Gut microbiome and orthopaedic health: Bridging the divide between digestion and bone integrity.

The gut microbiome, a complex ecosystem of microorganisms in the digestive tract, has emerged as a critical factor in human health, influencing metabolic, immune, and neurological functions. This review explores the connection between the gut microbiome and orthopedic health, examining how gut microbes impact bone density, joint integrity, and skeletal health. It highlights mechanisms linking gut dysbiosis to inflammation in conditions such as rheumatoid arthritis and osteoarthritis, suggesting microbiome modulation as a potential therapeutic strategy.

Molecular Mimicry Between Gut Microbiome and Rheumatoid Arthritis: Current Concepts.

Rheumatoid arthritis (RA) represents an autoimmune condition impacted by a combination of genetic and environmental factors, with the gut microbiome (GMB) being one of the influential environmental factors. Patients with RA display notable modifications in the composition of their GMB, characterised by decreased diversity and distinct bacterial alterations. The GMB, comprising an extensive array of approximately 35,000 bacterial species residing within the gastrointestinal tract, has garnered considerable attention as a pivotal contributor to both human health and the pathogenesis of diseases.

The Implementation and Outcomes of Personalized Antihypertensive Therapy Based on Pharmacogenetic Testing: A Retrospective Study Examining Blood Pressure Control and Medication Tolerability.

Background: Hypertension management typically relies on standardized treatment regimens, which may not account for individual genetic variations that affect drug metabolism and response.

Objective: The objective of this study was to evaluate the effectiveness of personalized antihypertensive therapy, guided by pharmacogenetic testing, in terms of blood pressure (BP) control and medication tolerability.

Materials And Methods: A retrospective cohort study was conducted at Jinnah Postgraduate Medical Centre, Karachi, from January 2023 to December 2023.

Comparative evaluation of artificial intelligence systems' accuracy in providing medical drug dosages: A methodological study.

Background: Medication errors, especially in dosage calculation, pose risks in healthcare. Artificial intelligence (AI) systems like ChatGPT and Google Bard may help reduce errors, but their accuracy in providing medication information remains to be evaluated.

Aim: To evaluate the accuracy of AI systems (ChatGPT 3.

Optimizing outcomes: Implementing enhanced recovery after surgery in orthopedic surgery.

In the realm of orthopedics, the adoption of enhanced recovery after surgery (ERAS) protocols marks a significant stride towards enhancing patient well-being. By embracing a holistic approach that encompasses preoperative counseling, dietary optimization, minimally invasive procedures, and early postoperative mobilization, these protocols have ushered in a new era of surgical care. Despite encountering hurdles like resistance to change and resource allocation challenges, the efficacy of ERAS protocols in improving clinical outcomes is undeniable.

Efficacy of Ultrasound-Guided Injection of Platelet-Rich Plasma in Treatment of Sports-Related Meniscal Injuries.

 Meniscal injuries are a common occurrence in sports-related activities, often leading to pain, reduced joint function, and impaired athletic performance. This study aimed to evaluate the role of ultrasound-guided intra-articular platelet-rich plasma (PRP)-rich fluid injection which was obtained through serial centrifugation in the treatment of meniscal injuries resulting from sports activities.  A prospective study was conducted involving 54 cases with grade I, II, and III meniscal injuries, aged 18 and 43 years.

Effect of granulocyte colony-stimulating factor (G-CSF) in functional outcome of acute spinal cord injury patients: A single-blinded randomized controlled trial.

Background: Spinal Cord Injury (SCI) is a major public health issue causing significant disability and economic burden. Current treatments primarily focus on mitigating secondary injury, with limited effective therapies available. This study explores the efficacy of the Granulocyte Colony-Stimulating Factor (G-CSF) in improving functional outcomes in acute SCI patients.

Predictive Modeling of Osteoarthritis Using Biochemical Markers: A Cross-Sectional Analysis.

Introduction: Osteoarthritis (OA) is a prevalent degenerative joint disease characterized by cartilage deterioration, joint pain, and reduced mobility. This study aimed to quantify the association between specific biochemical markers and OA and to develop a predictive model for assessing OA risk based on these markers.

Materials And Methods: A total of 200 participants (mean age: 55.

Enchondroma Protuberans of the Hand: A Rare Cartilaginous Tumor.

Introduction: Enchondroma protuberans (EP), a rare form of enchondroma with exophytic growth, differs radiographically from classical enchondromas and can mimic osteochondroma, periosteal chondroma, or chondrosarcoma. Proper differentiation is crucial to avoid unnecessary radical resection, as EP requires intralesional curettage rather than the surgical removal typical for osteochondromas.

Case Report: A 14-year-old male presented with a progressively enlarging, painless mass on the lateral aspect of his left hand, initially noticed 4 years ago.

The AI Orthopedician will see you now - But who is Liable if it's Wrong?

Artificial intelligence (AI) is revolutionizing various sectors, including health care, with orthopedics being no exception. Orthopedic practice, already familiar with technological advancements such as robotic surgery, is rapidly integrating AI into clinical workflows, enhancing precision in surgical planning, diagnostics, and patient care. However, this evolution raises critical questions, particularly regarding liability when AI systems fail and cause harm.

Autologous Growth Factor-Rich Concentrate (GFC) Injection in Non-union of Fractures: A Quasi-experimental Study.

Introduction: Non-union fractures represent a significant challenge in orthopedic practice, contributing to considerable morbidity and socioeconomic burden. Traditional treatments, such as autologous bone grafting, are effective but have limitations, including donor-site morbidity and limited tissue availability. Autologous peripheral blood-derived orthobiologics, including growth factor-rich concentrate (GFC), have emerged as a minimally invasive alternative, leveraging the body's natural healing mechanisms by concentrating and applying growth factors directly to the fracture site.

Correction: Lana et al. Sacral Bioneuromodulation: The Role of Bone Marrow Aspirate in Spinal Cord Injuries. 2024, , 461.

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Combating antimicrobial resistance in osteoarticular infections: Current strategies and future directions.

The emergence of antimicrobial resistance (AMR) has profoundly impacted the management of osteoarticular infections (OAIs), presenting significant challenges for healthcare systems worldwide. This review provides a comprehensive overview of the current landscape of AMR in OAIs, emphasizing the necessity for assertive and innovative strategies to combat this escalating health threat. It discusses the evolution of resistance among key pathogens, including ESKAPEE organisms, and the implications for treatment protocols and healthcare outcomes.

Insights of gut-liver axis in hepatic diseases: Mechanisms, clinical implications, and therapeutic potentials.

With the rising prevalence of chronic liver diseases worldwide, there exists a need to diversify our artillery to incorporate a plethora of diagnostic and therapeutic methods to combat this disease. Currently, the most common causes of liver disease are non-alcoholic fatty liver disease, hepatitis, and alcoholic liver disease. Some of these chronic diseases have the potential to transform into hepatocellular carcinoma with advancing fibrosis.

Management of knee osteoarthritis using bone marrow aspirate concentrate: a systematic review.

Introduction: Knee osteoarthritis (OA) is a common degenerative joint condition and a major cause of disability in the general population.

Source Of Data: Recent published literature identified from PubMed, EMBASE, Google Scholar, and Scopus.

Areas Of Agreement: Orthobiological therapies try to regenerate articular cartilage and stop the progression of the degenerative lesion.

Ketamine Impact on Kidney Health.

Ketamine-induced uropathy (KIU) is a serious consequence of chronic ketamine abuse, presenting with complex renal and urinary symptoms. This study describes a 34-year-old female with a history of chronic ketamine abuse, resulting in stage 3 chronic kidney disease (CKD) and severe urological complications. Despite discontinuing ketamine use five years ago, she remains dependent on ureteral stents due to recurrent hydronephrosis and ureteral obstruction.

Evidence-based orthobiologic practice: Current evidence review and future directions.

The field of orthopedic and regenerative medicine is rapidly evolving with the increasing utilization of orthobiologic. These biologically derived therapies, including platelet-rich plasma, mesenchymal stem cells, bone marrow aspirate concentrate, stromal vascular fraction (SVF), and autologous chondrocyte implantation, are gaining traction for their potential to enhance the body's natural healing processes. They offer a promising alternative to traditional surgical interventions for musculoskeletal injuries and degenerative conditions.

SDIMMMER: A Proposed Clinical Approach to Optimize Cellular Physiology in Regenerative Medicine.

SDIMMMER is an acronym intended for use in both clinical practice and medical research. It facilitates a comprehensive evaluation of a patient's metabolic profile and serves as a mnemonic for the following key assessment areas: Sleep, Diet, Microbiome, Metabolism, Medications, Exams, and Rehabilitation. In the clinical setting, SDIMMMER's primary objective is to monitor and manage the patient's metabolic status, particularly targeting low-grade chronic systemic inflammation, a hallmark of metabolic syndrome (MS).

Evolution and Innovations in Bone Marrow Cellular Therapy for Musculoskeletal Disorders: Tracing the Historical Trajectory and Contemporary Advances.

Bone marrow cellular therapy has undergone a remarkable evolution, significantly impacting the treatment of musculoskeletal disorders. This review traces the historical trajectory from early mythological references to contemporary scientific advancements. The groundbreaking work of Friedenstein in 1968, identifying fibroblast colony-forming cells in bone marrow, laid the foundation for future studies.

Immune Checkpoint Inhibitors and Endocrine Disruption: A Case of Hyponatremia and Adrenal Insufficiency.

Immune checkpoint inhibitors, such as pembrolizumab, have transformed cancer therapy by enhancing the immune system's ability to combat tumors, but they can also lead to immune-related adverse events, including adrenal insufficiency. This case report presents a 52-year-old male with a history of malignant melanoma who developed adrenal insufficiency after four months of pembrolizumab therapy. The patient was admitted with symptoms of malaise, vomiting, abdominal pain, and poor appetite.

The New Bharatiya Nyaya Sanhita Laws: Progress or Pitfall for Doctors?

The Indian Penal Code (IPC), a relic of British colonial rule, was recently replaced by the Bharatiya Nyaya Sanhita (BNS) in July 2024. While the overhaul of the IPC was largely welcomed, it has sparked significant concern among the medical community, primarily due to Section 106 of the BNS. This section mandates imprisonment for doctors involved in deaths caused by rash or negligent acts during medical procedures, which many in the profession fear could lead to a climate of fear and hesitancy in performing critical medical interventions.

Swallowing the Litigation Pill: The Future of Medical Lawsuits in India.

As the tide of medical lawsuits rises, doctors in India find themselves navigating increasingly treacherous waters. What drives this surge in litigation? Can we chart a course through these challenging times, or are we destined to face relentless legal battles? In this editorial, we unravel the complexities of this pressing issue and glimpse what lies on the horizon for India's medical community.

Pill Pushers or Partners in Progress: Should Pharmaceutical Companies Be Allowed to Sponsor Continuing Medical Education (CME)?

This article explores a timely and contentious issue within the Indian medical community: the relationship between doctors and pharmaceutical companies, particularly the sponsorship of continuing medical education (CME) events. Triggered by the National Medical Council's proposed guidelines in August 2023, which sought to ban such sponsorships, the article revisits the longstanding debate over potential conflicts of interest. While critics argue that these relationships could compromise medical ethics, the article questions whether this assumption holds up under scrutiny.