Is Insulin like Growth Factor a new wonder drug?

Insulin has been used since a long time to treat Diabetes Mellitus. Little is known about the potential new uses of insulin due to its structural similarities with Insulin Like Growth Factors (IGFs). This brief communication aims to throw light on the potential uses of this hormone and its future prospects. Keywords: Insulin, Growth factor, CTGF, Restenosis, Spinal injury, Fibrosis

Non-Spinal Causes of Back Pain: An ‘undiagnosed’ diagnosis

Low back pain is a common ailment affecting individuals all around the globe. Majority of Disability Adjusted Life Years lost amongst working population is due to low back pain. Though majority of surgeons/physicians keep only spinal causes in mind while treating such an ailments, a number of other causes exist for such a pathology. This editorial aims to make the readers aware about such non spinal causes of low back pain

Humility: A Key to get Published

Humility has been little understood despite being an important part of the scientific writing. Many manuscripts with good data remain unpublished due to their lack of humility leading to repeated rejections. This Editorial aims to highlight the importance of humble writing and how it can be incorporated by authors it in their scientific methodology

A study of patient satisfaction level in inpatient spine department of a tertiary care multi-speciality hospital

Background: Patient satisfaction at spine surgery centers is a matter of concern. In specialized surgeries like spine, the satisfaction of a patient is not merely because of surgical outcomes but also empathy of doctor, rehabilitation programs and friendliness of the hospital. Aims and Objectives: This study aims to investigate the prognosis and satisfaction level of patients/relatives operated with spinal surgery. This shall not only help the spinal hospitals to know the ways to improve the patient outcome but methods to provide better services. Material and methods: The study was conducted by carrying out survey amongst 39 patients and their relatives at inpatient department of spine surgical unit by using structured questionnaire and analysing the data using SPSS software. The patients were examined before and after surgery and their VAS (Visual Analogue Score) and ODI (Oswestry Disability Index) were also documented. The SERVQUAL methodology was also studied to understand if it could be implemented in the study to understand better and make the study more conclusive.   Results: The study composed of 39 individuals with an average age of 75.6 +-10.2 years.39 percent of the study group were females and 61 percent males. The ODI score in post-operative stage (18.97+_12.97) was significantly reduced as compared to pre-operative stage (76.66+-17.23) (p<0.05). The VAS score in post-operative stage (1.48 +-1.8) was also significantly reduced as compared to pre-operative stage ( 9.51 +- 0.22) (p<0.05). Ninety-Two percent people were satisfied with the housekeeping services while Ninety-Eight percentage were satisfied with the medical care provided. Ninety-five percentage of people were satisfied by the behaviour of staff and nurses. The nursing department, cleanliness and behaviour of the doctor satisfied 90 percent, 87 and 84.59 percent. The admission and reception satisfied only 66 percentage . The SERVQUAL study was not incorporated because the questionnaire designed through this methodology requires to be administrated by face to face interviews along with moderate to large sample size for statistical reliability.   Conclusion: This study has clearly shown that satisfactory results are obtained after spine surgery. However, the  results are better when performed by a fellowship trained surgeon. Moreover, doctors who spend time in explaining the ailments and possible outcomes to the patients have more satisfactory results. A caring attitude of the staff and empathy in interaction makes a lot of difference in the success of the practice of a surgeon

Behavioral and biochemical characterization of elevated “I-maze” as animal model of anxiety

AbstractThe elevated I-maze is a modification of the elevated plus-maze model of anxiety in mice. The design of I-maze comprises a straight wooden passage, resembling the English letter “I,” divided equally into three areas; two enclosed areas (close arms) at both ends of the “maze” and an open area in the center of two enclosed areas. The I-maze completely avoids the central platform of elevated plus-maze, removing any ambiguity in time spent on central platform and allowing uninterrupted animal exploration. In this model, diazepam (1 mg/kg) and gabapentin (10 mg/kg) significantly increased the percentage of time spent in the open areas (%TO) and the number of unprotected head dips (uHDIPS), and reduced the number of protected head dips (pHDIPS) and stretch attend postures (SAP) from close to open arm. Similarly, fluoxetine (5 mg/kg) significantly increased %TO and uHDIPS, and significantly decreased SAP from close to open arm, but it did not have any significant effect on pHDIPS. The 5-HT3 receptor antagonist, ondansetron (0.1 mg/kg), did not produce any significant change in all the behaviors, observed, as compared to vehicle-treated control mice. On the other hand, the anxiogenic agent, caffeine (15 mg/kg), did produce a significant decrease in %TO and uHDIPS, and significantly increased pHDIPS and SAP from close to open arm. Mice confined in open area of I-maze bring the relevant biochemical changes associated with anxiety behavior, showing significant increase in the levels of plasma nitrate and plasma corticosterone. These data indicate that a combination of novel design of elevated I-maze and a detailed behavioral analysis provides a sensitive model for the measurement of anxiety

ATTENUATION OF ANTINOCICEPTIVE EFFECT OF MORPHINE IN DIABETIC MICE: NITRIC OXIDE OR INTERLEUKIN-2

Objective: The present study was designed to explore the mechanistic role of interleukin-2 in diabetes-induced decrease in the antinociceptive effect of morphine in mice. Role of interleukin-2 was investigated by employing cyclosporin, a interleukin-2 synthesis inhibitor. Methods: Diabetes was induced in mice by single intra peritoneal injection of Streptozotocin (200 mg/kg, i. p.). Nociceptive threshold in diabetic mice was measured by Rodent tail-flick test. Nitrite levels in the urine of mice were estimated by employing Greiss reagent. Results: A significant decrease in antinociceptive effect of morphine was observed in mice. Administration of cyclosporin (20 mg/kg, s. c., b. d.) in diabetic mice significantly increased antinociceptive effect of morphine in diabetic mice. However, administration of cyclosporin (20 mg/kg, s. c., b. d.) failed to significantly change the increased nitrite levels in diabetic mice.Conclusion: The present study indicates that interleukin-2 may be responsible for decrease in antinociceptive effect of cyclosporine. The study also indicates that the increase in levels of interleukin-2 is independent of an increase in nitrite levels. It may, therefore, be concluded that nitric oxide has no role in nociceptive changes made by interekin-2 in diabetic mice. Â

Aneurysmal Bone Cyst of Clavicle in a Six-Year-Old Male Child

Aneurysmal Bone Cyst (ABCs) is a cystic expansile lesion which is usually found in solitary locations in the metaphysis of long bones. The most common locations of ABC are long bones of lower limbs. There is little knowledge about the presence of this tumor in Clavicle. Here we present a case of a six year old male child who presented with complaint of swelling in left shoulder for four months. There was a dilemma in the diagnosis of the swelling due to its unusual presentation and appearance. The Fine Needle Aspiration Cytology was also inconclusive. The diagnosis of ABC was made only by excision biopsy. The Clavicle regenerated to nearly normal anatomy at 15 weeks follow up period. The patient is asymptomatic now and is able to perform all daily activities without any restrictions. The uniqueness of this case lies in the fact that this is the first case where ABC has been reported in Clavicular region in young Asian male of less than 10 years age

Laparoscopic management of endometrial stromal sarcoma in young: a case report

Endometrial stromal sarcoma (ESS) is a case malignancy and accounts for 0.2% of all uterine malignancies and 10% of all uterine sarcomas. In the present case, an unmarried 27-year-old woman presented with complaints of on and off episodes of pain in the lower abdomen. On examination, a diffuse oval mass was felt occupying the hypogastrium, iliac and lumbar regions and extending up to the umbilicus. CT scan impression was given as? Complex retroperitoneal mass? solid cystic ovarian mass with grade I right hydro nephrosis. On laparoscopy, a huge mass measuring approximately 10×10 cm was noted arising from the uterus. Laparoscopic myomectomy was done and the specimen was retrieved in a bag and the tissue was sent for histopathological examination. The postoperative clinical course was uneventful. The patient was advised to undergo oocyte cryopreservation following which she was advised hysterectomy with bilateral salphingo-oophorectomy. Pelvic radiation was advised thereafter. ESS is a rare malignant tumor, which on histopathological examination reveals sheets of cells and endometrial stromal cell differentiation. Hysterectomy with bilateral salpingo-oophorectomy is optimum initial therapy. Radiotherapy is chosen when the tumour is inadequately excised or the pelvic disease is locally recurrent. Low grade ESS is a rare form of uterine sarcoma usually seen between 40-60 years of age with limited available data regarding the clinical course and management. Early diagnosis and management is associated with a favourable prognosis and outcome

A New Search Algorithm for Reducing the Incidence of Missing Cottonoids in the Operating Theater

Study Design Retrospective study. Purpose Missing cottonoids during and after spinal surgery is a persistent problem and account for the most commonly retained surgical instruments (RSIs) noticed during a final cottonoid count. The aim of this study was to enumerate risk factors and describe the sequence to look out for misplaced cottonoids during spinal surgery and provide an algorithm for resolving the problem. Overview of Literature There are only a few case reports on RSIs among various surgical branches. The data is inconclusive and there is little evidence in the literature that relates to spinal surgery. Methods This retrospective study was conducted at Indian Spinal Injuries Centre. The data was collected from hospital records ranging from January 2013 to December 2017. The surgical cases in which cottonoid counts were inconsistent during or after the procedure were included in the study. The case files along with operating theater records were thoroughly screened for selecting those in which there was confirmed evidence of such an event. Results There were 7,059 spinal surgeries performed during the study period. Fifteen cases of miscounts were recorded with an incidence of one in every 471 cases. Cottonoids were most commonly lost under the shoes of the surgeon or assistants. In two instances, cottonoids were found in the surgical field and trapped in the interbody cage site. Based on these locations, a systematic search algorithm was created Conclusions This study enumerates RSI risk factors in spinal surgical procedures and describes steps that can be followed to account for any missing cottonoids. The incidence of missing cottonoids can be decreased using a goal-oriented approach and ensuring that surgical teams work in collaboration

Impact of Uncertainty in the Input Variables and Model Parameters on Predictions of a Long Short Term Memory (LSTM) Based Sales Forecasting Model

A Long Short Term Memory (LSTM) based sales model has been developed to forecast the global sales of hotel business of Travel Boutique Online Holidays (TBO Holidays). The LSTM model is a multivariate model; input to the model includes several independent variables in addition to a dependent variable, viz., sales from the previous step. One of the input variables, “number of active bookers per day”, is estimated for the same day as sales. This need for estimation requires the development of another LSTM model to predict the number of active bookers per day. The number of active bookers is variable, so the predicted is used as an input to the sales forecasting model. The use of a predicted variable as an input variable to another model increases the chance of uncertainty entering the system. This paper discusses the quantum of variability observed in sales predictions for various uncertainties or noise due to the estimation of the number of active bookers. For the purposes of this study, different noise distributions such as normalized, uniform, and logistic distributions are used, among others. Analyses of predictions demonstrate that the addition of uncertainty to the number of active bookers via dropouts as well as to the lagged sales variables leads to model predictions that are close to the observations. The least squared error between observations and predictions is higher for uncertainties modeled using other distributions (without dropouts) with the worst predictions being for Gumbel noise distribution. Gaussian noise added directly to the weights matrix yields the best results (minimum prediction errors). One possibility of this uncertainty could be that the global minimum of the least squared objective function with respect to the model weight matrix is not reached, and therefore, model parameters are not optimal. The two LSTM models used in series are also used to study the impact of corona virus on global sales. By introducing a new variable called the corona virus impact variable, the LSTM models can predict corona-affected sales within five percent (5%) of the actuals. The research discussed in the paper finds LSTM models to be effective tools that can be used in the travel industry as they are able to successfully model the trends in sales. These tools can be reliably used to simulate various hypothetical scenarios also