A study of pattern of maxillofacial fractures and its complications

Background: Incidence of maxillofacial fractures is quite high worldwide. A very important aesthetic function is served by maxillofacial skeleton moreover the prominent position of maxillofacial skeleton makes it more susceptible to fracture.Methods: A prospective study was done to assess the main etiology and pattern of maxillofacial fractures of 60 patients who came to the emergency department of Sri Guru Ram Das Institute of Medical sciences and Research between January 2018 and June 2019.Results: Total number of patients taken for this study were 60. The number of male patients were 56 (93.33%) and number of female patients were 4 (6.66%) and male to female ratio was (14:1). The age range spanned from 11 years to 70 years with (mean age=37.30 years, SD=14.27). Primary etiologic factor for maxillofacial fractures was road traffic accidents (49, 81.66%), followed by fall (8, 13.33%), and assault accounted for (3, 5%). Total 229 fractures were present in 60 patients. Concerning the anatomical site of fractures, it was explored that most common site of fractures is orbit (59, 25.72%) followed by fractures of maxilla (55, 24%) and zygomatic complex (35, 15.28%). Infection was most common complication and was present in 2 (3.33%) of the patients during hospital stay. 21 (35%) of the patients had associated head injury and maximum patients 49 (81.66%) were treated by open reduction and internal fixation.Conclusions: It is concluded, that main etiology of maxillofacial trauma is road side accidents. Therefore, strict compliance of traffic rules can avoid such injuries.

Comparing the efficacy of nano crystalline silver dressing versus betadine dressing in management of diabetic foot ulcer

Background: The incidence of diabetes and its complications is rising as a result of the lifestyle changes. The foot is most frequent site for complication in patients with diabetes. Dressings have a vital part to play in the management of wounds. The ideal antiseptic is one that is lethal to all forms of bacteria, has no deleterious effect on healing tissues, delineates the operative areas, easily applied and has wide spectrum of activity and absence of acquired bacterial resistance. Nanotechnology makes it possible to expand the surface area of silver particles markedly to nanoscale. They expand the surface area of silver particles increasing their contact with bacteria.Methods: In the proposed study, over a period of 18 months, 60 cases (30-30 in 2 groups) of diabetic foot ulcers were studied with respect to response (healing) to nano silver dressing and betadine dressing after dividing them randomly. Assessment was based on various parameters like size reduction, healthy granulation tissue, etc.Results: It was seen that percentage reduction in size, was more in nano silver group as compared to betadine group. Wounds were managed successfully, early in nano silver group and wound healing was better in nano silver group as compared to betadine group. Also, nano silver was better antimicrobial.Conclusions: The prospective study showed nano silver gel is safe and effective in wound management and gives better efficacy and faster response as compared to traditional betadine dressing.

Prospective Study of Management of Solid Organ Injury in Blunt Trauma Abdomen

Blunt injury to abdomen is one of the most common injury caused by road traffic accidents. The advent of newer imaging techniques with high resolution computed tomography scanners (CT scan) has enabled the clinicians to exactly diagnose the extent of the intra abdominal injuries. High grade injuries are commonly managed by surgery but the shift to selective non operative management (NOM) of blunt injuries to abdominal solid organs are one of the most notable trends in the case of trauma. Methods: This study was conducted on 50 patients of blunt abdominal trauma admitted in Guru Nanak Dev Hospital, attached to Govt. Medical College, Amritsar. Patients of all age groups with blunt trauma abdomen were admitted in hospital. Results: In the present study, most common age group affected was 21-40 years (70%); out of which males were more commonly affected (90%); most common mode of injury was road traffic accident accounting for 76% of patients of all age groups. In this study, 2 out of 13 patients expired who were kept on NOM due to liver injuries. Failure to resuscitate these patients was the main cause of mortality. 4 out of 12 operative cases expired. Most common organ injured was liver (50%) followed by spleen (36%). Other organs injured were pancreas and kidney, 6% each. Mortality rate in patients who were receiving NOM was 5.26% while patients who received operative management had mortality rate of 33.3%. Conclusion: Morbidity and mortality can be prevented by timely initial resuscitation and correct diagnosis as well as management (non operative or operative) which depends on patient’s hemodynamic stability and findings of imaging studies.