Assessment framework for the selection of a potential interactive dressing material for diabetic foot ulcer.

Diabetic foot ulcer is a chronic health issue leading to lower leg amputations in approximately 15% of patients with diabetics. There are many factors directly or indirectly involved in the physiology of wound healing but being a multisystem disorder, wound healing in diabetic patients retard or worsen with heavy exudates and severe microbial infections. Wound management is of prime importance and is an emerging area to incorporate wound regenerative materials in natural or synthetic dressing materials along with proper microbial control. The article aim to identify suitable dressing materials which exhibit inherent wound healing properties at the same time flexible to be used as drug carriers for slow, consistent and effective delivery of 'functional drugs' to the wound environment. The authors selected nine materials from the popular and well accepted dressings of patient choice, analyzed them using graph theoretic approach and ranked them on the basis of graph index values obtained. A critical review has also been done on the basis of their ranking, providing insights to the advantages, disadvantage and potential of top 5 ranked candidate materials. Alginate, Honey, Medifoam, Saline, and Hydrogel dressings were the top five candidate materials ranked respectively, even then, the authors suggests that 'modified hydrogels' can have the potential to be used as a future candidate in DFU treatment as it is the only material (among the top ranked ones) which can effectively used as regenerative drug carrier, while providing all other wound healing properties in relative proportions. The proposed framework can be modified and applied in the selection and ranking of materials for any kind of applications both in industry and medical fields by identifying factors influencing the final outcome of study and by listing the characteristics of the materials selected.

Changing Trends in the Pattern of Maxillofacial Injuries in Helmeted Motorcycle Accident Patients when Compared to Non-helmeted Motorcycle Accident Patients.

Aim: Motorcycle accidents are the most predominant type of road traffic injuries in India. This prospective study aimed to evaluate the patterns of maxillofacial injuries in the three types of helmeted and non-helmeted individuals. Materials and Methods: All the patients reporting to the maxillofacial trauma unit of Sanjay Gandhi hospital with maxillofacial injuries were considered. The patients were analyzed for helmet wearing status, type of helmet worn-full-face, open-face and half-helmet, strap and visor fixation status, fit of the helmet, ownership of the helmet, helmet standardization, obeying traffic rules, alcohol consumption status, speed of the vehicle, volume of the engine, licensure of the driver, hard- and soft-tissue maxillofacial injuries were recorded. Results: A total of 741 patients participated in the study for a period of 10 months, majority being males and of a mean age of 31 years. Most common injuries to the face in the open- and half-helmet group were lacerations of the chin and mandibular fractures. Patients who wore ISI standard full-face helmets with strap and visor fixed experienced least injuries to the face. Conclusion: This study concluded that out of the three commonly used helmets, half-helmets provided the least protection against maxillofacial injuries during a crash, followed by the open-face helmets. The highest protection was provided by the full-face helmets with ISI standardization when secured properly with strap and visor.

Comparative evaluation of bite force in patients treated for unilateral mandibular condylar fractures by open and closed methods.

BACKGROUND/AIM: Condylar fractures account for a large proportion (20% to 52%) of mandibular injuries. The goal of treating these fractures is to restore the occlusion, thereby re-establishing the masticatory function as close as possible to the patient's pre-trauma state. The aim of this study was to compare the bite forces following unilateral condylar fractures treated by open reduction and internal fixation (ORIF) with those managed by the closed method. METHOD: Patients with unilateral mandibular condylar fractures were divided into two groups (n = 20) using a simple randomization method. Patients in group I were treated by open reduction and internal fixation (ORIF) using titanium miniplates and screws. Patients in group II were treated by the closed method with inter-maxillary fixation. Patients in both groups were evaluated pre-operatively and then post-operatively at one week, one month and three months for maximum bite force achieved at the central incisor, premolar and molar regions. RESULTS: Pre-operative bite forces on the unaffected site were significantly higher than the affected site in both groups, whereas no significant difference was observed in bite forces between the unaffected and affected sites in both groups post-operatively. The bite forces achieved at both the unaffected and affected sites in the ORIF group were significantly higher than in the closed group. CONCLUSION: Maximum bite forces differed significantly when the treatment was done with the open method, and the patients treated with the open method needed less time to achieve the maximum bite forces, thereby making an earlier return to function.

Efficacy of Platelet Rich Fibrin versus chitosan as a hemostatic agent following dental extraction in patients on antiplatelet therapy.

OBJECTIVES: The aim of this study is to compare the effectiveness of Platelet Rich Fibrin gel and Chitosan gel dressing in providing hemostasis in patients receiving Oral Antiplatelet Therapy and also to evaluate their surgical healing outcome following dental extractions. METHODOLOGY: A total of 60 patients under Oral Antiplatelet Therapy indicated for tooth extraction were included for treatment in the study without altering the oral antiplatelet regimens. Patients were allocated equally in two groups; Group A: where PRF gel was packed into the extraction socket, while Group B: Chitosan hydrogel was packed. Timing of hemostasis was noted for each patient of both the groups. Patients were examined for any pain/secondary bleeding/healing/soft tissue dehiscence/alveolar osteitis in the extraction site on first, third and seventh post-operative days. RESULTS: All extraction sockets with Platelet-rich fibrin achieved hemostasis in 2.64 min and sockets with Chitosan hydrogel achieved hemostasis in 1.182 min (p < 0.001). Post-operative pain in Group A sites (3.2, 1.4, 0.37 on 1st, 3rd & 7th day respectively) was significantly lower than the control sites (3.4, 1.67, 0.53 on 1st, 3rd & 7th day respectively) p-value 0.001, 0.001 respectively. CONCLUSION: In this study, Chitosan hydrogel dressing thus proved to be a superior hemostatic agent compared to PRF gel, that significantly shortens the clotting time following dental extraction in patients under antiplatelet therapy. But, PRF gel has superior wound healing properties than Chitosan with less postoperative pain following minor oral surgical procedures under local anesthesia.

In vitro propagation of a rare medicinal fern of Western Ghats--Diplazium esculentum (Reytz.).

Present study aimed for in vitro culture of circinate part of young leaves of D. esculentum which is amongst the leafy vegetables consumed as vegetable by Paniya and Chetti tribes of Western Ghats. The circinate part of young leaves (crosiers), excised before the beginning of foliar expansion, was inoculated on half strength Murashige and Skoog (MS) medium supplemented with auxins indole-3-butyric acid (IBA) or alpha-napthalene acetic acid (NAA) or 2,4-Dichlorophenoxyacetic acid (2,4-D) and cytokinin 6- benzylaminopurine (BA) in a range 0.5 to 2.5 mg L(-1). Combinations of different concentrations of 2,4 D + BA, IBA + BA as well as of NAA+ BA were also tested in half strength MS medium with 3% sucrose and with pH 5.8. The best morphogenic response was obtained with half strength MS medium supplemented with 2,4-D 0.5 mg L(-1) and BA 2.5 mg L(-1), 3% sucrose, at pH 5.8. For rooting of the microshoots, half strength MS medium supplemented with 2,4-D ( 2 and 1 mg L(-1)) exhibited best results. Present study reports the successful in vitro culturing of D. esculentum.