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

Machine learning assisted coupled frequency analysis of skewed multi-phase magnetoelectric composite plates with temperature and moisture dependent properties

In this article, the application of an artificial neural network (ANN)-based machine learning (ML) strategy to predict the coupled frequency of geometrically skewed multiphase magnetoelectric (MME) composite plate exposed to hygrothermal environment is presented. The ANN model is trained using a dataset comprising more than one million simulations conducted using an in-house developed finite element formulation. The underlying multiphysics governing equations are derived using Hamilton’s principle and higher-order shear deformation theory (HSDT). The influence of the hygrothermal environment on the elastic stiffness of MME composites is defined by the empirical constants in the constitutive relations. Four prominent combinations of the empirical constants leading to different elastic stiffness relations have been considered in this study. Alongside, the influence of geometrical skewness on the coupled fundamental frequency is also assessed. For the training of the ANN model, the Levenberg–Marquardt optimization algorithm with 30 neurons along with a tangent sigmoid activation function is used. The trained ANN model is tested on an unseen dataset, different from the training data, and it is shown to accurately predict the natural frequency of MME plate with a maximum error of 2.3%. Further, excluding the training time and considering the computational time alone, the ANN model is found to be 6.3 times faster than the FE simulations. It is anticipated that such ML-based reduced order models can be effective in the design process, especially in complex multiphysics problems, such as the one considered in the work, involving a multitude of geometric, loading and material parameters

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 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.

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.

Development and mechanical characterization of cenosphere-reinforced CFRP and natural rubber core sandwich composite

Driven by the growing concern for environmental sustainability, there is an increasing need to explore innovative approaches for repurposing industrial waste materials. This study focuses on investigating the potential uses and challenges associated with cenosphere, a waste product derived from coal combustion in thermal power plants. Typically regarded as waste, cenosphere offers an opportunity to contribute to sustainability efforts. The objective of this research is to evaluate the influence of cenosphere, a ceramic-rich industrial waste, on the mechanical properties of woven CFRP-Rubber-CFRP (Carbon fibre-reinforced polymers) sandwich composites. The composite specimens were fabricated using the conventional hand lay-up technique, incorporating different weight percentages (5, 10, 15, and 20 wt.%) of cenosphere as a particulate filler. Tensile, flexural, and impact testing were conducted according to ASTM standards to assess the impact of the filler content on the mechanical properties. The results demonstrate that the inclusion of approximately 15% by weight of discarded cenosphere significantly enhances the tensile strength, flexural strength, interlaminar shear strength (ILSS), and impact strength of the sandwich composites, yielding improvements of approximately 1.6, 1.56, 2.06, and 1.85 times, respectively, compared to unfilled composites. Microscopic analysis of the composites reveals a well-dispersed cenosphere distribution within the matrix, contributing to the notable enhancement in overall strength characteristics

An Ayurvedic approach to Koshtashakashrita Kamala w.s.r. to Alcoholic Hepatitis - A Case Study

Kamala explained in Ayurvedic texts is a disease therefore it cannot be correlate to jaundice as it is only sign which means yellowishness. But it can be correlated to hepatitis of either cause viral or nonviral. Yakrit Vikara is developed due to excessive consumption of Madya continuously for a prolonged period and is chronic in nature. Excessive alcohol consumption could result in alcoholic, fatty liver disease or steatosis, alcoholic hepatitis (AH), and eventually cirrhosis. Alcoholic hepatitis is a severe syndrome of alcoholic liver disease (ALD), characterized by rapid onset of jaundice, malaise, tender hepatomegaly, and with subtle features of systemic inflammatory response. Ayurveda is traditionally skilful in treating liver diseases since centuries. The description of Hepatocellular jaundice is similar to Ayurvedic description of Kamala Vyadhi. Here a case report of a 46 years male who is chronic alcoholic having Bahupitta Kamala who was treated with herbo mineral medicines and which gave effective result by Pitta Sramasana (lowering Pitta) in the same case

Management of Shirobhitapa w.s.r to Essential Hypertension - A Case Study

Hypertension is called a silent killer because it rarely causes symptoms before it damages the heart, kidneys or brain. It is estimated that 600 million people are affected worldwide with hypertension. By the year 2025, approximately 1 in 3 adults aged over 20 years, totally 1.56 billion people worldwide, will have hypertension. Many works have been carried out on hypertension to evaluate the perfect diagnosis and mode of treatment on the basis of Ayurvedic principles, different nomenclatures also have been adopted by Ayurvedic scholars like Shonitamada, Raktagata Vyana Vayu, Shiragatavata, Rakta Chapa, Raktavrita Vata, Raktavriddhi, Raktavata etc

Strain improvement for the production of antioxidant activity from Bacillus sp. by induced stress

In the present study, water samples were collected from different beaches in Chennai such as Marina beach, Elliott beach, VGP Golden beach and Kovalam beach to evaluate the best source for antioxidants. The bacteria were isolated on Starch Casein Agar media and screened for the antimicrobial activity. Among 11 isolates, 5 isolates showed antimicrobial potential which were further evaluated for the DPPH (2,2-diphenyl-1-picrylhydrazyl) scavenging activity. Among 5 isolates, one sample showed significant DPPH scavenging activity with half minimal inhibitory concentration of (IC50)344.754µg/mL. The maximum antioxidant production was observed at pH 7 and at temperature of 37ºC with an IC50 of 188.66µg/mL and 293.76µg/mL respectively. The potent antioxidant producing strain was subjected for mutagenesis. In physical mutagenesis, the organism exposed for UV light for 25 minutes showed maximum antioxidant production with an IC50 of 133.55µg/mL. This mutant strain was then subjected for chemical mutagenesis with the addition of different concentrations of Ethidium bromide such as 10µL, 20µL, 30µL, 40µL and 50µL. The mutant strain obtained with the addition of 20µL Ethidium bromide (EtBr) showed significant antioxidant activity with an IC50 of 325.4µg/mL. The sample was purified by solvent extraction method and was evaluated for antioxidant production. The analyte was subjected to HPLC (High Performance Liquid Chromatography) analysis to avince the presence of antioxidants. The ethyl acetate extract showed the total phenolic content of 0.892 mg GAE/g of dry extract. It also showed the total flavonoid content of 0.522mg RE/g of dry extract

Research for practice in small human service organisations: doing and disseminating smallscale research

A series of novel alkynyl substituted 3,4-dihydropyrimidin-2(1H)-one (DHPM) derivatives were designed, synthesized and evaluated in vitro as potential inhibitors of chorismate mutase (CM). All these compounds were prepared via a multi-component reaction (MCR) involving sequential I2-mediated Biginelli reaction followed by Cu-free Sonogashira coupling. Some of them showed promising inhibitory activities when tested at 30 μM. One compound showed dose dependent inhibition of CM with IC50 value of 14.76 ± 0.54 μM indicating o-alkynylphenyl substituted DHPM as a new scaffold for the discovery of promising inhibitors of CM