Facial Asymmetry-Demystifying the Entity.

Introduction/Background: Perfect facial symmetry has always been considered a hallmark of beauty, but, is almost elusive in nature. However, clinically evident skeletal facial asymmetry on the other hand is quite common, which can result from congenital deformities, developmental abnormalities, secondary to maxillofacial trauma and it is an entity maxillofacial surgeons deal with on a regular basis. Surgical correction of facial asymmetry is challenging, as it not only involves the correction of the skeletal asymmetry for an aesthetic outcome, but, also the improvement of the soft tissue drape and dental occlusal harmony. This results in rehabilitation of functional components of orofacial complex like speech, deglutition and phonation. Objective: With this paper, we intend to throw a light on this challenging aspect of maxillofacial surgery, along with giving the next generation of maxillofacial surgeons a direction to explore the topic further. Conclusion: Meticulous evaluation and diagnosis of the patient's problems with latest diagnostic methods like 3-dimensional imaging and surgical treatment with orthognathic surgery, gap arthroplasty or distraction osteogenesis, utilizing cutting edge 3-D virtual planning will result in better outcomes.This review will collate the information available in the literature, along with the authors' recommendations for better planning and execution of this challenging puzzle of facial asymmetry.

Women's experiences of more than one termination of pregnancy within two years: a mixed-methods study.

OBJECTIVE: To examine the experiences of women seeking more than one termination of pregnancy (TOP) within 2 years. DESIGN: Mixed methods study. SETTING: Six TOP services across Scotland. SAMPLE: Women presenting for TOP between July and December 2015. METHODS: Descriptive and inferential analysis of quantitative survey data, thematic analysis of qualitative interview data and integrative analysis. In quantitative analysis, multinomial logistic regression was used to compare three groups: previous TOP within 2 years, previous TOP beyond 2 years and no previous TOP. MAIN OUTCOME MEASURES: Characteristics and experiences of women seeking TOP. RESULTS: Of 1662 questionnaire respondents, 14.6% (n = 242) and 19.8% (n = 329) reported previous TOP within and beyond 2 years, respectively. The previous TOP within 2 years group was significantly less likely to own their accommodation than the no previous TOP group (adjusted odds ratio [aOR] 0.34, 95% CI: 0.18-0.62) and previous TOP beyond 2 years group (aOR: 0.44, 95% CI: 0.23-0.85); and more likely to report inconsistent (aOR: 1.63, 95% CI: 1.04-2.57; aOR: 1.95, 95% CI: 1.16-3.28) and consistent (aOR: 2.13, 95% CI: 1.39-3.26; aOR: 1.71, 95% CI: 1.07-2.76) contraceptive use than the no previous TOP and previous TOP within 2 years groups, respectively. Twenty-three women from the previous TOP within 2 years group were interviewed. Qualitative and integrative analyses highlight issues relating to contraceptive challenges, intimate partner violence, life aspirations and socio-economic disadvantage. CONCLUSIONS: Women undergoing more than one TOP within 2 years may experience particular challenges and vulnerabilities. Service provision should recognise this and move away from stigmatising discourses of 'repeat abortion'. FUNDING: Scottish Government. TWEETABLE ABSTRACT: Women having two or more terminations of pregnancy in 2 years may face key challenges/vulnerabilities including intimate partner violence and socio-economic disadvantage.