Effect of low-intensity pulsed ultrasound on fracture callus mineral density and flexural strength in rabbit tibial fresh fracture

Background  

Low-intensity ultrasound is a biophysical intervention on a fracture repair process. However, the effect of low-intensity ultrasound therapy on fracture healing is controversial. The aim of the present study was to evaluate the effect of low-intensity pulsed ultrasound (LIPUS) therapy on the fracture healing process, including mineral density and strength of callus using a rabbit model.     

Association of circulating resistin with metabolic risk factors in Indian females having metabolic syndrome

Role of resistin in insulin sensitivity and metabolic syndrome (MetS) is controversial till date. Increased serum resistin levels are associated with MetS and insulin resistance. The aim of this study was to investigate the relationship between serum resistin levels with markers of the MetS in females. In a cross-sectional study, a total of 170 healthy female subjects were selected for the study. Out of which 71 (age 31.59 ± 4.88 years) were with MetS and 99 (age 31.75 ± 6.34 years) were without MetS. Different parameters of MetS and serum resistin level were measured according to the standard protocols as given in NCEP ATP III 2001 guideline. Serum resistin levels were significantly higher in subjects with MetS when compared with subjects without MetS [13.54 ± 4.14 ng/ml (n = 71) vs. 7.42 ± 2.31 ng/ml (n = 99); P ≤ 0.001]. Resistin levels were positively associated with waist circumference, systolic and diastolic blood pressure, plasma glucose, waist/hip ratio, serum triglycerides, serum cholesterol, serum VLDL, plasma insulin, and insulin resistance, while it was negatively associated with high-density lipoprotein. This study demonstrates a positive correlation between resistin and factors of MetS except high-density lipoprotein which was found to be negatively correlated in Indian female subjects.     

The effect of pulpotomy using a Calcium-Enriched Mixture cement versus one-visit root canal therapy on postoperative pain relief in irreversible pulpitis: a randomized clinical trial

The purpose of this noninferiority trial was to compare postoperative pain relief after one-visit root canal therapy (ORCT) with a pulpotomy performed with a new endodontic calcium-enriched mixture cement (PCEM) in human permanent molars with irreversible pulpitis. A total of 407 selected patients were randomly allocated into the ORCT group (n = 202) or the PCEM group (n = 205). Numerical Rating Scale questionnaires were used to record pain intensity (PI) by the patients during the first 7 days after treatment. While there was no statistically significant difference in the mean PI at baseline between the two study groups (P = 0.45), changes in mean PI were significantly different between them (P < 0.001). In the ORCT group, pain relief was achieved after 36 h [95% confidence interval (CI), 27.00–45.00], compared to 18 h in the PCEM group (95% CI, 15.00–21.00), a significant difference (P < 0.01). Comparison of the mean PI sum recorded over 7 days showed that patients in the ORCT group experienced significantly more pain than those in the PCEM group (P < 0.001); a similar difference was observed for pain in response to percussion tests (P < 0.001). Treatment with PCEM thus had the better pain-reducing effects than ORCT in irreversible pulpitis cases.     

Glaucoma among Saudi Arabian population: a scoping review

Despite its high risk of leading to permanent visual dysfunction, glaucoma remains underdiagnosed in primary care settings. About 11% of glaucoma patients in Saudi Arabia end up with bilateral blindness. This scoping review investigates and presents results on the glaucoma profile, including its prevalence, knowledge, attitude, and practice of Saudi Arabians towards the disease. An online search using four databases through online software (www.rayyan.ai) was performed to extract the relevant articles. Out of 76 records, 21 articles were eligible for the analysis. All included studies were published between the years 2014 and 2022. Most studies were in Riyadh city, followed by Jeddah. All participants (n=11 388) were adults >18 years old, and male participants were generally higher than females. The findings showed poor knowledge of glaucoma among the general population, while the knowledge among glaucoma patients was acceptable. The attitude was positive, while the compliance and practice were fair. More educational programs about glaucoma, its risk to the eyes, and the overall quality of life are highly recommended.     

Self-induced subcutaneous facial emphysema in a prisoner: report of a case

Subcutaneous cervicofacial emphysema is a rare condition that results from various causes. Initially it might be misdiagnosed and managed as other clinical entities, such as angioedema. We report a case of self-induced subcutaneous facial emphysema in a prisoner who sought better living conditions by simulating an emergency.     

Septic shock caused by Sphingomonas paucimobilis bacteremia in a patient with hematopoietic stem cell transplantation

Abstract: Sphingomonas paucimobilis is an aerobic gram-negative bacillus that causes a variety of infections in healthy as well as in immunocompromised individuals. The organism is usually susceptible to tetracycline, chloramphenicol, aminoglycosides, trimethoprim–sulfamethoxazole, and carbapenems. However, resistance to penicillins and the first-generation cephalosporins is commonly encountered. Reported here is a patient with acute myeloid leukemia who developed S. paucimobilis bacteremia complicated by septic shock just before receiving an autologous hematopoietic stem cell transplant (SCT) at King Faisal Specialist Hospital and Research Centre in Riyadh. The septic episode was successfully treated in the intensive care unit. To our knowledge, this is the first case report of septic shock caused by S . paucimobilis bacteremia in a hematopoietic SCT recipient.     

Long-term outcome following stent reconstruction of the aortic bifurcation and the role of geometric determinants

We assessed the long-term patency of kissing stent reconstruction of the aortoiliac bifurcation and identified variables that may influence it. We retrospectively reviewed our experience with stent-reconstruction procedures of the aortoiliac bifurcation from January 1998 through June 2005. The impact of demographic variables, vascular risk factors, disease location and characteristics, stent material and design, and stenting configuration on stent patency was assessed using univariate and multivariate analysis. In particular, we evaluated the effect of geometric mismatch between the protruding segment of the stents and the distal aortic lumen. Sixty-six patients underwent aortobi-iliac stent reconstruction. Indications were bifurcation or bilateral proximal iliac disease in 52 patients and unilateral ostial disease requiring contralateral protection in 14 patients. Limited disease (TASC A and B) was present in 40 limbs in 19 patients; extensive/diffuse disease (TASC C and D) was present in 78 limbs in 47 patients. Complete occlusions were present in 37 limbs in 28 patients (bilateral in nine patients). Self-expanding stents were used in 56 procedures and balloon-expandable stents in 10. Crossing configuration was used in 43 procedures, while abutting configuration was used in 23 procedures. Technical success was achieved in 62 patients (94%), with all four failures due to inability to cross a chronically occluded limb. Three of these patients underwent aortomono-iliac stenting with a crossover femoral-femoral bypass graft, with the remaining one opting for no further interventions. Median combined follow-up was 37 +/- 27 months (range 0-102). Hemodynamically significant restenosis developed in nine patients (14%). The management of restenosis was endovascular in eight patients and was successful in all (balloon dilation in four, restenting in three, thrombolysis and stenting in one) and operative in one patient who developed aortic occlusion and underwent aortobifemoral grafting. Survival table analysis showed primary and assisted patency rates at 4 years of 81% and 94%, respectively. The mortality rate during follow-up was 19 (cardiac cause in eight, pulmonary cause in three, and malignancy in five). Univariate analysis showed radial mismatch (aortic lumen dead space around the protruding segment of the stents), female gender, prior occlusion, and residual stenosis to be significant predictors of restenosis. Multivariate logistic regression analysis showed radial mismatch to be the only significant determinant of restenosis, although the statistical power of the model was limited by the small number of restenoses. Stent reconstruction of the aortoiliac bifurcation for occlusive disease is effective and durable, even with complex aortoiliac disease and long segment occlusions. Most restenoses are amenable to endovascular treatment, with excellent long-term assisted patency. Geometric variables related to individual aortic anatomy and disease pattern (patient-dependent) and stenting configuration (operator-dependent) may have an impact on long-term patency.