Repair of horizontal root fracture: A case report

ABSTRACT: Horizontal root fractures in permanent teeth are uncommon injuries among dental traumas. The principle of treating horizontal root fractures of permanent teeth is repositioning and fixation of fractured segment. Diagnosis of tooth fractures based on radiographic findings and the fracture healing process are affected by factors before and after injury. The present case reports the treatment of horizontal root fracture located at the apical-third of upper left and right central incisors. Healing was observed at 1 year follow-up examination

Hamman's syndrome: a rare benign syndrome

Hamman’s syndrome by definition is spontaneous pneumomediastinum with the exclusion of thoracic trauma or iatrogenic cause. It is rare and is more common in adolescence male. Amongst the risk factors are underlying lung condition such as asthma and interstitial lung disease, drug inhalation and parturient woman. Patient usually presents with sudden onset of shortness of breath and chest pain with subcutaneous emphysema on examination. The diagnosis is confirmed with chest radiograph. The prognosis of Hamman’s syndrome is excellent. Most cases are self-limiting and resolve spontaneously. However, Hamman’s syndrome is a poorly recognised disease due to its rarity. Therefore, the patient may be subjected to misdiagnosis and treatment. This is a case report of Hamman’s syndrome misdiagnosed and treated as pneumothorax. The objective of this case report is to highlight the importance of differentiating this benign syndrome with life threatening differentials which may have similar clinical presentation. Thus, avoiding unnecessary costly investigation, treatment and invasive procedures

Whole brain radiation therapy alone versus radiosurgery for patients with 1–10 brain metastases from small cell lung cancer (ENCEPHALON Trial): study protocol for a randomized controlled trial

Background: Conventional whole brain radiotherapy (WBRT) has been established as the treatment standard in patients with cerebral metastases from small-cell lung cancer (SCLC), however, it has only modest efficacy and limited prospective data is available for WBRT as well as local treatments such as stereotactic radiosurgery (SRS). Methods/design: The present single-center prospective randomized study, conducted at Heidelberg University Hospital, compares neurocognitive function, as objectively measured by significant deterioration in Hopkins Verbal Learning Test – Revised total recall at 3 months. Fifty-six patients will be randomized to receive either SRS of all brain metastases (up to ten lesions) or WBRT. Secondary endpoints include intracranial progression (local tumor progression and number of new cerebral metastases), extracranial progression, overall survival, death due to brain metastases, local (neurological) progression-free survival, progression-free survival, changes in other cognitive performance measures, quality of life and toxicity. Discussion: Recent evidence suggests that SRS might be a promising treatment option for SCLC patients with brain metastases. The present trial is the first to prospectively investigate the treatment response, toxicity and neurocognition of WBRT and SRS in SCLC patients. Trial registration: Clinicaltrials.gov NCT03297788 . Registered September 29, 2017

Free convection boundary layer flow of viscoelastic micropolar fluid past a horizontal circular cylinder

This study intends to observe the behaviour of the flow of viscoelastic micropolar fluid under boundary layer approximation moving over a horizontal circular cylinder at constant wall temperature. First, a set of governing equations is formulated before they are transformed into dimensionless form. Stream function is then applied to the obtained equations, producing sets of partial differential equations which are then solved numerically using a finite difference scheme, namely the Keller-box method. The skin friction and heat transfer characteristics of the flow are observed at multiple values of viscoelastic parameter, K, material parameter, K1, and the magnetic parameter, M

Magnetohydrodynamics effect on convective boundary layer flow and heat transfer of viscoelastic micropolar fluid past a sphere

The main interest of this study is to investigate the effect of MHD on the boundary layer flow and heat transfer of viscoelastic micropolar fluid. Governing equations are transformed into dimensionless form in order to reduce their complexity. Then, the stream function is applied to the dimensionless equations to produce partial differential equations which are then solved numerically using the Keller-box method in Fortran programming. The numerical results are compared to published study to ensure the reliability of present results. The effects of selected physical parameters such as the viscoelastic parameter, K, micropolar parameter, κ and magnetic parameter, M on the flow and heat transfer are discussed and presented in tabular and graphical form. The findings from this study will be of critical importance in the fields of medicine, chemical as well as industrial processes where magnetic field is involved

Severe skin toxicity during whole-brain radiotherapy, targeted therapy, and additional drug intake including St. John’s wort skin oil

Background!#!Metastatic non-small cell lung cancer (NSCLC) often requires a multimodal treatment including chemotherapy, targeted therapy and radiotherapy. In addition to this, many patients take supportive drugs. Since only scarce data on possible interactions between radiotherapy and pharmaceutical or herbal drugs exist, description of clinical cases is of special interest.!##!Case report!#!A patient with stage IV NSCLC was treated with docetaxel/ramucirumab followed by radiotherapy for brain and bone metastases while taking several other over-the-counter drugs (OTCs) including topical St. John's wort skin oil.!##!Results!#!A 63-year-old female patient with stage IV NSCLC presented with 11 asymptomatic brain metastases and a painful osteolytic bone metastasis in the 12th thoracic vertebral body (T12). Four weeks before the start of palliative whole-brain radiotherapy and bone irradiation of T12, she was administered a combination of docetaxel and ramucirumab. At an administered dose of 24 Gy, the patient presented with severe folliculitis capitis, while skin examination over the thoracolumbar spine was unremarkable although skin dose was similar. After thorough questioning, the patient reported using a herbal skin oil that contained St. John's wort for scalp care only, but not for skin care of her back during radiotherapy. After stopping the topical application of the skin oil, folliculitis improved with a course of systemic and topical antibiotics within 10 days, though the healing process was prolonged and included desquamation and hyperpigmentation.!##!Conclusion!#!St. John's wort seems to be a significant radiosensitizer for photon radiotherapy and can cause severe skin toxicity even though the literature lacks data on this interaction. As an OTC, it is easily accessible and often used by oncological patients due to antidepressant and local antimicrobial and pain-relieving effects

Influence of aligned MHD on convective boundary layer flow of viscoelastic fluid

Effects of aligned Magnetohydrodynamics (MHD) on the mixed convection boundary layer flow of viscoelastic fluid past a circular cylinder with Newtonian heating is investigated. Appropriate transformation is applied to the governing partial differential equations to transform them into dimensionless forms which are then solved using finite difference method known as Keller box. For verification purpose, the preliminary numerical solutions of the model are compared with previous study with a particular condition that the magnetic and viscosity effect are both absent. With strong agreement between the previous and current results, the authors believe that the extended outcome produced from the present model is accurate. Findings from the study will be presented in tabular and graphical form

Outcome after radiotherapy for vestibular schwannomas (VS)-differences in tumor control, symptoms and quality of life after radiotherapy with photon versus proton therapy.

BACKGROUND: To evaluate differences in local tumor control (LC), symptoms and quality of life (QOL) of 261 patients with VS after stereotactic radiosurgery/hypofractionated stereotactic radiotherapy (SRS/HFSRT) vs. fractionated radiotherapy (FRT) vs. fractionated proton therapy (FPT) were studied. METHODS: For SRS/HFSRT (n = 149), the median fraction dose applied was 12 Gy. For FRT (n = 87) and FPT (n = 25), the median cumulative doses applied were 57.6 Gy and 54 Gy (RBE), respectively. FRT and FPT used single median doses of 1.8 Gy/Gy (RBE). Median follow-up was 38 months. We investigated dosimetry for organs at risk and analyzed toxicity and QOL by sending out a questionnaire. RESULTS: LC was 99.5% at 12 months after RT with no statistical difference between treatment groups (p = 0.19). LC was significantly lower in NF2 patients (p = 0.004) and in patients with higher tumor extension grade (p = 0.039). The hearing preservation rate was 97% at 12 months after RT with no statistical difference between treatment groups (p = 0.31). Facial and trigeminal nerve affection after RT occurred as mild symptoms with highest toxicity rate in FPT patients. CONCLUSION: SRS/HFSRT, FRT and FPT for VS show similar overall clinical and functional outcomes. Cranial nerve impairment rates vary, potentially due to selection bias with larger VS in the FRT and FPT group