OBJECTIVE: The systematic review is aimed at evaluating the value of PRF in different areas of surgery.
DATA SOURCES: A systematic review of articles sourced from MEDLINE-pubmed (2008-2017(July)) was done. Additional articles were searched through GOOGLE SCHOLAR and SCIENCE DIRECT. Search terms such as Platelet rich fibrin; Platelet rich fibrin, surgery; Platelet concentrate; second generation concentrate; Applications of PRF in surgery were used.
STUDY SELECTION: Systematic reviews, Randomized control trials, Pilot studies and Case reports were included. Non English articles, in-vitro and animal studies were excluded.
DATA EXTRACTION: Independent sourcing of articles by 3 authors using a set of predefined criteria.
DATA SYNTHESIS: Out of the 25 articles covering various surgical procedures that met the inclusion criteria, positive outcomes were noted in most. Although categorization into one specific type of study was not done, the overall success rate with PRF usage was 78%.No differences between test and control groups were observed in 2 studies and 3 studies showed no significant improvements with the usage of PRF.
LIMITATIONS: The systematic review did not categorize the study designs while evaluating success rates which might be considered as a shortcoming as case reports were also included.
CONCLUSIONS: The future propositions are vast and point towards innovative applications of this bio-material possibly in transplant and burn cases if a method of obtaining large amounts can be devised. However since we rely on evidence-based results, further long term studies are needed in distinct areas of applications to decisively prove its effectiveness.
CASE REPORT: We present a case report on management of an electrosurgery induced osteonecrosis involving maxillary alveolus of left premolars.
DISCUSSION: Inadvertent contact of the electrosurgery tip on bone can result in necrosis making it necessary to remove the sequestrum and graft the defect. Platelet rich fibrin in combination with bone grafts have been well documented to provide successful periodontal regeneration.
CLINICAL IMPLICATIONS: Our aim of presenting this report is to create awareness among the health care providers regarding electrosurgical injuries. To our knowledge, this is the first time platelet rich fibrin has been used in the management of intraoral electrosurgical injury. Combining bone grafts with platelet rich fibrin is a good alternative as it can be done with relative ease and predictable outcome.
MATERIALS AND METHODS: We retrospectively studied CD56 expression in 54 benign and 54 malignant thyroid lesions using archival formalin fixed paraffin-embedded tissue blocks for the study period from January 2010 to December 2015, diagnosed in a tertiary hospital.
RESULTS: CD56 was expressed in 52/54 (96.3%) of benign specimens and only 24/54 (44.4%) of malignant ones. The malignant specimens comprised 31 (57.4%) papillary thyroid carcinomas (PTC), 11 (20.3%) follicular carcinomas (FC), seven (13%) medullary thyroid carcinomas (MC), one (1.9%) poorly differentiated carcinoma (PC) and four (7.4%) anaplastic carcinomas (AC). CD56 was not expressed in 28/31 (90.3%) of the PTCs, 1/11 (9.1%) FCs, 1/4 (25%) of ACs while all MCs and the PD were positive. The benign group comprised nodular hyperplasias (29/54), lymphocytic thyroiditis (10/54), follicular adenomas (FA) (14/54) and one hyalinising trabecular tumour. CD56 was expressed in all the benign cases except one FA and one nodular hyperplasia. Thirteen of the 14 FAs were CD56 positive. The difference in expression between benign and malignant tumours was statistically significant as the p value was <0.01.
CONCLUSION: CD56 is a potentially good immunohistochemical marker for differentiating papillary thyroid carcinoma from other benign follicular lesions of the thyroid especially in differentiating follicular variant PTC from FA in equivocal cases.
MATERIALS AND METHODS: As a prerequisite for this, the solubility of the drug was assessed in media of different pH (1.2-7.4), and surfactant concentrations of 0.5-1.5% (w/v) sodium lauryl sulfate (SLS) in water, and pH 7.4 phosphate buffer. The dissolved drug concentration in each medium was quantified by UV analysis at 280 nm wavelength.
RESULTS: The drug solubility was found to be high at a pH of 1.2 and 7.4. The media with surfactant enhanced solubility of the drug by approximately 17-fold and exhibited better sink conditions. The discriminative power of the developed dissolution medium (i.e., 1% w/v SLS in pH 7.4) was determined by performing in vitro dissolution studies of the prepared THC tablets and comparing their release profiles using fit factors (f1 and f2). The results of the fit factor comparisons made between the dissolution profiles of THC tablets proved the discriminative ability of the medium. The validation of the developed dissolution method was performed by international guidelines and the method showed specificity, linearity, accuracy, and precision within the acceptable range.
CONCLUSION: The proposed dissolution method was found to be adequate for the routine quality control analysis of THC, as there is no specified dissolution method for the drug in the pharmacopoeia.