Proportion of Skeletal and Dental Components in Patients with Facial Asymmetry: A Cephalometry Study

Objective: To determine the skeletal and dental components in patients with facial asymmetry treated at the orthodontic specialist clinic of the Faculty of Dentistry, Universitas Indonesia. Material and Methods: This was a descriptive study using secondary data from the tracing of postero-anterior cephalograms of patients aged >14 years 4.2 months for males and >11 years 6.2 months for females using the Grummons analysis. A total of 46 patients were selected through purposive sampling. Data were analyzed using descriptive statistics. Results: The proportions of asymmetric direction based on the deviation of the mandibular menton, maxillary midline, and mandibular midline tending to the left and the right sides of the face were 58.7% and 41.3%, respectively. The skeletal component found in the vertical direction showed a greater mean value difference than that observed in the transverse direction. The mean value difference was greater in the midline of the mandibular teeth than in the maxillary teeth. Conclusion: Facial asymmetry tended more towards the left side of the face than the right side. Moreover, the skeletal component was greater in the vertical direction than the transverse direction. In the transverse direction, it was shown that the left side of the face was larger than the right side. In addition, dental asymmetry was more commonly observed in the midline of the mandibular teeth than the maxillary teeth.

Pulmonary involvement predicts mortality in severe leptospirosis patients.

Aim: to evaluate the influence of pulmonary involvement at admission in predicting mortality among patients with severe leptospirosis. Methods: reprospective cohort study from medical record registry in Dr. Sardjito Hospital, Yogyakarta from 2003 to 2007. Pulmonary involvement was defined by the presence of pulmonary infiltrate, consolidation or pleural effusion in thorax radiography. Pulmonary edema was excluded. Admission data were collected. Follow-up records were noted until patients were discharded or died. The correlation between predictors (some patient characteristics on admission) and outcome (mortality) were evaluated using univariate analysis, and then proceeded to multivariable logistic regression analysis. P < 0.05 is considered statistically significant. Results: sixty patients with severe leptospirosis as a main diagnosis were evaluated. Fifty-five subjects were eligible for analysis, male patients 37 (67.3%) and mean age 42 +/- 15 years old. Pulmonary involvement was presence in 7 patients (12.7%). In univariate analysis only the presence of meningismus and pulmonary involvement were associated with mortality (p=0.001 and 0.006 respectively). In multivariable logistic regression, pulmonary involvement was independently a strong predictor of mortality (OR 9.9 95% CI (1.17 - 84.03), p=0.035). Conclusion: pulmonary involvement at admission is a strong predictor of mortality among patients with severe leptospirosis.