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Introduction: Chloromas are defined as metastatic granulocytic solid tumors of myeloid origin occurring at an extramedullary site. In this case report, we present an uncommon case of chronic myeloid leukemia (CML) presenting with metastatic sarcoma to the dorsal spine causing acute paraparesis. Case Report: A 36-year-old male presented in the OPD with complaints of progressive upper back pain and acute paraparesis since a 1 week. The patient is a previously diagnosed case of CML on treatment for the same. MRI of the dorsal spine indicated extradural soft-tissue lesions in D5-D9 extending to the right side of the spinal canal displacing the cord to the left. Considering the acute paraparesis that the patient developed, he was taken for an emergency decompression of the tumor. Microscopy showed infiltration of fibrocartilaginous tissue of polymorphous origin mixed with atypical myeloid precursor cells. Immunohistochemistry reports show atypical cells diffusely expressing myeloperoxidase, focally expressing CD34 and CD117. Conclusion: Rare case reports like this are the only literature available on remission in CML cases with sarcomas. The acute paraparesis in our patient was prevented from increasing to a paraplegia by surgical means. Immediate decompression of the spinal cord in patients with paraparesis and associated radiotherapy and chemotherapy should be considered in all patients with myeloid sarcomas of CML origin. While examining patients of CML, the possibility of a granulocytic sarcoma should always be kept in mind. Keywords: Chronic myeloid leukemia, chloroma, spinal metastasis.

Retrospective analysis of prospectively collected data. To assess func Study Design: Objective: tional outcome of patients irrespective of timing of surgical intervention in cases with cauda equina syndrome. Cauda equina syndrome Background: (CES) is a spinal emergency requiring immediate surgical intervention. CES presents with constellation of symptoms like saddle anaesthesia, bladder or bowel dysfunction, sexual dysfunction, lower limb motor power loss having deep socioeconomic consequences on part of patients and medicolegal consequences on part of clinicians. 40 patients data were collected and compiled retrospectivel Methodology: y. Demographic data, Surgical data, Functional data in the form of bladder, bowel, sexual and motor power recovery were collected at 3 weeks, 6 months , 12 months follow-up and analysed based on Urinary symptom prole score, Neurogenic bowel dysfunction score, Arizona sexual experience scale, Medical Research Council grading respectively. Results: Though early presentation by the patient and emergent surgical intervention by clinician does play a decisive role in full and faster recovery of symptoms but our study suggests that even when patients presented with delay at our outpatient department and surgery was done on emergency basis, desired outcome was achieved in maximum number of cases presenting with incomplete CES.

Introduction and Aim: Diabetic foot ulcers (DFUs) are a common and debilitating diabetic consequence leading to lower-limb amputations, long-term disability, and reduced lifespan. There is a lack of clinical diagnosis expertise because of no adequate diagnostic signs for DFU. As a result, the current research aims to find out how differently expressed genes (DEGs) affect the DFU. Materials and Methods: Bioinformatics analysis was used to evaluate DEGs using the GSE132187 dataset of the NCBI-GEO database, which contained samples from three hyperglycemic and three normoglycemic macrophage-like cell lines. Following the discovery of DEGs, Gene Ontology (GO) and KEGG pathway enrichment analysis were used to investigate how genes are classified into preset bins based on their functional properties. To discover hub DEGs in DFU, a protein-protein interaction (PPI) network was built and five topological parameters such as degree, stress, Closeness centrality, betweenness centrality, and radiality were evaluated. Results: We found 547 DEGs using the GSE132187 dataset, comprising 79 upregulated DEGs and 468 downregulated DEGs. There were 434 nodes and 1724 edges in the PPI network. The giant network uncovered six modules that are significantly enriched in biological processes like positive JNK cascade regulation, positive interferon-gamma production regulation, negative cell proliferation regulation, cellular response to zinc ion, cellular response to lipopolysaccharide, wound healing, and inflammatory response. Conclusion: Bioinformatics analysis revealed the major differentially expressed hub-genes implicated in DFUs. These findings suggested that these genes could be used as a DFU prognostic, diagnostic, or therapeutic targets.

Introduction: In this case report, we question the safety associated with high velocity manipulations of the cervical spine. These procedures do not frequently cause catastrophic adverse effects but few and rare case reports like this make us aware about the possible complications of the maneuvers. Case Report: This case report presents an uncommon presentation of acute neurodeficit to a 57-year-old male following a neck manipulation by a barber in the saloon which recovered partially with Intravenous steroid therapy but required active intervention surgically to treat his complete symptomatology. The magnetic resonance imaging (T2-weighted) showed a high signal intensity within the spinal cord at the C4C5 level (cord edema). Here, we discuss the possible mechanism of injury and the need to educate the lesser common risks of performing such sudden and forceful maneuvers. Conclusion: This case report is a reminder that people should be careful while trying alterative types of therapy which use forceful neck manipulations to relieve pain as this maneuver could cause injuries to the disc complex especially when the patient already has a disc prolapse which is asymptomatic, causing the disc to fail again making it symptomatic. Keywords: Manipulation, neurodeficit, cervical spine, paraparesis.

The current study was undertaken to analyze the bacteriological profile among diabetic foot ulcer patients and to determine the antibiotic susceptibility and resistance pattern of the organisms isolated. This was a prospective observational study conducted among 102 patients for six months. All patients, aged above 18 years diagnosed with diabetic foot ulcers and performed with culture and sensitivity tests in the department of general surgery, were enrolled in the study. All the relevant details of the study were collected and analyzed. Out of 102 patients enrolled, 72 were males and 30 were females. The majority of the bacteria that were isolated from the culture samples were found to be gram-negative, 119 (79.33%) and 31 (20.97%) were found to be gram-positive. Methicillin-resistant coagulase-negative Staphylococcus was the most frequently isolated gram-positive micro-organism. It was found to have more sensitivity to both vancomycin and teicoplanin (100%) whereas it showed high resistance to benzylpenicillin (84.6%). Among various gram-negative organisms, Pseudomonas aeruginosa was the most commonly isolated. It showed high sensitivity to doripenem (70.9%) and was found to be more resistant to levofloxacin (51.6%). Our study concluded on the predominance of gram-negative bacteria among the enrolled patients. Among the 22 different types of bacteria identified, Pseudomonas aeruginosa was the most frequently isolated species.

Oil pulling or swishing, the ancient practice of healing developed originally in ayurvedic medicine. Coconut and sesame oil being common ingredients used in Indian foods are easy to access. Besides having numerous health benefits, these are also cheaper in comparison with avocado, black cumin seed, canola, cedar nut, and olive oil. Aim: The study herewith strives for a comparison on the effects of oil pulling with coconut and sesame oil for people with plaque-induced gingivitis. Materials & Modes: Participants were divided into 3, namely, Group A – 26 people with plaque-induced mild-to-moderate gingivitis using sesame oil for oil pulling, Group B – 26 those with plaque-induced mild-to-moderate gingivitis using coconut oil for oil pulling, and Group C – 26 those with plaque-induced gingivitis, following routine brushingalone. Plaque Index and gingival index (GI) scores for the groups were assessed at pre-intervention and post-intervention stage son 7 th and 14th day. Results: Severity of gingivitis had remarkably decreased in Groups A &B on 7 thand 14th day. The decrease was greater in these two groups when compared to Group C which depicted only mild reduction in mean GI and PI scores. Conclusion: Oil pulling can be effective for oral hygiene together with routine practices. Coconut and Sesame oils are helpful to reduce the acuteness of gingivitis.

The introduction of personalized periodontics is an exciting step toward a medical paradigm of disease management, namely, the recognition of the individual as the fundamental component in the management of extremely complicated diseases. Tobacco, uncontrolled diabetes, obesity, cardiovascular disease, and stress must all be considered in a recreational approach for comprehensive periodontal disease therapy. The many components of individualised periodontics are discussed in this review.

The risk of developing epilepsy in patients with gliomas or neuroepithelial tumours is extremely significant. Low-grade and high-grade gliomas are the two types of gliomas. Low-grade brain tumours, as well as tumours located in the temporal and insular cortex, have a higher proclivity for developing epilepsy. Seizure control is much improved by surgical treatment of the tumour, particularly gross tumour removal, especially in neuroglial tumours. Low-grade gliomas are more likely to cause refractory epilepsy, with 30–35 percent experiencing it. The therapy of combined drug-induced gingival expansion in a patient surgically treated for low-grade glioma is described in this case report.

Background: Spinal anaesthesia carries the advantage of having rapid onset, lesser blood loss, early recovery and hospital stay as compared to general anaesthesia. The present study evaluated outcomes of awake spinal fusion i.e., minimal invasive single level transforaminal lumbar interbody fusion (MIS-TLIF) under spinal anaesthesia. Current study is a retrospective analysis of prospectively collected data carried to assess patient related outcome benefits for a single level transforaminal lumbar interbody fusion done under spinal anaesthesia.Methods: Patients who fit deemed criteria not responding to 6 weeks of conservative treatment to lumbar degenerative pathologies underwent MIS-TLIF. The demographic data, visual analogue pain scale (VAS), Oswestry disability index (ODI), blood loss, time from entering operation theatre to time of incision, time of bandaging to exit from operation theatre, time of stay in post anaesthesia care unit (PACU), duration of surgery, nausea/vomiting, urinary retention, requirement of analgesics, duration of stay in hospital, peri-operative complications, fusion rate and satisfaction score were compiled and assessed.Results: 150 patients were operated with MISTLIF under spinal anaesthesia. VAS and ODI score improved significantly at final follow up (pConclusions: Awake spinal fusion should be considered as a novel surgical approach with newer minimal invasive surgical techniques and regional anaesthesia to improve patient satisfaction and overall surgical outcome.

To validate the diagnostic utility of oxidative stress markers along with glycated hemoglobin (HbA1c ) in the assessment of chronic vascular complications in type 2 diabetes mellitus (DM).Ischemia modified albumin (IMA), advanced oxidation protein products (AOPP) and malondialdehyde (MDA) were measured in 100 type 2 DM (without complications n = 50, with complications n = 50) and healthy controls (n = 50). Diagnostic potential was evaluated by receiver operating characteristic analysis and their relationships to risk variables were analyzed.MDA, IMA and AOPP were significantly increased in diabetics, both with and without complications. Oxidative stress parameters correlated with fasting blood glucose and HbA1c (independent predictors). Duration of diabetes was an independent predictor for AOPP and MDA. The association of IMA with diabetes duration was lost on multiple regression analysis. Area under the curve, sensitivity and specificity for MDA were 0.795, 84%, 66%; for AOPP, they were 0.762, 82%, 56%; for IMA, they were 0.611, 60%, 52%; and for HbA1c, they were 0.848, 90%, 70%, respectively.MDA and AOPP could be considered better than IMA in the evaluation of diabetes progression, but MDA is more useful as a diagnostic indicator to detect vascular complications. HbA1c measurement is of greater value than the oxidative stress markers in the prediction of vascular complications.

Objective: To determine the effect of Vitamin D3 on the rate and amount of orthodontic tooth movement in humans when injected locally at the site. Materials and Methods: A prospective, split-mouth clinical trial was carried out on 15 subjects who were referred for bilateral therapeutic extraction of the first premolars followed by canine retraction in the maxillary arch. Vitamin D3 in a vehicle of local anesthetic solution was injected into the buccal vestibule immediately distal to the canine to be retracted on the experimental side; on the contralateral side, only local anesthetic solution as control was injected into the correspnding site on the 7th, 21st, and 47th days of canine retraction. The amount of canine retraction was assessed using the palatal rugae as stable landmarks, and the values obtained were compared using preand postcanine retraction occlusograms. Results: The experimental teeth whose gingivae had received injections containing Vitamin D3 had moved considerably less than had the matched control teeth (P , .001). Conclusions: Localized injection of vitamin D3 produces a significantly decreased rate and amount of tooth movement in humans. (Angle Orthod. 0000;00:000–000.)