Comparative analysis of craniofacial asymmetry in subjects with and without symptoms of temporomandibular joint disorders: a cross-sectional study

Objectives@#The aim of the study was to quantify and compare craniofacial asymmetry in subjects with and without symptoms of temporomandibular joint disorders (TMDs). @*Materials and Methods@#A total of 126 adult subjects were categorized into two groups (63 with a TMDs and 63 without a TMDs), based on detection of symptoms using the Temporomandibular Joint Disorder-Diagnostic Index (TMD-DI) questionnaire. Posteroanterior cephalograms of each subject were traced manually and 17 linear and angular measurements were analyzed. Craniofacial asymmetry was quantified by calculating the asymmetry index (AI) of bilateral parameters for both groups. @*Results@#Intra- and intergroup comparisons were analyzed using independent t-test and Mann–Whitney U test, respectively, with a P<0.05 considered statistically significant. An AI for each linear and angular bilateral parameter was calculated; higher asymmetry was found in TMD-positive patients compared with TMD-negative patients. An intergroup comparison of AIs found highly significant differences for the parameters of antegonial notch to horizontal plane distance, jugular point to horizontal plane distance, antegonial notch to menton distance, antegonial notch to vertical plane distance, condylion to vertical plane distance, and angle formed by vertical plane, O point and antegonial notch. Significant deviation of the menton distance from the facial midline was also evident. @*Conclusion@#Greater facial asymmetry was seen in the TMD-positive group compared with the TMD-negative group. The mandibular region was characterized by asymmetries of greater magnitude compared with the maxilla. Patients with facial asymmetry often require management of temporomandibular joint (TMJ) pathology to achieve a stable, functional, and esthetic result. Ignoring the TMJ during treatment or failing to provide proper management of the TMJ and performing only orthognathic surgery may result in worsening of TMJ-associated symptoms (jaw dysfunction and pain) and re-occurrence of asymmetry and malocclusion. Assessments of facial asymmetry should take into account TMJ disorders to improve diagnostic accuracy and treatment outcomes.

Erratum: Correction of Figure. The Implication of Coronary Artery Calcium Testing for Cardiovascular Disease Prevention and Diabetes

We found an error in Fig. 5A in the review article.

The Implication of Coronary Artery Calcium Testing for Cardiovascular Disease Prevention and Diabetes

Over the last two decades coronary artery calcium (CAC) scanning has emerged as a quick, safe, and inexpensive method to detect the presence of coronary atherosclerosis. Data from multiple studies has shown that compared to individuals who do not have any coronary calcifications, those with severe calcifications (i.e., CAC score >300) have a 10-fold increase in their risk of coronary heart disease events and cardiovascular disease. Conversely, those that have a CAC of 0 have a very low event rate (~0.1%/year), with data that now extends to 15 years in some studies. Thus, the most notable implication of identifying CAC in individuals who do not have known cardiovascular disease is that it allows targeting of more aggressive therapies to those who have the highest risk of having future events. Such identification of risk is especially important for individuals who are not on any therapies for coronary heart disease, or when intensification of treatment is being considered but has an uncertain role. This review will highlight some of the recent data on CAC testing, while focusing on the implications of those findings on patient management. The evolving role of CAC in patients with diabetes will also be highlighted.

Antibacterial activity of bark extracts of Moringa oleifera Lam. against some selected bacteria

The methanol, chloroform, ethyl acetate and aqueous bark extracts of Moringa oleifera were evaluated for their antibacterial activity against four bacteria viz. Staphylococcus aureus, Citrobacter freundii, Bacillus megaterium and Pseudomonas fluorescens using erythromycin as positive control. The activity was analyzed using paper disc diffusion method at different concentration of the extract. The study revealed that all the bark extracts irrespective of their types, in different concentrations inhibited growth of the test pathogens to varying degrees. Ethyl acetate extract showed maximum activity against all the bacterial strains followed in descending order by chloroform, methanol and aqueous extracts. The activity decreased with decrease in concentration of the extract. Staphylococcus aureus was found to be the most sensitive test organism to different extracts of Moringa oleifera. Looking to these results it may be concluded that M. oleifera may be a potential source for the treatment of different infections caused by the resistant microbes

Ruptured Aortic Aneurysm Secondary to Psoas abscess after Intravesical Bacilli Calmette-Guérin

Bacillus Calmette-Guérin (BCG) is a live attenuated strain of Mycobacterium bovis that has been used as effective treatment for early-stage transitional carcinoma of the urinary bladder. We present a case of a 68 year old man who had an abdominal aortic aneurysm following BCG therapy for bladder cancer. Contrast enhanced computerized tomogram (CECT) of abdomen and pelvis revealed bilateral hypodense lesions suggestive of psoas abscesses. In addition, a saccular abdominal aortic aneurysm measuring 4x3.6 cm involving infrarenal aorta with surrounding hematoma was seen. At surgery, he was found to have a psoas abscess and hemorrhage. He underwent ligation of the aorta and an axillary-bifemoral bypass. He was given one year of anti-tubercular therapy to which he responded clinically.

A rare case of Emphysematous Pyelonephritis in renal allograft

Complications in Renal allograft are a well known fact, but Emphysematous Pyelonephritis is a rare complication. We hereby report a case of 26 year old male patient who underwent renal transplant and presented with this rare complication. Only few cases with this complication have been reported in literature so far