Posterior-only fixation in pelvic fractures: Is it sufficient in lateral compression injuries?

PURPOSE: Lateral compression (LC) injuries account for more than two-thirds of all pelvic fractures. The goal of surgical treatment is to provide adequate stability and early mobilization. The consensus on posterior fixation of such injuries is strong in the literature; however, the necessity of anterior ring fixation is not clear. Therefore, this study was formulated to determine the practicability of posterior-only fixation in LC injuries. METHODS: Between March 2015 and May 2020, all patients with LC type pelvic ring fractures who were admitted and operated upon in a single level 1 trauma center were included in this cross-sectional observational study. Demographic data, co-morbidities, treatment, types of surgical fixation, concomitant injuries and surgeries, surgical complications, length of hospital stay, injury to weight bearing duration, and follow-up period were documented. Functional outcome and quality of life were assessed using Majeed score and SF-36 questionnaire. Non-normally distributed data were presented as median (Q1, Q3) and normally distributed data were presented as mean ± SD. Spearman's rank correlation coefficient was used for correlation analysis. RESULTS: A total of 25 patients were included, with a mean age of 29.8 years. All patients were managed operatively with posterior-only fixation. The median Majeed score was 90 (76, 95). The median physical component summary score was 69.37 (38.75, 85.62). The median mental component summary score was 63.95 (39.25, 87.87). There was no significant difference compared to population norms of both physical component summary and mental component summary. Injury to weight bearing time correlated significantly (p = 0.002) with Majeed score as well as SF-36 score (p = 0.044). No other variable had a significant association with outcomes. CONCLUSION: Posterior-only fixation is sufficient for fixing LC injuries with up to 80% of cases having good to excellent functional outcomes. However, comparative studies with larger sample sizes are needed for further validation.

Exploring the natural efficacy of spirulina powder for combating obesity, diabetes, and inflammation.

BACKGROUND: An increasing incidence of metabolic disorders emphasizes the need to explore natural treatments. Spirulina, a microalga with a rich nutrient profile, offers a promising solution for obesity, diabetes, and inflammation. This study provides a meticulous analysis of spirulina powder, evaluating its physicochemical attributes and technofunctional properties through the use of advanced analytical techniques. RESULTS: Spirulina powder demonstrated strong flowability, substantial water and oil absorption capacity, and moderate foaming characteristics. The ethanolic extract of spirulina was found to be a repository of phenolic (6.93 mg GAE/g) and flavonoid (7.17 mg QE/g) compounds, manifesting considerable antioxidant activity with a 58.49 g kg-1 inhibition of 2,2-diphenyl-1-picrylhydrazyl (DPPH) radicals. The extract also exhibited pronounced inhibitory effects on lipase and amylase enzymes, with inhibition percentages of 72.05 g kg-1 and 70.28 g kg-1, respectively, and displayed a glucose retention capacity of 1.28 mg dL-1 (68.52 g kg-1) in a dialysis membrane assay. These results suggest its efficacy in modulating obesity and glycemic control. The powder also showed a potent anti-inflammatory response by mitigating protein denaturation. CONCLUSION: Spirulina powder is a potent natural agent with multiple health benefits, meriting its incorporation into functional foods. It could be suitable for application in the food industry, offering a natural strategy to combat metabolic diseases. This research adds to the scientific literature on spirulina, paving the way for future research into its utilization. © 2024 The Author(s). Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Predicting the Electrophoretic Mobility of Charged Particles in an Aqueous Medium.

Electrophoresis of charged particles has important applications in biochemical separation processes. The mobility of these particles depends on the surrounding electric double layer (EDL), which is impacted by solvent restructuring because of hydration interactions. Nevertheless, most theoretical estimates ignore such interactions during computation of the electrophoretic mobility. Here, we employ a complementary blend of mean-field analysis and molecular dynamics simulations performed for a peptide-G-quadruplex complex to assess how hydration interactions alter the mobility of a charged particle in an aqueous medium. These interactions are seen to stabilize the EDL, resulting in more significant localized counterion concentrations while strengthening the ensuing electrokinetic flow. The ordering of ions near the particle surface is obtained only upon including hydration interaction, revealing that the hydration water molecules act as a glue for forming a stable EDL, a key finding of this work. Conversely, the observed microstructure of ions near the charged surface as obtained from our theory establishes a bridge link between the micro and continuum model. The presence of larger counter ions enhances the drag on the particle, thus restricting its mobility. The mobility also becomes dependent on size, which may be useful for isolating a wide array of biomolecules. The impact of hydration interactions intensifies with increases in particle size, surface charge density, and bulk ion concentration.

In-vitro and in-vivo studies of two-drug cocktail therapy targeting chemobrain via the Nrf2/NF-κB signaling pathway.

Today, we critically need alternative therapeutic options for chemotherapy-induced cognitive impairment (CICI), often known as chemo brain. Mitochondrial dysfunction and oxidative stress are two of the primary processes that contribute to the development of chemobrain. Therefore, the purpose of this study was to investigate how CoQ10 and berberine shield neurons from chemotherapy-induced damage in in-vitro studies and memory loss in vivo studies. For the in-vitro investigation, we employed SH-SY5Y cell lines, and for the in-vivo study, we used female Swiss albino mice divided into seven different groups. Data from in-vitro studies revealed that treatment with coenzyme Q10 (CoQ10) and berberine improved chemotherapy-induced toxicity by reducing mitochondrial and total cellular ROS, as well as apoptosis-elicited markers (caspase 3 and 9). CoQ10 and berberine therapy inhibited the nuclear translocation of NF-κB and, consequently, the subsequent expressions of NLRP3 and IL-1ß, implying the prevention of inflammasome formation. Furthermore, CoQ10 and berberine therapy boosted Nrf2 levels. This is a regulator for cellular resistance to oxidants. The in vivo results showed that treatment with CoQ10 (40 mg/kg) and berberine (200 mg/kg) improved the behavioral alterations induced by CAF (40/4/25 mg/kg) in both the Morris Water Maze (MWM) and Novel Object Recognition (NOR) tests. Furthermore, biochemical and molecular evidence revealed the antioxidant, mitochondrial restorative, and anti-inflammatory potential of CoQ10 (40 mg/kg) and berberine (200 mg/kg) against CAF (40/4/25 mg/kg) subjected mice. In addition, the histological analysis using H&E staining and transmission electron microscopy (for mitochondrial morphology) showed that mice treated with the cocktails had an increased number of healthy neurons with intact mitochondria and a reduced presence of autophagic vacuoles in the hippocampal region of the brain. These findings back up our theory about this novel cocktail method for CAF-induced cognitive impairment.

Carbon Fiber-Based Vitrimer Composites: A Path toward Current Research That Is High-Performing, Useful, and Sustainable.

In the polymeric material industry, thermosets and related composites have played a substantial role in the production of rubber and plastics. One important subset of these is thermoset composites with carbon reinforcement. The incorporation of carbon fillers and fibers gives polymeric materials improved electrical and mechanical properties, among other benefits. However, the covalently crosslinked network of thermosets presents significant challenges for recycling and reprocessing because of its intractable nature. The introduction of vitrimer materials opens a new avenue to produce biodegradable and recyclable thermosets. Carbon-reinforced vitrimer composites are pursued for high-performance, long-lasting materials with attractive physical properties, the ability to be recycled and processed, and other features that respond uniquely to stimuli. The development of carbon-reinforced vitrimer composites over the last few years is summarized in this article. First, an overview of vitrimers and the methods used to prepare carbon fiber-reinforced vitrimer composites is provided. Because of the vitrimer nature of such composites, reprocessing, healing, and recycling are viable ways to greatly extend their service life; these approaches are thoroughly explained and summarized. The conclusion is our prediction for developing carbon-based vitrimer composites.

Comparison of endoscopic decompression to open laminectomy in patients with thoracic ossified ligamentum flavum - a systematic review and meta-analysis.

In recent years, there has been growing interest in an alternative approach for treating TOLF, such as endoscopic decompression, which minimizes the disruption of surrounding tissues. It is important to understand the advantages, disadvantages, and potential differences in outcomes associated with each approach. This comparative study aims to evaluate and contrast the effectiveness, safety, and outcomes of these two surgical techniques, open laminectomy and endoscopic decompression, in the management of thoracic OLF. The literature review was conducted on Embase, PubMed, Scopus and Google Scholar databases. After a thorough screening of all search results, 14 studies were shortlisted, from which data was extracted, and statistical analysis was done. Pooled analysis was done to ascertain the intra-operative and post-operative outcomes after surgery for TOLF. Overall, 351 patients were included in the study for evaluation. 174 patients were operated on by open laminectomy, and 177 patients were seen in the endoscopy group. Decreased operative time was seen in the endoscopic subgroup. The mean length of hospital stay of 6.6 days. Both groups showed improvement in mJOA and VAS score. The recovery rate for the reported study cohort was 66.8%, with the Endoscopic surgical approach showing a positive correlation with the mean recovery rate. The dural tear was the most common complication, with a rate of 6.6%. The mean estimated infection rate was 2.7% and postoperative CSF leak was 3.7%, with a trend of significantly higher rates in the open subgroup. Both of the groups showed improvement in functional scores, VAS scores, and cross-sectional area. However, the Endoscopic decompression group experienced reduced hospital stays, operating times, and intraoperative blood loss. The most frequent side effects were CSF leak and dural tear. A few cases showed revision and infection. None of the problems differed between the groups.

The kickstand rod technique for correction of coronal malalignment in patients with adult spinal deformity: a systematic review and pooled analysis of 97 cases.

Coronal malalignment (CM) has recently gained focus as a key predictor of functional outcomes in patients with adult spinal deformity (ASD). The kickstand rod technique has been described as a novel technique for CM correction using an accessory rod on the convex side of the deformity. This review aimed to evaluate the surgical technique and outcomes of corrective surgery using this technique. The literature search was conducted on three databases (PubMed, EMBASE, and Scopus). After reviewing the search results, six studies were shortlisted for data extraction and pooled analysis. Weighted means for surgical duration, length of stay, amount of coronal correction, and sagittal parameters were calculated. The studies included in the review were published between 2018 and 2023, with a total sample size of 97 patients. The mean age of the study cohort was 61.1 years, with female preponderance. The mean operative time was 333.6 minutes. The mean correction of CM was 5.1 cm (95% confidence interval [CI], 3.6-6.6), the mean sagittal correction was 5.6 cm (95% CI, 4.1-7.1), and the mean change in lumbar lordosis was 17° (95% CI, 10.4-24.1). Preoperative coronal imbalance and mean correction achieved postoperatively were directly related with age. The reoperation rate was 13.2%. The kickstand rod technique compares favorably with conventional techniques such as asymmetric osteotomies in CM management. This technique provides an additional accessory rod that helps increase construct stiffness. Because of limited data, definitive conclusions cannot be drawn from this review; however, this technique is a valuable tool for a surgeon dealing with ASD.

Biomarkers of Hepatic Toxicity: An Overview.

Background: Hepatotoxicity is the foremost issue for clinicians and the primary reason for pharmaceutical product recalls. A biomarker is a measurable and quantifiable attribute used to evaluate the efficacy of a treatment or to diagnose a disease. There are various biomarkers which are used for the detection of liver disease and the intent of liver damage. Objective: This review aims to investigate the current state of hepatotoxicity biomarkers and their utility in clinical settings. Using hepatic biomarkers, the presence of liver injury, its severity, prognosis, causative agent, and type of hepatotoxicity can all be determined. Methods: Relevant published articles up to 2022 were systematically retrieved from MEDLINE/PubMed, SCOPUS, EMBASE, and WOS databases using keywords such as drug toxicity, hepatotoxicity biomarkers, biochemical parameters, and nonalcoholic fatty liver disease. Results: In clinical trials and everyday practice, biomarkers of drug-induced liver injury are essential for spotting the most severe cases of hepatotoxicity. Hence, developing novel biomarker approaches to enhance hepatotoxicity diagnosis will increase specificity and/or identify the person at risk. Importantly, early clinical studies on patients with liver illness have proved that some biomarkers such as aminotransferase, bilirubin, albumin, and bile acids are even therapeutically beneficial. Conclusions: By assessing the unique signs of liver injury, health care professionals can rapidly and accurately detect liver damage and evaluate its severity. These measures contribute to ensuring prompt and effective medical intervention, hence reducing the risk of long-term liver damage and other major health concerns.

Comparison of bone health among pre-menopausal and post-menopausal females in rural Eastern India: A pilot study.

PURPOSE: The aim of this study was to identify the at-risk female population (pre- and post-menopausal), identify the risk factors for low bone mineral density (BMD) and assess the knowledge of the subjects regarding osteoporosis by Osteoporosis Knowledge Assessment Tool (OKAT) in both the groups and to determine areas for early intervention in a predominantly rural and tribal area of Eastern India. STUDY DESIGN: This was a cross-sectional hospital-based study conducted in a predominant tribal and rural area of Eastern India. Females who were pre- and post-menopausal without a prior diagnosis of osteoporosis were included in the study. MAIN OUTCOME MEASURES: Factors affecting osteoporosis and quantified knowledge regarding the disease. RESULTS: A total of 388 females were included in the study (pre-menopausal = 190 and post-menopausal = 198). Although no significant difference was noted in the age at menarche between both the groups, a gradual significant shift in the age at menarche was noted in the younger females (p = .031). The mean OKAT score in the pre-menopausal and post-menopausal group was 9.5 ± 3.4 and 9.2 ± 3.5, respectively. 80% of females in the pre-menopausal group had normal T-scores whereas only 25% of the females in the post-menopausal group had normal T-scores. CONCLUSION: Targeted educational programs which influence the preventive health behaviour in general and osteoporosis knowledge in particular would bridge this gap. Peer-led community intervention programs which focus on behaviour change with respect to lifestyle and diet modification in the younger population should be the step ahead to reduce the prevalence of the disease.

A systematic review and meta-analysis of long-term outcomes of femoral derotation surgery for intoeing gait in cerebral palsy.

BACKGROUND: Femoral derotation osteotomy is treatment of choice in intoeing gait secondary to cerebral palsy (CP). RESEARCH QUESTION: The aim of this study was to critically appraise the literature regarding the long-term outcomes of femoral derotation surgery in CP. METHODS: Electronic databases of PubMed and Scopus was used for the literature review by two researchers independently (SB, SC). The study population included patients of cerebral palsy undergoing femoral derotation surgery. The keywords used were "cerebral palsy", "intoeing gait", "femur anteversion", "hip anteversion", "femur derotation" and "femur osteotomy". RESULTS: Nine studies which included 657 limbs in 407 patients were selected for this study of which eight were retrospective in nature. The improvement in hip rotation at stance at last follow up (more than five years) maintained a statistical significance (SMD 1.67 95 %CI 1.12-2.22). Similar statistically significant outcomes were noted for foot progression angle (SMD 1.19 95 %CI 0.92-1.47), anteversion (SMD 2.75 95 %CI 1.49-4.01) and total passive internal rotation (SMD 1.71 95 %CI 1.19-2.22). SIGNIFICANCE: Femoral derotation surgery is the procedure of choice for correction of intoeing gait in CP. Even though, there is deterioration of results on long-term as compared to short term, majority of the patients shall maintain overall correction without recurrence of an intoeing gait. Future studies with uniform criteria for defining recurrence on the basis of functional limitations shall provide better idea about the natural course of this procedure.

In Vitro and In Vivo Investigations of Chromone Derivatives as Potential Multitarget-Directed Ligands: Cognitive Amelioration Utilizing a Scopolamine-Induced Zebrafish Model.

Alzheimer's disease is a complex neurological disorder linked with multiple pathological hallmarks. The interrelation of therapeutic targets assists in the enhancement of cognitive decline through interference with overall neuronal transmission. We have synthesized and screened various chromone derivatives as potential multitarget-directed ligands for the effective treatment of Alzheimer's disease. The synthesized compounds exhibited multipotent activity against AChE, BuChE, MAO-B, and amyloid ß aggregation. Three potent compounds, i.e., VN-3, VN-14, and VN-19 were identified that displayed remarkable activities against different targets. These compounds displayed IC50 values of 80 nM, 2.52 µM, and 140 nM against the AChE enzyme, respectively, and IC50 values of 2.07 µM, 70 nM, and 450 nM against the MAO-B isoform, respectively. VN-3 displayed potent activity against self-induced Aß1-42 aggregation with inhibition of 58.3%. In the ROS inhibition studies, the most potent compounds reduced the intracellular ROS levels up to 80% in SH-SY5Y cells at 25 µM concentration. The compounds were found to be neuroprotective and noncytotoxic even at a concentration of 25 µM against SH-SY5Y cells. In silico studies showed that the compounds were nicely accommodated in the active sites of the receptors along with thermodynamically stable orientations. Compound VN-19 exhibited a balanced multitargeting profile against AChE, BuChE, MAO-B, and Aß1-42 enzymes and was further evaluated for in vivo activities on the scopolamine-induced zebrafish model. VN-19 was found to ameliorate the cognitive decline in zebrafish brains by protecting them against scopolamine-induced neurodegeneration. Thus, VN-3, VN-14, and VN-19 were identified as potent multitarget-directed ligands with a balanced activity profile against different targets and can be developed as therapeutics for AD.

Comparative evaluation of full and partial pulpotomy in permanent teeth with irreversible pulpitis: A systematic review and meta-analysis.

The purpose of this systematic review and meta-analysis is to conduct a comparative evaluation of partial and full pulpotomy techniques in cariously exposed teeth with symptoms indicative of symptomatic irreversible pulpitis. Databases such as PubMed, EMBASE, Cochrane, and Web of Science were searched. Studies evaluating and/or comparing clinical and/or radiographic success of partial and full pulpotomy in teeth diagnosed with irreversible pulpitis with a minimum of 12 months follow-up were included. The risk of bias (ROB) tool was used for the assessment of ROB. A meta-analysis was conducted to compare the healing outcome of partial and full pulpotomy. Three studies fulfilled the inclusion criteria, there was a low risk of bias in each of the five domains. Full pulpotomy had a higher success rate than partial pulpotomy, according to meta-analysis, but the difference was not statistically significant.

Hydroxyapatite ceramic-coated femoral components in younger patients followed up for 27 to 32 years.

Aims: This study reports the results of 38 total hip arthroplasties (THAs) in 33 patients aged less than 50 years, using the JRI Furlong hydroxyapatite ceramic (HAC)-coated femoral component. Methods: We describe the survival, radiological, and functional outcomes of 33 patients (38 THAs) at a mean follow-up of 27 years (25 to 32) between 1988 and 2018. Results: Of the surviving 30 patients (34 THAs), there were four periprosthetic fractures: one underwent femoral revision after 21 years, two had surgical fixation as the stem was deemed stable, and one was treated nonoperatively due to the patient's comorbidities. The periprosthetic fracture patients showed radiological evidence of change in bone stock around the femoral stem, which may have contributed to the fractures; this was reflected in change of the canal flare index at the proximal femur. Two patients (two hips) were lost to follow-up. Using aseptic loosening as the endpoint, 16 patients (18 hips; 48%) needed acetabular revision. None of the femoral components were revised for aseptic loosening, demonstrating 100% survival. The estimate of the cumulative proportion surviving for revisions due to any cause was 0.97 (standard error 0.03). Conclusion: In young patients with high demands, the Furlong HAC-coated femoral component gives excellent long-term results.

Utility of three-dimensional printing in the surgical management of intra-articular distal humerus fractures: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Clinical outcomes after fixation of distal humerus intraarticular fractures are directly related to the quality of reduction. The use of three-dimensional (3D)-printed fracture models can benefit preoperative planning to ensure good reduction. This review aims to determine if surgery performed with 3D printing assistance are faster and result in fewer complications and improved clinical outcomes than conventional methods. We also outline the benefits and drawbacks of this novel technique in surgical management of distal humerus fractures. METHODS: A systematic literature search was carried out in various electronic databases. Search results were screened based on title and abstract. Data from eligible studies were extracted into spreadsheets. Meta-analysis was performed using appropriate computer software. RESULTS: Three randomized controlled trials with 144 cases were included in the final analysis. The 3D-printed group had significantly shorter mean operating time (mean difference, 16.25 minutes; 95% confidence interval [CI], 12.74-19.76 minutes; P<0.001) and mean intraoperative blood loss (30.40 mL; 95% CI, 10.45-60.36 mL; P=0.005) compared with the conventional group. The 3D-printed group also tended to have fewer complications and a better likelihood of good or excellent outcomes as per the Mayo elbow performance score, but this did not reach statistical significance. CONCLUSIONS: Three-dimensional-printing-assisted surgery in distal humerus fractures has several benefits in reduced operating time and lower blood loss, indirectly decreasing other complications such as infection and anemia-related issues. Future good-quality studies are required to conclusively demonstrate the benefits of 3D printing in improving clinical outcomes. Level of evidence: I.