Comparison of Different Genioplasty Techniques in Terms of Neurosensory Deficit and Haematoma Formation.

OBJECTIVE: To compare different types of genioplasty techniques (chin advancement, rotation and advancement, setback, and reduction) in terms of neurosensory deficit and haematoma formation. STUDY DESIGN: Comparative analytical study. Place and Duration of the Study: Department of Oral and Maxillofacial Surgery, Armed Forces Institute of Dentistry, Rawalpindi, Pakistan, from January 2022 to April 2023. METHODOLOGY: Patients requiring genioplasty and fulfilling the inclusion criteria i.e. both genders aged 16-60 years were included and divided into 4 groups according to the type of genioplasty performed. Genioplasty was planned as per the ortho treatment plan and performed under general anaesthesia. Setback genioplasty was performed on 8 patients, advancement genioplasty on 11 patients, reduction genioplasty on 3, and advancement with rotation genioplasty on 16 patients. Postoperatively neurosensory deficit was recorded on follow-up after 1 month by subjective and objective assessments, and haematoma formation was assessed clinically on the 7th day after the procedure. RESULTS: Advancement with rotation genioplasty showed the highest frequency of neurosensory deficit (almost 50%) and reduction type genioplasty showed the least frequency of neurosensory deficit (<1%, p = 0.49). The frequency of haematoma formation was maximum in the advancement with rotation genioplasty (62.5%) and minimum in equal setback genioplasty (25%, p = 0.61). CONCLUSION: Advancement with rotation genioplasty had the highest rate of postoperative neurosensory deficit and haematoma formation when compared with other techniques of genioplasty. KEY WORDS: Genioplasty, Neurosensory deficit, Haematoma, Advancement with rotation genioplasty, Setback genioplasty.

Mental Nerve Neurectomy: A Comparison of Titanium Screw Versus Gutta-Percha Oburation of the Mental Foramen.

OBJECTIVE:  This study aims to compare the two mental foramen obturating techniques in parameters like operator's ease, postoperative displacement of obturation material, and remission of pain after peripheral neurectomy in patients with trigeminal neuralgia. STUDY DESIGN:  This study adopts a single-centered comparative analytical approach. PLACE AND DURATION OF STUDY: This study was performed in the Department of Oral and Maxillofacial Surgery, Armed Forces Institute of Dentistry (AFID), from October 1, 2023, to February 10, 2024. METHODOLOGY: Sixty patients fulfilling the inclusion criteria were included and divided into two groups (30 each), and peripheral neurectomy was performed under local anesthesia. In one group, gutta-percha sticks were used to obturate the foramina, and in the other group, titanium screws were used. Postoperatively, the operator's ease, postoperative displacement, and relapse of pain were recorded. RESULTS:  Titanium screws were easy to handle, and there was no relapse of pain because of no displacement postoperatively when compared with gutta-percha sticks, which were hard to manipulate and showed a relapse of pain. CONCLUSIONS:  Titanium screws have better postoperative outcomes when compared with gutta-percha sticks in terms of the operator's ease, relapse of pain, and postoperative displacement.

Hydrophobic ammonium based ionic liquids for efficient extraction of textile dyes from aqueous media: Extraction study and antibacterial evaluation.

Alizarin red S (ARS) extraction from aqueous medium was carried out using hydrophobic ionic liquids (ILs) containing trioctylammonium cation paired with 4-tert-butylbenzoate ([TOA][Butbenz] (IL1), 4-phenylbutanoate ([TOA][PheBut] (IL2), 3-4-dimethylbenzoate ([TOA][DMbenz] (IL3), naphthoate, ([TOA][Naph]) (IL4), salicylate ([TOA][Sali]) (IL5) and nonanedioate ([TOA]2[Nona]) (IL6). The findings demonstrated that all of the tested ILs were efficient for extracting ARS, however, [TOA]2[Nona] was more effective than others. For the extraction of ARS from the aqueous phase, the effects of various parameters including the initial pH of the dye solution, contact time, ILs to dye volume ratio (VIL:VW), dye concentration, temperature, and salt effect were investigated. The spontaneity of the liquid-liquid extraction of ARS from the aqueous phase to the IL phase was confirmed by thermodynamic parameters. More than 90% of the ARS was extracted from the aqueous phase to the IL phase throughout all experiments. Interaction of selected IL with dyes were confirmed using FTIR analysis. The standard bacterial strains of Escherichia coli (E. coli) ATCC BAA-2471 (gram negative) and Methicillin-resistant Staphylococcus (MRSA) ATCC 43300 (gram positive) were used for evaluating antibacterial activity. The lower dose (250 ppm), the ILs1, 2, 3, 4, 5, and 6 inhibited 0.40, 1.50, 6.50, 1.50, 2.50, and 0.50 mm growth of E. coli, and 4.0, 2.0, 16.50, 0.40, 5.0, and 3.50 mm growth of MRSA, respectively. The experimental findings confirmed that the present ILs can be utilized as an effective solvent for ARS and other dyes extraction from aqueous media.

Synthesis of activated carbon-surfactant modified montmorillonite clay-alginate composite membrane for methylene blue adsorption.

In this research work, a novel composite membrane was synthesized from activated carbon (AC) derived from sesban, sodium benzyl dodycyel sulphate (SBDS) treated montmorillonite (MMT) clay and alginate (alg) for the adsorption of methylene-blue (MB) dye. The AC-MMT-alg composite membranes were characterized using analytical characterizations such as FTIR, SEM, EDX and TGA analysis. Several important factors like initial solution pH, contact time, membrane dose, MB concentrations and temperature effect on the adsorption efficiency of membrane were investigated. MB dye adsorption on the synthesized membrane was explained well by pseudo second order equation. Isotherm study showed that MB adsorption data followed Langmuir adsorption isotherm model. The adsorption capacity of membrane for MB was 1429 mg/g from aqueous solution. Thermodynamic study confirmed endothermic and spontaneous MB adsorption on the adsorbent. The mechanistic path way indicated that electrostatic forces were involved in this adsorption process. The synthesized membrane proved an efficient adsorbent for MB adsorption from aqueous media.

A Prospective Follow-Up Study on the Disease Course and Predictors of Poor Outcomes in a Random Population-Based Cohort of Newly Diagnosed Lupus Patients.

Background and objective Systemic lupus erythematosus (SLE) is one of the most devastating systemic autoimmune connective tissue diseases. There is a paucity of prospective data on Pakistani SLE patients, and in this prospective study, we aimed to investigate the disease course, clinical outcomes, and the predictors of poor outcomes in a random population-based cohort of newly diagnosed SLE patients (diagnosed within the last one year). Methods This was a prospective observational study carried out in the rheumatology department of the Fatima Memorial Hospital, Lahore. Lupus patients are regularly reviewed in our dedicated lupus clinic every one to three months. For the purpose of this study, a focus group of newly diagnosed patients (diagnosed within the last one year) attending our lupus clinic was identified and prospectively followed up for 12 months. A wide range of demographical and clinical parameters was recorded. The association of clinical variables with the progressive disease was determined using univariate and multivariate logistic regressions. Results Prospective data of 89 newly diagnosed SLE patients regularly attending our dedicated lupus clinic were reviewed. During the study period, (January 2021 through January 2022), these patients had multiple visits overall - median: five, minimum: three, and maximum: nine visits [interquartile range (IQR) 4-7]. All 89 patients had completed one year of follow-up. Of note, 46% of the cohort was noted to have an ongoing active disease during the majority of visits in the study period. On multiple logistic regression analysis, there was a significant association between ongoing active disease ("progressors") and low education status [odds ratio (OR): 2.81, 95% confidence interval (CI): 1.01-7.76, p=0.046], stress at home (OR: 5.8, 95% CI: 2.13-15.8, p=0.001), and hematologic manifestations (OR: 3.0, 95% CI: 1.08-8.32, p=0.03). Conclusions Almost half of our cohort of lupus patients demonstrated active disease manifestations throughout the one-year prospective follow-up, and these were found to be associated with low education status, stress at home, and hematological manifestations.

Stress at Home and Female Gender Are Significantly Associated With Non-adherence and Poor Illness Perception Among Patients With Rheumatoid Arthritis.

Aims We aimed to assess the level of non-adherence and poor illness perception among rheumatoid arthritis (RA) patients. Additionally, we examined their associations with clinical indicators and outcomes. Methods This was a cross-sectional study conducted using data collected at the time of patient enrolment in the Pakistan Registry of Rheumatic Diseases (PRIME) registry. A wide range of clinical variables was studied. To measure adherence, we used the Urdu version of the General Medication Adherence Scale (GMAS), which has recently been validated in RA patients. A Brief Illness Perception Questionnaire (BIPQ) was used to measure illness perception. Results The data of consecutive 320 RA patients were reviewed. Thirty-six percent of the cohort (n=116) was noted to have non-adherence. On multiple logistic regression analysis, a significant association of non-adherence was noted with moderate-to-severe stress (odds ratio {OR}: 1.85, confidence interval {CI}: 1.04-3.2), DAS-28 scores (OR: 1.83, CI: 1.52-2.21), Health Assessment Questionnaire (HAQ) scores (OR: 1.77, CI: 1.07-2.92), and deformed joint counts (OR: 1.30, CI: 1.15-1.46). Additionally, non-adherence due to "patient behavior" had a significant association with the male gender (OR: 0.48, CI: 0.26-0.87), unemployment (OR: 1.82, CI: 1.07-3.10), and stress at home (OR: 2.17, CI: 1.35-3.49). Twenty-six percent of the cohort (n=86) was noted to have the most negative illness perception, and on multiple logistic regression analysis, it was significantly associated with male gender (OR: 0.24, CI: 0.11-0.53), age of onset of arthritis (OR: 0.96, CI: 0.94-0.99), and worse HAQ scores (OR: 3.7, CI: 2.2-6.1). Conclusions Important adverse factors contributing to non-adherence and negative illness perception highlighted in this study were stress at home, female gender, and younger age of patients.

Hearing improvement after stapedotomy using teflon loop prosthesis.

OBJECTIVE: To assess hearing improvement after stapedotomy for otosclerosis using teflon loop prosthesis. DESIGN: Quasy experimental study. PLACE AND DURATION OF STUDY: January 2001 to May 2003 in the Otorhinolaryngology Department, CMH, Rawalpindi. PATIENTS AND METHODS: Thirty diagnosed cases of otosclerosis were included in the study. Ear with greater air-bone gap was selected and stapedotomy was done using teflon loop prosthesis (size 4 - 4.5 mm). Mild vertigo occurred during immediate postoperative period, which subsided with Inj. Prochlorperazine. Patients were followed-up postsurgically at one month, two months, four months, six months and one year and postoperative air-bone gap was calculated. RESULTS: Out of 30 cases, there were 24 males and 06 females. The age ranged from 18 to 50 years. Twenty-one (70%) patients had bilateral hearing loss and 09 (30%) had tinnitis also. Pre-operative audiograms showed conductive deafness. Carhart's notch was present in 10 (33.3%) cases. Tympanogram revealed loss of stapedial reflex. Postoperatively good hearing improvement was seen in 56.7% (postoperative air-bone gap closure upto 10 dB), fair improvement in 30% (postoperative air bone gap closure from 11 to 20 dB) and poor results in 10% (postoperative air-bone gap more than 21 dB) cases. One patient developed dead ear. CONCLUSION: Stapedotomy using teflon loop prosthesis for otosclerosis is an effective method to restore hearing. Complications are uncommon.