The Chronicle of French Revolution in Alejo Carpentier’s Explosion in a Cathedral

Alejo Carpentier was a well-known author of Latin American Literature of twentieth century. Explosion in a Cathedral, (El siglo de las luces, 1962) has disclosed the author’s approach, who knew how to take advantages of the chance. This is considered Carpentier’s most effective historical achievement that revealed his destiny accidently. The novel is based on chronicle of French revolution in different circumstances and revealed the French history with winning destiny. It portrays the revolutionary hurdles, which were adopted from the other historians, who wrote about revolutions. Ultimately, Carpentier became successful to assemble immense information, dates and several documents; which were required to write the history of French revolution. The novel presents rare figures as characters without giving more importance to them. Some critics argued that it is characters who are more influenced with European modernity less than Latin America. The novel is about French revolution that is depicted through the character Victor Huggies and Esteban. The French revolution was fought twice as land and water with great efforts. The novel leaves it’s most noteworthy mark in the field of history

Outcomes Following Total Hip Arthroplasty: A Review of the Registry Data.

While total hip arthroplasty remains one of the most reliable procedures with excellent, cost-effective outcomes, there remains controversy in the choice of implant in terms of method of fixation, bearing surface, and size of the femoral head, especially in the younger population. This review looks at the possible information base that surgeons can explore before choosing the implant that they are comfortable with. It also looks at the findings of various registries, which readers can use in the process of informed consent. We have provided certain recommendations with specific reference to the method of fixation, bearing surface, and head size that can be backed by the available registry data. However, the information provided should be used only after considering local, financial, and patient-specific issues that surgeons encounter on a daily basis during their practice

Who Publishes in Leading General Surgical Journals? The Divide Between the Developed and Developing Worlds

BackgroundMost articles in top general surgical journals seem to originate from a limited few developed countries. The purpose of this study was to establish which countries publish the most in leading general surgical journals.MethodsWe analysed all the studies, reviews and case reports published in 2003-2004 in 10 leading English-language general surgical journals with the highest impact factors to obtain country-wise data with regard to the origin of articles. Editorials, historical articles, commentaries, guidelines, biographies, interviews and letters to editors were excluded from the analysis.ResultsA total of 5,081 articles were reviewed. Out of these, 834 were excluded as detailed above and the remaining 4,247 articles were analysed. Most of these were from USA, European countries, Japan, and Australia. It seems that the vast majority of the world's population living in the developing countries do not find adequate representation in leading general surgical journals.ConclusionVery few articles are published from developing countries in leading general surgical journals. Both developing countries and medical journals need to take steps to curb this trend. Steps are suggested to improve the situation so that the developing world is also adequately represented in the surgical literature

Does hip preservation surgery prevent arthroplasty? Quantifying the rate of conversion to arthroplasty following hip preservation surgery.

Hip arthroscopic surgery for femoroacetabular impingement and periacetabular osteotomy (PAO) for dysplasia is the most commonly used contemporary treatment for these conditions and has been shown to provide pain relief and restore function. What is less understood and perhaps of more interest to health economists, is the role of these procedures in preserving the hip joint and avoiding hip arthroplasty. The aim of this systematic review was to determine whether hip joint preservation surgery, indeed, preserves the hip joint by looking at conversion rates to total hip arthroplasty (THA). Two separate searches were undertaken, using PRISMA guidelines and utilizing PubMed and Open Athens search engines, identifying manuscripts that looked at conversion to THA following either hip arthroscopy (HA) or PAO. When considering HA, we found 64 eligible papers. Out of these studies, there were 59 430 hips with 5627 undergoing conversion to THA (9.47% [95% CI 9.23-9.71%]) with a mean conversion time of 24.42 months. Regarding PAO, there were 46 eligible papers including 4862 patients who underwent PAO with subsequent conversion to THA in 404 patients (8.31% [95% CI 7.54-9.12%]). with a mean conversion time of 70.11 months. Certain features were associated with increased conversion rates, including increasing age, worsening arthritis and joint space <2 mm. This study demonstrates that the mean conversion rates to be <10% for HA and PAO, during the mean follow-up periods of included manuscripts. Joint preserving surgery appears to defer or at least delay the need for THA

Mechanics of Psoas Tendon Snapping. A Virtual Population Study.

Internal snapping of the psoas tendon is a frequently reported condition, especially in young adolescents involved in sports. It is defined as an increased tendon excursion over bony or soft tissue prominence causing local irritation and inflammation of the tendon leading to groin pain and often is accompanied by an audible snap. Due to the lack of detailed dynamic visualization means, the exact mechanism of the condition remains poorly understood and different theories have been postulated related to the etiology and its location about the hip. In the present study we simulated psoas tendon behavior in a virtual population of 40,000 anatomies and compared tendon movement during combined abduction, flexion and external rotation and back to neutral extension and adduction. At risk phenotyopes for tendon snapping were defined as the morphologies presenting with excess tendon movement. There were little differences in tendon movement between the male and female models. In both populations, abnormal tendon excursion correlated with changes in mainly the femoral anatomy (male r = 0.72, p < 0.001, female r = 0.66, p < 0.001): increased anteversion and valgus as well as a decreasing femoral offset and ischiofemoral distance. The observed combination of shape components correlating with excess tendon movement in essence presented with a medial positioning of the minor trochanter. This finding suggest that psoas snapping and ischiofemoral impingement are possibly two presentations of a similar underlying rotational dysplasia of the femur

Chitosan-Coated 5-Fluorouracil Incorporated Emulsions as Transdermal Drug Delivery Matrices

The purpose of the present study was to develop emulsions encapsulated by chitosan on the outer surface of a nano droplet containing 5-fluorouracil (5-FU) as a model drug. The emulsions were characterized in terms of size, pH and viscosity and were evaluated for their physicochemical properties such as drug release and skin permeation in vitro. The emulsions containing tween 80 (T80), sodium lauryl sulfate, span 20, and a combination of polyethylene glycol (PEG) and T20 exhibited a release of 88%, 86%, 90% and 92%, respectively. Chitosan-modified emulsions considerably controlled the release of 5-FU compared to a 5-FU solution (p < 0.05). All the formulations enabled transportation of 5-FU through a rat’s skin. The combination (T80, PEG) formulation showed a good penetration profile. Different surfactants showed variable degrees of skin drug retention. The ATR-FTIR spectrograms revealed that the emulsions mainly affected the fluidization of lipids and proteins of the stratum corneum (SC) that lead to enhanced drug permeation and retention across the skin. The present study concludes that the emulsions containing a combination of surfactants (Tween) and a co-surfactant (PEG) exhibited the best penetration profile, prevented the premature release of drugs from the nano droplet, enhanced the permeation and the retention of the drug across the skin and had great potential for transdermal drug delivery. Therefore, chitosan-coated 5-FU emulsions represent an excellent possibility to deliver a model drug as a transdermal delivery system

The role of hip arthroscopic intervention for femoroacetabular impingement on the quality of life and deferring the need for hip replacement

Background The role of hip arthroscopic intervention for Femoroacetabular impingement (FAI) is evolving with increasing ability to deal with impingement lesions and repair the chondrolabral tears. Initially, the procedure was thought to be most appropriate for treatment of athletes but the objective benefits in terms of return to sport at the same level were not considered. Moreover, any benefit in terms of overall quality of life, and potential efficacy of arthroscopic treatment in non-athletes has not been clarified. Currently, this procedure is still very new, and most published studies involve retrospective analysis of small numbers of patients and do not give an accurate picture of the frequency and severity of complications, in particular the potential to delay the need the have hip replacement. Aim The aim of this thesis is to establish the benefit of hip arthroscopic intervention for FAI by answering pertinent questions about the procedure: • Is it effective in terms of improvement in quality of life? • Is it beneficial for non-athletes? • Is it possible for athletes to return to sport at the same level? • What is the short-term complication rate? • Does it defer the need to have hip replacement in the future? Methods This thesis is based on four original published papers in various peer-reviewed journals that address the above questions. Results Does hip arthroscopic intervention improve quality of life (QoL) of patients with FAI? This publication reported the largest single-surgeon series, at the time of publication, and was the first to consider QoL outcomes. In a series of 612 patients at a mean follow-up of 3.2 years, we found that the QoL improved significantly after surgical intervention in 77%, remained unchanged in 14% and deteriorated in 9% of patients. The significant predictors of change in QoL were preoperative QoL scores and female gender. Is hip arthroscopic intervention for FAI only for athletes? In this prospective comparative study the trend for improvement in hip scores after surgery was compared between athletes and non-athletes and we found that, while the athletes had a significantly better score at six weeks, there were no significant differences between the two groups after one year. This study was the first prospective comparative study to look at these two groups of patients and demonstrated that arthroscopic surgery may be an appropriate treatment for FAI in both athletes and non-athletes. Does hip arthroscopic intervention for FAI improve the outcome in athletes? In this prospective comparative study we noted that both the training and time in competition improved approximately three-fold after surgery, with a mean time to return to sport at the same level of 5.4 months. Professional athletes (4.2 months) recovered more quickly than recreational athletes (6.8 months). A greater proportion of the professional athletes (88%) returned to their pre-injury level of sport than the recreational athletes (73%). Prior to this study, objective measures of return to sport were lacking, and there had been no prospective comparative studies of recovery time in professional and recreational athletes. What is the short-term complication rate? The national hospital episode statistics data on short-term complications after hip arthroscopy showed that, in 6395 hip arthroscopies performed in England between April 2005 and Jan 2013, the 30-day readmission rate was 0.5%; the 90-day incidence of deep vein thrombosis (DVT) was 0.08% and of pulmonary embolus (PE) 0.08%; and the 90-day mortality rate was 0.02%. Does it defer the need to have hip replacement in the future? In this series of 6395 hip arthroscopies, 680 patients (10.6%) underwent total hip replacement (THR), at a mean of 1.4 years after the index operation. Female patients had a 1.68 times (95% CI, 1.41 to 2.01) higher risk of conversion to THR than male patients, and patients aged 50 years or older had a 4.65 (95% CI, 3.93 to 5.49) times higher risk of requiring hip replacement than patients younger than 50 years. Kaplan-Meier survival analysis revealed an eight-year survival of 82%; while Cox proportional hazard analysis, adjusting for age, gender and Charlson comorbidity score, revealed an eight-year survival of 86%. Conclusion Arthroscopic surgery for FAI improves QoL, is beneficial for non athletes as well as athletes, enables athletes to return to their professional level of function and may delay the need for total hip replacement. These papers have helped, not only in establishing the outcome of surgery but also in identifying the patients who would benefit from intervention. This information is critical to the clinicians’ understanding of both the success of the intervention and limitations of the technique. Important information has been generated from this work that will be helpful during preoperative counselling, when it is imperative to obtain properly informed consent