Search results for: anterior open-bite

Authors: Islam Sherif, Ahmed Ashour, Ahmed Hassan, Hatem Osman

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Anterior Cruciate Ligament (ACL) injuries are common among athletes and individuals participating in sports with sudden stops, pivots, and changes in direction. Arthroscopic surgery is the gold standard for ACL reconstruction, aiming to restore knee stability and function. Recent years have witnessed significant advancements in arthroscopic surgery techniques, graft materials, and technological innovations, revolutionizing the field of ACL reconstruction. This presentation delves into the latest advancements in arthroscopic surgery techniques for ACL reconstruction and their potential impact on patient outcomes. Traditionally, autografts from the patellar tendon, hamstring tendon, or quadriceps tendon have been commonly used for ACL reconstruction. However, recent studies have explored the use of allografts, synthetic scaffolds, and tissue-engineered grafts as viable alternatives. This abstract evaluates the benefits and potential drawbacks of each graft type, considering factors such as graft incorporation, strength, and risk of graft failure. Moreover, the application of augmented reality (AR) and virtual reality (VR) technologies in surgical planning and intraoperative navigation has gained traction. AR and VR platforms provide surgeons with detailed 3D anatomical reconstructions of the knee joint, enhancing preoperative visualization and aiding in graft tunnel placement during surgery. We discuss the integration of AR and VR in arthroscopic ACL reconstruction procedures, evaluating their accuracy, cost-effectiveness, and overall impact on surgical outcomes. Beyond graft selection and surgical navigation, patient-specific planning has gained attention in recent research. Advanced imaging techniques, such as MRI-based personalized planning, enable surgeons to tailor ACL reconstruction procedures to each patient's unique anatomy. By accounting for individual variations in the femoral and tibial insertion sites, this personalized approach aims to optimize graft placement and potentially improve postoperative knee kinematics and stability. Furthermore, rehabilitation and postoperative care play a crucial role in the success of ACL reconstruction. This abstract explores novel rehabilitation protocols, emphasizing early mobilization, neuromuscular training, and accelerated recovery strategies. Integrating technology, such as wearable sensors and mobile applications, into postoperative care can facilitate remote monitoring and timely intervention, contributing to enhanced rehabilitation outcomes. In conclusion, this presentation provides an overview of the cutting-edge advancements in arthroscopic surgery techniques for ACL reconstruction. By embracing innovative graft materials, augmented reality, patient-specific planning, and technology-driven rehabilitation, orthopedic surgeons and sports medicine specialists can achieve superior outcomes in ACL injury management. These developments hold great promise for improving the functional outcomes and long-term success rates of ACL reconstruction, benefitting athletes and patients alike.

Keywords: arthroscopic surgery, ACL, autograft, allograft, graft materials, ACL reconstruction, synthetic scaffolds, tissue-engineered graft, virtual reality, augmented reality, surgical planning, intra-operative navigation

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Authors: Min Ye Koo, Ji Ho Ahn, Byung Il You, Gyo Woo Lee

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Everything that is attached to the outside of the vehicle to improve the driving performance of the vehicle by changing the flow characteristics of the surrounding air or to pursue the external personality is called a tuning part. Typical tuning components include front or rear air dam, also known as spoilers, splitter, and side air dam. Particularly, the front air dam prevents the airflow flowing into the lower portion of the vehicle and increases the amount of air flow to the side and front of the vehicle body, thereby reducing lift force generation that lifts the vehicle body, and thus, improving the steering and driving performance of the vehicle. The purpose of this study was to investigate the role of anterior air dam in the flow around a sedan passenger car using computational fluid dynamics. The effects of flow velocity, trajectory of fluid particles on static pressure distribution and pressure distribution on body surface were investigated by varying flow velocity and size of air dam. As a result, it has been confirmed that the front air dam improves the flow characteristics, thereby reducing the generation of lift force of the vehicle, so it helps in steering and driving characteristics.

Keywords: numerical study, air dam, flow field, pressure distribution

Procedia PDF Downloads 183

Authors: Hema Lattupalli

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Introduction: The palate forms a partition between the oral cavity and nasal cavity. The palate is made up of two parts hard palate and soft palate. The Hard palate forms the anterior part of the palate, the soft palate forms a movable muscular fold covered by mucous membrane that is suspended from the posterior border of a hard palate. Aim and Objectives: Soft palate morphological variations have a great paucity in the literature. It’s also believed that the soft palate has no such important anatomical variations. There is a variable presentation of the soft palate morphology in the lateral cephalograms. The aim of this study is to identify the velar morphology. Materials and Methods: 100 normal subjects between the age group of 20 – 35 were taken for the study. Method: Lateral Cephalogram (radiologic study). Results: Different shapes of the soft palate were observed in the lateral cephalograms. The morphology of soft palate was classified into six types 1.Leaf like (50 cases) most common type, 2.Straight line (20 cases), 3.S shaped (4 cases) very rare, 4.Butt like (10 cases), 5. Rat tail (6 cases), 6. Hook shaped (10 cases). Conclusion: This classification helps us to understand the better diversity of the velar morphology in mid-sagittal plane. These findings help us to understand the etiology of OSAS.

Keywords: soft palate, cephalometric radiographs, morphology, cleft palate, obstructive sleep apnoea syndrome

Procedia PDF Downloads 335

Authors: Hong Su, Qiuju Yan, Wei Du, En Hu, Zhaoyu Yang, Wei Zhang, Yusheng Li, Tao Tang, Wang yang, Shushan Zhao

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Osteoarthritis (OA) is a severe chronic inflammatory disease. As the main active component of Astragalus mongholicus Bunge, a classic traditional ethnic herb, calycosin exhibits anti-inflammatory action and its mechanism of exact targets for OA have yet to be determined. In this study, we established an anterior cruciate ligament transection (ACLT) mouse model. Mice were randomized to sham, OA, and calycosin groups. Cartilage synthesis markers type II collagen (Col-2) and SRY-Box Transcription Factor 9 (Sox-9) increased significantly after calycosin gavage. While cartilage matrix degradation index cyclooxygenase-2 (COX-2), phosphor-epidermal growth factor receptor (p-EGFR), and matrix metalloproteinase-9 (MMP9) expression were decreased. With the help of network pharmacology and molecular docking, these results were confirmed in chondrocyte ATDC5 cells. Our results indicated that the calycosin treatment significantly improved cartilage damage, this was probably attributed to reversing the imbalance between chondrocyte synthesis and catabolism.

Keywords: calycosin, osteoarthritis, network pharmacology, molecular docking, inflammatory, cyclooxygenase 2

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Authors: Zeinab Rasouli Kahaki, Mohammad Ali Sanjari, Reza Khani Jazani, Mahnaz Saremi, Amir Kavousi

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Work which requires prolonged standing, especially in a fixed position can cause discomfort and fatigue. The purpose of this study was to compare the effects of height footrest in discomfort and fatigue lower extremities during long-standing activities. This cross-sectional study was carried out on 15 students with a mean (SD) age of 21.5 ± (2.3) and mean height of 163 ± (2.8). Participants attended 3 sessions each lasting one hour. They stood on three different surfaces: ceramic, footrest 10 and 25 cm. Surface electromyography was used to assess muscle fatigue. Body map and visual analog scale were employed to evaluate discomfort ratings of the lower extremities and the back. Data analyses were performed using ANOVA-R. Based on the results of electromyography there was no difference between soleus, anterior tibial and lateral gastrocnemius muscles fatigue and type of surfaces. There was a significant variation between the surfaces (p < 0.05) and different areas of the body discomfort level; so that the ceramic had the highest discomfort rating, while the lowest ratings were related to the footrest. Further investigations are recommended on the properties of the footrest.

Keywords: electromyography, fatigue, gastrocnemius, lower extremities, soleus, tibial

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Authors: Yu-Hsiang Yu

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The immunomodulatory effect of propolis has been widely investigated in the past decade. However, the beneficial effects in broilers are still poorly understood. The aim of this study was to evaluate the effect of propolis added in drinking water on immunomodulatory and antibody production in broiler. Total of 48 chicks were randomly allocated into four groups with 12 broilers per group. All birds were intranasal inoculated with Newcastle Disease vaccine at 4 and 14 days old of age. Four groups, including control without any treatment, groups of A, B and F [3 days of anterior (A), 3 days of posterior (P) and 6 days of full (F)] were supplied the propolis at 300 ppm in drinking water when vaccination was performed, respectively. Our results showed that no significant difference was found in growth performance, antibody production and immune organ index among groups. However, propolis treatments in broilers significantly reduced IL-4 expression in spleen at 14 days-old of age and bursa at 28 days-old of age compared with control group. The expression of IFN-gamma in spleen (A, P and F group) and bursal (F group) were elevated compared with control group at 28 days-old of age. In conclusion, our results indicated that propolis-treated birds could bear the capability for immunomodulatory effects by change Th1 subset cytokine expression in vaccination.

Keywords: propolis, broiler, immunomodulatory, vaccination

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Authors: Yousif Mohamed Y. Abdallah, Eltayeb Wagi Allah Eltayeb, Mohamed E. Gar-elnabi, Mohamed Ahmed Ali

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To characterize coronary artery obstruction and related findings in ischemic heart patients using cardiac scintigraphy for the identification of myocardial ischemia, 146 patients were studied at basal conditions and also asked for fasting after night till the intravenous injection of the radiopharmaceutical. After the injection time about 15 to 20 minutes, the patient should eat a fatty meal and chocolate for the good excretion of the gall bladder, to evaluate the performance and regional wall motion of the left ventricle (LV). The results showed that the body mass index percentage in this sample was in range of 43.05 to 61.05. The number of patients who were catheter candidates were 56 with 43% and the patients that were not candidate to cathode were 74 patients with 57% of all patients. For the group of patients where type of ischemia was assessed, 29.5% of patients had reversible posterior and inferior wall, 15.1% of patients had fixed large from apex to base, 9.6% of patients had mild basal inferior wall, 4.8 % of patients had mild anterior wall, 6.2% of patients had antro-septal and 34.9% of patients had moderate ischemia.

Keywords: myocardial ischemia, myocardial scintigraphy, contrast ventriculography, coronary artery obstruction

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Authors: Rasha Sharaf, Nehal Sharaf

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Pulpectomy of primary teeth aims to remove the necrotic pulp tissue from the infected root canal and clean the root canal walls from any remnant of pulp tissue. Different irrigant activation systems have been recently used, and one of these devices is the Eddy which helps in removal of smear layer and improves the intimate contact between the filling material and the root canal wall. Aim: To evaluate the efficacy of Eddy in cleanliness of the root canal during pulpectomy of primary teeth. Materials and methods: 45 freshly extracted primary anterior teeth were divided into 3 equal groups, in the 1st group sodium hypochlorite only was used during pulpectomy, in the 2nd group irrigation using sodium hypochlorite with file agitation was performed and in the 3rd group sodium hypochlorite was used with Eddy for irrigant activation. All samples were sectioned longitudinally and scanned using scanning electron microscope to evaluate the cleanliness of the root canals. Results: It was found that Eddy showed high efficacy in removal of smear layer during pulpectomy of primary teeth.

Keywords: Eddy, irrigant activation, irrigation, pulpectomy

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Authors: Kim Ji-Hyun, Jeon Hye-Seon, Kwon Oh-Yun, Park Eun-Young, Hwang Ui-Jae, Gwak Gyeong-Tae, Yoon Hyeo-Bin

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Stress urinary incontinence (SUI), a common women health problem, is an involuntary leakage of urine while sneezing, coughing, or physical exertion caused by insufficient strength of the pelvic floor and sphincter muscles. SUI also leads to decrease in quality of life and limits sexual activities. SUI is related to the increased bladder neck angle, bladder neck movement, funneling index, urethral width, and decreased urethral length. Various pelvic floor muscle electrical stimulation (ES) interventions have been applied to improve the symptoms of the people with SUI. ES activates afferent fibers of pudendal nerve and smoothly induces contractions of the pelvic floor muscles such as striated periurethral muscles and striated pelvic floor muscles. ES via intravaginal electrodes are the most frequently used types of the pelvic floor muscle ES for the female SUI. However, inserted electrode is uncomfortable and it increases the risks of infection. The purpose of this preliminary study was to determine if the 8-week transcutaneous pelvic floor ES would be effective to improve the symptoms and satisfaction of the females with SUI. Easy-K, specially designed ES equipment for the people with SUI, was used in this study. The oval shape stimulator can be placed on a toilet seat, and the surface has invaded electrode fit to contact with the entire vulva area while users are sitting on the stimulator. Five women with SUI were included in this experiment. Prior to the participation, subjects were instructed about procedures and precautions in using the ES. They have used the stimulator once a day for 20 minutes for each session at home. Outcome data was collected 3 times at the baseline, 4 weeks and 8 weeks after the intervention. Intravaginal sonography was used to measure the bladder neck angle, bladder neck movement, funneling index, thickness of an anterior rhabdosphincter and a posterior rhabdosphincter, urethral length, and urethral width. Leavator ani muscle (LAM) contraction strength was assessed by manual palpation according to the oxford scoring system. In addition, incontinence quality of life (IQOL) and female sexual function index (FSFI) questionnaires were used to obtain addition subjective information. Friedman test, a nonparametric statistical test, was used to determine the effectiveness of the ES. The Wilcoxon test was used for the post-hoc analysis and the significance level was set at .05. The bladder neck angle, funneling index and urethral width were significantly decreased after 8-weeks of intervention (p<.05). LAM contraction score, urethral length and anterior and posterior rhabdosphicter thickness were statistically increased by the intervention (p<.05). However, no significant change was found in the bladder neck movement. Although total score of the IQOL did not improve, the score of the ‘avoidance’ subscale of IQOL had significant improved (p<.05). FSFI had statistical difference in FSFI total score and ‘desire’ subscale (p<.05). In conclusion, 8-week use of a transcutaneous ES on peri-vulva area improved dynamic mechanical structures of the pelvic floor musculature as well as IQOL and conjugal relationship.

Keywords: electrical stimulation, Pelvic floor muscle, sonography, stress urinary incontinence, women health

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Authors: Patricia Shirley Almeida Prado, Liz Brito, Selma Paixão Argollo, Gracie Moreira, Leticia Matos Sobrinho

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Diffuse idiopathic skeletal hyperostosis (DISH) is a degenerative bone disease also known as Forestier´s disease and ankylosing hyperostosis of the spine is characterized by a tendency toward ossification of half the anterior longitudinal spinal ligament without intervertebral disc disease. DISH is not considered to be osteoarthritis, although the two conditions commonly occur together. Diagnostic criteria include fusion of at least four vertebrae by bony bridges arising from the anterolateral aspect of the vertebral bodies. These vertebral bodies have a 'dripping candle wax' appearance, also can be seen periosteal new bone formation on the anterior surface of the vertebral bodies and there is no ankylosis at zygoapophyseal facet joint. Clinically, patients with DISH tend to be asymptomatic some patients mention moderate pain and stiffness in upper back. This disease is more common in man, uncommon in patients younger than 50 years and rare in patients under 40 years old. In modern populations, DISH is found in association with obesity, (type II) diabetes; abnormal vitamin A metabolism and also associated with higher levels of serum uric acid. There is also some association between the increase of risk of stroke or other cerebrovascular disease. The DISH condition can be confused with Heterotopic Ossification, what is the bone formation in the soft tissues as the result of trauma, wounding, surgery, burnings, prolonged immobility and some central nervous system disorder. All these conditions have been described extensively as myositis ossificans which can be confused with the fibrodysplasia (myositis) ossificans progressive. As in the DISH symptomatology it can be asymptomatic or extensive enough to impair joint function. A third confusion osteoarthritis disease that can bring confusion are the enthesopathies that occur in the entire skeleton being common on the ischial tuberosities, iliac crests, patellae, and calcaneus. Ankylosis of the sacroiliac joint by bony bridges may also be found. CASE 1: this case is skeletal remains presenting skull, some vertebrae and scapulae. This case remains unidentified and due to lack of bone remains. Sex, age and ancestry profile was compromised, however the DISH pathognomonic findings and diagnostic helps to estimate sex and age characteristics. Moreover to presenting DISH these skeletal remains also showed some bone alterations and non-metrics as fusion of the first vertebrae with occipital bone, maxillae and palatine torus and scapular foramen on the right scapulae. CASE 2: this skeleton remains shows an extensive bone heterotopic ossification on the great trochanter area of left femur, right fibula showed a healed fracture in its body however in its inteosseous crest there is an extensive bone growth, also in the Ilium at the region of inferior gluteal line can be observed some pronounced bone growth and the skull presented a pronounced mandibular, maxillary and palatine torus. Despite all these pronounced heterotopic ossification the whole skeleton presents moderate bone overgrowth that is not linked with aging, since the skeleton belongs to a young unidentified individual. The appropriate osteopathological diagnosis support the human identification process through medical reports and also assist with epidemiological data that can strengthen vulnerable anthropological estimates.

Keywords: bone disease, DISH, human identification, human remains

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Authors: Moustafa Ibrahim Moustafa

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The purpose of this study was to determine the immediate and long term effects of a multimodal program, with the addition of cervical sagittal curve restoration and forward head correction, on severity of dizziness, disability, frequency of dizziness, and severity of cervical pain. 72 patients with cervicogenic dizziness, definite hypolordotic cervical spine, and forward head posture were randomized to experimental or a control group. Both groups received the multimodal program, additionally, the study group received the Denneroll cervical traction. All outcome measures were measured at three intervals. The general linear model indicated a significant group × time effects in favor of experimental group on measures of anterior head translation (F=329.4 P < .0005), cervical lordosis (F=293.7 P < .0005), severity of dizziness (F=262.1 P < .0005), disability (F=248.9 P < .0005), frequency of dizziness (F=53.9 P < .0005), and severity of cervical pain (F=350.1 P < .0005). The addition of Dennroll cervical traction to a multimodal program can positively affect dizziness management outcomes.

Keywords: randomized controlled trial, traction, dizziness, cervical

Procedia PDF Downloads 279

Authors: Alexander V. Spirov, David M. Holloway, Ekaterina M. Myasnikova

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Segmentation of the early Drosophila embryo results from the dynamic establishment of spatial gene expression patterns. Patterning occurs on an embryo geometry which is a 'deformed' prolate ellipsoid, with anteroposterior and dorsal-ventral major and minor axes, respectively. Patterning is largely independent along each axis, but some interaction can be seen in the 'bending' of the segmental expression stripes. This interaction is not well understood. In this report, we investigate how 3D geometrical features of the early embryo affect the segmental expression patterning. Specifically, we study the effect of geometry on formation of the Bicoid primary morphogenetic gradient. Our computational results demonstrate that embryos with a much longer ventral than dorsal surface ('bellied') can produce curved Bicoid concentration contours which could activate curved stripes in the downstream pair-rule segmentation genes. In addition, we show that having an extended source for Bicoid in the anterior of the embryo may be necessary for producing the observed exponential form of the Bicoid gradient along the anteroposterior axis.

Keywords: Drosophila embryo, bicoid morphogenetic gradient, exponential expression profile, expression surface form, segmentation genes, 3D modelling

Procedia PDF Downloads 239

Authors: C. Labate, M. P. De Santo, G. Lombardo, R. Barberi, M. Lombardo, N. M. Ziebarth

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In the past decades, the importance of corneal biomechanics in the normal and pathological functions of the eye has gained its credibility. In fact, the mechanical properties of biological tissues are essential to their physiological function. We are convinced that an improved understanding of the nanomechanics of corneal tissue is important to understand the basic molecular interactions between collagen fibrils. Ultimately, this information will help in the development of new techniques to cure ocular diseases and in the development of biomimetic materials. Therefore, nanotechnology techniques are powerful tools and, in particular, Atomic Force Microscopy has demonstrated its ability to reliably characterize the biomechanics of biological tissues either at the micro- or nano-level. In the last years, we have investigated the mechanical anisotropy of the human corneal stroma at both the tissue and molecular levels. In particular, we have focused on corneal cross-linking, an established procedure aimed at slowing down or halting the progression of the disease known as keratoconus. We have obtained the first evidence that riboflavin/UV-A corneal cross-linking induces both an increase of the elastic response and a decrease of the viscous response of the most anterior stroma at the scale of stromal molecular interactions.

Keywords: atomic force spectroscopy, corneal stroma, cross-linking, viscoelasticity

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Authors: Karen Cilliers, Benedict John Page

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The middle cerebral artery (MCA) is the most complex cerebral artery although few anomalies are found compared to the other cerebral arteries. The branches of the MCA cover a large part of each hemisphere, therefore it is exposed in various operations. Although the segments of the MCA are similarly described by most authors, there is some disagreement on the branching pattern of the MCA. The aim of this study was to review the available literature on the anatomy and variations of the MCA, and to compare this to a pilot study. For the pilot study, 20 hemispheres were perfused with coloured silicone and the MCA was dissected. According to the literature, the two most common branching configurations are the bifurcating and trifurcating patterns. In the pilot study, bifurcation was observed in 19 hemispheres, and in one hemisphere there was no branching (monofurcation). No trifurcation was observed. The most commonly duplicated branch was the anterior parietal artery in 30%, and most commonly absent was the common temporal artery in 65% and the temporal polar artery in 40%. Very few studies describe the origins of the branches of the MCA, therefore a detailed description is given. Middle cerebral artery variations that are occasionally reported in the literature include fenestration, and a duplicated or accessory MCA, although no variations were observed in the pilot study. Aneurysms can frequently be observed at the branching of cerebral vessels, therefore a thorough knowledge of the vascular anatomy is vital. Furthermore, knowledge of possible variations is important since variations can have serious clinical implications.

Keywords: anatomy, anomaly, description, middle cerebral artery, origin, variation

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Authors: Ritesh Verma, Manisha Rathi, Chand Singh Dhull, Sumit Sachdeva, Jitender Phogat

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A Rathke's cleft cyst is a benign growth found on the pituitary gland in the brain, specifically a fluid-filled cyst in the posterior portion of the anterior pituitary gland. It occurs when the Rathke's pouch does not develop properly and ranges in size from 2 to 40mm in diameter. A 38-year-old male presented to the outpatient department with loss of vision in the inferior quadrant of the left eye since 15 days. Visual acuity was 6/6 in the right eye and 6/9 in the left eye. Visual field analysis by HFA-24-2 revealed an inferior field defect extending to the supero-temporal quadrant in the left eye. MRI brain and orbit was advised to the patient and it revealed a well defined cystic pituitary adenoma indenting left optic nerve near optic chiasm consistent with the diagnosis of Rathke’s cleft cyst (RCC). The patient was referred to neurosurgery department for further management. Symptoms vary greatly between individuals having RCCs. RCCs can be non-functioning, functioning, or both. Besides headaches, neurocognitive deficits are almost always present but have a high rate of immediate reversal if the cyst is properly treated or drained.

Keywords: pituitary tumors, rathke’s cleft cyst, visual field defects, vision loss

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Authors: Nikhat Iqbal Tamboli

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INTRODUCTION: road traffic accidents (RTAs) are one of the leading and common causes of ocular injuries especially in developing countries like India which are preventable with certain measures and so it is of public health importance. AIM: To study incidence and clinical presentation of ocular morbidity in road traffic accidents. METHOD: Prospective cross-sectional study was conducted on 360 patients reported in department of ophthalmology. Detailed ocular examination and relevant investigations done. RESULTS: Incidence of ocular injuries is 23%. male:female ratio is 4.5:1.Cases having Sub conjunctival haemorrhage [74].eccymosis[217]. lid lcerations [164]orbital fracture[12] corneal tear [7]corneal abrasion[2] sclera tear[6] hyphaema[4] traumatic mydriasis [7]traumatic cataract [2]vitreous haemorrhage [1]traumatic optic neuropathy[1].Maximum cases in age group 20-40 years, with two wheeler vehicles 94.7% .Under influence of alcohol 13.3%. CONCLUSION: Younger age group with male preponderance is involved in ocular trauma due to road traffic accidents .maximum cases reported are with anterior segment injuries. Alcohol and two wheeler vehicles are common risk factors. Injuries involving cornea had bad prognosis and involving retina had worst prognosis.

Keywords: ocular morbidity, eye trauma, RTA, eye injury

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Authors: H. Merhni, A. Sbiti, I. Ratbi, A. Sefiani

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The proximal spinal muscular atrophy (SMA) is a group of neuromuscular disorders characterized by progressive muscle weakness due to the degeneration and loss of anterior motor neurons of the spinal cord. Depending on the age of onset of symptoms and their evolution, four types of SMA, varying in severity, result in a mutations of the SMN gene (survival of Motor neuron). We have analyzed the DNA of 295 patients referred to our genetic counseling; since January 1996 until October 2014; for suspected SMA. The homozygous deletion of exon 7 of the SMN gene was found in 133 patients; of which, 40.6% were born to consanguineous parents. In countries like Morocco, where the frequency of heterozygotes for SMA is high, genetic testing should be offered as first-line and, after careful clinical assessment, especially in newborns and infants with congenital hypotonia unexplained and prognosis compromise. The molecular diagnosis of SMA allows a quick and certainly diagnosis, provide adequate genetic counseling for families at risk and suggest, for couples who want prenatal diagnosis. The analysis of the SMN gene is a perfect example of genetic testing with an excellent cost/benefit ratio that can be of great interest in public health, especially in low-income countries. We emphasize in this work for the benefit of the generalization of molecular diagnosis of SMA by the technique of PCR-enzymatic digestion in other centers in Morocco.

Keywords: Exon7, PCR-digestion, SMA, SMN gene

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Authors: Jyotismita Talukdar

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In this paper, a study has been made on the possibility and accuracy of early prediction of several Heart Disease using Artificial Neural Network. (ANN). The study has been made in both noise free environment and noisy environment. The data collected for this analysis are from five Hospitals. Around 1500 heart patient’s data has been collected and studied. The data is analysed and the results have been compared with the Doctor’s diagnosis. It is found that, in noise free environment, the accuracy varies from 74% to 92%and in noisy environment (2dB), the results of accuracy varies from 62% to 82%. In the present study, four basic attributes considered are Blood Pressure (BP), Fasting Blood Sugar (FBS), Thalach (THAL) and Cholesterol (CHOL.). It has been found that highest accuracy(93%), has been achieved in case of PPI( Post-Permanent-Pacemaker Implementation ), around 79% in case of CAD(Coronary Artery disease), 87% in DCM (Dilated Cardiomyopathy), 89% in case of RHD&MS(Rheumatic heart disease with Mitral Stenosis), 75 % in case of RBBB +LAFB (Right Bundle Branch Block + Left Anterior Fascicular Block), 72% for CHB(Complete Heart Block) etc. The lowest accuracy has been obtained in case of ICMP (Ischemic Cardiomyopathy), about 38% and AF( Atrial Fibrillation), about 60 to 62%.

Keywords: coronary heart disease, chronic stable angina, sick sinus syndrome, cardiovascular disease, cholesterol, Thalach

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Authors: Sayeeda Laeque Bangi

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Objectives: Treating white spot lesions (WSL) to create a sound and esthetically pleasing enamel surface is a question yet to be fully answered. The objective of this randomized controlled trial was to measure and compare the degree of regression of WSL during orthodontic treatment achieved by using three commercially available materials. Methods: A single-blinded randomized prospective clinical trial, comprising 80 patients categorized into four groups (one control group and three experimental groups, with 20 subjects per group) using block randomization, was conducted. Group A (control group): Colgate strong toothpaste; and experiments groups were Group B: GC tooth mousse, Group C: Phos-Flur mouthwash and Group D: SHY-NM. Subjects were instructed to use the designated dentifrice/mouthwash and photographs were taken at baseline, third and sixth months, and white spot lesions were reassessed in the maxillomandibular anterior teeth. Results: All the three groups had shown an improvement in WSL. But Group B has shown the greatest difference in mean values of decalcification index (DI) scores. Conclusion: All three commercially available products showed a regression of WSL over a 6-month duration. GC tooth mousse proved to be the most effective means of treating WSL over other regimens.

Keywords: white spot lesions, dentifrices, orthodontic therapy, remineralization

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Authors: Fatma Sümer

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Introduction: This case report aims to report myopic anisometropia with copy-image in monozygotic twins. Methods: In February 2021, a 6-year-old identical twin was seen, who was referred to us with the diagnosis of amblyopia in their left eye from an external center. Both twins had a full ophthalmic examination, which included visual acuity testing, ocular motility testing, cycloplegic refraction, and fundus examination. Results: On examination, “copy image” myopic anisometropia was discovered. Twin 1 had anisometropia with myopic astigmatism in the left eye. His cycloplegic refraction was +1.00 (-0.75x 75) in the right eye and -8.0 (-1.50x175) in the left eye. Similarly, twin 2 had anisometropia with myopic astigmatism in the left eye. His cycloplegic refraction was -7.75 (-1.50x180) in the left eye and +1.25 (-0.75x90 ) in the right eye. The best-corrected visual acuity was 20/60 in the amblyopic eyes and 20/20 in the unaffected eyes. There was no ocular deviation. In either patient, a slit-lamp microscopic examination revealed no abnormalities in the anterior parts of either eye. Fundoscopic examination revealed no abnormalities. No abnormal ocular movements were demonstrated. Conclusion: As far as we have reviewed in the literature, previous studies with twins were mostly concerned with mirror-effect myopic anisometropia and myopic anisometropia, whereas ipsilateral amblyopia and anisometropia were not reported in monozygotic twins. This case underscores the possible genetic basis of myopic anisometropia.

Keywords: amblyopia, anisometropia, myopia, twins

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Authors: Pietro Mortini, Marco Losa

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Objective: Resection of large lesions growing into the third ventricle remains a demanding surgery, sometimes at risk of severe post-operative complications. Transcallosal and transcortical routes were considered as approaches of choice to access the third ventricle, however neurological consequences like memory loss have been reported. We report clinical results of the previously described combined interhemispheric sub-commissural translaminaterminalis approach (CISTA) for the resection of large lesions located in the third ventricle. Methods: Authors conducted a retrospective analysis on 10 patients, who were operated through the CISTA, for the resection of lesions growing into the third ventricle. Results: Total resection was achieved in all cases. Cognitive worsening occurred only in one case. No perioperative deaths were recorded and, at last follow-up, all patients were alive. One year after surgery 80% of patients had an excellent outcome with a KPS 100 and Glasgow Outcome score (GOS) Conclusion: The CISTA represents a safe and effective alternative to transcallosal and transcortical routes to resect lesions growing into the third ventricle. It allows for a multiangle trajectory to access the third ventricle with a wide working area free from critical neurovascular structures, without any section of the corpus callosum, the anterior commissure and the fornix.

Keywords: craniopharingioma, surgery, sub-commissural translaminaterminalis approach (CISTA),

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Authors: Karissa A. Graham

Abstract:

Pyoderma gangrenosum (PG) is a prototypic autoinflammatory neutrophilic dermatosis that is a rare disorder. It presents a diagnostic challenge owing to its variable presentation, clinical overlap with other conditions, it is often associated with other systemic conditions, and there is no definitive histological or laboratory characteristic. The Delphai consensus for PG includes the presence of at least one ulcer on the anterior lower limb. Systemic corticosteroids and immunosuppressive therapies are the mainstay treatment for PG. We describe a case report of delayed diagnosis of ulcerative pyoderma gangrenosum in a 44-year-old male on his forearm. The patient presented with an infected ulcer on his right forearm that had been present for over three years. The patient was a Type 2 Diabetic with no personal or family history of inflammatory bowel disease or other autoimmune diseases. The patient was initially investigated for malignancy, but biopsies returned as chronic inflammatory tissue with neutrophilic infiltrate and no malignancy. The patient was commenced on systemic prednisone for the treatment of pyoderma gangrenosum. The diagnosis of ulcerative PG poses a challenge given the vast differential diagnosis for a cutaneous ulcer (i.e., malignant, vascular, autoimmune, trauma, infective, etc.). Diagnostic accuracy is important given that the treatment for PG with steroids does not go without risks and indeed may be contraindicated in other potential causes of the ulcer. Indeed, more common and more sinister causes of ulcers should be investigated first, as death from PG is quite rare.

Keywords: dermatological diagnosis, dermatosis, pyoderma gangrenosum, rare presentation

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Authors: Yasar Samet Gokceoglu, Ayse Nur Incesu, Furkan Okatar, Berk Nimetoglu, Serkan Bayram, Turgut Akgul

Abstract:

Ankle syndesmosis injuries pose a significant challenge in orthopedic practice due to their potential for prolonged recovery and chronic ankle dysfunction. Accurate diagnosis and management of these injuries are essential for achieving optimal patient outcomes. The use of radiological methods, such as X-ray, computed tomography (CT), and magnetic resonance imaging (MRI), plays a vital role in the accurate diagnosis of syndesmosis injuries in the context of ankle fractures. Treatment options for ankle syndesmosis injuries vary, with surgical interventions such as screw fixation and suture-button implantation being commonly employed. The choice of treatment is influenced by the severity of the injury and the presence of associated fractures. Additionally, the mechanism of injury, such as pure syndesmosis injury or specific fracture types, can impact the stability and management of syndesmosis injuries. Ankle fractures with syndesmosis injury present a complex clinical scenario, requiring accurate diagnosis, appropriate reduction, and tailored management strategies. The interplay between the mechanism of injury, associated fractures, and treatment modalities significantly influences the outcomes of these challenging injuries. The long-term outcomes and patient satisfaction following ankle fractures with syndesmosis injury are crucial considerations in the field of orthopedics. Patient-reported outcome measures, such as the Foot and Ankle Outcome Score (FAOS), provide essential information about functional recovery and quality of life after these injuries. When diagnosing syndesmosis injuries, standard measurements, such as the medial clear space, tibiofibular overlap, tibiofibular clear space, anterior tibiofibular ratio (ATFR), and the anterior-posterior tibiofibular ratio (APTF), are assessed through radiographs and computed tomography (CT) scans. These parameters are critical in evaluating the presence and severity of syndesmosis injuries, enabling clinicians to choose the most appropriate treatment approach. Despite advancements in diagnostic imaging, challenges remain in accurately diagnosing and treating ankle syndesmosis injuries. Traditional diagnostic parameters, while beneficial, may not capture the full extent of the injury or provide sufficient information to guide therapeutic decisions. This gap highlights the need for exploring additional diagnostic parameters that could enhance the accuracy of syndesmosis injury diagnoses and inform treatment strategies more effectively. The primary goal of this research is to evaluate the usefulness of traditional radiographic measurements in comparison to new CT-based measurements for diagnosing ankle syndesmosis injuries. Specifically, this study aims to assess the accuracy of conventional parameters, including medial clear space, tibiofibular overlap, tibiofibular clear space, ATFR, and APTF, in contrast with the recently proposed CT-based measurements such as the delta and gamma angles. Moreover, the study intends to explore the relationship between these diagnostic parameters and functional outcomes, as measured by the Foot and Ankle Outcome Score (FAOS). Establishing a correlation between specific diagnostic measurements and FAOS scores will enable us to identify the most reliable predictors of functional recovery following syndesmosis injuries. This comparative analysis will provide valuable insights into the accuracy and dependability of CT-based measurements in diagnosing ankle syndesmosis injuries and their potential impact on predicting patient outcomes. The results of this study could greatly influence clinical practices by refining diagnostic criteria and optimizing treatment planning for patients with ankle syndesmosis injuries.

Keywords: ankle syndesmosis injury, diagnostic accuracy, computed tomography, radiographic measurements, Tibiofibular syndesmosis distance

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Authors: Ahmad Shanei, Milad Baradaran-Ghahfarokhi

Abstract:

This study aimed to investigate testicular dose (TD) and the associated risk of heritable disease from common pelvis radiotherapy of male patients in Iran. In this work, the relation between TD and changes in beam energy, pelvis size, source to skin distance (SSD) and beam directions (anterior or posterior) were also evaluated. The values of TDs were measured on 67 randomly selected male patients during common pelvis radiotherapy using 1.17 and 1.33 MeV, Theratron Cobalt-60 unit at SSD of 80 cm and 9 MV, Neptun 10 PC and 18 MV, GE Saturne 20 at SSD of 100 cm at Seyed-Al Shohada Hospital, Isfahan, Iran. Results showed that the maximum TD was up to 12% of the tumor dose. Considering the risk factor for radiation-induced heritable disorders of 0.1% per Sv, an excess risk of hereditary disorders of 72 per 10000 births was conservatively calculated. There was a significant difference in the measured TD using different treatment machines and energies (P < 0.001). The TD at 100 cm SSD were much less than that for 80 cm SSD (P <0.001). The Pearson Correlation test showed that, as expected, there was a strong correlation between TD and patient’s pelvis size (r = 0.275, P <0.001). Using the student’s t-tests, it was found that, there was not a significant difference between TD and beam direction (P = 0.231). Iranian male patients undergoing pelvic radiotherapy have the potential of receiving a TD of more than 1 Gy which might result in temporary azoospermia. The risk for induction of hereditary disorders in future generations should be considered as low but not negligible in comparison with the correspondent nominal risk.

Keywords: pelvis radiotherapy, testicular dose, infertility, hereditary effects

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Authors: Ahmed Fawzy, Khaled Ayad, Gh. M. Koura, W. Reda

Abstract:

The knee joint complex is one of the most commonly injured areas of the body in athletes. Excessive frontal plane knee excursion is considered a risk factor for multiple knee pathologies such as anterior cruciate ligament and patellofemoral joint injuries, however, little is known about the biomechanical factors that contribute to this loading pattern. Objectives: The purpose of this study was to investigate if there is a relationship between hip abductors isometric strength and the value of FPPA during single leg landing tasks in normal male subjects. Methods: One hundred (male) subjects free from lower extremity injuries for at least six months ago participated in this study. Their mean age was (23.25 ± 2.88) years, mean weight was (74.76 ± 13.54) (Kg), mean height was (174.23 ± 6.56) (Cm). The knee frontal plane projection angle was measured by digital video camera using single leg landing task. Hip abductors isometric strength were assessed by portable hand-held dynamometer. Muscle strength had been normalized to the body weight to obtain more accurate measurements. Results: The results demonstrated that there was no significant relationship between hip abductors isometric strength and the value of FPPA during single leg landing tasks in normal male subjects. Conclusion: It can be concluded that there is no relationship between hip abductors isometric strength and the value of FPPA during functional activities in normal male subjects.

Keywords: 2-dimensional motion analysis, hip strength, kinematics, knee injuries

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Authors: Atef M. Ghaleb, Mohamed Z. Ramadan, Khalid Saad Aljaloud

Abstract:

The aim of this study is to assesses the lifting capabilities of persons experiencing hypoxia. It also examines the behavior of the physiological response induced through the lifting process related to changing in the hypoxia and lifting frequency variables. For this purpose, the study performed two consecutive tests by using; (1) training and acclimatization; and (2) an actual collection of data. A total of 10 male students from King Saud University, Kingdom of Saudi Arabia, were recruited in the study. A two-way repeated measures design, with two independent variables (ambient oxygen (15%, 18% and 21%)) and lifting frequency (1 lift/min and 4 lifts/min) and four dependent variables i.e., maximum acceptable weight of lift (MAWL), Electromyography (EMG) of four muscle groups (anterior deltoid, trapezius, biceps brachii, and erector spinae), rating of perceived exertion (RPE), and rating of oxygen feeling (ROF) were used in this study. The results show that lifting frequency has significantly impacted the MAWL and muscles’ activities. The oxygen content had a significant effect on the RPE and ROE. The study has revealed that acclimatization and training sessions significantly reduce the effect of the hypoxia on the human physiological parameters during the manual materials handling tasks.

Keywords: lifting capabilities, muscle activities, oxygen content, perceived exertion

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Authors: Masoumeh Shojaei, Natalie Gedayloo, Amir Sarshin

Abstract:

The purpose of the present study was to investigate the effect of Isokinetic fatigue of muscles around the ankle, knee, and hip on the indicators of dynamic postural stability. Therefore, 15 female university students (age 19.7± 0.6 years old, weight 54.6± 9.4 kg, and height 163.9± 5.6 cm) participated in within-subjects design for 5 different days. In the first session, the postural stability indices (time to stabilization after jump-landing) without fatigue were assessed by force plate and in each next sessions, one of muscle groups of the lower limb including the muscles around ankles, knees, and hip was randomly exhausted by Biodex Isokinetic dynamometer and the indices were assessed immediately after the fatigue of each muscle group. The method involved landing on a force plate from a dynamic state, and transitioning balance into a static state. Results of ANOVA with repeated measures indicated that there was no significant difference between the time to stabilization (TTS) before and after Isokinetic fatigue of the muscles around the ankle, knee and hip in medial – lateral direction (p > 0.05), but in the anterior – posterior (AP) direction, the difference was statistically significant (p < 0.05). Least Significant Difference (LSD) post hoc test results also showed that there was significant difference between TTS in knee and hip muscles before and after isokinetic fatigue in AP direction. In the other hand knee and hip muscles group were affected by isokinetic fatigue only in AP surface (p < 0.05).

Keywords: dynamic balance, fatigue, lower limb muscles, postural control

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Authors: Hanifa Maryani Ahmad, Muslim Yusuf

Abstract:

Background: Unilateral crossbite can be defined as an abnormal transverse relationship between the upper and lower teeth where the mandibular buccal cusp occluding to the maxillary buccal cusp and which involves only one side of the arch. This report describes the treatment of an adolescent female with Class III malocclussion unilateral crossbite resulting from a mildly constricted maxillary arch. The patient had a Class III skeletal relationship, Class III molar relationships, unilateral crossbite on the left side, and deviated midlines. Objectives: The treatment objectives were to correct the abnormal transverse relationship, achieve proper dental inclination, and correct the unilateral crossbites to improve the facial profile. Case management: The treatment protocol was using transpalatal arch with extension arm modification to expand the maxillary arch. Following the levelling and aligning stage of treatment, using a vertical loop while mandibular arch was expanded after getting an end to end relationship on the anterior side. Results: Corrections of the unilateral crossbite were achieved in 4 months. The treatment is still on process because the canines relationship were not corrected. Conclusions: This report highlights a treatment using transpalatal arch with extension arm modification that can be used to expand the transverse width of an arch to correct the discrepancy. Even though the treatment processes were still ongoing, the correction of the unilateral crossbite have been achieved in 4 months by only using the transpalatal arch.

Keywords: crossbite unilateral, late growing, non-extraction, transpalatal arch

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Authors: Behnam Shakerian, Negin Razavi

Abstract:

The pathogenesis of coronary artery disease is multifactorial. The epicardial fat pad is a localized fat depot lying between the myocardium and the visceral layer of the pericardium. The mechanisms through which epicardial fat pad can cause atherosclerosis are complex. The epicardial fat pad can surround the coronary arteries and contributes to the development and progression of coronary artery disease. Methods: we selected 50 patients who underwent coronary artery angiography for the evaluation of coronary artery disease that results were positive for coronary artery disease. All patients underwent an echocardiographic examination after coronary angiography to measure epicardial fat pad thickness. The epicardial fat pad was defined as an echo-free space between the myocardium's outer wall and the pericardium's visceral layer. Results: The epicardial fat pad was measured on the right ventricle apex in 46 patients. Sixty- five percent of the studied patients were male. The most common vessel with stenosis was the left anterior descending artery. A significant correlation was observed between epicardial fat pad thickness and the severity of coronary artery disease. Discussions: The epicardial fat pad provides a horizon on the pathophysiology of cardiovascular diseases. It directly contributes to the development and progression of coronary artery disease by causing inflammation and endothelial damage. Further investigations are needed to determine whether medical treatment can reduce the mass of epicardial fat pad and can help to improve atherosclerosis. Conclusion: The epicardial fat pad measurement could be used as an indicator of coronary arteries’ atherosclerosis. Therefore, thickness measurement of the epicardial fat pad in the clinical practice could be of assistance in identifying patients at risk and if required, undergoing supplementary diagnosis with coronary angiography.

Keywords: epicardial, fat pad, coronary artery disease, echocardiography

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Authors: Abdul M. Khan, Hafiza I. Naz, Ayesha Iqbal, Muhammad Akhtar

Abstract:

The fossil remains described in this study have been recovered during fieldwork by the authors from the Dhok Pathan Formation of Middle Siwaliks Pakistan in December, 2015. The sample comprises maxillary and mandibular fragments along with isolated upper and lower teeth. The morphometric analysis of the specimens led us to recognize the sample as belonging to Eotragus noyei, which has been considered as the smallest and the oldest bovid in the Siwaliks. Eotragus noyei is characterized by brachydont teeth, finely rugose enamel, more inclined buccal walls of the molars and small lingual cingula. The inclination of the metaconal area has caused rotation of the metastyle in relation to the antero-posterior tooth axis and thus situated more lingually. The protocone in second upper premolar is well developed and situated posteriorly and also has an anterior lingual constriction. The metaconule in the third upper molar is smaller than the protocone. The dentition in Eotragus noyei is smaller in size as compared to Eotragus sansaniensis and Eotragus lampangensis. In Eotragus noyei the buccal walls in molars are more inclined while in Eotragus sansaniensis they are less inclined. The genus Eotragus has been reported previously in the Lower and Middle Siwaliks of Pakistan; however, the recognition of the present sample as Eotragus noyei has extended the range of this species from Lower to the Middle Siwaliks of Pakistan.

Keywords: Boselaphini, Chakwal, Dhok Pathan, late miocene

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