A Multicenter Study of Needle Size and Safety for Splenic Biopsy.

Background Splenic biopsy is rarely performed because of the perceived risk of hemorrhagic complications. Purpose To evaluate the safety of large bore (≥18 gauge) image-guided splenic biopsy. Materials and Methods This retrospective study included consecutive adult patients who underwent US- or CT-guided splenic biopsy between March 2001 and March 2022 at eight academic institutions in the United States. Biopsies were performed with needles that were 18 gauge or larger, with a comparison group of biopsies with needles smaller than 18 gauge. The primary outcome was significant bleeding after the procedure, defined by the presence of bleeding at CT performed within 30 days or angiography and/or surgery performed to manage the bleeding. Categorical variables were compared using the χ2 test and medians were compared using the Mann-Whitney test. Results A total of 239 patients (median age, 63 years; IQR, 50-71 years; 116 of 239 [48.5%] female patients) underwent splenic biopsy with an 18-gauge or smaller needle and 139 patients (median age, 58 years [IQR, 49-69 years]; 66 of 139 [47.5%] female patients) underwent biopsy with a needle larger than 18 gauge. Bleeding was detected in 20 of 239 (8.4%) patients in the 18-gauge or smaller group and 11 of 139 (7.9%) in the larger than 18-gauge group. Bleeding was treated in five of 239 (2.1%) patients in the 18-gauge or smaller group and one of 139 (1%) in the larger than 18-gauge group. No deaths related to the biopsy procedure were recorded during the study period. Patients with bleeding after biopsy had smaller lesions compared with patients without bleeding (median, 2.1 cm [IQR, 1.6-5.4 cm] vs 3.5 cm [IQR, 2-6.8 cm], respectively; P = .03). Patients with a history of lymphoma or leukemia showed a lower incidence of bleeding than patients without this history (three of 90 [3%] vs 28 of 288 [9.7%], respectively; P = .05). Conclusion Bleeding after splenic biopsy with a needle 18 gauge or larger was similar to biopsy with a needle smaller than 18 gauge and seen in 8% of procedures overall, with 2% overall requiring treatment. © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Grant in this issue.

Novel approach of plate assisted buttressing in Hoffa fracture.

PURPOSE: Hoffa fracture is a femoral condyle fracture in the coronal plane. The lateral condyle is more commonly involved. The diagnosis is often difficult to detect with routine radiographs. Conservative management in this type of fracture resulted in nonunion, malunion, and other complications, such as stiff knee. Therefore, surgical management is mandatory in displaced fractures. Previous studies suggest only application of cancellous screw fixation, but these are not enough to counter vertical shear stress. Therefore, this study will evaluate the clinical outcomes of open reduction and internal fixation of Letenneur type I Hoffa fracture using cancellous screws with posterior buttressing plate. METHOD: This was a prospective cohort study conducted from March 2017 to July 2022 in orthopaedics department of tertiary care center after approval of institutional ethical committee. The study included 36 patients with Letenneur type I fractures treated by open reduction and internal fixation using posterior buttress plate and cancellous screws. Radiographs and clinical outcomes, range of movement (ROM), bone union, and knee society score (KSS) of patients were assessed at the end of 4 and 12 months in the follow-ups. All statistical analysis was done using Epi info version 7.2.1.0. RESULTS: In the 36 patients with Letenneur type I fracture, the majority belong to younger age group between 25 and 54 years with 22 males and 14 females. The modes of injury were road traffic accidents in 25 patients and fall from height in 11 patients. The right knee was involved in 21 cases and left was involved in 15 cases. Lateral condyle involvement was seen in 27 cases and medial condyle in 9 cases. All 36 patients with Letenneur type I Hoffa fracture were evaluated 4 months after surgical intervention. The notable improvements were observed in terms of ROM 120.4° ± 5.0° and KSS 85.0 ± 4.2. At the 12-month follow-up, considerably better outcomes were maintained regarding ROM 128.1° ± 5.2° and KSS 89.3 ± 4.8 with p < 0.05 which was statistically significant. At the final follow-up, all patients had routine fracture healing with a union time of (3.2 ± 3.4) months. CONCLUSIONS: Fixation of Letenneur type I Hoffa fracture with cancellous screws and posterior buttress plate is effective, reliable and capable of providing adequate stability. Buttress plate assisted fixation is a valuable enhancement of the conventional technique of lag screw fixation of Hoffa fractures.

Quantifying quadrupole effects in the NMR spectra of spin-1/2 nuclei in rotating solids.

Quantifying the NMR spectra of spin I = 1/2 nuclei coupled to quadrupolar spins (nuclei with spin quantum number, S > 1/2) has remained an arduous task in solid-state magic angle spinning (MAS) NMR experiments. In particular, extraction of chemical shift anisotropy (CSA) tensors from line-shapes of spin I = 1/2 nuclei coupled to quadrupolar spin (S = 1) in MAS experiments has remained challenging owing to the simultaneous presence of both heteronuclear dipolar interactions and quadrupolar interactions. Unlike experiments that involve only spin-1/2 nuclei, both faster spinning frequencies and stronger decoupling field strengths on the quadrupolar spins are essential to average/minimize the contributions from heteronuclear dipolar interactions. To this end, a quantitative theory based on the concept of "effective fields" is proposed to deduce optimal conditions in experiments that involve simultaneous recoupling and decoupling of heteronuclear dipolar interactions. Through analytic expressions, the spectral frequencies and intensities observed in experiments are quantified and rigorously verified. Since extraction of molecular constraints in NMR experiments involves iterative fitting of experimental data, we believe that the analytic expressions derived would speed up and be beneficial in quantifying such experiments.

Theory of radio-frequency pulses on periodically driven three-level systems: challenges and perspectives.

Understanding the evolution of nuclear spins subjected to radio-frequency (RF) pulses in periodically driven multi-level systems has remained a challenging problem in magnetic resonance. Here in this report, we focus on a formal description of the excitation of double-quantum (DQ) transitions in three-level systems. Through generalized time-propagators derived from Floquet theory, the excitation during a pulse at non-stroboscopic time intervals is analysed through expressions invoking the density operator formalism. In contrast to numerical simulations, the analytical expressions provide insights into the excitation phenomenon as well as facilitating the faster optimization of experiments and quantification of experimental data. Through rigorous comparison with simulations, the suitability and convergence criteria in the analytical methods are examined over a wide range of parameters (both internal and external) with appropriate examples.

Decreased biofilm formation by planktonic cells of Listeria monocytogenes in the presence of sodium hypochlorite.

The objective of this study was to determine if the adaptation at planktonic stage to subinhibitory concentrations (SIC) of sodium hypochlorite (NaOCl) could modulate the biofilm forming ability of five Listeria monocytogenes strains V7, Scott A, FSL-N1-227, FSL F6-154 and ATCC 19116 representing serotypes 1/2a, 4b and 4c. Biofilm formation by NaOCl nonadapted and adapted L. monocytogenes planktonic cells was measured in the presence or absence of SIC of NaOCl. The biofilm formation ability of NaOCl nonadapted and adapted L. monocyotgenes planktonic cells was reduced only in the presence of NaOCl (P < 0.05). Scanning electron microscopy revealed that the continuous exposure of NaOCl induced morphological changes in the L. monocytogenes biofilm structure and reduced its attachment to polystyrene surface. The qRT-PCR results also showed that the subinhibitory NaOCl reduced biofilm formation related gene expression such as motility and quorum sensing signals (P < 0.05). These findings indicate that subinhibitory NaOCl can reduce the ability of L. monocytogenes planktonic cells to form biofilms on polystyrene surface.

Impact of Different Antioxidants on the Bond Strength of Resinbased Composite on Bleached Enamel-An In Vitro Study.

AIM: The aim of this in vitro investigation was to assess the impact of various anti-oxidants namely 5% proanthocyanidin, 10% sodium ascorbate, 10% alpha tocopherol, and 10% green tea on the bond strength of resin-based composite on bleached enamel. MATERIALS AND METHODS: One hundred twenty human maxillary central incisors which were freshly extracted for periodontal reasons, having intact labial surface were us ed in this study. Specimens were randomly divided into six groups (n = 20). Group A: negative control-no bleaching treatment, group B-positive control -bleaching, group C-bleaching + 5% proanthocyanidins, group D-bleaching +10% green tea, group E - bleaching +10% alpha -tocopherol, group F-bleaching + 10% sodium ascorbate. Surfaces were etched followed by application of total-etch bonding system, and composite resin cylinders were bonded. Specimens were tested for shear bond strength using the universal testing machine. STATISTICAL ANALYSIS USED: The data obtained were subjected to ANOVA and post hoc Tukey's test for statistical analysis. RESULTS: After using bleaching agents and antioxidants for the different groups, Group A has the highest bond strength and group B has the lowest bond strength. Amongst the antioxidants group D showed significantly higher bond strength as compared group C, group E, and group F. CLINICAL SIGNIFICANCE: Use of antioxidants instantly following the bleaching procedure and before resin bonding reverses the compromised bond strength of composite resin on bleached enamel without sitting tight for a time of one day to one month. CONCLUSION: Bleaching of enamel reduced the shear bond strength. All the antioxidants used in this study increased the bond strength of bleached enamel. Among the antioxidant groups, green tea extract showed significantly higher bond strength compared to proanthocyanidin, tocopherol, and sodium ascorbate.

Scanning electron microscopy of Salmonella biofilms on various food-contact surfaces in catfish mucus.

The objective of this study was to determine the growth and survival of Salmonella enterica in the presence of high and low concentrations (375 µg/ml and 15 µg/ml) of catfish mucus extract at 10 °C and 22 °C for 63 days. The second objective of this study was to investigate the biofilm formation of Salmonella enterica serovar Blockley (7175) in catfish mucus extract for 48 h at 22 °C on four food-contact surfaces and to observe the biofilm populations using Scanning Electron Microscopy (SEM). The surface properties, surface roughness and surface energies were determined using contact angle measurement and atomic force microscopy. In 375 µg/ml of catfish mucus extract that was inoculated with 3 log CFU/ml, the growth of Salmonella counts were increased to a maximum of 6-7 log CFU/ml at 10 °C and 7-8 log CFU/ml at 22 °C in 7-14 d and decreased by 1-2 log CFU/ml from these peak levels at both 10 °C and 22 °C from 21 to 63 d. In 15 µg/ml of catfish mucus extract, Salmonella counts were in the range of 4-5 log CFU/ml at 10 °C and 5-6 log CFU/ml at 22 °C over 7-63 d of storage. By contrast, Salmonella counts were non-detectable in the absence of catfish mucus by 21-28 d of storage at 10 °C or 22 °C. The biofilm counts of S. Blockley (7175) on a stainless steel surface were 4 log CFU/cm2 and 5.5 log CFU/cm2 in 15 µg/ml and 375 µg/ml of catfish mucus extract respectively after 48 h incubation at 22 °C. SEM revelead that biofilm formation by S. Blockley (7175) was less in 15 µg/ml than 375 µg/ml of catfish mucus extract on stainless steel. In addition, SEM indicated that the visible biofilms were least on buna-N rubber as compared to stainless steel, polyethylene and polyurethane surfaces. Contact angle and atomic force microscopy confirmed that buna-N rubber was highly hydrophobic with low surface energy and low roughness when compared to other three surfaces. These findings indicate that Salmonella can utilize catfish mucus as a nutrient source to survive for longer periods and promote biofilm formation for its persistence on different food-contact surfaces.

Health literacy and oral health literacy: are they associated? A cross sectional survey among undergraduate students of tricity (Chandigarh, Mohali, Panchkula), India

INTRODUCTION: Health Literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate decisions. As with general health; achieving and maintaining oral health requires one to be able to understand, interpret and act on various types of health information. OBJECTIVE: The present study was conducted to determine the association between health literacy and oral health literacy among undergraduate students in tricity (Chandigarh, Mohali, Panchkula), India. MATERIAL AND METHODS: A cross-sectional study was conducted among 490 undergraduate students studying in tricity, from randomly selected 10 colleges. The data was collected by a single trained examiner, using a structured proforma. The questionnaire consisted of two parts, REALM-66 and REALD-30. The subject was given a copy of list of words to be pronounced and score one was given for each word pronounced correctly. RESULTS: REALM-66 scores showed that subjects with health literacy level equivalent to fourth- sixth grade is 1%, seventh- eighth grade was 64.4% and 29.6% for ninth grade and above. REALD-30 scores showed that 37.6% subjects had low level of literacy, 33.1% had moderate and 29.3% had high level of literacy. REALM and REALD scores were found to be positively correlated for qualification and genders. CONCLUSIONS: To our knowledge, this is the first study reporting association between health and oral health literacy. As the correlations were not strong, thus the results should be regarded as a first step to provide evidence.

A Prototype Hybrid Gypsum-Based 3-Dimensional Printed Training Model for Computed Tomography-Guided Spinal Pain Management.

This article details design methodology of an anatomically realistic and accurate physical 3-dimensional model of the lumbosacral spine from computed tomography data utilizing 3-dimensional printing. This model is unique in that the radiodense bony lumbosacrum is reconstructed using gypsum, which because of its high calcium content allows for the appropriate imaging characteristics mimicking bone. The model allows trainees to become competent in needle placement for image-guided diagnostic and therapeutic procedures.

Knowledge regarding Zika virus infection among dental practitioners of tricity area (Chandigarh, Panchkula and Mohali), India.

BACKGROUND: Zika virus (ZIKV), a vector-borne virus affecting a large number of people, has today become a major public health concern in the developed and developing countries worldwide. AIM: The purpose of this study was to assess the knowledge of ZIKV among dental practitioners residing in Tricity area (Chandigarh, Panchkula and Mohali), India. SUBJECTS AND METHODS: A total of 412 private dental practitioners were randomly sampled of whom 254 (61.6%) responded to participate in this cross-sectional survey. A self-structured, closed-ended questionnaire was administered to each participant to record demographic and professional characteristics followed by their knowledge regarding ZIKV. Statistical analysis was performed using SPSS Version 20 (IBM Corp, Armonk, NY). The results were expressed in percentages. Multivariable linear regression analysis was carried out to assess the association of participant's demographics and professional characteristics with knowledge. RESULTS: The sample consisted of 152 (59.9%) male and 102 (40.1%) female practitioners. Majority of the practitioners belonged to the age group of 25-34 years (66.1%). High knowledge was reported by only 38.2% of the practitioners. A statistically significant difference was seen when mean knowledge scores were compared with the qualification of the participants (P = 0.04), with postgraduates having more knowledge than graduates regarding ZIKV. Most of the knowledge of the practitioners came from television (37.8%) while journals only represented 4.7% of the total information gained. CONCLUSION: ZIKV infection, a new public health emergency, needs to be addressed urgently. All health care professionals should have adequate knowledge of the virus and be conversant with necessary precautionary measures to be taken making it imperative that dental practitioners strive to continually update their knowledge from time to time.

Perception of dental practitioners regarding the use of antioxidants in oral health.

BACKGROUND: Free radicals play a key role in the development of several pathological conditions. Therefore, antioxidants (AOs) are the first line of defense against free radical damage and are critical for maintaining optimum health and well-being. OBJECTIVES: To assess the perception of dental practitioners regarding use of antioxidants in oral health. METHOD: A cross-sectional questionnaire study was conducted among 296 dental practitioners in Tricity (Chandigarh, Mohali, Panchkula, India). A self-structured close-ended questionnaire was used to assess the perception of dentists regarding the use of antioxidants in their patients. It consisted of 12 questions with dichotomous response and five point likert scale ranging from strongly agree to strongly disagree. Descriptive statistics were used to summarize the data, followed by the Chi-square test to check significant differences between the responses. Correlation between responses were analysed through the Spearman's rank correlation. Statistical analysis was done using Statistical Package for Social Sciences version 20 (Illinois, Chicago, USA). RESULTS: A statistically significant difference was observed between genders, with females 181 (61%) having more knowledge than males 115 (39%) regarding the use of antioxidants in their clinical practice. It has been found that dental professionals in academics prescribes more antioxidants to their patients than the private practitioners. Postgraduates 76 (77.6%) had a higher level of knowledge than graduates 86 (43%). CONCLUSIONS: Knowledge about antioxidants should be highlighted in the health sciences curriculum. It is recommended to expand the use of antioxidants in oral health to bring down the burden of chronic diseases like periodontitis and catastrophic diseases like precancerous lesions and oral cancer. KEY WORDS: antioxidants, free radicals, mouth neoplasms, oral health.

Transcriptome-wide quantitative profiling of PUS7-dependent pseudouridylation by nanopore direct long read RNA sequencing.

Pseudouridylation is a prevalent post-transcriptional RNA modification that impacts many aspects of RNA biology and function. The conversion of uridine to pseudouridine (Ψ) is catalyzed by the family of pseudouridine synthases (PUSs). Development of robust methods to determine PUS-dependent regulation of Ψ location and stoichiometry in low abundant mRNA is essential for biological and functional understanding of pseudouridylation. Here, we present a framework, NanoPsiPy, for identifying Ψ sites and quantify their levels in poly-A RNA at single-nucleotide resolution using direct RNA long-read Nanopore sequencing, based on the observation that Ψ can cause characteristic U-to-C basecalling errors in Nanopore direct RNA sequencing data. Our method was able to detect low and high stoichiometric Ψ sites in human mRNA. We validated our method by transcriptome-wide quantitative profiling of PUS7-dependent Ψ sites in poly-A RNA from a MYCN -amplified neuroblastoma cell line. We identified 8,625 PUS7-dependent Ψ sites in 1,246 mRNAs that encode proteins involved primarily in ribosome biogenesis, translation, and mitochondrial energy metabolism. Our work provides the first example of using direct RNA long-read Nanopore sequencing for transcriptome-wide quantitative profiling of mRNA pseudouridylation regulated by a PUS. We envision that our method will facilitate functional interrogation of PUSs in biological and pathological processes.

The characteristics and predictors of mortality in periprosthetic fractures around the knee.

Aims: Periprosthetic fractures (PPFs) around the knee are challenging injuries. This study aims to describe the characteristics of knee PPFs and the impact of patient demographics, fracture types, and management modalities on in-hospital mortality. Methods: Using a multicentre study design, independent of registry data, we included adult patients sustaining a PPF around a knee arthroplasty between 1 January 2010 and 31 December 2019. Univariate, then multivariable, logistic regression analyses were performed to study the impact of patient, fracture, and treatment on mortality. Results: Out of a total of 1,667 patients in the PPF study database, 420 patients were included. The in-hospital mortality rate was 6.4%. Multivariable analyses suggested that American Society of Anesthesiologists (ASA) grade, history of peripheral vascular disease (PVD), history of rheumatic disease, fracture around a loose implant, and cerebrovascular accident (CVA) during hospital stay were each independently associated with mortality. Each point increase in ASA grade independently correlated with a four-fold greater mortality risk (odds ratio (OR) 4.1 (95% confidence interval (CI) 1.19 to 14.06); p = 0.026). Patients with PVD have a nine-fold increase in mortality risk (OR 9.1 (95% CI 1.25 to 66.47); p = 0.030) and patients with rheumatic disease have a 6.8-fold increase in mortality risk (OR 6.8 (95% CI 1.32 to 34.68); p = 0.022). Patients with a fracture around a loose implant (Unified Classification System (UCS) B2) have a 20-fold increase in mortality, compared to UCS A1 (OR 20.9 (95% CI 1.61 to 271.38); p = 0.020). Mode of management was not a significant predictor of mortality. Patients managed with revision arthroplasty had a significantly longer length of stay (median 16 days; p = 0.029) and higher rates of return to theatre, compared to patients treated nonoperatively or with fixation. Conclusion: The mortality rate in PPFs around the knee is similar to that for native distal femur and neck of femur fragility fractures. Patients with certain modifiable risk factors should be optimized. A national PPF database and standardized management guidelines are currently required to understand these complex injuries and to improve patient outcomes.

Atypical Lumbar Scheuermann's Disease: A Rare Entity and Literature Review.

Introduction: Atypical Scheuermann disease involves one or two vertebral bodies which result in kyphosis. Case Report: An 18-year-old male presented in OPD with a complaint of chronic lower back pain without any lower limb pain and neurological deficit. Radiological imaging and blood parameters were in favor of atypical Scheuermann disease. Conclusion: Radiological and blood investigations are required to rule out other possible causes of chronic back pain to make a diagnosis of atypical Scheuermann disease which should be treated conservatively initially.

Predictors of mortality in periprosthetic fractures of the hip: Results from the national PPF study.

INTRODUCTION: Periprosthetic fractures (PPFs) around the hip joint are increasing in prevalence. In this collaborative study, we aimed to investigate the impact of patient demographics, fracture characteristics, and modes of management on in-hospital mortality of PPFs involving the hip. METHODS: Using a multi-centre cohort study design, we retrospectively identified adults presenting with a PPF around the hip over a 10-year period. Univariate and multivariable logistic regression analyses were performed to study the independent correlation between patient, fracture, and treatment factors on mortality. RESULTS: A total of 1,109 patients were included. The in-hospital mortality rate was 5.3%. Multivariable analyses suggested that age, male sex, abbreviated mental test score (AMTS), pneumonia, renal failure, history of peripheral vascular disease (PVD) and deep surgical site infection were each independently associated with mortality. Each yearly increase in age independently correlates with a 7% increase in mortality (OR 1.07, p=0.019). The odds of mortality was 2.99 times higher for patients diagnosed with pneumonia during their hospital stay [OR 2.99 (95% CI 1.07-8.37) p=0.037], and 7.25 times higher for patients that developed renal failure during their stay [OR 7.25 (95% CI 1.85-28.47) p=0.005]. Patients with history of PVD have a six-fold greater mortality risk (OR 6.06, p=0.003). Mode of treatment was not a significant predictor of mortality. CONCLUSION: The in-hospital mortality rate of PPFs around the hip exceeds 5%. The fracture subtype and mode of management are not independent predictors of mortality, while patient factors such as age, AMTS, history of PVD, pneumonia, and renal failure can independently predict mortality. Peri-operative optimisation of modifiable risk factors such as lung and kidney function in patients with PPFs around the hip during their hospital stay is of utmost importance.

Osteotomies for lateral compartment knee osteoarthritis.

Lateral compartment osteoarthritis (LCOA) is often associated with valgus deformity of the knee. The concept of correcting the alignment by performing distal femoral varus osteotomy (DFVO) to unload the lateral compartment is well accepted and it is viewed as the preferred option for young active patients due to dissatisfaction from arthroplasty under 55 years of age or if they wish to remain active. Beyond this there is no consensus on patient selection, preoperative assessment, techniques to achieve correction, end point of correction, return to work or sports post-surgery, and survivorship of osteotomy with conversion to a total knee replacement as the end point due to heterogenous, retrospective studies. Here, we review relevant literature to help patient selection, preoperative work up, techniques, and outcomes.

MYCN and Metabolic Reprogramming in Neuroblastoma.

Neuroblastoma is a pediatric cancer responsible for approximately 15% of all childhood cancer deaths. Aberrant MYCN activation, as a result of genomic MYCN amplification, is a major driver of high-risk neuroblastoma, which has an overall survival rate of less than 50%, despite the best treatments currently available. Metabolic reprogramming is an integral part of the growth-promoting program driven by MYCN, which fuels cell growth and proliferation by increasing the uptake and catabolism of nutrients, biosynthesis of macromolecules, and production of energy. This reprogramming process also generates metabolic vulnerabilities that can be exploited for therapy. In this review, we present our current understanding of metabolic reprogramming in neuroblastoma, focusing on transcriptional regulation as a key mechanism in driving the reprogramming process. We also highlight some important areas that need to be explored for the successful development of metabolism-based therapy against high-risk neuroblastoma.

Vaccines Using Clostridium perfringens Sporulation Proteins Reduce Necrotic Enteritis in Chickens.

Clostridium perfringens is the prevalent enteric pathogen in humans and animals including chickens, and it remains largely elusive on the mechanism of C. perfringens-induced enteritis because of limited animal models available. In this study, we investigated the role of C. perfringens sporulation proteins as vaccine candidates in chickens to reduce necrotic enteritis (NE). C. perfringens soluble proteins of vegetative cells (CP-super1 and CP-super2) and spores (CP-spor-super1 and CP-spor-super2) were prepared, and cell and chicken experiments were conducted. We found that deoxycholic acid reduced C. perfringens invasion and sporulation using the Eimeria maxima and C. perfringens co-infection necrotic enteritis (NE) model. C. perfringens enterotoxin (CPE) was detected in the CP-spor-super1&2. CP-spor-super1 or 2 induced cell death in mouse epithelial CMT-93 and macrophage Raw 264.7 cells. CP-spor-super1 or 2 also induced inflammatory gene expression and necrosis in the Raw cells. Birds immunized with CP-spor-super1 or 2 were resistant to C. perfringens-induced severe clinical NE on histopathology and body weight gain loss. CP-spor-super1 vaccine reduced NE-induced proinflammatory Ifnγ gene expression as well as C. perfringens luminal colonization and tissue invasion in the small intestine. Together, this study showed that CP-spor-super vaccines reduced NE histopathology and productivity loss.

Prevalence of traumatic dental injuries and role of incisal overjet and inadequate lip coverage as risk factors among 4-15 years old government school children in Baddi-Barotiwala Area, Himachal Pradesh, India.

OBJECTIVE: To assess the prevalence of traumatic dental injuries (TDI) in school children in Baddi- Barotiwala, Himachal Pradesh, India. METHODS: A cross-sectional survey was carried out in Government schools among 1059 government school children aged 4- 15 years. The study was conducted from October 2009 to March 2010 during the school hours. The demographic detail was carried on a structured questionnaire. The data regarding the traumatic injuries was recorded using modified Ellis' classification. RESULTS: Prevalence of TDI was found to be 4.15 %. 95.45% of the injuries were to the maxillary anterior teeth. Maxillary central incisor was the most common tooth to be affected due to trauma (54.5 %). Enamel with dentin fracture with pulp exposure was the main type of TDI (43.1%). The majority of TDIs were untreated (97.7 %). Falls (54.5%) were found to be the main cause. Over jet over 3 mm and inadequate lip coverage were found to be important contributing factors for TDIs. CONCLUSION: The present study revealed a relatively low prevalence of dental trauma, but still this figure represents a large number of children. Therefore, educational programs are to be initiated for the community regarding causes, prevention and treatment of traumatic dental injuries. It is crucial to generate considerable efforts to implement health promotion strategies to reverse the observed trends and to provide treatment to TDIs to prevent their biologic and psychological consequences.

Bilateral Posterior Four-Part Fracture-Dislocation of the Proximal Humerus After First-Time Seizure.

This report presents a previously undescribed case and treatment of bilateral four-part proximal humerus (PH) fracture-dislocations presented in a 61-year-old Caucasian male patient following a first-time seizure episode. The patient was treated with bilateral reverse total shoulder arthroplasty due to pre-existing glenohumeral arthritis and rotator cuff atrophy. The surgery was successful, and the patient's postoperative recovery was uneventful. Fractures of the proximal humerus are a relatively common adult osteoporotic fracture; however, posterior fracture-dislocations of the PH, frequently related to motor vehicle accidents, seizures, or electrical shock, are remarkably scarce. A treatment algorithm for these injuries is lacking.