Reconstruction of defects of the oral cavity can be challenging. The armamentarium of the reconstructive surgeon includes local and regional flaps as well as free tissue transfer. The anatomy, location, and size of the defect guide the surgeon in treatment planning to determine the type of flap best suited for a specific reconstruction. Despite the enhanced techniques of repair of cleft palate, fistula occurrence is still a possibility either due to an inaccuracy in the surgical technique or due to the meagre tissue quality of the patient. Though usually the fistula closure is established by use of local flaps but at times the site and the size of the fistula make use of local flaps for its repair a remote possibility. Tongue flap can be the most versatile flap because of its central position in the floor of mouth good vascularity makes it a choice of flap for closure of anterior palatal fistulae than any other tissues. We are presenting a case report regarding closure of anterior palatal fistula with dorsal tongue flap.

Retinal nerve fiber layer thickness is affected in several ocular and systemic conditions, most commonly glaucoma and diabetes mellitus. The present cross sectional study was conducted to compare the retinal nerve fiber layer thickness in patients of primary open angle glaucoma and patients of type 2 diabetes mellitus. A total of 120 consecutive eyes of 60 patients were assigned to 2 groups of 30 patients each of primary open angle glaucoma and type 2 diabetes mellitus. Retinal nerve fiber layer thickness was measured with spectral-domain optical coherence tomography. Readings from all the areas of retina (superior nasal, inferior nasal, inferior temporal, superior temporal, nasal upper, nasal lower, temporal lower, temporal upper) were measured in both eyes. Retina nerve fiber layer thickness was negatively correlated with the duration of glaucoma, duration of diabetes and HBA1c levels. Hence, care should be taken in interpreting optical coherence tomography readings in patients of primary open angle glaucoma and diabetes mellitus. Such patients should not be over treated. The changes in retinal nerve fiber layer thickness can be used to monitor the progression or regression of diseases affecting nerve fiber layer and efficacy of treatment modalities in individual cases.

This study aims to determine and analyze partially and simultaneously the influence of service quality, image institution, and price toward student satisfaction of LP3I Jakarta Polytechnic. The type of research is quantitative approach, with data processing done using SPSS version 24. The object of this research student, with samples 132 students from levels I, II, and III. The analytical method used in this study is to use multiple linear regression analysis. The results showed that service quality, institutional image and price simultaneously and partially and simultaneously have positive and significant influence toward student satisfaction

Background: Good communication between the clinics and the laboratories and among the health professionals enhances diagnostic capability, efficiency and better management of the patient and is necessary for accurate and precise results. The study was carried out to audit and assess communication flow between the clinic and laboratory at the Haematology Department of the University of Nigeria Teaching Hospital - Enugu. Method: A total of 1000 laboratory request forms were collated in the study and each of these forms was monitored from time of inception till dispatch. Information in the laboratory request forms were grouped into four categories; patient’s biodata, clinical information, laboratory parameters and administrative parameters and analyzed statistically. Results: In patients biodata; age, sex and ethnic group fell short by 74.7%, 13.3% and 35.7% respectively. In clinical information category; clinical detail, provisional diagnosis, previous haematological requests and nature of specimen were insufficiently completed in 68.0%, 14.0%, 84.4% and 7.4% of the forms respectively. Ward, referring doctor and hospital reference number, were deficient by 1.2%, 2.4% and 65.0% respectively. Date, time of collection and date of arrival in the laboratory were lacking in all the forms. Out of the 1000 samples that arrived to the laboratory, 2% were inadequately collected or clotted and hence rejected. The information about these specimens was not communicated to the clinic/ward either through telephone or immediate dispatch for necessary repeat collection. Conclusion: We observed poor information communication between the clinicians and the laboratory and this may affect the accuracy of results. The inclusion of formal training in investigations, collection and handling of pathological samples in medical curriculum and training of practicing doctors through continuing education is recommended. Advances in technology or change in procedure should be adequately communicated to all concerned in the utility of laboratory results. Pathologists should play the critical roles of not only interpreting the results of the tests but also the continuing education of young doctors.

First thing which strikes in the mind after coming across with post traumatic necrosis of maxilla that is it possible? Looking back into literature we found only handful of incidences with traumatic maxillary necrosis. Osteonecrosis of the mandible and the maxilla is known; however, aseptic necrosis of the maxilla after traumatic fracture is hardly reported. Management of these cases can be quite cumbersome and require utmost care. We present a peculiar case report of post traumatic necrosis of maxilla and partial maxillectomy. This case aims to help clinicians realize the need to closely follow up and treat such patients with trauma as it can lead to osteonecrosis of the bone and cause difficulty in daily activities.

The aim of this article is to report three cases of multiple impacted supernumerary teeth and review the literature, analyzing their prevalence, etiology and classification. Supernumerary teeth are those that exceed the normal dental formula. They are more common in men, more common in the upper maxilla, and more prevalent in permanent dentition. Complications associated with supernumerary teeth include dental impaction, delayed eruption, ectopic eruption, overcrowding, spacing anomalies and the formation of follicular cysts. The treatment of supernumerary teeth depends on their type, position, and possible complications, detected clinically and radiographically. No clear consensus exists as to the best time to extract unerupted supernumerary teeth

Retinal nerve fiber layer thickness is affected in several ocular and systemic conditions, most commonly glaucoma and diabetic retinopathy. The present cross sectional study was conducted to compare the retinal nerve fiber layer thickness in patients of type 2 diabetes mellitus, and patients of primary angle glaucoma suffering from type 2 diabetes mellitus. A total of 120 consecutive eyes of 60 patients were assigned to 2 groups of 30 patients each of type 2 diabetes mellitus and patients of primary open angle glaucoma suffering from type 2 diabetes mellitus. Retinal nerve fiber layer thickness was measured with spectral-domain optical coherence tomography. Readings from all the areas of retina (superior nasal, inferior nasal, inferior temporal, superior temporal, nasal upper, nasal lower, temporal lower, temporal upper) were measured in both eyes. The presence of type 2 diabetes mellitus in patients of primary open angle glaucoma significantly affected the thickness of retinal nerve fiber layer specially in superonasal and inferotemporal quadrants as compared to patients of primary open angle glaucoma or diabetes mellitus individually. RNFLT is negatively correlated with the duration of glaucoma, duration of diabetes and HBA1c levels. Hence care should be taken in interpreting optical coherence tomography readings in patients of primary open angle glaucoma having diabetes mellitus, and such patients should not be over treated. The changes in retinal nerve fiber layer thickness can be used to monitor the progression or regression of diseases affecting nerve fiber layer and efficacy of treatment modalities in individual cases.

Perfusion index is a non-invasive method to assess the peripheral perfusion at a specific monitoring site measured by masimo pulse oximeter using signal extraction technology. Perfusion Index is an important measure to diagnose peripheral perfusion noninvasively. Present study is planned to find out the cut-off value of perfusion index for preterm neonates. 633 preterm neonates of 28-36 wks were followed simultaneously for perfusion index and capillary refill time. Capillary refill time more than 3 is a sign of poor peripheral circulation. Using the statistics of diagnostic tests, the perfusion index cut-off for sick preterm is 1.3sec by plotting in receiver operator characteristics curve. Capillary refill time more than 3 is taken as gold standard. The sensitivity of perfusion index is 88%. Perfusion index is a very important non-invasive measure to diagnose sick preterm.

Retinal nerve fiber layer thickness is affected in several ocular and systemic conditions, most commonly glaucoma and diabetic retinopathy. The present cross sectional study was conducted to compare the retinal nerve fiber layer thickness in patients of primary open angle glaucoma and patients of primary angle glaucoma suffering from type 2 diabetes mellitus. A total of 120 consecutive eyes of 60 patients were assigned to 2 groups of 30 patients each of primary open angle glaucoma and patients of primary open angle glaucoma having type 2 diabetes mellitus. Retinal nerve fiber layer thickness was measured with spectral-domain optical coherence tomography. Readings from all the areas of retina (superior nasal, inferior nasal, inferior temporal, superior temporal, nasal upper, nasal lower, temporal lower, temporal upper) were measured in both eyes. The presence of type 2 diabetes mellitus in patients of primary open angle glaucoma significantly affected the thickness of retinal nerve fiber layer specially in superonasal and inferotemporal quadrants as compared to patients of primary open angle glaucoma. Retinal nerve fiber layer thickness is negatively correlated with the duration of glaucoma, duration of diabetes and HBA1c levels. Hence, care should be taken in interpreting optical coherence tomography readings in patients of primary open angle glaucoma having diabetes mellitus, and such patients should not be over treated. The changes in retinal nerve fiber layer thickness can be used to monitor the progression or regression of diseases affecting nerve fiber layer and efficacy of treatment modalities in individual cases.

Background: Hepatitis B virus infection is a major global health problem and of immense clinical importance. Hepatitis B virus infection can lead to hepatocellular carcinoma (HCC) and is found to be associated with macrocytic anemia. The mechanism of anaemia largely depends on red cell membrane integrity. Osmotic fragility (OF) of red cells was therefore evaluated in patients with HBV infections to access the diagnostic/prognostic utility. Methods: A total of 1744 patients from surgical and medical wards/clinics of Alex Ekwueme University Teaching Hospital Abakiliki were screening serologically for HBV using immunochromatographic strip method and positive samples were confirmed by the use of One Step Hepatitis B Multi-5 Test. A total of 100 subjects (50 HBV positive and 50 HBV negative) were evaluated for osmotic fragility of red blood cells. Results: HBV prevalence rate of 3.5% was found among the patients. The osmotic fragility of red blood cells were significantly (p<0.05) decreased in Hepatitis B virus positive individuals compared to Hepatitis B virus negative individuals. Significant (p<0.05) differences were observed in the osmotic fragility of the two groups at 0.9%, 0.8%, 0.7%, 0.6%, 0.5%, 0.4%, 0.3%, 0.2% and 0.1% saline. The mean corpuscular fragility (MCF) which is the sodium chloride concentration causing 50% hemolysis for Hepatitis B positive individuals was 0.33% saline while that of Hepatitis B negative individuals was 0.41% saline. Conclusion: The HBV positive patients showed decreased OF compared with HBV negative control population. This study was on small population of HBV positive subjects without disease staging. Further studies using more sample size and clinical staging is recommended to clearly associate OF as a diagnostic or prognostic marker in HBV infection

This paper proposes a simple HPLC method for the identification of vitamin D3 in fortified milk powder. The method was applied to the determination of the vitamin D3 (as cholecalciferol) concentration in commercial products containing known amounts of vitamin D, under the following chromatographic conditions: C 18, 5 µrn, 120 A, 4.6 x 150 mm column, a mobile phase consisted of methanol and UV (DAD) set at 265 nm. The linearity range was established between 0.01-0.2 μg/ml of cholecalciferol prior to the analysis. The extraction was performed with dichloromethane: methane 1:1 (v/v) prior to the analysis. The limit of quantification was 50 ng/ml. Rapid determination of vitamin D through the chromatographic method represents a good solution for its quantification in the fortified milk powder.

Plant growth promoting rhizobacteria (PGPR) are soil-dwelling microorganisms that live in association with plant roots. PGPR can play an important role in agricultural by enhancing crop production as well as increasing plant resistance against damaging pests and diseases. In the case of the destructive viral disease of cereal crops barley yellow dwarf virus (BYDV), there is currently no treatment available after a plant becomes infected. Control of this aphid-transmitted viral disease is limited to resistant plant cultivars and/or chemical control of vector populations. With increasing environmental pressures to move towards sustainable agriculture, PGPR-based disease control provides a viable alternative to chemical pesticide applications. Here, we aimed to review the potential use of PGPR Azospirillum brasilense to protect wheat plants against barley yellow dwarf virus, and the underlying mechanisms for PGPR-mediated changes on plant-virus-vector interactions.

An esthetic smile is a common cosmetic concern in the dental field. Excessive gingival display (EGD), also called gummy smile (GS), is one of the main complaints related to an unsatisfying dental smile; it is said to be present when the gingival display exceeds 4 mm. The dental smile is achieved by a harmonious relationship between the size, shape, arrangement, and color of the anterior teeth; lip framework; and gingival contour. Altered passive eruption (AEP) is characterized by short square-shaped teeth occuring when the gingiva covers the crown of the teeth excessively. Altered passive eruption is one of the causes of GS along with maxillary lip length, bony maxillary excess, hyperactive upper lip, anterior dentoalveolar extrusion, and vertical maxillary excess. There are various options for periodontal management of EGD, such as surgical or laser gingivectomy, esthetic crown lengthening, forced eruption, lip repositioning surgery, use of Botox, or a combination of these. The aim of this paper is to review main etiologies and for proper diagnosis before the clinician can settle on the management. Dental professionals should also outline the principles of an acceptable esthetic smile, which should be the target of each GS correction procedure.

Introduction: There are various methods for dental rehabilitation but osseointegrated oral implants are now a days one of the most successful method to restore oral esthetics and function. But still immediate implants are often deferred or avoided at a site where infection is present because of the fear of failure. Recent experimental studies and updated literature have shown that with meticulous socket debridement and prophylactic use of antibiotics, successful outcome can be achieved for implants placed in infected socket. Aim and Objectives: The aim of this present study was to evaluate the feasibility of immediately placed dental implant into infected and debrided dentoalveolar socket and Clinico radiographic evaluation to assess the osseointegration of immediately placed dental implants. Materials and Method: A total of Twelve implants were placed in 10 patients reporting to Department of Oral and Maxillofacial Surgery at Guru Nanak Dev Dental College and Research Institute Sunam. All implants were immediately placed following extraction of tooth having periapical pathology where the extraction socket was thoroughly debrided and curetted to remove any granulation tissue and necrotic bone from the socket and treated with clindamycin prior to implant placement. Patients were examined on 1st day, 7th day, 1 month and 3 months post-operatively. Results: The various parameters evaluated included pain, inflammation, infection/suppuration, detectable implant mobility and periimplant radiolucency. Where pain, inflammation and infection was evaluated at 1st day, 7th day, 1 month and 3 months postoperatively and implant mobility and periimplant radiolucency was checked at 3rd month after implant surgery. None of the implants failed during the healing or follow-up period in our study. No peri-implant complications were seen either. Conclusion: It can be concluded that successful immediate implant placement in infected dentoalveolar socket depends upon the meticulous debridement of alveolar socket and controlled regeneration of alveolar defect.

Radicular cyst is the most common odontogenic cystic lesion of inflammatory origin. It is also known as periapical cyst, apical periodontal cyst, root end cyst, or dental cyst. It arises from epithelial residues in the periodontal ligament as a result of inflammation. This condition is usually asymptomatic but can result in a slow-growth tumefaction in the affected region. Radiographically, the archetypal description of the lesion is a round or oval, well circumscribed radiolucent image involving the apex of the infected tooth. In the management of these lesions the endodontic treatment only is not sufficient and it should be associated with surgical management. This paper presents a case of endodontics cum surgical management of large radicular cyst in the maxillary anterior region with complete resorption of maxillary nasal floor.