Obstructive sleep apnea (OSA) is a multi-level airway disease, and the specific site of obstruction may influence associated conditions such as eustachian tube dysfunction (ETD) and gastroesophageal reflux disease (GERD). This study aimed to explore the relationship between OSA, ETD, acid reflux, and the anatomical site of obstruction. Methods: Participants were assessed using validated questionnaires for OSA, ETD, and reflux symptoms. The site of upper airway collapse was determined objectively using apneagraphy or sleep MRI. Acid reflux symptoms were evaluated using a standardized reflux symptom questionnaire, and 24-hour pH monitoring was done when indicated. ETD was assessed both subjectively and objectively through the Toynbee maneuver. Results: Sixty-three individuals completed the evaluation. The mean age was 40.4 years, and the mean BMI was 28.1 kg/m2. Retroglossal obstruction was observed in 76.1% (48/63), while 23.9% (15/63) had retropalatal obstruction. ETD was diagnosed in 53% of participants, and GERD in 38% by objective testing. A statistically significant association was found between retroglossal collapse and complete ETD (p=0.02). However, no significant link was noted between the obstruction site and laryngopharyngeal reflux or partial ETD. Additionally, salivary pepsin levels showed no correlation with reflux (p=0.412). Conclusions: OSA is frequently accompanied by ETD and GERD. Notably, retroglossal obstruction appears to be significantly associated with complete ETD, suggesting a potential site-specific impact. These findings underscore the importance of anatomical localization in understanding OSA-related comorbidities and warrant further investigation in larger multicenter studies.

Objectives: Anemia is characterized by a reduction in red blood cells, leading to insufficient levels of hemoglobin, the molecule responsible for carrying oxygen. The current standard method for diagnosing anemia involves analyzing blood samples, a process that is time-consuming and can cause discomfort to participants. This study offers a comprehensive analysis of non-invasive anemia detection using conjunctiva images processed through various machine learning and deep learning models. The focus is on the palpebral conjunctiva, which is highly vascular and unaffected by melanin content. Methods: Conjunctiva images from both anemic and non-anemic participants were captured using a smartphone. A total of 764 conjunctiva images were augmented to 4,315 images using the deep convolutional generative adversarial network model to prevent overfitting and enhance model robustness. These processed and augmented images were then utilized to train and test multiple models, including statistical regression, machine learning algorithms, and deep learning frameworks. Results: The stacking ensemble framework, which includes the models VGG16, ResNet-50, and InceptionV3, achieved a high area under the curve score of 0.97. This score demonstrates the framework’s exceptional capability in detecting anemia through a noninvasive approach. Conclusions This study introduces a noninvasive method for detecting anemia using conjunctiva images obtained with a smartphone and processed using advanced deep learning techniques.

We aimed to examine the outcomes of arthritic congenital dislocation of hip in adults after subtrochanteric shortening derotation osteotomy (SSDO) with cementless hip arthroplasty at a minimum follow-up period of five years. Bibliographic databases were searched and isolated studies were divided into three groups (1, 2, and 3) based on the femoral stem type (modular, monoblock, or mixed). We pooled 931 hips/737 patients from 20 studies. The mean difference in the Harris hip score (HHS) before and after the operation was 47.55 (95% confidence interval [CI] 43.16, 51.94). On subgroup analysis the mean differences of 46.59 (95% CI 41.67, 51.51), 48.24 (95% CI 41.37, 55.11), and 47.30 (95% CI 43.85, 50.75), respectively in HHS were noted in groups 1, 2, and 3. The incidence of uncontrolled proximal femur fractures was comparable at 7.9% and 4.2% in groups 1 and 2; however, it was 0% and 16.6% for controlled fractures. The incidences of nonunion, dislocation, nerve paralysis, heterotopic ossification and revision due to any cause were 0.3%, 6.5%, 1.7%, 2.1%, and 7.9% for group 1 and 1.9%, 4.3%, 1.6%, 5.6%, and 7.4% for group 2. Similar improvements in functional outcome for both monoblock and modular stems can be expected. An increased incidence of controlled proximal femur fractures was observed with use of modular stems. The nonunion at the SSDO site was sporadic.

Pelvic ring injuries with rotational and translational instability are complex and often result from high-energy trauma, posing significant challenges in management. Internal fixation has emerged as the preferred approach, with traditional methods such as iliosacral screw fixation exhibiting drawbacks like implant-related morbidity and hardware complications. This paper presents a modified minimally invasive transiliac plating technique aimed at addressing these challenges. The surgical technique involves careful preoperative planning, precise patient positioning, and meticulous exposure of the posterior pelvic structures. Key steps include osteotomy of the posterior superior iliac spine (PSIS), formation of a subcutaneous tunnel, contouring and placement of the plate, and fixation with strategically positioned screws. Additionally, the modified technique incorporates the replacement of the osteotomized PSIS bony fragment, providing secondary stability and minimizing the risk of implant back out. This modification aims to enhance biomechanical stability, reduce implant-related morbidity, and ensure optimal functional outcomes. The technique’s efficacy is supported by biomechanical principles and clinical studies, indicating its potential as a promising alternative in the management of unstable pelvic ring injuries. Overall, this modified approach offers improved patient comfort, reduced surgical risks, and enhanced long-term outcomes, contributing to advancements in pelvic ring fracture management.

Purpose: The bisecting angle technique (BAT) encounters difficulties in positioning the X-ray cone and aligningthe central beam with the tooth. To address this, a rectangular laser featuring a pointed light was integrated into theintraoral X-ray cone. This study evaluated its effectiveness in improving radiograph quality and minimizing errors. Materials and Methods: Fifty fifth-year Bachelor of Dental Surgery students were divided into 3 groups. Group1 (n = 16) used the paralleling technique, group 2 (n = 17) employed the conventional BAT, and group 3 (n = 17) utilized the laser-assisted BAT on mannequins. Two independent oral radiologists assessed the quality of the radiographs, categorizing the images as either diagnostically acceptable or not acceptable. Inter-group comparisons of quality and error rates were conducted using the chi-square test (significance level: P<0.05). Results: The paralleling technique group produced 77.5% diagnostically acceptable radiographs and 22.5% that were not diagnostically acceptable. These percentages were 65.3% and 34.7%, respectively, in the conventional BAT group and 75.3% and 24.7%, respectively, in the laser-assisted BAT group, showing results similar to the paralleling technique group. The quality of radiographs differed significantly among the groups (P<0.05). The percentage of error-free radiographs was 38.1% in the paralleling technique group, 20.6% in the conventional BAT group, and 40.0% in the laser-assisted BAT group, with these differences being statistically significant (P<0.05). Conclusion The device produced higher acceptability and fewer radiographic errors than the conventional BATtechnique, suggesting accurate adjustment of the X-ray cone and central beam to the desired teeth.