Functional outcome of complex acetabular fractures by combined anterior and posterior approach in a single sitting: a case report

Complex acetabular fractures described by Judet and Letournel present with a formidable diagnostic and therapeutic challenge. Simultaneous anterior and posterior exposures of the acetabulum are a safe and are useful alternative to other extensile exposures and can be performed with similar morbidity. The advantages of simultaneous anterior and posterior approaches over extensile exposures include less morbidity, less hospital stay, early mobilisation and avoidance of soft tissue contracture. The combined approach is most useful in transverse, transverse posterior wall fractures with wide anterior displacement, T type fractures with significant anterior-inferior displacement, or both column fractures with posterior wall involvement. 23-year-old male came with chief complaints of pain and swelling at right hip since 3 days. He had history of fall from train and then referred to us for further management. clinical and radiological assessment was done. Approachment of the case was done with combined anterior and posterior incision in single sitting. It provided excellent clinical and radiological outcome. Complex acetabular fracture is a challenging entity. Association of these fractures with complex anatomy, delicate soft tissue handling and extensive blood loss makes it more difficult to manage. Combined anterior and posterior approaches of aceatabulum in a single sitting can be used as safe alternative to step wise extensible approaches used routinely. Outcomes associated with single sitting are good as its associated with lesser morbidity of patient, early functional mobility and less hospital stay. Though it’s not devoid of its own complications decision must be taken depending upon the condition of the patient and surgeon’s choice

Proximate Analysis of Biomass

One of the sustainable and renewable energy sources that doesn't produce a lot of greenhouse gas emissions is biomass. Using biomass energy effectively will aid in addressing issues brought on by the use of fossil fuels. The biomass has only issue of low calorific value. For biomass as a fuel the calorific value plays a very crucial role. Five diverse biomass species, such as dried Sugarcane Bagasse, Rice Husk, Cotton Waste, Mango leaves and Coal are represented in this context. Agricultural leftovers, coal, and sugarcane bagasse have all been identified through proximate analysis. In this we calculated (moisture, volatile matter, fixed carbon, and ash contents). Next, a number of empirical equations with linear and nonlinear terms are used. This paper also tells about the thermogravimetric analysis method

Tumor like swellings arising from Hoffa's fat pad: A report of three patients

We report three rare cases of tumor-like conditions arising from Hoffa's fat pad (HFP). Patients were having persistent knee pain, the cause of which was not diagnosed by the general physician, and then were referred to us for knee pain. Magnetic resonance imaging revealed the lesions to be arising from HFP (ganglion cysts and hemangioma), as was suggested by clinical findings. Anatomy, pathology, and radiological features of the Hoffa's disease are described here to increase awareness in orthopedic community of this rare but interesting disease which is often misdiagnosed as meniscal pathology. These cases illustrate that increased cognizance can facilitate timely intervention which will prevent morbidity of the patient

Anti-hyperglycemic and anti-hyperlipidaemic effect of Arjunarishta in high-fat fed animals

Background: Arjunarishta (AA), a formulation used as cardiotonic is a hydroalcoholic formulation of Terminalia arjuna (Roxb.) Wight and Arn. (TA) belonging to family Combretaceae. Objective: To evaluate the anti-hyperglycemic and anti-hyperlipidemic effect of Arjunarishta on high-fat diet fed animals. Materials and methods: High-fat diet fed (HFD) Wistar rats were randomly divided into three groups and treated with phytochemically standardized Arjunarishta (1.8 ml/kg), and hydroalcoholic extract of T. arjuna (TAHA) (250 mg/kg) and rosuvastatin (10 mg/kg), for 3 months. Intraperitoneal glucose tolerance test, blood biochemistry, liver triglyceride and systolic blood pressure were performed in all the groups. Effect of these drugs on the expression of tumor necrosis factor-α (TNF-α) and insulin receptor substrate-1 (IRS-1) and peroxisome proliferators activated receptor γ coactivator 1-α (PGC-1α) were studied in liver tissue using Quantitative Real-time PCR. Results: HFD increased fasting blood glucose, liver triglyceride, systolic blood pressure and gene expression of TNF-α, IRS-1 and PGC-1α. Treatment of AA and TAHA significantly reduced fasting blood glucose, systolic blood pressure, total cholesterol and triglyceride levels. These treatments significantly decreased gene expression of TNF-α (2.4, 2.2 and 2.6 fold change); increased IRS-1 (2.8, 2.9 and 2.8 fold change) and PGC-1α (2.9, 3.7 and 3.3 fold change) as compared to untreated HFD. Conclusion: Anti-hyperglycemic, anti-hyperlipidemic effect of Arjunarishta may be mediated by decreased TNF-α and increased PGC-1α and IRS-1. Keywords: Rosuvastatin, Type 2 diabetes, Insulin sensitizer genes, Arjunarisht

Flood Forecasting in Large River Basins Using FOSS Tool and HPC

The Indian subcontinent is annually affected by floods that cause profound irreversible damage to crops and livelihoods. With increased incidences of floods and their related catastrophes, the design, development, and deployment of an Early Warning System for Flood Prediction (EWS-FP) for the river basins of India is needed, along with timely dissemination of flood-related information for mitigation of disaster impacts. Accurately drafted and disseminated early warnings/advisories may significantly reduce economic losses incurred due to floods. This study describes the design and development of an EWS-FP using advanced computational tools/methods, viz. HPC, remote sensing, GIS technologies, and open-source tools for the Mahanadi River Basin of India. The flood prediction is based on a robust 2D hydrodynamic model, which solves shallow water equations using the finite volume method. The model is open-source, supports geographic file formats, and is capable of simulating rainfall run-off, river routing, and tidal forcing, simultaneously. The model was tested for a part of the Mahanadi River Basin (Mahanadi Delta, 9225 sq km) with actual and predicted discharge, rainfall, and tide data. The simulated flood inundation spread and stage were compared with SAR data and CWC Observed Gauge data, respectively. The system shows good accuracy and better lead time suitable for flood forecasting in near-real-time

Abstract 056: Patterns of Care in the Management of Intracranial Atherosclerosis‐related Large Vessel Occlusion–the RESCUE‐LVO survey

Introduction Intracranial atherosclerosis‐related large vessel occlusion (ICAS‐LVO) is a common cause of failed mechanical thrombectomy (MT) in acute ischemic stroke (AIS) [1]. Treatment of ICAS‐LVO with rescue stenting and/or angioplasty has shown promising outcomes, but diagnosing ICAS‐LVO during MT can be challenging [2, 3]. There are uncertainties regarding optimal approaches, techniques, and timing for treating ICAS‐LVO. To understand current practice patterns and address these uncertainties, we conducted a survey among neurointerventional practitioners experienced in ICAS‐LVO management during MT. Methods We conducted an international online survey of neurointerventionalist members of the Society of Neurointerventional Surgery (SNIS) and the Society of Vascular and Interventional Neurology (SVIN). The 28‐question poll evaluated the preferences on diagnosis, treatment, and endovascular approach to ICAS‐LVO. Results 168 individual survey responses were obtained from practicing neurointerventional physicians. Overall, 40.6% reported an incidence of 6–10% of ICAS‐LVO during MT. Most neurointerventionalists (91%) diagnose ICAS‐LVO after a continued or recurrent occlusion or by the presence of fixed focal stenosis (FFS) after multiple MT attempts. Most respondents (86%) preferred acute treatment of ICAS‐LVO with rescue stenting (RS) +/‐ angioplasty. However, in patients who achieved recanalization with a severe FFS, the majority (44%) recommended maximal medical management only. The preferred medication during acute RS was intravenous antiplatelet therapy (69%), and after acute RS was dual oral antiplatelet therapy (58%). Fear of hemorrhagic complications (70%) was the most compelling reason not to perform RS +/‐ angioplasty. Twenty‐five percent of respondents were hesitant to randomize patients to acute RS versus medical therapy in a future randomized trial because of the lack of sensitive and specific biomarkers to diagnose ICAS‐LVO before MT treatment. Conclusion Our survey highlights the significant variability and uncertainty in the diagnosis and management of ICAS‐LVO during MT among neurointerventional practitioners. There is no equipoise regarding the optimal treatment strategy, and the fear of hemorrhagic complications associated with antithrombotic medications contributes to the variation in practice. Our survey underscores the need for future research and randomized clinical trials to address the uncertainties in the management of ICAS‐LVO during MT. Improved imaging biomarkers and consensus guidelines are essential to guide clinical decision‐making and optimize patient outcomes in this challenging population of AIS patients

Ablation of cyclase-associated protein 2 (CAP2) leads to cardiomyopathy

Cyclase-associated proteins are highly con- served proteins that have a role in the regulation of actin dynamics. Higher eukaryotes have two isoforms, CAP1 and CAP2. To study the in vivo function of CAP2, we generated mice in which the CAP2 gene was inactivated by a gene-trap approach. Mutant mice showed a decrease in body weight and had a decreased survival rate. Further, they developed a severe cardiac defect marked by dilated cardiomyopathy (DCM) associated with drastic reduction in basal heart rate and prolongations in atrial and ventricular conduction times. Moreover, CAP2-deficient myofibrils exhibited reduced cooperativity of calcium- regulated force development. At the microscopic level, we observed disarrayed sarcomeres with development of fibrosis. We analyzed CAP2’s role in actin assembly and found that it sequesters G-actin and efficiently fragments filaments. This activity resides completely in its WASP homology domain. Thus CAP2 is an essential component of the myocardial sarcomere and is essential for physio- logical functioning of the cardiac system, and a deficiency leads to DCM and various cardiac defects