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1.
Theor Appl Genet ; 137(5): 106, 2024 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-38622441

RESUMO

KEY MESSAGE: A new resistance locus acting against the potato cyst nematode Globodera pallida was mapped to chromosome VI in the diploid wild potato species Solanum spegazzinii CPC 7195. The potato cyst nematodes (PCN) Globodera pallida and Globodera rostochiensis are economically important potato pests in almost all regions where potato is grown. One important management strategy involves deployment through introgression breeding into modern cultivars of new sources of naturally occurring resistance from wild potato species. We describe a new source of resistance to G. pallida from wild potato germplasm. The diploid species Solanum spegazzinii Bitter accession CPC 7195 shows resistance to G. pallida pathotypes Pa1 and Pa2/3. A cross and first backcross of S. spegazzinii with Solanum tuberosum Group Phureja cultivar Mayan Gold were performed, and the level of resistance to G. pallida Pa2/3 was determined in progeny clones. Bulk-segregant analysis (BSA) using generic mapping enrichment sequencing (GenSeq) and genotyping-by-sequencing were performed to identify single-nucleotide polymorphisms (SNPs) that are genetically linked to the resistance, using S. tuberosum Group Phureja clone DM1-3 516 R44 as a reference genome. These SNPs were converted into allele-specific PCR assays, and the resistance was mapped to an interval of roughly 118 kb on chromosome VI. This newly identified resistance, which we call Gpa VIlspg, can be used in future efforts to produce modern cultivars with enhanced and broad-spectrum resistances to the major pests and pathogens of potato.


Assuntos
Solanum tuberosum , Solanum , Tylenchoidea , Animais , Solanum tuberosum/genética , Solanum/genética , Doenças das Plantas/genética , Melhoramento Vegetal
2.
Protoplasma ; 2024 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-38607379

RESUMO

Globodera pallida, an obligate sedentary endoparasite, is a major economic pest that causes substantial potato yield losses. This research aimed to study the effects of gene silencing of three FMRFamide-like peptides (FLPs) genes to reduce G. pallida infestation on potato plants by using kaolinite nanoclay as a carrier to deliver dsRNAs via drenching. A dsRNA dosage of 2.0 mg/ml silenced flp-32c by 89.5%, flp-32p by 94.6%, and flp-2 by 94.3%. J2s incubated for 5 and 10 h showed no phenotypic changes. However, J2s of G. pallida efficiently uptake dsRNA of all targeted genes after 15 h of incubation. On the other hand, J2s that had been kept for 24 h had a rigid and straight appearance. Under fluorescence microscopy, all dsRNA-treated nematodes showed fluorescein isothiocyanate (FITC) signals in the mouth, nervous system, and digestive system. The untreated population of J2s did not show any FITC signals and was mobile as usual. The drenching of potato cultivar Kufri Jyoti with the dsRNA-kaolinite formulations induced deformation and premature death of J2s, compared with untreated J2s that entered J3 or J4 stages. This study validates that the nanocarrier-delivered RNAi system could be employed effectively to manage G. pallida infestations.

3.
Theor Appl Genet ; 137(3): 64, 2024 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-38430392

RESUMO

KEY MESSAGE: An improved estimator of genomic relatedness using low-depth high-throughput sequencing data for autopolyploids is developed. Its outputs strongly correlate with SNP array-based estimates and are available in the package GUSrelate. High-throughput sequencing (HTS) methods have reduced sequencing costs and resources compared to array-based tools, facilitating the investigation of many non-model polyploid species. One important quantity that can be computed from HTS data is the genetic relatedness between all individuals in a population. However, HTS data are often messy, with multiple sources of errors (i.e. sequencing errors or missing parental alleles) which, if not accounted for, can lead to bias in genomic relatedness estimates. We derive a new estimator for constructing a genomic relationship matrix (GRM) from HTS data for autopolyploid species that accounts for errors associated with low sequencing depths, implemented in the R package GUSrelate. Simulations revealed that GUSrelate performed similarly to existing GRM methods at high depth but reduced bias in self-relatedness estimates when the sequencing depth was low. Using a panel consisting of 351 tetraploid potato genotypes, we found that GUSrelate produced GRMs from genotyping-by-sequencing (GBS) data that were highly correlated with a GRM computed from SNP array data, and less biased than existing methods when benchmarking against the array-based GRM estimates. GUSrelate provides researchers with a tool to reliably construct GRMs from low-depth HTS data.


Assuntos
Técnicas de Genotipagem , Polimorfismo de Nucleotídeo Único , Humanos , Técnicas de Genotipagem/métodos , Análise de Sequência de DNA/métodos , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Alelos
4.
BMJ Open ; 14(3): e078596, 2024 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-38553070

RESUMO

OBJECTIVE: The study examined the influence of the COVID-19 pandemic in India on variation in clinical features, management and in-hospital outcomes in patients undergoing percutaneous coronary intervention (PCI). DESIGN: Prospective registry-based observational study. SETTING: A tertiary care hospital in India participant in the American College of Cardiology CathPCI Registry. PARTICIPANTS: 7089 successive patients who underwent PCI from April 2018 to March 2023 were enrolled (men 5627, women 1462). Details of risk factors, clinical presentation, coronary angiography, coronary interventions, clinical management and in-hospital outcomes were recorded. Annual data were classified into specific COVID-19 periods according to Government of India guidelines as pre-COVID-19 (April 2018 to March 2019, n=1563; April 2019 to March 2020, n=1594), COVID-19 (April 2020 to March 2020, n=1206; April 2021 to March 2022, n=1223) and post-COVID-19 (April 2022 to March 2023, n=1503). RESULTS: Compared with the patients in pre-COVID-19 and post-COVID-19 periods, during the first COVID-19 year, patients had more hypertension, non-ST elevation myocardial infarction (NSTEMI), lower left ventricular ejection fraction (LVEF) and multivessel coronary artery disease (CAD). In the second COVID-19 year, patients had more STEMI, lower LVEF, multivessel CAD, primary PCI, multiple stents and more vasopressor and mechanical support. There were 99 (1.4%) in-hospital deaths which in the successive years were 1.2%, 1.4%, 0.8%, 2.4% and 1.3%, respectively (p=0.019). Compared with the baseline year, deaths were slightly lower in the first COVID-19-year (age-sex adjusted OR 0.68, 95% CI 0.31 to 1.47) but significantly more in the second COVID-19-year (OR 1.97, 95% CI 1.10 to 3.54). This variation attenuated following adjustment for clinical presentation, extent of CAD, in-hospital treatment and duration of hospitalisation. CONCLUSIONS: In-hospital mortality among patients with CAD undergoing PCI was significantly higher in the second year of the COVID-19 pandemic in India and could be one of the reasons for excess deaths in the country. These patients had more severe CAD, lower LVEF, and more vasopressor and mechanical support and duration of hospitalisation.


Assuntos
COVID-19 , Doença da Artéria Coronariana , Intervenção Coronária Percutânea , Feminino , Humanos , Masculino , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/epidemiologia , Doença da Artéria Coronariana/terapia , COVID-19/terapia , Hospitais , Pandemias , Sistema de Registros , Volume Sistólico , Resultado do Tratamento , Estados Unidos , Função Ventricular Esquerda , Estudos Prospectivos
5.
J Ayurveda Integr Med ; 15(2): 100895, 2024 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-38537487

RESUMO

Acute upper limb ischemia (AULI) is a medical and surgical emergency involving sudden decrease in limb perfusion resulting in threat for limb viability. A 52 years old male patient was suffered from AULI. He had the complaints of numbness and pain in left upper limb, headache and pale discoloration of left-hand fingers and acute onset left upper extremity weakness.The Ayurveda diagnosis was considered as Vatarakta. He was advised oral medications - Kaishor guggulu in the dose of 750 mg twice a day with Jwarhar kashaya 40 ml twice a day, Ashwagandha Churna 3 g, Guduchi churna1g, Shatavari churna 2 g, Chopchini churna 1 g with milk twice a day, Shilajatwadi loha 500 mg and Mahavatvidhvansana rasa 250 mg twice a day with honey. All these medications were continued for 12 months. Two courses of Mustadi yapana basti (medicated enema enriched with milk) and Shalishastika pinda swedana (a specific type of sudation with a poultice of rice bolus) and Nasya (nasal therapy) with Shadabindu oil were given. Initial computed tomography (CT) angiogram revealed the abrupt cutoff of the left brachial artery in distal part due to hypodense lesion (thrombus) in the lumen while after 12 months of treatment CT angiogram revealed 70-80 % luminal narrowing in proximal part of left ulnar artery. It suggests the revascularization of left ulnar artery. All the symptoms of AULI were also resolved. We report a unique case of AULI managed with Ayurvedic interventions.

6.
Heliyon ; 10(4): e26718, 2024 Feb 29.
Artigo em Inglês | MEDLINE | ID: mdl-38434015

RESUMO

Soil salinity has emerged as a critical abiotic stress in potato production, whereas wilt disease, caused by Fusarium solani, is the significant biotic stress. An experiment was performed to decipher the occurrence of wilt incidence by F. solani FJ1 under the influence of salinity in both in vitroand pot culture conditions. High salt concentration negatively influenced root and shoot development in the variety "Kufri Jyoti" but positively affected the mycelial growth and sporulation behaviours of F. solani FJ1. There was abundant whitish mycelial growth with enhanced biomass and high sporulation (microconidia production) in F. solani FJ1 cultured on salt-supplemented media. Moreover, under high salinity conditions (EC 2-8 dS m-1), severe wilting and rotting of vascular bundles were observed in plants artificially inoculated with F. solani FJ1. The mortality rate of potato plants was significantly higher under individual and combined stresses as compared to control. The wilt index of individual and combined stressed plants was also substantially higher compared to the control. Additionally, compared to the control, there was a significant decrease in total chlorophyll content and membrane stability index of the leaves under combined stress. However, the total phenols were increased under stress conditions. The total sugar content of potato plants decreased in infected plants, but increased when exposed to salt stress or a combination of salt stress and pathogen infection. F. solani infection also increased the activity of peroxidase (POX) and decreased the activity of phenylalanine ammonia-lyase (PAL) and catalase (CAT). These results suggest that Fusarium wilt and dry rot will be a more severe disease for potato cultivation in saline soils.

7.
Health Inf Sci Syst ; 12(1): 23, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38469456

RESUMO

Diabetes mellitus has been regarded as one of the prime health issues in present days, which can often lead to diabetic retinopathy, a complication of the disease that affects the eyes, causing loss of vision. For precisely detecting the condition's existence, clinicians are required to recognise the presence of lesions in colour fundus images, making it an arduous and time-consuming task. To deal with this problem, a lot of work has been undertaken to develop deep learning-based computer-aided diagnosis systems that assist clinicians in making accurate diagnoses of the diseases in medical images. Contrariwise, the basic operations involved in deep learning models lead to the extraction of a bulky set of features, further taking a long period of training to predict the existence of the disease. For effective execution of these models, feature selection becomes an important task that aids in selecting the most appropriate features, with an aim to increase the classification accuracy. This research presents an optimised deep k-nearest neighbours'-based pipeline model in a bid to amalgamate the feature extraction capability of deep learning models with nature-inspired metaheuristic algorithms, further using k-nearest neighbour algorithm for classification. The proposed model attains an accuracy of 97.67 and 98.05% on two different datasets considered, outperforming Resnet50 and AlexNet deep learning models. Additionally, the experimental results also portray an analysis of five different nature-inspired metaheuristic algorithms, considered for feature selection on the basis of various evaluation parameters.

9.
Sci Rep ; 14(1): 1136, 2024 01 11.
Artigo em Inglês | MEDLINE | ID: mdl-38212647

RESUMO

Over 6.5 million people around the world have lost their lives due to the highly contagious COVID 19 virus. The virus increases the danger of fatal health effects by damaging the lungs severely. The only method to reduce mortality and contain the spread of this disease is by promptly detecting it. Recently, deep learning has become one of the most prominent approaches to CAD, helping surgeons make more informed decisions. But deep learning models are computation hungry and devices with TPUs and GPUs are needed to run these models. The current focus of machine learning research is on developing models that can be deployed on mobile and edge devices. To this end, this research aims to develop a concise convolutional neural network-based computer-aided diagnostic system for detecting the COVID 19 virus in X-ray images, which may be deployed on devices with limited processing resources, such as mobile phones and tablets. The proposed architecture aspires to use the image enhancement in first phase and data augmentation in the second phase for image pre-processing, additionally hyperparameters are also optimized to obtain the optimal parameter settings in the third phase that provide the best results. The experimental analysis has provided empirical evidence of the impact of image enhancement, data augmentation, and hyperparameter tuning on the proposed convolutional neural network model, which increased accuracy from 94 to 98%. Results from the evaluation show that the suggested method gives an accuracy of 98%, which is better than popular transfer learning models like Xception, Resnet50, and Inception.


Assuntos
COVID-19 , Telefone Celular , Cirurgiões , Humanos , COVID-19/diagnóstico , Teste para COVID-19 , SARS-CoV-2 , Hidrolases
10.
Int J Cardiol Cardiovasc Risk Prev ; 20: 200230, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38192277

RESUMO

Objective: Registry-based prospective study was conducted to evaluate association of body mass index (BMI) with major adverse coronary events (MACE) following percutaneous coronary intervention (PCI). Methods: Successive patients undergoing PCI were enrolled from April'19 to March'22 and classified into five BMI categories (<23.0,23.0-24.9,25.0-26.9,27.0-29.9, and ≥30.0 kg/m2). Clinical, angiographic features, interventions and outcomes were obtained by in-person or telephonic follow-up. Primary endpoints were (a) MACE(cardiovascular deaths, acute coronary syndrome or stroke, revascularization, hospitalization and all-cause deaths) and (b)cardiovascular deaths. Cox-proportionate hazard ratios(HR) and 95 % confidence intervals(CI) were calculated. Results: The cohort included 4045 patients. Mean age was 60.3 ± 11y, 3233(79.7 %) were men. There was high prevalence of cardiometabolic risk factors. 90 % patients had acute coronary syndrome(STEMI 39.6 %, NSTEMI/unstable angina 60.3 %), 60.0 % had impaired ejection fraction(EF) and multivessel CAD. Lower BMI groups (<23.0 kg/m2) had higher prevalence of tobacco use, reduced ejection fraction(EF), multivessel CAD, stents, and less primary PCI for STEMI. There was no difference in discharge medications and in-hospital deaths. Median follow-up was 24 months (IQR 12-36), available in 3602(89.0 %). In increasing BMI categories, respectively, MACE was in 10.9,8.9,9.5,9.1 and 6.8 % (R2 = 0.73) and CVD deaths in 5.1,4.5,4.4,5.1 and 3.5 % (R2 = 0.39). Compared to lowest BMI category, age-sex adjusted HR in successive groups for MACE were 0.89,0.87,0.79,0.69 and CVD deaths 0.98,0.87,0.95,0.75 with overlapping CI. HR attenuated following multivariate adjustments. Conclusions: Low BMI patients have higher incidence of major adverse cardiovascular events following PCI in India. These patients are older, with greater tobacco use, lower EF, multivessel CAD, delayed STEMI-PCI, and longer hospitalization.

11.
Cytotherapy ; 26(1): 96-102, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37943203

RESUMO

BACKGROUND AIMS: Hematopoietic stem cell transplants (HSCTs) are increasingly being offered to patients in India for various conditions. The Indian Stem Cell Transplant Registry shows that a total of 2533 transplants were done in India in 2019. METHODS: An epidemiological descriptive cross-sectional survey (55 questions) of centers providing HSCT in India was planned to analyze variations in policies and practices regarding HSCT graft manipulation (i.e., plasma reduction, red blood cell [RBC] depletion and cryopreservation). A total of 63 of 102 centers responded to the survey (response rate, 61.7%), mostly from the northern part of India (27 of 63 [42.8%]). RESULTS: The majority of responding centers reported performing >50 HSCTs annually (n = 24 [38%]), and 92% (58 of 63) performed stem cell collections from a pediatric donor/patient (age <18 years). A total of 56 of 63 responding centers indicated that they did product manipulations involving cryopreservation (n = 45), plasma reduction (n = 42) and RBC depletion (n = 28). Cryopreservation was primarily done by blood centers (27 of 45 [60%]), with dimethyl sulfoxide (DMSO) being the primary constituent, used most commonly at a concentration of 5-10% (28 of 45 centers). Dump freezing was most commonly used (27 of 45) with a -80°C deep freezer. A 7-aminoactinomycin D based viability assessment was also most commonly used (30 of 45). Thawing of the product was done mainly at the bedside (30 of 45) using a wet-type thawer (36 of 45), and washing of DMSO was done by a few centers (seven of 45). Plasma reduction and RBC depletion were primarily done for ABO incompatibility at blood centers. CONCLUSIONS: This survey demonstrates the lack of standardization and uniformity in the minimal manipulation of hematopoietic stem cell grafts in centers supporting HSCT in India. This work also highlights the need for more studies and country-specific recommendations to establish best practices.


Assuntos
Dimetil Sulfóxido , Transplante de Células-Tronco Hematopoéticas , Humanos , Criança , Adolescente , Estudos Transversais , Células-Tronco Hematopoéticas , Congelamento
12.
Radiother Oncol ; 190: 110020, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38007042

RESUMO

BACKGROUND: We aimed to characterize local control (LC) and overall survival (OS) following stereotactic ablative radiation therapy (SABR) for extracranial sarcoma metastases. METHODS: A prospectively-maintained institutional registry was queried for patients with metastases from sarcoma primaries managed with SABR. Kaplan-Meier analysis was utilized for univariate analyses to assess potential prognostic factors regarding LC and OS. A Cox proportional hazards multivariate (MVA) model was employed to further assess initially identified independent variables. RESULTS: A total of 94 patients with 118 lesions with LC information were identified. Common metastatic sites treated were lung (77), non-spinal bone (15), and spine (10). The median biologically effective dose (BED4) was 175 Gy4 (range56.3 Gy4-360 Gy4) with a median dose/fractionation schedule of 50 Gy/5 fractions. One- and 2-year OS rates were 81.3 % (95 % CI: 71.2-88.1 %6) and 50.5 % (95 % CI: 38.6-61.3 %, respectively. On Cox MVA, advanced age and non-lung metastases were associated with inferior OS (p < 0.03) with patients with 0-2 of these risk factors having estimated 2-year OS of 65.1 %, 38.9 %, and N/A, respectively. One- and 2-year LC rates were 85.3 % (95 % CI: 77.7-90.9 %) and 78.2 % (95 % CI: 67.9-85.6 %), respectively. On MVA, only BED4 < 175 Gy was associated with inferior LC (hazard ratio (HR) = 3.33; p = 0.01). Ten of 118 treated lesions had treatment-related toxicities (all Grade 1-2). CONCLUSION: Age and lung vs. non-lung metastases were prognostic of OS and should be considered in patient selection for SABR. Dose escalation when feasible with BED4 ≥ 175 Gy is recommended given durable LC achieved without a subsequent increase in toxicity.


Assuntos
Neoplasias Pulmonares , Radiocirurgia , Sarcoma , Humanos , Prognóstico , Fracionamento da Dose de Radiação , Modelos de Riscos Proporcionais , Estimativa de Kaplan-Meier , Sarcoma/radioterapia , Sarcoma/patologia , Radiocirurgia/efeitos adversos , Neoplasias Pulmonares/patologia , Estudos Retrospectivos
13.
J Orthop ; 45: 78-86, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37872977

RESUMO

Background and aims: Current evidence for the use of intra-articular injections for thumb base osteoarthritis (TBOA) is equivocal. This study aims to investigate the efficacy of intra-articular corticosteroids, hyaluronic acid and platelet-rich plasma. Methods: A Frequentist network meta-analysis was conducted comparing outcomes at short (≤3 months) and medium-term (>3-12 months) time points. Results: Data from 7 RCTs and 1 non-RCT (446 patients) were collected, consisting of corticosteroids (n = 7), hyaluronic acid (n = 7), platelet-rich plasma (n = 2) and placebo (n = 2). At the short-term time point, no intra-articular injection demonstrated superiority over placebo at reducing pain. At the medium-term time point, superiority of platelet-rich plasma at reducing pain over placebo and corticosteroids was seen following sensitivity analysis (RCTs only) (SMD -1.48 95 % CI -2.71; -0.25). No injection proved superior at improving function at short or medium-term time points. Conclusions: Overall, despite the promising result for platelet-rich plasma, the evidence quality was limited to two studies only justifying the need for further and larger methodologically robust trials investigating corticosteroids, hyaluronic acid and platelet-rich plasma vs each other and placebo.

14.
Front Plant Sci ; 14: 1211472, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37860256

RESUMO

Potatoes are an important source of food for millions of people worldwide. Biotic stresses, notably late blight and potato cyst nematodes (PCN) pose a major threat to potato production worldwide, and knowledge of genes controlling these traits is limited. A genome-wide association mapping study was conducted to identify the genomic regulators controlling these biotic stresses, and the genomic prediction accuracy was worked out using the GBLUP model of genomic selection (GS) in a panel of 222 diverse potato accessions. The phenotype data on resistance to late blight and two PCN species (Globodera pallida and G. rostochiensis) were recorded for three and two consecutive years, respectively. The potato panel was genotyped using genotyping by sequencing (GBS), and 1,20,622 SNP markers were identified. A total of 7 SNP associations for late blight resistance, 9 and 11 for G. pallida and G. rostochiensis, respectively, were detected by additive and simplex dominance models of GWAS. The associated SNPs were distributed across the chromosomes, but most of the associations were found on chromosomes 5, 10 and 11, which have been earlier reported as the hotspots of disease-resistance genes. The GS prediction accuracy estimates were low to moderate for resistance to G. pallida (0.04-0.14) and G. rostochiensis (0.14-0.21), while late blight resistance showed a high prediction accuracy of 0.42-0.51. This study provides information on the complex genetic nature of these biotic stress traits in potatoes and putative SNP markers for resistance breeding.

16.
ACS Omega ; 8(36): 32855-32866, 2023 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-37720773

RESUMO

In this study, a multiobjective optimization (MOO) approach was utilized for effective decision-making when several variables were changing simultaneously during frying. Carboxy methyl cellulose (CMC), xanthan gum, and carrageenan coatings in different concentrations (0.25-1.50%, w/v) were applied on fish strips to reduce the oil uptake and protein oxidation during frying. The pickup of the strips increased significantly (p < 0.05) with increasing concentration. The CMC was effective in oil uptake reduction and protein oxidation, as revealed by the lower carbonyl and sulfhydryl contents in the fried strip. The hardness and chewiness of the coated fish strips were found to be declined significantly (p < 0.05) with increasing coating concentrations. The moisture, lipid, toughness, hardness, cutting force, oiliness, sulfhydryl content (all min), oil uptake reduction, and carbonyl content (both max) were considered as multiple criteria for the MOO technique, and fried strips coated with 1% CMC, followed by 0.75% xanthan gum and 0.75% carrageenan, emerged as the best optimal coating.

19.
Indian J Plast Surg ; 56(4): 320-325, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37705820

RESUMO

Background Chat Generative Pre-Trained Transformer (ChatGPT) is a versatile large language model-based generative artificial intelligence. It is proficient in a variety of tasks from drafting emails to coding to composing music to passing medical licensing exams. While the potential role of ChatGPT in plastic surgery is promising, evidence-based research is needed to guide its implementation in practice. Methods This review aims to summarize the literature surrounding ChatGPT's use in plastic surgery. Results A literature search revealed several applications for ChatGPT in the field of plastic surgery, including the ability to create academic literature and to aid the production of research. However, the ethical implications of using such chatbots in scientific writing requires careful consideration. ChatGPT can also generate high-quality patient discharge summaries and operation notes within seconds, freeing up busy junior doctors to complete other tasks. However, currently clinical information must still be manually inputted, and clinicians must consider data privacy implications. Its use in aiding patient communication and education and training is also widely documented in the literature. However, questions have been raised over the accuracy of answers generated given that current versions of ChatGPT cannot access the most up-to-date sources. Conclusions While one must be aware of its shortcomings, ChatGPT is a useful tool for plastic surgeons to improve productivity for a range of tasks from manuscript preparation to healthcare communication generation to drafting teaching sessions to studying and learning. As access improves and technology becomes more refined, surely more uses for ChatGPT in plastic surgery will become apparent.

20.
J Ayurveda Integr Med ; 14(5): 100792, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37741160

RESUMO

Avascular necrosis (AVN) is the condition where an interruption of the sub-chondral blood supply leads to the death of cellular components of bones typically at the weight-bearing joints. Here we present a case of a 48 years old male patient suffering from AVN for the last two months. The patient had pain in bilateral hip joints which was gradually radiating to the bilateral thigh. The patient also felt difficulty in cross-legged, sitting, and squatting. The Ayurveda diagnosis of the case was established as Asthimajjagata-vata (∼disease due to vitiation of Vatadosha in bone and bone marrow tissues). Oral treatment was administred initially for eight months, followed by a course of Panchatikta-kshira basti (medicated enema enriched with milk) and Shalishastika panda swedana (a specific type of sudation with a poultice of rice bolus) for 24 days. Oral medications were continued during this duration and also for the subsequent 22 months. Kaishora guggulu in the dose of 750 mg twice a day with Dashamula kwath 40 ml twice a day, Ashwagandha churna (Powder of Withania somnifera Dunal) 3 g, Guduchi churna (Powder of Tinospora cordifolia L.) 1g, Chopchini churna (Powder of Smilax china L.) 2g and Shilajatwadi loha 500 mg with milk twice a day were advised to the patient. MRI scans of bilateral hip joints after 23 months of this treatment revealed changes in AVN grade, with the left hip joint transitioning from grade III-B to grade II, and the right hip joint progressing from grade IV-A to grade III. The range of motion at these joints was also improved significantly. Most of these medicines are Rasayana (∼immune-modulatory) in nature. The present case study suggests that Panchakarma procedures and Rasayana may be used for the treatment of AVN.

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