H-type tracheoesophageal fistula in a child with dysmorphism: vater or not?

Tracheo-Esophageal fistula [TEF] with or without esophageal atresia occurs in approximately 1 in 3500 births. In around half of the cases there are associated anomalies while esophageal atresia/TEF occurs in isolation in the remainder. Congenital H-type tracheoesophageal fistula [TEF] in adults is a rare presentation and can test the diagnostic acumen of a surgeon, endoscopist, and the radiologist. These undetected fistulas may present as chronic lung disease of unknown origin because repeated aspirations can lead to recurrent lung infections and bronchiectasis. Congenital TEFs should be considered in the diagnosis of infants and young adults with recurrent respiratory distress and/or infections. Here, we present the successful management of this rare case in an adult patient. Congenital H-type TEF in children is a rare presentation and search revealed no such case reported in local literature. Here, we present the diagnosis and successful management of a child with congenital H-type TEF with vertebral and limb defects

Change in arch width after extraction and non extraction treatment

The aim of this study was to compare the arch width dimension after extraction and non extraction in pre and post orthodontic treatment. Comparative cross sectional study was carried out in the Orthodontics Department of Alvi Dental Hospital, Karachi, from June to December 2010. Non probability, purposive type of sampling technique was used for data collection. Our sample consists of sixty patients, of which the extraction group was n= 30 [50%] and non extraction group n=30 [50%]. Pre treatment and post treatment intercanine [Anterior] and intermolar [Posterior] arch widths of maxillary and mandibular arch was calculated on cast and compared statistically. In extraction group maxillary intercanine width was 0.70 mm and mandibular intercanine arch width was 0.18 mm larger than non extraction group. In extraction group maxillary intermolar width was 1.65 mm and mandibular intermolar width was 1.3 mm smaller than non extraction group. Extraction treatment did not result in narrower dental arches as compared to non extraction Treatment