Insight about the biochemical composition, postharvest processing, therapeutic potential of Indian gooseberry (amla), and its utilization in development of functional foods-A comprehensive review

Indian gooseberry/Amla (Emblica officinalis Gaertn. syn. Phyllanthus emblica L) has an amazing nutritional profile and is a reservoir of biologically active compounds which have potential health benefits and are regarded as a remedy for lethal diseases. The unique features of amla, conferred by their bioactive components, have extended future prospects about their usage for useful effects on human nutrition and health globally. With the rapidly growing popularity of this unique therapeutic fruit, it is important to have comprehensive knowledge of this fruit. The current review article presents the nutritional profile, bioactive components, antioxidant and antimicrobial properties, and postharvest processing of amla fruit. Moreover, studies related to therapeutic properties of amla and its utilization in development of functional foods have been presented in this review. E. officinalis is a promising source of bioactive compounds which showed varied potential in the management of a number of human ailments which has been proven through various studies. Therefore, amla should be taken in the regular diet, thereby utilizing its potential health benefits. PRACTICAL APPLICATIONS: Amla (Indian gooseberry), as source of natural bioactive compounds, has a great potential application in improving the status of human nutrition and health. The utilization of amla extract has various biological effects, like antimicrobial, antioxidant, gastroprotective, anticancer, hepatoprotective, cardioprotective, radioprotective, anti-inflammatory, antidiabetic, neuroprotective, and immunomodulatory effect, owing to its bioactive components. The use of amla extract has recently increased in food, pharmaceutical, and cosmetic products to replace synthetic antioxidants which have inherent harmful health effects. The review report will provide information on bioactive components, therapeutic properties, utilization of amla in the development of future functional foods, and postharvest processing of amla, which will provide critical information to researchers all over the world.

Physiochemical, sensorial and rheological characteristics of puree developed from Kashmiri peaches: influence of sugar, KMS and storage conditions

The present investigation was undertaken to develop puree from peaches and to study the effect of peel, sugar, KMS concentrations and storage conditions on the acidity, pH, total soluble solids, total sugar and rheological behavior of purees. Two types of Purees (Peeled and unpeeled) were prepared by adding sugar (10% and 15%) and KMS (100ppm, 200ppm, 300ppm). A decrease in viscosity with an increase in shear rate was observed. The developed purees were stored at refrigerated and ambient conditions for 45 days and were analyzed at 15 days interval. During the storage period, there was a change in G' and G"and the changes in pH and TSS were observed. The highest decrease in G' and G" was observed in P_{1 and} P₀ at ambient storage. The overall organoleptic score of all samples was acceptable, however, the organoleptic score of the P₇ at refrigerated conditions was highest.

Indications of implant removal: A study of 83 cases

INTRODUCTION

Fracture fixation has become advanced with the advent of new and custom metal implants for each type of bone/fracture. After union though, the implant ceases to be important and may be removed. Routine removal is advocated by some and opposed by others. Nevertheless, some patients require removal of the hardware because of various implant-related problems. Our study was aimed at identifying the most common causes for implant removal.

OBJECTIVE

To investigate the common indications of orthopedic implant removal surgeries.

METHODS

Adult patients admitted for implant removal in our department were included in the study. They were operated in the next OT list. They were then followed for an average 4 months for resolutions of symptoms or appearance of new problems.

RESULTS

A total of 83 patients were studied. 71 of them were males. The mean age was 38 years. The reasons for removal of implants were found to lie in five categories: Pain/discomfort/prominent hardware, infected hardware, implant failure, elective (patient's insistence), and other reasons. Overall, the most frequently removed implants in our series were distal tibial/ankle plates (14.45% of implants removed), femoral intramedullary (IM) nails (13.25%), olecranon wires and plates (12.04%), and tibial IM nails and patellar tension band wirings (9.53% each).

DISCUSSION AND CONCLUSION

The clinical indications of implant removal are not well established, and few definitive data exist to guide whether routine implant removal is appropriate. Symptomatic hardware frequently needs removal. We found that pain and implant prominence (mechanical symptoms) are the most common indications. Infection is the next most common, followed by hardware failure. Other indications are implant failure, bone resorption due to excessive stress shielding and patient's will. Removal is, however, not an easy surgery, and several factors such as bone ingrowth and wear of the implant may make its removal difficult.

Endoscopic laser cricopharyngeal myotomy to salvage tracheoesophageal voice after total laryngectomy

Development of voice after tracheoesophageal puncture, following laryngectomy, is sometimes hampered by spasm of the cricopharyngeal muscle. This problem has been addressed by various means, including bougienage, botulinum toxin injection, and open surgical division of the muscle. We believe that endoscopic carbon dioxide laser cricopharyngeal myotomy represents a direct, simple, and effective solution.

A prospective study of the effects of irradiation on the carotid artery

OBJECTIVES/HYPOTHESIS

To prospectively assess the effects of irradiation on the carotid artery in patients with head and neck cancer, as a possibly relevant factor in cancer treatment planning.

STUDY DESIGN

Prospective study from a tertiary care academic setting on university (22 patients) and Veterans Affairs (14 patients) hospital patients; 1-year follow-up, including comparison of study data with age-matched and sex-matched control subjects from epidemiological studies.

METHODS

Thirty-six patients with head and neck cancer who underwent therapeutic neck irradiation were examined by high-resolution ultrasound before and 1 year after treatment. Twelve patients were also studied at 2 years. Measurements included the intima-media thickness (IMT) of the carotid artery wall, the degree of stenosis as estimated from velocity measurements, and the presence and size of plaque.

RESULTS

The pretreatment carotid IMT at baseline was 0.68 mm and was comparable to age-matched and sex-matched control subjects. Significant increase in the IMT was observed on both the left (0.67 vs. 0.84 mm) and the right (0.7 vs. 0.87 mm) sides (P < .001) 1 year after irradiation. In 12 patients who completed 24 months of follow-up the carotid IMT continued to significantly increase statistically compared with that at the first year after treatment (left side, 0.79 vs. 0.85 mm, P = .037; right side, 0.79 vs. 0.95 mm, P = .014). Statistically significant thickening of the carotid wall developed in all 36 patients by 1 year. Two patients experienced post-treatment neurological events and an area of stenosis greater than 75%.

CONCLUSIONS

Neck irradiation significantly increases the thickness of the carotid wall during the first year after treatment--on average, 21 times more than in epidemiologically matched control volunteers. This phenomenon should be taken into consideration when planning treatment for the node-negative (NO) neck.

Thorotrast (thorium dioxide) granuloma of the neck: Surgical considerations

Summary--Thorotrast (thorium dioxide) is a contrast material which was first used for angiography about 40 years ago. Its use was discontinued because of the reported incidences of malignancy following injection. Its long-term effects are related to its long half-life and slow excretion rate. Following extravasation into the soft tissues of the neck, the prolonged radiation effect results in tissue breakdown with formation of granulomas. There can also be cranial nerve palsies, occlusion of the major blood channels, laryngeal edema, pharyngeal and esophageal ulceration, and fistula formation. To avoid these late consequences, it is suggested that Thorotrast granuloma in the neck be excised radically. Partial or limited resections are inadequate.