Comparison of Clinical Efficacy of Screw-retained Arch Bar vs Conventional Erich's Arch Bar in Maxillomandibular Fixation: A Randomized Clinical Trial.

AIM: This study aimed to compare the clinical outcomes of a conventional Erich's arch bar vs a modified screw-retained arch bar in maxillomandibular fixation of mandibular fracture. MATERIALS AND METHODS: This parallel-arm randomized control trial included patients from the outpatient clinic with single favorable mandibular fractures that are indicated for closed reduction. They were subjected to maxillomandibular fixation using conventional Erich's arch bars in the control group and modified screw-retained arch bars in the study group. The outcome measures included operating time, glove perforations, postoperative pain, oral hygiene, fixation stability, occlusion, and mucosal coverage. RESULTS: A total of 20 patients (12 males and 8 females) with a 1:1 allocation ratio were included. There was a significant statistical difference regarding operation time and number of glove perforations in favor of group B as p < 0.001, p = 0.007, respectively. There was a significant statistical difference regarding pain after 1 day (p < 0.001), 1 week (p < 0.001) in favor of group B, and at 4 weeks (p = 0.015), and 6 weeks (p = 0.002) in favor of group A. Regarding oral hygiene at 1 week (p = 0.021) and at 6 weeks (p < 0.001), there was a significant statistical difference in favor of group B. Regarding mucosal coverage at 6 weeks, there was a significant statistical difference in favor of group A (p = 0.005). CONCLUSION: The modified screw-retained arch bar can be considered an alternative to conventional arch bar as it provided less application time and better operator safety. It also showed better patient satisfaction regarding pain and oral hygiene. CLINICAL SIGNIFICANCE: Maxillomandibular fixation with the conventional technique was modified to screw-retained arch bar which is less time-consuming and provides better patient and operator satisfaction. How to cite this article: Elhadidi MH, Awad S, Elsheikh HAE, et al. Comparison of Clinical Efficacy of Screw-retained Arch Bar vs Conventional Erich's Arch Bar in Maxillomandibular Fixation: A Randomized Clinical Trial. J Contemp Dent Pract 2023;24(12):928-935.

[Mathilde Ludendorff (1877-1966): specialist for nervous and mental diseases and Germanic philosopher]. / Mathilde Ludendorff (1877­1966): Nervenärztin und völkische Philosophin.

Mathilde Ludendorff (nee Spiess, widowed von Kemnitz, divorced Kleine) was one of the first women who studied medicine in Imperial Germany. She wrote a feminist doctoral thesis, refuted Sigmund Freud's psychoanalysis early in her career, detected the fraud of Albert von Schrenck-Notzing's spiritualist research, became a specialist for nervous and mental diseases after only 17 months of training with Emil Kraepelin, as his-according to her own words-best pupil, treated General Ludendorff's first wife and soon became his second, developed a Germanic philosophy too radical for Adolf Hitler's taste, was considered as a primary culprit after a first denazification trial in 1949 and contested the expert opinion of her colleague Professor Georg Stertz about her own mental state. Her books are still in print and her Alliance for God Cognizance (Ludendorff) still exists and is monitored by the National Intelligence Agency.

The Biography of Specimen "09.04.1954, 3.4 mm" from the "Blechschmidt Collection of Human Embryos" at Göttingen University with a Special Focus on the Production and Usage of Enlarged 3D Replicas of Embryos in the Anatomical Research on Human Embryos.

The "Blechschmidt Collection of Human Embryos" housed at the Anatomical Institute of Göttingen University (Germany) is an important historical collection of human embryo specimens whose history dates back up to the mid-1940s. It is named after its founder Prof. Erich Blechschmidt (1904-1992). A 2-year research project was conducted from 2017 to 2019 with the aim of clarifying the provenience of the human embryo specimens collected by Blechschmidt. This project not only has provided information on the origin of the specimens but, additionally, led to the discovery of photographic documents illustrating the process by which Blechschmidt built the enlarged 3-dimensional replicas of human embryos that are shown in a dedicated exhibition hall in the basement of the Anatomical Institute. Here, we report on an embryo from the Blechschmidt collection whose biography as a microscopical specimen as well as a source for objects of Blechschmidt's collection of 3-dimensional replicas of human embryos is documented by letters, lab-books, and photographs. Our report is complemented by a short historical review on the production and usage of enlarged 3-dimensional replicas in research on the anatomy of human embryo.

Variability in the Use of Platelet Transfusion in Patients with Intracerebral Hemorrhage: Observations from the Ethnic/Racial Variations of Intracerebral Hemorrhage Study.

BACKGROUND: We examined platelet transfusion (PTx) in the Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study, hypothesizing that rates of PTx would vary among hospitals and depend on whether patients were on an antiplatelet therapy or underwent intracerebral hemorrhage (ICH) surgical treatment. METHODS: The ERICH study is a prospective observational study evaluating risk factors for ICH among whites, blacks, and Hispanics. We identified factors associated with PTx, examined practice patterns of PTx across the United States, and explored the association of PTx with mortality and poor outcome (modified Rankin Scale score 4-6). RESULTS: Nineteen centers enrolled 2572 ICH cases; 11.7% received PTx. Factors significantly associated with PTx were antiplatelet use before onset (odds ratio [OR], 5.02; 95% confidence interval [CI], 3.81-6.61, P < .0001), thrombocytopenia (OR, 13.53; 95% CI, 8.43-21.72, P < .0001), and ventriculostomy placement (OR, 1.85; 95% CI, 1.36-2.52, P < .0001). Blacks were less likely (OR, .57; 95% CI, .41-0.80) to receive PTx. Among patients who received PTx, 42.4% were not on an antiplatelet therapy before onset. Twenty-three percent of patients on antiplatelet therapy received PTx, but percentages varied from 0% to 71% across centers. There was no difference in mortality or poor outcome at 3 months between patients receiving PTx and those who did not. CONCLUSIONS: The frequency of PTx for ICH varies across academic centers. Thrombocytopenia, antiplatelet use, vascular risk factors, and ventriculostomy placement were associated with PTx. PTx was not associated with improved outcomes. We anticipate reduced PTx use over time given recent clinical trial data suggesting its use could be harmful; however, the issue of whether surgical management warrants PTx remains.

Clinical Outcomes of ULTRA EZY Bar vs Erich Arch Bar in Conservative Management of Maxillofacial Fractures: A Randomized Controlled Trial.

Objective: Various techniques have been employed from time to time to achieve maxillomandibular fixation, and arch bars provide an effective and versatile means of maxillomandibular fixation, and however, some of the issues occurring with it have been eliminated with the introduction of Ultralock EZY bar. The aim of the present study is to compare the advantages and disadvantages of Ultralock Ezy bar over the Erich arch bar in mid-face fracture or maxillary fracture or mandibular fracture or both requiring conservative treatment. Materials and Methods: A total of 20 patients reported to the Department of Oral and Maxillofacial Surgery in Sudha Rustagi Dental College and Hospital, Faridabad, with mid-face fracture/maxillary fracture, mandibular fracture or both. The treatment plan required intermaxillary fixation. As a part of treatment plan, group was selected randomly divided into 20 arches in each group that is test arch group and control arch group.Test arch group included arches in which Ultralock EZY bar was done. Control arch group included arches in which Erich arch bar was done. The parameters compared in both the groups were surgical time taken, injuries due to wires, arch bar stability, oral hygiene index, patient acceptance and comfort, pulp vitality, and complication (if any). Results: The average surgical time taken was less, and oral hygiene status and patient acceptance were better in test group. There was not much statistically significant difference in pulp vitality but number of cases with absence of pulp vitality were more in test group. Conclusion: This study emphasizes the use of Ultralock Ezy bar as a quick and easy method than Erich arch bar. Oral hygiene maintenance was comparatively better in patients with Ultralock Ezy bar than those with Erich arch bar. For the patients who require long-term IMF, Ultralock Ezy bars can be a viable option. Supplementary Information: The online version contains supplementary material available at 10.1007/s12663-022-01821-3.

"There is No Reliable Evidence to Pass Moral Judgment on Frauwallner." : Erich Frauwallner, Jakob Stuchlik, Walter Slaje, and the Whitewashing of Austrian Indology During the Time of National Socialism.

This paper engages with a little-known controversy between Jakob Stuchlik and Walter Slaje on the involvement of Erich Frauwallner, the renowned scholar of Indian philosophy (1898-1974), with NS institutions. It sheds new light on this controversy and highlights the Aryan-supremacist ideology that is reflected in Frauwallner's division of the history of Indian philosophy into an Aryan and non-Aryan period. On the whole, the paper sides with Stuchlik and exposes Slaje's attempt to whitewash Frauwallner and certain aspects of his work, despite his adoption of NS ideology and involvement with NS institutions such as the Gestapo and SA. Moreover, the paper dwells on Frauwallner's adherence to antisemitism and Aryan-supremacist ideology even after the WWII and as late as the 1960s.

Comparison of Efficacy and Safety of Hybrid Arch Bar with Erich Arch Bar in the Management of Mandibular Fractures: A Randomized Clinical Trial.

Study Design: A clinical randomized control trial. Objective: To compare the efficacy and safety of Hybrid arch bar (HAB) with Erich arch bar (EAB) in fracture management of the mandible. Methods: In this randomized clinical trial, 44 patients were divided into 2 groups:- Group 1, N = 23 (EAB group) and Group 2, N = 21 (HAB group). The primary outcome was time taken for the application of arch bar, while the inner and outer glove puncture, operator prick, oral hygiene, arch bar stability, complications of HAB, and cost comparison were secondary outcomes. Results: The time taken for the application of arch bar in group 2 was significantly shorter than group 1 (55.66 ± 17.869 min vs 82.04 ± 12.197 min) and the frequency of outer glove puncture was also significantly lesser for group 2 (0 punctures vs 9 punctures). Better oral hygiene was found in group 2. EAB was cost-effective than HAB (Rs 700 ± 239.79 vs Rs 1742.50 ± 257.14). The stability of the arch bar was comparable in both groups. Group 2 had associated complications of root injury in 2 out of 252 screws placed and the screw head got covered by soft tissue in 137 out of 252 screws placed. Conclusions: Thus, HAB was better than EAB with a shorter time of application, less risk of prick injury, and improved oral hygiene.Clinical trial registry name- clinical trials registry- India, URL-http://ctri.nic.in, registration number- CTRI/2020/06/025966.

Management of Lingual Cortex Fracture of Mandible Using Lingual Arch Bar: A Finite Element Analysis of Reduction with a Pilot Clinical Trial.

Purpose: Fractures of lingual cortex are frequently left untreated leading to poor resolution of patient's symptoms and function. Positioning an implant on same side of fracture would provide better reduction. The study aims at improving stability offered by Erich arch bar placed on lingual surface, by Finite element analysis (FEA) along with a pilot clinical trial. Methods: Two FEA models were generated from CT scan of an individual having lingual cortex fracture: control model with labial arch bar and study model with lingual arch bar. Parameters assessed: Stress distribution (Mpa) along lines of osteosynthesis; Separation of fracture fragments (mm) across fracture line. Associated, was a clinical trial of 5 patients, managed by placing lingual arch bar. Feasibility of arch bar, post-operative pain, radiographic inter-fragmentary gap and complications were assessed clinically. Results: Lingual positioning of arch bar demonstrated less displacement (mm) of fracture fragments compared to labial placement (0.123 vs. 0.677) upon application of masticatory load. Insignificant lingual splay and lesser degree of stress distribution (Mpa) was observed (83.1 vs. 99.3) favoring placement of arch bar on lingual side. Clinical trial correlated with outcomes of FEA, resulting in improvement of patient's symptoms. Conclusion: FEA and supporting clinical trial provided an effective method of reduction for lingual cortical fracture.

Introduction: Indology and Aryanism: Knowledge of India in Nazi Germany-An Invitation for New Research.

The introduction to our special issue offers a brief survey of the historical literature on knowledge about India in Nazi Germany and distinguishes three different, but interrelated layers of such knowledge: disciplinary knowledge of Indology as an academic field, knowledge fulfilling the needs of state agencies, and popular knowledge (and beliefs) about India.

The ERICH3 rs11580409 polymorphism is associated with 6-month antidepressant response in depressed patients.

INTRODUCTION: Major Depressive Disorder (MDD) is the current leading cause of disability worldwide. The effect of its main treatment option, antidepressant drugs (AD), is influenced by genetic and metabolic factors. The ERICH3 rs11580409(A > C) genetic polymorphism was identified as a factor influencing serotonin (5HT) levels in a pharmacometabolomics-informed genome-wide association study. It was also associated with response following AD treatment in several cohorts of depressed patients. OBJECTIVE: Our aim was to analyze the association of the ERICH3 rs11580409(A > C) genetic polymorphism with response following AD treatment and plasma 5HT levels in METADAP, a cohort of 6-month AD-treated depressed patients. METHODS: Clinical (n = 377) and metabolic (n = 150) data were obtained at baseline and after 3 (M3) and 6 months (M6) of treatment. Linear mixed-effects models and generalized logistic mixed-effects models were used to assess the association of the rs11580409 polymorphism with the Hamilton Depression Rating Scale (HDRS) score, response and remission rates, and plasma 5HT levels. RESULTS: The interaction between the ERICH3 rs11580409 polymorphism and time was an overall significant factor in mixed-effects models of the HDRS score (F3,870 = 3.35, P = 0.019). At M6, CC homozygotes had a significantly lower HDRS score compared to A allele carriers (coefficient = -3.50, 95%CI [-6.00--0.99], P = 0.019). No association between rs11580409 and 5HT levels was observed. CONCLUSION: Our results suggest an association of rs11580409 with response following long-term AD treatment. The rs11580409 genetic polymorphism may be a useful biomarker for treatment response in major depression.

Are Embrasure Wires Effective and Reliable Method for Intraoperative Maxillomandibular Fixation in Mandibular Fractures?

Purpose: Maxillomandibular fixation (MMF) is a basic and fundamental principle in the management of the maxillofacial trauma patients. Some fractures require only intraoperative MMF, during open reduction and internal fixation but not in the postoperative period. The present study was aimed to assess and compare the efficacy of embrasure wire with Erich arch bar as methods of intraoperative maxillomandibular fixation in the management of mandibular fractures. Materials and Methods: The prospective randomized study was undertaken in 30 patients who required intraoperative maxillomandibular fixation for mandibular fractures. Patients were randomly divided into two groups of 15 each (Erich arch bar in Group A and embrasure wire in Group B). The preoperative assessment included evaluation of demographic data, fracture location, mechanism of injury, degree of displacement of fracture and occlusion. Intraoperative parameters assessed were the time consumed for the application of MMF technique, injury to the operator/assistant, injury to the patient, stability of MMF technique, incidence of glove perforations and the cost of the MMF device. Results: The mean time required for MMF and incidence of glove perforation were significantly (P < 0.001) less in embrasure wire group than the Erich arch bar group. The MMF technique maintained stable occlusion during open reduction and internal fixation in both the groups. Conclusion: Embrasure wire is an effective, reliable alternative form of intraoperative MMF, as needle-stick injury and time taken for placement were less as compared to the Erich arch bar group. However, Erich arch bar wiring is a versatile method and recommended where postoperative maxillomandibular fixation is also required.

Dental Trauma and Alveolar Fractures.

A dentoalveolar fracture requires thorough clinical and radiographic examination for an accurate diagnosis to guide appropriate treatment. Dentoalveolar fractures can be classified into the following 4 groups: (1) crown/root fractures, (2) luxation/displacement of teeth, (3) avulsion, and (4) alveolar fractures. Treatment can be divided into nonrigid fixation (splinting with wires and composite) and/or rigid fixation (Erich arch bars, Risdon cable wires) depending on the extent of dentoalveolar fractures. Special considerations must be made for primary teeth and mixed dentition to avoid injuring tooth buds and arising permanent dentition.

Comparison between Erich arch bars and intermaxillary screws in maxillofacial fractures involving the dental occlusion: a meta-analysis.

This systematic review aimed to compare the Erich arch bars (EABs) with intermaxillary fixation (IMF) screws in maxillofacial fractures involving dental occlusion on perioperative parameters. Four electronic databases were searched: MedLine (Pubmed), Web of Science, VHL, and Cochrane Library. Inclusion criteria comprised clinical trials comparing the two IMF methods, assessing at least one of the outcomes: occlusal stability, oral hygiene, quality of life, time to apply and remove IMF appliances, and complications. Risk of bias was evaluated through the Cochrane risk of bias tool. Fifteen papers were included in the qualitative analysis and 12 of those in the meta-analysis. Times for EABs application (mean difference (MD) 46.83; 95% confidence interval (CI): 30.63-63.02) and removal (MD 22.89; 95% CI 14.61-31.17) were longer compared with IMF screws. There is higher risk of glove perforation (risk ratio (RR) 3.81; 95% CI 2.41-6.04) and lower risk of iatrogenic injuries (RR 0.21; 95% CI 0.09-0.48) when placing EABs compared with IMF screws. No significant differences in plaque index were found (MD 1.07; 95% CI -0.17 to 2.31). The quality of this evidence ranged from very low to low and was mainly compromised by risk of bias assessment. Further studies are necessary to evaluate transurgical IMF stability and postoperative occlusal quality and quality of life when comparing EABs with IMF screws.

What is a better modality of maxillomandibular fixation: bone-supported arch bars or Erich arch bars? A systematic review and meta-analysis.

Any procedure that aims to manage maxillofacial fracture is incomplete without meticulous maxillomandibular fixation (MMF). For decades, Erich arch bars (EABs) have been used for this purpose, but with the advent of bone-supported arch bars (BSABs), more surgeons now prefer them to conventional EABs. The present study was designed to identify which of the two methods is best. An exhaustive literature search was conducted in June 2020 on various electronic databases to select studies that compared EABs and BSABs. Outcomes such as duration of placement, stability, oral hygiene, and complications such as damage to the roots of teeth and needle-stick injury, were analysed. A total of 716 studies were identified, of which seven were eligible for inclusion. The meta-analysis showed that the use of BSABs is significantly faster with no needle penetration and better oral hygiene. Both arch bars are equally stable, but root damage is an associated complication. The available literature to date shows that BSABs are a better option than EABs. However, further research is recommended, as these studies are associated with various confounding factors.

Is the Use of Intermaxillary Fixation Screws an Alternative to Erich Arch Bars for Maxillomandibular Fixation During Management of Maxillofacial Fractures? A Systematic Review and Meta-Analysis.

STUDY DESIGN: Systematic review and meta-analysis. OBJECTIVE: Maxillomandibular fixation (MMF) is a step of paramount importance during the management of maxillofacial trauma. Erich arch bars are being used for this purpose for decades but with advances in maxillofacial trauma management, intermaxillary fixation screws came into existence and are being used routinely. The present study was designed to identify if the intermaxillary fixation screws are really an alternative to Erich arch bars for management of maxillofacial trauma. METHODOLOGY: An exhaustive literature search was conducted in May 2020 on various electronic databases and studies comparing Erich arch bars and intermaxillary fixation screws were recruited for the analysis. Random-effects model with Mantel Haenszel statistics was used to analyze oral hygiene and duration of achieving MMF. RESULTS: A total of 96 studies were identified, out of which 8 studies were included in the meta-analysis. There was no statistically significant difference in oral hygiene status of the patients in both the groups. Intermaxillary fixations screws required statistically significantly less time in achieving MMF. Needle stick injury was prominently seen with the use of Erich arch bar whereas other complications like mucosal coverage, root injury, screw loosening and screw fracture makes the use of intermaxillary fixation screws questionable. CONCLUSION: The present meta-analysis suggests that there is not enough evidence to recommend the use of intermaxillary fixation screws as an alternative to Erich arch bars. Further research with large sample size, high quality evidence and better methodology is recommended in this direction.

The Use of Screw Retained Hybrid Arch Bar for Maxillomandibular Fixation in the Treatment of Mandibular Fractures: A Comparative Study.

Introduction: The use of screw-retained hybrid arch bars (HABs) is a relatively recent development in the treatment of mandibular fractures. The purpose of this study is to compare the clinical outcome between HAB and the conventional Erich arch bar (EAB) in the closed treatment of mandibular fractures. Materials and Methods: This study included 18 patients who were treated for mandibular fractures with maxillomandibular fixation (MMF), patients were randomly assigned into a control group (n = 10) in which EAB was used and study group (n = 8) in which HAB was used. The outcome variables were time required for application and removal, gingival inflammation scores, postoperative complications, and incidence of wire-stick injury or gloves perforation. The groups were compared using unpaired t-test, Mann-Whitney test, Chi-square test, or Fisher test. The differences were considered significant at P < 0.05. Results: The mean application time was significantly more in EAB than HAB (61.6 ± 11.4 vs. 41.6 ± 6 min, respectively). The mean time of removal for EAB was significantly less than HAB (11.1 ± 2 vs. 14.2 ± 3 min, respectively). There was nonsignificant difference in gingival inflammation between the groups. No major complications were recorded. Screw loosening and mucosal overgrowth were recorded in 12.5% and 31.2% of the screws, respectively, in HAB group. The incidence of gloves tear in EAB group was 70%. Discussion: HAB can be used as an alternative to EAB for MMF in patients with mandibular fracture, it requires less time for application and provides more safety for the surgeons.

Long non-coding RNA ERICH3-AS1 is an unfavorable prognostic factor for gastric cancer.

Long non-coding RNAs (lncRNAs) play important roles in gastric cancer (GC), but the mechanism is not fully clear. ERICH3-AS1 (ERICH3 antisense RNA1) is affiliated with the non-coding RNA class which has proven to be involved in the prognostic of GC, but the function of ERICH3-AS1 is still unclear. In this study, we aim to explore the potential function of ERICH3-AS1 in the development of GC and analyze the prognostic role of ERICH3-AS1 in GC. We found that the lncRNA ERICH3-AS1 was significantly up-regulated in GC tissues in the analysis of The Cancer Genome Atlas (TCGA) data; the Kaplan-Meier analysis showed that the higher the expression of ERICH3-AS1 was, the earlier the recurrence and the poorer the prognosis would be in patients. Cox univariate and multivariate analyses revealed that ERICH3-AS1 was a risk factor of disease-free survival (DFS) (p < 0.05) and overall survival (OS) (p < 0.05) of patients. Through Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses, it demonstrated that the ERBB pathways, the mitogen-activated protein kinase (MAPK) pathways, the MTOR pathways, p53 pathways and Wnt pathways were differentially enriched in ERICH3-AS1 high expression phenotype. Furthermore, the correlation analysis showed that ERICH3-AS1 had significant correlations with apoptosis-related proteins such as BCL2L10 and CASP14; cell cycle-associated proteins CDK14 and invasion and migration-associated proteins such as MMP20, MMP26 and MMP27. In summary, we identified that increased ERICH3-AS1 might be a potential biomarker for diagnosis and independent prognostic factor of GC. Moreover, ERICH3-AS1 might participate in the oncogenesis and development of tumors via cell cycle and apoptosis pathway mediated by ERBB, MAPK, MTOR, p53 and Wnt pathways.

A Comparative Randomized Prospective Clinical Study on Modified Erich Arch Bar with Conventional Erich Arch Bar for Maxillomandibular Fixation.

INTRODUCTION: Erich arch bar used for maxillomandibular fixation (MMF) since decades has several disadvantages such as risks of injury, additional operating room time, and gingival trauma. To overcome these downsides, modified Erich arch bar was introduced; however, there is not much available literature, indicating the efficacy of modified Erich arch bar over that of conventional arch bar wire. Therefore, the present study focuses on comparing efficiency of modified arch bar with conventional arch bar. MATERIALS AND METHODS: This comparative randomized study was conducted on 32 patients that required MMF and were divided into Group A patients who received intermaxillary fixation (IMF) with modified Erich arch bars and Group B patients with conventional Erich arch bars. The parameters recorded were average surgical time required, wire prick injuries, IMF stability, occlusal stability, screw loosening, oral hygiene status, and vitality response of the teeth. The variables were statistically analyzed using Student's t-test and Wilcoxon signed-rank test. RESULTS: The wire prick injury, intraoperative time noted in Group A was significantly reduced in comparison to Group B (P < 0.0001). Debris indices were significantly good in Group A in comparison to Group B (P < 0.0001). Nonvitality response of tooth was significantly more in Group B than in Group A patients (P < 0.05). DISCUSSION: The efficiency of modified Erich arch bar group was superior to the conventional arch bar with very limited restrictions.

Haven or Limbo? Neuroscientist Refugees From National Socialism Escape to Illinois.

At least 9 neuroscientists immigrated from Nazi Europe to Illinois to escape tyranny and attempt to re-establish their careers. Some work has been published in print on eponymous neuroscientist Adolf Wallenberg, as well as 2 others but not on Ernst Haase, Frederick Hiller, Erich Liebert, Bruno Volk, Heinz (Henry) von Witzleben, or Gerhard Pisk. Before leaving Germany or Austria, these downtrodden specialists were dismissed from long-held posts sometimes for trumped-up charges, stripped of their financial security, and forced to leave relatives behind. At least 1 left only for personal and political, but not because of racial, reasons. Illinois, in exemplary fashion, welcomed these unfortunate survivors more than many other states because of limited licensing requirements, numerous opportunities at state hospitals, and special internship programs. Some of them successfully continued their research agendas and published, taught neurology students and trainees, and added to the expansion of neurologic care in Illinois or elsewhere, but most of them took years to reacquire the academic rank they lost and never regained their career momentum. These refugees survived and passed on some of their extensive training and expertise to a new generation of neuroscientists in America, but not without significant cost.

A prospective comparative clinical study on modified screw retained arch bar (SRAB) and conventional Erich's arch bar (CEAB).

INTRODUCTION: Intermaxillary fixation (IMF) is commonly performed in the management of facial skeleton fractures. Various conventional methods like Erich's arch bar and Ivy eyelet wiring are the most commonly employed methods for achieving IMF, but they have their own disadvantages. Conventional Erich's arch bar (CEAB) has been modified recently by making perforations in the spaces between the winglets and securing the arch bar using 1 mm screws. IMF using intraoral modified screw retained arch bar (SRAB) has been introduced for the treatment of mandibular fractures. The aim of this study was to compare the efficacy, advantages, disadvantages, indications, and potential complications associated with CEAB versus modified SRAB in the management of mandibular fractures. MATERIALS AND METHODS: A randomized prospective study included 20 patients with mandibular fracture who were randomly allotted to two groups. Group A patients received modified SRAB and group B patients received CEAB. The parameters considered were time taken to place the arch bar, perforation in the gloves, patient acceptance, oral hygiene, iatrogenic dental injuries, and needle (wire) stick injuries during IMF. RESULTS: The mean time taken for arch bar placement was 27.20 min with modified SRAB as compared with 82.50 min with CEAB. Incidence of glove perforations was more in group B patients. Oral hygiene status was good in 90% of the patients from group A whereas it was 100% fair in group B patients. CONCLUSION: This study has shown that both the techniques achieve satisfactory IMF with post-operative occlusion. IMF with modified SRAB reduces the operating time and the incidence of the needle (wire) prick injuries. But modified SRAB has its own limitations in spite of its ease of application.