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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 Jul 28 2016
Journal Name
Journal Of Advanced Nursing
Cardiovascular medication adherence among patients with cardiac disease: a systematic review
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Abstract<sec><title>Aims

The aim of this study was to critically appraise and synthesize the best available evidence on the effectiveness of interventions suitable for delivery by nurses, designed to enhance cardiac patients' adherence to their prescribed medications.

Background

Cardiac medications have statistically significant health benefits for patients with heart disease, but patients' adherence to prescribed medications remains suboptimal.

Design

A systematic quantitative review of intervention effects.

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Publication Date
Tue Dec 05 2023
Journal Name
Baghdad Science Journal
AlexNet-Based Feature Extraction for Cassava Classification: A Machine Learning Approach
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Cassava, a significant crop in Africa, Asia, and South America, is a staple food for millions. However, classifying cassava species using conventional color, texture, and shape features is inefficient, as cassava leaves exhibit similarities across different types, including toxic and non-toxic varieties. This research aims to overcome the limitations of traditional classification methods by employing deep learning techniques with pre-trained AlexNet as the feature extractor to accurately classify four types of cassava: Gajah, Manggu, Kapok, and Beracun. The dataset was collected from local farms in Lamongan Indonesia. To collect images with agricultural research experts, the dataset consists of 1,400 images, and each type of cassava has

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Publication Date
Fri Jan 01 2016
Journal Name
Journal Of Computer And Communications
Pathfinding in Strategy Games and Maze Solving Using A* Search Algorithm
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Publication Date
Sun Apr 08 2018
Journal Name
Al-khwarizmi Engineering Journal
Building a Management System to Control the Construction Claims in Iraq
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The paper deals with claims in construction projects in Iraq and studies their types, causes, impacts, resolution methods and then proposes a management system to control the impacts of claims. Two parts have been done to achieve the research objective (theoretical part and practical part). The findings showed that the main types of the claims are extra work claims, different site condition claims, delay claims and the main causes of the claims are variation of the orders, design errors and omission, delay in payments by owner, variation in quantities and scheduling errors. The claims have bad impacts on the cost by increasing (10% to 25%) and also on the duration of the project by increasing from (25% to 50%).The negotiation is the main

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Publication Date
Wed Mar 30 2022
Journal Name
Nasaq Journal
Lingual Sovereignty: Chinua Achebe’s Novel Things Fall Apart A Postcolonial Study
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The discourse surrounding lingual sovereignty within the African postcolonial context is profoundly intertwined with the fabric of cultural identity and self-determination. Language serves not merely as a conduit for communication but as a repository for a people's collective consciousness, encapsulating their traditions, thoughts, and perspectives. In the realm of postcolonial literature, this dialogue often grapples with the paradox of expressing indigenous narratives through the linguistic tools of former colonizers. Chinua Achebe's seminal work, "Things Fall Apart," exemplifies this conundrum, artfully weaving the orature and culture of Umuofia within the English language. Achebe's choice to write in English—a language imposed upon hi

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Publication Date
Tue Sep 08 2020
Journal Name
Baghdad Science Journal
A Proposed Analytical Method for Solving Fuzzy Linear Initial Value Problems
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     In this article, we aim to define a universal set consisting of the subscripts of the fuzzy differential equation (5) except the two elements  and , subsets of that universal set are defined according to certain conditions. Then, we use the constructed universal set with its subsets for suggesting an analytical method which facilitates solving fuzzy initial value problems of any order by using the strongly generalized H-differentiability. Also, valid sets with graphs for solutions of fuzzy initial value problems of higher orders are found.

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Publication Date
Tue Nov 01 2022
Journal Name
Alustath
Metrical Phonology in Classical English and Arabic Poetry: A Contrastive Study
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One of the prominent goals of Metrical Phonology Theory is providing stress of poetry on the syllable-, the foot-, and the phonological word- levels. Analysing poetry is one of the most prominent and controversial issues for the involved number and types of syllables, feet, and meters are stable in poetry compared to other literary texts. The prosodic seeds of the theory have been planted by Firth (1948) in English, while in Arabic يديهارفلا in the second half of the eighth century (A.D.) has done so. Investigating the metrical structure of poetry has been conducted in various languages, whereas scrutinising the metrical structure of English and Arabic poetry has received little attention. This study aims at capturing the

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Publication Date
Fri Jan 05 2018
Journal Name
Asian Quarterly: An International Journal Of Contemporary Issue
Refugees and the Challenges for Language Education (LE): A Theoretical Study
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DBN Rashid, Asian Quarterly: An International Journal of Contemporary Issue, 2018

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Publication Date
Thu Nov 01 2018
Journal Name
Italian Journal Of Vascular And Endovascular Surgery
Retroperitoneal versus transperitoneal approach for aortoiliac occlusive disease: a comparative study
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Publication Date
Sun Jun 23 2019
Journal Name
Arma
Safe Mud Weight Window Determination: A Case Study from Southern Iraq
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ABSTRACT:. The Lower Cretaceous Zubair formation is comprised of sandstones intercalated with shale sequences. The main challenges that were encountered while drilling into this formation included severe wellbore instability-related issues across the weaker formations overlaying the reservoir section (pay zone). These issues have a significant impact on well costs and timeline. In this paper, a comprehensive geomechanical study was carried out to understand the causes of the wellbore failure and to improve drilling design and drilling performance on further development wells in the field. Failure criteria known as Mogi-Coulomb was used to determine an operating mud weight window required for safe drilling. The accuracy of the geomechanical

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