Non-extraction orthodontic treatment in a patient with severe anterior crowding

A 12 years 6 months old Indian male presented with a chief complaint of irregular upper and lower front teeth. Patient exhibited a mild convex profile on Class l skeletal base with slightly decreased vertical proportions. This was complicated by severe upper and lower labial segment crowding. Also the molar relationship was half unit class ll bilaterally. Since the patient did not want to go for extraction of premolars, treatment involved use of Pendulum appliance along with upper and lower pre-adjusted edgewise appliance (0.022x0.028” slot) with MBT prescription. Various elastics and overlay wires were used along with proximal stripping for the correction of severe crowding in upper and lower anterior teeth.: Clinically Angle’s Class I occlusion was achieved bilaterally with good intercuspal relationship. Vertical growth continued throughout the treatment.

Laryngeal Papillary Cystadenoma: A Case Report

Papillary cystadenoma is a rare, benign salivary gland neoplasm containing cystic cavities with intraluminal papillary projections. In the head and neck area, it occurs mainly in major and intraoral minor salivary glands, but rarely in the larynx. We report a case of a 67-year-old female with a chief complaint of hoarse voice diagnosed as laryngeal papillary cystadenoma. This paper emphasizes the need to consider papillary cystadenoma as one of differential diagnosis when benign looking lesions are observed in the larynx, where it uncommonly occurs.

Prosthodontic Rehabilitation of Hypodontia – A Team Approach

Hypodontia can have an impact on speech, aesthetics, function and psycho-social behavior of individuals afflicted by the problem. Rehabilitation of patients with hypodontia usually requires complex treatment planning, depending upon the pattern of tooth absence, amount of residual spacing, presence of malocclusion and patient compliance. It is an interdisciplinary intervention, involving prosthodontists, orthodontists, oral surgeons, speech pathologists and psychologists to achieve an optimal outcome for the patient. This case report describes the close work of a committed team from orthodontic, oral surgery and prosthodontic department of de'Montmorency College of Dentistry, Lahore, to reach final aesthetic and functional outcomes for an 18 year old girl with oligodontia. Her chief complaint was poor esthetics and absence of multiple anterior teeth with unsightly spacing between remaining teeth. Orthodontic redistribution of spaces followed by fixed full arch prosthetic rehabilitation were the goals achieved at the end of her treatment. KEYWORDS: Oligodontia, interdisciplinary team work, prosthodontic rehabilitation, fixed restorations.

Ductus Omphalocele Mesenteric Persisten: A Case Reports

Background: The ductus omphalomecenterica is a normal embryological structure where it serves to connect the midgut of the fetus to the yolk sac. Usually, this ductus will disappear at 9 weeks gestation. However, if this condition does not occur, then it can cause various anomalies to appear in the fetus. Case Presentation: The patient was reported to be hospitalized with the chief complaint of choking. Echocardiography examination with the results of the examination found the presence of cyanotic congenital heart disease (CHD). The patient was referred to pediatric surgery with a diagnosis of persistent mesenteric duct omphalocele. Terminal ileum anastomoses resection laparotomy was performed. Conclusion: After surgery due to complications of pneumonia and sepsis, the patient died.

Case Report: Management and Outcomes of COVID-19 in a Patient with Cirrhosis of Liver

Introduction: The outbreak of coronavirus disease 2019 (COVID-19) has recently become a major problem affecting thousands of individuals around the world. It is understood that a significant proportion of patients infected with COVID-19 have disturbed liver function tests. This is a case report of a patient with liver cirrhosis and COVID-19. Presenting Complaints and Investigations: A 39 year old female patient was admitted in AVBRH on 06/02/2021 with chief complaint of distension of abdomen, breathlessness, shortness of breath, reduced urine output over last 3 months. She had skin lesions over the hand, foot, abdomen and back with itching since 4 months. Physical examination, blood investigations and abdominal ultrasound showed cirrhosis of liver with gross ascites seen clinically. She had mild splenomegaly and gall bladder was enlarged. Laboratory tests showed elevated total bilirubin level. In peripheral blood examination, RBC count was low (3.66m/cu mm), Haemoglobin level was 8.2 gm/dl, Platelets count was low (1.19 lakh per cu. mm). WBC count was 3600 cu mm. Doctor diagnosed this as the case of cirrhosis of liver with pemphigus vulgaris with COVID-19. Past History: 6 months ago, patient was admitted in Aarogyadham hospital Yawatmal with chief complaint of abdominal pain, loss of appetites, fever. On ultrasonography, she had splenomegaly for which she took the treatment. The Main Diagnosis, Therapeutic Intervention and Outcomes: This case was diagnosed as a case of COVID-19 with Cirrhosis of liver. Interferon alpha 2b solution was given for 10 days to help improve the immunity. Tab. Ursoldiolis (ursodeoxycholic acid) was used to dissolve gallstones. Conclusion: Good clinical assessment, appropriate care, good nursing care by trained nurses and appropriate treatment can save lives even in complicated COVID-19 infected cases.

Case Report On: Complete Heart Block

When the electrical signal normally does not travel from the atria, the upper chambers of the heart, to the ventricles, or lower chambers, full heart block occurs. During surgery, the atrio ventricular (AV) node is weakened and complete heart block can result. Often, complete heart block occurs naturally without surgery [1]. Patient History: Heart block is an irregular heart rhythm where the heart (bradycardia) beats too slowly. In this condition, between the upper chamber (atria) and the lower chamber (ventricles), the electrical signals that tell the heart to contract are partially or completely blocked. Present history- The patient 71-year old male who was admitted to hospital on date 25/11/2019 with the chief complaint was severe chest pain, breathlessness, excessive palpitation, vertigo, and sweating since in 4 months. Conclusion: The patient was admitted in the hospital with the chief complaint of severe chest pain, breathlessness, excessive palpitation, vertigo and sweating since 4 months and his condition was very critical and the patient was admitted in AVBR Hospital and immediate treatment was started.

Primary intracranial peripheral primitive neuroectodermal tumor in an adult patient with aphasia: a rare case report

Primary intracranial primitive neuroectodermal tumors (PNETs) are extremely rare malignancies, affects children and adolescents with only 10 cases has been reported over 33 years old. we present a case of PNET in a 36 years old female patient with the chief complaint of aphasia for the first time

A Case Report on Acute Transient’s Psychotic Disorders

Background: Little is known about acute and transient psychotic disorders (ATPD), a diagnostic category introduced with ICD-10. Case Presentation: Acute transient psychotic disorder is a heterogeneous group of disorders characterised by the acute onset of psychotic symptoms such as delusion, hallucination and perceptual disturbances, and by the severe disruption of ordinary behaviour. Patient history: The Male patient 48 year old who was apparently admitted in AVBRH on date 08/05/2021 with chief complaint was Abnormal behaviour( taking clothes off in public ), irritability, aggressive, muttering and smiling to self from 10 days back. His parents once locked him in a room as they fear he might hurt him. He was taken to a faith healer in Pandarkawda twice by his parents. The Baba gave him some mysterious beats like bracelet to wear which eventually decreased his symptoms for 3 days but the symptoms persisted from the fourth day. This time, the Baba mixed a lemon juice, turmeric powder & kumkuma (a powder made from dried turmeric with a bit of slaked lime) and applied all over him eyes which severely inflamed & burnt his eyes. His eye injury elevated his psychotic symptoms which is why his parents took him to psychiatric OPD in AVBRH. Past History: Patient was apparently asymptomatic 2 yrs back. He was married to a woman of his parent’s choice. His marriage life was stressful and unhealthy. He was underestimated by his wife due to his low qualification and health problem. Clinical Finding: The patient has been undergone with various investigations like culture, blood tests, Physical examination and mental status examination symptomatically with antipsychotic agent and anticonvulsant such as Tab Olanzapine 10mg- HS, Tab Clonazepam 0.5mg – SOS. Medical Management: Antibiotic eye drop homatropine and eye ointment ciprofloxacin. Nursing Management: Administered fluid replacement i.e DNS and RL, eye care was done with betadine and Normal Saline solutions, eye care by administering eye drops and monitored all vital signs hourly. Conclusion: Patient was admitted to hospital with the chief complaint of muttering to self, irritability and eye injury, blisters, pus discharge from eyes and his condition was very critical and patient was admitted in AVBR Hospital ,immediate treatment was started by health team member and all possible treatment were given and now the patient condition is satisfactory.

Literatur Review : Penerapan Teknik Relaksasi Genggam Jari Untuk Menurunkan Intensitas Nyeri Pada Pasien Pasca Operasi

Postoperative is a time since patient entered the recorvery room until the follow-up evaluation in the treatment room. Pain is the most chief complaint experienced by postoperative patiens. One of the non-pharmacological pain management is grip finger relaxation therapy. The study purpose was to describe the application of grip finger relaxation techniques to reduce pain in postoperative patients. The study was done by researched articles related to the intervention. The result showed that the pain decreased in the experiment and control groups was 2.44 and 3.2 respectively. By using the Paired T-test, the result shows there was a significant decreased of pain among experiment group (p-value0.000). As the conclusion, the grip finger relaxation technique is effective for reducing pain in postoperative patiens. As the suggestion, nurses can be taught to postoperative patients to reduce pain.Keywords: Pain; Postoperative; Grip finger relaxation AbstrakPasca Operasi yaitu massa dimana pasien mulai memasuki ruang pemulihan sampai evaluasi tindak lanjut diruang perawatan. Pasien pasca operasi pasti akan merasakan nyeri. Menejemen nyeri non farmakologis yang dapat mengatasi nyeri yaitu terapi relaksasi genggam jari. Tujuan karya tulis ilmiah ini yaitu untuk mengetahui gambaran mengenai penerapan teknik relaksasi genggam jari terhadap penurunan intensitas nyeri pasca operasi. Metode dilakukan dengan mencari beberapa jurnal penelitian tentang penerapan teknik relaksasi genggam jari terhadap penurunan intensitas nyeri post operasi. Hasil yang didapatkan setelah diberikan pada kelompok eksperimen dan kontrol memiliki rata-rata 2.44 dan 3.2, nilai Pvalue 0.000, 0.003 dengan P = <0.005 menggunakan alat uji Pairet T test. Simpulan karya tulis ilmiah ini yaitu teknik relaksasi genggam jari efektif untuk menurunkan nyeri pada pasien pasca operasi. Saran bagi perawat sekiranya bisa diajarkan kepada pasien pasca operasi untuk mengurangi nyeri.Kata kunci: Nyeri; Pasca operasi; Relaksasi genggam jari

Predicting mortality and readmission based on chief complaint in emergency department patients: a cohort study

BackgroundEmergency department (ED) patients present with complaints and not diagnoses. Characterization and risk stratification based on chief complaint can therefore help clinicians improve ED workflow and clinical outcome. In this study we investigated the 30-day mortality and readmission among ED patients based on chief complaint.MethodsIn this cohort study we retrieved routinely collected data from electronic medical records and the Danish Civil Registration System of all ED contacts from July 1, 2016 through June 30, 2017. All patients triaged with one chief complaint using the Danish Emergency Process Triage system were included. Patients with minor injuries were excluded. The chief complaint assigned by the triaging nurse was used as exposure, and 30-day mortality and 30-day readmission were the primary outcomes. Logistic regression was used to determine crude and adjusted ORs with reference to the remaining study population.ResultsA total of 41 470 patients were eligible. After exclusion of minor injuries and patients not triaged, 19 325 patients were included. The 30-day mortality and 30-day readmission differed significantly among the chief complaints. The highest 30-day mortality was observed among patients presenting with altered level of conscousness (ALOC) (8.4%, OR=2.0, 95% CI 1.3 to 3.1) and dyspnea (8.0%, OR=2.1, 95% CI 1.6 to 2.6). 30-day readmission was highest among patients presenting with fever/infection (11.7%, OR=1.9, 95% CI 1.4 to 2.4) and dyspnea (11.2%, OR=1.7, 95% CI 1.4 to 2.0).DiscussionChief complaint is associated with 30-day mortality and readmission in a mixed ED population. ALOC and dyspnea had the highest mortality; fever/infection and dyspnea had the highest readmission rate. This knowledge may assist in improving and optimizing symptom-based initial diagnostic workup and treatment, and ultimately improve workflow and clinical outcome.Level of evidenceLevel III.