Outcome Analysis of Neglected Musculoskeletal Injuries

INTRODUCTION: Musculoskeletal injuries, as a non-communicable disease has become a major epidemic. Neglect of such injuries has become a major burden in our society due to the preference for native treatment. Especially in injuries involving the joints, this neglect has lead to severe disability and is affecting the productivity of our population. AIMS AND OBJECTIVES: To analyse the outcome of neglected periarticular injuries and to calculate the sample proportion of these injuries. MATERIALS AND METHODS: Out of 615 patients admitted in Rajiv Gandhi Government General Hospital in the age group of 14-60 years with injuries involving the major joints, 160 were neglected cases, 11 cases in shoulder, 13 cases in elbow, 7 cases in wrist, 96 cases in hip, 17 cases in knee, 13 cases in ankle were studied. Pre op X rays were taken, CT scan in selected cases were taken. The cases were evaluated for pre-procedure Visual Analogue Scale, Functional capacity. Patient tailored procedure was done based on findings during pre-interventional and interventional period. All patients were followed up for maximum 1 year. Protocol based physical therapy was done. Functional evaluation scoring was done exclusive for each joint. RESULTS: Sample proportion of neglected cases in our study was 26%. In 80% of the cases the neglect was due to native treatment. In rural areas 18% of the cases in our study presented untreated due to poor accessibility. The Sample proportion for neglected upper extremity cases was 19% and the sample proportion for neglected lower extremity cases was 28%. The sample proportion of shoulder, elbow, wrist, hip, knee and ankle cases were, 15%, 25%, 16%, 36%, 17%, and 16% respectively. The average outcomes were good in shoulder, elbow, hip, and knee cases and Excellent in wrist and ankle cases. CONCLUSION: The complications and outcome in all the cases depended on many factors as even in some cases with longer neglect duration excellent outcome was possible but in some cases with shorter neglect duration also fair outcome was only possible. Hence the commonly found factors that can influence the outcome of the neglected musculoskeletal injuries in pre intervention stage were: Age of patient, Type of native treatment availed, Duration of native treatment methods, Quality of native treatment methods, Associated co morbidities, Associated fractures. The factors which influence the outcome in intervention and post intervention stage were: Intraoperative findings of soft tissue distortion and loss of anatomical configuration; Type of procedure selected; Aseptic precautions taken; Patients’ will for functional betterment; Expertise of the surgeons; Regularity in visiting the hospital for physiotherapy. In our study all the patients had a common will for betterment and they cooperated in all the steps and thereby had a successful outcome at the end of follow up. Hence patients’ cooperation and perseverance is the foremost quality that defined success for them

Composition of primary cosmic rays near the knee

The size dependence of high energy muons and the size spectrum obtained in the air shower experiment suggest that the mean mass of cosmic rays remains nearly constant at approx 15 up to 5 x 1000,000 GeV and becomes one beyond. The composition model in which nuclei are removed spectrum steepens at 6.7 x 10 power GeV due to leakage from the galaxy, which explains the data which are consistent with data from other experiments

Probiotic activity of Pseudomonas aeruginosa (PIC-4) isolated from Visakhapatnam coast, Bay of Bengal, India, against Vibrio harveyi in Penaeus monodon

Pseudomonas aeruginosa (PIC 4), isolated from coastal waters of Visakhapatnam (Gen Bank Accession no: KF803248) was tested for its antagonistic activity against Vibrio harveyi as probiotic in cultured Penaeus monodon. Pseudomonas aeruginosa PIC 4 has proved to be non-pathogenic to the shrimp by pathogenicity tests. Vibrio counts in probiotic fed shrimp and the surrounding water medium were significantly lower when compared to the control group of shrimp and water during 50 days of culture. Mean weight of probiont fed shrimps after 50 days of culture was (2.21 + 0.15 g) , significantly higher than that of normal diet fed ones (1.33+0.18 g). Survival percent was also significantly higher in probiont fed shrimp (47.33% + 5.55%) than that of the control diet fed shrimp (26.33% + 7%). Percent survival in probiotic fed and normal diet fed shrimp after the challenge with V. harveyi was 93.04 and 38.87 respectively

Scrambling and quantum chaos indicators from long-time properties of operator distributions

Scrambling is a key concept in the analysis of nonequilibrium properties of quantum many-body systems. Most studies focus on its characterization via out-of-time-ordered correlation functions (OTOCs), particularly through the early-time decay of the OTOC. However, scrambling is a complex process which involves operator spreading and operator entanglement, and a full characterization requires one to access more refined information on the operator dynamics at several timescales. In this work we analyze operator scrambling by expanding the target operator in a complete basis and studying the structure of the expansion coefficients treated as a coarse-grained probability distribution in the space of operators. We study different features of this distribution, such as its mean, variance, and participation ratio, for the Ising model with longitudinal and transverse fields, kicked collective spin models, and random circuit models. We show that the long-time properties of the operator distribution display common features across these cases, and discuss how these properties can be used as a proxy for the onset of quantum chaos. Finally, we discuss the connection with OTOCs and analyze the cost of probing the operator distribution experimentally using these correlation functions.Comment: Main text: 14 pages, 7 figures. Appendices: 3 pages, 3 figure

Loose shell syndrome (LSS) of cultured Penaeus monodon - microbiological and histopathological investigations

Investigations were undertaken on loose shell syndrome (LSS) of cultured Penaeus monodon during the period 2009 - 2010. The infected shrimps were collected from culture ponds of east and west Godavari districts in Andhra Pradesh, India and were subjected to microbiological and histopathological studies. Four species of Vibrio were isolated from the diseased shrimps and were identified as V. harveyi, V. alginolyticus, V. metschnikovii and V. fluvialis based on morphological characteristics and biochemical tests. Histopathological studies revealed the presence of occlusion and inclusion bodies of monodon baculovirus (MBV), hepatopancreatic parvo-like virus (HPV), and white spot syndrome virus (WSSV) in hepatopancreatic and gill tissues. All the LSS affected shrimps collected during the present study were found infected with V. harveyi and concurrent infections of other Vibrio species were observed in 40% of the samples. Prevalence of infection with WSSV, MBV and HPV was less compared to Vibrio infections. Granuloma formation was observed in the affected tissues due to bacterial invasions. Multiple viral infections in association with Vibrio sp. were also observed in 2% of LSS affected shrimp

The composition of cosmic rays near the Bend (10 to the 15th power eV) from a study of muons in air showers at sea level

The distribution of muons near shower cores was studied at sea level at Fermilab using the E594 neutrino detector to sample the muon with E testing 3 GeV. These data are compared with detailed Monte Carlo simulations to derive conclusions about the composition of cosmic rays near the bend in the all particle spectrum. Monte Carlo simulations generating extensive air showers (EAS) with primary energy in excess of 50 TeV are described. Each shower record contains details of the electron lateral distribution and the muon and hadron lateral distributions as a function of energy, at the observation level of 100g/cm. The number of detected electrons and muons in each case was determined by a Poisson fluctuation of the number incident. The resultant predicted distribution of muons, electrons, the rate events are compared to those observed. Preliminary results on the rate favor a heavy primary dominated cosmic ray spectrum in energy range 50 to 1000 TeV

Family practices' achievement of diabetes quality of care targets and risk of screen-detected diabetic retinopathy

Background: We aimed to determine whether family practices' achievement of diabetes quality of care targets is associated with diabetic retinal disease in registered patients. Methods: Data for achievement of diabetes quality of care targets, including the proportion of patients with HbA1c≤7.5%, for 144 family practices in London UK, for the years 2004/5 to 2007/8, were linked to data from a population-based diabetes eye screening programme collected from September 2007 to February 2009. Analyses were adjusted for age, sex, duration and type of diabetes, unadjusted diabetes prevalence, ethnicity and deprivation category. Results: Data were analysed for 24,458 participants with one or more eye screening results in the period. There were 9,332 (38%) with any diabetic retinopathy and 2,819 (11.5%) with sight threatening diabetic retinopathy (STDR), including 2,654 (10.9%) with maculopathy. Among participants registered at 13 family practices that were in the highest quartile for achievement of the HbA1c quality of care target for all four years of study, the relative odds of any diabetic retinopathy were 0.78 (0.69 to 0.88) P<0.001. For participants at 12 practices consistently in the lowest quartile of HbA1c achievement, the relative odds of any diabetic retinopathy were 1.16 (1.03 to 1.30), P = 0.015. In the highest achieving practices, the relative odds of maculopathy were 0.74 (0.62 to 0.89), P = 0.001 and STDR 0.77 (0.65 to 0.92), P = 0.004. Conclusions: The risk of diabetic retinopathy might be lower at family practices that consistently achieve highly on diabetes quality of care targets for HbA1c

Study of muons near shower cores at sea level using the E594 neutrino detector

The E594 neutrino detector has been used to study the lateral distribution of muons of energy 3 GeV near shower cores. The detector consists of a 340 ton fine grain calorimeter with 400,000 cells of flash chamber and dimensions of 3.7 m x 20 m x 3.7 m (height). The average density in the calorimeter is 1.4 gm/sq cm, and the average Z is 21. The detector was triggered by four 0.6 sq m scintillators placed immediately on the top of the calorimeter. The trigger required at least two of these four counters. The accompanying extensive air showers (EAS) was sampled by 14 scintillation counters located up to 15 m from the calorimeter. Several off line cuts have been applied to the data. Demanding five particles in at least two of the trigger detectors, a total of 20 particles in all of them together, and an arrival angle for the shower 450 deg reduced the data sample to 11053 events. Of these in 4869 cases, a computer algorithm found at least three muons in the calorimeter

Structural Analysis and Finite Element Methods: Modeling and Simulation in Mechanical Engineering

This research dives into the space of "Structural Analysis and Finite Element Methods: Modeling and Reenactment in Mechanical Designing," utilizing a multifaceted approach to comprehensively get the mechanical behaviour of building structures. Finite Element Analysis (FEA) was utilized to scrutinize a steel structure beneath assorted stacking conditions, uncovering stretch conveyances basic for basic optimization. The study amplified its centre to Fluid-Structure Interaction (FSI), unravelling the complex flow between liquid forces and basic reactions, with suggestions for seaward building applications. Warm recreations of composite materials give bits of knowledge into temperature-induced stresses, directing fabric choice and plan alterations in extraordinarily warm situations. Sensitivity investigations and parametric studies methodically investigated plan impacts on auxiliary execution, helping in optimization endeavours. Approval against experimental information guaranteed the precision of numerical recreations, improving their validity

Oral Mineralocorticoid-Receptor Antagonists: Real-Life Experience in Clinical Subtypes of Nonresolving Central Serous Chorioretinopathy With Chronic Epitheliopathy.

PURPOSE: To evaluate the efficacy and safety of oral mineralocorticoid-receptor antagonist (MRa) therapy in three clinical presentations of nonresolving central serous chorioretinopathy (CSCR) with chronic epitheliopathy. METHODS: Retrospective case series of consecutive patients with nonresolving CSCR treated with oral eplerenone or spironolactone. Treatment criteria were: persistent CSCR with subretinal fluid (SRF) lasting longer than 4 months; recurrent CSCR with SRF lasting longer than 2 months; persistent CSCR (SRF ≥ 4 months) with fundus autofluorescence gravitational tracks. Outcomes at 1, 3, and 6 months were: foveal SRF height, central macular thickness (CMT), subfoveal choroidal thickness (SFCT), best-corrected visual acuity (BCVA), and occurrence of side effects. RESULTS: Among 54 eyes from 42 patients (mean age: 53 years), mean foveal SRF, CMT, and SFCT decreased significantly at 1, 3, and 6 months after treatment initiation. Mean BCVA improved significantly at 6 months. In the subgroup analysis, mean foveal SRF, CMT, and SFCT decreased significantly at 3 and 6 months in the persistent and recurrent groups. In persistent cases with tracks, a significant diminution of mean CMT and SFCT was achieved at 6 months. Treatment-related side effects were observed in 6 patients, prompting treatment discontinuation in one case. CONCLUSION: Response to treatment was observed in the three subgroups. In persistent CSCR with tracks the response was delayed compared with persistent and recurrent cases, suggesting that longer treatment durations would be beneficial in patients with gravitational tracks of RPE alteration. TRANSLATIONAL RELEVANCE: The clinical response to oral MRa is consistent with the involvement of the mineralocorticoid pathway in CSCR pathogenesis