A rare case of ribbing disease of the proximal tibia

Ribbing disease is a rare disease that causes bony growths to develop in long bones mostly the lower limbs. It often develops after puberty. The disease also goes by other names like multiple diaphyseal sclerosis. The disorder is caused by discrepancy in the osteoclast regulation process. Here in we report a 28 years old male presenting with a case of ribbing disease of right proximal tibia. A 28 years old male gives history of fall when he was 6 years old i. e., 22 years back. Now patient complaints of pain in right proximal tibia since last 6 months. Pain is of mild nature. It is most likely a case of ribbing disease based on the clinical, radiological findings. Ribbing disease is a disease of exclusion, needs high degree of suspicion for its diagnosis. However, patient should be advised for regular follow ups

A rare case of ulnar nerve calcification in a patient without Hansen’s disease

Ulnar nerve calcification is rarely seen without association with Hansen’s disease. Ulnar nerve arises from brachial plexus within the axilla and is a major peripheral nerve of the upper limb. Its root value is C8-T1. It is one of the superficial nerves and is the most commonly affected nerve in leprosy. Our patient 52 years old female, came to Dr. D. Y. Patil hospital, Nerul casualty with a history of fall in bathroom and complaining of pain in right elbow with no neurological deficit. The radiological investigations confirmed a severely comminuted intra-articular humeral condylar fracture of the right side with a linear calcification seen in soft tissues near the ulnar nerve. It is an idiopathic ulnar nerve calcification of the right side. Hence, ulnar nerve calcification can also be seen in patients without Hansen’s disease

Prospective study of radiological and functional outcomes of humeral mid-shaft fractures by anterior bridge plating technique

Background: The humerus can be considered the most versatile bone in the human body. Can be successfully approached by a variety of methods for fracture fixation including functional bracing, plating (posterior, lateral, and anterior), and intramedullary nailing (antegrade and retrograde). Notably, many humeral fractures can be successfully managed conservatively due to the wide range of acceptability for reduction. Anterior bridge plating (ABP) which utilizes the minimally invasive approach popularly known as the minimally invasive percutaneous plate osteosynthesis (MIPPO) technique can be said to be the latest entrant in this list. The present study was undertaken to evaluate the efficacy of ABP. Methods: The study was carried out from July 2020 to July 2022 in DR. D. Y. Patil medical college and hospital, Nerul, Navi Mumbai, involving 32 patients who met the selection criteria and were operated at the tertiary care centre. Informed consent was obtained from all the patients for use of their clinical and imaging data. Ethical committee approval was taken. The assessment of the patients was done based on functional and radiological outcomes periodically. Results: Majority of patients belongs to age group 18-25 years (46.87%). Majority of side of injury were found right side (65.62%). In most of the cases, the extent of the displacement of fractures were 2-5 cm (71.87). Conclusions: In conclusion ABP is a very good technique in treating mid-shaft humeral fractures with minimal soft tissue dissection, smaller scars, and early return to overhead activities

Price and margin negotiations in marketing channels: The influence of strategic information transmission.

Marketing channel members, i.e., manufacturers and distributors, commonly negotiate key terms of exchange such as prices and margins. These negotiations can have a significant impact on a channel member's profit stream over the duration of the business relationship. Despite the importance of these negotiations, channel negotiations have received relatively little attention. Previous research has focused on Nash's cooperative bargaining model although recent advances in noncooperative game theory offer new opportunities for modeling and testing negotiation behavior. Rubinstein (1982) extended Nash's (1953) noncooperative model to a sequential strategic approach where bargaining occurs in discrete time and negotiators make offers and counteroffers with time preferences denoted by discount factors or fixed costs. We adapt and extend a sequential strategic model (Grossman and Perry 1986) to describe bargaining behavior and outcomes in the context of marketing channels. The model involves a manufacturer and a distributor negotiating to establish the transfer price for a good in a one-sided incomplete information situation. The focus is on the forces that drive the two parties to bargain and reach an agreement on a specific price within a finite number of iterations. The baseline model examines how different levels of manufacturer uncertainty about distributor value (resale price to consumers) and opportunity cost of delay (denoted by a discount factor) influence the bargaining process and outcomes. The conceptual framework then empirically examines how incorporation of trust between parties, as well as opportunities for explicit communication, moderate bargaining behavior and outcomes. The predictions from the conceptual framework are tested in three laboratory experiments conducted in a channel negotiation scenario adapted from a popular pricing case study. In general, changes in the level of manufacturer uncertainty and opportunity cost of delay influenced the bargaining process and outcomes as predicted by the model. A reduction in manufacturer uncertainty reduced bargaining duration, increased manufacturer profits, and improved bargaining efficiency while an increase in opportunity cost of delay lowered bargaining duration but did not improve bargaining efficiency. Bargaining efficiency improved as the potential gains from trade increased. Variations in trust and the opportunity to communicate also had a significant impact on the bargaining outcomes