Comparative study of closed reduction vs. open reduction fixed with k-wiring in type 3 displaced supracondylar fractures in children

Background: Among all the fractures in upper limb in children, supracondylar fractures of the humerus are more common injuries. In general the fractures of children are treated conservatively. But the management of supracondylar fractures has evolved over years from conservative to more aggressive approach operative techniques.Methods: The study was conducted in children's presenting with type 3 Gartland supracondylar fractures to Adichunchanagiri Institute of Medical Sciences, B. G. Nagara between January 2014 to December 2016.Results: The study consisted of 40 type 3 supracondylar fractures cases. Group A (closed reduction) had 25 cases, among them were 20 males and 5 were females. Group B (open reduction) had 15 cases among them 12 males and 3 female cases. The patients were between the age of 6 to12 years. In Group A, 19 children were in the age group of 6-10 years where as Group B had 12 cases. In Group A, 6 were in the age group of 10-12 years and 3 cases in Group B. Among the 25 cases in Group A, 19 were left sided and 6 were right sided. In group B, 11 were left sided and 4 were right sided. All patients had achieved clinical and radiological union at 4 weeks. Conclusions: Closed reduction and k-wiring had very good results for type 3 supracondylar fractures of humerus in children than conservative/open reduction methods. However for cases which we didn't get proper/satisfactory reduction in closed method, open method with triceps splitting approach was used

Two Suns in The Sky: Stellar Multiplicity in Exoplanet Systems

We present results of a reconnaissance for stellar companions to all 131 radial-velocity-detected candidate extrasolar planetary systems known as of July 1, 2005. CPM companions were investigated using the multi-epoch DSS images, and confirmed by matching the trigonometric parallax distances of the primaries to companion distances estimated photometrically. We also attempt to confirm or refute companions listed in the Washington Double Star Catalog, the Catalogs of Nearby Stars, in Hipparcos results, and in Duquennoy & Mayor (1991). Our findings indicate that a lower limit of 30 (23%) of the 131 exoplanet systems have stellar companions. We report new stellar companions to HD 38529 and HD 188015, and a new candidate companion to HD 169830. We confirm many previously reported stellar companions, including six stars in five systems that are recognized for the first time as companions to exoplanet hosts. We have found evidence that 20 entries in the Washington Double Star Catalog are not gravitationally bound companions. At least three, and possibly five, of the exoplanet systems reside in triple star systems. Three exoplanet systems have potentially close-in stellar companions ~ 20 AU away from the primary. Finally, two of the exoplanet systems contain white dwarf companions. This comprehensive assessment of exoplanet systems indicates that solar systems are found in a variety of stellar multiplicity environments - singles, binaries, and triples; and that planets survive the post-main-sequence evolution of companion stars.Comment: 52 pages, 7 figures, Accepted for publication in Ap

Climate adaptation by crop migration.

Many studies have estimated the adverse effects of climate change on crop yields, however, this literature almost universally assumes a constant geographic distribution of crops in the future. Movement of growing areas to limit exposure to adverse climate conditions has been discussed as a theoretical adaptive response but has not previously been quantified or demonstrated at a global scale. Here, we assess how changes in rainfed crop area have already mediated growing season temperature trends for rainfed maize, wheat, rice, and soybean using spatially-explicit climate and crop area data from 1973 to 2012. Our results suggest that the most damaging impacts of warming on rainfed maize, wheat, and rice have been substantially moderated by the migration of these crops over time and the expansion of irrigation. However, continued migration may incur substantial environmental costs and will depend on socio-economic and political factors in addition to land suitability and climate

Comparative study of surgical management of humeral shaft fractures with dynamic compression plate in Henry’s and Thompson’s approach in adults

Background: Fractures of the humeral shaft account for roughly 3% to 5% of all fractures. The predominant causes of humeral shaft fractures include simple falls or rotational injuries in the older population and higher energy mechanisms in the younger patients including motor vehicle accidents, assaults, fall from height and throwing injuries. Treatment options for humeral fractures vary according to the type of fracture, age group, bone density, soft tissue status and associated complications. Surgical management of shaft humerus fractures by plating can be done mainly through Thompson’s (posterior) approach and Henry’s (antero-lateral) approach.Methods: The study was conducted in patients treated for shaft humerus fracture at Adhichunchanagiri Institute of Medical Science, BG Nagara from the month of August 2014 to January 2016. Twenty patients diagnosed as shaft humerus fracture were taken into the study, all were undergone open reduction and internal fixation using dynamic compression plate in Thompson’s and Henry approach. Patients’ age more than 18 years were taken up for the study. Patients were followed up at 3 weeks, 6 weeks, 6 months.Results: The sample consisted of twenty shaft humerus fracture patients with 10 males and 10 females. The patients’ ages were more than 18 years where 13 cases (65%) between 26 to 55 years. Among these 20 patients, 10 involved the right side and 10 involved the left side. All patients achieved clinical and radiological union at 6 month follow up. According to Constant Murley Score, excellent result were found in 11 patients (55%), good in 2 patients (10%) and fair in 7 patients (35%). According to Mayo elbow performance index, 17 patients showed excellent outcome (85%) and 3 patients showed good outcome (15%).Conclusions:Dynamic compression plating is the best modality of management for the internal fixation of humeral shaft fractures. It is found that the fracture fixation of upper and middle one-third humerus in Henry’s approach is easier, lower one-third humeral fractures are not possible because the plate at the supracondylar ridge poses difficulty to fix. Fracture fixation of the lower one third and middle one third is easier in Thompson’s approach because of the flat surface of the bone and offers better plate contour.

Functional outcome of displaced proximal humerus fractures managed by proximal humerus interlocking system plate

Background: Fractures of the proximal humerus are the second most common upper extremity fracture and the third most common fracture, after hip and distal radial fractures. The fractures can occur at any age, but the incidence rapidly increases with age.Methods: The study was conducted in patients treated for displaced proximal humerus fracture at Adichunchanagiri Institute Of Medical Sciences, BG Nagar from the month of June 2014 to August 2016. Twenty proximal humerus fracture patients were taken into the study; all were fixed with PHILOS plate. Patients’ age ranged from 18 to 75 years with a mean of 42.9.Results: The sample consisted of twenty patients of proximal humeral fractures. 08 were males and 12 females. The patients’ ages ranged from 18-75 years with a mean age of 42.9 years. The causes of fractures were road traffic accident in 13 patients, fall in 06 patients and electric shock in 1 patient. 11 fractures involved the right side and 09 involved the left. Patients were followed up from 03 weeks to 06 months. Functional outcome was rated as per Constant-Murley Shoulder Score, we got excellent results in 04 cases, satisfactory in 10, unsatisfactory in 05 xi and failure in 01 patient. Mean Constant-Murley score of this study at the end of the final follow-up period was 81.6. Conclusions: The PHILOS plate is a good implant to use for fractures of the proximal humerus. However, proper placement of the plate and fixation are required to produce satisfactory results. We recommend use of this implant in Neer 2-part, 3-part, 4-part fractures with or without dislocation and osteoporotic fractures

Comparative study of titanium elastic nailing v/s dynamic compression plating for the management of fracture shaft of femur in adolescent age group

Background: Femoral fractures are one of the common long bones fractured in paediatric age group. Over the past 20 years, there has been a dramatic and sustained trend toward the operative stabilization of femoral shaft fractures in school-aged children. Femoral fracture demands stable fixation in adolescent.Methods: A retrospective cohort study was conducted in a tertiary care hospital. All children’s between the age 11 to 18 years with femur fracture managed with either TENS or dynamic compression plating between march 2014 to march 2017 were included into the study.Results: most common mode of injury was RTA. Middle third being the most common site for fracture. There was100% union in our study. The mean time of union in TENS group was 12 weeks and that of Plating group Was 13.1 weeks. Irritation at entry site was seen in 11 (22.9%) out of 48 patients. Malunion was seen in 9 out of 48 children’s in group a, whereas malunion in group b seen in 1 child. All the malunion was less than 5 degree and Varus being most common type of malunion. Limb length discrepancy in group A was observed in 5 patents (10.5%) out which 3 were shortening and 2 were lengthening. In group b 1pateint had shortening at end of follow up. In group B superficial infection was seen in 4 (15%) out of 33 children’s and in group A it was observed in 2 children’s (5%).Conclusions: we concluded that compression plating in adolescent age group especially older and obese children for the management fracture shaft of femur comparatively better than TENS.

Sampling rare fluctuations of height in the Oslo ricepile model

We have studied large deviations of the height of the pile from its mean value in the Oslo ricepile model. We sampled these very rare events with probabilities of order $10^{-100}$ by Monte Carlo simulations using importance sampling. These simulations check our qualitative arguement [Phys. Rev. E, {\bf 73}, 021303, 2006] that in steady state of the Oslo ricepile model, the probability of large negative height fluctuations $\Delta h=-\alpha L$ about the mean varies as $\exp(-\kappa {\alpha}^4 L^3)$ as $L \to \infty$ with $\alpha$ held fixed, and $\kappa > 0$.Comment: 7 pages, 8 figure

Histopathological study of lung in autopsy cases: a prospective study

Background: Present days the air pollution and other environmental inhalants, chemical cum toxic substances become uncontrollable. The lungs are involved in a number of infectious, inflammatory and occupational diseases. But involved in almost all cases of terminal events due to cardiovascular causes. Autopsy is an important tool in identifying the cause and manner of death and hence to establish the preventive methods. The aim of this study was to analyse the findings by the histopathological examination in lung tissue received in autopsy specimens.Methods: This study is a prospective study done on 100 autopsy cases received in the Department of Pathology, Chengalpattu medical College for a period of 6 months during July to December 2013. Gross findings were noted during autopsy and specimen was subjected to routine processing and Hematoxylin and Eosin Stain. Histopathological findings were noted.Results: Of the 100 cases, 40% shows pneumonia, 28% shows congestion, 16% shows emphysema, 2% shows normal finding. 14% cases show overlapping. Males were more commonly affected than females.Conclusions: From this study of autopsy specimens of lung the most common findings were pneumonia, emphysema, and congestion. Pneumonia was found to be the most common finding in the study. We should plan to prevent the causes and reduce the prevalence of pneumonia. Educational counseling should be given on exposure of environmental pollutants to the people