Congenital Hyperlipidemia in Infants for Congenital Cardiac Surgery.

Infants with concurrent severe hypertriglyceridemia and complex congenital heart disease are a rare occurrence and can have life-threatening consequences when undergoing surgical intervention. This case series outlines two instances involving infants undergoing total anomalous pulmonary venous connection repair and surgical closure of a ventricular septal defect. The study explores troubleshooting the effects of hypertriglyceridemia on perioperative outcomes.

Potential bioactive compound and hub gene identification of endometrial carcinoma using systems biology.

Endometrial carcinoma is a frequent cancer of the female genital tract. Endometrial carcinoma accounts for 97% of all uterine malignancies and 3 % of sarcomas that develop from the endometrium's glands. Endometrial cancer is frequently found in its early stages since most women quickly report postmenopausal vaginal hemorrhage. The need for more advanced medications to improve survival in such situations is still unfulfilled. As a result, there is growing interest in employing an herbal treatment to treat endometriosis, which seems to be an effective strategy. We have discovered a few unintended targets (ligands) in our investigation that are active components of common therapeutic herbs. The differentially expressed genes (DEG - target protein) for endometrial cancer were found using the NCBI and CIViC databases. In our investigation, the protein used for docking and simulation was PDB ID: 3THW. Using the Cytoscape server, the gene-encoding protein network has been identified. It was discovered that the Protein 3THW's binding energy to the bioactive substance (Asarone) was -7.15 Kcal/mol. It was discovered that the crucial interacting amino acid residues were ILE648, PHE650, ILE651, VAL802, TYR815, VAL817. The properties of the pharmaceutical target are further investigated by employing a molecular simulation study for 100 ns with NAMD software. Low RMSD and SASA (Solvent accessible surface area), high RMSF, High hydrogen bonds, between Asarone and MSH2 demonstrated their potency as endometrial cancer inhibitor compounds. Based on these analyses we infer that the bioactive substances originating from medicinal plants may be an effective treatment for endometrial cancer.Communicated by Ramaswamy H. Sarma.

Red emission of copper aluminate synthesized via chemical and bio-mediated routes.

For the first time, copper aluminate nanoparticles (NPs) are synthesized by a combustion method using urea as a fuel (CAOU) and Ocimum sanctum (tulsi) extract as a reducing agent (CAOT). The Bragg reflections of the as-formed product confirm the formation of a cubic phase with Fd3̄m space group. The crystallite size, crystallinity and other structural parameters are discussed. The surface morphology of CAOU is agglomerated in nature whereas that of CAOT is hexagonal in shape. The smaller crystallite size CAOT NPs show a higher energy band gap. The photoluminescence (PL) analysis excited at 302 nm shows that the CIE coordinates fall in the red region. The oxygen defects are mainly responsible for the PL emission. The CCT coordinates confirm that both CAOU and CAOT NPs can find an application in warm light emitting diodes.

Genetic Analysis of the Single-Nucleotide Polymorphisms rs880810, rs545793, rs80094639, and rs13251901 in Nonsyndromic Oral Clefts: A Case-Parent Trio Study.

Oral clefts, including cleft lip (CL), cleft palate (CP), and cleft lip and palate (CLP), are the most common types of congenital anomalies of the human face. Various genetic and environmental factors play a role in developing oral clefts. Several studies have shown the association of the PAX7 gene and the 8q24 region with these oral clefts in different populations worldwide. However, there are no reported studies on the possible connection between the PAX7 gene and the 8q24 region nucleotide variants and the risk of developing nonsyndromic oral clefts (NSOC) in the Indian population. Hence, this study aimed to test the possible association between PAX7 gene single-nucleotide polymorphisms (SNPs) rs880810, rs545793,rs80094639, and rs13251901 of the 8q24 region using a case-parent trio design. Forty case-parent trios were selected from the CLP center. Genomic DNA was isolated from the cases and their parents. The rs880810, rs545793, rs80094639, and rs13251901 were genotyped by the MassARRAY technique. PLINK software was used for statistical analysis. All the SNPs were tested for Hardy-Weinberg equilibrium. No statistical significance was found with any SNPs, as none of the genotyped SNPs showed a p -value of less than 0.05. Hence, the rs880810, rs545793, and rs80094639 of the PAX7 gene, and rs13251901 of the 8q24 region are not associated with NSOC in the Indian population.

Evaluation of polycaprolactone scaffold for guided bone regeneration in maxillary and mandibular defects: A clinical study.

OBJECTIVE: This study was carried out to assess bone regeneration following the use of polycaprolactone (PCL) scaffold in maxillary and mandibular osseous defects. MATERIALS AND METHODS: This prospective study included ten patients with maxillary or mandibular osseous defects present due to enucleation of periapical cysts or alveolar clefts requiring bone grafting and for lateral ridge augmentation that were treated with PCL scaffold. The patients were assessed clinically for pain, swelling, infection, and graft exposure at 1 week, 3rd, and 5th month postoperatively and were also evaluated radiographically for bone fill using intraoral periapical and/or panoramic radiographs at 4th, 6th, and 9th month postoperatively. RESULTS: PCL scaffold was used in a total of six alveolar clefts and three cases of periapical cysts and one case of lateral ridge augmentation. Nine out of ten cases demonstrated wound dehiscence and scaffold exposure in the oral cavity. Radiographically, on comparison to the control regions, all these nine cases failed to demonstrate appreciable bone density gain. Only one case of radicular cyst in the mandible was recorded to have satisfactory healing. CONCLUSION: Although PCL scaffold has the potential for bone regeneration in osseous defects, the scaffold exhibited marked tendency for dehiscence in intraoral defects that significantly affected bone healing. A long-term study designed with a larger sample size and categorization of the defects is required to assess its efficacy in varied defects. Moreover, comparative evaluation of PCL and autogenous or alloplastic bone grafting material could provide assenting results.

Is it time to revise the acclimatization schedule at high altitude? Evidence from a field trial in Western Himalayas.

BACKGROUND: In Western Himalayas, Indian Army soldiers take 11 days (6 days of acclimatization and 5 days of travel) on a sea-level to high altitude road (SH road) to reach a high altitude location (HAL) situated at an altitude of 11,500 feet from sea-level location (SLL) at an altitude of 1150 feet while following acclimatization schedule (AS). AS has an extra safety margin over the conventional 'mountaineering thumb rule' of not exceeding 500 m sleeping altitude above 3000 m altitude. We carried out this randomised field trial to study the feasibility of moving large number of troops rapidly from SLL to HAL on SH road in western Himalayas in 4 days under pharmaco-prophylaxis. METHODS: Based on the pharmaco-prophylaxis, at SLL 508 healthy lowland soldiers were divided into two groups: 'A' (n = 256) with Acetazolamide + Dexamethasone and 'B' (n = 252) with Acetazolamide + Placebo. They travelled rapidly by road to HAL in 4 days and prevalence of acute mountain sickness (AMS), high altitude pulmonary edema (HAPE) and high altitude cerebral edema (HACE) during the ascent was measured. RESULTS: Prevalence of AMS was found to be 1.56% and 1.59% in group 'A' and group 'B' respectively during the ascent with no cases of HAPE and HACE. CONCLUSION: At least on SH road, troops can be inducted rapidly to HAL from SLL in 4 days under pharmaco-prophylaxis with Acetazolamide with minimal occurrence of acute high altitude illnesses.

Ameloblastic fibroma in a young adult.

Ameloblastic fibroma is a rare mixed odontogenic tumor of the jaw comprising 2.5% of all odontogenic tumors. It is most commonly seen in young adults as a gradually increasing swelling in the jaw. Treatment considered is meticulous enucleation and curettage of surrounding bone. This study presents a case of ameloblastic fibroma in a 15-year-old female patient with a swelling on the right side of the mandible which was managed by enucleation and curettage.

Superolateral dislocation of the intact mandibular condyle: report of a rare case with a review.

Dislocation of the temporomandibular joint, which represents 3% of all dislocated joints reported in the body, occurs when the mandibular condyle is displaced anteriorly beyond the articular eminence. Although anterior dislocation of the mandibular condyle is well documented in the literature, superior, lateral, and posterior dislocation of the condyle is rare. Only a few reports documenting superolateral dislocation with anterior mandible fractures have been published in the past. However such dislocations without any associated fractures are even rarer. This report documents a case of superolateral dislocation of an intact mandible in a 48-year-old woman following a traumatic incident. This paper also reviews previously documented case reports and focuses on the causative mechanism, dynamics, and management of such dislocations.

Negative pressure wound therapy in the management of mine blast injuries of lower limbs: Lessons learnt at a tertiary care center.

BACKGROUND: Mine blast injuries of foot are devastating injuries that result in composite tissue loss or amputations. Negative pressure wound therapy has helped in the management of such combat-related wounds. The aim of this study was to report experiences gained in managing such injuries at a tertiary care center. METHODS: 17 combatants who sustained mine blast injuries were included in this study. Severity of foot injury was assessed as per Foot and Ankle Severity Score. After wound debridement, negative pressure wound therapy was started and foot defect was appropriately reconstructed. Following wound healing, the foot was assessed for Foot and Ankle Severity Score in terms of impairment. The patients were then suitably rehabilitated by shoe modifications, orthosis, or custom-made prosthesis. RESULTS: Mean age of soldiers who sustained mine blast injuries was 30.2 years. The mean Foot and Ankle Severity Score was 3.76. Temporary wound closure was achieved using negative pressure wound therapy and it prevented local and systemic infection. The defect could be reconstructed appropriately using split skin graft, regional fasciocutaneous flap, or microvascular free flap. Mean time to definitive reconstructive procedure was 16.5 days. Mean Foot and Ankle Severity Score in terms of impairment was 4.11. All soldiers could be rehabilitated and were returned to their respective units and were able to perform sedentary duties assigned to them. CONCLUSION: The negative pressure wound therapy was helpful in preventing proximal amputations due to mine blast injury and was helpful in satisfactory reconstruction of foot defects.

Comparison of Outcome of Modified Millard's Incision and Delaire's Functional Method in Primary Repair of Unilateral Cleft Lip: A Prospective Study.

BACKGROUND: Certain preoperative anatomical features may lead the surgeon to choose one particular incision pattern in preference to another. No one technique of cleft lip repair consistently produces ideal aesthetic and functional results. OBJECTIVES: This study was conducted to compare the outcomes attained using two different designs of skin incision used for surgical correction of unilateral cleft lip. MATERIALS AND METHODS: Modified Millard's incision and Delaire's functional method techniques were performed and evaluated on 18 patients who received primary unilateral cleft lip repair. Soft-tissue measurements of the lip and nose were recorded preoperatively. Analysis was based on postoperative assessment of the white roll, vermilion border, scar, Cupid's bow, lip length, and nostril symmetry and appearance of the alar dome and base. Chi-square and Fisher exact test, Student t test (two tailed, independent) and Student t test (two tailed, dependent) were used for statistical analysis of study parameters at 5 % level of significance. RESULTS: Preconceptions that one particular technique was better suited to certain preoperative cleft anatomical forms were not proven statistically. The outcome of our surgical methods was good and suggested quantitative changes with progressive diminution of asymmetry of the cleft and non cleft sides. CONCLUSION: Lip length improvement was better in case of modified Millard's incision. The Delaire's functional method of cleft lip repair results in improved nasal symmetry due to correction of the abnormal insertions of the underlying musculature.

Chondromyxoid fibroma of zygoma: A rare case report.

Chondromyxoid fibroma (CMF) is a rare benign mesenchymal tumor of the bone. Clinically, it is characterized by a lobular growth pattern and histologically by chondroid and myxoid differentiation. The tumor is rare in the craniofacial bones with only 2% of all reported cases. Extragnathic location in the facial skeleton is extremely rare. Most of the cases reported either originate from gnathic sites or in the cranium. A case of CMF in a 3½-year-old male is presented here, which arose from the root of zygomatic arch. A detailed clinical history and histopathological picture of one more case is added to the literature. It is important to document such cases so that better light can be shed on future reviews and conclusions. This shall facilitate better treatment approaches and prognosis. This case is the first reported case of involvement of the zygomatic arch in a pediatric patient.

Automated detection of choroid boundary and vessels in optical coherence tomography images.

Structural changes in the choroid, a layer located between the retina and sclera, could indicate various vision impairments. Consequently, ophthalmologists inspect optical coherence tomography (OCT) scans of the posterior section of the eye towards making diagnosis. With a view to assist diagnosis, we propose an automated technique for segmentation of the choroid layer. Specifically, we detect the upper and lower boundaries of the choroid using structural similarity and adaptive Hessian analysis. Subsequently, we detect choroid vessels within those boundaries using a level set method. Experimental results are presented using spectral domain (SD) OCT images.

Monostostic fibrous dysplasia with nonspecific cystic degeneration: A case report and review of literature.

Fibrous dysplasia (FD) has been regarded as a developmental skeletal disorder characterized by replacement of normal bone with benign cellular fibrous connective tissue. It has now become evident that FD is a genetic disease caused by somatic activating mutation of the Gsα subunit of G protein-coupled receptor. Here we report a case of bilateral monostotic FD in a middle-aged female showing a classic histological picture, but radiologically presenting as a mixed radiolucent radiopaque lesion showing nonspecific cystic degeneration.

Anterior maxillary metastasis of gastric adenocarcinoma: A rare case.

Metastatic tumors of the oral cavity are rare, representing about 1% of oral tumors. Seventy percent of all tumors metastatic to the oral and maxillofacial region are adenocarcinomas, most commonly originating from the breast, kidney and lung. Carcinoma of stomach is generally described as one of the "captains of men of death". Usual sites of metastasis from gastric adenocarcinoma are direct invasion of adjacent organs, peritoneal dissemination, lymphatic metastasis and hematogenous spread. A primary carcinoma of the stomach may rarely metastasize to the oral cavity, it is important to bear this possibility in mind because such conditions may mimic a benign disease. This article describes a case of metastasis of gastric adenocarcinoma to the maxilla in a 50-year-old male.

Surgical removal of a left ventricular myxoma in an infant.

Left ventricular (LV) myxoma is particularly rare in children and has not been reported in infants. A five-month-old baby presented with a myxoma arising from the anterior, lateral, and superior aspect of the LV, causing severe left ventricular outflow tract obstruction. The LV was accessed through the conal septum after opening the right ventricular outflow. The child had transient complete heart block in the postoperative period. There was no recurrence of tumor at the nine-month follow-up.

Role of collagen impregnated with dexamethasone and placentrix in patients with oral submucous fibrosis.

PURPOSE: To evaluate the versatility of the collagen membrane as both drug carrier and biologic dressing material to cover the raw wounds created after the surgical excision of fibrotic bands in oral submucous fibrosis. MATERIALS AND METHODS: The study comprises of ten patients. The patients of age group 20 to 50 years were selected. The collagen is reconstituted by injecting with dexamethasone and placentrix solution leaving a small overlap on to the remaining mucous membrane and the graft is sutured. Preoperative and post operative assessment was done regarding the improvement in mouth opening, decrease in burning sensation, change in colour of oral mucosa and clinically grading the extent of lesion. RESULTS: The results were found appreciable in seven patients while in the remaining three patients it showed relapse because of inadequate physiotherapy. All the ten patients were comfortable with intra oral collagen grafting. The collagen remained moist and supple intraorally, and remained in close contact with the underlying tissues, providing a strong mechanical barrier. The material was effective in attaining haemostasis, relieving pain and preventing extensive contracture. CONCLUSION: In this study of short duration, the nature of collagen membrane was observed as both biological dressing material and drug carrier. It was found as a very suitable alternative to the other graft material mentioned for the repair of defects in the mucous membrane created by surgical excision of fibrous bands in oral submucous fibrosis.

Ptosis correction: a challenge following complex orbital injuries.

Ptosis occurs when the muscles that raise the upper eyelid (levator and Muller's muscle) get damaged. There are lot of ptosis correction surgery reported in the journals of oculoplastic surgery and opthalmic surgery. Most of these surgeries are cosmetic correction. Rarely ptosis can be seen as a complication following orbitozygomatic complex injuries. Cause of traumatic ptosis most often is levator detachment from the superior tarsal plate. Lacerations of the lid may sever the levator tendon leading to scarring and secondary mechanical ptosis. Challenge in surgical management lies in identification of Levator aponeurosis, posterior to orbital septum and preaponeuratic fat. Once the levator muscle is freed from scar tissue it should be reapproximated to tarsal plate.

Jeune syndrome with neonatal cholestasis.

Jeune syndrome or Asphyxiating Thoracic Dystrophy presenting clinically with hepatic manifestations is rarely seen. Very few cases of liver involvement have been reported antemortem. The authors report a three-month-old child with Jeune syndrome who presented with prolonged neonatal cholestasis and normal stools.

A comparitive study of diclofenac transdermal patch against oral diclofenac for pain control following removal of mandibular impacted third molars.

OBJECTIVE: The objectives of this study was to evaluate subjectively the analgesic efficacy of Oral Diclofenac Sodium against Diclofenac Sodium Transdermal patch in the management of postoperative pain following surgical removal of impacted mandibular third molars. MATERIALS AND METHODS: Twenty healthy subjects belonging to both the sexes in the age group of 18-40 years with bilateral mesioangular impactions of mandibular third molar teeth underwent surgical removal under local anaesthesia by administering an inferior alveolar nerve block on two different occasions with a minimum interval of 1 week in-between the procedures. The postoperative pain was recorded on visual analog scale, a verbal rating scale, a pain relief scale and a pain intensity scale. Readings were taken at 2 hours, 4 hours, 8 hours, 12 hours and 24 hours postoperatively, taking the time at which the surgery was completed as a reference. On the second and third days, the repeat medication was administered at that reference time and recordings taken at the same intervals for a total of 3 days. Patients received the study medication i.e. Diclofenac Sodium 100mg once a day for 3 days after performing surgery on one side and the same patients were given Diclofenac Sodium Transdermal Patch 100mg once a day for 3 days after performing surgery on the contralateral side. RESULTS AND OBSERVATIONS: Both the statistical analysis and clinical observation showed that on the first postoperative day diclofenac sodium administered orally has slightly more significant efficacy when compared to the drug administered transdermally. However, on the second and third postoperative days there was no statistical or clinical difference in the pain control by either route of administration. CONCLUSIONS: The study concludes that transdermal diclofenac sodium can be used as an alternative form of pain control following removal of impacted mandibular third molars, however considering that the analgesic potency might be lesser in the immediate postoperative period, it might be prudent to use oral diclofenac sodium for immediate postoperative pain relief, following which transdermal route can be used for pain control.

Pregnancy in an untreated case of transverse vaginal septum with vesicovaginal fistula.

An 18-year-old woman presented with history of cyclic hematuria, abdominal pain, and a mass in the hypogastrium. She was found to have transverse vaginal septum in the lower one-third of her vagina with congenital vesicovaginal fistula (VVF) and a dead fetus of approximately 20 weeks gestation. She underwent vaginotomy and removal of the dead fetus. Vaginal repair of VVF was carried out 3 months later.