1.Double jaw surgery – a modified surgical approach to treat skeletal class II
Meena Vora ; Punam Nagargoje ; Maggi Vettiyatil ; K. V. Suresh ; M. I. Parkar ; C. D. Mouneshkumar
Pacific Journal of Medical Sciences 2018;18(1):52-55
Patients with mandibular deficiency and skeletal class II malocclusions exhibit a wide spectrum of esthetic, cephalometric, and occlusal characteristics. The structure of chin determines facial attractiveness and is directly linked to a quality of life. Correction of dentoalveolar protrusion of maxilla is done by anterior maxillary subapical osteotomy by which anterior segment can be moved superiorly or inferiorly and posteriorly as indicated. Augmentation genioplasty is advocated to improve the overall facial esthetics of patient with mandibular deficiency. In skeletal class II malocclusions cases best results are obtained with double jaw surgery combined with the orthodontic treatment. This is a case report of skeletal class II malocclusion with mandibular deficiency and protruded maxilla in 22 year old female patient who was treated surgically by anterior maxillary subapical osteotomy and augmentation genioplasty along with the orthodontic treatment
2.Collagenase Clostridium Histolyticum Injection for Dupuytren Contracture: 2-Year Follow-up
Suresh K NAYAR ; Dennis PFISTERER ; John V INGARI
Clinics in Orthopedic Surgery 2019;11(3):332-336
BACKGROUND: Dupuytren disease is characterized by the development of palmar fibrous tissue that can lead to fixed flexion contracture (FFC) and contribute to functional loss of the involved digits. Our goal was to investigate rates of contracture resolution and recurrence in patients who underwent enzymatic fasciotomy for Dupuytren contracture consisting of collagenase clostridium histolyticum (CCH) injection followed by passive manipulation combined with splinting and home-based therapy. METHODS: We prospectively enrolled 34 patients (44 metacarpophalangeal [MCP] and 33 proximal interphalangeal [PIP] joints) treated by one orthopaedic hand surgeon between November 2010 and November 2014. On day 1, CCH was injected into a palpable fibrous cord of the involved fingers. The next day, the finger was passively extended to its maximal corrective position. FFC was measured for each joint before injection and immediately after manipulation. Patients were instructed to wear an extension splint at night and perform stretching exercises at home and were re-evaluated at 6 weeks, 4 months, 1 year, and 2 years. Resolution was defined as improvement of contracture to ≤ 5° of neutral. Recurrence was defined as an increase in FCC of ≥ 20° after treatment. RESULTS: Immediate contracture resolution occurred in 42 of 44 MCP joints (p < 0.001), improving from 50° to 1.5°, and in 14 of 33 PIP joints (p = 0.182), improving from 44° to 16°. Four joints had recurrence within 6 weeks. Of the 48 joints with minimum 4-month follow-up (mean, 26 months), 12 had recurrence at 2-year follow-up (MCP, 6; PIP, 6). At 2-year follow-up, MCP and PIP contractures measured 17° and 35.5°, respectively. Older age and multiple digit involvement were associated with higher recurrence rates. CONCLUSIONS: CCH offers a safe, nonoperative option to correct FCC in Dupuytren disease with greater success for MCP joints compared to PIP joints. There is a tendency of reoccurrence within 2 years of treatment. Further investigation is needed to determine optimal timing of repeat CCH injection to improve upon or extend the period of contracture resolution.
Collagenases
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Contracture
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Dupuytren Contracture
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Exercise
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Fingers
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Follow-Up Studies
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Hand
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Humans
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Joints
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Metacarpophalangeal Joint
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Microbial Collagenase
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Prospective Studies
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Recurrence
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Splints
5.Evaluation of anti-apoptotic activity of different dietary antioxidants in renal cell carcinoma against hydrogen peroxide.
Neeraj K GARG ; Sharad MANGAL ; Tejram SAHU ; Abhinav MEHTA ; Suresh P VYAS ; Rajeev K TYAGI
Asian Pacific Journal of Tropical Biomedicine 2011;1(1):57-63
OBJECTIVETo evaluate the anti-apoptotic and radical scavenging activities of dietary phenolics, namely ascorbic acid,α-tocopherol acetate, citric acid, salicylic acid, and estimate H2O2-induced apoptosis in renal cell carcinoma cells.
METHODSThe intracellular antioxidant potency of antioxidants was investigated. H2O2-induced apoptosis in RCC-26 was assayed with the following parameters: cell viability (% apoptosis), nucleosomal damage and DNA fragmentation, bcl-2 levels and flow cytometery analysis (ROS production evaluation).
RESULTSThe anticancer properties of antioxidants such as ascorbic acid, α-tocopherol acetate, citric acid, salicylic acid with perdurable responses were investigated. It was observed that these antioxidants had protective effect (anti-apoptotic activity) against hydrogen peroxide (H2O2) in renal cell carcinoma (RCC-26) cell line.
CONCLUSIONSThis study reveals and proves the anticancer properties. However, in cancer cell lines anti-apoptotic activity can indirectly reflect the cancer promoter activity through radicals scavenging, and significantly protect nucleus and bcl-2.
Antioxidants ; pharmacology ; Apoptosis ; drug effects ; Carcinoma, Renal Cell ; Cell Line, Tumor ; Cell Survival ; drug effects ; DNA Fragmentation ; drug effects ; Humans ; Hydrogen Peroxide ; toxicity ; Oxidative Stress ; drug effects ; Reactive Oxygen Species ; analysis ; metabolism ; Vitamins ; pharmacology
6.Tongue-lip adhesion in Pierre Robin sequence.
K. S. KRISHNA KUMAR ; Suresh VYLOPILLI ; Anand SIVADASAN ; Ajit Kumar PATI ; Saju NARAYANAN ; Santhy Mohanachandran NAIR
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2016;42(1):47-50
Patients with Pierre Robin sequence exhibit varying degrees of airway obstruction and feeding difficulty. In some patients, airway obstruction may be profound, warranting surgical intervention to maintain a patent airway. The purpose of this article is to highlight the advantages of the tongue-lip adhesion procedure for the management of airway obstruction in such patients compared to the currently available options.
Airway Obstruction
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Humans
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Pierre Robin Syndrome*
7.Correlation of morphological variants of the soft palate and Need's ratio in normal individuals: A digital cephalometric study.
Pradhuman VERMA ; Kanika Gupta VERMA ; Kikkeri Lakshminarayana KUMARASWAM ; Suman BASAVARAJU ; Suresh K SACHDEVA ; Suruchi JUNEJA
Imaging Science in Dentistry 2014;44(3):193-198
PURPOSE: The present study was aimed to investigate the variation of soft palate morphology in different age and gender groups. The correlations of radiographic velar length (VL), velar width (VW), pharyngeal depth (PD), and Need's ratio with soft palate variants were also studied in the North Indian subpopulation. MATERIALS AND METHODS: The study sample consisted of 300 subjects aged between 15 and 45 (mean: 31.32) years. The velar morphology on lateral cephalograms was examined and grouped into six types. The results obtained were subjected to a statistical analysis to find the correlation between variants of the soft palate with gender and different age groups. RESULTS: The most frequent type of soft palate was leaf shaped (48.7%), and the least common was crook shaped (3.0%) among both the genders and various age groups, showing a significant correlation. The mean VL, VW, and PD values were significantly higher in males and significantly correlated with the types of soft palate. A significant correlation was observed between the mean VL, VW, PD, and Need's ratio with various age groups, showing an inconsistent pattern with an increase in age. The types of soft palate, gender, and Need's ratio were also significantly correlated, with an overall higher mean value of the Need's ratio among female subjects and the S-shaped soft palate. CONCLUSION: The knowledge of a varied spectrum of velar morphology and the variants of the soft palate help in a better understanding of the velopharyngeal closure and craniofacial anomalies.
Female
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Humans
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Male
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Palate, Soft*
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Radiography
8.Inhibition of Cyclooxygenase-2 Alters Wnt/β-Catenin Signaling in the Regenerating Tail of Lizard Hemidactylus flaviviridis.
Pranav R BUCH ; Pradeep SARKATE ; Gowri K UGGINI ; Isha DESAI ; Suresh BALAKRISHNAN
Tissue Engineering and Regenerative Medicine 2017;14(2):171-178
Epimorphic regeneration in vertebrates involves the restoration of lost tissue or organs through the formation of a regeneration blastema and occurs through a complex interaction of a number of molecular signaling pathways. Of the many effectors of successful tail regeneration in the lizard Hemidactylus flaviviridis, one crucial pathway is the cyclooxygenase-2 (COX-2) mediated PGE2 signaling pathway. The current study was aimed at understanding whether COX-2 signaling plays any role in the expression of Wnt/β-Catenin signaling components during regenerative outgrowth in H. flaviviridis. Etoricoxib—selective inhibitor of the inducible isoform of COX-2—was administered to lizards orally. We tested the expression of β-Catenin during wound epidermis and blastema stages in the regenerating tail and found a reduction in its expression in response to drug treatment. Further, it was observed that the expression of canonical Wnt ligands was greatly altered due to COX-2 inhibition. Our results provide evidence of a cross-talk between the COX-2 induced PGE₂ pathway and Wnt/β-Catenin signaling in the regenerating lizard tail. An understanding of the interaction among various signaling pathways will help elucidate the mechanism underlying epimorphosis in lizards, the only amniotes capable of appendage regeneration.
beta Catenin
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Cyclooxygenase 2*
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Dinoprostone
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Epidermis
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Inflammation
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Ligands
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Lizards*
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Prostaglandin-Endoperoxide Synthases
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Regeneration
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Tail*
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Vertebrates
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Wounds and Injuries
9.Immunogenic and antigenic heterogeneity of Blastocystis sp. subtype 3 from symptomatic and asymptomatic individuals
Tropical Biomedicine 2019;36(1):234-244
Blastocystis sp. subtype 3 (ST3) has been implicated previously to be phenotypically
heterogeneous between isolates from symptomatic and asymptomatic persons in previous
studies. The aim of this study is to identify the immunogenic and antigenic heterogeneity
among three different isolates of Blastocystis sp. ST3 isolated from asymptomatic and
symptomatic individuals. Immunogenic and antigenic profile of ST3 isolates was assessed
through splenocyte proliferation, cytokine assessment and antibody measurements. The
total IgG antibody responses in mice immunised with symptomatic (0.736±0.033) and
asymptomatic (0.426±0.025) of ST3 Blastocystis sp. were significantly higher compared to
the controls respectively. High secretions of IgG antibody mixture of IgG1/IgG2a antibodies
were detected in sera of mice immunised with symptomatic and asymptomatic solubilised
Blastocystis sp. Antigen (Blastocystis-Ag). Predominant IgG1 production was detected higher
in mice injected with Blastocystis sp. ST 3 from asymptomatic individuals (0.148±0.016)
(P<0.05) whereas predominant IgG2a production was detected higher in mice injected with
the same subtype but from the symptomatic individuals (0.355±0.021). This data was supported
by the production of significantly higher Th1 (IFNγ and IL-2) response (393.56±49.21) and
(628.89±31.06) respectively in symptomatic isolates compared to Th2 (IL-4 and IL-10) response
(93±7.85) and (103.22±11.33) in asymptomatic isolates after in-vitro stimulations. Splenocyte
stimulation index (SI) was detected higher in symptomatic Blastocystis-Ag group. This study
is the first to demonstrate antigenic and immunogenic heterogeneity among ST3 symptomatic
and asymptomatic Blastocystis-Ag with symptomatic isolates being highly immunogenic and
antigenic. No significant variations among the three isolates of asymptomatic and symptomatic
groups. The study supports the suggestion from previous study that surface variations between
symptomatic and asymptomatic isolates as well their distinct phenotypic variation despite
being the same subtype may have caused the differences in the distinct immune responses.
10.Successful treatment of peritonitis by C. bertholletiae in a chronic kidney failure patient on continuous ambulatory peritoneal dialysis after kidney rejection.
Kanchan BHUTADA ; Suresh S BORKAR ; Deepak K MENDIRATTA ; Vikas R SHENDE
Singapore medical journal 2012;53(5):e106-9
Peritonitis is a common problem in patients undergoing peritoneal dialysis. However, peritonitis due to Cunninghamella (C.) bertholletiae, a fungus of the class Zygomycetes, is rare. We present a case of fungal peritonitis in a patient on continuous ambulatory peritoneal dialysis due to kidney rejection. Direct examination of the patient's peritoneal fluid showed fungal hyphae, and the culture was identified as C. bertholletiae. A cumulative dose of 1,600 mg fluconazole was given to the patient intraperitoneally over a one-week period. When his condition had stabilised, oral antifungal treatment was administered for two weeks. After removal of the Tenckhoff catheter, the patient was discharged with arteriovenous fistulation for haemodialysis. Zygomycosis due to C. bertholletiae is often fatal and non-responsive to systemic antifungal therapy. This case is the first from India with a successful outcome, and highlights the importance of early detection and intervention for successful outcome of peritonitis caused by C. bertholletiae.
Antifungal Agents
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administration & dosage
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Cunninghamella
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isolation & purification
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Drug Administration Routes
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Fluconazole
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administration & dosage
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Follow-Up Studies
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Graft Rejection
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complications
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Humans
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Kidney Failure, Chronic
;
complications
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therapy
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Kidney Transplantation
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Male
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Middle Aged
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Mucormycosis
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drug therapy
;
etiology
;
microbiology
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Peritoneal Dialysis, Continuous Ambulatory
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adverse effects
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Peritonitis
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drug therapy
;
etiology
;
microbiology