Shashibhushan Sharma

Assessment of deformities of the lip and nose in cleft lip alveolus and palate patients by a rating scale.

IntroductionLabial and nasal deformities have always been a fundamental problem in the treatment of cleft lip, alveolus and palate patients. The primary surgical treatment of nasolabial area is of paramount importance in order to obtain both an esthetical correction of the deformity and a progressive and a balanced development of mid-face. In this study the nasal deformities in patients with cleft lip, alveolus and palate (CLAP) were analyzed and the relevant role of the perinasal, perioral muscular balance and the inborn dislocation of the alar cartilages are presented.Patients and Methods50 CLAP patients were analyzed, 40 UCLP and 10BCLP. The lip repair was done by modification of Millard’s technique. The severity of the cleft appearance was evaluated pre and post operatively, according to a pre-agreed visual rating scale. There are 4° of severity of the deformity pre operatively (mild, moderate, severe and very severe) and post operatively 5 categories of outcome (excellent,very good, good, satisfactory and poor), depending on the scores obtained by summing up the points corresponding to different types of deformity. This scale is closely related to the American Cleft Palate classification of clefts.ResultsIn the 40 UCLP patients, 8 excellent, 10 very good, 16 good and 6 satisfactory results were obtained following primary cheiloplasty. In 10 BCLP patients 1 very good, 7 good, 1 satisfactory and 1 poor result were obtained.ConclusionsDuring the primary repair, it is important to correct the abnormal position of ala nasi, the nasal floor and the base of the columella. Abnormalities in the insertion of the nasolabial muscles with their abnormal function contribute to the cleft nose deformities. Therefore the reconstruction not only the orbicularis muscle but also of the paranasal muscles is therefore important for a symmetrical growth of the nose. Separate suture of intrinsic orbicularis oris provide a better shape to the vermillion. The position of the alar cartilage plays an important role for the symmetry of the nose. It is necessary to place the alar base symmetrically in three dimensions.

Standards of facial esthetics: an anthropometric study.

AimAnthropometry is an art and science used extensively for measuring the soft tissue proportions. While it is true that error is found in measurements of this kind, a great many trends of growth and development and therapy changes can be recorded with a significant degree of accuracy.ObjectiveFacial proportion varies among the different ethnic groups and today, most of the available studies are done on western population. Hence an Anthropometric study was conducted in the local population.Materials and MethodsThe study was carried out with the aim of measuring the facial soft tissue proportion in the local population using anthropometry. Study was done using 100 subjects (50 males and 50 females) with Class I skeletal relationship and pleasing profile. Using standard anthropometric landmarks the various anthropometric measurements and facial proportional indices were determined (both horizontal and vertical) and were compared with that for North American Caucasians.ResultsThe statistical analysis revealed significant differences in the facial proportion between the two populations.

Assessment of shoulder function after functional neck dissection and selective neck dissection (Levels I, II, III) in patients with carcinoma of tongue: a comparative study

Background and objectivesTo compare shoulder function with respect to pain and disability in patients who have undergone nerve sparing neck dissection i.e. selective neck dissection (levels I, II, III) and functional neck dissection as a part of their treatment modality for carcinoma tongue on a follow up of minimum six months.Material and methodsA total of 100 patients were selected for this study. 50 patients who had undergone selective neck dissection (levels I, II, III) and 50 who underwent functional neck dissection as a part of their treatment modality for squamous cell carcinoma of the tongue from January 2005 to January 2007 were asked to participate in this study. A standardized questionnaire was used to assess pain and disability. Pain and disability scores were then compared between the two nerve sparing dissections.Results100% of the patients in Selective Neck Dissection (SND) (levels I, II, III) group and in Functional Neck Dissection (FND) groups complained of pain. Though there is pain present in both the treatment groups, no significant difference in the pain values was found between FND and SND (levels I, II, III) in any of the pain parameters. Disability was present in both the treatment groups. However patients who have undergone FND had significantly higher severity of disability when compared to SND (levels I, II, III) especially during activities which involve shoulder abduction like dressing, doing heavy household work, hair wash and washing clothes/dishes (5.18, 5.22, 5.5, 4.88 in FND and 2.26, 4.08, 4.58, 2.2 in SND (levels I, II, III) respectively. Disability perceived during other activities like doing heavy household and facial care was 2.08 and 1.84 in both the treatment groups respectively.Interpretation and ConclusionDegree of shoulder morbidity is much higher in patients who have undergone FND as compared to SND (levels I, II, III) as a treatment modality for carcinoma tongue, even though both the treatment options are nerve preserving.

Secrecy outage probability of a two-way cooperative network with an energy harvesting untrusted AF relay

In this paper, we analyze the secrecy outage probability (SOP) of a two-way cooperative communication network aided by an energy harvesting untrusted half-duplex amplify and forward relay which conveys information between two legitimate users. The whole communication completes in two time slots. The relay receives signal from both users simultaneously in the first time slot meanwhile it harvests energy based on power splitting ratio scheme. In the second time slot, the relay amplifies and forwards the signal to both users as well as it eavesdrops the message. The relay works as an eavesdropper where signal from one user acts as a jamming signal for the signal of other user. An analytical expression of SOP involving a numerical integration has been derived in single integration form. We verify our analytical results with the simulated results.

Outage performance of secondary user in cognitive relay network with multiple PUs

In this report, we point out on a system in which secondary user (SU) transmitter communicates with a SU receiver via a secondary relay (SR) under the interference from multiple primary users (PUs). Power allocated to SU transmitter on the basis of two constraints of PU, viz., outage threshold and outage transmission rate. In this case, performance of PU does not degrade due to these tolerable constraints. Direct link does not occur between the SU transmitter and receiver because of shadowing. A SR used to link the SU transmitter to SU receiver that is based on decode-and-forward (DF) scheme. Outage probability (OP) calculated by considering the interferences from all PUs at SR and secondary receiver. We see that the performance of SU network does not always degrade after the consideration of interferences from all PUs and thus, SU transmitter reliably communicates with its receiver under the specific range of primary transmit power of PUs in this system model. Results of this model are verified by the MATLAB simulation.

Secrecy outage probability with destination assisted jamming in presence of an untrusted relay

The study of secrecy capacity of wireless networks, considering variety of powerful attacks is currently of great interest. In this paper, we have considered a possible attack scenario where an eavesdropper is present as a legitimate relay node in disguise in the network. A novel scheme of simultaneous transmission of jamming signal and message signal is proposed to confuse the eavesdropper. Here we consider a source, a destination and two amplify and forward (AF) relays each employed with a single antenna. One of the two relays used in the network is un-trusted and eavesdrop the information signal sent by the source. We analyze secrecy outage probability (SOP) of our proposed scheme under several network parameters such as target secrecy rate, transmit power of source, jamming power by destination and mean powers of fading channel. We also develop a simulation test bed to evaluate secrecy outage probability.

The role of systemic condition in the management of maxillofacial infections.

Ludwig’s Angina is a rare type of facial infection which formerly invariably was fatal but now with adequate surgical and antibiotic treatment has a much reduced mortality. In spite of the recent advances in therapy, rare and potentially life threatening complications may still arise from time to time and as a result account for significant morbidity and mortality. A case of Ludwig’s angina reported at A.B Shetty Memorial Institute of Dental Sciences, Mangalore, India resulting in fatality, in spite of surgical and antibiotic treatment, due to underlying systemic condition and involvement of multiple resistant organisms. The condition was worsened by subsequent esophageal rupture and death occurred due to multiple organ failure.