Evaluation of functional and clinical outcome of open reduction and internal fixation of Barton’s fracture of the wrist in a central hospital of Kashmir

Background: Fractures of the distal end of radius continue to pose a management challenge. Defective alignment of extra articular as well as intra articular fractures result in a variety of complications like post traumatic arthritis, decreased in grip strength and endurance as well as limited range of motion and instability of carpus. The main aim of this study is to assess the functional results of open reduction and internal fixation in the treatment of volar Barton’s fracture.Methods: From December 2006 to December 2019, forty cases of volar Barton’s fracture were operated in Skims Medical College Hospital, Srinagar, Kashmir, however only 32 cases were included in the study group and 8 cases were lost to follow up. In the majority of our cases the injury was sustained as a result of road traffic accident followed by fall. Majority (24) of the cases were operated within one week of trauma, followed by six in two weeks and two in 3 weeks of time since injury.Results: Functional evaluation was done after a mean follow-up of 28.7 months. Fracture union was achieved within 8 to 12 weeks and excellent results were obtained in 18 cases and 10 cases were categorized as good followed by fair result in 4 cases. Median nerve compression was not observed in any case.Conclusions: Good to excellent result can be achieved after open reduction and internal fixation which restores joint congruity

Treatment of supra condylar fractures of humerus in children, a SKIMS medical college study

Background: Supracondylar fractures of the humerus account for sixty percent of all fractures around the elbow in children. Delayed presentation of these fractures is very common even in developed countries. The aim of the present study was to evaluate the clinical, radiological and functional results following closed reduction (C/R) and percutaneous pinning of widely displaced supracondylar fractures of humerus. An objective of this study was to study supracondylar fractures of humerus in children in Skims medical College.Methods: A total 86 patients with displaced extension type supracondylar fractures (gartland type III) of humerus were managed by closed reduction and percutaneous fixation at Skims medical college after achieving optimal and satisfactory reduction. There were 52 boys and 28 girls. Average age was 6.69 years (range 2-12).Results: A total 86 patients were successfully treated with C/R and cross pinning. 6 patients were lost to follow-up. 80 patients with a minimum follow-up period of 12 months formed the basis of this study.Conclusions: C/R and pinning is effective method despite delayed presentation. Strict anatomical reduction and stable fixation minimises the risk of developing cubitus varus deformity

Beta-type Ti-Nb-Zr-Cr alloys with large plasticity and significant strain hardening

A series of Ti-25Nb-8Zr-xCr (x = 0, 2, 4, 6, 8 wt%) alloys were designed based on DV-Xα cluster method and e=a-Δr diagram with an anticipation to obtain high plasticity and significant strain hardening. The designed alloys were produced through cold crucible levitation melting technique in order to effectively investigate their micro-structures and mechanical properties. The addition of Cr significantly enhances the β stability in the microstructures of the Ti-25Nb-8Zr-xCr alloys. Both yield strength and hardness of the studied alloys increase due to the effect of solid-solution strengthening. By contrast, the plasticity, maximum strength and strain hardening rate are influenced by theβstability as well as the distinct deformation mechanisms. None of the alloys comprising Cr fail up to 100 kN (the load capacity used) and all show impressive plasticity (~75%) and superior maximum compressive strength (~4.5 GPa) at 100 kN. Moreover, the deformation bands, which are found around the hardness indentations, are analyzed for all the investigated alloys. The fracture behaviors of the Ti-25Nb-8Zr-xCr alloys are also studied to observe the characteristics related to crack propagation, plastic deformation and the formation of shear bands

Improved deformation behavior in Ti-Zr-Fe-Mn alloys comprising the C14 type Laves and β phases

Laves phase alloys are promising materials for several structural applications, but the extreme brittleness is the predominant shortcoming of a Laves matrix. One potential solution to overcome this shortcoming is to alloy Laves matrix with some soft matrix. A group of Ti-35Zr-5Fe-xMn (x = 0, 2, 4, 6, 8 wt%) alloys was cast with an aim to improve deformation in Laves alloy compositions. The phase and microstructure analyses reveal dual phase matrices, including a β phase and a C14 type Laves phase in the investigated alloys. The mechanical properties such as yield strength, hardness and plastic strain for the investigated alloys are found to be significantly sensitive to volume fraction of the Laves phase. Ti-35Zr-5Fe shows impressive ultimate compressive strength (~1.7 GPa), yield strength (1138 MPa) and large plastic strain (23.2 %). The fracture mechanisms are dependent on the microstructure of the alloys. Additionally, the work-hardening ability of the investigated alloys have also been evaluated based on the analyses of slip band patterns formed around the micro-hardness indentations. Notably, the extreme brittleness is not encountered in all the Ti-35Zr-5Fe-xMn alloys and all exhibit very good compressive elongation including the maximum (32.5 %) in Ti-35Zr-5Fe

Computational approaches for the design of novel anticancer compounds based on pyrazolo[3,4-d]pyrimidine derivatives as trap1 inhibitor

In the present in-silico study, various computational techniques were applied to determine potent compounds against TRAP1 kinase. The pharmacophore hypothesis DHHRR_1 consists of important features required for activity. The 3D QSAR study showed a statistically significant model with R2 = 0.96 and Q2 = 0.57. Leave one out (LOO) cross-validation (R2 CV = 0.58) was used to validate the QSAR model. The molecular docking study showed maximum XP docking scores (−11.265, −10.532, −10.422, −10.827, −10.753 kcal/mol) for potent pyrazole analogs (42, 46, 49, 56, 43), respectively, with significant interactions with amino acid residues (ASP 594, CYS 532, PHE 583, SER 536) against TRAP1 kinase receptors (PDB ID: 5Y3N). Furthermore, the docking results were validated using the 100 ns MD simulations performed for the selected five docked complexes. The selected inhibitors showed relatively higher binding affinities than the TRAP1 inhibitor molecules present in the literature. The ZINC database was used for a virtual screening study that screened ZINC05297837, ZINC05434822, and ZINC72286418, which showed similar binding interactions to those shown by potent ligands. Absorption, distribution, metabolism, and excretion (ADME) analysis showed noticeable results. The results of the study may be helpful for the further development of potent TRAP1 inhibitors

A Database Study of Visual Outcomes and Intraoperative Complications of Postvitrectomy Cataract Surgery

PURPOSE: To analyze the visual outcomes and rate of intraoperative complications of phacoemulsification surgery after prior pars plana vitrectomy (PPV). DESIGN: Retrospective, multicenter database study. PARTICIPANTS: Eyes that underwent phacoemulsification between June 2005 and March 2015 at 8 sites in the United Kingdom. METHODS: Study eyes were classified as vitrectomized (prior PPV group) or nonvitrectomized (reference group) depending on the vitreous state at the time of cataract surgery. Eyes with multiple intraocular surgeries or history of ocular diseases known to cause cataract progression or increased risk of intraoperative complications during phacoemulsification were excluded. MAIN OUTCOME MEASURES: Logarithm of the minimum angle of resolution (logMAR) visual acuity (VA), rate of intraoperative complications, and time interval to cataract surgery. RESULTS: Eyes in the prior PPV group (n = 2221) had worse preoperative logMAR VA (0.96±0.60 vs. 0.62±0.52, P \u3c 0.0001), were from younger patients, and had longer axial lengths than the nonvitrectomized group (n = 136 533). At all postoperative time points measured up to 24 weeks, mean vision was poorer in the prior PPV group (0.41±0.47 vs. 0.17±0.29 at 4-12 weeks, P \u3c 0.0001) and a smaller proportion of eyes achieved postoperative VA ≤0.30 logMAR (Snellen, ≥20/40) (60.8% vs. 86.5% at 4-12 weeks, P \u3c 0.0001). The rate of posterior capsular rupture was not different between the prior PPV (1.5%) and the nonvitrectomized (1.7%) groups, but the incidences of zonular dialysis (1.3% vs. 0.6%) and dropped nuclear fragments (0.6% vs. 0.2%) were higher in the prior PPV group (P \u3c 0.0001). The mean time interval between PPV and cataract surgery was 399 days. CONCLUSIONS: We found a significant improvement in VA with postvitrectomy cataract surgery. However, compared with eyes without prior PPV, there was a worse mean postoperative vision of 0.2 logMAR units, a higher rate of zonular dialysis and dropped nuclear fragments, and a similar rate of posterior capsule rupture

Increasing striatal dopamine release through repeated bouts of theta burst transcranial magnetic stimulation of the left dorsolateral prefrontal cortex. A 18F-desmethoxyfallypride positron emission tomography study

IntroductionTranscranial Magnetic Stimulation (TMS) can modulate fronto-striatal connectivity in the human brain. Here Positron Emission Tomography (PET) and neuro-navigated TMS were combined to investigate the dynamics of the fronto-striatal connectivity in the human brain. Employing 18F-DesmethoxyFallypride (DMFP) – a Dopamine receptor-antagonist – the release of endogenous dopamine in the striatum in response to time-spaced repeated bouts of excitatory, intermittent theta burst stimulation (iTBS) of the Left-Dorsolateral Prefrontal Cortex (L-DLPFC) was measured.Methods23 healthy participants underwent two PET sessions, each one with four blocks of iTBS separated by 30 minutes: sham (control) and verum (90% of individual resting motor threshold). Receptor Binding Ratios were collected for sham and verum sessions across 37 time frames (about 130 minutes) in striatal sub-regions (Caudate nucleus and Putamen).ResultsVerum iTBS increased the dopamine release in striatal sub-regions, relative to sham iTBS. Dopamine levels in the verum session increased progressively across the time frames until frame number 28 (approximately 85 minutes after the start of the session and after three iTBS bouts) and then essentially remained unchanged until the end of the session.ConclusionResults suggest that the short-timed iTBS protocol performed in time-spaced blocks can effectively induce a dynamic dose dependent increase in dopaminergic fronto-striatal connectivity. This scheme could provide an alternative to unpleasant and distressing, long stimulation protocols in experimental and therapeutic settings. Specifically, it was demonstrated that three repeated bouts of iTBS, spaced by short intervals, achieve larger effects than one single stimulation. This finding has implications for the planning of therapeutic interventions, for example, treatment of major depression

Child mental health differences amongst ethnic groups in Britain: a systematic review

BACKGROUND: Inter-ethnic differences have been reported for many mental health outcomes in the UK, but no systematic review on child mental health has been published. The aim of this review is to compare the population-based prevalence of child mental disorders between ethnic groups in Britain, and relate these findings to ethnic differences in mental health service use. METHODS: A systematic search of bibliographic databases for population-based and clinic-based studies of children aged 0-19, including all ethnic groups and the main child mental disorders. We synthesised findings by comparing each minority group to the White British study sample. RESULTS: 31 population-based and 18 clinic-based studies met the inclusion criteria. Children in the main minority groups have similar or better mental health than White British children for common disorders, but may have higher rates for some less common conditions. The causes of these differences are unclear. There may be unmet need for services among Pakistani and Bangladeshi children. CONCLUSION: Inter-ethnic differences exist but are largely unexplained. Future studies should address the challenges of cross-cultural psychiatry and investigate reasons for inter-ethnic differences