Functional outcome of middle third humeral shaft fractures treated with anteromedial plate osteosynthesis through an anterolateral approach

Background: The main aim of treatment of the humeral shaft fractures is to establish union with an acceptable humeral alignment and to restore the patient to pre-injury level of function. Plate osteosynthesis remains the standard of surgical treatment displaced middle third humeral fractures. The most commonly used approaches for treating these fractures are posterior and anterolateral, but these approaches can have iatrogenic radial nerve injury. Our aim is to study the incidence of radial nerve palsy and functional outcome of anterolateral approach with anteromedial plating.Methods: A total of 26 patients in the age group of 21 to 62 years were included in this prospective study, who were treated by anteromedial plating through anterolateral approach for humerus shaft. Functional assessment was done using Rodriguez-Merchan criteria.Results: 26 patients with shaft humerus fracture were included in the study with 19 (73%) patients were less than 40 years age. Most common type of fracture pattern is A3 type and the mean duration of surgical time was 60±10 min for anteromedial plating. The time taken for the fracture union was less than 4 months in the most patients (88%). There was no evidence of iatrogenic radial nerve injury. Functional assessment done using Rodriguez-Merchan criteria showed 84.6% of the patients had good to excellent functional outcome.Conclusions: For treatment of displaced middle third humeral fractures open reduction with anteromedial plating through anterolateral approach is surgically safer and gives better functional outcome.

Vitreoretinal biomarkers of retinopathy of prematurity using handheld optical coherence tomography: a review

Retinopathy of prematurity (ROP) is caused by abnormal retinal vascularization in premature infants that has the potential for severe long-term vision impairment. Recent advancements in handheld optical coherence tomography (OCT) have enabled noninvasive, high-resolution, cross-sectional imaging of the infant eye at the bedside. The use of handheld OCT devices in the diagnosis of ROP in premature infants has furthered our understanding of disease state and progression. This review discusses the known and novel biomarkers of ROP severity in premature infants identified through handheld OCT and potential for future directions

Rare presentation of accessory tubercles on permanent maxillary second molar

Tooth malformations may be related to heredity or injury during formation. Such morphological abnormalities may be found in the crown either in the form of anomalous cusps or in an increased number of roots, which in some cases are associated with an anomalous cusp. Cone-like enlargements on the buccal cusp of maxillary molar is one such anomaly. This case presents the anatomical and morphological characteristics of a rare case of three lobulated tubercles on the buccal surface of permanent maxillary right second molar tooth

Treatment of petrochemical wastewater by rotating biological contactor

A laboratory scale study has been conducted to assess the efficiency of rotating biological contactor (RBC) to treat the synthetic wastewater from a petrochemical industry producing acrylonitrile. The attached biomass was acclimatised by gradually increasing cyanide concentration from 5 to 40 mg 1(-1) with simultaneous increase in the concentration of chemical oxygen demand(COD)and ammonium nitrogen(NH4->-N). During acclimatization COD removal varied between 80-88 percent(%)while cyanide removal was more than 99%. The RBC was operated at varying hydraulic loading rates from 0.011 to 0.027 m(3) m(-2) d(-1). The performance of the RBC was monitored for various parameters like COD, 5-day biochemical oxygen demand at 20-degree centigrade (degrees C) [BOD5], cyanide, ammonium nitrogen etc., for all hydraulic loadings. At all hydraulic loadings the cyanide removal remained more than 99%. The removals obtained in terms of percentage, for cyanide, COD, BOD5, and NH4->-N were greater than (>) 99, 95.2, 99.1 and 77, respectively at hydraulic loading of 0.011 m(3) m(-2) d(-1). The effect of substrate/ cyanide ratio on the performance of the process at five different ratios, 100/1, 80/1, 60/1, 40/1 and 20/1, showed more than 99% cyanide removal at ratio 20/1. The effect of COD/nitrogen (N) ratio was studied at four different ratios, 12/1, 10/1, 8/1 and 6/1, showed cyanide removal remained unaffected. The variation of biomass concentration within the system was also studied

BIODEGRADATION OF WASTEWATER CONTAINING CYANIDE, ACETONITRILE, AND ACRYLONITRILE USING RBC AND SHOCK LOADING STUDY

A laboratory scale rotating biological contactor (RBC) was used to study the biodegradation of synthetic wastewater similar to the one from the petrochemical industry producing acrylonitrile (ACR). The study was carried out at hydraulic retention time (HRT) of 30 h for simultaneous removal of cyanide (CN), acetonitrile (ACN), and ACR in petrochemical wastewater stream. The attached biomass was acclimatised by gradually increasing CN, ACN, and ACR concentration from 5 to 40, 41 to 113, and 45 to 142 mg L(-1), respectively, with simultaneous increase in the concentration of chemical oxygen demand (COD) and ammonium nitrogen at HRT of 30 h. During acclimatisation the percent removal of COD, CN, ACN, and ACR were 90-95, > 99, 80-94, and 80-88, respectively. The performance of RBC was monitored for various parameters like COD, 5-day biochemical oxygen demand at 20 degrees C (BOD(5)), CN, ACN, ACR, ammonium nitrogen, etc. The removals obtained in terms of percentage, for CN, ACN, ACR, and COD were 97, 81, 89, and 95, respectively, at HRT 30 h. The quantitative shocks consisting of increase in influent substrate concentration with subsequent increase in concentration of other parameters proportionally were studied. The variation of biomass concentration within the system was also studied

Model for oxygen transfer in rotating biological contactor

Rotating biological contactor is being widely used for wastewater treatment but there is an apparent lack of knowledge about the rate at which oxygen transfer occurs, in physical and biological system. In this study the transfer of oxygen from air to water by a rotating disc air–liquid contactor in physical system is investigated. The oxygen transfer model suggested by Kim and Molof, Water Sci. Technol. 14 (1982) 569, was modified and the developed model is termed as modified Kim and Molof model. The model was calibrated by using available data in literature and validated by experiments conducted in this study. The effect of significant physical parameters was integrated into a single term and is termed as volume renewal number. The modified Kim and Molof model was compared with the other available models. The coefficient of determination (R2) for the modified Kim and Molof model obtained is 0.95 which is much higher than in the other available models. Thereby the model is expected to estimate oxygen transfer more accurately. Further, a simplified linear model between KLa and the volume renewal number is proposed. Both modified Kim and Molof and linear model estimate the overall oxygen transfer coefficient (KLa) accurately.© Elsevie

A Rare Case of Adolescent Girl with Beard-PCOS with a Difference: “HAIR-AN Syndrome”

“Hyperandrogenism” is one of the commonest reasons for consultation in the adolescent age group. The most common reason being polycystic ovarian syndrome (PCOS) caused due to the changing lifestyle and adopting to a more sedentary type of living. PCOS is an endocrine disorder becoming increasingly common in adolescent, with an incidence of 6–18% in the female population. HAIR-AN syndrome being a specific subtype of PCOS consists of hyperandrogenism (HA), insulin resistance (IR) and acanthosis nigricans (AN) with adipose tissue dysfunction as the initial pathophysiological stimulant. We report a 16-year-old developmentally normal adolescent girl with excessive facial hair growth, an irregular menstrual cycle, and hyperpigmentation who attained menarche at the age of 12. On clinical examination, she had features suggestive of HA and IR. Biochemical investigations showed highly elevated serum insulin with elevated testosterone and normal blood glucose.A multidisciplinary approach with lifestyle modifications combined with hormonal medications like oral contraceptive pills with metformin and spironolactone were required to control the disease and prevent the systemic manifestation and decrease the degree of virilization. As HAIR-AN syndrome is a disorder characterized by high IR, pediatricians, adolescent specialists, and obstetricians should be familiar with this condition in order to assess and manage it efficiently

Migratory abscess of the middle ear resulting from an odontogenic infection: an unusual case report

Abstract Infections of odontogenic origin are the commonly encountered diseases in their routine practice by head and neck specialists. Their spread to adjacent fascial spaces may follow as sequelae of untreated odontogenic infections, along a predictable route. Unusually, these infections may follow an uncommon path for the spread and may appear at a distant site in contrast to the site of infection, resulting in the formation of a ‘migratory abscess’. This case report is entitled to present an unusual and rare case of migratory abscess of the right middle ear in a 20-year old male patient, occurring as sequelae of an odontogenic infection in the right lower second molar and to explain a possible route of transmission of infection in this challenging case presentation