Fractures of the odontoid process of the axis usually occur transversely at the neck or base of the odontoid, are often displaced, and frequently require surgical fixation. Sagittal or coronal ...fractures are uncommon and can best be visualized on coronal or sagittal reconstruction of CT scans. Routine radiographs may not allow precise diagnosis. Vertical fractures, either sagittal or coronal, generally do not require operative treatment. This report describes an unusual fracture of the odontoid process sustained by a 56-year-old male after falling down a flight of stairs. He was neurologically intact, and the fracture healed with immobilization in a rigid cervical brace. Only 11 other case reports have been identified in a literature review. Both coronal and sagittal reconstructions should be obtained in suspected cases of odontoid fracture. Without instability on flexion/extension views or ligamentous injury on an MRI scan, a rigid brace or halo vest can be used to promote healing of the fracture, which may occur in 12 weeks.
Canadian contributions to cerebrovascular neurosurgery have been disproportionately large and, with some exceptions, relatively unrecognized. In this review, some of the efforts in the advancement of ...cerebrovascular neurosurgery by Canadian neurologists and neurosurgeons are described.
The present investigation was undertaken to study the role of polyamines and rutin in combination with metformin in the streptozotocin-induced diabetes mellitus rat model. The anti-hyperglycemic ...activity was evaluated using pharmacological, biochemical, cellular, and histological paradigm. Streptozotocin -induced diabetic rats with proven hyperglycemia (> 270 mg/dl) were treated orally with polyamines, rutin, and metformin in combination for 30 days. Parameters like blood glucose, oral glucose tolerance, glycosylated hemoglobin, glucose uptake, and transport, liver glycogen, serum insulin, endogenous antioxidants in vital organs, serum cytokines (TNF-α and IL-6), serum marker enzymes for liver and pancreas and histoarchitecture alterations were studied. Treatment with polyamines, rutin, and metformin elicited significant (
p
˂ 0.001) anti-hyperglycemic activity in combinatorial treated group rats. Furthermore, the treatment significantly altered the oral glucose tolerance pattern, enhanced glucose uptake, and transport, decreased glycogen content in the liver, increased serum insulin levels, restored depleted endogenous antioxidants, and inhibited elevated pro-inflammatory cytokines. Improvement in hepatic and pancreatic function was evidenced by the enzymatic markers studied. Histoarchitecture of the pancreas and liver was also improved remarkably. The enhanced anti-hyperglycemic activity with polyamines + rutin + metformin may be attributed to (a) amelioration of oxidative stress, (b) inhibition of inflammatory cytokines, and (c) enhancement of peripheral glucose utilization. Further, it emphasizes the specific role of polyamines and natural polyphenolic flavonoids in modulating glucose homeostasis possibly through insulin sensitization and potentiating metformin efficacy suggesting that polyamines and rutin may be combined as adjuvants along with metformin in the clinical management of diabetes mellitus.
Graphical Abstract
The stem bark of tree Ficus bengalensis Linn (Moraceae) is known to induce anti-inflammatory activity and also used for the treatment of inflammatory diseases in Indian traditional system of ...medicine. Therefore, in the present study, its anti-arthritic activity was evaluated and compared with methotrexate, dexamethasone and diclofenac sodium, using experimentally induced arthritic animal models.
The methanolic extract of Ficus bengalensis (MEFB) was studied in formalin and Complete Freund's adjuvant (CFA) induced arthritis in rats using relevant biological and biochemical parameters, viz. paw edema volume, arthritic score, oxidative stress biomarkers lipid peroxidation, nitric oxide (NO), antioxidants (enzymatic and non-enzymatic), serum lysosomal enzymes (AST, ALT and LDH), connective tissue biomarkers (hydroxyproline, sialic acid and glucosamine), pro-inflammatory mediators (TNF-α and IL-6) and radiographic pattern of hind legs.
Treatment with MEFB, methotrexate, diclofenac and dexamethasone elicited reduction in paw edema and arthritic score, amelioration of oxidative stress, prevention of elevation of LPO and NO, restoration of antioxidants (in edematous and liver tissues), inhibition of serum lysosomal enzymes, biomarkers of connective tissue, and pro-inflammatory cytokines along with improvement of radiographic features of hind legs. Further, MEFB reduced acetic acid induced pain syndrome in mice. Evaluation of our experimental findings suggests that anti-arthritic activity of MEFB (400mg/kg) was slightly better than diclofenac sodium and less than that of methotrexate and dexamethasone.
The antioxidant property of MEFB may largely be responsible for its anti-arthritic activity, and can be a feasible therapeutic candidate for the treatment of chronic arthritis.
Objective: To evaluate the anti-inflammatory activity of exogenously
administered polyamines on experimentally induced acute and chronic
inflammation in wistar rats and to elucidate their possible ...mechanism
of action. Materials and Methods: The in vivo anti-inflammatory
activity of polyamines was studied using acute (carrageenin paw edema),
sub-acute (cotton pellet granuloma) and chronic (Freund′s
adjuvant induced arthritis) models of inflammation. The biochemical
parameters like liver lipid peroxides, SGOT and SGPT were also
measured. Results: Polyamines exhibited significant anti-inflammatory
activity in acute, sub-acute and chronic models of inflammation.
Polyamines treatment inhibited the increase in lipid peroxides in liver
and the serum concentration of marker enzymes (glutamate oxaloacetate
transferase and glutamate pyruvate transferase) during inflammation.
Conclusion: Polyamines possess anti-inflammatory activity in acute and
chronic inflammation which can be attributed to their anti-oxidant and
/or lysosomal stabilization properties.
Case series.
To identify an alternative etiology for the development of upper extremity weakness after cervical spine surgery.
The development of proximal upper extremity paresis after cervical ...decompression surgery is commonly diagnosed as postoperative C5 palsy. Symptoms most commonly consist of weakness involving the deltoid and/or biceps brachii muscles, and in many patients there is also associated pain in the shoulder region with or without sensory deficits. Interestingly, the onset of symptoms is often delayed until days to weeks after surgery. The pathogenic mechanisms underlying postoperative C5 palsy remain unclear, although direct injury to the nerve root during surgery or a traction injury from a tethering phenomenon are frequently cited. These explanations seem unlikely, however, given the delayed onset of symptoms.
Two patients who underwent cervical decompression surgery with subsequent development of shoulder pain associated with proximal upper extremity weakness are presented.
Based on clinical presentation and nerve conduction/EMG studies, both patients were diagnosed with brachial neuritis. This article describes an alternative diagnosis for the constellation of symptoms typically attributed to postoperative C5 palsy. Specifically, brachial neuritis is a type of peripheral neuropathy that involves the sudden onset of pain in the shoulder girdle followed by weakness, most commonly of the deltoid and spinati muscles.
Brachial neuritis appears to be an under-recognized cause of delayed-onset shoulder pain associated with upper extremity weakness that develops as a consequence of the stress of surgery rather than as a complication of surgical technique.
The herbal formulation, AVM is a proprietary formula that consists of extracts of herbs that have been used in Indian traditional medicine to promote physical and mental health, improve defense ...mechanisms of the body and enhance longevity. AVM (500 and 1000 mg/kg) was tested for its adaptogenic activity by determining antistress, anabolic and immunomodulatory effects. In antistress activity, pretreatment with AVM significantly attenuated the changes in ascorbic acid (from blood and adrenal), cortisol (from plasma and adrenal) and adrenal gland weights induced due to restrain stress (physical immobilization). Its antistress effect at 1000 mg/kg was comparable to that of diazepam (5 mg/kg) treated group. Leucopenia, and anemia induced by cyclophosphamide (CYP) was shown to reduce significantly by AVM. Treatment of AVM + CYP had increased spleen and thymus weights significantly as compared to CYP alone treated group. The anabolic activity was evaluated by weight gain of the levator ani muscle, ventral prostrate gland and seminal vesicles in rats as compared to untreated control.
The effect of Shakrino, a herbomineral medicine (HMM)) on early diabetic nephropathy in rats was evaluated. The occurrence of early diabetic nephropathy (DN) in rats treated with streptozotocin was ...revealed by hyperglycemia, depleted liver glycogen, decreased glucose uptake by peripheral tissue, impaired renal function, increased lipid peroxidation and decreased antioxidants in kidney. These changes were associated with increased total urine output, urinary albumin excretion rate, urinary albumin to creatinine ratio, increased relative kidney weight, increased arterial blood pressure, decreased glomerular filtration rate and urinary creatinine in DN rat. HMM treatment (200 and 400mg/kg, p.o., 4 weeks) lowered blood glucose, glycosylated haemoglobin, creatinine, blood urea nitrogen, lipid profiles, serum albumin and total urine output, urinary albumin excretion rate, urinary albumin to creatinine ratio, relative kidney weight, increased urinary creatinine and GFR, and also restored depleted antioxidants, decreased malonolaldehyde formation in kidney of DN rats. Histoarchitecture study showed dense mesangial matrix in glomeruli of DN rats, which were improved by HMM treatment. The protective effect of HMM may be due to the presence of antioxidants like gallic acid, quercetin, β-sitosterol, Jamboline, ellagic acid, gymnemic acid B, α-amyrin and polyphenols.
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