Evaluation of impacts of aspirin therapy versus placebo on preeclampsia: An observational study.

Background: Gestational hypertension and pre-eclampsia often increase maternal and neonatal mortality. The illness usually appears after the 20th week of pregnancy due to malnutrition or obesity. Untreated, it can lead to neonatal and maternal mortality. Low-dose Aspirin can prevent preeclampsia if started between 11 and 28 weeks. Several studies support this technique, although others have shown limited effectiveness and negative side effects. Objective: This study aims to assess the effectiveness of aspirin treatment for the prevention of preeclampsia, taking into account any possible adverse reactions. Methods: This observational research comprised 600 singleton pregnant women at high risk of pregnancy-induced hypertension. The aspirin group had 301 individuals and the placebo group 299. From 11 to 36 weeks of pregnancy, they received 150 mg of aspirin and 150 mg of placebo. Gestational hypertension was assessed at 25 weeks, 36 weeks, and 37 weeks. If any, aspirin and placebo-related adverse pregnancy and neonatal outcomes were reported. Results: With aspirin therapy, 4 females and 14 females with placebo developed gestational hypertension before 25 weeks of pregnancy with an odds ratio of 0.283 (0.092-0.87); before 36 weeks, 5 females and 15 females with placebo developed GHD with an odds ratio of 0.331 (0.118-0.922); and after 37 weeks, 17 females and 35 females with placebo developed GHD. Preeclampsia occurred in 5 females in the aspirin group and 17 in the placebo group at <25 weeks (odds ratio 0.292 (0.106-0.802), 7 females in the aspirin arm and 25 females in the placebo arm at <36 weeks (odds ratio 0.278 (0.118-0.652), and 21 females in the aspirin arm and 39 females in the placebo arm at >37 weeks (odds ratio 0.5349 (0.307-0.930). Conclusion: In pregnant women at high risk of prenatal hypertension and preeclampsia, aspirin therapy is very effective with minimal side effects.

Laminar airflow ventilation systems in orthopaedic operating room do not prevent surgical site infections: a systematic review and meta-analysis.

BACKGROUND: Laminar airflow (LAF) technologies minimize infectious microorganisms to enhance air quality and surgical site infections (SSIs). LAF lowers SSIs in some clinical studies but not others. This study analyzes laminar airflow ventilation's capacity to reduce orthopaedic surgery-related SSIs. METHODS: The PRISMA-compliant keywords were utilized to conduct a search for pertinent articles in various databases including PubMed, MEDLINE, CENTRAL, Web of Sciences, and the Cochrane databases. Observational studies, including retrospective, prospective, and cohort designs, satisfy the PICOS criteria for research methodology. The assessment of quality was conducted utilizing the Robvis software, while the meta-analysis was performed using the RevMan application. The study's results were assessed based on effect sizes of odds ratio (OR) and risk ratio (RR). RESULTS: From 2000 to 2022, 10 randomized controlled clinical trials with 10,06,587 orthopaedic surgery patients met the inclusion criteria. The primary outcomes were: (1) Risk of SSI, (2) Bacterial count in sampled air and (3) Reduction in SSIs. The overall pooled OR of all included studies was 1.70 (95% CI 1.10-2.64), and the overall pooled RR was 1.27 (95% CI 1.02-1.59) with p < 0.05. LAF is ineffective at preventing SSIs in orthopaedic procedures due to its high-risk ratio and odds ratio. CONCLUSIONS: The present meta-analysis has determined that the implementation of LAF systems does not result in a significant reduction in the incidence of surgical site infections (SSIs), bacterial count in the air, or SSIs occurrence in orthopaedic operating rooms. Consequently, the installation of said equipment in operating rooms has been found to be both expensive and inefficient.

Effectiveness of zinc supplementation on the incidence of oral mucositis during chemotherapy and radiation: A meta­analysis.

Oral mucositis (OM) is a commonly observed and debilitating side effect of chemotherapy and radiation therapy in patients with cancer, especially head and neck cancer. Although there is no proven therapy for the prevention and treatment of OM, zinc supplementation effectively decreases the incidence of OM. This paper provides a current and comprehensive meta-analysis of the efficacy of zinc compared with placebo/control in OM. A systematic literature review was conducted using MEDLINE and Central databases for randomized control trials (RCTs) comparing zinc supplementation (oral or rinse) with placebo/control in patients with various types of cancer undergoing chemotherapy, radiation therapy or combined chemo-radiation. The outcome was OM incidence, independent of the severity. A random-effects model was used to calculate the pooled risk ratio and subgroup analyses were performed. A total of 12 RCTs were included, containing information from 783 patients. A decrease in OM incidence was observed overall when all cancer therapies were considered. However, subgroup analyses showed that zinc did not significantly decrease the incidence of OM when studies were stratified by cancer therapy or scale/criteria used to assess OM. The results of the meta-analysis support the use of zinc supplementation in decreasing OM incidence in patients with cancer receiving chemotherapy or radiation therapy. However, the high heterogeneity between studies and the small number of studies are limitations of the meta-analysis.

Evaluating the influence of health literacy and health-promoting COVID-19 protective behaviors on the spread of infection during the COVID-19 pandemic: A meta-analysis.

BACKGROUND: Health literacy and self-efficacy related to COVID-19 pandemic management are closely linked. Therefore, synthesis of relevant evidence regarding the positive aspects of health literacy and health-promoting protective measures among individuals during COVID-19 pandemic is necessary. OBJECTIVES: To determine the influence of e-health literacy and health-promoting coronavirus disease 2019 (COVID-19) protective behaviors on the spread of infection during the COVID-19 pandemic. MATERIAL AND METHODS: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, PubMed, MEDLINE, PsycINFO, EMBASE, and Cochrane Library databases, as well as PROSPERO and ClinicalTrials.gov registry platforms were searched for eligible literature published from January 2020 to July 2022. Studies were included based on predefined Population, Intervention, Comparison, Outcomes and Study design (PICOS) criteria, and a summary of each study was prepared. To estimate the effect size, the standardized mean difference (SMD) of the evaluated parameters, e-health literacy and health-promoting COVID-19 protective behaviors was extracted. Using RevMan and MedCalc software, a meta-analysis was performed. RESULTS: Twelve eligible studies involving a total of 9854 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected individuals were included in the meta-analysis. The pooled SMD for e-health literacy was 40.39 (95% confidence interval (95% CI): 28.14-52.63), with the following heterogeneity values: Tau2 of 396.80, ÷2 of 669.48, degrees of freedom (df) of 11, I2 of 98%, Z value of 6.47, and p < 0.001. Similarly, the pooled SM for COVID-19 protective behaviors was 15.90 (95% CI: 10.96-20.84) with Tau2 of 55.25, ÷2 of 252.92, df of 11, I2 of 98%, Z of 6.31, and p < 0.001. CONCLUSION: This study confirmed that e-health literacy and health-promoting COVID-19 protective behaviors have a strong positive impact on preventing the spread of COVID-19 infection and on its effective management. We recommend that interventions and applicable policies for promoting such e-literacy programs and preventative measures be given a high level of consideration.

Does enteral immune nutrition (EIN) boost the immunity of gastric cancer (GC) patients undergoing surgery? A systematic review and meta-analysis.

Introduction: The main components of enteral immunonutrition (EIN) are ω-3 fatty acids, glutamine, arginine, and nucleotide, which primarily raises the immunity of the host and helps to reduce postoperative infections and non-infectious difficulties. Although the potential benefits of EIN are widely reported, some researchers did not find it to be of much help, and hence valid conclusions about its role are still unclear. Aim: To evaluate the role of enteral immunonutrition on patients undergoing surgery for gastric cancer (GC). Material and methods: Appropriate articles were searched from the PubMed, Medline, and Central databases using the appropriate keywords as per the PRISMA guidelines. Randomized controlled trials, and retrospective, prospective, and open-label studies were included as per the predefined PICOS criteria. Demographic summary and event data for the effect of EIN on patients undergoing surgery for GC were extracted from the included studies. Results: Twelve randomized controlled clinical trials with a total of 10,422 gastric cancer patients were included. We found the odds ratio value of 0.23 (95% CI: 0.09-0.59). The results are heterogeneous with a τ2 value of 2.77, a χ2 value of 1707.96, a df value of 11, an I2 value of 99%, a z value of 3.04, and a p-value of less than 0.05. The risk ratio is 0.47 (95% CI: 0.29-0.77) with heterogeneity of τ2 value of 0.73, χ2 value of 1428.34, df value of 11, I2 value of 99%, z value of 2.99, and p-value < 0.05. Conclusions: The present meta-analysis strongly commends the use of EIN to boost the immunity of gastric cancer (GC) patients undergoing gastrectomy.

An Unconventional Route for Synthesis and Solid-State Processing of Low-Entangled Ultra-High Molecular Weight Isotactic Polypropylene.

Introducing the reverse micelle formation during polymerization, and thus avoiding the catalyst support, aggregated single crystals of ultra-high molecular weight isotactic polypropylene having spherical morphology are obtained. The ease in flowability of the spherical nascent morphology, having a low-entangled state in the non-crystalline region of the single crystals in the semi-crystalline polymer, allows the sintering of the nascent polymer in the solid state without melting. Thus maintains a low-entangled state, and facilitates the translation of macroscopic forces to macromolecular length scale, without melting, leading to the formation of uniaxially drawn objects having unprecedented properties that can be used in the development of one component, high-performance, easy-to-recycle composites. Thus having the potential of replacing difficult-to-recycle hybrid composites.

Role of emergency chest ultrasound in traumatic pneumothorax. An updated meta-analysis.

AIM: To assess chest ultrasound (US) diagnostic accuracy in pneumothorax diagnosing. MATERIAL AND METHODS: Prospec-tive studies related to the US pneumothorax diagnostic accuracy in trauma patients were extensively searched from 2000 up to November 2020. The studies features and findings were gathered using a standardised form and the methodological quality of the investigations was evaluated using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). RESULTS: Twelve articles were finally chosen for quantitative analysis. The overall sensitivity of US scan in pneumothorax diagnosis was 89% (95%CI 86-91%). Specificity was 96% (95%CI 95-97%). The diagnostic odds ratio was 193.94 (59.009-637.40) at 95%CI, thus demonstrating high chest US accuracy in pneumothorax diagnosis. CONCLUSION: Despite the limitations of the included studies, this systematic review and meta-analysis concluded that chest US is a reliable method for diagnosing pneu-mothorax in traumatized patients.

Formation of UHMWPE Nanofibers during Solid-State Deformation.

A network of nanofibers is formed in situ through solid-state deformation of disentangled ultra-high molecular weight polyethylene (dis-UHMWPE) during compounding with a polyolefin elastomer below the melting temperature of dis-UHMWPE crystals. Dis-UHMWPE was prepared in the form of powder particles larger than 50 µm by polymerization at low temperatures, which favored the crystallization and prevention of macromolecules from entangling. Shearing the blend for different durations and at different temperatures affects the extent to which the grains of dis-UHMWPE powder deform into nanofibers. Disentangled powder particles could deform into a network of nanofibers with diameters between 110 and 340 nm. The nanocomposite can be further sheared for a longer time to decrease the diameter of dis-UHMWPE nanofibers below 40 nm, being still composed of ≈70 wt.% of crystalline and ≈30 wt.% of amorphous components. Subsequently, these thinner fibers begin to melt and fragment because they are thinner and also because the amorphous defects locally decrease the nanofibers' melting temperature, which results in their fragmentation and partial loss of nanofibers. These phenomena limit the thickness of dis-UHMWPE nanofibers, and this explains why prolonged or more intense shearing does not lead to thinner nanofibers of dis-UHMWPE when compounded in a polymeric matrix.

Does pedicle flap design influence the postoperative sequel of lower third molar surgery and quality of life?

Objective: To determine the impact of the buccal envelope flap and pedicle design on the post-operative outcome and quality of life following lower third molar surgery (QoL). Materials and methods: A randomized case-control clinical study was carried out from September 2017 to September 2019. In this study, a total number of 50 patients with mandibular third molar impaction underwent surgical removal of the same using buccal envelope flap (group A) and pedicle flap (group B). The patients were assessed postoperatively for pain, swelling, trismus, wound dehiscence, dry socket, and quality of life for one month. Results: In terms of pain, swelling, and trismus, there was no statistical difference between the two groups (p > 0.05). However, there was a statistically significant difference found in group B (pedicle flap) in terms of wound dehiscence, dry socket, and quality of life (p < 0.05). Conclusion: The pedicle flap demonstrates fewer incidences of wound dehiscence, dry socket, and a better quality of life when compared to the envelope flap.

Hydration, Refinement, and Dissolution of the Crystalline Phase in Polyamide 6 Polymorphs for Ultimate Thermomechanical Properties.

Timescales of polyamide 6 melt-shaping technologies, relative to the dynamics of conformational rearrangements upon crystallization, challenge the formation of the most thermodynamically favorable chain packing and thus optimum performance. In this publication, we make use of the mediation of hydrogen bonding by water molecules in the superheated state of water, i.e., above 100 °C in a closed environment, in the structural refinement of polyamide 6 for enhanced thermomechanical performance. The paper addresses dissolution and (re)crystallization of different polyamide 6 polymorphs in the superheated state of water by time-resolved simultaneous small- and wide-angle X-ray scattering and solid-state 1H NMR spectroscopy and the effect on mechanical properties. The experiments reveal that upon heating in the superheated state of water, the pseudo-hexagonal phase dissolves at relatively low temperature and instantly crystallizes in a defected monoclinic phase that successively refines to a perfected monoclinic structure. The dissolution temperature of the pseudo-hexagonal phase of polyamide 6 is found to be dependent on the degree of crystal perfection originating from conformational disorder and misalignment of hydrogen bonding in the lattice, retrospectively, to the Brill transition temperature. The perfected monoclinic phase below the dissolution temperature can be preserved upon cooling but is plasticized by hydration of the amide moieties in the crystalline phase. The removal of water from the hydrated crystals, in the proximity of Brill transition temperature, strengthening the hydrogen bonding, occurs. Retrospectively, the most thermodynamically stable crystallographic phase is preserved and renders an increase in mechanical properties and dimensional stability of the product. The insight obtained on the influence of superheated water on the structural refinement of imperfected crystallographic states assists in polyamide 6 postprocessing strategies for enhanced performance.

Corrigendum: Glycemic Control Regimens in the Prevention of Surgical Site Infections: A Meta-Analysis of Randomized Clinical Trials.

[This corrects the article DOI: 10.3389/fsurg.2022.855409.].

Does povidone-iodine application in surgical procedures help in the prevention of surgical site infections? An updated meta-analysis.

Introduction: Surgical site infections (SSIs) occur after an operative procedure and can range from superficial to deep wound infections. The World Health Organization (WHO) and the Centers for Disease Control (CDC) have proposed guidelines recommending measures to prevent SSIs. Intraoperative measures are largely focused on decontamination of the skin and intraoperative wound irrigation using soap and antiseptics and are simple, efficient, and cost-effective measures to reduce SSIs. Povidone-iodine (PVI) is a topical antiseptic widely used for the reduction of SSIs. Aim: A meta-analysis was conducted to determine the efficacy of preoperative or intraoperative use of PVI from randomized controlled trials (RCTs). Material and methods: A systematic literature review was conducted using MEDLINE and Central databases for RCTs that involved PVI application versus saline or no treatment control groups across various surgical categories. The primary outcome was SSI or post-operative wound infections. A random-effects model was used to calculate the pooled risk ratio and subgroup analyses were performed. Results: A total of 59 RCTs were included in the meta-analysis with information from 20,497 patients. A reduction in overall SSI incidence was found (RR = 0.70, 0.60-0.80, p = 0.0002, I2 = 44%). Subgroup analyses showed that the comparator treatment and type of procedure did not modify the effect of PVI on SSI incidence. However, inconsistent results on SSI incidence were obtained when the data were stratified by PVI application method and surgery category. Conclusions: The results of the meta-analysis provide support for the preoperative or intraoperative use of PVI in decreasing the incidence of SSI.

Glycemic Control Regimens in the Prevention of Surgical Site Infections: A Meta-Analysis of Randomized Clinical Trials.

Background: Increased risk of surgical site infections (SSIs) caused by hyperglycemia makes it necessary to follow perioperative glucose lowering strategies to reduce postoperative complications. A meta-analysis was conducted to understand the efficacy of intensive vs. conventional blood glucose lowering regimens on the incidence of SSIs and hypoglycemia from various randomized controlled studies (RCTs). Materials and Methods: A systematic literature review was conducted using MEDLINE and Central databases for RCTs that involved intensive (lower blood glucose target levels) vs. conventional (higher blood glucose target levels) strategies in patients undergoing various types of surgeries. The primary outcomes were SSIs or postoperative wound infections. Hypoglycemia and mortality outcomes were also studied. A random-effects model was used to calculate the pooled risk ratio (RR), and subgroup analyses were performed. Results: A total of 29 RCTs were included in the meta-analysis with the information from 14,126 patients. A reduction in overall incidence of SSIs was found (RR 0.63, 0.50-0.80, p = 0.0002, I 2= 56%). Subgroup analyses showed that intensive insulin regimens decreased the risk of SSIs in patients with diabetes, in cardiac and abdominal surgical procedures, and during the intraoperative and postoperative phases of surgery. However, the risk of hypoglycemia and mortality was increased in the intensive group compared to the conventional group. Conclusion: The results of the meta-analysis provide support for the use of intensive insulin regimens during the perioperative phase for decreasing the incidence of SSIs in certain patient populations and surgical categories.

Does a single dose of palonosetron have any role in preventing acute chemotherapy-induced nausea and vomiting in pediatric osteosarcoma patients without dexamethasone? A randomized clinical trial.

BACKGROUND: Chemotherapy-induced nausea and vomiting (CINV) is a troublesome side-effect of chemotherapy in pediatric patients undergoing osteosarcoma treatment. In this context, the role of 5-hydroxytryptamine-3 (5-HT3) receptor antagonists needs to be explored. OBJECTIVES: To evaluate the superiority of single-dose palonosetron over granisetron in pediatric patients undergoing highly emetogenic chemotherapy (HEC) for osteosarcoma. MATERIAL AND METHODS: In this double-blind, randomized study, pediatric patients were assessed in terms of acute nausea and vomiting following HEC for osteosarcoma. These children were assigned to group 1 (palonosetron) and group 2 (granisetron) without any other antiemetic prophylaxis. The primary outcome variable was the children's segment with a complete response (CR) during the acute phase of the 1st on-study chemotherapy cycle. The risk factors associated with the emesis were analyzed. The patients were followed up for the first 24 h after chemotherapy. RESULTS: A total number of 200 children were evaluated in terms of the response, and other factors that might alter the response were assessed in the 2 groups. These 200 children underwent 604 blocks of chemotherapy. Complete responses were documented in 83% and 72% of children receiving palonosetron and granisetron, respectively, during the acute phase. Only dexamethasone, used as a rescue medication, was found to be a significant risk factor that predisposed to the response (p < 0.05). CONCLUSIONS: Single-dose palonosetron is an effective alternative to granisetron for preventing CINV in children receiving HEC for osteosarcoma.

Does a MediDiet With Additional Extra Virgin Olive Oil and Pistachios Reduce the Incidence of Gestational Diabetes?

OBJECTIVE: The present study aimed to evaluate gestational diabetes mellitus (GDM) incidence in pregnant women following the Mediterranean diet (MedDiet) with the addition of extra virgin olive oil (EVOO) and pistachios. METHODS: A total of 560 pregnant patients were enrolled in the present study. The MedDiet was introduced in both the interventional group (IG) and the control group. The women in the IG received 40 mL of EVOO every day along with 25 to 30 g of roasted pistachios. The incidence of GDM was recorded along with specific maternal and neonatal outcomes. RESULTS: The nutritional scores and MedDiet adherence screener scores were not statistically different between the groups at baseline, but the difference was statistically significant and higher in the IG at 24 to 28 weeks (P = .001) and at 36 to 38 weeks (P = .001). GDM was diagnosed in 51 (20.4%) women in the control group and 34 (13.6%) women in the IG. The MedDiet significantly reduced GDM incidence (P = .02) after adjusting for confounding factors. CONCLUSION: The present study shows that dietary intervention in pregnant women, including a MedDiet and increased consumption of EVOO and pistachios, decreases the incidence of GDM.

A randomized, double-blind, split-mouth controlled clinical trial of systemically administered Lycopene on periodontal health.

BACKGROUND/PURPOSE: This research aimed to compare the effects of systemically prescribed Lycopene as a monotherapy and as an alternative to scaling and root planing in patients with chronic gingivitis. MATERIALS AND METHODS: The participants were randomly assigned to one of two treatment groups: the experimental group (n = 50), which received 10 mg of Lycopene a day for two weeks, or the control group (n = 50) received a placebo for two weeks. For each category, quadrant distribution was randomized, with two quadrants receiving oral prophylaxis (OP) and two quadrants receiving no care (non-OP). At baseline, 1st, and 2nd weeks, the sulcus bleeding index, plaque index, gingival index, and salivary uric acid level were measured. RESULTS: All clinical criteria, including SBI, PI, GI, and salivary uric acid levels, showed a statistically significant decline in all patient types. Both clinical parameters were significantly reduced (p < 0.001) in the OP-lycopene group relative to the non-OP-placebo group and non-OP lycopene group (p < 0.05). The PI value in the OP-lycopene group was statistically significantly lower (p < 0.001) than in the non-OP-placebo group; there was no statistically significant difference in the other groups. Salivary uric acid levels in the OP- and non-OP- lycopene groups were significantly lower (p < 0.001) than in the non-OP-placebo population. CONCLUSION: Based on the findings of this study, Lycopene seems to have a bright future as a treatment option for plaque-induced generalized chronic marginal gingivitis. More research with a broad sample size and multicentre trials is required. CLINICAL RELEVANCE: The article reveals the positive relationship between Lycopene and gingivitis. The analysis shows that a combination of systemically administered Lycopene with oral prophylaxis can be a valuable tool in treating chronic gingivitis and controlling respiratory oxidative stress.

Is platelet-rich plasma better than hyaluronic acid in the treatment of knee osteoarthritis? A meta-analysis of randomized controlled trials.

Introduction: Due to the complicated surgical procedure of knee arthroplasty and low effectivity of hyaluronic acid (HA) in the treatment of knee osteoarthritis, various studies highly recommend the use of platelet-rich plasma (PRP). However, some studies also reported lower efficacy and limited use of PRP. Aim: To analyze systematically the different randomized controlled trials (RCTs) comparing the effectiveness of HA vs. PRP for the treatment of knee osteoarthritis. Material and methods: A systematic literature review was conducted using Medline and Central databases for RCTs about the comparison of HA vs. PRP for the treatment of knee osteoarthritis. Studies were included as per the PICOS criteria and relevant event data were extracted. Risk of bias was analyzed and a random-effects model was used to calculate the pooled odds ratio and risk ratio using RevMan software. Results: A total of 14 studies were included in the meta-analysis from year 2000 to 2021 including 613 patients. The current meta-analysis has a low risk of publication bias and we obtained the pooled odds ratio (OR) of 2.55 (95% CI: 1.35-4.84) with a τ 2 value of 1.01, χ 2 value of 52.79, I2 value of 77%, Z value of 2.87 and p-value < 0.00001. The pooled risk ratio was 1.34 (95% CI: 1.09-1.65) with a τ 2 value of 0.09, χ 2 value of 73.48, I2 value of 84%, Z value of 2.80 and p-value < 0.00001. Conclusions: The current meta-analysis highly recommends the use of PRP for the treatment of knee osteoarthritis.

Does botulinum toxin have any role in the management of chronic pain associated with bruxism?

OBJECTIVE: To determine the efficacy of injectable botulinum toxin (BTA) in the management of pain associated with nocturnal bruxism. METHODS: The study subjects consisted of 40 male and female volunteers who complained of chronic pain in the masseter muscles bilaterally due to bruxism. Twenty units of BTA were injected bilaterally into the masseter muscles. Clinical parameters of pain at rest and chewing were assessed at baseline, 2, 4, 8, 12, 16, 18, and 24 weeks using the visual pain scale (VPS). RESULTS: The study included 24 females and 16 males aged 21 to 52 years (mean 33.9 ± 31.0). The mean VPS score on the first day was 5.75 (SD 1.9), significantly decreasing after two weeks to 0.44 (SD 0.727). The mean difference of VPS from 8 weeks up to 24 weeks gradually increase from 0.69 at 8 weeks to 2.00 at 24 weeks. CONCLUSION: This study provides evidence that BTA could reduce the pain of nocturnal bruxism in affected patients.

Does initial reduction at infra-orbital rim first improve malar height and vertical dystopia in ZMC fractures?

PURPOSE: To estimate the clinical and functional results of patients who underwent distinctive types of open reduction and internal fixation of ZMC fractures, with particular emphasis on malar height and vertical dystopia. MATERIALS AND METHODS: A randomized clinical trial was conducted from August 2016 to October 2019 in which 40 adult patients with ZMC fractures of maxillofacial region were included. Patients were randomly allocated to group A (n = 20; frontozygomatic (F-Z) first 3-point reduction and fixation) or group B (n = 20; group B infra-orbital first 3-point reduction and fixation). All patients were evaluated objectively for malar height and vertical dystopia pre- and post-operatively at 3 months. The data were scrutinized by applying mean and standard deviation and unpaired t test. RESULTS: Mean values of the malar height and vertical dystopia were statistically significant (P < .05) for group B compared with group A at all intervals. Data analyzed for other secondary variables showed a statistically non-significant difference between the groups (P > 0.05). CONCLUSION: The results showed improvement in the malar height and vertical dystopia for infra-orbital first three-point fixation (group B) compared with F-Z first approach for initial reduction and fixation (group A). Furthermore, group B was better in terms of malar width and antero-posterior projection of the zygomaticomaxillary complex.

Synthesis of Ultrahigh Molecular Weight PLAs Using a Phenoxy-Imine Al(III) Complex.

l- and d-lactide polymerization kinetics using phenoxy-imine ligands of the type Me2Al[O-2-tert-Bu-6-(C6F5N=CH)C6H3] in the presence of n-butanol and benzyl alcohol by ring-opening polymerization into polylactide are investigated. Effects of initiator concentration, catalyst concentration, polymerization temperature, and time on the molecular weight of poly-l-lactide are also investigated. Purification and drying of l-lactide are found to significantly influence the polymerization kinetics and the final molecular weight achieved. Ultrahigh molecular weight poly(l-lactic acid) PLLA (M w = 1.4 × 106 g/mol with D = 1.8) and ultrahigh molecular weight poly(d-lactic acid) PDLA (M w = 1.3 × 106 g/mol with D = 2.0) are obtained when polymerization is performed with a molar ratio of monomer to catalyst (LA/Al) of 8000 for 72 h at 120 °C in the presence of benzyl alcohol with conversions of 96 and 91%, respectively. We report for the first time the synthesis of ultrahigh molecular weight poly-l- and d-lactide using the Me2Al[O-2-tert-Bu-6-(C6F5N=CH)C6H3] catalyst. The identified catalyst is found to be suitable for the synthesis of a broad range of molecular weights.