Functional outcome of an arthroscopic anatomical single bundle anterior Cruciate Ligament (ACL) reconstruction using Semi-tendinosus graft with fixation using Endo-button on femoral side and Suture Disc on Tibial side- A prospective clinical study

Background: Injury to the anterior cruciate ligament (ACL) is one of the most frequent injuries of the knee during different sports activities. Arthroscopic surgical reconstruction is the current standard of care for treatment of ACL injuries in young and active patients. The widespread adoption of ACL reconstruction over primary repair was based on early perception of the limited healing capacity of the ACL. Hamstring tendon is most favoured graft for ACL reconstruction. We wanted to study the outcomes particular method of fixation for fixing the hamstring tendon.Methods: In this study 30 patient with ACL injury were treated arthroscopically for the fixation of graft in bone tunnel we use endobutton for femur and suture disc for tibia as suspensor implant and prospective assessment of functional outcome using Tegner Lysholm knee scoring system.Results: The preoperative activity level could be maintained in 70% of the patients. The Lysholm score showed very good and good results in 80%. Functional and stability results in about 70% of the patients.Conclusions:This surgical technique can be recommended for the active patient with ACL deficiency. The functional outcome of anterior cruciate ligament reconstruction with quadrupled semitendinosus tendon autograft using Endobutton and suture disc is good. This method of fixation will help the graft to facilitate graft tunnel healing and also maintain its strength until there is a good graft to bone healing occurs completely

Plating as an operative management of intra articular fractures of the upper end of tibia: a prospective clinical study

Background: Tibial plateau fracture management is challenging because of the severe displacement of the bony fragments, the concomitant depression and impaction of the cancellous subchondral bone, and the inevitable associated cartilage injury.Methods: A prospective cohort study of 25 patients who suffered high energy intra-articular fractures of proximal tibia was done and they were diagnosed and classified according to Schatzker’s classification. The study was done to study the outcomes of surgical management of high energy tibial plateau fractures with buttress plate, to achieve anatomical reduction and absolute stable internal fixation to prevent malunion, to achieve early mobilisation, to prevent post-operative knee stiffness and also to determine timing of operation after trauma and sequence of fixation of bicondylar fractures. All patients were treated with open reduction and internal fixation with a buttress plate either a lateral, medial or bicondylar plating.Results: Average radio-graphic bony union time was 12 weeks. Average full weight bearing time was 13 weeks. Knee stiffness improved with physiotherapy and full range was achieved on an average in 8 weeks, mean range of movement 0-124.5º was achieved. 4 patients (16%) developed infection. Conclusions: Fractures of upper end of tibia can be treated with the plating technique, to achieve anatomical reduction and stable internal fixation with 82% good functional outcome. The plating technique facilitates early mobilisation of injured joint and attains good range of movements. Minimal mal reduction does not seem to vitiate the results. The infection rate of 16% is of concern with this procedure, but responds well to antibiotics and surgical debridement

Pretreatment of therapeutic cells with poly(ADP-ribose) polymerase inhibitor enhances their efficacy in an in vitro model of cell-based therapy in myocardial infarct.

The potential of cell-based therapies in diseases involving ischemia-reperfusion is greatly hampered by the excessive loss of administered cells in the harsh and oxidative environment where these cells are supposed to act. Therefore, we investigated if inhibition of poly(ADP-ribose) polymerase (PARP) in the therapeutically added cells would lead to their increased viability and, subsequently, to an enhanced effect in an in vitro simulated ischemia-reperfusion (I-R) setting. Ischemic conditions were simulated by oxygen and glucose deprivation for 160 min using H9c2 rat cardiomyoblast cells. After 30 min of reperfusion, these cells received 4 types of treatments: no added cells (I-R model), fluorescently labeled (Vybrant DiD) therapeutic H9c2 cells with vehicle (H9c2) or PARP inhibitor (10 microM or 100 microM PJ34) pretreatment. We assessed viability (live, apoptotic and necrotic) of both 'postischemic' and therapeutic cells with flow cytometric analysis using calcein-AM/ethidium homodimer-2 fluorescent staining after 24 h of co-culture. Further measurements on necrosis and metabolic activity were performed using lactate dehydrogenase (LDH) release and resazurin based assays. The percentage of surviving therapeutic cells increased significantly with PARP inhibition (untreated, 52.02+/-5.01%; 10 microM PJ34, 63.38+/-4.50%; 100 microM PJ34, 64.99+/-3.47%). The percentage of necrotic cells decreased in a similar manner (untreated, 37.23+/-4.40%; 10 microM PJ34, 26.83+/-3.49%; 100 microM PJ34, 24.96+/-2.43%). Notably, the survival of the cells that suffered I-R injury was also significantly higher when treated with PARP-inhibited therapeutic cells (I-R model, 36.44+/-5.05%; H9c2, 42.81+/-5.11%; 10 microM PJ34, 52.07+/-5.80%; 100 microM PJ34, 54.95+/-5.55%), while necrosis was inhibited (I-R model, 43.64+/-4.00%; H9c2, 37.29+/-4.55%; 10 microM PJ34, 30.18+/-4.60%; 100 microM PJ34, 25.52+/-3.47%). In subsequent experiments, PARP inhibition decreased LDH-release of the observed combined cell population and enhanced the metabolic activity. Thus, our results suggest that pretreating the therapeutically added cells with a PARP inhibitor could be beneficial in the setting of cell-based therapies

Transit Straddling System Straddling Bus

This paper illustrates the use of advanced Transit Elevated Travelling System used by most of the developed countries. It has a microcontroller which performs the controlling of the system and its peripherals. In this paper we will discuss about the driverless fully automated travelling system having ARM microcontroller. Proteus simulator is used for the actual simulation of the system. Hardware is mounted on the printed circuit board(PCB). All the sensors and actuators are mounted on the PCB. The overall setup is mounted on a prototype of The Transit Elevated Travelling System. Microcontroller coding is done using C language

Atmospheric pressure continuous flow methane oxidation to methanol and acetic acid using H2O2 over Au-Fe catalyst

An enormous value proposition exists when molecules like acetic acid and methanol are derived from natural gas. With abundant worldwide resources, methane to methanol (M2M) by partial oxidation or acetic acid through C-insertion is considered one of the catalysis\u27s most enterprising chemical transformations. In this work, significant catalytic challenges successfully tackled are the continuous partial oxidation of methane to methanol and acetic acid at atmospheric pressure. In continuous flow and at atmospheric pressure, a modified silica-supported bimetallic (AuFeHS) catalyzed methane to methanol using H2O2 with an impressive yield of 224 mmol/gFe+Au. Co-feeding CO in the stream produces acetic acid, demonstrating a selectivity switch from methanol with an overall yield of 92 mmol/gFe+Au

Potentially inappropriate medications, their adverse events, and impact on geriatric vulnerabilities, frailty, and survival in older Indian patients with cancer: A retrospective observational study

Background: Older adults often have chronic diseases for which they receive multiple drugs, which may be potentially inappropriate. Objectives: We aimed to describe the potentially inappropriate medications (PIMs) leading to adverse drug events (ADEs) in older patients with cancer. Our secondary objectives were to evaluate the association of nutrition, cognition, and frailty with PIM-related ADEs and to assess the impact of PIM-related ADEs on overall survival (OS). We also investigated the cut-off for defining polypharmacy as related to ADEs. Materials and Methods: This was a retrospective observational study on patients with cancer aged 60 years and over who were assessed in the geriatric oncology clinic at the Tata Memorial Hospital (Mumbai, India) from June 2018 to August 2022. Medications, PIM assessment, nutrition (assessed by Mini Nutritional Assessment [MNA]), cognition (assessed by Mini Mental State Examination [MMSE] and Hindi Mental State Examination), and frailty (assessed by the Clinical Frailty Scale [CFS]) were extracted from the geriatric oncology clinic database. PIMs were identified using the Beers criteria, European Union-7 (EU[7])-PIM, Screening Tool of Older person's Prescriptions/Screening tool to Alert to Right Treatment (STOPP/START), Fit fOR The Aged (FORTA), and PRISCUS list. Results: In total, 1472 patients were assessed in the geriatric oncology clinic, of which 823 (55.9%) were enrolled in the study. There were 1287 PIMs detected in 823 patients, of which 431 (33.5%) led to ADEs and 856 (66.5%) did not. Proton pump inhibitors and tramadol were the most common PIMs identified. ADEs were noted in 54 (14.7%) patients on proton pump inhibitors and in 145 (61.1%) patients on tramadol. ADEs were significantly associated with malnutrition, lower cognition, and frailty. The median MNA score in patients without and with ADEs was 20.5 (interquartile range [IQR], 17.5-24.0) and 19.5 (IQR, 15.5–23.5), respectively; P, 0.001. The median MMSE score for the patients without and with ADEs was 28 (IQR, 26-29) and 27 (IQR: 25-29), respectively; P, 0.001. The median CFS scores for the patients without and with ADEs were 3 (IQR, 2-4) and 4 (IQR, 3-5), respectively; P < 0.001. The median OS in patients without and with ADEs was 13.1 months (95% confidence interval [CI], 10.64-17.87) and 10.2 months (95% CI, 8.80-12.85), respectively; P, 0.002. The optimal cut-off for polypharmacy leading to ADEs was 4.5 medications. Conclusions: There is a dire need to recognize and appropriately manage PIMs in older patients with cancer as PIM-related toxicities may negatively impact survival. Monitoring PIMs and following the recommendations to optimize the dose, avoid the drug, and find alternatives may improve the oncologic outcomes. Future studies should focus on adding a control group of patients not on PIMs, following up on PIM after recommendations, and investigating the impact of these recommendations on oncologic outcomes (Clinical Trials Registry-India: CTRI/2020/04/024675)