The Role of the Lateral Pterygoid Muscle in Articular Disc Displacement: A Cross-sectional Magnetic Resonance Imaging Study.

OBJECTIVE: The objective of the study is to determine the role of Lateral Pterygoid Muscle LPM in the articular disc displacement ADD, which is considered controversial due to the variations in the pattern of insertion of the Superior Lateral Pterygoid Muscle SPLM. BACKGROUND: It is well understood that the superior head of the lateral pterygoid muscle has only a single insertion pattern among individuals, in which the muscle is attached to the articular disc and capsule. However, recent findings in many studies have shown a noticeable variation in the insertion pattern of the upper LPM. METHODS: MRI examinations were collected at King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia. Scans of 61 patients (41 females, 20 males; mean age 33 years old) with symptoms of temporomandibular dysfunction were reviewed retrospectively. The direction of their articular disc displacement was evaluated through sagittal and coronal views in both open and closed mouth positions. RESULTS: There was no statistical significance found between the LPM attachment types and TMJ disc position. The chi-square test also showed no significant difference between the type of LPM attachment and the condylar location. Forty-five percent of the articular discs were located between the articular eminence and the glenoid fossa. The majority of the disc displacement was in the anterior direction. CONCLUSION: There was no statistically significant association found between the type of LPM attachments and the direction of disc displacement.

Perception of the role of inhaled corticosteroids and factors affecting compliance among asthmatic adult patients.

OBJECTIVE: To examine the patient characteristics linked with reduced adherence to inhaled corticosteroids (ICS) use. METHODS: A prospective study of adult asthmatic patients who were prescribed with ICS and are under regular follow-up at the pulmonary outpatient clinics between June 1st, and December 31st, 2001, at King Fahad National Guard Hospital in Riyadh. All patients underwent structured interviews with an investigator. RESULTS: Included in the study were 334 patients. Thirty eight percent (38%) of the patients reported irregular use of ICS. Factors associated with irregular ICS use were a negative perception of the role of ICS (p=0.03) and less than high school education (p=0.03). Almost 50% (169/334) of all patients had concerns regarding ICS safety resulting in reduced willingness to use them. These concerns were again significantly related to the level of education and the patient's attitude to ICS. Among the most common fears hindering regular ICS use were their potential to lead to addiction (60%) and worry from steroid side effects (41%). CONCLUSION: The result of this study raises the importance of patient's education and the importance of treatment of those involved in asthma care to educate the patient and discuss with them the role of asthma medications, particularly ICS, and to correct common fears and misconceptions.