Pattern of maxillofacial trauma; a five years study of 3360 cases

Objectives: to determine the pattern of maxillofacial injuries in the local population

Study Design: retrospective clinical and epidemiologic study

Period: January 2009 to December 2013

Setting: tertiary care hospital

Methods: 3360 patients reported for maxillofacial injuries. A number of parameters, including age, gender, facial bone fractures, laceration on face, injury of trigeminal and facial nerve branches, sensory and motor deficit in relation to soft tissue trauma and bone fracture, were evaluated

Results: males were dominant and male to female ratio was 6.3:1. Patients of 3[rd] decade were more and constitute 63.2%. Road traffic accident was the common etiological factor [78%]. Mandible fracture was dominant and it was present in 1591 patients [47.7%]. Soft tissue laceration frequency was high in cheek region and was 13.7%. Sensory deficit [Trigeminal nerve injury] was present in 1167 patients [34.7%]. Motor deficit [Facial nerve injury] was present in 249 patients [6.83%]. Nerve injuries in relation to mandible fracture were common

Conclusion: road traffic accident was the most common etiological factor and mandible fracture was common. Trigeminal nerve injuries were common and frequency of nerve injuries was high in relation to mandible fracture

Status of glycemic control in patients of type 2 diabetes mellitus

To determine the status of glycemic control in patients of type 2 diabetes mellitus. Cross sectional descriptive study. Medical out-patient/ in -patient departments at Military Hospital Rawalpindi from January 2011 to December 2012. Six hundred and fifty patients of type 2 DM fulfilling the required criteria were included in the study. Glycemic control of these patients was determined by estimation of blood glucose [fasting and random] and glycosylated haemoglobin [HbA1c]. The patients were grouped in three categories good, fair and poor diabetic control having their HbA1c values of being 6-7%, 7.1-8% and more than 8.1% respectively. Statistical package for social sciences [SPSS] version 15 was used for analysis. Out of 650 patients 377 [58%] had poor glycemic control with mean HbA1c of 9.5% +/- 0.95, 78 [12%] patients had fair control of glycemic control with mean HbA1c of 7.8 +/- 0.25, and 195 [30%] patients had good glycemic control with mean HbA1c of 6.4 +/- 0.17. Majority of patients had poor control of their glycemic status which is an important indicator and predictor of both micro and macrovascular complications

Comparison of the analgesic effects of peripheral injections of streptomycin/bupivacain and anhydrous glycerol in relieving trigeminal neuralgia

Trigeminal neuralgia is an idiopathic, paroxysmal, painful, unilateral affliction of the face, evoked by trivial stimuli to the specific trigger lone, lasting from a few seconds to two minutes. Medical and surgical treatment options are available with varying degree of efficacy. The objective of the study is to compare the analgesic effects of streptomycin/bupivacain versus anhydrous glycerol injection in trigeminal neuralgia. Sixty patients were selected via Non- probability, purposive sampling technique, at the department of oral and maxillofacial surgery, king Edward Medical University Mayo Hospital Lahore, from 1[st] June 2008 to 30[th] Nov 2008. Patients were randomly distributed in to 2 equal groups. In Group A streptomycin/bupvivacain injection was administered, in Group B 1 ml anhydrous glycerol injection was administered. Patients were reviewed after one week, one month, three month and six months postoperatively. 25 [83.34%] patients of Group A had excellent pain relief, 03 [10%] had good results and 02 [6.66%] patients had poor results. 28 [93.34%] patients of Group B had excellent results, and 2 [6.66%] patients had good results while none of the patients had poor results. The p value for these two procedures is not significant [p=0.378]. The analgesic effect of streptomycin/bupvivacain injection is same as glycerol injection in trigeminal neuralgia. They are simple, quick, and easy to perform, and can be used as outpatient procedures. Trigeminal neuralgia, anhydrous glycerol, streptomycin, Visual analogue scale

Correlation between childhood chin trauma, condylar fracture and TMJ ankylosis

The objective of this study was to document the TMJ ankylosis resulting from trauma to the chin during childhood. All patients presenting with TMJ ankylosis at the Oral and Maxillofacial Surgery Department of Mayo Hospital, Lahore from July 2007 to March 2009 were included in this study. Patient's age, sex, socioeconomic status, previous history of injury to the chin [scar mark under the chin], level of health care center initially contacted, initial treatment received at the time of injury were documented. A total of 180 patients presented with TMJ ankylosis during the study period. 102 [56.7%]were male and 78 [43.3%] were female patients [Male: Female ratio was 1.3:1] with an age range of 4 to 35 years [mean 12.5 years]. 174 [96.7%] patients had a scar mark under their Chin. 120[66.7%] had a history of fall from roof or a tree, 54[30%] were involved in a road traffic accident, all before the age of 10 years

Prospective comparative study to determine the risk of syncope in a dental chair in supine position during administration of local anesthesia

This study was done to compare the incidence of syncope in supine position versus semi supine position during administration of local anesthesia for dental surgery procedures among the local population. One thousand healthy patients presenting for tooth extraction at the Oral and Maxillofacial Surgery Department of Dr Ishrat-ul-Ebad Khan Institute of Oral Health Sciences, Karachi from 15th January 2007 to 31st August 2007 were included in this study. Patients were divided into two groups. In Group A patients were administered local anesthetic injection in supine position i.e. with patients head and heart at the same level, while in the Group B patients were administered local anesthesia in semi-supine position. There were 1000 patients requiring tooth extraction under local anesthesia with an age range of 15-47years [Mean 28.31 +/- 8.55years]. It was noted that 135 patients [27%] treated in supine position had pre-syncope symptoms while 245 patients [49%] had pre-syncope symptoms in semi supine position. The difference was statistically significant [P< 0.0001]. No patient fainted in supine position in this study. It was concluded that it was easy to prevent syncope if all patients are placed in a supine position before hand