Degenerative tendoachilles tear repaired and augumented by peroneous brevis tendon by dynamic loop technique one year follow up

Background: Repair of degenerative rupture of tendoachilles is a challenge for orthopaedician. We used peroneus brevis tendon in our patients to augment the repair of degenerated tendoachilles tears by creating a dynamic loop.Methods: In our study, we evaluated 31 patients with Achilles tendon rupture treated by reconstruction using peroneus brevis tendon transfer by dynamic loop suture technique. The patients were from all age groups excluding those lesser than 35 years. The average follow-up being 6 months.Results: In total 31 patient’s majority of patients belong to 41-50 years (15 cases 48.4%). Male patients being 24 (77.4%) constituted the majority, right sided injury was noted in 23 (74.2%) of the patients. Most common symptom of Achilles tendon rupture is pain. The mechanism of injury in most of the patients by stumbling in the fields in 19 (61.3%). Results of testing the patient’s ability to heel raise for 60 seconds 20 patients were able to sustain, while 8 patients were able to stand on toe with heel raised but could not sustain it. 3 patients could not do raise the heel. 5 patients complained of sensory hypoesthesia at 12 months follow-up. By Rupp scoring, 77% patients had excellent or good results and 10% had fair or poor results.Conclusions: Results of reconstruction of Achilles tendon ruptures using peroneus brevis tendon show a strong and stable repair that allows early weightbearing ambulation with favourable clinical results in most patients

Surgical management of idiopathic congenital talipes equinovarus by Carroll twin incision

Background: Surgery for congenital idiopathic clubfoot has a number of complications in the postoperative period such as delayed wound healing, gaping, infection, and recurrence of the deformity. The aim of this study is to evaluate the results of primary correction of clubfoot by modified Carroll’s double incision technique.Methods: It is a prospective interventional for a period of 2 years 5 months. 56 foot of which 21 pts have bilateral deformity and 14 pts with unilateral deformity. Patients of 3 months to 2 years age with idiopathic clubfoot, who did not respond to initial Ponseti casting; and were planned for Carroll double incision technique of surgery were included in this study.Results: In total 56 foot of which male are 23 and female children are 12 in number with male: female ratio of 1.9:1, showing male predominance, 21 pts have bilateral deformity and 14 pts with unilateral deformities. The mean change in radiographic parameters achieved by correction is as postoperative mean talocalcaneal index achieved was 42.60 (Normal range >40°). The postoperative mean anteroposterior talo-calcaneal angle was 26.20 (Normal range 300 to 550). The Postoperative mean lateral talo-calcaneal angle was 24.40 (normal 200 to 400). Final outcome is 81% is good, 14 fair and 5% has poor outcome.Conclusion: Exposure and release by Carroll’s twin incision is good, no tension in sutures, especially medical incision at the time of wound closure

Surgical management of giant cell tumor in adolescent by excision or curettage followed by fibular strut graft

Giant cell tumour (GCT) in adolescent is a rare tumour. It commonly occurs in skeletally mature patients aged between 20-40 years. In adults it is seen in epiphyseal region. In patients with intact physis, it arises from the metaphysis. Giant cells are more common in females. It is more common in the ends of long bones of distal end of femur, proximal tibia, and distal radius. 14 cases of surgical management of GCT by excision or curettage in adolescent followed by fibular strut graft. 1 year follow up of all cases of GCT in adolescent treated with excision or curettage followed by fibular strut graft was done. Out of 14 patients, 12 patients did not develop any recurrence of GCT. 2 patient developed recurrence after 6 months. All the patients were able to attain good range of movements 2 months after surgery. GCT in adolescent surgically treated with excision or curettage followed by fibular graft had excellent results in terms of recovery of daily activities, wound healing. Chances of recurrence more in patients treated with curettage and bone grafting.

A study on functional outcome of posterior cruciate ligament substituted total knee arthroplasty

Background: Total knee replacement surgery is considered as a treatment of choice in patients with advanced arthritis, especially in patients where conservative treatment has been failed. Total knee replacement gives good pain relief, functional improvement of knee and correction of deformity.Methods: This is study of 39 patients following total knee arthroplasty, who were operated between August 2017 and March 2020 at MNR Medical College and Hospital, Sangareddy. They were followed up for a minimum period of 1 year and evaluated using oxford knee scoring system. Oxford knee score is designed specifically for measuring outcomes in knee arthroplasty. There were 14 right knees, 10 left knees, 15 bilateral knees.Results: There was a significant functional improvement of knee in patients and we had achieved excellent results, out of 39 patients and 4 patients had post op suprapatellar fullness, which was relieved with medications for 3 weeks and 2 patients (2 knees) without no signs of immediate post-operative period, developed infection after 6 months followed which underwent staged revision total knee replacement. The outcome categories based on oxford knee scoring system: excellent (40-48), good (30-39), fair (20-29) and poor (0-19).Conclusions: It is difficult to balance the knee with retention of posterior cruciate ligament, whereas posterior cruciate ligament substituting total knee replacement gives reproducible and good results, hence it is the preferred mode of management

Surgical management of middle and distal third fractures of scaphoid fixed with Herbert screw by volar approach

Surgical treatment of scaphoid fractures has evolved over the years to include variety of procedures and techniques. However scaphoid middle and distal third fractures fixation with Herbert screw by means of volar approach is a safe and effective method with good functional outcome and union rates. Our study concluded that management of middle and distal third scaphoid fractures with Herbert screw by volar approach gives excellent results in terms of union and recovery to daily activities. The wrist function improvement is more satisfactory, and the incidence of complications is low with this modality of treatment

An optimal power flow solution to deregulated electricity power market using meta-heuristic algorithms considering load congestion environment

In this article, the Improved Mayfly Algorithm (IMA) is used as an upgraded form of the Mayfly Algorithm (MA), featuring simulated binary crossover and polynomial mutation operators replacing the arithmetic crossover and standard distribution mutation operators of the MA. With MA, IMA's achievements and significance are acknowledged. The algorithms achieve a final best solution for the investigated objective functions of the optimal power flow problem in a deregulated electrical power market under different load conditions. The overall load of the power system varies between half of the base load (-50%) and twice the base load (+100%). The investigated objective functions are associated with the financial worth of generators, dissipation of active power in transmission lines, variation of voltage magnitudes at the system bus, and voltage stability index at the load bus of the power system networks. The result achieved by GA, PSO, MA and IMA are attained using the IEEE-30 bus test system in a deregulated power system. Investigations are conducted on the best solutions for each objective function; offers of generators and bids of loads; generator sales and load purchases; and system revenues associated with different load scenarios. The simulated outcomes have confirmed that IMA would triumph over GA, PSO and MA

Assessment of ferritin and its association with C - reactive protein and malondialdehyde in acute myocardial infarction

Background: There is increasing evidence that moderately elevated body iron stores, below levels commonly found in genetic hemochromatosis, may be associated with adverse health outcomes. Ferritin status has been implicated in atherosclerotic cardiovascular disease and hypothesis is that high iron status is associated with increased oxidation of LDL. The main objective of study is to evaluate the ferritin status and its association with C - reactive protein, malondialdehyde and serum lipids in acute myocardial infarction patients compared with healthy volunteers.Methods: Sixty seven acute myocardial infarction (AMI) patients in the age group of 30 to 50 years were selected for this study and 40 healthy age matched subjects were selected as control group. Diagnosis of AMI was made using guidelines of American College of Cardiology and European Society of Cardiology. The comprised group of 67 consecutive patients was divided based on the C - reactive protein (CRP) level into two groups (Group I <5 mg/L and Group II ≥5mg/L). Serum ferritin was assessed by ELISA method, C-reactive protein by turbilatex method and malondialdehyde (MDA) by Thiobarbituric Acid Reactive Substances (TBARS) method. Routine investigations were analysed by ERBA EM-360 fully automated analyzer.Results: The mean serum ferritin level was significantly increased in AMI patient groups compared with controls. The group II patients showed significantly increased serum ferritin levels compared to group I. In both the groups ferritin levels positively correlated with CRP and malondialdehyde. In group II serum ferritin levels showed positive correlation with serum Cholesterol, TGL, LDL and negative correlation with and HDL.  In group I serum ferritin levels showed positive correlation with triglycerides and LDL and there was no statistical significant correlation with HDL and total cholesterol.Conclusions: Iron, an essential dietary constituent is now considered as a pro oxidant. Higher levels of ferritin, seems to be a strong risk factor for AMI. Regular monitoring of serum ferritin level can be useful in reducing cardiovascular morbidity and mortality.

Alteration characteristics of illmenites from south India

Two different placer samples from the Navaladi and Surungudi area of Teri, Tamilnadu. in southern India. were collected and characterized in terms of their heavy mineral content. Mineralogical analysis on both the samples revealed the presence of high amounts of garnet and ilmenite. The alteration characteristics of ilmenite from these deposits were investigated by optical and electron probe microanalysis. Optical microscopic studies revealed that the alteration of ilmenite was seen to proceed along grain boundaries and/or fractures resulting in an amorphous to crypto- or microcrystalline mass resembling leucoxene. The alteration is in the nascent stage. Mineral chemistry by electron probe micro-analysis revealed the enrichment of Ti02, MgO, A1203•Cr203. Si02, V205 and Na20 in the altered products and loss of iron oxide and manganese oxide from the ilmenite grains during weathering leading to the formation of leucoxene. Similarly EPMA studies on garnet indicated that it is of the almandine variety. This study reveals that the alteration of ilmenite by weathering leads to unstable phases, with complex elemental distribution patterns. The physico-chemical characteristics of the mineral and, in turn, the down-stream metallurgical processing are affected by such alteration processes

Interactive Effects of Morphine on HIV Infection: Role in HIV-Associated Neurocognitive Disorder

HIV epidemic continues to be a severe public health problem and concern within USA and across the globe with about 33 million people infected with HIV. The frequency of drug abuse among HIV infected patients is rapidly increasing and is another major issue since injection drug users are at a greater risk of developing HIV associated neurocognitive dysfunctions compared to non-drug users infected with HIV. Brain is a major target for many of the recreational drugs and HIV. Evidences suggest that opiate drug abuse is a risk factor in HIV infection, neural dysfunction and progression to AIDS. The information available on the role of morphine as a cofactor in the neuropathogenesis of HIV is scanty. This review summarizes the results that help in understanding the role of morphine use in HIV infection and neural dysfunction. Studies show that morphine enhances HIV-1 infection by suppressing IL-8, downregulating chemokines with reciprocal upregulation of HIV coreceptors. Morphine also activates MAPK signaling and downregulates cAMP response element-binding protein (CREB). Better understanding on the role of morphine in HIV infection and mechanisms through which morphine mediates its effects may help in devising novel therapeutic strategies against HIV-1 infection in opiate using HIV-infected population

A new cache of Eoarchaean detrital zircons from the Singhbhum craton, eastern India and constraints on early Earth geodynamics

The dominant geodynamic processes that underpin the formation and evolution of Earth's early crust remain enigmatic calling for new information from less studied ancient cratonic nuclei. Here, we present U–Pb ages and Hf isotopic compositions of detrital zircon grains from ∼2.9 Ga old quartzites and magmatic zircon from a 3.505 Ga old dacite from the Iron Ore Group of the Singhbhum craton, eastern India. The detrital zircon grains range in age between 3.95 Ga and 2.91 Ga. Together with the recently reported Hadean, Eoarchean xenocrystic (up to 4.24 Ga) and modern detritus zircon grains from the Singhbhum craton, our results suggest that the Eoarchean detrital zircons represent crust generated by recycling of Hadean felsic crust formed at ∼4.3–4.2 Ga and ∼3.95 Ga. We observe a prominent shift in Hf isotope compositions at ∼3.6–3.5 Ga towards super-chondritic values, which signify an increased role for depleted mantle and the relevance of plate tectonics. The Paleo-, Mesoarchean zircon Hf isotopic record in the craton indicates crust generation involving the role of both depleted and enriched mantle sources. We infer a short-lived suprasubduction setting around ∼3.6–3.5 Ga followed by mantle plume activity during the Paleo-, Mesoarchean crust formation in the Singhbhum craton. The Singhbhum craton provides an additional repository for Earth's oldest materials.Financial support from the Ministry of Earth Sciences, New Delhi for Excimer 193 nm LA system at CSIR-NGRI MoES/P.O.(Seismo)/1(245)/2014 and for the project on Singhbhum craton to S. D., E. V. S. S. K. B., B. S. and T. V. K (No. MoES/ P.O.(Geosci)45/2015; GAP-738-28EVB). This work forms part of the CSIR-NGRI projects INDEX (PSC0204) and GEOMET. Support from Australian Scientific Instruments and Geoscience Australia in providing access to the SHRIMP IIe, and The ANU for SEM imaging, is acknowledged. Y. J. B. thanks the DAE-Raja Ramanna Fellowship