Patellar tendon mid-substance tear after total knee arthroplasty: a case report

Extensor mechanism of knee plays important role in successful long term functional outcome after total knee arthroplasty (TKA). Any injury to extensor mechanism during or after surgery can cause functional disability which can be devastating for patients. Patellar tendon injuries are not very common after TKA. The author reported a rare case of patellar tendon mid-substance tear after TKA, which was successfully managed by reconstruction using grafts without any implant

Feature Selection for Text and Image Data Using Differential Evolution with SVM and Naïve Bayes Classifiers

Classification problems are increasing in various important applications such as text categorization, images, medical imaging diagnosis and bimolecular analysis etc. due to large amount of attribute set. Feature extraction methods in case of large dataset play an important role to reduce the irrelevant feature and thereby increases the performance of classifier algorithm. There exist various methods based on machine learning for text and image classification. These approaches are utilized for dimensionality reduction which aims to filter less informative and outlier data. Therefore, these approaches provide compact representation and computationally better tractable accuracy. At the same time, these methods can be challenging if the search space is doubled multiple time. To optimize such challenges, a hybrid approach is suggested in this paper. The proposed approach uses differential evolution (DE) for feature selection with naïve bayes (NB) and support vector machine (SVM) classifiers to enhance the performance of selected classifier. The results are verified using text and image data which reflects improved accuracy compared with other conventional techniques. A 25 benchmark datasets (UCI) from different domains are considered to test the proposed algorithms.  A comparative study between proposed hybrid classification algorithms are presented in this work. Finally, the experimental result shows that the differential evolution with NB classifier outperforms and produces better estimation of probability terms. The proposed technique in terms of computational time is also feasible

Primary bipolar replacement arthroplasty versus internal fixation in the management of unstable intertrochanteric fractures in the elderly

Background: Management of unstable intertrochanteric femur fracture in the elderly has been always a matter of debate. There has been always a dilemma between osteosynthesis and prosthesis.Methods: We retrospectively evaluated, 108 osteoporotic elderly patients with unstable intertrochanteric for internal fixation versus primary bipolar replacement arthroplasty in a span of 4 years.Results: Bipolar replacement arthroplasty gives better outcome as compared to internal fixation with sliding hip screw.Conclusions: It was found that cemented bipolar arthroplasty is the choice in freely mobile elderly osteoporotic comminuted displaced intertrochanteric fracture, though is a surgically demanding technique, it spares the postoperative complication of non-weight bearing after internal fixation of these fracture. The internal fixation is also compounded by osteoporosis, medical illness, difficulty to achieve and maintain reduction of comminuted and widely displaced unstable fractures, which restricts the mobilization and weight bearing and further increase the risk of morbidity and mortality in elderly in comparison to cemented bipolar replacement arthroplasty which allows early mobilization and weight bearing

Bilateral Pleural Effusions due to Pulmonary Amyloidosis as the Presenting Manifestation of Multiple Myeloma

Multiple Myeloma is a hematologic malignancy of plasma cell origin. Pleural effusion may develop in the setting of myeloma due to various reasons but is extremely uncommon as a presenting symptom. A 69-year-old Caucasian man presented with pleural effusions of undetermined etiology after extensive work up, and multiple failed pleurodesis. Lung biopsy revealed pulmonary amyloidosis and led to the diagnosis of multiple myeloma. Patient was started on chemotherapy but died within 6 weeks of his diagnosis due to multiorgan failure. Pulmonary amyloidosis should be suspected as a cause of intractable pleural effusions, even in patient who do not have evidence of lung involvement on imaging studies or typical features of multiple myeloma. Pleural effusions due to amyloidosis are often refractory to treatment, and a high index of suspicion is required for early diagnosis and treatment

Prevalence of peripheral artery disease in diabetes mellitus: research article

Background: Peripheral artery disease is a major macrovascular complication of diabetes mellitus. Patients with diabetes mellitus have an increased prevalence of PAD. The ankle brachial pressure index is an easy, non invasive and often under utilised tool for diagnosis of PAD.Methods: In the present study, 100 patients from Western Uttar Pradesh with diabetes mellitus were enrolled to find out prevalence of peripheral vascular disease using ankle brachial pressure index and study the associated risk factors.Results: 59 percent of the subjects were female and 41 percent were male. Ankle-brachial index (ABI) examination of patients indicated Abnormal (ABI= <0.9), in 40 cases.Conclusions: it can be concluded that peripheral vascular disease in Diabetes Mellitus is more commonly associated than is generally believed

Determination of serum KIM-1 in patients with chronic kidney injury

Background: Chronic kidney disease (CKD) affects more than 800 million people worldwide and is one of the leading non-communicable causes of death. Despite being a latent issue, once renal damage has started, the disease can rapidly progress to an advanced stage. Aims and Objectives: Currently, the most commonly used markers for the diagnosis of renal disease are non-specific and insensitive. As a result, the goal of the current study is to investigate whether KIM-1 could be a precise and sensitive biomarker for identifying early kidney injury in CKD patients. Materials and Methods: This case–control study recruited 155 participants from the Index Medical College Hospital v Research Centre, Indore, Madhya Pradesh, based on inclusion and exclusion criteria. 150 non-CKD subjects matched for age and sex were also taken from the hospital. The levels of KIM-1 were compared between CKD and non-CKD participants. Serum creatinine, urea, and creatinine clearance were also measured. Results: The levels of KIM-1 were substantially higher in CKD patients than in non-CKD participants. In addition, a negative relationship between KIM-1 and creatinine clearance was observed with a P<0.05. Conclusion: KIM-1 is a precise and sensitive kidney injury biomarker that can identify early kidney injury in CKD and contribute to the progression of interstitial fibrosis in kidney disease

Multiple myeloma presenting with acute pancreatitis and renal failure

Multiple myeloma is the disease of elderly male with medullary and extramedullary involvement. Pancreatitis is rarely reported insuch cases. Here, we report a case of an elderly male who presented with a clinical picture of acute pancreatitis and when investigated,was found to have multiple myeloma and acute renal failure. He was further evaluated for various causes of pancreatitis and wasfinally concluded to have a possibility of a direct invasion of pancreas by plasma cells