An Unusual Case of Deep Vein Thrombosis After Orthognathic Surgery: A Case Report and Review of the Literature.

Deep vein thrombosis (DVT) is caused primarily by obstruction of blood flow in the deep veins in the lower limbs. It is a form of thrombophlebitis and can be a major cause of morbidity and mortality in hospitalized patients. This report describes an unusual case of DVT in a 21-year-old woman with Class III malocclusion who underwent bimaxillary orthognathic surgery (bilateral sagittal split osteotomy and Le Fort I osteotomy) under general anesthesia. She developed DVT unexpectedly 1 week after surgery, with episodes of sweating and chills in addition to lower limb edema, tenderness, and rigidity. D-dimer laboratory testing and venous Doppler sonography were performed and the DVT diagnosis was confirmed; therefore, the patient was admitted to the intensive care unit for anticoagulant and supportive therapy. Although the incidence rate of thromboembolism in hospitalized patients undergoing oral and maxillofacial surgery is low, it is not an operation without risk of DVT. This complication can cause fatal acute pulmonary thromboembolism and death. This case study illustrates that pharmacologic treatment of menorrhagia with mefenamic acid combined with intraoperative use of tranexamic acid for control of blood loss might put the patient at increased risk of DVT. Hence, maxillofacial surgeons should assess all their patients preoperatively for thromboembolism risk; if they suspect any risk factors in the patient, prompt diagnostic tests and management should be ordered.

Comparison of the frequency of psychiatric disorders among patients with chronic low back pain and control group.

BACKGROUND: Low back pain (LBP) is one of the most common complaints of patients referred to the clinics. Studies indicated that psychosocial factors have great impact on the patients' complaints and disability. The aim of this study was to evaluate a broad range of psychiatric disorders in patients with chronic LBP (CLBP) and compare them with those of the control group. PATIENTS AND METHODS: We applied Symptom Checklist 90-R to compare 50 CLBP patients in the case group with 100 participants without it in the control group. The questionnaire measured somatization, obsessive-compulsive disorder, depression, anxiety, phobic anxiety, hostility, interpersonal sensitivity, paranoid ideation, and psychoticism. RESULTS: Average "global severity index" was 1.10 in the case and 0.5 in the control group. Average "positive symptom total" was 45.26 in the case and 27.41 in the control group. Average "positive symptom distress index" was 2.50 in the case and 1.50 in the control group. Average scores for all test dimensions were significantly different between the two groups (P = 0.00). CONCLUSIONS: All dimensions were significantly more common in CLBP patients. Therefore, early diagnosis and treatment of these disorders may improve the outcome of CLBP.