A study on the development of scaffold fabrication using citric acid polyester – nanohydroxyapatite composite

ABSTRACT. Nano hydroxyapatite (n-HAp) and its composites have shown a great development in the field of tissue regeneration and in controlled drug delivery due to its good biocompatibility and bioactivity behavior. Furthermore, HAp-based nanocomposites enhance mechanical properties. These synthetic HAp nanocomposites can also be tailored to fabricate scaffold with controlled porosity which facilitate the growth of the cell in the field of tissue engineering. In this paper, we focus on the synthesis of nano hydroxyapatite (n-HAp) by sol-gel method. The synthesized nano powders were calcined at 500 oC and characterized by FT-IR, XRD and TEM. We have also described the synthesis of citric acid-based polyester by melt polycondensation method without adding catalyst. The monomers used were citric acid, 1,6-hexane diol and sebacic acid. The corresponding synthesized n-HAp/polyester composite have potential application in soft tissue engineering. The structures of polyester and its nanocomposite were studied by FT-IR and 1H NMR spectral studies. The thermal and mechanical properties of polyester, composites and cytotoxicity activity (MTT assay) using vero cells were also studied. Porous scaffold of the nano HAp/Polyester was fabricated by solvent-casting particulate leaching technique which is useful in the development of tissue engineering applications. SEM and TEM studies were carried out for nano HAp, polyester, composites and scaffold.   KEY WORDS: Cytotoxicity, Polycondensation, Sol-gel, Solvent-casting, Tissue engineering Bull. Chem. Soc. Ethiop. 2022, 36(4), 923-934.                                                                DOI: https://dx.doi.org/10.4314/bcse.v36i4.17                                                     &nbsp

Multimodality imaging of transient perivascular inflammation of carotid artery (TIPIC) syndrome: a case report

Abstract Background Transient Perivascular Inflammation of Carotid artery syndrome is a rare clinicoradiological entity characterized by inflammation of the carotid artery wall with surrounding perivascular inflammatory changes. This is a self-limiting condition and necessitates awareness and high degree of suspicion to differentiate from other serious pathologies involving the carotid artery. Case presentation A middle aged asian male patient presented with acute onset of intense pain in the right lateral aspect of neck. Ultrasonography and Magnetic Resonance Imaging showed wall thickening of the common carotid artery and carotid bulb with surrounding inflammation in the perivascular soft tissues. He was treated with brief course of oral anti-inflammatory medications. The patient’s symptoms improved and imaging findings resolved in 2 weeks. Conclusions Being infrequently encountered in clinical practice, recognition of transient perivascular inflammation of carotid artery syndrome by the physician is of prime importance. Prompt radiological investigation and follow-up imaging are crucial for accurate diagnosis, thereby leading to appropriate treatment

A prospective study of role of MRI evaluation in knee injuries in a tertiary care hospital

Introduction: Knee is one of the largest and most complex joints in the body. Disease processes and injuries that disrupt ligaments, menisci, articular cartilage and other structures of the knee cause painful knee resulting in significant morbidity and disability. Number of imaging modalities are currently used to evaluate knee abnormalities including standard radiography, scintigraphy, Computed Tomography (CT), planar tomography and arthrography. Materials and Methods: This study was a prospective, diagnostic descriptive study conducted in the Department of Radiology and Imaging Sciences, Tagore Medical College and Hospital, Rathinamangalam, Melakottaiyur, Chennai, Tamil Nadu. This study was conducted between January 2019 to December 2019. 100 patients presenting with knee injury referred from OPD (outpatient Department) & IPD (inpatient Department) of Department of Radiology and Imaging Sciences for MR imaging were included in the study, Arthroscopy was done in 39 patients and findings of arthroscopy were correlated with MRI findings. Sensitivity, specificity NPV, PPV and accuracy of MRI were calculated. Results: MR diagnosis of 100 cases was as follows: in ACL tear 50%; PCL tear 19%; MCL tear 17%; LCL tear 16%; MM tear 49%; LM tear 31%; Sensitivity, specificity, NPV, PPV and accuracy of MRI in detecting the knee injuries taking arthroscopy as gold standard are as follows ACL- 100%, 90.9%, 100%, 96.5% and 97.4 %; lateral meniscus-100%, 94.5%, 100%, 50% and 94.8%; medial meniscus 90.4%, 66.7%, 85.7%, 76% and 79.5% respectively. Correlation between MRI and arthroscopic findings regarding presence and absence of posterior cruciate ligament tear was highest with sensitivity -100%, specificity- 94.5%, NPV- 100% and accuracy-94.8%, There were 6 false positives for meniscus tear on MR examinations accounting for low positive predictive value (72%) of MR examination. Posterior horn tears of menisci are likely to be missed on arthroscopy. Out of 6 false positive cases of meniscus tear, 4 were located predominately in the posterior horn and 2 in the anterior horn. Thus, acceptance of MRI findings as false positive is controversial. Conclusion: MRI is a useful non-invasive modality having high diagnostic accuracy, sensitivity and negative predictive value making it a very reliable screening test for diagnosis of internal derangements of knee joint. Thus, MRI saves many knees from unnecessary arthroscopies

The Effectiveness of Intracameral Moxifloxacin Endophthalmitis Prophylaxis for Trabeculectomy

To analyze the effectiveness of intracameral moxifloxacin prophylaxis in reducing acute postoperative endophthalmitis after trabeculectomy and combined trabeculectomy plus cataract extraction. Retrospective clinical registry analysis. Patients undergoing either trabeculectomy or trabeculectomy plus cataract extraction at Aravind Eye Hospitals (AEH) between 2009 and 2018 (inclusive). Electronic health records data were analyzed before and after implementation of routine intracameral moxifloxacin, and acute postoperative endophthalmitis rates were compared. During 2015, routine intracameral moxifloxacin prophylaxis was added in a step-wise fashion throughout AEH. Date of implementation was used to create group 1 (without intracameral moxifloxacin prophylaxis) and group 2 (with intracameral moxifloxacin prophylaxis). The primary outcome was the difference in acute (≤6 weeks) postoperative endophthalmitis between groups 1 and 2. Review of culture results, visual acuity, and intraocular pressure also was performed for patients with endophthalmitis. Thirty-eight thousand nine hundred eyes (group 1) did not receive intracameral moxifloxacin, whereas 19 086 eyes (group 2) did. Although the rate of noninfectious postoperative complications was not significantly different (0.81% vs. 0.67%; P = 0.07), a significantly lower rate of acute postoperative endophthalmitis was found in group 2 versus group 1 (0.03% vs. 0.08%; P = 0.03). Patients receiving intracameral moxifloxacin showed approximately 2.5-times lower odds of infection (odds ratio, 0.39 for group 2 vs. group 1; 95% confidence interval, 0.16–0.95) and almost 4-times lower odds after adjustment for covariates (odds ratio, 0.26 for group 2 vs. group 1; 95% confidence interval, 0.09–0.74). The rate of early postoperative infection after intracameral moxifloxacin introduction was lower for patients undergoing both trabeculectomy alone (0.09%–0.03%; P = 0.27) and combined trabeculectomy plus cataract extraction (0.08%–0.03%; P = 0.06). Although most cultures yielded no growth, no Staphylococcus or gram-negative growth was found for patients in group 2, who received intracameral moxifloxacin. Intracameral moxifloxacin prophylaxis was associated with a nearly 4-fold lower rate of early postoperative endophthalmitis in patients undergoing trabeculectomy or combined trabeculectomy plus cataract extraction

Disseminated strongyloidiasis: Breaking brain barriers

Strongyloides stercoralis (SS) is one of the most overlooked helminthic infections despite being highly endemic in tropical and subtropical areas. In immunocompromised patients, especially those on long-term steroids, infection can often escalate to fatal dissemination into major organs. We present a compendium of two immunocompromised patients, who were on high-dose steroids and presented with worsening neurological status. Cerebrospinal fluid analysis was notable for larvae of SS as diagnosed by direct visualization. A syndrome of SS hyperinfection with dissemination was made after stool, and sputum samples also revealed SS larvae. SS is an elusive disease and should be considered early on, especially in endemic regions like India. Early diagnosis and prompt initiation of antihelminthic therapy is indispensable for favorable outcomes

Outcomes of Glaucoma Drainage Device Implantation and Trabeculectomy With Mitomycin C in Glaucoma Secondary to Aniridia

To compare the outcomes of Aurolab aqueous drainage implant (AADI; Aurolab) placement and trabeculectomy with mitomycin C (MMC) in patients with glaucoma secondary to aniridia. Retrospective comparative interventional case series. This study included patients with congenital aniridia who underwent AADI implantation or trabeculectomy with MMC. Surgical failure was defined as IOP > 21 mm Hg or reduced <20% from baseline, IOP ≤ 5 mm Hg, reoperation for glaucoma or a complication, or loss of light perception vision. A total of 30 eyes of 30 patients underwent surgical treatment, including 18 eyes that received an AADI and 12 eyes that had a trabeculectomy with MMC. The cumulative probability of failure at 2 years was 11.1% (95% CI = 2.9%-37.6%) in the AADI group and 58.3% (95% CI = 33.5%-84.8%) in the trabeculectomy group (P = .05, log-rank). At 2 years, IOP (mean ± SD) was 14.1 ± 2.8 mm Hg in the AADI group and 19.6 ± 6.6 mm Hg in the trabeculectomy group (P = .02), and the number of glaucoma medications was 1.7 ± 0.9 in the AADI group and 2.2 ± 0.8 in the trabeculectomy group (P = .25). Surgical complications developed in 1 patient in each treatment group (P = .65). Cataract surgery was performed in 5 (42%) patients in the trabeculectomy group and no patients in the AADI group (P = .01). Placement of an AADI resulted in lower IOP and a higher rate of surgical success compared to trabeculectomy with MMC in eyes with glaucoma associated with aniridia. Cataract extraction was more frequently required after trabeculectomy with MMC than AADI implantation