Determinants of range of motion in cruciate retaining total knee arthroplasty: a prospective study

Background: Total knee replacement (TKR) is to provide a stable painless knee with adequate range of motion (ROM) for daily activities. The aim of the study is to evaluate various factors that influence ROM in cruciate retaining TKR postoperatively.Methods: Fourty four patients with osteoarthritis knee treated in our institute with TKR using cruciate retaining prosthesis are included in study and analysed prospectively. Mean follow up was 6 months. Patients are analyzed for following factors–age, gender, BMI, preoperative ROM, changes in posterior femoral condylar offset, posterior tibial slope after surgery. Statistical analysis of effect of all factors on knee ROM was done. Assessment was done preoperatively and 3 and 6 months postoperatively.Results: Gender did not affect the final ROM. Mean age of patients is 65. Age has negative correlation with ROM (p=-0.45). The mean knee range improved from 92˚ to 101˚. Factors that negatively affect ROM include, BMI (p=-0.04) and Preoperative flexion deformity (p=-0.03). Factors that positively affect ROM include, knee scores and good preoperative flexion (p=0.001). Males have good amount of flexion preoperatively and post operatively when compared to females.Conclusions: Preoperative ROM, flexion contracture and BMI are the important factors affecting the range of motion in total knee arthroplasty. Proper counselling of patient preoperatively regarding these various factors and appropriate selection of patient is of utmost important for satisfactory functional outcome

Experiments in free shear flows: Status and needs for the future

Experiments in free turbulent flows are recommended with the primary concern placed on classical flows in order to augment understanding and for model building. Five classes of experiments dealing with classical free turbulent flows are outlined and proposed as being of particular significance for the near future. These classes include the following: (1) Experiments clarifying the effect of density variation owing to use of different gases, with and without the additional effect of density variation due to high Mach number or other effects; (2) experiments clarifying the role and importance of various parameters which determine the behavior of the near field as well as the condictions under which any of these parameters can be neglected; (3) experiments determining the cumulative effect of initial conditions in terms of distance to fully established flow; (4) experiments for cases where two layers of distinctly different initial turbulence structure flow side by side at the same mean speed; and (5) experiment using contemporary experimental techniques to study structure in free turbulent shear flows in order to compliment and support contemporary work on boundary layers

A study of maternal near miss at a district teaching hospital: a retrospective observational study

Background: Maternal health is an integral part of health care system. Maternal mortality is an indicator of maternal health and health care delivery system. Severe morbid conditions require comprehensive approach. Hence the concept of Maternal Near Miss (MNM) has emerged. The data of maternal near miss helps to reduce the maternal death and helps to achieve the goals related to reduce the maternal mortality rate of the country as well as the world and to improve the quality of life of the woman population by a quality care. Objectives of present study were to identify and analyze the strategies undertaken in the management of maternal near miss and outcome, measures to improve the quality of care and to assess the various indicators of MNM.Methods: With the permission from the hospital administrators and after taking the ethical clearance from the institutional ethical committee, a retrospective observational study was conducted for the period of one year between January 2016 to December 2016 at district teaching hospital of Kodagu Institute of Medical Sciences, Madikeri, by collecting data from hospital records. Admissions to the ICU as well as wards which fit in to the WHO maternal near miss criteria were included and studied.Results: WHO criteria for the MNM was followed. In present study, there were 25 MNM cases and four Maternal Deaths out of 3347 live births giving a maternal mortality ratio of 119/100000 live births (LB), Maternal Near Miss ratio of 7.46/1000LB, MNM:1MD ratio is 6.25 and mortality index (MI) is 13.79%. Twenty five cases of obstetric emergencies with serious concerns for maternal health were selected out of 97 cases who met the WHO criteria for MNM (25.77%). Twelve cases (48%) received multiple blood-transfusions, 8 cases (32%) of sepsis, 7 (28%) of PPH, and 5 (20%) of hypertensive disorder of pregnancy (pre-eclampsia, eclampsia). There were 12 cases (48%) that had more than one inclusion criteria. Surgical intervention was required in 8 (32%) i.e. 2 peripartum hysterectomies, 2 laparotomies, 1 manual removal of placenta, 1 uterine reposition and 2 traumatic PPH repair.Conclusions: Maternal-Near-Miss (MNM/SAMM) and its relation to maternal mortality contribute as sensitive measures of pregnancy outcome than mortality alone. Proper documentation is of paramount importance in analysis of data, to make conclusions and recommendation. Prospective structured study is required to get a clear picture and to suggest corrective measures which can be taken as far as obstetric care is concerned, to reduce maternal mortality and to achieve the sustainable developmental Goal (SDG) of maternal mortality ratio <70/100000 LB by 2030

AN EXPERIMENTAL STUDY OF VRIKSHAYURVEDA SEED TREATMENTS ON GERMINATION RATE AND ACTIVE INGREDIENT OF BAKUCHI (PSORALEA CORYLIFOLIA LINN.) BY HPLC METHOD

Bakuchi (Psoralea corylifolia Linn.) is one of the important endangered medicinal plants used in Ayurveda and other Traditional systems. Its cultivation and propagation is difficult due to its low germination rate (5-7%) &amp; prolonged seed dormancy. Bakuchi seeds made into 5 groups, the experiment was conducted in a complete randomized block design with 5 treatments and 5 replications totally 500 seeds in each group) &amp; observed for 50 days. Control Group 1 no- seed treatment, Group 2- Standard treated with 1% conc H2SO4, Group 3 Vrikshayurvedic treatment done by soaking in milk subsequently fumigation of Vidanga &amp; Ghee, Group 4- treated with paste of Brihati, Tila, Kamalanaala, Ghee &amp; Group 5 treated by soaking in milk subsequently Cow dung, Vidanga &amp; Honey applied. Number of seeds germinated, germination percentage, emergence index and relative seed germination parameters were observed. HPLC studies carried out of post harvested Bakuchi seeds of all 5 groups to know the effect of seed treatments on Psoralen content quantitatively. Overall results indicates that Group 4 (8.000 ± 0.8367) seeds soaked in 12 hrs milk followed by application of Brihati, Tila, Kamalanaala &amp; Ghee paste for 12 hrs treatment is statistically significant (P value&gt;0.05) in comparison with group 2 (4.600 ± 0.6782) Sulphuric acid treatment and Group 3 (4.200± 0.9165) fumigation with Honey &amp; Vidanga. Rest of the groups shown insignificant changes on germination parameters. HPLC Results found that generally seed treatments may reduce the content of Psoralen as in control (Group 1) maximum percentage (0.04%w/w) of Psoralen is noticed. Among treatment groups Group 4 contains maximum (0.027%w/w) Psoralen next to control (0.039%w/w). Psoralen content is very less in standard Group 2 (0.022%w/w), Group 3 (0.023%w/w) &amp; Group 4 (0.024%w/w). Maximum germination percentage was observed in Group 4 in comparison with the Group 2conventional method of treating with sulphuric acid. Estimation of Psoralen contents in the seeds from the plants grown by various treated seeds reveled that Group 4 is qualitatively better than standard, but inferior to the control, standard &amp; other Vrikshayurveda seed treatment techniques used in the current experiment

Prevalence of cricket-related musculoskeletal pain among Indian junior club cricketers

Background: Cricket is the most commonly played sport in India. The number of children playing cricket are increasing. There is growing evidence that injury rates in junior cricketers are higher than professional cricketers. In India at the community level, there are no standardized specific cricket injury prevention programmes (CIPP) which reduce injury risk. Minimal data is available from Asian countries, especially on junior cricketers. Our study is an attempt to focus on junior club cricketer injuries, plan safety precautions and emphasize role of CIPP.Methods: It was an observational study conducted on male junior club cricketers in the age group of 8-16 years. Based on a self-reported questionnaire, player’s physical status, training, injuries and their nature are assessed over a period of 12 months.Results: Over the study period 36 of 50 cricketers were symptomatic. The lower limb is the most frequently injured. Most common etiology is overuse. We found that the players are not following pre-training warm-up and post-training cool-down.Conclusions: CIPP should be implemented and strictly followed from the early stages of sports life. Pre-training warm-up and post-training cool-down should be included in their routine training. Overuse i.e. playing overtime and ignoring the pain during practice or match should be avoided. A supervised training and regular screening of players by orthopaedician or sports physician will keep them fit to play with full potential

Anatomical variations of sinonasal region: a CT scan study

Multislice CT is currently the imaging modality of choice for evaluating PNS & adjacent structures. Such a method has been increasingly utilized in the assessment of anatomical variations, allowing their accurate identification with high anatomical details. Some anatomical variations may predispose to sinonasal disease, constituting areas of high risk for injuries & complications during surgical procedures. Therefore, the recognition of such variations is critical in the preoperative evaluation for endoscopic surgery

The NANOGrav 12.5 yr Data Set: Observations and Narrowband Timing of 47 Millisecond Pulsars

We present time-of-arrival (TOA) measurements and timing models of 47 millisecond pulsars observed from 2004 to 2017 at the Arecibo Observatory and the Green Bank Telescope by the North American Nanohertz Observatory for Gravitational Waves (NANOGrav). The observing cadence was three to four weeks for most pulsars over most of this time span, with weekly observations of six sources. These data were collected for use in low-frequency gravitational wave searches and for other astrophysical purposes. We detail our observational methods and present a set of TOA measurements, based on narrowband analysis, in which many TOAs are calculated within narrow radio-frequency bands for data collected simultaneously across a wide bandwidth. A separate set of wideband TOAs will be presented in a companion paper. We detail a number of methodological changes, compared to our previous work, which yield a cleaner and more uniformly processed data set. Our timing models include several new astrometric and binary pulsar measurements, including previously unpublished values for the parallaxes of PSRs J1832−0836 and J2322+2057, the secular derivatives of the projected semimajor orbital axes of PSRs J0613−0200 and J2229+2643, and the first detection of the Shapiro delay in PSR J2145−0750. We report detectable levels of red noise in the time series for 14 pulsars. As a check on timing model reliability, we investigate the stability of astrometric parameters across data sets of different lengths. We also report flux density measurements for all pulsars observed. Searches for stochastic and continuous gravitational waves using these data will be subjects of forthcoming publications

Differing roles of CD1d2 and CD1d1 proteins in type I natural killer T cell development and function

MHC class I-like CD1 molecules have evolved to present lipid-based antigens to T cells. Differences in the antigen-binding clefts of the CD1 family members determine the conformation and size of the lipids that are presented, although the factors that shape CD1 diversity remain unclear. In mice, two homologous genes, CD1D1 and CD1D2, encode the CD1d protein, which is essential to the development and function of natural killer T (NKT) cells. However, it remains unclear whether both CD1d isoforms are equivalent in their antigen presentation capacity and functions. Here, we report that CD1d2 molecules are expressed in the thymus of some mouse strains, where they select functional type I NKT cells. Intriguingly, the T cell antigen receptor repertoire and phenotype of CD1d2-selected type I NKT cells in CD1D1−/− mice differed from CD1d1-selected type I NKT cells. The structures of CD1d2 in complex with endogenous lipids and a truncated acyl-chain analog of α-galactosylceramide revealed that its A′-pocket was restricted in size compared with CD1d1. Accordingly, CD1d2 molecules could not present glycolipid antigens with long acyl chains efficiently, favoring the presentation of short acyl chain antigens. These results indicate that the two CD1d molecules present different sets of self-antigen(s) in the mouse thymus, thereby impacting the development of invariant NKT cells