I, Dr. S. Mahesh Kumar solemnly declare that dissertation titled “A STUDY TO ASSESS THE FUNCTIONAL AND AESTHETIC OUTCOME OF SOFT TISSUE RECONSTRUCTION OF LEG AND FOOT DEFECTS USING CONVENTIONAL AND MICROVASCULAR FREE FLAP TECHNIQUES” is a bonafide work done by me at Govt. Stanley Medical College & Hospital during September 2010 to August 2012 under the guidance and supervision of Prof. Dr. J. MOHAN, M.S, M.Ch (Plastic Surgery) and Head of the Department.
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Patients and methods: A prospective comparative randomized single-center study enrolled 110 patients with bilateral congenital ptosis. One group (n=55) underwent AFLS and the sec- ond group (n=55) underwent GTS. Exclusion criteria were good levator function, absent Bell’s phenomenon, and abnormal ocular motility. Follow-up period was 2 years. Functional outcome was measured from digital photos by analysis of upper eyelid margin position relative to the superior limbus and classified as very good (,3 mm), good (3–5 mm), poor (.5 mm), and recurrent. Aesthetic outcome was assessed in terms of lid contour, symmetry of eyelid height, and lid crease presence. Complications were also reported.
To conclude, post-treatment assessment showed complete root coverage and an excellent aesthetic outcome of lateral pedicle graft and sub-epithelial connective tissue graft root coverage procedures of an isolated gingival recession. Case selection is foremost important criteria for a successful treatment. It is important to provide optimum functional and aesthetic solution for the missing gingival tissue and simultaneously to preserve periodontal health.
Gingival recession, the apical migration of gingival margin is a mucogingival defect of multifactorial origin. It can be defined as the exposure of root surface by an apical shift in the position of gingiva (Carranza et al., 1996). The various consequences are clinical crown lengthening esthetic problem, hypersensitivity, root caries, abrasion and fear of tooth loss (Zucchelli et al., 2003; Pabolu et al., 2013). The presence of gingival recessions at the anterior teeth may represent an esthetic problem. This disharmony may be apparent in the patient’s smile or even at a functional level (phonics, chewing). Root coverage has become an important treatment modality because of increasing cosmetic and functional treatment. The treatment of buccal gingival recession for aesthetics or root sensitivity is a frequent demand in patients (Gupta and Pradhan, 2015). Several root coverage procedures have been tested to move the position of the gingival margin coronally including pedicle flaps, free soft tissue grafts, combination of pedicle flaps plus grafts or barrier membranes (Prato et al., 1995). The international literatures (Prato et al., 1995; Dym and Tagliareni, 2012; De Sanctis and Clementini 2014; Wennstrom and Zucchelli 1996). Have thoroughly documented that gingival recession can be successfully treated using several surgical procedures, irrespective of the utilized technique, provided the biologic conditions for accomplishing root coverage are satisfied: no loss of interdental soft and hard tissue height (Miller, 1993). Irrespective of the surgical approach, the ultimate goal of a root coverage procedure is the complete coverage of the recession defect and an optimal integration of the covering tissue with the adjacent soft tissue.
uncomplicated MTBI, such that outcome scores after complicated MTBI more closely approximated those of patients with moderate TBI (Hsiang et al., 1997; van der Naalt et al., 1999; Williams et al., 1990). By using more sensitive measures of TBI outcome and assessing a broader range of functional abilities, the current results extend previous findings by demonstrating equivalent outcomes in terms of levels of physical (i.e., FIM motor domain) and cognitive (i.e., FIM cognitive domain) independence, employability (i.e., DRS), and degree of community integration (i.e., CIQ) between complicated MTBI and moderate TBI patients. As with neuropsychological outcome, recovery of functional status was far from complete by 1-year post-injury, thus providing further evidence of disparate outcomes after complicated MTBI vis-a-vis uncomplicated MTBI. For instance, within the complicated MTBI group total scores on the DRS corresponded to the partially impaired range, 29% of patients remained in the dependent range on the FIM cognitive domain, nearly one third of the group remained unemployable, and level of community integration at 1-year post-injury was similar to that of patients with moderate to severe TBI (Levin et al., 1990; Novack et al., 2000).
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undergoing hemicraniectomy, other authors did not find a relation between functional outcome and retrospective agreement to therapy [18-20]. In another study, the will- ingness of patients to undergo intensive care to achieve even 1 additional month of survival was high; however, when asked if this would also apply if the patients were in a vegetative or severely neurologically impaired state, willingness to undergo intensive care was much less . This again shows that there may be a difference in accepting general intensive care compared with neuro- intensive care, as the latter is associated with a higher likelihood of cognitive impairment.
The premature loss of primary incisors is usually given little clinical attention unless severe closure of the space is noticed or there is evidence of an aberrant speech pattern and oral habits developing as a result (Chakraborty et al., 2015). Northway (1984) stated that more space was lost in the first year of extraction than in successive years (Northway, 1984). Kumari (2006) found that the greatest space closure occurs during the first 4 months of the extraction (Padma Kumari, 2006). One of the important functions of the primary tooth is to occupy the physiological space and guide the eruption of its permanent successor (Singh, 2010). The aesthetic rehabilitation of primary anterior teeth has a vital psychological impact on recovery of patient’s self-esteem (Slack and Jones) (Slack, 1955). The successful restoration of badly mutilated primary anterior teeth in preschool children is a challenging task. Conventional glass ionomer restorations have demonstrated high failure rates in the primary dentition. In addition, adhesion of the bonding agents to the enamel and dentine of primary teeth (less mineralized structure) is poor as compared to that of permanent teeth and can compromise the final restoration (Mehra, 2012; Mortada, 2004). When there is severe loss of coronal tooth structure, the use of posts placed inside the canal after endodontic treatment will give retention, provide stability to the reconstructed crown, and withstand masticatory forces in function. There are a variety of root posts used in pediatric dentistry. A resin composite post building up directly, alpha or omega shaped orthodontic wires, stainless steel pre fabricated posts, nickel- chromium cast posts with macro retentive elements, biological posts prepared from natural teeth from a tooth bank
the gain in the angle of maximum range of motion possible at 6 months after surgery and scaled as good if there is improvement of more than 75% of normal range for that joint. Recovery of joint mobility is compared with each surgical procedure. Overall functional improvement in the study was satisfactory, with good recovery after 38 (66%) resurfacing procedures, average recovery in 15 (27%) procedures and poor recovery in only 4 (7%) procedures. However, the functional results varied slightly across the different surgical procedures with better recovery after Z plasty and loco- regional flaps. The contracture recurrence rate was 17.4% in the split thickness skin graft group in spite of prolonged use of extension splint; there was however no recurrence of contracture in the other procedures.
For example, booking.com, the most popular reservation system, gives hoteliers an opportunity to describe in detail everything which is remarkable for each hotel according to the following categories: "Internet", "Outdoors", "Media & Technology", "Food & Drink", "Parking", "Services", "General", "Languages Spoken" and some others. However, by no means all the hotels fully realize the given opportunity. Very little attention is paid so far to such significant characteristics for customers as: "Aesthetic Characteristics", "Peculiarities of Cuisine", "Location of Tourist Attractions and Ability to Visit Them", "Languages Spoken", "Quality of Beach and Sea", "Entertainment Programs" and others. It is only booking.com which expresses customers' interests, which were identified in comments, better than the other reservation systems, but still not to a full extent. In fact, these characteristics are necessary for a hedonic pricing method, which is more profitable for hoteliers.
This clinical report describes the oral rehabilitation of a 24-year-old woman affected by hypoplastic type of amelogenesis imperfecta along with palatally positioned maxillary lateral incisors with the use of porcelain bonded to metal FPDs and full ceramic, porcelain bonded to metal and full metal crowns to correct the malocclusion and aesthetic problem, to eradicate sensitivity and to restore the masticatory function. After three and six months recall there was no sensitivity or pathology associated with the rehabilitation. The patient was satisfied both esthetically and functionally about this pr
which were reported in other African surveys by using the IOTN. For instance, Otuyemi et al., and Mugonzibwa et al.,  found that 7% and 11% of Nigerian and Tanzanian children were in definite need of orthodontic treatments, on the basis of the AC component. On the other hand, greater rates of AC grades of 8–10 were reported for other racial groups. The high discrepancy between treatment needs, as was indicated by the AC and DHC of the IOTN and the ICON, may have occurred because of the fact that malocclusional traits such as missing teeth and crossbites of posterior teeth did not always make aesthetic impacts.
Ken Danyluk, DMD, Chris Lavelle (1999) 18 studied potential application of the dental aesthetic index to prioritize the orthodontic service needs in a publicly funded dental program. The pre-treatment records of 38 patients were prioritized on a visual-analog scale relative to their differential orthodontic service needs by 16 independent orthodontic specialists. When these same records were prioritized relative to their scores derived from the Dental Aesthetic Index, their assessments proved more consistent, especially when based on a modified Dental Aesthetic Index. The lack of established clinical guidelines to delineate the most appropriate service and timing for specific occlusal discrepancies used to hampers the prioritization of orthodontic service needs. Dental Aesthetic Index case-scores may therefore be considered as just one of many criteria to prioritize orthodontic service needs, although the potential impact of the others has yet to be quantified.
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Anatomically, nasal deviation may be categorized into the following deformities: “tilt deformity”, “S-shaped deformity”, and “C-shaped deformity” or a combination of them . Occasionally, nasal deviation is accompa- nied by other facial deformities, too [4,5]. The bony and the cartilage components of nose, together, form the functional nasal structure; and they are both subject to deviation, especially nasal septum. Nasal septum has a major role in forming the “nasal valve” with caudal por- tions of lateral nasal cartilages; even a slight change to its shape or length may affect nasal physiologic function through altering the nasal valve diameter; this ends up to
In recent times, multi-storey buildings in urban area are required to have column free space due to shortage of space, population and also for aesthetic and functional requirements. For this buildings are provided with floating columns at one or more storey. These floating columns are highly disadvantageous in a building built in seismically active areas. The earthquake forces that are developed at different floor levels in a building need to be carried down along the height to the ground by the shortest path. Deviation or discontinuity in this load transfer path results in poor performance of the building. The object of present work is to study the behaviour of multi-storey building with and without floating columns under seismic forces. For this purpose P+3 storey and P+20 storey building are considered and analyzed for zone III and zone V and for soil Type I, Type II and Type III by using software STAAD Pro. Present work gives good source of information on parameters like storey drift and base shear.
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Similarly, our study has some important contributions for practitioners. First, we provide evidence that although aes- thetic, functional, and symbolic designs positively improved the self-determined needs of consumers across samples, the aesthetic design appeared more promising to satisfy self- determined needs of Pakistanis and Chinese. Thus, practitio- ners targeting Pakistani and Chinese customers should pay special attention to improve the perceived appearance and beauty of a product since it creates an initial impression and provides a means of self-expression, the experience of inti- macy, and a sense of connectedness with the product/brand.
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mentation are individuals who demonstrate, after discussion with the physician, an understanding of the nature of dermal filling procedures, realistic expectations about aesthetic outcomes, a commitment to assist with their pretreatment and posttreatment care, and a willingness to schedule and attend follow-up examinations and additional or touch-up treatments as necessary. 2 It is important that patients explain
The worst functional outcomes for k-wiring were reported by Wirmer et al, with only 52% of their 21 participants having an excellent outcome. 28 The authors used the scoring system developed by Dhillon et al, which grades even a 1° loss of range of motion from the con- tralateral side as “ good ” and not “ excellent ” . 29 This will lead to patients with no true functional de ﬁ cit being down- graded and could lead to poorer results than if they had used a scoring system such as MEPS, which gives any range of motion above 100° the highest functional score.
moderate birth asphyxia and 35 controls matched for weight and gestation. They were followed up prospectively for neurodevelopmental outcome. 6 neonates with severe birth asphyxia had abnormal neurological signs such as delayed sucking, hypo or hypertonia, apneic spell or seizures. Of these only 2 had delayed developmental milestones. The study highlights the fact that a majority of survivors of birth asphyxia enjoy good quality of life thus emphasising the need for vigorous management of asphyxiated babies at birth.
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Obstructive sleep apnea (OSA) is a common sleep disorder that can have a significant detrimental effect on the quality of life of affected individuals. Although various therapies are available for the treatment of OSA, CPAP remains the gold-‐‑ standard of non-‐‑surgical treatment. Successful surgical treatment for OSA has been achieved via maxillomandibular advancement (MMA) surgery, and remains a definitive treatment option for patients unable to tolerate CPAP therapy, or who do not want to be burdened with long-‐‑term wear. Due to the large advancements required for surgical correction of OSA through MMA surgery, concerns may be raised about the post-‐‑surgical aesthetic outcome. Despite the possibility of
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Age did not seem to influence patient satisfaction. This confirms results from some previous studies [5, 7, 9], whereas others have shown that both younger [13, 14] and older age [5, 11] can increase the risk of poor out- come. In these studies, age groups have been defined dif- ferently, but most studies have had a cutoff at 60 years to define “younger” and “older”. It could be hypothesized that a potential negative impact of high age on aesthetic outcome could be concealed by less favourable ratings from younger women, with possibly higher demands regarding the aesthetic result. In a study by Cetintas et al., age >50 years was shown to be a risk factor for poor aesthetic outcome when the evaluation of outcome was made by a panel of observers, but not when the patients evaluated the results .
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