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Introduction: Bertolotti’s syndrome (BS) is defined as the presence of low back pain (LBP), radiculopathy or both with a dysplastic transverse process (TP) of the fifth lumbar vertebra that is articulated or fused with the sacral base or iliac crest. This study aimed to investigate the prevalence and severity of BS to promote awareness of this disease. Methods: A retrospective review of anteroposterior lumbosacral plain radiographs was conducted between 1 January and 31 December 2017. Patients were recruited via systematic randomised sampling and were then interviewed and examined. The severity of BS was measured objectively using the numerical pain rating scale (NPRS) and Oswestry disability questionnaire (ODQ). Data were analysed using IBM SPSS for Windows version 22. Results: The prevalence of BS was 9.6% (16/166). Age significantly affected the severity of BS. The older and younger groups had a mean ODQ score of 42.86% and 24.08%, respectively (P=0.006). There was no significant relationship found between the prevalence of BS and age (P=0.126). Only one patient was diagnosed with BS during medical consultation. The mean NPRS score was 5.5. The majority of the BS cases were of moderate severity (43.8%), followed by those of minimal severity (31.2%) and severe disability (25%). Conclusion: Early diagnosis of BS and orthopaedic referral are crucial to halt its progression. BS should be considered in patients presenting with LBP during assessments of lumbosacral radiographs.

This study is based on the premise of investigating antibacterial activity through a novel conjugate of silver nanoparticles (AgNPs) and antimicrobial peptides (AMPs) in line with a green synthesis approach by developing antimicrobial-coated implants to prevent bacterial resistance. The AMPs were obtained from Bellamya Bengalensis (BB), a freshwater snail, to prepare the nanocomposite conjugate, e.g., AgNPs@BB extract, by making use of UV-Visible spectroscopy. The antimicrobial assessment of AgNPs@BB extract conjugate was performed using the Resazurin Microtiter Assay Method (REMA), followed by the use of three biocompatible implant materials (titanium alloys, Ti 6AL-4V stainless steel 316L, and polyethylene). Finally, the coating was analyzed under confocal microscopy. The results revealed a significant reduction of biofilm formation on the surfaces of implants coated with conjugate (AgNPs@BB extract) in comparison to uncoated implants. For the MTT assay, no significant changes were recorded for the cells grown on the AgNPs/AMP++ sample in high concentrations. Staphylococcus epidermidis, however, showed more prominent growth on all implants in comparison to Staphylococcus aureus. It is evident from the results that Staphylococcus epidermidis is more susceptible to AgNPs@BB extract, while the minimum inhibitory concentration (MIC) value of AgNPs@BB extract conjugates and biosynthesized AgNPs was also on the higher side. This study indicates that AgNPs@BB extract carries antibacterial activity, and concludes that an excessive concentration of AgNPs@BB extract may affect the improved biocompatibility. This study recommends using robust, retentive, and antimicrobial coatings of AgNPs@BB extract for implantable biocompatible materials in accordance with the novel strategy of biomaterial applications.

The biosynthesis of silver nanoparticles and the antibacterial activities has provided enormous data on populations, geographical areas, and experiments with bio silver nanoparticles’ antibacterial operation. Several peer-reviewed publications have discussed various aspects of this subject field over the last generation. However, there is an absence of a detailed and structured framework that can represent the research domain on this topic. This paper attempts to evaluate current articles mainly on the biosynthesis of nanoparticles or antibacterial activities utilizing the scientific methodology of big data analytics. A comprehensive study was done using multiple databases—Medline, Scopus, and Web of Sciences through PRISMA (i.e., Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The keywords used included ‘biosynthesis silver nano particles’ OR ‘silver nanoparticles’ OR ‘biosynthesis’ AND ‘antibacterial behavior’ OR ‘anti-microbial opposition’ AND ‘systematic analysis,’ by using MeSH (Medical Subject Headings) terms, Boolean operator’s parenthesis, or truncations as required. Since their effectiveness is dependent on particle size or initial concentration, it necessitates more research. Understanding the field of silver nanoparticle biosynthesis and antibacterial activity in Gulf areas and most Asian countries also necessitates its use of human-generated data. Furthermore, the need for this work has been highlighted by the lack of predictive modeling in this field and a need to combine specific domain expertise. Studies eligible for such a review were determined by certain inclusion and exclusion criteria. This study contributes to the existence of theoretical and analytical studies in this domain. After testing as per inclusion criteria, seven in vitro studies were selected out of 28 studies. Findings reveal that silver nanoparticles have different degrees of antimicrobial activity based on numerous factors. Limitations of the study include studies with low to moderate risks of bias and antimicrobial effects of silver nanoparticles. The study also reveals the possible use of silver nanoparticles as antibacterial irrigants using various methods, including a qualitative evaluation of knowledge and a comprehensive collection and interpretation of scientific studies.

Introduction: Degenerative disorder involving the acromioclavicular joint (ACJ) is quite common especially in the elderly. One of the surgical modalities of treatment of this disorder is the Mumford Procedure. Arthroscopic approach is preferred due to its reduced morbidity and faster post-operative recovery. One method utilizes the anteromedial and Neviaser portals, which allow direct and better visualization of the ACJ from the subacromial space. However, the dangers that may arise from incision and insertion of instruments through these portals are not fully understood. This cadaveric study was carried out to investigate the dangers that can arise from utilization of these portals and which structures are at risk during this procedure. Methods: Arthroscopic Mumford procedures were performed on 5 cadaver shoulders by a single surgeon utilizing the anteromedial and Neviaser portals. After marking each portals with methylene blue, dissection of nearby structures were carried out immediately after each procedure was completed. Important structures (subclavian artery as well as brachial plexus and its branches) were identified and the nearest measurements were made from each portal edges to these structures. Results: The anteromedial portal was noted to be closest to the suprascapular nerve (SSN) at 2.91 cm, while the Neviaser portal was noted to be closest also to the SSN at 1.60 cm. The suprascapular nerve was the structure most at risk during the Mumford procedure. The anteromedial portal was noted to be the most risky portal to utilize compared to the Neviaser portal. Conclusion: Extra precaution needs to be given to the anteromedial portal while performing an arthroscopic distal clavicle resection in view of the risk of injuring the suprascapular nerve of the affected limb. [ABSTRACT FROM AUTHOR]

Septic arthritis of the knee is rare in adults. This leads to difficulty in making early diagnosis that invariably leads to delayed treatment with consequent destruction of the joint. The delay in diagnosis is largely attributed to absence of clinical signs of flagrant infection. Reported are three adult patients who presented with painful swollen knee and inability to walk few weeks after intra-articular injection for osteoarthritis. This paper discusses the cases in which the difficulties in the early diagnosis of septic arthritis of knee in adults led to the development of osteomyelitis.