1.Evaluation of stress contours on a maxillary molar subjected to simulated tooth loads by finite element analysis technique
Pratibha Panduranga Kundapura ; Yagnesh Sharma Narayan Raob ; Gopal Krishna Barkur
Archives of Orofacial Sciences 2012;7(2):43-49
Forces applied by dental occlusion generate stresses which are transmitted to the surrounding bone via the periodontal ligament causing a tissue response. The purpose of this study was to evaluate the response of a maxillary molar under secondary trauma from occlusion by observing the changes in its stress patterns. In order to visualize the exact pattern of stress distribution, three dimensional finite element analysis models were developed. A force of 3 N, moment of 27 Nmm and a counter rotation moment of 15 Nmm were applied to simulate orthodontic forces. Stresses produced at the periodontal ligament-tooth interface on a maxillary molar model with normal bone height subjected to an orthodontic force were compared with molar models showing bone loss and analyzed using finite element analysis technique. As the bone loss increased, it was observed that, the concentration of stresses at the apical one-third of the tooth also increased and there was high tendency for tooth displacement. The results suggest that an alteration in the magnitude of forces applied may be necessary in teeth with an increased crown to root ratio to maintain a healthy periodontium.
2.Optical Coherence Tomography-Guided Percutaneous Intervention: A Comparative Study
Sanjeeb ROY ; Ashwini SHARMA ; Anurodh DADARWAL ; Krishna Kumar SHARMA ; Manish NARANG ; Nick E.J. WEST
Cardiovascular Imaging Asia 2024;8(1):2-10
Objective:
Optical coherence tomography (OCT) is considered superior to coronary angiography (CA). However, OCT is not widely used, and data are limited in India. In the present study, the efficacy and safety of OCT for guiding percutaneous coronary intervention (PCI) in all-comer patients were evaluated and compared with those of CA.
Materials and Methods:
In this retrospective study, the data associated with 434 patients who underwent PCI between December 2018 and June 2020 were analyzed. The primary endpoint was major adverse cardiac events (MACEs) at 6 months.
Results:
The patients were divided into OCT-guided and angiography-guided PCI groups (217 in each group) after propensity matching. The OCT-guided PCI group had a significantly larger proportion of patients with unstable angina (55.7% vs. 43.3%, p=0.009) and non-STelevation myocardial infarction (NSTEMI; 17.5% vs. 10.0%, p=0.02) compared with the angiography-guided PCI group, and the proportion of patients with STEMI was significantly lower in the OCT-guided PCI group than in the angiography-guided PCI group (23.5% vs. 41.5%, p=0.00005). The OCT-guided PCI group had a lower incidence of MACEs at 6 months than the angiography-guided PCI group but without statistical significance (6.9% vs. 9.7%, p=0.296).Incidences of target lesion failure, target vessel myocardial infarction, in-stent restenosis, or stent thrombosis did not occur in either group. On post-PCI OCT, stent underexpansion, tissue prolapse, stent edge dissection, and stent malapposition were observed in 28.5%, 10%, 4.1%, and 3.7% of the cases, respectively.
Conclusion
When comparing OCT-guided PCI with angiography-guided PCI, OCT-guided PCI showed slightly superior clinical outcomes at 6 months, although the differences were not statistically significant.
3.Optical Coherence Tomography-Guided Percutaneous Intervention: A Comparative Study
Sanjeeb ROY ; Ashwini SHARMA ; Anurodh DADARWAL ; Krishna Kumar SHARMA ; Manish NARANG ; Nick E.J. WEST
Cardiovascular Imaging Asia 2024;8(1):2-10
Objective:
Optical coherence tomography (OCT) is considered superior to coronary angiography (CA). However, OCT is not widely used, and data are limited in India. In the present study, the efficacy and safety of OCT for guiding percutaneous coronary intervention (PCI) in all-comer patients were evaluated and compared with those of CA.
Materials and Methods:
In this retrospective study, the data associated with 434 patients who underwent PCI between December 2018 and June 2020 were analyzed. The primary endpoint was major adverse cardiac events (MACEs) at 6 months.
Results:
The patients were divided into OCT-guided and angiography-guided PCI groups (217 in each group) after propensity matching. The OCT-guided PCI group had a significantly larger proportion of patients with unstable angina (55.7% vs. 43.3%, p=0.009) and non-STelevation myocardial infarction (NSTEMI; 17.5% vs. 10.0%, p=0.02) compared with the angiography-guided PCI group, and the proportion of patients with STEMI was significantly lower in the OCT-guided PCI group than in the angiography-guided PCI group (23.5% vs. 41.5%, p=0.00005). The OCT-guided PCI group had a lower incidence of MACEs at 6 months than the angiography-guided PCI group but without statistical significance (6.9% vs. 9.7%, p=0.296).Incidences of target lesion failure, target vessel myocardial infarction, in-stent restenosis, or stent thrombosis did not occur in either group. On post-PCI OCT, stent underexpansion, tissue prolapse, stent edge dissection, and stent malapposition were observed in 28.5%, 10%, 4.1%, and 3.7% of the cases, respectively.
Conclusion
When comparing OCT-guided PCI with angiography-guided PCI, OCT-guided PCI showed slightly superior clinical outcomes at 6 months, although the differences were not statistically significant.
4.Optical Coherence Tomography-Guided Percutaneous Intervention: A Comparative Study
Sanjeeb ROY ; Ashwini SHARMA ; Anurodh DADARWAL ; Krishna Kumar SHARMA ; Manish NARANG ; Nick E.J. WEST
Cardiovascular Imaging Asia 2024;8(1):2-10
Objective:
Optical coherence tomography (OCT) is considered superior to coronary angiography (CA). However, OCT is not widely used, and data are limited in India. In the present study, the efficacy and safety of OCT for guiding percutaneous coronary intervention (PCI) in all-comer patients were evaluated and compared with those of CA.
Materials and Methods:
In this retrospective study, the data associated with 434 patients who underwent PCI between December 2018 and June 2020 were analyzed. The primary endpoint was major adverse cardiac events (MACEs) at 6 months.
Results:
The patients were divided into OCT-guided and angiography-guided PCI groups (217 in each group) after propensity matching. The OCT-guided PCI group had a significantly larger proportion of patients with unstable angina (55.7% vs. 43.3%, p=0.009) and non-STelevation myocardial infarction (NSTEMI; 17.5% vs. 10.0%, p=0.02) compared with the angiography-guided PCI group, and the proportion of patients with STEMI was significantly lower in the OCT-guided PCI group than in the angiography-guided PCI group (23.5% vs. 41.5%, p=0.00005). The OCT-guided PCI group had a lower incidence of MACEs at 6 months than the angiography-guided PCI group but without statistical significance (6.9% vs. 9.7%, p=0.296).Incidences of target lesion failure, target vessel myocardial infarction, in-stent restenosis, or stent thrombosis did not occur in either group. On post-PCI OCT, stent underexpansion, tissue prolapse, stent edge dissection, and stent malapposition were observed in 28.5%, 10%, 4.1%, and 3.7% of the cases, respectively.
Conclusion
When comparing OCT-guided PCI with angiography-guided PCI, OCT-guided PCI showed slightly superior clinical outcomes at 6 months, although the differences were not statistically significant.
5.Optical Coherence Tomography-Guided Percutaneous Intervention: A Comparative Study
Sanjeeb ROY ; Ashwini SHARMA ; Anurodh DADARWAL ; Krishna Kumar SHARMA ; Manish NARANG ; Nick E.J. WEST
Cardiovascular Imaging Asia 2024;8(1):2-10
Objective:
Optical coherence tomography (OCT) is considered superior to coronary angiography (CA). However, OCT is not widely used, and data are limited in India. In the present study, the efficacy and safety of OCT for guiding percutaneous coronary intervention (PCI) in all-comer patients were evaluated and compared with those of CA.
Materials and Methods:
In this retrospective study, the data associated with 434 patients who underwent PCI between December 2018 and June 2020 were analyzed. The primary endpoint was major adverse cardiac events (MACEs) at 6 months.
Results:
The patients were divided into OCT-guided and angiography-guided PCI groups (217 in each group) after propensity matching. The OCT-guided PCI group had a significantly larger proportion of patients with unstable angina (55.7% vs. 43.3%, p=0.009) and non-STelevation myocardial infarction (NSTEMI; 17.5% vs. 10.0%, p=0.02) compared with the angiography-guided PCI group, and the proportion of patients with STEMI was significantly lower in the OCT-guided PCI group than in the angiography-guided PCI group (23.5% vs. 41.5%, p=0.00005). The OCT-guided PCI group had a lower incidence of MACEs at 6 months than the angiography-guided PCI group but without statistical significance (6.9% vs. 9.7%, p=0.296).Incidences of target lesion failure, target vessel myocardial infarction, in-stent restenosis, or stent thrombosis did not occur in either group. On post-PCI OCT, stent underexpansion, tissue prolapse, stent edge dissection, and stent malapposition were observed in 28.5%, 10%, 4.1%, and 3.7% of the cases, respectively.
Conclusion
When comparing OCT-guided PCI with angiography-guided PCI, OCT-guided PCI showed slightly superior clinical outcomes at 6 months, although the differences were not statistically significant.
6.Platelet rich fibrin - a novel acumen into regenerative endodontic therapy.
Kavita HOTWANI ; Krishna SHARMA
Restorative Dentistry & Endodontics 2014;39(1):1-6
Research into regenerative dentistry has added impetus onto the field of molecular biology. It can be documented as a prototype shift in the therapeutic armamentarium for dental disease. Regenerative endodontic procedures are widely being added to the current armamentarium of pulp therapy procedures. The regenerative potential of platelets has been deliberated. A new family of platelet concentrates called the platelet rich fibrin (PRF) has been recently used by several investigators and has shown application in diverse disciplines of dentistry. This paper is intended to add light on the various prospects of PRF and clinical insights to regenerative endodontic therapy.
Blood Platelets*
;
Dentistry
;
Fibrin*
;
Humans
;
Molecular Biology
;
Research Personnel
;
Stomatognathic Diseases
7.Closed reduction and percutaneous pinning of displaced supracondylar fractures of humerus in children with delayed presentation.
Aman DUA ; Krishna Kiran EACHEMPATI ; Rajesh MALHOTRA ; Lalit SHARMA ; Mallinath GIDAGANTI
Chinese Journal of Traumatology 2011;14(1):14-19
OBJECTIVESupracondylar fractures of the humerus account for 60% of all the fractures around the pediatric elbow and even in developed countries 18% of patients undergo surgery 48 hours or longer following presentation in the hospital. Management guidelines are not clear yet for these patients who present late. The aim of this prospective study was to evaluate the clinical, radiological and functional outcome following closed reduction and percutaneous pinning of widely displaced supracondylar fractures of the humerus presenting 12 hours or more after injury.
METHODSWe reviewed the functional and radiological results of closed reduction and percutaneous pinning using crossed K-wires in 40 patients with displaced extension type supracondylar fracture of the humerus (Gartland type III) with a delay of more than 12 hours in presentation. The average age of patients was 4.5 years and the mean delay in presentation was 17.55 hours.
RESULTSClosed reduction and percutaneous pinning was successful in 90% of patients. The mean follow up period was 15 months. The Baumann's angle was restored within 4 degrees of the unaffected side in all patients. Use of a small medial incision in patients with severe swelling helped us avoid ulnar nerve injury. Using Flynn's criteria, 38 patients (95%) had an excellent result. Two patients had mild myositis and both had a poor result. None of the patients developed cubitus varus.
CONCLUSIONClosed reduction and crossed pinning of displaced supracondylar fractures of humerus in children is a safe and effective method even with delayed presentation.
Bone Wires ; Child ; Child, Preschool ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Humeral Fractures ; surgery ; Male ; Prospective Studies
8.Clinical presentation of COVID-19 in patients with inflammatory bowel disease: a systematic review and meta-analysis
Anupam K. SINGH ; Anuraag JENA ; Praveen KUMAR-M ; Daya Krishna JHA ; Vishal SHARMA
Intestinal Research 2022;20(1):134-143
Background/Aims:
Coronavirus disease 2019 (COVID-19) is recognized to have variable clinical manifestations. The clinical presentation of patients with inflammatory bowel disease (IBD) having COVID-19 is unclear.
Methods:
We identified articles reporting about the clinical presentation of COVID-19 in those with underlying IBD from PubMed and Embase. The studies, irrespective of design or language, were included. The overall pooled frequency of various symptoms was estimated. Joanna Briggs Institute Critical appraisal checklist was used to assess the quality of studies.
Results:
Eleven studies, including 1,325 patients, were included in the pooled analysis. The pooled estimates for clinical presentation were; fever: 67.53% (95% confidence interval [CI], 45.38–83.88), cough: 59.58% (95% CI, 45.01–72.63), diarrhea: 27.26% (95% CI, 19.51–36.69), running nose: 27% (95% CI, 15.26–43.19) and dyspnea: 25.29% (95% CI, 18.52–33.52). The pooled prevalence rates for abdominal pain, nausea and vomiting were 13.08% (95% CI, 9.24–18.19), 10.08% (95% CI, 5.84–16.85) and 8.80% (95% CI, 4.43–16.70) per 100 population, respectively.
Conclusions
The clinical presentation of COVID-19 in IBD patients is similar to the general population.
9.Thyroid Abscess After Fine Needle Aspiration with Spontaneous Rupture into the Trachea : A Case Report
Shouvik DAS ; Abhishek MANDAL ; Ritesh KUMAR ; Sandeep CHAUHAN ; Krishna Rekha MANTRY ; Sandeep Kumar MALIK ; Sanjay MARWAH
Journal of Acute Care Surgery 2023;13(2):70-73
Fine needle aspiration (FNA) of the thyroid is a well-tolerated minimally invasive procedure. Thyroid abscess, as a complication of FNA in an immune-competent adult, is extremely rare. Diagnosis requires a high index of suspicion, for which treatment is intravenous antibiotics, drainage, and sometimes surgery. Here we present a case of thyroid abscess in an otherwise healthy man who presented with neck pain, rapidly increasing neck swelling, difficulty in swallowing, and hoarseness of the voice that developed two weeks after diagnostic FNA of a thyroid nodule which had been present for ten months. Despite antibiotic treatment, the abscess ruptured into the trachea, requiring surgical intervention. This highlights the importance of maintaining asepsis during FNA of the thyroid. Timely diagnosis of a thyroid abscess is essential to avoid life-threatening airway complications.
10.Is Follow-up Co-Morbidity Assessment via Laboratory Investigations in Older High Energy Trauma Patients Justified? - A Prospective-Retrospective Study
Jain G ; Vadivelu G ; Krishna A ; Malhotra R ; Sharma V ; Farooque K
Malaysian Orthopaedic Journal 2023;17(No.1):1-9
Introduction: The objective of the current study was to test
our hypothesis that older patients sustaining high energy
trauma need to be evaluated for their comorbidities similar to
geriatric patients sustaining low energy trauma.
Materials and methods: This study was a retrospectiveprospective analysis of 173 patients of more than 50 years of
age enrolled between November 2017 and December 2018.
Herewith, we have compared retrospectively collected
laboratory investigations of 124 fragility fracture patients
with prospectively collected laboratory investigations of 49
patients with high energy trauma. The laboratory
investigations, including the liver function tests, renal
function tests, indices of calcium metabolism, serum
electrolytes, complete blood counts, and bone mineral
density (BMD) scores.
Results: Both groups were similar to each other as far as
baseline demographic characteristics were concerned. The
proportion of female patients and patients with nonosteoporotic range BMD (T-score >-2.5) was significantly
higher in the high-energy fracture group (P value <0.05).
Hypoalbuminemia (<3.4gm/dl) 17.3%, abnormalities
sodium (<135mmol/L or >148mmol/L) 23.2%, Anaemia
(<10g/dl) 12.7%, Hypercalcemia (>10.4mg/dl) 16.3%,
Vitamin D deficiency (<20ng/ml) 17.3% are the common
laboratory abnormality found in study population. No
statistically significant difference was found among the two
groups in terms of laboratory investigation abnormalities.
Conclusion: The laboratory investigation abnormality in an
older patient with a clinical fracture is independent of the
mechanism of injury. The results of the current study
emphasise the need for a comprehensive laboratory workup
in older patients with either high- energy fractures or
fragility fractures.