Comparison of intramedullary nailing versus proximal locking plating in the management of closed extra-articular proximal tibial fracture

Background: To compare the outcomes of closed reduction and expert tibial nailing (ETN) versus minimally invasive proximal tibial plating in treating proximal extraarticular tibial fractures.Methods: This study included 30 cases of extraarticular proximal tibial shaft fractures. They were admitted to our department between March 2014 and June 2016 and treated respectively by closed reduction and ETN (group A, n=15) or minimally invasive proximal tibial plating (group B, n=15). To compare the therapeutic effects between two groups, the intraoperative condition, post-operative function, related complications and malalignment were investigated.Results: All the patients were successfully followed up till radiological union. The average union time for group A was 14.2 months and for group B was 16.7 months. 3 patients in group A developed delayed union and was treated with dynamization and ultimately lead to union whereas 1 patient developed non-union in group B. There were 3 cases of superficial infection in group B cured by antibiotics and repeated dressing change. Moreover, group A showed better result in terms of intraoperative blood loss, operation time, postoperative weight bearing time and fracture union time. Functional scores as calculated by the knee rating scale of the hospital for special surgery, 12 (80%) had excellent results in group A compared to 10 (66.66%) in group B which was not statistically significant.Conclusions: Compared with plate and screw fixation, ETN fixation has the advantages of fewer complications, shorter operation time, being less invasive, earlier postoperative rehabilitation and weight bearing, quicker fracture union and better functional recovery, thus being an effective way to treat extra articular proximal tibial fractures

Hidden Degeneracy in the Brick Wall Model of Black Holes

Quantum field theory in the near-horizon region of a black hole predicts the existence of an infinite number of degenerate modes. Such a degeneracy is regulated in the brick wall model by the introduction of a short distance cutoff. In this Letter we show that states of the brick wall model with non zero energy admit a further degeneracy for any given finite value of the cutoff. The black hole entropy is calculated within the brick wall model taking this degeneracy into account. Modes with complex frequencies however do not exhibit such a degeneracy.Comment: 8 pages, Latex fil

Everyone everywhere: accessible household sanitation for persons with disabilities

The Constitution of India ensures equality, freedom, justice and dignity of all individuals and implicitly mandates an inclusive society for all including Persons with Disabilities (PwDs). However, in spite of the enabling policies at the national and state level, there have been challenges faced by implementers and service providers in providing accessible sanitation because of lack of appropriate technology options which are disabled friendly, adequate information on inclusive toilet designs not reaching the block functionaries, inherent existing challenges in inter-sectoral coordination and lack of skilled organisations for grassroots implementation. As part of the national effort to enable everyone, everywhere to access improved sanitation, the Ministry of Drinking Water and Sanitation (MDWS), Government of India in collaboration with WaterAid India (WAI) finalised a handbook on accessible sanitation options for PwDs. Through collaboration, MDWS and WAI ensured reaching out to the entire country with these cost effective and locally appropriate sanitation options

Pulmonary lymphoma mimicking metastases: a case report

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Over-expression of 14-3-3zeta is an early event in oral cancer

<p>Abstract</p> <p>Background</p> <p>The functional and clinical significance of 14-3-3 proteins in human cancers remain largely undetermined. Earlier, we have reported differential expression of 14-3-3ζ mRNA in oral squamous cell carcinoma (OSCC) by differential display.</p> <p>Methods</p> <p>The clinical relevance of 14-3-3ζ protein in oral tumorigenesis was determined by immunohistochemistry in paraffin embedded sections of oral pre-malignant lesions (OPLs), OSCCs and histologically normal oral tissues and corroborated by Western Blotting. Co-immunoprecipitation assays were carried out to determine its association with NFκB, β-catenin and Bcl-2.</p> <p>Results</p> <p>Intense immunostaining of 14-3-3ζ protein was observed in 61/89 (69%) OPLs and 95/120 (79%) OSCCs. Immunohistochemistry showed significant increase in expression of 14-3-3ζ protein from normal mucosa to OPLs to OSCCs (p_trend< 0.001). Significant increase in expression of 14-3-3ζ protein was observed as early as in hyperplasia (p = 0.009), with further elevation in moderate and severe dysplasia, that was sustained in OSCCs. These findings were validated by Western blotting. Using Co-immunoprecipitation, we demonstrated that 14-3-3ζ protein binds to NFκB, β-catenin and Bcl-2, suggesting its involvement in cellular signaling, leading to proliferation of oral cancer cells.</p> <p>Conclusion</p> <p>Our findings suggest that over-expression of 14-3-3ζ is an early event in oral tumorigenesis and may have an important role in its development and progression. Thus, 14-3-3ζ may serve as an important molecular target for designing novel therapy for oral cancer.</p

Evidence for multiple shocks from the γ\gamma-ray emission of RS Ophiuchi

In August of 2021, Fermi-LAT, H.E.S.S., and MAGIC detected GeV and TeV $\gamma$-ray emission from an outburst of recurrent nova RS Ophiuchi. This detection represents the first very high energy $\gamma$-rays observed from a nova, and opens a new window to study particle acceleration. Both H.E.S.S. and MAGIC described the observed $\gamma$-rays as arising from a single, external shock. In this paper, we perform detailed, multi-zone modeling of RS Ophiuchi's 2021 outburst including a self-consistent prescription for particle acceleration and magnetic field amplification. We demonstrate that, contrary to previous work, a single shock cannot simultaneously explain RS Ophiuchi's GeV and TeV emission, particularly the spectral shape and distinct light curve peaks. Instead, we put forward a model involving multiple shocks that reproduces the observed $\gamma$-ray spectrum and temporal evolution. The simultaneous appearance of multiple distinct velocity components in the nova optical spectrum over the first several days of the outburst supports the presence of distinct shocks, which may arise either from the strong latitudinal dependence of the density of the external circumbinary medium (e.g., in the binary equatorial plane versus the poles) or due to internal collisions within the white dwarf ejecta (as powers the $\gamma$-ray emission in classical novae).Comment: 18 pages, 10 figures, submitted to Ap

Effect of topological defects and Coulomb charge on the low energy quantum dynamics of gapped graphene

We study the combined effect of a conical topological defect and a Coulomb charge impurity on the dynamics of Dirac fermions in gapped graphene. Beyond a certain strength of the Coulomb charge, quantum instability sets in, which demarcates the boundary between sub and supercritical values of the charge. In the subcritical regime, for certain values of the system parameters, the allowed boundary conditions in gapped graphene cone can be classified in terms of a single real parameter. We show that the observables such as local density of states, scattering phase shifts and the bound state spectra are sensitive to the value of this real parameter, which is interesting from an empirical point of view. For a supercritical Coulomb charge, we analyze the system with a regularized potential as well as with a zigzag boundary condition and find the effect of the sample topology on the observable features of the system.Comment: 22 pages, 23 figure

Geometric Finiteness, Holography and Quasinormal Modes for the Warped AdS_3 Black Hole

We show that there exists a precise kinematical notion of holography for the Euclidean warped $AdS_3$ black hole. This follows from the fact that the Euclidean warped $AdS_3$ black hole spacetime is a geometrically finite hyperbolic manifold. For such manifolds a theorem of Sullivan provides a one-to-one correspondence between the hyperbolic structure in the bulk and the conformal structure of its boundary. Using this theorem we obtain the holographic quasinormal modes for the warped $AdS_3$ black hole.Comment: Latex file, 7 pages. Journal versio

Multiplex PCR technique could be an alternative approach for early detection of leprosy among close contacts - a pilot study from India

<p>Abstract</p> <p>Background</p> <p>Implementation of Multi drug Therapy (MDT) regimen has resulted in the decline of the total number of leprosy cases in the world. Though the prevalence rate has been declining, the incidence rate remains more or less constant and high in South East Asian countries particularly in India, Nepal, Bangladesh, Pakistan and Srilanka. Leprosy, particularly that of multibacillary type spreads silently before it is clinically detected. An early detection and treatment would help to prevent transmission in the community. Multiplex PCR (M-PCR) technique appears to be promising towards early detection among contacts of leprosy cases.</p> <p>Methods</p> <p>A total of 234 paucibacillary (PB) and 205 multibacillary (MB) leprosy cases were studied in a community of an endemic area of Bankura district of West Bengal (Eastern India). They were assessed by smear examination for acid-fast bacilli (AFB) and M-PCR technique. These patients were treated with Multidrug Therapy (MDT) as prescribed by WHO following detection. A total of 110 MB and 72 PB contacts were studied by performing M-PCR in their nasal swab samples.</p> <p>Results</p> <p>83.4% of MB patients were observed to be positive by smear examination for AFB and 89.2% by M-PCR. While 22.2% of PB patients were found to be positive by smear examination for AFB, 80.3% of these patients were positive by M-PCR. Among leprosy contacts (using M-PCR), 10.9% were found to be positive among MB contacts and 1.3% among PB contacts. Interestingly, two contacts of M-PCR positive MB cases developed leprosy during the period of two years follow up.</p> <p>Conclusion</p> <p>The M-PCR technique appears to be an efficient tool for early detection of leprosy cases in community based contact tracing amongst close associates of PB and MB cases. Early contact tracing using a molecular biology tool can be of great help in curbing the incidence of leprosy further.</p

Object search by manipulation

We investigate the problem of a robot searching for an object. This requires reasoning about both perception and manipulation: some objects are moved because the target may be hidden behind them, while others are moved because they block the manipulator’s access to other objects. We contribute a formulation of the object search by manipulation problem using visibility and accessibility relations between objects. We also propose a greedy algorithm and show that it is optimal under certain conditions. We propose a second algorithm which takes advantage of the structure of the visibility and accessibility relations between objects to quickly generate plans. Our empirical evaluation strongly suggests that our algorithm is optimal under all conditions. We support this claim with a partial proof. Finally, we demonstrate an implementation of both algorithms on a real robot using a real object detection system