Assessment patient satisfaction after total hip replacement in Indian population

Background: We aim to assess the satisfaction of patients after total hip replacement in Indian population. Nоwаdаys tоtаl hiр аrthrорlаsty is the finаl treаtment орtiоn рrоvided tо раtients with unsаlvаgeаble, severely аrthritiс, раinful аnd defоrmed hiрs. Раtient sаtisfасtiоn hаs been meаsured in multiрle оrthораediс рrосedures, inсluding tоtаl hiр аrthrорlаsty. THА is а соmmоn surgiсаl рrосedure thаt imрrоves the lives оf раtients with end-stаge аrthritis by deсreаsing раin, аnd imрrоving mоtоr function and mоbility аs measured by vаlidаted heаlth-relаted оutсоme tооls. Methods: Patients were assessed at OPD visit or with telephonic conversation scores are calculated and mentioned in excel sheet. Post-surgery satisfaction score is the score created to measure the satisfaction after total hip replacement. This score contains different questionnaires. These questions include inquiry about relieve of pain, ability to do daily routine activities, requirement of walking aids etc. Score contains total 7 questions with answers. Results: Out of 95 patients we found through this study that about 92.63% of patients are satisfied after total hip replacement. 7.37% of patients are dissatisfied. Satisfaction rate is more as compared to dissatisfaction rate. Conclusions: In present study we have tried to eliminate other factors responsible for dissatisfaction such as hospital ward cleanliness, hospital administration, patient and hospital staff communication. We recommend total hip replacement surgery for end stage arthritis and is more beneficial to the patients in terms of improvement in post-operative pain and function

Radiological and functional outcome of conservatively managed middle one third clavicle fractures

Background: We aim to assess radiological and functional outcome of conservatively managed middle one third clavicle fractures in Indian population. Clavicle fractures represent 2% to 10% of all fractures. In middle third clavicle fractures, conservative management is the commonest approach. In uncomplicated non displaced midshaft fractures, patients treated non operatively with these conservative measures have fewer complications and a timely recovery as those treated operatively. Conservative management is a simpler yet effective mode of management in middle one third clavicle fractures. Methods: Patients managed conservatively for clavicle fractures were assessed on OPD basis with follow up chest X-ray with bilateral shoulder AP view for radiological signs of union and assessing percent shortening and two questionnaires. Constant shoulder score which assess pain, degree of function, range of motion and muscular force and, simple shoulder test, self administered questionnaire defining one or more affirmative answers to find the satisfaction after treatment modality which were tabulated in Microsoft excel sheets. Results: Out of the 55 patients enrolled in the study 52 showed signs of union at 6 months follow up with mean fracture union time of 13.9 weeks. At 6 months follow up Mean Constant Shoulder score was 87.1 with excellent outcome in 67.67 percent patients and using Simple Shoulder Test satisfaction rate was found to be 78.18 percent. Conclusions: Solid evidence in favour of non-operative treatment for fractures with remaining contact of the bone fragments. Non-surgical management of middle third clavicle fractures yield excellent results. Clear indications for conservative treatment versus surgical fixation of displaced midshaft fractures have not finally been established yet. We recommend conservative management for uncomplicated middle one third clavicle fractures

A Composite Metric for Benchmarking Site Performance in TAVR: Results from the STS/ACC TVT Registry

Background: Transcatheter aortic valve replacement (TAVR) is a transformative therapy for aortic stenosis. Despite rapid improvements in technology and techniques, serious complications remain relatively common and are not well described by single outcome measures. The purpose of this study was to determine if there is site-level variation in TAVR outcomes in the United States using a novel 30-day composite measure. Methods: We performed a retrospective cohort study using data from the STS/ACC TVT Registry to develop a novel ranked composite performance measure that incorporates mortality and serious complications. The selection and rank order of the complications for the composite was determined by their adjusted association with 1-year outcomes. Sites whose risk-adjusted outcomes were significantly more or less frequent than the national average based on a 95% probability interval were classified as performing worse or better than expected. Results: The development cohort consisted of 52,561 patients who underwent TAVR between January 1, 2015 and December 31, 2017. Based on the associations with 1-year risk-adjusted mortality and health status, we identified four periprocedural complications to include in the composite risk model in addition to mortality. Ranked empirically according to severity, these included stroke, major, life-threatening or disabling bleeding, stage III acute kidney injury, and moderate or severe peri-valvular regurgitation. Based on these ranked outcomes, we found that there was significant site-level variation in quality of care in TAVR in the United States. Overall, better than expected site performance was observed in 25/301 (8%) of sites; performance as expected was observed in 242/301 sites (80%); and worse than expected performance was observed in 34/301 (11%) of sites. Thirty-day mortality, stroke, major, life-threatening or disabling bleeding, and moderate or severe peri-valvular leak were each substantially more common in sites with worse than expected performance as compared with other sites. There was good aggregate reliability of the model. Conclusions: There are substantial variations in the quality of TAVR care received in the United States, and 11% of sites were identified as providing care below the average level of performance. Further study is necessary to determine structural, process-related, and technical factors associated with high- and low-performing sites

Association of Cutibacterium acnes with human thyroid cancer

IntroductionThe diverse subtypes of thyroid carcinoma have distinct clinical outcomes despite a comparable spectrum of underlying genetic alterations. Beyond genetic alterations, sparse efforts have been made to characterize the microbes associated with thyroid cancer. In this study, we examine the microbial profile of thyroid cancer.MethodsWe sequenced the whole transcriptome of 70 thyroid cancers (40 papillary and 30 anaplastic). Using Infectious Pathogen Detector IPD 2.0, we analysed the relative abundance of 1060 microbes across 70 tumours from patients with thyroid cancer against 118 tumour samples from patients with breast, cervical, colorectal, and tongue cancer.ResultsOur analysis reveals a significant prevalence of Cutibacterium acnes in 58.6% thyroid cancer samples compared to other cancer types (p=0.00038). Immune cell fraction analysis between thyroid cancer samples with high and low Cutibacterium loads identify enrichment of immunosuppressive cells, including Tregs (p=0.015), and other anti-inflammatory cytokines in the tumour microenvironment, suggesting an immune evasion/immunosuppression milieu is associated with the infection. A higher burden of Cutibacterium acnes was also found to be associated with poor survival defining a distinct sub-group of thyroid cancer.ConclusionCutibacterium acnes is associated with immune suppression and poor prognosis in a subpopulation of thyroid cancer. This study may help design novel therapeutic measures involving appropriate antibiotics to manage the disease better

Factors Affecting Bubble Size in Ionic Liquids

This study reports on understanding the formation of bubbles in ionic liquids (ILs), with a view to utilising ILs more efficiently in gas capture processes. In particular, the impact of the IL structure on the bubble sizes obtained has been determined in order to obtain design principles for the ionic liquids utilised. 11 ILs were used in this study with a range of physico-chemical properties in order to determine parametrically the impact on bubble size due to the liquid properties and chemical moieties present. The results suggest the bubble size observed is dictated by the strength of interaction between the cation and anion of the IL and, therefore, the mass transport within the system. This bubble size – ILs structure–physical property relationship has been illustrated using a series of QSPR correlations. A predictive model based only on the sigma profiles of the anions and cations has been developed which shows the best correlation without the need to incorporate the physico-chemical properties of the liquids. Depending on the IL, selected mean bubble sizes observed were between 56.1 and 766.9 μm demonstrating that microbubbles can be produced in the IL allowing the potential for enhanced mass transport and absorption kinetics in these systems

Multi-band Extension of the Wideband Timing Technique

The wideband timing technique enables the high-precision simultaneous estimation of Times of Arrival (ToAs) and Dispersion Measures (DMs) while effectively modeling frequency-dependent profile evolution. We present two novel independent methods that extend the standard wideband technique to handle simultaneous multi-band pulsar data incorporating profile evolution over a larger frequency span to estimate DMs and ToAs with enhanced precision. We implement the wideband likelihood using the libstempo python interface to perform wideband timing in the tempo2 framework. We present the application of these techniques to the dataset of fourteen millisecond pulsars observed simultaneously in Band 3 (300 - 500 MHz) and Band 5 (1260 - 1460 MHz) of the upgraded Giant Metrewave Radio Telescope (uGMRT) as a part of the Indian Pulsar Timing Array (InPTA) campaign. We achieve increased ToA and DM precision and sub-microsecond root mean square post-fit timing residuals by combining simultaneous multi-band pulsar observations done in non-contiguous bands for the first time using our novel techniques.Comment: Submitted to MNRA