Simmonsvillumsen2959
South East Asian noses have a characteristic ala and columella disproportion and mostly manifest as hanging ala. Simultaneous correction during rhinoplasty is recommended to achieve a good aesthetic result. Since hanging ala is a common feature, a classification system is presented as a guide for surgical management. The classification is based on the frontal view showing the alar rim connecting to the columella lobule area simulating the wings of a gull in gentle flight. A mild deformity has the gull's wing in the horizontal direction. A moderate deformity has the gull's wing in a slight inferior direction. A severe hanging deformity has the gull's wing in the inferior direction, ending below the columella lobule area, and this is mostly accompanied by retracted columella. There are various techniques for the surgical correction of hanging ala. The author has made a modification of the internal approach called "sail excision" using the groove within the lateral nasal vestibule as a landmark. The author terms this area as the vestibular groove. Sail excision involves removal of a triangular portion of tissue anterior to this vestibular groove. Another aesthetic deformity noticed in South East Asian noses is that the alar rim base is lower than the columellar base. In correcting hanging ala with involvement of the alar rim base, the sail excision is extended posteriorly following the vestibular groove as its guide to the amount to be excised. To enhance the overall aesthetic outcome, the acute columella labial angle seen in South East Asian noses has to be made fuller through surgery. This is accomplished using septal extension graft for tip projection, with preservation of the posterior angle of the caudal septum. Plumping grafts are used as filler material in the premaxillary area.Osteotomies in rhinoplasty are performed to correct deformities in nasal contour. The size of osteotome used is dictated by the thickness of the bony nasal pyramid along the osteotomy route. The aim of this study is to determine whether nasal bony dimensions differ between different ethnic groups in Singapore. Randomly selected patients' computed tomography (CT) scans of the face performed between the years 2010 to 2013 in our institution (Khoo Teck Puat Hospital) were evaluated. The setting was a tertiary government hospital. CT images of 309 patients (233 Chinese [147 males, 86 females], 32 Malays [16 males, 16 females], and 44 Indians [33 males, 11 females]) were evaluated. Anthropomorphic measurements of the nasal bone along the track of the lateral, medial, and intermediate osteotomies, as well as the nasal bone length and pyriform aperture width were measured on the CT images by two independent observers. Statistical analysis was performed using Student's t-test and two-way analysis of variance (ANOVA) test. There was no significant difference between the nasal pyramid bone thickness between different ethnicities along the osteotomy tracks (p > 0.05; degrees of freedom [df] = 2). However, there was a significant difference between males and females of the same ethnicity at the low level of the lateral osteotomy (p = 0.003) and the midlevel (p = 0.002) and high-level (p = 0.004) of the intermediate osteotomy. There was a statistically significant difference in nasal pyramid length (p less then 0.05, df = 2) and pyriform aperture width (p less then 0.05, df = 2) among the races and between the genders (p less then 0.05). The mean difference in nasal pyramid length of 2.54 mm and pyriform aperture width of 1.89 mm was particularly significant between the Chinese and the Indians. Gender and ethnic differences in nasal bony dimensions should be considered in surgical planning for rhinoplasty.
The aim of this study was to assess whether social vulnerability among foreign-born pregnant women living with HIV is associated with maternal viremia during pregnancy.
This retrospective cohort study included all foreign-born pregnant women living with HIV who received prenatal care in a multidisciplinary prenatal clinic between 2009 and 2018. A licensed clinical social worker evaluated all women and kept detailed clinical records on immigration status and social support. Social vulnerability was defined as both living in the United States for less than 5 years and reporting no family or friends for support. The primary outcome was evidence of viral non-suppression after achievement of initial suppression. Secondary outcomes were the proportion of women who required > 12 weeks after starting antiretroviral therapy to achieve viral suppression, median time to first viral suppression (in weeks) after initiation of antiretroviral therapy, and the proportion who missed ≥ 5 doses of antiretroviral therapwere identified as socially vulnerable.. · Socially-vulnerable women were at higher risk for re-emergent viremia (24 vs. 7%, RR 3.44).. · Socially-vulnerable women were at higher risk for needing >12 weeks to become aviremic (64 vs. 36%, RR 1.7)..
12 weeks to become aviremic (64 vs. 36%, RR 1.7)..
This study aimed to examine the association between interpregnancy body mass index (BMI, kg/m
) change and intrapartum cesarean delivery in multiparous women without a history of cesarean delivery.
We conducted a retrospective cohort study of all women who had more than one singleton pregnancy at 23 weeks' gestation or greater at MedStar Washington Hospital Center from January 2009 to June 2018. We excluded women who had a history of cesarean delivery, prelabor cesarean delivery, and contraindications for vaginal delivery. Interpregnancy BMI change was calculated by the change of early pregnancy BMI measured in the office. Women were categorized according to the interpregnancy BMI change (BMI loss more than 2 kg/m
, BMI change ± 2 kg/m
, and BMI gain more than 2 kg/m
). The primary outcome was an intrapartum cesarean delivery. Multivariable logistic regression was performed to calculate adjusted odds ratio (aOR) with 95% confidence interval (CI) after adjusting for predefined covariates.
Of 2,168s was associated with intrapartum cesarean delivery.. · BMI loss between pregnancies was not associated with intrapartum cesarean delivery.. · Our study suggests that at least maintaining weight between pregnancies is beneficial..The difficulty in obtaining human teeth that are caries-free that have similar environmental exposure, e.g., diet intake and water fluoridation has lead researchers to opt for bovine teeth as a substitute for erosion studies. Bovine mandibular incisors are readily available at abattoirs and often originate from the same region and are likely to consume similar dietary intake. The bovine teeth for erosion or abrasion studies usually undergo specimen preparation to produce a "flat surface" baseline specimen. Among other terms used to define baseline specimens for erosion and abrasion studies include phrases like "optically flat" and "flat and smooth surface." However, these terms might have no quantitative value as it does not justify the actual surface characteristics of the prepared flattened surface. In dentistry, roughness average (Ra) is the most commonly used parameter when reporting the roughness of specimens Reporting Ra alone might not be sufficient as it does not provide information regarding the surface texture as there is no distinction between valleys and peaks, nor does it provide information about the core structure of a material unlike the bearing area curve. The incorporation of Ra and BAP values in baseline specimens has the potential in predicting the wear or lubricating potential of these specimens. Furthermore, standardization of baseline specimens by acknowledging its surface roughness values ensures comparability of erosion and abrasion studies as different specimen preparation technique might influence the outcome or results of research.
This study aimed to determine the association of personal protective equipment (PPE) usage with new-onset headaches and exacerbation of pre-existing headache disorders among healthcare workers at the frontlines during coronavirus disease 2019 (COVID-19) pandemic.
A descriptive cross-sectional survey was conducted across Pakistan in June-July 2020. The study was approved by Ethical Committee, Armed Forces Institute of Dentistry, Rawalpindi (IRB form no.905/Trg-ABP 1K2). A qualitative questionnaire was developed and was shared via different social networks. The questionnaire was closed when 241 responses were received.
Descriptive analysis was performed on demographic data. Chi-squared analysis was performed between demographic data and PPE-usage patterns among participants with or without de novo headaches. Univariable and multivariable logistic regression models were used to compare variables with the development of new-onset headaches. Chi-squared test was also performed between demographic data andaches during COVID-19 pandemic. However, age and the department where the healthcare workers performed may also be risk factors.
Healthcare workers with previous history of pre-existing headaches were found to be more susceptible to PPE-induced headaches during COVID-19 pandemic. However, age and the department where the healthcare workers performed may also be risk factors.
The aim of this study is to investigate the current knowledge and attitude of deep caries removal method among dental students in Malaysia.
A total of 303 students (
= 303) responded to the online questionnaire. The first part of questionnaire was to evaluate the demographic data of the respondents and focused on the technique and management approach used for deep caries lesion. The second part investigated the preferred treatment used for deep caries based on the designated clinical case, while the third part assessed the factors that affected the decision on deep caries management.
Independent
-test was used to compare difference between the two groups.
Seventy four percent of the students have the knowledge of the different methods of caries removal, while 25.8% were only familiar with complete caries removal. The preferred method for deep caries removal in permanent teeth was partial caries removal (53%). For primary dentition, 45.6% of the students prefer to perform pulpotomy as compared with other techniques. There was no significant difference in caries removal method for permanent teeth between undergraduate year of study (
> 0.05), which was partial caries removal at 52.7 and 53.5%, respectively. For primary dentition, the preferred caries removal method was pulpotomy for year 4 (39.8%) and year 5 (52%) students. The popular material to restore deep caries was resin composite (42%) followed by glass ionomer cement (23.3%).
This study showed that partial caries removal was the preferred method despite partial understanding on the identification of the clinical indicators of the technique.
This study showed that partial caries removal was the preferred method despite partial understanding on the identification of the clinical indicators of the technique.
This study aims to investigate the microtensile bond strength (µTBS), microleakage, and antibacterial effect of bulk fill resin composite with alkaline fillers (alkasite) (alkaline fillers such as barium aluminum silicate glass and ytterbium trifluoride) in comparison to incremental nanohybrid resin composite.
µTBS was evaluated by using 30 human mandibular molars. Teeth were randomly divided into three groups (C) nanohybrid resin composite (C0), self-cured alkasite (C1), and dual-cured alkasite (C2). Each group was subdivided into two subgroups according to the bulk thickness 4 mm (T1) and 6 mm (T2). PDTC The occlusal enamel of teeth was removed and the resin composite was applied to a flat dentin surface. Then, teeth were sectioned into beams to be tested under tension. For microleakage testing, mesio-occlusal class II cavities were prepared in 15 molars and divided into three groups as mentioned before. Then, cavities were restored, thermocycled, immersed in a dye, sectioned mesiodistally, and then dye penetration was assessed.
