Interdisciplinary orthognathic treatment of high angle class III malocclusion

For Class III adult patients, combined treatment strategy must be followed which includes either further dentoalveolar compensation or orthognathic surgery following decompensation of the teeth. This case report presents the interdisciplinary approach of a skeletal Class III malocclusion with increased vertical facial dimension, occlusal cant, extracted posterior teeth on the right upper and left lower segments, extensive restorations, and total circular crossbite. The orthodontic alignment took 10 months. LeFort 1 osteotomy with 7 mm advancement, 5 mm impaction on the left side, 3 mm impaction on the right side and 2 mm rotation for midline correction toward the left side, 3 mm set.back of mandible with bilateral sagittal split osteotomy were done. The surgery simulation, postoperative and 2 year follow up records were compatible. The treatment was finalized in a straight profile with stable occlusion and good smile characteristics without airway disturbance.Key words: Interdisciplinary treatment, orthognathic surgery, skeletal Class II

Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study

Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P < 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P < 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk

Determining firm characteristics and the level of voluntary corporate governance disclosures among Malaysian listed property companies

This study examined the level of voluntary corporate governance disclosures and the influence of firm characteristics (i.e., firm size, firm age, and firm market listing) on the level of these disclosures among Malaysian property listed companies. The check-list to measure the voluntary corporate governance disclosures was adopted from Malaysian corporate governance index 2011 by Minority Shareholder Watchdog Group (MSWG). The voluntary corporate governance disclosure practices and firm specific characteristics were obtained from annual reports of property listed companies on Bursa Malaysia for the period of 2012 to 2015. The findings suggested an improving voluntary corporate governance reforms in Malaysia. However, the firm size was found as an inflicting factor in determining the level and quality of voluntary corporate governance disclosure practices. On the contrary, the results found were contradicting the hypothesis related to firm age and firm market listing, as no relation of voluntary corporate governance disclosures and firm age and firm market listing. The study has made an interesting contribution toward the disclosure and corporate governance by contributing in understanding the importance of quality disclosure and good governance practices

The Bishop score as a determinant of labour induction success: a systematic review and meta-analysis

PURPOSE: To evaluate the association between the Bishop Score and successful induction. STUDY STRATEGY AND SELECTION CRITERIA: We searched the PubMed and the lists of references of relevant studies to identify reports on the association between Bishop Score and achieving active phase of labour or vaginal delivery. DATA COLLECTION AND ANALYSIS: We abstracted crude or adjusted measures of association from studies. Summary odds ratio (OR) and summary hazard ratio (HR), and 95 % confidence interval (95 % CI) were obtained by random effects meta-analysis. Study heterogeneity was assessed using the I (2) test. RESULTS: Fifty-nine studies met the inclusion criteria. Analyses with crude ORs showed that women with higher versus lower Bishop Score were more likely to achieve vaginal delivery either with no time limit for this to occur, or within a certain time interval; the summary ORs according to the Bishop Score cutoff ranged from 1.98 (95 % CI: 1.58-2.48; I (2) = 36.6 %) to 5.48 (95 % CI: 1.67-17.96; I (2) = 0.0 %) and from 2.15 (95 % CI: 1.36-3.40; I (2) = 0.0 %) to 4.22 (95 % CI: 2.48-7.17; I (2) = 11.0 %), respectively. Summary estimates per unit increase in the Bishop Score, based on adjusted ORs, showed a positive association with achieving vaginal delivery, either with no time limit (OR(summary) = 1.33; 95 % CI: 1.13-1.56; I (2) = 66.1 %) or within a certain time interval (OR(summary) = 1.52; 95 % CI: 1.37-1.70; I (2) = 42.4 %). Summary HRs per unit increase in Bishop Score showed an association with induction to vaginal delivery (HR(summary) = 1.28; 95 % CI: 1.21-1.36; I (2) = 0.0 %), but not with induction to active phase (HR(summary) = 1.21; 95 % CI: 0.88-1.68; I (2) = 70.7 %) time interval. CONCLUSIONS: Bishop Score seems be a determinant of achieving vaginal delivery and is associated with induction-to-vaginal delivery time interval

Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study

Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice

Safety and efficacy of intraperitoneal drain placement after emergency colorectal surgery. An international, prospective cohort study

Intraperitoneal drains are often placed during emergency colorectal surgery. However, there is a lack of evidence supporting their use. This study aimed to describe the efficacy and safety of intraperitoneal drain placement after emergency colorectal surgery. Method: COMPlicAted intra-abdominal collectionS after colorectal Surgery (COMPASS) is a prospective, international, cohort study into which consecutive adult patients undergoing emergency colorectal surgery were enrolled (from 3 February 2020 to 8 March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included rate and time-to-diagnosis of postoperative intraperitoneal collections, rate of surgical site infections (SSIs), time to discharge and 30-day major postoperative complications (Clavien-Dindo III-V). Multivariable logistic and Cox proportional hazards regressions were used to estimate the independent association of the outcomes with drain placement. Results: Some 725 patients (median age 68.0 years; 349 [48.1%] women) from 22 countries were included. The drain insertion rate was 53.7% (389 patients). Following multivariable adjustment, drains were not significantly associated with reduced rates (odds ratio [OR] = 1.56, 95% CI: 0.48-5.02, p = 0.457) or earlier detection (hazard ratio [HR] = 1.07, 95% CI: 0.61-1.90, p = 0.805) of collections. Drains were not significantly associated with worse major postoperative complications (OR = 1.26, 95% CI: 0.67-2.36, p = 0.478), delayed hospital discharge (HR = 1.11, 95% CI: 0.91-1.36, p = 0.303) or increased risk of SSIs (OR = 1.61, 95% CI: 0.87-2.99, p = 0.128). Conclusion: This is the first study investigating placement of intraperitoneal drains following emergency colorectal surgery. The safety and clinical benefit of drains remain uncertain. Equipoise exists for randomized trials to define the safety and efficacy of drains in emergency colorectal surgery