bluuebunny/crossref_metadata_2025 huggingface dataset:
Concentration and time of feeding with 17-α-methyltestosterone oil diluted and incorporated to the feed for masculinization of Nile tilapia
Authors: Ota Érika do Carmo , Inoue Luís Antônio Kioshi Aoki , Silva Tarcila Souza de Castro
Published: February 2024

Tilapia masculinization can be induced by oral administration of α-methyltestosterone (MT), which is commonly dissolved in ethanol to be added to the feed. However, there are many benefits in using alternative vehicles, such as oil. The incorporation time, vehicles quantity, safety for handlers, fish and the environment are favorable factors. In fry fed for 35 days under temperature control, we found that masculinization rate was similar in both incorporation vehicles of MT (oil or ethanol) in the concentrations studied (30 and 60 mg MT kg-1 feed). In an experiment, using hormone oil dissolution and oral administration at 30 mg MT kg-1 feed, it was observed that the longer the administration time, the lower the coefficient of variation in the masculinization rate. Therefore, administration for 32 days showed the lowest variability in the masculinization rate (99.8 ± 0.5 %), compared to 24 (98.5 ± 3.0 %), 16 (97.0 ± 6.0 %) and 8 (89.0 ± 8.8 %) days. The field experiment confirmed the results obtained in the lab. We concluded that the oil can be used as MT vehicle and we recommend to dispense it at the lowest hormonal concentration (30 mg MT kg-1 feed) for 32 days for tilapia masculinization.
The influence of in ovo feeding of black cumin extract on the physiological responses of broilers under hot tropical environments
Authors: Oyelola Omolayo Bose , Iyasere Oluwaseun Serah , Adeleye Oluwagbemiga Olanrewaju , Oke Oyegunle Emmanuel
Published: February 2024

An experiment was conducted to investigate the influence of in ovo feeding of black cumin extract (BC) on the intestinal morphology and physiological responses of broilers thermally challenged during incubation. The study involved the use of seven hundred Marshall broiler hatching eggs, which were assigned to 7 in ovo feeding treatments at embryonic day 17.5, as follows: eggs injected with 8 mg (EN), 6 mg (SN), 4 mg (FN), 2 mg (TN)BC, no in ovo feeding (NI), 0.9 % saline solution (SS), and 3 mg vitamin C (VC). Juvenile growth performance, plasma malondialdehyde (MDA), triiodothyronine (T3), superoxide dismutase (SOD), and haematological and serum biochemical indices were evaluated. The results revealed that the juvenile growth performance of SN birds was better than those of the NI, SS, FN and TN groups. The plasma SOD and T3 of the birds of SN and VC were significantly higher (p < 0.05) than the chickens of NI and SS treatments. The ileal crypt depth recorded in SN birds was lower (p < 0.05) compared to SS and NI values. To conclude, in ovo black cumin extract enhanced the gut health and lymphoid organs of broiler chickens with no pronounced effect on the thermotolerance of the birds at market age.
Diet supplementation formulated with Bacillus sp. SMIA-2 and its enzymes for Nile tilapia: zootechnical performance and effects on intestinal morphometry
Authors: Pierro Priscilla Cortizo Costa , Mendonça Pedro Pierro , Santos Paola de Oliveira , Pardo Thayna de Souza , Assis Thaianara Galdino do Nascimento , Silva Samuel Oliveira da Silva , Ribeiro David Carvalho dos Santos , Martins Meire Lelis Leal
Published: February 2024

The use of probiotics and exogenous enzymes in fish feed is a promising alternative to improve animal performance. This study evaluated the feasibility of applying Bacillus sp. SMIA-2 and its enzymes as supplements in the diet for juvenile tilapia. The effect of adding different concentrations of Bacillus sp. SMIA-2 and its enzymes in food on zootechnical development, intestinal morphometry of animals was analyzed. The bacteria could be recovered from the intestines of animals, demonstrating its ability to survive gastric and bile acids. The comparative study of SMIA-2 with commercial products showed a significant effect on individual food intake, final weight and weight gain in all treatments. Gut length, villus height and intestinal coefficient were an advantage of SMIA-2 compared to commercial products and the control group. Therefore, the inclusion of Bacillus sp. SMIA-2 and its enzymes in fish feed may represent a viable alternative to improve animal development and significantly increase intestinal villi, contributing to nutrient absorption and animal health.
Multivariate modeling to estimate the composition of carcass tissues of Santa Inês sheep
Authors: Maciel Marilene dos Santos , Arandas Janaína Kelli Gomes , Carvalho Francisco Fernando Ramos de , Cruz George Rodrigo Beltrão da , Costa Roberto Germano , Ribeiro Neila Lidiany , Ribeiro Maria Norma
Published: February 2024

The purpose of this study was to establish a multivariate model using two complementary multivariate statistical techniques: Factor Analysis and Stepwise Multiple Regression, to predict tissue composition through carcass characteristics of Santa Inês sheep. The data was obtained from 82 Santa Inês sheep under confinement. The predictor variables were carcass characteristics related to weight, yield, morphometric measures and meat cuts. The use of latent variables from factor analysis in multiple regression models eliminates the problem of multicollinearity of the explanatory variables, improving the accuracy of interpretation of results by proposing a better fit of the mathematical model. However, the coefficient of determination (R²) values were moderate for muscle proportion and total fat, and low for bone proportion, indicating that more appropriate independent variables should be used to better predict the proportion of tissues in Santa Inês sheep.
Kinetic-hydrodynamic models considering climatic influence on the domestic sewage treatment by constructed wetlands in tropical country
Authors: Silva Júnior Édio Damásio da , Souza Marco Antonio Almeida de
Published: February 2024

Typical constructed wetlands (CW) sizing methods in tropical countries rarely considers climate parameters as evapotranspiration (EPT) and rainfall (Ra), even though high levels of EPT and Ra can change the pollutant removal kinetic and Wastewater hydrodynamic. This paper aims to evaluate the climatic influences (EPT and Ra) on fit of several kinetic-hydrodynamic models used to describe the sewage organic matter removal in a real scale vertical (VSSF-CW) and horizontal (HSSF-CW) subsurface flow constructed wetland. Sewage quality (Biochemical Oxygen Demand - BOD and Chemical Oxygen Demand - COD) and sewage flow rates data were applied of First Order, Grau-Second Order, Monod, Monod Multi and Stover-Kincannon kinetic models, combined with ideal continuous stirred-tank reactor (CSTR) and plug-flow reactor (PF) hydrodynamic models. Monod, Monod Multi and Stover-Kincannon models (in CSTR) were more able to represent organic matter removal in CWs. Models considering EPT and Ra were more adequate or with no statistical difference compared with conventional models (that don’t consider EPT and Ra), except for BOD in VSSF-CW.
The results of experimental research of a rotor seed-metering unit for sowing non-free-flowing seeds
Authors: Ospanova Shinar , Aduov Mubarak , Kapov Sultan , Orlyansky Alexander , Volodya Kadirbek
Published: February 2024

The production and cultivation of new high-quality seed varieties are linked to the sowing of various crops with diverse physical and mechanical seed properties. Efficient seed-metering unit operation is critical during the technological process of fodder crop cultivation, predominantly when sowing non-free-flowing seeds. The quality of seed sowing and crop yield significantly rely on the design precision of seed-metering devices, technical maintenance and appropriate calibration. A rotary seed metering device was incorporated to ensure that non-friable seeds are uniformly sown, thus maintaining consistent seed supply and consumption at all stages of circulation. The study of the proposed device's productivity dependence on its operating parameters is justified because these variables affect crucial indicators such as the capacity to achieve and sustain the desired seeding rate over the entire operational duration. The study presents findings from an experimental investigation on sowing non-free-flowing (non-flowing) and finely dispersed seeds using a rotor seed-metering unit. The tests aimed to ascertain the precision and evenness of sowing such crops. It was observed that the speed of rotation of the seed-metering unit's vane disk is a key factor in the uniformity and supply of sown seeds. The limits of variation in rotor rotation speed and rotor seed-metering unit productivity per second were established to guarantee the desired seeding rate for various crops, including alfalfa, Agropyron, and Bromus inermis.
Bizarre Bilateral Adrenal Metastasis: A Sinister of Internal Malignancy
Authors: Jashwanthgowda S. , Rekha N. H. , Ameen Syed Sadiq , Krishnappa Premkumar
Published: February 2024

The ability to produce secondary metastatic deposits at a distant site is the single most essential biological process that symbolizes a malignant tumor. Metastasis to adrenal glands is known to spread from the primaries of the lungs, breast, melanoma, Gatro Intestinal Tract (GIT), pancreas, and kidneys. Here, we report a case of an elderly woman presenting with features of metastasis to subcutaneous tissue, lungs, liver, lymph nodes, and bilateral adrenal gland with symptomatic adrenal insufficiency and primary being in left kidney-renal cell carcinoma-clear cell type. The presence of bilateral synchronous adrenal metastasis with symptomatic adrenal insufficiency with evidence of metastasis to subcutaneous tissue is catastrophic since it marks disseminated cancer.
Clinical significance of serum CD155 levels in acute lymphoblastic leukemia patients
Authors: Ibrahim Ibrahim Nahed Moawad , Osman Mostafa Mariam Ahmed , Azzazi Mohamed Osman , Abd-Allah Hegab Hany Mohamed , Mohamed Said Rasha Magdy , Abdelfatah Rana G
Published: February 2024

Background

Acute lymphoblastic leukemia (ALL) is a hematologic malignancy characterized by poor outcomes in adults. Traditional diagnostic and prognostic markers take into account clinical data but also rely heavily on expensive and invasive tests such as bone marrow studies with cytogenetics. CD155 is an adhesion molecule that also modulates immune response in malignancy. Previous studies have shown that serum CD155 (sCD155) levels are higher in patients with malignancies, and have demonstrated a correlation between higher levels of sCD155 and poor outcomes. This study investigated the diagnostic and prognostic value of sCD155 in adult patients with acute lymphoblastic leukemia.

Methodology

32 adult patients with acute lymphoblastic leukemia and 15 control patients were enrolled in this study. Clinical and outcome data were collected from patients and a blood sample from patients and controls was collected with ELISA testing for sCD155 levels.

Results

sCD155 was found to be significantly higher in patients than controls (P<0.05) and was significantly associated with bone marrow aspirate blast count. It was not associated with other clinical parameters including Sex, age, initial CBC parameter counts, presence of lymphadenopathy, presence of CNS infiltration, presence of Philadelphia chromosome, type of ALL, or risk stratification of ALL besides being associated with hepatosplenomegaly. ROC curve showed high sensitivity and specificity of sCD155 and Kaplan Meir curve showed a trend towards worse outcomes in patients with high sCD155 but it was not statistically significant.

Conclusion

sCD155 remains a promising marker for diagnosis of ALL but further studies are needed to confirm prognostic value.
BAFF as a predictive marker for treatment response in immune thrombocytopenia patients
Authors: Hamza Mona Ashraf Al-dosoky , Elbedewy Tamer Abd Elhamid , Adel El-Kholy Rasha , Sheira Gehan Mohamed
Published: February 2024

Background

Immune thrombocytopenic purpura (ITP) is a hematological autoimmune bleeding disorder that characterized by isolated thrombocytopenia (platelet count <100 × 109/L) with unclear pathophysiology due to contribution of many cytokines, one of them is B-cell activating factor (BAFF) which affect both B-cell and T-cell activation and survival.

Objectives

This work aimed to study serum BAFF levels in the Egyptian ITP patients, and the relation between its level and response to steroid therapy, as well its value as a predictive marker for steroid response in ITP patients.

Patients and methods

90 subjects were recruited, and divided into 45 patients with primary ITP, and 45 healthy subjects. Serum BAFF was estimated using the ELISA technique.

Results

BAFF level was significantly higher in the ITP patients than in the control group. Serum BAFF level was significantly higher in newly diagnosed ITP cases and steroids-resistant ITP cases. BAFF was negatively correlated with platelet count, while MPV, PDW, and LDH were positively correlated, BAFF level at a cut-off 201.01 pg/ml is a good predictive for steroid resistance in ITP cases.

Conclusion

BAFF could be a good inexpensive helper to determine the response to steroid treatment in ITP cases.
Clinical relevance of cyclooxygenase 2 and vascular endothelial growth factor-A expression in classical Hodgkin lymphoma
Authors: Elrefaey Fatma A , Khorshed Amira , Aboulenin Khaled M , Eissa Lobna A , Ghareeb Mohamed
Published: February 2024

Background

Classical Hodgkin lymphoma (cHL) is a clonal lymphoid neoplasm derived from B cells. Cyclooxygenase 2 (COX2) and vascular endothelial growth factor-A (VEGF-A) play major roles in angiogenesis and impact cHL prognosis.

Aim

To measure COX2 and VEGF-A expression in cHL patients and assess their potential association with other laboratory and clinical parameters.

Patients and methods

Seventy-six cHL bone marrow (BM) biopsy specimens were histopathologically examined and immunohistochemically stained for COX2 and VEGF-A expression. Correlations between COX2 and VEGF-A expression and clinicopathologic factors were evaluated.

Results

COX2 and VEGF-A were expressed in 67/76 (88.2%) and 48/76 (63.2%) of BM specimens, respectively. VEGF-A was associated with advanced cHL stage (P=0.044) and BM infiltration confirmed by CD30 positivity (P=0.023). A significant association was found between VEGF-A positivity and mediastinal lymphadenopathy (P=0.049), inguinal lymphadenopathy (P=0.046), and pulmonary nodules (P=0.048). COX2 positivity was significantly associated with cervical lymphadenopathy (P=0.011). A positive association was found between expression of both markers (COX2 and VEGF-A) (P=0.001). Coexpression of COX2 and VEGF-A was associated with disease staging (P=0.016), mediastinal lymphadenopathy (P=0.019), and inguinal lymphadenopathy (P=0.044).

Conclusion

COX2 and VEGF-A, as major players in angiogenesis, are associated with tumor progression in cHL. These findings support targeting both markers as the potential therapeutic approach in cHL.
Vitamin B12 deficiency without anemia in Saudi Arabia: a single-center experience
Authors: AlShomar Ahmad
Published: February 2024

Objectives

The study aimed to estimate the prevalence of vitamin B12 deficiency in adult Saudi patients and anemia in those patients. Furthermore, the mean level of vitamin B12 in anemic and nonanemic participants was estimated.

Methodology

This retrospective study involved the evaluation of medical records from adult Saudi Arabian participants who underwent vitamin B12 level testing for nonspecific symptoms during 1 years (2022–2023) at a single center in the Al Qassim region of Saudi Arabia. The data for vitamin B12 level and anemia status among B12-deficient patients were estimated to calculate the prevalence of vitamin B12 deficiency and the prevalence of anemia in those patients.

Results

The prevalence of vitamin B12 deficiency was 11.46% among 8365 participants. The mean age among all vitamin B12-deficient patients was significantly lower compared with those with normal vitamin B12 levels. Female patients had a lower mean vitamin B12 level than male patients. The prevalence of anemia in the vitamin B12-deficient group was 23.46% among the total participants, with female patients having a significantly higher prevalence of anemia than males. The mean value for mean corpuscular volume (MCV) in anemic vitamin B12-deficient patients was normal, and the prevalence of macrocytosis was low (1.3%). The effect of gender on vitamin B12 deficiency and anemia status was significant.

Conclusion

The present study has provided additional evidence regarding the lack of a causal correlation between vitamin B12 deficiency and anemia. Moreover, the prevalence of vitamin B12 deficiency and anemia was higher in female patients than in males.
Double Aneuploidy (Trisomy 21 and XXX) in a Child with Down Syndrome Phenotype: A Case Report with Review of Literature
Authors: Mehta Parth , Chowdhary Samridhi , Rajeshwari K. , Kumar Deepak
Published: February 2024

Background:

Down syndrome is the most common and extensively studied disorder arising out of human chromosomal aberration. Several aneuploidies are associated with Down syndrome, but double trisomy (48 XXX + 21) is rarely described.

Clinical Description:

A 3-year-old girl presented with respiratory distress and a chronic history of feeding fatigue and failure to thrive. She had phenotypic features suggestive of Down syndrome and clinical signs of acyanotic heart disease in congestive cardiac failure.

Management and Outcome:

Echocardiography revealed ventricular septal defect and atrial septal defect. Karyotyping showed double trisomy (trisomy 21 and XXX). Trisomy X was an incidental finding on karyotyping with no clinical features suggestive of XXX syndrome specifically at this age. The patient was managed conservatively with decongestive therapy for congestive heart failure and oral sildenafil for pulmonary hypertension. Additional evaluations were done to identify associated anomalies, and the parents were counseled.

Conclusion:

Down and XXX syndromes share many clinical signs and symptoms, making karyotyping the only way to make an early diagnosis. A child having a phenotype characteristic of Down syndrome may have an unsuspected double trisomy of X chromosome along with 21 trisomy, which can only be identified by karyotyping.
Alopecia, Dermatitis and Seizures since Infancy: A Case of Biotinidase Deficiency
Authors: Ramesh Reshma , Rajendran Sakthivel
Published: February 2024

Background:

Biotinidase deficiency is a rare autosomal recessive metabolic disorder, having a wide spectrum of neurological, cutaneous, and immune-dysfunction-related clinical manifestations, which may be overlooked as common pediatric ailments.

Clinical Description:

A 2-year–7-month-old girl child, second born to third-degree consanguineous parents, presented with fast breathing and altered sensorium for a day, with a history of seizures and skin lesions since early infancy, developmental delay, and ataxia.

Management and Outcome:

Investigations revealed a normal septic screen, with metabolic acidosis which was unresponsive to therapy. After stabilizing the child with respiratory and vasopressor support, investigations for immunodeficiency were sent. Tandem mass spectrometry revealed increased C5OH levels, suggestive of holocarboxylase deficiency. Specific enzyme assay showed biotinidase activity deficiency. The child was initially empirically treated with metabolic cocktail comprising carnitine, biotin, thiamine, C0-enzyme Q10, and riboflavin, followed by specific therapy with biotin. The child showed dramatic clinical improvement and normalization of blood gas. Treatment has been advised lifelong with biotin supplementation.

Conclusion:

Careful observation by a pediatrician can identify the typical combination of clinical features in a child, suggestive of biotinidase deficiency. Evaluation and management of the condition are simple and rewarding.
Isolated Renal Manifestations as Presenting Features of Acute Leukemia: A Case Report with Review of Literature
Authors: Rajeswari Raja , Srinivasan Arathi , Vasanthi T. , Sairam V. K.
Published: February 2024

Background:

Although renal complications are well-known in hematological malignancies, they occur mostly after initiation of steroids and chemotherapy. We describe an unusual scenario of isolated renal complications as a presenting feature in children with acute lymphoblastic leukemia (ALL).

Clinical Description:

A 2-year-old girl presented with abdominal distension due to bilateral palpable renal masses associated with stage 2 hypertension. Investigations revealed ALL and impaired renal functions with enlarged kidneys on ultrasound, with no involvement of any other organ or lymph node.

Management and Outcome:

She required three antihypertensives for normalizing her blood pressure (BP). After initiation of chemotherapy, BP improved, kidney sizes reduced, and acute kidney injury resolved.

Conclusion:

Renal functions, BP and imaging for kidney sizes should not be missed in the initial work-up in children with ALL.
Acute Compartment Syndrome in a Neonate: May Be the First Manifestation of Hemophilia A
Authors: Tonge Rucha , Lalwani Shivkumar , Vageriya Natasha , Shrivastava Bijal
Published: February 2024

Background:

Acute compartment syndrome (ACS) most commonly results from traumatic or ischemic injuries, though rarely it may result from an underlying bleeding disorder. Reports of ACS in hemophilia are present; however, neonatal presentation secondary to hemophilia A is extremely rare.

Clinical Description:

A 5-day-old neonate presented with increasing swelling and hematoma over the dorsum of both hands following venipuncture. There was no other bleeding manifestations. Antenatal history and natal history were uneventful, and the baby had received a birth dose of Vitamin K. On examination, the hematoma was larger on the right hand than the left, extending from the proximal interphalangeal joints of all the digits to the wrist proximally, with tension on palpation and increased capillary refilling time, associated with bluish discoloration of hands and fingers with claw hand appearance. Oxygen saturation on pulse oximeter was 80%–85%.

Management and Outcome:

The baby had a hemoglobin of 16.3 g/dL, white blood cell count of 5300/mm3, platelet count of 2.33 lakhs/mm3, and elevated activated partial thromboplastin time >120 s with a normal prothrombin time of 12 s. Factor assay confirmed severe factor VIII deficiency (<1%). Ultrasonography Doppler of the hand confirmed compartment syndrome. Cryoprecipitate was given perioperatively, and fasciotomy was done. Perfusion of the hand improved, and oxygen saturation normalized. Healing was accomplished without any closure, with good cosmesis and complete functional recovery by 14 days.

Conclusion:

ACS may be an unusual primary presentation of hemophilia as early as in the neonatal period. Timely identification of ACS and early suspicion of an underlying bleeding disorder can help in undertaking appropriate evaluation and management strategies and preventing catastrophic consequences.
Hydranencephaly Associated with Bilateral Megalocornea and Bilateral Cleft Lip in an Infant of Mother with Gestational Diabetes Mellitus
Authors: Dehneh Younes , Khoulali Mohammed , Oulali Noureddine , Moufid Faycel
Published: February 2024

Background:

Hydranencephaly is a rare congenital disorder of the central nervous system, in which the cerebrum is replaced by a membranous sac of cerebrospinal fluid.

Clinical Description:

A 2-month-old baby girl presented with abnormal body movements. She was born to a mother with gestational diabetes and had been diagnosed with hydrocephalus antenatally. The baby had features of facial dysmorphism such as bilateral megalocornea, bilateral cleft lip, and cleft palate. A magnetic resonance imaging (MRI) brain revealed the absence of cerebral hemispheres with remnants of parenchyma in the orbitofrontal area that had been replaced by cerebrospinal fluid, diagnostic of hydranencephaly. Karyotyping and echocardiography findings were normal.

Management and Outcome:

The prognosis was explained to parents, who opted for no therapeutic intervention. The thus patient kept on supportive care and she succumbed at the age of 6 months.

Conclusion:

Our case creates awareness regarding a possible association between gestational diabetes and hydranencephaly. Furthermore, the hydranencephaly in this case was unique due to its association with bilateral megalocornea and cleft lip. The case reiterates the fact that a hydrocephalus diagnosed antenatally may actually be a hydranencephaly, which is confirmed in MRI brain imaging postnatally.
Spontaneously Regressing Retropharyngeal Neuroblastoma – A Rare Cause of Upper Airway Obstruction in a Neonate: A Case Report with Review of Literature
Authors: Piridi Raga Deepthi , Manugu Navya Sree , Kamuni Nikhitha , Reddy Sai Rama
Published: February 2024

Background:

Retropharyngeal masses may rarely cause persistent respiratory distress, stridor, and feeding difficulties in a neonate. We report a rare case of a primary cervical neuroblastoma presenting as a retropharyngeal mass, which underwent spontaneous regression.

Clinical Description:

A 29-day-old male baby was referred for recurrent vomiting since day 10 of life followed by severe difficulty in breathing since day 14 of life. At admission, the baby had stridor, cyanosis with respiratory failure, without any facial dysmorphism or cardiovascular involvement.

Management and Outcome:

After initial stabilization, investigations showed pneumonia in chest X-ray, with no evidence of sepsis. On intubation, a retropharyngeal bulge was noticed which was later confirmed by direct laryngoscopy. Later, computed tomography delineated the soft-tissue mass extending from C2–C5. Endoscopy with marsupialization of the tumor was done, and on histopathological examination, it was diagnosed as a small round blue cell tumor, suggestive of neuroblastoma, along with positive immunohistochemistry. According to the International Neuroblastoma Staging System, the tumor belonged to Stage I. As the baby had started improving clinically, further management by a multidisciplinary team was collectively decided to continue conservative observation. On follow-up, there was spontaneous regression in size of tumor with no recurrence of symptoms till the last follow-up at 11 months.

Conclusion:

Neuroblastoma, the most common solid tumor malignancy in children, may rarely have a primary cervical presentation, causing breathing and feeding difficulties. Depending on the course of symptoms, a strategy of observation and close monitoring by a multidisciplinary team can be taken, as such tumors may regress spontaneously.
Transfacetal and transpedicular anterior decompression with posterior stablilization: Effective way for managing all cases of andersson lesion
Authors: Anand Manikant , Nair Vishnu Vikraman , Shetty Abhijith , Kundnani Vishal , Raut Saijyot , Dewnany Nikhil
Published: February 2024

Background:

Andersson lesion (AL), also known as aseptic spondylodiscitis, is a pathological condition characterized by a destructive lesion in the vertebral or discovertebral region. The aim of this study was to assess functional, radiological, and neurological outcome of midline posterior surgery with transfacetal/transpedicular decompression and long-segment instrumentation and fusion in all patients with AL.

Materials and Methods:

A total of 36 consecutive patients with AL with or without neurodeficit were managed with midline posterior approach with long-segment fixation, decompression and anterior vertebral reconstruction added by same midline approach. The demographic data, visual analogue scale (VAS), modified Oswestry Disability Index (mODI), ankylosing spondylitis quality of life (ASQoL), local and global kyphosis angle, Frankel neurological grade, blood loss, duration of surgery, perioperative complications, and fusion rate were compiled and assessed.

Results:

The mean age of the patients was 52 years (26 males and 10 females). Among the patients, 9 patients had thoracic, 25 patients had thoracolumbar, and 2 patients had lumbar vertebral involvement. All patients in the study achieved fusion at final follow-up period of 24 months. The mean duration of hospital stay, intraoperative blood loss, and surgery duration was 6.17 days, 252 mL, and 130 min, respectively. VAS improved from mean 7.69 ± 0.98 to 1.67 ± 0.72, mODI from mean 70.28 ± 3.55 to 21.14 ± 2.13, ASQoL from mean 14.22 ± 1.59 to 7.17 ± 1.25, local kyphosis from 23.61 ± 1.67 to 18.52 ± 1.05, and global kyphosis from 57.02 ± 0.72 to 36.16 ± 1.23, leading to better sagittal balance. Except two patients all had full neurological recovery.

Conclusions:

Posterior midline approach with long-segment instrumentation and anterior decompression by transpedicular/transfacetal approach and bone grafting with selective use of cages can give satisfactory results with excellent fusion rates and good functional outcomes.
Hindi translation and modification of modified JOA score for cervical myelopathy and its validation for the Indian population
Authors: Nishant Nishant , Agarwal Varun Kumar , Garg Praveen , Somashekarappa Thimmappa
Published: February 2024

Objective:

To do a cross-cultural adaptation and validation of the translated Hindi version with Indian modification of the Japanese Orthopedic Association (In-mJOA-H) score for cervical myelopathy.

Background:

Indian modification of the Japanese Orthopedic Association (In-mJOA-H) score has never been translated and studied in any vernacular language. This is one of the biggest limitations in assessing disease severity where most of the population is speaking Hindi or other regional languages.

Materials and Methods:

A cross-sectional study of 193 patients, from November 2020 to May 2021, with cervical myelopathy or neck pain with radiculopathy was done. The acceptability, validity, responsiveness, reproducibility, and cross-cultural adaptation were evaluated for the Hindi version (In-mJOA-H).

Results:

A strong correlation was found between In-mJOA-H with the English version and its individual component of the English version Indian modification of the JOA scale (In-mJOA-E).

Conclusion:

Good acceptability, validity, responsiveness, and reproducibility were established for the Hindi version (In-mJOA-H) with Indian modifications and its correlation to the English version Indian modification of the JOA scale (In-mJOA-E).
A rare case of phrenic nerve palsy after cervical spine surgery
Authors: Lodha Shubham Sanjay , Mane Akash Vishnu , Borde Mandar , Menon K V
Published: February 2024

Phrenic nerve palsy is a rare complication of cervical spine surgery. There are very few previously reported cases of unilateral diaphragmatic paralysis following posterior cervical spine surgery. We present a case of a 61-year-old man with cervical canal stenosis and myelopathy for which we performed C3–C6 laminectomy and lateral mass screw fixation.

Postoperatively the patient developed right C5 palsy affecting his deltoid function which gradually improved. The patient developed respiratory distress postoperatively and was found to have an elevated hemidiaphragm secondary to phrenic nerve palsy. He was treated with respiratory support, with significant improvement in dyspnea.

It is a very rare case of unilateral diaphragmatic paralysis causing dyspnea due to phrenic nerve palsy following cervical spine surgery. This rare complication should be kept in mind when assessing any patient with respiratory distress following cervical spine surgery.
Effect of transforaminal lumbar interbody fusion on spinopelvic parameters in degenerative spondylolisthesis and its correlation to patient-reported functional outcome
Authors: Patil Deepak Dinkar , Kothari Abhishek , Hadgaonkar Shailesh , Kothari Ajay , Sancheti Parag K , Aiyer Siddharth Narasimhan
Published: February 2024

Background:

Degenerative spondylolisthesis (DS) is associated with altered radiological spinopelvic parameters (SPP) which leads to poor patient-reported clinical outcomes. Transforaminal lumbar interbody fusion (TLIF) is performed for DS however, its ability to adequately restore SPP is not well reported. The study was performed to determine the effect of TLIF on the SPP and its correlation to patient-reported functional outcomes.

Materials and Methods:

Prospective, consecutive recruitment of patients was performed, with single and double-level DS treated with TLIF between March 2019 to March 2020 with a 2-year follow-up. Functional outcomes were measured using the visual analog score (VAS) score, Oswestry Disability Index (ODI) score, and SF-36 questionnaire. SPPs (pelvic tilt [PT], pelvic inclination, sacral slope [SS], lumbar lordosis [LL], and PI-LL mismatch) were recorded. The correlation between SPP and functional outcomes was analyzed using Spearman’s correlation coefficient.

Results:

A total of 40 patients were included in the final analysis. Significant improvement in VAS score, ODI score, and SF-36 score was observed (P < 0.05 for all) at 2 years follow-up. No significant difference was noted in the PI, LL, and SS following surgery (P > 0.05). A significant change in mean PT from 15.76° to 19.53° was noted (P = 0.023). The mean PI-LL mismatch improved from 14.7° to 11.2° which was statistically significant (P < 0.05). However, no significant correlation between ODI score with PT (r = 0.156) and post-op PI-LL mismatch (r = 0.105) could be demonstrated.

Conclusion:

TLIF led to satisfactory improvement in the patient-reported outcomes, PT, and PI-LL mismatch. However, the improvement of the SPP did not correlate with improvements in the ODI score.
Conventional versus tubular microdiscectomy for lumbar disc herniation: A prospective randomized study
Authors: Sonawane Dhiraj V , Chobing Habung , Kolur Shivaprasad S , Chandanwale Ajay , Jawale Sagar A , Ansari Naved A F A , Pawar Eknath
Published: February 2024

Background:

Microdiscectomy is a commonly performed surgical technique used to treat lumbar disc prolapse. A minimally invasive alternative called tubular discectomy is hypothesized to cause less tissue damage and result in a faster recovery compared to conventional discectomy. Previous studies have found similar pain resolution outcomes between two techniques, but they were underpowered and lacked data on differences in recovery time. Our study aims to compare functional outcomes, and assess differences in recovery time and perioperative complications between the two procedures.

Materials and Methods:

This prospective randomized study included 63 patients, divided into two groups. The preoperative evaluation was done by clinical examination and documenting Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) scores. Intra- and postoperative complications were also noted. Postoperative follow-up assessment was done at regular intervals up to 2 years.

Results:

Both groups showed a significant decrease in ODI, VAS leg and back scores following surgery, which continued to decline throughout the follow-up period. However, there was no significant difference in outcomes between the two treatment groups at each postoperative follow-up. There were also no significant differences in blood loss or intra- and postoperative complications. Patients who underwent tubular microdiscectomy had a significantly shorter hospital stay compared to conventional microdiscectomy.

Conclusion:

Both conventional and tubular microdiscectomy are effective means of treating disc herniation. While patients who underwent tubular microdiscectomy had a shorter hospital stay, the modest clinical benefits do not necessarily warrant the transition to a minimally invasive approach given the learning curve associated with the technique.
Structured spine fellowship programs in India: Current trends and perceptions
Authors: Basu Saumyajit , Banta Aditya , Gohil Kushal
Published: February 2024

Introduction:

The present study aimed to assess the quality of training provided during Structured Spine Fellowships (SSF) and explore the expectations of candidates. The study sought to investigate the utility of SSFs and emphasized the importance of evaluating the fellowship center’s curriculum as well as trainees’ surgical and theoretical competency.

Materials and Methods:

A retrospective descriptive study was conducted on 100 spine surgeons, 66 from Fellow of the National Board and 34 from the Association of Spine Surgeons of India, using a questionnaire. The survey had three parts, assessing pre-fellowship demographics, feedback on the fellowship conducted, and post-fellowship settlement.

Results:

The hands-on experience was the most important factor affecting the choice of center, and the average work time was 14 h per day. Nearly 50% of fellows were doing independent cervical dorsal and lumbar surgeries by the end of the fellowship. Academics were mainly in the form of regular case presentations for 55% of fellows, and the average number of publications done was 1.6. Most fellows settled near their native city, practiced exclusive spine surgery, and did a mean of 2.6 additional fellowships.

Conclusion:

This study provides a comprehensive overview of the structured spine fellowship programs in India. The findings highlight the need for standardization and quality control measures in these programs to ensure that they provide a comprehensive and uniform education to the fellows. The study also underscores the importance of ongoing evaluation and assessment to improve the effectiveness of these programs in producing skilled and competent spine surgeons.
Does platelet-rich plasma enhance fusion in transforaminal lumbar interbody fusion? A prospective clinico-radiological comparative study
Authors: Sudhir G , Vignesh Jayabalan S , Prasath Gokul , Ravi Veeraraghavan Raghav , Kailash Karthik
Published: February 2024

Background:

Several animal studies have shown that platelet-rich plasma (PRP) is effective in enhancing bone fusion. However, the role and efficacy of PRP in spinal fusion surgery remain uncertain. The objective was to evaluate the efficacy of PRP in bone fusion and to compare the clinical and radiological outcomes of transforaminal lumbar interbody fusion (TLIF) with and without PRP.

Materials and Methods:

This prospective study was done on 50 patients who underwent TLIF surgery for various spinal pathologies. Patients were divided into the control group (underwent TLIF with interbody cage and local bone grafts alone) and the study group (underwent TLIF with interbody cage, local bone grafts, and PRP). Functional outcome was evaluated using visual analog score (VAS) and Oswestry disability index (ODI). Radiological outcome was assessed by Bridwell’s grading system for fusion on computed tomography scan at the end of 2 years.

Results:

The average bone fusion rate was significantly higher in the PRP group compared to the control group; however, the average duration of fusion was not statistically significant. There was no difference in VAS and ODI at 1 and 2 years. There was also no significant difference in lower back pain, leg pain, and numbness in both groups at the end of 1 year.

Conclusion:

Although there is no statistically significant difference in functional outcome between both groups, local application of PRP along with autologous bone grafts increases bone fusion rates with good clinical and radiological outcomes.
Stab injury to the spine with retained knife blade and aortic injury: A case report and review of the literature
Authors: Naicker Denver , Pswaryi Rudo
Published: February 2024

Nonmissile penetrating spine injuries are relatively common in developing countries. Associated injuries are most commonly pneumothoraxes or bowel injuries and rarely vascular injuries. Penetrating aortic injuries are life-threatening and require prompt workup and management. A 51-year-old male patient presented after being stabbed in the back with a blade lodged at vertebral body T10/T1l. The blade tip was in the lumen of the descending thoracic aorta. This patient was successfully managed with thoracotomy and aortic repair, followed by the removal of the blade via an open laminectomy. The patient remained neurologically intact with no complicating features. Patients with penetrating spine injuries and retained blades need adequate workup to exclude other injuries prior to the removal of the blade. A multidisciplinary approach is important in the management of these patients to prevent devastating outcomes.
Concomitant spinal and non-spinal osteoarticular infections
Authors: Fukushi Ryunosuke , Kawaguchi Satoshi , Horigome Keiko , Yajima Hideki , Yamashita Toshihiko
Published: February 2024

Background:

Treatment of pyogenic spondylodiscitis or septic arthritis can be complicated with a variety of concomitant infectious processes. No study has focused on concomitant osteoarticular infections.

Materials and Methods:

Between 2015 and 2019, patients over 18 years old, who were diagnosed and treated for spinal infections (SIs) or non-spinal osteoarticular infections, were included. There were six patients with concomitant spinal and non-spinal osteoarticular infections (concomitant infection [CI] group), 30 patients with SI alone (SI group), and 18 patients with articular infection (AI) alone (AI group). The data gained from the patients in the CI group were compared those in the SI group and the AI group.

Results:

Factors contributing to statistical significance included past or present history of cancer (100% in the CI group, 27% in the SI group, and 33% in the AI group), C-reactive protein (CRP) levels (27.4 mg/dL in the CI group, 13.4 mg/dL in the SI group, and 13.8 mg/dL in the AI Group), albumin levels (2.4 g/dL in the CI group and 2.9 in both the SI group and the AI group), detection of Group B Streptococcus (GBS) (50% in the CI group, 3.3% in the SI group and 5.6% in the AI group), and duration of intravenous antibiotic therapy (131 days in the CI group, 67 days in the SI group and 29 days in the AI group).

Conclusions:

Patients with concomitant spinal and non-spinal osteoarticular infections were more likely to present with a past and present history of cancer, severe hypoalbuminemia, higher levels of CRP and GBS bacteremia.
Dorsal epidural migration of lumbar disc herniation at L3-L4 level treated by minimally invasive microtubular decompression and fixation: A case report
Authors: Mittal Samarth , Bharti Bhupendra P , Verma Rajesh , Girdhar Puneet
Published: February 2024

Lumbar disc herniation with dorsal epidural migration is a rare clinical condition that can present with severe neurological deficit and cauda equina syndrome. Diagnosis poses a challenge as it mimics other dorsal epidural pathologies like tumors, cysts, and abscesses. Timely diagnosis and early surgical intervention with wide decompression can improve the neurological outcome. Minimally invasive technique has the advantage of minimal muscle damage, early rehabilitation, and equal clinical outcomes to those of standard laminectomy. In this report, we describe a case of a 63-year-old male with lumbar disc herniation at L3-L4 level with foraminal extension and dorsal epidural migration with neurological deficit managed by minimally invasive microtubular decompression and spinal stabilization.
Intradural lumbar disc herniation at the L3–L4 level: A case report and literature review
Authors: Nguyen Vinh-Lac , Le Trong-Hieu , Tran Duc-Hoang , Nguyen Thanh-Minh
Published: February 2024

Only 0.26% of all disc herniations are caused by intradural disc herniation (IDH), making it a rare pathology. We present the case of a 44-year-old man who suffered from right radicular low back pain and motor impairments. At the level of L3–L4, magnetic resonance imaging (MRI) revealed an intradural, extra-axial spinal mass. This individual had several specific MRI imaging characteristics. Laminectomy, durotomy, and transforaminal lumbar interbody fusion surgery was performed, and the disc was completely removed. At the 6-month follow-up, the patient showed full recovery. The diagnosis of IDH is very challenging and every spine surgeon must be aware. The best treatment for this pathology is surgical intervention.
Comparative evaluation of antifungal activity of Sodium Hypochlorite, Calcium Hypochlorite and modified Salt Solution associated with passive ultrasonic irrigation against Candida albicans - An In-Vitro study
Authors: Thomas Helen , Nirupama D. N. , Nainan Mohan Thomas , Naveen D. N. , Ranjini C. Y. , Vijay R.
Published: February 2024

Aim:

The study evaluated the antifungal activity of sodium hypochlorite (NaOCl), calcium hypochlorite (Ca(OCl)2), and modified salt solution (MSS) assisted with passive ultrasonic irrigation against Candida albicans.

Materials and Methods:

One hundred and thirty-six single-rooted premolars were decoronated and enlarged up to a file #45, autoclaved, inoculated with C. albicans, and incubated for 72 h. The samples were randomly distributed into eight groups (n = 17) according to the protocol for decontamination G1: No treatment, G2: Distilled water (DW), G3: 2.5% NaOCl, G4: 2.5% NaOCl + ultrasonic activation (US), G5: 2.5% Ca(OCl)2, G6: 2.5% Ca(OCl)2 + US, G7: MSS, G8: MSS + US. Microbiological testing (Colony forming Unit [CFU] counting) was performed before and after the treatment.

Statistical Analysis:

Data were subjected to the one-way analysis of variance followed by the Tukey’s post hoc test (P < 0.05).

Results and Conclusion:

Groups 1 and 2 showed the highest mean contamination (5.41 and 4.31 log10 CFU/mL, respectively), which was statistically different from all the other groups (P < 0.001). G4 showed the lowest mean contamination (0.24 log10 CFU/mL) with statistically significant value (P < 0.001). 2.5% NaOCl with ultrasonic activation can aid in significant fungal reduction. Ultrasonic activation of 2.5% NaOCl, 2.5% Ca(OCl)2, and MSS was also found to have improved antifungal activity against C. albicans.
Comparison of bond strength of self-adhesive and self-etch or total-etch resin cement to zirconia: A systematic review and meta-analysis
Authors: Borouziniat Alireza , Majidinia Sara , Shirazi Alireza Sarraf , Kahnemuee Fatemeh
Published: February 2024

The aim of this study was to systematically compare the bond strength of self-adhesive and self-etch or total-etch resin cement to zirconia. The PubMed, ISI (all), and Scopus databases were searched for the selected keywords up to November 1, 2021, without date or language restrictions. In vitro studies comparing the bond strength of self-adhesive and self-etch or total-etch resin cement to zirconia were eligible for inclusion in the study. The selected articles were divided into four groups based on the type of resin cement and the storage time. Statistical analysis was performed using the Biostat Comprehensive Meta-Analysis Software version 2 (α = 0.05). The effect of conventional cement ( Glass Ionomer (GI), Resin Modified Glass Ionomer (RMGI) and zinc phosphate) was analyzed using descriptive analysis. The initial search yielded 376 articles, of which 26 were selected after a methodological assessment. Two reviewers independently extracted data and assessed the risk of bias. The results showed that the immediate or delay bond strength of the self-adhesive resin cement to zirconia has no significant difference with the bond strength of self-etch resin cement to zirconia. The immediate and delay bond strength of total-etch cement-zirconia was significantly lower than that of self-adhesive cement-zirconia (P = 0.00). A descriptive analysis of the selected articles showed that the bond strength of self-adhesive resin cement to zirconia was significantly higher than total-etch cement. The results of the meta-analysis showed that both self-adhesive and self-etch resin cement (if applied according to their manufacturer’s instruction) are suitable for bonding to zirconia.