A rare case report of uterine rupture in a case of suspected septic abortion

There was a progressive rise in the rate of caesarean sections globally from 17.2% to 21.5% from 2017 to 2021. Caesarean sections have an improved feto-maternal outcome but come with a set of challenges. A second-trimester abortion in a previously scarred uterus is one of them. The incidence of uterine rupture is about 3.8�3% in a scarred uterus, which is much higher than in an unscarred uterus. Mifepristone 200 mg orally followed by misoprostol 800 mcg vaginally within 24� hours has been proven to be an effective method for medical abortion, but its safety in a previously scarred uterus has not been fully established. A 27-year-old P2L2A1 with two previous caesarean sections at 19 weeks of gestation was referred to our tertiary care center with bleeding per vagina following consumption of medical termination of pregnancy (MTP) pills, followed by dilatation and curettage outside. She was pale, and tachycardia was noted. Septic abortion was suspected due to repeated bouts of fever, raised total counts, and starting on higher antibiotics. Due to persistent tachycardia and computed tomography (CT) findings, she was subjected to exploratory laparotomy, and a uterine rupture was confirmed. She underwent an obstetric hysterectomy as a lifesaving procedure. Second-trimester abortions with misoprostol in a previously scarred uterus require a high index of suspicion and close monitoring. Detecting life-threatening complications early in at-risk patients plays a crucial role in uterine preservation. There is scope for research to incorporate methods like Foley's induction in these cases. The clinical picture of a ruptured uterus can be initially non-specific, delaying the diagnosis. Surgery depends on the extent of the rupture, maternal hemodynamic status, and family completion. It is challenging to rule out uterine rupture when there is a similar presentation as septic abortion, so ultrasound is the first investigation of choice in the diagnosis of uterine rupture, whereas CT abdomen and pelvis are confirmatory.

A study on role of vitamin D3 in uterine fibroids

Background: Fibroids are one of the significant non-cancerous growths prevalent in females. Vitamin D is found to have a significant influence in the development of fibroid by suppressing the formation of an impaired extracellular matrix (ECM) due to the abnormal reaction to tissue damage response by regulating it. The study is done to find out the mean vitamin D3 levels among women with fibroids and without fibroids, respectively.Methods: This study was a hospital based analytical study done in the department of obstetrics and gynaecology, Chettinad Hospital and Research Institute, Chennai, India for a period of 18 months. Two groups of 60 each, one group with fibroids and the other without fibroids were recruited. Venous blood was drawn from both groups using venipuncture technique and the serum vitamin D3 levels were estimated and compared.Results: The mean vitamin D3 level was 12.98�79 ng/ml for those with fibroids and 44.50�60 ng/ml for normal group. The mean value was significantly lesser among those with fibroids than those normal with p value of less than 0.05. The mean vitamin D3 levels were similar between various sizes of fibroids.Conclusions: In this study, the level of vitamin D3 was significantly lower among those with fibroids than those women who did not had any fibroids which shows that normal vitamin D3 levels might be protective against uterine fibroids and vitamin D deficiency can lead to the development of fibroids.

Relationship of vitamin D deficiency and gestational diabetes mellitus in pregnant women

Background: Gestational diabetes mellitus (GDM) is a common metabolic disorder among pregnant women. It is important to be diagnosed and treated early to minimize complications for both the mother and the foetus. Recent studies found that deficiency of vitamin D is a risk factor for GDM and its supplementation may be helpful in prevention of GDM. Objectives were to assess vitamin D status in pregnant women with or without GDM and to find out the association between vitamin D deficiency and GDM.Methods: A total of 400 patients were included in the study, 200 pregnant women diagnosed with GDM and 200 normoglycemic pregnant women. Serum 25 (OH) vitamin D concentration in these women were compared.Results: Only 6.75% of women were found to have normal vitamin D levels, all others having either insufficiency 18.5% or deficiency 74.75%. In case group around 79% of women had vitamin D deficiency, 70.5% in control group. In case group around 14.5% of women had vitamin D insufficiency, 22.5% in control group. In both case and control group around 6.5% and 7% of women were within the normal range respectively. Mean vitamin D is 14.3 ng/ml in case group and 15.4 ng/ml in control group.Conclusion: Prevalence of vitamin D deficiency is alarmingly high in pregnant women in India and has become a re-emerging public health issue and needs to be addressed.

Importancia diagnóstica del C4d en la nefropatía membranosa / Diagnostic significance of C4d in membranous ne phropathy

Resumen Introducción : La nefropatía membranosa (NM) es la causa más frecuente de síndrome nefrótico primario en adultos (20-30%). En la microscopia óptica se obser va engrosamiento de membrana basal glomerular con aparición de espigas. Estos hallazgos histológicos no son evidentes en formas tempranas, en cuyo caso el patrón de depósito granular de IgG y/o C3 en la membrana basal por inmunofluorescencia (IF) permite diferenciarla de enfermedad por cambios mínimos (ECM). El sistema del complemento juega un papel central en la fisiopatología de la NM. C4d es producto de degradación y un marcador de la activación del complemento. La marcación con C4d en muestras de biopsias re nales, por técnica de inmunohistoquímica (IH) puede colaborar en el diagnóstico diferencial entre ambas glomerulopatías. Nuestro objetivo fue explorar el poder de discriminación del C4d para diferenciar NM de ECM en material de biopsias renales. Métodos : Se recuperaron muestras en parafina de biopsias renales con diagnóstico de NM y ECM realizados entre 1/1/2008 y 1/4/2019. Se realizaron tinciones de IH por técnica de inmunoperoxidasa con C4d usando un anticuerpo policlonal antihumano de conejo. Resultados : En todos los casos con NM (n = 27, 15 hombres) con mediana de edad de 63 (rango: 18-86) años se detectaron depósitos de C4d. En los 21 casos con ECM (12 hombres) con mediana de edad de 51 (rango: 18-87) años la marcación de C4d fue negativa. Conclusión : Los resultados indican que la marcación de la biopsia renal con C4d es una herramienta útil para el diagnóstico diferencial entre NM y ECM.

Abstract Introduction : Membranous nephropathy (MN) is the most common cause of primary nephrotic syndrome in adults (20-30%). Light microscopy shows thickening of glomerular basement membrane with appearance of spikes. These histological findings are not evident in early forms, in which case the granular deposition pattern of IgG and/or C3 in the basement membrane by immunofluorescence (IF) constitutes the diagnostic tool that allows to differentiate it from minimal change disease (MCD). Complement system plays a key role in the pathophysiology of MN. C4d is a degradation prod uct and a marker of the complement system activation. C4d labelling by immunohistochemical (HI) technique can help in the differential diagnosis between both glomerulopathies NM and MCD when the material for IF is insufficient and light microscopy is normal. Our objective was to explore the discrimination power of C4d to differentiate between MN and MCD in renal biopsy material. Methods : Paraffin-embedded samples were recovered from renal biopsies with a diagnosis of MN and MCD performed between 1/1/2008 and 4/1/2019. IH staining was performed by immunoperoxidase technique using a rabbit anti-human C4d polyclonal antibody. Results : In all cases with MN (n = 27, 15 males) with a median age of 63 (range: 18-87) years, C4d deposits were detected. In 21 cases with MCD (12 males) with a median age of 51 (range: 18-87) years, the C4d marking was negative in every samples. Conclusion : The results indicate that the marking of the renal biopsy with C4d is a useful tool for the dif ferential diagnosis between NM and MCD.

Clinical improvement after removal of hypercalcemia-causing granulomas / Mejoría clínica posterior a la eliminación de granulomas causantes de hipercalcemia

Abstract In this report, we present the case of a woman with clinical characteristics of hypercalcemia due to ectopic production of 1,25(OH)2D. She reported a history of aesthetic surgery with gluteal fillers. The formation of granulomas after these interventions were previously described. In this case, surgical removal of the foreign formations was attempted with clinical stability during 3 years.

Resumen Presentamos el caso de una mujer con características clínicas de hipercalcemia secundaria a la producción ectópica de 1,25(OH)2D. La paciente informó una historia de rellenos glúteos con fines estéticos. La formación de granulomas posterior a este tipo de intervenciones fue previamente descrita por otros autores. En este caso se intentó la extirpación quirúrgica de las formaciones extrañas con estabilidad clínica durante 3 años.

Effect of temporary cement on the color of temporary crowns made by conventional pressing methods and substractive CAM/CAD technologies / Efecto del cemento temporal sobre el color de las coronas temporales realizadas mediante métodos de prensado convencionales y tecnologías sustractivas CAM/CAD

Abstract The color stability of temporary restoration is crucial, especially in sensitive areas in terms of aesthetics. This research aimed to determine the effect of temporary cement on the color of temporary crowns made by conventional pressing methods (indirect) and CAM/CAD technologies using milling machines and 3D printers. This study was carried out in a laboratory, utilizing A2 color in all manufacturing methods. The color of the restorations was measured by a spectrophotometer after cementation with semi-permanent resin cement. Subsequently, color changes of the samples (ranging from 0 to 100) were calculated using the Commission International de l'Eclairage (CIE) Lab system. Data analysis was based on descriptive statistics methods and statistical tests, including one-way analysis of variance (ANOVA) and Tukey's post hoc test. According to the results of ANOVA, there was a significant difference between the three groups in terms of the 'a' and 'b' indexes (P<0.001). However, regarding the 'l' index, no significant difference was observed among the three groups (P=0.250). Also, based on Tukey's post hoc test, a significant relationship was seen between the first and second pairs in the 3D printer group, and between the first and third pairs in the milling group (P<0.001). However, no significant difference was observed in the conventional pressing group. The results showed that the 3D printing method exhibited the highest amount of color change among the three methods, while the milling method demonstrated the lowest amount of change.

Resumen La estabilidad del color de la restauración temporal es muy importante, especialmente en zonas sensibles desde el punto de vista estético. En la presente investigación, el objetivo fue determinar el efecto del cemento temporal sobre el color de coronas temporales realizadas mediante métodos de prensado convencionales (indirectos) y tecnologías CAM/CAD utilizando fresadora e impresora 3D. Este estudio se llevó a cabo en un laboratorio y se utilizó color A2 en todos los métodos de fabricación. El color de las restauraciones se midió mediante un espectrofotómetro después de cementarlas con cemento de resina provisional. Luego se calcularon los cambios de color de las muestras (de 0 a 100) utilizando el sistema CIE Lab. El análisis de los datos se basó en métodos de estadística descriptiva y pruebas estadísticas, incluido el análisis de varianza unidireccional (ANOVA) y la prueba post hoc de Tukey. Según los resultados del análisis de varianza unidireccional, hubo una diferencia significativa entre los tres grupos en términos de los índices a y b (P<0,001), pero en términos del índice l, no hubo diferencias significativas entre los tres grupos (P=0,250). Además, según la prueba post hoc de Tukey, se observó una relación significativa entre el primer y el segundo grupo de impresoras 3D y entre el primer y el tercer grupo de fresado (P<0,001). Sin embargo, no se observó ninguna diferencia significativa en el grupo de prensado convencional. Los resultados mostraron que el mayor cambio de color entre los tres métodos fue con el método de impresión 3D, y la menor cantidad fue con el método de fresado.

Volumetric Analysis of Carpal Bones by Sex with 3D Slicer Software Program / Análisis Volumétrico de los Huesos del Carpo por Sexo con el Programa de Software 3D Slicer

SUMMARY: In this study, we aim to share the volumes of the carpal bone and the ratio of these volumes to the total volume of wrist bones from Computed Tomography (CT) images obtained from individuals of different ages and sex using 3D Slicer. Right wrist CT images of 0.625 mm slice thickness of 42 healthy individuals (21 female, 21 male) of both sexes were included in our study. Volume calculations were made by loading the images into 3D Slicer, an open-source software package. In this study, mean capitate volume was the largest in both sexes (male 3479.9±679.2; female 2207.1±272.1 mm3), while pisiform had the smallest mean volume (male 810.0±141.2; female 566.6±97.7 mm3). This order was ordered from largest to smallest as hamate, scaphoid, trapezium, lunate, triquetrum, trapezoid, and pisiform. According to this study, carpal bone volumes were larger in males than in females (p0.05). In this study, it was seen that carpal bone volume differed according to sex. However, it was observed that the bone volumes of both sexes took up the same amount in the total bone volume. This information will be very useful in sex determination, 3D anatomical material creation, implant applications and reconstructive surgery.

Nuestro objetivo fue determinar los volúmenes de los huesos del carpo y la relación entre estos volúmenes y el volumen total de estos huesos a partir de imágenes de TC obtenidas de individuos de diferentes edades y sexos utilizando 3D Slicer. En el estudio se incluyeron imágenes de TC del carpo de la mano derecha de los participantes en el estudio, con un grosor de corte de 0,625 mm, en 42 individuos sanos (21 mujeres, 21 hombres) de ambos sexos. Los cálculos de volumen se realizaron cargando las imágenes en 3D Slicer, un paquete de software de código abierto. El volumen medio del hueso capitado fue el mayor en ambos sexos (hombre 3479,9 ± 679,2; mujer 2207,1 ± 272,1 mm3), mientras que el hueso pisiforme tuvo el volumen medio más pequeño (hombre 810,0 ± 141,2; mujer 566,6 ± 97,7 mm3). De mayor a menor el volumen de los otros huesos fue: hamato, escafoides, trapecio, lunato, piramidal, trapezoide y pisiforme. Según este estudio, los volúmenes óseos del carpo eran mayores en hombres que en mujeres (p0,05). En este estudio se observó que el volumen de los huesos del carpo difería según el sexo. Sin embargo, se observó que los volúmenes óseos de ambos sexos ocuparon la misma cantidad del volumen óseo total. Esta información será de gran utilidad en la determinación del sexo, creación de material anatómico 3D, aplicaciones de implantes y cirugía reconstructiva.

Alert for the high prevalence of vitamin D deficiency in adolescents in a large Brazilian sample

Abstract Objective: To estimate the prevalence of vitamin D deficiency and severe deficiency in children and adolescents, in a large Brazilian sample. Methodology: Results of 413,988 25(OH)D measurements in children and adolescents aged 0 to 18 years collected between 01/2014 and 10/2018 were obtained from the database of a Clinical Laboratory. In this population, 25 hydroxyvitamin D concentrations below 20 ng/mL are considered deficient, and below 12 ng/mL as severe deficiency. All measurements were performed by immunoassay and the results were distributed by gender, age group, seasonality, and latitude. Results: The mean of 25(OH)D levels was 29.2 ng/mL with a standard deviation of 9.2 ng/mL. Of the total samples, 0.8% had a concentration < 12 ng/mL, and 12.5% of the samples had a concentration < 20 ng/mL, with a higher prevalence in females. Children under 2 years of age had the lowest prevalence. The effects of latitude and seasonality were quite evident. In samples of female adolescents from the southern region in winter, 36% of vitamin D deficiency and 5% of severe deficiency were found. Conclusion: In this large number of measurements of 25(OH)D in children and adolescents, 12.5% had a deficiency and 0.8% had severe deficiency. A greater deficiency was observed among adolescents, especially females, which raises questions about the need for supplementation during this period of life.

Comportamiento orgánico en la utilización de barreras con polímeros impresos 3D para la regeneración ósea guiada en implantología / Organic behavior in the utilization of barriers with 3D printed polymers for guided bone regeneration in implantology

Este estudio aborda la viabilidad y los retos inherentes al uso de barreras de polímeros impresos en 3D para la regeneración ósea guiada (en adelante, ROG) en procedimientos de implantología dental. A través del análisis exhaustivo de investigaciones y aplicaciones clínicas actuales, se evalúa detalladamente la biocompatibilidad, la funcionalidad estructural y las respuestas biológicas inducidas por estas barreras innovadoras en entornos terapéuticos. Este enfoque permite una comprensión más profunda de las interacciones osteointegrativas y las perspectivas de adaptabilidad tisular asociadas con materiales poliméricos avanzados (AU)

This scholarly investigation delineates the efficacy and inherent challenges of utilizing 3D printed polymer barriers for guided bone regeneration (GBR) in dental implantology procedures. An extensive review of current research and clinical implementations provides a critical assessment of biocompatibility, structural functionality, and the biological responses elicited by these innovative barriers within therapeutic contexts. The study delves into the osteointegrative interactions and tissue adaptability prospects facilitated by advanced polymeric materials, offering significant insights into their clinical utility.(AU)

Cardiac disease in pregnancy

Cardiac disease is an important cause of maternal morbidity and mortality. It can invariably affect fetus with variable intensity depending upon nature of cardiac disease in mother. Cardiac disease can affect women antenatally, in labor and even in post-partum period. It is a case series of 12 cases who presented to labor room in a particular unit at SSG hospital, Baroda over a period of 1 year starting from 1st May 2022 to 30th April 2023. Mean age at presentation was 24.8. 3 women were having valvular heart disease while 4 were having peri-partum cardiomyopathy (PPCM), 4 were having atrial septal defect (ASD), 1 was having ventricular septal defect (VSD). Associated medical comorbidities and obstetrical factors were evaluated. 2D ECHO findings of all cases were recorded. Risk assessment must be done for the mother and fetus to minimize the effect of cardiac disease in pregnancy. Joint consultation with cardiologist should be done in already known case of cardiac disease.

Organoides en Odontología. Avances en este Nuevo Enfoque de Investigación: Revisión Sistemática Exploratoria

Los Organoides (O) son un tipo de cultivo celular 3D, que reproducen las características morfológicas y funcionales de diversos órganos o tejidos en un entorno in vivo. Se logran a través de la proliferación y diferenciación de Células Madres (CM) en distintas líneas celulares con capacidad de autoorganizarse. Son capaces de reproducir forma, función, expresión génica o repuesta a estímulos de la misma forma que el órgano original. Esto le ha permitido servir de base para múltiples investigaciones en el ámbito médico y odontológico. En los últimos años, se ha podido recrear con éxito, prácticamente, todos los órganos de nuestro cuerpo, como pulmones, hígado, tracto reproductivo, cerebro y muchos otros (Bartfeld, 2021). De la misma forma, son varias las líneas de investigación odontológicas desarrolladas. En específico, la creación de O de órganos orales como dientes y glándulas salivales, son las más reportadas (Oshima et al., 2017). Sin embargo, no son del común conocimiento del odontólogo general. Esta revisión sistemática exploratoria, tiene como objetivo presentar una visión general de la evidencia acumulada, determinado las áreas odontológicas de investigación, así como sus resultados. La investigación odontológica, en base al uso de O, es de alta calidad y de vanguardia, mostrando resultados prometedores, que auguran un gran futuro, tanto para la odontología como para los pacientes.

Organoids (O) are a type of 3D cell culture, which reproduce the morphological and functional characteristics of various organs or tissues in an in vivo environment. They are achieved through the proliferation and differentiation of Stem Cells (SC) into different cell lines with the ability to self-organize. They are capable of reproducing form, function, gene expression, or responses to stimuli in the same way as the original organ. This has allowed it to serve as the basis for multiple investigations in the medical and dental field. In recent years, it has been possible to successfully recreate practically all human organs, such as the lungs, liver, reproductive tract, brain and many others (Bartfeld, 2021). In the same way, there are several lines of dental research developed, specifically, the creation of O from oral organs such as teeth and salivary glands, are the most reported (Oshima et al., 2017). However, they are not common knowledge of the general dentist. This exploratory systematic review aims to present an overview of the accumulated evidence, determining the dental research areas, as well as their results. Dental research, based on the use of O, is of high quality and cutting-edge, showing promising results and a favorable future, both for dentistry and for patients.

Interactive Atlas of the Canine Brain, Heart and Kidney Created from Plastinated Samples

SUMMARY: Currently, training in the field of anatomy requires the implementation of learning and knowledge technologies (TAC). Therefore, the objective of this work was to use digital images taken of plastinated canine brains, hearts, and kidneys to create an interactive atlas that facilitates the teaching-learning of the anatomy of these organs. The research was carried out in 3 phases. In the first, canine brains, hearts and kidneys were obtained using the cold-temperature silicone plastination. In the second stage, photographs were taken, the images were edited with Adobe Photoshop and converted to SVG format using Adobe Illustrator. During the last phase, the 2D atlas was created using MongoDB and Node.js for the backend and Vue.js as the framework for the frontend. In addition, it was used three.js to render the 3D models. As a result, the 'Interactive Canine Atlas', ATINCA, was created. The atlas comprises 27 interactive images and 27 in atlas mode view (28 of the brain, 20 of the heart, and 6 of the kidney). Furthermore, the atlas features 3D models of the three organs. The developed atlas constitutes the first digital tool created in Ecuador based on local institutional needs, including a 3D format. Consequently, ATINCA will be integrated into the curricula as a digital material that will facilitate significant autonomous and collaborative learning of canine anatomical knowledge.

Actualmente, la formación en el campo de la anatomía requiere la implementación de tecnologías del aprendizaje y el conocimiento (TAC). Por ello, el objetivo del trabajo fue utilizar imágenes digitales tomadas de cerebros, corazones y riñones caninos plastinados para crear un atlas interactivo que facilite la enseñanza-aprendizaje de la anatomía de estos órganos. La investigación se llevó a cabo en tres fases. En la primera se obtuvieron cerebros, corazones y riñones caninos mediante la técnica de plastinación con silicona al frío. En la segunda etapa se tomaron fotografías, las imágenes se editaron con Adobe Photoshop y se convirtieron a formato SVG con Adobe Illustrator. Durante la última fase, se creó el atlas 2D usando MongoDB y Node.js para el backend y Vue.js como framework para el frontend. Además, se utilizó three.js para renderizar los modelos 3D. Como resultado se creó el Atlas Interactivo del Canino, ATINCA. El atlas cuenta con 27 imágenes interactivas y 27 en vista modo atlas (28 del cerebro, 20 del corazón y 6 del riñón). Además, el atlas presenta modelos 3D de los tres órganos. El atlas desarrollado constituye la primera herramienta digital creada en el Ecuador con base en necesidades institucionales locales y donde se incluye el formato 3D. Con lo cual, ATINCA podrá incorporarse en las mallas curriculares como material digital que facilitará el aprendizaje autónomo y colaborativo significativo de conocimientos anatómicos de los órganos caninos.

Morphological Design and Study of a 3D Printed Integrated Fusion Device Based on CT Measurement Data Assisted Anterior Lumbosacral Spine / Diseño Morfológico y Estudio de un Dispositivo de Fusión Integrado Impreso en 3D Basado en Datos de Medición de TC Asistida de Columna Lumbosacra Anterior

SUMMARY: To measure and study the anatomical morphological data of the lumbar 5 to sacral 1 intervertebral space with the aid of CT and design an anatomical anterior lumbosacral 3D printed integrated interbody fusion for the treatment of degenerative lumbosacral spine diseases. 100 adults (50 of each sex) who underwent CT examination of the lumbar spine in our hospital were selected, and their lumbar 5 to sacral 1 intervertebral space anatomical data were measured, including the anterior lumbar convexity angle, different sagittal and coronal heights, and the sagittal and coronal diameters of the superior and inferior endplates. The measured data were also statistically analyzed, and morphological design and study of the 3D printed integrated fusion device in the anterior lumbosacral spine was performed by applying computer software. When comparing the coronal and sagittal diameters of the superior and inferior endplates from lumbar 5 to sacral 1, the differences were statistically greater in men than in women (P0.001). When comparing the height at different positions in the median sagittal plane, both males and females showed an anterior high and posterior low pattern. In the coronal plane, both males and females showed the highest height in the middle position (P0.001). CT can measure the anatomical data of the lumbosacral spinal hiatus more accurately. The 3D-printed anterior integrated fusion device of the lumbosacral spine designed according to the analysis of the data results is more in line with the anatomical structure of the lumbosacral spine, fits well with the superior and inferior endplates, and effectively restores the height and anterior convexity angle of the lumbosacral space.

El objetivo de este trabajo fue medir y estudiar los datos morfológicos anatómicos del espacio intervertebral lumbar 5 a sacro 1 con la ayuda de TC y diseñar una fusión intersomática integrada anatómica lumbosacra anterior impresa en 3D para el tratamiento de enfermedades degenerativas de la columna lumbosacra. Se seleccionaron en nuestro hospital 100 adultos (50 de cada sexo) que se sometieron a un examen de TC de la columna lumbar y se midieron los datos anatómicos del espacio intervertebral lumbar 5 al sacro 1, incluyendo el ángulo de la convexidad lumbar anterior, diferentes alturas sagital y coronal, y los diámetros sagital y coronal de las placas terminales superior e inferior. Los datos medidos también se analizaron estadísticamente y se realizó el diseño morfológico y el estudio del dispositivo de fusión integrado impreso en 3D en la columna lumbosacra anterior mediante la aplicación de software informático. Al comparar los diámetros coronal y sagital de las placas terminales superior e inferior desde lumbar 5 hasta sacro 1, las diferencias fueron estadísticamente mayores en hombres que en mujeres (P 0,001). Al comparar la altura en diferentes posiciones en el plano mediano, tanto hombres como mujeres mostraron un patrón anterior alto y posterior bajo. En el plano coronal, tanto hombres como mujeres mostraron la altura más alta en la posición media (P0,001). La TC puede medir los datos anatómicos del hiato espinal lumbosacro con mayor precisión. El dispositivo de fusión anterior integrado impreso en 3D de la columna lumbosacra diseñado de acuerdo con el análisis de los resultados de los datos está más en línea con la estructura anatómica de la columna lumbosacra, se adapta bien a las placas terminales superior e inferior y restaura eficazmente la altura y la parte anterior del ángulo de convexidad del espacio lumbosacro.

Role of vitamin D in controlling vertigo: a review

Vertigo is a disabling symptom that has a high recurrence rate and interferes with day-to-day functioning. Vertigo is frequently caused by Meniere's diseases and benign paroxysmal positional vertigo (BPPV). The most prevalent neuro-ontological condition causing vertigo is BPPV. Vertigo attacks that last only a few seconds and are brought on by changing the head's position with respect to gravity are the hallmark of BPPV. There is a suggestion that vitamin D deficiencies and BPPV and Meniere's diseases are positively correlated. However, there is not much awareness among clinicians about association between vitamin D deficiency and certain etiologies of vertigo. After taking vitamin D supplements, vertigo attacks stop happening. Supplementing with vitamin D may be beneficial for patients with low vitamin D levels who have BPPV and Meniere's disease. This review's goal is to discuss about how vitamin D helps to treat vertigo, especially BPPV and Meniere's disease.

Decoding pituitary tumors: a systematic analysis of diagnostic methods and treatment modalities

Pituitary tumors are growths that form in the gland these tumors are rare representing 10-15% of all brain tumors. They can disrupt the production of hormones, in the body leading to symptoms related to hormone imbalance. This review offers an overview of the methods used for diagnosing and treating tumors. It is worth noting that relying solely on references may restrict the scope and depth of discussions about tumors in this paper. Suggestions for research include exploring diagnostic tools like molecular imaging and liquid biopsy to enhance early detection and accurate assessment of these tumors. Additionally, more research is required to understand the long-term effects and quality of life outcomes for patients undergoing treatment options for tumors. In conclusion, significant progress has been made in diagnosing and treating tumors over time. Advances in imaging technologies such as diffusion-weighted imaging and magnetic resonance spectroscopy have enhanced precision and treatment strategies for these tumors. The discussion also covers the roles of surgery, radiation therapy and medical interventions, in managing tumor growth and hormonal imbalances further advancements, in research and innovation are crucial, for enhancing our knowledge and treatment of tumors ultimately bringing outcomes for both patients and healthcare professionals.

PREVALENCE OF DEPRESSION AND ANXIETY IN POLYCYSTIC OVARIAN SYNDROME WOMEN

Objective: The objective of the study was to determine the prevalence of depression and anxiety ranges in women having Polycystic Ovarian Syndrome (PCOS).Methods: An epidemiological observational study on 80 PCOS patients confirmed through ultrasound scanning over a study period of 6 mo at Government General Hospital, RIMS, KADAPA. HAM-D and HAM-A assessment scales were used to analyze the severity of depression and anxiety in PCOS women.Results: Among 80 patients, the prevalence of depression is 86.25% (n=69) and anxiety is 93.75% (n=75). Among 69 depressed patients 38 mild, 28 moderate, and 3 severe ranges were noted. Among 75 patients with anxiety, 52 mild, 18 moderate, and 5 severe ranges were noted. The age of the patient does not show a major difference in the development of depression and anxiety. PCOS women who married and have children (n=45) were mostly affected with depression (n=39) and anxiety (n=43). Menstrual irregularity in PCOS patients with depression and anxiety is majorly seen among those who have last menstrual between 30–60 d. Middle-income patients were affected by depression and anxiety greatly, according to this study.Conclusion: We conclude that the prevalence rate of depression and anxiety is greater in PCOS patients.

Acerca de la construcción de envoltorios subjetivantes y del armado de una historia: el caso Agustina / De la construction d'enveloppes subjectivantes et du montage d'un histoire: le cas Agustina / About the construction of subjectivizing envelopes and the assembly of a story: the Agustina case / Sobre a construção de envelopes subjetivantes e a montagem de uma história: o caso Agustina

En este trabajo se presentan recortes del caso clínico de una joven de 14 años, en tratamiento durante dos años y medio, encuadrado en el consultorio privado. Se abordan los acontecimientos que generaron quiebres en la continuidad de su historia, y cómo, a través del trabajo con los adultos referentes y con la joven, se habilitaron las posibilidades de un rearmado psíquico que apuntó a la subjetivación de su historia, y a posibilitar las condiciones psíquicas para el ingreso a la adolescencia AU

Cet ouvrage présente des coupures d'un cas clinique d'une jeune fille de 14 ans, en traitement depuis deux ans et demi, cadré dans le cabinet privé. Les événements qui ont généré des ruptures dans la continuité de son histoire sont abordés et comment, à travers le travail avec les références adultes et avec la jeune femme, les possibilités d'un réarmement psychique visant à la subjectivation de son histoire ont été activées et ont permis au conditions psychologiques d'entrée à l'adolescence AU

This work presents clippings of a clinical case of a 14-year-old girl, during twoand a half years of treatment, framed in the private office. The events that generated breaks in the continuity of her story are addressed, and how, through work with the adult references and with the young woman, the possibilities of a psychic rearming that aimed at the subjectivation of her story were enabled, and to enable the psychological conditions for entering adolescence AU

Este trabalho apresenta recortes do caso clínico de uma jovem de 14 anos, durante doisanos e meio de tratamento, enquadrado em consultório particular. São abordados os acontecimentos que geraram rupturas na continuidade de sua história e como, por meio do trabalho com as referências adultas e com a jovem, foram viabilizadas as possibilidades de um rearmamento psíquico que visava à subjetivação de sua história, e possibilitar a condições psicológicas para entrar na adolescencia AU

Phosphocalcic Profile of Chronic Kidney Disease at Libreville

Introduction: As kidney function declines towards the more severe stages of chronic kidney disease (CKD), the interactions between kidney, intestine and bone become increasingly unstable. CKD with mineral and bone disorders and secondary hyperparathyroidism would be developing. The aim of this study was to determine the phosphocalcic profile of CKD patients in Libreville.Materials and Methods: This was a cross sectional study with 89 CKD patients recruited. A blood sample was taken to measure PTH, vitamin D, FGF-23 by ELISA method; calcium, magnesium, fasting blood glucose, phosphate and creatinine by spectrophotometer.Results: Mean phosphorus levels were 1.3 � 0.5 mmol/L and hormone levels 81.8 � 26.2 pg/mL and 27.5 � 5.0 ng/mL for PTH and vitamin D respectively. Significant hyperphosphatemia was found among 43 (48.3%; p=0.0135) patients. There were 59 (66.3%) subjects with hypovitaminosis D p=0.0000. Less than 50% of patients had normal blood glucose levels (p=0.0034). PTH was 99.4 � 16.4 pg/mL in dialysis patients and 61.7 � 20.3 pg/mL in non-dialysis patients, with a p=0.0000. Vitamin D levels were significantly higher in patients without calcium supplementation (29.5 � 5.0 ng/mL) than in those with supplementation (25.1 � 4.0 ng/mL, p= 0.0000).Conclusion: Phosphate levels remained high in our study population. Vitamin D deficiency was found in the majority of our patients. It would be advisable to readjust the management of these patients in order to minimize the effects of hyperphosphatemia and improve life quality.

3D PRINTING TECHNIQUE: A REVIEW ON THE APPLICATIONS IN PHARMACEUTICAL MANUFACTURING

In the realm of pharmaceutical manufacturing, 3D printing technology stands on the brink of a transformable revolution. This article passionately explores the boundless potential of 3D printing in shaping the future of pharmaceuticals, aiming to inspire researchers. It delves into crucial aspects: an overview of 3D printings in drug development, its advantages in drug production, and the pivotal role of personalized medicine. The article also discusses the creation of patient-specific medical devices, novel drug delivery systems, and the anticipated challenges in adopting 3D printing. Real-world case studies showcase successful applications while addressing the regulatory challenges associated with 3D-printed pharmaceuticals. By bridging existing knowledge gaps, this comprehensive article acts as a guiding light for those dedicated to advancing pharmaceutical research. It empowers researchers with profound insights into this disruptive technology, fostering innovation and collaboration within the community. The untapped potential of 3D printing in pharmaceuticals is vast and promising. Together, researchers can pioneer the future of pharmaceutical manufacturing, benefiting patients globally and propelling scientific advancement. Join us in this exhilarating journey of exploration and discovery as we harness the full capabilities of 3D printing for the betterment of healthcare and the progress of science.

Differences in Muscle Strength Performance According to the Genotypes of the rs4646994 Polymorphism of the ACE Gene in a Sedentary Population / Diferencias en el Rendimiento de la Fuerza Muscular Según los Genotipos del Polimorfismo rs4646994 del Gen ACE en una Población Sedentaria

SUMMARY: The angiotensin converting enzyme gene (ACE) has been associated with endurance and strength performance through its I/D polymorphism. Nevertheless, contradictory results exist between different populations. In this context, the purpose of this research was to determine the influence of the I/D polymorphism of the ACE gene on muscle strength in a sedentary Chilean sample. In this study 102 healthy male students (21.3 ± 2.2 years) completed the assessment. I/D genotyping, cardiovascular, anthropometric, grip strength and knee extensor peak strength were evaluated. The ACE polymorphism frequency was: II, 33.3 %; ID, 46.1 %; DD, 20.6 %. The results showed significant differences and large effect size in maximum (p = 0.004; d = 0.85) and relative handgrip strength (p = 0.004; d = 0.9) between genotype II vs DD. No difference was found for maximal or relative knee extensor strength between groups (p = 0.74), showing a low effect size (d = 0.20). In conclusion, this study provides insights into the role of the ACE gene in muscle strength and highlights the importance of investigating genetic variants in sedentary populations to better understand strength performance.

El gen de la enzima convertidora de angiotensina (ACE) se ha asociado con el rendimiento de resistencia y fuerza a través de su polimorfismo I/D. Sin embargo, existen resultados contradictorios entre diferentes poblaciones. En este contexto, el propósito de esta investigación fue determinar la influencia del polimorfismo I/D del gen ACE sobre la fuerza muscular en una muestra chilena sedentaria. En este estudio, fueron evaluados 102 estudiantes varones sanos (21,3 ± 2,2 años). Se realizaron aplicaron las siguientes evaluaciones: genotipado del polimorfismo I/D, cardiovascular, antropométrica, fuerza de prensión y fuerza máxima de extensión de rodilla. La frecuencia del polimorfismo I/D de ACE fue: II, 33,3 %; DNI, 46,1 %; DD, 20,6 %. Los resultados mostraron diferencias significativas y un gran tamaño del efecto en la fuerza máxima (p = 0,004; d = 0,85) y relativa de prensión manual (p = 0,004; d = 0,9) entre el genotipo II y el DD. No se encontraron diferencias en la fuerza máxima o relativa de los extensores de rodilla entre los grupos (p = 0,74), lo que muestra un tamaño de efecto bajo (d = 0,20). En conclusión, este estudio proporciona información sobre el papel del gen ACE en la fuerza muscular y destaca la importancia de investigar variantes genéticas en poblaciones sedentarias para comprender mejor el rendimiento de la fuerza.