Antitumor activity of genetically engineered NK-cells in non-hematological solid tumor: a comprehensive review.

Recent advancements in genetic engineering have made it possible to modify Natural Killer (NK) cells to enhance their ability to fight against various cancers, including solid tumors. This comprehensive overview discusses the current status of genetically engineered chimeric antigen receptor NK-cell therapies and their potential for treating solid tumors. We explore the inherent characteristics of NK cells and their role in immune regulation and tumor surveillance. Moreover, we examine the strategies used to genetically engineer NK cells in terms of efficacy, safety profile, and potential clinical applications. Our investigation suggests CAR-NK cells can effectively target and regress non-hematological malignancies, demonstrating enhanced antitumor efficacy. This implies excellent promise for treating tumors using genetically modified NK cells. Notably, NK cells exhibit low graft versus host disease (GvHD) potential and rarely induce significant toxicities, making them an ideal platform for CAR engineering. The adoptive transfer of allogeneic NK cells into patients further emphasizes the versatility of NK cells for various applications. We also address challenges and limitations associated with the clinical translation of genetically engineered NK-cell therapies, such as off-target effects, immune escape mechanisms, and manufacturing scalability. We provide strategies to overcome these obstacles through combination therapies and delivery optimization. Overall, we believe this review contributes to advancing NK-cell-based immunotherapy as a promising approach for cancer treatment by elucidating the underlying mechanisms, evaluating preclinical and clinical evidence, and addressing remaining challenges.

The synergistic immunotherapeutic impact of engineered CAR-T cells with PD-1 blockade in lymphomas and solid tumors: a systematic review.

Currently, therapies such as chimeric antigen receptor-T Cell (CAR-T) and immune checkpoint inhibitors like programmed cell death protein-1 (PD-1) blockers are showing promising results for numerous cancer patients. However, significant advancements are required before CAR-T therapies become readily available as off-the-shelf treatments, particularly for solid tumors and lymphomas. In this review, we have systematically analyzed the combination therapy involving engineered CAR-T cells and anti PD-1 agents. This approach aims at overcoming the limitations of current treatments and offers potential advantages such as enhanced tumor inhibition, alleviated T-cell exhaustion, heightened T-cell activation, and minimized toxicity. The integration of CAR-T therapy, which targets tumor-associated antigens, with PD-1 blockade augments T-cell function and mitigates immune suppression within the tumor microenvironment. To assess the impact of combination therapy on various tumors and lymphomas, we categorized them based on six major tumor-associated antigens: mesothelin, disialoganglioside GD-2, CD-19, CD-22, CD-133, and CD-30, which are present in different tumor types. We evaluated the efficacy, complete and partial responses, and progression-free survival in both pre-clinical and clinical models. Additionally, we discussed potential implications, including the feasibility of combination immunotherapies, emphasizing the importance of ongoing research to optimize treatment strategies and improve outcomes for cancer patients. Overall, we believe combining CAR-T therapy with PD-1 blockade holds promise for the next generation of cancer immunotherapy.

Photolipid excitation triggers depolarizing optocapacitive currents and action potentials.

Optically-induced changes in membrane capacitance may regulate neuronal activity without requiring genetic modifications. Previously, they mainly relied on sudden temperature jumps due to light absorption by membrane-associated nanomaterials or water. Yet, nanomaterial targeting or the required high infrared light intensities obstruct broad applicability. Now, we propose a very versatile approach: photolipids (azobenzene-containing diacylglycerols) mediate light-triggered cellular de- or hyperpolarization. As planar bilayer experiments show, the respective currents emerge from millisecond-timescale changes in bilayer capacitance. UV light changes photolipid conformation, which awards embedding plasma membranes with increased capacitance and evokes depolarizing currents. They open voltage-gated sodium channels in cells, generating action potentials. Blue light reduces the area per photolipid, decreasing membrane capacitance and eliciting hyperpolarization. If present, mechanosensitive channels respond to the increased mechanical membrane tension, generating large depolarizing currents that elicit action potentials. Membrane self-insertion of administered photolipids and focused illumination allows cell excitation with high spatiotemporal control.

Oxaloacetate as a Holy Grail Adjunctive Treatment in Gliomas: A Revisit to Metabolic Pathway.

India experiences a significant amount of morbidity and mortality due to gliomas particularly glioblastoma multiforme (GBM), which ranks among the worst cancers. Oxaloacetate (OAA) is a human keto acid that is central to cellular metabolism; it has been recognized by the US FDA for use in GBM patients, triggering a review to revisit the cellular mechanism of its therapeutic action. Various cellular and molecular studies have proposed that instead of fueling the tricarboxylic acid (TCA) cycle and oxidative phosphorylation (OXPHOS), gliomas prefer to use glycolysis (the Warburg effect) to fuel macromolecules for the synthesis of nucleotides, fatty acids, and amino acids for the accelerated mitosis. A study found that oxaloacetate (OAA) inhibits human lactate dehydrogenase A (LDHA) in cancer cells, reversing the Warburg effect. Studies revealed that OAA supplementation reduced Warburg glycolysis, improved neuronal cell bioenergetics, and triggered brain mitochondrial biogenesis, thereby enhancing the efficacy of standard treatment. Similarly, OAA has been found in preclinical investigations to be able to decrease tumor development and survival rates by blocking the conversion of glutamine to alpha-ketoglutarate (alpha-KG) in the TCA cycle and lowering nicotinamide adenine dinucleotide phosphate (NADPH) levels. OAA is a safe adjuvant that has the potential to be an effective therapy in gliomas when combined with temozolomide (TMZ) chemotherapy and routine surgery.

Population-wise labeling of sulcal graphs using multi-graph matching.

Population-wise matching of the cortical folds is necessary to compute statistics, a required step for e.g. identifying biomarkers of neurological or psychiatric disorders. The difficulty arises from the massive inter-individual variations in the morphology and spatial organization of the folds. The task is challenging both methodologically and conceptually. In the widely used registration-based techniques, these variations are considered as noise and the matching of folds is only implicit. Alternative approaches are based on the extraction and explicit identification of the cortical folds. In particular, representing cortical folding patterns as graphs of sulcal basins-termed sulcal graphs-enables to formalize the task as a graph-matching problem. In this paper, we propose to address the problem of sulcal graph matching directly at the population level using multi-graph matching techniques. First, we motivate the relevance of the multi-graph matching framework in this context. We then present a procedure for generating populations of artificial sulcal graphs, which allows us to benchmark several state-of-the-art multi-graph matching methods. Our results on both artificial and real data demonstrate the effectiveness of multi-graph matching techniques in obtaining a population-wise consistent labeling of cortical folds at the sulcal basin level.

Photolipid excitation triggers depolarizing optocapacitive currents and action potentials.

Optically-induced changes in membrane capacitance may regulate neuronal activity without requiring genetic modifications. Previously, they mainly relied on sudden temperature jumps due to light absorption by membrane-associated nanomaterials or water. Yet, nanomaterial targeting or the required high infrared light intensities obstruct broad applicability. Now, we propose a very versatile approach: photolipids (azobenzene-containing diacylglycerols) mediate light-triggered cellular de- or hyperpolarization. As planar bilayer experiments show, the respective currents emerge from millisecond-timescale changes in bilayer capacitance. UV light changes photolipid conformation, which awards embedding plasma membranes with increased capacitance and evokes depolarizing currents. They open voltage-gated sodium channels in cells, generating action potentials. Blue light reduces the area per photolipid, decreasing membrane capacitance and eliciting hyperpolarization. If present, mechanosensitive channels respond to the increased mechanical membrane tension, generating large depolarizing currents that elicit action potentials. Membrane self-insertion of administered photolipids and focused illumination allows cell excitation with high spatiotemporal control.

Experimental IR, Raman, and UV-Vis Spectra DFT Structural and Conformational Studies: Bioactivity and Solvent Effect on Molecular Properties of Methyl-Eugenol.

Structural, conformational, and spectroscopic investigations of methyl-eugenol were made theoretically at the B3LYP-6-311++G**level. Experimental IR, Raman, and UV-vis spectra were investigated and analyzed in light of the computed quantities. Conformational analysis was carried out with the help of total energy vs. dihedral angle curves for different tops, yielding 21 stable conformers, out of which only two have energies below the room temperature relative to the lowest energy conformer. The effect of the solvent on different molecular characteristics was investigated theoretically. MEP and HOMO-LUMO analysis were carried out and barrier heights and bioactivity scores were determined. The present investigation suggests that the molecule has three active sites with moderate bioactivity. The solvent-solute interaction is found to be dominant in the vicinity of the methoxy moieties.

Exploring binding mode assessment of novel kaempferol, resveratrol, and quercetin derivatives with PPAR-α as potent drug candidates against cancer.

Peroxisome proliferator-activated receptors (PPAR)-α, a ligand-activated transcription factor stands out to be a valuable protein target against cancer. Given that ligand binding is the crucial process for the activation of PPAR-α, fibrate class of synthetic compounds serves as potent agonist for the receptor. However, their serious side effects limit the long-term application in cancer. This emphasizes the dire need to identify new candidates that would exert desired activation by abrogating the adverse effects caused by synthetic agonists. Natural dietary products serve as an important source of drug discovery. Hence, the present study encompasses the investigation of the role of natural plant phenolic compounds: kaempferol, resveratrol, and quercetin and their 8708 derivatives by the means of computational pipeline comprising molecular docking and molecular dynamic (MD) simulation techniques. Docking calculations shortlisted potential candidates, namely 6-cinnamylchrysin (6-CC), resveratrol potassium-4-sulfate (RPS) and 6-[2-(3,4-Dihydroxyphenyl)-5-hydroxy-4-oxochromen-7-yl]oxyhexyl nitrate (DHOON), and derivatives of kaempferol, resveratrol, and quercetin, respectively. 6-CC, RPS, and DHOON manifested better affinities of - 32.83 kcal/mol (Ala333, Lys358, His440), - 27.22 kcal/mol (Tyr314, Met355), and - 30.18 kcal/mol (Ser280, Tyr314, Ala333), respectively, and were found to act as good stimulants for PPAR-α. Among these three compounds, 6-CC caused relatively least deviations and fluctuations analyzed through MD simulation which judiciously held responsible to attain most favorable interaction with PPAR-α. Followed by the binding free energy (ΔG) calculations using MM-GBSA confirmed the key role of 6-CC toward PPAR-α. The compound 6-CC also achieved high drug-likeness and pharmacokinetic properties. Thus, these findings stipulate new drug leads for PPAR-α receptor which abets a way to develop new anti-cancer drugs.

A diet-independent zebrafish model for NAFLD recapitulates patient lipid profiles and offers a system for small molecule screening.

Non-alcoholic Fatty Liver Disease (NAFLD) or pathological hepatic lipid overload, is considered to affect obese individuals. However, NAFLD in lean individuals is prevalent, especially in South Asian population. The pathophysiology of lean NAFLD is not well understood and most animal models of NAFLD use the high-fat diet paradigm. To bridge this gap, we have developed a diet-independent model of NAFLD in zebrafish. We have previously shown that chronic systemic inflammation causes metabolic changes in the liver leading to hepatic fat accumulation in an IL6 overexpressing (IL6-OE) zebrafish model. In the present study, we compared the hepatic lipid composition of adult IL6-OE zebrafish to the controls and found an accumulation of saturated triacylglycerols and a reduction in the unsaturated triacylglycerol species reminiscent of NAFLD patients. Zebrafish is an ideal system for chemical genetic screens. We tested whether the hepatic lipid accumulation in the IL6-OE is responsive to chemical treatment. We found that PPAR-gamma agonist Rosiglitazone, known to reduce lipid overload in the high-fat diet models of NAFLD, could ameliorate the fatty liver phenotype of the IL6-OE fish. Rosiglitazone treatment reduced the accumulation of saturated lipids and showed a concomitant increase in unsaturated TAG species in our inflammation-induced NAFLD model. Our observations suggest that the IL6-OE model can be effective for small molecule screening to identify compounds that can reverse hepatic lipid accumulation, especially relevant to lean NAFLD.

ESTIMATION OF PERSONAL DOSE EQUIVALENT HP(0.07) USING CASO4:DY TEFLON DISC-BASED EXTREMITY DOSEMETER.

The radiation workers in India use extremity dosemeter in occupational areas where there is likelihood of receiving significant dose to extremities of the body. Algorithm used for the estimation of whole body dose and extremity dose of wrist are same and is based on slab phantom calibration. However, internationally, different phantoms are recommended for calibration of dosemeter used for extremity and whole body. The recommended quantity for estimation of dose to extremity is the personal dose equivalent Hp(0.07) at 0.07 mm depth. In light of this, an algorithm was developed for estimation of wrist dose in terms of Hp(0.07) based on calibration performed on ISO recommended pillar phantom. Performance of the dosemeter for the estimation of Hp(0.07) with new algorithm was carried out at different angular exposures of photon beams and mixed field of photon and beta. Comparison of results obtained for two types of ISO phantoms (slab and pillar) is also performed for photon beams to highlight the uncertainty caused due to the use of the slab phantom. In case of beta radiation, it was found that the size and shape of the phantom has very little influence in the response of the dosemeter. Performance of the dosemeter using ISO slab and ISO pillar phantoms for beta radiation using the prevalent algorithm was carried out and found to be within the uncertainty limits laid down by ISO except at angle 60°.

Dependence of Precursor Graphite Flake Size on Nitrogen Doping in Graphene Oxide and Its Effect on OER Catalytic Activity.

We report the synthesis of nitrogen-doped graphene oxide, with 5.7-7.0 wt % nitrogen doping, from different sizes of precursor graphite and study its effect on the oxygen evolution reaction (OER) activity of IrO2 in an acidic medium. The nitrogen-doped supports are expected to have pyridinic, pyrrolic, and graphitic functionalities at different ratios responsible for their improved performance. The N-doped supports and catalysts are synthesized via pyrolysis and the hydrothermal method using natural and synthetic graphite of three different flake sizes and evaluated for their structural and electrochemical characteristics. The average size of IrO2 nanoparticles deposited on the N-doped supports is independent of the flake size and doping amount of nitrogen. The catalysts show optimum current densities but improved stability with increasing flake sizes of 7, 20, and 125 µm. Our results demonstrate that the selection of the flake size of the doped support is necessary to achieve durable catalysts for the OER in an acidic medium.

Correction: Luminescent columnar discotics as highly efficient emitters in pure deep-blue OLEDs with an external quantum efficiency of 4.7.

Correction for 'Luminescent columnar discotics as highly efficient emitters in pure deep-blue OLEDs with an external quantum efficiency of 4.7%' by Joydip De et al., Soft Matter, 2022, DOI: 10.1039/d1sm01558c.

Probing intermolecular interactions and binding stability of kaempferol, quercetin and resveratrol derivatives with PPAR-γ: docking, molecular dynamics and MM/GBSA approach to reveal potent PPAR- γ agonist against cancer.

Peroxisome Proliferator-Activated Receptors-γ (PPAR-γ), a ligand-activated transcription factor, suggested having anti-inflammatory effects by activating the target genes when bound to the ligand. Herein, we examined a conformational analysis of 8708 derivatives of Kaempferol, Quercetin, and Resveratrol, the prime activators of PPAR-γ molecular target by employing molecular docking and dynamic simulation pipeline to screen out potential agonists. The structure-based docking procedure performed by FlexX tool shortlisted high binding affinities of these derivatives of Kaempferol, Quercetin and Resveratrol with the protein receptor with a score of -38.94 kcal/mol (4'-Carboxy-5, 7-Dihydroxyflavone-CDHF), -41.63 kcal/mol (Demethyltorosaflavone D- DMTF) and -31.52 kcal/mol (Resveratrol-O-disulphate- RD) respectively, signifying the selected derivatives forms interactions like H-bond, Aromatic H-Bond, Pi-Pi stacking and salt bridges with PPAR-γ. The PPAR-γ-derivative complex was stabilized by intermolecular hydrogen bonds and stacking interactions. A greater interaction was significantly observed between the binding affinities of derivatives compared to the standards. Based on the root mean square deviation (RMSD) and root mean square fluctuation (RMSF) carried by the means of high-speed molecular dynamics (MD) and simulation of best-docked poses, the ligand, DMTF attained the most favored interaction with PPAR-γ. Thus, it appeared to have high chemical scaffold diversity and may confer high drug-likeness. The binding free energy (ΔG) led us to manifest Quercetin derivative to have a key role for PPAR-γ receptor. The result obtained clearly indicates the exploitation of the promising new drug leads that may further influence in synthesizing and analyzing the development as anti-cancer agonists.Communicated by Ramaswamy H. Sarma.

Luminescent columnar discotics as highly efficient emitters in pure deep-blue OLEDs with an external quantum efficiency of 4.7.

Development of materials that serve as efficient blue emitters in solution-processable OLEDs is challenging. In this study, we report three derivatives of C3-symmetric 1,3,5-tris(thien-2-yl)benzene-based highly luminescent room temperature columnar discotic liquid crystals (DLCs) suitable as solid-state emitters in OLED devices. When employed in solution-processed OLEDs, one of the derivatives having the highest photoluminescence quantum yield exhibited a maximum EQE of 4.7% and CIE chromaticity of (0.16, 0.05) corresponding to the ultra deep-blue emission. The finding is sufficiently significant in the field of DLC-based deep blue emitters.

Genetic epidemiology of autoinflammatory disease variants in Indian population from 1029 whole genomes.

BACKGROUND: Autoinflammatory disorders are the group of inherited inflammatory disorders caused due to the genetic defect in the genes that regulates innate immune systems. These have been clinically characterized based on the duration and occurrence of unprovoked fever, skin rash, and patient's ancestry. There are several autoinflammatory disorders that are found to be prevalent in a specific population and whose disease genetic epidemiology within the population has been well understood. However, India has a limited number of genetic studies reported for autoinflammatory disorders till date. The whole genome sequencing and analysis of 1029 Indian individuals performed under the IndiGen project persuaded us to perform the genetic epidemiology of the autoinflammatory disorders in India. RESULTS: We have systematically annotated the genetic variants of 56 genes implicated in autoinflammatory disorder. These genetic variants were reclassified into five categories (i.e., pathogenic, likely pathogenic, benign, likely benign, and variant of uncertain significance (VUS)) according to the American College of Medical Genetics and Association of Molecular pathology (ACMG-AMP) guidelines. Our analysis revealed 20 pathogenic and likely pathogenic variants with significant differences in the allele frequency compared with the global population. We also found six causal founder variants in the IndiGen dataset belonging to different ancestry. We have performed haplotype prediction analysis for founder mutations haplotype that reveals the admixture of the South Asian population with other populations. The cumulative carrier frequency of the autoinflammatory disorder in India was found to be 3.5% which is much higher than reported. CONCLUSION: With such frequency in the Indian population, there is a great need for awareness among clinicians as well as the general public regarding the autoinflammatory disorder. To the best of our knowledge, this is the first and most comprehensive population scale genetic epidemiological study being reported from India.

Aggregation-Induced Enhanced Emission-Active Zinc(II) ß-Diketiminate Complexes Enabling High-Performance Solution-Processable OLEDs.

Earth-abundant and cheaper zinc-based organometallic molecules as luminophores are drawing significant research attention for solid-state lighting devices. In this paper, we report two air-stable zinc complexes, where the zinc is coordinated to two sterically encumbered ß-diketiminate ligands in a tetrahedral geometry. In such a geometry, eight phenyl/aryl rings from the ligand backbones are oriented in a propeller shape, augmenting the restricted rotation of the putative rings. Such an architecture harnesses aggregation-induced emission behavior with an excellent solid-state emission property. The rigidity of these molecules reduces the possibility of non-radiative transitions and makes them excellent fluorescence emitters. Both molecules exhibit electroluminescence (EL) in the yellowish-green region of the visible spectrum. We have utilized these molecules as emitters to fabricate multilayered organic light-emitting diode (OLED) devices. The emitter Zn-I in host m-MTDATA exhibits EL with a maximum external quantum efficiency of 4.4%. Among the handful of zinc-based OLEDs, the performance of this emitter is very commendable with power and current efficacies of 15.2 lm W-1 and 12.1 cd A-1, respectively, along with a brightness of 2426 cd m-2.

Expert Consensus Statements on the Use of Corticosteroids in Non-severe COVID-19.

INTRODUCTION: There is strong evidence for the use of corticosteroid in the management of severe coronavirus disease-2019 (COVID-19). However, there is still uncertainty about the timing of corticosteroids. We undertook a modified Delphi study to develop expert consensus statements on the early identification of a subset of patients from non-severe COVID-19 who may benefit from using corticosteroids. METHODS: A modified Delphi was conducted with two anonymous surveys between April 30, 2021, and May 3, 2021. An expert panel of 35 experts was selected and invited to participate through e-mail. The consensus was defined as >70% votes in multiple-choice questions (MCQ) on Likert-scale type statements, while strong consensus as >90% votes in MCQ or >50% votes for "very important" on Likert-scale questions in the final round. RESULTS: Twenty experts completed two rounds of the survey. There was strong consensus for the increased work of breathing (95%), a positive six-minute walk test (90%), thorax computed tomography severity score of >14/25 (85%), new-onset organ dysfunction (using clinical or biochemical criteria) (80%), and C-reactive protein >5 times the upper limit of normal (70%) as the criteria for patients' selection. The experts recommended using oral or intravenous (IV) low-dose corticosteroids (the equivalent of 6 mg/day dexamethasone) for 5-10 days and monitoring of oxygen saturation, body temperature, clinical scoring system, blood sugar, and inflammatory markers for any "red-flag" signs. CONCLUSION: The experts recommended against indiscriminate use of corticosteroids in mild to moderate COVID-19 without the signs of clinical worsening. Oral or IV low-dose corticosteroids (the equivalent of 6 mg/day dexamethasone) for 5-10 days are recommended for patients with features of disease progression based on clinical, biochemical, or radiological criteria after 5 days from symptom onset under close monitoring. HOW TO CITE THIS ARTICLE: How to cite this article: Nasa P, Chaudhry D, Govil D, Daga MK, Jain R, Chhallani AA, et al. Expert Consensus Statements on the Use of Corticosteroids in Non-severe COVID-19. Indian J Crit Care Med 2021;25(11):1280-1285.

Pyridinyl-Carbazole Fragments Containing Host Materials for Efficient Green and Blue Phosphorescent OLEDs.

Pyridinyl-carbazole fragments containing low molar mass compounds as host derivatives H1 and H2 were synthesized, investigated, and used for the preparation of electro-phosphorescent organic light-emitting devices (PhOLEDs). The materials demonstrated high stability against thermal decomposition with the decomposition temperatures of 361-386 °C and were suitable for the preparation of thin amorphous and homogeneous layers with very high values of glass transition temperatures of 127-139 °C. It was determined that triplet energy values of the derivatives are, correspondingly, 2.82 eV for the derivative H1 and 2.81 eV for the host H2. The new derivatives were tested as hosts of emitting layers in blue, as well as in green phosphorescent OLEDs. The blue device with 15 wt.% of the iridium(III)[bis(4,6-difluorophenyl)-pyridinato-N,C2']picolinate (FIrpic) emitter doping ratio in host material H2 exhibited the best overall characteristics with a power efficiency of 24.9 lm/W, a current efficiency of 23.9 cd/A, and high value of 10.3% of external quantum efficiency at 100 cd/m2. The most efficient green PhOLED with 10 wt% of Ir(ppy)3 {tris(2-phenylpyridine)iridium(III)} in the H2 host showed a power efficiency of 34.1 lm/W, current efficiency of 33.9 cd/A, and a high value of 9.4% for external quantum efficiency at a high brightness of 1000 cd/m2, which is required for lighting applications. These characteristics were obtained in non-optimized PhOLEDs under an ordinary laboratory atmosphere and could be improved in the optimization process. The results demonstrate that some of the new host materials are very promising components for the development of efficient phosphorescent devices.

Prospective Evaluation of Role of Limb Reconstruction System (Rail External Fixator) in Open Fractures and Infected Non-union of Femur.

INTRODUCTION: Severe open fractures continue to be a nightmare for orthopedicians even with use of more accepted line of treatment. Open fractures and infected non-union of femur bone are not infrequently seen in orthopedic wards as femur is the most common long bone injured. We present a case series of 14 such patients treated successfully with limb reconstruction system enabling recovery to pre-injury status and activities. CASE SERIES: The present study was done to access the role of limb reconstruction system in the management of open femur fractures and in infected non-union with modifications to meet the requirements of each case. We viewed the results of treatment of 14 cases of late presentation with complicated open femur fractures and infected non-unions. Average time of fixator removal was 4 months-24 months. Average follow-up duration was 18 months (range 6-36 months). Evaluation of results was based on ASAMI criteria. The excellent bone results were obtained in 85.72% of cases while 7.14% showed good and 7.14% were poor results. Excellent functional results were observed in 71.43% of cases and 28.57% of cases shows good and fair results. CONCLUSION: The use of limb reconstruction system is based on compression and distraction technique. It was found to be a simple and effective modality for open injuries in terms of enhanced union rate, rapid rehabilitation, and easy care of soft-tissue injury along with bone loss, thus avoiding multiple surgeries.