Branch Of Medicine Research Articles

Oral mesotherapy technique for the treatment of physiologic gingival melanin hyperpigmentation using locally injectable vitamin C: a clinical and histologic cases series.

Vitamin C (ascorbic acid) is widely used in dermatology for skin depigmentation. However, there are very few clinical studies on the efficacy of vitamin C in gingival depigmentation. This preliminary case series aims to present the clinical effectiveness, histologic changes, and patient-reported outcomes of intra-epidermal vitamin C injections (oral mesotherapy) for managing patients with gingival melanin hyperpigmentation. Five patients were administered locally injectable vitamin C (once per week for 4 to 5 visits) in maxillary or mandibular anterior pigmented gingiva. The depigmentation effect was evaluated using the Dummett Oral Pigmentation Index (DOPI) and Gingival Pigmentation Index (GPI). Digital photographs were used to assess gingival luminescence (L*) and pigmented surface area (PSA). Parameters were recorded at baseline and at 1 and 3 months. Melanocyte histopathologic count was determined at baseline and at 3 months. Pain, gingival color change, and patient satisfaction scores were also assessed. Median GPI, DOPI, and PSA were significantly reduced (P ≤ .05) from baseline to 1 month. There was no statistically significant change from 1 month to 3 months. L* value significantly increased from baseline to 3 months. A median pain score of 3 (scale of 0 to 10) was observed on the day of the procedure. A score of 3 (scale of 0 to 4) was reported for the gingival color and scores 3 and 4 (scale of 0 to 4) for the overall patient satisfaction. Oral mesotherapy using locally injectable vitamin C is a nonsurgical, minimally invasive, and efficient technique for gingival depigmentation. Indian patients were satisfied with the gingival color obtained and the overall treatment experience. As all the branches of medicine, specifically dentistry, direct to minimally invasive approaches, mesotherapy shows great importance to reduce the surgical interventions, especially when esthetic outcomes are needed. Oral mesotherapy using locally injectable vitamin C can be a useful nonsurgical technique for achieving gingival depigmentation in the esthetic zone.

Role of oral physician in private dental setting

The Oral Medicine and Radiology branch is an essential bridge between Dentistry and Medicine. Oral physicians are often sought to manage the oral symptoms or know if the oral disease poses a risk of oral cancer or cross-infection in the clinics. Recent studies indicate an increased prevalence of oral habits-related lesions in India. Hence, proper support of OMR specialists along with a global strategy to promote the clinical practice of Oral Medicine among patients and all other healthcare professionals is inevitable to increase awareness of the specialty, thus encouraging the budding OMR specialist to establish themselves independently in private practice.

Integrating the Synergy of the Gut Microbiome into Regenerative Medicine: Relevance to Neurological Disorders.

A new paradigm of cell therapy-based approaches as a solution to several diseases caused by damage or loss of cells/tissues leading to organ failure heralded the birth of a new branch in medicine called regenerative medicine (RM), which was further fueled by in vitro cell expansion and tissue engineering (TE) technologies, including the ability to grow embryonic stem cells, induce pluripotent stem cells, and so on. RM addresses organ failure by repair, regeneration, or restoration, rejuvenation using cells, stem cells, or progenitor cells as tools having added cell-derived products also as a tool, and extracellular matrix component–based support, either direct or indirect (e.g., matrix induced autologous chondrocyte implantation) using scaffolds. Now, the main objective of RM is to solve the functional loss of cells that have evolved from cells as tools to cell-derived factors and scaffolds per se as tools. In this context, an important yet indispensable group of cells that constitute the major portion of the human body in terms of the number of cells having several essential roles to play, both directly and indirectly, starting from digestion and the immune system to the growing evidence of influencing neuronal function, aging, and carcinogenesis has been ignored. We would like to focus on these in this review as they should essentially be considered as a tool of RM, especially for neurological disorders for their vital role. What we are indicating is the second genome or the gut microbiome.

Pathophysiological justification of acupuncture in the treatment of traumatic diseases of the musculoskeletal system (literature review)

The main pathogenetic mechanisms of the development of a traumatic disease of the musculoskeletal system are peripheral circulation disorder, hypoxia, and inflammation, which is accompanied by the development of pain. Pain management is a primary component in helping patients with various injuries. The activation of sanogenetic reactions is also crucial in accelerating the processes of damaged tissues regeneration. A scientific search on the impact of acupuncture on typical pathophysiological processes of traumatic disease was conducted in the Medline and Google Scholar databases. The analysis of scientific journal articles showed that despite the ambiguous attitude to acupuncture, the effectiveness of the method is quite high. Acupuncture is a branch of complementary medicine that has been used for thousands of years. Scientific research in recent decades has established a positive therapeutic effect on various links of pathogenesis through the implementation of the main mechanisms of acupuncture, at the segmental, suprasegmental and cortical levels, manifested in the form of neurohumoral and neuroimmune reactions. The presented literature review directs researchers to further study the possibilities of acupuncture in the treatment of traumatic diseases of the musculoskeletal system from the standpoint of evidence-based medicine.

Is General Surgery as Specialsed Medical Branch Getting Extinct in Country?

Today, in India, there are about 12,780 post-graduate seats in Master of Surgery of which there 1600 seats are in General Surgery offered by various Government and private medical colleges in India. There is a matter of grief situation that each year less number of undergraduates opting for the General Surgery branch. The foremost reason of it is that the amount of hardwork and stress which a trainee undergoes is incomparable to any other branch. Practicing General Surgery is not an easy job to have for anyone especially in an overpopulated country like India. Secondly, it is not a terminal branch as super-specialization in various disciplines is being offered after completion of postgraduation in General Surgery. So, again toiling for straight 3 years in General Surgery, a fresh Post Graduate (PG) has to again prepare hard to get into any Super-Specialty (SS) branch of his interest as only about 200 seats are being offered in various surgical super-specialty branches across the country. Finding General Surgery a hard road to walk, most undergraduates opt for less tiring branch which may also happens to be a terminal branch. The higher education in medical field is quite a costly affair owing to a few number of Government colleges offering the PG and SS seats. They may cost up to or more than one crore in many of the private medical colleges. To add to this is the ever increasing caste based reservation policy of the Government which is not doing justice to many according to many of the experts and educationists. All these factors result in many seats remaining vacant in the mentioned branch especially in SS across the country. Though the Government has established a new commission i.e. National Medical Commission (NMC) to look after the lacunae in the country’s medical education system, still there is lot that has to be done in this field. There aren’t sufficient faculty posts in the department of General Surgery and surgical super-specialties bearing burden over the system to look after increasing patient burden. General Surgery is the backbone of every institution and hospital which at present is overstressed thanks to the laid-back approach in policy making. Surgeon also has to face burnt of medico-legal proceedings every now and then in our country. Government is thumping it's back of opening more number of medical colleges in different states across the country but the fact is that nothing is on their agenda to improve the actual quality of medical education whatsoever is there. There is no concept of wet lab in surgery department even in various premium institutes of the country. There has not been any mentioning of arranging cadaveric dissection courses in the curriculum of post graduation. No fruitful research has come out from ages in the said department from so called research medical institutes. System has made the PG students to think each second about finishing off with their mandatory thesis work and pass the final exit examination without giving any attention to improve their clinical skills. And once they pass their examination, they start preparing for the entrance examination to get into SS branch of their choice. If this trend continues to work, time will come that patients will find it really tough to get well qualified surgeons for getting them operated in the country. Those who can afford will fly outside the country to get their ailment treated where better facilities are available as done by various dignitaries and politicians even now, whereas those who cannot afford to do so will ultimately succumb or may fall prey to the quacks. There is urgent need of revamp of the system where some better policies are being formulated to save this branch of medicine in our country. There is a need to ignite the interest among the medical undergraduates towards this branch so that more and more students should take up the General Surgery as their choice in future.

Contribution of Bangladesh College of Physicians and Surgeons to Health Sector and Medical Education in Bangladesh: A 50-year Perspective

Bangladesh College of Physicians and Surgeons (BCPS) was established in June 1972 through an Order revised in 2018 as an act with six functions which cover post-graduate education of all specialties of medical science. This commission report is to document the spectrum of contribution of BCPS in the health and education sector through its fellows and members. The data obtained for this report covers selected literature review, consultation with key official documents- Year Book of BCPS, Annual report of honorary secretary of BCPS, Health Bulletin of DGHS, various website, information from a brief quick Google survey on the fellows and focus group discussion (FGD) with senior present and past leaders of BCPS. BCPS is providing a skill based supervised comprehensive logbook based clinical training of five years’ duration through its recognized/accredited hospitals in different tiers of mostly public health system across the country. While undergoing clinical training the ‘would be fellows’ provide supervised quality clinical services to the patients attending the BCPS accredited hospitals. BCPS is producing specialists’ human resources by offering fellowship covering general and specialized subjects (n=59) and membership (n=16) in various branches of medicine. Immediately after independence there were 247 specialists altogether in the country. Since its inception, in 1972 after the liberation, 8266 fellows are entered as fellows, 7887 fellows with examinations, 111 without examinations and 268 honorary fellows; 3222 are entered as members of the College. The fellows of BCPS are engaged in providing specialized patient care in various fields of medical science as professor, associate professor, assistant professor and consultants in various public and non-government medical college hospitals, medical universities, post-graduate institutes, district hospital, and upazila health complexes. As a teacher most of the fellows are also heavily engaged in human resource development at both under-graduate and post-graduate level. Through their active voluntary engagement, the fellows of the College participate in the core activities of the College for HR development through activities related to monitoring & supervision, assessment, continuous professional development, skill development of the trainees and the fellows. Fellows are equally contributing in the armed forces medical services as clinical and para clinical specialists and development of specialist HRs. Additionally, fellows are contributing to various aspects of important public health topics relevant for SDG and Bangladesh. Fellows are also engaged in doing funded and non-funded quality researches and writing of scientific intellect at national and international publication system. Having achieved the various positions in academic, research and administrative arena BCPS fellows’ role in policy development and implementation, and scientific development deserve special appreciation. Future contribution of BCPS should prioritize quality assurance strategy for training-learning, enrich effectiveness of examination system, effective branding of BCPS, increase allocation and creating a conducive environment for conducting research. Conclusion: The glorious contribution of BCPS in the development of quality specialist health human resources over the last 50 years attained almost a self-sufficiency. Further ensuring quality assurance in training learning of future fellows and continued advanced training of the newly qualified fellows will help in branding of BCPS and technology transfer saving government exchequer. J Bangladesh Coll Phys Surg 2022; 40: 5-18

Biomaterials for Ophthalmic Applications

Ophthalmology is the branch of medicine that deals with diseases of the eye, the organ responsible for vision, and its attachments. Biomaterials can be made with different types of materials and can replace or improve a function or an organ, specifically the eye in the case of ophthalmic biomaterials. Biomaterials are substances that interact with biological systems for a medical purpose, either as a therapeutic (treat, augment, repair, or replace a tissue function of the body) or a diagnostic agent, and have continued to improve over the years, leading to the creation of new biomaterials. With the arrival of new generations, biomaterials have succeeded in reducing complications and toxicity and improving biocompatibilities associated with older generations. With the aging population, eye problems are becoming more prevalent, and biomaterials have helped in recent years to improve or restore vision, improving the quality of life of many patients. This review focuses on the most clinically used ophthalmic biomaterials, including contact lenses, intraocular lenses, artificial tears, inlays and vitreous replacements. Tissue engineering is presented as a new tool that is able to be treat several ophthalmologic disorders.

Bronchial asthma from the perspective of glycomics

Bronchial asthma is a widespread disease that is becoming increasingly costly to the medical and financial systems of many countries with each passing year. The rising prevalence of bronchial asthma necessitates a search for the most efficient diagnostic and treatment strategies for various asthma phenotypes, including some that are relatively uncommon.
 From this point of view, glycomics appears to be one of the most interesting and perspective branches of medicine. This research area studies various carbohydrate complexes and their roles in the development of various diseases.
 Researchers are interested in the study of the receptors for advanced glycation end products and their soluble variants with regard to bronchial asthma. Furthermore, sialic acid-binding immunoglobulin-type lectins (Siglecs) may play a vital role in the principal novel strategies of the treatment. By affecting Siglecs, a decrease in the proinflammatory activity of immunocompetent cells results, and the bronchial walls are protected. Finally, N- and O-glycans remain almost unresearched. These molecules, on the other hand, have the potential to play a significant role not only in the diagnosis and confirmation of asthma but also in the allergenicity of various molecules. Scientists are interested in N-glycans, not only in the diagnostic context but also in their role as a molecule that can reduce allergenicity, for example, egg white vaccines.
 Glycomics and glycoproteomics are cutting-edge disciplines of medical science that are opening up new perspectives in the management of patients with diseases of various organs and systems, including diseases of the respiratory tract in general and bronchial asthma in particular. Despite the fast-paced nature of the development of glycoscience, theories about the role of the molecules investigated in the pathophysiology of respiratory disorders are only beginning to emerge.

Malignant Central Airway Obstruction: What's New?

Malignant central airway obstruction (MCAO) is a debilitating and life-limiting complication that occurs in an unfortunately large number of individuals with advanced intrathoracic cancer. Although the management of MCAO is multimodal and interdisciplinary, the task of providing patients with prompt palliation falls increasingly on the shoulders of interventional pulmonologists. While a variety of tools and techniques are available for the management of malignant obstructive lesions, advancements and evolution in this therapeutic venue have been somewhat sluggish and limited when compared with other branches of interventional pulmonary medicine (e.g., the early diagnosis of peripheral lung nodules). Indeed, one pragmatic, albeit somewhat uncharitable, reading of this article's title might suggest a wry smile and shug of the shoulders as to imply that relatively little has changed in recent years. That said, the spectrum of interventions for MCAO continues to expand, even if at a less impressive clip. Herein, we present on MCAO and its endoscopic and nonendoscopic management-that which is old, that which is new, and that which is still on the horizon.

Profile of Medico-legal Cases and Body Injuries in a Tertiary Hospital in Padang, Indonesia 2010-2020

Forensic medicine is a branch of medicine that examines victims for the benefit of justice. Doctors play an important role in documenting injuries or abnormalities on the victim's body in the patient's medical record. This study aimed to determine the characteristics of cases and injuries of patients at M Djamil General Hospital during the period of 2010–2020. This was a descriptive retrospective study on secondary data from the medical records of patients who were examined and consulted to the Forensic Department of Dr. M. Djamil General Hospital, Padang during 2010–2020. During this period, 11.729 patients (victims) were examined by and consulted to the Department. Most of the victims were male (70.6%) aged 10–19 years old (29.2%). Most of the victims were involved in a traffic accident, followed by persecution. Victims of traffic accident dominated the forensic pathology cases after sudden death. Abrasions and open wound injury were the most frequent types of injury, with head and neck as the body parts mostly affected. In terms of the type of wound, most victims experienced injuries caused by blunt force (87%). This study concluded that the forensic cases managed at the Dr. M. Djamil General Hospital vary with blunt forces by a traffic accident as the most frequent cause of injuries while the head and neck become the body parts that are most susceptible to injury, both for survivors and those who died.

Artificial intelligence processing electronic health records to identify commonalities and comorbidities cluster at Immuno Center Humanitas.

BackgroundComorbidities are common in chronic inflammatory conditions, requiring multidisciplinary treatment approach. Understanding the link between a single disease and its comorbidities is important for appropriate treatment and management. We evaluate the ability of an NLP‐based process for knowledge discovery to detect information about pathologies, patients' phenotype, doctors' prescriptions and commonalities in electronic medical records, by extracting information from free narrative text written by clinicians during medical visits, resulting in the extraction of valuable information and enriching real world evidence data from a multidisciplinary setting.MethodsWe collected clinical notes from the Allergy Department of Humanitas Research Hospital written in the last 3 years and used it to look for diseases that cluster together as comorbidities associated to the main pathology of our patients, and for the extent of prescription of systemic corticosteroids, thus evaluating the ability of NLP‐based tools for knowledge discovery to extract structured information from free text.ResultsWe found that the 3 most frequent comorbidities to appear in our clusters were asthma, rhinitis, and urticaria, and that 991 (of 2057) patients suffered from at least one of these comorbidities. The clusters which co‐occur particularly often are oral allergy syndrome and urticaria (131 patients), angioedema and urticaria (105 patients), rhinitis and asthma (227 patients). With regards to systemic corticosteroid prescription volume by our clinicians, we found it was lower when compared to the therapy the patients followed before coming to our attention, with the exception of two diseases: Chronic obstructive pulmonary disease and Angioedema.ConclusionsThis analysis seems to be valid and is confirmed by the data from the literature. This means that NLP tools could have significant role in many other research fields of medicine, as it may help identify other important, and possibly previously neglected clusters of patients with comorbidities and commonalities. Another potential benefit of this approach lies in its potential ability to foster a multidisciplinary approach, using the same drugs to treat pathologies normally treated by physicians in different branches of medicine, thus saving resources and improving the pharmacological management of patients.

DETERMINING THE THERMODYNAMIC DISSOCIATION CONSTANTS OF 5-BROMO-6,7-DIHYDROXY-N-METHYL-3-SULFOQUINOLINE IN AQUEOUS SOLUTION AT 25 OC BY POTENTIOMETRIC METHOD

In this report, the thermodynamic dissociation constants of 5-bromo-6,7- dihydroxy-N-methyl-3-sulfoquinoline (signed H2BDMS) acid were firstly determined in the aqueous solution using potentiometric titration at (25.0 ± 0.1) oC in the ionic medium of 0.10 M KCl solution. This new acid is a compound containing the quinoline ring that may be applied in many branches of chemistry, biology, and medicine. The pKa values of H2BDMS acid which were determined by the potentiometric method are pKa1 = 2.79 ± 0.02 and pKa2 = 7.80 ± 0.06. To increase the precision and accuracy of the results, the pKa values were calculated at various concentration levels. The structure of the new acid and data of potentiometric titration were analyzed in detail before calculating and assigning the pKa values to suitable functional groups. These results will be applied to our further studies of this compound.

Gaps and Opportunities of Artificial Intelligence Applications for Pediatric Oncology in European Research: A Systematic Review of Reviews and a Bibliometric Analysis

The application of artificial intelligence (AI) systems is emerging in many fields in recent years, due to the increased computing power available at lower cost. Although its applications in various branches of medicine, such as pediatric oncology, are many and promising, its use is still in an embryonic stage. The aim of this paper is to provide an overview of the state of the art regarding the AI application in pediatric oncology, through a systematic review of systematic reviews, and to analyze current trends in Europe, through a bibliometric analysis of publications written by European authors. Among 330 records found, 25 were included in the systematic review. All papers have been published since 2017, demonstrating only recent attention to this field. The total number of studies included in the selected reviews was 674, with a third including an author with a European affiliation. In bibliometric analysis, 304 out of the 978 records found were included. Similarly, the number of publications began to dramatically increase from 2017. Most explored AI applications regard the use of diagnostic images, particularly radiomics, as well as the group of neoplasms most involved are the central nervous system tumors. No evidence was found regarding the use of AI for process mining, clinical pathway modeling, or computer interpreted guidelines to improve the healthcare process. No robust evidence is yet available in any of the domains investigated by systematic reviews. However, the scientific production in Europe is significant and consistent with the topics covered in systematic reviews at the global level. The use of AI in pediatric oncology is developing rapidly with promising results, but numerous gaps and challenges persist to validate its utilization in clinical practice. An important limitation is the need for large datasets for training algorithms, calling for international collaborative studies.

АНАЛИЗ МЕТОДОВ ИСКУССТВЕННОГО ИНТЕЛЛЕКТА, ПРИМЕНЯЕМЫХ ДЛЯ РЕШЕНИЯ ЗАДАЧ ПСИХИАТРИИ

The use of artificial intelligence methods in the field of medicine has become widespread,helping to diagnose, analyze and make recommendations for treatment. Psychiatry is a branch ofmedicine that studies mental disorders, methods for their diagnosis and treatment. Her range oftasks includes not only diagnosis and treatment, but also observation, monitoring and subsequentrehabilitation of patients. This subject area has significant problems, such as objectivity, inconsistencyin the diagnosis, the complexity of the classification of diseases, and the unpredictabilityof the course of the disease. With a number of these problems, the use of machine learning methodsand artificial intelligence algorithms helps to cope. This paper is devoted to a review of researchon artificial intelligence methods used to solve problems in the field of psychiatry.The relevance of the topic is due to the high need for improvements in this subject area. Specificissues are presented in this article. Among them, the main directions were identified: data deidentification,classification of symptom severity, accuracy of condition prediction. To solve them,the authors used such methods as latent semantic analysis for natural language processing, classificationmethods, convolutional neural networks for prediction, and cognitive modeling. Separately,the effectiveness of hybrid systems, including the implementation of several machine learningmethods at once, is noted. The aim of the study was to highlight the main directions of developmentof research in the scientific community, which demonstrate the successful integration of artificial intelligence into psychiatry, as well as to compare them with each other according to theobtained estimates of the accuracy of the models. Which, in turn, implies the analysis and analysisof specific algorithms, their performance for specific tasks

Targeted Search for Individualized Clinical Decision Rules to Optimize Clinical Outcomes.

Novel biomarkers, in combination with currently available clinical information, have been sought to enhance clinical decision making in many branches of medicine, including screening, surveillance and prognosis. An individualized clinical decision rule (ICDR) is a decision rule that matches subgroups of patients with tailored medical regimen based on patient characteristics. We proposed new approaches to identify ICDRs by directly optimizing a risk-adjusted clinical benefit function that acknowledges the tradeoff between detecting disease and over-treating patients with benign conditions. In particular, we developed a novel plug-in algorithm to optimize the risk-adjusted clinical benefit function, which leads to the construction of both nonparametric and linear parametric ICDRs. In addition, we proposed a novel approach based on the direct optimization of a smoothed ramp loss function to further enhance the robustness of a linear ICDR. We studied the asymptotic theories of the proposed estimators. Simulation results demonstrated good finite sample performance for the proposed estimators and improved clinical utilities when compared to standard approaches. The methods were applied to a prostate cancer biomarker study.

Cholestasis in Newborns and Infants

Pediatrics is the branch of medicine that involves the medical care of infants, children, and adolescents. Neonatology is a subspecialty of pediatrics that consists of the medical care of newborn infants, especially the ill or premature newborn. It is a hospital-based specialty, and is usually practiced in neonatal intensive care units.

Plumping up a Cushion of Human Biowaste in Regenerative Medicine: Novel Insights into a State-of-the-Art Reserve Arsenal.

Major breakthroughs and disruptive methods in disease treatment today owe their thanks to our inch by inch developing conception of the infinitive aspects of medicine since the very beginning, among which, the role of the regenerative medicine can on no account be denied, a branch of medicine dedicated to either repairing or replacing the injured or diseased cells, organs, and tissues. A novel means to accomplish such a quest is what is being called “medical biowaste”, a large assortment of biological samples produced during a surgery session or as a result of physiological conditions and biological activities. The current paper accentuating several of a number of promising sources of biowaste together with their plausible applications in routine clinical practices and the confronting challenges aims at inspiring research on the existing gap between clinical and basic science to further extend our knowledge and understanding concerning the potential applications of medical biowaste.Graphical abstract

Neuroauriculotherapy: Framework and Remarks for a possible use in Voice Medicine

Aim. Neuroauriculotherapy (NAT) is a branch of medicine, which, thanks to its diagnostic and therapeutic value, is a powerful tool at the service of both physician and patient. In our experience, as it is discussed in this article, neuroauriculotherapy can have successful applications in voice science and in phoniatrics. The aim of this article is to open a discussion about possible applications of neuroauriculotherapy in voice medicine. Introduction. From the diagnostic point of view, it is possible to explore, with a palpeur (i.e., a tool that provides a constant pressure) or a “spot-hunter”, the presence of a perturbation into a particular organ or area, and its return to normal during treatment. Indeed, at the level of the ear auricle, representations of an organ, its innervation, its muscular components, etc., are fixed. These spots or voxels correspond absolutely to the respective sensory, motor, visceral, among other spots. Therefore, if any abnormal potential comes from the periphery, it will illuminate the spots both at the cortical level and in the pavilion —a real display with a constantly active touch screen. The spot can be treated with needles in the context of a neurophysiological strategy to send a message to the brain. Reflection. NAT appears to be a good method to improve the treatment of voice problems, enhancing the results of other therapies based on drugs or rehab and inducing relaxation. In neuroauriculotherapy, the ear is used to give the brain orders in a process which has a logical basis in neurophysiology. Conclusion. Diseases of the vocal tract can be dysfunctional or organic. According to our clinical experience, we can say that neuroauriculotherapy can be used in both cases. Neuroauriculotherapy is also extremely effective in voice therapy, both alone and in combination with other therapies, as there is no conflict among them.

Avoiding Assumptions: Sexual Function in Transgender and Non-Binary Individuals

As the field of gender-affirming care continues its advancement, a clinical gap in the definition and evaluation of sexual function in transgender and non-binary (TGNB) individuals is becoming increasingly apparent. Recent speculations propose the modification of cis-gender heteronormative sexual function measurement tools as a useful way to close this knowledge gap. Although the use of previously validated tools creates an easier platform for modification, the assumption of cis-gender sexual function as baseline will further disrupt patient-provider relationships, leading to inaccurate scientific conclusions, and increase the healthcare barriers faced by this community. As the definition of health has grown to include sexual function, the responsibility of the physician has evolved to include the treatment of sexual dysfunction as well. Without the imminent establishment of a scientific definition of sexual function with an accompanying measurement tool, this lack of understanding continues a precedent that may further stigmatize and distance this population from healthcare. Although this challenge may seem daunting, it should be noted that this has been accomplished for both cis-gender heterosexual men and women. This failure to scrupulously address the needs of the TGNB community directly contradicts the medical profession's revered values of equity and compassion. This branch of sexual medicine and gender-affirming care is critical for maximizing the quality of life as well as equity of the TGNB community to their cis-gender, heteronormative counterparts. A careful, kinder, and more inclusive approach is necessary, and the TGNB community deserves optimized care which requires a uniquely developed definition of sexual function and the required measurement tools. Whitney N., Samuel A., Douglass L., etal. Avoiding Assumptions: Sexual Function in Transgender and Non-Binary Individuals. J Sex Med 2022;19:1032-1034.

MRI and Its Implications in Dentistry

Magnetic Resonance imaging (MRI) has become one of the most powerful diagnostic tools in radiology and diagnostic sciences. It is non-invasive and non-ionizing and the images are highly sensitive and specific with excellent soft tissue contrast. It gives excellent images of anatomic structures differing in proton density and other tissue characteristics. It can be used to assess intracranial and extracranial lesions particularly those involving the soft tissues.
 MRI has the shortcoming of being prone to magnetic susceptibility difference artefacts, caused by the presence of metallic materials such as dental restorative materials, implants and orthodontic appliances. All substances when placed in a magnetic field are magnetized to a degree which varies according to their magnetic susceptibility. Non precious dental alloys have the potential of causing image deformation or image voids. 
 Dentists are not the only professionals implanting metal devices. Heart pacemakers and defibrillators, aneurysm clips, cochlear implants, insulin pumps, vascular stents and artificial joints are widely used in various branches of medicine. In some cases, it is not possible to carry out MRI due to extensive dental hardware with a high ferromagnetic content. Severe image distortion or an inability to perform the MRI scan due to dental restorations is a rare problem, but cannot be completely eliminated. This article has been written to educate the dentists on the implications of metallic dental restorations on MRI scans.
 Keywords: Magnetic resonance imaging, MRI, Dentistry, Dental materials, artefact, artifacts.