Degenerative tendoachilles tear repaired and augumented by peroneous brevis tendon by dynamic loop technique one year follow up

Background: Repair of degenerative rupture of tendoachilles is a challenge for orthopaedician. We used peroneus brevis tendon in our patients to augment the repair of degenerated tendoachilles tears by creating a dynamic loop.Methods: In our study, we evaluated 31 patients with Achilles tendon rupture treated by reconstruction using peroneus brevis tendon transfer by dynamic loop suture technique. The patients were from all age groups excluding those lesser than 35 years. The average follow-up being 6 months.Results: In total 31 patient’s majority of patients belong to 41-50 years (15 cases 48.4%). Male patients being 24 (77.4%) constituted the majority, right sided injury was noted in 23 (74.2%) of the patients. Most common symptom of Achilles tendon rupture is pain. The mechanism of injury in most of the patients by stumbling in the fields in 19 (61.3%). Results of testing the patient’s ability to heel raise for 60 seconds 20 patients were able to sustain, while 8 patients were able to stand on toe with heel raised but could not sustain it. 3 patients could not do raise the heel. 5 patients complained of sensory hypoesthesia at 12 months follow-up. By Rupp scoring, 77% patients had excellent or good results and 10% had fair or poor results.Conclusions: Results of reconstruction of Achilles tendon ruptures using peroneus brevis tendon show a strong and stable repair that allows early weightbearing ambulation with favourable clinical results in most patients

Content Based Image Retrieval Using SVM Algorithm

Conventional content-based image retrieval (CBIR) schemes employing relevance feedback may suffer from some problems in the practical applications. First, most ordinary users would like to complete their search in a single interaction especially on the web. Second, it is time consuming and difficult to label a lot of negative examples with sufficient variety. Third, ordinary users may introduce some noisy examples into the query. This correspondence explores solutions to a new issue that image retrieval using unclean positive examples. In the proposed scheme, multiple feature distances are combined to obtain image similarity using classification technology. To handle the noisy positive examples, a new two step strategy is proposed by incorporating the methods of data cleaning and noise tolerant classifier. The extensive experiments carried out on two different real image collections validate the effectiveness of the proposed scheme

Surgical management of idiopathic congenital talipes equinovarus by Carroll twin incision

Background: Surgery for congenital idiopathic clubfoot has a number of complications in the postoperative period such as delayed wound healing, gaping, infection, and recurrence of the deformity. The aim of this study is to evaluate the results of primary correction of clubfoot by modified Carroll’s double incision technique.Methods: It is a prospective interventional for a period of 2 years 5 months. 56 foot of which 21 pts have bilateral deformity and 14 pts with unilateral deformity. Patients of 3 months to 2 years age with idiopathic clubfoot, who did not respond to initial Ponseti casting; and were planned for Carroll double incision technique of surgery were included in this study.Results: In total 56 foot of which male are 23 and female children are 12 in number with male: female ratio of 1.9:1, showing male predominance, 21 pts have bilateral deformity and 14 pts with unilateral deformities. The mean change in radiographic parameters achieved by correction is as postoperative mean talocalcaneal index achieved was 42.60 (Normal range >40°). The postoperative mean anteroposterior talo-calcaneal angle was 26.20 (Normal range 300 to 550). The Postoperative mean lateral talo-calcaneal angle was 24.40 (normal 200 to 400). Final outcome is 81% is good, 14 fair and 5% has poor outcome.Conclusion: Exposure and release by Carroll’s twin incision is good, no tension in sutures, especially medical incision at the time of wound closure

A PHARMACOLOGICAL STUDY ON AYURVEDA MANAGEMENT ON HEALING PROCESS OF TIBIA OF RATS WITH SPECIAL REFERENCE TO ARJUNA KSHEERA PAKA

The present study was under taken to evaluate the effect of Terminalia arjuna Linn on the healing process of experimentally fractured tibia of rats. 12 Adult male wistar rats were grouped into I, II and III groups. Arjuna, a Bhagna Sandhanakara drug, mentioned in Vrindamaddhava is taken for the study.The solution of test drugs for Group I is 2mg of Terminalia arjuna powder TAP boiled with milk and Group II by 8mg of Terminalia arjuna Ksheera paka powder TAKP (Arjuna powder boiled with milk and heated till it is semisolid and after cooling it is made into fine powder) and Group III with 2mg Placebo (PG) rice powder with milk. The test solution was introduced into the oral cavity of male wister rats by rat feeding needle.On observing the radiological images, Group I and Group II shows improvement in healing process of tibia by 30th day after treatment due to Jeevaniya and Sandhaniya karma of milk which causes synergetic action of Arjuna karmas than Group III. Group II shows early healing capacity of calcification than Group 1 by 20th day compared in between group I and Group III. Based on all the observed results it can be concluded that Group 2 (Terminalia arjuna ksheerapaka powder (TAKP) is highly significant in calcification between the three groups

QUALITY BY DESIGN APPROACH TO STABILITY-INDICATING REVERSE-PHASE HIGH-PERFORMANCE LIQUID CHROMATOGRAPHY METHOD DEVELOPMENT, OPTIMIZATION, AND VALIDATION FOR THE ESTIMATION OF SIMEPREVIR IN BULK DRUG:

Objective: A simple, robust, precise, and selective stability-indicating liquid chromatography (LC) method (reverse-phase high-performance LC) was developed for the estimation of simeprevir through quality by design paradigm. Methods: The chromatographic separation was performed on Water’s 2695(Alliance) equipped with a photodiode array detector at 300 nm. The method was developed on Discovery C18 column (250×4.6, 5 mm) using orthophosphoric acid and acetonitrile (55:45 % v/v) with the flow rate of 1 ml/min at 30°C. The degradation studies of simeprevir were carried out under the stress conditions of hydrolysis (acid, base, and neutral), oxidation, photolytic, and thermal as per the International Conference on Harmonization (ICH) guidelines. The peroxide hydrolysis shows more critical impurities which were well resolved from pure drug with the application of design of experiment and optimized the method. Results: Independent variables (critical analytical attributes) selected for the method optimization were mobile phase ratio, flow rate, and temperature of the column based on the risk assessment. The retention time and resolution were selected as the method response. In response surface method, the central composite design and 23 factorial designs were employed for the optimization of the method. The polynomial equation was derived for the estimation of method response. Conclusion: The method was optimized for better resolution among the drug, and impurity peaks were then validated as per the ICH parameters

Surgical management of giant cell tumor in adolescent by excision or curettage followed by fibular strut graft

Giant cell tumour (GCT) in adolescent is a rare tumour. It commonly occurs in skeletally mature patients aged between 20-40 years. In adults it is seen in epiphyseal region. In patients with intact physis, it arises from the metaphysis. Giant cells are more common in females. It is more common in the ends of long bones of distal end of femur, proximal tibia, and distal radius. 14 cases of surgical management of GCT by excision or curettage in adolescent followed by fibular strut graft. 1 year follow up of all cases of GCT in adolescent treated with excision or curettage followed by fibular strut graft was done. Out of 14 patients, 12 patients did not develop any recurrence of GCT. 2 patient developed recurrence after 6 months. All the patients were able to attain good range of movements 2 months after surgery. GCT in adolescent surgically treated with excision or curettage followed by fibular graft had excellent results in terms of recovery of daily activities, wound healing. Chances of recurrence more in patients treated with curettage and bone grafting.

A rare association of Kimura’s disease with chronic pulmonary aspergillosis

Kimura’s disease is a rare chronic benign inflammatory condition characterised by nodules of skin and soft tissue and lymphnodes. Eosinophilic infiltration is a prominent finding. It has been reported in association with various conditions like nephrotic syndrome, bronchial asthma, ulcerative colitis and aortitis syndrome. Hereby we present a case in medical literature to the best of our knowledge in Kimura’s disease in association with chronic cavitary pulmonary aspergillosis, which has never been reported. He was treated with antifungals, after which he responded clinically, eosinophilia has subsided and he is under regular follow up. Now This case report suggest possible role of chronic aspergillosis as a cause for Kimura’s disease

A study on functional outcome of posterior cruciate ligament substituted total knee arthroplasty

Background: Total knee replacement surgery is considered as a treatment of choice in patients with advanced arthritis, especially in patients where conservative treatment has been failed. Total knee replacement gives good pain relief, functional improvement of knee and correction of deformity.Methods: This is study of 39 patients following total knee arthroplasty, who were operated between August 2017 and March 2020 at MNR Medical College and Hospital, Sangareddy. They were followed up for a minimum period of 1 year and evaluated using oxford knee scoring system. Oxford knee score is designed specifically for measuring outcomes in knee arthroplasty. There were 14 right knees, 10 left knees, 15 bilateral knees.Results: There was a significant functional improvement of knee in patients and we had achieved excellent results, out of 39 patients and 4 patients had post op suprapatellar fullness, which was relieved with medications for 3 weeks and 2 patients (2 knees) without no signs of immediate post-operative period, developed infection after 6 months followed which underwent staged revision total knee replacement. The outcome categories based on oxford knee scoring system: excellent (40-48), good (30-39), fair (20-29) and poor (0-19).Conclusions: It is difficult to balance the knee with retention of posterior cruciate ligament, whereas posterior cruciate ligament substituting total knee replacement gives reproducible and good results, hence it is the preferred mode of management

Simulation of VSC Based HVDC Transmission System under Fault Conditions

Voltage-source-converter high-voltage dc (VSC-HVDC) transmission systems have evolved from simple two-level converters to neutral-point clamped converters and then to true multilevel converters such as modular converters. Present VSC-HVDC transmission systems rely on their converter station control systems and effective impedance between the point-of-common-coupling (PCC) and the converter terminals to ride-through dc side faults. A VSC-HVDC transmission system is a candidate to meet these challenges due to its operational flexibility, such as provision of voltage support to ac networks, its ability to operate independent of ac network strength therefore makes it suitable for connection of weak ac networks such as offshore wind farms, suitability for multi terminal HVDC network realization as active power reversal is achieved without dc link voltage polarity change, and resiliency to ac side faults. This paper proposes a new breed of high-voltage dc (HVDC) transmission systems based on a hybrid multilevel voltage source converter (VSC) with ac-side cascaded H-bridge cells. This paper assesses its dynamic performance during steady-state and network alterations, including its response to ac and dc side faults by using MAT Lab/Simulink

Chemically Reacting MHD Boundary Layer Flow of Heat and Mass Transfer over a Moving Vertical Plate in a Porous Medium with Suction

A mathematical model is presented for a two-dimensional, steady, incompressible electrically conducting, laminar free convection boundary layer flow of a continuously moving vertical porous plate in a chemically reactive and porous medium in the presence of a transverse magnetic field. The basic equations governing the flow are in the form of partial differential equations and have been reduced to a set of non-linear ordinary differential equations by applying suitable similarity transformations. The problem is tackled numerically using shooting techniques with the forth order Runga-Kutta method. Pertinent results with respect to embedded parameters are displayed graphically for the velocity,temperature and concentration profiles and were discussed quantitatively