Prospective study of management of unstable intertrochantric femur fractures in elderly: hemiarthroplasty vs. osteosynthesis by proximal femoral nail

Background: A prospective study was done to compare the outcomes of management of unstable intertrochantric femur fractures in elderly by hemiarthroplasty and osteosynthesis by proximal femoral nail.Methods: This was an interventional prospective study. The study was carried out over 3 years from 2019 to 2022 at PCMC’s PGI YCMH, Pimpri, Pune, Maharashtra, India. The study was carried out over 3 years from 2019 to 2022;50 Patients were randomly divided into two groups; Group A (unstable intertrochanteric femur fracture patients treated by bipolar hemi-arthroplasty) and Group B (unstable intertrochanteric femur fracture patients treated by proximal femoral nailing) with 25 patients in each group. Outcomes were evaluated based on functional outcomes, mean surgical time, mean blood loss during surgery, post-operative length of stay, post-operative complications. Harris hip Score was used to assess clinical functional outcomes.Results: The PFN group showed a better Harris Hip score at 1, 3, and 6 months follow ups. Mean surgical time was more in bipolar hemiarthroplasty group. Mean blood loss during surgery was more in bipolar hemiarthroplasty group. Post-operative length of stay was more in bipolar hemiarthroplasty group. Post-operative complications like infections, limb length discrepencies were more in bipolar hemiarthroplasty group, whereas 2 implant failures occurred in PFN group compared to a single one in bipolar hemiarthroplasty group.Conclusions: Both PFN and bipolar-hemiarthroplasty appear to produce satisfactory outcomes in surgically treated unstable IT fractures, bipolar-hemiarthroplasty has the advantages of early mobilization and early weight bearing, no risk of non-union but PFN group is superior when it comes to functional outcomes, mean surgical time, Mean blood loss during surgery, post-operative length of stay, post-operative complications

Prospective study comparing early functional outcome and gait analysis in femoral neck fracture treated by cemented hemiarthroplasty using modified Hardinge approach and conventional posterior approach

Background: A prospective study was done to compare the outcomes of management of fracture neck of femur by cemented hemiarthroplasty using modified Hardinge approach and conventional posterior approachMethods: The 2019 to 2022 50 patients underwent bipolar hemiarthroplasty for femoral neck fracture. Group A (Femoral neck fracture treated using conventional posterior approach) and group B (Femoral neck fracture treated using modified Hardinge approach) with 25 patients in each group. Outcomes were evaluated based on mean surgical time and Harris hip score and SF-36.Results: Mean duration of surgery in minutes was more for modified Hardinge approach. Harris hip score with standard deviation for modified Hardinge Approach for follow-ups was better and statistically significant than posterior approach. Similarly, quality of life after surgery, in terms of mean SF-36 score with standard deviation for modified Hardinge approach was better and statistically significant than posterior approach. Modified Hardinge approach has fewer complications in comparison to the posterior approach. With the advantages comes a longer learning curve to operate without complications. Hence, with proper surgical technique, and proper tight closure, we prefer the modified Hardinge approach over other approaches as it had nil dislocations and abductor lurch.Conclusions: Modified Hardinge approach for hip arthroplasty in elderly people with femoral neck fracture provide significant benefit in the early post operative period when compared to conventional posterior approach in terms of post operative pain, time of recovery, dislocation rate and quality of life

Evaluation of ultrasound guided verses nerve stimulator technique of interscalene brachial plexus block: insights from Indian multi-super specialty hospital

Background: To provide adequate intraoperative anaesthesia and postoperative analgesia for orthopaedic surgery continues to be a procedural challenge. The administration of brachial plexus anaesthesia can be facilitated through nerve stimulation or by ultrasound guidance. Hence study was conducted to compare differences in these techniques in patients undergoing interscalene brachial plexus block (ISSB).Methods: In this prospective, randomized, observer-blinded study, 60 patients (Male=41, Female=19) were scheduled for orthopaedic shoulder and upper arm surgeries matching inclusion and exclusion criteria. Patients were randomly allocated to either Ultrasound (US, n=30) group or Nerve Stimulator (NS, n=30) group through a computer-generated randomization.Results: There was significant difference between US and NS group with respect to average number of attempts taken, block performance time (BPT), onset of sensory and motor block, duration of motor block and patient satisfaction score. Whereas not much significant difference was observed in duration of sensory block, block success rate and incidence of post operative side effects.Conclusions: The results suggest that US guided ISBB is significantly superior to NS guided block in terms of faster onset of action; lower number of attempts to locate Interscalene brachial plexus; longer duration of block and overall success rate with favourable tolerability at real-life scenario

OPTIMIZATION OF MICROWAVE ASSISTED SOLVENT-FREE SYNTHESIS OF SOME SCHIFF BASES

Objective: To optimize microwave assisted solvent free synthesis of Schiff bases of aromatic aldehydes and aromatic amines (ethyl 4-aminobenzoate) by using wetting reagent ð›½-ethoxyethanol. The goal of this study was to investigate the % yields and time required for the completion of reaction for Schiff bases by microwave and conventional conditions.Methods: Schiff bases have been synthesized by condensation of substituted various aromatic aldehyde (.001 mol) with Ethyl 4-aminobenzoate (.001 mol) by two different methods as by conventional method (Heating) & Microwave accelerated synthesis by using wetting reagent ð›½-ethoxyethanol. The reaction time for conventional method and microwave method is in the range of 60-240 min and 10-180s respectively. All the synthesized compounds recrystallized & characterized by IR, NMR, and Mass and element analysis.Results: The simple microwave assisted solvent-free method for the synthesis of Schiff bases using a wetting reagent (ð›½-ethoxyethanol) led to improvement in the yield of all the target compounds with reduction in their reaction byproducts & substantially reduced the overall process time as expected as compare to traditional method. Excellent isolated yields (up to 96%) were attained within short reaction times (typically, 60s) when the reaction was performed under microwaves irradiation.Conclusion: The advantages of this environmentally benign and safe protocol include a simple reaction set-up, high product yields, short reaction times as well as the elimination of side products.Â

An alum [KAl (SO4)2.12H2O] catalyzed microwave assisted multicomponent synthesis of bioactive functionalized benzylpyrazolyl coumarin and quinolinone derivatives in PEG

An efficient and environmentally benign method has been developed for the synthesis of benzylpyrazolyl coumarin and quinolinone derivatives, hydroxy coumarin derivatives using Alum [KAl (SO4)2.12H2O] catalyst and Polyethylene glycol as green solvent under microwave condition. Keywords: Knoevenagel, Michael addition reaction, coumarins, quinolinones, alum, polyethylene glycol, multicomponent microwave irradiation method

Synthesis, characterization and anti-microbial screening of novel heterocyclic system containing bridgehead nitrogen atom

ABSTRACT The nicotino hydrazide (1) on reaction with carbon disulphide and ethanolic potassium hydroxide followed by treatment with hydrazine hydrate give 4-amino-5-(pyridin-3-yl)-4H-1,2,4-triazole-3-thiol (3). The compound (3) when treated carbon disulphide in ethanolic potassium hydroxide undergo cycloaddition to produce 3-(pyridin-3-yl)