Comparison between extra oral and intraoral surgical procedures for the management of mandibular angle fractures

Objective: To evaluate and compare the treatment outcomes of isolated mandibular angle fractures managed by open reduction and internal fixation using intra oral and extra oral approaches. Study Design: Randomized control trial. Place and duration of Study: Department of oral and maxillofacial surgery, Liaquat University Hospital Hyderabad, from May 2011 to Nov 2011

Patients and Methods: The patients who presented with isolated mandibular fracture were selected according to inclusion criteria. The diagnosis was made by standard history, clinical examination and radiographic investigations. The patients were randomly divided into two groups, A and B. Group A patients were managed by extra oral approach and group B patients were managed using intra oral approach. The patients were prescribed antibiotics for one week and follow up was carried for four weeks. Nerve damage, limited mouth opening, infection, mal-occlusion, hypertrophic scar and aesthetic dissatisfaction were immediate and late post operative complications observed and documented

Results: Road traffic accident [RTA] was the main etiologic factor [66.66%]. Marginal mandibular nerve damage was noted in 20% cases treated with extra oral approach [group A]. Post operative esthetic dissatisfaction was present in 60% patients [group A] as compared to 6.66% of the patients [group B]. The rate of mouth opening compromise and mal-occlusion were also higher in the patients treated with extra oral approach compared with intra oral approach, although statistically not significant

Conclusion: The intra oral approach for mandibular angle fracture management is an effective and comparatively better technique as compare to the extra oral approach

Pharyngeal Pouch co-existing with Thyroid Mass: a rare presentation

A 60-year male presented with a 4-year history of a mass in the lower third of the neck, which had gradually increased in size. On initial examination, it was considered a thyroid mass. On detailed examination, another mass was found in the upper neck which was doughy in consistency and reducible in size. With available investigations, he was diagnosed as a thyroid mass associated with pharyngeal pouch. On exploration of the neck, the whole mass revealed to be a pharyngeal pouch. We have discussed the patho-physiology of the pharyngeal pouch and reviewed the literature in detail

Kindler's syndrome: a report of five cases in a family

Kindler's Syndrome [KS] is a rare genodermatosis with autosomal recessive mode of inheritance. The disease results from homozygous mutations on both alleles of the FERMT-1 gene [also known as KIND-1 gene] that encodes the protein Kindlin-1 [kindlerin]. Clinical features include a constellation of early infantile skin blistering and mild photosensitivity, which improves with age, and progressive poikiloderma with widespread cutaneous atrophy. The differential diagnosis of Kindler syndrome include other congenital poikilodermatous and photosensitive conditions including Bloom syndrome, Cockayne syndrome, dyskeratosis congenita, epidermolysis bullosa, Rothmund-Thomson syndrome and xeroderma pigmentosum. We herein, report the presence of the Kindler's syndrome in 5 out of 7 children of consanguineous parents. To authors' knowledge, this is the first report of Kindler's syndrome involving 5 members of a family

Comparison between extraoral and intraoral surgical procedures for the treatment of mandibular angle fractures using semirigid fixation or rigid fixation

The purpose of this study was to determine various post operative complications associated with two surgical procedures used for reduction of mandibular angle fractures. Experimental study. The study was conducted in Department of Oral and Maxillofacial Surgery Liaquat University Hospital Hyderabad from February 2012 to February 2013. Thirty patients with mandibular fractures were divided in to two categories. Fifteen patients were treated by intra oral approach [Group A] and Fifteen by extra oral approach [Group B]. At different intervals of their post operative visits, these patients were evaluated for post operative complications of infection, nerve damage, keloid scar, facial cosmetic dissatisfaction, malocclusion and limitation in mouth opening. 23 male patients and 07 female patients were affected with mandibular fracture. Most common etiology was RTA in 66.6% case. Most common complication with intraoral approach was postoperative infection while facial dissatisfaction was most commonly noticed with extraoral approach. The intra oral approach with rigid fixation is our effective and superior technique as compare to the extra oral approach

Late onset erythropoietic porphyria [gunther's disease]

Congenital erythropoietic porphyria [CEP] or Gunther's disease is inherited disorder of porphyrin heme synthetic pathway that usually presents early in life. A very rare form of this disease has its onset in later years of life, called late onset erythropoietic porphyria [late onset EP]. Fourteen cases of late onset EP have been reported to-date. We report another case of this rare entity in a 40 years old male with associated findings of haemolysis and thrombocytopenia

Depression in adult dermatology outpatients

To determine the frequency of depression in adult male dermatology outpatients. Cross-sectional study. Combined Military Hospital, Bahawalpur, from January to March 2007. A consecutive sample was screened for depression by using Urdu version of General Health Questionnaire-12 [GHQ-12]. The final diagnosis of depression was based on criteria of International Classification of Diseases-10. Out of the 114 adult males with dermatological disorders, 39 [34.11%] had depression. The frequency and percentage of depression in dermatological conditions was 6 [100%] in psychocutaneous disorders, 2 [66.6%] in urticaria, 3 [66.6%] in pruritis, 7 [57.5%] in acne vulgaris, 4 [50%] in psoriasis, 4 [44.4%] in vitiligo, 3 [37.5%] in melasma, 1 [33.3%] each in hyperhidrosis and alopecia areata, and 9 [20.4%] in eczema. It was not recorded in leprosy and chronic fungal infections. Depression was frequently in adult males with dermatological disorders especially psychocutaneous disorders, urticaria, pruritis, acne vulgaris and psoriasis. Depressive symptoms should be specifically explored even at busy dermatology outdoors for early recognition and timely appropriate psychiatric referral

Miltefosine in treatment of old world cutaneous leishmaniasis in Pakistan

To evaluate the efficacy of miltefosine in the treatment of cutaneous leishmaniasis Uncontrolled, open label, quasi-experimental study Place and Duration of Study: The study was carried out in Military Hospital Rawalpindi and five other Army Hospitals from Jan 2006 to Aug 2006. This study was dome to investigate the efficacy of treatment of cutaneous leishmaniasis patients with oral miltefosine in doses of 2.5 mg/kg/day at 6 centers in Pakistan. The study was conducted among 90 hospitalized adult cutaneous leishmaniasis patients. All patients completed the full 28-days treatment course. The study revealed excellent response in 32[28.8%], good in 38[34.4%], fair in 17[15.3%] and poor in 3[2.7%] patients. Treatment-related adverse events were transient rise in ALT [95%], followed by myalgia [33%], arthralgia [15%], nausea vomiting [12%], bad oral taste [2%], testicular pain [4%], cough [2%], conjunctivitis [2%] and fever [1%]. All theses side effects were transient and settled on discontinuation of medication. Compliance was good The use of oral miltefosine in doses of 2.5 mg/kg/day is effective and well tolerated in old world cutaneous leishmaniasis

In vitro characterization of repair synthesis initiated by T4 endonuclease V on a synthetic DNA substrate.

The size of the repair patch produced by E. coli DNA polymerase (Pol I) following the removal of a pyrimidine dimer from DNA in response to the nicking activity of T4 endonuclease (T4 endo V) was determined. A 48-bp DNA containing a pyrimidine dimer at a defined location was labelled in the damaged strand and incubated with T4 endo V and E. coli endonuclease IV. Subsequently, DNA synthesis by DNA Pol I was carried out in the presence of four dNTPs, ATP and DNA ligase. Analysis of the reaction products on a sequencing gel revealed a ladder of only 4-oligonucleotides, 1-4 nucleotides greater in length than the fragment generated by the combined nicking activities of T4 endo V and E. coli endonuclease IV. Thus we conclude that the in vitro repair patch size of T4 endo V is 4 nucleotides and that in some cases the repaired DNA is not ligated.