Rehabilitation and Management of Complex Multiple Para-Symphysis Mandible Fracture: A Case Report.

Fractures of the parasymphysis occur in 15% of all cases of mandibular fracture. The mandible occupies the lowest portion of the face. The prominent bone of the face is severely injured when the lower face is hit by high impacts with upward or obliquely directed force. In this case study, we discussed the alleged trauma case of a 20-year-old man who fell from a height on August 27, 2022, at about 9:00 p.m. near Wardha. His family took him to the hospital in Wardha due to pain that was aggravated during chewing and swelling in his jaw. On investigation, an X-ray was done, and a left parasymphysis and right-side body fracture were noticed. Later, the patient underwent surgery, where open reduction and internal fixation of the left parasymphysis and the right-side body fracture with plating and intermaxillary fixation (IMF) were done. Then he was referred to the physiotherapy department for therapeutic intervention. Rehabilitation was given to reduce pain and swelling, regain full range of motion, gradually increase mobility, and keep associated muscles strong. A six-week protocol was administered to the patient. It was found that the therapeutic approach was quite effective for the patient.

Preparation and Evaluation of Modified Chitosan Nanoparticles Using Anionic Sodium Alginate Polymer for Treatment of Ocular Disease.

Mucoadhesive nanoparticles offer prolonged drug residence time at the corneal epithelium by adhering to the mucous layer of the eye. Here, in this research investigation, voriconazole-loaded chitosan mucoadhesive nanoparticles (VCZ-MA-NPs) were modified to mucous-penetrating nanoparticles (VCZ-MP-NPs) by coating them with anionic polymer sodium alginate. The ionic gelation method was utilized to prepare mucoadhesive chitosan nanoparticles, which were further coated with sodium alginate to obtain the surface properties essential for mucous penetration. The developed VCZ-MA-NPs and VCZ-MP-NPs were evaluated extensively for physicochemical delineation, as well as in vitro and ex vivo studies. The particle size, polydispersity index, and ζ potential of the VCZ-MA-NPs were discovered to be 116 ± 2 nm, 0.23 ± 0.004, and +16.3 ± 0.9 mV, while the equivalent values for VCZ-MP-NPs were 185 ± 1 nm, 0.20 ± 0.01, and -24 ± 0.9 mV, respectively. The entrapment efficiency and drug loading were obtained as 88.06%±1.29% and 7.27% ± 0.95% for VCZ-MA-NPs and 91.31% ± 1.05% and 10.38% ± 0.87% for VCZ-MP-NPs, respectively. The formulations were found to be stable under different conditions (4 °C, 25 °C, and 40 °C). Chitosan nanoparticles and modified nanoparticles showed a spherical and smooth morphology under electron microscopic imaging. An excised caprine cornea was used for the ex vivo permeation study, exhibiting 58.98% ± 0.54% and 70.02% ± 0.61% drug permeation for VCZ-MA-NPs and VCZ-MP-NPs, respectively. The findings revealed that the mucous-penetrating nanoparticles could effectively pass through the corneal epithelium, thus overcoming the mucous barrier and fungal layer of the eye, which highlights their potential in the treatment of fungal keratitis.

3D tumor angiogenesis models: recent advances and challenges.

The development of blood vessels, referred to as angiogenesis, is an intricate process regulated spatially and temporally through a delicate balance between the qualitative and quantitative expression of pro and anti-angiogenic molecules. As angiogenesis is a prerequisite for solid tumors to grow and metastasize, a variety of tumor angiogenesis models have been formulated to better understand the underlying mechanisms and associated clinical applications. Studies have demonstrated independent mechanisms inducing angiogenesis in tumors such as (a) HIF-1/VEGF mediated paracrine interactions between a cancer cell and endothelial cells, (b) recruitment of progenitor endothelial cells, and (c) vasculogenic mimicry. Moreover, single-cell sequencing technologies have indicated endothelial cell heterogeneity among organ systems including tumor tissues. However, existing angiogenesis models often rely upon normal endothelial cells which significantly differ from tumor endothelial cells exhibiting distinct (epi)genetic and metabolic signatures. Besides, the existence of intra-individual variations necessitates the development of improved tumor vascular model systems for personalized medicine. In the present review, we summarize recent advancements of 3D tumor vascular model systems which include (a) tissue engineering-based tumor models; (b) vascular organoid models, and (c) organ-on-chips and their importance in replicating the tumor angiogenesis along with the associated challenges to design improved models.

Overview of Current Developments in Biobutanol Production Methods and Future Perspectives.

Renewable biobutanol production is receiving more attention toward substituting fossil-based nonrenewable fuels. Biobutanol is recognized as the top most biofuel with extraordinary properties as compared with gasoline. The demand for biobutanol production is increasing enormously due to application in various industries as chemical substituent. Biobutanol production technology has attracted many researchers toward implementation of replacing cost-effective substrate and easy method to recover from the fermentation broth. Sugarcane bagasse, algal biomass, crude glycerol, and lignocellulosic biomass are potential cost-effective substrates which could replace consistent glucose-based substrates. The advantages and limitations of these substrates have been discussed in this chapter. Moreover, finding the integrated biobutanol recovery methods is an important factor parameter in production of biobutanol. This chapter also concentrated on possibilities and drawbacks of obtainable integrated biobutanol recovery methods. Thus, successful process involving cost-effective substrate and biobutanol recovery methods could help to implementation of biobutanol production industry. Overall, this chapter has endeavored to increase the viability of industrial production of biobutanol.

Examination of social decision making in patients with schizophrenia using ultimatum game.

Intact decision-making skills in the social context are essential for optimal functioning in the community. Despite its significance, social decision making in schizophrenia (SCZ) has not been adequately examined. Hence, we examined social decision making in SCZ using the Ultimatum Game(UG), a neuroeconomic paradigm that involves financial transactions between a proposer and a responder to split a sum of money between them. Thirty male patients with a diagnosis of schizophrenia as per DSM-IV (age = 30 ± 7.08) and thirty age-matched healthy male volunteers (HV;age = 28.48 ± 3.74) participated in the study. All participants functioned as responders and had to either accept or reject offers made by an anonymous proposer. We also examined whether the gender or emotional expression of the proposer influenced acceptance rates. SCZ had significantly lower acceptance rates than HV for slightly unequal offers (t = 3.94, p = < 0.0001). However, there was no significant difference between SCZ and HV for other offers. Gender and emotional expression of the proposer did not significantly influence the outcome. These results suggest aberrant social decision making and increased inequity aversion in patients with SCZ. The difficulty in incorporating social components while engaging in financial interactions could have important implications for rehabilitation, functional recovery, and successful community living in SCZ.

Oncogenic and drug-sensitive NTRK1 rearrangements in lung cancer.

We identified new gene fusions in patients with lung cancer harboring the kinase domain of the NTRK1 gene that encodes the high-affinity nerve growth factor receptor (TRKA protein). Both the MPRIP-NTRK1 and CD74-NTRK1 fusions lead to constitutive TRKA kinase activity and are oncogenic. Treatment of cells expressing NTRK1 fusions with inhibitors of TRKA kinase activity inhibited autophosphorylation of TRKA and cell growth. Tumor samples from 3 of 91 patients with lung cancer (3.3%) without known oncogenic alterations assayed by next-generation sequencing or fluorescence in situ hybridization demonstrated evidence of NTRK1 gene fusions.

Modified Turco procedure for treatment of idiopathic clubfoot.

UNLABELLED: Since 1980 we have used a modified Turco procedure for treating congenital clubfoot. The modifications include: (1) lateral position with the unaffected side on top; (2) Cincinnati-type transverse heel crease incision from the base of the first metatarsal around the ankle up to the lateral border of the tendoachilles; (3) complete excision of the abductor hallucis muscle; (4) complete tibialis posterior tendon tenotomy in the sheath; (5) no lengthening of long toe flexors; (6) no K wires for maintaining the correction; and (7) special splints instead of Denis Browne splints. Thirty-three feet in 18 patients were followed up prospectively at a mean of 13.8 years (range, 10-16 years). There were no wound complications. The mean Laaveg and Ponseti score was 87.2 (range, 49-98). Twenty-seven (82%) of 33 feet had good to excellent results. There were seven feet (21%) with recurrent deformities, which included two feet (6%) with recurrence of all deformities, two feet (6%) with forefoot adduction, one foot each (3%) with equinus and heel varus, and one (3%) with cavus. Ninety-four percent of patients were very satisfied or satisfied with the results. We think this modified approach has helped us to reduce the recurrence of forefoot adduction deformity and wound complications. LEVEL OF EVIDENCE: Therapeutic study, Level IV (case series-no, or historical control group). See Guidelines for Authors for a complete description of levels of evidence.

Erosive oesophagitis: outcome of repeated long term maintenance treatment with low dose omeprazole 10 mg or placebo.

AIMS: To investigate the efficacy of daily maintenance treatment with omeprazole 10 mg in reducing the relapse rate of healed erosive oesophagitis. METHODS: Three hundred patients with erosive oesophagitis (grade 2 or greater) received omeprazole 20 mg daily for 12 weeks, followed by 40 mg daily for a further 12 weeks if required. After healing, patients were randomised to double blind treatment with omeprazole 10 mg daily or placebo for up to 18 months. On relapse the treatment cycle was repeated. RESULTS: The cumulative healing rate at 12 weeks in the initial healing period was 95%, and 96% and 98% on rehealing courses after relapse in the first and second maintenance periods respectively. After 12 weeks of treatment, 98% of patients were free from heartburn and 97% were free of all reflux related symptoms. Relapse in the subgroup of patients who relapsed in both maintenance periods was infrequent on omeprazole 20 mg daily: only 9% at two years. Gastrin concentrations rose above normal in one third of patients. One patient had linear hyperplasia of endocrine cells and another had micronodular hyperplasia. There were no side effects definitely attributable to omeprazole. CONCLUSION: Maintenance treatment with omeprazole 10 mg daily keeps about 60% of patients with erosive oesophagitis in prolonged remission. Patients relapsing once are likely to do so again; they can subsequently be treated effectively with omeprazole 20 mg daily.

Histamine H2 receptor antagonist-refractory oesophagitis: the efficacy of long-term omeprazole maintenance treatment.

BACKGROUND: Erosive oesophagitis refractory to high dose histamine H2 receptor antagonists (definition: failure to heal fully after > or = 3 months' treatment with cimetidine 3.2 g or ranitidine 0.9 g) responds well to omeprazole 40 mg daily but frequently relapses when the patients are put back on maintenance H2 receptor antagonists at medium or even high dose (e.g. cimetidine 1.6 g and 3.2 g, respectively). AIM: To investigate the efficacy of maintenance omeprazole 20 mg daily in refractory erosive oesophagitis. PATIENTS & METHODS: In this open, sequential study, patients with H2 receptor antagonist-refractory oesophagitis were healed on omeprazole 40 mg daily and then put on maintenance H2 receptor antagonists (cimetidine 1.6 g or 3.2 g). Relapses were re-treated with omeprazole 40 mg; upon rehealing, patients were put on maintenance omeprazole 20 mg daily for up to 4.5 years. RESULTS: Healing on omeprazole occurred in 38 out of 39 patients (97%) at 12 weeks. Only six of the 38 patients (16%) relapsed (asymptomatic in half) during subsequent maintenance treatment, whereas all had relapsed earlier on high dose H2 receptor antagonists. CONCLUSION: Within the limits of interpretation of an open study, omeprazole 20 mg daily seems effective in maintaining prolonged remission in this group of patients with H2 receptor antagonist-refractory oesophagitis.