Masquelet technique in management of infective non-union of long bones- A prospective study

Introduction and Aim: Masquelet’s technique is a 2-staged procedure, for treatment of infected segmental bone defect. 1st stage involves radical debridement with antibiotic-induced cement spacer. During second stage, the spacer is removed and the autologous bone graft is applied into the biomembrane formed. In this study, we evaluate the Masquelet’s technique for the management of infective non-union of long bones. Materials and Methods: 15 patients with infective non-union of long bones- tibia, femur and a case of congenital pseudoarthrosis of tibia, were treated with Masquelet’s technique. They underwent 2 stages of procedures 6-8 weeks apart and was followed up for about 9 months and radiological and clinical outcomes were assessed. Results: Out of 15 patients with infective non-union, 8 patients attained union. Out of the 7 patients with failure of the technique, higher failure rates were attributed to Pseudomonas infection. Conclusion: Masquelet’s technique is a cost-effective method for treating infective segmental non-unions, not requiring special training or sophisticated instruments. This method shows good results with Gram positive infections. Although, the outcome with Pseudomonas aeruginosa infection, have not shown satisfactory results.

Role of systemic inflammatory markers (biomarkers) as important prognostic factors for survival in head and neck cancer

Introduction and Aim: Cancer related inflammation is recognized as a critical multifaceted player in tumour initiation and progression. The neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are important markers of systemic inflammatory burden in malignancy. The present retrospective study aimed to evaluate the prognostic value of pre-treatment baseline (NLR) and (PLR) for survival in HNC patients. Materials and Methods: Analysis of data of 257 patients with head and neck cancer treated with definitive therapy over 3.5 yrs. Neutrophil, lymphocyte and platelet counts before treatment of all patients were collected and NLR and PLR were calculated. Results: Median value of NLR and PLR were 3.7 and 170.63 respectively. Receiver operator characteristics (ROC) curve analysis showed the predictive cut-off value of NLR and PLR as 3.9 and 158.3. Univariate analysis using Cox-regression model showed NLR (p < 0.001) and PLR (p = 0.001) significantly influenced the locoregional recurrence free survival (LRRFS) and overall survival (OS). The multivariate analysis showed NLR is the independent prognostic factors influencing LRRFS (p = 0.007) and OS (p = 0.002). Kaplan-Meier survival curve (Log rank test; Chi-square (?2) value) showed OS is significantly influenced by NLR group (LRRFS; ?2 = 23.9 and OS; ?2 = 33.7) and PLR group (LRRFS; ?2 = 11.2 and OS; ?2 = 19.3) in contrast to LRRFS. Conclusion: NLR can be strongly used as biomarker for prognostication for outcome and survival in head neck cancer. However, a well-designed, larger studies with longer follow-up is warranted.

Effectiveness of Pilates exercises on non-specific low back pain to determine pain and disability

Introduction and Aim: Low back discomfort is one of the commonest musculoskeletal problems. The Pilates exercises are an approach to stretching and strengthening techniques and specifically train all the core muscles. The intend of the current study was to verify the influences of the Pilates exercises among pain and disability among patients with Non-specific Low Back Pain (NSLBP). Materials and Methods: A 100 non-specific low back pain subjects were randomly selected for this experimental study. The study includes of non-specific LBP age group between 25 to 40 years, both male and female patients with pain and disability and this study excludes spinal fractures and Pregnant Women. The estimations were taken utilizing Visual Analogue scale (VAS), Patient Specific Functional Scale (PSFS) and Modified Oswestry Low Back Pain Disability Questionnaire (MODQ). Subjects are allotted in two groups, Group A (Pilates group) receives Pilate’s exercise and Group B (conventional group) receives conventional exercise. Exercises were given for 3 times a week for 12 weeks and a regular follow up was done for every 4 weeks. Results: Group A (Pilates group) were found to be more effective than Group B (conventional group). It shows a highly significant difference in mean values at P ? 0.001. This implies that Pilates exercise is more beneficial in decreasing pain and functional disability. Conclusion: On comparing the mean values, Group A (Pilates group) showed significant improvement at the end of the study when compared with Group B (conventional group).

Prevalence of osteopenia and osteoporosis among the population of southern Kyrgyzstan - A cross-sectional observational study

Introduction and Aim: Osteoporosis is a skeletal disorder characterized by diminished bone strength that increases the risk of fracture in instances of trivial trauma. The objective was to conduct ultrasound bone densitometry in different age groups (18-60 years and older) in southern Kyrgyzstan, to identify and study the prevalence of osteopenia and osteoporosis. Materials and Methods: In this cross-sectional observational study a total of 1200 participants were included, where 580 men and 620 women were aged between 18-60 years and older. Based on the age, the participants were divided into three groups. Bone mineral density in participants was measured using a SONOST-3000 densitometer model. The study was conducted among the population of the Osh and Jalal-Abad regions. Results: Among the population of Osh state in the first group, normal values were found in 65.0%, osteopenia in 26.0%, and osteoporosis in 9.0% of participants. In the second group, values were significantly higher than in the first group. In the third age group, values exceeded significantly compared to the first and second groups. Similar data were obtained from the population of Jalal-Abad state, but a significant difference was found in the elderly people group with a higher percentage of osteopenia and osteoporosis. Conclusion: The results showed the prevalence of osteopenia and osteoporosis in participants of different age categories of Osh and Jalal-Abad states, and especially in the elderly. Depending on the gender distribution, the prevalence of osteopenia and osteoporosis in our study is significantly higher in women than in men.

Novel urinary markers: taurine, dopamine and L-fucose levels in predicting neonatal seizures

Introduction and Aim: Neonatal seizure is an age specific neurological emergency. Their unique pathophysiological mechanism has become subject of interest for many research studies. The recurrence risk for seizures is high during neonatal period and currently used treatment strategies have limited efficacy in preventing it. From past decades although the treatment has not changed, there is a gradual progress in various mechanisms that are involved in generation of seizures and their response to anti-epileptics. With the emergence of new biochemical parameters for risk assessment in patients with seizures, there is a strong need for their comparative evaluation in order to evaluate their potential clinical application. So, this study was carried out to compare the urine levels of taurine, dopamine and fucose in assessing their role in mechanism of seizure. Materials and Methods: After obtaining ethical approval and consent from parents total 43 neonates, urine taurine, dopamine and fucose were measured in 24 cases of seizures and 19 apparently healthy normal controls. Dopamine and Taurine were measured using ELISA and L-fucose by Dische and Shettles method. Results: The median level of urine fucose was significantly higher in male neonates, taurine was significantly decreased in cases compared to that of controls. Males had higher preponderance to develop seizures. The median levels of urine dopamine were high in cases compared to controls but has not showed any significance. Conclusion: Amino acid like taurine, carbohydrate moiety like fucose and a neuromodulator like dopamine may have a mechanistic role in development of seizures in neonatal period.

Does serum Vitamin D affect lipid profile?

Introduction and Aim: Vitamin D, besides its classical physiological functions, exerts effects on brain, prostate, breast, colon, pancreas, and immune cells due to the ubiquitous presence of its receptors. Hypovitaminosis D predisposes individuals to various micro and macro vascular complications of metabolic syndrome and diabetes mellitus. Despite speculations regarding implications of its deficiency on the cardio metabolic health of general/ susceptible population, its role remains underexplored in the Indian population. Materials and Methods: This cross-sectional study carried out in Biochemistry Department of the institution, recruited 219 patients (after obtaining written consent) of both genders above18 years who underwent Vitamin D testing. Blood samples obtained were assayed for HbA1c, C Reactive protein, thiol and lipid. Kruskal Wallis test and Spearman correlation were employed for statistical analysis. Results: Significantly low HDL and high atherogenic index of plasma (AIP) were observed in males with vitamin D deficiency. Significant inverse correlation of vitamin D with CRP and total cholesterol (among vitamin D deficient males) was observed. A significant inverse correlation between serum HDL and AIP and a significant direct correlation between triglyceride and AIP were observed irrespective of their vitamin D status. Heat map showed marginally elevated lipid parameters among vitamin D insufficient males. Conclusion: Vitamin D may emerge as a surrogate marker in risk stratification of patients with diabetes and dyslipidaemia. More insights are required to assess the gender specific susceptibility to dyslipidaemia and atherosclerosis in relation to vitamin D levels.

Awareness regarding breast cancer among urban women in South India

Introduction and Aim: Breast cancer is associated with increased morbidity and mortality and recent trends have shown increased incidence among younger women. There is, therefore, an imminent need to raise the level of awareness among the women in the entire population. The present study was carried out to evaluate the level of awareness among urban women in South India. Methodology: This hospital based cross sectional study was carried out among 1000 adult women who visited the outpatient clinics of our tertiary care hospital for various illness. The level of awareness regarding breast cancer was elicited based on the risk factors of breast cancer, symptoms, and role of family history. Awareness regarding the tools for early detection, management and preventive measures was also elicited. Results: The study observed that 78.9% of the participants who were illiterates had no awareness of the symptoms, while 57.9% of the participants with high school level education were unaware of the symptoms. Regarding the role of genetics in breast cancer occurrence, 47% of the illiterate participants reported that breast cancer is not hereditary. It was observed that lack of awareness regarding the early detection was prevalent among 81%, 87% and 93% of the participants who were illiterate, primary, and middle school level educated respectively. Conclusion: The present study has also elucidated the lack of adequate knowledge on important facts regarding the breast cancer is alarming and this needs to be addressed with due focus on providing health education by health care providers at various levels of health system.

Assessment of C-reactive protein, procalcitonin and interlukin-6 as diagnostic aid for neonatal infections at a tertiary care center

Introduction and Aim: Neonatal infections are the leading cause of mortality among neonates after prematurity. The importance determining biological markers to be used as a diagnostic test to detect neonatal infections the in early stage of the disease is a challenge. The purpose of this study was to evaluate the usefulness & sensitivity of various serological markers such as serum Procalcitonin, C-reactive protein and chemokine IL-6 for diagnosis of neonatal infections leading to sepsis in new born infants. Materials and Methods: This cross-sectional study was carried out among newborns admitted in neonatal intensive care unit (NICU) and meeting the selection criteria. Samples were collected for blood culture and ELISA was performed for detection of CRP, PCT & IL-6. Results: A total of 300 newborns were included in this study from NICU of which 132 (44%) neonates was found to be blood culture positive. The most frequently isolated organisms were Klebsiella pneumoniae (26.5%), followed by Candida albicans (18.1%). In case of confirmed neonatal sepsis, significant higher levels of CRP, PCT and IL-6 were detected than in cases of probable sepsis. Serum procalcitonin levels exhibit highest sensitivity and specificity as 65.91% and 91.67% respectively. Conclusion: Serum procalcitonin has better diagnostic utility in terms of biological marker for the diagnosis of neonatal infections than C- reactive protein and Interleukin-6.

Effect of vitamin D supplementation on fetal growth and development in pregnant women

Introduction and Aim: Fetal growth is a dynamic process that must be monitored in pregnant women to reduce the long-term consequences of fetal anomalies and post-natal effects on their life. The current study was aimed to find out the effectiveness and association of vitamin D on fetal growth during the prenatal period. Materials and Methods: It was a randomized control trial undertaken in 100 pregnant women who were allocated randomly into two groups based on calcemic state. After giving 6000 IU of vitamin D intervention the fetal growth was measured at the end of 3 months and the variables were obtained before and after the intervention. Results: The mean difference of fetal weight between groups was 77g was significantly increased to 277g (p<0.01) after 3 months. The mean difference of femur length before intervention was 0.95mm (p-0.18) significantly increased to 3.03mm (p<0.01). Further, the mean biparietal diameter difference was 0.13mm (p-0.92) was substantially increased to 4.77mm(p<0.01). Conclusion: The current study suggests that the fetal growth variables were significantly increased in post-intervention phases which can be attributed to vitamin D. It has an immense effect on fetal growth which can be supplemented during different trimesters to enhance fetal development.

review on anticancer potential of Quercus infectoria and its bioactive compounds

Cancer is a life-threatening disease if not diagnosed and treated early. Available cancer treatments with undesirable side effects have led to the search for safer and more effective treatments. Therapeutic intervention using plant-derived natural products have been of great interest these days. Many plant-derived phytochemicals have been implicated with anticancer activities. Quercus infectoria is one of the prominent candidates for its chemopreventive mechanisms of action in cancer. Worldwide, this plant has been used in various medicinal purposes. Based on the available data from previous scientific researches, this review focuses on the anticancer potentials of Q. infectoria, as well as its bioactive compounds such as tannic acid, gallic acid and ellagic acid. This review will trigger of generating new insights into possible application of this plant in cancer therapy.