Functional assessment after anterior cruciate ligament reconstruction using quadrupled semitendinosus graft

Background: Anterior cruciate ligament is the primary stabilizer of the knee and prevents translation and rotatory forces and it is one of the most prevalent ligament injuries in the knee. Arthroscopic ACL reconstruction is recommended for which different graft options can be Quadrupled Semitendinosus and Gracilis, doubled Peroneus, Quadriceps Tendon, and Bone patellar tendon-bone. As all grafts have their advantages and disadvantages in terms of donor site morbidity, fixation, and failure rate; the ideal ACL reconstruction graft remains a point of contention. So, we did a functional assessment after ACL reconstruction using Quadrupled Semitendinosus graft.Methods: The prospective cohort study included 30 patients under the age of 55 years admitted with ACL deficiency from August 2019 to August 2020 in the orthopedic department of a Sapthagiri hospital, Bangalore who underwent arthroscopic ACL reconstruction. This study aims to evaluate the functional result of arthroscopic anterior cruciate ligament reconstruction with only quadrupled semitendinosus tendon graft using the Tegner, Lysholm, and IKDC knee grading systems.Results: Patients were followed up for a minimum period of one year. On evaluation, the maximum Lysholm, IKDC score achieved was 97 and 79 respectively while the minimum score was 86 and 69 respectively. Comparisons of pre-and postoperative improvement scores were statistically significant.Conclusions: Arthroscopic ACL reconstruction with quadrupled semitendinosus graft yields good functional results with minimal postoperative morbidity irrespective of graft diameter

Non-ossifying fibroma of distal tibia: case report

Non-ossifying fibroma is a benign fibrohistiocytic lesion most commonly seen in the metaphyseal region in children. It usually doesn’t present with any symptoms. As the bone grows and undergoes remodeling, the lesion tends to vanish and get substituted with healthy bone. Nonetheless, the lesion can debilitate the affected bone, leading to a potential fracture. Here, we report a case of non-ossifying fibroma in the metaphyseal region of the tibia in a 13-year female. The patient presented with complaints of pain in the left leg for 5 months and underwent radiological investigation showing a well-defined, multi-loculated, expansile, radiolucent, lytic lesion with a thin sclerotic margin in the meta-diaphyseal region of the distal tibia, for which extended bone curettage with bone grafting was performed. The sample was sent for histopathological examination, which showed bony trabeculae with bits of tumor composed of spindle cells with elongated nuclei and scant cytoplasm, arranged in a storiform pattern along with many scattered multinucleate giant cells and foamy histiocytes suggestive of non-ossifying fibroma. Post operatively, non-weight bearing mobilization was advised for 4 weeks. Most non-ossifying fibromas were diagnosed in childhood to late adolescence, found incidentally, and clinically asymptomatic. Most distal tibial non-ossifying fibromas (NOFs) tend to transpire at a specific anatomical site located at the far end of the interosseous membrane. The prognosis for NOFs is typically excellent with a low risk of recurrence

Rescuing the knee: arthroscopic extraction of a long-neglected glass fragment: a case report

The knee joint frequently encounters penetrating injuries and has ample space to harbor foreign objects. While foreign bodies in the knee joint are unusual, especially those not originating from surgical procedures, extensive literature exists on the extraction of loose bodies and metallic objects from this articulation. However, documentation on uncommon intruders remains scarce. This case study delves into the experience of a 22-year-old male who suffered persistent pain due to a neglected foreign object in his knee joint. After its removal, a complete resolution of symptoms was achieved. It highlights the importance of prompt arthroscopic intervention for optimal outcomes. Here we present a unique case involving a 22-year-old male who underwent arthroscopic retrieval of a neglected glass fragment from his knee joint. The patient sought medical attention five months after the initial injury due to sudden and severe pain onset. Arthroscopy stands as the favored minimally invasive method for extracting foreign bodies from the knee joint, especially from its deeper and less accessible regions. Utilizing pre-operative radiological imaging enhances understanding of the anatomical placement, facilitates surgical orientation, and reduces operation time. A keen sense of suspicion and thorough history-taking are crucial in achieving an accurate diagnosis

A quest for measuring intra operative blood loss in Maxillofacial surgery

Aim: To find out a simple, standardized method to measure intra-operative blood loss during major oral surgical procedures which alerts the clinicians to manage untoward outcomes in time. Materials & Method: Patients who underwent surgical intervention for various dentofacial deformities, maxillofacial pathologies, maxillofacial trauma under general anesthesia via an intra oral approach from Jan 2014 – Aug 2015 were included in the study. Thirty such patients belonging to the above entities were randomly categorized into 2 groups of 15 each based on the method of measuring the intra op blood loss. In Group A the blood loss was measured by Sahlis method and in Group B, the blood loss was measured by cyanomethemoglobin method. All the procedures were performed via an intra oral approach under general anesthesia. Results: The amount of intra operative blood loss measured through Sahli’s method appeared to be insensitive and not standardized. However, the one measured through Cyanomethemoglobin method was more accurate, standardized and easy to perform. Conclusion: Cyanomethemoglobin method is an accurate, reliable, chair side, inexpensive, easy to perform, standardized technique to measure the intra operative blood loss in the recent times

EXPLORING THE INTERPLAY OF ENTREPRENEURS' AWARENESS, PERCEPTION AND INTENTION IN DRIVING DIGITALIZATION FOR MSMES: A FOCUSED INSIGHT INTO SIDBI'S ROLE

Business dynamics have undergone a remarkable transformation in recent years, primarily driven by the digital revolution. Micro, Small, and Medium Enterprises (MSMEs) are recognized as the cornerstone of economic growth and development, and their adaptability to this digital era is paramount. This empirical investigation explores the complex relationship between entrepreneurs' awareness, perceptions, and intentions and their influence on the adoption of digitalization, with a focus on the digital initiatives of the Small Industries Development Bank of India (SIDBI), which aims to transform MSMEs digitally. Various constructs, such as entrepreneurs' awareness, perceptions, and intentions, are used to evaluate digital adoption in small businesses. By examining entrepreneurs' levels of awareness, perceptions, and intentions, we aim to uncover the fundamental factors that shape their strategic choices regarding digital adoption. This study employs structural equation Modeling (SEM) through AMOS and adopts an explanatory survey method. It involved engaging Indian MSMEs with a total of 300 participants. Of these, 220 successfully submitted fully filled-out questionnaires through Google Forms. It is noteworthy that the examination of the research model revealed promising results by meeting the thresholds of CFI, RMSEA, and other similar measures. Findings reveal that entrepreneurs' awareness and intention positively influence digital adoption in MSMEs, whereas entrepreneurs' perception has no significant influence on digital adoption in MSMEs. This study has significant practical implications for policy formulation, entrepreneurial decision-making, collaborative efforts, risk mitigation, and future research directions in the context of digitalization within the MSME sector

Effect of Greater Duckweed Spirodela polyrhiza Supplemented Feed on Growth Performance, Digestive Enzymes, Amino and Fatty Acid Profiles, and Expression of Genes Involved in Fatty Acid Biosynthesis of Juvenile Common Carp Cyprinus carpio

The greater duckweed Spirodela polyrhiza (Lemnaceae) is a free-floating freshwater macrophyte. The effect of dietary inclusion of duckweed in the feed of common carp Cyprinus carpio fry was evaluated. The control feed (SP0) contained soybean meal as the primary protein source. In four experimental feeds, greater duckweed was incorporated at levels of 5% (SP5), 10% (SP10), 15% (SP15), and 20% (SP20) replacing soybean meal. Broken-line regression showed that incorporation of greater duckweed at 10 and 13.4% levels were the breakpoint for final weight and specific growth rate (SGR) of fish, respectively. The final weight and SGR of common carp fed diet SP20 were significantly higher compared with those of others. The feed conversion ratio was lowest in SP20 treatment. The inclusion of greater duckweed in the fish feeds showed linear relationships with amylase, trypsin, chymotrypsin, and lipase activities. The content of crude protein was significantly higher in SP10, SP15, and SP20 treatments compared with that of others. Significantly higher crude lipid and ash contents were found in SP20 diet-fed fish compared with other diet-fed fish. The essential amino acids composition was similar in five different diet-fed fish. The greater duckweed supplemented feeds influenced the fatty acid contents of fish. The monounsaturated fatty acids (MUFA) showed an inverse relationship with the inclusion level of greater duckweed in the feed. The highest MUFA content was found in fish fed SP0 diet. The highest level of linoleic acid was found in SP20 diet fed fish. The n-3 PUFA contents of fish showed an increasing trend with the increasing inclusion of greater duckweed, and a significantly higher level was found in SP20 compared with that of others. A significantly higher expression of fas was found in SP5 and fads2d6 in SP5 and SP10 compared with that of others. The expressions of elovl2 and elovl5 were significantly higher in SP5, SP10, and SP15 diet-fed fish compared with other diet-fed fish. The incorporation of greater duckweed in diets improved the growth performance and nutritional value of common carp

Virtual Learning during COVID-19: Exploring Challenges and Identifying Highly Vulnerable Groups Based on Location

Amid the outbreak of the COVID-19 pandemic in the year 2020, educational platforms have been forced to change and adapt from conventional physical learning to virtual learning. Nearly all higher learning institutions worldwide are forced to follow the new educational setting through virtual platforms. Sabah is one of the poorest states in Malaysia with the poorest infrastructure, with the technology and communication facilities in the state remaining inept. With the changes in virtual platforms in all higher education institutions in Malaysia, higher learning institutions in Sabah are expected to follow the lead, despite the state lagging in its development. This has certainly impacted the overall productivity and performance of students in Sabah. Therefore, this study aims to explore the challenges of the implementation of virtual learning among students in Sabah. More specifically, this study seeks to identify vulnerable groups among students based on their geographical location. To achieve the objective of this study, a survey has been conducted on a total of 1,371 students in both private and public higher learning institutions in Sabah. The sample selection for this study was determined using a purposive sampling technique. Based on Principal Component Analysis (PCA), it was found that there are five challenges in virtual learning faced by students in higher learning institutions in Sabah. These are the unconducive learning environment (var(X) = 20.12%), the deterioration of physical health (var(X) = 13.40%), the decline of mental health (var(X) = 12.10%), the limited educational facilities (var(X) = 10.14%) and social isolation (var(X) = 7.47%). The K-Means Clustering analysis found that there are six student clusters in Sabah (Cluster A, B, C, D, E & F), each of which faces different challenges in participating in virtual learning. Based on the assessment of location, almost half of the total number of districts in Sabah are dominated by students from Cluster A (9 districts) and Cluster B (4 districts). More worryingly, both Cluster A and Cluster B are classified as highly vulnerable groups in relation to the implementation of virtual learning. The results of this study can be used by the local authorities and policymakers in Malaysia to improve the implementation of virtual learning in Sabah so that the education system can be more effective and systematic. Additionally, the improvement and empowerment of the learning environment are crucial to ensuring education is accessible and inclusive for all societies, in line with the fourth of the Sustainable Development Goals (SDG-4)

Readiness and Challenges of E-Learning during the COVID-19 Pandemic Era: A Space Analysis in Peninsular Malaysia

During the COVID-19 era, most countries, including Malaysia, have shifted from face-to-face teaching systems to online teaching programs. The aim of this study is to identify the main challenges that higher education students face during e-learning based on their residential location throughout Peninsular Malaysia. This study further examines the readiness of higher education students to apply e-learning. Therefore, a cross-sectional survey approach is used to fulfill the outlined objectives. Accordingly, 761 public (95.3%) and private (4.7%) higher education students residing in Peninsular Malaysia are sampled in this study. The survey was administered online for 37 days, from 21 October 21 to 6 December 2021, using either WhatsApp or Facebook. The raw data is inferentially (Principal Component Analysis, K-Means Clustering, Kruskal Wallis, and spatial analysis) and descriptively (mean, standard deviation & percentage) analyzed. It has been revealed that six clusters of students in Peninsular Malaysia face various challenges while following the e-learning program. Most states in Peninsular Malaysia are dominated by students in Cluster D (Terengganu, Perlis, Penang, Selangor, WP Kuala Lumpur, and WP Putrajaya) and Cluster B categories (Melaka, Johor, Kelantan, and Kedah). Students in the Cluster D category tend to suffer from physical health disorders and social isolation, while students in the Cluster B category face problems with a decreased focus on learning, mental health disorders, and social isolation. The outcomes further indicate that the more challenges students face during e-learning programs, the lower their willingness to continue with the program. The results of this study are significant in addressing the challenges of e-learning, which will help stakeholders address and strengthen student abilities

Search for new particles in events with energetic jets and large missing transverse momentum in proton-proton collisions at root s=13 TeV

A search is presented for new particles produced at the LHC in proton-proton collisions at root s = 13 TeV, using events with energetic jets and large missing transverse momentum. The analysis is based on a data sample corresponding to an integrated luminosity of 101 fb(-1), collected in 2017-2018 with the CMS detector. Machine learning techniques are used to define separate categories for events with narrow jets from initial-state radiation and events with large-radius jets consistent with a hadronic decay of a W or Z boson. A statistical combination is made with an earlier search based on a data sample of 36 fb(-1), collected in 2016. No significant excess of events is observed with respect to the standard model background expectation determined from control samples in data. The results are interpreted in terms of limits on the branching fraction of an invisible decay of the Higgs boson, as well as constraints on simplified models of dark matter, on first-generation scalar leptoquarks decaying to quarks and neutrinos, and on models with large extra dimensions. Several of the new limits, specifically for spin-1 dark matter mediators, pseudoscalar mediators, colored mediators, and leptoquarks, are the most restrictive to date.Peer reviewe