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Introduction: Conservative and surgical approach timeline in post-operative spondylodiscitis (POS) following lumbar disc herniation (LDH) surgery is ill defined, and patients have a protracted recovery phase with social, psychological, and financial implications. Materials and methods: Retrospective analysis of patients operated by transforaminal lumbar interbody fusion (TLIF) in POS was done. Confirmed clinico-radiological diagnosed POS cases, not responding within three to four weeks were included. Normalisation of CRP and radiological stable reconstruction was assessed for objective clearance of POS and bony union. Results: Ninety-five patients were included in the study with minimum follow-up period of two years. The mean age was 51.63±13.63 years. There were organisms cultured in 55 patients (57.89%). The ODI improvement of the patients was noted to improve from 88.71±5.3 to 20.80±9.7 (8 weeks) and was incremental at 2 years follow-up (10.12±6.41) and maintained further at final follow-up at 9±4.3. Bony union achieved in all with stable reconstruction. The resumption of activities of daily living (ADL) was quick (15.90±8.20 days) and job (3.67±1.31 months) was achieved in all the patients. In poor outcomes, two patients didn’t respond, and one patient died due to uncontrolled infection. Conclusion: Early diagnosis and intervention is the key to effective management of POS. Utilisation of aggressive TLIF yields faster ADL resumption.

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Introduction: The nerve to mylohyoid is a branch of inferior alveolar nerve which arises just above the mandibular foramen. There is occasionally communicating branch between nerve to mylohyoid and lingual nerve. Knowledge of such variations has significance during oral and submandibular surgery. Aim: To detect and describe the existence and occurrence of anatomical variations in the innervation pattern of the nerve to mylohyoid by using the dissection technique. Materials and Methods: An observational study was carried out from January 2022 to April 2022 in a total of 15 embalmed and formalin-fixed cadavers in the Laboratory of Anatomy of SMBT Medical College, Nashik, Maharashtra. The nerve to the mylohyoid and lingual nerve were cleared and observed for any unusual communication between the two, if any. Results: In 13 (86.67%) cadavers, classical (normal) anatomical presentation of the nerve to mylohyoid was observed, whereas, in two male (13.33%) cadavers, the presence of communicating branch between the nerve to mylohyoid and lingual nerve was observed. In both the cadavers, the communicating branch was unilateral, in one cadaver on the right-side, and in the second cadaver same variation was noted on the left-side. Conclusion: The existence of communication between the nerve to mylohyoid and the lingual nerve is thought to be responsible for inadequate mandibular anesthesia. Through this study, surgeons will be aware of this variance, to explain unexpected findings in nerve injury following oral procedures.

Marburg virus (MARV) causes severe disease and high mortality in humans. The objective of this study was to characterize disease manifestations and pathogenesis in cynomolgus macaques exposed to MARV. The results of this natural history study may be used to identify features of MARV disease useful in defining the ideal treatment initiation time for subsequent evaluations of investigational therapeutics using this model. Twelve cynomolgus macaques were exposed to a target dose of 1000 plaque-forming units MARV by the intramuscular route, and six control animals were mock-exposed. The primary endpoint of this study was survival to Day 28 post-inoculation (PI). Anesthesia events were minimized with the use of central venous catheters for periodic blood collection, and temperature and activity were continuously monitored by telemetry. All mock-exposed animals remained healthy for the duration of the study. All 12 MARV-exposed animals (100%) became infected, developed illness, and succumbed on Days 8–10 PI. On Day 4 PI, 11 of the 12 MARV-exposed animals had statistically significant temperature elevations over baseline. Clinically observable signs of MARV disease first appeared on Day 5 PI, when 6 of the 12 animals exhibited reduced responsiveness. Ultimately, systemic inflammation, coagulopathy, and direct cytopathic effects of MARV all contributed to multiorgan dysfunction, organ failure, and death or euthanasia of all MARV-exposed animals. Manifestations of MARV disease, including fever, systemic viremia, lymphocytolysis, coagulopathy, and hepatocellular damage, could be used as triggers for initiation of treatment in future therapeutic efficacy studies.

Periodontitis is a microbial disease of tooth-supporting tissues that results in progressive destruction of surrounding soft and hard tissues with eventual loss of tooth or tooth mobility. A comprehensive literature search was performed by using the keywords: periodontitis, periodontal disease, combined with the word genes, mutation, or polymorphism. Gene polymorphism studies with a reported genotype frequency in chronic periodontitis (CP) and aggressive periodontitis (AgP) patients were searched and reviewed. There has been a growing evidence of polymorphisms in the interleukin (IL)-1, IL-4, IL-6, IL-10, IL-12, and tumor necrosis factor-alpha with CP and AgP in certain populations. However, carriage rates of the rare (R) allele of any polymorphism varied considerably among studies, and most of the studies appeared underpowered and did not correlate for other risk factors, hence furthermore researches are required including large sample size, different races, genotypes, and other risk factors which were found to be influential in expression and severity of CP and AgP to get a more comprehensive insight into the contribution of IL gene polymorphisms in CP and AgP.

Background: Thrombocytopenia (TCP) is the second most common haematological finding in pregnancy next to anaemia. It carries a risk for both the mother and the fetus, associated with substantial maternal or neonatal morbidity and mortality. However, a specific therapy, if instituted promptly, improves the outcome for affected patients and their offspring. In patients in India, TCP during pregnancy is an underexplored condition. Objectives: To assess the aetiology of TCP in pregnancy and to assess the maternal outcomes of TCP in pregnancy. Methodology: The authors included a total of 133 patients in their third trimester (>32 weeks), with a platelet count less than 149,000 /mm3, admitted to the authors’ institution from 1st January 2021 to 31st December 2021. Patient-related data such as menstrual and obstetric history, presenting complaints, obstetric examination, and basic investigations were collected in a pre-designed, pre-tested proforma. All cases were followed until delivery to record any maternal complications, or any other morbidities. The data were analysed using SPSS (International Business Machines Corporation, Armonk, New York, USA) software. χ2 test was used to compare the proportions between the groups. p less than 0.05 was considered significant. Results: Overall, 64.7 percent of patients were in the 18–25 years age group and 49.6 percent of patients were primigravida. Furthermore, 60.9 percent of patients were diagnosed to have mild TCP, 32.3 percent had moderate TCP, and only 6.8 percent patients had severe TCP. The majority (75.2%) of cases were of gestational TCP. In total, 15.8% of cases had pregnancy-induced hypertension (PIH); 3.0 percent had dengue; 2.3 percent were COVID-19 positive; 1.5 percent were diagnosed with haemolysis, elevated liver enzymes, and low platelets syndrome; 1.5 percent had immune TCP; and only one patient had leptospirosis. Four percent of cases had gestational TCP, 9.5% had PIH, one patient (25.0%) had dengue, and both cases of immune TCP had severe TCP. Twenty-eight percent of gestational TCP cases; 47.6 percent of PIH cases, both cases of haemolysis, elevated liver enzymes, and low platelets syndrome; 50.0 percent of dengue cases; and one COVID-19 positive case (33.0%) had moderate TCP. Finally, 6.25% of patients who underwent lower segment caesarean section had severe TCP, 6.00% of patients who underwent vaginal delivery had severe TCP, and out of two patients who had a spontaneous abortion, one (50.00%) had severe TCP at the time of admission. The association was significant (p less than 0.05). Conclusion: TCP is a crucial condition among pregnant patients. Mild TCP is a common type. Correct aetiological diagnosis, and promptly administered adequate and specific therapy are, therefore, essential to significantly improve the outcomes of pregnant patients and their offspring.

Ground-based active optical sensors (GBAOS) have been successfully used in agriculture to predict crop yield potential (YP) early in the season and to improvise N rates for optimal crop yield. However, the models were found weak or inconsistent due to environmental variation especially rainfall. The objectives of the study were to evaluate if GBAOS could predict YP across multiple locations, soil types, cultivation systems, and rainfall differences. This study was carried from 2011 to 2013 on corn (Zea mays L.) in North Dakota, and in 2017 in potatoes in Maine. Six N rates were used on 50 sites in North Dakota and 12 N rates on two sites, one dryland and one irrigated, in Maine. Two active GBAOS used for this study were GreenSeeker and Holland Scientific Crop Circle Sensor ACS 470 (HSCCACS-470) and 430 (HSCCACS-430). Rainfall data, with or without including crop height, improved the YP models in term of reliability and consistency. The polynomial model was relatively better compared to the exponential model. A significant difference in the relationship between sensor reading multiplied by rainfall data and crop yield was observed in terms of soil type, clay and medium textured, and cultivation system, conventional and no-till, respectively, in the North Dakota corn study. The two potato sites in Maine, irrigated and dryland, performed differently in terms of total yield and rainfall data helped to improve sensor YP models. In conclusion, this study strongly advocates the use of rainfall data while using sensorbased N calculator algorithms. [ABSTRACT FROM AUTHOR]

Recent Ebola virus (EBOV) outbreaks in West Africa and the Democratic Republic of the Congo have highlighted the urgent need for approval of medical countermeasures for treatment and prevention of EBOV disease (EVD). Until recently, when successes were achieved in characterizing the efficacy of multiple experimental EVD therapeutics in humans, the only feasible way to obtain data regarding potential clinical benefits of candidate therapeutics was by conducting well-controlled animal studies. Nonclinical studies are likely to continue to be important tools for screening and development of new candidates with improved pharmacological properties. Here, we describe a natural history study to characterize the time course and order of progression of the disease manifestations of EVD in rhesus monkeys. In 12 rhesus monkeys exposed by the intramuscular route to 1000 plaque-forming units of EBOV, multiple endpoints were monitored for 28 days following exposure. The disease progressed rapidly with mortality events occurring 7−10 days after exposure. Key disease manifestations observed consistently across the infected animals included, but were not limited to, viremia, fever, systemic inflammation, coagulopathy, lymphocytolysis, renal tubular necrosis with mineralization, and hepatocellular degeneration and necrosis.

The article presents a case study of an 18-year-old woman diagnosed with fetal bradycardia. Topics discussed include the medical history and records of the patient, her physical examination such as category-I emergency caesarean section, an overview of fetal bradycardia, its diagnosis, causes and its treatment.

Coronary artery calcification (CAC) in chronic kidney disease patients increases cardiovascular risk, especially in those on hemodialysis. Diabetes mellitus is an independent risk factor for coronary artery calcification in patients with or without renal disease. However, presence of diabetes mellitus in stage III and IV CKD is associated with more severe coronary calcification with advanced atherosclerosis and hence cardiovascular events. CAC scores are a reliable screening tool for cardiovascular disease, CAC scores help predict both incidence of myocardial infarction and death from cardiovascular disease. In this study we compared the CAC score in patients with CKD stage III and IV, with and without diabetes, using multi-detector computed tomography (MDCT). We also observed the association of other risk factors in CKD with CAC. [ABSTRACT FROM AUTHOR]

The current study was done to determine the incidence of CIN in patients of coronary angiography and angioplasty in Government Medical College, a tertiary care institution of Jammu province in Jammu and Kashmir State. Two hundred and fifty-four eligible patients scheduled for coronary angiography and angioplasty were enrolled from the outdoor/indoor departments of cardiology and medicine, Government Medical College, Jammu. Renal function was measured at baseline and 48 hours after the intervention, and CIN was defined by an increase in creatinine of >0.5 mg/dL or 25% of the initial value. The results were reported as percentages for the categorical variables. 95% CI were calculated, wherever required. Incidence of CIN following cardiac procedures in the study was observed in 11.02% subjects. In subjects with no risk factor (n=130), incidence of CIN was 2.31%, in diabetes/no renal insufficiency subjects (n=68), incidence was 5.88%, while it was much higher in subjects with renal insufficiency/no diabetes 31.03% and in subjects with both diabetes and renal insufficiency 44.44%. Among 43 subjects with age >70 years, 4.65% developed CIN. Mortality was recorded in 1.33% subjects without CIN and in 17.86% subjects with CIN. Although the incidence of CIN is low in general population without risk factors, it occurs frequently in patients with underlying diabetes mellitus or renal dysfunction or when both are present especially among elderly. A careful risk-benefit analysis must always be performed prior to the administration of contrast media to patient at risk of CIN. [ABSTRACT FROM AUTHOR]

Neurons deploy diverse adaptive strategies to ensure survival and neurotransmission amid cellular stress. When these adaptive pathways are overwhelmed, functional impairment or neurodegeneration follows. Here we show that stressed neurons actively induce a state of transmissive dormancy as a protective measure. Extending observations of neurotrauma in C. elegans and mice, human dopaminergic neurons capable of surviving severe cellular challenges both decrease spontaneous activity and modulate dopamine homeostasis through the transcriptional regulator Yin Yang 1 (YY1). To bolster stress resilience and mitigate dopamine toxicity, YY1 increases expression of the vesicular monoamine transporter 2, vMAT2, while coordinately inhibiting dopamine synthesis through stabilization of a guanine quadruplex in intron 10 of tyrosine hydroxylase, TH. This dopaminergic stress response has the potential to cause circuit inactivation, yet safeguards neurons by minimizing the toxic accumulation of cytosolic dopamine and inducing a state of neuronal dormancy. In essence, neurons appear to actively prioritize viability over functionality., Competing Interests: Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Study Design: Retrospective comparative study., Objective: To compare the accuracy of intra-operative navigation-assisted percutaneous pedicle screw insertion between bone fixed and skin fixed dynamic reference frame (DRF) in Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF)., Methods: Between October 2018 and September 2022, patients who underwent MIS-TLIF were included in this study with DRF fixed either on bone (group B) or skin (group S). Pedicle screws were inserted under the guidance of intra-operative Cone bean Computed tomography (cbCT) based navigation. Accuracy of pedicle screw placement was immediately checked by a final intra-operative cbCT Spin., Results: Among 170 patients, group B included 91 patients and group S included 79 patients. Out of total 680 screws, 364 screws (group B) and 316 screws (group S) were placed. Patient's demographic data and distribution of screws showed no statistically significant difference. The accuracy showed no significant difference between both the groups (94.5% in group B and 94.3% in group S)., Conclusion: Skin fixed DRF can serve as an alternate way for placement and avoids extra incision with similar accuracy in pedicle screw insertions with bone fixed DRF using intra-operative CT guided navigation in MIS TLIF., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.