Background: Orthognathic surgery has become increasingly accurate with the integration of computerized technologies. This study aimed to evaluate the accuracy of custom-made plates in transferring the three-dimensional virtual plan to intraoperative maxillary repositioning. Methods: This study included 10 patients. A digital surgical simulation technique was used for preoperative planning. The surgical components— osteotomy/plates, locating guides, and customized titanium plates—were fabricated using computer-aided design and manufacturing techniques, replacing the need for a surgical splint. Postoperative outcomes were assessed using unaltered anatomical landmarks from the preoperative virtual plan. Absolute discrepancies in translational and rotational movements between the planned and actual postoperative positions were measured through superimposition analysis. This evaluation assessed the precision of custom-made plates in transferring the virtual surgical plan, identifying deviations in the cephalocaudal, mediolateral, and anteroposterior directions that could influence functional and esthetic outcomes. Results: No statistically significant differences were observed for any landmarks across the axial, coronal, and sagittal planes. The greatest variability was noted at the posterior nasal spine landmark in the axial plane (1.7 mm), compared with the coronal (0.9 mm) and sagittal (0.5 mm) planes. Conclusion Customized titanium plates effectively transferred the virtual surgical plan for maxillary repositioning without the need for an occlusal splint. However, potential posterior interference should be considered during surgical execution.

Dengue remains a public health threat that consumes a significant number of resources for its prevention and control. This systematic review aimed to solidify recent costing evidence in dengue management among South East Asian (SEA) countries. All studies conducted between 2010 and 2020 were retrieved using four international databases i.e. PubMed, Scopus, Web of Science, and Emerald Insight. The review was reported according to PRISMA guidelines. Quality assessments were done independently by two reviewers using a checklist adapted for the cost of illness studies. We identified 13 original articles representing several SEA countries. Among the common reported costing measure include total cost/ health expenditure; direct medical cost; direct non-medical cost; and indirect cost. The estimated total cost for dengue management varied between countries largely due to the difference in the total incidence of dengue cases. The estimated cost spent on dengue per capita GDP ranges from less than 0.001% to 0.1%, depending on the recorded number of dengue cases of the year. The majority of the articles focused on the economic burden from the perspective of treatment such as hospitalization and ambulatory care. In a nutshell, the economic burden of managing dengue infection is costly and the evidence suggests a steady increase in health expenditure with the growing number of dengue cases

Purpose: This study evaluated the sensitivity, specificity, and accuracy of computed tomographic angiography (CTA) versus handheld Doppler (HHD) in detecting perforators for anterolateral thigh (ALT) flap surgery. Methods: This study was conducted on 20 patients randomly assigned to two groups from April 2023 to November 2024: One group received CTA and HHD, while the other group received only HHD. Perforators were evaluated for their number, location, and source and compared with intraoperative findings. Results: The sensitivity and specificity of CTA were 86.0% and 98.0%, respectively, while those of HHD were 81.0% and 86.5%. CTA exhibited an accuracy of 92.0% for perforator identification, whereas that of HHD was 83.5%. Conclusion CTA offers higher sensitivity, specificity, and accuracy in identifying ALT flap perforators than HHD. Its superior imaging capabilities can enable improved surgical planning, minimizing intraoperative challenges, reducing the risk of complications, and potentially increasing flap survival rates. As such, CTA could be considered a valuable standard tool in preoperative planning for ALT flap surgery, particularly in cases where anatomical variation poses a challenge.

Purpose: This study evaluated the sensitivity, specificity, and accuracy of computed tomographic angiography (CTA) versus handheld Doppler (HHD) in detecting perforators for anterolateral thigh (ALT) flap surgery. Methods: This study was conducted on 20 patients randomly assigned to two groups from April 2023 to November 2024: One group received CTA and HHD, while the other group received only HHD. Perforators were evaluated for their number, location, and source and compared with intraoperative findings. Results: The sensitivity and specificity of CTA were 86.0% and 98.0%, respectively, while those of HHD were 81.0% and 86.5%. CTA exhibited an accuracy of 92.0% for perforator identification, whereas that of HHD was 83.5%. Conclusion CTA offers higher sensitivity, specificity, and accuracy in identifying ALT flap perforators than HHD. Its superior imaging capabilities can enable improved surgical planning, minimizing intraoperative challenges, reducing the risk of complications, and potentially increasing flap survival rates. As such, CTA could be considered a valuable standard tool in preoperative planning for ALT flap surgery, particularly in cases where anatomical variation poses a challenge.

Purpose: This study evaluated the sensitivity, specificity, and accuracy of computed tomographic angiography (CTA) versus handheld Doppler (HHD) in detecting perforators for anterolateral thigh (ALT) flap surgery. Methods: This study was conducted on 20 patients randomly assigned to two groups from April 2023 to November 2024: One group received CTA and HHD, while the other group received only HHD. Perforators were evaluated for their number, location, and source and compared with intraoperative findings. Results: The sensitivity and specificity of CTA were 86.0% and 98.0%, respectively, while those of HHD were 81.0% and 86.5%. CTA exhibited an accuracy of 92.0% for perforator identification, whereas that of HHD was 83.5%. Conclusion CTA offers higher sensitivity, specificity, and accuracy in identifying ALT flap perforators than HHD. Its superior imaging capabilities can enable improved surgical planning, minimizing intraoperative challenges, reducing the risk of complications, and potentially increasing flap survival rates. As such, CTA could be considered a valuable standard tool in preoperative planning for ALT flap surgery, particularly in cases where anatomical variation poses a challenge.

Worldwide, cardiovascular disease is the main cause of death, which accordingly increased by hyperlipidemia. Hyperlipidemia therapy can include lifestyle changes and medications to control cholesterol levels. Statins are the medications of the first choice for dealing with lipid abnormalities. Rosuvastatin founds to control high lipid levels by hindering liver production of cholesterol and to achieve the targeted levels of low-density lipoprotein cholesterol, another lipid lowering agents named ezetimibe may be used as an added therapy. Both rosuvastatin and ezetimibe have low bioavailability which will stand as barrier to decrease cholesterol levels, because of such depictions, formulations of this combined therapy in nanotechnology will be of a great assistance. Our study demonstrated preparations of nanoparticles of this combined therapy, showing their physical characterizations, and examined their behavior in laboratory conditions and vivo habitation. The mean particle size was uniform, polydispersity index and zeta potential of formulations were found to be in the ranges of (0.181–0.72) and (–13.4 to –6.24), respectively. Acceptable limits of entrapment efficiency were affirmed with appearance of spherical and uniform nanoparticles. In vitro testing showed a sustained release of drug exceeded 90% over 24 h. In vivo study revealed an enhanced dissolution and bioavailability from loaded nanoparticles, which was evidenced by calculated pharmacokinetic parameters using triton for hyperlipidemia induction. Stability studies were performed and assured that the formulations are kept the same up to one month. Therefore, nano formulations is a suitable transporter for combined therapy of rosuvastatin and ezetimibe with improvement in their dissolution and bioavailability.

Background: The introduction of presurgical nasoalveolar molding represented a significant departure from traditional molding methods. Developed by Grayson and colleagues in 1993, this technique combines an intraoral molding device with a nasal molding stent. This study aimed to compare the Grayson nasoalveolar molding appliance versus DynaCleft appliance as two methods of presurgical nasoalveolar molding. Methods: A single-blinded, randomized, parallel-arm clinical trial was conducted. Sixteen infants with complete unilateral cleft lip and palate were enrolled and divided into two groups of eight. Group 1 was treated with a modified Grayson nasoalveolar molding appliance that included a nasal stent, while group 2 was treated with DynaCleft elastic adhesive tape and an external nasal elevator. Standardized digital photographs of each infant were taken at baseline and post-treatment using a professional camera. Nine extraoral anthropometric measurements were obtained from each image using image measurement software. Results: The modified Grayson nasoalveolar appliance demonstrated a more significant improvement compared to DynaCleft in terms of alar length projection (on both sides), columella angle, and nasal tip projection. Symmetry ratios also showed enhancement, with significant improvements observed in nasal width, nasal basal width, and alar length projection (p< 0.05). Conclusion Both the modified Grayson nasoalveolar appliance and DynaCleft appear to be effective presurgical infant orthopedics treatment options, demonstrating improvements in nasolabial aesthetics. The modified Grayson appliance, equipped with a nasal stent, improved nasal symmetry more effectively than DynaCleft, resulting in a straighter columella and a more medially positioned nasal tip.

Background: and Purpose Repetitive transcranial magnetic stimulation (rTMS) of the cerebellar hemisphere represents a new option in treating essential tremor (ET) patients. We aimed to determine the efficacy of cerebellar rTMS in treating ET using different protocols regarding the number of sessions, exposure duration, and follow-up duration. Methods: A randomized sham-controlled trial was conducted, in which 45 recruit patients were randomly allocated to 2 groups. The first (active group) comprised 23 patients who were exposed to 12 sessions of active rTMS with 900 pulses of 1-Hz rTMS at 90% of the resting motor threshold daily on each side of the cerebellar hemispheres over 4 weeks. The second group (sham group) comprised 22 patients who were exposed to 12 sessions of sham rTMS. Both groups were reassessed at baseline and after 1 day, 1 month, 2 months, and 3 months using the Fahn-Tolosa-Marin tremor-rating scale (FTM). Results: Demographic characteristics did no differ between the two groups. There were significant reductions both in FTM subscores A and B and in the FTM total score in the active-rTMS group during the period of assessment and after 3 months (p=0.031 and 0.011, respectively).However, subscore C did not change significantly from baseline when assessed at 2 and 3 months (p=0.073 and 0.236, respectively). Furthermore, the global assessment score was significantly higher in the active-rTMS group (p>0.001). Conclusions Low-frequency rTMS over the cerebellar cortex for 1 month showed relative safety and long-lasting efficacy in patients with ET. Further large-sample clinical trials are needed that include different sites of stimulation and longer follow-ups.