Observation of Medium-Induced Yield Enhancement and Acoplanarity Broadening of Low-p_{T} Jets from Measurements in pp and Central Pb-Pb Collisions at sqrt[s_{NN}]=5.02 TeV

The ALICE Collaboration reports the measurement of semi-inclusive distributions of charged-particle jets recoiling from a high transverse momentum (high p_{T}) hadron trigger in proton-proton and central Pb-Pb collisions at sqrt[s_{NN}]=5.02  TeV. A data-driven statistical method is used to mitigate the large uncorrelated background in central Pb-Pb collisions. Recoil jet distributions are reported for jet resolution parameter R=0.2, 0.4, and 0.5 in the range 7 Collapse

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Emergence of Long-Range Angular Correlations in Low-Multiplicity Proton-Proton Collisions

This Letter presents the measurement of near-side associated per-trigger yields, denoted ridge yields, from the analysis of angular correlations of charged hadrons in proton-proton collisions at sqrt[s]=13  TeV. Long-range ridge yields are extracted for pairs of charged particles with a pseudorapidity difference of 1.4<|Δη|<1.8 and a transverse momentum of 1 Collapse

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Lip Print Pattern among Children Visiting Dental Out patient department

BACKGROUND

Lip print patterns are unique in every individual. The uniqueness of lip print pattern assists in the personal identification. The objectives of the present study were to study the different lip print patterns among the children visiting Kanti Children's Hospital, and to compare the distribution of lip print patterns based on gender and race.

METHODS

A cross-sectional study was conducted among 300 children visiting the Dental Outpatient Department of Kanti Children's Hospital, Kathmandu, Nepal. Convenience sampling method was used to choose the study subjects. Digital photography method was used to record the image of lips.

RESULTS

The study showed 'Long vertical' (Type I) as the most frequent (41%) type of lip print pattern, whereas 'Unspecified' (Type V) was the least frequent (2.7%) type. Prevalence of 'Type I' pattern was significantly higher in males as compared to females (p=0.007) whereas prevalence of 'Type IV' pattern was significantly higher in females as compared to males (p=0.006). 'Type I' pattern was the commonest lip print pattern among both Caucasians and Mongolian, whereas 'Type V' (2%) and 'Type IV' (3.7%) were the least common lip print patterns in Caucasians and Mongolian children respectively.

CONCLUSIONS

'Long vertical' (Type I) was the most common lip print pattern among the children visiting the Dental Outpatient Department of Kanti Children's Hospital, Kathmandu, Nepal. Nevertheless, in higher or lesser numbers, all kinds of lip print patterns as described by Suzuki and Tsuchihashi were seen in the study population.

Delayed replantation of avulsed permanent maxillary central incisor: Case report with 6-year follow-up

Replantation should be attempted in any case of avulsion, be it immediate or delayed. Retention of the replanted tooth helps in preservation of adjacent alveolar bone. Despite the occurrence of replacement resorption, the tooth can stay healthy and functional in the arch for a longer duration.

Assessment of dental caries based on ICDAS and WHO criteria: A comparative study

BACKGROUND

The decayed, missing, and filled teeth (DMFT/dmft) index recommended by the World Health Organization (WHO), which measures the prevalence of caries based on the presence of cavitated caries lesions, is the most used dental caries index in epidemiological studies. Early diagnosis of noncavitated carious lesions enables preventive measures, which has the potential to prevent dental caries-related morbidity and reduce the financial burden associated with restorative or rehabilitative dental care. The International Caries Detection and Assessment System (ICDAS II) incorporates both the cavitated and noncavitated carious lesions with acceptable reliability.

AIM

To compare dental caries prevalence based on ICDAS II and WHO criteria.

DESIGN

A cross-sectional study was conducted among 362 children visiting People's Dental College and Hospital, Nayabazar, Kathmandu, Nepal to study dental caries prevalence based on the ICDAS II and WHO criteria.

RESULTS

Among the study population, 290 (90.34%) and 169 (68.42%) children had dental caries in primary and permanent teeth according to the ICDAS II criteria, whereas according to WHO criteria, 267 (83.18%) and 107 (43.32%) had dental caries in primary and permanent teeth, respectively. The prevalence of dental caries was significantly higher (p < .001) according to ICDAS II criteria than the prevalence based on WHO criteria in both dentitions.

CONCLUSION

This study showed a significant difference in dental caries prevalence between the ICDAS II and WHO methods of caries diagnosis. The presence of noncavitated carious lesions was alarming. To enable detection of early/noncavitated carious lesions, ICDAS II rather than WHO criteria of caries diagnosis may be a more a valuable tool.

Detection of early Alzheimer's disease-like molecular alterations in a mouse model expressing human ApoE4

The E4 allele of apolipoprotein E (ApoE4) is a key genetic risk factor for late-onset Alzheimer's disease (AD), increasing the risk of developing the disease by up to three-fold. However, the mechanisms by which ApoE4 contributes to AD pathogenesis are poorly understood. Here, we utilize a mouse model expressing either human ApoE3 or human ApoE4 to examine the effects of the E4 allele on a wide range of genetic and molecular pathways that are altered in early AD pathology. We demonstrate that ApoE4-expressing mice begin to show early differential expression of multiple genes, leading to alterations in downstream pathways related to neural cell maintenance, insulin signaling, amyloid processing and clearance, and synaptic plasticity. These alterations may result in the earlier accumulation of pathological proteins such as β-amyloid that may build up within cells, leading to the accelerated degeneration of neurons and astrocytes as observed in ApoE4-positive individuals. We also examine the metabolic effects associated with a high-fat diet (HFD) in male ApoE4-expressing mice compared with regular chow diet (RD) fed mice at different ages. We found that young ApoE4-expressing mice fed HFD developed metabolic disturbances, such as elevated weight gain, blood glucose, and plasma insulin levels that cumulatively have been observed to increase the risk of AD in humans. Taken together, our results reveal early pathways that could mediate ApoE4-related AD risk and may help identify more tractable therapeutic targets for treating ApoE4-associated AD.

Fabrication of Feeding Plate in Neonates with Cleft Lip and Palate: Case Series

Cleft lip and palate (CLP) is a common craniofacial anomaly which can be syndromic or non-syndromic. In children with CLP, feeding is the biggest concern due to lack of oral seal owing to the presence of clefts in the oral cavity. To achieve a near normal feeding, feeding plates are delivered to restore the separation thus helping to create negative intraoral pressure during suckling. Impression making for the fabrication of feeding plate is incredibly challenging procedure but selection of appropriate impression material, patient positioning during impression making and preparation for management of emergency mishaps can make the procedure easier and safer. Present case series highlights the fabrication and delivery of feeding plates made up of two different materials (Ethylene vinyl acetate and self-cure acrylic resin) in three neonates who were four, fourteen and five days old.

Exercise induced muscle damage and repeated bout effect: an update for last 10 years and future perspectives

Exercise-induced muscle damage (EIMD) and repeated bout effect (RBE) are widely researched across various populations. EIMD is the muscle damage occurring after one bout of unaccustomed exercise while RBE is the attenuation of the same muscle damage in subsequent second bout. RBE seems to have significant implications for exercise prescription. Despite existence of vast literature, there is lack of clarity on the effects of EIMD and RBE in a healthy population. The purpose of this study is to review the literature on EIMD and RBE in healthy participants published during the last 10 years. The search of major databases (including Scopus, Google Scholar and PubMed) was conducted using specific keywords ‘Exercise induced muscle damage’, ‘Repeated bout effect’, ‘Healthy participants’ ‘Pre-conditioning’, ‘Eccentric exercise’. Studies published from 2011 onwards which included EIMD and RBE assessment in healthy participants were included in this review. Database searching revealed a total of 38 studies on EIMD and RBE in healthy participants. Three major themes of papers were identified that focused on EIMD and RBE along with (1) age related differences, (2) sex-based differences, and (3) response in athletes. Findings of this comprehensive review suggests that both EIMD and RBE are age, and sex specific. Delayed onset muscle soreness played a major role in both EIMD and RBE in all the population types. Female participants are less susceptible to EIMD as compared to age-matched male counterparts. Moreover, both EIMD and RBE are more elicited in middle aged and younger adults as compared to children and older adults while the magnitude of RBE turns out to be minimal in trained individuals due to persisting adaptations.

Compound odontoma: A case report on 42 denticles hodgepodge in maxilla

Compound odontomas are the commonest benign odontogenic tumours of jaws affecting mostly children and adolescents. These developmental malformations display many tooth-like structures or denticles that consist of well-defined dental tissues with diverse morphologies. Majority of these lesions occur as intraosseous masses in the maxillary anterior region and are incidental radiographic findings. These are primarily associated with retention of primary teeth and delayed eruption of permanent teeth. The preferred treatment for these lesions is conservative surgical excision followed by a histopathological diagnosis. This case report presents a rare case of compound odontoma displaying numerous denticles (42 in number) in the maxillary anterior region of a 12-year-old male child and its surgical management.

Severe acute pancreatitis in the early postoperative period due to afferent loop syndrome following gastrectomy for gastric cancer

Afferent loop syndrome (ALS) is an uncommon complication of gastrojejunostomy. It may be acute or chronic depending on whether symptoms manifest within 7 days of surgery. Rarely acute ALS may give rise to acute pancreatitis. It may present early in the postoperative course and, if diagnosed late, may result in organ failure within 48h. We report a middle-aged woman with carcinoma of the stomach managed by subtotal gastrectomy with Billroth II gastrojejunostomy and Braun jejunojejunostomy. The patient developed vomiting and abdominal pain in the first postoperative day with acute renal shutdown and about 500ml drain output of dirty fluid. On investigation, a diagnosis of acute pancreatitis due to afferent loop syndrome was made, and the patient was resuscitated in the intensive care unit. However, she showed early signs of organ failure and succumbed to her condition within 6 days of surgery. Since the complication is rare following gastrojejunostomy and often mimics ALS, an early diagnosis becomes difficult. If delay in management happens, premature organ failure may lead to high morbidity and mortality.

Long-Term Variation in Carbonaceous Components of PM2.5 from 2012 to 2021 in Delhi

Carbonaceous species [organic carbon (OC), elemental carbon (EC), elemental matter (EM), primary organic carbon (POC), secondary organic carbon (SOC), total carbon (TC), and total carbonaceous matter (TCM)] of PM_2.5 were analyzed to study the seasonal variability and long-term trend of carbonaceous aerosols (CAs) in megacity Delhi, India from January, 2012 to April, 2021. The average concentrations (± standard deviation) of PM_2.5, OC, EC, TC, EM, TCM, POC and SOC were 127 ± 77, 15.7 ± 11.6, 7.4 ± 5.1, 23.1 ± 16.5, 8.2 ± 5.6, 33.3 ± 23.9, 9.3 ± 6.3 and 6.5 ± 5.3 µg m^-3, respectively during the sampling period (10-year average). The average CAs accounted for 26% of PM_2.5 concentration during the entire sampling period. In addition, the seasonal variations in PM_2.5, OC, EC, POC, SOC, and TCM levels were recorded with maxima in post-monsoon and minima in monsoon seasons. The linear relationship of OC and EC, OC/EC and EC/TC ratios suggested that the vehicular emissions (VE), fossil fuel combustion (FFC) and biomass burning (BB) are the major sources of CAs at megacity Delhi, India.

164 Testicular Torsion: A Race to Beat the Golden Hours

Introduction

Testicular torsion is a condition requiring immediate attention and the golden time period for its management is 6 hours at which rate of salvageability of the testes is 90 percent (NICE). This decreases considerably with passing time. Imaging has minimal value.

Method

The electronic data of 36 patients from June 2020 to May 2021 were reviewed and analysed. Majority of patients were between the age of 11–20 i.e., 21. We analysed the mode of admission of these patients, the time between the A&E triage and surgical clerking and A&E triage and induction of anaesthesia.

Results

Majority (70 percent) patients were admitted through Emergency A&E. The time between the A&E triage and surgical clerking was less than 30 minutes for 10 patients while 11 patients had no proper documentation of time. The time between the A&E triage and the induction of anaesthesia was less than 6 hours in 23 patients, and more than 6 hours for 7 of them. 14 underwent Scrotal Exploration and Bilateral orchidopexy and 13 orchidectomies. Out of 13 orchidectomies, 6 had crossed the golden time period at the time of induction. Out of 10 patients booked for USS testis, 8 underwent Orchidectomy and 6 had crossed the golden hour (6 Hours).

Conclusions

Early presentation, diagnosis and exploration of testicular torsion improves the salvable rate of testes. 6 patients who underwent USS testis passed the golden timeframe which shows that there is a scope for faster and appropriate management of testicular torsion.

Nodular regenerative hyperplasia in X-linked agammaglobulinemia: An underestimated and severe complication

BACKGROUND

Late-onset complications in X-linked agammaglobulinemia (XLA) are increasingly recognized. Nodular regenerative hyperplasia (NRH) has been reported in primary immunodeficiency but data in XLA are limited.

OBJECTIVES

This study sought to describe NRH prevalence, associated features, and impact in patients with XLA.

METHODS

Medical records of all patients with XLA referred to the National Institutes of Health between October 1994 and June 2019 were reviewed. Liver biopsies were performed when clinically indicated. Patients were stratified into NRH+ or NRH- groups, according to their NRH biopsy status. Fisher exact test and Mann-Whitney test were used for statistical comparisons.

RESULTS

Records of 21 patients with XLA were reviewed, with a cumulative follow-up of 129 patient-years. Eight patients underwent ≥1 liver biopsy of whom 6 (29% of the National Institutes of Health XLA cohort) were NRH+. The median age at NRH diagnosis was 20 years (range, 17-31). Among patients who had liver biopsies, alkaline phosphatase levels were only increased in patients who were NRH+ (P = .04). Persistently low platelet count (<100,000 per μL for >6 months), mildly to highly elevated hepatic venous pressure gradient and either hepatomegaly and/or splenomegaly were present in all patients who were NRH+. In opposition, persistently low platelet counts were not seen in patients who were NRH-, and hepatosplenomegaly was observed in only 1 patient who was NRH-. Hepatic venous pressure gradient was normal in the only patient tested who was NRH-. All-cause mortality was higher among patients who were NRH+ (5 of 6, 83%) than in the rest of the cohort (1 of 15, 7% among patients who were NRH- and who were classified as unknown; P = .002).

CONCLUSIONS

NRH is an underreported, frequent, and severe complication in XLA, which is associated with increased morbidity and mortality.

648 The Use of Antibiotics in Acute Pancreatitis - A Re-Audit of Current Practice

Introduction

The NICE guidelines do not advocate the use of prophylactic antibiotics in the management of acute pancreatitis. In severe pancreatitis with necrosis, local antimicrobial guidelines state that it ‘maybe reasonable to use antibiotics with good spectrum anaerobic cover’ and suggest the use of Amoxycillin, Metronidazole and Gentamicin as first line, and Meropenem as second line if needed. Previous audit showed 74% of patients receiving antibiotics without clear indication.

Method

A retrospective re-audit of the use of antibiotics in patients admitted with a clinical or radiological diagnosis of acute pancreatitis was undertaken in a single-centre University Hospital between July and October 2020.

Results

78 patients were admitted during this period, with a mean age of 52years (range 6-89 years), and male preponderance. All patients were conservatively managed with intravenous fluids, analgesics and antiemetics. 31(40%) received intravenous antibiotics, of whom, 14 (45%) had no clearly documented indication for their use. The remaining 17 had pancreatic necrosis (4), cholangitis/cholecystitis (4), infected pseudocyst (2), UTI (2), fever spike (1), positive blood cultures (1) and pancreaticoduodenal fistula (1). Metronidazole was the most commonly used antibiotic (58%), followed by Amoxicillin (38.7%), Co-amoxiclav (35.4%), Gentamicin (22.5%) and Meropenem (22.5%).

Conclusions

In line with the recommendations made from previous audit and improved awareness, there was a significant improvement in the number of patients receiving antibiotics without indications from 74% to 45%. We hereby stress the importance of the use of appropriate clinical judgement in decision-making and avoiding the unwarranted use of antibiotics in acute pancreatitis.

1450 Relationship between Spinopelvic Parameters and Symptomatic Femoroacetabular Impingment: A Scoping Review

Aim

Reports have shown that spinopelvic mobility influences the outcome following total hip arthroplasty. The aim of this scoping review was to investigate the relationship between spinopelvic parameters (SPP) and symptomatic femoroacetabluar impingement (FAI).

Method

A systematic computer search of EMBASE, PubMed and Cochrane for literature related to SPPs and FAI was undertaken as per PRISMA guidelines. Clinical outcome studies and prospective/retrospective studies that investigated the role of SPPs in symptomatic FAI were included. Review articles, case reports and book chapters were excluded. Information extracted pertained to symptomatic cam deformities, pelvic tilt, deviations in acetabular version, decreases in pain-free hip range of motion (ROM) on dynamic hip movements and radiological signs of FAI.

Results

The literature search identified 46 papers out of 1168 investigating the link between SPPs and pathological processes characteristic of FAI. Anteior pelvic tilt was associated with radiographic over-coverage parameters of FAI. Three studies associated FAI pathology with a greater pelvic incidence (PI), while four associated it with a smaller PI. In dynamic movements, decreased posterior pelvic tilt and reduced saggital pelvic ROM was found in symptomatic FAI patients during hip flexion.

Conclusions

Our study shows that spinopelvic parameters can influence radiological and clinical manifestations of FAI, with pelvic incidence, acetabular version and muscular imbalances being aetiologically implicated. Individual spinopelvic mobility may predispose to the development of FAI, which may be amenable to non-surgical management. If FAI pathoanatomy already exists however, sagittal pelvic parameters can influence whether FAI symptoms develop, and the extent to which they do so.

Versatility Of Square Flaps In Post-Burn Contractures Involving Upper Limb

Post-burn contractures are a common problem and functionally limiting for upper limbs. Many different techniques have been described in the literature for their treatment. Z-plasty and release with SSG cover are the commonest procedures done for post-burn contractures. In this study we assess the use of the square flap technique in post-burn contractures of upper limb. Eleven patients with a total number of twelve upper limb contractures (mild to moderate) involving axilla, elbow and finger underwent release by standard square flap technique. All cases were followed up for at least 6 months and analyzed for range of motion and aesthetic outcome. Patient and surgeon satisfaction was recorded. All operated cases achieved a satisfactory range of movement post-operatively without any recurrence. The number of patients who were satisfied with the surgery were 7 out of 11, and 4 patients were somewhat satisfied with the results obtained. In contrast, the surgeons were satisfied in all cases. Square flap is shown to be an easy and reliable flap for mild to moderate contractures of the anterior or posterior axillary folds, elbow contractures and finger contractures with low recurrence rate.

Pharmacological actions and underlying mechanisms of Catechin: A review

BACKGROUND

Catechin is a phytochemical and is a major component of our daily use beverages, which has shown great potential in improving general health and fighting against several medical conditions. Clinical studies have confirmed its effectiveness in conditions ranging from acute upper respiratory tract infection, neuroprotection, to cardio-protection effects. Though most studies relate their potential to anti-oxidative action and radical scavenging action, still the mechanism of action is not clearly understood.

OBJECTIVE

The present review article is focused on addressing various pharmacological actions and underlying mechanisms of catechin. Additionally, we will try to figure out the major adverse effect and success in trials with catechin and lead to a conclusion for its effectiveness.

METHODS

This review article is based on the recent/ most cited papers of PubMed and Scopus databases.

DESCRIPTION

Catechin can regulate Nrf2 and NFkB pathways in ways that impact oxidative stress and inflammation by influencing gene expression. Other pathways like MAPKs and COMT and receptor tyrosine kinase are also affected by catechin and EGCG that alter their action and barge the cellular activity. This review article explored the structural aspect of catechin and its different isomers and analogs. It also evaluated its various therapeutic and pharmacological arrays .

CONCLUSION

Catechin and its stereo-isomers have shown their effectiveness as anti-inflammatory, anti-diabetic, anti-cancer, anti-neuroprotective, bactericidal, memory enhancer, anti-arthritis, and hepato-protective mainly through its activity to alter the pathway by NF-κB, Nrf-2, TLR4/NF-κB, COMT, and MAPKs.

Oral semaglutide in the management of type 2 DM: Clinical status and comparative analysis

BACKGROUND

In the incretin system, Glucagon-like peptide-1 (GLP-1) is a hormone that inhibits the release of glucagon and regulates glucose-dependent insulin secretion. In type 2 diabetes, correcting the impaired incretin system using GLP-1 agonist is a well-defined therapeutic strategy.

OBJECTIVES

This review article aims to discuss the mechanism of action, key regulatory events, clinical trials for glycaemic control and comparative analysis of semaglutide with the second-line antidiabetic drugs.

DESCRIPTION

Semaglutide is a glucagon-like peptide 1 (GLP 1) receptor agonist with enhanced glycaemic control in diabetes patients. In 2019, USFDA approved the first oral GLP-1 receptor agonist, semaglutide to be administered as a once-daily tablet. Further, recent studies highlight the ability of semaglutide to improve the glycaemic control in obese patients with a reduction in body weight. Still, in clinical practice, in type 2 DM treatment paradigm the impact of oral semaglutide remains unidentified. This review article discusses the mechanism of action, pharmacodynamics, key regulatory events, and clinical trials regarding glycaemic control.

CONCLUSION

The review highlights the comparative analysis of semaglutide with the existing second-line drugs for the management of type 2 diabetes mellitus by stressing on its benefits and adverse events.