The value of manipulation of displaced distal radius fractures in the emergency department

The aim of this study was to report the success of maintaining reduced distal radius fractures with cast immobilisation and analyse risk factors for redisplacement. A retrospective analysis of distal radius fracture manipulated between April 2011 and 2013 was conducted. Age, gender, fracture classification, ulna fracture, dorsal comminution and volar alignment were recorded. Reduction and redisplacement were measured using Sarmiento's modification of Lidstrom's system. 110 patients were included ; mean age 62.8 years and 83.4% female. The AO classification was used to grade initial fractures A2 (44%), A3 (25%), C1 (20%) and C2 (10%). 86.4% of cases were improved following manipulation, although 48.4% redisplaced and 27.4% required surgical intervention. The radial length (60%) was harder to maintain than dorsal alignment (44%) in cases of redisplacement. Successful alignment of the volar cortices was associated with a statistically significant reduction in redisplacement (p = 0.024). Manipulation of distal -radius fractures is initially beneficial but half of cases redisplace.

Sudarshan Kriya yoga improves quality of life in healthy people living with HIV (PLHIV): results from an open label randomized clinical trial

Background & objectives:

Improving quality of life (QOL) of healthy people living with HIV (PLHIV) is critical needing home-based, long-term strategy. Sudarshan Kriya yoga (SKY) intervention is acknowledged for its positive impact on health. It is hypothesised that SKY would improve PLHIV's QOL, justifying an evaluation.

Methods:

In this open label randomized controlled pilot trial, 61 adult PLHIV with CD4 count more than 400 cells/µl and Karnofsky scale score above 70 were enrolled. Those with cardiac disease, jaundice, tuberculosis, or on antiretroviral therapy/yoga intervention were excluded. All were given standard care, randomized to SKY intervention (31: I-SKY) and only standard of care in control (30: O-SOC) arms. The I-SKY participants were trained for six days to prepare for daily practice of SKY at home for 30 min. A validated 31-item WHOQOL-HIVBREF questionnaire was used to document effect in both arms from baseline to three visits at 4 wk interval.

Results:

Baseline QOL scores, hypertension and CD4 count were similar in both arms. An overall 6 per cent improvement of QOL scores was observed in I-SKY group as compared to O-SOC group, after controlling for baseline variables like age, gender, education and occupation (P =0.016); 12 per cent for physical (P =0.004), 11 per cent psychological (P =0.023) and 9 per cent level of independence (P =0.001) domains. Improvement in I-SKY observed at post-training and in the SKY adherence group showed increase in these two domains.

Conclusions:

A significant improvement in QOL scores was observed for the three health related QOL domains in SKY intervention arm. This low cost strategy improved physical and psychological state of PLHIV calling for upscaling with effective monitoring for sustainability of quality of life.

Comparative Evaluation of Tensile - Bond Strength of An Orthodontic Adhesive with and without Fluoride Application, After Acid Etching -An Invitro Study

BACKGROUND

Fixed appliances hinder the effective control of plaque accumulation and white spot lesions may develop under the ill fitting bands or adjacent to the stainless steel brackets during orthodontic treatment particularly the etching process.

AIMS AND OBJECTIVES

Comparative study of tensile bond strength of an orthodontic adhesive with and without fluoride application after acid etching to know the effect of fluoride on bond strength.

MATERIALS AND METHODS

This study is carried out on 90 non carious human premolar teeth, and divided in 6 groups with each group of 15 specimens. In those Groups I and IV were control group acid etch treatment, Group II and V is 1.23% APF gel (acid etch plus APF gel treatment,) and group III and VI is 8% SnF2 (acid etch plus SnF2 treatment). Samples of Group I, II and III bond strength were tested after 24 h and groups IV, V and VI after one month on microtechtensometer machine. The scanning electron microscope (SEM) investigation was carried out for the 2 specimens for the control group after acid etch and 4 specimens after acid etch with fluoride application for fluoride groups.

RESULTS

Control and SnF2 treated groups was found to be nearly similar to the control group whereas APF treated group showed less focal holes than the other 2 groups.

CONCLUSION

Fluoride application after acid etching without having an adverse effect on bond strength but we can prevent the white spot lesions and caries.

A comparison of magnetic resonance arthrography and arthroscopic findings in the assessment of anterior shoulder dislocations

OBJECTIVE

The aim of this study is to establish the sensitivity and specificity of MRA in the investigation of patients with traumatic anterior shoulder dislocations.

MATERIALS AND METHODS

A retrospective analysis of consecutive patients undergoing both magnetic resonance arthrography and arthroscopic assessment after a traumatic anterior shoulder dislocation between January 2011 and 2014 was performed. Demographic data were collected from electronic records. Images were interpreted by 8 musculoskeletal radiologists and patients were treated by 8 consultant orthopaedic surgeons. Arthroscopic findings were obtained from surgical notes and these findings were used as a reference for MRA. The sensitivity, specificity, and positive predictive value were calculated for the different injuries.

RESULTS

Sixty-nine patients underwent both an MRA and shoulder arthroscopy during the study period; however, clinical notes were unavailable in 9 patients. Fifty-three patients (88 %) were male, the mean age was 28 years (range 18 to 50) and 16 subjects (27 %) had suffered a primary dislocation. The overall sensitivity and specificity of MRA to all associated injuries was 0.9 (CI 0.83-0.95) and 0.94 (CI 0.9-0.96) retrospectively. The lowest sensitivity was seen in osseous Bankart 0.8 (CI 0.44-0.96) and superior labral tear (SLAP) lesions 0.5 (CI 0.14-0.86). The overall positive predictive value was 0.88 (CI 0.76-0.91) with the lowest values found in rotator cuff 0.4 (CI 0.07-0.83) and glenohumeral ligament (GHL) lesions 0.29 (CI 0.05-0.7).

CONCLUSION

Magnetic resonance angiography has a high sensitivity when used to identify associated injuries in shoulder dislocation, although in 8 patients (13 %) arthroscopy identified an additional injury. The overall agreement between MRA and arthroscopic findings was good, but the identification of GHL and rotator cuff injuries was poor.

Comparison of curcumin with intralesional steroid injections in Oral Submucous Fibrosis - A randomized, open-label interventional study

INTRODUCTION

Oral Submucous Fibrosis (OSMF) is precancerous condition caused by areca nut chewing characterized by restricted mouth opening, burning sensation and stiffness & blanching of oral mucosa. Complete regression of the condition had not been achieved in all cases with any of the present treatment regimens. Curcumin is (diferuloylmethane), a yellow pigment in curry powder, exhibits anti-oxidant, anti-inflammatory, and pro-apoptotic activities. Hence an interventional study was undertaken to establish the efficacy of curcumin in OSMF patients.

SETTINGS & DESIGN

A randomized open label, interventional study was conducted in forty patients with clinically and histologically proven Oral Submucous Fibrosis.

MATERIALS & METHODS

Forty patients with clinically and histologically proven Oral Submucous Fibrosis were selected for the study and were randomly divided into 2 groups. The first group was treated with weekly intralesional injection of 4 mg Dexamethasone & 1500 I.U Hyaluronidase and the second group by oral administration of two Curcumin tablets (Turmix 300 mg) per day for 3 months each. Improvement of burning sensation, interincisal distance and tongue protrusion was evaluated on a weekly basis.

RESULTS

Burning sensation improved in both the groups from early to late stages. Complete resolution of burning sensation was noted with turmix. The mean increase in interincisal distance was 3.13 mm and 1.25 mm respectively in groups 1 &2. The interincisal distance improved in both the groups, with significant results at the end of first month. Tongue protrusion showed greater recovery at the end of 1st month in group 1 when compared with group 2.

CONCLUSION

Turmix is beneficial and effective in reducing burning sensation in early OSMF patients.

An Epidemiological Study on the Selection, Usage and Disposal of Dental Burs among the Dental Practioner's

AIM

The purpose of this cross sectional study was to understand and evaluate local practioner's knowledge on dental bur selection, its usage, sterilization procedures undertaken and the method of disposal of dental burs in restorative procedures.

MATERIALS AND METHODS

A Questionnaire proforma was prepared with each question having 4 answers. A total of 20 questions were framed and were sub-divided in to 3 categories namely selection, usage sterilization and disposal. These Questionnaire were sent to all the local practioner's by mail and to ensure a high response rate as they were followed up by telephone calls. The results were analyzed statistically and were represented in the form of percentage.

RESULTS

A total 131 out of 150 practioner's answered the questions, a response rate of 87%. Most of the practioner's preferred diamonds (75%) over tungsten carbide (15%) burs. most of the dentists used burs till they were worn out (85%) and many of the dentists agreed that the cutting efficiency of bur decreased with usage (33%). Clinicians usually sterilized burs either once daily (35%) or for every patient (35%). Almost every practioner discarded their worn out burs into dustbin (100%).

CONCLUSION

From the survey we came to know the operators attitude towards one group of burs in terms of cutting efficiency. In terms of cutting efficiency diamond burs predominated the choice irrespective of the grit size. Burs were used repeatedly till they were worn out and minimal coolant was used during tooth preparation and believed that it didn't have any effect on the cutting efficiency.

Protein interaction network for Alzheimer's disease using computational approach

Alzheimer's disease (AD) is the most common form of dementia. It is the sixth leading cause of death in old age people. Despite recent advances in the field of drug design, the medical treatment for the disease is purely symptomatic and hardly effective. Thus there is a need to understand the molecular mechanism behind the disease in order to improve the drug aspects of the disease. We provided two contributions in the field of proteomics in drug design. First, we have constructed a protein-protein interaction network for Alzheimer's disease reviewed proteins with 1412 interactions predicted among 969 proteins. Second, the disease proteins were given confidence scores to prioritize and then analyzed for their homology nature with respect to paralogs and homologs. The homology persisted with the mouse giving a basis for drug design phase. The method will create a new drug design technique in the field of bioinformatics by linking drug design process with protein-protein interactions via signal pathways. This method can be improvised for other diseases in future.

Prosthodontic treatment using vital and non vital submerged roots-two case reports

Residual ridge resorption has been considered as an inevitable consequence after extraction of the teeth. There is a gradual loss of the alveolar bone due to the pattern of bone remodeling. In spite of the availability of newer treatment modalities like endodontic restoration and periodontic procedures for preservation of the remaining teeth they are not feasible for the patients in severe stages where restoration might not be possible. The only reliable method of preserving the remaining bone is by maintaining the functional health of the teeth. Over the years, many studies showed that roots which are fractured and left behind during extractions are retained into the alveolar bone with no evidence of pathosis. Over denture as a treatment option was developed in an effort to preserve the remaining alveolar bone by retaining the natural teeth or roots. In over denture treatment, the teeth selected as abutments are prone to caries and periodontal disease over a period of time, hence evolved the vital or non vital root submergence concept. After a thorough radiographic and clinical examination, few teeth without pathosis are retained that eventually are surgically submerged in the alveolar ridge. After healing, the over denture with reaining vital or non vital teeth preserve the integrity of the bone, making the treatment an effective and successfull preventive prosthodontic treatment.

Response of multiple generations of semilooper, Achaea janata feeding on castor to elevated CO2

The growth, development and consumption of four successive generations of semilooper, Achaea janato reared on castor (Ricinus communis L.) foliage grown under elevated carbon dioxide (550 and 700 parts per million ) concentrations in open top chambers were estimated at Hyderabad, India. Significantly lower leaf nitrogen, higher carbon, higher relative proportion of carbon to nitrogen (C: N) and higher polyphenols expressed in terms of tannic acid equivalents were observed in castor foliage under elevated CO2 levels. Significant influence on life history parameters of A. jonata viz., longer larval duration, increased larval survival rates and differential pupal weights in successive four generations were observed under elevated over ambient CO2 levels. The consumption per larva under elevated CO2 increased from first to fourth generation. An increase in approximate digestibility and relative consumption rate, decreased efficiency of conversion of ingested food and digested food and relative growth rate of the four generations under elevated CO2 levels was noticed. Potential population increase index was lower for successive generations under both elevated CO, over ambient. The present findings indicated that elevated CO2 levels significantly alter the quality of castor foliage resulting in higher consumption and better assimilation by larvae, slower growth and longer time to pupation besides producing less fecund adults over generations.

Oral lichen planus - Review on etiopathogenesis

Oral lichen planus (OLP) is a chronic mucocutaneous disease of uncertain etiopathogenesis. Several factors including stress, genetics, systemic diseases, viruses, dental restorative materials and drugs have been implicated as causative agents. The disease seems to be mediated by an antigen specific mechanism, activating cytotoxic T cells, and non specific mechanisms like mast cell degranulation and matrix metalloproteinase activation. Further clarity on the pathogenesis will aid in modifying therapeutic interventions, thus significantly reducing the morbidity of OLP patients.

The ESI CAD fragmentations of protonated 2,4,6-tris(benzylamino)- and tris(benzyloxy)-1,3,5-triazines involve benzyl-benzyl interactions: a DFT study

The electrospray ionization collisionally activated dissociation (CAD) mass spectra of protonated 2,4,6-tris(benzylamino)-1,3,5-triazine (1) and 2,4,6-tris(benzyloxy)-1,3,5-triazine (6) show abundant product ion of m/z 181 (C(14) H(13)(+)). The likely structure for C(14) H(13)(+) is α-[2-methylphenyl]benzyl cation, indicating that one of the benzyl groups must migrate to another prior to dissociation of the protonated molecule. The collision energy is high for the 'N' analog (1) but low for the 'O' analog (6) indicating that the fragmentation processes of 1 requires high energy. The other major fragmentations are [M + H-toluene](+) and [M + H-benzene](+) for compounds 1 and 6, respectively. The protonated 2,4,6-tris(4-methylbenzylamino)-1,3,5-triazine (4) exhibits competitive eliminations of p-xylene and 3,6-dimethylenecyclohexa-1,4-diene. Moreover, protonated 2,4,6-tris(1-phenylethylamino)-1,3,5-triazine (5) dissociates via three successive losses of styrene. Density functional theory (DFT) calculations indicate that an ion/neutral complex (INC) between benzyl cation and the rest of the molecule is unstable, but the protonated molecules of 1 and 6 rearrange to an intermediate by the migration of a benzyl group to the ring 'N'. Subsequent shift of a second benzyl group generates an INC for the protonated molecule of 1 and its product ions can be explained from this intermediate. The shift of a second benzyl group to the ring carbon of the first benzyl group followed by an H-shift from ring carbon to 'O' generates the key intermediate for the formation of the ion of m/z 181 from the protonated molecule of 6. The proposed mechanisms are supported by high resolution mass spectrometry data, deuterium-labeling and CAD experiments combined with DFT calculations.

Monitoring the sedimentary carbon in an artificially disturbed deep-sea sedimentary environment

An area of 0.6 km(2) in the manganese nodule field of the Central Indian Basin was physically disturbed and sediments discharged in the near bottom waters to simulate seabed mining and study its impact on benthic ecosystem. An estimated 2 to 3 tonnes of sedimentary organic carbon (C(org)) was resuspended into the water column during a 9-day experiment. The majority of the sediment cores from within the disturbed area and areas towards the south showed a ~30% increase in C(org) content as well as an increase in carbon burial rates after disturbance, though with a reduction in carbon/phosphorus ratios. High specific surface area (SSA~25 m(2) g(-1)) and low C(org)/SSA ratios (mostly <0.5) are typical of deep-sea sediments. The increased C(org) values were probably due to the organic matter from dead biota and the migration and redeposition of fine-grained, organic-rich particles. Spatial distribution patterns of C(org) contents of cores taken before and after disturbance were used to infer the direction of plume migration and re-sedimentation. A positive relationship was observed between total and labile C(org) and macrobenthos density and total bacterial numbers prior to disturbance, whereas a negative relationship was seen after disturbance owing to drastic reduction in the density of macrofauna and bacteria. Overall decrease in labile organic matter, benthic biota and redistribution of organic matter suggest that the commercial mining of manganese nodules may have a significant immediate negative effect on the benthic ecosystem inducing changes in benthic community structure.