Effects of a Low-Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyol Diet on Symptoms of Functional Abdominal Pain in Pediatric Patients / 대한소아소화기영양학회지

Purpose@#Recently, great interest has been focused on dietary fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) for the treatment of functional abdominal pain (FAP). Several meta-analyses, including those on the adult population, have been published, potentiating its role. However, pediatric studies are scarce. We aimed to evaluate the effect of a low-FODMAP diet on the severity of FAP in children. @*Methods@#This clinical trial included 50 patients aged 3–18 years with irritable bowel syndrome and FAP that were not otherwise specified. The patients were instructed to receive a low FODMAP diet guided by a dietitian. The primary outcome was the percentage of responders after 2 months of dietary intervention compared with baseline. Other outcomes included changes in stool consistency and quality of life (QoL) scores using the KIDSCREEN-10 questionnaire, and weight-for-age z-scores. @*Results@#After the dietary intervention, 74% of patients showed more than 30% lower pain intensity, as examined using the Wong-Baker Faces pain rating scale. Their QoL significantly improved, and patients have gained weight. @*Conclusion@#A low FODMAP diet can improve pain intensity and QoL among children with functional abdominal pain, with no detrimental effects on body weight.

Fracture resistance of primary molars restored with endocrowns versus zirconia crowns (an in vitro study) / Resistência à fratura de molares decíduos restaurados com endocrowns versus coras de zircônia (um estudo in vitro)

Objective: This study aimed to assess the fracture resistance of primary molars restored with endocrowns compared to prefabricated zirconia crowns. Material and Methods: Twelve sound, defect-free primary second molars were selected and divided into two groups: group I included 6 molars restored with zirconia crowns, while group II included 6 teeth restored with endocrowns. For both groups access cavity was prepared for the teeth to open pulp chamber. Fracture resistance of both groups was tested using a universal testing machine. Results: Zirconia crown showed statistically significantly higher mean fracture resistance than Endocrown (P-value = 0.001, Effect size = 2.72). Conclusion: Pulpotomized primary molars restored with Zirconia crowns showed significantly higher mean fracture resistance compared to primary molars restored with endocrowns, meanwhile both restorations have shown higher mean fracture resistance than the maximum biting force in children. (AU)

Objetivo: Este estudo teve como objetivo avaliar a resistência à fratura de molares decíduos restaurados com endocrowns em comparação com coroas de zircônia pré-fabricadas. Material e Métodos: Doze segundos molares decíduos hígidos e livres de defeitos foram selecionados e divididos em dois grupos: o grupo l incluiu 6 molares restaurados com coroas de zircônia, enquanto o grupo ll incluiu 6 dentes restaurados com edocrowns. Para ambos os grupos, foi preparada uma cavidade de acesso à câmara pulpar. A resistência à fratura de ambos os grupos foi testada em uma máquina de ensaio universal. Resultados: A coroa de zircônia apresentou resistência média à fratura estatisticamente significativa maior do que endocrown (p=0,001, Tamanho do efeito = 2,72). Conclusão: Molares decíduos pulpotomizados restaurados com coroas de zircônia apresentam resistência média à fratura significativamente maior em comparação aos molares decíduos restaurados com endocrowns, entretanto, ambas as restaurações mostraram maior média à fratura do que a força máxima de mordida em crianças (AU)

Synthesis and biological activity of certain new indole derivatives via the utility of 2-acetylindole

The present work involves synthesis of 1-substitutedindole-2,3- dione-2-thiosemicarbazone derivatives in order to evaluate their antimicrobial, anti-inflammatory, analgesic, and anticonvulsant activities. The target compounds were prepared through oxidative deacetylation of 1-substituted-2-acetyl-3-hydroxyindole, which followed by the condensation with different thiosemicarbazide derivatives. The purity of all the newly synthesized compounds was checked by TLC and elucidation of their structures was confirmed by IR, 1H-NMR, and some representatives by mass spectrometry along with elemental microanalyses. Preliminary in-vitro antimicrobial evaluation [MIC] against some gram-positive and gram-negative bacteria as well as some fungi revealed that the tested compounds showed variable degrees of antibacterial activity, with little antifungal activity in comparison to chloramphenicol and fluconazole as reference drugs respectively. In addition, some of the tested compounds showed anti-inflammatory activity comparable to that of indomethacin. The most active compounds were further evaluated for their analgesic activity; results showed that these compounds were more active than indomethacin. Three compounds were tested for their ulcerogenicity; two of them were safer than indomethacin. Furthermore, in-vivo anticonvulsant evaluation of the tested compounds at 2.8, 2.0 and 1.4 mmol/Kg concentrations showed comparable anticonvulsant activity to that of diazepam using pentylenetetrazole induced seizure protocol. Moreover, LD50 of the most active compounds 4b and 4h were found to be 250 and 300 mg/Kg; respectively in comparison to the reported one for indomethacin 13 mg/Kg [i.p.]. Moreover, the study involved the docking of the most active compound in the active site of COX-2 enzyme

Late sequelae of anterior decompression and fusion for cervical spondylotic radiculo - myelopathy

Twenty-seven patients with cervical spondylotic radiculomyelopathy were managed by anterior decompression and fusion and were followed up for five years to review late sequelae in the adjacent segment to the site of previous fusion. The main evident complication was recurrent radiculomyelopathy at a new level adjacent to the site of previous fusion [five cases], three cases of them developed on the third year, one case on the fourth year and the last case on the fifth year, these levels were symptoms free on the first fusion. The greatest incidence was at the inter-space between the fifth and the sixth and between the sixth and the seventh cervical vertebrae, these cases did not respond to non-operative management and were treated by another anterior cervical decompression and fusion. It was observed that symptomatic adjacent segment disease affected about one fifth of all patients within five years after anterior cervical decompression and fusion. A single level fusion involving the fifth or sixth cervical space and pre-existing radiologic evidence of degeneration at adjacent levels appear to be the greatest risk factor for a new disease, so it is recommended that all degenerated segments causing radiculopathy or myelopathy should be included in the anterior cervical fusion and the patients should be informed of the substantial possibility that a new disease will develop at an adjacent level over the long term

Double v-shaped cancellous osteotomy of the radius for kienbock's disease

Seventeen patients with kienbock's disease were treated by radial shortening, by double V-shaped osteotomy. After and average of 2 years, relief of pain was satisfactory in ten patients [58.9%]; two patients [11.8%] were dissatisfied because they had persistant pain; while 5 patients [29.4%] had a mild tolerated pain. The range of motion improved moderately, in all cases, nonunion at the site of radial shortening osteotomy did not occur. Radiograph at follow up showed consolidation and healing of the lunate in 10 patients [58.9%], non progression of the disease in 5 patients [29.4%] and increase of the carpal collapse and osteoarthritis of the wrist in only 2 cases [11.8%]. The procedure helps to prevent further collapse of the lunate especially in early affected cases, provides a rich media for increase vasularity of the lunate and decrease the compressive forces of lower end of the radius on the lunate bone

comparative study between plaster casting and uniaxial external fixation with plating for comminuted distal radial fractures

External fixation in comminuted fractures of the distal radius has been used for almost 80 years, closed reduction and casting usually failed in 30% of unstable fractures, A comparative study was done for 14 comminuted fractures of the distal raduis treated by closed reduction and casting with another 14 comminuted fractures of the distal radius treated by combined uniaxial external fixator with open reduction and plate fixation, the cast group had a higher age incidence than the other group and they were more or less satisfied by the final end results [although they gave 50% satisfactory results], the combined external internal fixation group gave better results on the backgroup of Lindstrom and Sacraments scales, uriaxial external fixation maintained the length of the radius and provided facilities in reduction of the fractures, plate fixation provided buttressing effect on distal comminuted radial fracture and prevented angulation and deformity, the plaster group gave satisfactory results in 7 fractures [50%] while external-internal fixation group gave satisfactory results in 13 fractures [92.8%]

Evaluation of the results of internal fixation of displaced acetabular fractures

Displaced acetabular fractures must be treated as soon as the patient is stable, ideally in the first two weeks postinjury. Now, surgical reconstruction of recent displaced acetabular fractures has become the accepted treatment of choice for achieving the best long term results following injury. Early radiological evaluation yielded a perfect reduction in [26] patients [28.38%], near perfect reduction in [31] patients [37.11%], good reduction in [26] patients [28.38%] and failure in [7] patients [7.10%]. The late radiological results after at least 12 months, were excellent in [36] [13.3%], poor in [8] patients [8.8%], 34 patients were good and 12 patients were fair. The functional results were excellent in [29] patients [32.2%], good in 44 patients [48.9%].Fair in 10 patients [11.1%] and poor in 7 patients [7.8%]. The common postoperative complications, were sciatic nerve injury in [8] patients [8.9%] and heterotopic ossification in 8 patients [8.9%]

Atlanto - axial rotatory instability

Atlanto-axial rotatory subluxation was diagnosed in 13 patients. Traumatic cases has been recorded in [11] patients [84.16%] in which the rotatory instability was postulated as a result of direct trauma. Seven cases [63.63%] out of 11 cases] were diagnosed early by the aid of radiography and computed axial tomography and they were reduced spontaneously. While the remaining 4 cases [36.37%] were treated by short period of halter traction to achieved reduction and were followed by collar support. Non traumatic subluxation of the altantoaxial joint following peripharyngeal inflammation [Grisel's syndrome], were seen in 2 patients [15.48%] which has been attributed to laxity of the transverse ligament caused by inflammatory hyperemia. These [2 cases, [15.84%]] were diagnosed 10 months later and were submitted to cervical fusion in situ for instability