Occlusal splint therapy in the treatment of myofacial pain dysfunction syndrome [MPDS]

The aim of the present study was to compare the hard and soft occlusal splint therapy for the treat-ment of symptoms of temporomandibular myofacial pain dysfunction syndrome [TMPDs] .This study included 50 patients [age range 20-45 years] diagnosed with TMPDs. Patients were divided into two groups for providing hard and soft splints by simple randomization. Group I received vacuum formed Soft while Group II Hard acrylic resin maxillary splints for 6 months. Before treatment and on follow up at 1, 2, 3, 4 and 6 months after treatment, the researcher measured all parameters of TMJ function including mouth opening, pain visual analog scores and tenderness of masticatory muscles .All recorded TMJ function parameters showed statistically significant improvement in both groups during 6 months period.Both hard acrylic and soft rubber splints improved TMPDs symptoms but hard occlusal splints exhibited superior results after 6 months of use

Role of high resolution computed tomographic scan in diagnosis of interstitial lung diseases in local population

The objective of this study was to find the role of High Resolution Computed Topographic [HRCT] scan of the chest in the diagnosis of Interstitial Lung Diseases [ILD] in our local population. A prospective study of fifty patients already diagnosed as ILD on transbronchial or open lung biopsy was performed in the Medical B Unit of the Department of Medicine Khyber Teaching Hospital, Peshawar from January, 2008 to December, 2008. Both male and female admitted patients above 15 years of age were included in this study. Of the fifty patients meeting the inclusive criteria 18 were male and 32 were female. The commonest affected age was 40-60 years. The commonest symptoms were shortness of breath and cough respectively. Inspiratory crepts and wheezes were the most common physical findings followed by clubbing, raised jugular venous pressure and edema feet. HRCT Scan revealed ILD in 88% with sensitivity of 95% and specificity of 75% having 95% positive predictive value and 75% negative predictive value. HRCT Scan of chest is the most sensitive non invasive test in the diagnosis of ILD compared to chest X ray, pulomary faction tests and can abate the need of lung biopsy in many cases

Management of postburn digital flexion contractures

To determine the outcome of plantar/palmer skin graft for the management of postburn digital flexion contracture in terms of functional and cosmetic improvements. Interventional quasi-experimental study. Department of Plastic and Reconstructive Surgery, PGMI, Hayatabad Medical Complex, Peshawar. The duration of the study was 1-1/2 years [from January 2001 to June 2002]. Fifty patients with postburn digital flexion contracture were recruited in the study. Patients with posttraumatic and postinfective contractures were excluded from the study population. The contracture was released and the deficit produced was replaced by plantar/palmer split skin graft. Active range of motion [ROM] was measured before and after surgery. Postoperative follow-up was done for one year. The outcome measurements were color and texture match of graft with the adjacent palmer skin, sensibility, recurrence rate of contracture and donor site morbidity. The data collected was labeled with the help of statistical package for social sciences [SPSS] and descriptive statistics were calculated accordingly. The graft take was complete [100%] in 48 patients, 50% in one patient [2%] and nil in one [2%] patient. Recurrence of contracture occurred in 5 patients [10%]. Pre-operative median active range of motion [ROM] at proximal interphalangeal [PIP] joint was 60 degree to 90 degree [extension/ flexion]. Postoperatively median active range of motion [ROM] at PIP joint was 0 degree to 90 degree at one year follow-up examination. The healed graft showed good colour and texture match with the surrounding palmer skin. The sensory function return was satisfactory and there was no significant donor site morbidity. The excellent colour, texture match and the functional advantages in terms of active range of motion and sensibility offered by the split thickness palmer/plantar skin grafts exceeded the expected outcome of conventional techniques [thigh, groin and buttock skin grafts]

Mammalian bite injuries to the head and neck region

To determine the frequency and presentation of mammalian bite injuries to the head and neck region seen in a plastic surgery unit. Observational study. The Plastic and Reconstructive Surgery Unit, PGMI, HMC, Peshawar from July 1999 to June 2003. During the study period 40 patients presented with mammalian bite injuries to the head and neck region. Information about patient's demographics, biting animal, circumstances of sustaining injury, duration of injury, location and extent of injury, treatment administered, cosmetic outcome and complications were noted. The mammalian bite injuries accounted for 10% of patients managed within the study period for soft tissue injuries to the orofacial region. Among the 40 cases studied, 3 patients were females and 37 were males. Age ranged from 2.5 years to 71 years with the mean of 23 years. The duration of injury varied from 1 hour to 1 year [median 3+2 days]. Mammals implicated were humans, dogs, horse, donkey, bear and wolf. All of the 40 patients presented with head and neck injury. Auricular injury was seen in 10 patients, lip injuries in 10 patients, nasal injuries in 10 patients, cheek injuries in 6 patients and scalp injuries in 4 patients. In 70% [28] of cases avulsion of tissue [type-III] was noted. Patients presenting earlier for treatment achieved better cosmesis than the patients presenting late in the course of their injury. Mammalian bite injuries to the head and neck region can result in facial disfigurement with distressing physical and psychological consequences. Early management of such complex injuries usually guarantees satisfactory outcome