Evaluation of the clinical, functional and radiological outcomes in patients with distal tibia fractures with simple intra-articular extension treated with intramedullary multidirectional locking nail: a prospective study

Background: Distal tibia fractures with extension into the ankle joint (AO/OTA type 43C) poses challenge for an orthopedic surgeon, due to its subcutaneous nature and precarious blood supply. Literature has described various treatment modalities; most commonly used being locking compression pates, external fixators and intramedullary multidirectional locking nails. Methods: This prospective study included 60 patients with distal tibia fracture AO type 43C1 and 43C2, managed with intramedullary multidirectional locking nails in a close manner, with intra-articular fragment fixation preceding the nail insertion. The aim of this study was to evaluate the clinical, functional and radiological outcomes as well as the complications in these patients. Results: Patients’ mean age was 48.7±16.6 years; most had type 43C1 fractures (51 patients). The mean surgery time was 88.4±17.5 minutes, performed within 5.6±2.01 days post-injury. The 30 patients had fibula fracture with syndesmotic injury which was fixed with TENS nail. The functional assessment with Johner and Wruh’s criteria; 45 patients (75%) had excellent, 12 patients (20%) had good and 3 patients (5%) had fair outcomes. The fracture union averaged 16.7±1.63 weeks (14-20 weeks). 6 patients had superficial wound complication, while 3 patients had valgus malalignment; all managed without further surgery. Conclusions: Intramedullary nailing following specific surgical technique, and potential percutaneous screws; is a safe, effective and successful treatment option for AO/OTA types 43C1 and 43C2 fractures with high fracture union rates, high functional results, and low complication rates

A prospective and observational study to assess the efficacy of pregabalin versus Gabapentin in relieving early post operative neuropathic pain with respect to clinical and functional outcomes in patients undergoing open lumbar discectomy surgery

Background: Post-operative neuropathic pain is one of the most dreadful complications following lumbar spine surgeries. Owing to the similarities in the pathophysiological and biochemical mechanisms underlying epilepsy and neuropathic pain, many anti-epileptic drugs (AEDs) like pregabalin and gabapentin are being used in the treatment of post-operative neuropathic pain. Methods: This prospective and observational study included a total of 60 patients out of 261 patients undergoing lumbar discectomy surgery, who postoperatively had neuropathic pain as diagnosed with LANSS score; and were randomly divided into pregabalin (n=30) and gabapentin (n=30) supplementation groups, and the efficacy was compared with respect to visual analog scale (VAS) score (clinically) and Oswestry disability index (ODI) score (functionally) at pre-operative and post-operative follow-ups; and also, total analgesia consumed. Results: No statistical differences were observed between any of the demographic variables and surgical levels operated upon between the two groups. Both the groups showed significant improvements in clinical (VAS) and functional (ODI) outcome as compared to pre-operative status. Leeds assessment of neuropathic symptoms and signs scale (LANSS) score was significantly increased in both the groups postoperatively till the 3rdmonthfollow-up, after which there was a significant decrease in the score. The Pregabalin group showed significant (p<0.05) improvement in VAS and ODI scores at the post operative 1st, 3rd, and 6th month, as compared to the gabapentin group; however, at other follow-ups the difference was insignificant. Total analgesia consumed was significantly higher in the gabapentin group. Conclusions: Our study concluded that both pregabalin and gabapentin are highly effective in the treatment of early post-operative neuropathic pain; showing encouraging clinical and functional improvements. Pregabalin had significantly better outcomes on short-term follow-ups; however, on longer follow-ups, both had similar beneficial outcomes. Pregabalin supplementation showed a significant analgesia-sparing effect as compared to gabapentin

Assessment of clinical and functional outcomes after single dose injection of autologous platelet rich plasma in patients with chronic lateral epicondylitis: a prospective and brief follow up study

Background: Lateral epicondylitis is a chronic, painful, and debilitating elbow condition. The introduction of platelet-rich plasma as an adjunct to the conservative and operative treatment has revolutionized the research in this topic. PRP is considered to be the ideal autologous biological blood-derived product which helps in regenerating the degenerated tissue rather than just repairing it and helps in relieving pain and improving function. Methods: This is a prospective study where 40 patients diagnosed with tennis elbow, failing other conservative treatment modalities were enrolled; and treated with single dose injection of autologous PRP; and were evaluated for clinical and functional outcomes using the visual analogue scale and disabilities of arm, shoulder, and hand scores on the follow-ups. Results: Out of the 40 patients enrolled, there were 15 males and 25 females. The mean age of the population was 45.88±8.87 years. All the patients had improved statistically significant differences in mean VAS and DASH scores (p value<0.001) on each follow-up as compared to the baseline score with VAS score and DASH score improvement being more than 77% and 65% respectively at final follow up. Conclusion: Our study concludes that a single local injection of autologous PRP appears to be the promising and safe modality of treatment in lateral epicondylitis, helping to improve the pain as well as the clinical and functional outcomes

A prospective and comparative study to evaluate the efficacy of oral pregabalin vs gabapentin combined with IV paracetamol as preemptive analgesic for post-operative pain in patients undergoing single level open lumbar spine decompression surgery in a tertiary health care center

Background: Post-operative pain in spine surgery, whether neuropathic or nociceptive, presents a significant challenge for both surgeons and patients. Previous research has demonstrated the effectiveness of pre-operative oral gabapentinoids in reducing postoperative pain, extending the time to first rescue analgesia, and diminishing overall analgesic requirements. Methods: This study involved 120 patients undergoing lumbar discectomy for disc herniation. They were randomly assigned to receive pre-operative oral pregabalin, gabapentin, or a placebo, along with IV paracetamol as preemptive analgesia. The study assessed their efficacy through post-operative pain scores (VAS), and sedation scores (Ramsay sedation score) at various intervals, time to first rescue analgesia, and total analgesia consumption. Results: No significant differences were found in demographic variables, surgical levels, or duration among the groups. The placebo group had the shortest time to first rescue analgesia, while the pregabalin group showed the longest, with a notable difference. Across most time frames, the pregabalin group reported the lowest mean postoperative VAS scores, whereas the placebo group had the highest. Initial variations in sedation scores converged in later time frames, with the placebo group consistently recording the lowest scores. Total rescue analgesia (tramadol) in the initial 24 hours was highest in the placebo group, followed by the gabapentin group, and lowest in the pregabalin group, with no significant variance. Conclusions: This study affirms the superiority of pre-operative oral pregabalin with IV paracetamol. It effectively prolongs the time to first rescue analgesia and reduces overall analgesic consumption post-lumbar spine surgery, compared to pre-operative oral gabapentin with IV paracetamol

Assessment of vitamin C supplementation as an adjuvant analgesic therapy and evaluating its efficacy in terms of clinical and functional outcomes in post-operative patients undergoing surgical decompression for prolapsed intervertebral lumbar disc

Background: Post-operative pain is one of the most debilitating condition following lumbar spine surgery, which negates the clinical and functional outcomes. Vitamin C (ascorbic acid) due to its anti-oxidant, neuroprotective and neuromodulating properties; was evaluated to have adjuvant analgesic effects in these patients. Methods: This prospective study included 50 patients undergoing single level lumbar disectomy; randomly divided into group A (vitamin supplementation, n=25) and group B (no supplementation, n=25). Both the groups were evaluated on the follow ups for the clinical outcomes (visual analog scale-VAS score), functional outcomes (Oswestry disability index-ODI score) and total analgesia consumed. Results: Both the groups showed statistically significant improvements in clinical and functional outcomes with respect to pre-operative status. Group A showed statistically significant (p<0.05) improvement in VAS and ODI scores as compared to group B at 4th, 6th and 8th week follow up, however at 2nd and 12th week follow up the difference was found to be insignificant. Total analgesia consumed by group A patients was statistically lower than that consumed by group B patients. Conclusions: Vitamin C has analgesic effects in certain clinical conditions, thus reducing post-operative pain and improving the overall satisfaction and outcome of the surgery. It helps in bringing about the improvement in clinical as well as the functional outcome of the spine surgery and has an effective dose-sparing and adjuvant effect on the post-operative analgesia

Design and Development of Machine to Remove Outer Cover of Groundnut

In republic of India, most of the land is used for agricultural purpose that produces semi-finished merchandise or product. Groundnut is additionally one in every of the agriculture semi-finished product. Groundnut is grownup on tiny scale farmers in developing countries like Republic of India. Lack of groundnut process machines, particularly groundnut worker is major downside of groundnut production. In early stages folks accustomed decoct groundnut manually. The output obtained was terribly low by this methodology. The analysis work for style, fabricate and performance of groundnut worker systematically of feed hopper with a rate of flow, management devices, firing unit separating unit and blower system. The machine is supported by a ½ HP motor operational on 720rpm. Falling pods from hopper are stuck by rotating drum, the chaffs are blown out through a window and seeds settle via chute; overall, the outcome involves method like style, fabrication and collection of various part rising potency and reducing the wastage

Github in software testing

Software development has an around for quite a while but the progress that has been made in the last three decade is quite remarkable. Every few years there is an emergence of new concept, new programming language or framework for software development which leads to questions around management and control of the software development process. The goal of this paper is to explore the importance of software in everyday life and the need for advanced software testing methodologies for producing reliable software products. Further, this report takes a deep dive into the challenges associated with distributed software projects such as lack of effective collaboration, awareness of the project, code conflicts and resolutions which play a vital role in successful software development and how version control systems like GitHub can prove to be a helpful tool in overcoming these challenges. GitHub is a powerful version control system and there is discussion about GitHub how tester can harness the power of GitHub in testing. This paper will shed light on how GitHub is used by software testers to gain benefits that are sometimes missing in conventional software testing methods