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Atrial fibrillation in elite athletes. What is missing?

Published on: 27th October, 2022

Although the beneficial effect of physical activity in the general population is well established, in elite athletes under vigorous physical activity, the effect on the electrical system of the heart is controversial. Indeed, several studies have shown an increased rate of atrial fibrillation among athletes, whereas others suggest that improved exercise capacity with training reduces atrial fibrillation recurrence. The pathophysiologic explanation of that discrepancy is missing, although several underlying mechanisms have been proposed. Taking into account the current knowledge, it seems that, although the beneficial effects of exercise are well recognized, there are conflicting data regarding the relation of the occurrence - the rate of atrial fibrillation to high-volume exercise and too long-term training. Its significance on the quality of life especially in highly trained athletes remains to be elucidated. Therefore, this short review will try to discuss this discrepancy and hopefully underlie the arising arguments. 
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Alcohol drinking and driving habit particularly in Nigeria and the role forensic science could play

Published on: 28th October, 2022

Alcohol drinking habit is a serious epidemic that afflicts people worldwide regardless of socioeconomic class and the country’s development or civilization. The purpose of this systematic review was to summarize research findings on drinking and driving, its implications for Nigerian society, and the role forensic science can play in drunk driving. Nigeria, in particular has seen a lot of fatal accidents attributed to alcohol but due to a lack of forensic sobriety and toxicology drug tests at the crash scene that is not yet in place in the country, the offenders are not punished for this crime. The only two African countries that have legislation on Blood Alcohol Concentration (BAC) are South Africa and Zimbabwe. Nigeria has no such legislation and does not conduct such tests in injury and fatal accident cases. The prevalence of drinking habits among Nigerians and in particular the drivers cannot be ignored. This study examined global drinking habits including its prevalence in Nigeria and more importantly understudied the need for forensic science interplay in a criminal investigation against drunk driving in the country. Drunk driving in Nigeria is a serious problem. Establishing and enforcing drunken driving laws as a criminal offense would assist the country in the reduction of road accidents, injuries, and fatalities relating to road accidents. Forensic science is a unique field that is equipped with skills and knowledge that could be useful for criminal investigation in the country including accident cases. Forensic scientists have outstanding technical skills to identify, detect, and even assist the country’s prosecutors in the administration of justice in crime investigations. Nigeria as a country will be well served if forensic scientists work in partnership with the government. Drinking and driving in addition to other crimes has become a matter of concern. The country’s police force and courts still rely mostly on eyewitness circumstantial evidence, testimonies, and suspects’ confessions. Based on this, I personally believe that the advent of Forensic science in the country’s system will assist a great deal in solving crimes and reducing fatal accidents due to drunk driving.
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Neutrophil and platelet lymphocyte ratio in diabetes mellitus

Published on: 31st October, 2022

Background: This study, it was aimed to investigate the relationship between Neutrophil Lymphocyte Ratio (NLR) and Platelet Lymphocyte Ratio (PLR) in Type II Diabetes Mellitus (Type II DM) patients.Methods: The data of the study were obtained from 108 patients, 61 women and 47 men, who were diagnosed with Type II DM, who applied to the Diabetes Polyclinics of Training and Research Hospital between 01.01.2020 and 30.06.2020 and a healthy control group without Type II DM. The data of the patients were obtained retrospectively via the Hospital Information Management System (HIMS).Results: The mean age of the Type II DM patient meeting the study criteria were 57.9 ± 12.69 years. The mean age of the control group was determined as 55.8 ± 8.81. There was no significant difference between the patient and control groups in terms of age and gender. The NLR of type II DM patients was 2.96 ± 1.15 and that of the control group was 1.91 ± 0.81. The PLR of type II DM patients was found as 179.29 ± 61.81 and the PLR of the control group was found as 121.21 ± 51.33. When NLR and PLR values of type II DM patients and the control group were compared found that it was statistically significant (p < 0.05). Conclusion: Although more analysis is needed to prove that NLR and PLR are associated with type II DM disease, our study’s high NLR and PLR values in Type II DM patients should suggest that these parameters are essential in the diagnosis and follow-up. Also, NLR and PLR inflammatory diseases, acute coronary syndrome, rheumatoid arthritis, etc., is higher, suggesting that this is related to unsanitary conditions rather than a specific disease.
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Nutritional interventions for the prevention and treatment of neurological disorders such as anxiety, bipolar disorder, depression, epilepsy, multiple sclerosis, and schizophrenia

Published on: 11th November, 2022

Neurological disorders are a significant cause of mortality and disability across the world. The current aging population and population expansion have seen an increase in the prevalence of neurological and psychiatric disorders such as anxiety, bipolar disorder, depression, epilepsy, multiple sclerosis and schizophrenia. These pose a significant societal burden, especially in low - and middle-income countries. Many neurological disorders have complex mechanisms and lack definitive cures; thus, improving our understanding of them is essential. The pathophysiology of neurological disorders often includes inflammation, mitochondrial dysfunction and oxidative stress. Oxidative stress processes, especially the generation of reactive oxygen species, are key mechanisms in the development of neurological disorders. Oxidative stress refers to an imbalance between the production of reactive oxygen species and antioxidants that can counteract them. Through their impacts on the pathophysiology of neurological disorders, nutrients with anti-inflammatory, neuroprotective and antioxidative properties have been suggested to prevent or mitigate these disorders. Certain vitamins, minerals, polyphenols and flavonoids may have therapeutic effects as adjuvant treatments for neurological disorders. Diet quality is also a risk factor for some neurological and psychiatric disorders and addressing nutritional deficiencies may alleviate symptoms. Therefore, optimizing nutritional intake may represent a potential treatment or prevention strategy. This review summarizes a selection of promising nutrients for the prevention and amelioration of neurological disorders to provide a summary for scientists, clinicians and patients, which may improve understanding of the potential benefits of nutrients in the treatment of neurological disorders.
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Interface of polymers grafted on silica: Organization of the interfacial layer in presence and absence of solvent

Published on: 1st November, 2022

The 1H NMR technique is used to study the behaviour of the poly (ethylene oxide) (PEO) chains grafted chemically on silica in the presence or not of solvent. A noticeable influence of the different physicochemical parameters on the conformation of the grafted macromolecules is evinced. Different models are proposed for different lengths of grafted polymer chains on the surface in the absence and presence of a solvent. Without solvent, the macromolecules lie very flat and the layer is more organized. In the presence of a solvent, the chains spread out and adopt a more extended conformation and the local concentration of monomers decreases.
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Intravenous leiomyomatosis of the uterus: still discovered on anatomopathological examination

Published on: 2nd September, 2022

Background: Leiomyomas beyond the uterus are defined by benign smooth muscle cell tumors outside of the uterus. Intravenous leiomyomatosis is a rare type of uterine leiomyoma and is characterized by the formation and growth of benign leiomyoma tissue within the vascular wall. Herein, we present a case of Intravenous leiomyomatosis successfully treated by surgical removal and a review of actual medical recommendations.Case presentation: A 49 - year-old woman, maghrébin, G3 P2, no family history of uterine myomas mentioned, having systemic arterial hypertension, presented to our department with hypogastric pain and abnormal uterine bleeding in the prior five months resulting in anemia which required iron supplementation. On physical examination the vital signs were normal. A palpable mass in the hypogastrium was noted. The rest of the exam was unremarkable. Pelvic ultrasound showed a huge uterus with multiple heterogeneous leiomyomas, including at least one intracavity. Computed tomography scans and magnetic resonance imaging were not done initially due to the unaffordability of the patient. The initial diagnosis was leiomyoma. The decision to perform a total abdominal hysterectomy and bilateral salpingo-oophorectomy was taken. The abdomen was opened by a midline vertical incision. During surgery, multiple subserosal, intramural and submucosal fibroids ranging from 2 cm × 3 cm to 10 cm × 10 cm were seen. On pathological examination, the uterus measured 19 cm in the largest diameter and weighed 1.3 kg. The cut section showed white nodular myometrial masses. Microscopically, intravascular growth of benign smooth muscle cells is found within venous channels lined by endothelium. The diagnosis of Intravenous leiomyomatosis of the uterus without malignant transformation was retained. The patient was monitored for 14 months and subsequent computed tomography did not reveal any evidence of tumor recurrence. The follow-up will be performed annually till the age of menopause.Conclusion: Intravenous leiomyomatosis is a benign, rare and potentially lethal pathology. It especially affects premenopausal women with a history of uterine myoma, whether operated on or not. They require close and prolonged follow-up because of the high risk of recurrence.
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Idiopathic ascites following caesarean section: A case report

Published on: 1st November, 2022

Ms X is a 40-year-old gravida 12, para 2+9 woman, who was admitted for an elective caesarean section at 38 weeks gestation following the previous two caesarean sections. Ms X had abdominal distension and generalised abdominal tenderness in the postoperative period. On investigation, she was found to have an elevated white cell count (WCC), C - Reactive Protein (CRP) and creatinine with free fluid in the abdomen on imaging but there was no evidence of perforation of any visceral organ. Ms X was treated conservatively for sepsis, an Acute Kidney Injury (AKI) and post-operative ileus and her symptoms gradually resolved. This is a case of idiopathic ascites post caesarean delivery with no clear cause.
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Improving “quality of life” through exercise and proper nutrition

Published on: 2nd November, 2022

In line with what is defined by W.H.O. (World Health Organization) the objective of the work is to observe and define the interconnection between a healthy lifestyle and the quality of life perceived by people.For this purpose, 30 healthy subjects, who had never practiced sports at a competitive level, were recruited. All individuals were evaluated at T0 and T1 through clinical evaluation and specific functional tests to define the psycho-physical well-being of the person. For three months they were followed with a personalized diet. Subjects were divided into two randomized groups: group A called experimental that followed the protocol for the duration of the study, and group B said evaluation group that performed only evaluations at the same time as group A. both groups were evaluated twice, the first immediately after the last training session, the second evaluation was performed after 30 days from the first.The objective of the project was to analyze, after three months, the cognitive changes in memory and concentration skills, stress experienced at work or study, and psycho-physical well-being perceived by interested parties. The data collected during the evaluations showed that the interconnection between a healthy lifestyle and the quality of life perceived by people is evident.
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COVID-19 pandemic to endemic

Published on: 7th November, 2022

The COVID-19 pandemic appeared in late 2019 and became a major health concern with rapid transmission and very high mortality rates across the globe. Although precautionary, preventive, protective and therapeutic measures have been adopted against COVID-19, still the disease has drastically affected people. In order to overcome the challenges of the pandemic, the understanding of the route of transmission, its fusion with receptors and invasion into the human body and hacking the immune system, the viral genome was sequenced. The viral genome keeps on mutating and altering its original form into its subtypes. Moreover, age and comorbid conditions had their impact on developing the disease differing from individual to individual due to interaction varying between the host genome and virus. Considering the pathogenesis of the virus, neutralizing antibodies reduced the viral impact and severity. This review is focused on highlighting the COVID-19 genome, host genetic factors, the pathogenesis of the disease and available therapeutic measures to overcome the pandemic.
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Renal neoplasms and computed tomography

Published on: 8th November, 2022

Introduction: In recent years the increased utilization of imaging modalities has led to an accelerated diagnosis of renal masses. Initial diagnoses and staging are commonly done with the abdominal Computed Tomography (CT). This study evaluates the various aspects to consider when utilizing CT scan for the diagnosis of renal masses.Discussion: CT scan is the most important imaging modality to evaluate renal neoplasms. Postcontrast acquisitions can be tailored according to the indication for the study. This alongside various techniques, imaging modalities and classification systems may help differentiate the malignant Renal Cell Carcinoma, from benign or metastatic lesions, lymphomas or renal pseudotumor. Finally CT can also be utilized alongside other tools for staging the tumor. Conclusion: Certain CT imaging features are pertinent to evaluate the malignancy potential of renal lesions. However the CT alone may be inconclusive in diagnosing the majority of renal neoplasms, excluding AML with macroscopic fat. Hence it is recommended that the CT aid additional imaging modalities and tools to reach an accurate diagnosis.
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Assessment of indigenous methods of shea butter processing among rural women in Borgu Local Government Area of Niger State, Nigeria

Published on: 4th November, 2022

Indigenous food processing and preservation methods are on the verge of collapse, yet they proved promising and sustainable. The study assessed the indigenous methods of shea butter processing among rural women in the Borgu Local Government Area of Niger State, Nigeria. Specifically, it described the socioeconomic characteristics of respondents, examined the shea butter processing techniques used and identified the information sources of shea butter processors in the study area. A multistage sampling technique was used to select 100 respondents. Descriptive (such as frequency count, percentage, charts and tables) and inferential statistics (such as Pearson correlation and chi-square) were used to analyze the data. Findings showed the mean age of respondents was 45.61 ± 11.82, with mean years of experience of 20.39 ± 12.96, the majority (85%) were married and the major sources of information on indigenous shea butter processing came from family members and friends. At p ≤ 0.01 there was a significant association between respondents’ usage of indigenous methods and their marital status (ᵡ2 = 84.24; p ≤ 0.01), membership in cooperative society (ᵡ2 = 40.43; p ≤ 0.01), and community membership (ᵡ2 = 53.21; p ≤ 0.01). However, there was a significant relationship between respondents’ usage of indigenous methods and household size (b = 0.290; p ≤ 0.05), quantity produced (b = 0.616; p ≤ 0.10) and annual income (b = -0.765; p ≤ 0.05). It was concluded that indigenous methods of processing shea butter are widespread among respondents; knowledge is acquired through family and friends. Among others, the study recommends that extension agents be posted to rural areas to educate rural women and build on their indigenous knowledge of processing shea butter to introduce high-quality butter.
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Flashes of UV-C light are perceived by UVR8, the photoreceptor of UV-B light

Published on: 10th November, 2022

Light is an important regulator of plant morphogenesis and plant-pathogen interactions via specific photoreceptors and signaling pathways. Besides visible light, other electromagnetic radiations may play roles, notably ultraviolet (UV) light. The UV part of the electromagnetic spectrum includes UV-A (315 nm - 400 nm), UV-B (280 nm - 315 nm) and UV-C radiations (200 nm -280 nm). UV-B and UV-C have been reported to increase plant resistance to plant pathogens after the UV perception and signaling stages. The perception of UV-B radiation is achieved by the dimer protein UVR8 (UV RESISTANCE LOCUS 8). Even though the action spectrum of this photoreceptor overlaps in the UV-C domain, it has never been formally demonstrated that UVR8 could also act as a photoreceptor of UV-C light. We provide here original observations showing that UVR8 can indeed perceive UV-C light provided that the latter is in the form of flashes (1s) and not continuous illuminations (the 60s). Our observations also show that the response of UVR8 to flashes of UV-C light is dose-dependent. They could explain why flashes of UV-C light are more effective for stimulating plant defenses than continuous illuminations for the same amount of energy delivered to plants (J/m2). Eventually, our observations support ongoing trials that aim at using UV-C light as an environmental-friendly plant resistance inducer in field conditions.
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Dynamic knee valgus in anterior cruciate ligament non-contact injury and reinjury in professional female athletes. Determinant or not?

Published on: 15th November, 2022

Dynamic Knee Valgus (DKV) is correlated with both, Anterior Cruciate Ligament (ACL) injury and hip and ankle disorders in female athletes and has a more significant prevalence compared with male athletes because of numerous factors. The aim of this study is to determine if the connexion between DKV, landing errors, and non-contact ACL injury and re-injury in high-performance, adult, female team sport athletes can be eliminated by changing the frontal plane movement pattern and the landing errors during the rehabilitation process (RHB), a process which was focussed on dynamic knee stability with multidimensional single-leg jump landing training, on 3D knee balance improvement and multistimulus perturbation challenges and tasks,+ eccentric & concentric exercise, strength & conditioning, aerobic training that lasted from 26 - 44 weeks.Assessing and eliminating-reducing DKV during the RHB is mandatory in lowering the re-rupture rates in female professional athletes after ACL surgery and in preventing opposite knee trauma.
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Pseudomonas stutzeri meningitis in a patient with post-laminectomy CSF leak and infected pseudomeningocele: a case report

Published on: 11th November, 2022

Spine degenerative surgeries are very common but carry multiple complications such as dural tears, CSF leak, pseudomeningocele and very rarely meningitis. Here we report such a case and discuss the possible causes, management and review of the literature.It’s a case of a 68-year-old man who underwent a posterior laminectomy that was complicated by a CSF leak and pseudomeningocele. Twelve days later the patient developed a severe bifrontal headache and then altered sensorium. CSF studies revealed severe meningitis with Pseudomonas stutzeri. It was multi-sensitive and after initiation of gram-negative coverage the patient markedly improved. However, the meningitis was further complicated by cerebral venous sinus thrombosis and he was also started on anticoagulation.Conclusion: Pseudomonas stutzeri has rarely been reported as a cause of meningitis and has never been reported post-laminectomy. Meningitis symptoms and signs could be obscured by the use of steroids in the postoperative period. Hence, it is of paramount importance to look for any subtle signs of infection in the postoperative period and question the use of high-dose steroids that could easily mask them.
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How to avoid partial implantation of people with cochlear malformation

Published on: 14th November, 2022

Many advances have been made in recent years in the development of hearing and cochlear implants. These use acoustic and electrical stimulation technologies to improve speech intelligibility for the hearing impaired. However, for cochlear prostheses, the results are not very promising and vary from one patient to another. Certain technical and sometimes physiological problems have limited the expected performances of these devices, especially for children and the elderly. These problems include cochlear malformation and ossification of the auditory channels. This led us to reduce the number of electrodes in order to allow quality deep insertion while preserving the low-frequency acoustic bands of the operated patient.
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An updated review of published human health risk-benefit assessment studies in the scientific literature

Published on: 15th November, 2022

Background: Public health policies in the area of food and diets tend to separate recommendations on food safety and nutrition. However, food products can simultaneously have risks and benefits. Risk-benefit assessment (RBA) seeks to integrate the assessment of both risks and benefits to aid complex decision-making using a multidisciplinary approach. In this study, a systematic literature review of recent RBA studies was performed, focusing on food consumption and human health following earlier reviews by Boué, et al. (2015) and Thomsen, et al. (2021). Results: A total of 50 new RBA studies were reviewed since 20 May 2014. Our current literature review shows that the majority of RBA studies conducted in recent years remain focused on seafood, with studies on fish alone comprising 34% of all studies; the focus being on the benefits of fish consumption versus contaminant exposure. Most of the studies have been conducted in Europe (n = 31) and Asia (n = 11). Conclusion: RBA has the potential to be applied more widely to other food choices such as alternative proteins, yet application remains limited to specific applications and contaminant/nutrient case studies. In recent years, a few RBA studies have been reported on less mainstream food sources and one specifically on novel foods. Novel foods offer a unique application space for RBA as their development is focused heavily on the benefits to the consumer, society, and environment, yet there remains uncertainty as to their safety. 
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Interdictory contribution of Vitamin D to prevent corona virus infections

Published on: 16th November, 2022

The impact of vitamin D on the musculoskeletal system is well known. The diverse role of vitamin D is well supported by the functionality of vitamin D receptors and vitamin D activating enzymes (hydroxylase) present in tissues and cells. Hypovitaminosis D causes rickets, osteomalacia, hyperparathyroidism, and an increased risk of bone fracture. Vitamin D has immune-stimulatory effects on both the innate and adaptive immune systems. Vitamin D induces antimicrobial peptide cathelicidin and defensin that can inhibit viral replication of pro-inflammatory cytokines that regulate inflammatory encasement. Moreover, several studies on vitamin D have shown its interdictory role in the immune and respiratory systems. This global crisis, the COVID-19 pandemic condition has increased the risk of acute respiratory tract infection by immune dysregulation along with cytokine storm, which further progress into acute respiratory distress syndrome. Vitamin D has immunomodulatory and anti-inflammatory properties which are effective against respiratory viral infections. Vitamin D supplementation has shown a compatible effect on viral infection. This review article discusses the role of vitamin D in reducing the risk of respiratory infections including the severity of COVID-19 infections. This review focuses on the therapeutic role of vitamin D to improve clinical outcome during COVID-19 infection and suggest its possible role in the prevention and treatment of respiratory infections.
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Comparative study of once daily tacrolimus (extended-release capsule) versus conventional twice daily tacrolimus in renal transplant recipients

Published on: 15th November, 2022

Background: One of the common causes of chronic allograft nephropathy is nonadherence to medications, contributing to 30% of graft loss in the developed world. The non-adherence is attributed predominantly to pill burden.Once-daily dosing of tacrolimus instead of conventional twice-daily dosing may enhance adherence to medication and improve long-term outcomes. The present study is a retrospective analysis comparing the safety and effectiveness of De Novo (use from day 1) once daily (OD) Tacrolimus (extended-release capsules) to conventional twice-a-day (BD) tacrolimus, in renal transplant recipients operated at Suguna Hospital Bangalore India. Material and Methods: Records of 24 Transplant patients on De novo OD Tacrolimus were analyzed and compared retrospectively to 24 transplant patients treated De Novo with conventional BD tacrolimus on a regular follow-up for at least 2 yrs. post-transplant at our center. Results: Various parameters recorded till the last follow-up were analyzed and compared. The average weight of the cohort (64.6 kg vs. 66.6 kg), average tacrolimus dose (2.7 mg vs. 2.15 mg), average Tac dose/kg body weight (0.04 mg vs. 0.03 mg), average Sr.Creatinine, at Last, Follow up (1.2 mg/dl vs. 1.32 mg/dl) were comparable in both groups and were statistically insignificant (p > 0.05). However, there was a higher incidence of Post-Transplant Diabetes Mellitus (PTDM) noted in the Conventional BD Tacrolimus group (20.83%) compared to the OD Tacrolimus group (4.1%) and it was statistically significant (p = 0.17). The Infection rate of 41.67% in the conventional BD Tacrolimus group was much higher compared to the OD Tacrolimus group (4.17%) which was statistically significant (p = 0.01). There was 100% patient and graft survival at the end of two years in both groups. Tacrolimus Dose for OD and Conventional BD dosing were similar, unlike earlier studies recommending a 10% increase in dose for OD tacrolimus compared to BD dosing.Conclusion: OD Tacrolimus dose is comparable to conventional BD dose Tacrolimus in its safety and Efficacy; however, it scores over conventional BD dose Tacrolimus in terms of post-transplant infections and post-transplant diabetes mellitus (PTDM) and a more stable serum trough level. 
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Post-harvest assessment of infectious fruit rot on selected fruits in Lafia, Nasarawa State Nigeria

Published on: 15th November, 2022

The post-harvest health and microbial safety of plant products and foods continue to be a global concern to farmers, consumers, regulatory agencies and food industries. A study was carried out to evaluate the pathogenicity of fungi associated with post-harvest rot of oranges, watermelons and bananas in Lafia, Nasarawa State, Nigeria. Healthy fruits inoculated with fungal spores obtained from rotted fruit tissues were incubated at ambient temperature conditions and observed daily for the appearance and development of tissue rot. Oranges and Watermelons had the highest number of fungal isolates (3) compared to banana (2). Fungi belonging to the genus Curvularia were the most isolated (37.50%), followed by both Aspergillus and Colletotrichum (25.00% respectively) and lastly Alternaria (12.50%). The highest tissue rot diameter of sweet orange (2.40 cm) was induced by Alternaria sp. followed by Curvularia geniculate (1.40 cm) and lastly Colletotrichum sp. (1.28 cm). The highest rot of banana fruit tissues was produced by A. niger (3.90 cm), followed by Curvularia geniculate (3.40 cm). Aspergillus sp. produced the highest tissue rot diameter on watermelon fruits (1.93 cm), followed by Colletotrichum sp. (1.30 cm) and lastly Curvularia geniculate (1.20 cm). Differences in the susceptibilities of different fruits to rot by fungal pathogens were significant (p ≤ 0.05). There is need for improved handling of fruits after harvest to prevent losses due to bacterial and fungal rots in the study area.
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Neglected percutaneous rod extrusion following posterior occipitocervical instrumentation: a case report

Published on: 18th November, 2022

Purpose: The extrusion of implant material is a rare complication but has been reported in several cases following anterior cervical spine surgery. A posterior spontaneous percutaneous rod extrusion after rigid occipitocervical (OC) instrumentation (screw and rod construct) has not been reported yet. The authors discuss potential complications after cervical spine surgery and its clinical management.Methods: This is a case report of a 56-year-old patient after posterior OC spine surgery with initially unobserved implant failure and posterior percutaneous rod extrusion. The implant failure with a missing rod has been documented 4 years later during a routine follow-up visit.Results: At the four-year follow-up, the asymptomatic patient presented with a stable occipitocervical junction and an improved range of motion after generalized sepsis with an epidural spinal abscess, decompression and posterior OC instrumentation. A computed tomography scan of the implant failure of a broken rod was noticed two years postoperatively. The patient failed to return to the clinic. For years postoperatively he returned to the clinic and the broken rod could not be detectable in-situ on the X-rays anymore. Conclusion: The posterior percutaneous rod extrusion following an OC instrumentation not noticed by the patient, is a very rare complication that has not been described in the literature yet. Once seen back in the clinic, the patient unexpectedly reported an improved ROM without neck pain. Usually, revision surgery or implant removal is recommended if an implant failure is documented.
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