Objective assessment of progressive increase in bite force post surgical correction of mandibular fractures using Nupai bite scan analyser

Background: Fracture of mandible is a common condition which is increasing in incidence in the trauma centers due to increasing motor vehicles and failure to abide by traffic regulations. Patients undergo surgical open reduction and internal fixation where post-operative occlusion and normal masticatory functions are targeted. Bite force can be taken as a guide of normal masticatory function of an individual which is dependent upon craniomandibular biomechanics. The aim of the study was to analyse bite force measurements post-operatively in patients who underwent open reduction and internal fixation for mandible fractures at different sites.Methods: Molar bite force was recorded in 31 post-operative patients who underwent open surgical procedure for fracture mandible in the department of plastic surgery from January 2018 to June 2019 by a pre-scale bite force recorder-Nupai bite force prescale system (FujiTM). Various parameters were recorded pre and post-operatively including age, gender, history, comorbidities, requirement of MMF, site and number of fractures and age of injury. Bite force were compared and improvement of bite force every 2 weeks was noted and analyzed upto 6 weeks postoperatively.Results: Bite force improvement was seen in all types of mandible fractures irrespective of the site and type of fractures over a period of 6 weeks post-operatively. This improvement was however not statistically significant. Decreased time interval form injury to surgery resulted in improved bite force measurements though not statistically significant.Conclusions: Although objective improvement in bite force could be demonstrated but extensive study involving more subjects and more patient variables would have statistical significance

Coping Strategies and Help-Seeking Behaviors among Survivors of Intimate Partner Violence: A Qualitative Study of Spouses of Men with Heavy Drinking in India

Background. Despite the high prevalence of intimate partner violence (IPV) against women in India (33%), there are persistently low rates of disclosure and help-seeking amongst survivors. The aim of this study was to explore both coping strategies employed by survivors and the perceived barriers and facilitators to seeking support from informal and formal resource networks. Methods. We conducted semistructured, in-depth qualitative interviews with thirty-five women survivors of IPV in Goa, India, in secure, private locations, utilizing flipcharts and vignettes to elicit deeper insights into efficacies of support resources. The data were transcribed, translated, and analyzed utilizing qualitative content analysis. Results. The most common coping mechanisms cited by survivors involved passive resistance, such as self-distraction, keeping quiet during violent outbursts, and leaving the home temporarily. Generally, survivors sought support from informal support networks (the natal family, in-laws, neighbors/community members, and close friends) before approaching formal support structures (medical/legal professionals, professors, police, and nongovernment organizations). In fact, informal structures were often facilitators of formal help-seeking. Survivors sought help at various stages of their marital relationship. Primary deterrents to help-seeking included the normalization of IPV by survivors and providers alike, resulting in the stigmatization of disclosing experiences of IPV and ostracism of survivors and close relatives; another barrier was a general lack of awareness of existing support resources. Conclusion. Our findings reveal that there are numerous barriers to help-seeking and shortcomings of support resources. Survivors’ evaluations of support resources reveal that robust, community-level, and meso-level structural changes are required to promote help-seeking behaviors, including the destigmatization of IPV amongst providers and broader society and raising awareness of available support resources

PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec

Homeopathic treatment of Arabidopsis thaliana plants infected with Pseudomonas syringae

Homeopathic basic research is still in the screening phase to identify promising model systems that are adapted to the needs and peculiarities of homeopathic medicine and pharmacy. We investigated the potential of a common plant-pathogen system, Arabidopsis thaliana infected with the virulent bacteria Pseudomonas syringae, regarding its response towards a homeopathic treatment. A. thaliana plants were treated with homeopathic preparations before and after infection. Outcome measure was the number of P. syringae bacteria in the leaves of A. thaliana, assessed in randomized and blinded experiments. After a screening of 30 homeopathic preparations, we investigated the effect of Carbo vegetabilis 30x, Magnesium phosphoricum 30x, Nosode 30x, Biplantol (a homeopathic complex remedy), and Biplantol 30x on the infection rate in five or six independent experiments in total. The screening yielded significant effects for four out of 30 tested preparations. In the repeated experimental series, only the homeopathic complex remedy Biplantol induced a significant reduction of the infection rate (p = 0.01; effect size, d = 0.38). None of the other four repeatedly tested preparations (Carbo vegetabilis 30x, Magnesium phosphoricum 30x, Nosode 30x, Biplantol 30x) yielded significant effects in the overall evaluation. This phytopathological model yielded a small to medium effect size and thus might be of interest for homeopathic basic research after further improvement. Compared to Bion (a common SAR inducer used as positive control), the magnitude of the treatment effect of Biplantol was about 50%. Thus, homeopathic formulations might have a potential for the treatment of plant diseases after further optimization. However, the ecological impact should be investigated more closely before widespread application

Prevalence of glaucoma in pathological myopia

Purpose: To find association of glaucoma in pathological myopia for their early diagnosis and treatment and to prevent patients from glaucoma associated blindness. Settings and design: Cross sectional study. Materials and methods: 102 high myopic patients coming to the outpatient department at Dhiraj hospital, Waghodia, Piparia, Vadodara had undergone complete ophthalmic evaluation along with detailed ocular and medical history followed by examination. Results: A detailed clinical observation was done on 102 eyes with pathological myopia with an average axial length of 28 mm which showed an overall glaucoma prevalence of 25%. The study population was divided into four different groups which showed an increased prevalence of glaucoma up to 10-20% for the first group with an axial length of 26 mm; 30% for the second group with an axial length of &gt;26 mm; 36% for the third group with an axial length &gt;28 mm; and finally, 40% for the fourth group with an axial length of &gt;29 mm. It becomes very important to rule out the co-existence of myopic maculopathy and glaucomatous optic neuropathy (GON) in pathological myopia due to increased prevalence of glaucoma.&nbsp

Postavulsion complete loss of both lids with corneal injury and orbital floor fracture: A surgical challenge

Total upper and lower eyelid reconstruction remains a challenging task for plastic and reconstructive surgeons. Repair of full-thickness defects >50% of the horizontal length of the lids can be particularly complex. Here, we discuss a case of a 52-year-old male who presented to the emergency with avulsion of the right upper and lower eyelids associated with corneal injury and orbital floor fracture. Among all the possible choices of locoregional flap available, we chose the paramedian forehead flap for anterior lamella reconstruction of both upper and lower lids, and the posterior lamella was reconstructed with buccal mucosal graft while orbital floor reconstruction was carried out with prosthesis. This reconstructive modality resulted in satisfactory function and esthetic outcome

Managing blisters in minor burns: Should they be deroofed?

Introduction: Management of burn blister has always been controversial. The options available are deroofing the blister, aspiration of fluid or leaving the blister intact. There is no set dressing protocol for managing blisters. Aims and objectives: To compare two treatment modalities i.e. deroofing and keeping the burn blister intact for the optimal management of minor superficial 2nd degree burns. Material and Methods: This prospective study was done on 27 patients who presented with minor superficial 2nd degree burns of upper limbs. Total of 50 blister wounds were randomly split into two categories of 25 each. One subset of blisters (Category 1) was deroofed and dressed every alternate day with silver alginate dressing. The other subset of blisters was left intact (Category 2) and dressed every alternate day. The parameters assessed and compared were pain at burn site, soakage of dressing and time to complete healing Statistical Analysis: Student t –test and Chi square (χ2) test . SPSS 21 software Results: The mean age of patients was 36 years. Category 1 wound patients had more pain (as assessed by Visual Analogue Scale) in comparison to Category 2 wounds. The time to wound healing was less by mean of 1.7days in Category 1 wounds compared to Category 2 wounds. Wound soakage was comparable in both subsets. Conclusion: De roofing a burn blister results in statistically significant decrease in time to wound healing and is recommended for management of minor superficial 2nd degree burns

Use of homeopathic preparations in phytopathological models and in field trails: a critical review

Background: The literature on the applications of homeopathy for controlling plant diseases in both plant pathological models and field trials was first reviewed by Scofield in 1984. No other review on homeopathy in plant pathology has been published since, though much new research has subsequently been carried out using more advanced methods. Objectives: To conduct an up-to-date review of the existing literature on basic research in homeopathy using phytopathological models and experiments in the field. Methods: A literature search was carried out on publications from 1969 to 2009, for papers that reported experiments on homeopathy using phytopathological models (in vitro and in planta) and field trials. The selected papers were summarized and analysed on the basis of a Manuscript Information Score (MIS) to identify those that provided sufficient information for proper interpretation (MIS ≥ 5). These were then evaluated using a Study Methods Evaluation Procedure (SMEP). Results: A total of 44 publications on phytopathological models were identified: 19 papers with statistics, 6 studies with MIS ≥ 5. Publications on field were 9, 6 with MIS ≥ 5. In general, significant and reproducible effects with decimal and centesimal potencies were found, including dilution levels beyond the Avogadro's number. Conclusions: The prospects for homeopathic treatments in agriculture are promising, but much more experimentation is needed, especially at a field level, and on potentisation techniques, effective potency levels and conditions for reproducibility. Phytopathological models may also develop into useful tools to answer pharmaceutical questions

The use of plant-based bioassays in homeopathic basic research.

OBJECTIVES The objective was to evaluate homeopathic basic research studies that use plant-based bioassays. With this in view, a compilation was made of the findings of three systematic literature reviews covering plant-based bioassays in the three fields of healthy, abiotically, or biotically stressed plants. This compilation focused on investigations using advanced experimental methods and detailed descriptions, also with the aim of supporting the design of future experiments. METHODS Publications included had to report on studies into the effects of homeopathic preparations on whole plants, seeds, plant parts and cells. Outcomes had to be measured by established procedures and statistically evaluated. A Manuscript Information Score (MIS) was applied using predefined criteria to identify publications with sufficient information for adequate interpretation (MIS ≥ 5). Additional evaluation focused on the use of adequate controls to investigate specific effects of homeopathic preparations, and on the use of systematic negative control (SNC) experiments to ensure the stability of the bioassay. Only a fraction of the studies reported here were performed with 'ultra high' dilutions, whereas other studies were performed with moderate or high dilutions. RESULTS A total of 157 publications were identified, describing a total of 167 experimental studies. 84 studies included statistics and 48 had a MIS ≥ 5, thus allowing adequate interpretation. 29 studies had adequate controls to identify specific effects of homeopathic preparations, and reported significant effects of decimal and centesimal homeopathic potencies, including dilution levels beyond Avogadro's number. 10 studies reported use of SNC experiments, yielding evidence for the stability of the experimental set-up. CONCLUSION Plant models appear to be a useful approach for investigating basic research questions relating to homeopathic preparations, but more independent replication trials are needed in order to verify the results found in single experiments. Adequate controls and SNC experiments should be implemented on a routine basis to exclude false-positive results