Physiotherapeutic Rehabilitation for a Geriatric Patient With Discitis Associated With Pott's Spine: A Case Report.

Discitis linked to Pott's spine is an infrequent yet severe issue, especially difficult to manage among elderly individuals due to age-related bodily changes and concurrent health issues. This report details the successful physiotherapy-based recovery of a senior patient afflicted with discitis related to Pott's spine. The individual, a 61-year-old man, presented symptoms including intense back pain, restricted movement, and neurological issues. The diagnosis was confirmed via imaging scans, indicating spinal tuberculosis and vertebral disc involvement. Treatment embraced a comprehensive approach involving medication alongside physiotherapy. The physiotherapeutic regimen aimed at pain alleviation, enhancing spinal flexibility, strengthening weakened muscles, and promoting functional autonomy. Techniques such as manual therapy, targeted exercises, and patient education were employed. Despite the challenges posed by the patient's age and existing conditions, significant enhancements in pain management, mobility, and everyday functioning were noted during the rehabilitation journey. This case underscores the significance of prompt diagnosis, collaborative care, and personalized physiotherapeutic interventions in attaining positive outcomes for elderly patients grappling with discitis associated with Pott's spine. Further investigation is needed to delineate optimal rehabilitation approaches for this intricate condition among the elderly.

Performance evaluation of carbon quantum dots impregnated glass ionomer cement to avoid peri-implant disease.

Dental cement residues exacerbate peri-implant tissue irritation and peri-implantitis. The present study aims to evaluate the cytotoxicity, physiochemical, optical, and rheological properties of carbon quantum dots (CQDs) impregnated glass ionomer cement (GIC). Surface passivated fluorescent CQDs were synthesized using citric acid via thermal decomposition and blended with GIC. Characterization studies and rheological measurements were made to evaluate their performance. 3D-printed dental implant models cemented with GIC and GIC-CQD were compared to analyze excess cement residues. MTT assay was performed with human dental pulp stem cells (hDPSCs) and statistically analyzed using ANOVA and Tukey's test. CQDs with a particle dimension of ∼2 nm were synthesized. The amorphous property of GIC-CQD was confirmed through XRD. The fluorescence properties of GIC-CQD showed three times higher emission intensity than conventional GIC. GIC-CQD attained maturation with a setting time extended by 64 s than GIC. Cement residue of size 2 mm was detected with a UV light excitation at a distance between 5 to 10 cm. Biocompatibility at 0.125 mg ml-1dilution concentrations of GIC-CQD showed viability greater than 80% to hDPSCs. For the first time, we report that CQDs-impregnated GIC is a unique and cost-effective strategy for in-situ detection of excess cement rapidly using a hand-held device. A novel in-situ rapid detection method enables the dentist to identify residual cement of size less than 2 mm during the implantation. Therefore, GIC-CQD would replace conventional GIC and help in the prevention of peri-implant diseases.

A Comparative Evaluation of Three Methods of Disinfection of Gypsum Casts and the Changes in Surface Roughness and Dimensional Accuracy after Disinfection-An Ex Vivo Study.

BACKGROUND: One of the major problems of everyday dental practice is cross-contamination. It can place office personnel, dentists, and patients at risk of acquiring serious illness. Disinfection helps in controlling this cross-contamination to an extent. The evaluation was done to find the efficient disinfection method on gypsum casts. AIMS: The aim of this study is to evaluate and compare the efficacy of three methods of disinfection of gypsum casts, namely, chemical disinfection by immersion, spray method, and microwave method, and also to evaluate and compare changes in surface roughness and dimensional accuracy between the three methods after disinfection. MATERIALS AND METHODS: Ex vivo and experimental study. Thirty participants were selected, and impressions of the maxillary arch were made using polyvinyl siloxane impression material. Ninety type IV die stone gypsum casts were poured. It was divided into three groups and was subjected to chemical disinfection by immersion and spray methods, and microwave method. The disinfected casts were evaluated for microbial growth, surface roughness, and dimensional accuracy. It was performed by using the one-way analysis of variance test and paired t-test followed by the Kruskal - Wallis test and Wilcoxon signed rank test (α = 0.05). RESULTS: Microwave disinfection was more effective than both immersion and spray chemical disinfection methods (P < 0.010 and <0.001). The surface roughness of the microwave-irradiated casts had significantly increased after disinfection. However, there were no significant dimensional changes by any of the methods of disinfection. CONCLUSION: Within the limitations of the study, the microwave method of disinfection is more effective in eradicating microorganisms when compared to chemical methods of disinfection by immersion and spray methods.

Catamenial haemothorax-A rare cause of pleural effusion.

Common causes of haemorrhagic pleural effusions include malignancy (primary or metastatic), tuberculosis, pulmonary embolism, collagen vascular diseases, trauma and iatrogenic causes. Clinical history along with pathologic, microbiologic and biochemical evaluation of pleural fluid confirms the diagnosis in most cases. However, if there is recurrent haemorrhagic effusion without corroborative history or mass lesion in lung, or evidence of microorganisms, then we should think of uncommon causes. Catamenial haemothorax (CHt) is a rare cause of haemorrhagic pleural effusion, which recurs during each menstrual cycle. This is a manifestation of thoracic endometriosis syndrome (TES) caused by ectopic endometrial tissue in the thoracic cavity in women of child-bearing age. This extremely rare condition is difficult to diagnose, unless direct correlation with the menstrual cycle is established. TES consists of pleural forms such as catamenial pneumothorax, non-catamenial endometriosis-related pneumothorax and haemothorax; and parenchymal forms such as catamenial haemoptysis and lung nodules. Here we report a case of CHt in a 43-year-old female whose diagnosis was established by thoracoscopic pleural biopsy.

Dimensional Stability and Retention Strength of Impressions to Custom Impression Trays Fabricated Using Conventional Method and Additive Technology - An In-vitro Study.

BACKGROUND: 3D printing technology is replacing manual fabrication in all fields. 3D-printed impression trays should be assessed as they could replace conventional impression trays in the future. AIM: In-vitro comparison and evaluation of the dimensional stability and retention strength of impressions to custom impression trays fabricated using conventional method and additive technology. MATERIALS AND METHODS: A maxillary edentulous auto-polymerizing acrylic resin model served as the master model. Two moulds were prepared from the master model in order to obtain 12 casts. One cast was scanned for 3D printing digital light processing (DLP) and fused deposition modelling (FDM) 24 impression trays using polylactic acid (PLA). Twelve casts were used to fabricate light cure impression trays. Polyvinyl-siloxane impressions were made on the master model using 36 impression trays and 18 trays each were used to assess dimensional stability and retention strength. RESULTS: In dimensional stability analysis, one sample t-test revealed a statistically significant difference between each group and the master model followed by a one-way ANOVA. There were significant differences, but the difference was less with FDM trays (P < 0.05). In retention strength analysis, one-way Analysis of variance (ANOVA) revealed statistically significant difference between each group and post-hoc test revealed specific difference, the highest with FDM trays (P < 0.05). CONCLUSION: Dimensional changes were observed at 30 minutes and 72 hours. Lesser dimensional changes were observed when impressions were made using FDM trays followed by DLP and light cure trays. The mean retention strength seen in descending order was FDM, followed by DLP and light cure trays. The best retention strength was noticed when impressions were made using FDM trays.

Orthosurgical Management of a Patient with Cleft Lip and Palate.

A 31-year-old male patient reported with a chief complaint of a forwardly placed lower jaw. Oral examination revealed Angle's Class III relationship bilaterally and cephalometrically; the patient presented with a small-sized retrognathic maxilla and normal mandible. Orthosurgical treatment was carried out with 4 mm of maxillary advancement and 4 mm of mandibular setback to achieve ideal overjet, overbite, and intercuspation of teeth. The ANB angle showed a drastic change from -9.5° to 1° and a successful conversion of the skeletal profile from Class III to Class I. Orthosurgical treatment can thus be an effective means of treating a patient with cleft lip and palate but requires a detailed understanding of the case and a sound diagnosis to attain a successful outcome.

Long-Term Mortality Risk of People with Epilepsy Who Underwent Seizure Monitoring.

AIM: The aim is to study survival outcome and sudden unexpected death in epilepsy (SUDEP) of people with epilepsy who underwent epilepsy monitoring. SUBJECTS AND METHODS: Between 2000 and 2004, 558 persons were admitted to the epilepsy monitoring unit of SCTIMST who fulfilled the selection criteria. Their survival status as on December 31, 2013, was ascertained by clinic attendance record and by mail or telephone contact. RESULTS: Five hundred and fifty-eight persons with epilepsy (males 319, 6408 person-years) were included in this study. There had been 20 deaths till December 31, 2013, and 5 additional deaths were reported when followed up till May 2016. The standardized mortality ratio was 5.35 and higher for males (6.25) than for females (3.52). Those with generalized seizures (tonic and myoclonic seizures), electroencephalography (EEG) showing multifocal and generalized interictal discharges, and polypharmacy had a higher risk of mortality. SUDEP accounted for 5 deaths. CONCLUSION: People with refractory epilepsy who had undergone presurgical video EEG monitoring had higher mortality risk. Generalized or myoclonic seizures, multifocal or generalized interictal discharges, and polypharmacy independently increased their risk of mortality. SUDEP is an important cause of death.

A CBCT evaluation of molar uprighting by conventional versus microimplant-assisted methods: an in-vivo study.

OBJECTIVE: The aim of this prospective study was to compare the three-dimensional effects of the conventional helical uprighting spring (CA) and the mini-implant assisted helical uprighting spring (MIA), using CBCT scans. METHODS: Twenty patients with mesially tipped second mandibular molars were divided into two groups: CA group, in which 10 patients were treated using a conventional helical uprighting spring with conventional anchorage; and MIA group, in which 10 patients were treated using a mini-implant supported uprighting spring. Molar uprighting was observed in both groups for a period of four months. Two standardized 11×5-cm CBCT sections of the mandible were taken, being one prior to uprighting and one at the end of the four month follow-up. Statistical analyses at the beginning of treatment and after a 4 month follow-up were performed, with a significance level of p< 0.05. RESULTS: The mean amount of change in mesiodistal angulation in the MIA group was 8.53 ± 2.13o (p< 0.001) and in the CA group was 9.8 ± 0.5o (p< 0 .001). Statistically significant differences were found between the two groups with regard to buccolingual inclination of canine, first and second premolars (p< 0.05), second molar (p< 0.001) and extrusion of second molar (p< 0.05). CONCLUSIONS: The mean amount of change in the mesial angulation of the second molar in the CA as well as the MIA groups was similar. MIA, which used mini-implant as a source of anchorage, was more effective in preventing movement of the anchorage teeth as well as preventing extrusion of the second molar in the vertical plane, when compared to the CA group, which used dental units as a source of anchorage.

A CBCT evaluation of molar uprighting by conventional versus microimplant-assisted methods: an in-vivo study

ABSTRACT Objective: The aim of this prospective study was to compare the three-dimensional effects of the conventional helical uprighting spring (CA) and the mini-implant assisted helical uprighting spring (MIA), using CBCT scans. Methods: Twenty patients with mesially tipped second mandibular molars were divided into two groups: CA group, in which 10 patients were treated using a conventional helical uprighting spring with conventional anchorage; and MIA group, in which 10 patients were treated using a mini-implant supported uprighting spring. Molar uprighting was observed in both groups for a period of four months. Two standardized 11×5-cm CBCT sections of the mandible were taken, being one prior to uprighting and one at the end of the four month follow-up. Statistical analyses at the beginning of treatment and after a 4 month follow-up were performed, with a significance level of p< 0.05. Results: The mean amount of change in mesiodistal angulation in the MIA group was 8.53 ± 2.13o (p< 0.001) and in the CA group was 9.8 ± 0.5o (p< 0 .001). Statistically significant differences were found between the two groups with regard to buccolingual inclination of canine, first and second premolars (p< 0.05), second molar (p< 0.001) and extrusion of second molar (p< 0.05). Conclusions: The mean amount of change in the mesial angulation of the second molar in the CA as well as the MIA groups was similar. MIA, which used mini-implant as a source of anchorage, was more effective in preventing movement of the anchorage teeth as well as preventing extrusion of the second molar in the vertical plane, when compared to the CA group, which used dental units as a source of anchorage.

RESUMO Objetivo: o objetivo deste estudo prospectivo foi comparar, usando imagens de TCFC, os efeitos tridimensionais da mola convencional de verticalização (CA) e da mola de verticalização com ancoragem em mini-implantes (MIA). Métodos: vinte pacientes com segundos molares inferiores inclinados mesialmente foram divididos em dois grupos: grupo CA, no qual 10 pacientes foram tratados usando mola helicoidal de verticalização com ancoragem convencional; e grupo MIA, com 10 pacientes tratados usando mola de verticalização ancorada em mini-implantes. A verticalização dos molares foi observada nos dois grupos por um período de quatro meses. Foram obtidas duas secções tomográficas da mandíbula, com dimensões padronizadas de 11 x 5 cm, uma antes da verticalização e outra ao fim dos quatro meses de acompanhamento. As análises estatísticas ao início do tratamento e após os quatro meses de acompanhamento foram realizadas a um nível de significância de p< 0,05. Resultados: a média das alterações na angulação mesiodistal do grupo MIA foi de 8,53 ± 2,13o (p< 0,001), e do grupo CA foi de 9,8 ± 0,5o (p< 0,001). Diferenças estatisticamente significativas foram encontradas entre os dois grupos em relação à inclinação vestibulolingual do canino, do primeiro e segundo pré-molares (p< 0,05) e do segundo molar (p< 0,001), bem como para a extrusão do segundo molar (p< 0,05). Conclusões: a alteração média na angulação mesial do segundo molar nos grupos CA e MIA foi semelhante. O método MIA, que usou mini-implantes como ancoragem, foi mais efetivo na prevenção da movimentação dos dentes de ancoragem, bem como na prevenção da extrusão do segundo molar no plano vertical, quando comparado com o grupo CA, em que dentes foram usados como fonte de ancoragem.

Epileptiform discharges in EEG and seizure risk in adolescent children of women with epilepsy.

We aimed to study the epileptiform discharges (ED) and seizure risk in EEG of 12-18-year-old children of women with epilepsy (WWE). Children of WWE who were prospectively followed up in the Kerala registry of epilepsy and pregnancy (KREP), aged 12-16years (n=92; males 48, females 44) underwent clinical evaluation and a 30-min digital 18-channel EEG. The EEG showed epileptiform discharges in 13 children (5 males and 8 females). The EDs were generalized in 9 and focal in 4 (occipital 2, frontal 1, and centroparietal 1). They had significantly higher risk of ED (odds ratio 4.02, 95% CI 1.04-15.51) when compared to published prevalence of ED in healthy children. There were 2 children with epilepsy (one with localization-related epilepsy and the other generalized epilepsy). The children under study had a trend towards higher prevalence of epilepsy (odds ratio 3.39, 95% CI 0.82-13.77) when compared to age specific prevalence of epilepsy from community surveys in same region. Children of WWE showed increased risk of ED in EEG and trend towards increased seizure risk when compared to healthy children.

A conserved sequence in calmodulin regulated spectrin-associated protein 1 links its interaction with spectrin and calmodulin to neurite outgrowth.

Calmodulin regulated spectrin-associated protein 1 (CAMSAP1) is a vertebrate microtubule-binding protein, and a representative of a family of cytoskeletal proteins that arose with animals. We reported previously that the central region of the protein, which contains no recognized functional domain, inhibited neurite outgrowth when over-expressed in PC12 cells [Baines et al., Mol. Biol. Evol. 26 (2009), p. 2005]. The CKK domain (DUF1781) binds microtubules and defines the CAMSAP/ssp4 family of animal proteins (Baines et al. 2009). In the central region, three short well-conserved regions are characteristic of CAMSAP-family members. One of these, CAMSAP-conserved region 1 (CC1), bound to both ßIIΣ1-spectrin and Ca(2+)/calmodulin in vitro. The binding of Ca(2+)/calmodulin inhibited spectrin binding. Transient expression of CC1 in PC12 cells inhibited neurite outgrowth. siRNA knockdown of CAMSAP1 inhibited neurite outgrowth in PC12 cells or primary cerebellar granule cells: this could be rescued in PC12 cells by wild-type CAMSAP1-enhanced green fluorescent protein, but not by a CC1 mutant. We conclude that CC1 represents a functional region of CAMSAP1, which links spectrin-binding to neurite outgrowth.

Preliminary impressions in microstomia patients: an innovative technique.

Microstomia has been defined as an abnormally small oral orifice associated with various etiopathologic factors. Management of these patients poses extreme difficulties in every procedure during prosthesis fabrication. Restricted mouth opening of the patient makes the insertion and the removal of the tray extremely difficult. So sectioning of the existing stock tray is necessary, so that the trays can be inserted and removed in sections. The main problem encountered during this procedure is the reorientation of the tray back in position. This article presents an innovative technique for the easy handling of the sectioned stock impression trays.

Direct metal laser sintering: a digitised metal casting technology.

Dental technology is undergoing advancements at a fast pace and technology is being imported from various other fields. One such imported technology is direct metal laser sintering technology for casting metal crowns. This article will discuss the process of laser sintering for making metal crowns and fixed partial dentures with a understanding of their pros and cons.

Isoforms of protein 4.1 are differentially distributed in heart muscle cells: relation of 4.1R and 4.1G to components of the Ca2+ homeostasis system.

The 4.1 proteins are cytoskeletal adaptor proteins that are linked to the control of mechanical stability of certain membranes and to the cellular accumulation and cell surface display of diverse transmembrane proteins. One of the four mammalian 4.1 proteins, 4.1R (80 kDa/120 kDa isoforms), has recently been shown to be required for the normal operation of several ion transporters in the heart (Stagg MA et al. Circ Res, 2008; 103: 855-863). The other three (4.1G, 4.1N and 4.1B) are largely uncharacterised in the heart. Here, we use specific antibodies to characterise their expression, distribution and novel activities in the left ventricle. We detected 4.1R, 4.1G and 4.1N by immunofluorescence and immunoblotting, but not 4.1B. Only one splice variant of 4.1N and 4.1G was seen whereas there are several forms of 4.1R. 4.1N, like 4.1R, was present in intercalated discs, but unlike 4.1R, it was not localised at the lateral plasma membrane. Both 4.1R and 4.1N were in internal structures that, at the level of resolution of the light microscope, were close to the Z-disc (possibly T-tubules). 4.1G was also in intracellular structures, some of which were coincident with sarcoplasmic reticulum. 4.1G existed in an immunoprecipitable complex with spectrin and SERCA2. 80 kDa 4.1R was present in subcellular fractions enriched in intercalated discs, in a complex resistant to solubilization under non-denaturing conditions. At the intercalated disc 4.1R does not colocalise with the adherens junction protein, ß-catenin, but does overlap with the other plasma membrane signalling proteins, the Na/K-ATPase and the Na/Ca exchanger NCX1. We conclude that isoforms of 4.1 proteins are differentially compartmentalised in the heart, and that they form specific complexes with proteins central to cardiomyocyte Ca(2+) metabolism.

Modulation of phosducin-like protein 3 (PhLP3) levels promotes cytoskeletal remodelling in a MAPK and RhoA-dependent manner.

BACKGROUND: Phosducin-like protein 3 (PhLP3) forms a ternary complex with the ATP-dependent molecular chaperone CCT and its folding client tubulin. In vitro studies suggest PhLP3 plays an inhibitory role in ß-tubulin folding while conversely in vivo genetic studies suggest PhLP3 is required for the correct folding of ß-tubulin. We have a particular interest in the cytoskeleton, its chaperones and their role in determining cellular phenotypes associated with high level recombinant protein expression from mammalian cell expression systems. METHODOLOGY/PRINCIPAL FINDINGS: As studies into PhLP3 function have been largely carried out in non mammalian systems, we examined the effect of human PhLP3 over-expression and siRNA silencing using a single murine siRNA on both tubulin and actin systems in mammalian Chinese hamster ovary (CHO) cell lines. We show that over-expression of PhLP3 promotes an imbalance of α and ß tubulin subunits, microtubule disassembly and cell death. In contrast, ß-actin levels are not obviously perturbed. On-the-other-hand, RNA silencing of PhLP3 increases RhoA-dependent actin filament formation and focal adhesion formation and promotes a dramatic elongated fibroblast-like change in morphology. This was accompanied by an increase in phosphorylated MAPK which has been associated with promoting focal adhesion assembly and maturation. Transient overexpression of PhLP3 in knockdown experiments rescues cells from the morphological change observed during PhLP3 silencing but mitosis is perturbed, probably reflecting a tipping back of the balance of PhLP3 levels towards the overexpression state. CONCLUSIONS: Our results support the hypothesis that PhLP3 is important for the maintenance of ß-tubulin levels in mammalian cells but also that its modulation can promote actin-based cytoskeletal remodelling by a mechanism linked with MAPK phosphorylation and RhoA-dependent changes. PhLP3 levels in mammalian cells are thus finely poised and represents a novel target for engineering industrially relevant cell lines to evolve lines more suited to suspension or adherent cell growth.

Expression of neuregulin 4 splice variants in normal human tissues and prostate cancer and their effects on cell motility.

The neuregulin 4 gene encodes at least five different variants (designated A1, A2, B1, B2 and B3) produced as a result of alternative splicing. We have determined their sites of expression in normal human adult tissues using isoform-specific antibodies. Their expression is cell type specific and differs in subcellular location suggesting that they may have varied functions in these contexts. We have shown in a panel of prostate cancers that each form is present to differing degrees, and that principal component analysis indicates that there are three patterns of expression. Some isoforms were positively correlated with high prostate-specific antigen levels and others were inversely associated with Gleason score. Synthetic, refolded A forms promoted lamellipodia and filopodia formation in cells expressing the ErbB4 (CTa) receptor and stimulated cell motility in wound healing assays. The data suggest that the different forms have varied sites of expression and function, and this includes effects on cell architecture and motility.

Hydrogen bond, dimerization and vibrational modes in 2-chloro-3-hydroxybenzaldehyde and 3-chloro-4-hydroxybenzaldehyde from vibrational and ab initio studies.

Ab initio conformers and dimers have been computed at RHF and B3LYP/6-31G* levels for isomers 2-chloro-3-hydroxybenzaldehyde and 3-chloro-4-hydroxybenzaldehyde to explain the observed infrared absorption and Raman vibrational spectral features in the region 3500-50 cm(-1). The position of the chlorine in ortho position with respect to aldehyde group in 2-chloro-3-hydroxybenzaldehyde yields four distinct conformers; whereas the chlorine in meta position in 3-chloro-4-hydroxybenzaldehyde yields effectively only three conformers. Major spectral features as strong absorptions near 3160-80 cm(-1), down-shifting of the aldehydic carbonyl stretching mode and up-shifting of hydroxyl group's in-plane bending mode are explained using ab initio evidence of O-H⋯O bond-aided dimerization between the most stable conformers of each molecule. Absorption width of about 700 cm(-1) (∼8.28 kJ/mol) of O-H stretching modes suggests a strong hydrogen bonding with the ab initio bond lengths, O-H⋯O in the range of 2.873-2.832 Å. A strong Raman mode near 110-85 cm(-1) in each molecule is interpreted to be coupled vibrations of pseudo-dimeric trans and cis structures.

Periapical radiolucency not requiring endodontic therapy: an unusual case.

The article is a case report of an unusual manifestation of primary hyperparathyroidism seen in the mandible. Primary hyperparathyroidism is a rare disorder that can present its first symptoms in the jaws. The pre- and post-treatment radiographic features of such cases have only rarely been reported in dental literature. This case report highlights the importance of careful clinical and radiographic examination before commencing root canal treatment.

Impact of service delivery model on health care access among HIV-positive women in New York City.

As the New York City HIV=AIDS epidemic began generalizing beyond traditionally high-risk groups in the early 1990s, AIDS Service Organizations (ASO) sought to increase access to medical care and broaden service offerings to incorporate the needs of low-income women and their families. Strategies to achieve entry into and retention in medical care included the development of integrated care facilities, case management, and a myriad of supportive service offerings. This study examines a nonrandom sample of 60 HIV-positive women receiving case management and supportive services at New York City ASOs. Over 55% of the women interviewed reported high access to care, 43% reported the ability to access urgent care all of the time and 94% reported high satisfaction with obstetrics=gynecology (OB=GYN) care. This held true across race=ethnicity, income level, medical coverage, and service delivery model.Women who accessed services at integrated care facilities offering onsite medical care and case management=supportive services perceived lower access to medical specialists as compared to those who received services at nonintegrated sites. Data from this analysis indicate that supportive services increase access to and satisfaction with both HIV and non-HIV-related health care. Additionally, women who received services at a medical model agency were more likely to report accessing non-HIV care at a clinic compared to those receiving services at a nonmedical model agencies, these women were more likely to report receiving non-HIV care at a hospital.