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1.
Acta Neurochir (Wien) ; 165(12): 3993-4002, 2023 Dec.
Article in English | MEDLINE | ID: mdl-37907766

ABSTRACT

PURPOSE: Polyethylene glycol is known to improve recovery following its use in repair of acute peripheral nerve injury. The duration till which PEG works remains a subject of intense research. We studied the effect of PEG with augmentation of 20Htz of electrical stimulation (ES) following neurorrhaphy at 48 h in a rodent sciatic nerve neurotmesis model. METHOD: Twenty-four Sprague Dawley rats were divided into 4 groups. In group I, the sciatic nerve was transected and repaired immediately. In group II, PEG fusion was done additionally after acute repair. In group III, repair and PEG fusion were done at 48 h. In group IV, ES of 20Htz at 2 mA for 1 h was added to the steps followed for group III. Weekly assessment of sciatic functional index (SFI), pinprick, and cold allodynia tests were done at 3 weeks and euthanized. Sciatic nerve axonal count and muscle weight were done. RESULTS: Groups II, III, and IV showed significantly better recovery of SFI (II: 70.10 ± 1.24/III: 84.00 ± 2.59/IV: 74.40 ± 1.71 vs I: 90.00 ± 1.38) (p < 0.001) and axonal counts (II: 4040 ± 270/III: 2121 ± 450/IV:2380 ± 158 vs I: 1024 ± 094) (p < 0.001) at 3 weeks. The experimental groups showed earlier recovery of sensation in comparison to the controls as demonstrated by pinprick and cold allodynia tests and improved muscle weights. Addition of electrical stimulation helped in better score with SFI (III: 84.00 ± 2.59 vs IV: 74.40 ± 1.71) (p < 0.001) and muscle weight (plantar flexors) (III: 0.49 ± 0.02 vs IV: 0.55 ± 0.01) (p < 0.001) in delayed repair and PEG fusions. CONCLUSION: This study shows that PEG fusion of peripheral nerve repair in augmentation with ES results in better outcomes, and this benefit can be demonstrated up to a window period of 48 h after injury.


Subject(s)
Peripheral Nerve Injuries , Trauma, Nervous System , Rats , Animals , Rats, Sprague-Dawley , Polyethylene Glycols/therapeutic use , Hyperalgesia , Disease Models, Animal , Sciatic Nerve/surgery , Electric Stimulation , Nerve Regeneration/physiology , Recovery of Function
2.
Public Health Action ; 13(3): 104-106, 2023 Sep 21.
Article in English | MEDLINE | ID: mdl-37736577

ABSTRACT

Most ongoing and planned TB therapeutic trials are focused on shortening the duration of treatment while giving less consideration to other aspects of TB care that are important to people with TB. Here we argue that other variables besides duration of TB treatment should also be considered when developing new TB treatment regimens, including drug toxicity, time spent in monitoring and overall quality of life while on therapy. We examine the specific use of linezolid in treatment-shortening trials for drug-susceptible TB and propose additional endpoints that should be prioritised in TB treatment studies.


La majorité des essais thérapeutiques en cours et prévus sur la TB se concentrent sur la réduction de la durée du traitement tout en accordant moins d'attention à d'autres aspects des soins de la TB qui sont importants pour les personnes atteintes de la TB. Nous soutenons ici que d'autres variables que la durée du traitement de la TB devrait également être prises en compte lors de l'élaboration de nouveaux schémas thérapeutiques, notamment la toxicité des médicaments, le temps passé à la surveillance et la qualité de vie globale pendant le traitement. Nous examinons l'utilisation spécifique du linézolide dans les essais de raccourcissement du traitement de la TB sensible aux médicaments et proposons des critères d'évaluation supplémentaires qui devraient être prioritaires dans les études sur le traitement de la TB.

3.
Musculoskelet Surg ; 107(2): 179-186, 2023 Jun.
Article in English | MEDLINE | ID: mdl-35288845

ABSTRACT

PURPOSE: Increasing demands on skills with mounting pressures from expectations from arthroscopic anterior cruciate ligament (ACL) reconstructions requires precise knowledge of technical details by surgeons. One such element is the minimum length of graft in femoral tunnel to allow for adequate tendon-to-bone healing and early return to activities and sports. This has, however, remained an unanswered question. PURPOSE: To study and compare clinico-radiological outcomes of ACL reconstructions in patients with < 20 mm of intra-femoral tunnel graft length with those measuring ≥ 20 mm. METHODS: All eligible patients undergoing arthroscopic ACL reconstruction were sequentially divided into two groups based on the intra-femoral tunnel graft lengths (A: < 20 mm, n = 27; and B: ≥ 20 mm, n = 25). Exclusions were made for those > 45 years of age, with chondral and/or multi-ligamentous injuries and with systemic pathologies. All patients were postoperatively evaluated in clinics by physical examination and functional scoring (Lysholm and modified Cincinnati scores) at 3, 6 and 12-month intervals. Graft vascularity was assessed by signal-to-noise quotient ratio (SNQR) using magnetic resonance imaging (MRI) at 3 and 12 months. RESULTS: No significant differences were noted in mean Lysholm and modified Cincinnati scores between the two groups at the end of 1 year. There were also no significant differences in graft maturation over time and SNQR at 3 and 12 months in the region of interest (ROI). CONCLUSIONS: Intra-femoral tunnel graft length of less than 20 mm does not compromise early clinical and functional outcomes of ACL reconstructions.


Subject(s)
Anterior Cruciate Ligament Injuries , Anterior Cruciate Ligament Reconstruction , Humans , Anterior Cruciate Ligament Injuries/diagnostic imaging , Anterior Cruciate Ligament Injuries/surgery , Prospective Studies , Femur/diagnostic imaging , Femur/surgery , Anterior Cruciate Ligament Reconstruction/methods , Radiography , Magnetic Resonance Imaging
4.
Int J Environ Sci Technol (Tehran) ; 20(4): 4673-4694, 2023.
Article in English | MEDLINE | ID: mdl-35638092

ABSTRACT

Plastic pollution in various forms has emerged as the most severe environmental threat. Small plastic chunks, such as microplastics and nanoplastics derived from primary and secondary sources, are a major concern worldwide due to their adverse effects on the environment and public health. Several years have been spent developing robust spectroscopic techniques that should be considered top-notch; however, researchers are still trying to find efficient and straightforward methods for the analysis of microplastics but have yet to develop a viable solution. Because of the small size of these degraded plastics, they have been found in various species, from human brains to blood and digestive systems. Several pollution-controlling methods have been tested in recent years, and these methods are prominent and need to be developed. Bacterial degradation, sunlight-driven photocatalyst, fuels, and biodegradable plastics could be game-changers in future research on plastic pollution control. However, recent fledgling steps in controlling methods appear insufficient due to widespread contamination. As a result, proper regulation of environmental microplastics is a significant challenge, and the most equitable way to manage plastic pollution. Therefore, this paper discusses the current state of microplastics, some novel and well-known identification techniques, strategies for overcoming microplastic effects, and needed solutions to mitigate this planetary pollution. This review article, we believe, will fill a void in the field of plastic identification and pollution mitigation research.

5.
Musculoskelet Surg ; 107(1): 105-114, 2023 Mar.
Article in English | MEDLINE | ID: mdl-35195844

ABSTRACT

PURPOSE: Ultrasonography is currently used for both diagnostic and therapeutic purposes in de Quervain's tenosynovitis. There is a dearth of information on how effective an ultrasound-guided (USG) steroid injection is when compared to surgical release of the first extensor compartment. Hence, we performed a non-randomized two-armed comparison study to test our hypothesis that USG guided steroid injection is equally effective as surgery. METHOD: 62 consecutive patients participated in the study with 32 of them selecting the option of USG guided injection (Set A), and the rest undergoing surgical release (Set B). We reviewed them after 3 and 6 weeks and 6 months for functional outcome using DASH, PRWE and VAS scores, recurrence, or any complications. They were further followed if they were symptomatic. RESULTS: The DASH/PRWE/VAS scores improved at the end of 6 months from 81.7/79.3/6.8 to 1.0/1.7/1.0, respectively for patients undergoing USG guided steroid injection. Similarly, for the patient undergoing surgery, the scores improved from 82.2/81.5/6.7 to 1.7/3.4/1.0, respectively. This was statistically significant in both the groups (p < 0.05) and was comparable to each other. Two patients in Set A came back with recurrence at eight and 10 months and two reported occasional pain on heavy work. Three patients had tenderness and two had numbness in Set B at the scar site. CONCLUSION: We observed that USG guided steroid injections are comparable to surgical release in terms of pain relief, functional outcome, complications.


Subject(s)
De Quervain Disease , Tenosynovitis , Humans , Tenosynovitis/diagnostic imaging , Tenosynovitis/drug therapy , Tenosynovitis/surgery , De Quervain Disease/diagnostic imaging , De Quervain Disease/drug therapy , De Quervain Disease/surgery , Pain/etiology , Ultrasonography , Steroids/therapeutic use , Ultrasonography, Interventional/adverse effects
6.
Community Dent Health ; 40(1): 23-29, 2023 Feb 28.
Article in English | MEDLINE | ID: mdl-36269067

ABSTRACT

OBJECTIVE: The frequency of Preventable Infectious Dental Disease (PIDD) visits in medical centers was examined pre and post establishment of expanded dental access and adoption of an integrated medical-dental care delivery model. METHODS: A retrospective observational study of patient attributes and frequency of unscheduled PIDD visits between January 1, 1990 and February 29, 2020. Chi-squared tests compared (a) the number of PIDD visits (pre/post dental center establishment), (b) age at first diagnosis, (c) gender, (d) race, (e) primary insurance at the time of PIDD visits and (f) healthcare setting where visit occurred. RESULTS: System-wide, 21,957 unique patients were documented with a total of 34,892 PIDD visits as the primary diagnosis. Patients between 18-30 years and patients with Medicaid had the highest frequency of PIDD visits in medical settings. Following the establishment of dental centers, reduced relative risk of PIDD visits was observed for patients with no health insurance or self-pay/other coverage. PIDD visits in primary care settings was 0.87 times as likely as PIDD visits at ED/UCs after dental centers opened. CONCLUSIONS: The number of PIDD visits to medical centers increased before the dental infrastructure was established, followed by a decline afterwards, inclusive of disparity populations. Some residual persistence of PIDD visits to primary care settings was identified. This study reinforced importance of dental healthcare access for achieving appropriate PIDD management while reducing PIDD visits to medical settings.


Subject(s)
Emergency Service, Hospital , Stomatognathic Diseases , United States , Humans , Wisconsin , Medicaid , Health Services Accessibility , Stomatognathic Diseases/epidemiology , Stomatognathic Diseases/prevention & control
7.
iScience ; 25(5): 104207, 2022 May 20.
Article in English | MEDLINE | ID: mdl-35494221

ABSTRACT

In the era of antiretroviral therapy, inflammation is a central factor in numerous HIV-associated comorbidities, such as cardiovascular disease, cognitive impairment, and neuropsychiatric disorders. This highlights the value of developing therapeutics that both reduce HIV-associated inflammation and treat associated comorbidities. Previous research on monoamine oxidase inhibitors (MAOIs) suggests this class of drugs has anti-inflammatory properties in addition to neuropsychiatric effects. Therefore, we examined the impact of deprenyl, an MAOI, on SIV-associated inflammation during acute SIV infection using the rhesus macaque model of HIV infection. Our results show deprenyl decreased both peripheral and CNS inflammation but had no effect on viral load in either the periphery or CNS. These data show that the MAOI deprenyl may have broad anti-inflammatory effects when given during the acute stage of SIV infection, suggesting more research into the anti-inflammatory effects of this drug could result in a beneficial adjuvant for antiretroviral therapy.

8.
J Forensic Odontostomatol ; 39(1): 24-34, 2021 04 30.
Article in English | MEDLINE | ID: mdl-34057155

ABSTRACT

OBJECTIVES: The metric and non-metric features of the fragmented, badly damaged and commingled human remains play a significant role in their identity establishment in forensic anthropology. The main objective of the present study was to assess the population specific attributes of the unknown human dental remains excavated from an abandoned well, found underneath a religious structure at Ajnala (Punjab, India). Written accounts mentioned that Ajnala skeletal remains belonged to 282 Indian origin soldiers of the British army who had revolted against the colonial rulers in 1857, who were killed after capture, and their bodies dumped in an abandoned well. MATERIALS AND METHODS: Eleven non-metric dental traits were investigated in a sample of 1527 teeth (1200 dislodged teeth comprising of 300 canines, 300 premolars and 600 molars along with 93 jaw fragments having 327 teeth of different types) collected from this non-scientifically exhumed skeletal assemblage. These selected traits were examined with adequate magnification and lighting, using a flexible arm illuminated magnifier (Lensel Optics Pvt. Ltd., Pune, India), identified and scored in accordance with the descriptions provided in the Arizona State University Dental Anthropology System (ASUDAS). RESULTS: Eight of the eleven features examined (Carabelli trait, Hypocone absence, Cusp 5, Cusp 6, Tomes root, mesial canine ridge, Y-groove pattern, and four-cusp mandibular second molar) exhibited frequencies that were distinctly higher or lower than the three major continental ancestries. DISCUSSION: Some amateur historians doubted the authenticity of the written versions and argued that these remains might belong to the non-Indians. Present study results revealed that the studied dental trait frequencies were not similar to any major continental ancestry and were relatively unique in Ajnala teeth like previous Indian studies. While this in itself does not guarantee that these teeth belong to individuals of the Indian subcontinent, it endorses previous scientific analyses and supports the written accounts that the majority of Ajnala teeth were probably Indian in origin. However, the determination of ethnicity from dental morphological features remains debatable and can be used only as suggestive than diagnostic tool owing to possible bias in recording morphological features of teeth. Although determining the racial affinity from teeth is very difficult, caution must be exercised in concluding the racial identity of an individual from the teeth.


Subject(s)
Body Remains , Molar , Arizona , Bicuspid , Humans , India
10.
Protoplasma ; 258(4): 863-878, 2021 Jul.
Article in English | MEDLINE | ID: mdl-33582844

ABSTRACT

K, P, Cl, and Ca are distributed in tissue-specific patterns in Zea mays seedlings. These elements were mapped and analyzed using a relatively simple semi-quantitative technique, i.e., fast freezing, followed by freeze fracturing, then freeze drying, and finally scanning electron microscopy/energy-dispersive spectroscopy (SEM/EDS). In the radicle, endogenously derived (i.e., from seed) K and P transition from being homogenous in the apical meristem to tissue-specific in older regions. At 3 mm from the radicle apex, K concentration is approximately 40 mM in mid-cortex and decreases by approximately 50% at 15 mm. From 3 to 55 mm, P concentration in pericycle is approximately twice that found in adjacent regions. Ca is not detectable in younger portions of the radicle by SEM/EDS, but in older regions, it is present at 13 mM in mid-cortex. K concentration values of entire radicles analyzed with inductively coupled plasma optical emission spectrometry (ICP-OES) exceeded the SEM/EDS values. For Ca, the reverse was true. But, SEM/EDS analysis did not include several vascular tissues that contained high concentrations of K and low concentrations of Ca. The inception of lateral root primordia was accompanied by a localized decrease in Ca in cortical regions that were centrifugal to the primordium tip. A region of O-rich cells in endosperm was identified centripetal to the aleurone. These results indicate that (1) outer, mid-, and inner cortical regions, as well as the adjacent tissues, have distinct ion accumulation properties, and (2) ions are concentrated in some radicle tissues prior to development of Casparian strips.


Subject(s)
Seedlings , Zea mays , Ions , Nutrients , Plant Roots , Seeds
11.
J Chem Inf Model ; 60(12): 5832-5852, 2020 12 28.
Article in English | MEDLINE | ID: mdl-33326239

ABSTRACT

We present a supercomputer-driven pipeline for in silico drug discovery using enhanced sampling molecular dynamics (MD) and ensemble docking. Ensemble docking makes use of MD results by docking compound databases into representative protein binding-site conformations, thus taking into account the dynamic properties of the binding sites. We also describe preliminary results obtained for 24 systems involving eight proteins of the proteome of SARS-CoV-2. The MD involves temperature replica exchange enhanced sampling, making use of massively parallel supercomputing to quickly sample the configurational space of protein drug targets. Using the Summit supercomputer at the Oak Ridge National Laboratory, more than 1 ms of enhanced sampling MD can be generated per day. We have ensemble docked repurposing databases to 10 configurations of each of the 24 SARS-CoV-2 systems using AutoDock Vina. Comparison to experiment demonstrates remarkably high hit rates for the top scoring tranches of compounds identified by our ensemble approach. We also demonstrate that, using Autodock-GPU on Summit, it is possible to perform exhaustive docking of one billion compounds in under 24 h. Finally, we discuss preliminary results and planned improvements to the pipeline, including the use of quantum mechanical (QM), machine learning, and artificial intelligence (AI) methods to cluster MD trajectories and rescore docking poses.


Subject(s)
Antiviral Agents/chemistry , COVID-19 Drug Treatment , SARS-CoV-2/drug effects , Viral Nonstructural Proteins/chemistry , Artificial Intelligence , Binding Sites , Computer Simulation , Databases, Chemical , Drug Design , Drug Evaluation, Preclinical , Humans , Molecular Docking Simulation , Protein Conformation , Spike Glycoprotein, Coronavirus/chemistry , Structure-Activity Relationship
12.
ChemRxiv ; 2020 Jul 29.
Article in English | MEDLINE | ID: mdl-33200117

ABSTRACT

We present a supercomputer-driven pipeline for in-silico drug discovery using enhanced sampling molecular dynamics (MD) and ensemble docking. We also describe preliminary results obtained for 23 systems involving eight protein targets of the proteome of SARS CoV-2. THe MD performed is temperature replica-exchange enhanced sampling, making use of the massively parallel supercomputing on the SUMMIT supercomputer at Oak Ridge National Laboratory, with which more than 1ms of enhanced sampling MD can be generated per day. We have ensemble docked repurposing databases to ten configurations of each of the 23 SARS CoV-2 systems using AutoDock Vina. We also demonstrate that using Autodock-GPU on SUMMIT, it is possible to perform exhaustive docking of one billion compounds in under 24 hours. Finally, we discuss preliminary results and planned improvements to the pipeline, including the use of quantum mechanical (QM), machine learning, and AI methods to cluster MD trajectories and rescore docking poses.

13.
J Clin Orthop Trauma ; 11(4): 597-605, 2020.
Article in English | MEDLINE | ID: mdl-32684696

ABSTRACT

Radial longitudinal deficiency represents a spectrum of musculoskeletal hypoplasia and dysplasia affecting the upper limb involving mainly the radial aspect of the forearm, wrist, and hand and not infrequently the proximal arm. 2/3rd of the patients with this condition suffer from an associated medical or musculoskeletal disorder and 1/3rd of them show features of a well-known syndrome with systemic manifestations. Hence it is mandatory to do a detailed clinical, radiological and laboratory evaluation which should also include genetic counselling and assessment. Its management has evolved greatly since the beginning of last century. The vast variations developed for the treatment only reflects on the persisting controversy on the ideal treatment which still eludes the medical fraternity. Current treatment options for wrist deformities include radialization or centralization with or without distraction which unfortunately has often shown poor outcomes with high rates of recurrence and poor growth of ulna leading some workers to suggest alternative techniques, which include microsurgical reconstruction using the proximal fibula and the second toe. The management of the associated hypoplastic thumb has been encouraging with recent improvements in classifications and increased options for milder deformities. The article reviews the management options available for this common condition with respect to the recent developments in literature.

14.
J Clin Orthop Trauma ; 11(4): 620-625, 2020.
Article in English | MEDLINE | ID: mdl-32684699

ABSTRACT

BACKGROUND: The widely used Hand Injury Severity Score (HISS) has intrinsic drawbacks like inability to score vascular status and questionable correlation with Disability of Arm, shoulder and Hand. We compared it with the Strickland score which is easier to calculate and has provision for evaluation of vascular status. We assessed correlation of both the scores with the Michigan Hand Outcome Questionnaire (MHQ). METHODS: In a prospective study of 1574 patients admitted with hand injuries, we recorded their HISS and Strickland scores and followed them up for a year and later interviewed for MHQ score. Statistical correlation was done comparing the HISS and Strickland score with the MHQ using the SPSS package. RESULTS: Majority of these injuries were in manual labourers (47.5%) with agricultural or industrial background with a mean age of 25 years (18-26 years). Using the One-way ANOVA test we found a significant correlation between the HISS and MHQ (P Value < 0.001). Using the Unpaired T-test, statistically significant association (P < 0.001) was seen between the Strickland score and MHQ. The correlation between HISS and Strickland Score done by One-way ANOVA Test was also found to be significant (P Value < 0.001). On evaluating the group of patients with a Strickland score >10, we observed that the MHQ was almost similar between those who underwent amputation with those who underwent a successful salvage, though not statistically significant. CONCLUSION: HISS and Strickland score correlated significantly with each other and with the MHQ. Strickland score was easy and quicker to determine the salvagability of hand injury. However, small group of patients who may benefit from salvage in spite of a high Strickland score where factors like patient's age, occupation, comorbid health condition, motivation, expenses, and social environment needs to be taken into account in decision making.

15.
Kathmandu Univ Med J (KUMJ) ; 18(70): 15-20, 2020.
Article in English | MEDLINE | ID: mdl-33605233

ABSTRACT

Background The COVID-19 pandemic has caused lockdown situation impeding all educational institutions including dental colleges. The circumstance demanded online classes as the alternative strategy for continuation of education. Objective To assess current practice and perception about online education among faculties of dental colleges in Nepal. Method A cross-sectional study was conducted among 208 faculties of all dental colleges in Nepal. Data collection was done through structured online questionnaire comprising demographic information, practice and perception of the respondents towards online education. Descriptive statistics surveyed the frequency distribution and Chisquare test assessed the difference in perception among the faculties of different universities. Result The response rate was 74.3%. Faculties commonly used PowerPoint presentation (96.6%) on Zoom platform (83.3%) using laptop (94.7%) with Wi-Fi connection (91.8%). Majority of faculties had good or satisfactory access to internet (94.8%). The faculties believed that the online class environment was interactive (95.2%); but it was not effective (86.5%) as live classroom. Majority of the faculties (79.4%) felt tracking of students' presence was difficult. There was no significant difference on perception towards online class among the faculties of Kathmandu University, Tribhuvan University and BP Koirala Institute Health Sciences at p < 0.05. Conclusion The COVID-19 pandemic has paved the way for e-learning in dental education in Nepal. Faculties agree to complete the theory syllabus and conduct sessional exams as an alternative during the lockdown period. However, they show strong reservations in carrying out practical/clinical simulations and university exams online. Training on e-learning and institutional strategy for online education is recommended.


Subject(s)
COVID-19 , Education, Distance , Communicable Disease Control , Cross-Sectional Studies , Humans , Nepal/epidemiology , Pandemics , SARS-CoV-2 , Universities
16.
Musculoskelet Surg ; 104(3): 285-294, 2020 Dec.
Article in English | MEDLINE | ID: mdl-31448392

ABSTRACT

PURPOSE: A popular choice for lateral epicondylitis (LE), corticosteroid injections have been associated with prominent side effects, which has led to the conception of modalities like platelet-rich plasma (PRP). This randomised trial aimed to evaluate and compare the 6-week, 3-month and 1-year outcomes with PRP and corticosteroid injections in LE. We hypothesised that PRP would prove more effective in relieving pain and improving function. METHODS: At the sports medicine unit of our tertiary care teaching centre, 80 patients with LE were randomised into either receiving PRP (group A) or corticosteroids (group B) injections. Pre-injection visual analogue scale (VAS), disabilities of the arm, shoulder and hand (DASH) score, Mayo elbow performance score (MEPS) and grip strength score (GSS) were recorded. Common extensor origins were identified and infiltrated with 3 ml of either PRP or corticosteroid (triamcinolone in 2% xylocaine) using a peppering technique. Follow-up scores and extent of pain relief were recorded and compared. RESULTS: At 6 weeks, there were greater improvements in group B versus A in mean VAS (13.8 vs. 44.5; p < 0.001), DASH (64.2 vs. 53.3; p < 0.001), MEPS (88.0 vs. 74.5; p = 0.004) and GSS (89.3 vs. 73.4; p = 0.039). These scores showed a reversed pattern at 3 months when group A outcomes superseded group B (VAS p = 0.002; DASH p < 0.001; MEPS p = 0.002; GSS p = 0.045). At 1-year follow-up, group A continued to enjoy better pain relief and function (VAS p = 0.024; DASH p < 0.001; MEPS p = 0.009; GSS p = 0.028). CONCLUSIONS: Albeit corticosteroid injections show good short-term results at 6 weeks, patients receiving PRP injections fare better at 3 and 12 months.


Subject(s)
Adrenal Cortex Hormones/therapeutic use , Anti-Inflammatory Agents/therapeutic use , Platelet-Rich Plasma , Tennis Elbow/therapy , Triamcinolone/therapeutic use , Adult , Anti-Inflammatory Agents/administration & dosage , Female , Hand Strength , Humans , Injections, Intra-Articular , Lidocaine/administration & dosage , Male , Middle Aged , Pain Management , Pain Measurement/methods , Prospective Studies , Tennis Elbow/drug therapy , Tennis Elbow/physiopathology , Tennis Elbow/rehabilitation , Tertiary Care Centers , Time Factors , Treatment Outcome , Triamcinolone/administration & dosage , Young Adult
17.
J Orthop ; 17: 53-58, 2020.
Article in English | MEDLINE | ID: mdl-31879474

ABSTRACT

We studied the diagnostic accuracy of MRI in 35 adult patients with traumatic brachial plexus injury in comparison with intra operative findings. The overall sensitivity to detect root avulsions was 39% and specificity was 75%. MRI was more useful in the diagnosis of lower root avulsions. At trunk and division level injuries, the sensitivity was 87% but specificity was only 26%. It was not able to differentiate the type and extent of post-ganglionic injuries. The accuracy of pseudomeningocele as avulsion on surgical finding was 96% (27/28). Pseudomeningocele correlates well with root avulsions. Its presence warrants early referral and surgical exploration.

18.
J Forensic Odontostomatol ; 37(2): 45-50, 2019 Sep 30.
Article in English | MEDLINE | ID: mdl-31589595

ABSTRACT

OBJECTIVE: Sex estimation of skeletons is important in forensic reconstructive identification. The mandible is a durable component that is suitable to discriminate the sexes while lateral cephalometry is a standardised radiographic technique accepted as a tool in personal identification. Limited data is available for the mandibular/gonial angle as a parameter for sex assessment using lateral cephalometric radiographs. The aim of this study is to determine the gonial angle's accuracy in sexing Indians using a new digital method and statistical approach. METHOD: The sample comprised of 304 digital lateral cephalometric radiographs (155 females and 149 males, age between 18-30 years) of Indian subjects. The mandibular/gonial angle was measured on these radiographs using Adobe Photoshop software using tools available therein. The obtained angles for the sexes were subjected to logistic regression analysis (LRA), which forms a composite of weighted independent variables using a multivariate strategy. RESULTS: The average angle was 122.7° for females and 121.1°for males. LRA produced an accuracy rate of 56.3% in sex assessment, with females being more accurately identified (61.9%) than males (50.3%). CONCLUSION: The study demonstrated significant univariate sexual dimorphism among males and females in this population. However, the sex prediction value of this approach was low and thus may not be useful in sex estimation involved in human identification of Indians.


Subject(s)
Mandible , Sex Characteristics , Adolescent , Adult , Cephalometry , Female , Forensic Anthropology , Humans , Male , Young Adult
19.
J Orthop ; 16(4): 369-376, 2019.
Article in English | MEDLINE | ID: mdl-31193279

ABSTRACT

We evaluated the outcome of new technical refinements in abdominal flap coverage of major defects in upper limb for its reliability and safety. 68 patients were assessed for indications, additional procedures, complications and DASH questionnaire evaluation at the end of a year. The mean size of flap was 56 cm2 (range 6-250 cm2). Median DASH score was 11.5 (range: 0-63). Hand stiffness was observed in 39% of patients. However, this was absent in whom prophylactic pinning of metacarpophalangeal joints were done in James position. Abdominal flaps give satisfactory results in hand injuries. Competent hand therapy program is essential to get best results.

20.
Clin Transl Oncol ; 21(3): 259-267, 2019 Mar.
Article in English | MEDLINE | ID: mdl-30062522

ABSTRACT

Classical protein kinase C (cPKC) enzymes are ser/thr protein kinases that have been an important factor in regulating a variety of cellular functions required for both in terms of health and disease. Therefore, precise control of cPKC-mediated signal is necessary for cellular homeostasis; however, their dysregulation leads to the development of several pathophysiological conditions including cancer. In cellular microenvironment, cPKC-mediated signaling is accompanied by multiple molecular mechanisms including phosphorylation, second messenger binding, and scaffold proteins. Functional cPKC interacts with a number of cellular proteins involved in the regulation of multiple biological functions such as cell growth, survival, migration, and adhesion. Further, the role of cPKC varies from cell to cell, substrate to substrate and, therefore, it is plausible to assume that the dysregulation of cPKC activity causes cellular transformation. Currently, there is no sufficient literature available to provide better understating to develop an effective therapeutic regimen to reverse pathophysiological condition caused by functionally dysregulated cPKC. Therefore, in the present review, we have focused on to provide a better and detail information on the various aspects of cPKC such as structure, mode of activation, regulation, and distinct cellular functions useful for the development of an effective therapeutic regimen against the breast cancer.


Subject(s)
Breast Neoplasms/enzymology , Protein Kinase C/metabolism , Female , Humans
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