Ultrasound-guided procedures for postoperative pain management in pediatric patients undergoing abdominal surgeries: A systematic review

Many ultrasound-guided procedures are available for administering analgesia via peripheral nerve blockade. This systematic review aims to compare different ultrasound-guided procedures to determine which procedure is better suited for pediatric abdominal surgeries. The objective is to understand the efficacy of ultrasound-guided procedures for postoperative pain management in children undergoing abdominal surgeries and to identify which procedure takes less time and is better suited for a particular surgery. A systematic literature search was performed in PubMed, SCOPUS, Central Cochrane Registry of Controlled Trials (The Cochrane Library), and ScienceDirect databases for pediatric abdominal surgeries conducted with ultrasound-guided procedures for administering analgesia. We included studies involving randomized controlled trials (RCTs). Quasi-randomized controlled studies, prospective, retrospective observational studies, case series, case reports, letters, editorials, comments, animal studies, and studies from non-English literature were excluded. We reviewed 13 articles with 910 patients included. Age groups varied from 6 months to 21 years. The most common block used was the transversus abdominis block (47.76%), and the most common surgery performed was hernia and hydrocele (52.10%). Quadratus lumborum block was used in 26.92%, erector spinae block in 8.97%, modified transversus abdominus block and rectus sheath block in 9.62%, and ilioinguinal block in 6.73% of the patients. No complications were reported in any of the studies. Transversus abdominus block is less effective in two of the studies. Each procedure for pediatric postoperative analgesia has specific advantages and limitations, highlighting the complexity of tailoring interventions. Our review focuses on the advancements in ultrasound-guided analgesia for lower abdominal surgeries in pediatric patients while also emphasizing the need for future randomized controlled trials (RCTs) to compare efficacy, standardize practices, and improve patient outcomes.

Prediction of the difficult airway by pre-operative ultrasound-based measurement of airway parameters: A prospective observational study

Background and Aims

Ultrasonography has emerged as a new airway assessment tool. However, its role in predicting difficult airways needs to be explored. This study aimed to evaluate the accuracy of pre-operative ultrasound assessment of the neck in predicting difficult airways in patients undergoing elective surgery under general anaesthesia.

Methods

One hundred and fourteen adult patients undergoing elective surgeries under general anaesthesia were enrolled in this study. In the pre-operative room, upper airway ultrasound measurements of the neck were obtained, namely, distance from skin to the hyoid bone, distance from skin to the thyroid isthmus and thickness of the base of the tongue. Clinical airway assessment details were noted from the pre-anaesthetic evaluation form. The airway management technique was noted. Receiver operating characteristic curves were used to assess the diagnostic value of these upper airway ultrasound measurements in predicting difficult airways.

Results

The distance from the skin to the thyroid isthmus in the difficult airway group (0.37 ± 0.133 cm) was significantly higher than in the non-difficult group (P = 0.007). It appeared to be a better predictor of difficult airways and correlated better with clinical tests among the measured ultrasound parameters. The body mass index was significantly higher in the difficult airway group (P = 0.009).

Conclusion

Considering the difference in means between the two groups, distance from the skin to the thyroid isthmus should be explored as a potential predictor of a difficult airway in studies with a larger sample size.

Development of novel isothermal-based DNA amplification assay for detection of pig tissues in adulterated meat

For the first time, we describe an innovative polymerase spiral reaction (PSR) assay for the rapid, simple, and accurate detection of pig tissues or pork in adulterated meat including heat-treated and processed ones. The PSR assay specifically targeting the mitochondrial cytochrome b (cyt-b) gene of the pig was successfully optimized permitting assay results in 65 min time. The developed detection method was 100% specific amplifying only the cyt-b gene and displaying negative results with all the tested non-pork meats. The sensitivity of the developed PSR (760 fg porcine DNA) was tenfold better than the end-point PCR and able to detect heat-treated (121 °C) and adulterated (0.5% pork in beef) meat and processed pork products such as sausages, salami, meatball, soup, curry, etc. The developed PSR-based method can be used for point-of-care detection with minimum instrumentation and technical expertise to guarantee instant clearance of exported and imported meat products. This is the first time that PSR has been adapted for food authenticity purposes.

Factors predicting difficulty in insertion of real-time-three-dimensional transesophageal echocardiography probe in adult patients undergoing cardiac surgery

Background

Transesophageal echocardiography (TEE) probe insertion may be associated with many complications. Demographic factors and airway conditions such as high Mallampati scores (MMC) and Cormack-Lehane grades (MCLG) are likely to have an impact on its ease of insertion. The primary aim of this study was to identify the predictive factors for difficult real-time-three-dimensional TEE probe insertion.

Methods

A total of 153 adult patients undergoing cardiac surgery were prospectively evaluated. The upper airway manipulations required for TEE probe placement were jaw thrust, reverse Sellick's maneuver, and laryngoscopy. All the patients who required airway manipulations were grouped under difficult TEE probe placement group. We evaluated the patients' predictive factors such as demographic characteristics and factors related to difficult intubation.

Results

Out of 153 patients, 123 were males and 30 were females. Overall, 27.5% (n = 42) patients had difficulty in probe placement. About 31.7% (n = 39) males had difficulty in TEE probe placement against 13% (n = 4) females (P-value 0.045). Difficulty in TEE probe placement was found in 72.7% (n = 16) of obese patients (body mass index [BMI] > 30), compared to 18.6% (n = 17) in the patients with BMI less than 25 (P-value < 0.001). Probe insertion was significantly more difficult in the presence of MMC III and IV (50%, n = 18) compared to class I (19.2%, n = 10) (P-value 0.001) and MCLG III (73.3%, n = 22) compared to grade I (11.1%, n = 7) (P-value 0.001).

Conclusion

Male gender, obesity, higher grades of MMC and MCLG were found to be the risk factors for difficult TEE probe placement in anesthetized patients.

A Rare Cause of Gross Hematuria Due to Placing a Patient with Distended Bladder in Prone Position

How to cite this article: Seema S, Trivedi S, Padala SRAN, Kiran M. A Rare Cause of Gross Hematuria Due to Placing a Patient with Distended Bladder in Prone Position. Indian J Crit Care Med 2023;27(1):73-74.

Fungal Planet description sheets: 1436-1477

Novel species of fungi described in this study include those from various countries as follows: Argentina, Colletotrichum araujiae on leaves, stems and fruits of Araujia hortorum. Australia, Agaricus pateritonsus on soil, Curvularia fraserae on dying leaf of Bothriochloa insculpta, Curvularia millisiae from yellowing leaf tips of Cyperus aromaticus, Marasmius brunneolorobustus on well-rotted wood, Nigrospora cooperae from necrotic leaf of Heteropogon contortus, Penicillium tealii from the body of a dead spider, Pseudocercospora robertsiorum from leaf spots of Senna tora, Talaromyces atkinsoniae from gills of Marasmius crinis-equi and Zasmidium pearceae from leaf spots of Smilaxglyciphylla. Brazil, Preussia bezerrensis from air. Chile, Paraconiothyrium kelleni from the rhizosphere of Fragaria chiloensis subsp. chiloensis f. chiloensis. Finland, Inocybe udicola on soil in mixed forest with Betula pendula, Populus tremula, Picea abies and Alnus incana. France, Myrmecridium normannianum on dead culm of unidentified Poaceae. Germany, Vexillomyces fraxinicola from symptomless stem wood of Fraxinus excelsior. India, Diaporthe limoniae on infected fruit of Limonia acidissima, Didymella naikii on leaves of Cajanus cajan, and Fulvifomes mangroviensis on basal trunk of Aegiceras corniculatum. Indonesia, Penicillium ezekielii from Zea mays kernels. Namibia, Neocamarosporium calicoremae and Neocladosporium calicoremae on stems of Calicorema capitata, and Pleiochaeta adenolobi on symptomatic leaves of Adenolobus pechuelii. Netherlands, Chalara pteridii on stems of Pteridium aquilinum, Neomackenziella juncicola (incl. Neomackenziella gen. nov.) and Sporidesmiella junci from dead culms of Juncus effusus. Pakistan, Inocybe longistipitata on soil in a Quercus forest. Poland, Phytophthora viadrina from rhizosphere soil of Quercus robur, and Septoria krystynae on leaf spots of Viscum album. Portugal (Azores), Acrogenospora stellata on dead wood or bark. South Africa, Phyllactinia greyiae on leaves of Greyia sutherlandii and Punctelia anae on bark of Vachellia karroo. Spain, Anteaglonium lusitanicum on decaying wood of Prunus lusitanica subsp. lusitanica, Hawksworthiomyces riparius from fluvial sediments, Lophiostoma carabassense endophytic in roots of Limbarda crithmoides, and Tuber mohedanoi from calcareus soils. Spain (Canary Islands), Mycena laurisilvae on stumps and woody debris. Sweden, Elaphomyces geminus from soil under Quercus robur. Thailand, Lactifluus chiangraiensis on soil under Pinus merkusii, Lactifluus nakhonphanomensis and Xerocomus sisongkhramensis on soil under Dipterocarpus trees. Ukraine, Valsonectria robiniae on dead twigs of Robinia hispida. USA, Spiralomyces americanus (incl. Spiralomyces gen. nov.) from office air. Morphological and culture characteristics are supported by DNA barcodes. Citation: Tan YP, Bishop-Hurley SL, Shivas RG, et al. 2022. Fungal Planet description sheets: 1436-1477. Persoonia 49: 261-350. https://doi.org/10.3767/persoonia.2022.49.08.

Considerations to Prevent Intraoperative Fluid Spillage Into the Airway From a Bronchogenic Cyst During Anesthesia: A Case Report

In patients with bronchogenic cysts, spillage of cyst contents into the airway during anesthesia and surgery has been reported. Methods to prevent this complication are not definitive. A 21-year-old man with a large bronchogenic cyst was scheduled for cyst excision during which large quantities of purulent fluid spilled into the airway immediately after induction of anesthesia. This was due to unmasking of the existing communication between the cyst and the bronchial tree. Preoperative percutaneous drainage of the cyst contents, awake intubation, and lung isolation with a bronchial blocker before paralyzing and positioning the patient may be helpful.

589 Early Results of Single Anaesthetic Bilateral Fixed Bearing Cemented Medial Unicompartmental Knee Replacement

Introduction

Unicompartmental knee replacement (UKR) results in less morbidity, early mobilisation, and better PROMs in appropriately selected patients. There has been a steady increase in the number of fixed bearing UKRs in the NJR. We present the early results of single anaesthetic bilateral fixed bearing cemented medial UKR.

Method

All patients undergoing bilateral UKR using the ZUK prosthesis (LIMA, UK) under a single anaesthetic between March 2013 and March 2019 were included in this study. Demographic data, surgical data, change in haemoglobin after surgery and occurrence of complications were prospectively recorded in the hospital database. Pre-op and follow-up Oxford knee scores were recorded. Statistical analysis was performed using SPSS 25.0 (IBM, USA) and paired t-test was used to analyse improvement in functional score.

Results

Nine patients were included in this study. The mean age was 53.2years (range 43-71 years). There were 2 females and 7 males. A significant improvement in Oxford knee score from a mean of 37.2 to 53.6(p &lt; 0.01) was seen. The mean drop in Hb was 4.1mg/dl. The mean follow up was 28 months (range 12-76 months).

Conclusions

There was good improvement in functional scores without any significant drop in Hb. Therefore, it is a safe and beneficial procedure.

Quantification of Right Atrial-Indexed End-Systolic Volumes and Emptying Fraction in Children Undergoing Cardiac Surgery With Two-Dimensional Transesophageal Echocardiography: A Prospective Observational Study

OBJECTIVES

The primary objective of this study was to establish "normal" right atrial (RA)-indexed end-systolic volumes (ESVs) and emptying fraction (EF) in children undergoing ventricular septal defect (VSD) repair using two-dimensional (2D) transesophageal echocardiography (TEE). Secondary objectives were to obtain RA-indexed ESV and EF in children with RA/right ventricular (RV) volume overload (atrial septal defect [ASD]) and RV pressure overload (tetralogy of Fallot [TOF]) and to determine whether baseline differences existed in these indices among the three lesions.

DESIGN

A prospective observational study.

SETTING

Tertiary referral center and a university level teaching hospital.

PARTICIPANTS

The study comprised 90 children (30 in each cohort) >3 kg and <14 years old admitted for elective repair of either VSD, TOF, or ASD.

MEASUREMENTS AND MAIN RESULTS

RA ESV and EF were measured in the midesophageal four-chamber view using the area-length and the modified Simpson's methods with 2D TEE in the prebypass period. Mean RA- indexed ESV (area-length method) in the VSD cohort was 24.2 ± 6.7 mL/m², whereas it was significantly greater in the TOF (31.9 ± 9.8 mL/m²; p = 0.0008) and ASD (52 ± 12.9 mL/m²; p < 0.0001) cohorts. RA EF in the TOF cohort was 48.4% ± 7.6%, which was significantly more than in the VSD (41.5% ± 11.8%; p = 0.0093) and ASD (39.1% ± 12.3%; p = 0.0008) cohorts.

CONCLUSIONS

This was the first study using 2D TEE to measure RA indices in children with and without right-sided heart dilation undergoing cardiac surgery. In this study, RA, ESV, and EF were considerably different in children with congenital heart disease causing RV pressure or volume overload. Additional studies can examine how these values can be used for risk stratification in this cohort of patients or how they correlate with measures of ventricular performances.

Is a single dose of preoperative antibiotic therapy effective for patients treated with megaendoprosthesis after metastatic bone tumour resection?

Purpose The timing and number of doses of antibiotics required for megaendoprosthetic replacement (MPR) in metastatic bone disease (MBD) is a matter of debate. The aim of our study is to present the results of a prospective cohort of MPR for MBD receiving a single dose of antibiotic at induction of anaesthesia.

METHODS

All patients who underwent primary MPR in MBD were included in this prospective study. All penicillin-sensitive patients received one dose of cefuroxime 1.5gm intravenous at induction. In penicillin-allergic patients, teicoplanin 1.2gm and ciprofloxacin 500 mg intravenous was administered. The patients were followed up in the wound clinic and the specialist MBD clinic at 2 weeks, 3 months, 6 months and then annually. Data collected included demographics, primary tumours, surgical procedures, complications and duration of follow-up. All calculations were performed using SPSS^® 25(IBM, USA). A p value ≤ 0.05 was considered to be significant.

RESULTS

There were 51 patients with a mean age of 65.4 years. Procedures included proximal femoral replacement (35), distal femoral replacement (7), proximal humeral replacement (4), distal humeral replacement (3) and total femoral replacement (2). Thirty-seven patients received cefuroxime, and fourteen patients received teicoplanin and ciprofloxacin at induction of anaesthesia. The deep infection rate was 1.9%. Thirty-seven patients died with a median survival of 10 months (1 to 51 months). Mean follow-up was 18.9 months (1 to 70 months).

CONCLUSION

Single dose of preoperative antibiotics at anaesthetic induction seems to be safe and effective for preoperative prophylaxis in orthopaedic oncology.

Persistent falcine sinus with temporo-occipital schizencephaly: case report with a review of literature in relation to the undeveloped vein of Galen and/or straight sinus

Falcine sinus is a normal midline embryonic venous sinus present in the fetal brain and usually disappears by birth. Persistent falcine sinus (PFS) has been reported as a normal variant or along with vein of Galen (VOG) malformation, encephalocele, and other abnormalities. Schizencephaly, either closed or open type, has been reported with other associated vascular anomalies. We report a 22-month-old child, who presented with delayed milestones and referred for magnetic resonance (MR) imaging, and the child was found to have PFS with associated bilateral temporo-occipital closed-lip schizencephaly, hippocampal abnormalities, falco-tentorial dehiscence, and white matter abnormalities. The vein of Galen and straight sinus were absent, and the internal cerebral veins were seen draining into superior sagittal sinus via the falcine sinus. These set of abnormalities are unique from abnormalities reported previously in association with the falcine sinus.

Fungal Planet description sheets: 951-1041

Novel species of fungi described in this study include those from various countries as follows: Antarctica, Apenidiella antarctica from permafrost, Cladosporium fildesense from an unidentified marine sponge. Argentina, Geastrum wrightii on humus in mixed forest. Australia, Golovinomyces glandulariae on Glandularia aristigera, Neoanungitea eucalyptorum on leaves of Eucalyptus grandis, Teratosphaeria corymbiicola on leaves of Corymbia ficifolia, Xylaria eucalypti on leaves of Eucalyptus radiata. Brazil, Bovista psammophila on soil, Fusarium awaxy on rotten stalks of Zea mays, Geastrum lanuginosum on leaf litter covered soil, Hermetothecium mikaniae-micranthae (incl. Hermetothecium gen. nov.) on Mikania micrantha, Penicillium reconvexovelosoi in soil, Stagonosporopsis vannaccii from pod of Glycine max. British Virgin Isles, Lactifluus guanensis on soil. Canada, Sorocybe oblongispora on resin of Picea rubens. Chile, Colletotrichum roseum on leaves of Lapageria rosea. China, Setophoma caverna from carbonatite in Karst cave. Colombia, Lareunionomyces eucalypticola on leaves of Eucalyptus grandis. Costa Rica, Psathyrella pivae on wood. Cyprus, Clavulina iris on calcareous substrate. France, Chromosera ambigua and Clavulina iris var. occidentalis on soil. French West Indies, Helminthosphaeria hispidissima on dead wood. Guatemala, Talaromyces guatemalensis in soil. Malaysia, Neotracylla pini (incl. Tracyllales ord. nov. and Neotracylla gen. nov.) and Vermiculariopsiella pini on needles of Pinus tecunumanii. New Zealand, Neoconiothyrium viticola on stems of Vitis vinifera, Parafenestella pittospori on Pittosporum tenuifolium, Pilidium novae-zelandiae on Phoenix sp. Pakistan, Russula quercus-floribundae on forest floor. Portugal, Trichoderma aestuarinum from saline water. Russia, Pluteus liliputianus on fallen branch of deciduous tree, Pluteus spurius on decaying deciduous wood or soil. South Africa, Alloconiothyrium encephalarti, Phyllosticta encephalarticola and Neothyrostroma encephalarti (incl. Neothyrostroma gen. nov.) on leaves of Encephalartos sp., Chalara eucalypticola on leaf spots of Eucalyptus grandis × urophylla, Clypeosphaeria oleae on leaves of Olea capensis, Cylindrocladiella postalofficium on leaf litter of Sideroxylon inerme, Cylindromonium eugeniicola (incl. Cylindromonium gen. nov.) on leaf litter of Eugenia capensis, Cyphellophora goniomatis on leaves of Gonioma kamassi, Nothodactylaria nephrolepidis (incl. Nothodactylaria gen. nov. and Nothodactylariaceae fam. nov.) on leaves of Nephrolepis exaltata, Falcocladium eucalypti and Gyrothrix eucalypti on leaves of Eucalyptus sp., Gyrothrix oleae on leaves of Olea capensis subsp. macrocarpa, Harzia metrosideri on leaf litter of Metrosideros sp., Hippopotamyces phragmitis (incl. Hippopotamyces gen. nov.) on leaves of Phragmites australis, Lectera philenopterae on Philenoptera violacea, Leptosillia mayteni on leaves of Maytenus heterophylla, Lithohypha aloicola and Neoplatysporoides aloes on leaves of Aloe sp., Millesimomyces rhoicissi (incl. Millesimomyces gen. nov.) on leaves of Rhoicissus digitata, Neodevriesia strelitziicola on leaf litter of Strelitzia nicolai, Neokirramyces syzygii (incl. Neokirramyces gen. nov.) on leaf spots of Syzygium sp., Nothoramichloridium perseae (incl. Nothoramichloridium gen. nov. and Anungitiomycetaceae fam. nov.) on leaves of Persea americana, Paramycosphaerella watsoniae on leaf spots of Watsonia sp., Penicillium cuddlyae from dog food, Podocarpomyces knysnanus (incl. Podocarpomyces gen. nov.) on leaves of Podocarpus falcatus, Pseudocercospora heteropyxidicola on leaf spots of Heteropyxis natalensis, Pseudopenidiella podocarpi, Scolecobasidium podocarpi and Ceramothyrium podocarpicola on leaves of Podocarpus latifolius, Scolecobasidium blechni on leaves of Blechnum capense, Stomiopeltis syzygii on leaves of Syzygium chordatum, Strelitziomyces knysnanus (incl. Strelitziomyces gen. nov.) on leaves of Strelitzia alba, Talaromyces clemensii from rotting wood in goldmine, Verrucocladosporium visseri on Carpobrotus edulis. Spain, Boletopsis mediterraneensis on soil, Calycina cortegadensisi on a living twig of Castanea sativa, Emmonsiellopsis tuberculata in fluvial sediments, Mollisia cortegadensis on dead attached twig of Quercus robur, Psathyrella ovispora on soil, Pseudobeltrania lauri on leaf litter of Laurus azorica, Terfezia dunensis in soil, Tuber lucentum in soil, Venturia submersa on submerged plant debris. Thailand, Cordyceps jakajanicola on cicada nymph, Cordyceps kuiburiensis on spider, Distoseptispora caricis on leaves of Carex sp., Ophiocordyceps khonkaenensis on cicada nymph. USA, Cytosporella juncicola and Davidiellomyces juncicola on culms of Juncus effusus, Monochaetia massachusettsianum from air sample, Neohelicomyces melaleucae and Periconia neobrittanica on leaves of Melaleuca styphelioides × lanceolata, Pseudocamarosporium eucalypti on leaves of Eucalyptus sp., Pseudogymnoascus lindneri from sediment in a mine, Pseudogymnoascus turneri from sediment in a railroad tunnel, Pulchroboletus sclerotiorum on soil, Zygosporium pseudomasonii on leaf of Serenoa repens. Vietnam, Boletus candidissimus and Veloporphyrellus vulpinus on soil. Morphological and culture characteristics are supported by DNA barcodes.

Diagnostic utility of fluorodeoxyglucose positron emission tomography in prosthetic joint infection based on MSIS criteria

AIMS

Prosthetic joint infection (PJI) and aseptic loosening in total hip arthroplasty (THA) can present with pain and osteolysis. The Musculoskeletal Infection Society (MSIS) has provided criteria for the diagnosis of PJI. The aim of our study was to analyze the utility of F18-fluorodeoxyglucose (FDG) positron emission tomography (PET) CT scan in the preoperative diagnosis of septic loosening in THA, based on the current MSIS definition of prosthetic joint infection.

PATIENTS AND METHODS

A total of 130 painful unilateral cemented THAs with a mean follow-up of 5.17 years (sd 1.12) were included in this prospective study. The mean patient age was 67.5 years (sd 4.85). Preoperative evaluation with inflammatory markers, aspiration, and an F18 FDG PET scan were performed. Diagnostic utility tests were also performed, based on the MSIS criteria for PJI and three samples positive on culture alone.

RESULTS

The mean erythrocyte sedimentation rate, C-reactive protein, and white cell count were 47.83 mm/hr, 25.21 mg/l, and 11.05 × 10⁹/l, respectively. The sensitivity, specificity, accuracy, negative predictive value, and false-positive rate of FDG PET compared with MSIS criteria were 94.87%, 38.46 %, 56.38%, 94.59 %, and 60.21%, respectively. The false-positive rate of FDG PET compared with culture alone was 77.4%.

CONCLUSION

FDG PET has a definitive role in the preoperative evaluation of suspected PJI. This the first study to evaluate its utility based on MSIS criteria and compare it with microbiology results alone. However, FDG PET has a high false-positive rate. Therefore, we suggest that F18 FDG PET is useful in confirming the absence of infection, but if positive, may not be confirmatory of PJI. Cite this article: Bone Joint J 2019;101-B:910-914.

Pulmonary Atresia with Ventricular Septal Defect: Rare Presentation with Coronary-to-Pulmonary Artery Collaterals from Both Right and Left Coronaries

Pulmonary atresia with ventricular septal defect and coronary-dependent pulmonary circulation arising from both major coronary arteries is rare. Dependence of pulmonary blood flow on the coronaries and the risk of early development of pulmonary vascular obstructive disease warrant early surgical repair in these patients. We report a case of a ten-month-old infant with pulmonary atresia with ventricular septal defect and coronary artery-to-main pulmonary artery connections who was successfully managed with ligation of the coronary fistulas and intracardiac repair.

Traditional halal slaughter without stunning versus slaughter with electrical stunning of sheep (Ovis aries)

Thirty Nellore crossbred male sheep (Ovis aries) were divided into two groups of 15 animals each and subjected to either pre-slaughter electrical stunning followed by slaughter (ST) or traditional halal slaughter without stunning (NST) to investigate the changes in blood biochemical parameters, meat quality and proteomic profile. Higher (P < .05) pH, water holding capacity and Warner-Bratzler shear force were observed in meat from stunned sheep. Quantitative proteomic approach using DIGE was employed to find a panel of protein markers that could differentiate ST and NST muscle proteome. Comparison of muscle proteome of ST and NST samples by 2D-DIGE and MALDI-TOF/TOF MS analysis revealed 46 significant (P < .05) differentially expressed proteins. Our analysis revealed changes in the abundance of proteins involved in catalytic, structural, and stress related process. Current study has demonstrated variation meat quality and identified important proteins that correlate with meat texture and pre-slaughter stress in sheep that are slaughtered without and with electrical stunning.

Multi-centre cross sectional observational study of hand preference for perineal hygiene: An essential question in upper limb surgery

Hand preference for perineal hygiene is not a commonly recorded data unlike hand dominance. Ability to reach the perineum is essential for a good functional outcome. There is no evidence in orthopaedic literature regarding its variability. The aim of this study was to examine hand preference for perineal hygiene in a cohort of hospital staff and enumerate possible factors that may associate with this preference. One hundred hospital staff in two NHS hospitals were asked questions regarding dominance of hand and hand preference for personal hygiene, ethnicity and gender. They were also asked which hand they thought others used for perineal hygiene. Data was analysed using Fischer exact and Chi² tests. The most common ethnicity was British (64%). Male/female ratio was 56/44; 88 participants were right hand dominant; 71.8% of British ethnicity used the right hand and 81.25% of South Asians used the left hand for perineal hygiene. There was a significant correlation between hand preference and ethnicity (P<0.001) but not with gender (P=0.402) or hand dominance (P=0.063). There is a significant variation in hand preference for personal hygiene between different groups. The common assumption is that the hand used by others is the same as that used by the participant. Documentation of this hand preference is important while planning procedures like wrist or elbow arthrodesis and for the analysis of the functional outcome of other upper limb procedures. LEVEL OF EVIDENCE: II.

Ultrasound Imaging of the Inferior Vena Cava to Confirm Correct Guidewire Placement After Femoral Venous Cannulation in Critically Ill Neonates: A Case Report

Ultrasound-guided femoral venous cannulation is frequently performed in neonates. Identification of femoral vessels under ultrasound navigation is unreliable and time consuming in hemodynamically unstable neonates with feeble femoral arterial pulse. Confirming the guidewire placement in a femoral vein is a crucial step for preventing inadvertent femoral artery dilation, which may be a challenging task in an emergency situation. We describe 2 incidents wherein guidewires placed via femoral veins in neonates were detected in the inferior vena cava on abdominal ultrasound. We advocate abdominal inferior vena cava imaging to confirm the correct placement of a guidewire placed via femoral vein in emergency situations.

Prevalence of Deleterious Oral Habits and Oral Mucosal Lesions among Fishermen Population of Mahe, South India

INTRODUCTION

Fishing is an occupation associated with uneven diet, strain, drunkenness, tobacco use, and deleterious habits. The physical state of laborers on a large scale will also be influenced by conditions at their work site. Oral mucosal lesions can occur as a result of infections, local shock or infuriation, systemic diseases, and uncontrolled usage of tobacco, betel quid, and alcohol. The aim of the present study is to assess the prevalence of deleterious oral habits and oral mucosal lesions among fishermen population of Mahe, South India.

MATERIALS AND METHODS

The study population consists of 362 fishermen aged between 15 and 54. The questionnaire consisted of questions on personal data, and information related to the subjects' oral habits were collected by the interview. The World Health Organization (WHO) Oral Health Assessment Form was designed for the assessment of oral mucosal lesions.

RESULTS

Among the 362 fishermen, 266 (73.48%) were males and 96 (26.52%) were females. The overall prevalence of smoking, alcohol consumption, and gutka chewing was found to be 24.3, 48.85, and 32.4% respectively. Smokeless tobacco (32.4%) was the most prevalent habit followed by smoking tobacco (24.3%). The prevalence of oral mucosal lesions was 14.9%. There is a statistically significant association between age groups and habits considered.

CONCLUSION

Findings of the present study suggest that oral health condition of the fisherfolk community was relatively poor, with high habit prevalence and oral mucosal lesions. This epi-demiological study has provided baseline data to plan further research in this area.

CLINICAL SIGNIFICANCE

Low socioeconomic status, strenuous working hours, inadequate diet and nutrition intake, stress, and use of tobacco and alcohol act as contributing factors for ill health and oral diseases. It is a challenging population to the clinician to identify and treat them.

Effect of fluoridated water on intelligence in 10-12-year-old school children

Aim:

The aim of the present study was to evaluate the relationship of drinking water fluoride levels with children's intelligence quotient (IQ).

Materials and Methods:

Water was collected from initially identified endemic fluoride regions according to the geological research of Government of India. Fluoride concentration of the water was assessed by utilizing fluoride ion selective electrode, Orion 9609BN, and categorized on the basis of fluoride concentration into low, medium, and high-fluoride regions, i.e., Virajpet (low fluoride level < 1.2 ppm), Banavara (Medium fluoride level 1.2–2 ppm), and Mastihalli (High fluoride levels > 3 ppm). Government school from all three villages were selected randomly and IQ levels were assessed by using Raven's Standard Progressive Matrices. This test was conducted on each child in the study sample.

Results:

A significant inverse relationship was found between the fluoride concentration in drinking water and IQ (r value = −0.204; P < 0.000). It was observed that IQ level was negatively correlated with fluoride concentration in drinking water.

Conclusion:

It is concluded that IQ level was negatively correlated with fluoride level in drinking water. Factors that might affect children's IQ need to be considered, and it is necessary to devise solutions for preventing the harmful effects of excessive intake of fluoride ion to the body.

Interaction and localization diversities of global and local hubs in human protein–protein interaction networks

Hubs, the highly connected nodes in protein–protein interaction networks (PPINs), are associated with several characteristic properties and are known to perform vital roles in cells.

Shear induced micromechanical synthesis of Ti3SiC2 MAXene nanosheets for functional applications

Ultrathin Ti₃SiC₂ MAXene nanosheets were synthesized by shear induced micromechanical technique. This new class of 2D functional material is an ideal candidate for energy and electronic applications.

Carcass characteristics, composition, physico-chemical, microbial and sensory quality of emu meat

1. In order to investigate whether emu meat is a potential red meat alternative, this work was carried out with the objective of studying the carcass characteristics, proximate composition, physico-chemical and microbial characteristics and sensory attributes of emu meat. 2. Carcass characteristics clearly indicate that emus are a significant source of lean meat, fat, skin and edible by-products and these findings confirm earlier reports. 3. Proximate composition of emu meat indicated higher protein and ash content and lower fat, total lipids and cholesterol content than meat from other meat animals. 4. The pH, water holding capacity, collagen content and solubility, protein extractability, muscle fibre diameter and Warner-Bratzler shear force values of emu meat are similar to the earlier reports for meats from other food animals. 5. Emu meat is dark, cherry red in colour with significantly higher myoglobin content and the myoglobin is more prone to oxidation as evidenced by higher initial metmyoglobin percentage. The initial thiobarbituric acid reactive substances (TBARS) values and free fatty acids percentage in emu meat were higher than those in meats from other species. 6. Sensory evaluation of cooked emu meat curry revealed highly acceptable scores relative to goat meat curry, the most preferred meat in India. 7. The study shows the potential of emu meat as a new source of low fat, quality meat proteins. However, more studies are required to elucidate the effect of age, sex, muscles, pre-slaughter and post-slaughter factors on different carcass and meat quality characteristics.

Effect of low fluoride dentifrices on microhardness of sound enamel. In vitro study

The present study was undertaken to evaluate the effect of dentifrices containing low fluoride concentrations on microhardness of sound enamel in 50 healthy young premolar teeth. They were divided into five different groups according to the concentrations of fluoride in dentifrice used. The Vickers hardness of enamel was measured using a Zwick microhardness tester under 1000 g load and a Vickers indenter before and after the application of fluoride dentifrices. The results of the present study suggest that low fluoride concentration dentifrices are as effective as the higher concentrations in increasing the hardness of enamel.

Prosthetic rehabilitation of a child with induced anodontia

A case of prosthetic rehabilitation of a five and half year old child with induced anodontia is presented. Complete dentures were provided and patient was followed for a period of 20 months. As the permanent teeth erupt into the oral cavity, regular modifications have to be made on the denture base to facilitate their eruption.