Introduction: A 17 years old male patient was treated at the University orthodontic department. He had the chief complaint of unaesthetic appearance of his teeth, mostly for anterior crowding. The pretreatment records showed a Class II skeletal relation, moderate upper and lower anterior crowding, 0.5mm of overbite and 2mm of overjet.
Materials and Methods: It was suggested Osteogenic Accelerated Orthodontics (OAOTM), the treatment option was very attractive to the patient although it required a surgical procedure and a more expensive type of treatment.
Results: The overall treatment time was 6 months, facial balance was improved and the final occlusal relationships from the functional and aesthetics perspective were good.
Conclusion: OAOTM is a good alternative to reduce extractions rate as it increases the scope of tooth movement and strengthen the periodontal tissues thru bone grafting, although these claims require more scientific data to be validated.
Selective alveolar decortication and periodontal augmentation with a bone graft were the two procedures used for the correction of the skeletal class II malocclusion in the case reported. A 25-year-old male patient presented with a skeletal class II malocclusion with increased bi-maxillary dento-alveolar protrusion, increased overjet, deep bite and imbricated and rotated mandibular incisors with bilateral presence of supernumerary teeth in the maxillary right and left premolar regions. Extraction of supernumerary in the maxillary right and left premolar region, and impacted UL5 was done. Pre-adjusted edgewise appliance, Roth’s prescription (0.022x0.028-inch slot), was bonded and a week later full thickness labial and lingual flaps were reflected in the maxillary and mandibular arches. Circumscribed corticotomy cuts was done and subsequently augmented with a bone graft. Orthodontic treatment was commenced immediately after surgery and orthodontic adjustments were performed every 2 weeks. The entire orthodontic treatment was completed in 9 months. Regional acceleratory phenomenon, triggered by the alveolar decortication, was responsible for the rapid correction of the malocclusion and the augmentation with the bone graft provided adequate bone volume for housing the teeth, thereby decreasing the possibility of subsequent relapse.
Necrotizing fasciitis is a quickly progressing soft tissue infection that can be described with diffuse necrosis of subcutaneous tissue and superficial fascia. The cause of this can be infectious process of odontogenic origin, most commonly caused by mixed gram+ and gram- , aerobic and anaerobic microorganisms that are found in patients that are predisposed to infections. In a case of undiagnosed illness, there is a possibility of life threatening complications. This case analysis introduces the diagnostic criteria of the disease and treatment plan, encouraging doctors to devote more attention to prevention of infections.
Salivary stone (sialothiasis) is a calcifying concentration within the ductal system of salivary gland [1]. The majority of salivary calculi occur in the submandibular gland duct because of its length, upward course and the thicker mucus [2].
Mesenteric cysts are rare benign intra-abdominal tumors with an incidence of 1 case per 250,000 hospital admission. This lesion occurs most frequently in women in the reproductive period.The etiology of such cysts remains unknown but several theories regarding their development exist. Most of these lesions present with vague abdominal pain and nausea. Less commonly they will present with bowel obstruction due to external compression. The diagnosis of these tumors is by abdominal ultrasound or computed tomography. We report a case of Mesenteric cyst in 51-year-old female patient.
Pierre Maria and Sainton syndrome or cleido-cranial dysplasia (CCD) is a rare syndrome presenting an autosomal pattern of inheritance, characterized by characterized by a triad: clavicular aplasia, delayed ossification of the fontanelles and sutures of the vault of the skull. To these may be added multiple dental inclusions.
Parry-Romberg syndrome is an uncommon condition, self-limiting with slow progressive hemifacial atrophy. This syndrome can lead to several progressive congenital and developmental deformities. It can cause severe facial asymmetry and subsequently lead to esthetic and psychological problems and adversely affect patient’s quality of life, so its treatment holds great importance. Still, there is no exact treatment protocol for this disease, treatment approaches are bounded and patient’s response to the treatment is imponderable. However, most of the patients can benefit from conservative treatments. In this paper, we have reported a moderate case of Parry-Romberg syndrome, with no familial history of any syndromes. We also have discussed about present anomalies and the steps of exerted conservative treatments.
Introduction: Temporomandibular joint (TMJ) ankylosis is one of the most disruptive anomaly that affects the masticatory system and is referred as permanent movement disfunction of the mandible caused by bilateral or unilateral fibrous or bony adhesions and create problems. The etiology is congenital or idiopathic and include trauma, arthritis, infection, previous TMJ surgery etc. Management requires extensive resection of the ankylotic mass and reconstruction of the ramus-condyle unit with autogenous or alloplastic grafts. Most of the time, combination of surgical treatment with physiotherapy is needed in order to achieve maximum rehabilitation and functionality of the mandible.
Purpose: The aim of this study is to present the surgical management of an unusual case of unilateral TMJ ankylosis and recent of literature review.
Case report: A thirty-seven-year old patient reported unable moving his lower jaw. Clinical examination revealed unilateral TMJ ankylosis of congenital cause and the lateral movement of the mandible was impossible. The patient surgical treatment included resection of the newly formed bone mass, replacement of the condyle with costo-chondral graft and replaced of articular disc with the temporal fascia. Since and for ten years after surgery the patient shows no signs of relapse.
Conclusion: The development of TMJ ankylosis may be congenital or acquired etiology. In order to manage it required a comprehensive clinical and radiographic examination. Surgical resection of the bone and coronoid process on the entire side is necessary and a graft that mimics the articular disc is placed, while it is necessary the immediate postoperative kinesiotherapy.
Functional and aesthetic rehabilitation of an extremely worn dentition is one of the most challenging aspects of Prosthodontics. A thorough examination and diagnosis & selection of appropriate occlusal scheme are key factors to achieve optimal clinical outcome. Among the variety of techniques suggested in the literature, the twin-stage technique given by Hobo & Takayama has emerged as a popular choice for clinicians in recent times. Instead of the condylar path, it utilizes standard cuspal angle as the main determinant of articulation to produce predictable disocclusion in eccentric movements. It is relatively simple, does not require special armamentarium and can be incorporated easily with commonly used clinical techniques such as face bow transfer.
The present case report describes the full mouth rehabilitation of a severely mutilated dentition using Hobo’s twin-stage technique to achieve a functionally and aesthetically favourable outcome.
Morbidly adherent placenta (MAP) includes the spectrum of placenta accreta, increta, and percreta. It is a major cause of obstetric hemorrhage. Caesarean section is main risk factor for MAP. Ultrasound scan is highly sensitive method for MAP diagnosis and sometime Magnetic resonance image is of choice. Early diagnosis timed elective planned intervention after preparation under skillful multidisciplinary team improve the outcome and minimize the morbidity. Caesarean hysterectomy, major arteries ligation, arteries embolization and leave the placenta in-situ all are choices of management. Use of Methotrexate for the placenta in-situ in MAP is still debatable. We present a case of MAP in which placenta left in- situ followed by multiple Methotrexate injection during postpartum with good outcome and acceptability.
A clinical case of treatment of two severe intrabony defects on the aesthetic zone is reported and followed for one year.
The biomaterial of choice was enamel matrix derivative (Emdogain®; Straumann™) alone with a preservation papilla flap and a minimally invasive surgical technique.
After surgical treatment, the patient was kept in a supportive periodontal therapy programme with 6-month interval between appointments.
In the one year after surgery appointment, clinical and radiographic changes were observed, showing periodontal health and stability.
Marzia Cottini*, Amedeo Pergolini, Giordano Zampi, Vitaliano Buffa, Paolo Giuseppe Pino, Federico Ranocchi, Riccardo Gherli, De Marco Marina, Carlo Contento, Myriam Lo Presti and Francesco Musumeci
Despite the background of advances in cardiac surgery procedures for higher risk population, the postoperative complication has already been a challenge for cardiac surgeon and Heart-Team. Future perspectives to exceed this challenge could be periodically patient’s follow up and advance diagnostic workup. We describe the diagnosis of a large sub mitral left Ventricle Pseudoaneurysm that was identified in a 59-year-old woman 17 years after she underwent aortic and mitral valve replacement for rheumatic valvular disease
The Transcatheter Aortic Valve Implantation (TAVI) had emerged more and more in the last twenty years. According to the scientific literature, this is an approved, suitable and alternative therapeutic choice to conventional surgery for aortic valve disease in high risk patients. The most of patients are octogenarians or nonagenarians, with multiple comorbidities (neurological,vascular,oncologic, haematological, etc). The evolution of TAVI techniques and its devices have improved the quality of results and reduced the peri- and post-procedural complications. Cardiac anaesthesia and analgesia in TAVI patients is very important and fundamental to a quickly and complete clinical restoring after the procedure. An optimal balance of drugs and peri-procedural management could reduce the neurological events (such as delirium), the days of hospitalization and the admission of intensive care unit. According to our experience in transapical approach, the low dose of propofol and desflurane allowed to optimal cardiac anaesthesia and rapid mechanical ventilation weaning in complex patient undergone to transcatheter valve implantation with transapical approach. Moreover, our protocol reduced considerably the incidence of perioperative delirium.
Triploidy is one the most common chromosomal abnormality in humans, complicating about 1% of all human pregnancies. Most affected conceptions undergo spontaneous abortion in the first trimester, making the prevalence of second trimester triploidy low. Viable triploidy is associated with high rates of maternal morbidity, including hypertensive disorders, hemorrhage, and persistent trophoblasic disease, as well as fetal and neonatal severe adverse outcomes. Given these complications, early identification of triploidy in ongoing pregnancies may inform patient counseling and management.
We wish to present our case of the rare Meckel-Gruber syndrome, diagnosed prenatally at 18 weeks’ gestation. Informed consent was obtained from both parents for publishing this case and including photos.
Background: Leiomyoma itself is not a rare disease, but it is rarely found intravascularly.
Case presentation: A 54-year old female sought medical help after noticing her leg being swelling. A diagnosis of deep vein thrombosis (DVT) was made and antithrombotic treatment was given after her initial imaging exam. Several days later, a contrast CT and sequential pathology revealed the real diagnosis was intravascular leiomyoma. The patient was discharged after a successful surgery.
Conclusion: Intravascular leiomyoma should not be confused with DVT.
Andreas Suhartoyo Winarno*, Lukas Schloesser, Frederic Dietzel, Percy Balan, Thomas Hoehn, Monika Hampl and Tanja Natascha Fehm
Published on: 16th December, 2019
Deliveries prior to 28 weeks’ gestation (extreme preterm birth) pose a global health concern, according to the World Health Organization (WHO). Extreme preterm birth is associated with several complications in the newborn and management in neonatal intensive care unit would incur high expenses. In parallel, advancements in in vitro fertilization will give an opportunity for women to conceive in cases of ovarian failure. At the same time, health providers also encourage patients to receive more than one embryo simultaneously during an embryo transfer. Here we report a case of a patient in coma condition of triplet pregnancy, post ovum donation with three-embryo transfer. Following stabilization, cranial computed tomography (CCT) was performed. The result showed bleeding in the brainstem and into intraventricular spaces at 25+4 gestation weeks. Furthermore, ICH during pregnancy is considered as a rare case in obstetrical field, especially involving the brainstem. This could lead to life-threatening conditions and serious disability in the future. On the fifth day of hospitalization, she suffered from pneumonia and pulmonary edema. On the eight day (26+5 gestations weeks), an emergency caesarean section was performed due to fully dilated of the cervix with breech presentation of all fetuses. Mother and the children survived with some non-life-threatening disabilities.
This is the very first case reported of intracerebral hemorrhage in the brainstem in triplet pregnancy after receiving ovum donation. Heterologous conception could be an iceberg phenomenon of gestational complications among the population. Reproductive tourism could still become greater in the future.
Background and Purpose: Injuries for the pre-adolescent female Irish Dancer (FID) are not well recognized. The purpose of this case study is to report imaging assisted diagnosis and management of atypical medial and plantar foot pain (MPFP) in an 8-year-old FID.
Description: The patient presented with chief complaint of diffuse left MPFP. The patient was initially evaluated by a Physical Therapist for persistent foot pain. The patient experienced minimal pain in non-weightbearing (NWB). Pain intensified in weightbearing (WB) escalating with a heel raise. The patient experienced pain with resistance testing, ankle passive range of motion (PROM) and first metatarsophalangeal joint (MTPJ) PROM. Diffuse tenderness with palpation over the medial column of the left foot was noted. The patient was unable to complete single leg dynamic activity on the left foot. There was suspicion for a metatarsal stress fracture (MSF). Radiographs were ordered and read as negative. The patient was treated with immobilization in a walking boot, WB as tolerated and relative rest including cessation of dance. The patient returned for re-evaluation 2 weeks after reporting no change in symptoms. Magnetic Resonance Imaging (MRI) was then ordered.
Outcome: Results of the MRI identified 2 stress fractures in the first metatarsal. The treatment plan changed to NWB status with immobilization for an additional 6 weeks. The patient returned to full WB status and participated in all dance activity 15 weeks after the initial presentation to the Physician and 27 weeks after the initial onset of MPFP.
Discussion/Conclusion: In this pre-adolescent FID, the presentation of MPFP can be misinterpreted as a soft tissue injury. It is important to consider the diagnosis of first MSF in a pre-adolescent FID to allow appropriate management.
We evaluated a total of 115 patients diagnosed with anal cancer, who were treated at our clinic from 1995 to 2012. Their average age was 61 years, most often were diagnosed in stages II and III, in most cases it was a squamous cell carcinoma located in the anal canal. The mean follow-up was 83 months (minimum 1 month and maximum 240 months). We combined external radiotherapy with boost of brachytherapy or boost of external radiotherapy and possibly a combination of both boosts. Half of the patients received concomitant chemotherapy. We specifically evaluated local tumor regression, overall survival and the impact to therapeutic effect of the chosen irradiation technique. Complete regression was achieved in 92 patients, partial regression in 21 patients. Overall survival, regardless of stage, was 80% 3-year, 74% 5-year and 67% 10-year. The age of patients, the size of their own primary tumor and the therapeutic method used had a statistically significant effect on survival - especially the importance of brachytherapy was irreplaceable.
Introduction: Contraception is a method or device used to prevent pregnancy. In the first year of postpartum period around 65% of women are having unmet need of family planning. Post Placental Intrauterine Contraceptive Device is not only advantageous to the women and couples; even the service providers benefit from PPIUCD. PPIUCD insertion on the same delivery table saves time and separate clinical procedure is not required.
Methodology: The Quantitiative Pre-Experimental One Group Pre and Post Test research design was used. 70 Antenatal mothers were selected by using Purposive Sampling Technique who fulfilled the inclusion criteria and who were available during the period of data collection at selected hospital, Puducherrry. Data was collected by using Structured Interview Schedule.
Result: The Pre test mean score of Knowledge was 9.98 ± 2.38 and Post Test mean score of Knowledge was 14.91 ± 1.15. The calculated paired‘t’ value was (-20.82) found to be statistically significant at p < 0.001 level. The Pretest mean score of Attitude was 34.67 ± 5.67 and Post test mean score of Attitude was 44.27 ± 4.70. The calculated paired‘t’ value was (-17.25) found to be statistically significant at p < 0.001 level. The Pretest mean score of Acceptance was 0.11 ± 0.320 and Post Test mean score of Acceptance was 0.29 ± 0.455. The paired‘t’ value of t = -3.778 found to be statistically significant at p < 0.001 level. The Demographic and Obstetrical Variables like age at marriage, previous childbirth and decision maker of family about family planning have shown significant association with Post Test level of Knowledge, Attitude and Acceptance of PPIUCD at p < 0.05 and p < 0.001.
Conclusion: The researcher concluded that Prenatal Intensive Counselling increases the mother’s Knowledge, Attitude and Acceptance of PPIUCD. So Prenatal Intensive Counselling on PPIUCD can be given to Antenatal Mothers during their antenatal visits to meet the unmet needs of family planning.
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