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Purpose: This study aimed to evaluate the impact of Robotic-Assisted Total Hip Arthroplasty (RATHA) versus Conventional Total Hip Arthroplasty (CTHA) on perioperative blood loss, blood transfusion requirements, and early clinical outcomes. Methods: A prospective cohort study was conducted at a high-volume tertiary care center from January 2021 to January 2023. A total of 200 patients undergoing primary THA were equally divided into RATHA (using the MAKO SmartRobotics system) and CTHA cohorts. Propensity score matching adjusted for demographics and baseline characteristics, resulting in 172 matched patients. Primary outcomes included changes in perioperative hemoglobin, estimated blood loss (EBL), and transfusion rates. Secondary outcomes assessed were operative time, length of stay, and transfusion-related adverse events. Results: The RATHA group demonstrated significantly lower post-operative hemoglobin drops (2.49 ± 0.6 g/dL vs. 3.38 ± 1.0 g/dL; p

Study Design Developing an in vitro model for assessing the anti-inflammatory properties of curvularin. Purpose To evaluate the efficacy of natural fungal macrolactone as a therapeutic drug against lipopolysaccharide (LPS)-induced inflammation in primary human nucleus pulposus cells (NPCs) in vitro. Overview of Literature Lumbar disk disease is a common cause of lower back pain (LBP) and sciatica. It is an established fact that inflammation, rather than mechanical compression on the nerve root, plays a role in the cause of LBP and sciatica. Current treatment options for reducing inflammation are either nonsteroidal anti-inflammatory drugs or steroids, prolonged use of which can potentially lead to adverse effects such as gastrointestinal disturbances and renal and cardiac issues. Hence, there is a need for better antiinflammatory drugs with no or minimal complications for treating inflammation-induced LBP and sciatica. Curvularin (Cur), a fungal macrolactone, is known for its anti-inflammatory activity, but nothing is known about its impact on inflammation due to disk pathologies. Methods Primary NPCs were cultured and characterized by flow cytometry and immunocytochemistry using the CD24 antibody and treated with 10 μg/mL LPS for 36 hours and then treated with Cur, betamethasone, and dexamethasone (10 μg/mL) for 48 hours, after which cell cycle analysis, cell viability assay, and gene expression studies (quantitative polymerase chain reaction [PCR] and quantitative real-time-PCR) were conducted. The NPCs treated with Cur downregulated the expression of pro-inflammatory cytokines (tumor necrosis factor-α, interleukin [IL]-1β, and IL-6); matrix metalloproteinases (MMPs; MMP-2 and MMP-3), ADAMTS; and apoptotic marker (cytochrome c). Results In our study, Cur-treated cells showed enhanced expression of collagen 9A1 and insulin-like growth factor receptor 1, indicating the recovery of NPCs from inflammatory assault. Conclusions Based on observations, the anti-inflammatory properties of Cur render it an excellent drug molecule for treating disk degeneration nonsurgically, by direct injection into spinal disks when treating LBP and sciatica.

Aim: This study aimed to compare the patient-reported functional outcomes and patient satisfaction after medial Unicompartmental Knee Arthroplasty (UKA) versus Total Knee Arthroplasty (TKA), performed for anteromedial osteoarthritis (AMOA) of the knee in patients from an Indian population, at a minimum 3-year follow-up. Methods: This is a prospective matched cohort study (1:2 ratio). One hundred and one UKA cases were matched to 206 TKA cases by propensity score matching for age, body mass index (BMI), gender distribution, and the Charlson Comorbidity Index (CCI). The primary outcome (Oxford knee score, OKS) was assessed at a 3-year follow-up, along with secondary outcomes (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC] Score, Forgotten Joint Score (FJS), Anterior Knee Pain (Kujala) score, patient satisfaction, and revision rate at the final follow-up). Results: The UKA group was superior to the TKA group in patient-reported functional outcomes based on the OKS (p = 0.004). Using the FJS score, UKA was more likely to be a forgotten joint compared to TKA (p

Study Design Development of an in vitro model for assessing the anti-inflammatory efficacies of naringin (Nar) and naringenin (NG). Purpose To evaluate the efficacy of natural flavonoids as therapeutic drugs against anti-inflammatory processes in the nucleus pulposus (NP) cells using in-vitro and in-silico methods. Overview of Literature Intervertebral disc (IVD) disease is a common cause of low back pain. Chronic inflammation and degeneration play a significant role in its etiopathology. Thus, a better understanding of anti-inflammatory agents and their role in IVD degeneration and pro-inflammatory cytokines expression is necessary for pain management and regeneration in IVD. Methods We performed primary cell culture of NP cells; immunocytochemistry; gene expression studies of cytokines, metalloproteases, extracellular proteins, and apoptotic markers using quantitative polymerase chain reaction and reverse transcription-polymerase chain reaction (RT-PCR); cytotoxicity assay (MTT); and molecular docking studies using AutoDock 4.2 software (Molecular Graphics Laboratory, La Jolla, CA, USA) to confirm the binding mode of proteins and synthesized complexes. We calculated the mean±standard deviation values and performed analysis of variance and t-test using SPSS ver. 17.0 (SPSS, Inc., Chicago, IL, USA). Results Molecular docking showed that both Nar and NG bind to the selected genes of interest. Semi-quantitative RT-PCR analysis reveals differential gene expression of collagen (COL)9A1, COL9A2, COL9A3, COL11A2, COMT (catechol-O-methyltransferase), and THBS2 (thrombospondin 2); up regulation of ACAN (aggrecan), COL1A1, COL11A1, interleukin (IL)6, IL10, IL18R1, IL18RAP, metalloprotease (MMP)2, MMP3, MMP9, ADAMTS5 (a disintegrin and metalloproteinase with thrombospondin motifs 5), IGF1R (insulin-like growth factor type 1 receptor), SPARC (secreted protein acidic and cysteine rich), PARK2 (parkin), VDR (vitamin D receptor), and BCL2 (B-cell lymphoma 2); down regulation of IL1A, CASP3 (caspase 3), and nine genes with predetermined concentrations of Nar and NG. Conclusions The present study evaluated the anti-inflammatory and regenerative efficiencies of Nar and NG in degenerated human NP cells. Altered gene expressions of cytokines, metalloproteases, extracellular proteins, apoptotic genes were dose responsive. The molecular docking (in silico) studies showed effective binding of these native ligands (Nar and NG) with genes identified as potent inhibitors of inflammation. Thus, these natural flavonoids could serve as anti-inflammatory agents in the treatment of low back pain and sciatica.

Study Design To induce scoliosis in young female Wistar rats using a noninvasive method and to validate this model. Purpose To induce scoliosis in a rat model noninvasively by bracing and to study the corresponding gene-expression profile in the spine and different organs. Overview of Literature Scoliosis involves abnormal lateral curvature of the spine, the causes of which remain unclear. In the literature, it is suggested that scoliosis is genetically heterogeneous, as there are multiple factors involved directly or indirectly in its pathogenesis. Clinical and experimental studies were conducted to understand the etiology of anatomical alterations in the spine and internal organs, as the findings could help clinicians to establish new treatment approaches. Methods Twelve female Wistar rats aged 21 days were chosen for this study. Customized braces and real-time polymerase chain reaction (RT-PCR) primers for rats were designed using Primer 3 software. Radiological analysis (X-rays), histopathological studies, SYBR green, and RT-PCR analysis were performed. Results The spines of six rats were braced in a deformed position, which resulted in a permanent structural deformity as confirmed by X-ray studies. The remaining rats were used as controls. Quantitative studies of the expression of various genes (osteocalcin, pleiotrophins, matrix metalloproteinase-2 [MMP2] and MMP9, TIMP, interleukins 1 and 6, tumor necrosis factor-α) showed their differential expression and significant upregulation (p

Objective: In the Re-NOVATE II study, oral dabigatran provided thromboprophylaxis after total hip arthroplasty and improved compliance postdischarge in a global population. This article aims to identify trends (if any) in the Indian population. Methods: In this prospective, double-blind, double-dummy study, patients scheduled for primary, unilateral, elective total hip arthroplasty were randomized to 220 mg oral dabigatran once daily, starting with a 110 mg half-dose, 1–4 hours after surgery, or subcutaneous enoxaparin 40 mg once daily, starting the evening before surgery. Each group received a placebo of the other study drug. The primary efficacy outcome was the composite of total venous thromboembolism (VTE) and all-cause mortality. Secondary outcome measures were composite of major VTE and VTE-related mortality during the treatment period. The major safety outcome was incidence of bleeding events. Results: Of the 179 Indian patients randomized, 91 received oral dabigatran and 88 received subcutaneous enoxaparin for 28–35 days. Total VTE and all-cause mortality occurred in 18.7% of patients in the dabigatran group and 13.7% in the enoxaparin group [odds ratio = 1.4 (95% confidence interval 0.6, 3.5)]. Major VTE and VTE-related mortality was numerically lower in the dabigatran group (7.9%) compared with the enoxaparin group (9.9%). Safety outcomes were comparable between both groups. Conclusion: Dabigatran is an effective oral alternative to enoxaparin for thromboprophylaxis as demonstrated by the RE-NOVATE II study global results. Data analyzed in Indian patients indicate comparable effects of dabigatran etexilate for major efficacy and safety outcomes.

Glomus tumours are benign neoplastic lesions of glomus body, a thermoregulatory apparatus of cutaneous microvasculature. These tumours can arise at any location of the body but most commonly seen in subungual region of fingers. Bilateral solitary glomus tumour of hand is a rare entity. We report a case of 54-year-old female who presented with complaints of pain in the right thumb since three years and left thumb pain since 20 years. Clinical examination revealed acute tenderness of both the thumbs. Love’s pin test and Hildreth’s test were positive. MRI revealed characteristic features of glomus tumour. Excision of both the lesions was done and proceeds forwarded to histopathology which confirmed diagnosis. Patient was symptom free immediately following surgery. No nail deformities were noticed and there was no recurrence of symptoms in one year follow up. Glomus tumours of the hand are a rare entity and often missed.

AbstractThe dynamics of international trade play a pivotal role in shaping economic growth and development for nations worldwide. This significance is particularly pronounced in the context of India’s agrarian economy. With a substantial portion of its population dependent on agriculture, engaging in global trade presents a myriad of advantages. As a member of the World Trade Organization (WTO), India benefits from a framework that fosters transparent and fair-trade relations, enabling dispute resolution and favourable negotiations. India’s agro-climatic diversity grants it a competitive edge in cultivating various agricultural products, predominantly rice. Enabling policies, like Minimum Support Price and subsidies, incentivize farmers, while adherence to international quality standards enhances the acceptance of Indian rice abroad. The gravity model employed in this study to analyze India’s rice trade with major importing countries, offers valuable insights into trade dynamics. When delving into specific determinants of trade, the Heckman selection equation proves useful. Factors like Gross Domestic Product (GDP), per capita income, trade history, and exchange rates consistently impact partner selection. The likelihood of choosing a trading partner is influenced by economic compatibility, historical trade relations and WTO membership. Additionally, shared borders and regional affiliations play a role, while economic recessions tend to decrease partner selection due to reduced demand. Examining trade quantity reveals nuanced dynamics. Historical trade interactions, economic indicators and WTO membership consistently influence trade volumes. Larger GDPs, per capita incomes, and populations of trading partners enhance trade prospects, while disparities in income and exchange rate fluctuations impact trade negatively. Importantly, distance remains a key factor affecting trade volume, as logistical complexities and transportation costs influence trade decisions. These findings shed light on trade dynamics, enabling evidence-based policy decisions to enhance trade relationships, boost competitiveness and propel India’s rice exports to new heights.

AbstractThis study offers a comprehensive analysis of the impact of extreme weather events, intensified by climate change, on India’s real Gross National Product. Focusing on hydro-geological factors crucial for India’s Gross National Product, the Auto Regressive Distributed Lag model reveals significant insights. Notably, the study reveals a significant positive correlation between the lagged real GNP (GNP(−1)) and current real GNP, emphasizing the persistence of economic growth trends. Gross Fixed Capital Formation emerges as a key determinant, with a 0.50% increase in economic growth corresponding to a 1% rise in GFCF. Forest land and rainfall exhibited substantial positive associations, contributing to a noteworthy 1.674 and 0.099% with economic growth. Conversely, CO2 emissions, rising temperatures (both Maximum Temperature and Minimum Temperature) exerted a significant negative influence on real GNP, emphasizing the need for sustainable emission reduction strategies. ARDL Bounds Test, revealed existence of a long-run relationship between real GNP and the selected variables. An ECM-Long Run Test underscores the lasting impact, with a 32.4% adjustment towards long-run equilibrium. The study establishes a bi-directional causality between real Gross National Product and carbon dioxide emissions, emphasizing the interconnectedness of economic growth and emissions. This underscores the urgency for addressing climate change alongside sustainable economic development. The findings serve as a crucial guide for evidence-based policymaking, urging proactive strategies to navigate climate challenges and ensure a prosperous, sustainable future for India. The findings contribute to the existing literature, emphasizing the multifaceted nature of factors shaping India’s sustained economic development.

Objective: The objective of this study was to investigate the relationship between Vitamin D levels, radiographic severity, and functional status in patients with primary knee osteoarthritis (OA). Materials and Methods: A cross-sectional study was conducted on 71 patients with primary knee OA. Clinical and radiological evaluations were performed to confirm the diagnosis of knee OA. Vitamin D levels were measured, and radiographic severity was assessed using the Kellgren–Lawrence grading system. Functional status was evaluated using Lequesne’s indices. Statistical analyses were conducted to compare variables between patients with deficient Vitamin D levels (

Introduction: Silver nanoparticles (AgNPs) derived from natural sources have garnered significant attention due to their unique properties and eco-friendly production methods. With lung cancer remaining a major global health issue, there is a continuous need for novel and effective therapeutic approaches beyond conventional treatments such as chemotherapy, immunotherapy, and targeted therapies. Objective: This study aims to synthesize AgNPs using plant extracts from Gymnema sylvestre, Moringa oleifera, and Azadirachta indica and to evaluate their anticancer activity, particularly their effects on gene expression in A549 lung cancer cells. Methods: AgNPs were synthesized using green chemistry techniques and characterized by X-ray diffraction (XRD) and Fourier-transform infrared spectroscopy (FTIR). Gene expression studies were performed to assess the impact of AgNPs on cancer-related genes such as VEGF and CYCLIN-D1. Cytotoxicity assays were conducted on A549 cells to determine the anticancer potential of the synthesized AgNPs compared to plant extracts alone. Results: XRD confirmed the formation of crystalline AgNPs, while FTIR indicated the presence of bioactive compounds interacting with the nanoparticles. Gene expression analysis revealed significant downregulation of VEGF and CYCLIN-D1, suggesting inhibitory effects on angiogenesis and cell cycle progression. The synthesized AgNPs exhibited potent cytotoxic activity against A549 cells, with enhanced efficacy compared to the leaf extracts alone. Conclusion: The study highlights the potential of AgNPs synthesized from medicinal plant extracts as promising candidates for lung cancer therapy. Their environmentally sustainable production, combined with their ability to target key cancer pathways, positions them as innovative and affordable therapeutic agents in the field of nanomedicine. [ABSTRACT FROM AUTHOR]