Recurrent oronasal fistulas after cleft palate repair present a difficult problem for the cleft surgeon. Repeated surgeries to close the fistula results in increased scar formation with associated soft tissue contracture and a resultant increase in fistula size. Although locally available flaps has been the standard procedure for closure of small fistulae, Large fistulas requires regional flaps like tongue flaps requiring multistage transfer, with resultant intra oral scarring, to avoid the problems associated with loco regional flaps and recent increase in success rates of free tissue transfers make them a viable, one-stage means of closing these defects. In this case report we present our clinical experience with recurrent palatal fistula and highlight the effective use of the free vastuslateralis muscle flap as a means of repair.

Background: With more than 25 lakh power-looms, the sector provides employment to about 65 lakh persons in India. Like many other occupations, the power-looms produce noise and vibrations affecting the health, with increase in morbidities.1The common health problems faced by power-loom workers were musculoskeletal problems, mental disorders, stress, respiratory problems, eye diseases, gastritis and injuries.2 This study was conducted to assess the morbidity prole among the power-loom workers and to assess the association of socio demographic factors with the morbidity prole among the power-loom workers in Bengaluru rural. Methods: A Community based cross-sectional study was conducted during March-July 2019, among 134 Power-loom workers situated in the rural eld practice area of a medical college in Bengaluru. Data was collected using semi-structured, interviewer-administered questionnaire and analysed using Epi Info Version 7.2.1. Chi-squared test was used to test association and p-value <0.05 considered statistically signicant. Results: Mean age of the Power-loom workers studied was 42.38 (± 9.66) years and 76.1% were males. majority 56% belong to class-II socioeconomic status. The most common morbidities were musculoskeletal problems (81.3%), vision problems (53.8%), gastrointestinal problems (53.8%) and hearing problems (24%). Multi-morbidity was seen in 75.4% of study participants and was signicantly more among males. There was a signicant association between morbidity pattern and age-group, duration of current job, lifting of heavy objects (P<0.05). Conclusion: The prevalence of morbidity among power loom workers was high and there is need to develop appropriate strategy to tackle, including preventive strategy.