ATOM technique: Anatomic reduction using screw-wire Traction for Open reduction and internal fixation of Mandibular fractures

Various techniques are well documented to obtain anatomic reduction, such as reduction forceps, manual reduction, or a combination of these methods. However, these techniques have inherent drawbacks. We propose a new intra-operative technique for anatomic reduction using screw-wire traction for open reduction and internal fixation of mandibular fractures.

Craniospinal irradiation for respiratory failure secondary to central nervous system Erdheim-Chester disease

Erdheim-Chester disease (ECD) is a rare non-Langerhans cell histiocytosis typically featuring lower extremity osteosclerosis (96%) from Langerin-negative histiocytes with fibrosis. Central nervous system (CNS)-only disease is extremely rare, and particularly difficult to diagnose and manage. Neurologic complaints may be refractory to systemic therapy (ST), and the role of radiation therapy (RT) is undefined. We present a patient with ECD of the medulla complicated by respiratory failure and strength deficits with disseminated leptomeningeal disease (LMD) but not systemic disease, representing the first report of CNS-limited ECD with LMD. He received upfront craniospinal irradiation (CSI), representing a rare account of CSI for ESD, with marked clinical improvement resulting in extubation and improved strength. CSI facilitated excellent preservation of quality of life, and no treatment-related toxicity was observed prior to eventual, unrelated cardiopulmonary arrest. Thus, palliative CSI may augment ST by safely offering improved local control and symptomatic relief for CNS ECD.

Patterns of Mobile Phone use and Self-reported Health Problems among Adults Visiting a Private Dental Institute

Background: Increased use of mobile phones has led to increase in the prevalence of health problems. Hence, the presentstudy was undertaken to assess the pattern of the use of mobile phone and its association with self-reported health problemsamong adults.Materials and Methods: A total of 1520 participants visiting a private dental institute in Dhule, Maharashtra, were interviewedusing a pre-tested, structured questionnaire. The questionnaire included variables such as socio-demographic details, use ofmobile phone use and its pattern, selected health problems, perceived benefits, or threats of the use of mobile phone. Dataobtained were analyzed using SPSS software.Results: The majority of the participants (87.9%) were using mobile phone for up to 3 h daily. The majority of the participants(98.3%) reported using mobile phone for calling facility followed by internet or social networking purpose (67.2%). Healthsymptoms such as headache, stressful eyes, tiredness, and painful fingers showed an increased prevalence with increase in thedaily usage of mobile phones; whereas hypertension was inversely related to the use of mobile phone. Most of the participantsagreed that they start feeling stressed or anxious without their mobile phones.Conclusion: Selected health problems showed a positive association with increasing mobile phone use. People should bemade aware of harmful effects caused due to over-indulgence in the use of mobile phone and should restrict the use of focusonly on mobile positive phones to the minimum possible.

Fibroadenoma/benign phyllodes: a cytologic diagnostic challenge

Background: To study and compare cytomorphological features of histologically proven cases of benign phyllodes and cellular fibroadenoma.Methods: Smears of histologically-proven cases of benign phyllodes and cellular fibroadenoma in one year, were reviewed. The cellular fibroadenoma had epithelial and/or stromal hypercellularity. The stromal and epithelial components as well as the background cells were qualitatively and quantitatively analyzed.Results: Number, cellularity and type of stromal fragments varied significantly in two groups. Higher number, intermediate to large-sized and hypercellular stromal fragments were commonly seen in phyllodes. Hypercellular (3+ cellularity) fragments were seen in 100% cases of phyllodes against 11.1% cases of fibroadenoma. Large-sized stromal fragments were found in 100% of phyllodes while in only 11.1% cases of fibroadenoma. The ratio of number of epithelial to stromal fragments was significantly high (58.5:1) in fibroadenoma against phyllodes (1.3:1). The epithelial architecture, atypia, apocrine metaplasia and presence of cystic macrophages did not very much in the two groups. The cellularity of the dispersed cells in background did not reveal significant difference though the type of cells varied; the proportion of long and short spindle cells was higher in PT group while proportion of oval cells was higher in FA group.Conclusion: The number, cellularity and nature of stromal fragments, ratio of epithelial to stromal fragments, cellularity and type of background cells are helpful in distinguishing benign phyllodes from cellular fibroadenoma. The identification of these features can improve the pickup rate of phyllodes tumor, thereby assisting proper management.

Comparison of two different matrix band systems in restoring two surface cavities in posterior teeth done by senior undergraduate students at Qassim University, Saudi Arabia: A randomized controlled clinical trial

Dental students commonly face the problem of overhanging proximal margins and unsatisfactory proximal contact points (PCPs) while restoring Class II cavities in posterior teeth. Various matrix band systems are used in dental clinics to avoid such problems. Aims: The aim of this study is to compare the effects of two matrix band systems, circumferential matrix system and sectional matrix system on the PCPs and contours when restoring Class II cavities in posterior teeth. Settings and Design: This was a randomized controlled clinical trial done at College of Dentistry, Qassim University, Saudi Arabia. Subjects and Methods: Total 1200 Class II cavities in teeth were selected for this study. Treatment was done by senior undergraduate students. Cavities were randomly divided into two groups. Group 1: Total 600 cavities were restored using circumferential band system. Group 2: Total 600 cavities were restored using sectional band system. Teeth were restored either with the composite or the amalgam restoration. Contact points were evaluated. The presence or absence of proximal overhangs was assessed. Overhanging margins were categorized as positive overhangs, negative overhangs, and absent overhangs. Statistical Analysis Used: To identify the relationship between matrix band systems and other factors, Chi-square tests (χ2-tests) and Z-tests were used. Pearson correlation coefficient was computed and logistic regression analysis was carried out to assess variables that can affect proximal margins and contact points of final restorations. Results: All optimum contacts 389 (100%) were found in restorations done using sectional band system. A highly significant association was found between open contact points and negative overhanging margins with the use of circumferential matrix band system (P < 0.00). Conclusion: Sectional matrix band system has been found superior to circumferential matrix band system.

Utilization, Manpower and Information Management of the Blood Transfusion Services in a Large New Rural Based Tertiary Care Centre

Background:We present our experience in utilization, manpower and information management with paucity of resources in a large academic medical centre, situated in a most backward, least literate, remote pocket of the Haryana state in India. Methods:1> Electronic and manual database with their analysis. 2> Previous literature.Results:Budget provided is very low, so cost containment is very significant in our BTS (Blood Transfusion Service). Conclusion:The combinations of therapeutic and diagnostic roles necessitate a multi-pronged approach to utilization management in the BTS. This study will be very helpful for organized approach in a newly stabilizing BTSes of remote areas of other developing countries.

ABO and Rhesus (D) Blood Group Distribution among Blood Donors in Rural South Haryana (Mewat-Region): A 5 Years Retrospective Study

Background: In India, geographical distribution of blood groups and Rhesus (D) factor varies across the country. The aim of this study is to examine the distribution of these groups among voluntary blood donors at a large academic medical centre; SHKM which is situated in a rural, most backward, least literate, remote pocket of south (Mewat-region) Haryana state in India. Methods: A retrospective study was conducted using 5 year data (August 2013–December 2017) from a regional blood bank in rural south (Mewat-region) Haryana of India. Records of 16,121 voluntary blood donors were reviewed. Results: The distribution of ABO blood group was; blood group O (29.69%); blood group A (22.37%); blood group B (37.72%) and blood group AB (10.22%). A significantly higher proportion of Rhesus (D) positive than Rhesus (D) negative in blood group A and AB (respective p-values are .018 and .089). Conclusion: The sequence of ABO distribution among the rural population in south (Mewat- region) Haryana of India is; B > O > A > AB, with males as the predominant donors.

Abutment Options for the Restoration of the Malaligned Implants: A Review.

It is rightly said, “implant dentistry is a prosthodontic discipline that happens to have a surgical component.” Even though the most recommended concept is restoration driven implant placement, the anatomical features of the bone may not allow for the ideal placement of the implant. One of the complications occurring during the implant placement is malalignment or placement in less ideal positions. Various techniques have been discussed in the literature to describe the correction of this malpositioning of the implants. These methods encompass both surgical and prosthodontic aspects. Where in surgical methods are more of invasive for an osseointegrated implant, prosthodontic methods offer better results with less complicated procedures with the use of customized or angulated abutments. This review gives an insight into the various options of abutment available for the restoration of the angulated implants.

Spectrum of lymph node lesions on cytology in rural Haryana: a retrospective analysis.

Background: Fine Needle Aspiration Cytology (FNAC) is a simple, rapid, cost effective and reliable technique which can be used as a routine outpatient department (OPD) procedure and first line of investigation in diagnosing a variety of superficial and deep lesions. Lymphadenopathy is of great clinical significance and the underlying cause may range from a treatable infectious etiology to malignant neoplasms. In this study, we describe the diagnostic utility of FNAC in the assessment of lymph node lesions with an emphasis on the diagnosis of non-neoplastic, benign and malignant neoplastic processes. Cytomorphological patterns of tuberculous lymphadenitis were also observed. Methods: This was a retrospective study and a total of 736 patients including all age groups and both sexes presenting with palpable or deep lymph nodes in FNAC clinic of our institute over a period of 2 years were included in our study. FNAC was conducted with 22-24 Gauge disposable needles attached to 20c.c syringes. Smears were fixed in 95% ethyl alcohol and stained with Papanicolaou stain. Leishman stain was done on air dried smears. Ziehl- Neelsen (ZN) staining was done wherever required. Results: Out of 736 aspirations from lymph nodes, the most frequent cause of lymphadenopathy was found to be Tuberculosis with 419 cases (56.92%). The next frequent diagnosis was reactive lymphadenitis with 193 cases (26.22%) followed by metastatic lymphadenopathy in 47 cases (6.38%). A diagnosis of lymphoproliferative disorder was rendered in 20 cases (2.71%). In 10 cases (1.35%) FNAC was inconclusive. Conclusion: In our study, the predominant cause of lymphadenopathy was tuberculous lymphadenitis, seen in more than half of total cases, followed by reactive lymphadenopathy and malignant neoplasms. FNAC was helpful in establishing the diagnosis in 98.65% of the cases.

Pulmonary blastomycosis on autopsy: a rare case report.

A case of pulmonary blastomycosis on autopsy in a middle aged male from rural background is presented herewith. Blastomycosis is a pyogranulomatous disease caused by the dimorphic fungus blastomyces dermatitidis. Blastomycosis is endemic in regions of North America that border the Great Lakes. It is one of the great mimickers in medicine. Pulmonary blastomycosis has a broad range of clinical presentations, varying from completely asymptomatic pulmonary infiltrates to diffuse and massive parenchymal involvement that can lead to Acute Respiratory Distress Syndrome (ARDS). Human infection occurs when soil containing microfoci of mycelia is distributed and airborne conidia are inhaled. If natural defences in the alveoli fail to contain the infection, lymphohematogenous dissemination ensues. Diagnosis is based on culture and direct visualization of round, multinucleated yeast forms that produce daughter cells from a single broad- based bud. Most of the cases of blastomycosis reported in India are imported from the endemic areas of the World except a few authochthonous cases in North India.

Trends in Choosing Place of Delivery and Assistance during Delivery in Nanded District, Maharashtra, India.

Delivery in a medical institution promotes child survival and reduces the risk of maternal mortality. Many initiatives under the National Rural Health Mission (NRHM) focus on increasing the institutional deliveries. This study describes the trends in choosing place of delivery in Nanded district at the end of the first phase of the mission. Key informants were interviewed to document the initiatives under NRHM implemented in the district. A cross-sectional descriptive study was conducted in 30 villages selected using one stage cluster-sampling method. A house-to-house survey was conducted in June 2009. A set of structured open-ended questionnaire was used for interviewing all women who had delivered during January 2004–May 2009. The outcomes studied were place of delivery and assistance during delivery. Analysis was done by calculating chi-square test and odds ratio. Interventions to improve the quality of health services and healthcare-seeking behaviour were implemented successfully in the district. The proportion of institutional deliveries increased from 42% in 2004 to 69% in 2009. A significant increase was observed in the proportion of institutional deliveries [60% vs 45%; χ2=173.85, p<0.05, odds ratio (OR)=1.8 (95% confidence interval (CI) 1.65-1.97)] in the NRHM period compared to the pre-NRHM period. The deliveries in government institutions and in private institutions also showed a significant rise. The proportion of deliveries assisted by health personnel increased significantly during the NRHM period [62% vs 49%; χ2=149.39; p<0.05, OR=1.73, 95% CI 1.58-1.89] However, less than 10% of the deliveries in the home (range 2-9%) were assisted by health personnel throughout the study period. There was a wide geographic variation in place of delivery among the study villages. The results showed a significant increase in the proportion of institutional deliveries and deliveries assisted by health personnel in the NRHM period. Since a less proportion of deliveries in the home is conducted by health personnel, the focus should be on increasing the institutional deliveries. Special and innovative interventions should be implemented in the villages with a less proportion of institutional deliveries.