Principle of Lag-Screw Fixation in Mandibular Trauma.

AIMS AND OBJECTIVES: The aim of the study is to assess the effectiveness of lag screw fixation in mandibular fractures with respect to parameters such as stability of the occlusion, functional stability, infection rates, neurosensory deficit, ease of technique, and maximum interincisal opening. MATERIALS AND METHODS: Our study was carried out on 13 patients with mandibular fractures. Selected cases were treated with lag screw technique and 2.7 mm titanium screws were used. Postoperative complications such as wound dehiscence, infection, neurosensory disturbance, nonunion, malocclusion, postoperative mouth opening, and occlusal discrepancies were assessed. RESULTS: All the patients were male, aged between 17 and 50 years. The cause of the injury was road traffic accidents in all, except for two assaults. Our study of 13 cases of fractured mandible included five symphyses, five parasymphyses, two angle, and one body fracture cases. Our observation with open reduction and rigid internal fixation with 1-2 lag screws revealed close approximation of fractured fragments in all the cases, except in three patients who had mild discrepancy of occlusion. CONCLUSION: Lag screw technique provides good interfragmentary compression and restoration of premorbid anatomic alignment of fracture fragments. In displaced mandibular fractures, especially in oblique fractures, the use of lag screw has proven to be ideal. The complications were found to be low. It was concluded that the lag screw provided excellent stability and occlusion.

Acetate Kinase (AcK) is Essential for Microbial Growth and Betel-derived Compounds Potentially Target AcK, PhoP and MDR Proteins in M. tuberculosis, V. cholerae and Pathogenic E. coli: An in silico and in vitro Study.

BACKGROUND: Mycobacterium tuberculosis, Vibrio cholerae, and pathogenic Escherichia coli are global concerns for public health. The emergence of multi-drug resistant (MDR) strains of these pathogens is creating additional challenges in controlling infections caused by these deadly bacteria. Recently, we reported that Acetate kinase (AcK) could be a broad-spectrum novel target in several bacteria including these pathogens. METHODS: Here, using in silico and in vitro approaches we show that (i) AcK is an essential protein in pathogenic bacteria; (ii) natural compounds Chlorogenic acid and Pinoresinol from Piper betel and Piperidine derivative compound 6-oxopiperidine-3-carboxylic acid inhibit the growth of pathogenic E. coli and M. tuberculosis by targeting AcK with equal or higher efficacy than the currently used antibiotics; (iii) molecular modeling and docking studies show interactions between inhibitors and AcK that correlate with the experimental results; (iv) these compounds are highly effective even on MDR strains of these pathogens; (v) further, the compounds may also target bacterial two-component system proteins that help bacteria in expressing the genes related to drug resistance and virulence; and (vi) finally, all the tested compounds are predicted to have drug-like properties. RESULTS AND CONCLUSION: Suggesting that, these Piper betel derived compounds may be further tested for developing a novel class of broad-spectrum drugs against various common and MDR pathogens.