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Paediatric mandibular fractures: report of a case

Qadri GW, Mokhtar SM

Dent Traumatol, 2008 Dec;24(6):e67-70.
PMID: 19021642 DOI: 10.1111/j.1600-9657.2008.00700.x

The conservative approach in the treatment of maxillofacial trauma in children has been widely adopted. The type of fracture and its presence within the growing facial skeleton along with the presence of tooth buds may result in different management strategies to that employed in adults. An understanding of conservative treatment options is essential to make informed choices which will best manage these injuries, and an example is presented in this paper. This case report describes a 14-year-old boy who sustained trauma to the chin as a result of a fall, causing a mandibular symphyseal fracture. He was successfully treated by the means of applying direct interdental wiring combined with an acrylic splint.
Fulltext Preauricular Pilomatricoma Manifesting as an Aggressive Mass

Tang PP, Kalimuthu S, Mokhtar SM, Wahab SA

Oman Med J, 2019 Mar;34(2):160-163.
PMID: 30918611 DOI: 10.5001/omj.2019.29

Pilomatricoma is an uncommon benign skin tumor arising from the hair follicle. It usually occurs in the head and neck region and is typically found in the pediatric age group particularly girls. The tumor has inconsistent clinical features and may manifest as a small superficial lesion with benign features or a large and seemingly aggressive lesion with local invasion. Due to its variable clinical presentations, it can occasionally be misdiagnosed as a malignant tumor. We encountered a case of pilomatricoma in a 12-year-old girl with a left preauricular swelling for two years, which became progressively larger and more painful in the few weeks before presentation. Clinically, the swelling resembled a malignant parotid tumor. Multiple fine-needle aspirations were performed, but the cytology results were all inconclusive. Subsequent computed tomography scan revealed a well-defined calcified subcutaneous mass with suspicious parotid involvement. The case was posted for tumor excision and superficial parotidectomy. Intraoperatively, however, the mass could be easily separated from the parotid gland. Histopathological examination of the excised specimen showed characteristic ghost cells, basophilic cells, and ossifications typical of pilomatricoma. In conclusion, preauricular pilomatricoma may pose a diagnostic dilemma. A heightened knowledge of the disease is needed for early recognition of its clinical and imaging features to prevent aggressive therapy than is required.
Fulltext Deaths associated with GA for dentistry 1948 - 2016: the evolution of a policy for general anaesthesia (GA) for dental treatment

Roberts GJ, Mokhtar SM, Lucas VS, Mason C

Heliyon, 2020 Jan;6(1):e02671.
PMID: 31938737 DOI: 10.1016/j.heliyon.2019.e02671

BACKGROUND: Following the inception of the National Health Service in 1948 dental treatment under General Anesthesia (GA) became easily available. An unexpected consequence of this was a disconcerting number of deaths associated with GA. Over the decades since 1948 there have been a number of specialist medical society, royal college, and government working parties deliberating on the appropriateness of GA being conducted in general dental practice and community dental practice.
METHODS: The figures for the number of general anaesthetics per annum in England and Wales were obtained from the general dental services board, the community dental service, and records from hospital inpatient episodes. The number of deaths per annum were obtained from coroners' enquiries and dental protection societies.
FINDINGS: Prior to 2001 there is a strong correlation between the number of GA's per annum and deaths. Since 2001, when the UK government directed that all GAs for dentistry must be administered in a hospital with Intensive Care facilities the number of deaths per annum has reduced to nil.
INTERPRETATION: The change in the arrangements under which GA for dentistry are administered was coincident with improved training and knowledge of GA for dentistry. This has led to a cessation of deaths associated with GA for dentistry. The incidence rate is now estimated at less than 1 death per 3.5 million GAs.
PEDOT coated microneedles towards electrochemically assisted skin sampling

Ajmal Mokhtar SM, Yamada M, Prow TW, Moore M, Strudwick XL, Evans DR

J Mater Chem B, 2023 Jun 07;11(22):5021-5031.
PMID: 37226634 DOI: 10.1039/d3tb00485f

Skin sampling is a diagnostic procedure based on the analysis of extracted skin tissues and/or the observation of biomarkers in bodily fluids. Sampling using microneedles (MNs) that minimize invasiveness is gaining attention over conventional biopsy/blood lancet. In this study, new MNs for electrochemically assisted skin sampling are reported, specifically tailored for combined skin tissue biopsy and interstitial fluid (ISF) extraction. To overcome risks associated with using metal MNs, a highly electroactive, mechanically flexible, and biocompatible organic conducting polymer (CP) coated onto plastic is chosen as an alternative. Two different variants of doped poly(3,4-ethylenedioxythiophene) are coated on polymethyl methacrylate and used in combination as a MN pair with subsequent testing via a variety of electrochemical techniques to (i) give real-time information of the MN penetration depth into the skin, and (ii) yield new information on various salts present in the ISF. The MN skin sampler shows the ability to extract ions from the hydrated excised skin as a step towards in vivo ISF extraction. The presence of ions was analyzed using X-ray photoelectron spectroscopy. This added chemical information in conjunction with the existing biomarker analysis increases opportunity for disease/condition detection. For example, in the case of psoriasis, information about salt in the skin is invaluable in combination with pathogenic gene expression for diagnosis.