An evaluation of congenital talipes equinovarus patients treated by various methods

Background: Idiopathic congenital talipes equinovarus is one of the commonest congenital anomaly. Although treatment provides many options, near universal agreement exists that initial management should consist of gentle manipulation of the affected foot. In developing country like India presentation is extremely variable from soon after birth to very late childhood and irregular follow up makes treatment more difficult.Methods: 100 cases of congenital talipes equinovarus who attended the Orthopedics OPD of our hospital (March 2013  to 2016) were taken up. In neonates with delicate skin, the passive manipulation was demonstrated to the mother which they did 5-6 times daily. The application of plaster of Paris cast and passive manipulation was done every 15th day upto 3 months of age. After the 3-month age, passive manipulation was done every 3 weeks. If no normalization, surgery was advised and done to correct the resistant component accordingly. All the analyses were performed in R-programming language (R- 3.0.0).Results: 6 cases,10 feet were lost during follow-up. Results were assessed in 134 feet, 128 cases managed conservatively, 13 surgically. Results were assessed according to clinical, radiological criteria of Beatson and Pearson. 13 feet were operated of 144 feet,11 cases posteromedial soft tissue release (PMSTR) was done. In two Joshi’s external stabilizing system (JESS) fixator was applied.Conclusions: Majority of cases can be treated successfully by conservative means and only in 11 cases PMSTR was done, 2 cases of relapsed feet JESS was applied

A long term functional and radiological outcome assessment study of management of high grade acromioclavicular joint injury

Background: Acromioclavicular joint dislocation (ACD) of Rockwood types III and above require surgical intervention. We used a unique technique for CC interval fixation using endobutton with two separate small incisions, which did not need dissection through the joint at all. It replaces the anatomical course of conoid and trapezoid part of the CC ligament. The purpose of the present study was to describe an innovative method of fixation and evaluate its functional outcome using subjective as well as objective measures. We aimed to determine whether this fixation method could be an optimal alternative to address this injury.Methods: A total of 24 patients were enrolled for this prospective longitudinal study. Coraco-clavicular distance was calculated radiologically preoperatively and at the final follow up.  Clinically, the final outcome was assessed using the Shoulder Constant score and visual analogue scale (VAS) for residual pain at the final follow up.Results: There was no statistically significant difference between the two shoulders and results were considered as an excellent in terms of constant shoulder score. The VAS was 0.42 (0-1) at final follow-up. The coraco-clavicular distance (CC) reduced significantly postoperatively and was comparable to the contralateral side.Conclusions: Our study results suggested that this is a simple, safe and effective technique which needed minimal dissection

Beaconless position based routing with guaranteed delivery for wireless ad-hoc and sensor networks

Existing position-based routing algorithms, where packets are forwarded in the geographic direction of the destination, normally require that the forwarding node knows the positions of all neighbors in its transmission range. This information on direct neighbors is gained by observing beacon messages that each node sends out periodically. Several beaconless greedy routing schemes have been proposed recently. However, none of the existing beaconless schemes guarantee the delivery of packets. Moreover, they incur communication overhead by sending excessive control messages or by broadcasting data packets. In this paper, we describe how existing localized position based routing schemes that guarantee delivery can be made beaconless, while preserving the same routes. In our guaranteed delivery beaconless routing scheme, the next hop is selected through the use of control RTS/CTS messages and biased timeouts. In greedy mode, neighbor closest to destination responds first. In recovery mode, nodes closer to the source will select shorter timeouts, so that other neighbors, overhearing CTS packets, can eliminate their own CTS packets if they realize that their link to the source is not part of Gabriel graph. Nodes also cancel their packets after receiving data message sent by source to the selected neighbor. We analyze the behavior of our scheme on our simulation environment assuming ideal MAC, following GOAFR+ and GFG routing schemes. Our results demonstrate low communication overhead in addition to guaranteed delivery.1st IFIP International Conference on Ad-Hoc NetWorkingRed de Universidades con Carreras en Informática (RedUNCI

Maternal complications in twin pregnancy; recent trends: a study at a tertiary care referral institute in Northern India

Background: This study aims to determine the maternal complications in twin pregnancy in North Indian population at tertiary institute.Methods: This was a retrospective cohort review of multiple pregnancies after 20 weeks gestation at a tertiary teaching hospital (2011-2015). Maternal data was collected from the labor room delivery data entry register and patient’s admission file. Patients with diabetes mellitus and chronic hypertension were excluded from the study.Results: Out of 19539 births during this period, 432 were twin pregnancies with an incidence of 22/1000 birth. Most of them were 282 (65.4%) were referred patients. Eighty seven percent patients were in the age group of 21-30 years and primigravida contributed to 45.7% of total patients. Maternal complications noticed were as preterm deliveries in 304 (70%), anaemia in 259(60%) patients, preterm rupture of membranes in 120 (39.4%) patients, hypertensive disorders of pregnancy in 122(28.3%) patients, cholestasis of pregnancy in 24(5.5%) of patients, hypothyroidism in 22(5.1%) of patients, antepartum hemorrhage (APH) in 20(4.6%) and gestational diabetes mallitus (GDM) in 08(1.8%) of patients. Among postpartum complications, atonic postpartum haemorrhage (PPH) was observed in 44 (10.2%) and maternal mortality happened in 02(0.46%) cases.Conclusions: This study reveals higher percentage of, preterm labor, anaemia, and gestational hypertension than other studies. More number of intensive care unit should be established in high prevalence areas to prevent perinatal mortality due to prematurity. Treatment of anaemia requires more aggressive approach by considering intravenous iron whenever compliance is in doubt. Frequent antenatal care is required for early diagnosis of these complications to prevent maternal and fetal morbidity

Recent Advancement and Emerging Applications of Lignin

Lignin is a significant renewable natural energy resource these days, used as an environmentally acceptable and sustainable alternative fossil fuel feedstock in a huge possibility of value-added products. Lignin is a polymeric molecule that possesses an aromatic unit structure, together with cellulose, and is a main component of the cell walls of plants. It is the byproduct of agriculture residues and biorefinery products and can be extracted from paper-pulp industries. Properties of lignin may differ depending on the extraction method and source and also on an aromatic ring as the main constituent of lignin in the structure. This rare composition of lignin makes it more valuable, allowing for value-added applications such as in the field of storage devices and energy harvesters. This review focuses on derivatives of lignin, structure and composition sources and characteristics, and its sustainable emerging application in various fields are discussed

Cortical Current Density vs. Surface EEG for Event-Related Potential-based Brain-Computer Interface

In this paper we use the cortical current density based inverse solution to classify Event Related Potential, in particular for error-related potential elicited during Brain-Computer Interface experiment. We selected discriminant cortical sources for comparing classification performance with respect to surface EEG. We found that the data from cortical sources achieves higher classification accuracy for most of the subjects. In addition, the inverse method exhibits consistently discriminant activity for the sources located over the anterior cingulate cortex region for different time points. This level of neurophysiological interpretation in terms of localisation of selected cortical sources is enabled with the use of inverse solution

Online BCI with Stable Sources

In this paper, we show that the estimated intra-cranial sources using source localization on EEG signals can be used for online Brain Computer Interation (BCI) and the discriminant sources remain stable over days. Classifiers are trained on discriminant sources obtained for Error-related Potential (ErrP) based BCI on day 1 and then tested online on day 2. The results for nine subjects show that the source localization with discriminant sources can be used for online detection of ErrPs. Furthermore, the number of common sources among the discriminant sources for different days is above chance which shows that the discriminant sources remain stable over days