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This study was designed to compare different techniques of managing cleft maxillary hypoplasia and to propose a treatment protocol taking patient's age of presentation, amount of maxillary hypoplasia, and presence/absence of velopharyngeal insufficiency (VPI) into consideration. Five treatment modalities, viz. facemask therapy (Group I), anterior maxillary distraction (Group II), total maxillary distraction osteogenesis using rigid external distraction devices (Group III) and internal distraction devices (Group IV), and conventional orthognathic surgery (Group V), were assessed retrospectively using lateral cephalograms (taken at 3 intervals) and speech records (studied pre- and post-operatively). The results were subjected to statistical analysis. A P value of less than 0.05 was considered statistically significant. The mean advancement achieved in groups I, II, III, IV, and V was 4.2±1.54, 9.03±2.62, 11.82±1.18, 10.41±1.42, and 7.24±2.44 mm, respectively. The mean horizontal relapse noted in Groups I, II, III, IV, and V was 2.3 mm (n=8), 2.1 mm (n=14), 3.4 mm (n=10), 1.4 mm (n=5), and 2.4 mm (n=24), respectively. Compared to other groups, group II had fewer patients exhibiting relapse, a statistically significant observation. Similarly, statistically significant improvement in speech outcomes was found only in group II compared to other groups. Based on the results, a treatment protocol was proposed. The authors conclude that the proposed protocol would enable surgeons to decide the most appropriate treatment modality paying attention to not only the age of presentation and amount of advancement but also presence/absence of VPI which is instrumental in deciding upon the most appropriate treatment., Competing Interests: The authors report no conflicts of interest., (Copyright © 2023 by Mutaz B. Habal, MD.)

Abstract: Rhinoplasties are the most challenging facial aesthetic procedures with the majority of the cases requiring dorsal augmentation either in the form of autogenous or alloplastic materials. Although autogenous grafts are the gold standard, these grafts have their innate issues such as donor site morbidity, occasional displacement, resorption, tendency to warp or develop sharp edges over time with increased perceptibility and clinical visibility of the graft with time. These issues were addressed by Erol in 2000 who advocated the use of finely diced autologous cartilage wrapped in a monolayer of surgical and termed it Turkish delight. This technique has been extensively modified by surgeons across the world with an attempt to forgo the use of autogenous grafts preventing donor site morbidity and replacing it with alloplastic materials. Silicon's inert nature, resorption resistance, absence of a secondary surgical site and economical value make it a widely utilized allograft augmentation option in Asian countries. The authors hereby present a modification of the original Turkish delight technique by utilizing diced silicone pieces amalgamated with 1 to 2 ml of autologous blood and wrapped in monolayer of surgicel (oxidized cellulose). The technique produced clinically stable results in 27 patients who were followed up for a period of 24 to 60 months (average 30 months). Improved pliability, negated risk of graft extrusion with no donor site morbidity are the key advantages of this technique over conventional autologous grafts and silicon block augmentation techniques. These results point towards the viability of the technique for performing dorsal augmentation in rhinoplasty., Competing Interests: The authors report no conflicts of interest., (Copyright © 2021 by Mutaz B. Habal, MD.)

The benzophenone scaffold represents a ubiquitous structure in medicinal chemistry because it is found in several naturally occurring molecules which exhibit a variety of biological activities, such as anticancer, anti-inflammatory, antimicrobial, and antiviral. In addition, various synthetic benzophenone motifs are present in marketed drugs. They also represent important ingredients in perfumes and can act as photoinitiators. This review will provide an overview of benzophenone moieties with medicinal aspects synthesized in the last 15 years and will cover the most potent molecule in each report. In this review, only benzophenones with substitutions on their aryl rings, i.e. diphenyl ketone analogues, have been covered.

In cyclotridecanone 2,4-dinitrophenylhydrazone, C(19)H(28)N(4)O(4), the 13-membered carbocycle exists in the triangular [337] conformation. The 2,4-dinitrophenylhydrazone group is almost perpendicular to the 13-membered ring, with a dihedral angle of 82.66 (2) degrees between the mean planes. The dinitrophenylhydrazone rings are packed parallel to each other and separated by 3.28 (1) A. The NH group forms an intramolecular hydrogen bond to a nitro O atom, and there is a weaker C-H...O interaction between a cyclotridecane CH group and a symmetry-related 4-nitro O atom, with a C...O distance of 3.436 (2) A and a 150 degrees angle about the H atom. The structure, in combination with additional evidence, indicates that [337] is the preferred conformation of cyclotridecane and other simple 13-membered rings.