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.

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.

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.

Background: ABO-incompatible (ABOi) kidney transplantation poses significant challenges in achieving successful outcomes. This study aimed to investigate the impact of various interventions and techniques on improving the success rates of ABOi kidney transplantation. Methods: We conducted a retrospective observational analysis of patients who underwent ABOi kidney transplantation from November 2012 to March 2023. The study included a total of 105 patients. We collected and analyzed data on patient demographics, preoperative assessments, surgical details, and postoperative outcomes. Results: The mean ages of the donors and recipients were 50.52±10.32 and 36.63±11.61 years, respectively. The majority of recipients were male (81.9%), while most donors were female (89.5%). The most common blood group among recipients was O (69.5%), and among donors, it was B (46.7%). The median durations of chronic kidney disease and dialysis were 12 months (interquartile range [IQR], 7–28 months) and 6 months (IQR, 2–12 months), respectively. Baseline antibody titers (anti-A and anti-B) ranged from 64.0 to 256.0, while on the day of surgery, they were ≤8. Perioperative complications in-cluded hypotension (10.5%), acute tubular necrosis (5.7%), delayed graft function (3.8%), and reexploration (3.8%) due to hematoma. Conclusions ABOi kidney transplantation is a viable option for recipients lacking available donors with an ABO-compatible match. Perioperative concerns, including hypoalbuminemia, heightened risk of infections, coagulopathies, aseptic precautions, and immunological surveillance, must be carefully addressed.

Background: When applying lung-protective ventilation, fluid responsiveness cannot be predicted by pulse pressure variation (PPV) or stroke volume variation (SVV). Functional hemodynamic testing may help address this limitation. This study examined whether changes in dynamic indices such as PPV and SVV, induced by tidal volume challenge (TVC), can reliably predict fluid responsiveness in patients undergoing renal transplantation who receive lung-protective ventilation. Methods: This nonrandomized interventional study included renal transplant recipients with end-stage renal disease. Patients received ventilation with a 6 mL/kg tidal volume (TV), and the FloTrac system was attached for continuous hemodynamic monitoring. Participants were classified as responders or nonresponders based on whether fluid challenge increased the stroke volume index by more than 10%. Results: The analysis included 36 patients, of whom 19 (52.8%) were responders and 17 (47.2%) were nonresponders. Among responders, the mean ∆PPV 6-8 (calculated as PPV at a TV of 8 mL/kg predicted body weight [PBW] minus that at 6 mL/kg PBW) was 3.32±0.75 and ∆SVV 6-8 was 2.58±0.77, compared to 0.82±0.53 and 0.70±0.92 for nonresponders, respectively. ∆PPV 6-8 exhibited an area under the curve (AUC) of 0.97 95% confidence interval [CI], 0.93–1.00; P≤0.001), with an optimal cutoff value of 1.5, sensitivity of 94.7%, and specificity of 94.1%. ∆SVV 6-8 displayed an AUC of 0.93 (95% CI, 0.84–1.00; P≤0.001) at the same cutoff value of 1.5, with a sensitivity of 94.7% and a specificity of 76.5%. Conclusions TVC-induced changes in PPV and SVV are predictive of fluid responsiveness in renal transplant recipients who receive intraoperative lung-protective ventilation.

Background: High blood glucose levels in diabetes lead to vascular inflammation which accelerates atherosclerosis. Herein, Morin was orally administered in male Wistar rats, at the dose of 40 mg/kg for 28 days, and on the 27th and 28th day, ISO was administered to designate groups at the dose of 85 mg/kg s.c., to induce myocardial infarction. Results: Free radical generation, including ROS, in diabetes following ISO administration, leads to the activation of both intrinsic and extrinsic pathways of apoptosis. Morin significantly (p ≤ 0.05) reduced oxidative stress (GSH, MDA, SOD), cardiac injury markers (CK-MB, LDH), inflammation (TNF, IL-6), and apoptosis (Bax, ­BCl 2 , Caspase-3). In addition, it also reduced insulin and blood glucose levels. Akt/eNOS, Nrf2/HO-1, MAPK signaling pathways, and Insulin signal transduction pathways were positively modulated by morin pre-treatment. Conclusions Morin attenuated oxidative stress and inflammation and also modified the activity of various molecular pathways to mitigate cardiomyocyte damage during ISO-induced MI in diabetic rats.

Ischemic heart disease is the most prevalent cause of death worldwide affecting both the gender of all age groups.The high mortality rate is due to damage of myocardial tissue that emanates at the time of myocardial ischemia and re-oxygenation, thus averting reperfusion injury is recognized as a potential way to reduce acute cardiac injury and subsequent mortality. Flavonoids are polyphenol derivatives of plant origin and empirical shreds of evidence substantiate their numerous activities such as antioxidant, anti-inflammatory, anti-apoptotic, and anti-thrombotic activity, leading to their role in cardio protection. Recent investigations have unveiled the capacity of flavonoids to impede pivotal regulatory enzymes, signaling molecules, and transcription factors that orchestrate the mediators participating in the inflammatory cascade. The present comprehensive review, dwells on the preclinical studies on the effectiveness of flavonoids from the year 2007 to 2023, for the prevention and therapeutics for myocardial ischemia-reperfusion injury.

Bilateral distal anterior cerebral artery (DACA) aneurysms also called “kissing aneurysms” or “mirror aneurysm” are extremely rare, accounting for only 0.2% of all intracranial aneurysms. There have only been a few examples of mirror DACA aneurysms reported in the literature. Here, we report a rare case of mirror DACA aneurysm in a middle aged female with its successful clipping. Patient was admitted with severe headache and altered sensorium. Computed tomography (CT) head was suggestive of anterior inter-hemispheric hematoma. Digital subtraction angiography (DSA) was done which was suggestive of two distal anterior cerebral artery aneurysms located at same anatomical position. It was treated through microsurgical clipping. Mirror image DACA aneurysms are rare occurrence. All patients with ruptured DACA aneurysms should have angiography with 3D reconstruction studies. This aids in determining the aneurysm’s morphology and planning treatment accordingly.

Complex craniovertebral junction (CVJ) defects account for a considerable proportion of CVJ diseases. Given the heavily assimilated C1, an unfavorable C1–C2 joint orientation, an overriding C2 superior facet, a low-hanging occiput, and an abnormal vertebral artery course with a high-riding vertebral artery, placement of C1 lateral mass screws might be difficult. To address this, a novel technique for placing C1 lateral mass screws that avoid vertebral artery injury, low-hanging occiput, and overriding C2 superior facet was developed in this study. This approach enables firm fixation of C1–C2 even in difficult situations where the placement of the C1 lateral mass is challenging.

Background/Aims: Exclusive enteral nutrition (EEN), an established modality for pediatric Crohn’s disease (CD) is seldomly utilized in adults. The present study reports the outcome of EEN in adult CD patients at a tertiary care hospital in India. Methods: This was a retrospective analysis of CD patients who received EEN as a sole modality/adjunct to other treatment. The primary and secondary outcomes changed in Crohn’s Disease Activity Index (CDAI), and clinical response (decline in CDAI > 70), respectively, at 4 and 8 weeks. Subgroup analysis evaluated response across different phenotypes, EEN formulations and prior treatment. Linear mixed effect model was created to assess the predictors of EEN response. Results: Thirty-one CD patients received EEN over median duration of 4 weeks (range, 2–6 weeks). CDAI showed a significant improvement post EEN at 4 (baseline 290 [260–320] vs. 240 [180–280], P= 0.001) and 8 weeks (baseline 290 [260–320] vs. 186 [160–240], P= 0.001), respectively. The cumulative clinical response rates at 4 and 8 weeks were 37.3% and 80.4% respectively. The clinical response rates at 8 weeks across B1 (n = 4), B2 (n = 18) and B3 (n = 9) phenotypes were 50%, 78.8% and 100% respectively (log-rank test, P= 0.093). The response rates at 8 weeks with polymeric (n = 8) and semi-elemental diet (n = 23) were 75% and 82.6%% respectively (log-rank test, P= 0.49). Baseline CDAI (odds ratio, 1.008; 95% confidence interval, 1.002–1.017; P= 0.046) predicted response to EEN. Conclusions EEN was effective in inducing clinical response across different phenotypes of CD. Baseline disease activity remained the most important predictor of clinical response to EEN.