Evaluation of Records of Oral and Maxillofacial Surgery Cases Reported at Abbasi Shaheed Hospital and Karachi Medical and Dental College, Pakistan

Background: Oral and Maxillofacial Surgery department is a diverse field in dentistry. Record maintenance has been established as one of the key factors in the success and integrity of health care institutes.Objective: The objective of the study was to evaluate the records of oral and maxillofacial surgery casesreported to oral and maxillofacial surgery department, Abbasi Shaheed Hospital and oral surgery OPD ofKarachi Medical and Dental College.Methods: Cross sectional study was conducted in at ASH and KMDC from July 2019 to September 2019.The data from January 2017 to July 2019 was retrospectively noted through electronic surgical recordof ASH and records of the Oral Surgery OPD of KMDC. Inclusion criteria was patients records of bothgenders of 5–70 years age, having complaint of any oral or dental pathology or pathologies, trauma andimpactions. Data was calculated manually by calculating frequencies and percentages for the trauma,impaction and pathology cases of patients.Results: In 2017, 239 cases were treated under general anesthesia from which trauma 11. 45% (n=11),followed by 48. 11% (n=115) cases of oral pathologies, total 11.7% (n=28) cases of complicated exodontias. In2018, among 211, 51.1% (n=108) cases were trauma followed by 39.3% (n=83) cases of oral pathologies,whereas, total 9.4% (n=20) complicated exodontias cases were observed. During 2019 (January to July),168 cases 36.2% (n=62) cases were diagnosed as trauma, in oral pathology, overall 36.2% (n=62) caseswere surgically excised. Total 23.2% (n=39) complicated exodontias. In 2017, 25122 cases were reported in Surgery OPD of Karachi Medical and Dental College. Total 36.2% (n=9097) teeth were extracted from which 1.93% (n=486) cases were surgical impaction. On the other hand, 1.65% (n=416) patients were treated through minor oral surgeries. In 2018, 29008 cases were reported in Surgery OPD. Total 42.7% (n=12377) teeth were extracted from which 0.92% (n=268) cases were surgical impaction. On the other hand, 0.71% (n=208) patients were treated through minor surgeries. In 2019, January till July 13028 cases were reported in Surgery OPD. Total42.6% (n=5559) teeth were extracted from which 0.66% (n=87) cases were surgical impaction. On the other hand, 0.68% (n=89) patients were treated through minor surgeries.Conclusion: It has been concluded that evaluation of the records of oral and maxillofacial surgery casesreported to oral and maxillofacial surgery department, Abbasi Shaheed Hospital and oral surgery OPD ofKarachi Medical and Dental College were high and appropriate measures should be taken in order tomanage these problems timely and effectively

Endoscopy assisted extended curettage in a rare case of aneurysmal bone cyst involving the 2nd metatarsal of a child

Aneurysmal bone cysts account for only 1% of all bone tumours and of these only a handful of reported cases occur in the foot. They can mimic other bone tumours on imaging studies, thus making histological diagnosis mandatory. Aneurysmal bone cyst of a metatarsal is very rare especially in children and only few cases have been reported in the literature. We report the novel management option for a rare case of an Aneurysmal bone cyst localized to the second metatarsal in a 5 years old boy who presented with limping, local pain, and minimal swelling in his left foot. Tissue diagnosis was confirmed on the basis of needle biopsy. Surgery was in the form of extended curettage using an endoscope with a high-speed burr and cautery. The remnant cavity was filled up with artificial bone graft. Histopathology analysis of the resected tissue was consistent with Aneurysmal bone cyst. There was complete healing at final follow-up at 2 years. Endoscopy assisted extended curettage appears to be an ideal treatment option as it provides a perfect visualisation of the interior of the entire cyst and use of cautery and burr more accurately under direct vision which potentially leaves only a minimal scope for recurrence. Use of artificial bone grafts instead of conventional autogenous bone grafts to reduce graft site morbidity in children and stimulate local foreign body reaction for enhancing residual tumour cell kill if any and also to promote bony sclerosis for healing

Extremity chronic osteomyelitis in a population of North East India: epidemiology, clinical characteristics and management

Background: The purpose of this study was to review the epidemiology, clinical features and the management of extremity chronic osteomyelitis in a population of North East India and to provide evidenced based guidelines for early diagnosis and treatment.Methods: We retrospectively reviewed patients who were diagnosed and treated for extremity chronic osteomyelitis at a tertiary care hospital at Shillong in North East India. Medical records for all patients were analysed and details on gender, age at incidence, anatomical site, infecting organisms, levels of inflammatory markers, and the various treatment modalities were evaluated.Results: A total of 131 patients (96 males and 35 females) were included in this study. The median age at first diagnosis was 17 years for all. Infections caused by hematogenous osteomyelitis was found to be slightly more than those of traumatic origin. All patients had single site infections with a majority of lesions affecting the lower extremities. The tibia was the most common site in traumatic osteomyelitis while the femur was mostly involved in hematogenous osteomyelitis. The positive rate for all cultures was at 57.25% with the most commonly encountered organism being Staphylococcus aureus. Treatment methods used in our study included radical debridement with the use of local and systemic antibiotics and reconstruction of bony or soft tissue defects. The overall infection control rate was 96.18%.Conclusions: The findings from this study can provide information for early diagnosis and treatment of this form of bone infection particularly in this part of the country.

Clinical outcome and cost analysis of negative pressure wound therapy in extremity wounds: a comparison to conventional wound management

Background: Open fractures and traumatic wounds constitute a major health problem. Amongst the armamentarium of wound care products available, negative pressure wound therapy (NPWT) is a modality that has transformed wound care and has been recommended for treating all kinds of acute and chronic wounds.Methods: This prospective randomised comparative study was conducted at a tertiary care hospital in Northeast India. 30 patients were included in this study over a period of 24 months commencing from January 2018. The patients consisted of two groups of 15 each, the first group comprised patients who underwent treatment using NPWT and the second group was treated using standard wound therapy (SWT). The endpoint taken was a granulated wound or a wound ready for split skin grafting (SSG).Results: The mean wound size difference between the NPWT group and the SWT group on day nine was 13±7.17 mm and 4.53±0.99 mm, respectively. Likewise, on day nine, 11 (73.3%) patients in the group treated using NPWT had no positive bacterial cultures compared to 8(53.3%) patients on SWT. The estimated cost of materials for each NPWT dressing change was roughly INR₹ 3446 (US$ 45.57).Conclusions: NPWT is not a magic bullet and will not replace the basic methods of wound treatment such as wound debridement, infection control and ensuring adequate blood supply. Nevertheless, NPWT remains an integral part of the current scenario in wound care management and is cost effective under the condition that it accelerates wound healing when compared to traditional treatment

Comparative Analytical Study on Crack Width of Reinforced Concrete Structures

This paper presents a comparative study for the cracking limit state according to design codes. It aims mainly to connect research findings with design code equations. Appropriate recommendations are reached and the various factors and parameters influencing crack width investigated. The most appropriate equation for crack width calculation can be found. This is done by creating an analytical and numerical program studied various factors and parameters affecting on the crack width. The Analytical study includes some variables affecting the crack width such as steel stress, concrete cover, flexural reinforcement ratio and rebar arrangement. A 3-D finite element analysis by ABAQUS were used to model and idealize the problem. The numerical results were compared with the analytical results. It was concluded that some codes did not take into account the impact of some major variables and cases on the crack width. Also, it was found that some codes are not clear in the region concerning the position of the crack width calculation and the values obtained for the crack width. For calculating crack width values, JSCE (2007) equation is the most appropriate equation as it takes into account the main parameters that affect crack width. Doi: 10.28991/cej-2021-03091720 Full Text: PD

The effect of fermentation process on bioactive properties, essential oil composition and phenolic constituents of raw fresh and fermented sea fennel (Crithmum maritimum L.) leaves

800-804The influence of fermentation on antioxidant activity, total phenol, total flavonoid and phenolic compounds of sea fennel and also volatile compounds of sea fennel essential oil was investigated and compared with fresh samples. Antioxidant activity, total fenolic and flavonoid contents decresed from 89.79 to 63.13%; from 259.58 to 77.92 mg/100 g; from 2114.67 to 390.50 mg/100 g, respectively. Twenty-six and thirty-three components of sea fennel oils were identified in raw and fermented sea fennel, accounting to about 99.99% and 99.44% of the total oil, respectively. The raw and fermented sea fennel leaves contained 22.31 and 1.32% sabinene, 12.08% and 7.45% limonene, 10.30% and 11.61% β-phellandrene, 8.59% and 9.17% (Z)-β-ocimene, 7.08% and 3.55% α-pinene, 28.36% and 42.05% γ-terpinene, 2.57% and 8.64% terpinene-4-ol, respectively. Dominant phenolic compounds were (+)-catechin, gallic acid, 3,4-dihydroxybenzoic acid and p-coumaric acid. Generally, all of the phenolic compounds reduced the effect of microorganisms during,. However, essential oil contents of sea fennel were not effected from fermentation process

Phytochemical Profiling of the Ethanolic Extract of Zaleya pentandra L. Jaffery and Its Biological Activities by In-Vitro Assays and In-Silico Molecular Docking

Zaleya pentandra L. jaffery is the only species of the genus Zaleya that grows in the Cholistan desert, Pakistan. It is a Xero-halophyte plant with high phenolic and flavonoid content. The present research was designed to investigate the phytochemical composition, biological activities, and in silico molecular docking of the ethanolic extract of Z. pentandra. The phytochemical evaluation was done through preliminary phytochemical testing, estimation of total bioactive content, and gas chromatography–mass spectrometry (GC–MS) analysis for the identification of volatile compounds. For the evaluation of biological activities, antioxidants, and enzyme inhibition (α-glucosidase, cholinesterase, and tyrosinase), antibacterial and antiviral assays were performed. GC–MS analysis revealed the presence of 29 tentative volatile compounds. The ethanolic extract of Z. pentandra contains high phenolic content (119.6 ± 0.12 mg GAE/g extract) and flavonoid content (45.5 ± 0.19 mg QE/g extract), which correlates with the strong DPPH, FRAP, and enzyme inhibition results. The ethanolic extract of Z. pentandra also showed dose-dependent antibacterial activity. Micrococcus luteus and Pseudomonas aeruginosa were found to be most susceptible, with 16 mm and 17 mm zone of inhibitions at a maximum dose of 20 mg/mL. Antiviral results showed that the ethanol extract has excellent activity against H9, IBV, and NDV viral strains. Additionally, in silico molecular docking was performed in order to determine the interaction and binding affinity between the enzymes and compounds identified by GC–MS. α-glucosidase, cholinesterase, and tyrosinase showed the highest binding affinity toward 1,2-benzenedicarboxylic acid, 2-hydroxy-n-(2-phenylethyl) benzamide, γ-sitosterol, and lactose. These findings can serve as a benchmark for anti-diabetic-, neuro-, and skin-protective uses of this plant and can be used for the isolation of pure bioactive compounds in the future

Robust Navigational Control of a Two-Wheeled Self-Balancing Robot in a Sensed Environment

This research presents an improved mobile inverted pendulum robot called Two-wheeled Self-balancing robot (TWSBR) using a Proportional-Derivative Proportional-Integral (PD-PI) robust control design based on 32-bit microcontroller in a sensed environment (SE). The robot keeps itself balance with two wheels and a PD-PI controller based on the Kalman filter algorithm during the navigation process and is able to stabilize while avoiding acute and dynamic obstacles in the sensed environment. The Proportional (P) control is used to implement turn control for obstacle avoidance in SE with ultrasonic waves. Finally, in a SE, the robot can communicate with any of the Internet of Things (IoT) devices (mobile phone or Personal Computer) which have a Java-based transmission application installed and through Bluetooth technology connectivity for wireless control. The simulation results prove the efficiency of the proposed PD-PI controller in path planning, and balancing challenges of the TWSBR under several environmental disturbances. This shows an improved control system as compared to the existing improved Adaptive Fuzzy Controller