South Eastern European Journal of Public Health (SEEJPH - Universität Bielefeld)
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OUTCOMES OF SURGICAL MANAGEMENT OF HAGLUND’S TRIAD BY USING ACHILLES TENDON CENTRAL SPLITTING APPROACH ANDREATTACHING WITH SUTURE ANCHORS - A PROSPECTIVE STUDY
Full text linkPosterosuperior calcaneal prominence, also known as Haglund’s deformity, can often lead to retrocalcaneal bursitis, a significant cause of posterior heel pain. Surgery is indicated for symptomatic patients, after a period of conservative treatment including analgesia, physiotherapy, activity and/or shoe wear modification has failed. Surgical options include both open and endoscopic techniques, and typically involve excision of the retrocalcaneal bursa, resection of the calcaneal prominence, and debridement of the diseased Achilles tendon.In our study, weevaluated the outcomes of surgical management of Haglund\u27s triad using Achilles tendoncentral splitting approach with Achilles tendon partial detachment and debridement, excision of the retrocalcaneal bursa, resection of Haglund\u27s prominence, and reattachment of the Achilles tendon with anchor sutures. A total of 22 patients who came to OPDwere taken into the study, the surgical outcomes of whom were evaluated and postoperative followupwas done .The VisualAnalogScale (VAS)pain score, and American Orthopaedic Foot and Ankle Society(AOFAS) Ankle-Hindfoot scale score were collected preoperatively, 6 months postoperatively and at the last visit. Significant improvement was found in the mean VAS pain score, and average AOFAS Ankle-Hindfoot scale score. The technique of excision of Haglund’s lesion we used, not only provided good pain relief and functional improvement, but also enhanced thepatients’ daily activity of living. More research is required to further evaluate the outcomes of our surgical approach to treat Haglund\u27s triad and the possible risk factors
Guided Endodontics: Redefining accuracy in Endodontic treatment
Full text linkGuided endodontics has emerged as a transformative approach in modern endodontic care, particularly for cases involving complex anatomical challenges such as pulp canal obliteration and calcified root canals. This study explores the principles, clinical applications, and future directions of guided endodontics, with a focus on static/template-guided techniques. By integrating cone-beam computed tomography (CBCT), digital planning software, and 3D printing technologies, guided endodontics offers superior precision, reduced procedural errors, and enhanced preservation of tooth structure compared to conventional methods. The study also highlights the benefits of minimally invasive dentistry, demonstrating improved outcomes for patients and a significant reduction in operator dependency. However, challenges such as limited applicability in curved canals, high equipment costs, and the steep learning curve for dynamic systems remain barriers to widespread adoption. Future advancements, including the integration of artificial intelligence, augmented reality, and improved biocompatible materials, hold promise for expanding the clinical utility of guided endodontics. High-quality clinical studies and cost-effective innovations are needed to address current limitations and establish guided endodontics as a standard of care. This comprehensive review underscores the potential of guided endodonticsto redefine the field by enhancing precision, efficiency, and patient outcomes in endodontic procedures
The Gingee Nayak Dynasty: An Epigraphical Study of Economic Strategies and Taxation
Full text linkThe Gingee Nayaks, who ruled from the 16th to 17th centuries in Tamil Country, implemented various innovative measures to ensure economic stability and prosperity. This study delves into the economic strategies and taxation policies during the Gingee Nayak Dynasty, as revealed through epigraphical evidence. By examining inscriptions found in temples and other historical sites, the research uncovers the intricacies of their tax policies, including land grants, tax exemptions, and support for religious institutions. These records illustrate how the Nayaks used economic tools to foster growth and maintain social order. The study highlights the significance of land donations for lamp lighting and other temple needs, reflecting the deep integration of economic practices with religious and cultural life. Through this epigraphical analysis, the research provides a comprehensive understanding of the socio-economic landscape during the Gingee Nayak period, offering insights into the administration and its impact on the region\u27s development. The findings underscore the importance of inscriptions in reconstructing historical narratives and understanding the governance mechanisms of the past.
Maternal Visceral Adipose Tissue as a Predictor of Gestational Diabetes Mellitus
Full text linkBackground: Gestational Diabetes Mellitus (GDM) is a significant health concern during pregnancy, affecting both maternal and fetal outcomes. Timely identification of women at high risk for GDM is critically important for promptly initiating interventions. This study investigates the potential of first-trimester visceral adipose tissue (VAT) thickness, measured via ultrasound, as a predictor for GDM.Methodology: This hospital-based prospective cohort study was conducted at Mahatma Gandhi Medical College and Research Institute, Pondicherry. A total of 212 pregnant women attending the antenatal outpatient department for their nuchal translucency (NT) scan at 11-14 weeks of gestation, between December 2022 and February 2024, were enrolled. Pre pregnancy BMI was calculated based on self –reported pre pregnancy weight (kg) or retrieved from medical charts. VAT and SAT (Subcutaneous Adipose Tissue thickness) was measured at the time of ultrasound scan. Women were followed up till delivery. Association of SAT and VAT measurements as a predictor of GDM was determined using multiple regression analysis and ROC analysis was used to determine the cutoff value of SAT, VAT for prediction of GDM.Results: The prevalence of GDM among the antenatal women was 17.5%. Management of GDM included diet and medical nutrition therapy (10.81%), oral hypoglycemic agents (43.24%), insulin (37.83%), and a combination of both (8.10%). There was no significant difference in age or obstetric score between the GDM and non-GDM groups. However a higher prevalence of GDM was observed in the well-educated group (p=0.025). Significant differences were also noted in SAT, VAT, and total adipose tissue (TAT) measurements, with higher values in the GDM group. VAT and TAT demonstrated strong predictive validity for GDM, as indicated by high AUC values and significant p-values (both <0.001). The GDM group had higher mean newborn weights (p<0.001), although differences in APGAR scores at 1 and 5 minutes were not statistically significant.Conclusion: Measuring visceral adipose tissue via ultrasound in early pregnancy shows promise as an effective predictor of gestational diabetes mellitus. Incorporating VAT measurement into routine early pregnancy screening could facilitate early interventions, potentially improving outcomes for both mothers and their infants
“Facial nerve monitoring and Diffusion Tensor Imaging in vestibular schwannoma surgery in low- and middle-income countries -A systematic review of financial consideration”.
Full text linkThere are differences in surgical care comparing the nations with high, low, and moderate incomes. Vestibular Schwannoma surgery techniques have undergone lot of revolution in the last century. IONM are being widely used in developed countries and being propagated in LMICs with great enthusiasm. The goal of the current investigation was to systematically review the published literature and to find out the costs and utility of vestibular schwannoma surgery performed with the aid of IONM and DTI in resources poor countries. Methods: -Direct basic costs for surgery and cost of IONM and DTI were calculated from previous studies. Cost of IONM and DTI is added to overall cost if they are used. To assess the impact of these modern technologies ,3 macro-scenarios were considered: (1) Vestibular schwannoma surgery without IONM (2) Vestibular schwannoma surgery with IONM (3) Vestibular schwannoma surgery with IONM and DTI. To calculate the average cost, probability model was used and it was assumed that 100 cases were operated in each scenario and average cost were calculated after including complications and their management. Results: The average cost in the group without IONM was highest (91,699 USD) and in the IONM and DTI group was lowest (83,983 USD) and was 84,686 USD in IONM group. The additional cost of IONM and IONM with DTI cost was 0.414% and 0.558% of total cost respectively per case.Discussion: - In the setting of vestibular schwannoma surgery, IONM with or without DTI is more cost-effective considering impact of facial nerve injury than surgery without IONM. Conclusion: - This analysis shows that the cost-effectiveness of the vestibular schwannoma surgery with IONM and DTI for facial nerve injury and should be encouraged
Risk factors for disabilities among leprosy patients: A systematic review
Full text linkBackground:Physical disability is the main sequelae of leprosy disease that leads to stigma, discrimination, socioeconomic and healthcare burden. The countries with the highest number of new leprosy cases every year are India, Brazil, Indonesia, and Bangladesh. More than half of all new cases of leprosy in the world are diagnosed in India.Considering this, National Strategic Plan (NSP) and Roadmap for leprosy was launchedin January2023, for zero transmission of leprosy by 2027. However, newly reported leprosy cases still have high incidence of disabilities due to multiple factors. Methods and Materials: A total of 110 research articles were reviewed in the (PubMed, GoogleScholar, Cochrane library, Academia, Open access, Directory of open access journals) databasesby using the keywords “leprosy”, “disabilities”, risk factors”. Based on the inclusion and exclusion criteria studies were sorted out and 22 studies were selected for the main analysis. The present systematic review was conducted following published guidelines for reporting systematic reviews and meta-analysis (PRISMA).Results:Most studies used cross-sectional research design and significant studies were retrospective record based. Maximum studies were from India. Sample size ranged from 55 to 22585 cases. Age, male gender, duration of disease, delayed diagnosis, multibacillary lepromatous type of leprosy, number of affected nerves and leprosy reactions were among the most evaluated risk factors
ANTIFUNGAL ACTIVITY OF BIOGENIC METAL SALT COMPLEXES (MnCL2, ZnSO4) WITH AMINO ACIDS
Full text linkThe antifungal activity of complexes formed between biogenic metal salts ( MnCl₂ and ZnSO₄) and amino acids (L-tryptophan) has garnered significant attention due to the combined effects of metal ions and amino acids on biological activity. The interaction between metal ions and amino acids can influence the stability and bioactivity of the resulting complexes, including their potential to inhibit fungal growth. Metal complexes may act synergistically with other antifungal agents, enhancing their efficacy. This synergy can arise from complementary mechanisms of action, such as disrupting fungal cell integrity while concurrently inhibiting key enzymatic functions.The findings show that the zinc and manganese complexes exhibited superior antibacterial activity compared to the tested standard, while the complex with tryptophan (Trp) exhibited satisfactory antifungal properties. This suggests that the complexes could potentially serve as novel active ingredients in dermatological products due to their promising antimicrobial effects. Further research and development could investigate their efficacy and safety in practical applications, particularly in the treatment of skin infections or as part of skin care formulations
Freedom of Expression on Social Networking Sites to Ensure Environmental Justice in India: A Legal Analysis
Full text linkIn a time with many environmental issues, the link between free speech on social media and environmental fairness in India becomes an important legal topic. The growth of digital platforms has changed how activism works, allowing people to raise concerns about environmental damage and lack of government action. This essay provides an in-depth look at the legal rules regarding free speech in India, especially related to discussions about the environment. The role of social media as a way to support environmental efforts is very important; it not only helps spread information but also encourages people to come together against environmental wrongs. By looking closely at the relationship between constitutional rights, social media practices, and environmental laws, this analysis seeks to clarify how strong support for free speech can lead to real advancements in environmental fairness in India, thus protecting the rights of vulnerable communities who suffer more from ecological damage
INFLUENCE FACTORS OF SALES OF VOCAL MUSIC ONLINE LESSONS ON CONSUMERS\u27 PURCHASE INTENTION
Full text linkThis study examines the key factors influencing consumers\u27 purchase intention for online vocal music lessons. The research adopts a quantitative approach, utilizing Structural Equation Modeling (SEM) to analyze the relationships between price, convenience, instructor credibility, and content quality. Data were collected from 401 participants through an online survey, ensuring a diverse representation of consumers engaged in online vocal training. The findings reveal that price (β = 0.199, p < 0.05) and instructor credibility (β = 0.111, p < 0.05) significantly influence purchase intention, confirming H1 and H3. Conversely, convenience (p = 0.872) and content quality (p = 0.942) do not exhibit significant effects, leading to the rejection of H2 and H4. The SEM model demonstrated strong fit indices (SRMR = 0.045, NFI = 0.91), validating the proposed framework. These results indicate that consumers prioritize affordability and instructor reputation over platform accessibility and course materials when selecting online vocal lessons. The study provides practical implications for online education platforms by recommending tiered pricing models, instructor branding strategies, and enhanced consumer engagement techniques. Additionally, future research should explore the role of psychological factors, such as motivation and perceived self-efficacy, in shaping purchase behavior
A Rare Case of Pulmonary Plasmacytoma with Multiple Myeloma Presenting with Bilateral Consolidative Cavitary Lung Lesions
Full text linkPrimary pulmonary plasmacytoma is a rare plasma cell neoplasm. Most reported cases involve the upper aerodigestive tract. Here, we report a 58‐year‐old male presenting with bilateral consolidative cavitary lung lesions. After an extensive investigation, the diagnosis of pulmonary plasmacytoma was suggested and then confirmed with histological and immunohistochemical examinations in addition to kappa light chain paraproteinemia that progressed to multiple myeloma. An autoimmune work-up showed that cytoplasmic and perinuclear antineutrophil cytoplasmic antibodies (C-ANCA and P-ANCA) and other various antibodies being positive but without evidence of vasculitis or autoimmune disease. The patient was started on bortezomib, cyclophosphamide, and dexamethasone chemotherapy for three cycles but subsequently developed a respiratory infection that required intensive care management; he died after few months