A working paradigm for managing mandibular fractures under regional anesthesia

OBJECTIVES: Isolated mandibular fractures contribute to approximately 45% of maxillofacial traumas. Improper management of mandibular fractures can cause myriad potential complications and can lead to serious functional and aesthetic sequelae. The objective of the study is to design a stepwise approach for managing isolated mandibular fractures using open reduction and internal fixation (ORIF) with regional anesthesia on outpatient basis. MATERIALS AND METHODS: Patients with isolated mandibular fractures presenting to the department of maxillofacial surgery were selected for ORIF under regional anesthesia based on occlusion, age, socioeconomic status, general condition, habits, and allied medical ailments. Standard preoperative, intraoperative, and postoperative protocols were followed. All patients were followed up for a minimum of 4 weeks up to a maximum of 1 year. RESULTS: Of 23 patients who received regional anesthesia, all but one had good postoperative functional occlusion. One patient was hypersensitive and had difficulty tolerating the procedure. Two patients developed an extraoral draining sinus, one of whom was managed with local curettage, while the other required hardware removal. One patient, who was a chronic alcoholic, returned 1 week after treatment with deranged fracture segments after he fell while intoxicated. CONCLUSION: With proper case selection following a stepwise protocol, the majority of mandibular fractures requiring ORIF can be managed with regional anesthesia and yield minimal to no complications.

Effect of petroleum ether extract of Sesbania sesban (Merr.) roots in streptozotocin (STZ) induced diabetes in mice

Objective: The present study was carried out to investigate the hypoglycemic effects of the petroleum ether extract of Sesbania sesban (SS)(Merr.) roots, which are widely used in inflammation, fever, ulcers, leucoderma and diabetes in various parts of India. Methods: SS was administered orally at different doses (250, 500 and 1000mg/kg) to normal and streptozotocin (STZ) induced type- 2 diabetic mice. The fasting blood glucose (FBG), biochemical parameters in serum, change in body weight, internal organs weight, food intake, water intake and glycogen level in livers were performed for the evaluation of hypoglycemic effects.Results: All the doses of SS caused a marked decrease of FBG in STZ induced type -2 diabetic mice. SS decreased the cholesterol, triglyceride (TG), urea, creatinine level and increased the insulin, HDL cholesterol, and total protein level. Decrease in body weight and glycogen level induced by STZ was restored. Increase in water and food intake induced by STZ was decreased. Conclusions: The results suggest that SS may have hypoglycemic potential for the type 2- diabetes and support the traditional use of the roots of plant as a hypoglycemic agent.