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BACKGROUND Faciomaxillary fractures are caused mainly by road traffic accidents and are often associated with life threatening emergency situations. They are treated extensively by open reduction and internal fixation with Stainless Steel Mini Plate (SSMP) implants in our medical college hospital. We come across miniplate exit on occasions. Hence, we decided to do a retrospective study on the subject of SSMP implant exit. The aim of the study is to find out the incidence and causes of SSMP implant exit following faciomaxillary fracture fixation over a period of three years. MATERIALS AND METHODS The case records of a total of 189 patients who had undergone faciomaxillary fracture fixation over a period of three years from Jan 2015 to Dec 2017 were perused with respect to the incidence and causes of SSMP implant removal. In addition, demographic parameters like age, sex and type of fracture, site of fracture, number of implants removed, and implant life in-situ were also analysed. RESULTS The SSMP implant exit was done in 14 cases (7.4 %); males-11, females-3. A total of 34 plates were removed. The commonest cause for implant exit was infection and the commonest site was body of mandible. CONCLUSION SSMP implants were well tolerated by most of the patients. SSMP implant exit was done in less than 10% of patients, the main reason being infection. This does not warrant a routine asymptomatic removal of SSMP implant in all cases.

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Dengue is a prevailing infectious disease in India currently associated with high mortality and morbidity. It is a viral disease without any specific treatment or specific drug availability. Some reports show that carica papaya leaves extract are said to improve the platelet count among dengue patients: but to support this, the prescription pattern and its common usage among the registered medical practitioners are not available. Objectives: This study is to evaluate the pharmaco epidemiology of the use of caripill among the registered medical practitioners in an urban population, Chennai. By knowing this, the popularity of the drug and its usage in the market can be evaluated.

<p class="abstract"><strong>Background:</strong> Injuries of lower limb due to road traffic accidents are challenging to reconstruct due to paucity of tissues and damage to vasculature. Recurrent trophic ulcers are also difficult to reconstruct due to stigmata of previous surgeries. When local and regional flaps are not available, free flaps become the best option. The success of free flap depends on the presence of healthy recipient vessels and microsurgical expertise. In cases where the free flaps have failed or when there is no available soft tissue for local flaps, cross leg flaps are a method of resurfacing and salvaging the limb.</p><p class="abstract"><strong>Methods:</strong> This Study was done from January 2013 to January 2016 in Rajiv Gandhi Government General Hospital, Chennai. 20 patients were included in the study and the flaps used were conventional cross leg and cross leg reverse superficial sural artery flap.<strong></strong></p><p class="abstract"><strong>Results:</strong> All flaps survived. There was one case of wound dehiscence managed by re-insetting, two cases with marginal necrosis which were managed conservatively. One case of partial loss which was managed by STSG and one case of sinus formation due to tuberculosis managed with ATT. Remaining flaps had no complications.</p><p class="BodyA"><strong>Conclusions:</strong> Cross leg flaps are still relevant in the present era of microsurgery. They can be the primary choice of reconstruction or as a workhorse when free flaps have failed or other loco regional flaps are already exhausted. Immobilisation and two stage reconstruction are few disadvantages which when weighed against limb salvage are acceptable. </p>