[ investigation of the amount of preparation of abutments receiving metal-ceramic crowns by postgraduate students]

The main principle of tooth preparation to receive full crowns is to preserve tooth structure. The aim of this study is to investigate the amount of preparation of abutments receiving Metal-Ceramic crowns provided by postgraduate [MSc] students at Dental School-Damascus University. The data were collected from one hundred dental casts of teeth prepared to receive full crowns with their natural antimeres intact. The study investigated the dimensional characteristics of prepared teeth, in relation to unprepared antimeres. The mean amounts of tooth preparation were either comparable to or greater than the ideal amounts suggested in the literature. This was especially true of the buccolingual dimension, since the mean amounts of preparation exceeded the ideal amount by nearly 1.00 mm. It can be concluded that over-preparation was a predominant finding in the course of this study

Voice dysfunction following thyroidectomy

Voice dysfunction after thyroidectomy is not rare, and is generally reported in terms of recurrent laryngeal nerve [RLN] or superior laryngeal nerve [SLN] injuries. However, voice dysfunction can occur without laryngeal nerves injuries. Prompt recognition of causes of dysphonia is essential so that relevant therapeutic decision allows early management. The aim is to analyze voice change after thyroidectomy for patients with normal pre-operative voice. The study included 30 patients who had developed voice change within 6 months after thyroidectomy. They were subjected to voice evaluation, indirect laryngoscopy, videostroboscopy and electromyography [EMG]. It was found that dysphonia after thyroid surgery was caused by neurogenic causes [RLN and SLN injuries] in 23 patients [76.7%], non-neurogenic causes in 5 patients [16.7%] and combined causes in 2 patients [6.6%]. EMG studies revealed complete denervation in 6 patients [20] and incomplete denervation [paresis] in 19 patients [63.3%]. Post-thyroidectomy dysphonias are not rare. Injuries of the RLN constitute the main cause. Non-neurogenic injury is another contributing factor. Diagnosis is essential for early management through videostroboscopy and EMG which is specific to differentiate between neurogenic and traumatic injuries and to detect complete or incomplete denervation

One-stage primary ileo-colic or ileo-rectal anastomosis. For acute malignant left colonic obstruction

The aim of this study was to evaluate the immediate and short-terme follow-up results of one-stage subtotal or total colectomy and anastomosis for patients with malignant left colon obstruction. The study comprised 21 patients [10 males and 11 females] with age range of 36-81 years; presented by acute large bowel obstruction with clinical and radiological evidence of obstruction. The choice of the extent of resection was determined by the extent of fecal load, the presence of colonic perforation, serosal tears of the cecum and/or massive colonic distension with concomitant ischemia: the presence of these features in a hemodynamically stable patient favored subtotal or total colectomy and ileo-colic or ileo-rectal anastomosis. The site of obstruction was at the sigmoid colon in 9 patients [42.9%], rectosigmoid in 8 patients [38.1%], splenic flexure in 3 patients [14.3%] and descending colon in one patient [4.7%]. Ileosigmoid anastomoses were done in 13 patients [61.9%] and 8 patients [38.1%] had ileorectal anastomoses. The mean operative time was 201+/-33.2; range: 150-270 minutes, the mean operative blood loss was 633.3+/-408.2; range: 250-1800 cc; 11 patients [45.8%] required blood transfusion with a mean number of blood bags used was 2.8+/-1.2; 1-5 bags. Oral feeding was resumed after a mean period of 4.9+/-0.9; range: 4-7 days and the mean postoperative hospital stay was 10+/-2.2; range: 8-18 days. Overall, after 12-months follow-up only one patient had anastomotic line recurrence with a recurrence rate of 4.75%, one patients died of acute liver failure secondary to hepatic metastasis with mortality rate of 4.75% and 19 patients had follow-up free of morbidity with no-local recurrence or metastasis and a follow-up free rate of 90.5%. Thus, it could be concluded that one-stage subtotal or total colectomy and ileo-colic or ileo-rectal anastomosis are safe procedure with satisfactory outcome for management of obstructing malignant lesions of the left colon