Risk factors associated with short-term complications in mandibular fractures: the MANTRA study-a Maxillofacial Trainee Research Collaborative (MTReC).

INTRODUCTION: Complications following mandibular fractures occur in 9-23% of patients. Identifying those at risk is key to prevention. Previous studies highlighted smoking, age and time from injury to presentation as risk factors but rarely recorded other possible confounders. In this paper, we use a collaborative snapshot audit to document novel risk factors and confirm established risks for complications following the treatment of mandibular fractures. METHODS: The audit was carried out by 122 OMFS trainees across the UK and Ireland (49 centres) over 6 months, coordinated by the Maxillofacial Surgery Trainees Research Collaborative. Variables recorded included basic demography, medical and social history, injury mechanism and type, management and 30-day outcome. RESULTS: Nine hundred and forty-seven (947) patients with fractured mandibles were recorded. Surgical management was carried out in 76.3%. Complications at 30 days occurred 65 (9%) of those who were managed surgically. Risk factors for complications included male sex, increasing age, any medical history, increasing number of cigarettes smoked per week, increasing alcohol use per week, worse oral hygiene and increased time from injury to presentation. DISCUSSION: We have used a large prospective snapshot audit to confirm established risk factors and identify novel risk factors. We demonstrate that time from injury to presentation is confounded by other indicators of poor health behaviour. These results are important in designing trial protocols for management of mandibular fractures and in targeting health interventions to patients at highest risk of complications.

An update on prevalence and risk of snus and nicotine replacement therapy during pregnancy and breastfeeding.

AIM: In parallel with falling smoking rates, use of the oral moist tobacco product snus increases among women in reproductive age. We report an update on prevalence and effects of maternal use of snus and nicotine replacement therapy (NRT) during pregnancy and breastfeeding. METHODS: A literature search of human studies in Medline, PubMed and EMBASE was conducted from September 2016 to May 2018, with stepwise screening of abstracts and subsequent relevant full-text papers for inclusion in Scandinavian and English languages. RESULTS: Based on three studies, the prevalence of snus use in pregnancy was up to 3.4% in the first trimester and 2.1% in the third trimester. In 12 studies, we found increased risk of several adverse effects, especially preterm delivery, stillbirth and small for gestational age associated with maternal snus use during pregnancy. Knowledge on effects of NRT during pregnancy was conflicting and inconclusive in 10 studies. We did not identify any studies on prevalence or potential health effects of snus or NRT during breastfeeding. CONCLUSION: Few studies with updated data on the prevalence and adverse health effects of maternal use of snus and NRT during pregnancy were found. No studies during breastfeeding were identified.

Cochlear function in chronic kidney disease and renal transplantation: a longitudinal study.

Hearing loss on pure-tone and brainstem-evoked response audiometry is well documented in chronic kidney disease patients, but there are only scant data in renal allograft recipients. The aim of this study was to evaluate cochlear function on pure-tone and brainstem-evoked response audiometry among patients of chronic kidney disease to document changes after renal transplantation. The study included 20 healthy controls and 40 patients: 10 each at stage 3 and 4 and 20 with stage 5 chronic kidney disease. Patients with known causes for hearing loss were not included. Patients with stage 5 chronic kidney disease were reevaluated 1 year after renal transplantation. Compared with healthy controls, chronic kidney disease patients showed a highly significant bilateral sensorineural hearing loss at all frequencies of 0.25 to 8.0 kHz, which was more marked in higher frequencies. A highly significant delay in the latencies of waves I, III, and V and interpeak latencies of I to III and I to V was also noted on brainstem-evoked response audiometry. Compared with their pretransplant values, there was a significant improvement in the delay in absolute latencies of I, III, and V among renal allograft recipients. There was no correlation of audiometry findings with gender, degree of renal failure, and serum sodium. Hearing loss was seen in 70% of stage 3 and 4 chronic kidney disease and 60% in stage 5. The intensity of hearing loss was variable. In conclusion, chronic kidney disease patients shows definitive audiologic dysfunction with some improvement in hearing and wave latencies after successful renal transplantation.

A study of the risk factor profile of cardiovascular diseases in rural Punjabi male patients.

One hundred rural Punjabi males (40-60 years old) admitted to Hero DMC Heart Institute, Ludhiana with first cardiac attack were studied to identify major determinants of cardiovascular diseases (CVD) among this group. The results revealed that 20% and 56% of the subjects were smokers and alcohol takers, respectively. Smoking had a significant (p< or =0.01) correlation with serum LDL-C, triglycerides and systolic blood pressure. 84% had sedentary life style. 36% and 7% of the subjects were overweight and obese. The body mass index was positively and significantly (p< or =0.01) correlated with serum triglycerides. 32% and 20% of the subjects had systolic and diastolic blood pressure above normal. 22% were diagnosed for hyperglycemia. 6% suffered from hypercholesterolemia and 28% had borderline high values of serum cholesterol. 22% and 6% had high triglyceride and LDL-C levels, respectively. The study concluded that the etiology of CVD is multifactorial and no single factor is an absolute cause among the rural Punjabi male patients. Therefore, desirable modification in diet and life style can significantly reduce the risk of CVD among rural males of Punjab.

Serum ferritin as a measure of iron stores in the college girls.

The average daily iron consumption of the college girls was 48 per cent of the recommended dietary allowances of ICMR (1990). The Hb level was below the normal value. The values of serum iron, transferrin saturation (TS) and unsaturated iron bearing capacity (UIBC) were in the normal range but near the lower margin. The TIBC was above the normal range. The serum ferritin values showed very poor iron stores. A highly significant (p < 0.01) correlation was observed between Hb, serum iron and TS with serum ferritin. There is a superiority of ferritin over other blood parameters as it indicates the liver iron stores, hence, a better predictor of iron deficiency status.

Degradation and induction specificity in actinomycetes that degrade p-nitrophenol.

We have isolated two soil bacteria (identified as Arthrobacter aurescens TW17 and Nocardia sp. strain TW2) capable of degrading p-nitrophenol (PNP) and numerous other phenolic compounds. A. aurescens TW17 contains a large plasmid which correlated with the PNP degradation phenotype. Degradation of PNP by A. aurescens TW17 was induced by preexposure to PNP, 4-nitrocatechol, 3-methyl-4-nitrophenol, or m-nitrophenol, whereas PNP degradation by Nocardia sp. strain TW2 was induced by PNP, 4-nitrocatechol, phenol, p-cresol, or m-nitrophenol. A. aurescens TW17 initially degraded PNP to hydroquinone and nitrite. Nocardia sp. strain TW2 initially converted PNP to hydroquinone or 4-nitrocatechol, depending upon the inducing compound.

Genetic analyses for certain plant and ear characters in pearl millet top-crosses.

Combining ability and the genetics of tiller number, days taken to flower and ear thickness were studied in top-cross progenies of pearl millet. General combining ability seemed to be more important for all the characters. The prevalence of epistatic variation, presumably of the type additive x additive, additive x dominance and dominance x dominance gene effects, with a non-significant contribution of additive and dominance components of genetic variance, was observed for tiller number. For days taken to flower, the importance of additive genetic variance was greater than that of the dominance component with directional dominance towards the recessive allele. However, for ear thickness, the existence of additive genetic variability together with the additive x additive type of genic interaction was suggested.An appreciable effect of epistasis on[Formula: see text] andH 1 components was observed for tiller number, whereas this effect was not so marked for other characters.