Functional outcome of elastic stable intramedullary nailing of diaphyseal fractures of paediatric long bones

Background: After the advent of titanium elastic nails (TENs) and gratifying results of elastic stable intramedullary nailing (ESIN) in diaphyseal fractures of paediatric long bones, not only the parents of patients are opting surgical treatment over conservative, but also more and more orthopaedicians are offering ESIN with TENs to obviate the inherent problems of conservative treatment. We took up this study to evaluate the functional outcome of ESIN with TENs.Methods: 44 patients aged 5-15 years suffering from diaphyseal fractures of femur, tibia, humerus, and forearm bones were treated by ESIN with TENs.Results: All 44 patients showed uneventful union, femur in an average period of 8.3 weeks, tibia in 7.3 weeks, forearm bones within 7 weeks and humerus in 7.5 weeks. Commonest complication was pain at insertion site. 1 femur patient had lengthening of 1.5 cm. 1 femur and 1 forearm patient showed joint stiffness. No patient had delayed/non-union, sagittal/coronal/rotational mal-union, and deep infection. Partial weight bearing (PWB) started from 2nd/3rd day attaining full weight bearing (FWB) in 6-10 weeks. Conclusions: ESIN with TENs appears logical and safe to obviate the inherent problems of conservative treatment, as ESIN is least invasive and allows early PWB/FWB leading to early independence of personal hygiene/toilet use with early social integration/return to school

A clinico-radiological evaluation of functional outcome of proximal fibular osteotomy for medial compartment knee osteoarthritis: a new emerging technique

Background: The medial compartmental osteoarthritis (OA) knee is initially treated conservatively followed by lateral close/open medial wedge high tibial osteotomy (HTO), or by unicompartmental or total knee replacement (UKR/TKR). Though HTO and UKR/TKR yield good results but are technically more demanding and are fraught with risk of complications, moreover replacement may not be the treatment of choice for younger patients. The objective of this study was to evaluate the efficacy of proximal fibular osteotomy (PFO), a minimally invasive procedure minus risks associated with HTO/TKR.Methods: Thirty-eight patients, 15 males and 23 females with a mean age of 54.46 years (range, 35 to 80 years) underwent PFO for OA knee and were followed for a mean period of 8.63 months (range 6 to 12 months).Results: After PFO all patients experienced immediate significant relief in medial knee pain with improved walking distance. Postoperatively, all patients showed radiological improvement in femorotibial angle (FTA), medial/lateral joint space ratio.Conclusions: PFO is safe, minimally invasive technique with minimal complications. It gives immediate relief of medial knee pain with improved function of joint

Detection of the infective Plasmodium falciparum gametocytes by RT-qPCR assay from a malaria-endemic region of Northeastern India

IntroductionThe diagnosis of infectious reservoirs in malaria (gametocytes) is necessary, especially in low-density infections and asymptomatic malaria patients. The gametocyte stage is a surrogate marker for infection of P. falciparum malaria in healthy individuals. The early detection of infectious gametocytes and treatment will strengthen our efforts in curbing transmission. The nested PCR and real-time quantitative PCR (RT-qPCR) methods have been demonstrated for the diagnosis of infectious gametocyte reservoirs. In this study, RDT, blood smear microscopy, and nested-PCR were used for the detection of P. falciparum and P. vivax, and compared with RT-qPCR detection of Pfg27 gametocyte biomarker gene.MethodsIn the present cross-sectional study, 356 human blood samples were collected from endemic areas of Kokrajhar Assam (asymptomatic and symptomatic malaria patients) for malaria diagnosis.ResultsA total of 8.42%(30/356) incidence of malaria was observed. Malaria patients were observed to be both symptomatic, 80%(24/30; 13Pf+11Pv), and asymptomatic, 20%(6 (4Pf +2Pv)). More than 64%(11/17) of Pf and 92.3%(12/13) of Pv infections were observed in children and the adolescent population (age <20 years) by RDT, microscopy, nested PCR, and RT-qPCR methods. The prevalence of Pf infection was 4.77%(17/356) by RT-qPCR method. Of 16 the Pf positive samples 81.25%(13/16) were symptomatic and 18.75%(3/16) were asymptomatic. One asymptomatic individual was found positive for Pf infection by the RT-qPCR method.ConclusionThe findings from this research study revealed that the routine microscopy and RDT methods are insufficient for detecting all asymptomatic malaria and gametocyte infectious reservoirs. The early detection of infectious P. falciparum gametocytes and the treatment of patients will be helpful in preventing the transmission of malaria

“COVID- 19 Vaccination utilization pattern of the beneficiaries attending COVID 19 vaccination centre at a Medical college in Haryana, India”

Introduction: The COVID vaccination was introduced this year and there was lot of hesitancy amongst the people including health care workers. The pace of COVID vaccination increased with each passing day. No previous data was available about the utilization pattern of beneficiaries of COVID vaccination. Objective : This study was conducted to know the vaccine utilization pattern amongst general population as well as health care workers at a tertiary care health institute.Method: The beneficiaries who received COVID vaccination from 16th January 2021 to 15th June 2021 at a COVID Vaccination Centre of a tertiary care health institute in Haryana ( n= (Total = 9721).Result : Total number of beneficiaries vaccinated with 1st dose during the study period were 9721. Out of total vaccinated, 1600 (16.45%) were health care workers. Coverage of vaccination with first dose was maximum in the administrative staff (Data Entry Operators /Clerk/IT/other managers, Receptionist, Technical Staff etc) was 100 % and minimum in doctors ( 66.4 %) .Conclusion: Vaccine coverage in HCW with first dose in the study hospital was 82.27 % and for 2nd dose was 64.35% which is comparatively less to first dose. More sensitization of HCW is required to motivate them for second dose of Covid vaccination

Prevalence of multidrug-resistant tuberculosis among newly diagnosed cases of sputum-positive pulmonary tuberculosis

Background & Objectives: The prevalence of multidrug-resistant tuberculosis (MDR-TB) is increasing throughout the world. Although previous treatment for TB is the most important risk factor for development of MDR-TB, treatment-naove patients are also at risk due to either spontaneous mutations or transmission of drug-resistant strains. We sought to ascertain the prevalence of MDR-TB among new cases of sputum-positive pulmonary TB. Methods: This was a prospective, observational study involving newly diagnosed cases of sputum-positive pulmonary tuberculosis diagnosed between 2008 and 2009 carried out in New Delhi, India. All sputum-positive TB cases were subjected to mycobacterial culture and first-line drug-susceptibility testing (DST). MDR-TB was defined as TB caused by bacilli showing resistance to at least isoniazid and rifampicin. Results: A total of 218 cases of sputum-positive pulmonary tuberculosis were enrolled between 2008 and 2009. Of these, 41 cases had negative mycobacterial cultures and DST was carried out in 177 cases. The mean age of the patients was 27.8 ± 10.2 yr; 59 patients (27%) were female. All patients tested negative for HIV infection. Out of 177 cases, two cases of MDR-TB were detected. Thus, the prevalence of MDR-TB among newly diagnosed pulmonary tuberculosis patients was 1.1 per cent. Interpretation & Conclusions: MDR-TB prevalence is low among new cases of sputum-positive pulmonary TB treated at primary care level in Delhi. Nation-wide and State-wide representative data on prevalence of MDR-TB are lacking. Efforts should be directed towards continued surveillance for MDR-TB among newly diagnosed TB cases