Maxillary Artery Pseudoaneurysm as a Complication of Maxillofacial Injuries: Report of three cases and literature review

Traumatic maxillary artery pseudoaneurysm is an uncommonly reported complication in the field of oral and maxillofacial surgery. It is usually discovered incidentally, either early after trauma or weeks-to-months later. Quick recognition and prompt management are essential to avoid devastating consequences. In this paper, we report three uncommon cases of maxillary artery pseudoaneurysm recognised during the surgical management of maxillofacial injuries in Muscat, Oman. All cases presented as sudden brisk bleeding during the intraoperative surgical repair and were subsequently diagnosed and successfully managed by endovascular embolisation with platinum coils. This case report highlights the clinical presentation, diagnosis and management of maxillary artery pseudoaneurysm, in addition to a brief review of the literature.Keywords: Maxillofacial Injuries; Maxillary Artery; Pseudoaneurysm; Mandibular Condyle; Angiography; Therapeutic Embolization; Case Report; Oman

Temporomandibular Joint Ankylosis as a Complication of Neonatal Septic Arthritis : Report of two cases

Temporomandibular joint (TMJ) ankylosis as a complication of neonatal septic arthritis is rarely reported in the literature. We report two clinical cases of unilateral TMJ ankylosis occurring in paediatric patients subsequent to neonatal septic arthritis. The first case was a 15-month-old male infant who presented to the Sultan Qaboos University Hospital, Muscat, Oman, in May 2010. According to the published English scientific literature, he is the youngest person yet to be diagnosed with this condition. The second case was a five-year-old female who presented to the Al-Nahda Hospital, Muscat, Oman, in October 2011. Both cases presented with facial asymmetry and trismus. They subsequently underwent gap arthroplasty and interpositional temporalis muscle and fascia grafts which resulted in an immediate improvement in mouth opening. Postoperatively, the patients underwent active jaw physiotherapy which was initially successful. Both patients were followed up for a minimum of two years following their surgeries

Complications of Open Reduction and Internal Fixation of Mandibular Condyle Fractures in Oman

Objectives: This study aimed to report the complication rate associated with open reduction and internal fixation (ORIF) of mandibular condyle fractures in Oman. Methods: This retrospective cohort study was conducted among patients who underwent ORIF of mandibular condyle fractures at Al-Nahdha Hospital and the Sultan Qaboos University Hospital in Muscat, Oman, from January 2008 to December 2020. Data collected included patient demographics, fracture aetiology, fracture side and type, surgical approach and recorded complications and outcomes. Results: A total of 68 patients (59 males and 9 females; mean age of 30.1 years) with 83 mandibular condyle fractures underwent ORIF during the study period. Subcondylar fractures were the most common type, occurring in 62.7% of patients, while bilateral fractures were observed in 21 (30.8%) patients. The most common surgical approach was retromandibular, used in 42.2% of patients. The overall complication rate was 42.6%, with the most frequently reported complications being transient facial nerve palsy (18.1%), malocclusion (14.7%) and restricted mouth opening (10.3%). Subsequent surgical interventions to correct malocclusion were performed in 6 cases. There was no statistically significant association between the overall complication rate and the patients’ clinical characteristics. Conclusion: Although ORIF of mandibular condyle fractures generally offers favourable outcomes, it carries a risk of complications. Keywords: Mandibular Fracture; Mandibular Condyle; Open Fracture Reduction; Complications; Facial Nerve Injuries; Oman

Modified Le Fort I Osteotomy and Genioplasty for Management of Severe Dentofacial Deformity in β-Thalassaemia Major: Case report and review of the literature

β-thalassaemia major is an autosomal recessive form of haemoglobinopathy that is characterised by complete lack of production of the β-chains resulting in multiple complications that include severe anaemia, failure to thrive and skeletal abnormalities. Facial deformities induced by β-thalassaemia major are rare and are very challenging to treat from a surgical point of view. We report a 33-year-old female patient with β-thalassaemia major who presented to the Dental & Maxillofacial Surgery Department, Sultan Qaboos University Hospital, Muscat, Oman, in 2017 with gross dentofacial skeletal deformity contributing to her psychosocial issues. The facial deformity was corrected surgically by excision of the enlarged maxilla, modified Le Fort I osteotomy and advancement genioplasty. This case highlights the pre-operative preparation, surgical management, encountered complications and treatment outcome within 24 months of follow-up.Keywords: Beta-Thalassaemia; Thalassaemia Major; Cooley's Anemia; Le Fort Osteotomy; Genioplasty; Dentofacial Deformities; Case Report; Oman

Bilateral Elastofibroma Dorsi

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Predictors of Developing a Complex Course of Osteomyelitis in Patients with Sickle Cell Anaemia

Objective: Despite the numerous advances in management strategies, treating osteomyelitis in individuals with sickle cell disease remains a significant challenge, leading to severe long-term consequences. This study aimed to assess the key factors potentially linked to a complex progression of osteomyelitis in patients diagnosed with sickle cell disease. Methods: A cohort of thirty-four patients was identified, and their progress was monitored over a span of twelve months, during a ten-year period (2010-2020). The variables under investigation encompassed demographic and clinical traits, laboratory analyses, imaging data, as well as the strategies employed for treatment. Results: The risk prediction model has pinpointed five factors (severity of sickle cell disease, involvement of lower limbs, presence of bacteraemia, MRI findings, and utilization of surgical debridement) that exhibited an Area Under the Curve (AUC) exceeding 0.7. Causative organisms were identified in 9 out of the total cases, constituting 26.47% of the patient cohort. Among the 34 patients, 17 displayed a severe course of sickle cell disease (AUC 7.88), with MRI being highlighted as a valuable contributing factor (AUC 7.88). Furthermore, thirteen patients (38.2%) underwent surgical debridement, a procedure that yielded a statistically significant P-value of 0.012 and an AUC of 0.714. Conclusion: Osteomyelitis within the context of severe sickle cell disease, particularly when accompanied by lower extremity infection, bacteraemia, and positive MRI findings, and necessitating surgical debridement, emerges as a cluster of risk factors predisposing individuals to osteomyelitis relapse and a more intricate disease trajectory. Keywords: Sickle cell disease, Osteomyelitis, Disease Severity, Debridement, bacteraemi

Preparation and characterization of silver nanoparticles using aniline

AbstractUV–Vis spectroscopy, transmission electron microscopy (TEM) and selected area electron diffraction (SAED) have been employed to characterize silver nanoparticles (AgNPs) using aniline and silver nitrate as reductant and oxidant, respectively. A broad surface resonance plasmon (SRP) band appears at 400nm, indicating that the AgNPs are spherical. The TEM images show that AgNPs aggregated in an unsymmetrical manner, leading to the formation of beautiful silver nanocrystals. Aniline adsorbed onto the surface of Ag-nanocrystals through electrostatic, van der Walls forces and hydrogen bonding. Cetyltrimethylammonium bromide (CTAB) acted as a stabilizer and/or capping agent

Abnormality of geothermal gradients in Iraqi western desert inferred from borehole temperatures

Geothermal gradient is an important tool in petroleum exploration and critical to several reservoir evaluations. Borehole Temperature data from 14 wells are utilized to find the geothermal tendency of the Western Desert in Iraq. The discrepancies in geothermal gradients throughout the area are a consequence of variability of sediment's thermal conductivity, direction of groundwater flow, fault pattern, and heat generation. High value converts liquid hydrocarbon to dry gas and low value will not help organic matter to reach maturity level. The lowest gradient within the units above Palaeozoic Era's section is 12.2 °C/km for well KH-9/7 in the eastern part of the area and the highest is 31.3 °C/km for well KH-5/4 in the middle part of the region. Whereas, the highest geothermal gradient which is 61.0 °C/km within the Palaeozoic section is recorded within Akkas Formation in 2100-2350 m subsurface. The mean geothermal gradient in Western Desert is 26 °C/km within the units younger than the Palaeozoic, but this average rises up to 40 °C/km within Palaeozoic units due to existence of Silurian hot shales and heat flow from the Proterozoic section especially from Halaban Group andesites

A Triad of Temporomandibular Joint Ankylosis, Mandibular Retrognathia and Severe Obstructive Sleep Apnoea: Case report

The surgical management of paediatric patients with temporomandibular joint (TMJ) ankylosis, mandibular retrognathia and obstructive sleep apnoea (OSA) is challenging. We report a nine-year-old boy who presented to the Department of Oral Health, Sultan Qaboos University Hospital, Muscat, Oman, in 2016 with complaints of limited mouth opening, loud snoring and excessive daytime sleepiness. He was diagnosed with TMJ ankylosis, mandibular retrognathia and severe OSA. The patient initially underwent mandibular distraction and, subsequently, release of the TMJ ankylosis and rib graft reconstruction. The overall patient outcome was successful, with improvement in OSA-related symptoms, good facial symmetry and adequate mouth opening. Keywords: Temporomandibular Joint Disorders; Temporomandibular Ankylosis; Retrognathia; Obstructive Sleep Apnea; Case Report; Oman

Analyzing the Effectiveness of Hand Washing Programs in Reducing Hospital Infection Rates

A total of 27 articles were included in this review, and data were extracted and reviewed using a data matrix. A qualitative synthesis was employed. Findings showed that hand washing can be effective in reducing hospital-acquired infections, but the behavior is complex and multifaceted, and there is no one universally effective intervention. Several specific hand hygiene interventions designed to improve compliance that were related to decreases in infection rates were identified. These components for success included effective educational strategies, access to continual resources, integrating the hand hygiene program into an organizational culture, and dissemination of results. (Mouajou et al., 2022) The aim of the study was to analyze the effectiveness of hand washing programs in reducing hospital-acquired infections and identify the components of a successful hand hygiene behavior intervention. An integrative review was employed in this study and articles were retrieved from three databases: PubMed, CINAHL, and Academic Search Premier. Searches were initially conducted using key terms such as hand washing, hand hygiene, and nosocomial infections. Articles were included if the populations were hospital patients and healthcare workers, the interventions involved hand hygiene behavior, and the outcomes were changes in infection rates or compliance with the intervention. Primary and secondary articles were selected using additional search criteria, and articles were critically appraised and classified according to the level of evidence