Pattern of Bimalleolar Ankle Fractures

To determine the pattern and outcome of bimalleolar ankle fractures .Methods: In this prospective observational study of 72 patients with bimalleolar ankle fractures were included and were followed up for 12 weeks. The American Orthopaedic Foot and Ankle Score (AOFAS) and Visual Analog Pain Scale (VAS) were used to assess short term outcomes as at 12 weeks. The main outcome measures were pain, functional capacity and alignment.Results: The patients’ age ranged from 19 to 63 mean 36.4 ±10.4 years. The male to female ratio was 3:2. Falls caused 50% of the fractures, motor vehicle accidents 36.1% and motor cycle accidents 13.9%. Closed fractures accounted for 63.9% of the cases. The most common fractures based on the Weber classification were B and C which occurred in 33 (45.8%) and 31 (43.1%) patients, respectively. At 3 months, the mean AOFAS was 78.2. The VAS between 1 and 3 was 43.1%. Twenty eight patients (38.8%) had no pain. There was no difference in AOFAS and VAS between operative and non operative, open or closed Weber B fracture outcomes. The Weber C fractures managed operatively had a significantly lower AOFAS, 63 compared to non-operative cases who scored 84.3. Medial clear space greater than 4mm was associated with a poor outcome.Conclusion: Patients mostly were young. Delay in definitive treatment of up to a week post-fracture does not seem to adversely affect the outcome. The main determinant of good outcome was the medial clear space that was less than 4m

Association of Folic Acid Deficiency with Ischemic Heart Disease

Background: To assess the association between folic acid deficiency and ischemic heart diseaseMethods: In this observational study patients of 25-65 years of age with newly diagnosed ischemic heart disease were included. All the patients on folic acid or vitamin B12 therapy, pregnant females, patients with any type of malignancy or patients with the history of megaloblastic anemia were excluded from the study. A 3-5ml serum sample for the estimation of folic acid levels was obtained. Tests were performed using chemiluminescent Microparticle Immunoassay (CMIA). Odds ratio was determined to measure the association between folic acid deficiency and ischemic heart disease.Results: Folic acid level was assessed both in cases and controls, with a mean folic acid level of 4.19±2.11ng/mL among patients and in controls mean folic acid level was 5.05±1.67ng/mL (p-value=0.015). The folic acid deficiency was found in 41.7% in cases. Odds ratio was 2.347 (95% CI; 1.067, 5.162, p<0.05).Conclusion: Folic acid deficiency was found high significantly in patients with ischemic heart disease as compared to that of controls and risk of ischemic heart disease is higher in patients with folic acid deficiency

Steroid Injection as an Effective Treatment for Lateral Epicondylitis

Methods: In this case control study 70 patients with lateral epicondylitis with no previous history of trauma, surgery around elbow joint or previous history of steroid injection were included. Patients were given local steroid injection after preparing the area with an antiseptic solution. The most tender point was localized and 40 mg methyl-prednisolone solution mixed with one ml of 2% xylocaine solution was infiltrated. Patients were followed up at six weeks for the evaluation of global improvement in symptoms using Likert-type scale. Results:The mean age of the sample was 43 years. 42 patients were in the age group of 41-50 years. Majority (81.4%) patients were females. Most of the patients (81.4%) scored 1 and 2 on Linkert type scale, showing global improvement. Nine patients improved with the second dose of steroid injection making cumulative efficacy to 94%. Conclusion: Local steroid infiltration is an effective method of relieving pain and improving function in patients with tennis elbowBackground: To determine efficacy of local steroid infiltration in patients with lateral epicondylit

Management of Undisplaced and Minimally Displaced Colles’ Fracture with Thermoplastic Splint Versus Conventional Colles Casting

Background: To compare the outcome in Colles’ fracture treated with thermoplastic splint versus conventional Colles cast.Methods: In this observational study 62 patients having Colles fracture were included. Patients were placed in two groups; group A were treated with Colles’ cast while group B with Thermoplastic splint. Radiographic evaluation was done, using Antero-posterior and lateral view wrist radiographs. Functional outcome assessed with Gartland and Werley Score demerit system.Results: Out of 62 patients, 28 (45.1%) were male with mean age of 38.67 and 34(54.8%) were female patients having mean age of 47.20. The total number of patients that had excellent functional outcome was 34 out of 62 (54.8). The excellent functional outcome was achieved in 16(50%) patients treated with colles brace. However, in patients treated with thermoplastic splint the functional outcome was excellent in 18(60%) patients.Conclusion: Best functional outcome after the treatment of Colles’ fracture is achieved by the use of thermoplastic splint

EMI shielding properties of polymer blends with inclusion of graphene nano platelets

Polymer blends of poly vinyle chloride (PVC) and polyaniline (PANI) with the inclusion of graphene nano platelets (GNP) are fabricated to enhance the EMI shielding effectiveness. The initial assessment with cyclic voltammetry has shown improved electrical conductivity both for PVC/PANI blends and PVC/PANI/GNP composites. The capacitive effect of the blends and composites is evaluated at lower frequency region (100 Hz-5 MHz). EMI shielding measurements of PVC/PANI/GNP composites is performed in the frequency range 10 MHz-20 GHz. In case of PVC/PANI (15 wt%) blends, a maximum attenuation of similar to 27 dB is attained which is enhanced to similar to 51 dB (max.) with the inclusion of 5 wt% GNP, mainly due to the absorption phenomena. The enhanced shielding effectiveness is achieved mainly in the frequency range 11-20 GHz. The dispersion state, fillers nature and their interaction may be the main aspects for the enhanced EMI shielding effectiveness of hybrid polymeric nanocomposites.publishedVersionPeer reviewe

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population.The aim of this study was to inform vaccination prioritization by modelling the impact of vaccination on elective inpatient surgery. The study found that patients aged at least 70 years needing elective surgery should be prioritized alongside other high-risk groups during early vaccination programmes. Once vaccines are rolled out to younger populations, prioritizing surgical patients is advantageous