 Hope you are all doing well and safe. As the exam dates of Kerala University Health Sciences, final BDS are nearing and students have a general confusion regarding how to answer or what to write for a given question. We have decided to discuss the recent OMFS question paper topic-wise. The purpose of these discussions is to give an idea as to how to frame an answer. Hope this helps. Today's topic for discussion is principles of oral and maxillofacial surgery. All these are the short essay questions asked from this particular topic over last few years and they carry 8 marks each. Let's move on to the discussion. The first question is teachers. This is more like a general question. And the students might be confused as to what to write. So in these type of questions, where they haven't specified anything, try to cover everything that comes under suture. These are the headings under which you may answer sutures and you can limit your answers to points and you cannot elaborate on each point. So start your answer with definition if there is one. And do not write your own definition. Write the definition given in textbooks. So define what a suture is. Then you write why you suture a wound or what are the indications or purpose of sutures. Then in points, you mention what are the requisites of suture materials or what are the ideal properties of suture materials. Like it should have good tensile strength, it should be tissue biocompatible, etc. So you mention each of them in points. Then you classify sutures. You can classify sutures into natural, synthetic, absorbable, non-absorbable, monofilament and multi-filament. You also write two or three examples under each classification. Then you mention about size of suture materials. You know that suture materials are available in various sizes depending upon its tensile strength. So the standard for identifying the varying tensile strength of a suture material is by the number of zeros. So you mention a note about the size of suture material. And finally you can add a note on the biological response of tissues to suture materials. Here you write about the cellular response that occurs when a suture material is implanted in a living tissue. So all these completes your answer. Other aspects like principles and types of suturing and suture notes though they are important, it's not necessary to write. This autoplaying, which is a direct question, can be answered also directly to the point. You can find detailed description of autoplaying in oral surgery of microbiology experts. Here you are expected to write the principle of autoplay, which is moist feet under high pressure. Different textbooks have mentioned different types of autoplays. You may mention them as well here. Parts of an autoplay can be described with a diagram, which is very important. Do not forget to draw a diagram of autoplay. Mention the different articles summarized in autoplay and write about the steps in autoplaying in flow chart. So here you can illustrate the process of autoplaying with the help of a flow chart. And do not write in paragraphs. Always mention the process of autoplaying in flow chart. Do not miss to mention the relevant temperature or pressure of time for autoplaying. These factors change according to the type of sterilizer and types of mechanical sterilizer. So the sixth point is a very important point. Next you mention about the efficiency test. That means there are several mechanical, chemical and biological parameters which are used to evaluate the sterilizing conditions and also the procedure materials. So mention about those. And finally you complete your answer with the advantages and limitations of autoplaying. Absorbable suture materials again is a very direct and specific question. So here first you explain regarding the biologic response of body to suture materials and the mechanism of resorption of absorbable suture materials. Then you write about the natural and synthetic absorbable suture materials available. You need not mention the entire classification of suture materials. You can limit your answer to absorbable sutures only. Once you classify it into natural and synthetic, then you list out all the examples under each heading. And also mention key points about each example. So that will suffice for absorbable suture materials. To answer indications of biopsy, first you define biopsy. Then you write what are the general aims of performing a biopsy. Next you list out the various types of biopsy procedures like incisional and excisional biopsy, aspiration biopsy, punch biopsy, exfoliative cytology and fine needle aspiration. And under each of these settings where they are specifically indicated, what are the particular condition or relation in which each of these procedures are performed. So this is what completes your answer. You write the definition, the general aims of biopsy, the types and the specific indications of each type. Principles of antibiotic therapy is a direct question from therapeutics in overall surgery. So here you need to list out the selection criteria of antimicrobials. So you list out each principle and explain each principle in points. You may also add a note on combination therapy and antibiotic profile axis. Here you are not expected to explain or elaborate on combination therapy and profile axis. But just mention why you combine two antibiotics and where all you give antibiotic profile axis. That is sufficient. Now because you have been asked about the principles of antibiotic therapy, you may also mention the adverse effect of injurious use of antibiotics. That is bacterial resistance. You may also mention about bacterial resistance of unwise use of antibiotic. So that is all about principles of antibiotic therapy. Antiplatelet drugs have been explained in detail in pharmacology textbooks. So kindly refer them for this answer. Before explaining about antiplatelet drugs, you first mention what are the actions of platelets. You all know that platelets form the initial hemostatic plug at the site of vascular injury. So by inhibiting platelet function, thrombosis and atherosclerotic vascular diseases can be largely prevented. Then you mention about indications of antiplatelets, antiplatelet drugs. Mention what are the conditions in which these drugs are administered. Moving on to classification. There are at least five categories of antiplatelet drugs which you need to list out with examples. Also describe in brief the commonly used drugs. You all know that aspirin in its low dosage act as antiplatelet agent. So mention about aspirin and clopidogrel which is another commonly used antiplatelet agent. So briefly describe at least four to five antiplatelet agents. So that's all about this answer. Question is management of patients on long-term steroid therapy, for which you can refer to mental emergencies and dental office by Stanley F. Manema. For this question, the examiner expects you to explain the effects of long-term steroid therapy in the first half of your answer and management in the second. Firstly you illustrate the HPA axis and cortisol production with a note on the significance of cortisol during stress conditions. Secondly, explain what is adrenal cortical insufficiency. How it happens due to exogenous steroid administration. Also write about rule of two. This is the criteria used to determine the patients with risk of adrenal cortical insufficiency. And accordingly you decide whether to administer the steroids, pre-peri or post-operative. So this comprises your first part of the answer. Moving on to the second part which is the management. In the management part, consider all the adverse effects of long-term steroid therapy. To practice stress reduction protocol, decide if you need to administer steroids or not to the patient, pre-peri and post-operative. Monetary vitals. Understand that the patient is highly susceptible to infection. Therefore, practice A-success and also prophylactic antibiotics. Patient also will be immunocompromised. Therefore, he has the risk of developing systemic complications or diseases. So all these factors need to be taken into consideration. Then you write about the definitive management in case an emergency arises due to adrenal cortical insufficiency. So these are the points under which this question has to be answered. In the next video, we have completed the discussion on majority of questions from principles of organ and maxillofacial surgery. We shall discuss questions from local anesthesia in the next video. Thank you.