Self knotting of Naso gastric tube in paediatric Burns patient.

Nasogastric tube feeding is one of the most accepted modes of enteral feeding in adult as well in the paediatric patients who require prolonged hospitalization due to various conditions. Enteral feeding is one of the most commonly used method for feeding in Burns patients. As per our protocol for feeding in all Burns patients, including adults and children are kept on Ryles tube enteral feeds every hourly. We routinely take check X-rays after insertion of Ryles tube and central lines. In majority of cases we never come across any complications arising from insertion of Ryles tube but in our experience at Eric Kharas memorial Burns center, Masina hospital we had two cases in which complications were encountered from inserting long Ryles tube. The aim of this paper is to emphasize on the role of proper calculation of exact length of Ryles tube prior to insertion and routine X ray examination, which can prevent complications arising from long and coiled Ryles tube.

Secondary bilateral cleft lip-nose deformity correction by rhinoplasty with simultaneous Abbe flap.

AIM: The purpose of this article is to review modification and outcome of secondary rhinoplasty along with Abbé flap for correction of secondary bilateral cleft lip deformity. MATERIALS AND METHODS: A total of thirteen patients of secondary bilateral cleft lip-nose deformity having tight upper lip, lack of acceptable philtral column, Cupid's bow definition, irregular lip scars, and associated nasal deformity were selected. All the patients received Abbé flap and simultaneous nasal correction. All cases were treated during a period of three years. Mean patient age at the time of the operation was 21 years, and ranged from 16 to 27 years. The average follow-up period was three years. RESULTS: Assessment of results was based on comparing preoperative and postoperative clinical photographs done by surgeon and patient relatives and patient satisfaction questionnaires. The columellar lengthening and upper lip vermillion correction achieved was satisfactory. There were no perioperative complications such as airway obstruction, bleeding, infection, wound disruption, or flap necrosis.

Binder's syndrome (maxillonasal dysplasia) different treatment modalities: Our experience.

AIM: Being an uncommon congenital condition, the treatment modalities of maxillonasal dysplasia are not clearly defined. Our aim is to discuss the availability and utility of various treatment options to achieve optimum results. In patients with Binder's syndrome, the midface appears flattened, the columella is short and the upper lip slants backwards. MATERIALS AND METHODS: We report here 15 patients with Binder's syndrome who were operated over a period of 5 years. Different treatment options in the form of correction of the depressed nasal dorsum and maxillary hypoplasia with split cranial bone graft or synthetic materials such as high-density porous polyethylene implant were used. Two patients with Angle class III malocclusion underwent a Le Fort I osteotomy for maxillary advancement. The patients were followed over a period of 3 years. RESULTS: We achieved a reasonable augmentation of the nose and the maxilla in our patients. We faced complications in two of our patients; in one patient there was fracture of the dorsal nasal bone graft and the other patient had protrusion of paranasal screws into the palate, which were removed. CONCLUSION: In this series of cases, we were able to utilise various treatment modalities appropriately to achieve satisfactory outcome with no significant complications.

Efficacy and safety of oxum in treatment of chronic wounds.

Chronic wounds represent a major health burden contributing to substantial mortality, morbidity and costs. Several new treatment options are currently available, which has revolutionised the management of chronic wounds. The present study is a single centre, prospective, clinical trial comparing oxum (super oxidised water) and betadine as a topical treatment of chronic wounds conducted in 30 Indian patients, with 15 patients in each group. At the end of the study, there was a significant reduction in primary parameters such as wound area and microbial colony count in oxum treated group compared to betadine group. However, both the oxum and betadine treated group showed a similar results when the secondary parameters such as oedema, erythema and granulation tissue were considered. Oxum was better tolerated than betadine. It can be concluded that use of oxum (super oxidised water) is a novel technological innovation in the therapy of chronic wounds. Oxum has been shown to be effective, well tolerated and superior to betadine in wound care.