400 Govt doctors face suspension in Uttarakhand for inactive membership

Dehradun: The Provincial Medical and Health Services Association (PMHS) Uttarakhand, the largest umbrella body of government doctors has suspended the membership of 400 doctors who have been inactive.

The association members made the significant decision to suspend the membership of the doctors after discovering that the newly joined and existing doctors had not renewed their membership and demonstrated unsatisfactory performance towards the association. 

Hence, this decision was taken to ensure that all doctors within the association are up to date with their membership requirements and obligations. The association have strongly encouraged the doctor who has been suspended to renew their memberships before being reinstated.

Also read- UP Govt New PMHS Rules Allow MBBS Doctors, Specialists To Be Posted In Their Home District

In addition to this, the doctors’ lack of involvement in the association’s work was also discovered. As a result, the association has instructed Chief Medical Officers in all 13 districts to ensure that doctors actively participate in the association’s work to get their concerns addressed. 

The association members announced the suspension of the membership of the doctors during a meeting held in Dehradun on Saturday. Apart from deciding on the suspension of the membership in the meeting, the office-bearers also made other decisions regarding the smooth functioning of PMHS and upcoming elections.

Speaking to TOI, Dr Manoj Verma, secretary of PMHS Dehradun branch, said, “Every doctor’s say in matters related to policies is imperative so that a holistic view can be presented before the higher authorities.”

The Provincial Medical and Health Services is Uttarakhand’s largest umbrella body of government doctors. The PMHS currently comprises 1,400 registered government doctors out of approximately 2,500 in the state.

Medical Dialogues team had earlier reported that the condition of the government hospitals in the US Nagar District has been deteriorating as many hospitals have reported a severe shortage of specialist doctors and basic healthcare facilities which is seriously affecting patient healthcare. 

Also read- Negligence: Gujarat Medical Council Suspends Doctor For Three Months

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In The Interest Of Patients, Doctors Need Better Protection Of Law – Dr Rajeev Joshi

वैद्यराज नमस्तुभ्यं यमराज सहोदर ।

यमस्तु हरति प्राणान् वैद्यो प्राणान् धनानि च ॥

This is an ancient saying which means “O vaidya (doctor), brother of Yama (God of Death), I bow down to you. Yama only steals away one’s life, but the vaidya steals one’s life as well as money.” It is obvious that it was a sarcastic manner of equating doctors with Gods.

Life expectancy of Indian citizens was 40 years at the time of independence, it has increased to 75, 75 years after independence. While there are many factors which are responsible for this, doctors of modern medicine have played an important role in enhancing the life expectancy in digital India.

Unfortunately, the cost of healthcare is simultaneously rising because of the cost of technology acquired by hospitals for treatment of diseases hitherto considered untreatable. Increasing consumerism expects a positive outcome of expenses on treatment. Compensation culture is rising exponentially.

There is no doubt that like every other domain, there are black ships in the medical profession also. However, it does not mean that the entire medical profession should be painted with black paint.

Contribution of medical professionals was applauded by all citizens with tali and thali when Prime Minister Narendra Modiji made an appeal during Covid-19 pandemic. Flowers were showered on the corpses of doctors.

More than 2000 doctors have lost their lives while fighting as covid-warriers. Most of their families did not get insurance money. Home minister promised that a Central Act for prevention of violence against will be promulgated, asking IMA to withdraw the candlelight march.

Epidemic Diseases Act 1897 was amended soon after IMA withdrew the protest and only a short term relief was provided. This time IMA was promised change in Bharatiya Nyay Samhita to protect doctors and a statement to that effect was made in parliament.

However, it turns out that section 304A of IPC 1860 has been re-introduced as subsection of 106 (1). Even before this, the intention of parliament was to exclude doctors from the Consumer Protection Act, but it did not reflect in the CPA by mentioning healthcare in the exclusion list.

While doing this, the section 106 (1) creates discrimination between doctors of AYUSH and doctors of modern medicine. IMA consistently opposed crosspathy, but has never opposed AYUSH doctors practising AYUSH sciences, as each science has its advantages and disadvantages.

Doctors need better protection of law, failing which there will be further increase in defensive medicine. This will indirectly harm every citizen of the country by increasing the number of investigations to prove that doctors are not failing in duty to care.

Cost of treatment will continue to rise and soon healthcare in India will become similar to healthcare in the USA where doctors are reluctant to take any risk whatsoever. It is said,

क्वचित् धर्म क्वचित् मैत्री क्वचित् अर्थ क्वचित् यश ।

कर्माभ्यासं क्वचितश्चेति चिकित्सा नास्ती निष्फला ।।

The Vaidya is doing their Dharma in treating patients who come in seeking help, he will make new friends, get connected with new people and receive what is meaningful to them. This could be money and / or something else.

The Vaidya will get success, that which is pleasing to their mind, by feeling satisfaction when patients get results, he will become an expert in managing certain conditions after continuous practice.

People will start finding the Vaidya in exactly the same way as the bee finds nectar in a flower. None of the Vaidya’s efforts, medicines, or prescriptions are going to waste.

Hope good sense will prevail, and the Act will be amended to protect doctors.

Disclaimer: The views expressed in this article are of the author and not of Medical Dialogues. The Editorial/Content team of Medical Dialogues has not contributed to the writing/editing/packaging of this article.

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Forceps Left Inside Patient’s Abdomen At GMC Kozhikode: Govt grants permission to prosecute doctors, nurses

Kozhikode: In connection with the alleged medical negligence case at Government Medical College Hospital (GMC) Kozhikode, where forceps were reportedly left inside a female patient’s abdomen, the Kerala Health Department has authorized the police to initiate legal proceedings against all four accused in the case.

The Principal Secretary of the Health Department issued the instruction on Saturday. In compliance with this directive, the charge sheet will be presented to the Kundamangalam court on Tuesday.

This measure is a result of the DGP’s transmission of the request, submitted by the City Police Commissioner, to prosecute the four medical personnel to the government.

Also read- Forceps Left Inside Patient’s Abdomen At GMC Kozhikode: Doctors, Nurses To Face Action, Police Looks For Prosecution

The four accused in the case involve two doctors – an assistant professor at the gynaecology department of Manjeri Government Medical College and the other is a gynaecologist at a private hospital in Kottayam and two staff nurses at Kozhikode Medical College Hospital.

They have been charged under sections punishable by imprisonment of up to two years. The probe by police revealed that a pair of artery forceps were stuck in the patient’s stomach during her third delivery-related surgery at the Kozhikode Medical College Hospital on November 30, 2017.

Medical Dialogues team had earlier reported that the matter came to light after Harshina, a 30-year-old woman from Kozhikode filed a complaint seeking a probe in October last year. She alleged that she faced health complications after undergoing a caesarean at the Government Medical College Hospital in 2017.

The woman had undergone her third caesarean at the Medical College in November 2017, with her earlier two C-sections performed in different private hospitals.

On September 17, 2022, the doctors of Kozhikode Medical College conducted a significant surgery on Harshinia, who was suffering from severe pain, to remove a mosquito artery forceps that had been in her stomach for the past five years. The mosquito artery forceps is a scissor-like piece of equipment surgeons use to clamp bleeding vessels during surgeries.

Based on the complaint, Kerala police conducted an investigation and found that forceps were accidentally left inside a woman’s abdomen after surgery in 2017, The report indicated two doctors and two nursing staff of the hospital were responsible for the costly good-up.

A senior police officer had earlier said that the investigation confirmed that the forceps were accidentally left inside the woman’s body after the caesarean section, which was an alleged act of negligence by the doctors.

“We were worried as the sanction was delayed for three-and-half months. I’m relieved that we finally got the sanction. Since our main objective is compensation, we’ll continue our legal battle to secure this,” Harshina said while responding to Onmanorama.

Also read- Forceps Left Inside Patient’s Abdomen At GMC Kozhikode In 2017: Doctor, 2 Nurses Served Arrest Notices; Released

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Initiative for empowerment of innovators, advance healthcare solutions: Dr Mansukh Mandaviya virtually unveils ‘MedTech Mitra’

New Delhi: Dr Mansukh Mandaviya, Union Minister of Health and Family Welfare and Chemicals & Fertilizers has virtually launched ‘MedTech Mitra’: A Strategic Initiative to Empower MedTech Innovators and Advance Healthcare Solutions in the presence of Prof. S.P. Singh Bhagel, Union Minister of State for Health and Family Welfare who virtually joined and Dr. V.K Paul, Member Health, Niti Aayog.

“MedTech Mitra is a platform that will help the young talents of the country by holding their hands and giving them final shape to their research, knowledge, logic etc. and help them in getting regulatory approval,” said Dr Mansukh Mandaviya.

“The medical devices sector is an essential and integral constituent of India’s healthcare sector. Pursuing the vision of Viksit Bharat, India is taking a holistic approach to health with a vision to transform the health landscape in the country by 2047,” he added.
Noting that India’s MedTech sector is highly import dependent, measuring upto 80%, the Union Health Minister emphasized that “to ensure that medical devices are supplied within the country, this sector has seen phenomenal progress with the implementation of production linked incentive schemes and investments for medical drug parks, MedTech research policy and MedTech research incentive scheme.
He further added “this collaborative initiative will facilitate indigenous development of affordable, quality MedTech devices and diagnostics leading to considerable reduction in the import dependence of this sector.” Underscoring the growth and potential of this sector, Dr. Mandaviya stated that “I am confident India will grow to become $50 billion industry by 2030.”
Highlighting the fast pace of growth in technology, Dr. Mandaviya added, “Due to the developments taking place in sectors like Robotics, Artificial Intelligence, Big Data, Virtual Reality, Nano Technology, the medical device sector is changing rapidly today.”
Lauding the initiative and efforts of the innovators and youth, Dr. Mandaviya stated, “There is immense power among the innovators, researchers and start-up youth in the country who know how to do Research and Logic Development. If one gets help at the approval stage itself, then wonders can be achieved which will take India miles ahead in becoming Atmanirbhar and achieving the vision of Viksit Bharat”
Elaborating further the Union Health Minister, “backed by growing healthcare needs and government’s commitment to facilitate growth, Indian medical devices industry has the power to emerge as a powerful leader in innovation in the coming years”
Commending the initiative, Prof. S.P Singh Bhagel stated, “MedTech Mitra is a platform for budding entrepreneurs and innovators in India. It is more than an ecosystem, a community. It is a harbinger of revolutionary change.”
He further added “In our country the use of accurate and cost-effective indigenous technologies to bring about a change in the scenario of healthcare is of utmost importance. MedTech Mitra is one such initiative that brings together various stakeholders in the field of medical technology to enhance cooperation among various stakeholders and partner with them to promote progress in the health sector.”

Highlighting the challenges facing the innovators in bringing innovations to light, Dr. V.K Paul underscored the role of MedTech Mitra in handholding the innovators for clinical evaluations and regulatory compliance, emphasizing that “MedTech Mitra will empower emerging start-ups and ensure ease of innovation, ease of doing research and development, ease of rendering service in building an Atmanirbhar Bharat.” He further added, “in harboring collaboration amongst all stakeholders, it will effectively break silos, catalyzing growth and independence in this sector.”

Underlining the alignment of MedTech Mitra with the medical devices ecosystem as well as overall boosting the growth and development of health domain, Dr. V.K Paul stated “this platform will serve to strengthen India’s commitment to Universal Health Coverage, further consolidating reach of healthcare services to the innermost corners of the nation to become an integral aspect of Viksit Bharat.”

The event was attended by Dr. Rajiv Bahl, Secretary, DHR and Director General, ICMR, Dr. Suchita Markan Sc-E, Mission In-charge, Medical Device and Diagnostics Mission Secretariat (MDMS), ICMR, Dr. Taruna Madan Sc-G, Head (Development Research), ICMR, Dr. Rajeev Singh Raghuvanshi Drugs Controller General of India, CDSCO, Smt. Manisha Saxena Sr DDG(A), ICMR and senior government officials

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AIIMS Nagpur inaugurates Autopsy complex

Nagpur: The long-awaited establishment of an autopsy facility at All India Institute of Medical Sciences (AIIMS), Nagpur has finally come to fulfilment, with the premier institution recently inaugurating one at the campus. 

This significant progress brings a sense of relief to the bereaved families who previously had to go through the difficult process of transferring their deceased relative body to another hospital and enduring the wait for the post-mortem examination.

This state-of-the-art advanced facility at the renowned institute will now allow for post-mortem examinations to be carried out. Family members coming to the institute will no longer have to travel to the Government medical college and hospital (GMCH) for postmortem examinations of their deceased kin. 

Also read- AIIMS Nagpur Becomes First AIIMS To Get NABH Accreditation, PM Modi Congratulates The Team

The new facility was inaugurated in an unprecedented event by Dr. (Prof.) M. Hanumantha Rao, Executive Director, AIIMS, Nagpur on December 19.

The Department of Forensic Medicine & Toxicology, AIIMS, Nagpur has sought permission to get post-mortem examinations. As per the approval letter medicolegal postmortem on the dead bodies in the jurisdiction of the Police station of Sonegaon, Hingana, Hingna MIDC, Beltarodi, Butibori MIDC, Buttibori, Bela will be conducted at the Autopsy Block of AIIMS Nagpur.

Dr. Manish Shrigiriwar, Professor and head of the Department of Forensic Medicine & Toxicology, extended a warm welcome to all the dignitaries by presenting them with beautiful flower bouquets. The esteemed guests included Mr Vijay Kumar Nayak (Deputy Director (Admin)), Mr B. K. Agrawal (Financial Advisor), Dr Sanjiv Choudhary (Dy. Medical Superintendent), and Dr Ganesh Dakhale (Dean Examination), who graced the occasion with their presence.

Previously, the autopsies of such deaths were conducted at Government Medical College, Nagpur, which unfortunately resulted in unavoidable delays, causing both the Police and the relatives to suffer throughout the entire process.

However, with the opening of the new facility, the post-mortem will be conducted at the premier institute putting the relatives and the police at ease. According to a TOI news report, Sonegaon, Beltarodi, MIDC, Hingna, MIDC Bori, Buti Bori and Bela police stations will now send bodies to conduct the procedure to AIIMS in Mihan.

Soon, the hospital will have two autopsy tables, cold storage for keeping eight bodies, a workstation for organ dissection, a room for performing the panchanama, a separate space for waiting relatives and a help desk for handling queries as reported by the daily.

In addition, AIIMS has ambitious plans to establish the autopsy facility as one of the finest in the country. It will feature cold storage for 80 bodies, along with a camera facility to showcase the procedures to post-graduate students at the viewers’ gallery.

Dr Harshal Thube skillfully hosted the inaugural ceremony, and the success of the program was greatly attributed to the efforts of Dr Ashok Jiwane, Dr Jayesh Dudhe, Dr Jishnu V, Dr Animesh Gupta, Dr Priyanshu Garg, Dr Avinash Kumar Anand, Mr Shobhit Kapse, Miss. Prachi, Miss. Sandhya Wani, Miss. Vaishnavi, Mr. Sanket Giri, Mr. Lokshankar Megdarat, and Mr. Ishwar Chachane.

The institute has been in communication with the state home department to obtain approval for their proposed post-mortem facility, according to TOI sources. Approximately three months ago, the state’s Medical Education and Drug Department (MEDD) inspected the ‘autopsy block’, which was followed by a visit from the city police chief, Amitesh Kumar. After receiving the police chief’s No Objection Certificate (NOC), AIIMS obtained clearance from the local gram panchayat to carry out the medico-legal procedures.

Apart from this, AIIMS Nagpur also inaugurated its “Heart Failure Clinic” on December 19 which will open every Thursday from now on. The heart failure clinic was launched in the presence of Dr Ravinulata Venkata Kumar, Professor of Cardiovascular and Thoracic Surgery; and Director and Vice-Chancellor of Sri Venkateshwara Institute of Medical Sciences (SVIMS), Tirupati.

The highly skilled cardiac team of AIIMS, Nagpur will conduct this heart failure clinic every Thursday. This team comprises cardiologists, Dr Arijit Kumar Ghosh, Dr Sagar Makode, and Dr Gunjan Godeshwar; cardiac anaesthetist Dr Omshubham Asai; and cardiac-vascular and thoracic surgeons, Dr Pravin Salunkhe, Dr Hemant Kumar Bodhankar, and Dr Frankleena Parage.

The heart failure clinic aims to deal with problems encountered by heart failure patients. This will facilitate the optimization of anti-failure medical therapy, rehabilitation, reduction of patient admission rate, and duration of hospitalization.

Also read- ICMR Designates AIIMS Nagpur As Nodal Centre For HINI Study

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Carrot intake reduces cancer risk by 10 to 20 per cent, meta-analysis reveals

UK: A recent study published in Critical Reviews in Food Science and Nutrition has revealed a robust association between carrot consumption and reduced cancer risk; the authors recommend encouraging carrot consumption and further investigation of the causal mechanisms in randomized clinical trials.

A meta-analysis of 80 prospective cohort studies showed that carrot intake lowers cancer risk by 10%-20%. Findings apply across a wide range of exposure types, geographical regions, and cancer types.

“Carrot intake across 50 prospective cohorts with 52,000 cancer cases revealed a relative risk reduction of 10% (relative risk, 0.90) compared to controls,” reported Charles C Ojobor, Newcastle University, Newcastle upon Tyne, UK, and colleagues reported.

Carrots are the main dietary source of potential anti-cancer compounds, including polyacetylenes, while β-carotene showed no benefits in controlled cancer trials.

The meta-analysis was performed to quantify the association between carrot intake and cancer incidence across all types of cancer focusing on high-quality (prospective) data. Secondarily, the researchers sought to estimate dose dependency, to facilitate the development of quantitative recommendations, and also to allow comparison of separate datasets to assess the robustness of the outcomes.

Specifically, the analysis aimed to ‘provide evidence for a dose–response relationship and for consistency of the association across studies’, as required by the European Food Safety Authority (EFSA) as one prerequisite for a health claim for carrot consumption to lower the cancer risk.

For this purpose, the researchers performed a meta-analysis of 50 prospective cohort studies capturing a wide variety of cancer types (colorectal, breast, prostate, lung, and other types), geographic regions (Asia, Europe, USA, other regions), and exposure types (alpha-carotene intake by plasma level and carrot intake from Food Frequency Questionnaire).

The intake of beta-carotene (another compound in carrots) was not evaluated because previous randomized clinical trials showed limited benefits in cancer reduction.

The researchers reported the following key findings:

  • Compared to controls, carrot intake across 50 prospective cohorts with 52,000 cancer cases finds a relative risk reduction of 10% (relative risk, 0.90).
  • Alpha-carotene (another compound found in carrots) plasma levels evaluated in 30 prospective cohorts with 9331 cancer cases found a relative risk reduction of 20% (relative risk, 0.80).
  • Studies of both types of exposure (carrots and alpha-carotene plasma levels) showed a significant linear dose-response relationship whereby one serving per week lowers risk by 4±2% and five servings per week lowers risk by 20±10%.

“These results provide enhanced support for cost-effective and safe public health recommendations and interventions to increase carrot intake, as part of the overall consumption of vegetables and fruits, to reduce the risk of cancer and other diet-related diseases,” the researchers wrote.

“The results also underscore the need to determine the roles of a wider range of vegetable phytochemicals, specifically isocoumarins and polyacetylenes, in pre-clinical studies regarding cancer-related effects,” they concluded.

Reference:

Ojobor CC, O’Brien GM, Siervo M, Ogbonnaya C, Brandt K. Carrot intake is consistently negatively associated with cancer incidence: A systematic review and meta-analysis of prospective observational studies. Crit Rev Food Sci Nutr. 2023 Dec 17:1-13. doi: 10.1080/10408398.2023.2287176. Epub ahead of print. PMID: 38104588.

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Tirzepatide significantly lowers albuminuria across all administered doses in patients with type 2 diabetes: Study

Greece: Tirzepatide, across all administered doses, probably leads to a significant reduction in albuminuria, while its use is linked with a neutral effect on creatinine clearance as a measure of kidney function, a recent systematic review and multilevel meta-analysis has suggested. The findings were published online in the Diabetes, Obesity and Metabolism on December 20, 2023.

“In patients with type 2 diabetes mellitus (T2DM), tirzepatide showed a significant and dose-dependent reduction in urine albumin-to-creatinine ratio,” the researchers reported.

“The reduction in albuminuria was consistent across all doses (15, 10, and 5 mg), highlighting a dose-response relationship.”

The researchers showed a neutral effect on the estimated glomerular filtration rate (eGFR), indicating no adverse impact on renal function.

Paschalis Karakasis, Aristotle University of Thessaloniki, General Hospital “Hippokration”, Thessaloniki, Greece, and colleagues aimed to summarize the available evidence from published randomized controlled trials (RCTs) regarding the effect of tirzepatide on renal function and albuminuria levels in patients with type 2 diabetes in a systematic review.

For this purpose, the researchers searched the online databases until 20 October 2023. They performed double-independent study selection, data extraction and quality assessment. Evidence pooling was done with a three-level mixed-effects meta-analysis. The analysis included 9533 participants from eight RCTs.

The researchers reported the following findings:

  • All RCTs had a low risk of bias, according to the Cochrane Collaboration tool (RoB2).
  • Tirzepatide was associated with a significantly greater reduction in urine albumin-to-creatinine ratio compared with controls [mean difference (MD) −26.9%; level of evidence (LoE) moderate]. This effect remained significant in participants with baseline urine albumin-to-creatinine ratio ≥30 mg/g [MD −41.42%; LoE moderate].
  • Based on subgroup analysis, the comparative effect of tirzepatide was significant against placebo and the insulin regimen, whereas no difference was observed compared with semaglutide.
  • The beneficial effect of tirzepatide on albuminuria levels remained significant across all investigated doses (5, 10 and 15 mg), showing a dose-response relationship.
  • A neutral effect was observed on the estimated glomerular filtration rate [MD 0.39 ml/min/1.73m2; LoE moderate].

“Our results suggest that tirzepatide probably leads to a significant reduction in albuminuria across all administered doses, while its use is associated with a neutral effect on creatinine clearance as a measure of kidney function,” the researchers concluded.

Reference:

Karakasis P, Patoulias D, Fragakis N, Klisic A, Rizzo M. Effect of tirzepatide on albuminuria levels and renal function in patients with type 2 diabetes mellitus: A systematic review and multilevel meta-analysis. Diabetes Obes Metab. 2023 Dec 20. doi: 10.1111/dom.15410. Epub ahead of print. PMID: 38116693.

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Computer-assisted implant surgery crucial tool in zygomatic implant placement

Computer-assisted implant surgery crucial tool in zygomatic implant placement suggests a new study published in Journal of Prosthetic Dentistry.

Digital technology can improve the success of zygomatic implant (ZI) surgery. However, the reliability and efficacy of computer-assisted zygomatic implant surgery (CAZIS) need further analysis.

The purpose of this scoping review was to provide an overview of the placement accuracy, implant survival, and complications of CAZIS.

A systematic search of English and Mandarin Chinese publications up to May 2023 was conducted in PubMed, Web of Science, Embase, and Wanfang database. The nonpeer-reviewed literature was searched in the trial register (clinicaltrials.gov). Clinical studies and cadaver studies on CAZIS were included. After data extraction and collection, the findings were critically reviewed, analyzed, interpreted, and discussed.

Results

Forty-one studies met the inclusion criteria. After excluding publications with duplicate data, retaining the most recent, 28 articles were included in this scoping review. Of these, 18 were on static computer-assisted zygomatic implant surgery (sCAZIS), 8 on dynamic computer-assisted zygomatic implant surgery (dCAZIS), and 2 on robot-assisted zygomatic implant surgery (rAZIS). Excluding the outliers, the mean deviations of ZIs in the sCAZIS group (with 8 articles reporting implant placement accuracy, 183 ZIs involved) were: 1.15 ±1.37 mm (coronal deviation), 2.29 ±1.95 mm (apical deviation), and 3.32 ±3.36 degrees (angular deviation). The mean deviations of dCAZIS (3 articles, 251 ZIs) were: 1.60 ±0.74 mm (coronal), 2.27 ±1.05 mm (apical), and 2.89 ±1.69 degrees (angular). The mean deviations of rAZIS (2 articles, 5 ZIs) were: 0.82 ±0.21 mm (coronal), 1.25 ±0.52 mm (apical), and 1.46 ±0.35 degrees (angular). Among the CAZIS reported in the literature, the implant survival rate was high (96.3% for sCAZIS, 98.2% for dCAZIS, and 100% for rAZIS, specified in 14 of 21 clinical studies). The incidence of complications was low, but, because of the few relevant studies (4/21 specified), valid conclusions regarding complications could not be drawn.

CAZIS has demonstrated clinical efficacy with high implant survival rates and placement accuracy. Of the 3 guided approaches, rAZIS showed the smallest 3-dimensional deviation

Reference:

Clinical efficacy of computer-assisted zygomatic implant surgery: A systematic scoping review. Wenying Wang, Xinbo Yu, Feng Wang, Yiqun Wu. Published:November 24, 2023DOI:https://doi.org/10.1016/j.prosdent.2023.10.032

Keywords:

Computer-assisted, implant, surgery, crucial, tool, zygomatic, implant placement, Journal of Prosthetic Dentistry, Wenying Wang, Xinbo Yu, Feng Wang, Yiqun Wu

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Firework Bans linked to Lower Ocular Trauma finds JAMA Study

In a recent case-control study explored the connection between local legislation on fireworks and the occurrence of vision-threatening injuries. The findings  of this study were published in the Journal of American Medical Association revealed important details about the impact of firework bans on ocular trauma during the Independence Day holiday.

Fireworks are known for their dazzling displays, but the accompanying risks to eye health have been a cause for concern. The study mainly aimed to evaluate the odds of firework-related ocular trauma in areas where fireworks are either permitted or banned.

This analysis was conducted at a level 1 trauma center in Seattle which spanned over eight years from 2016 to 2022. The case-control study involved 230 patients presenting with ocular trauma, with 94 who sustained firework-related injuries. The odds of such injuries were found to be significantly higher among residents in areas where fireworks were legally permitted compared to those living in areas where they were banned (OR, 2.0 [95% CI, 1.2-3.5]; P = .01).

The study also underscored the higher odds of patients under 18 years (OR, 3.1 [95% CI, 1.7-5.8]; P < .001) and male patients (OR, 3.3 [95% CI, 1.5-7.1]; P = .004). Also, firework injuries were more likely to be vision-threatening (57%) compared to non–firework-related injuries (40%) (OR, 2.1 [95% CI, 1.2-3.5]; P = .01).

The study highlights that residents in areas where fireworks are banned may experience a slightly lower risk of firework-related ocular trauma. While the findings imply that local firework bans could contribute to a modest reduction in these injuries, the study team emphasize the need for further studies to identify more effective measures that could help in minimizing the risks associated with fireworks.

Reference:

Harrison, L., Yee, P., Sundararajan, M., Ding, L., & Feng, S. (2023). Local Firework Restrictions and Ocular Trauma. In JAMA Ophthalmology. American Medical Association (AMA). https://doi.org/10.1001/jamaophthalmol.2023.5698

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Miniscrew sliding mechanics tied to changes in dimensions of upper dentition

Miniscrew sliding mechanics during space closure tied to changes in both sagittal and vertical dimensions of upper dentition suggests a new study published in the Head & Face Medicine.

This study aimed to investigate vertical changes in the maxillary central incisor and the maxillary first molar, along with alterations in the mandibular plane angle during space closure using miniscrew sliding mechanics.

Twenty adult patients treated at Peking University Hospital of Stomatology between 2008 and 2013 were included. Digital dental models and craniofacial cone-beam computed tomography (CBCT) scans were obtained at the start of treatment (T0) and immediately after space closure (T1). Stable miniscrews were used for superimposing maxillary digital dental models (T0 and T1), and vertical changes in the maxillary first molar and the maxillary central incisor were measured. Three-dimensional changes in the mandibular plane were assessed through CBCT superimposition.

Results

The maxillary central incisor exhibited an average extrusion of 2.56 ± 0.18 mm, while the maxillary first molar showed an average intrusion of 1.25 ± 1.11 mm with a distal movement of 0.97 ± 0.99 mm. Additionally, the mandibular plane angle decreased by an average of 0.83 ± 1.65°. All three indices exhibited statistically significant differences.

During space closure using the miniscrew sliding technique, significant changes occurred in both the sagittal and vertical dimensions of the upper dentition. This included extrusion of the maxillary central incisors, intrusion of the maxillary first molars, and a slight counterclockwise rotation of the mandibular plane.

Reference:

Su, H., Zhuang, Z., Han, B. et al. Vertical changes in the hard tissues after space closure by miniscrew sliding mechanics: a three-dimensional modality analysis. Head Face Med 19, 52 (2023). https://doi.org/10.1186/s13005-023-00388-9

Keywords:

Miniscrew, sliding, mechanics, during, space, closure, tied, changes, both, sagittal, vertical, dimensions, upper dentition, Su, H., Zhuang, Z., Han, B, Head & Face Medicine

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