Comparison of the Glenoid Index by Computed Tomography With Magnetic Resonance Imaging.

Introduction Anterior shoulder instability results in labral and osseous glenoid injuries. With a large osseous defect, there is a risk of recurrent dislocation of the joint, and therefore the patient has to undergo surgical correction. An MRI evaluation of the patient helps to assess the soft tissue injury. Currently, the volumetric three-dimensional (3D) reconstructed CT image is the standard for measuring glenoid bone loss and the glenoid index. However, it has the disadvantage of exposing the patient to radiation and additional expenses. This study aims to compare the values of the glenoid index using MRI and CT. Methodology The present study was a two-year cross-sectional study of patients with shoulder pain, trauma, and dislocation in a tertiary hospital in Karnataka. The sagittal proton density (PD) section of the glenoid and enface 3D reconstructed images of the scapula were used to calculate glenoid bone loss and the glenoid index. The baseline data were analyzed using descriptive statistics, and the Chi-square test was used to test the association of various complications with selected variables of interest. Results The glenoid index calculated in the current study using 3D volumetric CT images and MR sagittal PD images was 0.95±0.01 and 0.95±0.01, respectively. The CT and MRI glenoid bone loss was 5.41±0.65% and 5.38±0.65%, respectively. When compared, the glenoid index and bone loss calculated by MRI and CT revealed a high correlation and significance with a p-value of <0.001. Conclusions The study concluded that MRI is a reliable method for glenoid measurement. The sagittal PD sequence combined with an enface glenoid makes it possible to identify osseous defects linked to glenohumeral joint damage and dislocation. The values derived from 3D CT are identical to the glenoid index and bone loss determined using the sagittal PD sequence in MRI.

A Case Series of Dengue Myocarditis: A Complication Observed in Dengue Patients.

Dengue is a prevalent arthropod-born viral disease with a wide spectrum of clinical presentations ranging from undifferentiated fever to a more severe form of the disease, dengue hemorrhagic fever, and dengue shock syndrome. However, atypical manifestations such as hepatic, neurological, cardiac, and kidney involvement are increasingly being reported, thus the term "expanded dengue syndrome". We report a series of cases with an atypical presentation of dengue fever marked by various cardiac manifestations, including cardiogenic shock secondary to myocardial involvement.

The effect of a Mn(III)tetrakis(4-benzoic acid)porphyrin (MnTBAP) coating on the chronic recording performance of planar silicon intracortical microelectrode arrays.

Intracortical microelectrode arrays (MEAs) are used to record neural activity. However, their implantation initiates a neuroinflammatory cascade, involving the accumulation of reactive oxygen species, leading to interface failure. Here, we coated commercially-available MEAs with Mn(III)tetrakis(4-benzoic acid)porphyrin (MnTBAP), to mitigate oxidative stress. First, we assessed the in vitro cytotoxicity of modified sample substrates. Then, we implanted 36 rats with uncoated, MnTBAP-coated ("Coated"), or (3-Aminopropyl)triethoxysilane (APTES)-coated devices - an intermediate step in the coating process. We assessed electrode performance during the acute (1-5 weeks), sub-chronic (6-11 weeks), and chronic (12-16 weeks) phases after implantation. Three subsets of animals were euthanized at different time points to assess the acute, sub-chronic and chronic immunohistological responses. Results showed that MnTBAP coatings were not cytotoxic in vitro, and their implantation in vivo improved the proportion of electrodes during the sub-chronic and chronic phases; APTES coatings resulted in failure of the neural interface during the chronic phase. In addition, MnTBAP coatings improved the quality of the signal throughout the study and reduced the neuroinflammatory response around the implant as early as two weeks, an effect that remained consistent for months post-implantation. Together, these results suggest that MnTBAP coatings are a potentially useful modification to improve MEA reliability.

Comparing the Efficacy of Paracetamol, Ibuprofen, and a Combination of the Two Drugs in Relieving Pain and Fever in the Pediatric Age Group: A Prospective Observational Study.

Introduction Fever and pain are common afflictions in the pediatric population, prompting the use of paracetamol and ibuprofen as primary treatment options. However, a comprehensive understanding of their comparative efficacy, safety profiles, and potential combined use remains crucial for informed clinical decision-making. In this prospective observational study, we aimed to delve into these aspects, shedding light on the optimal management strategies for fever and pain in pediatric patients. Methodology A total of 108 children were enrolled and categorized into three groups, namely, paracetamol monotherapy, ibuprofen monotherapy, and a combination of both drugs. Axillary temperature monitoring and assessment of pain on the Face, Legs, Activity, Cry, and Controllability (FLACC) scale/Visual Analog Scale (VAS) were employed as critical indicators. Concurrently, associated symptoms encompassing discomfort, activity levels, and appetite were meticulously recorded. To ensure safety, laboratory parameters including serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), serum creatinine, platelet count, and stool for occult blood were closely monitored before and after drug administration. The study duration spanned 48 hours post-initiation of the initial drug dose. Results A total of 108 pediatric cases were included in the study, spanning ages from six months to 18 years. Among them, the majority fell within the age group of six months to five years (n = 77). Participants were categorized based on the duration of fever, with 81 cases having a fever lasting more than 24 hours and 27 cases having a fever lasting less than 24 hours. The majority of cases presented with temperatures ranging from 38°C to 39°C. Comparison of drug efficacy in defervescence within the first four hours revealed that paracetamol alone took significantly longer than ibuprofen monotherapy or the paracetamol and ibuprofen combination (p = 0.026). In terms of the onset of effect, the paracetamol and ibuprofen combination showed comparable efficacy to ibuprofen alone. Regarding the total time without fever in 48 hours, significant differences were observed among the three drug regimens (p = 0.001 by the one-way analysis of variance (ANOVA) test). Paracetamol and ibuprofen were superior to paracetamol alone (p < 0.001) and ibuprofen alone (p = 0.014), while paracetamol alone and ibuprofen alone exhibited similar efficacy (p = 0.197). Based on the laboratory results as well as the clinical profile observed over 48 hours, we confirm safety based on this study. The combination of paracetamol and ibuprofen showed enhanced effectiveness in fever and pain relief. Conclusion This study demonstrates the favourable efficacy of paracetamol, ibuprofen, and their combination in the pediatric population. The combination of paracetamol and ibuprofen showed enhanced effectiveness in fever and pain relief, with minimal adverse effects and no significant derangements in biochemical parameters. This study thus contributes valuable insights to optimize the therapeutic approach to fever and pain in pediatric patients.

Sympathovagal Balance and Body Shape Index in Elite and Amateur Athletes: The Relationship Unraveled.

Background Heart rate variability (HRV) is one piece among a complex network of adaptations existent in athletes that help them gain a better understanding of their own physiology. Sympathovagal balance is one of the spectral components of HRV analysis and is used to assess the frequently changing oscillations of a healthy heart, which can help in gauging the response of cardiac function towards physiological stress during exercise. This index is extensively used in appraising cardiac autonomic modulation. An evaluation of body composition in athletes has become a critical consideration when tracking HRV, as it helps practitioners understand the role of the autonomic nervous system (ANS) in obesity. The body shape index (BSI), which is based on waist circumference (WC), is an anthropometric parameter with decent predictive ability when measuring centripetal obesity. In this regard, the current study is an attempt to unravel the relationship between BSI and sympathovagal balance during exercise performed on two different instruments (treadmill and ergometer) by elite and amateur athletes. Methods It was an observational case-control study that included 30 elite and 120 amateur athletes. Symptom-limited exercise testing was performed by athletes on a motorized treadmill and ergometer in the sports physiology laboratory of a rural medical college in central India. Different anthropometric parameters like BSI and body surface area (BSA) were also recorded. Short-term HRV extracted from electrocardiogram (ECG) recordings was obtained using the Power Lab system and HRV analysis by LabChart software. Results The sympathovagal ratio, i.e., ratio of low frequency (LF) to high frequency (HF) in elite and amateur male populations showed a higher value than that in females, indicating a dominant sympathetic response in the males. There was a significant (p=0.042) positive correlation (r=0.24) between BSI and LF/HF Ratio in amateur females during treadmill exercise, whereas a significant (p=0.049) negative correlation (r=-0.27) was obtained in amateur males during ergometer exercise. Hence, increased weight and BSI were found to be associated with high sympathetic dominance, indicating a sympathovagal imbalance. Conclusion We attempted to explore the interaction between BSI and LF/HF during exercise performed on two different instruments (treadmill and ergometer) by elite and amateur athletes, which can help in testing the response of cardiac function to stress experienced during exercise. The study's uniqueness stems from discovering the relationship between BSI and HRV and how this relationship impacts sports performance. BSI measurement in athletes, both elite and amateur, allows for the assessment and forecasting of potential autonomic activity under exercise-induced stress by linking HRV with BSI.

Obstructive Sleep Apnea and Venous Thromboembolism: Unraveling the Emerging Association.

Oxidative stress has emerged as a significant contributor to skeletal muscle atrophy, influencing cellular processes that underlie muscle wasting. This review article delves into the intricate interplay between oxidative stress and muscle atrophy, shedding light on its mechanisms and implications. We begin by outlining the fundamental concepts of oxidative stress, delineating reactive oxygen species (ROS) and reactive nitrogen species (RNS), their sources, and the ensuing oxidative damage to cellular components. Subsequently, we delve into skeletal muscle atrophy, elucidating its diverse forms, molecular pathways, key signaling cascades, and the role of inflammation in exacerbating muscle wasting. Bridging these concepts, we explore the connections between oxidative stress and muscle atrophy, unveiling how oxidative stress impacts muscle protein synthesis and breakdown, perturbs cellular signaling pathways, and contributes to mitochondrial dysfunction. The review underscores the complexity of quantifying and interpreting oxidative stress markers, highlighting the challenges posed by the dynamic nature of oxidative stress and the presence of basal ROS levels. Addressing the specificity of oxidative stress markers, we emphasize the importance of selecting markers pertinent to muscle tissue and considering systemic influences. Standardization of experimental protocols emerges as a critical need to ensure consistency and reproducibility across studies. Looking ahead, we discuss the implications of oxidative stress in diverse scenarios, encompassing age-related muscle loss (sarcopenia), muscle wasting in chronic diseases like cancer cachexia, and disuse-induced muscle atrophy. Additionally, we delve into potential therapeutic strategies, including antioxidant supplementation, exercise, pharmacological interventions, nutritional approaches, and lifestyle modifications, as avenues to mitigate oxidative stress-driven muscle atrophy. The review concludes by outlining promising future directions in this field, calling for deeper exploration of specific oxidative stress markers, understanding the temporal dynamics of oxidative stress, validation through translational studies in humans, and the development of targeted therapeutic interventions. By advancing our understanding of the intricate relationship between oxidative stress and skeletal muscle atrophy, this review contributes to paving the way for innovative strategies to address muscle wasting and improve muscle health.

Examining Body Fat Percentage, Galvanic Skin Response, and Muscle Grip Strength in Female Hypothyroid Patients.

Background The thyroid gland is an indispensable organ exerting control over the activity of multiple organ systems including the autonomic nervous system. This study attempted to monitor the variations in autonomic function parameters such as galvanic skin response (GSR) and muscle grip strength (HGS) in conjunction with changes in body fat percentage (BFP). Methodology This case-control study was conducted among 40 female hypothyroid patients as cases and 40 age-matched female healthy volunteers as controls. Anthropometric data were collected using standard techniques. GSR and HGS were measured using Equivital Sensory Electronic Module and Grip Force Transducer, respectively. Data extraction and analysis were done using the LabChart software. Results The mean age of the 40 female hypothyroid patients was 30.14 ± 5.91 years, whereas the mean age of the female controls was 29.37 ± 6.59 years. The waist circumference of cases was 85.81 ± 10.39 cm while that of controls was 80.90 ± 11.18 cm. The BFP of cases was 35.38% ± 6.74% while that of controls was 31.72% ± 5.63%. The GSR amplitude showed a significant difference between hypothyroid and healthy volunteers with values of 1.34 ± 1.14 µS and 2.40 ± 1.86 µS, respectively. The HGS indices showed no significant difference between the two groups. A statistically negative correlation was noted between BFP and GSR amplitude (-0.32), whereas a positive correlation was noted between BFP and mean handgrip strength (0.31) in hypothyroid patients. Conclusions The changes in BFP and autonomic function through GSR and HGS were evaluated in female hypothyroid patients with respect to healthy females. The interrelationship between anthropometry and autonomic function was also explored in this study. The findings of this study can augment prognosis in patients and ensure timely corrective treatment for improving quality of life.

Exploring the Relationship Between the Indices of Body Composition With Grip Strength Performance and Peak VO2.

Background The importance of measurements of body composition in terms of various indices including Body Mass Index (BMI), Body Surface Area (BSA), Body Size Index (BSI), and Waist to Height ratio (WtHR) in the diagnosis of health risks and mortality outcome analysis has largely been limited to their use relating to determining abdominal obesity. The understanding of the extent of implications of the newer, underutilized indices of body composition is deficient. Peak VO2 (maximal oxygen uptake) majorly serves for the evaluation of the measure of aerobic capacity. Grip strength performance is a simple, primary, objective predictor of overall physical status and muscular and cardiovascular fitness. This study aimed to derive the relationship between a gamut of parameters such as BMI, BSA, WtHR, BSI, grip strength performance and peak VO2 investigated using the latest scientific methodology in a cross-section of the population in a rural tertiary care center. Methodology This study was a descriptive, cross-sectional study carried out in a rural medical college in central India. Sixty participants from the healthcare setting were considered eligible for the study within the age group of 18 to 45 years. Anthropometric assessments like height (in cm), weight (in kg), waist circumference (in cm), and BMI were carried out. BSA, WtHR, and BSI were calculated using the respective formulae. VO2 max (maximal oxygen uptake) recordings were done using the treadmill/ergometer and metabolic module of LabChart software (Bella Vista, New South Wales, Australia). Grip Strength Performance was quantified by measuring the amount of static force with which the hand is able to squeeze a transducer. It was measured using Grip Force Transducer (MLT004 / ST) from AD Instruments (Bella Vista, New South Wales, Australia). Results Upon analysis, a significant negative correlation was obtained between BSI and BMI (r= -0.51, p<0.0001) whereas a significant positive correlation was found between BSA and BMI (r= 0.71, p< 0.0001). A significant correlation was also seen between WtHR and BMI (r= 0.71, p< 0.0001) while a negative significant correlation between peak VO2 and BMI (r= -024,p=0.0425) was deduced. Similarly, a negative correlation was evident between BSA and BMI (r= -0.46, p=0.0002) with a positive correlation between WtHR and BSA (r= 0.30,p=0.0188). Grip strength performance positively correlated with BSA (r= 0.58, p< 0.0001) whereas peak VO2 showed a significant negative correlation with WtHR (r= -026,p=0.043). There was also a positive significant correlation between grip strength performance and peak VO2 (r= 0.37, p=0.0033) Conclusion The study determined the relationships of grip strength performance and peak VO2, with the body composition indices in order to provide an overview of the mortal risks of an individual which might mediate the prognosis. Based on the relative independence of BSI with peak VO2 and grip strength performance, the unification of these parameters can help assess the overall health of an individual.

Evaluation of three different 99mTc-based mock-venom agents for lymphoscintigraphy studies in preclinical models of peripheral snakebite envenomation.

Snakebite envenomation is one of the major public health concerns across many countries; with the WHO designating it as a 'priority neglected tropical disease' and stressing for a need to develop novel therapeutic strategies to reduce death and disability rate by end of 2030. Since a major component of venom; the high molecular weight (HMw) toxins enter the bloodstream through lymphatic system, research is focusing on modulating the lymphatic flow rate after topical application of suitable drug candidates. Present study compared the suitability of three radiopharmaceutical agents, namely 99mTc-Sulfur colloid (SC), 99mTc-Phytate (Phy) and 99mTc-Human serum albumin (HSA), to be used as mock-venom agent in studying modulation in lymphatic flow rate in preclinical models of peripheral snakebite envenomation using lymphoscintigraphy studies. The study was performed in 72 Sprague Dawley rats; divided into six groups of 12 rats each. Control groups were given intradermal injection (1.29-1.48 MBq in 100 µl normal saline) of either 99mTc-Phy/ 99mTc-SC/ 99mTc-HSA into the tail as 'mock-venom'. In respective test groups, commercially available topical formulation (Anobliss® Cream) containing Nifedipine (Nif; 0.3% w/w) and Lidocaine (Lid; 1.5% w/w) was applied topically over the animals' lower body (tail and hind limbs) immediately within 20s of administering intradermal injection of the radiopharmaceutical. Any modulation in lymph transit time from periphery to systemic circulation was assessed using lymphoscintigraphy by taking dynamic gamma-scintigraphy images of 60s each till 1 h post-injection of the test radiopharmaceuticals. Significant difference in movement of the three radiopharmaceuticals was noted in terms of their lymphatic movement. 99mTc-Phy did not show significant travel through the lymphatics and the liver was faintly visualized in control as well as test intervention groups. In case of 99mTc-SC, significant changes in movement of the radiotracer after topical application of Nif/Lid in the test intervention groups were clearly noted in comparison to control (P < 0.05). Multiple numbers of lymph nodes (LNs) could be clearly visualized in control (5 ± 1 LNs) and test intervention groups (3 ± 1 LNs). Liver uptake was more prominent in control animals and it reduced significantly in test intervention groups. On the other hand, 99mTc-HSA showed lesser number of lymph nodes and higher accumulation in liver as compared to 99mTc-SC, suggesting very fast movement of this radiopharmaceutical. Results indicates that 99mTc-SC could be used as a suitable agent to mimic lymphatic transit behavior of HMw toxin components of snake venom and could therefore be used as a model in studying the effect of any test pharmacological intervention in modulating lymphatic transit rate. Additional advantage could be a significant reduction in the need for sacrificing large number of animals, particularly during initial screening phase of drug development cycle.

Divulging the Impetus of Yoga on Cardiorespiratory Fitness and Its Persona in Alleviating Anxiety Experienced by Youth: A Cohort Interventional Study.

BACKGROUND:  Globalization endangers youngsters worldwide with new standards and possibilities. Hereat of being exposed to greater demands and expectations, when it comes to performance review, their life may become more distressed. Yoga with revolutionary methods may assist youngsters in bettering their physical health regarding their maximal oxygen uptake, and also help manage their anxiety. This study ascertains the effect of yoga on youth's anxiety levels and cardio-respiratory fitness. METHODS:  It was a longitudinal interventional study recruiting 99 medical students wherein VO2 max (maximal oxygen uptake) on the treadmill/ergometer exercise and anxiety scores through Spielberger's anxiety scale was assessed at baseline and evaluated after 6 months of a regular yogic regime. The VO2 max was recorded by the metabolic module of Labchart software (Bella Vista, New South Wales, Australia). FINDINGS:  The VO2 max evaluated by incremental exercise to volitional fatigue was found to be 2.64 ± 0.49 L/min in males and 1.51 ± 0.44 L/min in females pre-yoga and 2.81 ± 0.52 L/min in males and 1.69 ± 0.47 L/min in females post yoga. The difference in the endline and baseline VO2 max values of yoga-performing males (t=6.595, p<0.001) and females (t = 2.478, p = 0.017) was found to be significantly higher than non-yoga performers. The METS value obtained in males was 11.96 and in females was 7.68 before yoga. Post-yoga values were 13.44 and 8.37, respectively. The difference in total anxiety scores post-intervention was 34.6 which was statistically significant (t= 4.959, p <0.001). CONCLUSION:  From the viewpoint of a physiologist, higher VO2 max in young adults links to better physical fitness which is the potential outcome of regular yogic practice. As a result of regular yogic practice, initial soaring anxiety levels of subjects culminated in a drastic observable reduction in anxiety, which helped inculcate a judicious acumen in youngsters.

Exploring the Effect of Yoga on Exercise Endurance As Assessed by Cardiorespiratory Efficiency Tests in Exercise Physiology Laboratory: A Pilot Study.

Background Today's world of cut-throat competition is boggling with stress as the most common problem among the modern generation, and reduction in stress demands a radical solution. Yoga comes as a rescuer that focuses on improving one's physical and spiritual well-being. It can increase one's strength and flexibility. Yoga practitioners have asserted the effect of physical exercise involved in it on balancing physical and spiritual health for decades, but only recently has there been a move to substantiate these claims through research. This study aimed at assessing the effect of yogic practice on exercise endurance and physical fitness as assessed by important physical fitness parameters through cardiorespiratory efficiency tests in an Exercise Physiology Laboratory. Methodology A total of 60 Bachelor of Medicine, Bachelor of Surgery (MBBS) students from a rural medical college in central India were recruited for the study. Thirty MBBS students who had undergone yogic training for six months comprised the trained or the case group, and another group of 30 students comprising the untrained group were recruited for the study from different levels of the course within the age group of 17-25 years. Body mass index (BMI) and body surface area (BSA) were calculated. Resting pulse rate and blood pressure, resting respiratory rate, maximal oxygen consumption (VO2 max), physical fitness index (PFI), breath holding time (BHT), and 40 mm Hg endurance test time was measured.  Results The mean PFI (%) in males was 88.82±5.56 and 96.05±7.44, and that in females was 82.06±8.95 and 96.55±6.47 in the control and case groups, respectively. The mean 40 mm Hg endurance test (in seconds) in males was 36.47±8.45 and 48.88±8.64 and in females was 29.79±10.30 and 38.4±10.69 in the control and test groups, respectively. The mean BHT (in seconds) in males was 44.80±14.18 and 58.91±12.35, and that in females was 42.29±15.37 and 54.60±13.36 as in control and case groups, respectively. The VO2 max evaluated by the modified Harvard step test was 2.41±0.58 L/min in control males and 3.6±0.90 L/min in the case group of males, and it was 2.14±0.49 L/min in the control group of females, and 3.76±0.69 L/min in case group of females. Conclusion By studying the dynamics of the various cardiorespiratory responses, we have determined the values of fitness parameters in the case group. It was found that the yoga group had statistically significantly higher VO2 max per minute and better PFI, BHT, and 40 mm Hg endurance values (p<0.05).

Fabrication, characterization and efficacy evaluation of natural gum-based bioactive haemostatic gauzes with antibacterial properties.

Management of uncontrolled bleeding due to traumatic injuries occurring in battlefields and road traffic accidents is a major healthcare concern, especially in developing countries like India. Since natural coagulation mechanism alone is insufficient to achieve haemostasis quickly in such cases, application of an external haemostatic product is generally required to accelerate the coagulation process. We had recently reported preliminary comparison of four natural absorbent gums, which indicated towards haemostatic potential of gum tragacanth (GT) and xanthan gum (XG). Present study involves fabrication of haemostatic dressings incorporated with different concentrations of GT or XG, along with ciprofloxacin (a broad-spectrum antibiotic) and other excipients over woven cotton gauze. Prepared gauzes were investigated for physico-chemical characteristics, in-vitro blood interaction studies, antibacterial effect and in-vivo haemostatic efficacy in Sprague Dawley rats using two bleeding models. Acute dermal toxicity studies were also carried out as per OECD guidelines. SEM studies showed that gauzes coated with XG had thin, uniform layer of coating, while in case of GT; coating was comparatively rough with insoluble particles of GT adhering over gauze surface, forming voids on the fibers. Coated gauzes exhibited optimum mechanical properties in terms of tensile strength and percent extension at break. GT coated dressings showed good fluid uptake and retention ability in-vitro. Test gauzes were non-hemolytic in nature, did not elicit any dermal toxicity on animals' skin and had the ability to protect against E. coli infection. In-vivo efficacy studies in rat femoral artery and liver laceration bleeding models indicated that gauzes coated with 4% GT were able to clot blood in least time (36.67 ± 3.33s and 40 ± 2.58s respectively) as compared to other gum combinations and commercially available dressing 'Surgispon® (103.3 ± 4.22s and 85 ± 5.62s respectively). Results of this study validate our initial findings of the potential of gum tragacanth to be developed into a suitable haemostatic product.

A Case Report of Fahr's Disease and Its Clinical Heterogeneity.

Fahr's disease is an exceptionally rare and complex neurological disorder characterized by abnormal calcium deposition in the basal ganglia and cerebral cortex. This case report presents a 27-year-old female with Fahr's disease, showcasing the striking clinical diversity and challenging diagnostic landscape associated with this condition. Despite its rarity, Fahr's disease can have a profound impact on patients, manifesting as a spectrum of neurological symptoms, cognitive deficits, and motor impairment. Recent advancements in research have illuminated genetic aspects, offering potential avenues for enhanced diagnostic accuracy and therapeutic interventions. Treatment for Fahr's disease remains primarily supportive, targeting neuropsychiatric symptoms and seizure prophylaxis. Our case highlights the unique presentation of a young female patient with Fahr's disease, challenging conventional demographic profiles and emphasizing the need for individualized patient assessments. The utilization of non-contrast CT scans in diagnosis underscores the importance of appropriate imaging techniques, given the diverse clinical manifestations of this condition. This case adds to the growing understanding of Fahr's disease, emphasizing its clinical heterogeneity and advancing the quest for tailored approaches to diagnosis and intervention.

A comparative study on efficacy of immediate and delayed placement of cylindrical and tapered dental implants: A clinical prospective study.

Introduction: The study deals with improving the understanding of implant design in various situations. Materials and Method: 40 implants were placed out of which 20 were tapered and rest were cylindrical. These were further divided into immediate and delayed settings. The patients were followed upto 6 months and the results were compiled. Result: Statistically significant difference were found between tapered and cylindrical implants in terms of quality of osseointegration and maintenance of crestal bone height. Conclusion: It has been gathered from the study that while delayed placement suggests waiting time period varying between 3 and 6 months, it offers a predictable procedure in terms of visibility, good implant-bone contact, and closure all of which, promote a better outcome for dental implant therapy. Immediate implant placement solution is very viable in reducing the time period involved in dental implant therapy. Apart from few to minimum contraindications, it can be predictably performed.

Trigeminocardiac reflex during maxillary third molar extraction: Our experience.

Trigeminocardiac reflex (TCR) is a cascade of physiological response secondary to the stimulation of any of the sensory divisions of the trigeminal nerve, which is the largest cranial nerve and provides sensory supply to the face, scalp, mucosa of the nose, and mouth. This response usually presents as a triad including bradycardia, apnea, and gastric motility changes. On the another side, transient loss of consciousness or vasovagal syncope, a well-known phenomenon in dentomaxillofacial surgery with its pathophysiology fully elucidated, is thought to be mediated by TCR and sometimes termed as dentocardiac reflex. Thus, it is imperative to know about TCR and its association with routine dental and maxillofacial surgery procedures. It can potentially happen during any minor or major oral surgical procedures ranging from simple third molar extractions, soft tissue surgeries, root canal treatments, or management of maxillofacial fractures. This paper presents two case reports demonstrating TCR which presented during maxillary third molar extraction and author(s) own experience in managing the same.