Public Financed Health Insurance (PHFIs) Schemes in India | Chapter 6 | Contemporary Research in Business, Management and Economics Vol. 3

 The study aims to highlight the failures of the public financed health insurance (PHFIs) schemes in India. It also aims to highlight the persistence of basic flaws in the new health policy, namely the Ayushman Bharat National Health Protection mission (AB-NHPM). The new National Health Policy (NHP) announced by the government recently, has the same objectives of health attainment, as earlier stated, without specific timeline. The present government has been ambitious and aims to achieve many goals in quick time. The use of military words like “surgical” and “strategic” in government programs and schemes including the present NHP, 2018, indicates towards more clarity and focus on the objectives. Two innovative characteristics of the current program are the "strategic purchase of health care" from the private sector and the integration of health care into a social movement, among many other features. These are large-scale, long-term goals without a deadline, unlike military precision. By its own admission, the key government intervention by spending of 3 percent of GDP in public health facilities is to be achieved only by 2025. The social movement is still a longer-term goal involving decades of scaling and sustainment. Drug pricing of an increasing range of essential drugs should continue to be regulated, along with timely revisions of National Essential List of Medicines (NELM) and appropriate price control mechanisms for generic drugs.

Author(s) Details:

Anil Kumar,
Department of Economics, BITS, Pilani – K. K. Birla Goa Campus, Zuarinagar 403 726, Goa, India.

Aswini Kumar Mishra,
Department of Economics, BITS, Pilani – K. K. Birla Goa Campus, Zuarinagar 403 726, Goa, India.

Please see the link here: https://stm.bookpi.org/CRBME-V3/article/view/13782

Preoperative Soft Tissue Thickness Influences the Alteration of Soft Tissue Movement in Orthognathic Surgery | Chapter 1 | Advancement and New Understanding in Medical Science Vol. 10

 Background: Reports on soft tissue movement after orthognathic surgery exhibit significant variability, with a lack of consensus on standardized measurements. This creates challenges in making accurate predictions about post-surgery tissue movement and determining the potential impact of preoperative soft tissue thickness on the extent of movement.

 

Aim: To investigate the relationship between preoperative soft tissue thickness and the degree of soft tissue movement in comparison to hard tissue movement following orthognathic surgery.

 

Materials and Methods: This study involves a retrospective analysis of lateral cephalometric X-rays obtained from patients who underwent orthognathic surgery at a single medical center between September 1, 2013, and September 1, 2018. Demographic and operative data were gathered. Preoperative cephalometric X-rays were used to measure soft tissue thickness, and postoperative X-rays (taken >6 months after surgery) were superimposed by aligning fixed bony points. Linear regression was employed to investigate the correlation between different variables and the extent of jaw movement.

 

Results: For upper jaw surgeries involving advancements up to 5 mm, there was an observed reduction in the relative movement of soft tissue, correlating with an increase in the initial thickness (r = -0.288). In mandibular advancements, there was a distinct decrease in the ratio of soft tissue movement with an increase in initial soft tissue thickness (r = -0.418). Conversely, there was no correlation in mandibular setback cases (r = 0.062). A similar correlation, demonstrating a decrease in relative soft tissue movement with an increase in initial soft tissue thickness, was identified in advancement genioplasty (r = -0.411).

Conclusion: The findings of this research reveal a consistent pattern of decreased relative movement of soft tissue in orthognathic surgery, which is associated with an increase in its initial thickness.

Author(s) Details:

Michael V. Joachim,
Unit of Oral and Maxillofacial Surgery, Shamir (Assaf Ha-Rofeh) Medical Center, Tzrifin, Israel and Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.

Yair Brosh,
Unit of Oral and Maxillofacial Surgery, Lady Davis Carmel Medical Center, Haifa, Israel.

Murad Abdelraziq,
Department of Oral and Maxillofacial Surgery, The Baruch Padeh Tzafon Medical Center, Poriya, Israel.

Imad Abu El-Naaj,
Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel and Department of Oral and Maxillofacial Surgery, The Baruch Padeh Tzafon Medical Center, Poriya, Israel.

Amir Laviv,
Department of Oral and Maxillofacial Surgery, The Maurice and Gabriela Goldschleger School of Dentistry, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Please see the link here: https://stm.bookpi.org/ANUMS-V10/article/view/13920

Excision of a Gingival Fibroma in the Anterior Maxillary Region of an Edentulous Patient with Diode Laser | Chapter 8 | Advancement and New Understanding in Medical Science Vol. 10

 Gingival fibromas are benign growths of the gingiva with unique histological features. Clinically, they frequently appear as solitary, smooth, hard nodules that may or may not have surface ulcerations. In this report, we discuss the case of a 60-year-old female patient who presented with a nodular gingival mass located on the edentulous alveolar ridge in the maxillary left canine region. The diagnosis of gingival fibroma, which is a gingival pathology with unique histological features, was made based on clinical and histopathological examinations. The lesion was successfully removed with a diode laser in a chairside procedure.

Author(s) Details:

Wissam Sharrouf,
Department of Oral Medicine and Maxillofacial Radiology, Faculty of Dental Medicine, Lebanese University, Lebanon.

Elias Ghosein,
Faculty of Dental Medicine, Lebanese University, Lebanon.

Karim Kaddour,
Faculty of Dental Medicine, Lebanese University, Lebanon.

Georges Aoun,
Department of Oral Medicine and Maxillofacial Radiology, Faculty of Dental Medicine, Lebanese University, Lebanon.

Please see the link here: https://stm.bookpi.org/ANUMS-V10/article/view/13928

Pivotal Roles of APN/AdipoRs Signaling in Maintaining Ocular Homeostasis and Protecting against Eye Ailments | Chapter 10 | Advancement and New Understanding in Medical Science Vol. 10

 This comprehensive review critically examines the latest findings and breakthroughs that underscore the pivotal roles of APN/AdipoRs signaling in maintaining ocular homeostasis and protecting against eye ailments. Explaining the complex interactions between ocular diseases and the flexible fat-associated adipokine adiponectin (APN) has garnered a lot of attention in recent years. Discovering the complex connection between aging eye problems and adipocytokine and its receptors (AdipoRs) has become an exciting area of medical research. Here, we meticulously explore the intriguing mechanisms by which APN protein influences retinal function and overall visual acuity. Drawing from an extensive array of cutting-edge studies, the article highlights APN’s multifaceted functions, ranging from anti-inflammatory properties and oxidative stress reduction to angiogenic regulation within retinal and macula tissues Targeting common aging eye diseases with treatment approaches could be made possible by the role that APN/AdipoRs play in mediating these effects. Furthermore, the interaction between APN signaling pathways and age-related macular degeneration (AMD) is unraveled in this review. The single-cell RNA-seq results validate the expression of both the receptor isoforms (AdipoR1/R2) in retinal cells. The transcriptomic analysis showed lower expression of AdipoR1/2 in dry AMD pathogenesis compared to healthy subjects. The inhibitory adiponectin peptide (APN1) demonstrated over 75% suppression of choroidal neovascularization (CNV), whereas the control peptide did not exert any inhibitory effect on CNV. The elucidation of these relationships fosters a deeper understanding of adipose tissue’s profound influence on ocular health, presenting new prospects for personalized treatments and preventative measures. Because APN1 inhibits CNV and leakage, it can be used to treat human AMD. In conclusion, this review provides a captivating journey into the enthralling world of APN, intertwining the realms of adipose biology and ophthalmology in aging. The remarkable connection between fat, in the form of adiponectin, and t654r4dexzsight opens exciting avenues for advancing eye health and improving patient outcomes.

Author(s) Details:

Mayank Choubey,
Department of Foundations of Medicine, NYU Grossman Long Island School of Medicine, Mineola, NY 11501, USA.

Munichandra B. Tirumalasetty,
Department of Foundations of Medicine, NYU Grossman Long Island School of Medicine, Mineola, NY 11501, USA.

Nalini S. Bora,
Department of Ophthalmology, Jones Eye Institute, Pat & Willard Walker Eye Research Center, 4301 West Markham, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.

Puran S. Bora,
Department of Ophthalmology, Jones Eye Institute, Pat & Willard Walker Eye Research Center, 4301 West Markham, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.

Please see the link here: https://stm.bookpi.org/ANUMS-V10/article/view/13958

Understanding the Pathoanatomy of Arthritic Hip for Improvising the Technique in Primary Uncemented Total Hip Arthroplasty | Chapter 7 | Advancement and New Understanding in Medical Science Vol. 10

 Background: Hip osteoarthritis is a condition that leads to significant morbidity and decreases the quality of patient’s life. Total Hip Arthroplasty (THA) is preferred by most of orthopaedic surgeons to relieve pain, provide motion while maintaining stability. In this study we aim to discuss the difficulties encountered in reference to patho-anatomy during THA in various conditions along with their solutions.

 

Materials and Methods: In our study, we had observed 100 hip joints of secondary osteoarthritis in 67 patients of with different type of underlying pathology like avascular necrosis, sickle cell disease, rheumatoid arthritis, ankylosing spondylitis. All the patients were evaluated using modified harris hip score. The findings were evaluated using SPSS software (Ilionois, Chicago) with p value less than 0.05 considered as significant.

 

Observation and Results: We had operated 100 hip joints (n=100) having arthritic changes among 67 patients (33 patients with bilateral hip affection, 34 patients with unilateral hip affection) at our tertiary care hospital from June 2015 till December 2019. The mean Harris Hip Score at the final follow up was 88 among them 98 hip joints had excellent and 2 hip joints had good to fair results. During our study we majorly encountered three types of collapse – Anterosuperior collapse (56%), Concentric collapse (25%) and hip arthritis due to inflammatory conditions (19%). We had found that according to duration and types of collapse different soft tissues were contracted and a step-wise release of those structures is necessary for proper intra-operation reduction and post-operative better range of motion. The steps for global release as and when required in different patients include adductor tenotomy, release of external rotator muscles, release of anterior fibers of  gluteus medius, release of tensor fascia lata and tendinous insertion of gluteus maximus along with release of posterior capsule, release of anterior capsule followed by release of iliopsoas tendinous insertion on lesser trochanter.

 

Conclusion: The chronicity of the disease will lead to anatomical changes of the surrounding soft tissue and that will affect the surgical dissection. We had described surgical problems encountered during the operation and their solutions for each type of pathoanatomy. This will help orthopedic surgeons to anticipate and prepare well in advance while performing total hip arthroplasty.

Author(s) Details:

Paresh Golwala,
SBKS& MIRC, Sumandeep Vidyapeeth (Deemed to be University), India.

Parth N. Rathi,
MM Hospital & Hariom Trust, Adipur, Bhuj Kutch 370205, Gujarat, India.

Prassana Shah,
Department of Orthopedics, Dhiraj Hospital, Smt. BK Shah Medical Institute & Research Centre, Sumandeep Vidyapeeth (Deemed to be University), Waghodia, Vadodara 391760, Gujarat, India.

Please see the link here: https://stm.bookpi.org/ANUMS-V10/article/view/13927

Determination of Interfraction Variation in Interstitial High dose Rate Brachytherapy | Chapter 6 | Advancement and New Understanding in Medical Science Vol. 10

 The positional stability of the catheters and the resultant dosimetric variation over a period of time is studied and presented. The ability of brachytherapy to deliver high radiation doses over a short time period means patients can complete treatment in days rather than weeks required for EBRT. Brachytherapy is generally well tolerated with a good toxicity profile for many of its applications, largely due to its tissue sparing approach. The remote after-loading HDR Brachytherapy treatment unit Gamma Med iX plus (Varian Medical Systems, Palo Alto, CA) or Microselectron HDRV3 (Nucletron, BV) using single sealed Iridium 192 radioactive source was used for treatment and for treatment planning, Eclipse (Varian Medical Systems, Palo Alto, CA) or Oncentra Master plan (Nucletron, BV) was used. Interfraction errors occur frequently in interstitial HDR brachytherapy. If no action is taken it will result in a significant risk of geometrical miss and overdose to the organs at risk. The effect of interfraction variation also depends on the fractionation schedule of the brachytherapy treatment. It is recommended to complete the treatment within 5 days. For cancer cervix (MUPIT) interstitial implant planning before each fraction is recommended.

Author(s) Details:

Saravanan Kandasamy,
Department of Radiotherapy, Regional Cancer Centre, JIPMER, Puducherry, India.

K. S. Reddy,
Department of Radiotherapy, Regional Cancer Centre, JIPMER, Puducherry, India.

Vivekanandan Nagarajan,
Medical Physics Department, Cancer Institute (WIA), Adyar, Chennai, India.

Parthasarathy Vedasoundaram,
Department of Radiotherapy, Regional Cancer Centre, JIPMER, Puducherry, India.

Gunaseelan Karunanidhi,
Department of Radiotherapy, Regional Cancer Centre, JIPMER, Puducherry, India.

Please see the link here: https://stm.bookpi.org/ANUMS-V10/article/view/13926

Research on Liver Organoid: Present Situation, Limiting Factors and Future Therapeutical Potential in Pediatric Diseases | Chapter 9 | Advancement and New Understanding in Medical Science Vol. 10

 Scientists often use organoids to research diseases. Organoids are three-dimensional, organ-like cell assemblies in which different cell types have organized themselves in a way that is approximately typical for the corresponding organ in the body. They show three characteristics: self-organization, multicellularity and functionality. This study concentrates on liver organoid research and its future role in different pediatric diseases. The range of organs that can be studied with organoids is growing rapidly and includes the brain, intestine, kidney, stomach, pancreas, lung, liver, prostate, esophagus, gallbladder, and the female reproductive tract, among others, and also the embryo. Organoids enable the scientific study of human development, physiology and pathology on a scale. Organoids are grown either from pluripotent stem cells or from tissue-specific adult stem cells. Adult stem cells are present in a large number of tissues and are responsible for renewing the cells in these tissues. They can only give rise to the cell types that are present in the particular tissue, the stem cell of the intestinal epithelium only produces cells of the intestinal epithelium, but not muscle cells or nerve cells. They are thus multipotent. Today, it is possible to reconstruct organ-like tissue organoids in the laboratory. Stem cells are thereby induced to differentiate by molecular signals and grown in culture systems that promote their three-dimensional self-organization. Rapidly developing organoid technology makes it possible to phenotypically copy cell structure. To some extent, this is also true for the functions of various human organs (for example, brain, thyroid, thymus, intestine, liver, pancreas, stomach, lung, kidney) and even early-stage embryos. As near-physiological 3D culture systems, organoids open up new possibilities to study the development of healthy and diseased organs and offer great potential for translational research. Further research in the field of paediatrics will show further development of in vivo use of organoids in the future, especially in liver diseases in childhood.

Author(s) Details:

Stefan Bittmann,
Department of Pediatrics, Ped Mind Institute, Medical and Finance Center Epe, Hindenburgring 4, 48599 Gronau, Germany.

Gloria Villalon,
Department of Pediatrics, Ped Mind Institute, Medical and Finance Center Epe, Hindenburgring 4, 48599 Gronau, Germany.

Elena Moschüring-Alieva,
Department of Pediatrics, Ped Mind Institute, Medical and Finance Center Epe, Hindenburgring 4, 48599 Gronau, Germany.

Lara BIttmann,
Department of Pediatrics, Ped Mind Institute, Medical and Finance Center Epe, Hindenburgring 4, 48599 Gronau, Germany.

Elisabeth Luchter,
Department of Pediatrics, Ped Mind Institute, Medical and Finance Center Epe, Hindenburgring 4, 48599 Gronau, Germany.

Please see the link here: https://stm.bookpi.org/ANUMS-V10/article/view/13957