Objectives: This study is aimed to evaluate and compare the effect of moist heat fomentation therapy with ultrasound therapy in patients with the masticatory myalgia. Materials and Methods: The study was conducted on 42 patients with masticatory myalgia, dividing them into two groups; Group A (21 patients), received moist heat therapy and Group B (21 patients), received ultrasound therapy for seven effective days. Prior and after the treatment the numeric rating scale (NRS) and the electromyography (EMG) scores were recorded and compared. The observations were analyzed clinically and statistical support was taken to assess the NRS and EMG data. Results: Irrespective of the groups, patients testified a significant reduction in pain after the treatment. From the EMG readings; even though the standard deviation for each group was varied considerably, EMG recorded an improved muscle activity. Statistical analysis was used to assess and identify the best treatment methodology between the two modalities. Conclusion From the statistical analysis, it is concluded that, though both the therapies had significantly reduced the symptomatic response, it is moist heat fomentation that improved muscle activity both statistically and clinically in comparison to ultrasound.

ABSTRACT The use of tooth-derived material as a scaffold has gained attention recently due to its ease of availability and bioactive properties. Hence, the objective of this study was to determine in vitro interaction of human gingival mesenchymal stem cells (hGMSCs) with human demineralised teeth matrix (hDTM) on osteogenic potential with or without osteogenic inducers. The hGMSCs were established and characterised on their morphology, proliferation, population doubling time (PDT), viability, colony-forming ability, expression of cell surface markers and adipogenic differentiation. Further, the effect of hDTM on the biocompatibility and osteogenic differentiation ability of hGMSCs was evaluated. The hGMSCs displayed a fibroblast-like appearance and exhibited a greater proliferative activity. The cells showed > 91% viability, and PDT varied between 39.34 hours and 62.59 hours. Further, hGMSCs indicated their propensity to form clusters/ colonies, and expressed the markers, such as CD29, CD44, CD73 and CD90, but were negative for CD34 and CD45. When treated with adipogenic induction medium, hGMSCs were able to exhibit the formation of neutral lipid vacuoles. The hGMSCs cultured with hDTM did not show any cytotoxic changes including morphology and viability. Mineralisation of calcium nodules was observed in hGMSCs when cultured in osteogenic induction (OI) medium as an indication of osteogenesis. hGMSCs when cultured with hDTM confirmed the presence of a mineralised matrix. Further, when the cells were cultured with hDTM along with OI, they showed slightly enhanced differentiation into osteocytes. In conclusion, hGMSCs were shown to be biocompatible with hDTM, and demonstrated their enhanced osteogenic potential in the presence of hDTM and osteogenic supplements.
Mesenchymal Stem Cells ; Dental Pulp--cytology ; Dentin

ABSTRACT The use of tooth-derived material as a scaffold has gained attention recently due to its ease of availability and bioactive properties. Hence, the objective of this study was to determine in vitro interaction of human gingival mesenchymal stem cells (hGMSCs) with human demineralised teeth matrix (hDTM) on osteogenic potential with or without osteogenic inducers. The hGMSCs were established and characterised on their morphology, proliferation, population doubling time (PDT), viability, colony-forming ability, expression of cell surface markers and adipogenic differentiation. Further, the effect of hDTM on the biocompatibility and osteogenic differentiation ability of hGMSCs was evaluated. The hGMSCs displayed a fibroblast-like appearance and exhibited a greater proliferative activity. The cells showed > 91% viability, and PDT varied between 39.34 hours and 62.59 hours. Further, hGMSCs indicated their propensity to form clusters/ colonies, and expressed the markers, such as CD29, CD44, CD73 and CD90, but were negative for CD34 and CD45. When treated with adipogenic induction medium, hGMSCs were able to exhibit the formation of neutral lipid vacuoles. The hGMSCs cultured with hDTM did not show any cytotoxic changes including morphology and viability. Mineralisation of calcium nodules was observed in hGMSCs when cultured in osteogenic induction (OI) medium as an indication of osteogenesis. hGMSCs when cultured with hDTM confirmed the presence of a mineralised matrix. Further, when the cells were cultured with hDTM along with OI, they showed slightly enhanced differentiation into osteocytes. In conclusion, hGMSCs were shown to be biocompatible with hDTM, and demonstrated their enhanced osteogenic potential in the presence of hDTM and osteogenic supplements.
Mesenchymal Stem Cells ; Dental Pulp--cytology ; Dentin

PURPOSE: Long proximal femoral nail anti-rotation (PFNA-II) is a preferred implant in recent years for fixation of pertrochanteric fractures, especially in osteoporotic patients. The purpose of this study is to prospectively investigate the effect of distal locking in long PFNA-II fixation of stable intertrochanteric fractures. METHODS: A total of 58 patients with isolated stable intertrochanteric fractures and treated in our hospital during the study period of 2017-2019 by distal locked or unlocked long PFNA-II fixation were included in this study. Patients who had multiple injuries or open fractures were excluded. There were 40 female and 18 male patients, with 33 affecting the left side and 25 the right side. Of them, 31 belonged to the distal locked group (group A) and 27 to the unlocked group (group B). Surgical procedures and implants used in both groups were similar except for the distal locking of the nails. General data (age, gender, fracture side, etc.) showed no significant difference between two groups (all p > 0.05). The intraoperative parameters like operative time, radiation exposure and follow-up parameters like functional and radiological outcomes were recorded and compared. Statistical tests like the independent samples t-test Fischer's exact and Chi-square test were used to analyze association. RESULTS: The distribution of the fractures according to AO/OTA classification and 31A1.2 type of intertrochanteric fractures were most common in our study. All the included fractures united and the average functional outcome in both groups were good and comparable at the end of one year. The operative time (mL, 107.1 ± 12.6 vs. 77.0 ± 12.0, p < 0.001) and radiation exposure (s, 78.6 ± 11.0 vs. 40.3 ± 9.3, p < 0.001) were significantly less among the patients in group B. Fracture consolidation, three months after the operative procedures, was seen in a significantly greater proportion of patients in group B (92.6% vs. 67.7%, p = 0.025). Hardware irritation because of distal locking bolt was exclusively seen in group A, however this was not statistically significant (p = 0.241). CONCLUSION We conclude that, in fixation of stable intertrochanteric fractures by long PFNA-II nail, distal locking not only increases the operative time and radiation exposure but also delays the fracture consolidation and increases the chances of hardware irritation, and hence is not required.
Humans ; Male ; Female ; Fracture Fixation, Intramedullary/methods* ; Bone Nails ; Treatment Outcome ; Retrospective Studies ; Hip Fractures/etiology* ; Femoral Fractures/etiology*

PURPOSE: Intramedullary interlocking nailing is one of the accepted methods of treating humerus diaphyseal fractures. Appropriate nail length and diameter are of paramount importance to achieve a stable fracture fixation. Estimating the nail length can be as challenging in certain cases as it is important. This study aims to provide an easy-to-use formula utilizing clinical measurements from contra lateral arm to accurately estimate humeral nail length. METHODS: This descriptive cross-sectional study was conducted at 3 tertiary care hospitals in Mangalore, India. Patients above the age of 18 years coming to the outpatient department with elbow, shoulder or arm complaints requiring radiological investigation from July 2021 to July 2022 were included. Patients with fractures or dislocations of upper limbs, malunited or non-united fractures of upper limbs, congenital or developmental deformities and patients with open growth plates were excluded. Patients' variables (like age and gender), radiological humerus length and contralateral arm clinical measurements were recorded. An independent samples t-test was used for univariate analysis, and linear regression analysis was done to estimate the desired nail length using the clinical measurement of the humerus (cm) in both genders separately. The significance level was set at p < 0.05. RESULTS: Our study included 204 participants of which 108 were male and 96 were female. The formula for predicting humeral nail length in males is (-2.029) + (0.883 × clinical measurement). The formula for females is 1.862 + (0.741 × clinical measurement). A simplified formula to determine humeral nail length is 0.9 clinical length - 2 cm (in males) and 0.7 × clinical length + 2 cm (in females). CONCLUSION To improve the stability of fixation with intramedullary nails it is imperative to select the appropriate nail length. There have been studies that devised reliable methods of determining nail lengths in the tibia and femur using preoperative clinical measurements. A similar clinical method of determining humeral nail length is lacking in the literature. Our study was able to correlate radiological lengths of the humerus medullary canal with clinical measurements performed using anatomical landmarks to arrive at a formula. This allows for a reliable and easy nail length determination preoperatively.
Humans ; Male ; Female ; Adolescent ; Cross-Sectional Studies ; Bone Nails ; Humerus/surgery* ; Fracture Fixation, Intramedullary/methods* ; Humeral Fractures/surgery* ; Treatment Outcome