Chemotherapy for Salivary Gland Malignant Carcinoma : Meta-analysis and Systemic Review.

 The primary form of treatment for salivary gland cancer is surgical resection. Radiation therapy is used as adjuvant therapy in cases of aggressive tumours, currently patients with recurrent or metastatic cancer who are not suitable for surgery or radiation are most often treated with chemotherapy. PRISMA guidelines for systematic reviews were followed to evaluate salivary gland malignancies involving cytotoxic chemotherapy and biologic agents. An electronic literature search of Medline, PubMed, Scopus, etc. was performed and relevant articles were selected based on the inclusion criteria. Cytotoxic chemotherapies and biologic drugs such as anti HER - 2, anti-EGFR and anti-C-Kit are used to treat salivary gland cancer. Although most trials have respond poorly to standard chemotherapy with short durability and significant toxicity. Most of the research has focused on ACC and the use of combination therapy with cisplastin in conjunction with other treatments has been found to improve overall survival rate. Due to the limited patient population it was difficult to assess the efficacy of chemotherapy, which achieved very modest results. There are potential molecular targets such as HER2,NTRK and targeted treatments are becoming more popular. However to further explore potential treatment alternatives SGC patients should be enrolled in clinical trials.

Anaesthetic and Surgical Considerations in Post COVID-19 Patients Requiring Head and Neck Surgery.

As the cases of COVID-19 have declined, the number of patients who have recovered from the dreaded disease is reporting for elective or emergency surgeries. Surgical planning in patients who have recovered from COVD-19 requires special considerations because of the morbidity and mortality associated with the infection and its devastating after-effects. There is a distinct paucity of literature on guidelines and protocols to follow in the perioperative management of these patients. With the help of experience gained over the past 2 years of the 'COVID-19 era', we have been able to establish important recommendations, guidelines and useful protocols during perioperative management of COVID-recovered patients. These protocols include important anesthetic and surgical considerations, which are both practical as well as implementable and are also in cognizance with government-laid down advisories. Although SARS-CoV-2 infection primarily affects the pulmonary and cardiac systems, it has the potential for serious and severely affect multiple organs and various other body systems in erratic and unpredictable manner. All of these factors can have significant implications that make the perioperative management of post-COVID-19 patients, difficult and challenging. Considering the far-reaching and long-lasting effects of this infection on the human body, the protocols and recommendations presented in this article can serve as a valuable guide for clinicians to effectively manage the surgical patient and help reduce perioperative complications attributable to COVID-19 infection.

Unusual case of Trigeminal Neuralgia Associated with Poland -Moebius Syndrome.

Moebius Syndrome is a rare congenital neurological condition characterized by paralysis of several cranial nerves, commonly the VI(Abducens) and VII(Facial) cranial nerves which causes lateral gaze strabismus and internal strabismus & classical mask like appearance respectively. Other cranial nerves such as V, VII, IX, X, XI, XII are rarely affected. Von Graefe and German neurologist Moebius (1888), after whom the syndrome was eventually named, provided the earliest descriptions of it. Although the etiopathogenesis is unknown, it appears to occur sporadically in the majority of cases, and some documented cases show hereditary predisposition. This paper presents a rare instance of trigeminal neuralgia associated with Moebius syndrome. According to the author's research, this is the first case of Poland Moebius syndrome with trigeminal neuralgia documented from India.

Kinesiologic Tape on Post Operative Swelling, Pain, Trismus in Zygomatico-Maxillary Complex Fracture after Orif: A Changing Tactics.

There has been always a need of new methods to control post operative complications in OMFS. A randomized prospective study was done to assess the effect of K tape on postoperative swelling, pain, trismus in Zygomatico-maxillary Complex (ZMC) fracture after open reduction with internal fixation using two point fixation. 30 patients of either gender undergoing ORIF for ZMC fracture using two point fixation of age group between 18 and 50 years were included in the study. Patients were divided into treatment either with or without Kinesiologic tape. Tape was applied directly after surgery and maintained for at least 5 days postoperatively. Facial swelling was quantified using a five-line measurement at six specific points of time. Pain and degree of mouth opening was measured. Patient's subjective feeling was asked. The values were subjected to Fischer's exact test, Independent sample test, Mann whitney U test, Wilocoxon sign rank test. The results of this study show that application of Kinesiologic tape after zygomatico maxillary complex fracture surgery significantly reduced the incidence of swelling with an earlier resolution of swelling, and decreased the maximum turgidity for more than 60% during the first 2 days after surgery. Although, Kinesiologic tape has no significant influence on pain control but reduction in trismus in the Kinesiologic tape group compared to the non-Kinesiologic tape group. Furthermore, patients with Kinesiologic tape felt significantly lower morbidity than those without Kinesiologic tape. This study suggests that Kinesiologic tape is a promising, simple, less traumatic, economical approach, which is free from adverse reaction and improves patients quality of life.

Soft Skills and Psychosocial Counselling in COVID-19 Times: the Changing Tactics.

Introduction: As the COVID-19 pandemic is increasingly griping the world, it starts effecting the psychosocial health of the patients, health care workers, frontline workers and their dependents. The entire landscape of existing patient psychological counselling and management needs to be changed to avoid fear and misinformation about COVID-19. Material and methods: In this article, we have tried to summarize the rules, regulations and protocols in accordance with government guidelines along with practical implementation of counselling in management of psychological health condition of patients and frontline workers. Conclusion: If used wisely and as per recommendations, psychosocial counselling is a very useful tool in the present COVID-19 pandemic, to avoid spread of misinformation, fear and grief about the disease which creates mental health issue and anxiety among close contacts as well as health care workers.

Compare the Efficacy of Open Reduction and Internal Fixation of Mandibular Fractures With and Without Use of Intra-Operative Inter-Maxillary Fixation.

Mandible fractures are regularly encountered by maxillofacial surgeons and various treatment protocols are available for the management of these fractures. The aim of study compares the efficacy of open reduction and internal fixation of mandibular fractures with and without use of intra-operative inter-maxillary fixation. Twenty patients between age group ranging l8-65 years who reported with single mandibular fracture in Dental college in India, during Oct 2012-March 2015 were the study subjects. These patients were divided into two groups. In one group fracture reduction was done by using inter-maxillary fixation and miniplate fixation was done. In other group fracture reduction was done manually and then fractured fragments were held in position by the assistant and miniplate fixation was done. Post-operatively patients were evaluated for occlusion, bone alignment and soft tissue/hard tissue infection at 1st, 4th, 8th, 12th weeks in both the groups. Statistics done by using Spearman's Rank correlation coefficient and Mann-Whitney U test. It was observed thatthere was no statistically significant difference seen in both the groups in terms of post-operative occlusion, radiological alignment and soft/hard tissue infection. Statistically significant difference was seen when the mean operating time was compared. The Group A showed mean difference of 35.50 min more time than Group B. The results of our study suggested that, use of intra-operative IMF does not show any advantages in terms of post-operative occlusion, bone alignment and soft/hard tissue infection. We have concluded from the study that the increased intra-operative time for the placement of IMF increases the cost of the surgery in regard to equipment and theatre time. There is no benefit in terms of radiographic and clinical outcome. Hence use of intra-operative IMF can be avoided for ORIF of single mandibular fracture.

Role of Telemedicine for Facio-Odontogenic Pain Management During COVID-19 Pandemic.

INTRODUCTION: As the COVID-19 pandemic is increasingly griping the world, the entire landscape of existing patient management needs to be changed to avoid spread of Corona virus. In cases of emergencies, there is no option other than getting in-person consultations with doctors. But, in non-emergency patients, telemedicine can serve as a boon. MATERIAL AND METHODS: In this article, we have tried to summarize the rules, regulations and protocols in accordance with government guidelines along with practical management for urgencies in dento-/oro-facial pains. CONCLUSION: If used wisely and as per recommendations, telemedicine is a very useful tool in the present COVID-19 pandemic, to avoid spread of infection to patients as well as health care workers.