BACKGROUND Trauma is the most common cause of maxillofacial injury. Maxillofacial injuries can cause long-term functional, aesthetic, and psychological complication. Road traffic accidents (RTA) are the major causes in developing countries like India. Restraint devices significantly reduce the risk and severity of injury, and the number of deaths resulting from crashes. RTA is often related to the use of alcohol and has a strong association with facial injuries. The present study evaluated the demographic pattern, aetiology, management of maxillofacial injuries, its association of alcohol abuse and the effect of restraint/protective devices influencing their distribution. METHODS A four-year retrospective study was done between January 2014 to December 2017 on patients with maxillofacial injuries attending dental OPD and emergency department. A total of 225 patients with maxillofacial injury/trauma were analysed. Age ranged between 5-75 years. Patient with head injury, polytrauma and pregnant females were excluded from the study. Patients were evaluated by age, gender, mode of injury, aetiology, history of alcohol intake, maxillofacial injury sites, use of protective device at the time of injury and treatment rendered. Data was expressed in percentages. RESULTS A total of 225 patients accounting for 288 maxillofacial fractures were included and analysed. The male:female ratio was 3:1. Commonly affected age group was 21-30 year (49.3%). Road traffic accidents accounted for 49.01 %. Two wheelers were the most commonly involved vehicle. Mandible was the most commonly fractured site. Patients under the influence of alcohol contributed to more number of maxillofacial injuries. Also, non-use of restraining device increased the incidence of facial injury. CONCLUSIONS RTA with two wheelers is the most common aetiology of maxillofacial injuries, involving young adult (21-40 years) male patients. Mandible is most commonly fractured. Not using safety measures (helmets and seat belts) and also influence of alcohol are the major factors responsible for the injuries.

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Background: Post-operative pain is a protective but an unwanted effect which is to be treated for the better outcome of surgery. Aims and Objectives: The aim of this study is to compare the safety and analgesic efficacy of intravenous patient-controlled analgesia (IV PCA) using morphine and fentanyl for post-operative pain management in major surgery patients. Materials and Methods: The randomized clinical study initiated after the ethics committee approval and informed consenting. A total of 60 patients belonging to the American Society of Anesthesiology Grade -I, II, and III physical status, scheduled for major abdominal, oncological surgeries under general anesthesia were randomly allocated to two groups. Group M received IV PCA with morphine (basal continuous infusion 0.02 mg/kg/h, bolus dose of 0.02 mg/kg, and lockout period of 20 min), and the Group F received IV PCA with fentanyl (basal continuous infusion 0.5 µg/kg/h, bolus dose of 0.5 µg/kg, and lockout period of 20 min). Fentanyl dosage was converted into morphine equivalents. The outcomes such as visual analog scale (VAS), sedation score, hemodynamic parameters, and adverse effects were compared between groups and analyzed statistically. Results: Morphine provides better analgesia than fentanyl as indicated by lower VAS scores (score = 3) at the end of 24-72 h. Mean cumulative analgesic consumption was higher in fentanyl group (436.3 ± 330.2 mg) compared with morphine group (123.9 ± 28.2 mg) by 72 h. Regarding the hourly consumption, Group M consumed less drug than fentanyl group was statistically significant (P = 0.05). Conclusion: Morphine provides more effective post-operative analgesia than fentanyl administered through IV PCA. The PCA allows patients to balance between administration of analgesics and adverse events by self-adjusting the dose of analgesic used.

BACKGROUND Mandibular fracture treatment includes restoration of anatomic form and function with establishment of occlusion. Different methods are used to provide stable fixation like metallic compression plates, mini plates, locking plates, 3D plates and bioresorbable plates, etc.The present study compared the effectiveness of bioresorbable plates to the conventional titanium miniplates. MATERIALS AND METHODSNon-randomised controlled trial conducted on patients aged between 16 -56 years of either gender with clinical and radiographical evidence of mandibular fractures requiring open reduction and internal fixation, visiting dental department for the period of one year were enrolled for the study. They were intervened with either Bioresorbable Plates or Titanium Miniplates for the management of mandibular fractures under general anaesthesia. The patients were allotted in 2 groups. Group-I was treated with 2.5 mm Bioresorbable plates and screws; Group-II was treated with 2.0 mm Titanium miniplates and screws. Clinical and radiographic outcome parameters such as stability of occlusion, mobility of fracture fragments, need for intermaxillary fixation, wound healing, stability of fixation, displacement of fracture fragments and healing of fracture site were evaluated. RESULTSIn Group-I 6 patients showed unstable occlusion, 4 patients showed fracture mobility, 6 patients required intermaxillary fixation, whereas in Group-II only 3 patients had unstable occlusion, none of the patients showed fracture mobility (p < 0.05), only 3 patients required IMF during 1 st week post-operatively. There was no abnormality in wound healing/ soft tissue dehiscence and post-operative healing was satisfactory in both the groups. CONCLUSIONThe use of 2.0 mm titanium miniplates is a viable and better option as compared to bioresorbable plates for fixation of mandibular fractures. The stability of titanium plates is significantly higher than the bioresorbable plates for early function of mastication.