Patellar tendon rupture is an uncommon but serious complication that results in loss of knee extension during and after total knee arthroplasty (TKA), significantly impacting the patient’s quality of life. Various surgical treatments, ranging from initial repair to reconstruction, are available and accessible. In recent years, the peroneus longus tendon autograft has been utilised to restore the knee extensor system. The purpose of this case report was to present the case of a patient who had a traumatic patellar tendon rupture following TKA and requiring surgery along with peroneus tendon augmentation. A 71-year-old woman underwent bilateral robotic-assisted cruciate retaining TKA for a Grade IV arthritic knee. Post surgery, on day five patient had a history of a fall at home, following which she was unable to extend her knees. On evaluation through ultrasonography and radiographs, she was found to have a ruptured patellar tendon and sprain of the medial collateral ligament. Primary repair of the tendon along with augmentation with the peroneus tendon was performed, and the patient was followed for 12 months, at the end of which, the patient was able to achieve a good functional outcome. In conclusion, early results from patellar tendon reconstruction using an ipsilateral peroneus longus tendon autograft following TKA suggest that this technique is effective for managing acute post-traumatic patellar tendon rupture. It facilitates early recovery, yields favourable outcomes, and may reduce the risk of infection.

Gestational diabetes mellitus (GDM) is a condition with hyperglycaemia first seen in pregnancy. GDM is still diagnosed in the late second or early third trimester, because accurate diagnostic approaches in first trimester are still lacking and increasing burden of non-communicable diseases in the country. New diagnostic approaches allow early assessment. To assess the efficacy of glycosylated fibronectin in detecting GDM. In this case control study the pregnant women coming to outpatient department were recruited based on inclusion and exclusion criteria. It was carried out at RajaRajeswari Medical College and Hospital between January 2024 to February 2025. The participant’s oral glucose tolerance test (OGTT) was done at 24 to 28 weeks. Diagnostic cut off value based on Diabetes in Pregnancy Study Group India is considered. Based on OGTT value participants were divided into GDM group and control group. Glycosylated fibronectin was estimated by enzymelinked immunosorbent assay. The concentration of glycosylated fibronectin level between the control and GDM group was analysed using unpaired t-test. The P-value was 0.0001 suggesting significant difference between GDM and control group.The area under the ROC curve equals 0.8096 suggesting that the power of the model to distinguish between two outcomes is excellent. R 2 value by the regression analysis in GDM group is 0.9813 whereas in control group it is 0.9991 suggesting that glycosylated fibronectin can be used to make accurate predictions. Glycosylated fibronectin is a very potent biomarker in early diagnosis of GDM.

Background: s/Aims: Early liver graft regeneration after living donor liver transplantation (LDLT) is critical for patient outcomes, yet prospective volumetric data from Indian recipients remain limited. This study quantifies early graft regeneration and identifies predictors using computed tomography (CT) volumetry. Methods: In this prospective single-center study, 34 consecutive adult LDLT recipients underwent CT volumetry on postoperative days 7 and 30. Results: Mean baseline graft volume was 607.9 ± 137.9 cm3 , increasing to 957.3 ± 175.7 cm3 at day 7 (+62%, p < 0.001) and 1,293.4 ± 247.0 cm3 at day 30 (+111%, p < 0.001), achieving 93% ± 22.7% of predicted standard liver volume (SLV). Multivariate analysis identified recipient body mass index (BMI) (β = 29.4 cm3 /kg/m2 , 95% CI 14.4–44.4, p < 0.001) and graft-to-recipient-weight ratio (GRWR) (β= 435.9 cm3 per unit, 95% CI 95–777, p = 0.015) as independent predictors of day-30 graft volume (adjusted R2 = 0.349). Left-lobe grafts showed higher proportional growth than right-lobe grafts (174% ± 41% vs. 103% ± 34%, p < 0.001) with comparable absolute volumes (p = 0.56). Younger recipients (19–41 years) demonstrated greater regeneration than older recipients (56–64 years; 160% ± 32% vs. 109% ± 38%, p = 0.01). Mild macrosteatosis (< 30%) did not impair regeneration. Conclusions Liver graft regeneration in this Indian LDLT cohort was rapid, with near-complete SLV restoration by 30 days. BMI and GRWR independently predicted volumetric recovery, supporting personalized graft selection and the expanded use of left-lobe grafts.

Traditional surgery for spinal tumors involves midline incision, extensive dissection, muscle damage, blood loss, ligament injury, and bone removal, with an elevated risk of complications. In contrast, minimally invasive techniques cause less soft tissue trauma, bleeding, infections, cerebrospinal fluid leaks, while enabling shorter hospital stays, and yielding similar results compared to open surgery. There have been reports of prior studies have reported the full endoscopic excision of small intradural extramedullary tumors. Here we report a case of a large intradural extramedullary tumor treated with a full endoscopic translaminar approach and dural repair.

Objective: Interlaminar endoscopic lumbar decompression is an increasingly used minimally invasive technique for treating lumbar disc herniation and lumbar spinal canal stenosis. However, technical difficulty varies substantially across cases because of anatomical and patient-related factors. This prospective study evaluated clinical and radiological predictors of surgical ease using an objective Endoscopic Ease Index (EEI). Methods: This prospective observational study included 122 patients who underwent interlaminar endoscopic lumbar decompression between January 2021 and May 2025. Preoperative clinical data and magnetic resonance imaging morphometric parameters—including interlaminar window dimensions, ligamentum flavum (LF) thickness, facet hypertrophy, and canal stenosis—were analyzed. Intraoperative difficulty was quantified using the EEI, which incorporates operative time, docking time, bleeding score, field clarity, and surgeon-rated difficulty. Predictors of difficult surgery (defined as the upper EEI tertile) were examined using multivariable logistic regression. Results: Of 122 cases, 41 (33.6%) were classified as difficult. Difficult cases had significantly narrower interlaminar windows (10.8±1.9 mm vs. 13.6±2.4 mm, p<0.001), greater LF thickness (5.0±0.9 mm vs. 3.6±0.7 mm, p<0.001), and a higher prevalence of facet hypertrophy (58.5% vs. 27.1%, p=0.004). In the multivariable model, 3 variables independently predicted difficult surgery: LF thickness >4 mm (odds ratio [OR], 5.22; p<0.001), interlaminar height <11 mm (OR, 4.48; p=0.001), and facet hypertrophy ≥ grade 2 (OR, 3.27; p=0.02). The predictive model demonstrated excellent discrimination (area under the receiver operating characteristic curve, 0.87). Despite greater operative complexity, postoperative improvements in pain (visual analogue scale) and disability (Oswestry Disability Index) were comparable between groups. Conclusion LF hypertrophy, reduced interlaminar height, and facet hypertrophy independently predict greater technical difficulty during interlaminar endoscopic lumbar decompression. Preoperative identification of these morphometric parameters may improve surgical planning and help optimize outcomes.

Background: Lapsi (Choerospondias axillaris), a plant native to Nepal, has been traditionally used in Asian countries to treat cardiovascular conditions. However, its effects on immune regulatory function remain largely unexplored.This study aimed to in vivo evaluate the immunoregulatory properties of Lapsi fruit extract in mice on immunotoxic responses with analysis on in vitro mechanism for immune suppression, oxidative stress, and inflammatory response.Male Balb/c mice were intragastrically administered various doses of the extract for 21 days. In some mice, immune suppression was induced with cyclophosphamide, and subsequent immune recovery was assessed. In addition, RAW264.7 cells and THP-1-derived macrophages were treated in vitro with lipopolysaccharide and different concentrations of the extract. Results: Administration of extract increased the IgG2a/IgG1 ratio while reducing serum IgE and IgG1 level compared with control mice. Tumor necrosis factor (TNF)-α and interleukin (IL)-17 levels were lower in splenic culture supernatants of mice administered extract. Lapsi extract also effectively reversed cyclophosphamide (CP)-induced immunosuppression by enhancing serum levels of IgA and IgG2a, of interferon-γ and interleukin (IL)-4 secreted by splenic T cells, and of IgG1 and IgG2a secreted by B cells, as well as by increasing immune cell counts. In cell cultures, the extract decreased the levels of inflammation markers, including nitric oxide, reactive oxygen species, prostaglandin E2, and pro-inflammatory cytokines (IL-6, TNF-α, and IL-1β). Mechanistic analysis showed that Lapsi extract modulated the NF-κB p65, MAPK, and inflammasome pathways. Conclusions Lapsi extract may act as both an immunostimulatory and anti-inflammatory agent, indicating its potential as a candidate immunomodulatory activity under polyclonal and CP-suppressed conditions; however, further disease-specific studies, along with isolation and characterization of active phytochemicals, are warranted to evaluate its therapeutic applicability.

Methods: This study involved 104 asymptomatic adults (females 62 [59.6%]) aged 18–50 years. Whole-spine standing lateral radiographs were obtained, and the pelvic, lumbar, thoracic, cervicothoracic, and cervical parameters were studied. Pearson’s correlation coefficient was used to assess correlations, with a significance threshold of p<0.05. Results: The mean age of participants was 38.27±9.93 years. The pelvic incidence (PI) significantly correlated with C7 slope (r=−0.212, p=0.05). The pelvic tilt (PT) exhibited significant correlations with T1 slope−CL mismatch (r=−0.229, p=0.05) and C2 slope (r=−0.202, p=0.05). Furthermore, PI–LL mismatch showed a significant correlation with TIA (r=−0.197, p=0.05), T1 slope (r=−0.228, p=0.05), and C7 slope (r=−0.251, p=0.05). Conclusions This study reveals a significant correlation between cervical and spinopelvic parameters, emphasizing the interconnectedness of pelvic, lumbar, thoracic, and cervical spine parameters.

Tooth eruption is a localised event whereby the signals for eruption for a given tooth are synthesised in the dental follicle of that tooth with a possible cross talk of signals coming from the adjacent stellate reticulum. The eruption process requires alveolar bone resorption that is primarily regulated by the dental follicle. This is reflected by the fact that failures of eruption often can be traced to either osteoclast deficiencies or to dental follicle abnormalities. Recent advances in application of molecular techniques to animal models allowed for better understanding of gene regulatory events involved in the physiology of tooth eruption. This article attempts to consolidate and organise the facts that offshoot from animal studies.
Tooth Eruption ; Dental Sac ; Molecular Biology

Emerging evidence suggests that systemic inflammation may play a critical role in neurological disorders. Recent studies have shown the connection between inflammatory bowel diseases (IBD) and neurological disorders, revealing a bidirectional relationship through the gut-brain axis.Immunotherapies, such as Treg cells infusion, have been proposed for IBD. However, the role of adaptive immune cells in IBD-induced neuroinflammation remains unclear. In this study, we established an animal model for IBD in mice with severe combined immune-deficient (SCID), an adaptive immune deficiency, to investigate the role of adaptive immune cells in IBD-induced neuroinflammation. Mice were fed 1%, 3%, or 5% dextran sulfate sodium (DSS) for 5 days. We measured body weight, colon length, disease activity index (DAI), and crypt damage. Pro-inflammatory cytokines were measured in the colon, while microglial morphology, neuronal count, and inflammatory cytokines were analyzed in the brain. In the 3% DSS group, colitis symptoms appeared at day 7, with reduced colon length and increased crypt damage showing colitis-like symptoms. By day 21, colon length and crypt damage persisted, while DAI showed recovery. Although colonic inflammation peaked at day 7, no significant increase in inflammatory cytokines or microglial hyperactivation was observed in the brain. By day 21, neuroinflammation was detected, albeit with a slight delay, in the absence of adaptive immune cells. The colitis-induced neuroinflammation model provides insights into the fundamental immune mechanisms of the gut-brain axis and may contribute to developing immune cell therapies for IBD-induced neuroinflammation.