Evaluation of bacteriological contamination pattern of open fractures of extremities in tertiary care hospital

Background: Open fractures and associated complications like infection are fairly common in developing countries due to rising incidence of high velocity trauma. Primary goal of study is to evaluate the pattern of bacteriological contamination of open fractures of extremities in tertiary care hospital.Methods: A total of 316 patients of all the age group, both the sexes with open fractures of extremities presented within 6 hours were taken in to study. 1st swab taken at the time of primary wound examination followed by 2nd culture swab on just after debridement followed by 3rd culture swab on the day of 1st aseptic dressing followed by 4th culture swab if infection continues or asepsis score is more than 20 till the duration of 4 days. Culture and sensitivity reports were collected for studying pattern of bacterial isolates and their sensitivity.Results: Infection developed in 22.5% of the patients with open fractures of extremities in whom most of bacterial infections were caused by gram-negative organisms (80.3%). Cultures on admission were positive in 41 patients, out of which 11 patients had developed infection in the final cultures but with different flora. While cultures taken at 1st aseptic dressing were found to be positive in 51 cases, out of which 31 had developed infection with prognostic value of 57%.Conclusions: We concluded that cultures obtained at 1st aseptic dressing are far more predictive than pre and post-debridement cultures in management of patients with open fractures of extremities and are important in formulating an antibiotic policy

A comparative study between dynamic hip screw and intramedullary nail fixation in trochanteric fractures

Background: The trochanteric fractures are one of the commonest fractures in elderly population. Incidence of these fractures is increasing due to better life expectancy, growing number of population, industrialization and the road traffic accidents. Variety of implants are available but still there is no consensus for single implant.Methods: A prospective randomized control study was conducted on total 60 patients of intertrochanteric fractures which were randomized into 2 groups of 30 each, treated with dynamic hip screw (DHS) and proximal femoral nail (PFN). All the patients were followed up for a maximum of 6 months. Outcomes were reviewed and compared such as mode of injury, complications, functional and radiological outcomes.Results: There was no significant difference between two groups of patients as regards to mean age and sex. The mode of injury by slip and fall was main cause. The most common type of fracture as per AO-orthopaedic trauma association (OTA) classification was 31-A2 (65%) and 31-A3 (5%) being the least common type. Mean surgical time of DHS group and PFN group was 125.17 minutes and 89.93 minutes respectively. Mean blood loss in DHS group and PFN group was 251.67 ml and 158.67 ml respectively. Mean radiological union time of fracture in DHS group and PFN group was 12.3 and 9.5weeks respectively. Mean Harris hip score at six month in DHS group and PFN group was 80.77 and 85.47 respectively.Conclusions: We conclude that though both the implants can achieve comparable union rates but PFN are better than DHS as of better Harris hip score, shorter surgical time and less intra operative blood loss

Dapsone induced photosensitivity in Indian women: a rare case

Dapsone, a potent antileprotic anti-inflammatory drug is used in treatment and prophylaxis of many dermatological and non dermatological conditions. Cutaneous adverse reactions to dapsone are uncommon ranging from mild maculopapular rash to fatal toxic epidermal necrolysis. We report here a case of 40-year-old, housewife treated for leprosy with paucibacillary multi drug therapy who presented with red itchy skin lesions over exposed areas of skin which worsened on exposure to sunlight. The patient was diagnosed as a case of dapsone-induced photosensitive dermatitis which was confirmed by improvement of symptoms on withdrawal of dapsone and recurrence of similar lesions on rechallenge with dapsone in reduced dose. Photosensitivity as adverse drug reaction to dapsone is rare and very few reports are available in the literature.

Role of mitochondria in progression of cancer: a semi-quantitative study

Mitochondria have been an area of scientific study for more than 100 years. It was in early 20th century that Otto Warburg first described differences in the mitochondria of tumors v/s normal cells. It was observed that tumor cells have increased rate of aerobic glycolysis compared with normal cells. The study was carried out in patients diagnosed as premalignant and malignant conditions which had three objectives that is to demonstrate the presence or absence of mitochondria in cytological smears, in order to perform a semi-quantitative analysis on the number of mitochondria and to identify the difference in distribution mitochondria if any. The study was carried out in the Department of Oral and Maxillofacial Pathology of S.P.D.C., Sawangi, Wardha with consent from patients and approval from the institutional ethical committee. 20 patients each diagnosed clinically and histo-pathologically with OSCC and Premalignant conditions or lesions respectively were selected for the purpose of the study. 20 subjects who had come for routine endodontic treatment were taken as control group for the purpose of the study. It was observed that there was even distribution of mitochondria throughout the cytoplasm in smear that had been taken from normal mucosa which appeared sharply defined whereas in premalignant mitochondria were located in the perinuclear zone and 10% in the peripheral zone and in malignant conditions distribution was sparse in the perinuclear area and appeared ill-defined

Dynamic Phenotypic Switching and Group Behavior Help Non-Small Cell Lung Cancer Cells Evade Chemotherapy

Drug resistance, a major challenge in cancer therapy, is typically attributed to mutations and genetic heterogeneity. Emerging evidence suggests that dynamic cellular interactions and group behavior also contribute to drug resistance. However, the underlying mechanisms remain poorly understood. Here, we present a new mathematical approach with game theoretical underpinnings that we developed to model real-time growth data of non-small cell lung cancer (NSCLC) cells and discern patterns in response to treatment with cisplatin. We show that the cisplatin-sensitive and cisplatin-tolerant NSCLC cells, when co-cultured in the absence or presence of the drug, display dynamic group behavior strategies. Tolerant cells exhibit a \u27persister-like\u27 behavior and are attenuated by sensitive cells; they also appear to \u27educate\u27 sensitive cells to evade chemotherapy. Further, tolerant cells can switch phenotypes to become sensitive, especially at low cisplatin concentrations. Finally, switching treatment from continuous to an intermittent regimen can attenuate the emergence of tolerant cells, suggesting that intermittent chemotherapy may improve outcomes in lung cancer

Optimasi Portofolio Resiko Menggunakan Model Markowitz MVO Dikaitkan dengan Keterbatasan Manusia dalam Memprediksi Masa Depan dalam Perspektif Al-Qur`an

Risk portfolio on modern finance has become increasingly technical, requiring the use of sophisticated mathematical tools in both research and practice. Since companies cannot insure themselves completely against risk, as human incompetence in predicting the future precisely that written in Al-Quran surah Luqman verse 34, they have to manage it to yield an optimal portfolio. The objective here is to minimize the variance among all portfolios, or alternatively, to maximize expected return among all portfolios that has at least a certain expected return. Furthermore, this study focuses on optimizing risk portfolio so called Markowitz MVO (Mean-Variance Optimization). Some theoretical frameworks for analysis are arithmetic mean, geometric mean, variance, covariance, linear programming, and quadratic programming. Moreover, finding a minimum variance portfolio produces a convex quadratic programming, that is minimizing the objective function ðð¥with constraintsð ð 𥠥 ðandð´ð¥ = ð. The outcome of this research is the solution of optimal risk portofolio in some investments that could be finished smoothly using MATLAB R2007b software together with its graphic analysis

Combined searches for the production of supersymmetric top quark partners in proton-proton collisions at root s=13 TeV

A combination of searches for top squark pair production using proton-proton collision data at a center-of-mass energy of 13 TeV at the CERN LHC, corresponding to an integrated luminosity of 137 fb(-1) collected by the CMS experiment, is presented. Signatures with at least 2 jets and large missing transverse momentum are categorized into events with 0, 1, or 2 leptons. New results for regions of parameter space where the kinematical properties of top squark pair production and top quark pair production are very similar are presented. Depending on themodel, the combined result excludes a top squarkmass up to 1325 GeV for amassless neutralino, and a neutralinomass up to 700 GeV for a top squarkmass of 1150 GeV. Top squarks with masses from 145 to 295 GeV, for neutralino masses from 0 to 100 GeV, with a mass difference between the top squark and the neutralino in a window of 30 GeV around the mass of the top quark, are excluded for the first time with CMS data. The results of theses searches are also interpreted in an alternative signal model of dark matter production via a spin-0 mediator in association with a top quark pair. Upper limits are set on the cross section for mediator particle masses of up to 420 GeV

Search for new particles in events with energetic jets and large missing transverse momentum in proton-proton collisions at root s=13 TeV

A search is presented for new particles produced at the LHC in proton-proton collisions at root s = 13 TeV, using events with energetic jets and large missing transverse momentum. The analysis is based on a data sample corresponding to an integrated luminosity of 101 fb(-1), collected in 2017-2018 with the CMS detector. Machine learning techniques are used to define separate categories for events with narrow jets from initial-state radiation and events with large-radius jets consistent with a hadronic decay of a W or Z boson. A statistical combination is made with an earlier search based on a data sample of 36 fb(-1), collected in 2016. No significant excess of events is observed with respect to the standard model background expectation determined from control samples in data. The results are interpreted in terms of limits on the branching fraction of an invisible decay of the Higgs boson, as well as constraints on simplified models of dark matter, on first-generation scalar leptoquarks decaying to quarks and neutrinos, and on models with large extra dimensions. Several of the new limits, specifically for spin-1 dark matter mediators, pseudoscalar mediators, colored mediators, and leptoquarks, are the most restrictive to date.Peer reviewe

Measurement of prompt open-charm production cross sections in proton-proton collisions at root s=13 TeV

The production cross sections for prompt open-charm mesons in proton-proton collisions at a center-of-mass energy of 13TeV are reported. The measurement is performed using a data sample collected by the CMS experiment corresponding to an integrated luminosity of 29 nb(-1). The differential production cross sections of the D*(+/-), D-+/-, and D-0 ((D) over bar (0)) mesons are presented in ranges of transverse momentum and pseudorapidity 4 < p(T) < 100 GeV and vertical bar eta vertical bar < 2.1, respectively. The results are compared to several theoretical calculations and to previous measurements.Peer reviewe

Probing effective field theory operators in the associated production of top quarks with a Z boson in multilepton final states at root s=13 TeV

Peer reviewe