Size and morphology of sella and volumetric evaluation of pituitary gland: a radiological survey

Background: Sella turcica is an important anatomical structure in the middle cranial fossa. It’s size follows the size of pituitary gland. The present study aimed to evaluate the size and morphology of sella and pituitary gland in the same patients without known hormonal or pituitary pathology.Methods: In this cross-sectional observational study three hundred patients underwent lateral x-ray of skull for sella turcica measurements and MRI brain for pituitary gland measurements.Results: We observed normal shape of sella (round or oval) in 66.7% of the study participants. Maximum mean anterior-posterior (AP) dimension was seen in the age group of 41 to 50 years (1.24±0.19 cm), while maximum length (0.87±0.12 cm), depth (0.87±0.21 cm) and volume (0.49±0.21 cu cm) was observed in the age group of 51 to 60 years. Similarly, CC dimension was observed to be maximum in the age group 41 to 50 years (5.9±0.51 mm). Study participants of age group more than 60 years had the maximum mean transverse dimension (12.73±0.29 mm) and the pituitary volume on MRI was observed to be maximum for the age group 51 to 60 years (398.45±61.24 cu mm).Conclusions: In our sample of 300 patients, sella turcica was normally shaped in 66.7%. Various dimensions of sella turcica and pituitary gland increased significantly till 50 to 60 years of of age, after which they decreased

Internet addiction: A Growing Threat: A cross-sectional among the Undergraduate medical students of Tertiary care Hospital, Mysuru

Background: The internet has quickly become a part of our lives, impacting every part of our existence. Its use has expanded beyond simply being a communication tool and a source of information. The objective of the study is to assess the prevalence of Internet addiction among the Undergraduate medical students of Mysuru. Methods: This cross-sectional study was conducted among 255 medical students of a Tertiary care Hospital, Mysuru for three months from September 1st to November 30th,2023. Data was collected using a semi-structured questionnaire. The semi-structured questionnaire covered details of demographic data and twenty questions of the Internet Addiction Test. Data were entered into MS Excel and analyzed using SPSS Version 26.0. Results: The prevalence of severe internet addiction was found to be 0.4 %, moderate addiction was found to be 27.8%, mild addiction was found to be 71.8% and there were no normal users. It was also found that 27.8% of males and 43.9 % of females have mild internet addiction, 14.9% and 12.9% have moderate internet addiction and 0.4% of females have severe internet addiction and there was no association between gender and internet addiction. Conclusion: Increased awareness of this issue among college professors and students is necessary, as is the development of a comprehensive program for students, to identify individuals who are at risk of developing an internet addiction before it becomes pathological

In era of gold standard laparoscopic surgery, a study profile of open Nissen’s fundoplication for drug refractory endoscopically diagnosed and manometrically confirmed hiatus hernia in a tertiary care hospital

Hiatus hernia is a condition in which part of the stomach protrudes into the chest cavity through the esophageal hiatus, a hole in the diaphragm. The condition is often asymptomatic but can cause gastroesophageal reflux disease (GERD), dysphagia, chest pain, and other complications in some cases. The diagnosis of hiatus hernia is typically made using imaging tests such as endoscopy or radiography and confirmation done using esophageal motility studies. Management of hiatus hernia depends on the severity and symptoms of the condition. Mild cases may be managed with lifestyle modifications such as weight loss, dietary changes, and avoiding certain trigger foods. Medications such as proton pump inhibitors (PPIs) and histamine receptor antagonists may also be used to control GERD symptoms in maximum number of cases. Surgical intervention will be necessary for more severe cases or cases that do not respond to conservative management. The two main types of surgery for hiatus hernia are conventional/open Nissen fundoplication and laparoscopic fundoplication. These procedures aim to strengthen the lower esophageal sphincter and prevent stomach acid from flowing back into the esophagus. Overall, the management of hiatus hernia requires a multidisciplinary approach involving gastroenterologists, surgeons, and primary care providers. The optimal management will be an individualized approach addressing severity of symptoms and responses to drugs. This study aims to review the drug refractory cases of hiatus hernia in a select group of adult patients not eligible for standard laparoscopic approach diagnosed endoscopically and managed by open Nissen’s fundoplication

FORMULATION OPTIMIZATION AND EVALUATION OF FLURBIPROFEN EMULGEL

Objective: The objective of the present study was to formulate flurbiprofen (FLB) emulgel, evaluation of the formulations and the selection of an optimized formulation through in vitro drug release and drug content studies. Flurbiprofen is a non-steroidal anti-inflammatory drug (NSAID) requiring frequent administration and its chronic intake can lead to systemic side effects like gastric irritation and GI bleeding. The development of a dermal drug delivery system can overcome these side effects. Methods: The emulgel formulations were produced using different combinations of oil and emulsifying agents. Carbopol 940 was used as a gelling agent. The prepared emulgels were evaluated for general appearance, pH, spreadability, extrudability, drug content, in vitro drug release, average globule size and viscosity. Results: Optimized formulation F7 showed a better in vitro drug release compared to the marketed gel preparation. The stability study for the optimized formulation was carried out at 25 °C/60 % RH for 3 mo and the emulgel was found to be stable concerning the physical appearance, pH and drug content. Conclusion: The study revolved around the formulation of emulgel containing Flurbiprofen for dermal delivery of the drug. Emulgel was formulated with the purpose to enhance the permeation of poorly water-soluble drug FLB. The study concluded that the optimized emulgel containing FLB exhibited better in vitro drug release profile compared to the marketed formulation

Surgical management of complex Fistula-in-ano (Bhagandara) by Sphincter Preserving Technique (with Ksharasutra Therapy) - A Case Study

Surgical management of complex fistula-in-ano is difficult and it is a challenge to any surgeon because there is high chances of recurrence and fear of incontinence due to injury of anal sphincteric muscles during surgical intervention. Sushruta has developed many surgical procedures, Ksharasutra is one of them. It is a medicated alkaline thread, which cut the fistulous tract slowly and gradually followed by healing. It also helps in draining pus from fistulous tract. Its treatment is still a challenge to the surgeons because of its high reoccurrence rate. So, the main goals for the treatment of Fisutula-inAno are preservation of continence, cicatrisation as possible due to low rate of recurrence. In Ayurveda, Ksharasutra therapy could reduce recurrence with success rate of 96.67%. A 30 years/male came to Shalya OPD with complaints of intermittent watery discharge from perianal region. After local examination and investigations he diagnosed as a case of Fistula-in-ano. He got operated thrice already for this complaint. He was put on for Ksharasutra therapy and the patient got cured from fistula with no complications. Therefore, the Ayurvedic surgery has shown potential for larger public health benefits for such type of cases

Urgent Need for Field Surveys of Coronaviruses in Southeast Asia to Understand the SARS-CoV-2 Phylogeny and Risk Assessment for Future Outbreaks

Phylogenetic analysis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is focused on a single isolate of bat coronaviruses (bat CoVs) which does not adequately represent genetically related coronaviruses (CoVs) [...

The structural basis of accelerated host cell entry by SARS-CoV-2 dagger

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of the pandemic coronavirus disease 2019 (COVID-19) that exhibits an overwhelming contagious capacity over other human coronaviruses (HCoVs). This structural snapshot describes the structural bases underlying the pandemic capacity of SARS-CoV-2 and explains its fast motion over respiratory epithelia that allow its rapid cellular entry. Based on notable viral spike (S) protein features, we propose that the flat sialic acid-binding domain at the N-terminal domain (NTD) of the S1 subunit leads to more effective first contact and interaction with the sialic acid layer over the epithelium, and this, in turn, allows faster viral ‘surfing’ of the epithelium and receptor scanning by SARS-CoV-2. Angiotensin-converting enzyme 2 (ACE-2) protein on the epithelial surface is the primary entry receptor for SARS-CoV-2, and protein–protein interaction assays demonstrate high-affinity binding of the spike protein (S protein) to ACE-2. To date, no high-frequency mutations were detected at the C-terminal domain of the S1 subunit in the S protein, where the receptor-binding domain (RBD) is located. Tight binding to ACE-2 by a conserved viral RBD suggests the ACE2-RBD interaction is likely optimal. Moreover, the viral S subunit contains a cleavage site for furin and other proteases, which accelerates cell entry by SARS-CoV-2. The model proposed here describes a structural basis for the accelerated host cell entry by SARS-CoV-2 relative to other HCoVs and also discusses emerging hypotheses that are likely to contribute to the development of antiviral strategies to combat the pandemic capacity of SARS-CoV-2

Possible Transmission Flow of SARS-CoV-2 Based on ACE2 Features

Angiotensin-converting enzyme 2 (ACE2) is the cellular receptor for the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) that is engendering the severe coronavirus disease 2019 (COVID-19) pandemic. The spike (S) protein receptor-binding domain (RBD) of SARS-CoV-2 binds to the three sub-domains viz. amino acids (aa) 22-42, aa 79-84, and aa 330-393 of ACE2 on human cells to initiate entry. It was reported earlier that the receptor utilization capacity of ACE2 proteins from different species, such as cats, chimpanzees, dogs, and cattle, are different. A comprehensive analysis of ACE2 receptors of nineteen species was carried out in this study, and the findings propose a possible SARS-CoV-2 transmission flow across these nineteen species

A unique view of SARS-COV-2 through the lens of ORF8 protein

Immune evasion is one of the unique characteristics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) attributed to its ORF8 protein. This protein modulates the adaptive host immunity through down-regulation of MHC-1 (Major Histocompatibility Complex) molecules and innate immune responses by surpassing the host\u27s interferon-mediated antiviral response. To understand the host\u27s immune perspective in reference to the ORF8 protein, a comprehensive study of the ORF8 protein and mutations possessed by it have been performed. Chemical and structural properties of ORF8 proteins from different hosts, such as human, bat, and pangolin, suggest that the ORF8 of SARS-CoV-2 is much closer to ORF8 of Bat RaTG13-CoV than to that of Pangolin-CoV. Eighty-seven mutations across unique variants of ORF8 in SARS-CoV-2 can be grouped into four classes based on their predicted effects (Hussain et al., 2021) [1]. Based on the geo-locations and timescale of sample collection, a possible flow of mutations was built. Furthermore, conclusive flows of amalgamation of mutations were found upon sequence similarity analyses and consideration of the amino acid conservation phylogenies. Therefore, this study seeks to highlight the uniqueness of the rapidly evolving SARS-CoV-2 through the ORF8