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Author(s): Dipasha K. Rao [1]; Bhagyalakshmi Avinash [1]; T. M. Amulya [2]; B. S. Prakash [2]; N. Raghunath [1]; Vidya G. Doddawad (corresponding author) [3] Sleep-disordered breathing (SDB), characterized by [...], : BACKGROUND: Sleep-disordered breathing (SDB) is characterized by upper airway dysfunction and is linked to severe health issues. Individuals with SDB have distinct craniofacial morphology for which orthodontists are most suitable for the management due to their dental expertise. AIM: This study aims to discern key differences in dental parameters between individuals with and without SDB. METHODS: The present study is a cross-sectional observational study conducted for 12 months. Out of 70 participants, 35 were placed in the SDB group as per the Berlin questionnaire (BQ) and 35 in the control aged 18-22 years. Criteria excluded individuals with preexisting illnesses, missing teeth, tonsillectomy, orthodontic or jaw surgeries, cleft lip/palate, or craniofacial anomalies. Dental assessments included interdental width, palatal vault depth and shape, molar relation, overjet, and overbite. In addition, self-perceived orthodontic treatment needs were evaluated as a secondary measure. RESULTS: In the SDB group, interdental distances were significantly reduced in the canine, first premolars, second premolars, and molar regions by 2, 3, 4, and 1.8 mm, respectively. A noticeable V-shaped arch was observed. Overjet and overbite increased by 42.85 and 31.42, respectively, with Class 1 malocclusion more prevalent than Class 2. The Berlin questionnaire identified 54.3 as high-risk SDB. The Index of Orthodontic Treatment Need-Esthetic Component (IOTN-AC) revealed that 68.6 of snoring participants required orthodontic treatment. CONCLUSION: Individuals with SDB exhibit a constricted maxilla and reduced interdental measurements, indicating a moderate risk. The Berlin questionnaire proves valuable in assessing SDB severity. Moreover, individuals displaying signs of SDB often present a high prevalence of orthodontic treatment needs, as indicated by the IOTN-AC. Keywords: Index of Orthodontic Treatment Need, mouth breathing, questionnaire, sleep, sleep apnea syndromes, sleep disorder

Background and objectives: Rubber band ligation (BL) is the most widely used technique for treatment of symptomatic internal haemorrhoids (IH) that are refractory to conservative treatment. The aim of this study is to assess the efficacy of colonoscopic BL as therapy for symptomatic IH. Methods: Patients seen at our center with symptomatic IH who underwent BL between January 2006 and December 2011 were included in this prospective study. The clinical and colonoscopic details were entered in uniform structured data forms. Results: Two hundred and eighteen consecutive patients with symptomatic IH were enrolled in the study. The presentations were rectal bleeding in 150 (69%) and prolapse in remaining 68 (31%) patients. Twenty-four patients (11%) had chronic liver disease (child B-C). Same operator treated all the patients. The severity of the IH was classified by using Goligher grading system. The mean age of patients was 48.3 + 15 years with range of 22 - 85 years. The mean follow up was 3months (range 1 month - 36 months). In 209 patients (96%) there was at least 1 grade reduction in hemorrhoids as well the symptoms were controlled. Two patients required surgery and another 7 patients required repeat session of banding. After banding session 32 (15%) patients had perianal pain and 13 (6%) had mild bleeding. Conclusions: Colonoscopic BL is a safe, and effective outpatient therapeutic procedure for symptomatic internal hemorrhoids. Furthermore, the BL is safe and effective in patients of coagulopathy associated with chronic liver disease. (J Dig Endosc 2013;4(1):6–9)

The knowledge on the anatomical variations of the deep flexor muscles is important due to its evolutionary significance. The flexor digitorum profundus is the deep flexor muscle of the forearm. It is a composite muscle with a dual nerve supply. The medial half of muscle is supplied by the ulnar nerve, and lateral half of the muscle is supplied by the anterior interosseous nerve, a branch of the median nerve. It flexes the distal phalanges of the medial four digits. In the present case, we observed the presence of extensive cleavage of belly and tendon of flexor digitorum profundus to form flexor indicis profundus on the right side in an adult male cadaver. Flexor indicis profundus muscle is an example of progressive type of variation and it is usually asymptomatic, but it may cause compression of the anterior interosseous nerve, which can lead to compression neuropathy. If it is enlarged, it may simulate a ganglion.