Road accidents, industrial accidents and engaging in sporting activities are responsible for most fractures of the midface. A careful history, oral and facial examination and radiographs are imperative whenever any fracture is suspected. Treating edentulous or partially dentate patients of maxillary /mandibular fracture with gunning splints is the standardized procedure followed. For the elderly patients it becomes difficult to do open reduction surgery due to various complications and compromised medical conditions. The complication rate of infection or mal-union is higher as compared to fractures in younger dentulous patients. The present article discusses a case where a patient who had met a road accident was treated with gunning splint which was customized suiting the prevailing condition as only few teeth were present at the time of trauma.

e18523 Background: A significant proportion of patients with oral cancer require perioperative tracheotomy. The altered oral anatomy post surgery significantly impairs the first and second stages of swallowing, resulting in swallowing dysfunction and potential aspiration. There is no priordata on utilization of FEES or other objective tools to predict successful tracheotomy decannulation in patients with oral cancer. Methods: This constituted a retrospective analysis of 237 patients with oral cancer treated at our institution between Feb 2017 and Dec 2019. Seventy two (30.4%)patients underwent perioperative tracheotomy. Post surgery,after excluding patients who were not considered candidates for early decannulation, 48 (65.7%) underwent FEES with the endpoint of tracheotomy decannulation. The number of FEES procedures required for decannulation was correlated with patient and disease-specific variables utilizing Chi square analysis. Results: The rate of successful decannulation was 100%. The mean number of days from tracheotomy to decannulation was 24.9. Thirty two (66.7%) patients underwent decannulation post the first FEES, notablyupon documentation of no penetration or aspiration to three bolus consistencies. However, 33.3% patients needed swallowing therapy followed by a second (18.8%) or a third (14.6%) FEES before they could be decannulated (late decannulation). No patients required a repeat tracheotomy. A significantly higher proportion of individuals at or younger than median age were decannulated earlier, compared with individuals above median age ( p= 0.01). There was no statistically significant difference between early (T1/2) and advanced (T3/4) primary lesions and timing of decannulation ( p= 0.83). The presence of comorbid diabetes mellitus did not correlate with decannulation timing ( p= 0.81). Conclusions: FEES constitutes a reliable, minimally invasive and cost-effective tool to aid successful decannulation across all stages of oral cancer. It may be indicated especially in older individuals. It helps guide swallowing therapy, and thus potentially augments quality of life by tailoring serial evaluations to aid early decannulation.

Aim:To determine the frequency of hypothyroidism in women with recurrent pregnancy loss in first trimester in the Indian rural population. Study Design: The study included 50 women with one successful pregnancy and no history of miscarriages were selected as a control and total of 50 similar age group of pregnant women with recurrent pregnancy loss in gestational age up to ≤ 12 weeks verified by pregnancy test or ultrasonography. Method: Levels of thyroid hormones T3, T4 and TSH were estimated in pregnant and non pregnant women with recurrent pregnancy loss and controls. Result: The hypothroidism was found to be more significant cause of recurrent pregnancy loss in women as comparative to the euthyroid women. Conclusions: The study demonstrates that hypothyroidism has a statistically significant relationship with recurrent pregnancy loss in the first trimester and suggests that diagnosis of hypothyroidism could help couples with recurrent pregnancy loss to have a successful outcome in subsequent pregnancies.