Comparison of Lumbar Laminectomy Alone, Lumbar Laminectomy and Fusion, Stand-alone Anterior Lumbar Interbody Fusion, and Stand-alone Lateral Lumbar Interbody Fusion for Treatment of Lumbar Spinal Stenosis: A Review of the Literature.

Lumbar spinal stenosis is defined as narrowing of the lumbar spinal canal, which causes compression of the spinal cord and nerves. Spinal stenosis can cause leg pain and potentially back pain that can affect the quality of life. Ultimately, surgical decompression is required to alleviate the symptoms. In this review, we first utilize several important studies to compare lumbar laminectomy alone versus lumbar laminectomy and fusion. We also compare the effectiveness of more novel surgical approaches, stand-alone anterior lumbar interbody fusion (ALIF), and stand-alone lateral lumbar interbody fusion (LLIF). These techniques have their own advantages and disadvantages in which many factors must be taken into account before choosing a surgical approach. In addition, the patient\u27s anatomy and pathology, lifestyle, and desires should be analyzed to help determine the ideal surgical strategy

Preferences and attitudes of physicians in India towards continuing medical education

Introduction: Physicians in India display an enthusiasm for continuing medical education (CME), however a proper system for facilitation and organisation of CME activities is yet to evolve in the country. Methods: A questionnaire-based survey was conducted among 751 physicians from eight medical specialties across India and the data retrieved was analysed at individual physician and collective specialty-specific levels. Results: The surveyed physicians considered case presentations (73%), live speaker programmes (70%) and round-table meetings/focus group meetings (70%) as the most effective CME activities. They preferred a duration of <2 h for CME activities such as webcasts (89%) and lectures (86%). Most of them considered scientific agenda (78%) and stature of speakers (77%) as the most important determinants of the quality of a CME event. Most physicians wanted topics such as disease guidelines (88%) and new drugs/devices/interventions (86%) for discussion in CME activities. Medical associations (87%) were the most desirable organisations for holding the CME activities and face-to-face modules appealed to majority of the physicians (64%). Conclusions: This study indicates that Indian physicians prefer live, interactive, short, specialty-specific educational sessions for CME activities, delivered by Indian experts and organised by medical associations at domestic destinations

Comparative Study of Bupivacaine-Fentanyl versus Ropivacaine-Fentanyl for Epidural Analgesia in Labor.

Background Labor pain is one of the most intense pains that a woman experiences. Almost 60% of primiparous women described the pain of uterine contractions as unbearable extremely severe or excruciating. Aims Our study aimed to relieve pain suffering of mother and to decrease fetal acidosis to make the delivery process safer for mother and baby. Settings and Design Thus, epidural labor analgesia was designed comparing ropivacaine-fentanyl (RF) and bupivacaine-fentanyl (BF) as intermittent bolus technique. Materials and Methods Sixty women who requested epidural analgesia having ≥3 cm cervical dilatation were allocated in two groups, one group received RF and the other group received BF. Each group received study drug 16 mL with 50 μg fentanyl and top of 10 mL and 25 μg fentanyl when visual analog scale (VAS) ≥3. The efficacy of analgesia, adverse effects, and obstetric and neonatal outcomes were compared. Statistical Analysis For skewed data or ordered categorical data, nonparametric Mann-Whitney -test was used for statistical analysis of two groups. For categorical data, comparisons were made by Pearson's Chi-square test or Fisher's exact test as appropriate (%). Results Both groups were comparable in terms of demographic data and obstetric and neonatal parameters at the onset of labor Comparison of heart rate, systolic blood pressure (BP), diastolic BP, and saturation between Group RF and Group BF. It was found statistically not significant. VAS score before the epidural study drug was given, was 5 (4-5) in RF group, and was 5 (3-6) in BF group, and after 1 min, VAS score was 1 in both the groups thereafter. The score remained zero till at 100 min in both the groups till the time when the top-up dose was given. Bearing down reflex was present in all the patients as judged by the obstetrician. It was sluggish in 20% of patients in Group RF as compared to 10% in Group BF. Conclusions From clinical and safety perspective, both RF and BF were reasonable choice for labor analgesia

RFX transcription factors are essential for hearing in mice

Sensorineural hearing loss is a common and currently irreversible disorder, because mammalian hair cells (HCs) do not regenerate and current stem cell and gene delivery protocols result only in immature HC-like cells. Importantly, although the transcriptional regulators of embryonic HC development have been described, little is known about the postnatal regulators of maturating HCs. Here we apply a cell type-specific functional genomic analysis to the transcriptomes of auditory and vestibular sensory epithelia from early postnatal mice. We identify RFX transcription factors as essential and evolutionarily conserved regulators of the HC-specific transcriptomes, and detect Rfx1,2,3,5 and 7 in the developing HCs. To understand the role of RFX in hearing, we generate Rfx1/3 conditional knockout mice. We show that these mice are deaf secondary to rapid loss of initially well-formed outer HCs. These data identify an essential role for RFX in hearing and survival of the terminally differentiating outer HCs

Mass spectra of four-quark states in the hidden charm sector

Masses of the low lying four quark states in the hidden charm sector ($cq\bar c \bar q; q\in u,d$) are calculated within the framework of a non-relativistic quark model. The four body system is considered as two two-body systems such as diquark-antidiquark ($Qq-\bar Q \bar q$) and quark antiquark-quark antiquark ($Q\bar q -\bar Qq$) molecular-like four quark states. Here, Cornell type potential has been used for describing the two body interactions among $Q-q$, $\bar Q-\bar q$, $Q-\bar q$, $Qq-\bar Q \bar q$ and $Q\bar q-\bar Qq$, with appropriate string tensions. Our present analysis suggests the following exotic states, $X(3823)$, $Z_c(3900)$, $X(3915)$, $Z_c(4025)$, $\psi(4040)$, $Z_1(4050)$ and $X(4160)$ as $Q\bar q-\bar Qq$ molecular-like four quark states while $Z_c(3885)$, $X(3940)$ and $Y(4140)$ as the diquark-antidiquark four quark states. We have been able to assign the $J^{PC}$ values for many of the recently observed exotic states according to their structure. Apart from this, we have identified the charged state $Z(4430)$ recently confirmed by LHCb as the first radial excitation of $Zc(3885)$ with G=+1 and $Y(4360)$ state as the first radial excitation of $Y(4008)$ with $G=-1$ and the state $\psi(4415)$ as the first radial excitation of the $\psi(4040)$ state