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Oral clefts represent a significant craniofacial anomaly in neonates, presenting multifaceted challenges such as feeding difficulties, recurrent ear infections, speech impediments, poor growth, hearing impairments, and dental misalignments. These anomalies not only affect physical health but also have profound psychosocial implications for affected individuals and their families. Current management strategies aim to address these challenges comprehensively, and recent advancements in technology have offered innovative solutions. Among these, the integration of ultrasound-guided (USG) three-dimensional (3D)-constructed obturator devices has emerged as a promising approach to enhancing patient outcomes, particularly in achieving facial symmetry and facilitating early nutritional rehabilitation. This study presents a detailed case series of three term infants born to non-consanguineous parents with appropriate birth weights for their gestational age, each diagnosed with a unilateral cleft lip and palate (UCLP). The first infant also presented with left-hand polydactyly and a preauricular sinus, while the second was diagnosed with multicystic kidney disease based on kidney, ureter, and bladder (KUB) scan findings. Collaborating with the Smile Train organization and the maxillofacial surgery team, a comprehensive management plan was devised. In the initial phase, intraoral scanning (Medit Intraoral Scanner™, Seoul, South Korea; done at Saveetha Medical College and Hospitals, Chennai) and digital printing of the obturator plate were performed to capture precise anatomical details. Subsequently, 3D printing technology (Ender 3D Printer™, Creality, Shenzhen, China; done at Saveetha Medical College and Hospitals, Chennai) was employed to fabricate a customized obturator plate equipped with a nasal stent. This ultrasound (US)-guided 3D-constructed obturator device was designed to fit each infant's unique oral anatomy, providing optimal support and alignment. The implementation of this device within a week post birth played a pivotal role in expediting the initiation of direct breastfeeding and nutritional rehabilitation. Furthermore, one of the infants underwent cleft lip surgical repair at four months of age, showcasing the device's compatibility with subsequent surgical interventions. The utilization of US-guided 3D-constructed obturator devices in the management of cleft lip and palate (CLP) has demonstrated significant clinical benefits. These devices contribute to reduced facial deformities, mitigate nasal cartilage sagging, and foster enhanced weight gain. Additionally, they facilitate successful breastfeeding, thereby promoting early nutritional recovery. Moreover, the improved facial symmetry and cheek fullness resulting from this approach contribute to accelerated rehabilitation, thereby reducing the societal stigma often associated with craniofacial anomalies.

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Introduction Midline incision provides a rapid and thorough approach to the abdominal cavity and, therefore, is widely employed in both emergency and elective procedures. However, midline laparotomy is associated with many post-operative complications like wound dehiscence, incisional hernia, fistula formation, and surgical site infection (SSI). The purpose of the study is to compare the complications that occurred post-operatively in association with the long and small bite suture techniques for midline laparotomy incisions. Methodology A prospective comparative study was carried out among 90 cases of midline laparotomies for 18 months (January 2021 to June 2022). The participants were categorized into two groups: (1) Group A, which included 45 patients, underwent small-suture abdominal fascia closure, and (2) Group B, which consisted of the remaining 45 patients, underwent large-suture abdominal midline wound closure. Patients were followed up in the hospital till the day of discharge and in the outpatient department (visit 1, within one month of surgery) for pain, wound dehiscence, and surgical site infection. Patients were called for visit 2 (six months post-surgery) and incisional hernia rates were assessed. Results On the numerical pain rating scale, the mean score was higher in Group B, that is, 4.1 than in Group A, which was 3.5. Wound dehiscence and incisional hernia rates were higher among Group B cases. The majority of SSIs were noted in Group B with statistically significant results. Conclusion Despite the lack of randomization, the results demonstrated in this study support the use of small bite sutures in comparison to long bite sutures for laparotomy closure.

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Breast cancer, the most common female malignancy, represents a heterogeneous group of tumors, which presen both varied behaviors and response to therapy. This study was done with an attempt to evaluate the role of D-dimer in patients of carcinoma breast, in predicting lymph node metastasis in carcinoma patients and to look for relationship of these markers with histopathologic parameters. Clinical data was obtained from clinical examination of patients admitted in the Department of Surgery with history of breast lump and confirmed with fine needle aspiration cytology (FNAC). Clinical staging was done using TNM staging. D-dimer level was measured prior to commencement of treatment, i.e., modified radical mastectomy (MRM) or neoadjuvant chemotherapy and finally 6 months after surgery or completion of 6 cycles of chemotherapy. The characteristics of the study population Out of 60 study cases minimum age of the patient being 30 years and maximum being 74 years. Of all histopathologic variables examined, D-dimer levels directly correlated with extent of lymph node involvement and lymphovascular invasion, D-dimer levels correlated strongest with the number of positive lymph nodes, but not with tumor size, estrogen receptor status, and progesterone receptor status. This study clearly shows that plasma D-Dimer levels are elevated in carcinoma breast patients. Increased D-Dimer levels are an important marker of clinical stage, lymphovascular invasion, lymph node involvement, and tumor metastasis.

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A major impediment in the success of cell therapy for neurodegenerative diseases is the poor survival of grafted cells in the in vivo milieu, predominantly due to accumulated reactive oxygen species, thus prompting the search for suitable alternatives. Accumulating evidence suggests that the therapeutic potential of transplanted cells is partially attributed to the secretome released by them into the extracellular milieu. Studies that investigated the neuroprotective potential of the secretome attributes to the mere presence of growth factors without addressing other underlying cellular/molecular changes that occur upon post-secretome intervention like re-establishing the host cell's free radical scavenging machineries. In the present study, we investigated the neuroprotective effects of human embryonic kidney (HEK-293) cell line derived secretome (HEK-S) in an in vitro model of kainic acid (KA) induced neurodegeneration and explored the possible neuroprotective mechanism(s) of HEK-S. Murine hippocampal cells were exposed to toxic doses of KA (200µM) for 6hours (H) or 24H to induce excitotoxicity. Kainic acid exposed hippocampal cells were then treated with HEK-S either simultaneously or 6h post-KA exposure. Our results revealed that HEK-S confers significant neuroprotection in early/later stages of neurodegeneration through insulin like growth factor (IGF) - phosphatidylinositol-3-kinases (PI3K) pathway, efficiently restoring the host's free radical scavenging mechanisms at molecular-cellular-biochemical levels and also by modulating kainate receptor subunit expressions in host neurons.

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BACKGROUND: Organophosphorus (OP) compounds are a heterogeneous group of insecticides widely used in agricultural industry. These OP compounds are likely to have more adverse effects in developing countries like India due to its easy availability and less awareness which results in high morbidity and mortality. AIMS AND OBJECTIVES: 1. To estimate plasma cholinesterase, amylase, lipase and, creatine phosphokinase (CPK) in acute OP poisoning. 2. To correlate these biochemical parameters with plasma cholinesterase levels in OP poisoning. 3. To determine the use of a biochemical marker in predicting the severity of acute OP poisoning. MATERIALS AND METHODS: A hospital based observational study was conducted on 53 subjects who have clinically diagnosed of acute OP poisoning and admitted in emergency unit of a tertiary care rural hospital. Subjects of either gender of all age-groups were included in the study. On admission, plasma cholinesterase, serum amylase, lipase and CPK were measured. Based on plasma cholinesterase activity at the time of admission, subjects were divided into three groups. Group I-having 20-50% of plasma cholinesterase activity; Group II-10-20% of plasma cholinesterase activity; and group III-<10% of plasma cholinesterase activity. RESULTS: Serum amylase, lipase and CPK were negatively correlated with plasma cholinesterase levels. Serum amylase showed statistically significant negative correlation with plasma cholinesterase. Serum amylase showed the highest diagnostic accuracy for assessing severity of poisoning followed by CPK and Lipase. CONCLUSION: OP poisoning is associated with hyperamylasemia. Serum amylase, lipase and CPK can be used as an additional prognostic indicator with plasma cholinesterase levels. Serum amylase could be considered as a better predictor of severity followed by CPK and lipase.

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INTRODUCTION: Bromocriptine, an ergot derivative, is an agonist at the dopamine 2 receptor and a sympatholytic. It is a well established drug in Parkinsonism, hyperprolactinaemia and acromegaly and it has various other clinical indications like induction of ovulation in female infertility. Bromocriptine has been evaluated in alloxan induced diabetic rats for its anti-hyperglycaemic effect with and without simultaneous use of glipizide. METHODS: Diabetes was induced in albino rats by giving a single subcutaneous injection of alloxan in a dose of 150 mg/kg body weight. After 72 hours of giving alloxan injection, depending upon their blood glucose levels (350mg/dl and above), the rats were included into the study and they were divided into four groups, each comprising of 6 rats (n=24): Group 1 which was taken as control was given distilled water. Group 2 was treated with glipizide, a standard drug. Group 3 was treated with the test drug, bromocriptine and Group 4 was treated with sub therapeutic doses of test and standard drugs. The drugs were given to the diabetic rats once daily by oral route for 30 consecutive days, in order to assess their effects in terms of reduction in blood glucose levels. Blood glucose was estimated on 0(th), 10(th), 20(th), and 30(th) days of the study at fixed time intervals. RESULTS AND CONCLUSION: Bromocriptine, which was used alone, lowered the blood glucose levels appreciably; whereas the concomitant administration of bromocriptine and glipizide in sub therapeutic doses produced a much more appreciable reduction. The results which were obtained in the group which received simultaneous administration of test and standard drugs in sub therapeutic doses were comparable to those of the group which received reference drug, glipizide. Hence, it can be concluded that bromocriptine may serve as a valuable adjunct to available anti-diabetic medication.

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OBJECTIVES: 1) To evaluate the analgesic effect of atorvastatin and simvastatin. 2) To compare analgesic activity of these with an established drug tramadol. MATERIALS AND METHODS: Healthy Albino rats were taken. They were randomly divided into 4 groups of six animals each. Group I: Normal Saline (0.5 ml), Group II: Tramadol (10 mg/kg BW), Group III: Atorvastatin (10 mg/kg BW) and Group IV: Simvastatin (10 mg/kg BW). The animals were subjected to 3 different tests at different interval of time. The tests conducted were tail clip method, Eddy's hot plate and hot water tail immersion method. RESULTS: Atorvastatin and simvastatin differ significantly from control hence they have analgesic action and even at any of the time intervals they do not differ significantly from tramadol; hence their analgesic effect is nearly comparable to tramadol. The results of the present study indicate that atorvastatin and simvastatin have analgesic action. CONCLUSION: These statins are found to have analgesic effect other than hypolipidemic activity and can be used in these patients. However further study has to be undertaken in a broader way.