Complications of Orthognathic Surgery

Orthognathic surgery is a common approach for treatment of maxillofacial deformities. Sagittal split ramus osteotomy (SSRO) is one of the most common techniques used to treat various mandibular deformities. A LeFort I osteotomy is suggested in deformities of the maxilla and can be used along with SSRO or intra‐oral vertical ramus osteotomy (IVRO).The aim of orthognathic surgery is to improve function and facial appearance; this benefits the patient psychologically and socially. Common complications which may occur in orthognathic surgery include vascular disease, temporomandibular joints (TMJ) problems, nerve damage, infection, bone necrosis, periodontal disease, vision impairment, hearing problems, hair loss, and neuropsychiatric problems. Rarely complications could be fatal. Because of the wide range of complications the surgeon should keep prevention protocols in mind and be prepared to treat them should they occur. In this chapter, common complications of various osteotomies in the mandible and maxilla are discussed

Confronting the opioid crisis: Practical pain management and strategies: AOA 2018 critical issues symposium

The United States is in the midst of an opioid crisis. Clinicians have been part of the problem because of overprescribing of narcotics for perioperative pain management. Clinicians need to understand the pathophysiology and science of addiction to improve perioperative management of pain for their patients. Multiple modalities for pain management exist that decrease the use of narcotics. Physical strategies, cognitive strategies, and multimodal medication can all provide improved pain relief and decrease the use of narcotics. National medical societies are developing clinical practice guidelines for pain management that incorporate multimodal strategies and multimodal medication. Changes to policy that improve provider education, access to naloxone, and treatment for addiction can decrease narcotic misuse and the risk of addiction

International Corporate Governance Comparison – Pakistan and Sweden

Purpose: To compare the differences and similarities that apart the corporate governance systems of Pakistan and Sweden by using a research model developed for this purpose. The same model will compare how major companies of the countries are expressing this in information to shareholders. The thesis begins with an introduction to corporate governance and its internalization of the subject. It is stated in above-mentioned purpose of the study what the aim is with this research. Pakistani and Swedish legislation and companies are compared against each other and the view of best practice. To conduct the research much consideration has been given to the construction of the research model that has been used in the conduction of this two-fold study. The comparison will take place on five main key dimensions in the countries and companies that are ownership structure, board, disclosures and internal control, shareholder’s rights and corporate social responsibility. Mainly three conclusions will be presented where most of the focuses have been on adequacy of research mechanism, comparative findings, corporate governance development stages and convergence

Application of Blockchain and Internet of Things to Ensure Tamper-Proof Data Availability for Food Safety

Food supply chain plays a vital role in human health and food prices. Food supply chain inefficiencies in terms of unfair competition and lack of regulations directly affect the quality of human life and increase food safety risks. This work merges Hyperledger Fabric, an enterprise-ready blockchain platform with existing conventional infrastructure, to trace a food package from farm to fork using an identity unique for each food package while keeping it uncomplicated. It keeps the records of business transactions that are secured and accessible to stakeholders according to the agreed set of policies and rules without involving any centralized authority. This paper focuses on exploring and building an uncomplicated, low-cost solution to quickly link the existing food industry at different geographical locations in a chain to track and trace the food in the market.Comment: Journal of Food Quality, 202

Epidemiology of prediabetes and prehypertension-progression, regression and interaction

Background: The major portion of the non-communicable diseases is formed by cardiovascular diseases. The two major modifiable risk factors are hypertension and diabetes. The probable CVD risk with pre-hypertension and pre-diabetes, to some extent, is dependent on whether pre-HTN leads to hypertension and pre-DM leads to diabetes. Our aim was to study: the progression of prehypertension and prediabetes to overt hypertension and diabetes or to normal status, and the association of pre-obesity and obesity with prehypertension and prediabetes. Methods: A total of 1200 patients equally distributed among three groups were studied for progression or regression. Group A included 400 patients of pre-hypertension, and group B included 400 patients of pre-diabetes and group C included 400 patients of pre-diabetes and pre-hypertension. Results: Among the 400 studied patients with prediabetes 31 (7.8%) progressed to diabetes and only 9 (2.3%) progressed to hypertension over a period of two years. Patients with both prehypertension and prediabetes had a higher risk of progression to hypertension and diabetes (3% to hypertension and 15.5% to diabetes). Males were more prone to develop both pre-hypertension and pre-diabetes mellitus and progression. Obesity increased the risk of progression to hypertension and diabetes significantly. Conclusions: The screening of people for pre-diabetes mellitus and pre-hypertension should be carried out at mass levels so as to diagnose them at an early stage and hence, their progression can be either halted or modified

Phage Therapy an Effective Remedy Against Drug-Resistant Bugs and Hard to Treat Bacterial Infections-A Review

The injudicious use of antibiotics not only in medicine but also to promote the growth of farm animals has led to the development of antibiotic resistance against many bacterial diseases. One of the remedy against such drug resistant bacterial infections is the application of phage (Bacteriophage) therapy. Phage therapy involves using phages or their products as bioagents for the treatment or prophylaxis of bacterial infections. There are two types of phages based on their type of life cycle: the lytic and the lysogenic phages. Only the lytic phages are used in phage therapy, because of the disadvantages of lysogenic pahges (Superinfection immunity, lysogenic conversion, specialized transduction). Apart from live phages the phage byproducts like phage lysins can also be used specifically against certain bacterial infections. The reports indicate that appropriate administration of living phages can be used to treat lethal infectious diseases caused by bacteria, like Pseudomonas aeruginosa, Escherichia coli, Acinetobacter baumannii, Klebsiella pneumoniae, Salmonella spp. and Staphylococcus aureus etc. In the coming time the phage therapy will compensate for unavoidable complications of antimicrobial therapy, particularly the appearance of multidrug resistance bacteria (super bugs)

Unintentional childhood poisoning, epidemiology and strategies for the prevention and policy change in Pakistan

Poisoning is the fifth leading cause of unintentional injuries among young children. Agents most commonly ingested by young children include medicines, cleaning substances, hydrocarbons, pesticides and cosmetics. Children with less educated fathers, living in more crowded conditions and from lower income families are more predisposed to unintentional poisoning. Unsafe storage of medicines, chemicals and other hazardous substances is one of the leading reasons for childhood poisoning. Knowledge of parents and caregivers about prevention of poisoning may be the basis to prevent subsequent injuries. This paper is a review of the epidemiology of unintentional poisonings among young children (less than five years) and its risk factors especially in the context of Pakistan

Evaluation of Demineralized Freeze- Dried Bone in Augmentation of Buccal Defects during Implant Placement

Introduction: Bone thickness in the anterior of the maxilla is one of the major concerns for implant placement. The aim of the present study is to evaluate stability of demineralized freeze- dried bone (DFDB) graft for augmentation of buccal defects during implant placement at the anterior of the maxilla using cone-beam computed tomography (CBCT).Materials and Methods: The DFDB graft was used for augmentation of buccal defects during implant placement at the anterior of the maxilla. The amount of remnant DFDB was measured in three points: Coronal, middle and apical portion of the buccal sides of implants after one year. Results: Twenty-two samples were included in this study. All of the exposed implants were osseo-integrated. A significant difference was detected for remnant grafting bone in the coronal and apical portion of the implants between the central site and the lateral site (P<0.05) without any difference in the middle portion. Analysis of data did not show any differences of remnant grafting bone thickness among one-third coronal ,one-third middle and one-third apical portion of the buccal sides of implants after one year (P>0.05). Conclusion: DFDB could be used successfully for augmentation of buccal defects during implant placement. It is assumed that approximately 50% of DFDB is resorbed one year after grafting. The recipient site may influence the amount of resorption rate

Effect of Biochar and Microbial Inoculation on P, Fe, and Zn Bioavailability in a Calcareous Soil

To identify effective ways of increasing the yield of crops grown in nutrient-poor calcareous soils, the combined effects of biochar addition and inoculation with plant growth promoting rhizobacteria (PGPR) and arbuscular mycorrhizal fungi (AMF) on wheat growth and soil properties were investigated under rhizobox conditions. Measured soil properties included pH, electrical conductivity (EC), organic matter content (OM), the availability of P, Fe, and Zn in the rhizosphere, and the uptake of these elements by plants. Combined biochar addition and microbial inoculation were shown to significantly increase the concentration of available forms of P, Fe, and Zn in the soil when compared to non-biochar treatments. The highest soil pH (7.82) was observed following biochar addition without microbial inoculation. The EC following biochar addition and PGPR inoculation was significantly higher than the other treatments, and the soil OM content was highest when combining AMF inoculation with biochar addition. The available P content after AMF inoculation combined with biochar addition was 27.81% higher than the control conditions, and AMF inoculation increased Fe and Zn bioavailability by factors of 2.38 and 1.29, respectively, when combined with biochar addition relative to AMF inoculation alone. The simultaneous biochar addition and PGPR inoculation significantly increased P uptake by the plants. The highest shoot Fe and Zn uptake rates were observed after a simultaneous application of biochar and PGPR inoculation. Under these conditions, shoot uptake was higher than seen when combining biochar addition with AMF inoculation by factors of 1.64 and 1.21, respectively. In general, it can be concluded that combining inoculation with growth-promoting bacteria and biochar addition can effectively improve nutrient availability to plant and soil conditions