Background: Out of 3 billion base pairs in human genome only ~2% code for proteins; and out of 180,000 transcripts in human cells, about 20,000 code for protein, remaining 160,000 are non-coding transcripts. Most of these transcripts are more than 200 base pairs and constitute a group of long non-coding RNA (lncRNA). Many of the lncRNA have its own promoter, and are well conserved in mammals. Accumulating evidence indicates that lncRNAs act as molecular switches in cellular differentiation, movement, apoptosis, and in the reprogramming of cell states by altering gene expression patterns. However, the role of this important group of molecules in angiogenesis is not well understood. Angiogenesis is a complex process and depends on precise regulation of gene expression. Conclusion:Dysregulation of transcription during this process may lead to several diseases including various cancers. As angiogenesis is an important process in cancer pathogenesis and treatment, lncRNA may be playing an important role in angiogenesis. In support of this, lncRNA microvascular invasion in hepatocellular carcinoma (MVIH) has been shown to activate angiogenesis. Furthermore, lncRNA-Meg3-knockout mouse showed increased expression of vascular endothelial growth factor pathway genes and increased cortical microvessel density. Overall, there is strong evidence that lncRNA is an important class of regulatory molecule, and a number of studies have demonstrated that these can be targeted to change cellular physiology and functions. In this review, we have attempted to summarize these studies and elucidate the potential of this novel regulatory molecule as a therapeutic target.
BACKGROUND Diagnostic imaging is one of the most revolutionary innovations in the medical world. It has revolutionized how physicians and patients view health and diseases. However, the dearth of radiologists to read these images has been an impending problem worldwide. Digitization of medical images in standard Digital Imaging and Communications in Medicine (DICOM) format and the seamless integration of imaging modalities through the Picture Archiving and Communication System (PACS) has enabled easy acquisition and transfer of images across networks for viewing, enabling the teleradiology platform for reporting by radiologists from anywhere. CARE was one of the first to adopt this technology through a public private partnership model with district hospital, Mahabubnagar in 2001. Over the last 18 years, we are connected to district hospitals, private centres across India, small sized hospitals and also to some international diagnostic centres in Nigeria and Iraq. This paper highlights our experiences in Teleradiology across district hospitals, private centres and international centres and also showcases the turnaround time for reporting routine and emergency cases through this mode of technology. METHODS All imaging modalities namely computed radiography (CR), computed tomography (CT) and magnetic resonance imaging (MRI) that were used are DICOM compliant. These machines were seamlessly integrated and configured adhering to the DICOM protocol to push images through DICOM gateway service to receive images according to set predefined standards. The PACS server had MS SQL database to host all the patient demographics along with history for each case and all images were archived based on a file system architecture. Virtual assistants help radiologists by transcribing the report online, after which another team scrutinizes for quality assurance of the reports transcribed before finally signing off the report. RESULTS Teleradiology network was established with 3 district hospitals (Mahabubnagar, Tandur and Nalgonda), 9 private centres (Balaji
There are a few signs in radiology which are based on many common objects or patterns that we come across in our routine lives. The objective behind the association between such common objects and the corresponding pathologies is to make the reader understand and remember the disease process. These signs do not necessarily indicate a particular disease, but are usually suggestive of a group of similar pathologies which will facilitate in the narrowing down of the differential diagnosis. These signs can be seen in different imaging modalities like plain radiograph and computed tomography. In this essay, we describe 24 classical radiological signs used in chest imaging, which would be extremely helpful in routine clinical practice not only for radiologists but also for chest physicians and cardiothoracic surgeons.
Introduction: Total knee replacement (TKR) surgery has become the most successful surgery for patients with severe debilitating arthritis. The guidelines for rehabilitation progression should be tailored respecting the tissue healing parameters. Hence, the current literature states a need for protocol to mitigate these impairments and ultimately result in improved functional outcomes.Objective: The present study aimed to validate the content of TKR rehabilitation protocol in Indian population. Materials and Methods:The process of content validation involves development stage and expert judgment stage. The protocol was designed into three stages with extensive review of literature. After designing the protocol, nine experts in field of musculoskeletal Physiotherapy performed the judgemental process. The process of validation includes rating of experts in a 5 point likert grading on two parameters namely relevance and ease of performance. Based on expert's inputs on TKR protocol, the level of agreement, content validation index and kappa value was calculated. Results:The three staged TKR protocol almost exhibited an excellent agreement on all stages. However, muscle activation exercises (except Vastus medialis obliques activation), stretching, strengthening program and functional training showed 100% agreement than other stages. Conclusion:The structured TKR protocol exhibited excellent content validity to its use in Indian population.
Purpose.To evaluate outcome of 6-strand triple Kessler repair for flexor tendon injuries, followed by early active motion rehabilitation. Methods. 25 men and one woman (36 fingers) underwent 6-strand triple Kessler repair for flexor tendon injuries in zones 2 to 5, followed by early active motion rehabilitation. Rehabilitation was started at days 3 to 5. Patients were instructed to passively flex all the fingers with the uninjured hand and to actively retain this position for 10 seconds. Active extension within the confines of the splint was allowed. At the end of week 8, strength training was commenced until a satisfactory range of motion was regained. Outcome measures included total active motion, grip strength, and the Disabilities of the Arm, Shoulder and Hand (DASH) score. Complications such as infection and wound dehiscence were recorded. Results. The mean follow-up was 1.2 (range, 1-2) years. Outcome was excellent in 24 digits, good in 4, and poor in 8. The mean grip strength was 80%Early active motion protocol following triple Kessler repair for flexor tendon injury S Rajappa, PG Menon, M Mohan Kumar, D Gokul RajDepartment of Orthopedics and Hand surgery, Sri Ramachandra University, Porur, Chennai, Tamil Nadu, India Address correspondence and reprint requests to: Dr S Rajappa, B2 Clinic, Sri Ramachandra Medical Centre, Porur, Chennai, Tamil Nadu, 600 116, India. Email: chickko2002@yahoo.com Surgery 2014;22(1):96-9 (range, 60-100%) of normal in dominant hands and 60% (range, 50-65%) of normal in non-dominant hands. The mean DASH score was 15 (range, 0-52). One patient had wound dehiscence and superficial infection. Conclusion. Six-strand triple Kessler repair for flexor tendon injuries, followed by early active motion rehabilitation yields satisfactory results. Journal of Orthopaedic
ObjectiveProspectively analyze the effect of preoperative walking status and the patient's surgical education on functional outcomes and the three dimensions of quality of life (QoL) (pain, physical function, and mental health) after elective total knee arthroplasty (TKA).MethodsA comparative analysis on the QoL and functional outcomes in patients who underwent total knee arthroplasty between January 2014 and June 2015. To compare effects of the patient's walking status and knowledge of the surgical procedure on QoL and functional outcomes following TKA by means of SF-36 questionnaire, CES D10, VAS, KSS, KSFS, WOMAC, as well as Friedmann and Wyman scores, 10MWT, and 30-second timed chair test, assessed before the operation and one, three, and six months after the operation.ResultsThere were 168 knees in 154 patients: 46.75% men and 53.24% women. 52.38% of knees had grade-III OA and 40.47% of knees had grade-IV OA. Preoperatively, SF-36 PCS was 33.2 and MCS was 35.4. Mean KSS and KSFS in females was 37.3 (16.2) and 31.5 (13.8); in males it was 49.2 (18.4) and 42.5 (15.7), respectively. Mean WOMAC scores were 64.2 in females and 56.5 in males. Mean VAS and CES D10 scores were 8.8 and 8.2 in females, and 6.9 and 6.4 in males, respectively. Post operatively at the first, third, and sixth month, significant improvements in QoL and mean SF-36, CES D10, VAS, KSS, KSFS, WOMAC, and Friedmann and Wyman scores were observed, as well as in the 10MWT and 30 s timed chair test scores. Patients with better preoperative functional activity and satisfactory understanding of TKA presented a better functional performance and achieved a good quality life (p < 0.01).DiscussionSurgeons educate TKA candidates regarding the surgical procedure, the nature of implants, and how the procedure would affect their lifestyle and what their expectations from TKA should be. These crucial considerations should boost their confidence, enhancing their involvement and cooperation in post-surgical rehabilitation, thereby improving their QoL, functional results, and post TKA experience.ConclusionTKA candidates with good preoperative walking ability and understanding of knee arthroplasty have better QoL in early and late post-surgery periods. Patient's lifestyle and understanding significantly enhances the postoperative functional ability.
<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">We planned to evaluate functional and radiological outcomes of mono-lateral limb reconstruction system for infected non-union of long bones and to analyse its complications occurring.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">It was a prospective study, conducted during period of September 2015 to August 2017 and consisted of 73 cases of these 60 cases were available for final assessment. This infected non-union were classified by AO classification and were treated with mono lateral limb reconstruction system. All the cases were evaluated by ASAMI criteria for bony and functional outcomes. Our mean follow up period was 16.8 months</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> Among 60 cases of infected non-union with mono-lateral external fixator were followed for mean 16.8 months. According to these ASAMI criteria in our study 26.6% had excellent; 46.6% had good; 16.6% fair; and 10% poor bony outcome. And the functional outcomes were 13.3%, 60%, 16.6%, 10% were excellent, good, fair and poor respectively. <span lang="EN-IN">Among the cases 50% had pin tract infections and loosening. Two cases pin revision was done. Sinus tract got cleared in all cases except 6 where multiple sinus tracts were present and healing did not occur. There were no infections at the corticotomy site. Delay in the consolidation phase was present in all cases. There was no difficulty in transportation of bone. Post-operatively wound dehiscence in eight cases was managed with split skin graft cover. Limb length discrepancy upto 2.5 cms in lower limb was managed with modified footwear with heel and sole raise. Non-healing fractures united in mean 5.9 months after start of treatment. Non-union site united in 90% cases. </span><strong>Conclusions:</strong> <span lang="EN-IN">Mono-lateral limb reconstruction system is efficient method for treatment of infected non-union of long bones. It has an additional advantage of correcting limb length discrepancies which sometimes occur during the course of treatment.</span></p><p class="keywords"><strong>Keywords: </strong>Non-union, Infection, Long bones, Limb reconstruction system, External fixator</p>
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