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1.
Braz J Biol ; 84: e278393, 2024.
Article in English | MEDLINE | ID: mdl-38422290

ABSTRACT

Artemisia vulgaris L. belongs to Asteraceae, is a herbal plant that has various benefits in the medical field, so that its use in the medical field can be explored optimally, the plant must be thoroughly identified. This study aims to identify A. vulgaris both in terms of descriptive morpho-anatomy and DNA barcoding using BLAST and phylogenetic tree reconstruction. The morpho-anatomical character was observed on root, stem, and leaf. DNA barcoding analysis was carried out through amplification and alignment of the rbcL and matK genes. All studies were conducted on three samples from Taman Husada (Medicinal Plant Garden) Graha Famili Surabaya, Indonesia. The anatomical slide was prepared by the paraffin method. Morphological studies revealed that the leaves of A. vulgaris both on the lower-middle part and on the upper part of the stem have differences, especially in the character of the stipules, petioles, and incisions they have. Meanwhile, from the study of anatomy, A. vulgaris has an anomocytic type of stomata and its distribution is mostly on the ventral part of the leaves. Through the BLAST process and phylogenetic tree reconstruction, the plant sequences being studied are closely related to several species of the genus Artemisia as indicated by a percentage identity above 98% and branch proximity between taxa in the reconstructed phylogenetic tree.


Subject(s)
DNA Barcoding, Taxonomic , Plants, Medicinal , DNA Barcoding, Taxonomic/methods , DNA, Plant/genetics , Phylogeny , Plants, Medicinal/genetics , Plant Leaves/genetics
2.
Med J Malaysia ; 78(7): 876-882, 2023 Dec.
Article in English | MEDLINE | ID: mdl-38159921

ABSTRACT

INTRODUCTION: The fourth leading cause of cancer-related mortality and morbidity worldwide is colorectal cancer (CRC). Numerous reasons have contributed to the massive rise in CRC cases, for which Asian nations differ significantly in terms of risk incidence rates. The objectives of this study were to, first, identify the socio-demographic characteristics of those of North Borneo ethnicity and body mass index (BMI) and, second, determine the association of these factors with CRC. This research will contribute to preventing this form of cancer. MATERIALS AND METHODS: This study is an analysis of a matched case-control study with a ratio of 1:2. The case group contained 206 respondents, and the control group contained 412. All CRC cases were confirmed with the histological results. The control group was matched for links between age, sex and ethnicity with CRC. The Statistical Package for Social Sciences Statistics (SPSS) IBM version 28.0 was used to conduct descriptive analysis using chi-squared testing and simple logistic regression. The statistical significance was P < 0.05. RESULT: Overall, 618 respondents took part in this survey, of which 256 (41.4%) were female and 362 (58.6%) were male. The maximum age was 76, with a mean age ± SD of 53.17 ± 11.4. Those of Bajau ethnicity comprised 24.6% (152) of the population, followed by Dusun with 22.8% (141), Kadazan with 17.6% (109%), other North Borneo ethnic groups with 15.5% (96), Bugis with 9.7% (60), Brunei with 4.4% (27) and other predominant races with 5.3% (33). Regression analyses revealed that the incidence of CRC in North Borneo, Malaysia, was substantially correlated with income, occupation, other linked diseases and BMI. CONCLUSION: Various risk factors are linked to CRC, based on the findings related to socio-demographic characteristics and BMI. Therefore, to lower the nationwide prevalence of CRC, national public health campaigns should include collaboration with the regional authorities to highlight the incidence and risk factors of CRC based on ethnicity.


Subject(s)
Colorectal Neoplasms , Humans , Male , Female , Colorectal Neoplasms/epidemiology , Body Mass Index , Case-Control Studies , Malaysia/epidemiology , Borneo , Ethnicity , Risk Factors
3.
Braz J Biol ; 83: e274315, 2023.
Article in English | MEDLINE | ID: mdl-38126630

ABSTRACT

Safety regarding herbal products is very necessary; therefore, routine identification of raw materials should be performed to ensure that the raw materials used in pharmaceutical products are suitable for their intended use. In order for the identification-related data obtained to be accurate, the identification of various kinds of markers is also very necessary. The purpose of this study was to describe the characteristics of Eclipta alba (L.) Hassk. based on qualitative morpho-anatomical markers and quantitative DNA coding. The morphology of this plant has herbaceous habit with a taproot and a stem with branches that appear from the middle. Leaves are single type imperfectly arranged oppositely, lanceolatus, finely serrated on the edges, tapered at the base, pointed at the end, and have a pinnate and hairy leaf surface. The flowers consist of ray flowers and tube flowers with a cup shape. Meanwhile, in terms of anatomy, E. alba has aerenchyma, which are scattered in the cortex of the root and stem. In addition, there are anisocytic stomata, glandular trichomes, and non-glandural trichomes with an elongated shape accompanied by ornamentation found on the leaf epidermis. The results of sequence alignment and phylogenetic tree reconstruction show that the sample plants are closely related to species in the genus Eclipta.


Subject(s)
Eclipta , DNA Barcoding, Taxonomic , Phylogeny , Plant Leaves/anatomy & histology , Flowers
4.
Int J Oral Maxillofac Surg ; 52(12): 1244-1245, 2023 Dec.
Article in English | MEDLINE | ID: mdl-37567837

ABSTRACT

This is the first published case report of a successful radial forearm free flap harvest on the same side in a patient who had undergone a mastectomy, axillary dissection, and radiotherapy 10 years prior to flap harvest.


Subject(s)
Breast Neoplasms , Free Tissue Flaps , Plastic Surgery Procedures , Humans , Female , Breast Neoplasms/radiotherapy , Breast Neoplasms/surgery , Mastectomy , Lymph Node Excision
5.
Int J Oral Maxillofac Surg ; 52(3): 328-333, 2023 Mar.
Article in English | MEDLINE | ID: mdl-35791995

ABSTRACT

The aim of this study was to determine the incidence of postoperative cerebrovascular accident (CVA) following head and neck free tissue transfer and to identify predictive risk factors. A retrospective audit was performed of patients who underwent head and neck reconstructive surgery at Queen Elizabeth University Hospital between 2009 and 2020. The patient records were analysed to identify those who developed CVA within 30 days after surgery. A total of 1109 patients underwent head and neck free tissue transfer surgery, including 1048 neck dissection procedures. Of these, 78.6% had one or more identified risk factors for perioperative stroke. Five patients (0.45%) developed postoperative CVA. The results showed that CVA correlated to patients with hypercholesterolemia (P = 0.007). This study demonstrates the safety of free tissue transfer. Despite underlying co-morbidities and risk factors, the incidence of CVA is low following surgery and manipulation of the major vasculature of the neck.


Subject(s)
Free Tissue Flaps , Head and Neck Neoplasms , Stroke , Humans , Retrospective Studies , Incidence , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Stroke/epidemiology , Stroke/etiology , Neck/surgery , Head and Neck Neoplasms/surgery
6.
Int J Oral Maxillofac Surg ; 52(1): 1-12, 2023 Jan.
Article in English | MEDLINE | ID: mdl-35667947

ABSTRACT

Epithelial-myoepithelial carcinoma (EMC) is a rare salivary gland malignancy. Controversy exists in the literature regarding the effectiveness of treatment modalities employed in the management of EMC. This systematic review was undertaken to understand the presenting characteristics of EMC and identify the most common treatment modalities and their associated outcomes, in order to help guide an evidenced-based approach to the algorithm of care. The MEDLINE (PubMed) and Embase databases were searched (up to February 23, 2022), and the review was performed in accordance with the PRISMA statement. Fifty-seven studies (51 case reports and six case series) describing 91 cases of EMC were included in this review. In the included studies, a slow-growing painless mass was the most common presenting clinical feature. EMC was most frequently treated with surgery alone (65%). Local disease recurrence occurred in 24% of the cases and metastatic disease in 11%. A positive surgical margin was found to be associated with a higher risk of recurrence (P < 0.001), while adjuvant radiotherapy was associated with a decreased risk of local disease recurrence (P = 0.034). Metastatic disease and multimodal therapy were found to be associated with decreased disease-free and overall survival (all P < 0.05). The current literature supports surgery with clear margins as the mainstay of treatment for EMC of the salivary and seromucous glands of the head and neck. In certain situations, radiotherapy may improve disease-free survival.


Subject(s)
Carcinoma , Myoepithelioma , Salivary Gland Neoplasms , Humans , Myoepithelioma/surgery , Myoepithelioma/pathology , Neoplasm Recurrence, Local , Salivary Gland Neoplasms/surgery , Carcinoma/surgery , Carcinoma/pathology , Disease-Free Survival
7.
Ann Med Surg (Lond) ; 73: 103171, 2022 Jan.
Article in English | MEDLINE | ID: mdl-34984099

ABSTRACT

INTRODUCTION: Extra-skeletal Ewing sarcoma - a rare clinical entity. After the tumour resection, a huge upper anterior abdominal wall defect poses a challenge in soft tissue reconstruction in a thin individual. CASE PRESENTATION: We report an anterior abdominal wall Ewing sarcoma in a 22-year-old gentleman, arising from the left rectus abdominis muscle. After wide local excision, the reconstruction was achieved with free anterolateral thigh(ALT) fasciocutaneous flap with arteriovenous(AV) loop graft, right medial intercostal artery perforator(MICAP) flap and split-thickness skin graft(SSG). DISCUSSION: The goals of anterior abdominal wall reconstruction are to restore the integrity of the abdominal wall, prevent visceral eventration, and provide functional support. In view of the size of the defect, a free ALT flap was harvested and anastomosed to the left deep inferior epigastric bundle with the AV loop graft. Although the current trend is skewed towards the use of biologic mesh, an on-lay prolene mesh was used due to its affordable cost and that the biologic mesh was not available in Malaysia. The options of further reconstruction after the patient developed marginal flap necrosis and surgical site infection were also discussed. Post-operation 3 months, there was denser hair growth on the ALT flap. This finding has never been reported before and warrants further studies. CONCLUSION: The use of combination of various technique, namely free ALT fasciocutaneous flap with AV loop graft, right MICAP flap and SSG in reconstruction ensures a satisfactory functional and aesthetic outcome in the upper anterior abdominal wall reconstruction.

8.
Indian J Otolaryngol Head Neck Surg ; 74(Suppl 3): 5888-5892, 2022 Dec.
Article in English | MEDLINE | ID: mdl-36742794

ABSTRACT

Presentation with cervical lymphadenopathy would usually have an aetiology of neoplasm, infection or reactive cause. Dual pathology of regional metastasis with simultaneous occurrence of tuberculous lymphadenopathy is rather rare. Herein the authors present a case of primary occult carcinoma and tuberculous lymphadenopathy in an unfortunate patient. The reliability of fine-needle aspiration cytology as a first-line investigation, with alternative methods in approaching cervical lymphadenopathy, was further dissected.

9.
Int J Biol Macromol ; 193(Pt B): 1716-1726, 2021 Dec 15.
Article in English | MEDLINE | ID: mdl-34742842

ABSTRACT

Phosphorylated chitosan (P-CS) was successfully synthesized using a facile experimental setup of hydrothermal method that was applied to the adsorption of anionic Acid Red 88 (AR88) from aqueous media. The adsorption process obeyed the pseudo-second-order (PSO) kinetic model. In contrast, the adsorption isotherm conformed to the Langmuir model, with the maximum adsorption capacity (qm = 230 mg g-1) at 303 K. Both external and intraparticle diffusion strongly influenced the rate of adsorption. The insights from this study reveal that P-CS could be easily prepared and regenerated for reusability applications. The adsorption mechanism and intermolecular interaction between P-CS and AR 88 were investigated using Fourier transform infrared (FTIR) spectroscopy and calculations via Density Functional Theory (DFT). The key modes of adsorption for the P-CS/AR 88 system are driven by electrostatic attractions, H-bonding, and n-π interactions. The findings herein reveal that P-CS is a promising adsorbent for the removal of anionic dyes such as AR88 or similar pollutants from water.


Subject(s)
Azo Compounds/chemistry , Chitosan/chemistry , Coloring Agents/chemistry , Hot Temperature , Phosphorylation
10.
Br J Oral Maxillofac Surg ; 59(9): 1079-1084, 2021 11.
Article in English | MEDLINE | ID: mdl-34275677

ABSTRACT

The British Association of Oral and Maxillofacial Surgery is soon to implement the Quality Outcomes in Oral in Maxillofacial Surgery (QOMS) to provide a platform for quality management across the specialty in the UK. The initial oncology and reconstruction audits for QOMS involves data collection on specific procedures and metrics. The aim of this report is to determine their appropriateness using extant audit datasets in our institution that overlap substantially with the QOMS audits. Pre-existing datasets comprising information on patients treated for oral cavity SCC with curative intent were analysed. Data on surgical margins, lymphadenectomy lymph node yield, delay between surgery and adjuvant radiotherapy, duration of hospital stay, and complications including flap failures were analysed. All statistical analyses were performed with SPSS 25. Run charts describing longitudinal data were generated using SPC for Excel version 6. Twenty three patients (3.1%) of 701 resections had a positive surgical margin reported. Seventeen (4.3%) of patients had less than 18 LNs in the ND specimen analysed. Mean time to start date of adjuvant therapy was 62 days. Only 9% of patients commenced adjuvant therapy within 6 weeks. The median duration of stay was 18 days. In 1153 free flaps a failure rate of 4.3% was identified. A total of 1349 complications (CD I-V) were recorded in the 1111 patients undergoing major surgery with free flap reconstruction. The QOMS selected metrics for oncology and reconstruction are clinically relevant, readily measurable, and likely to be actionable by the surgical team.


Subject(s)
Free Tissue Flaps , Plastic Surgery Procedures , Benchmarking , Humans , Oral and Maxillofacial Surgeons , Retrospective Studies , United Kingdom
11.
Sci Adv ; 7(12)2021 03.
Article in English | MEDLINE | ID: mdl-33731358

ABSTRACT

Understanding the mechanisms of myogenesis in human induced pluripotent stem cells (hiPSCs) is a prerequisite to achieving patient-specific therapy for diseases of skeletal muscle. hiPSCs of different origin show distinctive kinetics and ability to differentiate into myocytes. To address the unique cellular and temporal context of hiPSC differentiation, we perform a longitudinal comparison of the transcriptomic profiles of three hiPSC lines that display differential myogenic specification, one robust and two blunted. We detail temporal differences in mechanisms that lead to robust myogenic specification. We show gene expression signatures of putative cell subpopulations and extracellular matrix components that may support myogenesis. Furthermore, we show that targeted knockdown of ZIC3 at the outset of differentiation leads to improved myogenic specification in blunted hiPSC lines. Our study suggests that ß-catenin transcriptional cofactors mediate cross-talk between multiple cellular processes and exogenous cues to facilitate specification of hiPSCs to mesoderm lineage, leading to robust myogenesis.


Subject(s)
Induced Pluripotent Stem Cells , Cell Differentiation/genetics , Humans , Induced Pluripotent Stem Cells/metabolism , Mesoderm , Muscle Development/genetics , Muscle, Skeletal
12.
J Appl Microbiol ; 130(4): 1273-1284, 2021 Apr.
Article in English | MEDLINE | ID: mdl-32813902

ABSTRACT

AIMS: To identify Botryosphaeriaceae fungal species that are associated with stem-end rot of mango, and to study their pathogenicity on mango fruit. METHODS AND RESULTS: Based on the sequences of internal transcribed spacer (ITS), TEF1-α and ß-tubulin, as well as on the phylogenetic analysis of combined sequences, four species of Lasiodiplodia (L. theobromae,L. pseudotheobromae, L. iranensis, L. mahajangana) and two species of Neofusicoccum (N. ribis, N. parvum) were identified. Pseudofusicoccum violaceum, Neoscytalidium dimidiatum and three species of Botryosphaeria (B. scharifii, B. dothidea, B. ramosa) were identified based on sequences of ITS and TEF1-α. Pathogenicity test of selected isolates were tested on Chok Anan, Waterlily and Falan mango cultivars. Generally, all species were observed to be pathogenic on the three tested mango cultivars on wounded fruits, except for N. ribis and N. parvum, which were pathogenic on both wounded and unwounded fruits. However, N. ribis was only pathogenic on cultivar Falan, whereas B. ramosa were pathogenic on cultivars Waterlily and Falan. CONCLUSIONS: Eleven species of Botryosphaeriaceae were associated with mango stem-end rot in Malaysia. To the best of our knowledge, four species, namely L. mahajangana, B. ramosa, N. ribis and P. violaceum are the first recorded Botryosphaeriaceae fungi associated with stem end rot of mango. SIGNIFICANCE AND IMPACT OF THE STUDY: The identification of Botryosphaeriaceae fungi is important to establish suitable control measures and quarantine requirements. Many species have a wide host range, which means that there is a possibility of cross infection from other infected plants.


Subject(s)
Ascomycota/isolation & purification , Mangifera/microbiology , Plant Diseases/microbiology , Ascomycota/classification , Ascomycota/genetics , Ascomycota/physiology , DNA, Fungal/genetics , DNA, Fungal/metabolism , Fruit/microbiology , Fungal Proteins/genetics , Fungal Proteins/metabolism , Malaysia , Phylogeny
13.
Br J Oral Maxillofac Surg ; 59(1): 5-15, 2021 01.
Article in English | MEDLINE | ID: mdl-33143945

ABSTRACT

Complete tumour resection (R0 margin) is an axiom of surgical oncology. Oral cancer ablation is challenging, due to anatomical, functional, and aesthetic considerations. R0 margin is strongly linked to better survival outcomes with great variation in the R0 % across units. This is commonly attributed to disease biology. Without disputing the importance of biological characteristics, we contend that image-based anatomical surgical planning has an important role to play in achieving complete resection. Here, we present our approach utilising cross-sectional imaging, anatomical characteristics and spatial awareness in planning resections for floor of mouth (FOM) and oral tongue cancers. We highlight the challenge of controlling the deep tumour margin lingual to mandible due to anterior vector constraints and emphasise the importance of resecting the genial muscles in a planned fashion and that any rim resection should be obliquely sagittal. In resecting lateral FOM tumours, assessing extension to the parapharyngeal fat is crucial; and mandibular rim resection at a sagittal plane below the mylohyoid line is often required. Assessing the proximity of the contralateral neurovascular pedicle, pre-epiglottic space and hyoid bone are crucial parameters to determine the extent of tongue tumour resection. Our cohort included 173 patients with FOM SCC and 299 patients with tongue SCC. Six patients (3.5%) from the FOM group and eight patients (3%) from the tongue group had involved (R1) margins following surgery. This was associated with local relapse (p<0.05). In conclusion, we demonstrate that image-based planning can aid achieving R0 resections and reduce disease relapse.


Subject(s)
Head and Neck Neoplasms , Tongue Neoplasms , Esthetics, Dental , Humans , Mouth Floor/diagnostic imaging , Mouth Floor/pathology , Mouth Floor/surgery , Neoplasm Recurrence, Local/pathology , Neoplasm Staging , Tongue/diagnostic imaging , Tongue/pathology , Tongue/surgery , Tongue Neoplasms/diagnostic imaging , Tongue Neoplasms/pathology , Tongue Neoplasms/surgery
14.
Int J Oral Maxillofac Surg ; 49(6): 700-708, 2020 Jun.
Article in English | MEDLINE | ID: mdl-31892444

ABSTRACT

Adenoid cystic carcinoma (ACC) is an aggressive salivary gland neoplasm characterized by high rates of local recurrence, early metastasis, and a poor long-term prognosis. Approximately 20-50% of cases result in distant metastasis, commonly involving the lung, bone, liver, and brain. Cutaneous metastasis is a rare occurrence, with a small number of cases reported previously in the context of multiple metastatic sites of involvement. We present a unique case of ACC of the hard palate with isolated cutaneous metastasis. A 36-year-old woman underwent a subtotal maxillectomy and skull base resection for the treatment of a T4N0 ACC of the right maxilla. One year postoperatively, the patient presented with multiple rapidly growing painful nodules on the skin of the scalp, neck, and chest. Biopsy confirmed metastatic poorly differentiated ACC, and positron emission tomography demonstrated cutaneous metastatic lesions without evidence of other tissue involvement. This case highlights the possible rare and aggressive pathways of metastasis of ACC. Currently there is no consensus for the treatment of disseminated disease, due to the poor efficacy of current treatment modalities. Where isolated metastasis is present, surgical resection can be attempted to control disease progression; however the benefit of metastasectomy on survival is not substantiated. As such, the role of newer targeted systemic therapies needs to be further investigated in the hope of achieving disease control.


Subject(s)
Carcinoma, Adenoid Cystic , Salivary Gland Neoplasms , Skin Neoplasms , Adult , Female , Humans , Neoplasm Recurrence, Local , Palate
15.
Br J Oral Maxillofac Surg ; 57(10): 957-966, 2019 12.
Article in English | MEDLINE | ID: mdl-31653434

ABSTRACT

Despite many advances in surgery, radiotherapy, and systemic treatments, only modest improvements in survival, function, and quality of life have been achieved after treatment of squamous cell carcinoma (SCC) of the head and neck. With a better understanding of the biology and genetics of tumours, the emergence of a paradigm shift towards the further development of non-surgical treatments may result in less morbidity and better outcomes than are seen currently. SCC of the head and neck is known to be a complex disease that has a sophisticated interaction with the human immune system. At the forefront of emerging treatments is immunotherapy, which has already been established in many other areas of oncology. The rapidly evolving nature of immunotherapeutic agents and, sometimes, their complex mechanisms can make the understanding of these concepts challenging, and could discourage clinicians from engaging in clinical trials. The aim of this paper therefore was to review the current premise for immunotherapeutic approaches, and to provide a contemporary evidence-based rationale for their use.


Subject(s)
Head and Neck Neoplasms , Immunotherapy , Squamous Cell Carcinoma of Head and Neck , Head and Neck Neoplasms/therapy , Humans , Quality of Life , Squamous Cell Carcinoma of Head and Neck/therapy
16.
J Crohns Colitis ; 13(11): 1394-1400, 2019 Oct 28.
Article in English | MEDLINE | ID: mdl-30994915

ABSTRACT

BACKGROUND AND AIMS: Inflammatory bowel disease is associated with an increased risk of colorectal cancer, with estimates ranging 2-18%, depending on the duration of colitis. The management of neoplasia in colitis remains controversial. Current guidelines recommend endoscopic resection if the lesion is clearly visible with distinct margins. Colectomy is recommended if complete endoscopic resection is not guaranteed. We aimed to assess the outcomes of all neoplastic endoscopic resections in inflammatory bowel disease. METHODS: This was a multicentre retrospective cohort study of 119 lesions of visible dysplasia in 93 patients, resected endoscopically in inflammatory bowel disease. RESULTS: A total of 6/65 [9.2%] lesions <20 mm in size were treated by ESD [endoscopic submucosal dissection] compared with 59/65 [90.8%] lesions <20 mm treated by EMR [endoscopic mucosal resection]; 16/51 [31.4%] lesions >20 mm in size were treated by EMR vs 35/51 [68.6%] by ESD. Almost all patients [97%] without fibrosis were treated by EMR, and patients with fibrosis were treated by ESD [87%], p < 0.001. In all, 49/78 [63%] lesions treated by EMR were resected en-bloc and 27/41 [65.9%] of the ESD/KAR [knife-assisted resection] cases were resected en-bloc, compared with 15/41 [36.6%] resected piecemeal. Seven recurrences occurred in the cohort. Seven complications occurred in the cohort; six were managed endoscopically and one patient with a delayed perforation underwent surgery. CONCLUSIONS: Larger lesions with fibrosis are best treated by ESD, whereas smaller lesions without fibrosis are best managed by EMR. Both EMR and ESD are feasible in the management of endoscopic resections in colitis.


Subject(s)
Endoscopic Mucosal Resection , Inflammatory Bowel Diseases/surgery , Intestinal Mucosa/surgery , Adult , Aged , Aged, 80 and over , Cohort Studies , Colorectal Neoplasms/prevention & control , Europe , Feasibility Studies , Female , Fibrosis/surgery , Gastrointestinal Tract/pathology , Gastrointestinal Tract/surgery , Humans , Intestinal Polyps/surgery , Male , Middle Aged , Retrospective Studies
17.
Surg Neurol Int ; 10: 251, 2019.
Article in English | MEDLINE | ID: mdl-31893152

ABSTRACT

BACKGROUND: Spinal arteriovenous fistulas (AVFs) are vascular lesions that often pose significant surgical challenges. This is particularly true for those located close to the anterior spinal artery. Here, we analyzed the surgical options for treating an anterior perimedullary AVF (pAVFs). CASE DESCRIPTION: A 66-year-old male with the right lower extremity weakness was diagnosed with a spinal dural AVF at the L1 level. It was initially treated with open surgery followed by CyberKnife radiosurgery at another institution. Five years later, he presented with a persistent pAVF fistula now involving the T11 level; the major feeder originated on the left at the T7-T8 level (e.g., involving a left-sided "duplicated" anterior spinal artery). Utilizing a three-dimensional (3D) computer tomography (CT) guided approach; he underwent a left-sided posterolateral T10-T12 laminectomy, sufficient to allow for 30-40° of anterior spinal cord rotation. This was performed under neurophysiological monitoring without any significant changes. Surgery included indocyanine green video angiography, temporary feeder clipping, and complete occlusion of the AVF, followed by complete clipping/resection as confirmed on postoperative magnetic resonance imaging. CONCLUSION: Utilizing a 3D CT image, a ventral pulmonary arteriovenous malformation was excised utilizing a left-sided posterolateral approach allowing for 30-40° of cord rotation.

18.
Dent Res J (Isfahan) ; 15(5): 327-333, 2018.
Article in English | MEDLINE | ID: mdl-30233652

ABSTRACT

BACKGROUND: Yogic stretching (asana) has been proven to have an effect on salivary human beta-defensin-2 (HBD-2) concentration, which is an antimicrobial peptide and is an inflammatory marker in periodontal disease. Sudarshan Kriya Pranayama (SKP) is a part of yoga which involves rhythmic breathing. Hence, we aim to evaluate the periodontal parameters and to estimate the salivary HBD-2 level before and after SKP program in periodontitis individuals. MATERIALS AND METHODS: An interventional study was designed and individuals were divided into three groups: Group I - healthy periodontium, Group II - chronic gingivitis, and Group III - chronic periodontitis. SKP was the interventional tool. The clinical parameters such as plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), and salivary HBD-2 level were analyzed at baseline and 90 days after the SKP practice. Enzyme-linked immunosorbent assay (ELISA) was used to evaluate salivary HBD-2. McNemar's Chi-square, Paired samples t-test, and one-way ANOVA were used to analyze the results. P < 0.05 was considered statistically significant. RESULTS: Following the SKP intervention, the clinical parameters such as PI and GI improved significantly in all the groups (P < 0.001); however, Group III showed a significant reduction as compared to the other groups. The mean baseline salivary HBD-2 levels of Group I, Group II, and Group III were 91.78 ng/µl, 110.22 ng/µl, and 157.63 ng/µl which was further decreased to 95.22 ng/µl, 98.22 ng/µl, and 132.88 ng/µl, respectively, following SKP intervention (P < 0.001). However, Group III had a higher HBD-2 level at 90 th day as compared to other groups. CONCLUSION: There was an improvement in PI and GI with a decrease in salivary HBD-2 in chronic periodontitis patients following SKP. Hence, SKP can be considered as an adjunct to treatment modality in patients with periodontal disease.

19.
Br J Oral Maxillofac Surg ; 56(6): 531-535, 2018 07.
Article in English | MEDLINE | ID: mdl-29895392

ABSTRACT

Biopsy of the superficial temporal artery is often used in the diagnosis of giant cell arteritis, but at traditional sites there is a risk of injury to the facial nerve. Recently the Gillies incision has been suggested as an alternative means of access for the biopsy, but the anatomical basis of this has not been fully elucidated. We therefore undertook a radiographic review of 150 patients, and examining 300 vessels, to find out. Our results indicated that there is considerable variability in the position of the bifurcation of the superficial temporal artery, and so a Gillies approach may not be reliable, particularly if access to the bifurcation is required.


Subject(s)
Biopsy/methods , Giant Cell Arteritis/diagnosis , Temporal Arteries/diagnostic imaging , Temporal Arteries/pathology , Adult , Aged , Aged, 80 and over , Anatomic Landmarks , Anatomic Variation , Female , Humans , Male , Middle Aged , Reproducibility of Results
20.
Clin Otolaryngol ; 43(5): 1219-1225, 2018 10.
Article in English | MEDLINE | ID: mdl-29733506

ABSTRACT

OBJECTIVES: To assess postoperative pain and pattern of recovery to normal diet in children who underwent tonsillectomy. METHODS: Cold steel tonsillectomy (or adenotonsillectomy) was performed in 61 children. Haemostasis was attained with sutures in Group 1 (n = 30, 8 tonsillectomy and 22 adenotonsillectomy), and electrocautery in Group 2 (n = 31, 6 tonsillectomy and 25 adenotonsillectomy). Information obtained included postoperative pain scores and the number of postoperative days taken to resume normal diet. The pain score was evaluated with the Wong-Baker FACES® Pain Rating Scale (WBFS). RESULTS: Pain values in Group 1 (haemostasis with sutures) were significantly lower than those in Group 2 (haemostasis with cauterisation) from the 6th hour to the 7th postoperative day (P < .05). For both liquid and solid food, Group 1 returned to normal diet earlier, compared to Group 2 (P < .05). When comparing patients undergoing tonsillectomy vs adenotonsillectomy, resumption of normal diet was achieved later in the adenotonsillectomy patients (P < .05). In terms of postoperative bleeding, there were 2 significant events in Group 2 (electrocautery group), occurring on the 1st (severe) and 10th day (slight) in 2 children (6.5%). There were no postoperative bleeding events in Group 1. CONCLUSION: Our results showed that suture haemostatis causes less pain and faster resumption of normal diet compared to electrocautery. In view of this, we recommend the use of sutures for achieving intraoperative haemostasis in paediatric patients.


Subject(s)
Electrocoagulation , Hemostasis, Surgical/methods , Pain, Postoperative/epidemiology , Sleep Apnea, Obstructive/surgery , Suture Techniques , Tonsillectomy , Tonsillitis/surgery , Adenoidectomy , Child , Diet , Female , Humans , Male , Pain Measurement , Pain, Postoperative/diagnosis , Prospective Studies , Recovery of Function
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