New Frontiers in Medicine and Medical Research Vol. 13

Purpose: This work attempts to investigate the clinical profile as well as consequences of globe rupture, which constitutes a key subclass of open globe ocular trauma, in pediatric patients as per the Birmingham Eye Trauma Terminology System.

Methods: All pediatric ocular trauma patients with mechanical eye injury who were enrolled at the ocular trauma care center between 2007 and 2019 were included in this prospective cohort study. The international ocular trauma society form was employed to acquire the data through our online MIS, and the details were exported to Excel sheet. The data were statistically analyzed by performing univariate analysis and cross tabulation with the help of SPSS 22 software. 

Results: Among the 12687 patients with mechanical ocular trauma, 7546 (59.4%) had endured open globe injuries while 5328 (41.9%) had sustained closed globe injuries. In the former, 818 (10.8%) fell under the globe rupture category and 417 (51%) belonged to the pediatric age group (0–18 years). The mean age of the patients was 8.4±4.5 years; 283 were males (67.9%) and 134 were females. (32.1%). 

Conclusion: Based on our findings, it could be inferred that open globe injury is a leading cause of vision loss in the pediatric age group (45.1% <1/60), with the problem being more widespread among the males (>67.2%) than females. The therapeutic approach encompasses multiple surgeries and is beneficial in improving the vision of the young patients.

Medical researchers at the University of Manchester and the University of Calabria recently found potential use for graphene - as a cancer treatment. After a series of tests on Cancer stem cells (CSC), discovered that graphene oxide (GO) targets and neutralizes these particularly hardy cancer cells. However, we have been researched nanographene particles that also affect the life of cancer cells. Several tests have been undertaken and the experiments of nanographene particles have shown promising results. This study on this treatment was then developed based on the results in applying the appropriate concentrations of nanographene to malignant lymphatic cells and the cancerous lump or mass in skin, breast and neck cancer in vitro to reduce and kill cancer cells. Another purpose of this study is to directly apply this treatment to external cancer areas. These treated cancer areas are shown on the image-guided localization to suppress the cancer cells. And we made these nanographene particles which are charged particles to wreck the growth of the cancer cells.

Cutaneous odontogenic fistulas or sinus tracts are frequently misdiagnosed and incorrectly treated, leading to unnecessary procedures and patient suffering. An understanding of the draining of cutaneous sinus tracts will lead to more appropriate treatment, the elimination of the source of infection reducing the incidence of complications [1].

 Most cases respond to conservative, nonsurgical root canal therapy.

Our objective is to report a case of cutaneous sinus tract evolving for 6 years secondary to chronic periapical dental infection caused by old trauma. The conservative treatment of the causal teeth was sufficient to achieve healing despite the oldness of the fistula.

The study's major goal was to determine the exact involvement of HDACs in the pathophysiology of Diabetic Nephropathy and whether targeting individual HDACs could slow the course of Diabetic Nephropathy. HDACs inhibitor benefits and drawbacks, as well as prospective challenges.

HDAC inhibitors have several advantages in Diabetic Nephropathy:-Anti-inflammatory effect, anti-fibrotic effect, TGF-beta 1 decreased, Collagen I reduced, Fibronectin reduced-SMA decreased- cadherin reduced, Reduces fibrogenesis, apoptosis, and DNA damage caused by eNOS, iNOS, and TGF-1, Preserves Klotho, Inhibits  Wnt pathway, Inactivation of EGFR pathway, Increases insulin sensitivity, Decreases insulin resistance, Beta cell proliferation, Decreases apoptosis, Restores nephrin and podocin, Suppress inflammatory protein, Insulin secretion increased and improved glucose control. Prevents endothelial  dysfunction due to Diabetes via activation of Nrf2, Prevents hepatic lipid dysfunction. Decrease diabetic retinopathy, Corrects cardiac metabolic function in Diabetic, Decrease body weight and obesity, Prevents aging, Prevents atherosclerosis, Prevents cardiac autophagy, Decreases TNF\(\alpha\), Decreases MMP, Reduces ER stress and Decreases caspase activation via inhibition of ER Stress pathway. The only drawback is many HDAC inhibitors are reported to have excessive ROS generation. However this is counter balanced with klotho which may be activated by specific inhibition of HDAC thus decreasing oxidative stress.

Connection of a tooth to an implant by means of prosthesis has always been debatable.

Aim: The aim of this review is to summarize and discuss the available information including literature review and other documentation available and our experience regarding the rigid connection between tooth and implant in fixed partial Prosthesis.

Objective:  We addressed clinical indications, contraindications advantages, disadvantages,  and potential risks like intrusion, marginal bone loss, tooth mobility ,while fabricating teeth implant supported prosthesis and also drew few recommendations to gain and facilitate enhanced success rate with teeth implant supported prosthesis.

Materials & Methods: Thirty Six (36) articles related to survival of implant supported prosthesis (ISP) and tooth implant supported prosthesis(TISP), prosthetic options like rigid connector (RC) or non rigid connector(NRC)and complications such as intrusion of teeth were selected and analyzed in order to get some outcome.

Results: Although surrounded with some controversy, tooth implants supported prosthesis provides clinicians more treatment option, reduces treatment cost if used rationally.

Conclusion: Connecting tooth to implant has its own benefits and risks, but it can be used a viable option in properly indicated situations.

This is a report of a female newborn baby who presented at the age of one hour after birth with signs of respiratory distress with marked cyanosis. The critical condition of the baby and the stormy course of the disorder highlighted the importance of starting immediate management and establishing an etiological diagnosis. Left ventricular noncompaction (LVNC) was eventually diagnosed in the baby and together with the metabolic management the baby survived the episode. This rare disorder of LVNC points to the importance of understanding the anatomical, physiological and metabolic processes which occur in the cardiac muscle to carry out its functions. Although LVNC has been described mostly in adults, more cases are now reported in children. However; cases with neonatal presentation of LVNC have been scarce in the literature. Hence it is important to report such cases because it provides the clue to uncover the etiological genetic disorders and familial occurrence.

Left ventricular pseudoaneurysm is a rare mechanical complication of acute myocardial infarction. The study aims at early detection of a rare complication of myocardial infarction which carries a grave prognosis and whose mainstay of management is surgical. We describe a 60 year old male who presented with typical ischemic type of chest pain with low blood pressure and heart rate. A 12 lead electrocardiogram showed atrioventricular (AV) dissocation with ST segment elevation in the inferior leads. The initial echocardiography depicted moderate pericardial effusion without tamponade. The possibilities of both, acute mechanical complications of myocardial infarction, and acute aortic dissection were sought of. The echocardiography on the following day revealed a free wall rupture of the infero-posterior wall of left ventricle with formation of a pseudoaneurysm. This was further proved by the computed tomography (CT) of chest with contrast, which in addition, ruled out acute aortic dissection. The patient was planned for an early surgery. Pre-operative coronary angiogram revealed complete occlusion of distal left circumflex artery and 70-80% discrete stenosis of mid left anterior descending artery.

The objectives of this paper was to see if Lipp Stress Control Training will also promote beneficial changes in risk factors with metabolic syndrome, that is defined by the presence of several risk factors such as glucose intolerance, dyslipidemia, and hypertension, as well as an inadequate diet, sedentariness, tobacco use, alcoholism, and excessive stress. The study involved 45 older women with MetS, ranging in age from 60 to 75 years old.Lipp Stress Control Training was given to them once a week, consisting of eight two-hour sessions with five groups of eight individuals. Stress levels were observed to have decreased significantly (p=0.005) after the intervention. Total cholesterol (p=0.012), LDL (p=0.0133), and triglycerides (p=0.05) were also significantly lower in the group before and after treatment. Stress Control Training lowered some MetS risk variables, such as stress, and may have contributed to MetS components like glucose, triglycerides, total cholesterol, and LDL cholesterol being reduced.  Stress Control Training will be a helpful, psychological therapy model representing a preventative approach for coronary illnesses, insofar as it could minimise the risk variables implicated in MetS, if the current data are verified in future research with a greater number of participants.

Emerging evidence indicate various environmental factors include stressors cause mental illness. Currently, unmet medical outcomes and surveillance platform demand in the field of mental disorders to implement of sensitivity associated along with key biomarker in the process of detection, evaluation and validation. The use of omics, based on macromolecule dependent data analysis such as bioinformatics in mental disorders and in a health care assessment platform, has the potential to increase identification of risk genes and treatment option by validate functional efficacy of drug or recovery status of brain function utilize behavioral assessment and metabolomics include neuro-pharmacogenomics study. This concept sounds futuristic but ideal. If the multiple data bases around the world continue to grow, making identification of a strand more likely, then health professional include clinicians and lab scientists could predict the likelihood of a disease outbreak, drug addiction, and the probability of synaptic malfunction that a treatment will work. Being able to stratification of risk gene profile and biomarker monitoring prior to disease dissemination has the potential to greatly diminish the current health care economic burden. However, the implementation in the clinical setting may take time; the therapeutic alternative includes biological and synthetic product will be worth the wait. Herein, to visualize impact of molecular connectivity and dynamics on functional imbalance resulted in phenotypic changes which reflect gene alterations such as single nucleotide polymorphism in several mental disorders, we conducted short review of mental illness which predominantly occurred and unknown causes by visualize identifying risk genes and functional susceptibility in the molecular diagnostic advances using Omics platform. In the future, it is likely that a majority of our treatment and care for patients or personal medicine/population medicine will be based on an omics strategy, molecular based risk assessment tools, as a safe and empower sensitivity to validate potential risk gene or therapeutic gene by adopting early detection risk management such as Integrated Omics.

The word ankylosis means stiff joint. Ankylosis is restriction of movement of the condyle disc complex resulting in restriction of mouth opening. Trauma is the leading cause of TMJ ankylosis. TMJ ankylosis leads to decrease in interincisal distance leading to poor oral hygiene and nutritional intake. Here is a case of 18 year old female patient who complained of pus discharge from her right side of face since 3-4months. She presented with history of poor oral hygiene due to restricted mouth opening. There was restriction in movement of right condyle along with decreased height of ramus. Correlating clinical and radiological findings, a diagnosis of osteomyelitis with ankylosis of right condyle and right hemifacial hypoplasia was given and was referred to higher centre for needful management. Although not directly but indirectly ankylosis is related to osteomyelitis as TMJ ankylosis causes reduced mouth opening leading to poor oral hygiene which subsequently leads to dental caries and when untreated osteomyelitis as one of its consequences. This case report will of academic and clinical importance as there are very few cases that are documented.

Lumbosacral spinal stenosis is a narrowing of the spinal canal, which compresses the nerves travelling through the lower back into the lower limbs. Symptomatic patients often have intermittent neurogenic claudication, and with diagnostic procedures at rest, it is difficult to evaluate it objectively

Measurement of conduction in the cauda equine at rest and after walking may be a valuable tool in lumbosacral spinal stenosis work-up.

The aim of our study was to compare results of magnetic in electrical stimulation, and the peripheral motor conduction time. Methods: M and F waves and compound muscle action potentials were recorded after L1 MS, S1 MS, and L1 ES. Results: The compound muscle action potential latency on L1 MS was 26.9 ± 2.6 milliseconds and on L1 ES was 25.6 ± 2.2 milliseconds, and the peripheral motor conduction time was 27.0 ± 2.5 milliseconds (analysis of variance P = 0.0008). The compound muscle action potential amplitude was 12 ± 11% of M-wave on L1 MS, 32 ± 18% on S1 MS, and 31 ± 17% on L1 ES. Conclusions: Dorsal MS reliably elicits responses in the abductor hallucis muscle. The latency of compound muscle action potentials on L1 MS is comparable to peripheral motor conduction time. A potential drawback of MS may be too weak stimulation at the proximal end of the cauda equina. 

Using Mayfield's scalp clamp became mandatory in most craniotomies but it leads to potentially hazardous hemodynamic pressor effects. Many interventions like infiltration of local anaesthetics at insertion sites or injecting ketamine, dexmedetomidine, clonidine and magnesium sulphate (MgSO₄) had been studied to attenuate these effects. This chapter aims to highlight the efficacy of these interventions through the previously published researches.

In conclusion: these undesired pressor effects can be attenuated or even abolished using either one modality or combination of two or more.

Current guidelines for acute coronary syndrome are derived from the data in randomized clinical trials and metanalysis conducted in patients. These patients are generally of younger age. The data of acute coronary syndrome in octogenarians is mainly derived from registries. This mid- and long-term data regarding medical therapy or interventions in octogenarians is low in number with smaller subsets of patients. Most of the physicians are reluctant to use the same guidelines in these elderly patients due to increased chances of complications. This article reviews the available data and literature in acute coronary syndrome in octogenarians and provides management perspectives for these elderly patients. Literature has proved that early invasive protocols seem to be just as feasible in the elderly as in the general population. In order to mitigate any pharmacological side effects, it is imperative to correct the dosages to age- adjusted renal function.

Introduction: A device for correcting unilateral Class II molar relationship was reported, as well as the clinical and laboratory methods for making the appliance. The clinical application for the Uni-lateral Atalla Distalizing (UAD) appliance was illustrated by a case report. The appliance's benefits and drawbacks were discussed in detail.

Methods and Materials: The palatal Temporary Anchorage Device (TAD) was placed just mesial to the front molars, at their resistance centres. The appliance that is installed on the lingual sheath of the maxillary molar's band on the Class II side, extending as far anteriorly as feasible parallel to the mid-palatal raphe. The distal end of the same wire was tightened in the lingual sheath while the mesial end served as a hook into which the NiTi coil spring was inserted.

Results: A Class I molar and canine associations were established in the clinical application. Overjet and overbite were likewise within acceptable limits. The roots of the teeth were fairly parallel on the post-treatment panoramic radiograph. The roots of the teeth were parallel in the post-treatment panoramic radiograph, and the supporting tissues were healthy. After treatment, the skeletal measurements on the post-treatment cephalometric radiograph indicated no significant alterations. Conclusion: Since the UAD appliance has been shown to be helpful in correcting unilateral molar Class II malocclusion, it is suggested for clinical usage in circumstances where it is indicated.

The exact cause of motion sickness is unknown. This vestibular malfunction can be associated with motion sickness. Hence there is a possibility of impaired balance in individuals with motion sickness.

Complementary and alternative medicine (CAM) has been defined as a group of diverse medical and health care systems, practices, and products not considered in conventional medicine. Efficacy and safety of many of CAM therapies for Juvenile Idiopathic Arthritis (JIA) have not been clearly demonstrated. The objective of this study was to assess the effectiveness and safety of Bach flowers remedies as a CAM therapy in children with Juvenile Idiopathic Arthritis.

Methods: Prospective, randomized, double-blind, placebo-controlled trial in 30 patients with JIA assigned to receive Bach flowers therapy (Healing HerbsÒ, United Kingdom) or placebo. Both groups underwent five medical visits over the course of 5 months follow up. At first and last visit, the American College of Rheumatology Pediatric 30 (ACR Pedi-30) criteria for improvement were applied. At all medical visit, clinical evaluation, symptoms, adverse events, changes in conventional medication and parents and patient’s perception of the therapy were evaluated.

Results: We found that 67% (10/15) of patients in the flower solution group and 77% (10/13) in the placebo group improved according to ACR-30 score, difference was not statistically significant (p=0.83). Ten children had no changes in drug regimen, 5 were of the flower therapy group (p>0.05). Nine children were able to decrease their use of medications; 6/9 in the flower therapy group, difference was not significant (p=0.43). About of opinion of the complementary therapy received, 75% (21/28) patients or family members rated the therapy as good or very good, 14 from the flower therapy group and 8 from the placebo group with no significant differences between groups (p= 0.19).

Conclusions: Bach flower therapy in JIA was not able to demonstrate greater effectiveness than a placebo in this study. Conventional therapy for JIA should not be replaced by CAM therapy, however, this study shows this type of therapy to be safe and therefore it may be used as a complement to traditional therapy. Bach flower therapy can help and support patients and families with emotional disturbances. Pediatricians could have an open relationship with families on this topic, allowing for discussion, information sharing, and research on chronic diseases.

The primary goal of this research is to determine the precise role of Sirtuins in physiology and pathology. Is it possible to identify sirtuins as a novel pharmacological target that can be easily manipulated by inhibitors or activators?

Natural products, semi-synthetic, synthetic and repurposing drugs such as alpha lipoic acid, resveratrol, vitamin D3, GLP-1, DPP-4 inhibitors, gene therapy with apelin, Icariin, coumestrol, dietary fatty acids, melatonin, Honokiol, SRT1460 etc. SIRT is a promising target for a variety of diseases and catastrophic complications, including metabolic, cardiovascular, neurological, neuropsychiatry, neurodegenerative, diabetes, and diabetic complications such as neuropathy, nephropathy, and retinopathy. It's also a possible target for osteoporosis, bone disorders, age-related alterations, male and female infertility, obesity, and metabolic syndrome. SIRT inhibitors can be used as anticancer agents. However, very few drugs specific SIRT activators are under investigation.

First episode of Seizure in a pregnant woman is always presumed as Eclampsia. Diagnosis of neurocysticercosis in pregnancy is often confounded by fact that associated symptoms of headache, nausea & vomiting, visual disturbance, neurological changes and seizures maybe presentation of Eclampsia Syndrome. Neurocysticercosis, although rare, is an important cause of first-time convulsions in pregnancy specially in tropical country like India. It can be very well treated with minimal interruption to the course of the pregnancy as in non-pregnant women and medical treatment is effective in most cases. In this this chapter along with management, we also report cases of pregnant patients with atypical features which were misdiagnosed as Eclampsia but they were later diagnosed to be Neurocysticercosis on Neuroimaging.

Deviated nasal septum after some time in most of the patients is associated with compensatory hypertrophy of the contra lateral inferior nasal turbinate. This is a compensatory mechanism to prevent excessive air entry in contra lateral nose. Till now the treatment of the condition was septoplasty but majority of the patients were not relieved of nasal obstruction caused by hypertrophy of the inferior nasal turbinate; hence treating the condition became necessary.

Aim of chapter: Was to establish the reason of hypertrophy; causes of the hypertrophy not reverting after the correction of the Nasal septum which was the cause of hypertrophy along with finding the indications and best possible treatment option for the condition.

We concluded that Compensatory Hypertrophy can easily be established by endoscopy and radiological methods; it involves both the mucosa (predominantly medial side of Inferior turbinate mucosa) as well as the turbinate bone; treating this Compensatory Hypertrophy at the time of septal correction is advisable as this Compensatory Hypertrophy is irreversible; depending upon the radiological evaluation of the predominant area of hypertrophy surgery can be planned.

“Isthmocele” or ‘Uterine Diverticulum” or “Uterine Niche” is being increasingly reported during the past three decades and it’s incidence is rising with the rising incidence of Caesarean section.  Gynaecological as well as Obstetrical morbidities are reported due to its presence and it is often missed when pregnancy occurs and thus can be” a maternal near miss” or can lead to maternal mortality.

 Gynecological morbidity is mostly in the form of abnormal uterine bleeding, secondary infertility, new onset dysmenorrhea and chronic pelvic pain. High index of suspicion is important for diagnosis and it can only be diagnosed by imaging such as USG and MRI and the criteria are well defined in recent literature. Management involves repair after exicision of isthmocele laparoscopically or hysteroscopically or by combined route and very rarely hysterectomy is needed to save maternal life in cases of caesarean scar ectopic in shock when encountered as a surprise. This is an iatrogenic condition due to caesarean section and thus it is preventable when adequate precautions are taken during caesarean section in the techniques of incision and suturing and correction of risk factors.