bluuebunny/crossref_metadata_2025 huggingface dataset:
Antiglycation, antioxidant, antiacne, and photoprotective activities of crude extracts and triterpene saponin fraction of Sapindus saponaria L. fruits
Authors: Silva Regildo M. G. , Martins Gustavo R. , Nucci Laura M. B. , Granero Filipe O. , Figueiredo Célia C. M. , Santiago Patrícia S. , Silva Luciana P.
Published: September 2022

Objective:

To evaluate the photoprotective, antioxidant, antiglycation, and antiacne activities of crude extract (CESs) and triterpene saponin fraction (TSSs) of Sapindus saponaria.

Methods:

HPLC-MS purification was performed on a Symmetry TM C18 column. The saponins were identified by a UV detector. Antioxidant activity was evaluated by DPPH and O2
- radicals scavenging, and FRAP and TBARS assays. Glycation activity was assessed by relative electrophoretic mobility and inhibition of advanced glycation end products (AGEs) formation. Additionally, antiacne activity was determined by inhibition of Cutibacterium acnes, and photoprotective effect was evaluated by Mansur’s method.

Results:

Most of the triterpene saponins detected in the fraction by HPLC-MS analysis were hederagenin as the aglycon. CESs and TSSs presented varying antioxidant activity in DPPH (CESs: 75.69% and TSSs: 83.65%), FRAP (CESs: 425.39 μM TE/g DW and TSSs: 649.36 μM TE/g DW), TBARS (CESs: 42.96% and TSSs: 52.16%) and O2
- radicals scavenging (CESs: 61.33% and TSSs: 86.69%) tests. CESs and TSSs also exhibited antiglycation activity comparable to bovine serum albumin treated with aminoguanidine. In addition, CESs and TSSs showed inhibition of AGE formation (34.48% and 61.85%, respectively). Antiacne activity against Cutibacterium acnes was observed with a minimum inhibitory concentration equal to minimum bactericidal concentration (CESs: 36.11 μg/mL and TSSs: 18.34 μg/mL). In photoprotective assays, CESs and TSSs showed maximum absorbance of 1.42 to 0.20 and 2.80 to 1.30, respectively, in the wavelength range of 260 to 400 nm. Furthermore, CESs and TSSs showed sun protection factors of 8.89 and 14.89, respectively.

Conclusions:

Sapindus saponaria fruit extracts show strong antioxidant potential and antiglycation activity against bovine serum albumin glycation and AGE formation. Besides, they presented antibacterial activity against Cutibacterium acnes and photoprotective effect against UV-A and UV-B.
Extract of Codiaeum luzonicum Merr. overcomes multidrug resistance in human colon cancer cells by modulating P-glycoprotein
Authors: Ferrer Regina Joyce , Ong Marc Justin , Jacinto Sonia D.
Published: September 2022

Objective:

To investigate anti-multidrug resistance (MDR) activity and safety of the bioactive fraction (CL11) from Codiaeum luzonicum crude leaf extract.

Methods:

Cytotoxic activity of CL11 against MDR and non- resistant colon cancer cells was assessed using MTT assay. Mode of cell death was investigated by annexin V-propidium iodide staining, TUNEL, and JC-1 assays. To examine mechanism of action, the effect on the expression and function of the MDR-implicated protein P-glycoprotein was tested using Western blotting and calcein assay, respectively.

Results:

CL11 had an EC50 of 0.18, 1.03 and 38.52 μg/mL against HCT-15, HCT-15/Dox and HCT116, respectively. Cytotoxicity was mediated by inhibition of P-glycoprotein function and expression. The mode of cell death involved mitochondrial membrane depolarization and was mostly non-apoptotic at EC50 concentrations against HCT-15 and HCT-15/Dox.

Conclusions:

Fraction CL11 of Codiaeum luzonicum induces non- apoptotic cell death in MDR cancer cells by overcoming MDR through inhibition of P-glycoprotein expression and function.
Optical Coherence Tomography Biomarkers in Diabetic Macular Edema
Authors: Mostafa Amira Mohamed , Ashraf Mohamed , Souka Ahmed Abdel Razak , Raafat Karim Adly
Published: September 2022

Biomarkers are defined as measurable objective indicators that can be used to assess normal physiological process, pathological process and/or tissue response to pharmacological therapeutic agents. In this review article, we address the most notable structural changes encountered in DME patients and their impact on treatment planning and outcomes.
Diabetic Retinopathy Clinical Research Retina Network Protocols in the Management of Diabetic Macular Edema
Authors: Ashraf Mohamed , Gilbert Michael , Rageh Abdulrahman , Souka Ahmed , Sun Jennifer K.
Published: September 2022

The Diabetic Retinopathy Clinical Research Network (DRCR) retina network was formed in 2002 through a United States National Eye Institute and National Institute of Diabetes and Digestive and Kidney Diseases-sponsored cooperative agreement with the objective of creating a collaborative network for multicenter clinical trials focusing on diabetic retinopathy (DR) and its associated complications. The DRCR Retina Network has initiated and completed 30 multicenter studies in over 350 clinical sites. The goals of the DRCR was to design, implement, and report clinical studies that would answer important questions related to clinical practice and management of DR as well as DME. Diabetic macular edema (DME) is the leading cause of vision loss in the working age population and until the turn of the century the treatment options were limited to macular laser. This review aims to summarize the major DME studies completed by the DRCR The current review covers the major clinical trials that have helped help establish the current standard of care in the management of DME including protocols A, B, I, T, U and V.
Dedifferentiated Liposarcoma Masquerading as a Recurrent Inflammatory Pseudotumor
Authors: Shen Yi-Hsuan , Ho Kung-Chen , Wu Pao-Shu , Lee Wei-Cheng , Liu Tsang-Pai , Ko Wen-Chin , Yang Po-Sheng , Liu Chien-Liang
Published: September 2022

Liposarcoma is a heterogeneous cancer that typically presents at an advanced stage, which leads to a poor prognosis, especially when it is located in the retroperitoneum. Although there are plenty of treatment strategies for liposarcoma, surgery is currently the primary therapeutic choice. Several cases of dedifferentiated liposarcomas that were masquerading as inflammatory pseudotumor have been previously reported, and this contributes to the diagnostic challenge. Many studies have suggested that inflammatory pseudotumor is a type of neoplasm or cancerous process. The use of immunostaining and genetic testing would be very helpful for making a correct diagnosis. Here we present the case of a recurrent tumor located in the retroperitoneum. The patient was initially diagnosed with an inflammatory pseudotumor and then a dedifferentiated liposarcoma following their second presentation.
Significance of Morphological Markers of Chromosomal Instability in Differentiating Malignant and Benign Effusions
Authors: Deshmukh Abhay Vilas , Yadav Akshay Sudhir , Shivkumar Vitaladevuni Balasubramanyam
Published: September 2022

Background:

Chromosomal instability (CI) is critical for carcinogenesis. The morphological markers of CI include multipolar mitosis (MPM), chromatin bridge (CB), micronuclei (MN), and nuclear bud (NB). These represent an underlying genetic instability and can be studied in routine cytological specimens. The aim of this study was to evaluate the significance of morphological markers of CI in differentiating malignant and benign effusion smears.

Materials and Methods:

In this retrospective observational pilot study, 25 cases of benign and 25 cases of malignant effusion smears were selected. All of the malignant cases were reconfirmed by histopathology for primary sites. One thousand cells in May–Grunwald–Giemsa-stained smears were counted for MPM, CB, MN, and NB. The significance of these markers of CI was compared between the benign and malignant cases.

Results:

The mean numbers of MPM, CB, MN, and NB in malignant cases were 10.52, 7.72, 1.36, and 0.40 per 1000 cells counted, compared to 0.7, 0.5, 0.3, and 0 per 1000 cells counted in benign cases, respectively. The Student's t-test showed highly significant differences between the benign and malignant effusion smears for the CI markers, with P < 0.000001, < 0.000001, and <0.00001 for MN, NB, and MPM, respectively.

Conclusion:

There were significant differences in the scores of morphological markers of CI in cytological smears between malignant and benign effusions. This is a convenient and reliable method to differentiate between malignant and benign effusions and can be used in conjunction with cytomorphology if a larger study is able to establish the significance in effusions.
Poorly Differentiated Neuroendocrinecarcinoma of the Gallbladder
Authors: Chang Chen-Hao , Lin Jiunn-Chang , Lin Johnson , Chang Ching-Wei
Published: September 2022

Poorly differentiated neuroendocrine carcinoma of the gallbladder is an aggressive and extremely rare type of neuroendocrine tumor. The clinical presentations in most cases are nonspecific, resulting in patients being diagnosed at an advanced stage of the disease. Herein, we report our experience with the case of a 63-year-old woman with no comorbidities who underwent radical resection for a diagnosed gallbladder mass. Abdominal computed tomography scans and magnetic resonance cholangiopancreatography indicated intraluminal masses in the gallbladder with liver invasion. Histologically, the mass was composed of solid sheets of poorly differentiated carcinoma cells with hyperchromatic nuclei; a high Ki-67 index of approximately 80%. The cells were positive for chromogranin A and synaptophysin, and small-cell-type neuroendocrine carcinoma was diagnosed. Postoperatively, she underwent adjuvant chemotherapy with four cycles of cisplatin/etoposide chemotherapy and was disease-free 16 months after surgical treatment with normal hormone-specific markers.
Rare Case of Appendiceal Signet-ring Cell Carcinoma Mimicking Advanced Ovarian Cancer
Authors: Yang I-Fang , Huang Shu-Han , Huang Lee-Wen
Published: September 2022

Primary signet-ring cell carcinoma of the appendix is extremely rare, and because the symptoms are vague and nonspecific, obtaining a preoperative diagnosis is difficult. It cannot be detected using imaging modalities because its radiologic features are undefined, and its appearance on both computed tomography and ultrasound images is similar to that of nontumorous appendicitis. Usually, a diagnosis is made after surgery for other diseases involving the removal of the appendix. The right hemicolectomy is suggested for invasive adenocarcinoma; however, diagnosing primary signet-ring cell carcinoma before surgery and managing tumors with adequate surgical resection remain challenging. We present a case of a large ovarian tumor with peritoneal carcinomatosis diagnosed with advanced ovarian cancer but subsequently revealed through pathology to be primary appendiceal signet-ring carcinoma. Detecting appendiceal signet-ring carcinoma warrants additional surgical management, and treating it involves chemotherapy. This rare disease should be kept in mind when encountering abdominal right lower quadrant pain and tumors to allow for a full treatment plan.
Immobilization devices used to treat unusual sites for better radiation delivery
Authors: Kumar Santosh , Kumar Rajeev , Kumar Satya , Roy Bodhisatta , Singh Rajesh Kumar , Kumar Alok
Published: September 2022

The present article illustrates an attempt to design and test the reproducibility of low-cost patient positioning devices prepared in-house in the radiotherapy department. A rigid wood-polymer composite material stands with angulations, scales, and support was designed as a new method for immobilization of the mobile target using a thermoplastic mask and a carbon fiber base plate. The lower mobile target, i.e., the penis of a patient, was immobilized by this method. A computed tomography simulation was performed for the patient. This device fit was suitable, comfortable, and had good reproducibility and repeatability, which was proven in daily radiotherapy. Reproducibility and accuracy were tested by serial electronic portal imaging detectors. The positioning devices showed variations within 2–3 mm on consecutive treatment days which were within acceptable limits. It is therefore concluded that low-cost patient positioning devices for the mobile target can be fabricated from available materials in-house. With the help of these in-house available materials, we can also fabricate other types of immobilization devices for particular techniques. It is considerably cheaper than commercially available products.
Parental knowledge and awareness about measures taken by the dentist and attitude of parents toward bringing their children to dental hospital during the COVID-19 pandemic
Authors: Thimmegowda Umapathy , Pai K. Soumya , Krishnamurthy Navin Hadadi , Chikkanarasaiah Nagarathna
Published: September 2022

Background:

In the early 2020, the world witnessed an enormous spread of coronavirus disease 2019 (COVID-19) caused by a novel coronavirus (2019-nCoV or SARS-CoV-2). It is common for parents to be frightened and their attitudes toward dental visits to change, given COVID-19's high contagion and fast spread.

Aim:

The aim of this study is to assess the parents' knowledge about coronavirus disease 2019 and measures taken by the dentist and to evaluate their attitudes/fears about bringing their children for dental visits during the pandemic.

Materials and Methods:

A structured questionnaire was developed in English and local language Kannada, which was applied to a sample of 400 parents of children aged between 4 and 12 years, of different socioeconomic backgrounds.

Results:

Regarding the knowledge about the COVID-19 pandemic among parents, 94% were aware about the present situation. 66% of parents perceived the dental hospital to be more dangerous when compared to public places. Regarding the attitude of parents in bringing their children to the dental clinic during the COVID-19 pandemic, 87.5% of the parents were comfortable in bringing their child to the hospital on following the COVID safety protocol.

Conclusion:

Majority of the parents remained well aware of the current situation about the pandemic. Patients were unlikely to take their children to the dentist except for an emergency and perceived the dental clinic as a risky place for contracting the virus. However, on providing reassuring information about infection control measures taken at the dental hospital, they were more comfortable in bringing their child to the dental hospital.
Craniofacial syndromes
Authors: Deo Jaspreet Kaur
Published: September 2022

Syndromes can potentially affect every part of the craniofacial system. While they have been described individually in the literature, there is lack of a classification system encompassing the entities affecting the craniofacial region. The purpose of this review was to provide clinicians an approach to categorize syndromes according to the morphostructural characteristics, which can aid in diagnostic ease and treatment planning.
Effects of preprocedural mouth rinse on microbial load in aerosols produced during the ultrasonic scaling
Authors: Das Swarga Jyoti , Kharbuli Darimeka , Alam Syed Tanwir
Published: September 2022

Background:

During ultrasonic scaling, the harbored microorganisms in the oral cavity get aerosolized, which have important impacts on air quality and can cause a serious health threat to the clinician, patients, and the surroundings. Therefore, this study was conducted to evaluate whether preprocedural mouth rinse has any effect on bacterial load in aerosols generated during ultrasonic scaling.

Materials and Methods:

A total of 80 subjects with chronic periodontitis were selected and randomly grouped into four comprising twenty in each. The groups were based on the use of preprocedural mouth rinse: no rinse group (control) (A), and test groups with preprocedural mouth rinse with water (B), 0.2% Chlorhexidine gluconate (C), and herbal mouthwash (D). The aerosol produced during ultrasonic scaling was collected on blood agar plates positioned at the chest area of patients, operators, and assistants. Aerosol collected in the operatory before the procedure was considered as baseline. Colonies on the blood agar plates were counted after incubating at 37°C for 24 h. Pairwise comparisons involving positions and mouth rinses on microbial colonies were conducted using independent sample t-test and Tukey's test for post hoc analysis considering 0.05 as the significance level.

Results:

Microbial colonies were significantly reduced with chlorhexidine gluconate compared to that of others (P < 0.001), followed by herbal mouthwash and water. Again, microbial colonies were highest at the chest area of the operator and lowest at the chest area of the assistant.

Conclusions:

0.2% Chlorhexidine gluconate is superior in reducing the microbial load in aerosols produced during ultrasonic scaling.
Local delivery of hyaluronic acid as an adjunct to scaling and root planing in the treatment of chronic periodontitis in smokers and non-smokers
Authors: Vajawat Mayuri , Rao Deepika Pawar Chandrashekara , Kumar G. S. Vijay , Rajeshwari Kempireddygaripalli Gangulappa , Hareesha Manohar Sharma
Published: September 2022

Objective:

The objective of the study is to assess the effects of adjunctive use of hyaluronic acid (HA), clinically and microbiologically in smokers and nonsmokers, in the management of chronic periodontitis.

Material and Methods:

48 sites from 24 chronic periodontitis patients, including smokers and nonsmokers with probing depth >5 mm, were selected for the study. A split-mouth design was followed. Scaling and root planing (SRP) was performed for all the patients. The test sites received 0.8% HA gel whereas the control site received placebo gel. The clinical parameters plaque, gingival and bleeding indices, Pocket Probing Depth (PPD), and clinical attachment level (CAL) were evaluated at baseline, 1 and 3 months. Microbiological parameters were evaluated at baseline and 1 month.

Results:

The results showed reduction in PPD and gain in CAL in both smokers and nonsmokers at the end of 3rd month. The improvements in the test sites were statistically significant when compared with that of control sites. The microbiological analysis showed a significant reduction in Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis at the test sites when compared to the controls in both the groups.

Conclusion:

The findings in both groups suggest that the use of locally delivered 0.8% HA gel may be valuable as an adjunct to SRP in the treatment of chronic periodontitis.
Comparative assessment of periodontal status and genotoxicity in orthodontic patients on fixed mechanotherapy with and without adjunct chlorhexidine mouthrinse
Authors: Akhtar Farheen , Khan Saif , Tariq Mohammad , Siddique Yasir Hasan
Published: September 2022

Background:

Adjunct chlorhexidine mouthrinse is used routinely in orthodontic clinical practice for plaque control. However, chlorhexidine has genotoxic effects on the oral cells. Moreover, orthodontic appliance leach Ni, Cr metals ions into saliva causing toxicity of surrounding mucosa. Hence, the aim of the study was to assess the periodontal status and genotoxicity in orthodontic patients on fixed mechanotherapy with and without adjunct chlorhexidine using micronucleus (MN) test.

Materials and Methods:

A randomized control clinical trial was conducted in 30 patients who were on fixed mechanotherapy. The patients were randomly assigned into two treatment groups; Group-A (Control Group): Included 15 patients who are on fixed orthodontic therapy with mechanical plaque control measures only., Group-B (Experimental Group:) included 15 patients on fixed orthodontic therapy with mechanical plaque control and adjunct chlorhexidine mouthrinse (0.2%) for 2 weeks. Periodontal status and genotoxicity using MN test were done at following time points; T0: Just before start of the orthodontic treatment., T1: 2 weeks after start of the orthodontic treatment., T2: 6 weeks after start of the orthodontic treatment., T3: 12 weeks after start of the orthodontic treatment.

Results:

Plaque index (PI) and bleeding on probing (BOP) were significantly decreased in Group B as compared to Group A in the time intervals; T0-T2, T0-T3, T1-T3 (P < 0.05). Probing pocket depth (PPD) and Clinical attachment level (CAL) showed no significant change in both the groups. The genotoxicity assessed by MN test was significantly increased in Group B than Group A at time intervals; T0-T1, T0-T2 and T0-T3.

Conclusion:

Adjunct chlorhexidine resulted in decreased PI and BOP scores but nonsignificant change in PPD and CAL. However, the genotoxicity increased significantly in both the groups but more with adjunct chlorhexidine.
COVID tongue
Authors: Sharma Shikha , Bhardwaj Amit
Published: September 2022

Since the advent of the coronavirus disease (COVID-19) infection, this highly infectious virus has spread worldwide infecting millions of people. Not only it has affected the pulmonary function of the body, leading to difficulty in breathing, but at the same time, an array of other systemic infections which may or may not be directly due to coronavirus infection, due to an absent established relationship. The mucocutaneous manifestations seen in COVID-19 infection include depapillation of the tongue, lesions seen on alveolar mucosa, gingiva, buccal mucosa, dysgeusia, and dry mouth. This case report highlights the effect of COVID-19 on the tongue also known as COVID tongue seen as depapillation of the tongue surface. Due to the absence of long-term studies and time-limited research, a direct relationship between COVID-19 and the systemic manifestation is not yet established. More research has to be done in this direction, to chart out the exact etiology of these systemic infections.
Clinicopathological and immunohistochemical analysis of plasma cell gingivitis- A retrospective study
Authors: Gupta Vandana , Kaur Harpreet , Yadav Vikender Singh , Kala Sunny , Mishra Deepika
Published: September 2022

Background:

This study aims to describe the demographics and clinicopathological characteristics of the cases of plasma cell gingivitis (PCG) reported in our institute, supported by a review of pertinent literature. Further, we investigated the role of the cluster of differentiation CD138, Ki67, CD56, and CD117 immunoexpression in the differential diagnosis of PCG from plasma cell dyscrasias.

Materials and Methods:

All histopathologically confirmed cases of PCG, whose relevant details could be obtained, were included in this study. They were subjected to panel of immunohistochemical markers to exclude plasma cell malignancies. Further, published English literature for PCG since 1970–2020 was reviewed.

Results:

Nine histopathologically confirmed cases of PCG, were retrieved from the archives of our department. The cases comprised 3 males and 6 females with their ages ranging between 14 and 82 years. The plasma cells exhibited equivocal reactivity for kappa and lambda; and immunonegativity for CD56, CD117 with low Ki67 proliferation index. Published literature in English showed 43 cases of PCG were predominantly female; the diffuse involvement of maxilla and mandible was a common finding.

Conclusion:

In addition to kappa lambda reactivity, an immunoprofile of CD138, Ki67, CD56, and CD117 may be used as a diagnostic adjunct to exclude malignant plasma cell lesions in confusing cases.
Socket-shield technique with minimally invasive osteotomy preparation as well as simultaneous sinus lift utilizing Densah Bur and platelet-rich fibrin membrane followed by immediate implant placement in a symptomatic posterior endodontically treated decayed root stumps site
Authors: Deshwal Rahul , Salaria Sanjeev Kumar , Dahiya Ritu , Deshwal Neha
Published: September 2022

Soft-tissue defect and alveolar bundle bone resorption (horizontally and vertically) are inevitable events following tooth extraction predominately on the buccal aspect which will impact the implant surgical planning starting from implant size selection, position, emergence profile, etc. To overcome the same, complex soft and hard tissue regeneration procedures have been recommended in the literature but they are highly expensive and technique sensitive too. To prevent buccal bone resorption and gain good emergence profile socket-shield technique (SST) is widely recommended. Additionally, in order to improve implant biomechanical primary stability, bone mineral density, and bone to implant contact novel osseodensification approach is recommended for osteotomy preparation and sinus membrane lift whereas platelet rich fibrin (PRF) autograft is a suitable alternative for the protection of Schneiderian membrane during immediate implant placement in sinus sub cavity. The present case report describes the successful single-stage management of symptomatic endodontically maltreated posterior root stumps site utilizing SST in conjunction with Densah Bur and PRF autograft-assisted minimally invasive osteotomy preparation and sinus lift with immediate implant placement.
Biological reactions of dental pulp stem cells cultured in presence of new xenograft bone substitutes from different sources
Authors: Lafzi Ardeshir , Saravi Najmeh Sadat Valed , Amid Reza , Kadkhodazadeh Mahdi , Shojaei Narges
Published: September 2022

Aims:

This study aimed to compare the biological reactions of dental pulp stem cells (DPSCs) cultured on new xenograft bone substitutes derived from camel and bovine bones.

Materials and Methods:

DPSCs were cultured and placed on different xenograft materials including Bone Plus (bovine), Camel Bone, and demineralized bovine bone matrix. The viability and proliferation of cells were evaluated by the methyl thiazolyl tetrazolium assay after 24, 48, and 72 h. The alkaline phosphatase (ALP) test and Alizarin red staining were performed at 7 and 21 days to assess the osteoblastic differentiation of cells. Osteocalcin (OCN) gene expression was evaluated qualitatively at 3-, 7- and 14-days using polymerase chain reaction (PCR). Semi-quantitative PCR was also performed using ImageJ software. Data were analyzed by ANOVA and Tukey's honestly significant difference test.

Results:

The cell proliferation rate was significantly different among the three xenograft bone substitutes at 24-, 48- and 72 h (P < 0.05). The ALP activity of DPSCs in all three xenograft bone substitute groups was greater than that in the control group (P < 0.05). Alizarin red staining showed no significant difference in the formation of calcified nodules among the groups. Qualitative and semi-quantitative PCR displayed that the expression of OCN gene in the Camel Bone and Bone Plus groups was higher than that in the demineralized bovine bone matrix group.

Conclusions:

The Camel Bone xenograft caused a high proliferation rate and optimal osteogenic differentiation of DPSCs qualitatively and semi-quantitatively in vitro. Further studies are required on this xenograft bone substitute.
Early Outcomes of Ultra-congruent Insert in Cruciate-retaining Total Knee Arthroplasty
Authors: Jaura Sandeep Singh , Tiwari Punit , Kaur Harmeet , Bansal Nitish
Published: September 2022

Introduction:

The exponents of cruciate-retaining (CR) total knee arthroplasty (TKA) assert that the retention of posterior cruciate ligament (PCL) preserves more normal knee kinematics, femoral rollback on the tibia during flexion, greater stabilization of the prosthesis, and improved position sense as compared to PCL resection TKA. However, one has to shift to the posterior stabilized (PS) femoral component with box and accompanying cam postpolyethylene, especially in cases where PCL is too attenuated to be functional or too tight predisposing to accelerated polyethylene wear. To minimize both the cam mechanism polyethylene wear and the bone sacrifice due to the intercondylar box cut, the ultra-congruent (UC) inserts have been developed that are characterized by a high anterior wall and a deep-dished plate, promising good stability without cam mechanism.

Materials and Methods:

We did a prospective study to clinically evaluate the short-term results of the patients who underwent TKA using cemented posterior CR implants and UC inserts. PCL was required to be released either partially or completely in all the study patients. Thirty patients were evaluated preoperatively and postoperatively after 12 months with the new Knee Society Knee Scoring System (2011) and the findings were statistically analyzed.

Results:

There was a statistically significant postoperative improvement in flexion (from mean of 87.69° to 111.53°, P = 0.000), objective knee indicators (33.53 ± 8.51–70.84 ± 4.91, P = 0.000), patient satisfaction scores (7.48 ± 2.12–21.53 ± 4.26, P = 0.000), and the functional activities score (32.53 ± 5.12–69.02 ± 6.36, P = 0.000). We did not note any disadvantage of CR TKA with UC insert and no patient underwent an early revision for instability.

Conclusion:

Using UC insert in CR TKA is a reliable procedure that has decreased the dependence on the PS designs.
Functional Assessment of Surgically Managed Ankle Fractures
Authors: Kiran Kumar K. K. , Lalithmohan C. , Pradeep K. Sai , Chandrashekhar P.
Published: September 2022

Background:

Civilization has made man more prone to injuries. Ankle fractures are one of the most common injuries treated by orthopedic surgeons.

Aims and Objectives:

The aim of the study is to assess the functional outcome in surgically managed ankle fractures.

Materials and Methods:

Sixty patients were included in this study with ankle fractures that were surgically treated at NIMS Hospital, Hyderabad.

Observations:

The study had a male preponderance of 66.6%, with road traffic accidents being the major cause of injury. Supination-external rotation was the most common mechanism of injury and Weber's type B fractures were the most common type of fracture. The associated fractures and injuries noted and the comorbidities seen in these patients have been enumerated. Open reduction and internal fixation under image intensifier control was done in all patients. Postoperatively, patients were immobilized with a plaster splint for a period of 3–6 weeks and were followed up with full weight-bearing walking and active range of movement of ankle exercises. The final outcome as per the Weber's radiological criteria was 66.6% good, 26.6% fair, and 6.8% poor result which showed a good correlation between the immediate postoperative radiological score and the final radiological outcome. The factors that affected the final poor outcome were late presentation, patients with fracture subluxation, post massaging, the presence of long-standing and uncontrolled diabetes, and old age.

Conclusion:

The present study suggests that anatomical reduction of the ankle fracture and restoration of the joint congruity at the earliest will give a good functional outcome. The postoperative immobilization in a plaster slab up to 3–6 weeks (depending on associated injuries, fracture severity, bone quality, quality of fixation, and patient compliance) does not affect the final outcome with respect to achieving the ankle and subtalar range of movements as most of the patients had achieved full range of motion at the end of 12 weeks.
Nonunion of Clavicle Treated with Precontoured Locking Compression Plate Fixation and Bone Grafting
Authors: Shah Nissar Ahmad , Dar Nisar Ahmad , Rashid Badoo Abdul
Published: September 2022

Background:

Plate fixation with bone grafting is the treatment of choice for nonunion of the clavicle and the use of precontoured locking compression plate (LCP) has been proposed to have an advantage of minimal hardware prominence and low rate of implant removal surgery.

Materials and Methods:

The retrospective analysis was performed to assess the long-term efficacy of precontoured LCP and bone grafting in nonunion of the clavicle. Fifteen patients who had undergone the surgery were assessed retrospectively in terms of clinical and radiological outcome for 4.1 years (range 2–7 years). The outcome was assessed using clinical and functional assessment by QuickDASH scoring and visual analog scale (VAS) system, radiological assessment in terms of union, time of return to previous activities, and any adverse results during the surgery or in the postoperative follow-up.

Results:

The radiological consolidation was achieved in all patients in a mean period of 18 weeks (range14–20 weeks). All patients returned to their previous activity level in a mean period of 5.9 months (range 2.5–9 months). There was a statistically significant improvement in QuickDASH and VAS scores (P < 0.05); however, one patient had symptomatic hardware prominence.

Conclusion:

The use of precontoured LCP in nonunion clavicle is a well-tolerated surgery giving promising results with most patients returning to previous activity level with the advantage of minimal hardware prominence and low rate of implant removal surgery.
The Not So Familiar Silent Joint Killer
Authors: Bandi Gowtham , Randhi Ram Kartheek , Shaik Jameer , Paka Varun Kumar , Seerapu Raviteja V. S.
Published: September 2022

Ochronosis is rarely considered a cause for knee synovitis due to its rare occurrence. It starts affecting the joint from the third decade onward causing premature joint damage. The damaged joint and surrounding tissue present as blackish decolorated mass and can surprise the operating surgeon, unless diagnosed beforehand. Prior diagnosis helps both the anesthetist and operating surgeon to better handle the associated complications of ochronosis during surgery. Diagnosis is essentially based on prior knowledge of the disease and its markers. Here, we report a rare case of ochronosis of the knee that was treated elsewhere previously as tuberculosis of the knee. A history evaluation along with intraoperative findings helped arrive at the possible diagnosis of ochronosis. Total synovectomy was done. Postoperative improvement of visual analog scale score was significant and the patient was satisfied with the pain relief attained through treatment. Early diagnosis and timely management is critical to avoid unwanted complication related to both anesthesia and surgery pertaining to the disease. Knowledge of skin markers and urine darkening helps in identifying the disease early.
Traumatic Sternoclavicular Joint Dislocation - A Case Series and Discussion of Methods of Management
Authors: Ravish V. N. , Channappa T. S. , Raju G. Bharath , Jayaram Manju , Karan C. L.
Published: September 2022

Traumatic sternoclavicular (SC) joint injuries account for <3% of all traumatic joint injuries. Instability of the SC joint (SCJ) is a difficult problem to treat and can present with gross limitations in activities. Prompt diagnosis and intervention are imperative in the management of these fracture dislocations. We present three cases of posttraumatic SCJ dislocation treated conservatively and two cases treated with open reduction and internal fixation with reconstruction plate and its functional outcome and discuss the various modes of management of these dislocations.
Prognostic Factors to Predict the Progression of Adolescent Idiopathic Scoliosis
Authors: Gantaguru Amrit , Marathe Nandan , Mulkalwar Alhad , Mallepally Abhinandan Reddy
Published: September 2022

Scoliosis has always presented a challenge to the clinicians both at the stage of decision-making and at the stage of correcting the same. Predicting curve progression is important as it helps in selecting the patients who may benefit from an earlier intervention. Patients can be treated either by brace application or by operative intervention depending on the magnitude of curve and potential of curve progression. In this review, we have summarized the past and present parameters used to predict scoliosis progression with a brief introduction about the future trend in this respect. We identified and reviewed a total of 46 relevant papers written in English language utilizing PubMed, Google Scholar, and Scopus search engines. Many clinicians had come up with various radiological methods such as Risser grading, Tanner–Whitehouse staging (TW2-RUS and TW3) methods, Greulich–Pyle method, Sauvegrain method using only olecranon process radiographs and various clinical methods such as age of menarche and Tanner staging for sexual maturity. Apart from these, recently, various genetic factors such as single-nucleotide polymorphism of various genes, platelet calmodulin, peripheral blood mononuclear cell, impairment in melatonin signaling, DNA-based test called “ScoliScore” and hormones such as serum ghrelin and leptin have been investigated. Changes in brainstem vestibular function and alteration in electrical activities of paraspinal muscles are also studied to predict the curve progression. The two most important dilemmas faced by clinicians while approaching patients with scoliosis are the identification of patients requiring intervention and the right time to intervene in the selected patients. The goal of scoliosis treatment is to halt the progression. Predicting the growth spurt in an individual patient will guide the appropriate timing of intervention which can prevent complications associated with adolescent idiopathic scoliosis so that they can lead a better quality of life.
Functional Outcome of Distal End Radius Fractures Managed with Variable-Angle Locking Plates
Authors: Kumarasamy Manikandan , Kumar K. Naveen , Akashdeep A. A. , Uma Anand K. P.
Published: September 2022

Introduction:

Management of distal end radius intraarticular fractures is difficult to manage and these fractures account for 10% of all fractures. Multiple treatment options ranging from conservative to internal fixation, of which volar plate fixation has emerged as an effective method of internal fixation in comparison with other fixed-angle locking plates as they ensure proper restoration of the articular surfaces and anatomical alignment.

Materials and Methods:

A hospital-based prospective study was conducted on 14 patients with distal end radius fractures admitted in our hospital from January 2019 to December 2019. Patients with distal end radius fractures treated with variable-angle locking plate were included and were followed-up minimum of 6 months. The results were analyzed based on radiological parameters and Mayo Wrist Score (MWS).

Results:

Of 14 patients, 11 were male patients and three were female patients. Seven patients had right-sided fracture whereas remaining seven patients had left-sided fractures. All 14 patients were treated with variable-angle locking plate. Among 14 patients, 12 patients achieved union by 12 weeks, only two patients achieved union by 24 weeks. Ten patients had excellent results while four patients had a good outcome based on MWS. All patients in our study had painless union without any complications.

Conclusion:

The use of variable-angle locking plates in distal end radius fractures helps to maintain perfect anatomical reduction, early mobilization, and better postoperative outcome.
A comparative evaluation of oral clonidine and oral gabapentin as a premedication on postoperative analgesia duration in patients undergoing spinal anesthesia
Authors: Das Rituparna , Paul Kallol , Halder Pankaj Kumar , Choudhury Arpita , Roy Sourav , Debbarma Ambika
Published: September 2022

Background and Objectives:

Premedication with oral clonidine or gabapentin reduces the perioperative pain and decreases the requirement of analgesics. Our study aims at comparing the efficacy of oral clonidine and oral gabapentin for postoperative analgesia duration in surgeries done under spinal anesthesia.

Materials and Methods:

A prospective, double-blinded study was conducted in randomly selected 100 patients undergoing spinal anesthesia for any surgery (excluding cesarean section). Group C received 100 μg oral clonidine and Group G received 600 mg oral gabapentin, 1 h before spinal anesthesia. Blood pressure, heart rate, and Spo2 were recorded at 0, 15, 30, and 60 min interval. Visual analog scale (VAS) was documented for pain assessment at 2, 4, 6, 8, and 24 h from the time of onset of spinal anesthesia. The number of rescue analgesic doses required in 24 h postoperatively was noted. The data regarding the patient's demography, changes in the hemodynamics, VAS score, and requirement of rescue analgesia were analyzed.

Results:

There was no statistically significant difference in the hemodynamic changes with either group. The mean VAS score in the first postoperative hour was significantly higher for Group C than Group G (P < 0.0001). The mean requirement of rescue analgesic doses per patient was 3.00 ± 0.35 and 1.84 ± 0.58 in Groups C and G, respectively (P < 0.0001).

Conclusions:

Oral gabapentin is more effective than oral clonidine as a premedication in patients undergoing spinal anesthesia belonging to American Society of Anesthesiologists I and II.
Role of “Ferritin” in COVID-19 pneumonia
Authors: Patil Shital , Toshniwal Sham , Acharya Abhijit , Narwade Ganesh
Published: September 2022

Aims and Objectives:

Robust data of ferritin are available as a prognostic marker in bacterial infection and we have analyzed its usefulness in coronavirus disease 2019 (COVID-19) pneumonia in predicting severity of illness, response to treatment, and final outcome.

Materials and Methods:

A multicentric, prospective, observational, and interventional study included 1000 COVID-19 cases confirmed with reverse transcription–polymerase chain reaction. All cases were assessed with lung involvement documented and categorized on high-resolution computed tomography (CT) thorax, oxygen saturation, inflammatory marker, ferritin at entry point, and follow-up during hospitalization. Age, gender, comorbidity and use of BIPAP (bilevel positive airway pressure)/NIV (non-invasive ventilation) /NIV, and outcome as with or without lung fibrosis as per CT severity were key observations. Statistical analysis was done using Chi-square test.

Observations and Analysis:

In a study of 1000 COVID-19 pneumonia cases, age (<50 and > 50 years) and gender (male versus female) had a significant association with ferritin (P < 0.00001 and P < 0.010, respectively). CT severity score at entry point with ferritin level had a significant correlation in severity score (P < 0.00001). Ferritin level had a significant association with duration of illness (P < 0.00001). Comorbidities had a significant association with ferritin level (P < 0.00001). Ferritin level had a significant association with oxygen saturation (P < 0.00001). BIPAP/NIV during hospitalization had a significant association with ferritin level (P < 0.00001). Timing of BIPAP/NIV requirement in critical care setting had a significant association with ferritin level (P < 0.00001). Follow-up ferritin titer during hospitalization as compared to entry point normal and abnormal ferritin had a significant association in post-COVID lung fibrosis, respectively (P < 0.00001).

Conclusions:

Ferritin has documented very crucial role in COVID-19 pneumonia in predicting severity of illness, progression of illness and requirement of mechanical ventilation, assessing response to treatment during hospitalization. Follow up ferritin titre during hospitalization and at discharge can be used as early predictor of post-covid lung fibrosis.
Knowledge on risk factors and warning signs of stroke in Udupi
Authors: Cutinho Maryl Candida , Chakrabarty Jyothi , Menon Girish
Published: September 2022

Background:

World Health Organization reports that stroke is the third among the top 10 causes of death in India. Despite this, knowledge among general public about stroke and its risk factors is a bare minimum. The objective of this study was to assess the knowledge on risk factors and warning signs of stroke among selected caregivers and students.

Materials and Methods:

A descriptive survey was conducted in the medical, neurologic and cardiac outpatient departments of a tertiary care hospital. The participants of the survey were students of the allied health sciences, nursing and engineering, and care givers of patients attending the outpatient departments. The data on the knowledge of risk factors and warning signs of stroke were collected using convenient sampling technique.

Results:

Twenty-five percentage of the students and 65% of the care givers had only less than average knowledge on warning signs and risk factors of stroke.

Conclusions:

Knowledge level of the students as well as the care givers is not satisfactory considering the increasing incidence and mortality related to stroke in India. Therefore, training the individuals on identification of signs of stroke and immediate management is vital.
Diagnostic dilemma in childhood intussusception presenting with encephalopathy
Authors: Ganguly Madhurima , Biswas Prativa , Chakraborty Partha , Halder Pankaj
Published: September 2022

Intussusception is the telescoping of one bowel segment into another. Usually, children below 1 year of age experience this condition and have classical symptoms such as abdominal pain, vomiting, and bleeding per rectum. However, unusual clinical presentations, especially in older children, may deceptively mislead the diagnosis, particularly in the absence of the classical symptoms. We report a case of an 11-year-old male child who presented with seizures, altered sensorium, and nonbilious vomiting. During the emergency surgery, he was diagnosed with an ileoileal intussusception with proximal gut perforation and peritonitis. He had a speedy recovery from neurological symptoms after the surgical intervention.
PUNGGAWA-SAWI VALUES EDUCATION IN OVERSEAS BUGIS ETHNIC FAMILY AS LOCAL WISDOM OF THE FISHERMAN COMMUNITY (DESCRIPTION ANALYSIS FISHERMAN SOCIETY ON COAST BANDAR LAMPUNG)
Authors: Irawan Rudi
Published: September 2022

In changes the values of life skills that occur in the Bugis ethnic fishing community, Karang Village, Telukbetung Timur District, Bandar Lampung City as local wisdom are due to incompatibility between the rules that are lived by the behavior they carry out, the weak role of social institutions in conducting supervision and socialization.  The values of life that are framed in the activities of Bagang in the next generation are low in interest and the next generation to apply the values of life of the Bugis ethnic in overseas lands in their interactions among family members, the community as well as in the development and implementation of the Bagang activity.  This study aims to determine the description of local wisdom in the process of educating the value of the life of the Bagang fishing community (read; Bagan) of the Overseas Bugis ethnicity in Karang Village, Teluk Betung Timur District, Bandar Lampung City. The method used in this research is descriptive analytical research with a qualitative approach that functions to describe and explain a complex reality by applying concepts and theories that have been developed by scientists.Based on the results of the research and analysis, it was found that (1) the pattern of punggawa fishermen's families in preserving local wisdom in overseas lands by inculcating life skills values was more likely to be participatory education patterns.  This pattern tends to emphasize the process of the child's association with other punggawa or sawi who are more mature in developing their potential by providing maximum opportunities for achieving independence in living their lives.  (2) The sawi family in the process of preserving local wisdom by instilling life skills values their education, tends to use a repressive pattern from older family members to younger family members, either directly or indirectly.  Consequently, those with low education are positioned as people who accept the values of local wisdom in the lower class social strata.  (3) The process of applying the life skills values of punggawa or sawi  as local wisdom in the Bagang fishing community of the overseas Bugis ethnic in the Karang City Village area occurs because of the community's desire to survive with their existence as a fishing community that is unique with its traditions.