Chemical Characterisation, Antidiabetic, Antibacterial, and In Silico Studies for Different Extracts of Haloxylon stocksii (Boiss.) Benth: A Promising Halophyte.

The objective of the study is to evaluate the chemical characterisation, and biological and in silico potential of Haloxylon stocksii (Boiss.) Benth, an important halophyte commonly used in traditional medicine. The research focuses on the roots and aerial parts of the plant and extracts them using two solvents: methanol and dichloromethane. Chemical characterisation of the extracts was carried out using total phenolic contents quantification, GC-MS analysis, and LC-MS screening. The results exhibited that the aerial parts of the plant have significantly higher total phenolic content than the roots. The GC-MS and LC-MS analysis of the plant extracts revealed the identification of 18 bioactive compounds in each. The biological evaluation was performed using antioxidant, antibacterial, and in vitro antidiabetic assays. The results exhibited that the aerial parts of the plant have higher antioxidant and in vitro antidiabetic activity than the roots. Additionally, the aerial parts of the plant were most effective against Gram-positive bacteria. Molecular docking was done to evaluate the binding affinity (BA) of the bioactive compounds characterised by GC-MS with diabetic enzymes used in the in vitro assay. The results showed that the BA of γ-sitosterol was better than that of acarbose, which is used as a standard in the in vitro assay. Overall, this study suggests that the extract from aerial parts of H. stocksii using methanol as a solvent have better potential as a new medicinal plant and can provide a new aspect to develop more potent medications. The research findings contribute to the scientific data of the medicinal properties of Haloxylon stocksii and provide a basis for further evaluation of its potential as a natural remedy.

Pattern of Oral and Maxillofacial New Referrals During COVID-19 Lockdown

ABSTRACT@#The study aimed to quantify the impact of lockdown during the COVID-19 pandemic on new case referrals to the Oral and Maxillofacial Surgery (OMS) service. The researchers retrospectively reviewed all new referrals received during a government-imposed 47-day lockdown period and a similar period pre-lockdown as a control group. The main outcome was the differences in the number of new case referrals between the two periods. The contributing clinical and demographic factors were also explored. Appropriate bivariate statistics were computed and the level of significance was set at 0.05 for all tests. A total of 309 referrals were received during the study period. There was a reduction of new referrals due to the lockdown from five to two cases per day. There was a statistically significant reduction of cases referred from outpatient and emergency departments. There was also a statistically significant difference with regard to home address distance to the centre. Medically compromised and orofacial infection referrals were not affected by lockdown. The lockdown imposed due to the pandemic has significantly impacted the pattern of new OMS referrals. Referrals for orofacial infections, the medically compromised and inpatients were minimally affected by lockdown.

Intraoperative Computed Tomography Image Fusion for Orbital Blowout Fracture Reconstruction

ABSTRACT@#Intraoperative computed tomography (CT) has been previously described and acknowledged for its use in orbital blowout fracture reconstructions. We described a clinical case series managed by this technique combined with intraoperative image fusion for accuracy in orbital implant position. In total, eight patients who sustained a total number of 19 orbital wall fractures were described. From the total number of 19 blowout orbital fracture reconstructions comprised of medial and inferior (floor) orbital fractures, malposition was identified in a total of four orbital implants by using image fusion. All cases of implant malposition were immediately revised intraoperatively. Subsequent fusion was carried out to confirm whether the revision was satisfactorily achieved. We found that the intraoperative image fusion technique utilised to determine orbital implant position, especially at the posterior ledge, further augmented the role of intraoperative CT scanning. Image fusion conceptually provides an immediate, real-time, and objective solution for intraoperative image analysis and potentially eliminates problems with misaligned CT images. It also reduces the need for the surgeon to ‘eye-ball’ the CT images acquired or the need for additional intraoperative time, since the patient’s head orientation is always axially at random during the acquisition of the CT. Conventional methods for CT image assessment are subjected to one’s own interpretation and may introduce inconsistent or longer intraoperative decision-making. The technique facilitates intraoperative decision-making and reduces the risk of orbital implant malposition in orbital blowout fracture reconstructions. Hence, surgical complication in relation to orbital implant malposition in orbital blowout fracture management could be minimised. In addition, no further postoperative imaging is required.

Enteral glutamine supplementation in surgical patients with head and neck malignancy: A randomized controlled trial.

BACKGROUND: Glutamine supplementation is a novel approach to perioperative nutritional management. METHODS: This study was a prospective randomized clinical trial of effects of enteral glutamine supplementation in surgical patients with head and neck malignancy in a tertiary center. This study measured the effects of supplementation within 4 weeks of the postoncologic surgical period in relation to fat-free mass, serum albumin, and quality of life scores. RESULTS: The study population consisted of 44 patients. There was significant difference in serum albumin (p < .001), fat-free mass (p < .001), and quality of life scores (p < .05) between control and interventional groups. Significant correlation exists between fat-free mass and quality of life score difference in our study population (p < .05). CONCLUSION: Enteral glutamine supplementation significantly improves fat-free mass, serum albumin, and quality of life scores postoperatively and maintenance of lean body mass correlated with improved postoperative outcomes in terms of the patient's quality of life.

Maxillofacial injuries and traumatic brain injury--a pilot study.

BACKGROUND: Maxillofacial injuries comprising hard tissue as well as soft tissue injuries can be associated with traumatic brain injuries due to the impact of forces transmitted through the head and neck. To date, the role of maxillofacial injury on brain injury has not been properly documented with some saying it has a protective function on the brain while others opposing this idea. AIM: This cross-sectional retrospective study evaluated all patients with maxillofacial injuries. The aim of the study was to analyze the occurrence and relationship of maxillofacial injuries with traumatic brain injuries. MATERIAL AND METHODS: We retrospectively studied the hospital charts of all trauma patients seen at the accident and emergency department of UKM Medical Centre from November 2010 until November 2011. A detail analysis was then carried out on all patients who satisfied the inclusion and exclusion criteria. RESULTS: A total of 11294 patients were classified as trauma patients in which 176 patients had facial fractures and 292 did not have facial fractures. Middle face fractures was the most common pattern of facial fracture seen. Traumatic brain injury was present in 36.7% of maxillofacial cases. A significant association was found between facial fractures and traumatic brain injury (P < 0.05). Patient with facial fractures had a 1.5 increased risk of having a traumatic brain injury (95% CI 1.197-1.909). CONCLUSION: Patients with maxillofacial injuries with or without facial fractures are at risk of acute or delayed traumatic brain injury. All patients should always have proper radiological investigations together with a proper observation and follow-up schedule.