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Mandible Wiring

Mandible Wiring

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In childhood, generally impetuous nature and adventurous spirit combine to encourage participation in physical activities with little thought to immediate consequences, still paradoxically facial injuries in children are much less common than in adults. Above all the immense capacity for healing in children within the shortest possible time with a minimum of complications, the assistance that growth can give, and the inherent ability to adapt to new situations are quite different from what we see in adults. The principles involved in the treatment of facial injuries are the same irrespective of the age of the patient. However, the techniques in children are necessarily modified by certain anatomical, physiological and psychological factors. This article aims to cover comprehensively the review of these modifications and preferable options for the management of Mandibular fractures in these children.

The surgery used to correct a severe malocclusion from a misaligned jaw is called orthogenetic surgery. This includes procedures to move the upper jaw or maxilla forward, backward, or even widen it. It also includes procedures to move the lower jaw or mandible rotationally to correct asymmetry, forward or backward.  Orthogenetic surgery is usually completed in conjunction with orthodontic treatment or braces. Most of the time your orthodontist will be the one to refer you to a surgeon to discuss jaw surgery. At times adjunctive procedures are completed to ensure symmetry and harmony of the facial profile, which can include chin surgery or Genioplasty as well as cheek augmentation or molar implants.

Mandibular fractures usually occur secondary to trauma, although pathologic fractures during dental procedures are not uncommon. A traumatic etiology means that serious concurrent injuries are commonly requiring prompt clinical attention, notably to the brain, maxilla, and chest. An expanded discussion of head trauma and preoperative stabilization is presented in the next lecture 'Fractures of the Skull and Maxilla.' However, it is important to note that management of life-threatening injuries and normalization of patient physiology is paramount before surgical stabilization of Mandibular fractures. This discussion will focus on principles of dentistry and fracture biomechanics for the surgeon.

Palpation of the jaw inside and outside the mouth can assist in oral visual assessment. Fractures are often open with obvious mucosal defects. Preoperative broad-spectrum antibiotic administration is recommended.1 however, providing the surgical reduction is mechanically stable, infections are less common due to the excellent blood supply of the mouth. Any instability of the fracture repair will create the conditions ideal for infection. Imaging involves the use of either intraoral film to acquire views of the arcade or conventional radiographic views (lateral and Dorsoventral skull, and lateral oblique views). Complex fractures are best visualized with computed tomography.

Without a thorough understanding of the dental components of treating oral disease, iatrogenic oral pain is a possible sequel. Small animals, especially dogs, appear to cope well with chronic oral pain but that does not mean that the impact of that discomfort on an animal's welfare is not as distressing as our own. Therefore, a discussion of the important dental attributes of successful Mandibulo-maxillofacial trauma treatment is indicated.


Posted on January 09 Jul, 2022 Posted by :


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Computerised Navigation System (Nav-3)  for a Joint Replacement Surgery: A Boon for Patients

Computerised Navigation System (Nav-3) for a Joint Replacement Surgery: A Boon for Patients

Computerized Navigation System in Joint Replacement has revolutionized Joint Replacement Surgery. Poor alignment is the most common cause of premature failure of the implant in manual Joint Replacement. New technology of computer based navigation system has completely eliminated poor alignment and made Joint Replacement surgery 100% accurate. The Computerized Navigation System (Nav-3) enables surgeons to consistently obtain results that are far more accurate than conventional methods. Dr. Ankur Goel is working on the most Advanced Navigation System for Joint Replacement by Computerized Navigation System (Nav-3) at Sri Sai Hospital Moradabad.

Since the level of accuracy is very high, it also helps in increasing the life of the implant by 20-25 years, and also reduces the blood loss to the patient. Patients who undergo this type of Surgery in our hospital are able to walk and climb stairs without assistance within a few days after surgery. The Computerized Navigation System helps the surgeon to make precise cuts and correct deformities in the knee. It also removes human errors in surgery.

Sri Sai Hospital, Moradabad uses Computerized Navigation System (Nav-3) to provide real-time, patient-specific information about patients during surgery, including infrared cameras, state-of-the-art software, due to while costly Investigations like Intensive CT and MRI Scans prior to surgery etc. does not need to be done. At the beginning of the operation, the surgeon strategically places small transmitters on the patient's leg. The surgeon then guides the foot through a series of prescribed movements, which, in turn, are recorded by the navigation's infrared camera and transmitted to a computer. The computer analyzes those positions to create an anatomical 'model' of the knee and updates this information throughout the procedure, displaying all relevant axes, angles and distances for the surgeon. Analyzing and providing this continuous data, navigation helps guide the surgeon through the bone cut, implant positioning.

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Urinary problems can be an indicator of Kidney Damage

Urinary problems can be an indicator of Kidney Damage

Urinary problems are commonly encountered in children of all age groups. It may vary from burning Micturating, pain during passage of urine, dribbling of urine, not passing urine in stream, recurrent urinary tract infection, bedwetting in older children, frequent passage of urine unknowingly in clothes. It is troublesome for the child most of the time. Sometimes it may become a social stigma, as no one likes to play with a child having wet and smelly clothes. It becomes difficult for the child to attend school, as frequent complaints from teachers and fellow classmates reduce the self-esteem of the child. These problems could be an indication of various Paediatric Urology diseases that may cause kidney damage if not detected and treated on time. Nowadays antenatal ultrasound done during pregnancy detect several common Pediatric Urology problems which can be treated after birth and hence kidney damage and an array of urinary problems can be avoided. Broadly there are four kinds of paediatric urology diseases encountered in day to day practice. Posterior urethra valve is a disease which can be detected during pregnancy before the birth of the child. There is partial obstruction in the urethra (part through which urine passes to come out of the body). If undetected for a long period of time and finally if the diagnosis is delayed, the child may have permanent kidney damage. Ultrasound, Micturating cystourethrogram are two investigations that can confirm the diagnosis. Treatment is done by Pediatric Cystoscopy in which no cut is made over body and obstruction is removed and the child leads a happy life thereafter. child may suffer from recurrent urinary infection, dribbling of urine Hydronephrosis is swelling up of the kidney because of obstruction in outflow of urine from kidney. It is usually diagnosed during pregnancy and Paediatric Surgeons operate and cure the disease by creating a pathway for drainage of urine as early as 4 to 6 weeks of age and hence kidney is protected from getting damaged. Vesicoureteric reflux (VUR) is a disease where the urine keeps circulating in the system. Urine is waste product of the body meant to be thrown out. There is unidirectional flow of urine from kidney to outside. Here, when we urge to urinate, bladder compresses and urine is sent back to kidneys, hence it keeps infecting and damaging the kidney. The child presents with recurrent urinary infections. The diagnosis is made by Micturating Cystourethrogram. Treatment is by creating a valve mechanism to prevent reflux and hence the cure. Neurogenic bladder is a complex entity due to neural dysfunction. So, the crux is don't ignore urinary problems in children. Meet your nearest Pediatric Surgeon whenever there is a problem so that the kidneys of your child can be saved in time before they get damaged.

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Weight Loss and Bariatric Surgery Clinic

Weight Loss and Bariatric Surgery Clinic

Sri Sai Hospital is organizing  Weight loss and Bariatric Surgery Clinic for obese people on Every Tuesday. People who were obese and facing health problems due to obesity came to the Clinic for their medical check-up, which includes BMI, body fat analysis, blood sugar. Also free nutrition and diet advice was given by experts.

Dr. Zuhaib Naseem, Consultant Minimal Access and Bariatric Surgeon at Sri Sai Hospital said, "Today among all other diseases, obesity has emerged as one of the growing health problem among people especially those living in urban areas.  Sedentary life style and lack of physical exercise is one of the major cause of  obesity.  Also, an obese person can have other health complications like high blood pressure, heart disease, diabetes mellitus, sleep apnea etc. Hence it is essential for people with obesity to get the right medical treatment at the right time and protect themselves from further health hazards".

The camp was organized with the sole purpose of helping people to know their obesity level and opt for the right treatment. A person with a BMI (Body Mass Index) of 25 to 30 is said to be overweight and if it is greater than 30 it is generally considered obese. Overweight conditions can be easily managed with proper diet control, exercise and physical activities. In severe cases where BMI is greater than 30, it is often difficult to maintain and reduce weight. According to Dr Zuhaib Naseem of Sri Sai Hospital, bariatric surgery is an ideal option in such situations. Surgery reduces the size of the stomach and sometimes bypasses a part of the small intestine. Bariatric Surgery improves health problems related to obesity and also improves physical function, mood, and improved quality of life.

 Dr. Zuhaib Naseem said, "We will regularly conduct weight loss and bariatric surgery clinics every Tuesday at Sri Sai Hospital and it will be our pleasure to do more and more free camps in the near future".

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Dengue Fever: Causes, Complications, and Vaccine Strategies

Dengue Fever: Causes, Complications, and Vaccine Strategies

Dengue is the most extensively spread mosquito-borne disease; endemic in more than 100 countries.  Approximately 2.5 billion people live in dengue-risk regions with about 100 million new cases each year worldwide. The cumulative dengue diseases burden has attained an unprecedented proportion in recent times with sharp increase in the size of human population at risk.Amid the rising cases, Uttar Pradesh has become one of the worst-hit states in India by the dengue fever outbreak.

Dengue is a mosquito-borne viral infection, and the virus responsible for causing dengue, is called dengue virus (DENV). There are four DENV serotypes, meaning that it is possible to be infected four times.While many DENV infections produce only mild illness, DENV can cause an acute flu-like illness, occasionally developing into a potentially lethal complication, called severe dengue. There is no specific treatment for dengue/severe dengue, however Dengue deaths are preventable if we take timely interventions.Early detection of disease progression associated with severe dengue, and access to proper medical care lowers fatality rates of severe dengue to below 1%. Until now, no vaccine has been developed to prevent Dengue virus. The only prevention is to avoid mosquito bites. Dengue prevention and control depends on effective vector control measures.

Dengue is one of the major public health problems which can be controlled with active participation of the community. Need is to organize health education programmes about dengue disease to increase community knowledge and sensitize the community to participate in integrated vector control programmes.

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कंप्यूटर नेविगेशन तकनीक से प्रभावी घुटना प्रत्यारोपण

कंप्यूटर नेविगेशन तकनीक से प्रभावी घुटना प्रत्यारोपण

अनियमित जीवनशैली, अनुचित खान पान व उम्र बढ़ने के कारण घुटनो की समस्या बढ़ जाती है। जैसे-जैसे घुटने जवाब देने लगते है, चलना-फिरना, उठना-बैठना, यहाँ तक कि बिस्तर से उठ पाना भी मुष्किल हो जाता है ऐसी स्थिति में भी रिप्लेसमेंट यानी घुटनो का प्रप्यारोपण पीड़ित व्यक्ति को राहत देने के लिये प्रभावी विकल्प है। नी रिप्लेसमेंट के लिए कम्प्यूटर नेविगेषन तकनीक के आ जाने के बाद यह बेहद प्रभावी और आसान हो गया है।

श्री साई सुपर स्पेशीऐलिटी हाॅस्पिटल में डाॅ0 अकुर गोयल के सक्षम नेतृत्व में कंप्यूटर नैविगेशन तकनीक से घुटनोे का सफलतापूर्वक प्रप्यारोपण किया जा रहा है। यह संस्थान उत्तर प्रदेश में कंप्यूटर नैविगेशन तकनीक से सफल घुटना प्रत्यारोपण करने के लिये बेहद प्रसिद्ध है। इस तकनीक से नी-रिप्लेमेंट सर्जरी में काफी बेहतरी आई है, इसमें जख्म जल्द भरता है और ट्रांसप्लान्ट का फायदा लोगो को लंबे समय तक मिलता है। इसके अलावा यह तकनीक किसी भी संभावित गलती को कम करके मरीज की परेशानी के अनुसार इलाज करती है।

घुटना प्रप्यारोपण की सटीक तकनीक है कंप्यूटर नेविगेशन

पिछलें 10 सालो की तुलना में जोड़ प्रप्यारोपण की संख्या में कई गुना वृद्धि हुई है उसके साथ-साथ नई तकनीको का भी इस्तेमाल बढ़ा है कंप्यूटर नेविगेशन भी एक सटीक तकनीक है कंप्यूटर नेविगेशन द्वारा प्रप्यारोपित जोड़ को सटीक अलाइनमेंट एवं पूरी तरह से बैलेस करके लगाया जा सकता है। कंप्यूटर नेविगेषन के द्वारा लगाया गया कृत्रिम जोड़ सटीक अलाइनमेंट एवं सही बैलेंस होने के कारण मैनुवल तकनीक से किए गये घुटना प्रप्यारोपण की तुलना में कई वर्ष अधिक चलता है। इस तकनीक के और भी कई फायदे है। श्री साई हाॅस्पिटल में इस तकनीक का उपयोग कर प्रप्यारोपण करने के लिए अनुभवी व विषेशज्ञ चिकित्सकों की टीम है। अभी तक कंप्यूटर नेविगेशन के द्वारा जोड़ प्रप्यारोपण करवाने के लिये रोगी को दिल्ली,मुबंई, अहमदाबाद एवं जयपुर जैसी जगह पर जाना पड़ता था आज इस संस्थान के माध्यम से मुरादाबाद में भी इस तकनीक द्वारा सफल घुटना प्रप्यारोपण किया जा रहा है। सटीक प्रप्यारोपण के लिये कंप्यूटर नेविगेटेड सिस्टम से एक विषेश जाँच की जाती है। यह मषीन घुटनों के सटीक अलाईनमेंट के लिए बहुत उपयोगी है। कंप्यूटर नेविगेटेड सर्जरी एक अत्याधुनिक शल्य चिकित्सक तकनीक है। कंप्यूटर असिस्टेड सर्जरी द्वारा प्रप्यारोपण कराने के दौरान रोगी की हड्डीयों और जोड़ों के सूक्ष्म बिंदू तक नजर आते  जिन्हें नंगी आँखो द्वारा देख पाना सम्भव नही है।

अत्याधुनिक कंप्यूटर नेविगेशन माॅडल के उपयोग से इंप्लाट फिटिगं परफेक्ट होती है इसमें गलती की आषंका बिल्कुल कम हो जाती है। इस तकनीक में छोटे से चीरे के साथ ऑपरेशन करके घुटने का जोड़ बदला जाने लगा है। मरीज के घुटने  का सीटी स्कैन करके उसकी सही फिटिगं वाला जोड़ नही लगा पाने से जो घुटना प्रप्यारोपण 15-20 साल तक ही चल पाता था अत्याधुनिक कंप्यूटर नेविगेशन माॅडल के उपयोग से अब इसकी लाईफ दोगुनी हो गयी है हाल ही में घुटना प्रप्यारोपण की दरो में आई कमी के बाद आज कल यह बहुत कब दरों में संभव है।

डाॅ0 अंकुर गोयल

वरिश्ठ ज्वाइंट रिप्लेसमेंट सर्जन

यू.के. एवं जर्मनी से प्रशिक्षित  

श्री साई सुपर स्पेशीऐलिटी हाॅस्पिटल, दिल्ली रोड, मुरादाबाद।

विषेशता:-

  • प्रिसिज़न नी नेविगेशन सिस्टम का इस्तेमाल करने वाला पष्चिमी यू0पी0 का प्रमुख संस्थान 
  • तेजी से रिकवरी
  • प्राकृतिक घुटनो का एहसास
  • स्थिरता मिलती है
  • प्रप्यारोपण लंबे समय तक चलता है
  • सुरक्षित व कारगर तकनीक है।

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Burn Management in Children

Burn Management in Children

Dr. Madhusoodan Gupta is a board-certified Plastic, Cosmetic & Burn Surgeon. Presently he is working as a Consultant Plastic, Cosmetic, Burn & Reconstructive Surgery at Sri Sai Hospital, Moradabad, Uttar Pradesh.

Burn is a devastating and emergent situation. Hot water burn or Scald burn is the most common type of burn among all. Scald burn is difficult to manage especially in children. The challenge in treating a burned child is the changing of burn dressing. Scald Burns or burn from hot liquids such as water, tea, milk, rice water, and oil are more commonly seen in kids. The first aid after scald burn is to remove the wet cloths and wash that area thoroughly with water of normal temperature under the running tap. This will definitely decrease the intensity and degree of burn and help in further management. The second important thing is not to put any local home remedies over the burnt area. People generally apply some home remedies such as toothpaste, kapoor, coconut oil and other spices. The best is to consult a qualified Plastic surgeon as soon as possible. All these things used as home remedies cause irritation, pain and sometimes convert superficial burn into deep burn due to undergoing infections.

The Scald burn or hot liquid burn is usually a second-degree burn and if treated properly it can heal without scarring and skin color mismatch. Dressing of burn plays a very important role here. Only in cases when scald burn get infections, superficial second-degree burn changes into the deep burn and can cause hypopigmentation of skin or skin discoloration and hypertrophic scarring. We at Sri Sai Hospital have treated many scald burn children and almost all treated children had satisfying results.  Also, Dr. Madhusoodan Gupta has published his original article in an international journal “Biological dressing is a paradigm shift in the surgical management of scald burn in children’’.

Biological dressing or Collagen dressing is  the ideal dressing for scald burn specially in children. During the dressing this Collagen dressing makes the innermost layer over the burn area. After  that other layer of dressing is applied over the collagen inner layer. Once Collagen dressing is done it will not required daily change of dressing which is most difficult task in children. Usually the change of dressing is done at every 5th day and only the outer layers have to be change, collagen layers are left unchanged over the burn area. This causes very minimal or I have to say no pain at all at the time of change of burn dressing in children. With the use of  Collagen dressing for scald burn ,scarring and skin color mismatch do not occur. Almost all scald burn use to heal within 10-14 days after applying the collagen dressing. It is also scientifically proven dressing  to help in burn wound healing.  Lastly we have to say Collagen dressing or biological dressing is a paradigm in the management of scald burn in children.

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