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Partial Bone Necrosis Following Sagittal Split Ramus Osteotomy: Report of a Complicated Orthognathic Jaw Surgery
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Study Design

Case Report.

Objective

To present a case of a previous complicated mandibular orthognathic surgery that aimed to setback the mandible in a female cleft lip and palate (CLP) patient, which led to bone necrosis on one side with subsequent severe mandibular deviation and facial asymmetry. We additionally reviewed the previous reports of similar complications, the pathophysiology and the factors that could lead to this dreadful result.

Method

A 27-year-old female patient presented with a severe dentofacial deformity secondary to a complicated bilateral sagittal split ramus osteotomy performed five years earlier, which resulted in aseptic bone necrosis on the right side. The patient had marked mandibular deviation, chin and midface retrusion and a pronounced occlusal discrepancy. Imaging demonstrated a bony defect at the right mandibular angle with a superiorly displaced proximal segment. Deviation of the mandible was corrected first by performing vertical ramus subsigmoid osteotomy (RSO) on the left side. The right bone defect was then reconstructed with a reconstruction plate and bone grafting. Maxillary and chin advancement was performed at a second stage.

Results

On follow-up, the patient shows a significant improvement in facial esthetics and mandibular symmetry and is currently under orthodontic management to enhance the occlusal relationship.

Conclusion

Bone necrosis is a rare but dreaded problem in orthognathic surgery. Minimizing the musculo-periosteal dissection and competent execution of the bone osteotomy is substantially effective in reducing the risk of bone ischemia and necrosis.

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Publication Date
Thu Apr 04 2024
Journal Name
Chemchemtech
ANALYTICAL TECHNIQUES IN PHARMACEUTICAL POLLUTION OF THE WORLD’S RIVERS; A REVIEW
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Recent reports of new pollution issues brought on by the presence of medications in the aquatic environment have sparked a great deal of interest in studies aiming at analyzing and mitigating the associated environmental risks, as well as the extent of this contamination. The main sources of pharmaceutical contaminants in natural lakes and rivers include clinic sewage, pharmaceutical production wastewater, and sewage from residences that have been contaminated by drug users' excretions. In evaluating the health of rivers, pharmaceutical pollutants have been identified as one of the emerging pollutants. The previous studies showed that the contaminants in pharmaceuticals that are widely used are non-steroidal anti-inflammatory drugs, ant

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Publication Date
Sun Mar 26 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Formulation and Evaluation of Nystatin Microparticles as a Sustained Release System
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Nystatin is the drug of choice for treatment of cutaneous fungal infections with main disadvantage that is the need for multiple applications to achieve complete eradication which may reduce patient compliance. Microparticles offer a solution for such issue as they are one of sustained release preparations that achieve slow release of drug over an extended period of time. The objectives of this study were to fabricate nystatin-loaded chitosan microparticles with the ultimate goal of prolonging drug release and to analyze the influence of polymer concentration on various properties of microparticles. Microparticles were prepared by chemical cross-linking method using glutaraldehyde as cross-linking agent. Five formulas, namely N1C1, N1C2,

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Publication Date
Sat May 01 2021
Journal Name
Journal Of Physics: Conference Series
Generalizations of Fuzzy k-ideals in a KU-algebra with Semigroup
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Abstract<p>We present the notion of bipolar fuzzy k-ideals with thresholds (<italic>θ, λ</italic>) of a KU-algebra with semigroup and give some basic properties of this ideal. Also, we study some relations about a bipolar fuzzy k-ideal with thresholds (<italic>θ, λ</italic>) and a k-ideal of a KU-semigroup.</p>
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Publication Date
Fri Mar 31 2017
Journal Name
Journal Of Engineering
Aerodynamic Characteristics of a Rectangular Wing Using Non-LinearVortex Ring Method
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The aerodynamic characteristics of general three-dimensional rectangular wings are considered using non-linear interaction between two-dimensional viscous-inviscid panel method and vortex ring method. The potential flow of a two-dimensional airfoil by the pioneering Hess & Smith method was used with viscous laminar, transition and turbulent boundary layer to solve flow about complex configuration of airfoils including stalling effect. Viterna method was used to extend the aerodynamic characteristics of the specified airfoil to high angles of attacks. A modified vortex ring method was used to find the circulation values along span wise direction of the wing and then interacted with sectional circulation obtained by Kutta-Joukowsky the

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Publication Date
Sun Apr 30 2017
Journal Name
Journal Of Engineering
Implementation of a Proposed Load-Shedding System Using Altera DE2 FPGA
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A load-shedding controller suitable for small to medium size loads is designed and implemented based on preprogrammed priorities and power consumption for individual loads. The main controller decides if a particular load can be switched ON or not according to the amount of available power generation, load consumption and loads priorities. When themaximum allowed power consumption is reached and the user want to deliver power to additional load, the controller will decide if this particular load should be denied receiving power if its priority is low. Otherwise, it can be granted to receive power if its priority is high and in this case lower priority loads are automatically switched OFF in order not to overload the power generation. The

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Publication Date
Fri Jul 01 2022
Journal Name
Journal Of Engineering
A Review of the Asphalt Mixtures Containing Recycled Solid Waste Materials
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Landfill and incineration are the most common and widely used methods to dispose of solid wastes; both of these techniques are considered the main sources of pollution in the world due to the harmful toxic emissions that are considered an environmental problem. Because of the large areas used by landfills, they are not always considered an economical method. With the increase in the production of solid materials, solid wastes increase the pressure on incinerators and landfills, making the environmental pollution hazard more serious. Instead, these waste materials can be used in some other applications. One of the most important of these applications is asphalt pavements, which are the most used types of pavements in the

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Publication Date
Thu Dec 01 2016
Journal Name
2016 Ieee Symposium Series On Computational Intelligence (ssci)
A fusion of time-domain descriptors for improved myoelectric hand control
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Publication Date
Fri May 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
A review of ultra-high temperature materials for thermal protection system
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Abstract<p>Ultra-High Temperature Materials (UHTMs) are at the base of entire aerospace industry; these high stable materials at temperatures exceeding 1600 °C are used to manage the heat shielding to protect vehicles and probes during the hypersonic flight through reentry trajectory against aerodynamic heating and reducing plasma surface interaction. Those materials are also recognized as Thermal Protection System Materials (TPSMs). The structural materials used during the high-temperature oxidizing environment are mainly limited to SiC, oxide ceramics, and composites. In addition to that, silicon-based ceramic has a maximum-use at 1700 °C approximately; as it is an active oxidation process o</p> ... Show More
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Publication Date
Wed Oct 12 2022
Journal Name
Axioms
Razy: A String Matching Algorithm for Automatic Analysis of Pathological Reports
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Pathology reports are necessary for specialists to make an appropriate diagnosis of diseases in general and blood diseases in particular. Therefore, specialists check blood cells and other blood details. Thus, to diagnose a disease, specialists must analyze the factors of the patient’s blood and medical history. Generally, doctors have tended to use intelligent agents to help them with CBC analysis. However, these agents need analytical tools to extract the parameters (CBC parameters) employed in the prediction of the development of life-threatening bacteremia and offer prognostic data. Therefore, this paper proposes an enhancement to the Rabin–Karp algorithm and then mixes it with the fuzzy ratio to make this algorithm suitable

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Publication Date
Tue Jan 01 2019
Journal Name
Plant Archives
The role and importance of amino acids within plants: A review
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