Pseudoaneurysm of profunda femoris artery: a rare complication after intramedullary fixation for an intertrochanteric femur fracture

Intertrochanteric fracture fixation with a trochanteric femoral nail rarely leads to any vascular or neurological complications. The aim of this case report is to identify a patient with post-operative Pseudoaneurysm of profunda femoris artery and how to manage it. We report a case of 79-year-old male who developed a Pseudoaneurysm of the profunda femoris artery 3 days after intramedullary femoral nailing for a intertrochanteric femur fracture. Percutaneous embolization was performed with subsequent resolution of the symptoms. Diagnosis of vascular complications after hip surgery may be very challenging because symptoms are often nonspecific. Despite their rarity, it is important to know this type of complications to address the diagnostic pathway in the right direction and to treat them promptly

Assessment of radiological evidence of collapse of distal end radius fracture after treating with cast, percutaneous k-wire fixation and external fixator

Background: Distal end radius fractures are the most common fractures seen among all orthopaedic injuries, accounts for nearly 20% of all fractures coming to the emergency department.There are various treatment modalities for distal end radius fracture which includes closed reduction and casting, closed reduction with external fixation and closed reduction with internal fixation.Methods: This retrospective study was done on patients who underwent distal end radius fracture surgery in the Department of Orthopaedics at MGM Hospital Kamothe in the last 2 years from May 2015 to May 2017. Total of 108 patients were included in the study, out of which 62 were males and 46 were females undergoing distal end radius fracture surgery. The mean age was 34.5 (28-75 years age group). All patients were assessed with wrist radiograph to see the collapse post-operatively and after 4-6 weeks.Results: The mean age was 34.5 (28-75 years age group). Out of 108, three females treated with cast lost for follow up. Out of all three modalities we took under study, we found that the average radial height in cast was 15 mm, in k wire was 10.5 mm while in external fixator was 12.5 mm. The average articular step in cast was 1.3 mm, in k wire was 2.1 mm while in external fixator was 1.8 mm. Fracture collapse was seen as 23.3% in cast, 21.4% in k-wire and 13.8% by external fixator.Conclusions: Distal end radius fractures are most common fractures seen daily in both OPD and emergency. A basic idea about this fracture should be known general physicians also such as splinting as they also encountered with them routinely. External fixator is quite effective method of treatment for these fractures. In our study we have discussed closed reduction and fixation techniques and found better results with external fixator using principle of ligamentotaxis

Comparison of the outcomes of pull through suturing vs. tension band wiring fixation techniques in the management of patellar fractures

Background: Operative fixation of displaced patella fractures has now become the standard of care. This study aims to asses functional outcomes, as well as identify complications in a patients treated with non-absorbable braided suture fixation for patellar fractures. These patients were then compared to a group of patients treated with K-wires with tension band wiring.Methods: This study was conducted on the patients admitted to orthopaedic ward at MGM medical college and hospital, Kamothe, Navi Mumbai. Total number of patients was taken for this study. Patients were followed up for a period of 6 weeks, 3 months, 6 months and at each visit. Patients were assessed by Lysholm knee score.Results: The mean age was 43.33 years for TB wiring group and 46.26 years for pull through suturing group. Out of 30, 15 were in TB wiring group in which 14 males and 1 female and, 15 in pull through suturing group 4 females and 11 males. The mean Lysholm knee score at 6 weeks for TB wiring group was 68.2 at 3 months was 81.4 at 6 months was 87. The mean Lysholm knee score for 6 weeks for pull through suturing was 69.2, at 3 months was 72.5 and at 6 months was 79.2.Conclusions: Patella fracture most common fractures, in this study we have discussed two modalities of treatment one is TB wiring and second is pull through suturing showing results that TB wiring have better results

A case of mucoid hypertrophic degeneration of anterior cruciate ligament with ganglion cyst causing extension block treated with arthroscopic debridement of the cyst and partial debulking surgery

Mucoid degeneration of anterior cruciate ligament (ACL) is an uncommon cause of knee pain and restriction of movements. It uncommonly presents with a coexisting ACL ganglion cyst. Typically present between ages of 40-60 years, however, the true incidence and symptoms are variable. We present our experience with one such case with loss of knee extension treated with arthroscopic debulking. The patient regained both full range of motion and resolution of symptoms after the treatment

Lipid-Based Nano-Formulation Development to Enhance Oral Bioavailability of Weakly Aqueous-Soluble Drug for Obesity and Hypertension

The most practical method of drug delivery is oral administration because it has a high rate of patient compliance. However, there are significant obstacles to effective oral medication delivery, including low drug enzymatic/metabolic stability and poor water solubility. Especially in the development of drug formulations for the treatment of obesity and hypertension. This research article aims to formulate solid lipid nanoparticles (SLN) of Fucoxanthin and Ramipril by the emulsification and ultrasonication methods. The nanoparticles size, polydispersity index, and the zeta potential, among other parameters, were computed. In addition, FT-IR analysis of compatibility tests between the SLNs and the loaded drug and in vitro drug release experiments were carried out. Lipid-based nano preparations have drawn plenty of interest as efficient vehicles to increase the oral bioavailability of these kinds of medications. We observed that lipid nanoparticles, have enhanced the oral bioavailability of poorly water-soluble drugs used for obesity and hypertension. Provided the above information, formulated SLNs should be further investigated using cutting-edge scientific methodologies to improve its bioavailability

The Association of Social Distancing, Population Density, and Temperature with the SARS-CoV-2 Instantaneous Reproduction Number in Counties Across the United States

AbstractImportanceThe Covid-19 pandemic has been marked by considerable heterogeneity in outbreaks across the United States. Local factors that may be associated with variation in SARS-CoV-2 transmission have not been well studied.ObjectiveTo examine the association of county-level factors with variation in the SARS-CoV-2 reproduction number over time.DesignObservational studySetting211 counties in 46 states and the District of Columbia between February 25, 2020 and April 23, 2020.ParticipantsResidents within the counties (55% of the US population)ExposuresSocial distancing as measured by percent change in visits to non-essential businesses, population density, lagged daily wet bulb temperatures.Main Outcomes and MeasuresThe instantaneous reproduction number (Rt) which is the estimated number of cases generated by one case at a given time during the pandemic.ResultsMedian case incidence was 1185 cases and fatality rate was 43.7 deaths per 100,000 people for the top decile of 21 counties, nearly ten times the incidence and fatality rate in the lowest density quartile. Average Rt in the first two weeks was 5.7 (SD 2.5) in the top decile, compared to 3.1 (SD 1.2) in the lowest quartile. In multivariable analysis, a 50% decrease in visits to non-essential businesses was associated with a 57% decrease in Rt (95% confidence interval, 56% to 58%). Cumulative temperature effects over 4 to 10 days prior to case incidence were nonlinear; relative Rt decreased as temperatures warmed above 32°F to 53°F, which was the point of minimum Rt, then increased between 53°F and 66°F, at which point Rt began to decrease. At 55°F, and with a 70% reduction in visits to non-essential business, 96% of counties were estimated to fall below a threshold Rt of 1.0, including 86% of counties among the top density decile and 98% of counties in the lowest density quartile.Conclusions and RelevanceSocial distancing, lower population density, and temperate weather change were associated with a decreased SARS-Co-V-2 Rt in counties across the United States. These relationships can inform selective public policy planning in communities during the SARS-CoV-2 pandemic.Key PointsQuestionHow is the instantaneous reproduction number (Rt) of SARS-CoV-2 influenced by local area effects of social distancing, wet bulb temperature, and population density in counties across the United States?FindingsSocial distancing, temperate weather, and lower population density were associated with a decrease in Rt. Of these county-specific factors, social distancing appeared to be the most significant in reducing SARS-CoV-2 transmission.MeaningRt varies significantly across counties. The relationship between Rt and county-specific factors can inform policies to reduce SARS-CoV-2 transmission in selective and heterogeneous communities.</jats:sec

Development of A Method To Quantify The DNA Content in Cationic Peptide-DNA Nanoparticles

Gene therapy has the potential to provide safe and targeted therapies for a variety of diseases. A range of intracellular gene delivery vehicles have been proposed for this purpose. Non-viral vectors are a particularly attractive option and among them cationic peptides have emerged as promising candidates. For the pharmaceutical formulation and application to clinical studies it is necessary to quantify the amount of pDNA condensed with the delivery system. There is a severe deficiency in this area, thus far no methods have been reported specifically for pDNA condensed with cationic peptide to form nanoparticles. The current study seeks to address this and describes the evaluation of a range of disruption agents to extract DNA from nanoparticles formed by condensation with cationic fusogenic peptides RALA and KALA. Only proteinase K exhibited efficient and reproducible results and compatibility with the PicoGreen reagent based quantification assay. Thus we report for the first time a simple and reliable method that can quantify the pDNA content in pDNA cationic peptide nanoparticles

Association of Social Distancing, Population Density, and Temperature With the Instantaneous Reproduction Number of SARS-CoV-2 in Counties Across the United States.

Importance: Local variation in the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) across the United States has not been well studied. Objective: To examine the association of county-level factors with variation in the SARS-CoV-2 reproduction number over time. Design, Setting, and Participants: This cohort study included 211 counties, representing state capitals and cities with at least 100 000 residents and including 178 892 208 US residents, in 46 states and the District of Columbia between February 25, 2020, and April 23, 2020. Exposures: Social distancing, measured by percentage change in visits to nonessential businesses; population density; and daily wet-bulb temperatures. Main Outcomes and Measures: Instantaneous reproduction number (Rt), or cases generated by each incident case at a given time, estimated from daily case incidence data. Results: The 211 counties contained 178 892 208 of 326 289 971 US residents (54.8%). Median (interquartile range) population density was 1022.7 (471.2-1846.0) people per square mile. The mean (SD) peak reduction in visits to nonessential business between April 6 and April 19, as the country was sheltering in place, was 68.7% (7.9%). Median (interquartile range) daily wet-bulb temperatures were 7.5 (3.8-12.8) °C. Median (interquartile range) case incidence and fatality rates per 100 000 people were approximately 10 times higher for the top decile of densely populated counties (1185.2 [313.2-1891.2] cases; 43.7 [10.4-106.7] deaths) than for counties in the lowest density quartile (121.4 [87.8-175.4] cases; 4.2 [1.9-8.0] deaths). Mean (SD) Rt in the first 2 weeks was 5.7 (2.5) in the top decile compared with 3.1 (1.2) in the lowest quartile. In multivariable analysis, a 50% decrease in visits to nonessential businesses was associated with a 45% decrease in Rt (95% CI, 43%-49%). From a relative Rt at 0 °C of 2.13 (95% CI, 1.89-2.40), relative Rt decreased to a minimum as temperatures warmed to 11 °C, increased between 11 and 20 °C (1.61; 95% CI, 1.42-1.84) and then declined again at temperatures greater than 20 °C. With a 70% reduction in visits to nonessential business, 202 counties (95.7%) were estimated to fall below a threshold Rt of 1.0, including 17 of 21 counties (81.0%) in the top density decile and 52 of 53 counties (98.1%) in the lowest density quartile.2. Conclusions and Relevance: In this cohort study, social distancing, lower population density, and temperate weather were associated with a decreased Rt for SARS-CoV-2 in counties across the United States. These associations could inform selective public policy planning in communities during the coronavirus disease 2019 pandemic

Abraham model correlations for solute partitioning into o-xylene, m-xylene and p-xylene from both water and the gas phase

Article on Abraham model correlations for solute partitioning into o-xylene, m-xylene and p-xylene from both water and the gas phase

Breast cancer management pathways during the COVID-19 pandemic: outcomes from the UK ‘Alert Level 4’ phase of the B-MaP-C study

Abstract: Background: The B-MaP-C study aimed to determine alterations to breast cancer (BC) management during the peak transmission period of the UK COVID-19 pandemic and the potential impact of these treatment decisions. Methods: This was a national cohort study of patients with early BC undergoing multidisciplinary team (MDT)-guided treatment recommendations during the pandemic, designated ‘standard’ or ‘COVID-altered’, in the preoperative, operative and post-operative setting. Findings: Of 3776 patients (from 64 UK units) in the study, 2246 (59%) had ‘COVID-altered’ management. ‘Bridging’ endocrine therapy was used (n = 951) where theatre capacity was reduced. There was increasing access to COVID-19 low-risk theatres during the study period (59%). In line with national guidance, immediate breast reconstruction was avoided (n = 299). Where adjuvant chemotherapy was omitted (n = 81), the median benefit was only 3% (IQR 2–9%) using ‘NHS Predict’. There was the rapid adoption of new evidence-based hypofractionated radiotherapy (n = 781, from 46 units). Only 14 patients (1%) tested positive for SARS-CoV-2 during their treatment journey. Conclusions: The majority of ‘COVID-altered’ management decisions were largely in line with pre-COVID evidence-based guidelines, implying that breast cancer survival outcomes are unlikely to be negatively impacted by the pandemic. However, in this study, the potential impact of delays to BC presentation or diagnosis remains unknown