Nasal continuous positive airway pressure (nCPAP) in premature babies may rarely lead to necrosis of the columella. Subsequent functional and cosmetic impairments require surgical corrections to restore nasal anatomy and architecture. The objective of this report is to document the technique of reconstruction in a baby with columella necrosis due to nCPAP treatment. A 21-month-old baby was referred to the oral and maxillofacial unit with a necrotic columella following nCPAP ventilation in a neonatal intensive care unit. Nearly 75% of the vertical columella length was affected. A neocolumella was created using tissues mobilised from the nasal sill region. This report provides a detailed description of a columella reconstruction technique which is valuable to restore aesthetics and function.
Although dental trauma is common in bilateral cleft lip and palate (BCLP), patients’ reports on bony fractures of the vomero-premaxillary junction cannot be found. The aim of this report is to illustrate clinical findings and the technique of fracture fixation in a child suffering from a fractured vomero-premaxillary junction as well as subsequent columella lengthening. A 4-year-old girl with a repaired BCLP presented with an open mucosal laceration and fractured vomero-premaxillary junction. Open reduction and fixation of the dislocated premaxilla was performed under general anesthesia. Fractured bone pieces of the vomero-premaxillary junction were removed and sharp bone edges at the vomer and the premaxilla were grinded. The repositioned premaxilla was fixed to the lateral alveolar arches with two mucoperiosteal sutures on each side. Additional columella lengthening was performed 2 years later. All family members were very happy about the new aesthetics of the girl. Although rare, fractures of the vomero-premaxillary junction present several challenges to clinicians related to anatomical, physiological, and psychological issues. Immediate and minimal invasive treatment strategies are recommended when managing such cases.
It is universally accepted that everyone has the right to citizenship. Myanmar's framework on the right to nationality constitutes a unique, exclusive, ethnic citizenship system based on jus sanguinis, or the law of blood. Myanmar's Citizenship Law was enacted in 1982 by repealing the Union Citizenship Act of 1948. As citizenship parameters were changed by the Law, many people in the Kachin, Karen, and Rakhine states lost their nationality rights and consequently suffered human rights abuses. In the Rakhine state, serious communal violence occurred in 2012, 2016, and 2017, and the government declared a state of emergency. This research paper focuses on how Myanmar can adhere to international standards for nationality rights. It provides a historical overview and legal analysis of citizenship laws in Myanmar using a human rights lens and offers suggestions for legal reforms that can help address the problem of statelessness in Myanmar. Specifically, it recommends the use of the jus soli, or law of the soil, approach to citizenship.
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