Management of complete dislocation of tarsal scaphoid without fracture

Background: Injuries to the mid tarsal joints usually occur in the form of various combinations such as fracture, fracture subluxation, and fracture dislocation. Dislocations of navicular without fracture are rare injuries, minimal literatures exist, which describe the probable mechanism of injury and optimal treatment.Methods: Four patients with complete dislocation of navicular without fracture presented to us following a history of trauma. The diagnosis was confirmed by radiology and further details were studied by CT scans. One injury was open and the rest were closed. One had associated fracture of talus and two had metatarsal fracture and one was purely isolated navicular dislocation without any associated injury. All were initially stabilized in a below knee plaster of paris slab and foot end elevated. All were successfully treated surgically under spinal anesthesia with open reduction and internal fixation with Kirschner wires through a dorsomedial approach. Postoperative immobilization was continued for twelve weeks then gradual mobilization begun followed by physiotherapy.Results: All patients had good clinical results with two patients resuming their work within twelve weeks and the one with open wound took twenty weeks for resuming his original work. One with associated talar fracture later had to undergo subtalar arthrodesis for pain in the foot while weight bearing after one year of surgery for navicular dislocation. Conclusions: Open reduction and internal fixation with Kirschner wire is an effective way of managing patients with complete dislocation of tarsal navicular for early resuming of the functions and return to work

Closed diaphyseal fractures of femur in children treated by hip spica: early result of a clinical study

Background: Diaphyseal fracture of femur is a common injury in children with bimodal age distribution. The treatment modality of these fractures depend on several factors such as age of the patient, characteristics of the fracture– degree of displacement, location of fracture in femur, comminution, and open or closed injury. With the invention of titanium elastic nails, the recent trend in treating these fractures is by closed reduction and TENS, but the surgical management is not without complications hence we share our experience to reemphasize the role of hip spica cast immobilisation in treating these injuries.Methods: This is a prospective study of 30 cases of diaphyseal fractures of femur in children between the ages of 6 month to 6 years. History and mode of injury were recorded and complete physical examination was done. Plain anteroposterior and lateral radiographs confirmed diagnosis. Hip spica cast was applied under sedation or short general anesthesia. One and half spica was applied over thick padding with hip flexed 45 degrees abducted 30 degrees and external rotation of 10 degree. No attempt was made to obtain an end to end reduction. Patients were allowed to go home the same day after giving instructions regarding spica care. Follow up was done and radiographs were taken at 1, 2, 4 and 12 weeks. Any malunion– LLD, angulation or rotation were recorded.Results: The mean age of patients was 3.5 years (range 0.5 to 6 years). Of these 12 (40%) were male and 18 (60%) were female. The commonest mode of injury was fall while play in 73.33% (n=22) of patients. Mid shaft fractures are more common 53.33% (n=16) followed by upper third 40% (n=12). Average time for fracture union was 6 weeks (range 4-10 weeks). At one year all fractures healed in a satisfactory position without any LLD. Two patients had minor skin problems which were easily treated and cast continued. No stiffness of hip, knee or ankle was noted. Conclusions: Hip spica casting is an effective and reliable method for treating femoral shaft fractures in children with a union rate of 100%. The advantages of conservative treatment such as the avoidance of general anaesthesia on two occasions and the avoidance of surgery make a compelling argument in favour of this form of treatment

Autologous blood injection technique in the treatment of refractory lateral elbow tendinopathy

Background: Lateral elbow tendinopathy is a very common clinical condition whose management by the consultant often shifts from one to another modality. This study was conducted to know the efficacy of a minimally invasive technique of autologous blood injection in patients who were resistant to more conservative methods.Methods: This is a randomized prospective study of forty-eight patients (median age, 37 to 40 years), presenting with lateral elbow symptoms for a duration of more than six weeks and failed to respond to other methods of conservative treatment. Patients were consecutively grouped into treatment with autologous blood injections (Group I, n = 24) and control group with injection of normal saline (Group II, n = 24). 1 ml of autologous blood was drawn from dorsal venous arch and injected into the site of maximum tenderness over lateral aspect of the elbow under all aseptic precautions for all patients in group I. Similarly 1 ml of normal saline was injected at the site of maximum tenderness for patients in group II.  Results were evaluated based on severity of the elbow complaints, tenderness and Cozen’s test at the end of follow-up of twenty weeks.Results: The incidence of this condition was more in the third decade 39.6% (n=19), with female preponderance 58.3% (n=28) and the dominant arm being more commonly involved 58.3% (n=28). Excellent results were found in group I in n=15 (62.5%) whereas poor results were more in group II in n=14 (58.3%). Group I had poor result only in n=03 (12.5%) of patients who later were given another dose of autologous blood or were treated surgically. Conclusions: Injection of autologous blood is a very efficacious minimally invasive procedure with satisfactory results in patients of lateral elbow tendinopathy who do not respond to other conservative methods of treatment

On the nonlinear implicit complementarity problem

In this paper, we consider a new class of implicit complementarity problem and study the existence of its solution. An iterative algorithm is also given to find the approximate solution of the new problem and prove that this approximate solution converges to the exact solution. Several special cases are also discussed

RF Conditioning of 75 MHz Prototype Heavy Ion RFQ

Abstract The Pelletron Accelerator Facility (PAF), Mumbai is engaged in development of a 75 MHz prototype Heavy Ion Radio Frequency Quadrupole (RFQ). The RF characterization of this RFQ consisting of 1.34m modulated vanes is completed. The medium power conditioning of the RFQ was started with the available 1 KW RF amplifier and results are discussed

Holographic dark energy in a universe with spatial curvature and massive neutrinos: a full Markov Chain Monte Carlo exploration

In this paper, we report the results of constraining the holographic dark energy model with spatial curvature and massive neutrinos, based on a Markov Chain Monte Carlo global fit technique. The cosmic observational data include the full WMAP 7-yr temperature and polarization data, the type Ia supernova data from Union2.1 sample, the baryon acoustic oscillation data from SDSS DR7 and WiggleZ Dark Energy Survey, and the latest measurements of $H_0$ from HST. To deal with the perturbations of dark energy, we adopt the parameterized post-Friedmann method. We find that, for the simplest holographic dark energy model without spatial curvature and massive neutrinos, the phenomenological parameter $c<1$ at more than $4\sigma$ confidence level. The inclusion of spatial curvature enlarges the error bars and leads to $c<1$ only in about $2.5\sigma$ range; in contrast, the inclusion of massive neutrinos does not have significant influence on $c$. We also find that, for the holographic dark energy model with spatial curvature but without massive neutrinos, the $3\sigma$ error bars of the current fractional curvature density $\Omega_{k0}$ are still in order of $10^{-2}$; for the model with massive neutrinos but without spatial curvature, the $2\sigma$ upper bound of the total mass of neutrinos is $\sum m_{\nu} < 0.48$ eV. Moreover, there exists clear degeneracy between spatial curvature and massive neutrinos in the holographic dark energy model, which enlarges the upper bound of $\sum m_{\nu}$ by more than 2 times. In addition, we demonstrate that, making use of the full WMAP data can give better constraints on the holographic dark energy model, compared with the case using the WMAP ``distance priors''.Comment: 21 pages, 10 figures; major revision; new figures and discussions added; accepted by JCA

TAT-peptide conjugated repurposing drug against SARS-CoV-2 main protease (3CLpro): potential therapeutic intervention to combat COVID-19

The Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that originated in Chinese city of Wuhan has caused around 906,092 deaths and 28,040,853 confirmed cases worldwide (WHO, 11 September, 2020). In a life-threatening situation, where there is no specific and licensed anti-COVID-19 vaccine or medicine available; the repurposed drug might act as a silver bullet. Currently, more than 211 vaccines, 80 antibodies, 31 antiviral drugs, 35 cell-based, 6 RNA-based and 131 other drugs are in clinical trials. It is therefore utter need of the hour to develop an effective drug that can be used for the treatment of COVID-19 before a vaccine can be developed. One of the best-characterized and attractive drug targets among coronaviruses is the main protease (3CL^{pro}). Therefore, the current study focuses on the molecular docking analysis of TAT-peptide^{47–57} (GRKKRRQRRRP)-conjugated repurposed drugs (i.e., lopinavir, ritonavir, favipiravir, and hydroxychloroquine) with SARS-CoV-2 main protease (3CL^{pro} to discover potential efficacy of TAT-peptide (TP) - conjugated repurposing drugs against SARS-CoV-2. The molecular docking results validated that TP-conjugated ritonavir, lopinavir, favipiravir, and hydroxychloroquine have superior and significantly enhanced interactions with the target SARS-CoV-2 main protease. In-silico approach employed in this study suggests that the combination of the drug with TP is an excelling alternative to develop a novel drug for the treatment of SARS-CoV-2 infected patients. The development of TP based delivery of repurposing drugs might be an excellent approach to enhance the efficacy of the existing drugs for the treatment of COVID-19. The predictions from the results obtained provide invaluable information that can be utilized for the choice of candidate drugs for in vitro, in vivo and clinical trials. The outcome from this work prove crucial for exploring and developing novel cost-effective and biocompatible TP conjugated anti-SARS-CoV-2 therapeutic agents in immediate future

Potential Utilization of Alternative Construction Materials in Qatar, in lieu of Conventional Washed Sand

Natural sand that has been washed is an essential material used in infrastructure development and construction projects of all sizes. Due to the depletion of natural sand sources in Qatar, there has arisen a need to develop alternate materials to replace it. Substitutes such as wadi gravel, marine sand and manufactured sand, including crushed imported limestone, recycled sand and crushed gabbro have been considered and explored. Consequently, a proposal to encourage local washed sand producers to incorporate varying proportions of these alternate materials into the various material demands was considered by the Public Works Department, depending on the application in either structural and/or precast members. This paper primarily focuses on providing an overview of some of the available alternate materials to washed sand that could be utilized without affecting the physical, mechanical, or strength properties of concrete, precast, and other construction materials that use washed sand, while at the same time providing a long-lasting, durable and economically beneficial alternative material to the national economy