The Tribune, Chandigarh, India - Chandigarh Stories

HEALTH

Treating patients suffering from maxillofacial trauma
Tribune News Service

CHANDIGARH, March 4 — With the ever-increasing vehicular traffic in India and changing attitudes of people leading to violence and the existing risk of accidents at home and outside, maxillofacial trauma is emerging as one of the major thrust areas for dentists, needing comprehensive management. It was with this objective in mind that the Department of Oral Health Sciences, PGI conducted a day-long CME programme on “Dento-Maxillofacial Trauma’’ at Lecture Theatre I today to train the PCMS dental doctors and the general dentists from the city and the surrounding areas in the complete management and rehabilitation of patients with maxillofacial trauma.

The CME organised under the auspices of Punjab Health System Corporation (PHSC) also commemorated the 5th anniversary of the Department of Oral Sciences. About 170 delegates from various districts of Punjab , Chandigarh and the nearby areas attended the workshop.

In his inaugural address, Mr P.K. Verma, Principal Secretary, Health, Punjab, and Chairman, PHSC, highlighted the importance of good natural teeth. He called upon the dental surgeons to make use of this opportunity and learn from the specialists the comprehensive methods of proper diagnosis and management. They should also update their knowledge by knowing about the latest equipment and technology, he added.

Talking about the objective of the workshop, Prof H.S. Chawla, Professor and Head of the department, pointed out that head and face, the exposed parts of the body are involved in the highest percentage of injuries of all body regions. These injuries may involve brain, eyes, nose, neck, facial bones and teeth. The primary cause of such injuries in most cases is an accident in one form or the other. He revealed that increase in population and introduction of fast moving vehicles has led to an increase in the cases of high velocity trauma and the severity of injuries. However, simple preventive measures, which are being followed in the West such as wearing of seat belts during car driving and use of helmet by both the driver and pillion rider during two wheeler driving should be strictly enforced. It will reduce not only the number of injuries but also their impact.

In the rural areas, the cause of traumatic injuries is the slipping out of the nail from the nozzle of the handpump and its handle striking and fracturing the maxillary anterior teeth. Fall from the stairs is another cause. Dr Chawla further said that people very often open soda bottles with their teeth to show manliness. They do not realise that these broken parts never grow. And the repaired tooth, which may live for life never equals the natural tooth, he added. He later delivered talk on “Fracture of teeth and their management.’’

The day’s programme began with a lecture by Prof Pramila Chari , Head, Department of Anaesthesia, PGI on “Cardio Pulmonary Cerebral Resuscitation’’ in which she explained the precise method of reviving a patient from a cardiac arrest till you reach a professional.

Dr V.K. Khosla, Head, Department of Neurosurgery, PGI, emphasised on the neurological considerations during the management of facio-maxillary trauma. He said that management of these injuries could be best carried out by specialised teams consisting of trauma and the dental surgeons in quality trauma centres.

Dr Vidya Rattan, Assistant Professor in the department, talked at length about the diagnosis and tips on management of dento-maxillofacial trauma such as how to detect a fracture of jaws and how to unite the same. He pointed out that injuries of the face and the jaws are often associated with other injuries. Hence, close cooperation with general surgeons, neurosurgeons, plastic surgeons, anaesthetist and ophthalmologist is required in prioritising the treatment. He further said that while simple injuries requiring basic minimum investigations can be handled by dentists with sufficient experience in maxillofacial trauma and management, the serious ones which require open reduction and fixation should be referred to oral and maxillofacial surgeons.

Dr A.K Tutreja, Additional Professor, said that dento-maxillofacial trauma is very often accompanied by orthodontic implications. For instance protruding teeth are prone to fractures and an early treatment should be sought. Trauma in growing children may cause maxillo-mandibular growth aberrations which manifest as facial deformities, which cannot be treated successfully without extensive orthodontic mechanotherapy, he added.

Dr Ajay Juneja, a senior resident in his lecture on “Prosthodontic Rehabilitation of cases with Dento-Maxillofacial trauma’’ pointed out that before reaching the restorative/prosthodontic phase the patients of dentofacial trauma have been through a state of physical and emotional unrest.

Such individuals thereby have high expectations and want to look and function as well as before the trauma and even better. Hence, the job of a prosthodontist becomes more demanding.

The delegates were shown a live demonstration of management of a fracture of a mandible, which is broken below the condyle and at the angle of the mouth or the other side of the jaw. It was conducted by Dr Vidya Rattan and Dr Preet K. Singh.

Dr K. Gauba, Additional Professor in the Department, talked about prevention and control of maxillofacial trauma. He said that maxillofacial trauma is more prevalent in the age range of 16-30 years, when children and young adults are in their most active phase of their lives. He elaborated on tips for walking on the road, safe cycling and prevention of such injuries in sports. He advocated use of protective devices like a mouth guard during contact sports. The last talk on “Medicolegal Implications and Disability with regard to Dento-Maxillofacial Trauma’’ was given by Dr S.P. Mandal, a senior resident in the Department of Forensic Medicine.

Rs 135 crore for PGI in 2000-2001
By V.P. Prabhakar

THE Central Government has provided a sum of Rs 135 crore for the Postgraduate Institute of Medical Education and Research, Chandigarh, for the next year (2000-2001).

The PGI was set up by an Act of Parliament as an institute of national importance having the same functions as AIIMS, New Delhi, but in the field of Postgraduate medical education. The institute is wholly financed by the Central Government and is a centre for medical education, research and specialised hospital services. Nehru Hospital, according to the budget papers, attached to the institute has a bed strength of 1268.

The outlay for the PGI is about Rs 2 crore more than the budget estimates for the year 1999-2000, but Rs 22.66 crore more than the revised budget for 1999-2000.

This shows that there was a cut of Rs 20.66 crore in the revised budget for 1999-2000 as compared to the budget estimates for the same year. Of Rs 133 crore for 1999-2000, Rs 47 crore was under the plan and Rs 86 crore under non-plan. However, under the plan a drastic cut was imposed, as a result of which only Rs 25 crore remained in the revised budget. In the non-plan side, there was an increase of Rs 1.34 crore from Rs 86 crore to Rs 87.34 crore.

In the budget for 2000-2001, Rs 44 crore has been provided under the plan and Rs 91 crore under the non-plan. This shows that while there is a jump of Rs 19 crore in the plan side as compared to the revised budget of 1999-2000, the increase on the non-plan side is of the order of only Rs 3.66 crore.

The statistical figures of the four years of the PGI budget present an interesting facts. While the total budget (both plan and non-plan) for the institute shows 73 per cent rise in these years, the non-plan budget alone increased by 47 per cent. It was Rs 78.36 crore in the 1997-98 and it has reached this time Rs 135 crore. In between two years, the total budget of the institute was like this: Rs 121.47 crore in 1998-99 and Rs 112.34 crore (revised) in 1999-2000.

The non-plan budget during these four years was Rs 48.36 crore in 1997-98 and it jumped to Rs 91 crore in 2000-2001. In fact the quantum jump was witnessed in 1998-99 when the non-plan budget of the institute went up to Rs 81.47 crore in the revised estimates for the year 1998-99 as compared to the budget estimates of Rs 53.20 crore. In 1999-2000, the non-plan revised estimates are Rs 87.34 crore.

The plan side also showed an increase of 46 per cent during four years. The plan allocation in 1997-98 (both estimates and revised estimates) was Rs 30 crore which has now gone up to Rs 44 crore. It was Rs 40 crore in 1998-99. However, in the plan side, reduction was made under the revised estimates for 1999-2000 to Rs 25 crore from Rs 47 crore in the budget estimates.

The budget allocation for the Central Research Institute, Kasauli, has been made at Rs 17.08 crore for 2000-2001 as compared to Rs 13.36 crore in the revised budget for 1999-2000.

This institute was established in 1905 for research in the field of medical health problems and production and quality control of immunobiologicals. The institute is the biggest and most comprehensive producer of immunobiologicals — diphtheria, petussis and tetanus, cholera vaccines, anti-snake venom, anti-rabis serum etc. The institute is also running regular classes of B.Sc., M.Sc. and M.Phil (microbiology) of the Himachal Pradesh University. In addition, the institute is recognised for M.D. pathology and bacteriology, Ph.D. biochemistry and microbiology by the various universities in the country.

Of Rs 17.08 crore, Rs 6.61 crore is under the plan head and Rs 10.47 crore under the non-plan side.

In the budget estimates for 1999-2000, Rs 14.21 crore (Rs 3.21 crore for plan and Rs 11 crore for non-plan) was provided. However, in the revised budget the allocation was reduced to Rs 13.36 crore (Rs 3.36 crore under plan and Rs 10 crore under non-plan).

In the four years, the allocation has increased by 30 per cent. The allocation was of the order of Rs 13.10 crore in 1997-98 and it is now Rs 17.08 crore.

Guidelines on HIV tests cause concern
By Gautam Dheer

PANCHKULA, March 4 —The recently concluded state-level workshop for specialist doctors, on prevention of HIV/ AIDS held at the State Institute of Family Health and Welfare, Sector 6, has ignited a debate, challenging the rationality of certain guidelines of the National AIDS Control Organisations (NACO) in regard to HIV tests.

The guidelines, which are being visualised as unjustified, allegedly have overlooked alarming facts, which may result in the failure of phase 2 of the National AIDS Control Programme. Along with vital information on the subject, the workshops have contributed towards giving rise to certain apprehensions.

The guidelines of the NACO, underline that no individual should be made to undergo mandatory testing of HIV and the mandatory testing of HIV, cannot be imposed as a precondition for employment or health care facilities. The guidelines lay stress that HIV tests which cannot be assumed as a precondition, can only be undertaken at the discretion of the doctor treating the patient.

Specialists say since they have to treat scores of patients everyday, they are vulnerable to menace compounds. While performing major and minor surgeries, the exposure to a patient’s blood, body fluid and other potentially infectious material is likely to infect the operating doctor or the health worker, if he gets a cut during the process.

Since NACO guidelines prohibit HIV test for routine patients, the status of patients in regard to HIV/AIDS is unknown to the doctor or the health worker. Consequently, his likelihood to fall a victim during the process is enhanced.

The guidelines suggest that the doctor or health worker who has been exposed to the blood source of the patient, should undergo prophylaxis or post exposure prophylaxis treatment, costs of which will be borne by the NACO. The guidelines add that the therapy should be started within 2 hours of the exposure. Sources reveal that the cost of a single PEP treatment varies between Rs 18,000 and Rs 20,000.

Senior medical sources argue that a doctor or a health worker, especially those performing surgeries in operation theatres, get the exposure several times, despite adequate precautions, while handling sharp medical tools. Owing to side effects of the therapy and high cost factor involved, it is irrational to undergo the treatment as many times as one gets the exposure, they argue.

SPORT

Lions Club crush Himachal Club
By Our Sports Reporter

CHANDIGARH, Mar 4 — Lions Club, Ambala, beat Himachal Club by seven goals to nil today in the qualifying rounds of the National Football League (second division) being played here at the Sector 17 Football Stadium. Tomorrow, the final league match will be played between Himachal Club and Youngsters Club, Chandigarh. One team out of the three participating teams will qualify for the NFL.

Today, Sunil of the Ambala team stole the show by scoring four goals. However, in the dying minutes of the match, he was also shown a yellow card by officials. Sunil scored the first goal in the 25th minute of the match. Rajesh scored a goal after getting a pass from Sunil in the 38th minute, followed by Sunil who scored from a pass by Khairati Lal in the 40th minute. Before the end of the first half, Rajesh gave the team a 4-0 lead by scoring in the 54th minute.

Himachal Club could not get the opening for making any comeback into the game. Ravinder Yadav scored a goal in the 60th minute. In the 72nd minute, Sunil scored his third goal after receiving a pass from Rajesh. In the 85th minute, Wilson gave a long corner pass to Sunil to help him score the seventh goal for his team.

The teams which took part in today's match were as follows: Lions Club, Ambala — Vikram, Manglesh, Surinder Mohan, Pardeep, Sanjay Jha, Wilson, Khairati Lal, Sunil, Ravinder Yadav, Rajesh, Vishal, Sanjeev, Rajiv, Ajmer, Vivek and Manish.

Himachal Club — Ashok, Harvinder, Ashu Aggarwal, Neeraj Chandel, Ravinder Thakur, Sunil Kumar, Naveen Verma, Jafer Ali, Deepak Kumar, Jatinder, Parvinder, Yam Prashad, Sandeep, Sachin, Sher Singh and Ajay.

Cricket tourney

Panther Cricket Club and Evergreen XI entered the last eight of the MM Lal Jain Memorial Tournament organised by the Chandigarh Cricket Association here today.

In the matches played here today, Panther Club beat Domino XI by eight wickets, while Evergreen XI also beat Chetna Club by eight wickets.

Brief scores: Domino XI — 124 runs all out in 19.2 overs (Sohan 19, Pintoo 17, Gurbachan 3 for 7, Sanjay Rana 2 for 10, Major Singh 2 for 19, Devi Singh 2 for 22); Panther CC — 126 runs for two in 17.2 overs (Kuldeep Singh 57, Tilak Raj 29, Parvinder 19, Sunil 2 for 16).

Second match: Chetna XI — 159 all out in 25 overs (Narinder Kwatra 34, Dharamveer 31, Naresh 30, Gurdeep Rana 5 for 14); Evergreen XI — 161 for two in 22.3 overs (Inderjeet 58 n.o., Girish Bhanot 47 n.o., Navneet Thapar 31).

In last match of the day, Sohal XI defeated Shine Star XI by 61 runs. Brief scores: Sohal XI — 161 runs for nine wickets in 20 overs (Harpal 41, Mohan Lal 23, Anup 25, Rajinder 3 for 35, Shamlal 2 for 24, Parveen 2 for 18); Shinestar XI — 100 runs all out in 17 overs (Gagan 28, Vishal 17, Manjit 3 for 10, Dinesh 2 for 18).

GCC win

Godrej Cricket Club defeated Punjab Civil Secretariat team by four wickets, while Khalsa Cricket Club beat Pace XI by 58 runs today in the first B.S. Duggal Memorial Cricket Tournament being played here.

Brief scores: Punjab Secretariat XI — 174 runs all out (Prabhjot Johny 55, Gurbachan 30, Harpal Singh 25, Sanjay Dhull 15, Umesh Kaura 3 for 29, Vinod Binta 2 for 45, Amit Bhardwaj 2 for 31, Anil Chaudhary 2 for 22); Godrej CC — 178 runs for six in 22.1 overs (Amit Bhardwaj 51, Harminder Bawa 28, Gurinder Saini 15, Harjeet 2 for 14, Sanjay Dhull 2 for 23, Ricky 2 for 36).

Second match — Khalsa CC — 177 runs for nine wickets in 25 overs (Anil 38, Ramesh 27, Chandan 19, Pardeep 3 for 18, Rockey 2 for 32); Pace XI — 119 runs all out (Pankaj 25, Happy 19, Devinder 23, Kuku 3 for 13, Chandan 3 for 16, Rahul 2 for 11).

Village sport to get finances
From Our Correspondent

ZIRAKPUR, March 4 — The Punjab Government will give financial help to construct stadiums and purchase sport goods to boost village-level games.

The statement was made by Mr Ajaib Singh Mukhmailpur, PWD State Minister of Punjab, while addressing the players on the second day of the International Kabaddi Tournament at Zirakpur today.

Matches were conducted in three weight categories (52 kg, 57 kg and 62 kg) among 40 teams today. In all, 14 teams each participated in these classes.

The results are as as follows: 52 kg — Bajehari 1, Noor Kheri 2; 57 kg — Shazad 1, Agampur 2; 62 kg — Dasharna 1; Bajehari 2.

Darshan Singh of Rajgarh, a handicapped person, lifted 200 kg and Mohan Singh of Sihala made a record by lifting 260 kg on his back. Harmel Singh stopped two speeding motorcycles today and was the chief attraction.

The winning teams were given cash awards. Mr S.S. Sidhu, SDM; Mr Jaspal Singh, Chairman of the local Sher-e-Punjab Sports Club; and other residents of the surrounding areas were also present.