Objective: Patients with severe symptomatic aortic stenosis are assessed for coronary artery disease (CAD) prior to transcatheter aortic valve implantation (TAVI) with treatment implications. Invasive coronary angiography (ICA) is the recommended modality but is associated with peri-procedural complications. Integrating machine learning (ML)-based computed tomography-derived fractional flow reserve (CT-FFR) into existing TAVI-planning CT protocol may aid exclusion of significant CAD and thus avoiding ICA in selected patients. Materials and Methods: A single-center, retrospective study was conducted, 41 TAVI candidates with both TAVI-planning CT and ICA performed were analyzed. CT datasets were evaluated by a ML-based CT-FFR software. Beta-blocker and nitroglycerin were not administered in these patients. The primary outcome was to identify significant CAD. The diagnostic performance of CT-FFR was compared against ICA. Results: On per-patient level, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy were 89%, 94%, 80%, 97% and 93%, respectively. On per-vessel level, the sensitivity, specificity, PPV, NPV and diagnostic accuracy were 75%, 94%, 67%, 96% and 92%, respectively. The area under the receiver operative characteristics curve per individual coronary vessels yielded overall 0.90 (95% confidence interval 85%–95%). ICA may be avoided in up to 80% of patients if CT-FFR results were negative. Conclusion ML-based CT-FFR can provide accurate screening capabilities for significant CAD thus avoiding ICA. Its integration to existing TAVI-planning CT is feasible with the potential of improving the safety and efficiency of pre-TAVI CAD assessment.

Objective: To investigate the effect of Foeniculum vulgare extract against lipopolysaccharide (LPS)-induced microglial activation in vitro as well as cognitive behavioral deficits in mice. Methods: LPS-activated BV-2 cell viability was measured using MTT assay and reactive oxygen species (ROS) was studied using DCF-DA assay. The antioxidative enzymes and pro-inflammatory mediators were analyzed using respective ELISA kits and Western blotting. For in vivo testing, LPS (1 mg/kg, i.p. ) was given daily for five days in male Swiss albino mice to produce chronic neuroinflammation. Cognitive and behavioral tests were performed using open-field, passive avoidance, and rotarod experiments in LPS-induced mice. Results: Foeniculum vulgare extract (25, 50 and 100 μg/mL) significantly attenuated the LPS-activated increase in nitric oxide (NO), ROS, cyclooxygenase-2, inducible NO synthase, IL-6, and TNF-alpha (P < 0.05). Moreover, LPS-induced oxidative stress and reduced antioxidative enzyme levels were significantly improved by Foeniculum vulgare extract (P < 0.05). The extract also regulated the NF-κB/MAPK signaling in BV-2 cells. In an in vivo study, Foeniculum vulgare extract (50, 100, and 200 mg/kg) markedly mitigated the LPS-induced cognitive and locomotor impairments in mice. The fingerprinting analysis showed distinctive peaks with rutin, kaempferol-3-O-glucoside, and anethole as identifiable compounds. Conclusions: Foeniculum vulgare extract can ameliorate LPS-stimulated neuroinflammatory responses in BV-2 microglial cells and improve cognitive and locomotor performance in LPS-administered mice.

Seat belt-related injuries are frequent and are often associated with a specific injury pattern known as “seat belt syndrome.” The presence of the seat belt sign can facilitate the early identification of seat belt injuries, which can help prevent the delayed or missed diagnosis of certain intestinal injuries, such as obstructions. We report the case of a 39-year-old man who sustained a bone fracture and a seat belt injury that led to an intestinal stricture. This condition manifested as delayed acute small bowel obstruction, necessitating laparoscopic intestinal resection and side-to-side anastomosis with a linear stapler. In polytrauma patients with seat belt syndrome, abdominal pain may be overshadowed by the pain from extra-abdominal injuries. Nevertheless, this pain should not be overlooked and must be thoroughly evaluated during regular follow-up visits to prevent complications.

Background: Tooth hypersensitivity presents a significant clinical challenge in managing molar-incisal hypomineralization (MIH), potentially compromising the effectiveness of restorative treatments. Cryotherapy has emerged as a promising approach to reduce pain and inflammation. This study aimed to evaluate and compare the effects of cryotherapy as an adjuvant to nerve blocks in reducing operative pain and sensitivity in patients. Methods: A split-mouth randomized controlled trial was conducted in 28 patients with MIH of the right and left lower molars. ie, 56 teeth. Group (1) control group (n = 28) was administered an Inferior Alveolar Nerve block and group (2) was administered cryotherapy spray after the Inferior Alveolar Nerve block. The Visual Analog Scale (VAS) and Legs, Activity, Cry, Consolability (FLACC) scales were used to compare intraoperative pain. The Mann-Whitney U test was used to test the significance across the study groups, and the chi-square test was used to compare success rates between the two groups; a value of less than 0.05 was considered significant. Results: For VAS scale, the mean value in Group A is 8.89 ± 0.79, whereas in Group B, the values are 4.71 ± 1.46. For the FLACC scale, Group A scores were 7.14 ± 1.04, and Group B scores were 4.48 ± 1.37.When intergroup values were compared, the FLACC and VAS scores were statistically significant at P < 0.001. Conclusion Within the limitations of this study, applying cryotherapy to tooth surfaces following an Inferior Alveolar Nerve block effectively reduces pain and sensitivity in teeth affected by MIH.