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Introduction: Maxillofacial trauma is a regularly reported occurrence in the emergency room. Of all maxillofacial injuries worldwide, the mandible is the most commonly involved facial bone, with etiologies ranging from assaults and interpersonal violence to RTAs. Objectives: We aim to identify the patterns of incidence, etiology, age groups, anatomical location and gender in mandibular fractures in the population of Karachi, Pakistan. Study Design: Observational cross sectional study. Setting: Dow International Dental College. Period: January 2012 - September 2017. Materials and Methods: Informed consent was obtained along with a comprehensive history; a systematic clinical examination was supplemented by radiographs of the face as required to confirm the presence of fractures. Statistical analysis was done using SPSS v.21. Results: Over 5 years, an overall 156 patients sustained 250 fractures of the mandible. Most affected gender was male, the age group was 20-30 years, most common cause was Road Traffic Accidents and site was the parasymphysis. Conclusion: Mandibular fractures have a higher incidence in young males driving motorbikes or cars. More rigorous legislative action and community awareness is required to lessen the rate of mandibular fractures in Karachi, Pakistan. [ABSTRACT FROM AUTHOR]

Introduction: Paresthesia-free spinal cord stimulation (SCS) techniques, such as burst and high-frequency (HF) SCS, have been developed and demonstrated to be successful for treating chronic pain, albeit via different mechanisms of action. The goal of this review is to discuss the mechanisms of action for pain suppression at both the cellular and systems levels for burst and HF SCS. In addition, we also discuss the neuromodulation devices that mimic these paradigms. Areas covered: The authors performed a literature review to unravel the mechanisms of action for burst and HF SCS coupled with booklets and user manuals from neuromodulation companies to understand the programmable parameters and operating ranges. Burst SCS modulates the medial pathway to suppress pain. On cellular level, burst SCS is independent on activation of γ-aminobutyric acid (GABA) receptors to inhibit neuronal firing. HF SCS blocks large-diameter fibers from producing action potentials with little influence on smaller fibers, increasing pain suppression as frequency increases. Expert commentary: The neuromodulation industry is in a phase of intense innovation characterized by adaptive stimulation to improve patients’ experience and experiment with alternative frequencies and novel stimulation targets. [ABSTRACT FROM PUBLISHER]

This descriptive study assessed the pattern of maxillofacial injuries seen at the Emergency Department of Abbasi Shaheed Hospital, Karachi, Pakistan from January 2014 to December 2015. A total of 464 patients with maxillofacial trauma were included in the study, of whom 329 (70.25%) were males and 135 (29.28%) female. The most common cause was road traffic accidents (220) and fall was second most common cause (86). The mandible was the most common bone fractured (243), followed by Zygomatic Bone Complex fracture (118). Majority of patients were treated with closed methods of treatment (189) and (256) patients with open reduction and internal fixation. Maxillofacial trauma was more prevalent in males and in young age groups. The common management modality was open reduction and internal fixation. [ABSTRACT FROM AUTHOR]

Oral submucous fibrosis (OSF) is a chronic, progressive, debilitating condition affecting oral mucosa with recognized high risk of transformation into malignancy. Areca nut, betel quid, and gutka consumption are the established primary culprits culminating in chronic irritation leading to inflammation and fibrosis of exposed mucosa. The aim of the study was to describe the pattern of presentation for oral submucous fibrosis (OSF) patients who were seen in dental OPD at Dow International Medical and Dental College, Ojha campus, Karachi during one year (January 2015 to January 2016). Data pertaining to patient demographics, oral habits, clinical history and presentation were gathered and analyzed using SPSS 16.0. OSF was seen mostly during third decade of life with a strong male predilection (male to female ratio 5:1). The predominant complaint at presentation was trismus followed by stomatitis. Majority of the patients indicated a positive history of certain oral habits. More than half of the patients presented in stage 3. A small percentage of patients also reported with unknown etiology suggesting a possible role of genetics in pathogenesis. Increasing incidence in younger adults, particularly men from low socio-economic status should alarm the healthcare providers to target their preventive programs at this population. An incurable, progressive disease like OSF needs more efforts to prevent than cure particularly when the causative agents are established and widely available in the market. [ABSTRACT FROM AUTHOR]

Background: Oral mucosa is often affected by many diseases including mucocutaneous disorders. The diagnoses of these disorders are primarily based on history, clinical features, and histopathology. For the past few years' immunofluorescence techniques emerged as an important tool to study the pathogenesis and in the diagnosis of oral mucocutaneous and vesiculobullous disorders. The present study was designed to carry out retrospective and prospective analysis of oral mucocutaneous lesions to elucidate the clinicopathologic features and its immunofluorescence findings. Materials and Methods: A total of 70 subjects with oral mucocutaneous lesions were retrieved from the oral pathology files of Tamil Nadu Govt. Dental College and their clinical features were evaluated, and the histopathology was also evaluated with the help of hematoxylin and eosin stained sections. For the prospective study, biopsy from 12 subjects with oral mucocutaneous lesions was subjected to routine histopathological examination and DIF to evaluate the consistency of the methods. Results: In the retrospective analysis of 70 subjects with oral mucocutaneous lesions in relation to clinical features and histopathology, most of the findings were similar to the previous studies except for few criteria like male predilection in lichen planus and mucous membrane pemphigoid (MMP) and more prevalence of pemphigus vulgaris than MMP (2:1). In the prospective analysis of 12 subjects, the histopathological diagnosis was consistent with DIF study in 66% of cases. Conclusion: The diagnostic efficiency of oral mucocutaneous lesions can be improved by modern tools like DIF studies in addition to traditional methods like clinical and histopathology. [ABSTRACT FROM AUTHOR]

Effective training programs are critical for successful employee performance. The same can be said for volunteer programs. Volunteers need to have the knowledge and skills necessary to fulfill the mission of the organization. In this study, we examine the impact of training methods and trainees’ demographic factors on the effectiveness of a training program for a voluntary program. Survey results (N = 5,727) indicate a very low percentage of participation (16.46%) in the voluntary program after training. Responses also indicate that content knowledge recall after training is affected by training year (the year receiving training), industrial sector, calling history, and training delivery method. Participants’ desires for retraining are also impacted by the type of training received, the industry sector, as well as past participation in the program. Recommendations for voluntary training programs based on study results and future research directions are presented. [ABSTRACT FROM PUBLISHER]