bluuebunny/crossref_metadata_2025 huggingface dataset:
Robotic versus Laparoscopic Colorectal Surgeries
Authors: Heroor Anil , Khan Aysha , Jain Kashish , Patil Akshay , Singhavi Hitesh Rajendra
Published: April 2023

In recent times, there has been a logarithmic rise in the use of robotics in colorectal surgery. The latest systematic review comparing intraoperative and postoperative prognostic factors influencing outcomes between laparoscopic and robotic surgery is lacking. The meta-analysis was done using Preferred Reporting Items for Systematic Review (PRISMA) and Meta-analysis of Observational Studies in Epidemiology and searching Medline, PubMed, and Web of Science published from January 2014 to May 2020. All statistical analysis and data synthesis were conducted using STATA/IC version 14.2 WINDOWS 64 bit (Stata Corp LP College Station, TX, USA). Sixty-four studies published in last 5 years from January 2014 to May 2020 consisting of 74,281 participants comparing laparoscopic versus robot-assisted colorectal surgery were analyzed. Robotic-assisted surgery reported lower conversion to open surgery compared to laparoscopic surgery (P < 0.0001) with a narrow (95% confidence interval: 0.35–0.62). We did not find any significant difference between the two approaches for anastomotic leak (P = 0.599). The mortality rate was significantly higher in laparoscopic surgery (P < 0.002). Postoperative ileus was comparable significantly in robotic surgery (P < 0.577). Length of hospital stay (HS) was similar in both groups (P = 0.058), with lower trends in robotic surgery. Harvested lymph nodes and intraoperative blood loss were similar in both groups. Descriptive cost analysis favored laparoscopic-assisted colorectal surgeries. Intraoperative time was significantly longer for robot-assisted colorectal surgery (P = 0.001). Robotic-assisted colorectal surgery is oncologically safe with less requirement of conversion of open, reduced mortality rate, while anastomotic leak, blood loss, HS, postoperative ileus, and harvested nodes were comparable with laparoscopically assisted colorectal surgery.
Using Traditional Typologies to Understand Posture Movement and Cognitive Performance - A cross sectional study
Authors: Gupta Ankit , Garg Rahul , Singh Varsha
Published: April 2023

Context:

We employed two classification methods that characterize psycho-somatotype categorization to understand motor and cognitive performance. The Trunk Index produces three somatotypes/body type categories: ectomorphs, mesomorphs, and endomorphs, and Prakriti classifications categorizes people into three categories: Vata, Pitta, and Kapha. Comparing these two categorization methods offers insights into anthropometric measures that combine psychological and physical characteristics to account for motor and cognitive behavior.

Aims:

The present study examined variations in cognitive and motor performances using the two typologies – prakriti and somato body types using cross-sectional study design.

Subjects and Methods:

The study employed fifty-eight healthy young adults, classified into prakriti (vata, pitta, kapha) and ecto-, meso-, endo-morph body types, to examine their cognitive performance (reaction time [RT] and accuracy), and motor performance (posture stability and posture accuracy) in standing yoga postures.

Statistical Analysis Used:

Analysis of covariance was performed to compare the cognitive and postural performance across the three somato and prakriti types after adjusting for age and gender as covariates. Post-hoc analysis of Bonferroni was performed with the consideration of Levene's test. Partial correlations were employed to investigate the correlation between postural stability and cognitive performance measures for each of the prakriti- and somato-body types as well as between the prakriti typology (scores) and trunk index values (adjusting the effects of age and gender as control variables). A P < 0.05 was selected at the statistical significance level. SPSS 26.0 version was used for the analysis.

Results:

Cognitive performance was observed to vary in terms of RT across somato- and prakriti body types (P < 0.05). Postural stability and cognitive performance are positively connected only for ectomorph body types (P < 0.05). Variations in motor performance were not significant. Barring ectomorph type, no other somato- and prakriti body types showed significant relationships between postural stability and cognitive performance. Likewise, the association between the features used for prakriti classification, and the trunk index scores showed marginal significance, only for a small subset of physical features of prakriti assessment (P = 0.055) (P1).

Conclusions:

Comparing classifications that use psychophysical attributes might offer insights into understanding variations in measures of motor and cognitive performance in a sample of healthy individuals.
Effective Stress Management through Meditation
Authors: Daniel Ronnie V. , Sharma Greeshma , Chandra Sushil
Published: April 2023

Introduction:

Stress among college students is a common health problem that is directly correlated with poor cognitive health. For instance, cognitive mechanisms required for sustenance can be affected due to stress caused by daily mundane events, not necessarily by chronic events. Thus, it becomes essential to manage stress effectively especially for college students. Meditation is one of the useful techniques that facilitates cognitive flexibility and has consequences at the molecular and endocrinal level to treat stress.

Objectives:

The present study attempts to understand the effect of meditation on the brain waves when participants face stressful events.

Methods:

A randomized controlled pre-post experimental design was used. Total 18 subjects were randomly assigned to control group and experimental group. Subsequently, Electroencephalograph (EEG) data were recorded during the determination test (DT) before and after the meditation. The Control group underwent relaxation music while the experimental group practiced Sudarshan Kriya Yoga (SKY) (a type of meditation). Non-linear EEG signal processing algorithm was applied to capture dynamics and complexity in brain waves. Results: Results indicated that the efficacy of meditation was reflected with the improved information processing in the brain. Improved performance and reduced errors were reported in DT Scores in the experimental group. Increased complexity of beta band was observed for non-linear features, signifying efficient utilization of cognitive resources while performing the task.

Conclusion:

Findings implicated the usefulness of the meditation process for effective stress management.
Perceptions about the Benefits and Negative Outcomes of Yoga Practice by Yoga-Naïve Persons
Authors: Sharma Sachin Kumar , Agnihotri Savita , Kala Niranjan , Telles Shirley
Published: April 2023

Background and Objective:

Understanding the way nonexercisers view the benefits and barriers to physical exercise helps promote physical exercise. This study reports perceived benefits and negative outcomes of yoga perceived by yoga-naïve persons.

Methods:

The 2550 yoga-naïve respondents of both sexes (m:f = 2162:388; group mean age ± SD 23.5 ± 12.6 years) participated in a convenience sampling in-person survey conducted to determine the perceived benefits and negative outcomes of yoga.

Results:

Among 2550 respondents, 97.4% believed yoga practice had benefits. The three most common perceived benefits of yoga were improvement in (i) physical health (39.8%), (ii) cognitive functions (32.8%), and (iii) mental health (20.4%). Among the respondents, 1.4% believed that yoga had negative outcomes. The three most common perceived negative outcomes were (i) apprehension that wrong methods may be harmful (0.24%), (ii) apprehension that excessive practice may harm (0.24%), and (iii) laziness (0.12%).

Conclusion:

The most common perceived benefit of yoga practice was “improvement in physical health,” with “apprehension that wrong or excessive practice could be harmful” as the most common perceived negative outcomes of yoga.
Study of Emotion Regulation Based on Yogic Personality Using Implicit, Explicit, and Eye Tracking Techniques
Authors: Kumar R. Senthil , Britto John , Ilavarasu Judu , Rajesh S. K.
Published: April 2023

Context:

Emotion regulation (ER) is vital for well-being. Yogic personality traits,gunas, influence the expression of ER.

Aims:

To investigate the expression of ER based on guna-related personality traits employing explicit, implicit, and objective eye-tracking techniques.

Settings and Design:

Quota sampling was used, with a cross-sectional design with three groups, sattva, rajas, and tamas. Three hundred and ninety-four female students were screened and finally, 30 fromsattva, 34 fromrajas, and 36 fromtamaswere analyzed.

Methods:

Participants were given State and Trait Mindfulness Scales, Gita Inventory, Social Desirability Scale, state-trait anxiety inventory, Adult Attachment Scale, and Emotional Regulation Questionnaire. ER-Implicit Association Test (ER-IAT) and Eye Tracker were also used to evaluate the participants.

Statistical Analysis Used:

One-way repeated-measures analysis of variance was used to examine differences betweensattva,rajas, andtamas.

Results:

Sattvagroup adopted a higher level of regulation strategy, ER-IAT scores were positive forsattva, negative for rajas and tamas. Mindfulness was highest and anxiety was least insattva. In the eye tracker, within the non-emotional areas of interest (eAOI) regions of pleasant condition, and eAOI regions of unpleasant condition,sattvagroup had considerably higher dwell time. Pupil dilation was lowest in sattva for all the conditions, both within and outside eAOIs.

Conclusions:

Sattvagunawas found to foster healthy ER, and other psychological attributes. Conscious cultivation of sattva is needed for healthy emotional life.
Integrative Approach Improves Fall Risk and Postural Stability in Spinocerebellar Ataxia-2 – A Case Report
Authors: Kulamarva Kavyashree , Chikkanna Umesh , Ramakrishna Kishore Kumar , Bhargav Hemant , Velayutham Selva Ganapathy , Varambally Shivarama
Published: April 2023

Spinocerebellar ataxias (SCAs) comprise a large heterogeneous group of autosomal dominant cerebellar ataxias. Despite availability of various conventional treatments, reducing disability and improving the quality of life is a challenge in this condition. In the present case report, based on the clinical symptoms and site of pathology, an Ayurveda-based diagnosis of kaphavruta vayana and kaphavruta udana was considered. Therapeutic measures such as rookshana (drying therapy), vatahara (measures to pacifying vata), balya (strengthening), and brimhana (nourishing) regimens were adopted along with oral medications and specific yoga practices. The objective of the treatment was to improve stability, posture, and balance. After 10 weeks of integrative treatment, a demonstrable improvement was observed in scale for assessment and rating of ataxia Scale for the Assessment and Rating of Ataxia (SARA), fall risk, and limit of stability (using computerized dynamic posturography). Hence, an integrated Ayurveda and Yoga-based lifestyle regimen may serve as a useful adjuvant in improving fall risk and limit of stability in patients with SCAs.
Consciousness, Awareness, and Presence
Authors: Deshmukh Vinod D.
Published: April 2023

It is proposed that consciousness is different from awareness. Consciousness can be thought of as a dualistic, embodied, and embedded cognitive process, whereas awareness is a nondual and nonlocal process. Nonlocal awareness is the ever-present, ever-fresh, and an affective self-awareness that can be aware of itself as well as of the ongoing subject-object duality, and cognitive conscious contents. This nonlocal awareness is our default mode state. Although very few of us are aware of it due to our habitual mental preoccupation and mind-wandering. We need to relax, learn to meditate, let go of all preoccupations, and return to our default mode state of being, which is peaceful, silent, fulfilling, energetic, and ever-fresh. Then, one feels effortlessly alive and free and at home in the world. This is the essence of meditation for living a happy, peaceful, and meaningful life. The rest of the article provides details of meditative presence, yoga meditation, and mindfulness meditation with their current practice and applications. The main focus of the article is on the neurobiology of meditation, which is discussed in detail. It covers the experientially perceived mind-space including personal, peripersonal, and extrapersonal space, the concepts of mind in the Western and Eastern literature, and the neurobiological foundation in the brain stem, reticular-limbic system, forebrain including the five thalamo-cortical-basal ganglia circuits, multiple sensory modalities, integrated perception, speech production, language communication, voluntary movements, and intentional actions. The wholeness of conscious mind is expressed as bio-psycho-social-abstract/spiritual.
Surya Namaskar
Authors: Bandyopadhyay Abhishek , Halder Kaushik , Pathak Anjana , Kumar Bhuvnesh , Saha Mantu
Published: April 2023

Context:

“Surya Namaskar” (SN) may be used as a need-based short-duration aerobic activity in a confined space to establish as a substitute of an equivalent routine physical training in challenging stressful conditions.

Materials and Methods:

Noninvasive oxygen-kinetics metabolic responses between SN and endurance work on bicycle ergometry (BE) were compared across different phases of maximal oxygen uptake percentage (%VO2 max). SN, comprising three complete rounds per min (36 beats/min of a metronome; SN consists of 12 poses per round), was performed rhythmically and continuously for 5 min to simulate an incremental BE test (25 watts/2 min at 60 rpm).

Results:

SN results in a significant (P < 0.05) greater increase of arteriovenous oxygen difference at 71%–80% VO2 max while keeping a low respiratory exchange ratio (P < 0.01 and 0.001) at 41%–80% VO2 max exercising state.

Conclusions:

SN could be an ideal form of aerobic exercise instead of BE.
Estimation of Yoga Postures Using Machine Learning Techniques
Authors: Kishore D. Mohan , Bindu S. , Manjunath Nandi Krishnamurthy
Published: April 2023

Yoga is a traditional Indian way of keeping the mind and body fit, through physical postures (asanas), voluntarily regulated breathing (pranayama), meditation, and relaxation techniques. The recent pandemic has seen a huge surge in numbers of yoga practitioners, many practicing without proper guidance. This study was proposed to ease the work of such practitioners by implementing deep learning-based methods, which can estimate the correct pose performed by a practitioner. The study implemented this approach using four different deep learning architectures: EpipolarPose, OpenPose, PoseNet, and MediaPipe. These architectures were separately trained using the images obtained from S-VYASA Deemed to be University. This database had images for five commonly practiced yoga postures: tree pose, triangle pose, half-moon pose, mountain pose, and warrior pose. The use of this authentic database for training paved the way for the deployment of this model in real-time applications. The study also compared the estimation accuracy of all architectures and concluded that the MediaPipe architecture provides the best estimation accuracy.
Effect of Yoga on Stress, Anxiety, Depression, and Spinal Mobility in Computer Users with Chronic Low Back Pain
Authors: Singphow Chametcha , Purohit SatyaPrakash , Tekur Padmini , Bista Suman , Panigrahy Surya Narayan , Raghuram Nagarathna , Nagendra Hongasandra Ramarao
Published: April 2023

Background:

Office workers who need to use a computer while maintaining a static position for prolonged periods have more chance of having low back pain (LBP).

Objective:

The objective of the study is to investigate the effect of yoga on stress, anxiety, depression, and spinal mobility in computer users with chronic LBP (CLBP).

Materials and Methods:

In this randomized control trial, eighty computer users (42.6 ± 8.45 years of age; suffering from CLBP since 5.20 ± 3.01 years; 51 males and 29 females) who use a computer for their professional work, recruited from Bengaluru, India, were randomized into two groups: yoga group (n = 40) and physical exercise group (n = 40). The yoga group practiced an integrated module comprising yoga postures and mindfulness meditation, and the physical exercise group practiced physical exercise designed for LBP (1 h/day, 3 days/week for 16 weeks). Assessments of dial-type goniometer and Depression Anxiety Stress Scale-42 were performed at baseline, after 8 weeks, and after 16 weeks.

Results:

Stress, anxiety, and depression scores were significantly lower in the yoga group as compared to the physical exercise group at 16 weeks (P < 0.001), whereas spinal flexion (P < 0.001), spinal extension (P < 0.001), right lateral flexion (P = 0.001), and left lateral flexion (P = 0.007) scores were significantly higher in the yoga group as compared to the physical exercise group at 16 weeks.

Conclusion:

Yoga is more effective in reducing stress, anxiety, and depression and improving spinal mobility in computer users with CLBP than physical exercise designed for LBP.
Uncommon Foot Pain
Authors: Sales Kelsen dos Santos , de Matos Mota Anacélia Gomes , Gusmão Camilla Teixeira Pinheiro , Ribeiro Junior Howard Lopes
Published: April 2023

Cutaneous pili migrans (CPM) is an uncommon condition in which a hair fragment penetrates the skin and produces a creeping lesion similarly of cutaneous larva migrans associated with local pain. There are few reports of CPM in the literature, and none visually describes the migration of the hair shaft in the epidermis associated with pain. Herein, we showed the first report describing a case of an in situ sequential migration of CPM in an adult patient.
Efficacy of Low-Level Laser Therapy in Androgenetic Alopecia – A Randomized Controlled Trial
Authors: Sondagar Dharm Mansukh , Mehta Hita H. , Agharia Rashmiben Sabbirali , Jhavar Milan K.
Published: April 2023

Background:

Androgenetic alopecia (AGA) is caused by the susceptibility of hair follicles to androgenic miniaturization, which leads to hair loss. The most common modalities for the treatment of AGA include the use of topical minoxidil and oral finasteride. Low-level laser therapy (LLLT) is a newer modality of treatment for AGA. We tried to evaluate the added benefit of LLLT in AGA compared with topical minoxidil 5% alone.

Aim:

The aim of this study was to compare the efficacy of LLLT combined with topical 5% minoxidil in AGA versus topical 5% minoxidil used alone.

Materials and Methods:

After ethics committee approval, 54 patients of AGA were randomly divided into two groups. Group A participants received LLLT therapy twice a week plus topical 5% minoxidil and Group B participants received only minoxidil 5% solution. Both the groups were followed up for 16 weeks and evaluated with gross photographs, TrichoScan analysis, and dermoscopy to look for any improvement in hair density.

Results:

After 16 weeks, improvement in hair density of 14.78% ± 10.93% in Group A was recorded compared to 11.43% ± 6.43% in Group B. However, while comparing both means, P value was 0.45 which was not significant. The physician global assessment and patient satisfaction score revealed no significant difference between both the groups.

Conclusion:

Although LLLT appears to be safe and effective in the treatment of male pattern hair loss, we did not observe any significant difference in terms of improvement in hair density between both the groups.
Conjoint Bicondylar Hoffa’s Fracture with Associated Supracondylar Fracture
Authors: Anwer Adnan , Siddiqui Yasir Salam , Abbas Mazhar , Chowdhry Madhav
Published: April 2023

Conjoint bicondylar Hoffa’s fracture is a rare fracture pattern with a coronal split of posterior femoral condyles with an interconnecting bridge of bone. This fracture pattern generally occurs in high-velocity road traffic accidents and is associated with injuries around distal femur, proximal tibia, patella, or extensor mechanism at the knee joint. Due to extensive associated injury patterns, definitive surgical management often varies. This is a case of conjoint bicondylar Hoffa’s fracture with associated comminuted supracondylar fracture of femur. A 40-year-old male presented to the emergency room after sustaining injury to his right knee, previously ambulating on a malunited tibia. Radiographic examination demonstrated conjoint bicondylar Hoffa’s fracture with associated supracondylar fracture right distal femur. Open reduction and internal fixation was done using two T-plates fixed with screws. Due to malunited tibial and fibular fracture with intra-articular extension of the implant, the patient had a decreased range of motion (ROM) up to 120° preoperatively. Early physiotherapy was emphasized, and postoperatively similar ROM was achieved. Conjoint bicondylar Hoffa’s fracture is a rare fracture pattern, which can be associated with a supracondylar fracture of the femur. For this combined fracture fixation, open reduction internal fixation with two T-plates and screws offers a viable treatment option. The patient achieved complete preoperative ROM.
Tibial Hemimelia-Polysyndactyly-Triphalangeal Thumb Syndrome
Authors: Anwer Adnan , Siddiqui Yasir Salam , Abbas Mazhar , Chowdhry Madhav
Published: April 2023

Triphalangeal thumb (TPT) is a rare clinical entity, with majority of cases being hereditary in origin. Two syndromes associated with TPT are triphalangeal thumb-polysyndactyly syndrome (TPTPS) and tibial hemimelia-polysyndactyly-triphalangeal thumb syndrome (THPTTS). Hypoplasia or aplasia of tibia is the primary difference between them. Although having many common clinical features, TPTPS and THPTTS are considered two different entities. Here, we report a rare situation of these two conditions occurring in the same family: a mother with TPTPS and her son with THPTTS. A 4-month-old male child presented to outpatient clinic with complaints of 2.5 cm shortening and clubfoot present on the right side. The child had five-fingered hands without thumbs or thenar muscles along with preaxial polydactyly with seven toes in the left foot and six toes in the right foot. Radiographic examination revealed hypoplasia of the right tibia (tibial hemimelia) with thickened and superolaterally displaced fibula. While applying cast for club foot to the child, his mother’s hands came into notice. The lady was 26 years old, born to nonconsanguineous parents, with no similar history in parents or siblings. Clinical examination of hands revealed TPTs in both hands. She had no difficulty in her activities of daily living. Her legs appeared normal. Her feet were normal except for the duplicated right great toe with fused nails and duplicated left great toe floating separately. TPTs, polydactyly of hands, and feet along with syndactyly of digits are cardinal findings seen in both TPTPS and THPTTS. Both can also be traced to 7q36. The presence of a tibial defect seems to be the only difference between the two disorders. In this case report, we highlight the occurrence of two seemingly different clinical entities within the same family, suggesting the possibility of an overlying common entity with a wide spectrum of clinical presentations.
Bicondylar Hoffa Fracture
Authors: Singh Shailendra , Mishra Prakhar , Mohan Ravindra , Kumar Deepak , Singh Arpit
Published: April 2023

A Shear fracture of posterior aspect of femoral condyles in coronal plane is known as Hoffa fracture. This fracture pattern, originally described by Hoffa, is an intra-articular fracture and radiologically and clinically silent most of the times and thus commonly missed. The bicondylar variant of this fracture is a rare injury. We report a case of 38-year old male patient presenting with one day old bicondylar Hoffa fracture managed with headless compression screw and cannulated cancellous screws.
Long-Segment Myelitis after Traumatic Paraplegia in COVID-19 Positive Patient
Authors: Mohan Ravindra , Sharma Yashvardhan , Singh Akanksha , Singh Shailendra , Singh Arpit
Published: April 2023

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has devastated the mankind globally, and countless lives have been lost all around the world. This disease has been linked to various extrapulmonary symptoms and consequences in addition to typical respiratory illness. This case highlights a probable neurological complication of SARS-CoV-2 infection. A 28-year-old healthy man, sustained wedge compression of D12 vertebra following road traffic accident, presented with paraplegia. One week following admission, the patient had a progressive neurological deterioration and developed high grade fever with weakness in both upper limbs. The patient developed quadriplegia 10 days after admission. Magnetic resonance imaging (MRI) brain and spine were done. MRI brain was normal, whereas MRI spine showed D11-D12 anterolisthesis with cord compression with T2 hyperintensity of cervical cord. His SARS-CoV-2 reverse transcriptase polymerase chain reaction turned out to be positive. We hereby report a case of posttraumatic long-segment myelitis with coronavirus disease 2019 as a probable etiology.
Single-stage Bilateral Revision Knee Arthroplasty with Unilateral Tibial Tubercle Osteotomy
Authors: Tomar Lavindra , Govil Gaurav , Dhawan Pawan
Published: April 2023

A revision total knee arthroplasty (Rev-TKA) for bilateral affection presents surgical complexities. Rev-TKA as a single stage has been rarely advocated. A 76-year-old woman presented with painful bilateral knees and a history of bilateral TKA done fourteen years ago. The right knee required unilateral tibial tubercle osteotomy with cerclage wire fixation to remove the incarcerated cemented tibial extension rod and extensile medial parapatellar approach for the left knee in single-stage. The osteotomy united at 14 weeks. At 2-year follow-up, range of movements improved, allowing pain-free walking without support and laxity. No radiological evidence of loosening or wear. Rev-TKA challenges include obtaining adequate joint exposure without compromising the integrity of the extensor mechanism. The crucial factors for achieving an uneventful single-stage surgery include thorough pre-operative planning, prophylactic thromboprophylaxis, measures to reduce blood loss, and meticulous execution of planned surgery. The bilateral Rev-TKA should be planned after the stratification of the risk-benefit ratio.
To Assess the Functional and Radiological Outcomes of Intra-Articular Fractures of Distal end Radius by Open Reduction and Internal Fixation with Locking Distal Radius Volar Plate
Authors: Verma Ashutosh , Saroj Atul Kumar , Kumar Ankit , Patel Upendra , Prajwal M. C.
Published: April 2023

Background:

Intra-articular fracture distal radius is a common fracture and remains one of the most challenging fractures to treat without any complications. In unstable intra-articular fractures, re-establishment of intra-articular integrity of the wrist and maintaining the radiological parameters are often not possible with close methods. In such cases where an open reduction is required, various surgical methods and fixation materials can be used.

Materials and Methods:

A total of 35 patients with clinico-radiological diagnoses of intra-articular fractures of the distal end of the radius participated in the study. All the patients were followed up for a minimum of 6 months after the procedure, and the observations thus made were tabulated.

Results:

Functional outcome in terms of Quick DASH was excellent to good in 88.6% patients on the basis of Quick Dash Score Grading with no significant loss of radiographic reduction and a better range of movements throughout the follow-up period.

Conclusion:

Volar plate fixation is viable and one of the most favorable means of management with maximum anatomical restoration and functional gain.
Management of Traumatic Proximal Tibia Fracture with Migrated Bioscrew after Anterior Cruciate Ligament Reconstruction
Authors: Kar Santanu , Singh Mohit , Pandey Sarvesh K. , Yadav Ajay K. , Khare Rahul , Kumar Satish
Published: April 2023

The anterior cruciate ligament (ACL) is injured most during sports activity, which has to be reconstructed to regain painless, functional, and stable knee. Tibial plateau fractures after arthroscopic ACL reconstruction (ACLR) are being increasingly reported in the literature. Revision ACLR may be required after fracture union due to possible disruption of the previous reconstruction. Here is the case of operated bicondylar tibial plateau fracture with the excellent outcome at 2-year follow-up with a previous history of ACLR 5 years back with abutting of the tibial-sided biodegradable screw to the knee joint in a recreational soccer player. This case report of a 46-year-old male patient hereby describes the management of the fracture and possible factors responsible for bioscrew migration.
Is Tension Band Wiring (Osteosynthesis) with Three Kirschner Wires Provide Better Outcome as Compared with Two Kirschner Wires in Patella Fracture
Authors: Kumar Sachin , Singh Mohit , Kumar Satish , Khare Rahul , Yadav Ajay Kumar , Kumar Deepak
Published: April 2023

Background:

Fractures of the patella constitute approximately 1% of all skeletal injuries, resulting from either direct or indirect trauma. Many forms of internal fixation for patellar fractures have been described in the literature but perfect anatomical reduction during surgery has an excellent outcome irrespective of the method of fixation used. The conventional method of patellar tension band wiring (TBW) is being done always with the help of two parallel Kirschner wires (K-wires).

Objectives:

Here in our prospective study, we intended to see whether the use of three parallel K-wires in comparison to the conventional one results in superior functional outcomes.

Materials and Methods:

A prospective cohort study was carried out in New Delhi from November 2016 to November 2019 in a total of 44 patients with patellar fractures operated by TBW with 22 patients in two parallel K-wires and three parallel K-wires groups, respectively. Patients were followed up postoperatively for 1 year and assessed by Lysholm knee score (LKS), pain status, working status, and other variables Normality of data was tested by Kolmogorov–Smirnov test and paired t test/Wilcoxon rank-sum test.

Results:

The total mean age was 40.27 years (41.86 in 2K-wire and 38.68 in 3K-wire) in this study. LKS (0.00 in both groups on first day; 99.23 and 99.45 after 1 year in 2K-wire and 3K-wire groups, respectively, pain status (was 5.0 in both groups on the first day and 1.0 after 6 month), and working status (was 5.0 in both groups on the first day and 1.09 after 1 year), were not significantly different throughout the mean to follow up periods for both groups (P > 0.05).

Conclusions:

No significant difference was observed between patellar TBW in 3K-wire and 2K-wire groups.
Tubercular Flexor Tenosynovitis with Carpal Tunnel Syndrome Mimicking as Compound Palmar Ganglion
Authors: Mahapatra Swagat , Mishra Madhusudan , Patel Jaydeep , Mishra Prakhar , Singh Devta
Published: April 2023

Introduction:

Tubercular flexor tenosynovitis is an infrequent condition, which has a mixed clinical picture, but with careful examination and investigation, it should be diagnosed earlier before the involvement of underlying bones and nerves.

Case Report:

We present a case of a 69-year-old man who came with complaints of progressive swelling over the palm and forearm. He was presented as compound palmar ganglion but finally diagnosed as a case of chronic flexor tenosynovitis with association of carpal tunnel syndrome of tubercular origin without involvement of the underlying bones and was treated by complete excision and antitubercular therapy.

Conclusion:

Tuberculous flexor tenosynovitis is a condition that can be managed by excision and antitubercular therapy. However, it presents as a challenge to the surgeons when the presentation is very late. Hence, early identification and treatment are the main goals of this article.
Extracorporeal irradiation in malignant bone tumors: Single institution experience and review of literature
Authors: Agarwal Shruti , Rathi Arun Kumar , Singh Kishore , Melgandi Wineeta , Ansari Faiz Akram , Arora Savita
Published: April 2023

In the last couple of decades, the management of malignant bone tumor (MBT) has seen a sea change. With the advent in surgical technics, radiation therapy, and chemotherapy, it has moved from disabling amputation to limb salvage surgery. Extracorporeal irradiation (ECI) and re-implantation of resected bone is a useful method of limb salvage of MBTs. In our study, we analyzed and presented the results of 8 cases of MBTs treated with this modality. Between 2014 and 2017, 8 patients with primary MBT were enrolled for ECI technique who are meeting the eligibility criteria. Before taking the patient for ECI treatment, a multispecialty tumor board discussion was done for each patient. All of them received neo-adjuvant and adjuvant chemotherapy except the patients with histology of giant cell tumor. Following neoadjuvant chemotherapy bone excision surgery was performed, and the resected bone was taken for ECI with the dose of 50 Gray in a single fraction. After ECI, bone segment was re-implanted at osteotomy site in the same setting. After completion of adjuvant chemotherapy, the patients were then followed up for any sequelae, local and systemic control, ambulation, and functional outcome. Out of 8 patients, there were 5 males and 3 females with mean age of 22 (range 13–36). The involved bone was the tibia in 6 patients, ischium in 1 patient, and femur in 1 patient. Histopathologically, the malignancies included 3 osteosarcoma, 3 Giant cell tumor, 1 Ewing’s sarcoma and 1 chondrosarcoma. At median follow-up of 12 months (range 6–26 months), local control rate was 87.5% and systemic control rate was 75%. Perioperative ECI and re-implantation is a useful, convenient, and inexpensive technique. The overall treatment time is reduced. The patient’s own bone fits perfectly to the resection site with reduced risk of graft site infection. The risk of local recurrence due to tumor re-implantation is negligible with tumoricidal radiation doses of ECI, and it is usually associated with manageable sequelae. Recurrence rates are acceptable and salvageable with surgery.
An adding up of an exceptionally rare case report: Primary Squamous cell carcinoma of Jejunum from North India
Authors: Singh Divya , Kumar Arvind , Gowda Vinay , Sahai Rishabh , Kumar Sudhir , Kishore Sanjeev
Published: April 2023

Squamous cell carcinoma (SCC) of lower gastrointestinal tract is a rare tumor and duodenum is the most common site of involvement. In addition, involvement of jejunum by SCC is further exceptionally rare, and only nominal cases are present world literature. Being a very infrequent finding, a clinician and a pathologist must be aware of this rare entity. Diagnosis requires histopathology along with clinico-radiological correlation since merely histopathology is unable to differentiate between primary and metastatic tumor. Treatment modality is totally different in primary and secondary tumor of lower gastrointestinal tract. Being an extremely rare case of primary SCC of jejunum in an elderly female makes it eligible to be acknowledged at the global platform of medical literature.
Evaluation of quality of life in posttreatment upper aerodigestive tract cancer patients
Authors: Sujith Akshay , Sharma Neeta , Guruprasad R. , Gupta Manish
Published: April 2023

Background:

Cancers of the upper aerodigestive tract constitute approximately 4% of all malignancies. Posttreatment cancer patient faces serious adversities that affect the quality of life. Out of the various scales available to measure the quality of life, we chose the quality of life-oral cancer (QOL-OC), which was developed and evaluated by Nie et al. in 2018.

Aims and Objectives:

The aim of our study was to assess the quality of life in posttreatment upper aerodigestive tract cancer patients in a tertiary care center and also to check the reliability and validity of the questionnaire QOL-OC.

Methodology:

We communicated with 89 patients who were pathologically tested positive for upper aero digestive tract cancer from January 2019 to December 2019.

Results:

The most prevalent adversity was found to be altered salivary flow, followed by diet and difficulty while eating. The QOL-OC was found to be a highly valid and reliable questionnaire.

Conclusion:

The study points out regarding the prevalence of various adversities in post treatment cancer patients, a discussion has also been made suggesting the importance of multidisciplinary approach that should be provided in such patients. Finally, the study also concludes regarding the generalizability of the questionnaire QOL-OC.
Anticancer potential of Nymphaea nouchali Brum flowers against Ehrlich ascites carcinoma cell lines
Authors: Nagavani V. , Raghavarao T.
Published: April 2023

Background:

Nymphaea nouchali Brum is exotic and medicinal plant in India.

Aim of the Study:

The main of this study is to evaluate the anticancer properties of Nymphaea nouchali Brum flowers against Ehrlich ascites carcinoma (EAC)-induced Swiss albino mice.

Materials and Methods:

The anticancer properties of Nymphaea nouchali Brum dry and fresh methanol extracts was investigated using EAC in Swiss albino mice. After inoculation of EAC cells into mice, treatment with NNDM flower extract (200 and 400 mg/kg) and standard drug 5-Fluorouracil (20 mg/kg) was continued for 9 days. The evaluation of the effect of drug response was made by the study of tumor growth response including increase in lifespan, the study of hematological parameters, biochemical estimations, and antioxidant assay of liver tissue compared to EAC control. The viability of cancer cell lines (such as HeLa, MCF-7, and MDA-MB 231 cells) was evaluated by 3-(4, 5-dimethylthiazolyl-2)-2, 5-diphenyltetrazolium bromide (MTT) assay.

Results:

Therefore, from the results of the present study, it can be concluded that NNDM exhibited significant antitumor activity against EAC in Swiss albino mice. The effect of NNDM on viability of cancer cell lines (such as HeLa, MCF-7, and MDA-MB 231 cells) was evaluated by MTT assay, apoptosis in HeLa cell lines was evaluated by DNA laddering assay, HeLa cells treated with NNDM exhibited a characteristic “ladder” pattern after separation of the fragments by agarose gel electrophoresis and subsequent visualization, by ethidium bromide staining. NNDM exhibited a significant effect on cell viability.

Conclusions:

Based on results, it was concluded that NNDM exhibited cytotoxic effect on cancer cells and, from DNA laddering assay, it can be concluded that NNDM-induced apoptosis in EAC cells.
To evaluate eosinophilia (tissue eosinophilia, blood eosinophilia and tissue eosinophilia/blood eosinophilia ratio) in increasing grades/ severity of oral neoplastic lesions
Authors: Kaur Navpreet , Zaheer Sufian , Sangwan Shruti , Ranga Sunil
Published: April 2023

Oral squamous cell carcinoma (OSCC) is the most common cause of morbidity and mortality in India. Buccal mucosa is the most common site because of tobacco quid. Several parameters for the assessment of OSCC have been studied like lymph node metastasis, tumor stage, grade, and perineural invasion. Tumor-associated tissue eosinophilia is another parameter, on which several studies have been done because of its favorable and unfavorable prognosis. The aim of our study is to study quantitative and qualitative eosinophilia in premalignant and malignant lesions of squamous origin in oral cavity with respect to tumor-associated blood eosinophilia. A retrospective study was done at Tertiary care hospital between January 2016 and December 2016. A total of 150 cases of premalignant (oral leukoplakia and dysplasia) and malignant oral squamous cell carcinoma (of various grades) along with blood pictures were evaluated.
A study on histological grading systems of oral squamous cell carcinoma and comparison of their efficacy in determining the nature (clinical and histopathological) and prognosis of oral squamous cell carcinoma
Authors: Pandya Jay A. , Natarajan Srikant
Published: April 2023

Purpose:

Tumour-Node-Metastasis (TNM) staging has been widely used for treatment planning and prognostication of oral cancers; however, TNM staging system alone is insufficient for optimal prognostication. A combined assessment of clinical staging and cytomorphology might serve as a more specific measure for prognostication. The present study attempted to compare the efficacy of histologic grading systems (Jakobbson et al., Anneroth et al. and Bryne et al.) of malignancy in determining the nature and prognosis of oral squamous cell carcinoma (OSCC). Tumour protein (TP53) immunohistochemical marker was used to determine the aggressiveness of OSCC.

Materials and Methods:

Tissue sections from 24 biopsy-proven cases of OSCC were stained with anti-TP53 antibody. Hundred cells in each case were counted and tabulated. Cases were graded using three histopathological grading systems. Findings were compared and correlated with TP53 immunopositivity and clinical parameters.

Results:

Positive correlation was observed between TP53 immunostaining and grading scores of each system. Highest correlation was observed with Jakobbson et al. grading system (r2 value = 0.91, P < 0.001). Significant results were observed on comparing grades of Jakobsson et al., Anneroth et al. and Bryne et al. grading system with segregated groups of TP53 immunopositive cases (P = 0.004, P = 0.003, P = 0.001, respectively). No significant results were observed on comparing grades of histopathological systems with clinical parameters.

Conclusion:

Both, clinical and histopathological grading systems, with immunohistochemistry, should be taken into account during the assessment of OSCC, for treatment planning and better prediction of tumour prognosis.
Multidrug resistance protein 1 silencing in osteosarcoma and chondrosarcoma cell lines
Authors: Freund Sarah S. , Bendtsen Michael M. , Safwat Akmal , Joergensen Peter H.
Published: April 2023

Background:

The poor response of metastatic osteo- and chondrosarcomas to chemotherapy could be the result of multidrug resistance (MDR), which may be overcome through the use of small interfering RNA (siRNA). However, several methodologic questions remain unresolved.

Aims:

To test the toxicity of three commonly used siRNA transfection reagents and apply the least toxic reagent to investigate the siRNA-induced MDR1 mRNA knockdown.

Methods:

The toxicity of TransIT-TKO, Lipofectamine 2000, and X-tremeGENE siRNA transfection reagents was investigated on osteosarcoma (MG-63) and chondrosarcoma (SW1353) cell lines. The toxicity was measured at 4 and 24 hours using a MTT toxicity assay. The least toxic transfection reagent was applied to investigate the siRNA-induced MDR1 mRNA knockdown effect using qRT-PCR. Furthermore, five housekeeping genes were assessed in the BestKeeper software to obtain mRNA expression normalization.

Results:

Lipofectamine 2000 was the least toxic transfection reagent, reducing the cell viability only in chondrosarcoma 24 hours following exposure to the highest dose. In contrast, TransIT-TKO and X-tremeGENE transfection reagents displayed a significant reduction in cell viability in both chondrosarcoma after 4 hours and in osteosarcoma after 24 hours. Significant MDR1 mRNA silencing of over 80% was achieved in osteo- and chondrosarcoma using Lipofectamine at a final siRNA concentration of 25 nM. No significant dose response was observed in knockdown efficiency in either Lipofectamine or siRNA concentration.

Conclusion:

Lipofectamine 2000 was the least toxic transfection reagent in osteo- and chondrosarcoma. Successful siRNA-induced MDR1 mRNA silencing of over 80% was achieved.
Evaluation of Her-2 protein in histologically tumor-free margins of oral squamous cell carcinoma: An immunohistochemical study
Authors: Kamat Mamata , Puranik Rudrayya S. , Rai Bhagawan Das , Patil Basavaraj R. , K Varsha V. , Kamat Sharad
Published: April 2023

Background:

The status of the 5-year survival rate and loco-regional recurrence in oral squamous cell carcinoma (OSCC) has remained unchanged over the decades. Recent advances in oral cancer research have revealed that the presence of molecular alterations in histologically tumor-free margins of OSCC has a prognostic significance and can aid in designing therapeutic strategies. However, the literature on molecular studies on histologically tumor-free margins is scant, especially in the Indian population. Considering the prognostic implications of Her-2 in malignancies of the breast, ovary, and OSCC, we aimed to assess the expression of Her-2 protein in histologically tumor-free margins of OSCC and to establish correlation with clinico-pathological parameters.

Methods:

4 μ m thick sections from formalin-fixed paraffin-embedded tissue blocks of 40 histologically tumor-free margins of OSCC affecting the buccal mucosa and/or lower gingiva-buccal sulcus and 40 normal oral mucosa samples were subjected to immunohistochemical analysis for the Her-2 antibody. The obtained data were analyzed statistically.

Results:

The mean ages in study and control groups were 49.83 years (SD ± 10.43) and 37.28 years (SD ± 8.61), respectively, with male predominance. Local recurrence was seen in 52.5% of patients. Follow-up data revealed that a total of 71.4% of patients succumbed to mortality and all of them had reported local recurrence. Overall, the presence of local recurrence and the status of survival showed a statistically significant association (p = 0.0001). All the samples in the study and control groups were negative for Her-2 immuno-expression.

Conclusion:

The study indicated the lack of Her-2 immuno-expression in histologically tumor-free margins of OSCC with several speculated explanations. As it is a preliminary study, further studies employing both immunohistochemistry (IHC) and gene amplification in histologically tumor-free margins of OSCC affecting different anatomical sites are warranted. This will aid in identifying the subset of patients that may benefit from targeted therapy.
Utility of Glasgow Microenvironment Score as a prognostic tool in colorectal carcinoma
Authors: Ahuja Manisha , Dwarak Amritha , Mallya Varuna , Mandal Shramana , Tomar Reena , Khurana Nita , Lal Pawanindra , Singh Kishore
Published: April 2023

Background:

Colorectal carcinoma (CRC) is third most common malignancy in the world. The presence of Lymphocytes particularly at the invasive margin of the tumor have been associated with good immune response indicating better prognosis. The relative tumor stroma is also important in deciding the course of the disease. The Glasgow Microenvironment Score (GMS) comprises of assessment of tumor cell infiltrate using Klintrup-Makinen (KM) grade and tumor stroma percentage.

Aims:

The aim of the present study is to evaluate the utility of GMS score in relation to parameters of adverse histopathological outcome in carcinoma colon that is grading, staging, LVI, PNI and nodal metastasis.

Setting and Design:

Colectomy specimens received over 3 year period were subjected to microscopic evaluation for LVI, PNI, grade, stage & lymph node metastasis.

Materials and Methods:

Lymphocytes at the deepest invasive margin of tumor were counted as per KM score in 5 HPF by two independent pathologists . Patients were classified as Low grade (0/1) or high grade (2/3) response. Tumor stroma percentage was calculated as stroma poor (<50%) and stroma rich (>/= 50 %). The GMS was scored by combining the two and scored 0, 1 and 2.

Statistics and Results:

Total 37 patients with no prior therapy were included out of which 23 were males and 14 females. 15 patients (40.54%) had GMS of 0, 6 (16.21%) had GMS 1 and 16 (43.24%) had GMS 2. A high GMS was associated with LVI (P = 0.02), PNI (P = 0.01) lymph node metastasis (P = 0.003). However, no significant association was found between GMS with Grade (P = 0.98) and Stage (P = 0.36).

Conclusion:

Low GMS was associated with good outcome and high GMS with poor outcome. This score can be used for risk stratification, can be of clinical utility and may be applied to pathological descriptions of CRC.