Evaluation of functional outcome of tibial plateau fractures managed by different surgical modalities

Background: Tibial plateau makes up one of the most important weight bearing surface. Its fractures are commonly faced entity encompassing a wide spectrum of injuries of variable fracture morphology. Due to in-crease in incidence of high velocity trauma and higher functional demands of patients, surgery is warranted in most of the cases. Although, there is advancement in fracture fixation methods, apt treatment of tibial plateau fractures still remains controversial.Methods: In our series, we analyzed the functional outcomes of 58 of surgically treated tibial plateau fractures. Fractures were classified with Schatzker’s classification. Various fixation modalities of fixation were employed. Functional outcome was evaluated with modified Rasmussen’s criteria.Results: Most of the patient’s belonged to younger age groups (58.62%) and males (79.31%) were predominately involved. Road traffic accidents were the most common etiological factor (70.69%). Schatzker types I (29.31%) and II (27.59%) were the most common observed fracture type. The majority of the patients had a complication free recovery (81.03%). Infection was reported in only one case (1.72%). Similarly, malunion was noticed in only in one case (1.72%). None of the patients had complications like nonunion or neurovascular damage. The functional outcome assessment according to Modified Rasmussen’s criteria at the end of 12 months showed the excellent functional outcome in 41 (70.68%), good in eight (13.79%), fair in five (10.34%) and poor in four (6.9%) patients.Conclusions: Surgical treatment of tibial plateau fractures is challenging, yet it helps in achieving excellent anatomical restoration and rigid fracture fixation enabling in the restoration of articular congruity and facilitation of early knee motion thus achieving optimal knee function

Study of risk factors and perinatal outcome in meconium stained deliveries from a district of Uttar Pradesh, India

Background: The objective is to identify the risk factors of Meconium stained deliveries and evaluate the perinatal outcomes in Meconium Stained deliveries.Methods: This prospective observational study included those pregnant women who had completed 37 weeks of gestation, with singleton pregnancies with cephalic presentations and with no known fetal congenital anomalies. Among these, we selected 110 cases with Meconium stained amniotic fluid and they were compared with 110 randomly selected controls.Results: Regular antenatal visits were seen in 22.73 % of the cases while 77.27% cases had no previous visit. Majority of cases were primigravida and gestational ages of >40 weeks was seen in 55.45 % cases. 19.09% cases had meconium staining among pregnancies complicated with pregnancy induced hypertension, as compared to those among controls (5.45%). Fetal heart rate abnormalities were seen in 29.09% cases, and statistically significant fetal bradycardia was seen in cases. Caesarean section rates were nearly double in cases (54.55%). Poor perinatal outcome was found in cases as seen in results by low Apgar score (40 weeks, pregnancy induced hypertension and fetal bradycardia, increased cesarean section rates, low APGAR score and higher incidence of birth asphyxia and NICU admissions. Meconium aspiration syndrome was associated with early neonatal death

Informing the public health response to COVID-19: a systematic review of risk factors for disease, severity, and mortality

Funding: HRS and MF are supported by the Medical Research Council [MR/R008345/1]. CJ’s salary came through MRC core funding MC_UU_12023/26. SJS is funded by the Wellcome Trust [WT 209560/Z/17/Z]. CRS has received funding from the Medical Research Council [MR/R008345/1], the National Institute for Health Research [11/46/23] and the New Zealand Health Research Council [20/1018] and Ministry for Business, Innovation and Employment. EV is funded by the Medical Research Council [MR/R008345/1] through the EAVE II grant and supported by the Scottish Government. We also acknowledge the support of HDR UK. The views and opinions expressed here are those of the authors and do not necessarily reflect those of the Health Technology Assessment programme, NIHR, NHS, or the UK Department of Health.Background Severe Acute Respiratory Syndrome coronavirus-2 (SARS-CoV-2) has challenged public health agencies globally. In order to effectively target government responses, it is critical to identify the individuals most at risk of coronavirus disease-19 (COVID-19), developing severe clinical signs, and mortality. We undertook a systematic review of the literature to present the current status of scientific knowledge in these areas and describe the need for unified global approaches, moving forwards, as well as lessons learnt for future pandemics. Methods Medline, Embase and Global Health were searched to the end of April 2020, as well as the Web of Science. Search terms were specific to the SARS-CoV-2 virus and COVID-19. Comparative studies of risk factors from any setting, population group and in any language were included. Titles, abstracts and full texts were screened by two reviewers and extracted in duplicate into a standardised form. Data were extracted on risk factors for COVID-19 disease, severe disease, or death and were narratively and descriptively synthesised. Results One thousand two hundred and thirty-eight papers were identified post-deduplication. Thirty-three met our inclusion criteria, of which 26 were from China. Six assessed the risk of contracting the disease, 20 the risk of having severe disease and ten the risk of dying. Age, gender and co-morbidities were commonly assessed as risk factors. The weight of evidence showed increasing age to be associated with severe disease and mortality, and general comorbidities with mortality. Only seven studies presented multivariable analyses and power was generally limited. A wide range of definitions were used for disease severity. Conclusions The volume of literature generated in the short time since the appearance of SARS-CoV-2 has been considerable. Many studies have sought to document the risk factors for COVID-19 disease, disease severity and mortality; age was the only risk factor based on robust studies and with a consistent body of evidence. Mechanistic studies are required to understand why age is such an important risk factor. At the start of pandemics, large, standardised, studies that use multivariable analyses are urgently needed so that the populations most at risk can be rapidly protected.Publisher PDFPeer reviewe

DFG partitioning algorithms for coarse grained reconfigurable array assisted RTL simulation accelerators

As the complexity of circuit design increases, verification of these circuits through simulation also becomes extremely challenging. This creates a bottleneck in the IC design process. Distributed simulation is one way of solving this problem where the simulation workload is distributed among the parallel processors involved in the simulation. However the design has to be carefully partitioned for this purpose. In order to perform distributed simulation, many efficient partitioning algorithms have been proposed till date. These algorithms mostly partition gate level netlist or logic circuits and reduces inter-processor communication by minimizing cutsize for a given constraint of load balance. In this paper, we present two different partitioning schemes for performing distributed simulation. They are: a Discrete Particle Swarm Optimization (DPSO) based partitioning algorithm (DPSO-PA) and an effective partitioning heuristic. These algorithms partitions Data Flow Graph (DFG) for a recently proposed Coarse Grained Reconfigurable Array assisted Hardware Accelerator (CGRA-HA). We also propose an improved version of the original DPSO methodology through careful selection of initial partition sets. It is found that the proposed heuristic based partitioning algorithm outperforms the modified DPSO-PA in terms of lesser cut-edges

Clinical profile of children with juvenile idiopathic arthritis: A study from a tertiary care center in Uttar Pradesh

Juvenile idiopathic arthritis is a chronic disorder distinguished by continuous joint inflammation; the usual indicators of joint inflammation include pain, swelling and limitation of mobility. "Idiopathic" indicates that we do not know the aetiology of the disease and "juvenile", in this situation, means that the beginning of the symptoms generally occurs before 16 years of age. JIA is categorized into oligoarticular, polyarticular, systemic, psoriatic, enthesitis-related and undifferentiated arthritis. To assist better comprehend JIA for research objectives; generally agreed categorization criteria are applied. Although these are not diagnostic, they can assist guide physicians when treating a youngster with arthritis. One of the most extensively used categorization criteria was developed by the International League of Associations for Rheumatology (ILAR) in 1995 by expert consensus, and has undergone additional adjustments. In this nation, the number of JIA is huge: the estimated prevalence ranges from 350 000 to 1.3 million. Almost all children with arthritis experience chronic or recurring pain with 70 percent impairment in physical activities. Approximately half of patients with JIA have limited use of upper limbs or hands and difficulty with hand strength.&nbsp