Healing of a large avulsed mandibular bony segment: report of a unique case.

This case report puts an emphasis on retaining and re-fixing any avulsed bony segments in the maxillofacial region and maintaining the periosteal layer whenever possible, especially in young patients. Adequate bony fixation and watertight soft tissue closure are vital components for bone healing. The healing potential of facial bones is much higher as compared to the long bones, due to the superior blood supply.

Devoid Knowledge and Low Adherence Precipitate Uncontrolled Blood Pressure: A Depiction From Cross-Sectional Study.

OBJECTIVE: The present study was aimed to assess knowledge regarding disease, adherence to medication and blood pressure control among hypertensive patients. METHODS: A cross-sectional study involving 384 hypertensive patients attending a tertiary care, public sector hospital in Islamabad, Pakistan, was conducted. Data was collected by using Urdu versions of pre-validated hypertension knowledge questionnaire and Medication Adherence Scale by Morisky. Each patient's blood pressure was measured through a calibrated mercury sphygmomanometer. Data was analyzed statistically by using SPSS software version 21.0. Chi-square test was performed to determine association level among study variables. Mann-Whitney and Kruskal-Wallis tests were performed to assess for statistically significant differences of demographic variables with systolic BP and diastolic BP. Multiple regression was used to predict the impact of two or more independent variables on dependent variable. P value of <.05 was considered to be significant. RESULTS: Mean (SD) systolic and diastolic blood pressures of 384 patients were 140.39 ± 15.485 and 88.74 ± 10.683 in mmHg respectively. The mean knowledge score was (13.26 ± 5.16 out of 22) and median score was 13. 103 (26.8%) of the patients had poor knowledge, whereas, 191 (49.7%) had moderate knowledge regarding hypertension with most of them at bottom line in the scale of moderate knowledge. The mean medication adherence score was (4.66 ± 2.743 out of 8), while 204 (53.1%) were categorized as poor adherent. CONCLUSION: The current study concluded that knowledge regarding hypertension, adherence to treatment and blood pressure control among hypertensive patients was found poor.

sessment Of Blood Pressure and Health-Related Quality of Life Among Hypertensive Patients: An Observational Study.

OBJECTIVES: Objective • Health-related quality of life (HRQoL) is an important tool in the assessment of treatment outcomes. Healthcare professionals use the concept of HRQoL to measure factors other than illness which affect human health and its status. Patient's everyday activities are adversely affected by hypertension (HTN) and results in decreased self-confidence. The present study was aimed to assess blood pressure and health-related quality of life (HRQoL) of hypertensive patients in Pakistan. METHODS: A questionnaire-based cross-sectional study was undertaken with 384 hypertensive patients attending a tertiary care public sector hospital in Islamabad, Pakistan. The assessment of HRQoL was done by using an EuroQol EQ-5D scale. Values derived from the UK general population survey were used to score HRQoL. The blood pressure of each patient was measured by using a calibrated sphygmomanometer. Data analysis was performed by using SPSS version 21 (SPSS Inc., Chicago, IL, USA). P ≤ .05 was taken as significant. RESULTS: Two hundred and fifteen (56%) patients were male with 3.31 ± 2.13 years of history of hypertension. The majority (n = 138, 35.9%) was categorized in the age group of 41 to 50 years with mean age of 50.21 ± 9.51. Mean (SD) systolic BP and mean (SD) diastolic BP was measured as 140.39 ± 15.485 and 88.74 ± 10.683 in mmHg respectively. Poor HRQoL was measured among the study participants (0.6456 ± 0.2317). Age, gender, education, occupation and monthly income had a significant relation with HRQoL score. CONCLUSION: Hypertension imposes an adverse effect on patient's HRQoL. Results from this study could be useful in clinical practice. Attention is required to highlight determinants of HRQoL and policies should be implemented for better management of HTN, particularly in early treatment phases where it is still possible to improve HRQoL.

Herpes simplex encephalitis presenting with normal CSF analysis.

A 28 years old female presented with headache, fever, altered sensorium and right side weakness for one week. She was febrile and drowsy with right sided hemiplegia and papilledema. Tuberculous or bacterial meningitis, tuberculoma and abscess were at the top of the diagnosis list followed by Herpes simplex meningo-encephalitis (HSE). MRI showed abnormal signal intensity of left temporal lobe without significant post-contrast enhancement and midline shift. CSF examination was normal, gram stain and Ziehl-Neelsen stain showed no micro-organism, or acid fast bacilli. CSF for MTB PCR was negative. PCR DNA for Herpes simplex 1 on CSF was detected. Acyclovir was started and the patient was discharged after full recovery. A high index of suspicion is required for HSE diagnosis in Pakistan where other infections predominantly affect the brain and HSE may be overlooked as a potential diagnosis.