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Background: Spinal infections are still showing increased incidence throughout the years as our surgical capabilities increase, coupled with an overall aging population with greater number of chronic comorbidities. The management of spinal infection is of utmost importance, due to high rates of morbidity and mortality, on top of the general difficulty in eradicating spinal infection due to the ease of hematogenous spread in the spine. We aim to summarize the utility of vacuum-assisted closure (VAC) and local drug delivery systems (LDDS) in the management of spinal infections., Methods: A narrative review was conducted. All studies that were related to the use of VAC and LDDS in Spinal Infections were included in the study., Results: A total of 62 studies were included in this review. We discussed the utility of VAC as a tool for the management of wounds requiring secondary closure, as well as how it is increasingly being used after primary closure as prophylaxis for surgical site infections in high-risk wounds of patients undergoing spinal surgery. The role of LDDS in spinal infections was also discussed, with preliminary studies showing good outcomes when patients were treated with various novel LDDS., Conclusions: We have summarized and given our recommendations for the use of VAC and LDDS for spinal infections. A treatment algorithm has also been established, to act as a guide for spine surgeons to follow when tackling various spinal infections in day-to-day clinical practice., Competing Interests: None, (© 2023 The Author(s).)

In this paper, we designed and demonstrated a stimuli-responsive hydrogel that mimics the mass diffusion function of the liver. We have controlled the release mechanism using temperature and pH variations. Additive manufacturing technology was used to fabricate the device with nylon (PA-12), using selective laser sintering (SLS). The device has two compartment sections: the lower section handles the thermal management, and feeds temperature-regulated water into the mass transfer section of the upper compartment. The upper chamber has a two-layered serpentine concentric tube; the inner tube carries the temperature-regulated water to the hydrogel using the given pores. Here, the hydrogel is present in order to facilitate the release of the loaded methylene blue (MB) into the fluid. By adjusting the fluid's pH, flow rate, and temperature, the deswelling properties of the hydrogel were examined. The weight of the hydrogel was maximum at 10 mL/min and decreased by 25.29% to 10.12 g for the flow rate of 50 mL/min. The cumulative MB release at 30 °C increased to 47% for the lower flow rate of 10 mL/min, and the cumulative release at 40 °C climbed to 55%, which is 44.7% more than at 30 °C. The MB release rates considerably increased when the pH dropped from 12 to 8, showing that the lower pH had a major impact on the release of MB from the hydrogel. Only 19% of the MB was released at pH 12 after 50 min, and after that, the release rate remained nearly constant. At higher fluid temperatures, the hydrogels lost approximately 80% of their water in just 20 min, compared to a loss of 50% of their water at room temperature. The outcomes of this study may contribute to further developments in artificial organ design.

Bioactive glass (BAG) is a well-known biomaterial that can form a strong bond with hard and soft tissues and can also aid in bone regeneration. In this study, BAG is added to a polymer to induce bioactivity and to realize fused filament fabrication (FFF) based printing of polymer composites for potential orthopaedic implant applications. BAG (5, 10, and 20 wt%) is melt compounded with high density polyethylene (HDPE) and subsequently extruded into feedstock filament for FFF-printing. Tensile tests on developed filaments reveal that they are stiff enough to resist forces exerted during the printing process. Micrography of printed HDPE/BAG reveals perfect diffusion of raster interface indicating proper selection of printing parameters. Micrography of freeze fractured prints shows the homogeneous distribution and good dispersion of filler across the matrix. The tensile, flexural, and compressive modulus of FFF-printed HDPE/BAG parts increases with filler addition. BAG addition to the HDPE matrix enhances flexural and compressive strength. The tensile and flexural behaviour of FFF-prints is comparable to injection molded counterparts. Property maps exhibit the merits of present study over the existing literature pertaining to desired bone properties and polymer composites used in biomedical applications. It is envisioned that the development of HDPE/BAG composites for FFF-printing can lead to possible orthopaedic implants and scaffolds to mimic the bone properties in customised anatomical sites or injuries., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background: Construction industry is the second largest employment giving industry in India with many semi-skilled or unskilled workers taking up the occupation for livelihood without any training and proper guidance., Aim: To evaluate the pathogenic association of cement exposure to occupational contact dermatoses as evidenced by immune markers and to correlate their pulmonary functions with years of exposure to cement., Setting and Design: This was a cross-sectional study conducted among randomly selected cement workers. Methods and material: Evaluation of socioeconomic status (SES) and years of exposure of cement workers was done using a questionnaire. Clinical examination of skin lesions and strip patch test with application of potassium dichromate on unexposed skin was performed. Results were interpreted after 48 hours. Absolute eosinophil count (AEC) and IgE levels measured, and spirometric evaluation was performed., Statistical Analysis: Analysis of variance and Pearson's correlation test were used for data analysis. P < 0.05 was considered to be statistically significant., Results: Clinically, skin lesions were noticed in 51%, elevated AEC in 47%, and raised Anti IgE in 73%. Two participants developed positive reactions to the skin strip patch test. Duration of exposure to cement and SES were compared with clinical skin lesions. Spirometry result was normal in 81%, obstruction in 8%, restriction in 10%, and mixed pattern in 1%. Forced expiratory volume at 1.0 second, forced expiratory flow (25-75%), and  (PEFR) Peak Expiratory Flow Rate were markedly reduced with years of exposure. Workers who had greater skin lesions and with increase in exposure had increased AEC and IgE levels, although statistically not significant., Conclusions: Exposure to cement and poor SES is strongly correlated to increased prevalence of skin lesions and reduced pulmonary functions., Competing Interests: There are no conflicts of interest.

A 55 year old male, who presented with a painless swelling of six months duration on his thigh, was clinically diagnosed to have a benign soft tissue neoplasm. Histological examination of the excision biopsy specimen revealed a benign tumour of the vascular smooth muscle, which was diagnosed as angioleiomyoma. Angioleiomyomas are painful lesions that can occur anywhere in the body. We present this case for its atypical clinical presentation and discuss its histologic features with a review of literature.

Fibromatosis is a group of disorders characterized by infiltrating fibroblastic proliferation. Among them Juvenile hyaline fibromatosis (J.H.F) is a rare, progressive, crippling autosomal recessive disorder diagnosed based on the characteristic clinicopathological findings of generalized cutaneous nodular lesions, gingival hypertrophy, flexion contractures of large joints with osteolytic lesions, and proliferating fibroblasts set within a hyalinized stroma. This disorder commonly manifests in childhood with family history of consanguinity and in siblings. A case of seven year old boy born to consanguinous parents is reported who presented with multiple subcutaneous nodules and gingival hypertrophy. Histopathological examination revealed proliferating fibroblasts embedded in an abundant homogeneous eosinophilic hyalinized matrix. The matrix showed PAS stain positivity, supporting the pathogenesis of this disorder as an inborn error of glycosaminoglycans metabolism. The differential diagnosis is discussed and the literature reviewed.