Systematic review: chronic obstructive pulmonary disease and work-related outcomes.

Background: Several studies have assessed the impact of chronic obstructive pulmonary disease (COPD) on work ability and work productivity; however, this relationship is poorly understood. Aims: To undertake a systematic review to assess the effects of COPD on employment, absenteeism and presenteeism. Methods: A comprehensive search using CINAHL, Embase, MEDLINE and the Cochrane Library was conducted to include epidemiological studies from 1937 to August 2017. One reviewer screened all citations. Shortlisted full-text articles were independently assessed by a second reviewer. Data were extracted by one reviewer with a random sample of papers (45%) checked by a second reviewer. Results: Forty-four studies were included; the majority of evidence was from cross-sectional studies, and some cohort studies. COPD patients had lower employment rates than those without COPD. Among those in work, most studies showed patients with COPD took more time off work than those without and reported poorer work performance (presenteeism), although evidence for this association was weaker. The influence of disease severity on these outcomes was unclear; however, it appeared that increasing severity of airflow obstruction was associated with reduced likelihood of being employed. A number of methodological limitations were found among the evidence, including the lack of adjustment for important confounders. Conclusions: Future studies are required which assess the impact of COPD on presenteeism using validated presenteeism instruments and consistent reporting methods. Robust studies are now needed to identify modifiable factors associated with these poorer working outcomes to inform future interventions aimed at improving work productivity among those with COPD.

Evaluation of Mandibular Condylar Changes in Patients Following Orthognathic Surgery: A Retrospective Study.

BACKGROUND: Condylar resorption as a cause of relapse after orthognathic surgery is well known. Several authors have presented evidence of the relation between orthognathic surgery and condylar remodeling and resorption. This study was done to appraise the condylar changes along with the form and function following orthognathic surgery, as well as to assess what factors may have contributed to the problems. METHODOLOGY: A diagnosis of progressive condylar resorption (PCR) was made by comparison of preoperative and postoperative radiographs (cephalometric radiograms), as well as clinical evaluations. The radiographs were taken for each patient preoperatively and postoperatively, which include immediately after osteotomy, at 6 months and 24 months. Additional radiographs were taken when required. Then, preoperative and postoperative tracings were compared at 24 months postoperatively. RESULTS AND CONCLUSION: It can be concluded from this study that females of relative low age (<18 years) appeared to be a high-risk factor for the occurrence of condylar alteration including PCR. A steep mandibular plane angle, the low facial height ratio (post/ant), and magnitude of surgery were also significantly related to the occurrence of condylar alteration, but the multivariance regression showed that these parameters had only limited value.

Efficacy of v-y closure of upper lip after le fort I osteotomy advancement and superior repositioning on facial esthetics in comparison to simple continuous closure: a statistical analysis.

This study aims to evaluate efficacy of V-Y closure of upper lip incision on facial esthetics in comparison to simple continuous closure after Le Fort I advancement and superior repositioning of maxilla. Thirty-four patients were divided in two groups i.e. V-Y closure group (group I = 17 patients) and simple continuous closure group (group II = 17 patients). The preoperative and 1 year post-operative linear and angular changes of hard and soft tissue points of groups I and II were statistically compared. Labial changes were more favourable in V-Y closure group in comparison to simple continuous closure group in both the Le Fort I maxillary movements. The upturning and forward movement of the nose were seen in both the maxillary movements but these nasal changes did not differ significantly between the groups. It was observed that the technique of V-Y closure of upper lip delivers adequate results contributing to better facial esthetics when compared to simple continuous closure.

Setbacks of bio-resorbable plates and screws in the management of condylar fractures: our experience.

PURPOSE: Fractures of the condyle can be managed by open or by closed reduction. This study was designed to mention the complications of the bio-resorbable material we had experienced while using them in the management of condylar fractures. METHODS: Fifteen (11 men and four women) patients with subcondylar fractures were included in the study. Resorbable poly-l-lactide plates and screws were used for the fracture fixation. Patients were followed up clinically and radiographically for a period of 2 years. RESULTS: Seven patients had a satisfactory reduction following the placement of bio-resorbable plates. Three patients had developed a swelling in the pre-auricular region, extending till the angle. Two patients had a screw breakage whereby leading to malunion and three other patients had bone resorption, at the fractured site that was appreciated radiographically. CONCLUSION: Inspite of the advantages of these materials, certain complications has been experienced in our study with regard to the resorption and degradation of the material which has been mentioned and explained in our article.

Evaluation of the outcome of secondary rhinoplasty in cleft lip and palate patients.

PURPOSE: A definitive correction of nasal deformity is best performed by creating symmetry and addressing the nostril/tip/columella complex, which is more easily handled by direct vision. The main objective is to evaluate the nasal changes along with function and also to evaluate the satisfaction outcome of the patients following secondary rhinoplasty. METHODS: Ten patients who were admitted to our unit for secondary rhinoplasty procedure involving the cleft lip-palate defects associated with nasal deformities were considered for the study. All the patients were evaluated pre- and postoperatively for aesthetics and function along with patient satisfaction and perception. RESULTS: All the operated cases of cleft nasal deformity had a significant improvement in the facial aesthetics and function postoperatively. Clinical evaluation revealed that the post-nasal changes were significant with no nasal obstruction. Statistically, the results were significant (p<0.05). CONCLUSION: Although our sample is small, this study would assist in some preliminary conclusions. From our present study, in the view of a distinct deformity of the internal and external nose associated with cleft lip/nose/palate in adolescents or adults, septal rhinoplasty or rhinoplasty alone provides good aesthetics and functional results.