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BACKGROUND: Leukaemia can be reliably diagnosed and classified by the simultaneous application of multiple techniques. Cytochemical stains that are cheap and do not require any special instruments are very important in developing countries for the diagnosis of acute leukaemia (AL). AIM: To diagnose AL in all suspected cases by flow cytometry and to correlate the diagnosis with morphological and special staining like myeloperoxidase (MPO) and periodic acid-Sciff (PAS) techniques. Methods and materials: The study participants' peripheral blood smear details and bone marrow aspirate smear morphologic findings, as well as socio-demographic information, were taken from the patients' medical files. In total, 57 newly diagnosed instances of acute leukaemia confirmed by flow cytometry were incorporated into the study, which underwent cytochemical labeling and morphological diagnosis. All patients who gave previous consent had their bone marrow aspirated, and a Wright-stained smear was produced for microscopic inspection, cytochemical staining, and immunophenotyping. In an ethylenediaminetetraacetic acid (EDTA) container, peripheral blood was also drawn for the same purpose. During the entire bone marrow smear examination, we used both MPO and PAS staining techniques. RESULTS: The study was carried out between July 2019 and June 2020. Out of 57 cases in the study, 29 (50.9%) cases on cytochemical analysis of leukaemia using PAS and MPO were diagnosed with acute myeloid leukaemia (AML) and 28 (49.1%) were diagnosed as acute lymphoid leukaemia (ALL). Cytochemical analysis of leukaemia using PAS and MPO rendered the diagnosis in 92.9% of acute leukaemia cases in our study. A total of 25 out of 25 AML cases and 28 out of 32 cases of ALL were correctly diagnosed based on morphology and cytochemical staining. Morphology and cytochemical analysis alone were unable to correctly diagnose a total of four ALL cases. All AML cases that were wrongly diagnosed as ALL were mostly M0 and M1-AML. CONCLUSION: Morphological staining diagnosis by itself is capable of correctly identifying a large proportion of cases of AL, which comprised 92.98% of total cases. There was also a favorable relationship between findings of diagnosis by flow cytometry and findings of diagnosis by morphology assessment in determining acute leukaemias.
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BACKGROUND: Improved patient safety for those undergoing treatment of head and neck cancers depends on prompt identification of warning indicators from severely critical patients and appropriate treatment. As a result, many hospitals all around the world have implemented quick response techniques, including medical emergency teams (MET), which have systems and personnel that are highly trained to deal with patients who are deteriorating. Nowadays, automated activation and alert programs are also being discussed. AIM: To compare the patient outcomes in two conditions: one before the application of the automated MET alert and activation program and the other after the application of the automated MET alert and an activation program was used. METHODS AND MATERIALS: There was an examination of clinical data on MET-managed patients before and after the computerized alert and activation approach was put in place. The study comprised all adult head and neck cancer patients who were treated by the MET between March 1, 2017, and December 31, 2021. The physiologic abnormalities of the patient at the moment of the MET initiation were recorded as causes for MET activation when the MET was alerted by the computerized alert, and activation system. From activation through deactivation, the MET intervention lasted. Hospital mortality served as the study's primary outcome. The duration of stay at the hospital and unscheduled ICU hospitalizations were secondary outcomes. Medical records from hospitals were examined retrospectively to get information on clinical outcomes. RESULTS: The percentage of unplanned admissions in ICU was greater in the pre-implementation stage (22.34%) as compared to that in the post-implementation stage (13.56%) (p value<0.001). The duration of stay of patients at the hospital also got reduced in the post-implementation phase (13.23 ±1.47 days) as compared to the pre-implementation stage (24,76± 1.12 days) (p<0.001). The median time of derangement of activation of MET was greater in the pre-implementation stage (62 minutes) as compared to the post-implementation stage (34 minutes) (p-value <0.001). The most common complications leading to MET activation in a pre-implementation phase were neurological and respiratory complications. On the other hand, overall deterioration was the most common cause of MET activation. The mortality rate of patients in the pre-implementation stage was 36.23% as compared to 22.12% in the post-implementation stage (p<0.001). CONCLUSION: The hospital experienced improved clinical outcomes with the adoption of an automated alarm and activation system using a cumulative weighted scoring methodology, which significantly reduced the time from disruption to MET activation.
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Background: Surgical excision of the problematic mandibular third molars causes substantial tissue damage and an inflammatory response. Discomfort and edema are common postoperative signs and symptoms caused by the latter. To find out whether dexamethasone may help with the edema and pain that come along with the surgical removal of impacted mandibular third molars, researchers have performed clinical studies. Methods: Twenty individuals with bilaterally affected mandibular third molars who were scheduled for extraction participated in a prospective trial. At two separate sessions, teeth were raised and cut after buccal ostectomy. Since the surgical operation on the left foot, both patients were administered a mixture of 4 mg dexamethasone submucosal injection and antibiotics for 3 days. On the 1st, 3rd, and 7th postoperative days, edema and pain were assessed. Results: At the 1st, 3rd, and 7th postoperative days, there was a clinically meaningful decrease in the level of edema and discomfort in both arms. Conclusions: The current report offers empirical proof that administering a 4 mg dexamethasone submucosal injection during surgery greatly reduced post-surgical edema and discomfort.
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BACKGROUND: Malocclusions are expected to affect subjective attraction, social recognition, and intellect. For dentofacial deformities, functional concerns can also arise. The previous research has established a gradient on oral health-related quality of life (OHRQoL) scores through malocclusion intensity, particularly in the social and emotional realms. This study is used to assess the quality of oral health. MATERIALS AND METHODS: A total of sixty patients began orthodontic therapy at a tertiary-care facility. Treatment in the orthodontic clinic is restricted to serious malocclusions. The study was selected from patients who meet the qualifying requirements of extreme malocclusion and orofacial clefting. The research removed patients with diagnosed hereditary syndromes. Patients got either single-arch or double-arch fixed equipment during their orthodontic procedure. Subjects were categorized as orthodontic patients with extreme malocclusions, needing orthodontic therapy, and severe spinal discrepancies, requiring both orthodontic treatment and orthognatic surgery. The overall score of one subject was 0-56, while the domain score was 0-8. Higher ratings for oral health profiles reflect a stronger effect on the relative quality of life of oral health. RESULTS: For the 14 objects, the mean baseline Oral Health Impact Profile-14 (OHIP-14) score for all three categories was not statistically different for about half of the items. For surgery participants, the OHIP-14 baseline scores were nearly twice as large as the scores of the other two categories for each of these things (P = 0.05). There were a lot of statistically important variations involving the categories, and the three most significant ones are revealing pattern here. The multiple comparison power of nonsignificant predictive variables was extremely weak for the area of physical pain is 5.2%; 41.2% of remaining tests, and 84% for the functional limitation and mental deficiency domain. CONCLUSION: Patients receiving a mixture of orthognathic surgery and orthodontic therapy have comparatively low OHRQoL baseline; however in contrast with normal and cleft patients, they still gain the most from care.
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The aim of this simple nonrandomized and observational study was to evaluate the efficacy of single three-dimensional (3D) plate for the treatment of mandibular angle fractures without maxillomandibular fixation. A total of 30 patients with noncomminuted fractures of mandibular angle requiring open reduction and internal fixation were included in the study. All the patients were treated by open reduction and internal fixation using single 3D titanium locking miniplate placed with the help of transbuccal trocar or Synthes 90-degree hand piece and screw driver. 3D locking titanium miniplates used in our study was four-holed, box-shaped plate, and screws with 2 mm diameter and 8 mm length. The following clinical parameters were assessed for each patient at each follow-up visit: pain (visual analog scale: 0-5), swelling (visual analog scale: 0-5), mouth opening, infection, paresthesia, hardware failure (plate fracture), occlusal discrepancies, and mobility between fracture fragments. A significant decrease in pain level was seen during the follow-up visits. No statistically significant changes were seen in swelling, but mouth opening increased in the subsequent visits. Also better results were seen in terms of fracture stability and occlusion in the postoperative period. Two cases of infection and two cases of hardware failure were noted in sixth postoperative week. 3D plating system is an easy to use alternative to conventional miniplates to treat mandibular angle fractures that uses lesser foreign material, thus reducing the operative time and overall cost of the treatment. Better fracture stability and occlusion was also achieved using the 3D plating system.
