iosr-JDMS   Volume-25 ~ Issue-6 ~ June 2026

Abstract: Iatrogenic bowel injury during surgery is the most common cause of enteroatmospheric fistula (EAF). Management of high-output EAF, especially multiple fistulas with distal obstruction, often fails when nutritional support is neglected.

[1]. Baker, M. L., Williams, R. N., & Nightingale, J. M. D. (2011). Causes and management of a high-output stoma. Colorectal Disease, 13(2), 191–197.
[2]. Carlson, G. L. (2003). Surgical management of intestinal failure. Proceedings of the Nutrition Society, 62(3), 711–718.
[3]. Lloyd, D. A., Gabe, S. M., & Windsor, A. C. J. (2006). Nutrition and management of enterocutaneous fistula. British Journal of Surgery, 93(9), 1045–1055.
[4]. Pironi, L., Arends, J., Baxter, J., et al. (2015). ESPEN endorsed recommendations: Definition and classification of intestinal failure in adults. Clinical Nutrition, 34(2), 171–180.
[5]. Nightingale, J., & Woodward, J. M. (2006). Guidelines for management of patients with a short bowel. Gut, 55(Suppl 4), iv1–iv12.

Abstract: Lower lip swelling is a diagnostic challenge in emergency settings, with angioedema and cellulitis representing important differential diagnoses. Although cellulitis involving the facial region is relatively common, isolated lower lip cellulitis progressing to septic shock and acute kidney injury (AKI) is rare and potentially life-threatening.......

Keywords: Lower lip cellulitis; Angioedema; Septic shock; Acute kidney injury; Necrotizing fasciitis; Oro-cutaneous fistula; Facial cellulitis.

[1]. Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections. Clinical Infectious Diseases. 2014;59(2):e10-e52.
[2]. Raff AB, Kroshinsky D. Cellulitis: A review. JAMA. 2016;316(3):325-337.
[3]. Hirschmann JV. Differential diagnosis of cellulitis and stasis dermatitis. Journal of the American Academy of Dermatology. 1995;32(2):201-203.
[4]. Brook I. Microbiology and management of soft tissue and muscle infections. International Journal of Surgical Pathology. 2008;16(4):328-338.
[5]. Bisno AL, Stevens DL. Streptococcal infections of skin and soft tissues. New England Journal of Medicine. 1996;334(4):240-245.

Abstract: Background: Heart Failure with Reduced Ejection Fraction (HFrEF) poses significant morbidity and mortality risks globally. Goal-Directed Medical Therapy (GDMT) improves outcomes but is often underutilized due to poor medication adherence.
Aim: To evaluate the impact of GDMT on clinical outcomes such as quality of life, morbidity, and hospitalizations in HFrEF patients, and to assess the level and predictors of medication adherence. Methods: A cross-sectional study was conducted at Shree Krishna Hospital involving 100 adult patients with HFrEF. Adherence was measured using the Morisky Green Levine Scale.......

[1]. Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA guideline for the Management of Heart Failure. Circulation. 2022;145(18):e895–1032.
[2]. Savarese G, Becher PM, Lund LH, et al. Global burden of heart failure: a comprehensive and updated review of epidemiology. Cardiovasc Res. 2023;118(17):3272–87.
[3]. McMurray JJ, Packer M, Desai AS, et al. Angiotensin–neprilysin inhibition versus enalapril in heart failure. N Engl J Med. 2014;371(11):993–1004.
[4]. Greene SJ, Butler J, Albert NM, et al. Medical therapy for heart failure with reduced ejection fraction: The CHAMP-HF Registry. J Am Coll Cardiol. 2018;72(4):351–366.
[5]. Kosiborod M, Arnold SV, Inzucchi SE, et al. Health status outcomes with dapagliflozin in heart failure with reduced ejection fraction: A secondary analysis of DAPA-HF. Lancet Diabetes Endocrinol. 2020;8(10):859–869.

Abstract: Reconstruction of oral cavity defects following oncologic excision demands simultaneous restoration of mucosal lining, oral competence, cheek contour, and satisfactory aesthetics. Local flap techniques remain indispensable for small-to-medium defects because of their simplicity, tissue compatibility, reliable vascularity, and feasibility in resource-limited or high-risk surgical settings. The Yu flap, originally devised for lower lip reconstruction, integrates rotational and advancement components to achieve tension-free closure with favorable functional outcomes. Modifications of this technique have broadened its applicability to perioral and intraoral defects, including those of the buccal mucosa.......

Keywords: Buccal mucosa carcinoma; squamous cell carcinoma; Yu flap; oral reconstruction; local flap; oncologic surgery; commissuroplasty.

[1]. Warnakulasuriya S. Global epidemiology of oral and oropharyngeal cancer. Oral Oncol. 2009;45(4-5):309-316.
[2]. Sharma P, Saxena S, Aggarwal P. Trends in the epidemiology of oral squamous cell carcinoma in India: incidence, mortality, and survival. Oral Surg Oral Med Oral Pathol Oral Radiol. 2010;110(4):e33-39.
[3]. Rogers SN, Lowe D, Fisher SE, Brown JS, Vaughan ED. Health-related quality of life and clinical function after primary surgery for oral cancer. Br J Oral Maxillofac Surg. 2002;40(1):11-18.
[4]. Brown JS, Rogers SN, McNally DN, Boyle M. A modified classification for the maxillary defect after oncological resection. Head Neck. 2000;22(1):17-26.
[5]. Wei FC, Demirkan F, Chen HC, et al. The outcome of failed free flaps in head and neck and extremity reconstruction. Plast Reconstr Surg. 2001;108(5):1154-1160.

Abstract: Background: Bismuth Iodoform Paraffin Paste (BIPP) is a compound surgical dressing originally introduced by Rutherford Morrison during World War I. Comprising bismuth subnitrate, iodoform, and liquid paraffin, it exerts antiseptic, hemostatic, and wound-healing properties. Despite its established role in ENT and general surgery, its systematic documentation as a cavity-packing adjunct following enucleation of large odontogenic jaw cysts remains sparse in the oral and maxillofacial literature.......

Keywords: Bismuth iodoform paraffin paste; BIPP; odontogenic cyst; odontogenic keratocyst; keratocystic odontogenic tumor; dentigerous cyst; cyst enucleation; wound packing; jaw cyst.

[1]. Roy S, Basu S, Bose A, Samanta D. Management of Odontogenic Keratocyst (OKC): A Case Series. J Orofac Res. 2024;13(3):20–25.
[2]. Randhawa GK, Graham RM, Matharu KS. Bismuth Iodoform Paraffin Paste: History, Uses and Alternatives in Oral and Maxillofacial Surgery. Dent Update. 2021;48:207–211.
[3]. Gaur G, Agarwal P, Goyal G, Sharma S. Management of a Large Dentigerous Cyst with Enucleation and Packing Open with BIPP in 9-year-old Child: A Case Report. Int J Clin Pediatr Dent. 2023;16(3):515–517.
[4]. Morawala A, Shirol D, Chunawala Y, Kanchan N, Kale M. Bismuth subnitrate iodoform paraffin paste used in the management of inflammatory follicular cyst – Report of two cases. J Indian Soc Pedod Prev Dent. 2017;35:269–274.
[5]. Choudhary S, Cariappa KM, Kamath AT, Dayashankar, Singh RK, Dahiya A, et al. Applications of Bismuth Iodoform Paraffin Paste in Maxillofacial Surgery – Case Series. Int J Enhanced Res Med Dent Care. 2015;2(9):20–22.

Abstract: Background: Halitosis, commonly known as oral malodor, is a prevalent oral health condition with significant social and psychological consequences. The majority of halitosis cases originate from the oral cavity, with tongue coating recognized as one of the primary etiological factors due to its role as a reservoir for anaerobic microorganisms responsible for volatile sulfur compound production. Mechanical tongue cleaning has been recommended as an effective approach for reducing oral malodor; however, limited short-term clinical evidence exists regarding structured tongue cleaning guided by objective tongue coating assessment......

[1]. Silva MF, Leite FRM, Ferreira LB, Pola NM, Scannapieco FA, Demarco FF, et al. Estimated prevalence of halitosis: a systematic review and meta-regression analysis. Clin Oral Investig. 2018;22(1):47–55.
[2]. Rösing CK, Loesche W. Halitosis: an overview of epidemiology, etiology and clinical management. Braz Oral Res. 2011;25(5):466–71. We
[3]. Bornstein MM, Kislig K, Hoti BB, Seemann R, Lussi A. Prevalence of halitosis in the population of the city of Bern, Switzerland: a study comparing self-reported and clinical data. Eur J Oral Sci. 2009;117(3):261–7.
[4]. Du M, Li L, Jiang H, Zheng Y, Zhang J. Prevalence and relevant factors of halitosis in Chinese subjects: a clinical research. BMC Oral Health. 2019;19(1):45.
[5]. Ueno M, Ohnuki M, Zaitsu T, Takehara S, Furukawa S, Kawaguchi Y. Prevalence and risk factors of halitosis in Japanese school children. Pediatr Int. 2018;60(6):588–92.

Abstract: Deep bite associated with loss of vertical dimension of occlusion (VDO) represents a significant restorative challenge requiring accurate diagnosis and careful treatment planning. This case report describes the rehabilitation of a 21-year-old male patient presenting with severe tooth wear, reduced VDO, and multiple inadequate restorations associated with endodontic complications.
A digitally guided workflow combined with occlusal deprogramming using a Leaf Gauge was used to establish a reproducible mandibular position and increase the VDO......

Keywords: Deep bite; Vertical dimension of occlusion; Digital workflow; Zirconia crowns; Endocrowns; Injectable composite

[1]. Turner KA, Missirlian DM. Restoration of the extremely worn dentition. J Prosthet Dent. 1984;52(4):467-474.
[2]. Dawson PE. Functional Occlusion: From TMJ to Smile Design. St Louis: Mosby; 2007.
[3]. Okeson JP. Management of Temporomandibular Disorders and Occlusion. 8th ed. St Louis: Elsevier; 2019.
[4]. Güth JF, Edelhoff D, Schweiger J, Keul C. A new method for the evaluation of the accuracy of full-arch digital impressions in vitro. Clin Oral Investig. 2013;17(5):1487-1494.
[5]. Luna-Domínguez CR, Bustamante-Hernández N, Torres-González G, et al. Full-mouth rehabilitation in a completely digital workflow: A clinical report. J Esthet Restor Dent. 2023;35(4):623-632.

Abstract: Background: Clavicle fractures are among the most common injuries of the shoulder girdle, with mid-shaft fractures accounting for the majority of cases. Surgical fixation often requires effective peri-operative analgesia. The clavipectoral fascia block (CPB) is a relatively new regional anesthesia technique that provides targeted analgesia for clavicular.....

Keywords: Clavipectoral fascia block, clavicle fracture, regional anesthesia, bupivacaine, ultrasound-guided block

[1]. Postacchini F, Gumina S, De Santis P, Albo F. Epidemiology of clavicle fractures. J Shoulder Elbow Surg. 2002;11(5):452-6.
[2]. Robinson CM. Fractures of the clavicle in the adult: epidemiology and classification. J Bone Joint Surg Br. 1998;80(3):476-84.
[3]. Stanley D, Trowbridge EA, Norris SH. The mechanism of clavicular fracture. A clinical and biomechanical analysis. J Bone Joint Surg Br. 1988;70(3):461-4.
[4]. Valdés JL. Clavipectoral plane block: description of a novel technique. Presented at: 36th Annual ESRA Congress; Lugano, Switzerland; 2017.
[5]. Yang HM, Won HJ, Kim HJ, Hu KS. Anatomic basis of the clavipectoral fascial plane block: a cadaveric study. Reg Anesth Pain Med. 2021;46(4):319-25..

Abstract: Background: Arteriovenous malformations (AVMs) are congenital vascular anomalies characterised by abnormal direct shunting between arteries and veins, bypassing the capillary bed. They represent a therapeutically challenging subset of vascular anomalies, particularly in the oral and maxillofacial region where they involve critical anatomical structures. Optimal management necessitates a combination of interventional and surgical modalities.
Methods: We present a case series of four patients — ranging in age from 6 to 25 years — treated at the Department of Oral.....

Keywords: Arteriovenous malformation; bleomycin; sclerotherapy; vascular ligation; oral and maxillofacial surgery; vascular anomalies

[1]. Mulliken JB, Glowacki J. Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg. 1982;69(3):412–420.
[2]. Legiehn GM, Heran MKS. A step-by-step practical approach to imaging diagnosis and interventional radiologic therapy in vascular malformations. Semin Intervent Radiol. 2010;27(2):209–231.[3]. Stretton M, Toll E, Johnston J, Buckley B. Efficacy of intralesional bleomycin sclerotherapy for head and neck vascular malformations. Aust J Otolaryngol. 2025;8:51.
[4]. Jafarian M, Dehghani N, Shams S, Esmaeelinejad M, Aghdashi F. Comprehensive treatment of upper lip arteriovenous malformation. J Maxillofac Oral Surg. 2016;15(3):394–399.
[5]. Tiwari R, Singh VK. Arterio venous malformation of the face: surgical treatment. J Maxillofac Oral Surg. 2015;14(Suppl 1):S25–S31..

Abstract: Background : Radicular cysts are the most common inflammatory odontogenic cysts of the jaws, arising secondary to pulpal necrosis and chronic periapical infection of non-vital teeth. Surgical enucleation is often required for large lesions to completely remove the cystic lining and prevent recurrence. In extensive defects, autogenous bone grafting remains the gold standard for reconstruction, providing osteogenic cells and structural support. The tibia serves.....

Keywords: autogenous bone graft, tibial bone graft, radicular cyst, bone grafting, secondary alveolar bone grafting, cystic enucleation

[1]. Malara P, von Krockow N, Niedzielska I, Malara B. Evaluation of the Proximal Tibia as a Donor Site of Cancellous Bone for Intraoral Grafting Procedures-A Retrospective Study. J Clin Med. 2022 Mar 9;11(6):1493. doi: 10.3390/jcm11061493. PMID: 35329821; PMCID: PMC8953495.
[2]. Atil F, Kocyigit ID, Suer BT, Alp YE, Yazan M, Tekin U, Tuz HH. Clinical Evaluation of the Use of Tibial Bone Grafting in Dentoalveolar Reconstructive Surgery. Med Princ Pract. 2016;25(1):72-8. doi: 10.1159/000440998. Epub 2015 Oct 27. PMID: 26501218; PMCID: PMC5588298.131313
[3]. AboulHosn M, Noujeim Z, Nader N, Berberi A. Decompression and Enucleation of a Mandibular Radicular Cyst, Followed by Bone Regeneration and Implant-Supported Dental Restoration. Case Rep Dent. 2019 Jan 9;2019:9584235. doi: 10.1155/2019/9584235. PMID: 30729045; PMCID: PMC6343149.13
[4]. Zhang, F. et al. Engineered Fe(OH)3 Nanoparticle-coated and rhBMP-2-releasing PLGA Microsphere Scaffold for Promoting Bone Regeneration by Facilitating Cell Homing and Osteogenic Differentiation. Journal of Materials Chemistry B https://doi.org/10.1039/C8TB00569A (2018).
[5]. Wang J, Yao QY, Zhu HY. Efficacy of bone grafts in jaw cystic lesions: A systematic review. World J Clin Cases 2022;10(9):2801-2810. doi:10.12998/wjcc.v10.19.2801..

Abstract: Background: The global rise in antidepressant prescriptions has led to an increasing prevalence of drug-induced oral complications in dental practice. Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs), are associated with a range of oral adverse effects that carry significant periodontal implications....

Keywords: Antidepressants; Oral Adverse Effects; Xerostomia; Tricyclic Antidepressants; Bruxism; Drug-Induced Oral Reactions

[1]. Yang X, Fang Y, Chen H, et al. Global, regional and national burden of anxiety disorders from 1990 to 2019: results from the Global Burden of Disease Study 2019. Epidemiol Psychiatr Sci. 2021;30:e36. doi:10.1017/S2045796021000275
[2]. Chu A, Wadhwa R. Selective serotonin reuptake inhibitors. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023.
[3]. Lunghi C, Dugas M, Leclerc J, et al. Global prevalence of antidepressant drug utilization in the community: protocol for a systematic review. BMJ Open. 2022;12:e062197. doi:10.1136/bmjopen-2022-062197
[4]. Friedlander AH, Mahler ME. Major depressive disorder: psychopathology, medical management and dental implications. J Am Dent Assoc. 2001;132(5):629–638.
[5]. Scully C. Drug effects on salivary glands and oral mucosa. Oral Surg Oral Med Oral Pathol Oral Radiol. 2021;131(2):123–130. doi:10.1016/j.oooo.2020.09.010.

Abstract: Background: Severe Acute necrotizing pancreatitis is a potentially life-threatening form of pancreatitis characterized by pancreatic parenchymal necrosis and systemic inflammatory response. We report a rare case of a 32-year-old male who developed infected pancreatic necrosis requiring exploratory laparotomy and open necrosectomy after failure of conservative management including pigtail drainage. Early recognition, timely imaging, and appropriate escalation of treatment were crucial in improving outcomes. This case highlights the importance of a step-up approach while emphasizing the continued relevance of open necrosectomy in selected critically ill patients.

Keywords: acute pancreatitis; necrotizing pancreatitis; Step up approach; Percutaneous drainage; open necrosectomy.

[1]. Sorrentino L, Chiara O, Mutignani M, Sammartano F, Brioschi P, Cimbanassi S. Combined totally mini-invasive approach in necrotizing pancreatitis: a case report and systematic literature review. World J Emerg Surg. 2017 Dec;12(1):16. doi:10.1186/s13017-017-0126-5
[2]. Baron TH, DiMaio CJ, Wang AY, Morgan KA. American Gastroenterological Association Clinical Practice Update: Management of Pancreatic Necrosis. Gastroenterology. 2020 Jan;158(1):67-75.e1. doi:10.1053/j.gastro.2019.07.064
[3]. Heckler M, Hackert T, Hu K, Halloran CM, Büchler MW, Neoptolemos JP. Severe acute pancreatitis: surgical indications and treatment. Langenbecks Arch Surg. 2021 May;406(3):521–35. doi:10.1007/s00423-020-01944-6
[4]. Lee PJ, Papachristou GI. Management of Severe Acute Pancreatitis. Curr Treat Options Gastro. 2020 Dec;18(4):670–81. doi:10.1007/s11938-020-00322-x
[5]. Ben-Ami Shor D, Ritter E, Borkovsky T, Santo E. The Multidisciplinary Approach to Acute Necrotizing Pancreatitis. JCM. 2025 Apr 23;14(9):2904. doi:10.3390/jcm14092904.

Abstract: Background: Migraine is a prevalent and disabling neurological disorder characterized by recurrent headaches, often accompanied by nausea, vomiting, and sensitivity to light and sound. This study aimed to evaluate the efficacy of Topiramate, Nortriptyline, and their combination in reducing migraine frequency, duration, and severity, as measured by the Headache Impact Test-6 (HIT-6) score.
Methods: A quasi experimental.....

Keywords: Quasi experimental study, migraine prophylaxis, topiramate, nortriptyline, combination therapy..

[1]. Puledda F, Silva EM, Suwanlaong K, Goadsby PJ. Migraine: from pathophysiology to treatment. Journal of neurology. 2023 Jul;270(7):3654-66.
[2]. Raval AD, Shah A. National trends in direct health care expenditures among US adults with migraine: 2004 to 2013. The Journal of Pain. 2017 Jan 1;18(1):96-107[3]. Ailani J, Burch RC, Robbins MS, Board of Directors of the American Headache Society. The American Headache Society Consensus Statement: update on integrating new migraine treatments into clinical practice. Headache: The Journal of Head and Face Pain. 2021 Jul;61(7):1021-39.
[4]. Dodick DW. A phase‐by‐phase review of migraine pathophysiology. Headache: the journal of head and face pain. 2018 May;58:4-16.
[5]. Krymchantowski AV, da Cunha Jevoux C, Bigal ME. Topiramate plus nortriptyline in the preventive treatment of migraine: a controlled study for nonresponders. The journal of headache and pain. 2012 Jan;13(1):53-9.

Abstract: Abstract Background: Biomonitoring of occupational health diseases has gained importance to evaluate health hazards of human. In Bangladesh, the employees of fuel stations are exposed regularly to toxic fuel vapors containing benzene, toluene, ethylbenzene and xylene (BTEX).
Aim of the study: The goal of this study is to assess the effect of fuel exposure on hematological parameters of filling station.....

Keywords: Fuel, filling station, filling station workers, hematological parameters.

[1]. Christian, S. G. and Eze, E. M., 2017. Effect of exposure to petroleum products on methaemoglobin levels of fuel station attendants in port harcourt, Nigeria. Sokoto Journal of Medical Laboratory Science, 2(3), 69–74.
[2]. Ekpenyong, C. E. and Asuquo, A. E., 2017. Recent advances in occupational and environmental health hazards of workers exposed to gasoline compounds. International Journal of Occupational Medicine and Environmental Health, 30(1), 1–26.
[3]. Hussain, S., Mehmood, R., Arshad, F. A., Khan, S. and Khan, A., 2019. Evaluation of comparative effects of the exposure of gasoline fumes/vapors on the blood and urine picture of gasoline filling workers of Multan City, a populous city of Southern Punjab, Pakistan. Journal of Environmental & Analytical Toxicology, 9(3), 1-7.
[4]. Abou-ElWafa, H. S., Albadry, A. A., El-Gilany, A. H. and Bazeed, F. B., 2015. Some biochemical and hematological parameters among petrol station attendants: a comparative study. BioMed Research International, 1-8.
[5]. Shaikh, A. & Chandel, D., 2017. Biomonitoring study on workers occupationally exposed to automobile fuels. International Journal of Human Genetics, 17(1), 31-37..