Medical Science: Updates and Prospects Vol. 10

Risk Factors and Incidence of Pharyngocutaneous Fistula

Md. Abdus Sattar, Belayat Hossain Siddiquee — Tue, 02 Jun 2026 00:00:00 +0000

Background: Pharyngocutaneous fistula remains a significant postoperative complication following total laryngectomy, contributing substantially to patient morbidity, prolonged hospital stay, delayed adjuvant therapy, and increased healthcare costs.

Objective: This study has been conducted to establish the incidence, risk factors, and their relation to the management of pharyngocutaneous fistula (PCF). Thorough knowledge of modifiable, possibly modifiable and non-modifiable risk factors is essential for the appropriate management of PCF.

Design and Setting: This is an Observational, Cross-sectional study which is conducted in the Department of Otolaryngology and Head-Neck Surgery of Bangladesh Medical University (BMU), the only functioning, service and research-oriented medical university of Bangladesh since 2006-2017.

Methods: All patients treated with Total laryngectomy for advanced laryngeal carcinoma and Total Thyroidectomy for advanced thyroid disease with extrathyroidal extension were included in this study.

Results: The duration of this study was 12 years (2006–2017). A total of 249 patients were included, of whom 48 (19.28%) developed PCF. Irradiated patients with multiple co-morbidities were more susceptible to developing PCF.

Conclusion: High occurrence of pharyngocutaneous fistula, mostly due to the advanced stage of disease, various levels of surgical expertise and post irradiated patients with multiple comorbidities.

Understanding Family Planning: Knowledge, Attitudes, and Practices among Married Women in Jalingo, Nigeria

Tue, 02 Jun 2026 00:00:00 +0000

Background: Family planning is a cornerstone of maternal and child health improvement, fertility reduction, and socioeconomic development globally. In sub-Saharan Africa, where maternal mortality and unmet contraceptive need remain disproportionately high, access to and sustained use of family planning services are critical public health priorities. Nigeria bears a significant share of this burden, with national modern contraceptive prevalence rates among married women remaining well below regional targets. Despite growing policy commitments and programme investments, contraceptive uptake in many Nigerian states, particularly in the North-East geopolitical zone, continues to be constrained by complex sociodemographic, cultural, and behavioural determinants. Understanding the knowledge, attitudinal, and practice profiles of women at the primary healthcare level is therefore essential for designing contextually appropriate interventions.

Objective: The objective of this study is to assess the knowledge, attitudes, and practices (KAP) regarding family planning among married women attending Township Primary Healthcare Centre (PHCC), Jalingo, Taraba State, and to examine the influence of selected socio-demographic variables on these outcomes.

Methods: A descriptive cross-sectional survey was conducted among 359 married women of reproductive age attending Township PHCC, Jalingo, selected via simple random sampling. Data were collected using a structured, pretested, self-administered questionnaire comprising four sections: socio-demographic characteristics, knowledge of contraceptive methods and family planning benefits, attitudes toward family planning, and current contraceptive practice. Data were analysed using IBM SPSS; descriptive statistics (frequencies, percentages, means) summarised participant characteristics, while inferential statistics (chi-square tests) examined associations between socio-demographic variables and KAP outcomes. Statistical significance was set at p < .05.

Results: Most participants were within the reproductive age range of 20–39 years and had attained at least secondary-level education. Knowledge of family planning was high, with the majority demonstrating awareness of multiple contraceptive methods, their correct use, and associated health benefits. Attitudes toward family planning were predominantly positive; most respondents expressed support for contraceptive use, rejected religion-based misconceptions, and reported open communication with their spouses on reproductive health matters. Contraceptive practice was notably high, with 79.1% of participants reporting current use of at least one family planning method — a figure substantially exceeding national averages and indicative of relatively strong service uptake within this facility-based sample. Despite this, side effects, fear of adverse reactions, and sociocultural pressures — most notably spousal disapproval and community stigma — were identified as significant barriers to consistent and sustained contraceptive use. Inferential analysis demonstrated that educational attainment significantly predicted knowledge (p = .042), while attitude (p = .008) and marital status (p = .001) were significant predictors of contraceptive practice.

Conclusion: Knowledge of, attitudes toward, and practice of family planning among married women attending Township PHCC Jalingo are comparatively high relative to national benchmarks; however, sustained contraceptive use remains constrained by concerns about side effects, inadequate male partner engagement, and entrenched sociocultural barriers. These findings underscore the need for targeted, multi-level interventions that address side-effect misconceptions through evidence-based counselling, actively engage male partners in reproductive health education, and strengthen community mobilisation strategies. Health policymakers and primary healthcare providers in Taraba State and similar contexts should prioritise interventions that tackle sociocultural determinants of contraceptive discontinuation and promote equitable, informed reproductive decision-making among couples.

Intentional Replantation in Dentistry: From Last Resort to Clinical Viability

Tue, 02 Jun 2026 00:00:00 +0000

Background: Intentional Replantation (IR) has historically been regarded as a last-resort procedure in Endodontics due to concerns regarding root resorption and ankylosis. However, advances in periodontal ligament biology, biomaterials, and microsurgical techniques have improved its clinical predictability.

Objective: The study intends to present a comprehensive chronological review of the literature on intentional tooth replantation, emphasising biological principles, clinical indications, technical evolution, and prognostic factors.

Methods: A narrative literature review was performed using PubMed and SciELO databases, including studies published between the 1980s and 2026, using “intentional tooth replantation" AND/OR "intentional replantation” as search terms. Classical reports, clinical studies, cohort analyses, systematic reviews, and meta-analyses were included. Studies with tooth replantation originated from dental trauma; in vitro and research with animal models were excluded.

Results: The literature demonstrates a progressive evolution of intentional replantation from an empirical and limited approach to a biologically driven and clinically reliable procedure. Contemporary evidence indicates survival rates ranging from approximately 80% to 90%, strongly associated with preservation of periodontal ligament viability, reduced extraoral time (less than 10 minutes), atraumatic handling, and appropriate apical sealing. The incorporation of bioceramic materials, magnification and advanced imaging techniques, such as cone beam tomography, has further enhanced treatment outcomes and predictability.

Conclusion: Intentional replantation is a biologically sound and clinically reliable therapeutic option when properly indicated and executed. It represents a conservative alternative to extraction and implant placement, particularly in patients where preservation of natural dentition is prioritised.

Successful Simultaneous Closed Management of Group VI Zygomatic and Unstable Parasymphysial Mandibular Fractures Without Open Reduction and Internal Fixation (ORIF): A Case Report

Tue, 02 Jun 2026 00:00:00 +0000

Background: Mandibular fractures are the most common facial skeletal injuries, often resulting from high-energy trauma, with zygomatic fractures being the second most frequent midfacial injury. Combined fractures of the mandible and zygomaticomaxillary complex typically require open reduction and internal fixation (ORIF) according to most treatment guidelines. However, the question of when closed reduction may be sufficient in such combined injuries remains poorly defined in the literature.

Case Presentation: A 25-year-old healthy male presented after a high-velocity motor vehicle collision (dashboard injury) with a closed, unstable right parasymphysial mandibular fracture (Loukota Type C) and a right zygomatic fracture classified as Knight and North Group VI (complex). Clinical findings included malocclusion with anterior open bite, restricted mouth opening (interincisal distance 15 mm), right periorbital oedema and ecchymosis, conjunctival hyperemia, and infraorbital hypoesthesia (MRC Grade 2).

Management: Both fractures were managed simultaneously under general anaesthesia using only closed reduction techniques. The zygomatic fracture was reduced via a 3 mm percutaneous puncture using a Langenbeck bone hook, achieving an audible click and immediate release of the compressed mandibular condyle (mouth opening increased to 25 mm intraoperatively). The mandibular parasymphysial fracture was reduced by digital manipulation, followed by arch bar application and intermaxillary fixation with elastic traction. Total operative time was 30 minutes.

Results: Postoperative recovery was uneventful. At 2 weeks, mouth opening improved to 35 mm with stable Angle Class I occlusion and no open bite. Infraorbital hypoesthesia improved to Grade 1. By 6 months, mouth opening reached 42 mm, sensation returned to normal (Grade 0), and radiographic bone healing was confirmed. No complications (malunion, nonunion, diplopia, enophthalmos, infection) occurred. Patient satisfaction was 9/10.

Conclusion: Simultaneous closed reduction of a complex zygomatic fracture (Group VI) and an unstable parasymphysial mandibular fracture can achieve excellent functional and aesthetic outcomes without ORIF in carefully selected patients. The key criteria for success include minimal comminution, reducibility of fragments, intraoperative stability, restorable occlusion, and favourable patient factors (young age, non-smoker, good bone quality). This case challenges the automatic indication for open fixation and supports individualised, minimally invasive treatment planning in maxillofacial trauma.