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Obesity is a global health crisis affecting developing nations, including India. The management of obesity continues to evolve with newer drugs, metabolic and bariatric surgery and endoscopic interventions, requiring family physicians and specialists to adapt their clinical practice accordingly. There is an urgent need for a standardized algorithm to diagnose, stage, and treat obesity. The Endocrine Society of India (ESI) and the Obesity Surgeons Society of India (OSSI) appointed a steering committee to develop an evidence-based algorithm for managing patients with obesity in India. This was put to vote by 80 specialists (38 from OSSI and 42 from ESI) in a physical meeting. A proposed stage-wise algorithm based on Edmonton Obesity Staging System, Asian definition of obesity, and resources in India, received 100
Abstract Background Chronic neck pain is one of the common musculoskeletal condition associated with prolonged sitting, poor posture, increased screen time and muscle imbalance. It typically results in neck pain, tight upper trapezius muscles, decreased cervical ROM, and difficulty with activities of daily living. Myofascial release (MFR) and postural correction are common physiotherapy interventions to manage these symptoms. Case Presentation: A 25-year-old female student presented with a 4-month history of bilateral neck pain. She reported a VAS score of 7/10, tenderness and tightness of the bilateral upper trapezius muscles, and mild restriction in the cervical R.O.M. The symptoms were aggravated by prolonged sitting, mobile phone use and increased academic workload. Intervention: The patient was given 5 sessions per week for 2 weeks of myofascial release (MFR) to the bilateral upper trapezius muscles, postural correction exercises, and ergonomic education. Results: In this patient the pain was reduced from VAS 7/10 to 3/10 after treatment for 2 weeks. There was a decrease in upper trapezius tightness, increase in cervical ROM, improvement in posture, and ability to perform activities of daily living with less discomfort.. Conclusion The combination of myofascial release and postural correction effectively reduced pain, improved cervical ROM, reduced muscle tightness and improved functional ability in a chronic cervical pain patient. Keywords: Chronic cervical pain, Myofascial release, Upper trapezius, Postural correction, Physiotherapy
Dentinal microcrack formation during root canal preparation is a critical concern as it predisposes to vertical root fracture and treatment failure. Therefore, it is of interest to evaluate microcrack formation after instrumentation with three nickel-titanium systems (ProTaper Gold, WaveOne Gold and HyFlex EDM) using high-resolution micro-computed tomography. Hence, sixty human mandibular premolars (n=20 per group) were scanned pre-and post-instrumentation and microcracks were assessed for number, length and depth by blinded examiners. WaveOne Gold showed the highest microcrack formation, ProTaper Gold demonstrated intermediate values and HyFlex EDM exhibited the least dentinal damage, with statistically significant differences among groups (p<0.05). Heat-treated NiTi instruments produced fewer microcracks, indicating that file design and kinematics significantly influence dentinal integrity during root canal preparation.
Alzheimer's Disease (AD) is a progressive neurodegenerative condition and the leading cause of dementia, marked by memory impairment, cognitive deterioration, and alterations in behaviour. Initially identified by Alois Alzheimer in 1906, the disorder has since garnered significant attention within the field of neuroscience. The defining pathological characteristics include the presence of extracellular amyloid-beta plaques, intracellular neurofibrillary tangles formed by hyperphosphorylated tau protein, and extensive neuronal degeneration. On a global scale, AD poses a considerable public health issue, currently affecting over 55 million individuals with dementia, a figure anticipated to rise beyond 139 million by 2050 due to the aging population. The disease predominantly impacts those aged 65 and older, with a higher incidence observed in women. Contributing factors to the development of AD encompass genetic vulnerabilities, such as mutations in the allele, alongside modifiable elements like cardiovascular health, educational attainment, and lifestyle choices. The economic and social ramifications of AD are significant, with an estimated annual global expenditure exceeding $1 trillion, which includes healthcare costs, caregiving expenses, and lost productivity. Furthermore, the emotional toll on families and caregivers is considerable, often resulting in psychological distress and financial hardship. Epidemiological research indicates variations in the prevalence and incidence of AD across different regions, shaped by demographic, cultural, and healthcare-related factors. Initiatives to combat AD include progress in early diagnostic methods utilizing biomarkers and neuroimaging, the creation of disease-modifying treatments, and public health strategies focused on prevention through the management of risk factors. This review seeks to present a comprehensive overview of the historical context, epidemiology, and global implications of AD, highlighting the pressing necessity for ongoing research and international cooperation to address this escalating crisis.
AIM:The integration of radiomics and radiogenomics in the prognostication of head and neck cancer represents a rapidly evolving field within precision oncology. This systematic review aims to appraise advanced methods in radiomics and radiogenomics concerning prognostication in head and neck cancer, with a particular focus on methodological developments and clinical applications. METHODS:A systematic literature search was conducted across seven major electronic databases: PubMed/MEDLINE, Embase, Web of Science, Scopus, Cochrane Library, CINAHL, and Google Scholar from January 2013 to December 2023. The search strategy incorporated database-specific syntax, controlled vocabulary such as Medical Subject Headings (MeSH) and Emtree terms, and supplementary free-text terms. RESULTS:Twelve studies were included in the review, and the qualitative analysis revealed three distinct research clusters: prognostic applications, development of predictive models, and molecular-immunological characterization. In all scenarios, studies employing multi-modality modelling were significantly more competent than those relying on single-modality analyses. The area under the curve values of machine learning ranged across 0.71-0.86, outperforming traditional statistical approaches. Larger cohort studies exhibited superior validation metrics. While predictions of molecular characteristics varied, the prediction of immune phenotypes was superior to that of specific genetic alterations. Studies incorporating external validation provided stronger evidence supporting clinical usability. Although some studies presented moderate risk due to early-phase methodological variability, nearly half demonstrated low overall bias. CONCLUSIONS:Our findings indicate significant advances in the prognostication of head and neck cancer through radiomics and radiogenomics approaches. Combined modelling strategies that integrate clinical, radiomic, and genomic features yielded enhanced performance. Despite the development of newer studies with greater methodological rigor and robust validation, variability in feature extraction, processing pipelines, and reporting metrics necessitates further consolidation of methodologies in this field.
