Exploring the potential of Eu3+ ions doped heavy metal oxide containing germanium borate glasses for high efficiency red emitting solid-state lasers.

Glasses activated with europium show promising potential for use in applications relating to photonics, in particular solid-state laser generation. In the current work, Eu2O3 incorporated gemanium borate glasses were developed and explored their potentiality towards lasing active medium by probing physical, structural, optical and lasing properties in detail. The physical and structural features of each glass indicated the presence of non-bridging oxygens (NBOs) and an enhancement in network stability on account of the inclusion of europium ions into the GeO2 glass network. Optical energy band gaps, Ed, Eo, no, So, and λo values were obtained by absorption spectra and found to be increased with europium content. The sequence of Judd-Ofelt (JO) intensity parameters (Ω2, Ω4, and Ω6) exhibited the trend Ω2 > Ω4 > Ω6, and it confirmed the covalent nature of the as-developed glasses. 1 mol% Eu2O3 doped glasses exhibited the highest photoluminescence, quantum efficiency and fluorescence intensity ratio (R). The decay profiles showed single exponential nature for 5D0 state of Eu3+ ions and their lifetime values were calculated. The results amply demonstrated the viability of the manufactured glasses as a potential solid-state active laser medium, with the CIE diagram confirming the intense red color emission as seen from the PL spectra.

Effects of exclusive breastfeeding on educational attainment and longitudinal trajectories of grade progression among children in a 13-year follow-up study in Malawi.

The benefits of exclusive breastfeeding (EBF) for infant health and survival are well documented. However, its impact on educational outcomes has been contested and poorly researched in Africa. It has been hypothesised that positive associations reported in high-income countries can be attributed to residual confounding by socioeconomic status (SES). Our study investigated whether EBF duration in infancy is associated with educational attainment and age-for-grade attainment trajectories at school-age in rural Malawi. Longitudinal data on 1021 children at the Karonga demographic surveillance site in Malawi were analysed. Breastfeeding data were collected 3 months after birth and again at age one. The school grade of each child was recorded each year from age 6 until age 13. We calculated age-for-grade based on whether a child was at, over, or under the official expected age for a grade. Generalised estimating equations estimated the average effect of breastfeeding on age-for-grade. Latent class growth analysis identified age-for-grade trajectories, and multinomial logistic regression examined their associations with EBF. Maternal-child characteristics, SES, and HIV status were controlled. Overall, 35.9% of the children were exclusively breastfed for 6 months. Over-age for grade steadily increased from 9.6% at age 8 to 41.9% at age 13. There was some evidence that EBF for 6 months was associated with lower odds of being over-age for grade than EBF for less than 3 months (aOR = 0.82, 95%CI = 0.64-1.06). In subgroup analyses, children exclusively breastfed for 6 months in infancy were less likely to be over-age for grades between ages 6-9 (aOR = 0.64, 95%CI = 0.43-0.94). Latent class growth analysis also provided some evidence that EBF reduced the odds of falling behind in the early school grades (aOR = 0.66, 95%CI = 0.41-1.08) but not later. Our study adds to the growing evidence that EBF for 6 months has benefits beyond infant health and survival, supporting the WHO's recommendation on EBF.

Fine needle aspiration cytopathology of pleomorphic dermal sarcoma.

INTRODUCTION: Pleomorphic dermal sarcoma (PDS) is an uncommon cutaneous mesenchymal neoplasm. It is cytomorphologically identical to atypical fibroxanthoma (AFX), but differs due to its invasion beyond the dermis. We undertook an examination of our experience with fine needle aspiration (FNA) biopsy cytology of PDS. MATERIALS AND METHODS: Our cytopathology files were searched for examples of PDS with concomitant histopathological verification. FNA biopsy smears and cell collection were performed using standard techniques. RESULTS: Seven cases of PDS were retrieved from four different patients (M:F, 1:1; age range: 63-88 years; mean age = 78 years). All patients (57%) presented with a primary tumour with one having an FNA biopsy of two local recurrences and a single distant metastasis. Five aspirates were from the extremities and two from the head/neck. Tumours ranged from 1.0 to 3.5 cm (mean, 2.2 cm). Specific cytological diagnoses were pleomorphic spindle/epithelioid sarcoma (3 cases), PDS (2), AFX (1), and atypical myofibroblastic lesion, query nodular fasciitis (1). Immunohistochemical (IHC) staining from FNA-generated cell blocks in two cases showed non-specific staining with vimentin in both cases; positive CD10, CD68, and INI-1 staining in one case; and smooth muscle actin expression in the other. Multiple negative stains were performed in both of these cases to exclude malignant melanoma, carcinoma, and specific forms of sarcoma. Cytopathology consisted of a mixture of spindle, epithelioid, and bizarre pleomorphic cells. CONCLUSION: Coupled with ancillary IHC stains, FNA biopsy can help recognise PDS as a sarcomatous cutaneous neoplasm, but is unable to distinguish PDS from AFX.

Haemoglobin spherulosis: Fine needle aspiration biopsy of an unusual ocular lesion.

OBJECTIVE: Haemoglobin spherulosis (HS) is a rare lesion occurring post-vitreous haemorrhage that is absent from the cytopathology literature. METHODS: We present the fine needle aspiration (FNA) biopsy cytological features of a case of HS occurring in a 73-year-old woman. RESULTS: FNA smears of hemorrhagic vitreous fluid showed numerous variably sized smooth glassy spherules ranging from 3-20 µm. Occasional red cells and a rare lymphocyte were observed, but other cell types were absent. Immunohistochemical staining of a cell block showed diffuse positive staining of spherules with haemoglobin A. CONCLUSIONS: HS is a rare lesion that occurs post-subretinal haemorrhage and may be encountered by pathologists examining ocular cytological specimens.

Estimation of Yoga Postures Using Machine Learning Techniques.

Yoga is a traditional Indian way of keeping the mind and body fit, through physical postures (asanas), voluntarily regulated breathing (pranayama), meditation, and relaxation techniques. The recent pandemic has seen a huge surge in numbers of yoga practitioners, many practicing without proper guidance. This study was proposed to ease the work of such practitioners by implementing deep learning-based methods, which can estimate the correct pose performed by a practitioner. The study implemented this approach using four different deep learning architectures: EpipolarPose, OpenPose, PoseNet, and MediaPipe. These architectures were separately trained using the images obtained from S-VYASA Deemed to be University. This database had images for five commonly practiced yoga postures: tree pose, triangle pose, half-moon pose, mountain pose, and warrior pose. The use of this authentic database for training paved the way for the deployment of this model in real-time applications. The study also compared the estimation accuracy of all architectures and concluded that the MediaPipe architecture provides the best estimation accuracy.

COVID-19 Misinformation on Social Media: A Scoping Review.

Social media allows for easy access and sharing of information in real-time. Since the beginning of the coronavirus disease (COVID-19) pandemic, social media has been used as a tool for public health officials to spread valuable information. However, many Internet users have also used it to spread misinformation, commonly referred to as "fake news." The spread of misinformation can lead to detrimental effects on the infrastructure of healthcare and society. The purpose of this scoping review was to identify the sources and impact of COVID-19 misinformation on social media and examine potential strategies for limiting the spread of misinformation. A systemized search of PubMed, Embase, and Web of Science electronic databases using search terms relevant to the COVID-19 pandemic, social media, misinformation, or disinformation was conducted. Identified titles and abstracts were screened to select original reports and cross-checked for duplications. Using both inclusion and exclusion criteria, results from the initial literature search were screened by independent reviewers. After quality assessment and screening for relevance, 20 articles were included in the final review. The following three themes emerged: (1) sources of misinformation, (2) impact of misinformation, and (3) strategies to limit misinformation about COVID-19 on social media. Misinformation was commonly shared on social media platforms such as Twitter, YouTube, Facebook, messaging applications, and personal websites. The utilization of social media for the dissemination of evidence-based information was shown to be beneficial in combating misinformation. The evidence suggests that both individual websites and social media networks play a role in the spread of COVID-19 misinformation. This practice may potentially exacerbate the severity of the pandemic, create mistrust in public health experts, and impact physical and mental health. Efforts to limit and prevent misinformation require interdisciplinary, multilevel approaches involving government and public health agencies, social media corporations, and social influencers.

Cross sectional study of depression, anxiety and quality of life in glaucoma patients at a tertiary centre in North Kerala.

PURPOSE: To determine the magnitude and direction of association of anxiety and depression and the quality of life (QoL) in persons with glaucoma. METHODS: This prospective cross-sectional study in conducted in a tertiary eye center in north Kerala included glaucoma patients and normal subjects aged 40-80 years. The Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7), Glaucoma Quality of Life (GQOL), and glaucoma evaluation were performed for all participants. One-way analysis of variance was used for statistical analysis. RESULTS: The study included 148 subjects with glaucoma and 150 subjects without glaucoma. The prevalence of depression (35.81%) and anxiety (25.0%) was significantly higher in glaucoma patients. In a multivariate regression model, PHQ-9 (adjusted OR: 2.39, 95% CI: 1.31-4.38, P < 0.001), GAD-7 (adjusted OR: 2.06, 95% CI: 1.01-4.19, P = 0.01) and GQOL (coefficient: 6.92, 95% CI: 4.52-9.31, P = < 0.001) was significantly associated with glaucoma. The GAD-7 score was significantly higher (P = 0.02) in PACG compared to POAG in moderate and severe anxiety. ADL scores (one-way ANOVA, P = 0.001) and GQOL scores (one-way ANOVA, P < 0.001) were significantly associated with vision impairment and blindness. CONCLUSION: Depression and anxiety are common in glaucoma patients, indicating the need for screening protocols using PHQ and GAD scales to identify persons at risk. The lack of ophthalmic risk factors associated with depression and anxiety emphasizes the importance of psychological evaluation and combined management with a psychiatrist in glaucoma management.

Smart Yoga Instructor for Guiding and Correcting Yoga Postures in Real Time.

In recent days, Yoga is gaining more prominence and people all over the world have started to practice it. Performing Yoga with proper postures is beneficial. Hence, an instructor is required to monitor the correctness of Yoga postures. However, at times, it is difficult to have an instructor. This study aims to provide a system that will act as a personal Yoga instructor and practitioners can practice Yoga in their comfort zone. The device is interactive and provides audio guidance to perform different Yoga asanas. It makes the use of a camera to capture the picture of the person performing Yoga in a particular position. This captured pose is compared with the benchmark postures. A pretrained deep learning model is used for the classification of different Yoga postures using a standard dataset. Based on the comparison, the practitioner's posture will be corrected using a voice message to move the body parts in a certain direction. As the device performs all the operations in real-time, it has a quick response time of a few seconds. Currently, this work aids the practitioners in performing five Asanas, namely, Ardha Chandrasana/Half-moon pose, Tadasana/Mountain pose, Trikonasana/Triangular pose, Veerabhadrasana/Warrior pose, and Vrikshasana/Tree pose.

Managed care COVID-19 outcomes in a population health program.

OBJECTIVES: To determine (1) factors linked to hospitalizations among managed care patients (MCPs), (2) outcome improvement with use of outpatient off-label treatment, and (3) outcome comparison between MCPs and a mirror group. STUDY DESIGN: Retrospective cohort study comparing MCPs with an age- and gender-matched mirror group in Florida from April 1, 2020, to May 31, 2020. METHODS: A total of 38,193 MCPs in a Florida primary care group were monitored for COVID-19 incidence, hospitalization, and mortality. The highest-risk patients were managed by the medical group's COVID-19 Task Force. As part of a population health program, the COVID-19 Task Force contacted patients, conducted medical encounters, and tracked data including comorbidities and medical outcomes. The MCPs enrolled in the medical group were compared with a mirror group from the state of Florida. RESULTS: The mean (SD) age among the MCPs was 67.9 (15.2) years, and 60% were female. Older age and hypertension were the most important factors in predicting COVID-19. Obesity, chronic kidney disease (CKD), and congestive heart failure (CHF) were linked to higher rates of hospitalizations. Patients prescribed off-label outpatient medications had 73% lower likelihood of hospitalization (P < .05). Compared with the mirror group, MCPs had 60% lower COVID-19 mortality (P < .05). CONCLUSIONS: MCPs have risk factors similar to the general population for COVID-19 incidence and progression, including older age, hypertension, obesity, CHF, and CKD. Outpatient treatment with off-label medicines decreased hospitalizations. A comprehensive population health program decreased COVID-19 mortality.

A Crucial Role for Antimicrobial Stewardship in the Midst of COVID-19.

As the world deals with a pandemic, there remains another global challenge that cannot be ignored. Use of broad-spectrum antibiotics may be justified as we are trying to treat a novel disease condition, which in turn could lead to an increase in antimicrobial resistance. We can decrease morbidity, mortality, and health care costs by controlling antimicrobial resistance, but it requires antimicrobial stewardship. Major components of effective and timely antimicrobial stewardship are diagnostic stewardship, infection prevention and control, and integration of COVID-19 specific flags into electronic health records, all of which may be integrated into current strategies of COVID-19 mitigation and management. Going through the influenza season of 2020, implementation of antimicrobial stewardship education efforts in the United States can help us contend with influenza in addition to COVID-19 and any bacterial co-infections or secondary infections. Additional solutions include the development of vaccines, alternative therapies such as antibodies, and advanced diagnostics using advances in genomics and computer science.

Psychological correlates of arbovirus preventive health behaviour.

BACKGROUND: Current arbovirus preventive health interventions do not take social and personality variables into account. Social cognition models posit that people engage in preventive health behaviour (PHB) after an assessment of the perceived risk of disease, an analysis of potential consequences and an evaluation of self-efficacy. METHODS: In a sample of 385 undergraduate and medical students, we examined the association between social relationships, conscientiousness and mosquito repellent use. Data were analysed in a series of stepwise regression analyses. RESULTS: Social relationships influenced the association between conscientiousness and mosquito repellent use. As expected, perceptions of positive social relationships and conscientiousness are positively linked with mosquito repellent use. Conversely, perceptions of negative social relationships are linked to an inverse association between conscientiousness and mosquito repellent use. CONCLUSIONS: Future interventions designed to increase perceptions of social relationships might be helpful in increasing arbovirus preventive health behaviour such as using mosquito repellents. Since the present study was concurrent correlational in nature, future research would benefit from experimental interventions designed to directly examine the effect of enhancing positive relations and social support on arbovirus preventive health behaviour.

The role of Neuropilin-1 in COVID-19.

Neuropilin-1 (NRP-1), a member of a family of signaling proteins, was shown to serve as an entry factor and potentiate SARS Coronavirus 2 (SARS-CoV-2) infectivity in vitro. This cell surface receptor with its disseminated expression is important in angiogenesis, tumor progression, viral entry, axonal guidance, and immune function. NRP-1 is implicated in several aspects of a SARS-CoV-2 infection including possible spread through the olfactory bulb and into the central nervous system and increased NRP-1 RNA expression in lungs of severe Coronavirus Disease 2019 (COVID-19). Up-regulation of NRP-1 protein in diabetic kidney cells hint at its importance in a population at risk of severe COVID-19. Involvement of NRP-1 in immune function is compelling, given the role of an exaggerated immune response in disease severity and deaths due to COVID-19. NRP-1 has been suggested to be an immune checkpoint of T cell memory. It is unknown whether involvement and up-regulation of NRP-1 in COVID-19 may translate into disease outcome and long-term consequences, including possible immune dysfunction. It is prudent to further research NRP-1 and its possibility of serving as a therapeutic target in SARS-CoV-2 infections. We anticipate that widespread expression, abundance in the respiratory and olfactory epithelium, and the functionalities of NRP-1 factor into the multiple systemic effects of COVID-19 and challenges we face in management of disease and potential long-term sequelae.

Influence of ZrO2 Addition on Structural and Biological Activity of Phosphate Glasses for Bone Regeneration.

Zirconium doped calcium phosphate-based bioglasses are the most prominent bioactive materials for bone and dental repair and regeneration implants. In the present study, a 8ZnO-22Na2O-(24 - x)CaO-46P2O5-xZrO2 (0.1 ≤ x ≤ 0.7, all are in mol%) bioglass system was synthesized by the conventional melt-quenching process at 1100 °C. The glass-forming ability and thermal stability of the glasses were determined by measuring the glass transition temperature (Tg), crystallization temperature (Tc), and melting temperature (Tm), using differential thermal analysis (DTA). The biological activity of the prepared samples was identified by analyzing X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR) and scanning electron microscopy-energy dispersive spectra (SEM-EDS), before and after immersion in simulated body fluid (SBF) for various intervals of 0, 1 and 5 days, along with the magnitude of pH and the degradation of glasses also evaluated. The obtained results revealed that the glass-forming ability and thermal stability of glasses increased with the increase in zirconia mol%. The XRD, FTIR, and SEM-EDS data confirmed a thin hydroxyapatite (HAp) layer over the sample surface after incubation in SBF for 1 and 5 days. Furthermore, the development of layer found to be increased with the increase of incubation time. The degradation of the glasses in SBF increased with incubation time and decreased gradually with the increase content of ZrO2 mol% in the host glass matrix. A sudden rise in initial pH values of residual SBF for 1 day owing to ion leaching and increase of Ca2+ and PO43- ions and then decreased. These findings confirmed the suitability of choosing material for bone-related applications.

Impact of pyriproxyfen on virus behavior: implications for pesticide-induced virulence and mechanism of transmission.

BACKGROUND: More than 3 years since the last Zika virus (ZIKV) outbreak in Brazil, researchers are still deciphering the molecular mechanisms of neurovirulence and vertical transmission, as well as the best way to control spread of ZIKV, a flavivirus. The use of pesticides was the main strategy of mosquito control during the last ZIKV outbreak. METHODS: We used vesicular stomatitis virus (VSV) tagged with green fluorescent protein (GFP) as our prototypical virus to study the impact of insecticide pyriproxyfen (PPF). VZV-GFP infected and uninfected Jurkat, HeLa and trophoblast cells were treated with PPF and compared to untreated cells (control). Cell viability was determined by the MTT assay. Cell morphology, presence of extracellular vesicles (EVs), virus infection/GFP expression as well as active mitochondrial levels/localization were examined by confocal microscopy. RESULTS: PPF, which was used to control mosquito populations in Brazil prior to the ZIKV outbreak, enhances VSV replication and has cell membrane-altering properties in the presence of virus. PPF causes enhanced viral replication and formation of large EVs, loaded with virus as well as mitochondria. Treatment of trophoblasts or HeLa cells with increasing concentrations of PPF does not alter cell viability, however, it proportionately increases Jurkat cell viability. Increasing concentrations of PPF followed by VSV infection does not interfere with HeLa cell viability. Both Jurkats and trophoblasts show proportionately increased cell death with increased concentrations of PPF in the presence of virus. CONCLUSIONS: We hypothesize that PPF disrupts the lipid microenvironment of mammalian cells, thereby interfering with pathways of viral replication. PPF lowers viability of trophoblasts and Jurkats in the presence of VSV, implying that the combination renders immune system impairment in infected individuals as well as enhanced vulnerability of fetuses towards viral vertical transmission. We hypothesize that similar viruses such as ZIKV may be vertically transmitted via EV-to-cell contact when exposed to PPF, thereby bypassing immune detection. The impact of pesticides on viral replication must be fully investigated before large scale use in future outbreaks of mosquito borne viruses.

Uveitis as a Predictor of Predisposition to Autoimmunity.

The right environmental trigger can lead to immune system activation, which, in turn, can create an autoimmune reaction. Although each autoimmune disease is characterized by specific symptoms, many nonspecific symptoms can make these conditions difficult to diagnose. In this literature review, we seek an association between immunization-induced uveitis and an autoimmune diagnosis and/or autoimmune flare-up in patients. Our goal is to consider adverse reactions to vaccines as a possible warning sign of current or future autoimmune disease. If an immunization-induced adverse reaction is known to be a predictor of an autoimmune disease, the clinician could raise suspicion for autoimmune disease when a patient presents with vaccine-associated uveitis. While no direct correlations can be made yet, our review supports closer scrutiny of the association of immunizations and autoimmune disorders. The occurrence of uveitis across several autoimmune diseases could mean a possible link between vaccine-induced uveitis and undiagnosed autoimmune disease. Researchers can, therefore, perform retrospective studies on vaccinated patients and investigate the occurrence of uveitis, along with the timeframe of resolution and presenting symptoms at the time of the diagnosis of autoimmune disease.

Lusting, learning and lasting in school: sexual debut, school performance and dropout among adolescents in primary schools in Karonga district, northern Malawi.

Age at sexual debut is known to have implications for future sexual behaviours and health outcomes, including HIV infection, early pregnancy and maternal mortality, but may also influence educational outcomes. Longitudinal data on schooling and sexual behaviour from a demographic surveillance site in Karonga district, northern Malawi, were analysed for 3153 respondents between the ages of 12 and 25 years to examine the association between sexual debut and primary school dropout, and the role of prior school performance. Time to dropout was modelled using the Fine and Gray survival model to account for the competing event of primary school completion. To deal with the time-varying nature of age at sexual debut and school performance, models were fitted using landmark analyses. Sexual debut was found to be associated with a five-fold increase in rate of subsequent dropout for girls and a two-fold increase in dropout rate for boys (adjusted hazard ratio [aHR] of 5.27, CI 4.22-6.57, and 2.19, CI 1.77-2.7, respectively). For girls who were sexually active by age 16, only 16% ultimately completed primary schooling, compared with 70% aged 18 or older at sexual debut. Prior to sexual debut, girls had primary completion levels similar to those of boys. The association between sexual debut and school dropout could not be explained by prior poor school performance: the effect of sexual debut on dropout was as strong among those who were not behind in school as among those who were overage for their school grade. Girls who were sexually active were more likely to repeat a grade, with no effect being seen for boys. Pathways to dropout are complex and may differ for boys and girls. Interventions are needed to improve school progression so children complete primary school before sexual debut, and to improve sex education and contraception provision.

Does early linear growth failure influence later school performance? A cohort study in Karonga district, northern Malawi.

INTRODUCTION: Stunting or linear growth retardation in childhood is associated with delayed cognitive development due to related causes (malnutrition, illness, poor stimulation), which leads to poor school outcomes at later ages, although evidence of the association between the timing and persistence of stunting and school outcomes within the sub-Saharan African context is limited. METHODS: Anthropometric data around birth (0-4 months), early (11-16 months) and late childhood (ages 4-8 years) along with school outcomes up until the age of 11 were analysed for a cohort of 1,044 respondents, born between 2002-2004 in Karonga district, northern Malawi. The schooling outcomes were age at school enrolment, grade repetition in Standard 1 and age-for-grade by age 11. Height-for-Age Z-scores (HAZ) and growth trajectories were examined as predictors, based on stunting (<-2SD HAZ) and on trajectories between early and late childhood (never stunted, improvers, decliners or persistently stunted). Multinomial and logistic regression were used to estimate the association between stunting/trajectories and schooling, adjusted for socioeconomic confounders. RESULTS: The effects of stunting on schooling were evident in early childhood but were more pronounced in late childhood. Children who were stunted in early childhood (9.3%) were less likely to be underage at enrolment, more likely to repeat Standard 1 and were 2-3 times more likely to be overage for their grade by the age of 11, compared to their non-stunted peers. Those persistently stunted between early and late childhood (7.3%) faced the worst consequences on schooling, being three times as likely to enrol late and 3-5 times more likely to be overage for their grade by the age of 11, compared to those never stunted. Compared to improvers, those persistently stunted were three times as likely to be overage by two or more years by the age of 11, with no effect on enrolment or repetition. CONCLUSION: Our findings confirm the importance of early childhood stunting on schooling outcomes and suggest some mitigation by improvements in growth by the age of starting school. The nutritional and learning needs of those persistently stunted may need to be prioritised in future interventions.

Associated Injuries in Maxillofacial Trauma: A Study in a Tertiary Hospital in South India.

AIM: Maxillofacial trauma when associated with concomitant injuries has a significant potential for increased morbidity. This study aims to identify the causes of trauma, evaluate the types of associated injuries and to highlight the significance of multi professional collaboration in sequencing of treatment. PATIENTS AND METHODS: A total of 300 patients who reported to the casualty of a tertiary Hospital in Karnataka with facial fractures were enrolled. RESULTS: Associated injuries were sustained by 162 patients. The predominant aetiology was the Road Traffic Accident with maximum number of patients in the age group of 20-29 and a male to female ratio of 10.1:1. The mandible was the most frequently fractured bone. Head injury was the most common associated injury. The mortality rate was 0.66%. The mean ISS and GCS values among the patients who sustained associated injuries along with maxillofacial trauma were higher and lower respectively, as compared to those without associated injuries with a statistically significant difference (p < 0.001). CONCLUSION: Implementation of strict road safety measures in the rural and interior regions of South India, to prevent morbidity and mortality due to road traffic accidents is essential. Injuries to the facial skeleton must be approached with the knowledge of probable associated injuries that could have been incurred.