To analyze etiology, incidence and management of facial trauma over a period of 5 years in a tertiary care center in North India.

Records of 195 patients with 274 facial fractures were analyzed retrospectively from 2009 to 2013. Fractures were classified according to anatomical area involved (zygoma, maxilla, mandible, teeth), and etiology was divided into road traffic accidents (RTAs), falls, sports injuries and assaults. It was found that RTA was most common etiologic factor for facial trauma, followed by falls, assaults and sports injuries. Mandibular fractures were most common, followed by midface fractures and dental injuries. Various treatment options were also evaluated.

Mandibular fractures were more common than midface fractures. Most common line of treatment was open reduction and internal fixation with mini-plate fixation. Mandible reconstruction was done in one case of bone defect following a gun-shot injury. Coronoidectomy had to be performed in one case of zygoma fracture.

Patient's best interest, affordability and general well being should be kept in mind while managing trauma of maxillofacial region. Surgeon should utilize his knowledge to the best possible level as any injury to this region has a direct impact on psyche as well as general well being of patient.

Sharma R, Esht V, Goomer P. Retrospective Analysis of Etiology, Incidence and Management of Facial Trauma Over 5 Years in North India: A Clinical Audit. J Postgrad Med Edu Res 2015;49(2):59-61.

Preinduction cardiac output (CO) is a small but significant predictor of induction dose of propofol. We hypothesized that glycopyrrolate, by inducing tachycardia (although to a small extent) would increase CO, and hence the induction dose of propofol. Aim of the study was to find out the dose of propofol required to induce anesthesia in patients receiving glycopyrrolate as compared to those not receiving it.

Eighty female patients (25-60 years, ASA-1, 2) undergoing elective procedures under general anesthesia were randomized into group G (glycopyrrolate) and group C (control). Patients received 1 ml (0.2 mg) glycopyrrolate (group G) or 1 ml normal saline (group C) intravenously 5 minutes before induction. Anesthesia was induced with propofol at a rate of 0.8 mg/kg/min titrated to achieve a target BIS = 40. Dose of propofol required for induction of anesthesia (loss of consciousness) and to reach the target BIS, heart rate (HR) and mean arterial pressure (MAP) at various intervals were compared. Correlation between the dose of propofol required to reach target BIS = 40 and heart rate after giving the test drug was performed by regression analysis.

The dose of propofol required for achieving target BIS was significantly higher (p < 0.001) in group G (2.08 ± 0.42 mg/kg) (mean ± SD) as compared to group C (1.66 ± 0.23 mg/ kg). There was a significant positive correlation between the preinduction HR (3 minutes after giving the test drug) and the propofol dose required to reach target BIS = 40 (r = 0.356, p < 0.01).

Administration of 0.2 mg of glycopyrrolate intravenously before induction of general anesthesia significantly increased the dose of propofol required for induction of anesthesia.

Arora S, Hegde HV, wig J, Puri GD. The Effect of Glycopyrrolate on Induction Dose of Propofol during General Anesthesia. J Postgrad Med Edu Res 2015;49(2): 62-65.

Study carried out to investigate the relationship of amphotericin B (AmB) therapy with hearing loss developing in patients with rhinocerebral aspergillosis during prolonged AmB therapy.

To study the effect of prolonged AmB therapy on the hearing acuity of patients suffering from invasive fungal sinusitis. Setting and design: Nonrandomized prospective study carried in Department of Otolaryngology and Head and Neck Surgery from January, 2010 to June, 2013.

High frequency pure tone audiometry (PTA) and cold caloric test (CCT) were done for all patients before starting of therapy with AmB. Both tests were repeated at 500 mg, 1 and 2 gm of AmB administration. Follow-up was done for all patients at 3 and 6 months after completion of therapy.

Twenty-four patients of invasive fungal sinusitis included. On prolonged AmB therapy some patients had deterioration in hearing. But these changes were not statistically significant. The changes were mild and shift was one grade above or below. It was also seen that the hearing complaints were reported in the middle of the therapy although all these patients had baseline hearing loss.

Amphotericin B does cause some change in hearing pattern; although not statistically significant. A further study is required with more number of patients so as to say definitively that AmB causes a change in hearing. Though these patients have numerous factors which can affect hearing in many ways, a systematic study is required to go a long way in clearing the doubts attached to AmB therapy.

Amphotericin related hearing loss has not been reported in English literature till date. Our study focuses on the effect of AmB on hearing. Amphotericin B does cause some change in hearing pattern, although not statistically significant. All the patients complained of hearing deterioration while some showed improvement on audiogram (though not significant) showing a paradoxical feature.

Mohindra S, Gupta B, Mohindra S, Gupta K, Singh D. Hearing Loss with Amphotericin B Therapy in Patients with Rhinocerebral Aspergillosis: Is it a Reality? J Postgrad Med Edu Res 2015;49(2):66-69.

Sharma R, Atri G, Verma M. Awareness of Oral and Maxillofacial Surgery among Medical Practitioners in North India: A Survey. J Postgrad Med Edu Res 2015;49(2):70-73.

Chakrabarty G, Varghese M, Thambapillay S. Unicompartmental Arthroplasty of the knee. J Postgrad Med Edu Res 2015;49(2):74-78.

Dasan A, Kalanayak V, Deepashri B. Solitary Fibular Metastasis from Hilar Adenocarcinoma of Lung. J Postgrad Med Edu Res 2015;49(2):79-82.

Prabhakar N, Gupta V, Panda N, Khandelwal N. Dual Ectopic Thyroid: An Uncommon Imaging Diagnosis. J Postgrad Med Edu Res 2015;49(2):83-84.

Yadav S, Jayaswal A, Vijayraghavan G, Goswami A. Coexistent Tuberculosis of Spine and Chronic Myeloid Leukemia: Resolving the Diagnostic Dilemma and Management. J Postgrad Med Edu Res 2015;49(2):85-87.

Sharma R, Kashyap R. Successful Treatment of a Complicated Case of Neuroleptic Malignant Syndrome with a Higher Dose of Bromocriptine and Lorazepam. J Postgrad Med Edu Res 2015;49(2):88-90.

Gupta K, Virk RS, Sunku SK. Isolated Sphenoid Sinus Mucocele: A Rare Case and Review of Literature. J Postgrad Med Edu Res 2015;49(2):91-93.