Comparative analysis of outcome of displaced middle third clavicle fractures in patients treated with plate osteosynthesis and intramedullary nailing

INTRODUCTION: The clavicle is the most commonly fractured bone, which accounts for 5–10% of all fractures.More than half of these fractures are displaced. Traditionally clavicle fractures are treated non operatively. But recent studies show higher rates of non union upto 15% and unsatisfactory functional outcomes despite fracture union with conservative management. Operative management of these fractures had better outcomes and a lower rate of non union and symptomatic mal union when compared with non operative treatment. Commonly either plating or nailing is done for middle third clavicle fractures. It is imperative to know the complications and outcomes with both these procedures. AIM: The aim of our study is comparative analysis of outcome of displaced middle third clavicle fractures in patients treated with plate osteosynthesis and intramedullary nailing. MATERIALS AND METHODS: This is a prospective study undertaken in the department of orthopaedics, Coimbatore medical college hospital, Coimbatore from May 2011 to October 2013.Within the period of study,20 patients with displaced middle third clavicle fractures were operated alternatively with plating nailing(titanium elastic nail).We had 11 patients who were operated with plating (6-RECONSTRUCTION plate and 5- PRECONTOURED CLAVICLE PLATE) and 9 patients who were operated with nailing(titanium elastic nail).Outcome measures like Blood loss, operative time, wound size, union rate and union time and complications like infection, Non union, implant irritation and shortening were compared between the two groups. Functional outcome was based on Quick DASH score. RESULTS: The mean blood loss in plating group was 97.27 ml and nailing group was 62.22 ml(p<0.05).The mean operative time in plating was 77.27 and in nailing was 61.67(p=0.005).Mean wound size in plating was 7.22 cms and nailing was 4.55 cms (p<0.05).We had 100% union rate in both the groups. The mean time for clinical and radiological union in plating group was 7.9 weeks and 14 weeks whereas in nailing group it was 7.55 weeks and 13 weeks(p=0.40 and p=0.070).We had excellent outcomes in 7 patients (63.63%),good outcome in 3 patients (27.27%) and poor outcome in 1 patient (9.09%) in the plating group whereas in the nailing group we had 6 patients (66.66%) with excellent,3 patients (33.33%) with good outcome. No poor outcome in nailing group. We had superficial infection in 2 patients (18.18%) in plating group and 1 patient (11.11%) in nailing group. Implant irritation occurred in 2 patients (18.18%) in plating and 1 patient (11.11%) in nailing groups. Shortening was 4.5 mm in plating and 4.8 mm in nailing group. CONCLUSION: We conclude that though nailing has advantage over plating during surgery and postoperative period, on long term follow up there is no significant functional difference between plating and nailing for displaced middle third clavicle fractures

Serum S100B is increased during early treatment with antipsychotics and in deficit schizophrenia

Previous studies reported controversial results concerning alterations of astrocytes in schizophrenia. Because S100B may be regarded as a marker for astrocytes, the objective of this study was to examine S100B serum concentrations in 30 patients with schizophrenia with a monoclonal two-site immunoluminometric assay that specifically detects S100B. An ANOVA revealed medication (p0.05). Patients with deficit (250.6±154.9 ng/l) had higher S100B levels than patients with nondeficit schizophrenia (146.7±107.2 ng/l, p<0.05) or controls (p<0.005). S100B was positively correlated with the subscore ‘thought disturbance’ of the Brief Psychiatric Rating Scale (p<0.05). In summary, increased serum levels of S100B may indicate alterations of astrocytes during early treatment with antipsychotics and in deficit schizophrenia. Whether S100B is elevated due to injured astrocytes and a disrupted blood–brain barrier, or by active secretion of S100B by astrocytes, has to be clarified by further studies

A rare case of supraspinatus tendon rupture

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RetroSpective cohort stUdy of PD-L1 expression in REcurrent and/or MEtastatic squamous cell carcinoma of the head and neck (SUPREME-HN)

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Serum hCG Levels following the Ovulatory Injection: Associations with Patient Weight and Implantation Time

Objective. To test if serum hCG levels the morning after the ovulatory hCG injection correlate with (1) retrieval efficiency, (2) oocyte maturity, (3) embryo quality, (4) pregnancy, and/or (5) time to implantation in patients undergoing in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI). Design. Retrospective cohort analysis. Setting. University-based IVF clinic. Patient(s). All IVF/ICSI cycles from April 2005 to February 2008 whose hCG administration was confirmed ( = 472 patients). Intervention(s). Serum hCG was measured the morning following the ovulatory injection, on the 16th day following retrieval, and repeated on day 18 for those with positive results. Main Outcome Measure(s). Number of follicles on the day of hCG injection, number of oocytes retrieved, maturity of oocytes, embryo quality, pregnancy outcome, and time to implantation. Result(s). hCG levels did not correlate with retrieval efficiency, oocyte maturity, embryo quality, or pregnancy. Postinjection hCG levels were inversely associated with patient weight and time to implantation. Conclusion (s). No correlation was found between hCG level and any parameter of embryo quality. Patient weight affected hCG levels following hCG injection and during the early period of pregnancy following implantation. No association between postinjection hCG level and time of implantation (adjusted for patient weight) was apparent

Serum hCG Levels following the Ovulatory Injection: Associations with Patient Weight and Implantation Time

Objective. To test if serum hCG levels the morning after the ovulatory hCG injection correlate with (1) retrieval efficiency, (2) oocyte maturity, (3) embryo quality, (4) pregnancy, and/or (5) time to implantation in patients undergoing in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI). Design. Retrospective cohort analysis. Setting. University-based IVF clinic. Patient(s). All IVF/ICSI cycles from April 2005 to February 2008 whose hCG administration was confirmed (n=472 patients). Intervention(s). Serum hCG was measured the morning following the ovulatory injection, on the 16th day following retrieval, and repeated on day 18 for those with positive results. Main Outcome Measure(s). Number of follicles on the day of hCG injection, number of oocytes retrieved, maturity of oocytes, embryo quality, pregnancy outcome, and time to implantation. Result(s). hCG levels did not correlate with retrieval efficiency, oocyte maturity, embryo quality, or pregnancy. Postinjection hCG levels were inversely associated with patient weight and time to implantation. Conclusion(s). No correlation was found between hCG level and any parameter of embryo quality. Patient weight affected hCG levels following hCG injection and during the early period of pregnancy following implantation. No association between postinjection hCG level and time of implantation (adjusted for patient weight) was apparent

A doubly stochastic rainfall model with exponentially decaying pulses

We develop a doubly stochastic point process model with exponentially decaying pulses to describe the statistical properties of the rainfall intensity process. Mathematical formulation of the point process model is described along with second-order moment characteristics of the rainfall depth and aggregated processes. The derived second-order properties of the accumulated rainfall at different aggregation levels are used in model assessment. A data analysis using 15 years of sub-hourly rainfall data from England is presented. Models with fixed and variable pulse lifetime are explored. The performance of the model is compared with that of a doubly stochastic rectangular pulse model. The proposed model fits most of the empirical rainfall properties well at sub-hourly, hourly and daily aggregation levels

Physiological and cell ultrastructure disturbances in wheat seedlings generated by Chenopodium murale hairy root exudate.

Chenopodium murale L. is an invasive weed species significantly interfering with wheat crop. However, the complete nature of its allelopathic influence on crops is not yet fully understood. In the present study, the focus is made on establishing the relation between plant morphophysiological changes and oxidative stress, induced by allelopathic extract. Phytotoxic medium of C. murale hairy root clone R5 reduced the germination rate (24% less than control value) of wheat cv. Nataša seeds, as well as seedling growth, diminishing shoot and root length significantly, decreased total chlorophyll content, and induced abnormal root gravitropism. The R5 treatment caused cellular structural abnormalities, reflecting on the root and leaf cell shape and organization. These abnormalities mostly included the increased number of mitochondria and reorganization of the vacuolar compartment, changes in nucleus shape, and chloroplast organization and distribution. The most significant structural changes were observed in cell wall in the form of amoeboid protrusions and folds leading to its irregular shape. These structural alterations were accompanied by an oxidative stress in tissues of treated wheat seedlings, reflected as increased level of H2O2 and other ROS molecules, an increase of radical scavenging capacity and total phenolic content. Accordingly, the retardation of wheat seedling growth by C. murale allelochemicals may represent a consequence of complex activity involving both cell structure alteration and physiological processes.This is a post-peer-review, pre-copyedit version of an article published in Protoplasma. The final authenticated version is available online at: [http://dx.doi.org/10.1007/s00709-018-1250-0