BACKGROUND: Local and locoregional flaps are very useful in reconstruction of head and neck defects. Each case should be judged on its merits and selection of flap (local or locoregional) should be done by considering various factors. AIM: To study the etiological factors, type, distribution, management of head and neck defects (post traumatic, post malignancy & congenital) by using local and locoregional flaps and the overall cosmetic effect and function of both donor as well as recipient sites. MATERIAL AND METHODS: 40 patients were studied in a multispecialty hospital admitted in the trauma unit or as OPD patients. After stabilization, especially in trauma patients, patients were fully investigated and treatment protocol was made and reconstruction was done as per protocol. RESULTS: In this study, the mean age of patients was 29.8 years. The main cause of head and neck defects was post traumatic (58%) followed by malignancy (23%), infections (10%) and others (9 %). The mean age for post traumatic defects was 26.42 years. In post malignant defects, Basal cell carcinoma was the major cause of defect (50%) followed by oral malignancy (54%). All the patients with oral carcinoma were tobacco chewers and 50 % were alcoholic. Middle third of face (67%) was most common site for defect followed by scalp (14%), upper third (7%) and lower third face (6%). In the middle third of face, nose (38%) was commonest site of defects followed by cheek (34%) and ears (28%). Local flaps were used in 38% of defects as compared to locoregional flaps (62%). Advancement flaps were mainly done for cheek defects (70%). Rotation and transposition flaps were done mainly for scalp defects. Most common locoregional flap done was median forehead flap (27%) followed by deltopectoral flap. CONCLUSION: Local and locoregional flaps are still very useful in reconstruction of head and neck defects. This is in accordance with Gille's rules of reconstruction i.e." like replaces like". Treatment of the head and neck defects should be individualized. Each case should be judged on its merits and selection of flaps (local or locoregional) should be done by considering various factors like type of defect, site of defect, amount of associated injuries, and the condition of adjacent skin.
Injuries to finger tips remain a very common type of injury and these injuries may result from industrial accidents or these may be house hold injuries. The injuries are small lacerations or amputations or may be nail bed injuries. There are various options for the management of these injuries but the treatment of choice is which results in best cosmetic and functional results. The various factors which dictate this depend upon the age of the patient, type of injury, physical needs and occupation of the patient and also on as to which hand is dominant.
BACKGROUND Extraoral force has been in use in orthodontics since Cellier introduced it in early 1800s. Like many other treatment modalities, interest in headgears and the understanding of its probable effect has varied over the years. From only dental changes to skeletal changes affecting the cranial base structures as well, all have been attributed to headgear use at various times. At present, it is well established that headgears have a retarding effect on the growth and development of maxilla. However, the exact biomechanical effect of different force directions on the sutural response is still under consideration. MATERIALS AND METHODS The present study was undertaken to examine the effect of posteriorly directed headgear forces on the various nasomaxillary sutures. FEM model was created having 236685 elements and 56052 nodes and 1 Kgf force was applied at-30 0 , 0 0 , 30 0 , 52.4 0 and 60 0 to the functional occlusal plane.
Carcinoma of the bladder is a disease of the elderly. Bladder cancer is three times more common in males than in females and more common in whites than in blacks. Patients with bladder cancer have a 1% to 4% incidence of synchronous or metachronous upper tract urothelial tumors. There are many risk factors for urothelial cancer, classified into (1) Genetic (2) chemical exposure, and (3) chronic irritation. Genetic abnormalities associated with CIS include alterations in the retinoblastoma gene (Rb), p53, and PTEN. Chemical exposure has the most epidemiologic evidence to support it as an inciting agent (Aromatic amines, aniline dyes, and nitrites and nitrates). Chronic irritants include catheters, recurrent urinary track infections, Schistosoma haematobium, and irradiation. There are many studies that suggest high water consumption, vitamin intake, and various diets that are beneficial in preventing bladder cancer. However, none of these have shown any clear benefit with respect to prevention.
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