
Ramus
Subcondyle
Condyle
Coronoid
Dentoalveolar
Comminuted
∗
Includes one case of hit against object.
The parasymphysis is probably the commonest site due
to the presence of permanent tooth buds in the pediatric
mandible presenting a high tooth to bone ratio, while in
adults it is partly to the length of canine root weakening the
structure.
The other reason for being the commonest site of fracture
is as follows. The bone fracture at site of tensile strain since
their resistance compressive force is greater. Mandible being
similar to an architectural arch distributes the applied force
along its length but not being a smooth curve in a uniform
cross-section. There are parts at which force per unit area
developed is greater resulting in increased concentration of
tensile strength leading to a fracture at the site of maximum
convexity of the curvature.
The commonest combination of fracture in this study
is parasymphysis with subcondyle accounting for 18.8%,
probably due to the horizontally directed impact to parasym-physis
resulting fracture at the site of impact, this axial
force of impact against parasymphysis proceeded along the
mandibular body to the cranial base through the condyle
leading to the concentration of the tensile strain at the
condylar neck hence resulting in its fracture.
This is in contrary to Dongas and Hall [12] who found
parasymphysis with angle, Ogundare et al. [16] reported
body with angle as the commonest combination.
The association of site of mandibular fracture with
etiology had no significant variation, as the most common
fractured site is parasymphysis followed by body and condyle
showing the relation of site of fracture with point and
intensity of impact rather that the etiological factor.
The patients in lower age group, that is, 0–10 years and
the higher age group, that is, 51 and above had greater than
two fracture sites attributing to the higher tooth-to-bone
ratio, thereby decreasing the bone mass among the lower age
group and increased fragility of bone in higher age group.
5. Conclusions
The following conclusions have been drawn from the forego-ing
study.
The mandibular fractures were more common in males
(81.8%) than females (18.2%) with the highest percentage
in 21–30 years of age (28.8%), followed by 11–20 years of age
6. 6 Plastic Surgery International
Table 9: Age group versus number of fracture sites in mandible.
Age group
S. no. Number of
fractures
0–10 11–20 21–30 31–40 41–50 51 and above Total
(n = 9; 13.6%) (n = 17; 25.8%) (n = 19; 28.8%) (n = 14; 21.2%) (n = 4; 6.1%) (n = 3; 4.5%)
N % N % N % N % N % N % N %
(1) 1 4 44.44 11 64.71 8 42.11 8 57.14 2 50 1 33.3 34 51.52
(2) 2 4 44.4 6 35.3 11 57.9 6 42.9 2 50 0 0 29 43.94
(3) >2 1 11.1 0 0 0 0 0 0 0 0 2 66.7 3 4.556
Total 9 17 19 14 4 3 66
80
70
60
50
40
30
20
10
0
0–10 11–20 21–30 31–40 41–50 51 and
Age group
Patients (%)
1
2
>2
above
(25.8%). Road traffic accidents were the most common cause
of fracture followed by fall from height. 56.1% fractures
were unilateral fractures and 62.1% were isolated fractures
of mandible of which parasymphysis (31.4%) was the most
common site of fracture in mandible followed by body
(24.5%). There was only 1 case of coronoid fracture.
Commonest combination was parasymphysis with sub-condyle
followed by body and angle. There was no gender
bias in etiology with number of fracture sites as the site of
impact, intensity of trauma, and direction of force determine
the number and fracture sites. Due to smaller sample
size among various groups, statistical correlation was not
possible; but patients in lower age group (0–10 years) and
higher age group (51 and above) were more susceptible to
multiple fracture sites.
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