bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of the quality of life among transgender men before and after gender reassignment surgery: a survey from Iran
Authors: Rahimpour Elham , Askary Elham , Alamdarloo Shaghayegh Moradi , Alborzi Saeed , Poordast Tahereh
Published: August 2024

Background

Gender dysphoria, characterized by a misalignment between one’s gender identity and assigned sex, propels individuals towards medical interventions like gender reassignment surgery (GRS) to harmonize their bodies with their gender. This process aims to enhance overall quality of life (QoL), functioning, and body image. Recognizing the importance of cultivating a positive body image for transgender individuals navigating societal norms, this narrative highlights the ongoing debate surrounding QoL post-GRS. In response, our study is outlined, aiming to scrutinize QoL and self-image among transgender men post-GRS, offering valuable insights into societal perceptions and psychological well-being in this context.

Method

This cross-sectional survey focused on transgender men aged 15 to 35 who underwent gender reassignment surgery (GRS) in 2018–2022 in Shiraz, Iran. Participants, after passing psychiatric evaluations, completed World Health Organization Quality of Life (WHOQOL-100) questionnaires pre- and at least one-year post-surgery. The scores of the Brief-WHOQOL questionnaire were evaluated in four domains of physical health, psychological health, social relationships, and environmental health.

Results

A total of 60 individual who underwent GRS completed our questionnaire. The average age of the patients was 24.1 ± 3.8 years. Following GRS, the most increase was observed in the psychological factor (by 25.6%). The increase in score was statistically significant in all subgroups (P < 0.001) after operation. Urban living location had a significant association with higher increase in physical health (P < 0.010), psychological health (P = 0.005), and environmental health (P = 0.012) after GRS. In regards to physical health, the low socioeconomic group had a significantly less physical score improvement in QoL compared to the moderate group (P = 0.024) following GRS. In regards to environmental health, the high socioeconomic groups had significantly higher improvement in QoL compared to the low (P = 0.006) and moderate (P < 0.001) group after operation.

Conclusion

The results demonstrate that GRS brings about improvements across all aspects of QoL. However, this enhancement is less pronounced among patients hailing from low socioeconomic backgrounds and rural areas.
Autophagy-mediated ID1 turnover dictates chemo-resistant fate in ovarian cancer stem cells
Authors: Phadte Pratham , Bishnu Aniketh , Dey Pranay , M Manikandan , Mehrotra Megha , Singh Prerna , Chakrabarty Shritama , Majumdar Rounak , Rekhi Bharat , Patra Malay , De Abhijit , Ray Pritha
Published: August 2024

Background

The mechanisms enabling dynamic shifts between drug-resistant and drug-sensitive states in cancer cells are still underexplored. This study investigated the role of targeted autophagic protein degradation in regulating ovarian cancer stem cell (CSC) fate decisions and chemo-resistance.

Methods

Autophagy levels were compared between CSC-enriched side population (SP) and non-SP cells (NSP) in multiple ovarian cancer cell lines using immunoblotting, immunofluorescence, and transmission electron microscopy. The impact of autophagy modulation on CSC markers and differentiation was assessed by flow cytometry, immunoblotting and qRT-PCR. In silico modeling and co-immunoprecipitation identified ID1 interacting proteins. Pharmacological and genetic approaches along with Annexin-PI assay, ChIP assay, western blotting, qRT-PCR and ICP-MS were used to evaluate effects on cisplatin sensitivity, apoptosis, SLC31A1 expression, promoter binding, and intracellular platinum accumulation in ID1 depleted backdrop. Patient-derived tumor spheroids were analyzed for autophagy and SLC31A1 levels.

Results

Ovarian CSCs exhibited increased basal autophagy compared to non-CSCs. Further autophagy stimulation by serum-starvation and chemical modes triggered proteolysis of the stemness regulator ID1, driving the differentiation of chemo-resistant CSCs into chemo-sensitive non-CSCs. In silico modeling predicted TCF12 as a potent ID1 interactor, which was validated by co-immunoprecipitation. ID1 depletion freed TCF12 to transactivate the cisplatin influx transporter SLC31A1, increasing intracellular cisplatin levels and cytotoxicity. Patient-derived tumor spheroids exhibited a functional association between autophagy, ID1, SLC31A1, and platinum sensitivity.

Conclusions

This study reveals a novel autophagy-ID1-TCF12-SLC31A1 axis where targeted autophagic degradation of ID1 enables rapid remodeling of CSCs to reverse chemo-resistance. Modulating this pathway could counter drug resistance in ovarian cancer.
Comprehensive analysis of flavohemoprotein copy number variation in Giardia intestinalis: exploring links to metronidazole resistance
Authors: Korenková Vlasta , Weisz Filip , Perglerová Aneta , Cacciò Simone M. , Nohýnková Eva , Tůmová Pavla
Published: August 2024

Background

Giardiasis, caused by the protozoan parasite Giardia intestinalis, often presents a treatment challenge, particularly in terms of resistance to metronidazole. Despite extensive research, markers for metronidazole resistance have not yet been identified.

Methods

This study analysed 28 clinical samples of G. intestinalis from sub-assemblage AII, characterised by varying responses to metronidazole treatment. We focussed on copy number variation (CNV) of the multi-copy flavohemoprotein gene, analysed using digital polymerase chain reaction (dPCR) and next generation sequencing (NGS). Additionally, chromosomal ploidy was tested in 18 of these samples. Flavohemoprotein CNV was also assessed in 17 samples from other sub-assemblages.

Results

Analyses revealed variable CNVs of the flavohemoprotein gene among the isolates, with no correlation to clinical metronidazole resistance. Discrepancies in CNVs detected from NGS data were attributed to biases linked to the whole genome amplification. However, dPCR helped to clarify these discrepancies by providing more consistent CNV data. Significant differences in flavohemoprotein CNVs were observed across different G. intestinalis sub-assemblages. Notably, Giardia exhibits a propensity for aneuploidy, contributing to genomic variability within and between sub-assemblages.

Conclusions

The complexity of the clinical metronidazole resistance in Giardia is influenced by multiple genetic factors, including CNVs and aneuploidy. No significant differences in the CNV of the flavohemoprotein gene between isolates from metronidazole-resistant and metronidazole-sensitive cases of giardiasis were found, underscoring the need for further research to identify reliable genetic markers for resistance. We demonstrate that dPCR and NGS are robust methods for analysing CNVs and provide cross-validating results, highlighting their utility in the genetic analyses of this parasite.

Graphical Abstract
Full-length 16S rRNA gene sequencing combined with adequate database selection improves the description of Arctic marine prokaryotic communities
Authors: Pascoal Francisco , Duarte Pedro , Assmy Philipp , Costa Rodrigo , Magalhães Catarina
Published: August 2024

Background

High-throughput sequencing of the full-length 16S rRNA gene has improved the taxonomic classification of prokaryotes found in natural environments. However, sequencing of shorter regions from the same gene, like the V4-V5 region, can provide more cost-effective high throughput. It is unclear which approach best describes prokaryotic communities from underexplored environments. In this study, we hypothesize that high-throughput full-length 16S rRNA gene sequencing combined with adequate taxonomic databases improves the taxonomic description of prokaryotic communities from underexplored environments in comparison with high-throughput sequencing of a short region of the 16S rRNA gene.

Results

To test our hypothesis, we compared taxonomic profiles of seawater samples from the Arctic Ocean using: full-length and V4-V5 16S rRNA gene sequencing in combination with either the Genome Taxonomy Database (GTDB) or the Silva taxonomy database. Our results show that all combinations of sequencing strategies and taxonomic databases present similar results at higher taxonomic levels. However, at lower taxonomic levels, namely family, genus, and most notably species level, the full-length approach led to higher proportions of Amplicon Sequence Variants (ASVs) assigned to formally valid taxa. Hence, the best taxonomic description was obtained by the full-length and GTDB combination, which in some cases allowed for the identification of intraspecific diversity of ASVs.

Conclusions

We conclude that coupling high-throughput full-length 16S rRNA gene sequencing with GTDB improves the description of microbiome profiling at lower taxonomic ranks. The improvements reported here provide more context for scientists to discuss microbial community dynamics within a solid taxonomic framework in environments like the Arctic Ocean with still underrepresented microbiome sequences in public databases.
Association between foreign agricultural investments and adoption of soil and water conservation practices in Uganda
Authors: Byaruhanga Bruce Michael , Bashaasha Bernard , Turinawe Alice , Nakanwagi Teddy , Tumusiime David
Published: August 2024

Objectives

Recently, some developing countries are promoting foreign agricultural investments in Agriculture to exploit currently under-exploited land. Yet, the benefits to recipient countries remains less understood and inconclusive. The study sought to understand the association between proximity to a foreign agricultural investments (FAI) and adoption of soil and water conservation farming methods by smallholder farmers in Uganda.

Methodology

We used cross-sectional data collected from a total of 1,181 smallholder respondents, sampled through a multi-stage random sampling process resulting in three independent samples from South-western, Central and Northern Uganda. Using logistic regression analysis and pooled data, we study the association between proximity to a FAI and other factors that influence the adoption of soil and water conservation farming practices by smallholder farmers in Uganda.

Results

Descriptive results show that at the aggregate level proximity to a FAI, the education level of the farmer and ownership of information and communication assets (radio and mobile phone) are significantly different between adopter and non-adopters of soil and water conservation farming methods in the research area. The econometric findings of the study suggest that proximity to a foreign agricultural investments (FAI) has weak but significant spillovers on soil and water conservation farming practices of smallholder farmers it their vicinity with possible site specific variations that warrant more in-depth investigation. The effect of proximity to FAI on the adoption of soil and water conservation farming practices is complemented by the education level of the farmer and access to means of communication (radio, and in particular mobile phone set) indicating the importance of information and also broader socio-economic conditions.

Recommendation

We recommend policies that enhance increased exposure of smallholder farmers to FAI especially those that help promote rural digital penetration through increased band width, FM radios and affordable data packages.
Revisiting gliomatosis cerebri in adult-type diffuse gliomas: a comprehensive imaging, genomic and clinical analysis
Authors: Shin Ilah , Park Yae Won , Sim Yongsik , Choi Seo Hee , Ahn Sung Soo , Chang Jong Hee , Kim Se Hoon , Lee Seung-Koo , Jain Rajan
Published: August 2024

Although gliomatosis cerebri (GC) has been removed as an independent tumor type from the WHO classification, its extensive infiltrative pattern may harbor a unique biological behavior. However, the clinical implication of GC in the context of the 2021 WHO classification is yet to be unveiled. This study investigated the incidence, clinicopathologic and imaging correlations, and prognostic implications of GC in adult-type diffuse glioma patients. Retrospective chart and imaging review of 1,211 adult-type diffuse glioma patients from a single institution between 2005 and 2021 was performed. Among 1,211 adult-type diffuse glioma patients, there were 99 (8.2%) patients with GC. The proportion of molecular types significantly differed between patients with and without GC (P = 0.017); IDH-wildtype glioblastoma was more common (77.8% vs. 66.5%), while IDH-mutant astrocytoma (16.2% vs. 16.9%) and oligodendroglioma (6.1% vs. 16.5%) were less common in patients with GC than in those without GC. The presence of contrast enhancement, necrosis, cystic change, hemorrhage, and GC type 2 were independent risk factors for predicting IDH mutation status in GC patients. GC remained as an independent prognostic factor (HR = 1.25, P = 0.031) in IDH-wildtype glioblastoma patients on multivariable analysis, along with clinical, molecular, and surgical factors. Overall, our data suggests that although no longer included as a distinct pathological entity in the WHO classification, recognition of GC may be crucial considering its clinical significance. There is a relatively high incidence of GC in adult-type diffuse gliomas, with different proportion according to molecular types between patients with and without GC. Imaging may preoperatively predict the molecular type in GC patients and may assist clinical decision-making. The prognostic role of GC promotes its recognition in clinical settings.
Recurrent adamantinomatous craniopharyngiomas show MAPK pathway activation, clonal evolution and rare TP53-loss-mediated malignant progression
Authors: Apps John R. , Gonzalez-Meljem Jose Mario , Guiho Romain , Pickles Jessica C. , Prince Eric , Schwalbe Edward , Joshi Nikhil , Stone Thomas J. , Ogunbiyi Olumide , Chalker Jane , Bassey Akang , Otto Georg , Davies Rosalind , Hughes Debbie , Brandner Sebastian , Tan Enrica , Lee Victoria , Hayhurst Caroline , Kline Cassie , Castellano Sergi , Hankinson Todd , Deutschbein Timo , Jacques Thomas S. , Martinez-Barbera Juan Pedro
Published: August 2024

The two types of craniopharyngioma, adamantinomatous (ACP) and papillary (PCP), are clinically relevant tumours in children and adults. Although the biology of primary craniopharyngioma is starting to be unravelled, little is known about the biology of recurrence. To fill this gap in knowledge, we have analysed through methylation array, RNA sequencing and pERK1/2 immunohistochemistry a cohort of paired primary and recurrent samples (32 samples from 14 cases of ACP and 4 cases of PCP). We show the presence of copy number alterations and clonal evolution across recurrence in 6 cases of ACP, and analysis of additional whole genome sequencing data from the Children’s Brain Tumour Network confirms chromosomal arm copy number changes in at least 7/67 ACP cases. The activation of the MAPK/ERK pathway, a feature previously shown in primary ACP, is observed in all but one recurrent cases of ACP. The only ACP without MAPK activation is an aggressive case of recurrent malignant human craniopharyngioma harbouring a CTNNB1 mutation and loss of TP53. Providing support for a functional role of this TP53 mutation, we show that Trp53 loss in a murine model of ACP results in aggressive tumours and reduced mouse survival. Finally, we characterise the tumour immune infiltrate showing differences in the cellular composition and spatial distribution between ACP and PCP. Together, these analyses have revealed novel insights into recurrent craniopharyngioma and provided preclinical evidence supporting the evaluation of MAPK pathway inhibitors and immunomodulatory approaches in clinical trials in against recurrent ACP.
PvMYB60 gene, a candidate for drought tolerance improvement in common bean in a climate change context
Authors: Martínez-Barradas Vera , Galbiati Massimo , Barco-Rubio Francisco , Paolo Dario , Espinoza Carmen , Cominelli Eleonora , Arce-Johnson Patricio
Published: August 2024

Background

Common bean (Phaseolus vulgaris) is one of the main nutritional resources in the world, and a low environmental impact source of protein. However, the majority of its cultivation areas are affected by drought and this scenario is only expected to worsen with climate change. Stomatal closure is one of the most important plant responses to drought and the MYB60 transcription factor is among the key elements regulating stomatal aperture. If targeting and mutating theMYB60gene of common bean would be a valuable strategy to establish more drought-tolerant beans was therefore investigated.

Results

TheMYB60gene of common bean, with orthology to the ArabidopsisAtMYB60gene,was found to have conserved regions with MYB60 typical motifs and architecture. Stomata-specific expression ofPvMYB60was further confirmed by q-RT PCR on organs containing stomata, and stomata-enriched leaf fractions. Further, function ofPvMYB60in promoting stomata aperture was confirmed by complementing the defective phenotype of a previously described Arabidopsismyb60-1mutant.

Conclusions

Our study finally pointsPvMYB60as a potential target for obtaining more drought-tolerant common beans in the present context of climate change which would further greatly contribute to food security particularly in drought-prone countries.
Interventional solutions for post-surgical problems: a lymphatic leaks review
Authors: Gómez Fernando M. , Baetens Tarik R. , Santos Ernestos , Rocha Boris León , Horwitz Benjamín , Lojo-Lendoiro Sara , Vargas Patricio , Patel Premal , Beets-Tan Regina , Martínez-Rodrigo José J. , Bonmatí Luis Martí
Published: August 2024

The lymphatic circulation plays a crucial role in maintaining fluid balance and supporting immune responses by returning serum proteins and lipids to the systemic circulation. Lymphatic leaks, though rare, pose significant challenges post-radical neck surgery, oesophagectomy, and thoracic or retroperitoneal oncological resections, leading to heightened morbidity and mortality. Managing lymphatic leaks necessitates consideration of aetiology, severity, and volume of leakage.

Traditionally, treatment involved conservative measures such as dietary restrictions, drainage, and medical management, with surgical intervention reserved for severe cases, albeit with variable outcomes and extended recovery periods. Lymphography, introduced in the 1950s, initially served as a diagnostic tool for lymphoedema, lymphoma, tumour staging, and monitoring chemotherapy response. However, its widespread adoption was impeded by alternative techniques like Computed Tomography, learning curves, and its associated complications. Contemporary lymphatic interventions have evolved, favouring nodal lymphangiography over pedal lymphangiography for its technical simplicity and reduced complexity.

Effective management of chylous leaks mandates a multimodal approach encompassing clinical evaluation and imaging techniques. In cases where conservative management proves ineffective, embolization through conventional lymphangiography by bipedal dissection or intranodal injection emerges as a viable option. This review underscores the importance of a comprehensive approach to diagnosing and treating lymphatic leaks, highlighting advancements in imaging and therapeutic interventions that enhance patient outcomes.
Effects of dietary supplementation with
Acacia
mearnsii
tannin extract on carcass characteristics and meat quality of lambs
Authors: Venter Megan , Hassen Abubeker , Pophiwa Pamela , Webb Edward C.
Published: August 2024

Background

Plant extracts are used as possible methane mitigants and to replace antibiotic feed supplements previously used prophylactically to improve the adaptation of lambs in intensive feeding systems. This study investigated the effects of 
Acacia mearnsii
tannin extract used as anti-methanogenic feed additives on carcass and meat quality of lambs.

Methods

Forty Dohne Merino lambs, with an initial mass between 23.90 kg and 37.40 kg, were first stratified according to their initial body weight and thereafter one of the eight lambs with similar body weight were randomly assigned to four treatment groups (n = 10 lambs/treatment). The lambs were fed ad libitum with a basal total mixed ration. Four experimental diets were formulated: TMR diet (control); TMR diet with Rumensin
®
at a dosage of 75 mg/kg of DM feed (Monensin; Positive control); TMR diet with raw condensed Acacia tannin at 20 g/kg of DM feed (Crude tannin); TMR with addition of encapsulated condensed Acacia tannin at 20 g/kg of DM feed (Encapsulated condensed tannins). The lambs were slaughtered at a live mass of about 50 kg after a 19 week trial period.

Results

Dietary tannin additives did not affect the carcass composition or colour aspects of lamb meat. However, there were minor changes in fatty acid profiles, particularly in the intramuscular adipose tissue. The addition of encapsulated tannin extract resulted in a higher proportion of C18:2n6t (0.15% ± 0.03
vs.
0.19% ± 0.03; 
p
 < 0.05), C18.3n3 (0.24% ± 0.04
vs.
0.29% ± 0.04; 
p
 < 0.05), C22:6n3 (0.02 ± 0.01
vs.
0.05 ± 0.03; 
p
 < 0.05), in comparison to monensin. This improvement in fatty acid profiles is presumably beneficial for human health, but it could affect the sensory quality of meat.

Conclusion

Our results suggest that
Acacia mearnsii
tannin extracts can be included as anti-methanogenic feed additives in lamb diets without compromising product quality.
Motorized hospital bed for mobility of patients: a review on wheel type design
Authors: Rabbani Ariq Naufal , Hadisujoto Budi , Dhelika Radon
Published: August 2024

Mobile bed to move patients in hospitals is a critical aspect in a healthcare system. Typical hospital beds often require significant manpower and impose physical stresses on caregivers. This paper explores potential solutions to improve hospital bed mobility, focusing on the integration of robotic technologies. Existing literatures on the subject are reviewed, including studies on hospital bed design structures, ergonomic considerations, and implementations of robotics. Different types of wheels suitable for robot movements are discussed, covering conventional wheels, omniwheels, mecanum wheels, swerve drives, and powered fifth wheels. Each wheel type is described and its advantages and disadvantages are highlighted. The comparison of these wheel types helps identify the most suitable option for modifying hospital beds while maintaining their maneuverability. Furthermore, the paper draws inspiration from many applications of mobile robots in other industries, such as automated guided vehicles (AGVs) and autonomous mobile robots (AMRs), to explore potential innovations for the healthcare. By leveraging robotic technologies, hospitals can enhance efficiency and alleviate the burden on healthcare workers.
Increased Risk of Chronic Kidney Disease After Total Thyroidectomy: A Nationwide Matched Cohort Study
Authors: Reinke Rasmus , Udholm Sebastian , Christiansen Christian Fynbo , Almquist Martin , Londero Stefano , Rejnmark Lars , Rasmussen Thomas Bøjer , Rolighed Lars
Published: August 2024

Background

Development of hypoparathyroidism (hypoPT) after total thyroidectomy (TT) may increase the risk of kidney-related morbidity. We aimed to examine the risk of hypoPT and chronic kidney disease (CKD) in patients undergoing TT in Denmark over a 20-year period.

Materials and Methods

Using population-based registries, we identified all Danish individuals with TT between January 1998 and December 2017. We included a matched comparison cohort by randomly selecting 10 citizens for each patient by sex and birth year. We calculated the cumulative incidence and hazard ratio (HR) of CKD by Cox regression in patients with TT compared with the comparison cohort. Further, CKD risks were stratified by indications for TT and comorbidity groups according to the Charlson Comorbidity Index.

Results

We included 2421 patients with TT; 21.5% had hypoPT. After 10 years, the risk of developing CKD for hypoPT patients was 13.5% [95% confidence interval (CI): 9.8-17.7], 11.6% (95% CI: 9.7-13.7) for patients without hypoPT, and 5.8% (95% CI: 5.3-6.2) for the comparison cohort. When compared with the matched comparison cohort, the adjusted HR for CKD in hypoPT patients was 3.23 (95% CI: 2.37–4.41) and 2.27 (95% CI: 1.87-2.75) for patients without hypoPT. For patients without previous comorbidities, the adjusted HR of CKD was higher than in patients with several comorbidities.

Conclusion

HypoPT was a frequent complication after TT and was associated with an increased risk of CKD. We also found an increased risk of CKD in patients with a normal parathyroid function after TT, which needs to be further evaluated.
ECG of the month
Authors: Bloe Charles
Published: August 2024

In this issue's ECG of the month, Charles Bloe presents the case of an 88-year-old man with heart failure and vascular dementia, who was experiencing multiple cardiac arrests.
Revamped social action scheme sees NCS aim for greater impact
Authors: Lepper Joe
Published: August 2024

National Citizen Service boss sets out rationale for moving programme to a year-round offer while slimming down core residential element to reduce costs, but experts fear it may dilute the experience for young people
Economic crisis sees young people's mental health and wellbeing suffer
Authors: Parton Dan
Published: August 2024

The rising cost of living is adversely impacting children's mental health, resulting in a rise in referrals to health and social care services. Experts call for more funding so agencies can deliver vital support to prevent long-term harm
Boosting attainment with tech
Authors: Kingsley Al
Published: August 2024

Expert sets out ways cutting-edge technology can be used in education to narrow the attainment gap
Jon Sparkes
Authors: Hayes Derren
Published: August 2024

The chief executive of Unicef UK tells Derren Hayes why we need an early child guarantee
ESCAPING THE WAR IN UKRAINE: A NEW LIFE FOR CHILDREN IN CARE
Authors: Jóźwiak Gabriella
Published: August 2024

Children in care are among those who have faced danger and disruption due to the war in Ukraine. Gabriella Jóźwiak reports on the evacuation of more than 50 looked-after young people to the UK
Practice examples: CEOP ambassador programme trains education staff
Authors: Bosworth Rosie
Published: August 2024

Training scheme helps staff, parents and children understand the risks of online child sexual abuse
Adoption board closes to make way for Care Review's reforms
Authors: Simpson Fiona
Published: August 2024

Closure of the Adoption and Special Guardianship Leadership Board after a decade is ‘in light of’ review's focus on keeping families together, say experts who call for a fairer, more equitable and more inclusive care system
Management Principles in a Case of True-positive Loss of Neuromonitoring Signals during Scoliosis Surgery: A Case Report
Authors:   Scottish National Spine Deformity Centre, Royal Hospital for Children and Young People, Edinburgh, UK., Tsirikos Athanasios I , Ahuja Kaustubh ,   Scottish National Spine Deformity Centre, Royal Hospital for Children and Young People, Edinburgh, UK., Jordan Brian ,   Scottish National Spine Deformity Centre, Royal Hospital for Children and Young People, Edinburgh, UK., Fisher Katie ,   Scottish National Spine Deformity Centre, Royal Hospital for Children and Young People, Edinburgh, UK.
Published: August 2024

Introduction: Multimodal intraoperative neuromonitoring (IOM) is essential in scoliosis surgery. This is affected by misplaced instrumentation, cord trauma, hemodynamic instability, and anesthesia. We present an irreversible loss of IOM without identifiable intra-operative cause to highlight its occurrence and discuss post-operative investigations and management. Case Report: A 14-year-old girl with adolescent idiopathic scoliosis, no co-morbidities, and normal spinal magnetic resonance imaging (MRI) underwent posterior spinal fusion. During screw placement, bilateral motor evoked potentials (MEPs) and right somatosensory evoked potentials (SSEPs) were lost in the legs. All screws were removed with no evidence of cortical breach. Left leg responses gradually improved, but there was no recovery of right leg SSEPs or MEPs. Subsequently, the procedure was abandoned. The patient had reduced right leg strength (3/5) and sensation with the left leg was normal. Immediate post-operative spinal MRI identified no abnormality. Computed tomography (CT) showed no cortical breach with satisfactory pedicle screw tracts. Repeat MRI (day 7) showed high T2-signal within the cord at T11 indicating ischemia. Gradual neurological recovery occurred and on day 15, repeat neurophysiology found reproducible SSEPs and MagStim MEPs. The patient underwent revision posterior fusion with single rod correction without complication and IOM was maintained. By day 24, the patient had 5/5 power and normal sensation in both legs. Good scoliosis correction was achieved and maintained at 3-year follow-up. Conclusion: This patient represents a vascular event affecting the lower spinal cord and highlights the role of sequential imaging and pre-operative neurophysiology including MagStim in deciding when to proceed with revision surgery while reducing risk using conservative techniques. Keywords: Intraoperative neuromonitoring, Idiopathic scoliosis, Transcranial magnetic stimulation
Traumatic Shoulder Dislocation in a Child: A Case Report
Authors:   Department of Trauma and Orthopedics, Orthopaedic Division, Sahloul Teaching Hospital, Faculty of Medicine, University of Sousse, Sousse, Tunisia,, Aloui Yahia , Hassini Lassaad ,   Department of Trauma and Orthopedics Department, Sahloul Teaching Hospital, Faculty of Medicine, University of Sousse, Sousse, Tunisia., Wajdi Chermiti ,   Department of Trauma and Orthopedics Department, Sahloul Teaching Hospital, Faculty of Medicine, University of Sousse, Sousse, Tunisia., Bagga Houssine ,   Department of Trauma and Orthopedics, Orthopaedic Division, Sahloul Teaching Hospital, Faculty of Medicine, University of Sousse, Sousse, Tunisia,, Mtaoumi Mourad ,   Department of Trauma and Orthopedics, Medicine Division, Sahloul Teaching Hospital, Faculty of Medicine, University of Sousse, Sousse, Tunisia,, Bouattour Karim ,   Department of Trauma and Orthopedics, Medicine Division, Sahloul Teaching Hospital, Faculty of Medicine, University of Sousse, Sousse, Tunisia,
Published: August 2024

Introduction: The traumatic dislocation of the shoulder in a toddler is rare and is typically observed in children with neuromuscular issues. The treatment approach for this condition is extrapolated from that of shoulder dislocations in adults and teenagers. The primary complication is recurrence. Case Report: We present the case of a 20-month-old infant with no significant medical history, who experienced a post-traumatic pure luxation of the left shoulder. The dislocation was successfully reduced under general anesthesia, followed by immobilization in a short sling for 3 weeks. Four years post-treatment, there was no recurrence, and the shoulder remained stable with complete mobility. Conclusion: While uncommon, traumatic shoulder luxation in toddlers should be considered in the presence of functional impairment or abnormal limb posture, and non-surgical intervention is recommended. Keywords: Shoulder dislocation, children, treatment
A Rare Case of Idiopathic Elbow Septic Arthritis in an Adult
Authors:   Department of Orthopaedic Surgery and Trauma, Hassahisa Teaching Hospital, Gazera State, Sudan,, Alhadi Alamin Ahmed Altayeb , Mohamed Ahmed Almostafa Balla Dafalha ,   Department of Orthopaedic Surgery and Trauma, Hassahisa Teaching Hospital, Gazera State, Sudan,, Abdalla Esra Mustafa Hamed ,   Department of Family Medicine, Michigan State University, East Lansing, Michigan, USA, Adam Mohammed Yousif Abdelrahman ,   Department of Orthopaedic Surgery and Trauma, Hassahisa Teaching Hospital, Gazera State, Sudan,, Mohammed Hanaa Abdalla Mustafa ,   Department of Orthopaedic Surgery and Trauma, Hassahisa Teaching Hospital, Gazera State, Sudan,
Published: August 2024

Introduction: Septic arthritis of the elbow is a rare, serious condition that requires prompt medical attention. With proper treatment, most individuals are able to recover fully and regain function in the affected joint. However, without treatment, septic arthritis of the elbow can lead to long-term joint damage and disability. Case Report: This case report presents a rare occurrence of septic arthritis in the elbow joint of a 23-year-old male patient. The patient presented with pain, swelling, and limited range of motion in the affected joint. After a thorough clinical assessment and diagnostic imaging, a diagnosis of septic arthritis was confirmed. The patient was promptly treated with intravenous antibiotics and joint aspiration to drain the infected fluid. Following treatment, the patient showed significant improvement in symptoms and regained full range of motion in the affected elbow joint. Conclusion: Prompt drainage and washout of the impacted joint are recommended for both diagnostic and therapeutic reasons. The functional outcome of the affected joints depends on the time interval between the onset of the symptoms and surgical intervention and it is crucial to quickly and precisely identify the presence of microorganisms in the synovial fluid. Keywords: Elbow, small joint, septic arthritis, adult.
Isolated Tear of the Vastus Lateralis Tendon: A Rare Case Managed Conservatively
Authors:   B’ Department of Orthopaedics, KAT General Hospital of Attica, Athens, Greece., Lykos Stavros , Tsivelekas Konstantinos ,   B’ Department of Orthopaedics, KAT General Hospital of Attica, Athens, Greece., Pallis Dimitrios ,   B’ Department of Orthopaedics, KAT General Hospital of Attica, Athens, Greece., Ampadiotaki Margarita-Michaela ,   B’ Department of Orthopaedics, KAT General Hospital of Attica, Athens, Greece., Papadakis Stamatios A ,   B’ Department of Orthopaedics, KAT General Hospital of Attica, Athens, Greece.
Published: August 2024

Introduction: Isolated ruptures of the vastus lateralis (VL) tendon are exceptionally rare, with few reported cases in the orthopedic literature. This case report sheds light on non-surgical management for partial VL tendon ruptures, providing insight into an alternative treatment pathway that avoids surgical intervention. Case Report: A 27-year-old Caucasian male experienced a partial, isolated rupture of the VL tendon after a minor fall. The injury was confirmed through magnetic resonance imaging at the lateral patellar insertion. The patient displayed no knee instability and was treated conservatively with platelet-poor plasma injections, a hinged knee brace, and targeted physiotherapy. Conclusion: This case illustrates that conservative treatment can be effective for patients with isolated partial VL tendon ruptures, particularly when knee stability is maintained. The patient achieved full activity recovery within 6 months, highlighting the potential of non-surgical options to provide successful outcomes in similar cases. This report enriches our understanding of tendon injury management and emphasizes the clinical viability of conservative strategies, potentially influencing treatment decisions for similar orthopedic injuries. Keywords: Vastus lateralis rupture, conservative management, orthopedic rehabilitation.
Use of Hartshill Rectangle with Sublaminar Wiring in Spinal Stabilization of D4-D5 Fracture Dislocation with Acute Spinal Cord Injury – A Cost-Effective Treatment
Authors:   Department of Orthopaedics, B.Y.L Nair Charitable Hospital, Mumbai, Maharashtra, India,, Avhad Tanmay Anil , Gunay Siddharth ,   Department of Orthopaedics, HBT Medical College and Dr. R.N Cooper Hospital, Mumbai, Maharashtra, India., Kokate Sagar ,   Department of Orthopaedics, B.Y.L Nair Charitable Hospital, Mumbai, Maharashtra, India,, Subith S ,   Department of Orthopaedics, B.Y.L Nair Charitable Hospital, Mumbai, Maharashtra, India,
Published: August 2024

Introduction: Fractures in the upper thoracic spine pose technical challenges due to the transition from cervical to thoracic spine, often resulting in complete spinal cord injuries necessitating stabilization. Various posterior fixation techniques include Harrington rods, wired distraction rods, L-rods with sub-laminar wiring, and pedicle screw fixation. Luque pioneered sublaminar wiring (SLW), later enhanced by Dove’s Hartshill system for superior biomechanical stability. This case underscores the efficacy of the Hartshill system in stabilizing upper thoracic fractures with severe cord injuries, offering a cost-effective alternative to pedicle screw fixation. Case Report: A 30-year-old female with polytrauma presented symptoms of lower limb paralysis, bladder and bowel dysfunction, and loss of sensation. Imaging showed a severe D4-D5 fracture with retrolisthesis and spinal cord compression, necessitating surgical stabilization using a Hartshill rectangle with SLW. Following surgery, early rehabilitation and physical therapy were initiated, demonstrating the effectiveness of proper fixation in facilitating early mobilization. Conclusion: The Hartshill rectangle, with SLW, offers enduring spinal stabilization for unstable thoracic fractures with spinal cord injuries, enabling early mobilization and reducing neurological risks. Its versatile application spans scoliosis corrections and trauma-related spinal stabilization, reflecting its widespread use in spinal surgery. Keywords: Hartshill rectangle, spinal cord injury, paraplegia, neurodeficit, thoracic fracture, posterior fixation.
Core Decompression with Bone Marrow Aspirate Concentrate Implantation in Osteonecrosis of the Femoral Head with a Minimum of 2-year Follow-up – A Pilot Study
Authors:   Department of Orthopaedics, Government Medical College, Ramanathapuram, Tamil Nadu, India,, Ferozkhan S , Sivakumar A P ,   Department of Orthopaedics, Tagore Medical College and Hospital, Chennai, Tamil Nadu, India,, Elumalai Sathish Balaji ,   Department of Orthopaedics, Tagore Medical College and Hospital, Chennai, Tamil Nadu, India,, Jeyaraman Naveen ,   Department of Orthopaedics, ACS Medical College and Hospital, Dr. MGR Educational and Research Institute, Chennai, Tamil Nadu, India, Jeyaraman Madhan ,   Department of Orthopaedics, ACS Medical College and Hospital, Dr. MGR Educational and Research Institute, Chennai, Tamil Nadu, India
Published: August 2024

Introduction: Osteonecrosis of the femoral head (ONFH), resulting from impaired blood supply to the head of the femur, presents a significant challenge to clinicians due to its debilitating nature. Conservative treatment often offers insufficient pain relief and debilitating functional outcomes which necessitate alternative therapies. Bone marrow aspirate concentrate (BMAC), a potent orthobiologics and rich in mesenchymal stromal cells and growth factors, holds good promise as the minimally invasive procedure for ONFH. With the preceding research suggesting clinical and functional efficacy, we assessed the therapeutic effectiveness of BMAC in ONFH management in joint preservation. Materials and Methods: A prospective cohort study was conducted with 20 patients suffering from ONFH who failed to respond to 6 months of conservative treatment. A uniform surgical procedure was performed by a single surgeon, involving bone marrow extraction from the anterior iliac crest and subsequent processing into an 8–10 mL of BMAC concentrate. The BMAC was then injected into the implanted into the decompressed femoral head. The post-operative protocol comprised weight-bearing mobilization, physiotherapy, and a 4-week NSAID-free regimen. Outcome measures included pain scores, hip function, knee symptoms, sports activities, patient satisfaction, and recommendation of the procedure. Results: Of the 20 patients suffering from ONFH, primarily the left side, most of whom were at stage 2b, significant pain reduction and functional improvement were observed over 24 months. The mean pain score decreased from 9.00 to 3.55, while the hip function score increased from 46.12 to 88.60. However, some patients encountered complications such as symptom recurrence (5%), disease progression (10%), and persistent pain (5%). Conclusion: Core decompression with BMAC implantation emerges as a promising, effective, and safe treatment for ONFH with better cost-effectiveness and minimal side effects, making it a feasible treatment alternative. Keywords: Femoral head, osteonecrosis, bone marrow aspirate concentrate, decompression.
A Comparative Study on Correlation between Magnetic Resonance Imaging and Arthroscopic Findings in the Knee Joint Injuries
Authors:   Department of Orthopaedics, Chettinad Hospital and Research Education, Chettinad Academy of Research and Education, Kelambakkam, Tamil Nadu, India., Kumar K V Arun , Thavasianantham Krishnavel ,   Department of Orthopaedics, Chettinad Hospital and Research Education, Chettinad Academy of Research and Education, Kelambakkam, Tamil Nadu, India., Pandian Prashanth ,   Department of Orthopaedics, Chettinad Hospital and Research Education, Chettinad Academy of Research and Education, Kelambakkam, Tamil Nadu, India., Pandian Haemanath ,   Department of Orthopaedics, Chettinad Hospital and Research Education, Chettinad Academy of Research and Education, Kelambakkam, Tamil Nadu, India., Sheik E Pradeep Mohideen ,   Department of Orthopaedics, Chettinad Hospital and Research Education, Chettinad Academy of Research and Education, Kelambakkam, Tamil Nadu, India.
Published: August 2024

Introduction: The knee joint primarily allows for flexion and extension and is essentially a hinge joint. The knee joint, like all hinge joints, is strengthened by collateral ligaments – one on each side of the joint. Objective: Our study sought to investigate potential correlations between arthroscopy and magnetic resonance imaging (MRI) examination in the diagnosis of traumatic diseases of the knee. Methods and Materials: A prospective study was conducted on 30 persons who showed signs of having traumatic knee disease. Following a comprehensive evaluation of the patient’s medical history and current state of health, we opted to undergo an arthroscopic evaluation and knee MRI. Results: The sensitivity of the MRI was 93.87%, the specificity was 91.54%, the accuracy was 92.50%, and the negative predictive value was 95.58% when compared to arthroscopic inspection as the gold standard. Conclusion: This study demonstrates that MRIs frequently misdiagnose individuals with multiple knee injuries or fail to detect a lesion while doing a diagnostic evaluation. Therefore, if the MRI comes out normal, there is no reason to deny the patient arthroscopy. Due to this MRI flaw, researchers have determined that arthroscopy can be performed following a comprehensive clinical assessment without the need for an MRI. Keywords: Knee, anterior cruciate ligament injury, posterior cruciate ligament injury, medial meniscal injury, lateral meniscal injury, magnetic resonance imaging, arthroscopy.
Hemodynamic Effects of Bone Cement Implantation in Hip Arthroplasty: Insights from a Prospective Study in Eastern India
Authors:   Department of Orthopaedics, Paras HMRI Hospital, Patna 14, Bihar, India, Bhadani Janki Sharan , Kumar Indrajeet ,   Department of Orthopaedics, Indira Gandhi Institute of Medical Science, Patna 14, Bihar, India, Ahmed Wasim ,   Department of Orthopaedics, Indira Gandhi Institute of Medical Science, Patna 14, Bihar, India, Akhileshwar Akhileshwar ,   Department of Trauma and Emergency, Indira Gandhi Institute of Medical Science, Patna 14, Bihar, India, Kumar Santosh ,   Department of Orthopaedics, Indira Gandhi Institute of Medical Science, Patna 14, Bihar, IndiaDepartment of Orthopaedics, Indira Gandhi Institute of Medical Science, Patna 14, Bihar, India, Kumar Alok ,   Department of Orthopaedics, Indira Gandhi Institute of Medical Science, Patna 14, Bihar, India
Published: August 2024

Introduction: Bone cementation has various effects on hemodynamics including potentially fatal bone cement implantation syndrome (BCIS). Most of the studies on BCIS are from developed countries. We have studied the effect of bone cement on hemodynamics in hip arthroplasty in the eastern Indian population and compared it with the available literature. Materials and Methods: This prospective study was done by a team of orthopedic surgeons and anesthesiologists in a tertiary center in eastern India between March 2020 and December 2022. Result: Seventy-two patients (Male 38: and Female 34) of age between 25 and 100 years fulfilling the inclusion criteria were included. In 43 patients (28/72, 38.88%) systolic and diastolic blood pressure fell in the range of 10 mmHg, in 22 patients (22/72, 30.56%) fall in blood pressure was in the range of 10–20 mmHg, and more than 20 mmHg fall in blood pressure were seen in seven patients (7/72, 9.72%). SPO2 decreased from 97–100% to 94–96% in 28 patients and 90–93% in six patients, which began to rise after 5 min of cementing and returned to normal after 10 min. Arrhythmias were seen in 16 patients with multiple comorbidity. Two patients had a cardiac arrest and one patient died after 6 h in the intensive care unit. Conclusion: Pre-operative evaluation, perioperative monitoring of hemodynamic parameters during cementing especially in high-risk patients with multiple comorbidities, and taking essential precautions during cemented arthroplasty are the key to preventing complications like BCIS. Keywords: Total hip arthroplasty, hemiarthroplasty, bone cement, bone cement implantation syndrome, hemodynamics, Eastern India.
A Case Series of Selective Nerve Root Block – A Technique for Delaying Surgery in Patients with Lumbar Radiculopathy
Authors:   Department of Orthopeadics, Rajah Muthiah Medical College, Government Cuddalore Medical College, Chidambaram, Tamil Nadu, India., Murugun Gurumoorthy , Singh Dhanpal ,   Department of Orthopeadics, Rajah Muthiah Medical College, Government Cuddalore Medical College, Chidambaram, Tamil Nadu, India., Selvamuthu Naveen ,   Department of Orthopeadics, Rajah Muthiah Medical College, Government Cuddalore Medical College, Chidambaram, Tamil Nadu, India.
Published: August 2024

Introduction: The aim of this research is to study the clinical outcome and symptomatic improvement for patients with lumbar radiculopathy treated with selective nerve root block (SNRB) under fluoroscopic guidance. This non-surgical management can be used at various sites including cervical and lumbar regions and also can prevent early surgeries for patients with radiculopathy. Materials and Methods: Thirty patients with low back pain with or without sciatica were treated by fluoroscopic-guided nerve root block (F-NRB) as therapeutic management in government Cuddalore Medical College during the period of August 2020–2022. These patients were studied prospectively for the period of 6 months and assessed with the Visual Analog Scale to quantify the severity of pain. Discussion: 30 patients underwent S-NRB, in that 26 patients had an immediate recovery and four patients showed delayed recovery, so that four patients underwent surgery. At the 3rd and 6th-month follow-up, 14 patients did not have a recurrence of pain and 12 had a recurrence of pain. Out of these 12 patients who had pain recurrence, only four needed surgery and the rest were managed conservatively. Accordingly, out of 30 patients who underwent SNRB, only eight patients needed surgery. Conclusion: Patients with lumbar radiculopathy caused by lumbar disc prolapse and foraminal stenosis have good clinical outcomes by SNRB. This method had good pain relief for about 86% of patients immediately and prevented surgery for about 73.3% of patients. Out of 26.7% who underwent surgery, the majority had sequestrated discs. Thus, the sequestrated disc is one of the major negative predictors of successful outcomes for SNRB. Keywords: Lumbar radiculopathy, selective nerve root block, sciatica.