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200 papers
Preoperative Angioembolization of Pediatric Solid Tumors: Does It Facilitate the Surgeon's Task?
Lamprinou Z, Kanna E, Tsanis A … +2 more , Ptohis N, Skondras I
Maedica (Bucur) · 2025 Sep · PMID 41403801 · Full text
The use of angioembolization in trauma situations is widely reported in both the adult and pediatric populations. However, its application in pediatric oncology is limited due to insufficient data in the literature. Ther...
The use of angioembolization in trauma situations is widely reported in both the adult and pediatric populations. However, its application in pediatric oncology is limited due to insufficient data in the literature. There are documentations that arterial embolization of the tumor preoperatively can reduce blood loss, achieve resectability and favorable outcomes. We describe two cases of children with solid tumors who underwent angioembolization during the management of their disease, as well as the outcomes of our intervention.
Anatomical Variations of Palmaris Longus Muscle and Its Clinical Implications: a Cadaveric Study.
Sambhav K, Krishna H, Singh P … +2 more , Bhardwaj N, Ghatak S
Maedica (Bucur) · 2025 Sep · PMID 41403800 · Full text
INTRODUCTION: Palmaris longus (PL) is the most superficial flexor muscle of the anterior compartment of the forearm in humans, which exhibits frequent anatomical variance. It has been observed that the complete absence o...
INTRODUCTION: Palmaris longus (PL) is the most superficial flexor muscle of the anterior compartment of the forearm in humans, which exhibits frequent anatomical variance. It has been observed that the complete absence of PL is the most commonly reported variance, followed by reversed, duplicated and hypertrophied muscle variants. The incidence of the complete agenesis of PL varies from 0.6% to 26.6%. So, it may be considered as an inconstant muscle. It is known to be more commonly absent unilaterally than bilaterally. The prevalence of unilateral absence of the PL is more commonly found on the left side. Unilateral agenesis of the PL is relatively more widely encountered in males compared to females. MATERIAL AND METHODS: During the routine cadaveric dissections at the Department of Anatomy, AIIMS, Jodhpur, we observed palmaris longus muscle variations in 64 upper limbs of 32 cadavers (22 males and 10 females). RESULTS: We observed agenesis of the palmaris longus muscle in six (9.4%) upper limbs out of 64 cadaveric upper limbs. The bilateral absence of palmaris longus was observed in two cadavers (6.25%), while unilateral absence was also observed in two cadavers (6.25%). We also observed agenesis of the PL was more prevalent in males (11.33%) in comparison to females (5%). CONCLUSION: Palmaris longus is significant surgically as it is employed for various tendon graft procedures, lip augmentation, ptosis correction and management of facial palsy.
Management of Physiological Gingival Pigmentation Using Two Treatment Modalities: Clinical and Patient-Reported Outcomes.
Aseri AA, Khan SD, Alojem KD … +1 more , Abusag HS
Maedica (Bucur) · 2025 Sep · PMID 41403799 · Full text
OBJECTIVES: Physiological gingival pigmentation is considered aesthetically unappealing, and individuals diagnosed with it often want to reduce or remove the pigmentation. There are various techniques for depigmentation,...
OBJECTIVES: Physiological gingival pigmentation is considered aesthetically unappealing, and individuals diagnosed with it often want to reduce or remove the pigmentation. There are various techniques for depigmentation, with laser treatment considered the simplest, most reliable and most cost-effective option. This study assessed two different treatments for physiological gingival pigmentation. MATERIALS AND METHODS: A total of 12 patients who had gingival pigmentation were randomly divided into a control group (treated with a bur) and a test group (treated with a laser). The same experienced periodontist performed all the procedures. Patient-reported outcomes of the treatments were obtained through a quality of life questionnaire adapted from Melzack's McGill pain questionnaire, which patients completed one day, one week and four weeks after therapy. Additionally, 15 experienced dentists assessed clinical photographs using a Likert scale to compare the clinical outcomes before and one month after the intervention. RESULTS: Patients were similarly satisfied with both laser and bur depigmentation treatments (54.17%, mean = 2.71, SD = 0.624; 50.0%, mean = 2.50, SD = 1.034, respectively). The patients' satisfaction results were non-significant (P > 0.05), except in terms of noticing an aesthetic change, which was significant (P < 0.05) in favor of the laser approach. The satisfaction rate was higher for laser treatment (84.44%, mean = 4.21) compared to bur depigmentation (78.67%, mean = 3.93). The results were statistically non-significant (P > 0.05). One month after treatment, four patients from the control group reported that the treatment met their expectations, while one participant said it exceeded expectations. CONCLUSION: Within the limitations of this study, the findings suggested that laser treatment was slightly superior to bur treatment for managing gingival pigmentation.
Retinal Vascular Occlusion in Patients on Anticoagulation and Antiplatelet Therapy: a Case Report and Comprehensive Review.
Madi M, Harb A, Jabbour N … +5 more , Daher A, Tlaiss Y, El Chakik G, Haddam M, Warrak R
Maedica (Bucur) · 2025 Sep · PMID 41403798 · Full text
The purpose of this study was to evaluate any protective role of anti-platelet and/or anticoagulation therapy in preventing retinal vascular occlusions, whether arterial or venous. We have described the case of a 47-year...
The purpose of this study was to evaluate any protective role of anti-platelet and/or anticoagulation therapy in preventing retinal vascular occlusions, whether arterial or venous. We have described the case of a 47-year-old male who presented with a left-eye branched retinal artery occlusion despite being on both anticoagulation and anti-platelet therapy. A narrative literature review of reports published between 2000 and 2024 identified twelve relevant articles, which collectively indicated no protective or preventive benefit of anti-platelet or anticoagulant therapy against retinal vascular occlusions.
Common Pathophysiological Mechanisms Connecting Dyslipidemia and Hyperuricemia: a Narrative Review.
Paduraru L, Vesa C, Popoviciu MS … +1 more , Zaha DC
Maedica (Bucur) · 2025 Sep · PMID 41403797 · Full text
This review presents the pathophysiological changes underlying dyslipidemia and hyperuricemia. The way in which these health conditions influence each other is through insulin resistance, persistent inflammatory state, o...
This review presents the pathophysiological changes underlying dyslipidemia and hyperuricemia. The way in which these health conditions influence each other is through insulin resistance, persistent inflammatory state, oxidative stress and endothelial damage. Insulin resistance influences lipid metabolism and uric acid elimination, leading to triglyceride accumulation and increased uric acid levels. Inflammatory mediators in adipose tissue and cytokine cascades maintain an inflammatory status, favor lipid peroxidation and decrease renal uric acid clearance. Reactive oxygen species amplified by oxidized lipoproteins and urate compromise nitric oxide signaling pathways and vascular homeostasis. Genetic and epigenetic alterations in genes involved in metabolic transport, cytokine regulation and microRNA expression also occur. This dual pathology favors vascular vulnerability and systemic metabolic dysregulation. Effective management requires more than simple monitoring of serum markers. This should target the molecular mechanisms that fuel cardiovascular and metabolic damage.
Finite Element Analysis to Evaluate the Biomechanical Effects of the Different Cortical Cuts on Canine and Related Supporting Tissues During Retraction.
Modi HS, Kulkarni N, Trivedi I … +3 more , Shah S, Jivrani H, Doshi L
Maedica (Bucur) · 2025 Sep · PMID 41403796 · Full text
BACKGROUND: Corticotomy-assisted orthodontics (CAOT) has shown potential in accelerating tooth movement by reducing alveolar bone resistance. However, the biomechanical effects of varying corticotomy designs on canine re...
BACKGROUND: Corticotomy-assisted orthodontics (CAOT) has shown potential in accelerating tooth movement by reducing alveolar bone resistance. However, the biomechanical effects of varying corticotomy designs on canine retraction remain insufficiently explored. MATERIALS AND METHODS: A cone-beam computed tomography (CBCT) scan of a 26-year-old male with bimaxillary protrusion was used to create a three-dimensional finite element model of the maxillary dentition, including alveolar bone, periodontal ligament (PDL), teeth and orthodontic appliances. Twenty-four corticotomy configurations were modeled based on varying anatomical positions (e.g., mesial, distal, labial, lingual), proximity (2 mm and 4 mm from distal cut) and cut widths (0.6 mm, 0.8 mm). A standardized 100-cN retraction force was applied using miniscrews in a segmented arch technique. ANSYS 14.5 software was used to analyze stress (von Mises), strain (in PDL) and initial displacement. RESULTS: The continuous circumscribing cut showed the greatest canine displacement and PDL strain, followed by distal + labial + lingual and distal cut configurations. The highest stress in trabecular bone was seen with 0.8 mm wide cuts, while the greatest strain in PDL occurred with mesial cut. Tooth displacement decreased as the distance of corticotomy from the canine increased (distal > 4 mm > 2 mm). Among widths, 0.4 mm distal cuts (not explicitly simulated but inferred) were biomechanically more favorable than 0.6 mm and 0.8 mm. CONCLUSION: Distal corticotomy cuts, particularly those closer to the canine and of optimal width, exhibit biomechanical advantages similar to circumscribing cuts with lower surgical morbidity. These designs may reduce resistance to movement, optimize force distribution and enhance clinical outcomes during canine retraction.
Septal Cartilage Defect with Intact Mucosa Bilaterally. A Rare Clinical Presentation.
Lianou AD, Faliagka S, Simou D … +1 more , Giotakis E
Maedica (Bucur) · 2025 Sep · PMID 41403795 · Full text
Septal cartilage defect with intact mucosa bilaterally refers to a condition where there is a loss or absence of cartilage within the nasal septum, while the overlying mucosal lining remains intact on both sides. This is...
Septal cartilage defect with intact mucosa bilaterally refers to a condition where there is a loss or absence of cartilage within the nasal septum, while the overlying mucosal lining remains intact on both sides. This is typically identified accidentally during surgical or radiological assessments. A wide range of possible causes has been documented, resulting in a diverse diagnostic approach. In this study, we present a rare case of septal cartilage defect with intact mucosa bilaterally after nasal decongestant abuse.
My I Could Never Die.
PhD MCM
Maedica (Bucur) · 2025 Sep · PMID 41403794 · Full text
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Novel Inflammatory Hematological Ratios and Hematological Parameters in Diabetes Mellitus - a Cross-Sectional Study in a Hospital Setting in Gujarat.
Anandani G, Motiani A, Goswami P … +2 more , Dholariya S, Bhankhodia V
Maedica (Bucur) · 2025 Sep · PMID 41403793 · Full text
INTRODUCTION: Diabetes mellitus (DM) is a chronic metabolic disorder characterized by hyperglycemia due to insulin deficiency or resistance, often accompanied by systemic inflammation and vascular complications. Hematolo...
INTRODUCTION: Diabetes mellitus (DM) is a chronic metabolic disorder characterized by hyperglycemia due to insulin deficiency or resistance, often accompanied by systemic inflammation and vascular complications. Hematological parameters and inflammatory markers derived from complete blood counts (CBC) may reflect glycemic control and disease progression. This study investigates the association between HbA levels and hematological indices, including NLR (neutrophil-to-lymphocyte ratio), MLR (monocyte-to-lymphocyte ratio), PLR (platelet-to-lymphocyte ratio), RDW (red cell distribution width), MPV (mean platelet volume) and PDW (platelet distribution width), to assess their diagnostic utility in DM. OBJECTIVES: This study aims to identify the association between glycated hemoglobin (HbA) levels and a range of hematological parameters, while also evaluating their diagnostic significance in patients with DM. Extensive research has been carried out on hematological parameters and potential systemic inflammatory markers, including NLR and MLR, concerning tumors, cardiovascular diseases and various systemic inflammatory conditions. Nonetheless, only few studies have explored the correlation between DM and these hematological inflammatory markers. MATERIAL AND METHODS: The present cross-sectional study was carried out over a period of two months, from December 2024 to January 2025, in a tertiary care center located in Rajkot, India. It included 753 cases, with 424 patients exhibiting HbA values within the diabetic range, 182 in the prediabetic range and 147 subjects in the non-diabetic range. Comprehensive data was collected and glycated hemoglobin levels, complete blood count results and inflammatory hematological parameters were analyzed. Statistical analyzes was conducted using the Statistical Package for the Social Sciences version 28.0 software. Univariate analysis using one-way ANOVA and Pearson correlation, followed by multinomial logistic regression were utilized to investigate the relationship between HbA and hematological parameters. RESULTS: The red blood cell indices and platelet distribution width were notably lower in diabetic patients, while the monocyte lymphocyte ratio was found to be significantly higher in non-diabetic ones. Correlation analysis between HbA levels and hematological parameters indicated several significant yet weak associations. Furthermore, multinomial logistic regression analysis suggested that hematological parameters played a role in differentiating diabetic individuals from prediabetic and non-diabetic ones. CONCLUSION: Understanding the associations between hematological parameters and HbA is important, as these correlations may reveal how glycemic control affects blood cell dynamics and systemic inflammation, thus contributing to effective diagnosis and management.
A Comparative Study Using Four Different Techniques of Nasogastric Tube Insertion in Anaesthetised and Intubated Patients Undergoing Laparoscopic Surgery: a Randomized Controlled Prospective Observational Study.
Keerthan G, Sholapur I, Hussain A
Maedica (Bucur) · 2025 Sep · PMID 41403792 · Full text
BACKGROUND: Insertion of a nasogastric tube (NGT) in anaesthetised and intubated patients remains technically challenging, with conventional methods reporting more than 50% first-attempt failures. Factors such as anatomi...
BACKGROUND: Insertion of a nasogastric tube (NGT) in anaesthetised and intubated patients remains technically challenging, with conventional methods reporting more than 50% first-attempt failures. Factors such as anatomical barriers, kinking and trauma contribute to difficulties. Since laparoscopic procedures require gastric decompression, alternative methods have been introduced to improve success and safety. This study compared four insertion techniques: conventional, guidewire-assisted, slit endotracheal tube-guided and neck flexion with lateral pressure. MATERIALS AND METHODS: This prospective randomized controlled trial included 240 adults (ASA I-II) undergoing laparoscopic surgery under general anaesthesia between November 2018 and July 2020. Patients were randomly allocated into four groups (n=60 each): Group C (conventional), Group G (guidewire-assisted), Group E (slit endotracheal tube-guided) and Group N (neck flexion with lateral pressure). The primary outcome was first-attempt success. Secondary outcomes included insertion time and complications (kinking, coiling, trauma). Chi-square and ANOVA tests were applied (SPSS v22, p<0.05 significant). RESULTS: Group E achieved the highest first-attempt success rate (90%), followed by G (71.7%), N (70%) and C (53.3%) (p<0.001). Mean insertion times were shortest with Group C (19.5 ± 2.1 s) and longest with Group E (34.0 ± 3.5 s). Kinking was most frequent in Group C (25%), but absent in Groups G and E. Coiling was highest in Group C (21.7%). Trauma incidence was the greatest in Group E (31.7%) and the lowest in Group C (11.7%). CONCLUSION: Modified techniques improve first-attempt success compared to the conventional method. Although the slit endotracheal tube achieved the highest success, it was associated with greater trauma and longer insertion time. Guidewire-assisted insertion offered the most balanced profile of success, efficiency and minimal complications, thus making it a reliable alternative.
Clinical and Treatment Approach of Multiple Head and Neck Cancers.
Litsou E, Goussia A, Sioka C … +2 more , Katiniotis G, Zarkavelis G
Maedica (Bucur) · 2025 Sep · PMID 41403791 · Full text
The development of a second primary malignancy in patients with head and neck cancer (HNC) is not a rare event. According to the literature, the incidence of multiple HNCs is increasing in recent years due to improved di...
The development of a second primary malignancy in patients with head and neck cancer (HNC) is not a rare event. According to the literature, the incidence of multiple HNCs is increasing in recent years due to improved diagnostic tests, meliorated screening and surveillance of patients with cancer, more sophisticated treatment, increased life expectancy and high population survival. The risk of developing second primary cancer increases by 3% per year in patients who have survived HNC. Second tumors can be diagnosed either simultaneously (synchronous) or more than six months after the index tumour (metachronous). Nowadays, the situation of patients with multiple primaries HNCs is of increasing relevance and importance and follow-up of those patients is recommended, not only to detect relapse and manage treatment-related toxicities but also for early detection of metachronous HNCs. This review focuses on practical clinical implications of the management of patients with multiple HNCs. Diagnostic challenges and distinction from recurrence, treatment planning and surveillance, prognostic implications and risk stratification, precision oncology and future directions are the main topics contained in it confirming the necessity of a highly customized and interdisciplinary clinical and treatment approach for the management of HNCs, both synchronous and metachronous.
Composite Adhesion Performance in Focus: a Shear Bond Strength Analysis.
Ciorniciuc IAM, Comaneanu RM, Ionescu T … +4 more , Biculescu A, Dobrescu AM, Cosac D, Gioga C
Maedica (Bucur) · 2025 Sep · PMID 41403790 · Full text
OBJECTIVE: The goal of this study was to test and compare how well three modern composite materials - Charisma Classic (Kulzer), G-ænial Anterior (GC Corporation) and Omnichroma (Tokuyama) - adhere to enamel surfaces tha...
OBJECTIVE: The goal of this study was to test and compare how well three modern composite materials - Charisma Classic (Kulzer), G-ænial Anterior (GC Corporation) and Omnichroma (Tokuyama) - adhere to enamel surfaces that were prepared in the same way for all three of them. MATERIALS AND METHOD: Fifteen human teeth were extracted out, cleaned and kept in isotonic saline for the study. Before the adhesive system was applied, the enamel surfaces were etched with 37% phosphoric acid, cleaned and dried. Each composite was poured into standardised cylindrical moulds (3 mm diameter, 3 mm height) and light-cured for 40 seconds. The specimens were placed in epoxy resin and evaluated using an Instron 8872 universal testing equipment to determine shear bond strength. Five tests were conducted on each material and the mean results were identified by leaving out the outliers. RESULTS: G-ænial Anterior had the highest average SBS value (about 341 N), followed by Omnichroma (about 269 N) and Charisma Classic (about 266 N). Notably, two G-ænial samples showed cohesive fractures within the composite, which means that the bonds between the different parts are very strong. Most of the time, the Charisma and Omnichroma samples failed to adhere at the tooth-composite interface. CONCLUSIONS: G-ænial Anterior had the best adhesion to enamel among all examined materials. This was shown by both the bond strength and the way the bond failed. The results indicate that using it in high-stress clinical situations may make it work more effectively and last longer. Even though Charisma Classic and Omnichroma demonstrated steady and moderate adherence, improved adhesive procedures might help them achieve the best possible clinical results.
A Case of Erythema Induratum of Bazin Necessitating Protracted Treatment for Complete Remission: Are We in Need of Disease-Specific Therapy Guidelines?
Mavridou K, Zampeta A, Gavriil S … +3 more , Lampri E, Chronis C, Gaitanis G
Maedica (Bucur) · 2025 Jun · PMID 40880723 · Full text
Erythema induratum of Bazin (EIB) is a rare subcutaneous granulomatous disease that is considered to represent a form of tuberculin hypersensitivity. We present the case of a 74-year-old Bacillus Calmette-Guerin (BCG)-va...
Erythema induratum of Bazin (EIB) is a rare subcutaneous granulomatous disease that is considered to represent a form of tuberculin hypersensitivity. We present the case of a 74-year-old Bacillus Calmette-Guerin (BCG)-vaccinated female patient, who presented to our dermatology clinic with painful, erythematous purple nodules on the lower extremities. Clinical examination, histopathological analysis, a positive tuberculin skin test (TST) and interferon-gamma release assay (IGRA) supported the diagnosis of EIB. A standard six-month anti-tubercular therapy (ATT) led to improvement of the clinical presentation. However, after discontinuation of ATT, the clinical symptoms and sings relapsed and ATT had to be extended for a total of 10 months to achieve complete remission without relapse for 12 months. Given the lack of established treatment guidelines for the management of EIB, this case underscores the need for prolonged ATT for the effective management of this condition, which is guided by the relevant clinical picture and sometimes goes beyond standardized anti-tubercular treatment protocols.
Innate Immunity Receptor TLR9 Drives Erythrocyte Cholesterol and Ferroprotin Accumulation in a Glutaminase-Independent Manner. Implications for Metabolic Associated Fatty Liver Disease.
Mimidis K, Kyriakou Z, Politis N … +5 more , Veniamis P, Vlachos D, Ioannis T, Anagnostopoulos K, Papadopoulos C
Maedica (Bucur) · 2025 Jun · PMID 40880721 · Full text
BACKGROUND: During metabolic associated fatty liver disease (MAFLD), lipotoxicity induces toll-like receptor 9 (TLR9) upregulation and mitochondrial DNA-induced TLR9 activation in the liver, driving metabolic hepatic inf...
BACKGROUND: During metabolic associated fatty liver disease (MAFLD), lipotoxicity induces toll-like receptor 9 (TLR9) upregulation and mitochondrial DNA-induced TLR9 activation in the liver, driving metabolic hepatic inflammation. We wondered whether there is augmented erythrocyte TLR9 in MAFLD and we explored the effect of erythrocyte TLR9 activation on cholesterol and sphingomyelin content, glutaminase activity and TLR9, ferroportin and monocyte chemoattractant protein 1 (MCP-1) levels. METHODS: Twenty-four patients (15 men and nine women) with MAFLD and nine healthy controls (four men and five women) were enrolled. Erythrocytes were isolated from EDTA-containing blood. Protein levels were measured in erythrocyte lysates (Triton X-100 0.1% v/v), erythrocyte membranes (isolated by hypotonic lysis) with enzyme-linked immunosorbent assays, whereas lipids and enzyme activities were measured in erythrocyte hemoglobin-free membranes by a semi-quantitative thin layer chromatography and assay kits, respectively. RESULTS: The total but not surface levels of TLR9 were increased (p=0.002) in erythrocytes of MAFLD patients. Erythrocyte TLR9 activation drove cholesterol and ferroportin-1 accumulation, but not glutaminase-1 upregulation. Toll-like receptor 9 activation did not induce a significant change on the levels of TLR9 and MCP-1. CONCLUSIONS: Erythrocyte TLR9 is upregulated in MAFLD patients and drives cholesterol and ferroportin-1 accumulation in a glutaminase-independent manner. Augmented erythrocyte TLR9 could participate in metabolic inflammation during MAFLD.
Urinary Tract Injuries in Abdominal, Laparoscopic and Robotic Surgery: a Comprehensive Review.
Polykalas S, Chronopoulou A, Bompoula MS … +5 more , Garmpis N, Damaskos C, Tsourouflis G, Kykalos S, Dimitroulis D
Maedica (Bucur) · 2025 Jun · PMID 40880719 · Full text
BACKGROUND/AIM: Urinary tract injuries (UTIs) are a significant complication in abdominal, laparoscopic and robotic surgeries. Due to the proximity of the urinary tract to critical structures, procedures like colorectal...
BACKGROUND/AIM: Urinary tract injuries (UTIs) are a significant complication in abdominal, laparoscopic and robotic surgeries. Due to the proximity of the urinary tract to critical structures, procedures like colorectal surgery, hysterectomy and prostatectomy pose risks. Minimally invasive techniques like laparoscopy and robotic surgery offer benefits but introduce unique challenges. This review explores the incidence, risk factors and management strategies for UTIs across surgical approaches. MATERIALS AND METHODS: A systematic review of PubMed, Embase and Web of Science was conducted. Studies on abdominal, gynecological, and urological surgeries reporting UTIs were included. After screening, 17 studies published between 1990 and 2024 were analyzed. The PRISMA method was used for selection and data extraction. RESULTS: The incidence of UTI varies by surgery type: for open surgery, higher rates (0.5%-3.0%) were recorded due to invasive techniques and longer operative times, particularly in colorectal surgeries and hysterectomies. In laparoscopic surgery, a lower incidence (0.1%-1.0%) was noted, though thermal injury and visualization challenges remain. Finally, in robotic surgery, incidence ranges from 0.2% to 1.5%, with enhanced precision reducing the risk of UTIs in complex surgeries like prostatectomy and hysterectomy. CONCLUSION: The primary causes of UTIs include direct trauma, thermal injury and postoperative ischemia. Advanced technologies like robotic systems and intraoperative imaging reduce risks but require surgeon expertise. Preventing UTIs in surgery involves meticulous planning, advanced intraoperative technologies and comprehensive postoperative care. Continued research into minimally invasive techniques will further reduce complication rates and improve patient outcomes.
Corneal Topography - a Review of Available Investigation Methods and Impact in the Diagnosis and Follow-Up of Keratoconus.
Dina MS, Marinescu MC, Corbu CG … +3 more , Constantin MM, Tataru CI, Tataru CP
Maedica (Bucur) · 2025 Jun · PMID 40880718 · Full text
Keratoconus is a bilateral non-inflammatory ectatic disease of the cornea, with an asymmetrical evolution, that occurs in young people during puberty, progressing during the second and third decades and stabilizing aroun...
Keratoconus is a bilateral non-inflammatory ectatic disease of the cornea, with an asymmetrical evolution, that occurs in young people during puberty, progressing during the second and third decades and stabilizing around the age of 40. It is characterised by an insidious and progressive thinning of the cornea, myopia and astigmatism, which lead to a decrease in visual acuity. Slit-lamp examination findings in the early stages of keratoconus may appear normal. However, in advanced stages of untreated keratoconus, visual acuity is diminished, which leads to a lower quality of life. Corneal topography is essential in the early diagnosis of the disease, analyzing the corneal geometry and thus helping to establish the method of treatment and to follow patients' evolution. This investigation combines the projection of a light source and a video capture system of corneal images with computer processing, providing maps of the distribution of dioptric power over the entire surface of the cornea. Topography can be classified into measuring the anterior surface of the cornea (keratometry and reflection-based topography) as well as both the anterior and posterior surfaces of the cornea (Scheimpflug slit-lamp scanning and pinhole optics). Understanding and reading corneal topographies is essential in correctly diagnosing and staging a keratoconus case. The present review constitutes a comprehensive evaluation of available methods and expected typical results and interpretation, in order to support clinicians in better managing this underdiagnosed ectasia affecting young patients.
Effect of Dietary Intervention in Paediatric Patients with Chronic Spontaneous Urticaria: Open Labelled Randomised Controlled Trial.
Kapat A, Murmu R, Mandal S … +3 more , Biswas K, Sarma N, Bala AK
Maedica (Bucur) · 2025 Jun · PMID 40880715 · Full text
OBJECTIVES: Chronic spontaneous urticaria (CSU) is a skin disorder characterized by itchy wheal, angioedema or both that persists for over six weeks. 'Pseudoallergens' in food induce hypersensitive reactions similar to t...
OBJECTIVES: Chronic spontaneous urticaria (CSU) is a skin disorder characterized by itchy wheal, angioedema or both that persists for over six weeks. 'Pseudoallergens' in food induce hypersensitive reactions similar to true allergic reactions and are linked to CSU. These consist of food additives, vasoactive amines (histamine) and a few natural substances in fruits, vegetables and spices. This study aimed to investigate if dietary restriction (pseudoallergen-free and low histamine diet) can improve the clinical outcome in paediatric CSU patients. MATERIALS AND METHODS: The present open-label randomized control trial was conducted in a paediatric tertiary care centre of Eastern India from September 2021 to August 2022. Paediatric CSU patients (n=140) attending the centre were randomly allocated to one of two treatment interventions: DR group (n=70, drug) or DRDI group (n=70, drugs and dietary intervention). Both groups were compared at baseline. The weekly urticaria activity score (UAS7) was calculated by trained parents. All data were entered in an Excel spreadsheet. T-test was used to compare the UAS7 of both groups at baseline, three and six weeks of treatment. RESULTS: There was no significant difference in demographic characteristics, clinical features, laboratory parameters and weekly urticaria activity score (UAS7) between groups at baseline. After six weeks of treatment, the UAS7 of patients in the DRDI group was lower as compared to those in the DR group (8.80±4.27 vs 10.19±4.66), though statistically insignificant (t=1.79, p=0.07). CONCLUSION: Pseudoallergen-free diet is a safe and cost-effective measure to decrease CSU patients' symptoms.
The Importance of Diet in Patients with Obstructive Sleep Apnea Syndrome and Continuous Positive Airway Pressure Therapy - a Case Report.
Burcea R, Mihaltan FD
Maedica (Bucur) · 2025 Jun · PMID 40880713 · Full text
INTRODUCTION: The increase in the proportion of obese patients in both paediatric and elderly populations worldwide made obstructive sleep apnea syndrome (OSAS) an important contributor to the range of comorbidities enco...
INTRODUCTION: The increase in the proportion of obese patients in both paediatric and elderly populations worldwide made obstructive sleep apnea syndrome (OSAS) an important contributor to the range of comorbidities encountered in the current population. Continuous positive airway pressure (CPAP) therapy is the main treatment for OSAS and it has an effect in decreasing the severity of OSAS, with decreasing the apnea hypopnea index (AHI) and improving hypoxemia. RESULTS: and discussion: We present the case of a 48-year-old woman with newly diagnosed severe OSAS for which she was on CPAP therapy. After the patient followed a diet and had a significant weight loss, her symptomatology improved and overnight cardiorespiratory polygraphy showed a decrease in nocturnal respiratory events. This demonstrates the important role that weight loss plays in certain diseases - in this case, in a patient with OSAS. CONCLUSIONS: Losing weight can have important benefits in many diseases. In OSAS, weight reduction is associated with significant improvement in symptoms and nocturnal respiratory events, including apnea and hypopnea.
Exploring the Knowledge and Attitudes of Physicians on Polypharmacy and Deprescribing in Clinical Practice: a Cross-Sectional Study.
Eerike M, Raj GM, Rajendran P … +18 more , Nayak V, Mathai P, Karra VK, Varatharajan S, Priyadarshini R, Ramaswamy G, Gunasekaran V, Selvaraj J, Selvarajan S, Chandran A, Kattimani S, Potangadi R, Kunhipilakkandiy SP, Veettil NP, Rao R, Prabhu M, Cherian JJ, Anand T
Maedica (Bucur) · 2025 Jun · PMID 40880710 · Full text
UNLABELLED: Objective: Polypharmacy, defined as the use of five or more medications, is increasingly prevalent among geriatric patients due to the complexity of managing multiple chronic conditions. This study aimed to e...
UNLABELLED: Objective: Polypharmacy, defined as the use of five or more medications, is increasingly prevalent among geriatric patients due to the complexity of managing multiple chronic conditions. This study aimed to evaluate physicians' knowledge of deprescribing, their familiarity with deprescribing tools and the factors influencing the deprescribing process. MATERIALS AND METHODS: This cross-sectional survey was conducted among 290 physicians from four prominent tertiary care centers in South India between October 2023 and March 2024. A self-administered semi-structured questionnaire was employed to evaluate physicians' knowledge of polypharmacy, attitudes toward fall-risk-increasing drugs (FRIDs) and practices related to deprescribing interventions. Data collection was managed using Microsoft Excel, while descriptive and bivariate analyses were performed using SPSS to analyze the findings. RESULTS: The study revealed that a majority of physicians (148; 51.0%) were unfamiliar with the term "deprescribing" and reported no formal training in the practice. Analysis based on physicians' knowledge scores showed that participants with higher scores (≥28) demonstrated significantly greater awareness of the Tool to Improve Medications in the Elderly via Review (TIMER) and Fit fOR The Aged (FORTA) list compared to those with lower scores. Among these more knowledgeable physicians, 48.1% (n=13; p=0.054) were aware of TIMER but had not utilized it in practice, while 33.3% (n=9; p=0.016) reported familiarity with the FORTA list without its practical application. CONCLUSION: Deprescribing plays a vital role in managing polypharmacy and minimizing its associated risks in the aging population. However, its adoption is constrained by significant barriers, including a lack of awareness, insufficient formal training and limited integration of evidence-based deprescribing tools into clinical practice.
Anthropometric Cadaveric Analysis of the Quadrangular Space and Deltoid Region: Anatomical Perspectives for Clinical Applications in the Indian Population.
Charmode SH, Mishra AK, Mehra S
Maedica (Bucur) · 2025 Jun · PMID 40880708 · Full text
BACKGROUND: Neurovascular structures beneath the deltoid, particularly the axillary nerve and posterior circumflex humeral artery, are vulnerable to injury from intramuscular injections or compression in the quadrangular...
BACKGROUND: Neurovascular structures beneath the deltoid, particularly the axillary nerve and posterior circumflex humeral artery, are vulnerable to injury from intramuscular injections or compression in the quadrangular space, especially in overhead athletes. Studies by Kakati et al (2013) and Desai et al (2019) report intramuscular injection-related nerve injury rates of 1.5% to 15% and 82.5%, respectively. However, there is a lack of cadaveric studies in the Indian population, prompting this anthropometric study. AIM: Aims and objectives: This study aims to assess the dimensions of the quadrangular space and examine the branching pattern of the axillary nerve and its relationship with the posterior circumflex humeral artery. METHODS: This two-year cross-sectional study, approved by the Institutional Ethical Committee (Protocol ID: F-IM/15/2023), was conducted at AIIMS Rajkot in collaboration with Orthopaedics. Anthropometric measurements of the quadrangular space (height, width, and depth), deltoid muscle, distances of the axillary nerve and posterior circumflex humeral artery from the origin point and AXN-PCHA relationship patterns were obtained from 12 (seven male and five female) cadavers using vernier callipers. RESULTS: Among the 24 specimens, type 1 branching pattern was the most common, observed in 12 specim ens (50 %), followed by type 2 in six specimens (25%), type type-3 in five specimens (21%), and type 4 in one specimen (0.041%). The dimensions of quadrangular space varied, with height ranging from 4.28 mm to 5.57mm, width from 10.57 mm to 13.75 mm, and depth from 9.97 mm to 12.84 mm. CONCLUSION: The mean dimensions (in mm) of the quadrangular space in males and females were 4.77 for height, 11.79 for width, and 11.01 for depth. The type-1 branching pattern was the most frequently observed.
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