Surgical treatment of oral submucosal fibrosis

Oral submucosal fibrosis is a serious condition that might be associated with serious complications in the affected patient. The disease also represents a major challenge to the healthcare specialists and the patient before achieving proper management of the condition. Different pharmacological and surgical interventions have been validated. However, no single modality has been proved as an adequate management approach for the disease, which is probably due to the limited number of investigations in this concern and the limited knowledge about the pathogenesis of the condition. In the present literature review, we have discussed the different surgical approaches that have been reported in the literature for managing patients with oral submucosal fibrosis. These approaches mainly aimed to remove the fibrous bands in the oral cavity and maintain adequate mouth opening. It should be noted that it would be hard to write a solid conclusion in this concern because most of the current evidence was either lacking or obtained from a limited number of studies with no proper sample sizes or adequate follow up durations. Accordingly, the indication of the surgical intervention should be primarily done by the surgeon based on the degree of involvement of the oral cavity. Finally, we recommended that further comparative investigations be carried out to further demonstrate the most appropriate management modality and to rule out whether pharmacological or surgical modalities are more efficacious in these settings.

Types and role of cytological molecular analysis in thyroid carcinomas

Estimates show that thyroid nodules are commonly reported among populations residing in iodine-sufficient countries, with estimated prevalence rates of 1%, and 4% of palpable nodules among men and women in these countries, respectively. Furthermore, early diagnosis can effectively direct clinicians to the right management modality, especially in cases with malignant lesions. In this literature review, we have discussed the types and roles of cytological molecular analysis in thyroid carcinomas. Our findings indicate the molecular analysis can significantly add to the diagnostic accuracy of cytological analysis and can greatly add to the efficacy of differentiating benign from malignant lesions. We have discussed the roles of different genetic mutations that were reported among the various studies in the literature, including BRAF, RAS, PAX8/PPARγ, and RET mutations. BRAF mutations are the most validated mutations among the current studies in the literature, which has been reported to greatly increase the positive predictive values in detecting thyroid carcinomas. Some genetic mutations can be used to diagnose difficult to differentiate malignancies by fine needle aspiration (FNA) analysis. For instance, RAS mutations were reported to accurately diagnose follicular variants of papillary thyroid carcinomas that are difficult to detect using routine FNA analysis.

Skin manifestations of autoimmune diseases in the pediatrics

Autoimmune diseases during childhood are common and are usually observed to affect multiple systems. Among many pediatric autoimmune diseases, several cutaneous manifestations were reported in the literature, and the adequate examination and detection of these manifestations might significantly enhance the chances of establishing an adequate diagnosis of the underlying diseases and conditions because the affected patients usually present with typical symptoms. Establishing a proper diagnosis can enhance the prognosis of the affected patients and might prevent the development of serious complications and other adverse events. Besides, it was also previously indicated that establishing an early diagnosis will furtherly help with deciding the most appropriate interventions, which will also enhance the prognosis of the pediatric population. In this literature review, we have discussed the cutaneous manifestations of several autoimmune diseases that might affect the pediatric population. We have majorly discussed the conditions that are associated with systemic lupus, juvenile idiopathic arthritis, dermatomyositis, juvenile-onset systemic sclerosis and morphea. The cutaneous manifestations of these conditions are hugely variable and usually need careful examination and adequate differential diagnosis to establish the best management modality. Besides, some manifestations might gradually develop which might even make the diagnostic approaches even more difficult. Accordingly, clinicians should provide full and thorough examination and diagnosis of the suspected patients because detecting such cases might significantly enhance the prognosis and lead to adequate treatment.

Chloroquine and Hydroxychloroquine in the Era of COVID-19: A Mini-Review

Coronavirus disease of 2019 (COVID-19) has severely affected global health, and caused a significant health burden worldwide in all, the patients, and healthy people. Globally, 17 August 2021, there have been 207,784,507 confirmed cases of COVID-19, including 4,370,424 deaths reported to WHO. As of 16 August 2021, a total of 4,462,336,040 vaccine doses have been administered. Many risk factors, such as older adults, people with medical conditions and pregnant people and recently pregnant people are at an increased risk for severe illness from COVID-19 when compared to non-pregnant people. CQ and HCQ also used in the management of rheumatism, joint inflammation, systemic lupus and showed positive and promising results in the primary research for COVID-19 management but, it’s still confusing whether to use them in patients infected with COVID-19 or it is better to avoid them. Although these drugs, chloroquine (CQ) and hydroxychloroquine (HCQ), which have been tried for the treatment of this disease, COVID-19 vaccines can help end the pandemic. In this review we aim to evaluate the evidence regarding the efficacy and safety of CQ and HCQ used against viral infection caused by COVID-19. Our hope is to shed light on CQ and HCQ as a management modality in the era of COVID-19. We can’t do without drug therapy as a mainstream till antiviral agents and effective vaccines would be available.

La Gobernanza SocioComunitaria. La construcción de poder comunitario en la política pública en salud mental

El propósito de este ensayo es reflexionar sobre el sistema de gobierno de los programas de proximidad comunitaria de la política en salud mental proponiendo el concepto de Gobernanza SocioComunitaria, entendida como un modo de conducir estos programas gestionando lo común “desde abajo” (Vega, 2019, p. 50)) mediante un dispositivo que posibilite la toma de decisiones colectivas entre los actores institucionales y comunitarios involucrados. Es un manejo de los programas que se opone a la modalidad gerencial verticalista y burocrática donde la construcción de lo común está capturada enteramente por el equipo central de gestión. Explicito los argumentos que apoyan esta tesis en tres secciones: salud mental y comunidad, la gestión del conocimiento en los programas de proximidad comunitaria, para finalizar con una descripción más detallada de la Gobernanza SocioComunitaria como modalidad de gestión de estos programas. -- The purpose of this essay is to reflect on the government system of community proximity programs in mental health public policies by submitting the concept of SocioCommunity Governance. This, understood to carry out these programs by managing the common “from below” (Vega, 2019, p. 50), through a device that enables collective decision-making among the institution and the community actors involved. This program management opposes top-down approach and bureaucratic leadership in which the construction of the common is entirely contained by the central management team. The arguments that support this thesis are explained in three sections: mental health and community, knowledge management in community proximity programs and, at last, a more detailed description of the SocioCommunity Governance as a management modality applied to these programs.

APPRAISAL OF CLINICAL OUTCOME OF BIPLANE DOUBLE SUPPORTED SCREW FIXATIONS (BDSF) FOR FEMORAL NECK FRACTURES

Background: Over the years, primary hip arthroplasty has become a popular choice of management modality for intracapsular fracture neck of femur in geriatric hip. Although the complication of nonunion and avascular necrosis (AVN) is nullied by arthroplasty, the probability of re-operation and high surgical stress is substantially high as compare to osteosynthesis. The aim of this study was to determine the clinical outcome of biplane double supported screw xation (BDSF) for femoral neck fracture. Material And Methods: A total of 37 patients (15 males, 22 females) with a mean age of 75.97 years underwent BDSF for femoral neck fracture and were followed up for a period of 10-12 months. They were assessed on the basis of improvement in Harris Hip Score (HHS) and Garden Index. Results: After BDSF the union was achieved in 89.18% (33) patients.The mean HHS was 91.027 points and a garden index of 161-170 was achieved in 56.76% (21) patients at one year of follow up. The majority of patients had good to excellent functional outcomes. The average time of clinico-radiological union was 9.3 weeks. BDSF method used in femoral neck fracture Conclusion: xation has given very good results in this study. Though anatomical reduction is crucial, BDSF method ensures reliable xation, early rehabilitation and good functional outcome especially in elderly

Wood Loss Assessment in Forest of Sal (Shorea robusta) by Heart Rot of Central Terai of Nepal

A significant volume of wood was lost due to wood defects; however, few studies were done to quantify wood loss by wood defects. This study was focused on quantifying wood loss by heart rot, especially hollowness in Shorea robusta. The study was conducted in Tileswornath community forest of Rautahat district. The data were collected from the felling site of the regeneration felling block of Tileswornath community forest. 44 trees were selected randomly, and tree diameter, total height, and volume were measured. The destructive method was followed as heart rot cannot be visible from the surface. Felled trees were sanctioned into 285 logs and separated based on the hollowness. Hollow diameters at both thin end and mid and thick end, as well as length, were measured on the hollow log, and Smalian’s formula was used to calculate the volume of hollowed portion, and volume calculation formula for the cylinder was used to calculate total volume. For the solid logs, mid diameter and length of the log were measured and volume calculation formula for the cylinder was used to calculate total volume. Logistic regression was performed to identify the relation of total height and diameter with the probability of hollowness presence. The study showed that 59% of sampled trees and 34.39% of logs were found to be hollowed due to heart rot. 41.79% volume was occupied by hollow on the hollowed log. Logistic regression discards the relation of height to the hollowness but signified the relation of diameter to the probability of hollowness presence. Before implementation of scientific forest management modality, the timber retained in stump per tree was found as 0.18 cubic feet.

Tuberculosis of breast: scrofulous swelling in the bosom of young women

Background: Tuberculous breast is a rare extra pulmonary presentation of tuberculosis with nonspecific clinical, radiological and histological findings. The significance of breast tuberculosis lies in its rare occurrence and mistaken identity with breast carcinoma and pyogenic abscess.Methods: A prospective observational study was done to know the incidence, presentation and management modality of tuberculosis of breast.Results: 8 female patients, ranging between 21- 50 years were included, painless lump in breast in 4 patients (50%) was the most common presentation followed by 2 (25%) multiple discharging sinus,1 (12.5%) patient presented as abscess and one had painful lump. Axillary lymphadenopathy seen in 3 (37.5%) patients. All patients had an FNAC but Core needle biopsy or excisional biopsy was definitive for diagnosis. Anti-tubercular chemotherapy was the mainstay of treatment.Conclusions: Breast tuberculosis is an obscure disease and clinical signs can be insidious and non-specific Diagnostic expertise can identify a potentially curable disease of breast tuberculosis.

Analysis of the etiologies, treatments and prognoses in children and adolescent vitreous hemorrhage

AIM: To determine the etiologies, treatment modalities and visual outcomes of vitreous hemorrhage (VH; range from birth to 18y). METHODS: A total of 262 eyes from 210 patients between January 2010 and September 2016 were included. All children underwent an appropriate ocular and systemic examination. Data collected included demographics, clinical manifestations, details of the ocular and systemic examination, management details, final fundus anatomy and visual acuity (VA). RESULTS: The most common etiologies were non-traumatic VH (64.89%), most of which were due to retinopathy of prematurity (ROP; 37.10%); while traffic accidents, including 16 (21.00%) eyes, was the most common ocular traumas. Surgery, performed in 143 (54.58%) eyes, was the most common management modality. The initial mean baseline visual acuity was 2.77±0.21 logarithm of the minimal angle of resolution (logMAR) in children and adolescent with traumatic VH, which was significantly improved to 2.15±1.31 logMAR (P<0.05). CONCLUSION: VH in children and adolescent has a complicated and diverse etiology. ROP is the primary cause of non-traumatic VH, which is the most common etiology. Appropriate treatment of traumatic VH is associated with obvious improvement in visual acuity. The initial VA is one of most important predictors of outcome.