Ayurvedic and modern review on types of Sugar

Sugar is a natural ingredient that has been part of our diet, medicine since ancient times. Sugar made from sugar cane is consumed mostly and said to have health benefits. There are some Sharkara’s (sugar) told in Ayurvedic classics which are not in use now days. The functional quality and medicinal quality differ according to form and origin of sugar. In Ayurveda specific description of different types of Sharkara method of processing and their properties can be seen. Now industrializations keep sugar to undergo several chemical processing steps to make it into the refined sugar. This results into decline in health benefits of sugar. This article reviews Sharkara in Ayurveda classics and different forms of sugar used in present days. Information collected from various classics and published information on recent research articles in PubMed, Dhara online data bases and other allied databases were taken into consideration for the review

Surveillance of Transmitted Antiretroviral Drug Resistance among HIV-1 Infected Women Attending Antenatal Clinics in Chitungwiza, Zimbabwe

The rapid scale-up of highly active antiretroviral therapy (HAART) and use of single dose Nevirapine (SD NVP) for prevention of mother-to-child transmission (pMTCT) have raised fears about the emergence of resistance to the first line antiretroviral drug regimens. A cross-sectional study was conducted to determine the prevalence of primary drug resistance (PDR) in a cohort of young (<25 yrs) HAART-naïve HIV pregnant women attending antenatal clinics in Chitungwiza, Zimbabwe. Whole blood was collected in EDTA for CD4 counts, viral load, serological estimation of duration of infection using the BED Calypte assay and genotyping for drug resistance. Four hundred and seventy-one women, mean age 21 years; SD: 2.1 were enrolled into the study between 2006 and 2007. Their median CD4 count was 371cells/µL; IQR: 255–511 cells/µL. Two hundred and thirty-six samples were genotyped for drug resistance. Based on the BED assay, 27% were recently infected (RI) whilst 73% had long-term infection (LTI). Median CD4 count was higher (p<0.05) in RI than in women with LTI. Only 2 women had drug resistance mutations; protease I85V and reverse transcriptase Y181C. Prevalence of PDR in Chitungwiza, 4 years after commencement of the national ART program remained below WHO threshold limit (5%). Frequency of recent infection BED testing is consistent with high HIV acquisition during pregnancy. With the scale-up of long-term ART programs, maintenance of proper prescribing practices, continuous monitoring of patients and reinforcement of adherence may prevent the acquisition and transmission of PDR

Effect of microstructure and surface roughness on the wettability of superhydrophobic sol–gel nanocomposite coatings

Sol–gel nanocomposite coatings were fabricated by spraying precursor mixtures containing hydrophobically modified silica (HMS) nanoparticles dispersed in sol–gel matrices prepared with acid-catalyzed tetraethoxysilane (TEOS), and methyltriethoxysilane (MTEOS). The hydrophobicity of the coatings increased with increase in the concentration of HMS nanoparticles. Superhydrophobic coatings with water contact angle (WCA) of 166� and rolloff angle \2� were obtained by optimizing the sol–gel processing parameters and the concentration of silica nanoparticles in the coating. FESEM studies have shown that surface has a micro-nano binary structure composed of microscale bumps and craters with protrusions of nanospheres. The properties of composite coatings fabricated by spin coating and spray coating methods were compared. It was found that the microstructure and the wettability were also dependent on the method of application of the coating

Zone 2 5th Metatarsal Fractures Treated Nonoperatively Have Similar Time to Healing to Those Treated Operatively

Category: Midfoot/Forefoot; Trauma Introduction/Purpose: The purpose of this study was to quantify the time to clinical and radiographic healing in Zone 2 proximal 5th metatarsal (MT) fractures and to compare these outcomes to those of Zone 2 fractures treated operatively. Methods: A retrospective cohort study of all Zone 2 metatarsal fractures seen at a single large, urban, academic medical center between December 2012 and April 2022 was performed. Zone 2 injuries were defined as fractures entering the proximal 4-5 MT articulation on the oblique radiographic view. Clinical healing was characterized by the return to baseline ambulatory function without discomfort and a lack of tenderness on physical examination. Radiographic healing was defined as complete osseous consolidation. A total of 374 patients with Zone 2 proximal 5th MT fractures were included in the analysis. The mean age of patients was 53.8 +/- 16.6 years, and 74.3% were female. Results: 93.3% of patients with Zone 2 metatarsal fractures were treated nonoperatively. In the nonoperative group, 6.6% experienced delayed bony union with incomplete radiographic healing after 6 months, compared to 16.0% of the operative group (p = 0.095). However, by 1 year post-injury, 98.9% of patients who underwent nonoperative management and 96.0% of operative patients demonstrated radiographic union. Two patients failed nonoperative management and underwent operative fixation for symptomatic nonunions. There was no difference in time to radiographic healing between patients treated nonoperatively and those treated operatively (4.4 +/- 2.8 months vs 5.4 +/- 4.7 months, p = 0.413). Similarly, there was no difference in time to clinical healing between both groups (2.3 +/- 1.9 months vs 2.6 +/- 3.8 months, p = 0.723). Conclusion: Zone 2 5th metatarsal base fractures, which are often incorrectly referred to as Jones fractures despite being proximal to the fractures originally characterized by Jones, can be successfully treated with nonoperative management. There is no evidence that operative treatment leads to significantly faster clinical or radiographic healing for patients

Variations in the Management of Zone 2 5th Metatarsal Fractures Based on Physician Specialty

Category: Midfoot/Forefoot; Trauma Introduction/Purpose: There is a wide variation in the management of acute “Zone 2” 5th metatarsal (MT) base fractures. The purpose of this study was to quantify these differences and evaluate the effect of treating physician specialty. Methods: This was a retrospective cohort study of patients with acute Zone 2 5th MT fractures who presented to a single large, urban, academic medical center between December 2012 and April 2022. Zone 2 was defined as the region of the 5th MT base bordered by the 4th and 5th MT articulation on the oblique radiographic view. Logistic regression was used to evaluate the odds of undergoing operative treatment based on provider specialty. Results: A total of 633 patients presented with Zone 2 fractures during the study period. 40.6% of patients initially presented to the ED, 36.3% to an urgent care (UC) center, and 23.1% directly to the office. Ultimately, 57.2% of patients were treated by orthopedic surgeons, 39.6% by podiatrists, and 3.2% by primary care physicians. For patients treated nonoperatively, the management plan significantly differed by treating specialty. Compared to podiatrists, patients treated by orthopedic surgeons were more likely to be treated in a hard sole shoe (30.8% versus 7.6%, p< 0.001) and less likely to be treated using a CAM boot (57.3% versus 76.3%, p< 0.001). Similarly, patients treated by orthopedic surgeons were more likely to be made WBAT compared to patients treated by podiatrists (71.8% versus 42.0%, p< 0.001). Conclusion: Overall, 2.5% of patients with Zone 2 metatarsal fractures were treated operatively. 0.5% of patients treated by orthopedic surgeons underwent surgery compared to 6.1% of patients treated by podiatrists (p=0.001). Furthermore, when controlling for age, sex, and time between injury and initial presentation to the office, the likelihood of undergoing operative treatment was still significantly greater when being treated by a podiatrist (OR=16.5, p=0.009). There is considerable heterogeneity among the treatment strategies for Zone 2 proximal 5th MT fractures. Compared to podiatrists, orthopedic surgeons are less likely to treat patients operatively and more likely to allow early weight bearing

Operative Treatment of Jones Fractures (OTA Type 87,5.2A) is not Associated with Earlier Clinical or Radiographic Healing

Category: Midfoot/Forefoot; Trauma Introduction/Purpose: The purpose of this study was to compare the time to radiographic and clinical healing between patients with metadiaphyseal metatarsal fractures (True Jones) treated operatively and those treated nonoperatively. Methods: This was a retrospective cohort study of patients presenting to a single large, urban, academic hospital center with Jones fractures between December 2012 and April 2022. Jones fractures were defined as 5th metatarsal base fractures occurring in the proximal metadiaphyseal region, just distal to the articulation of the 4th and 5th metatarsals on the oblique radiographic view (Zone 3). Information regarding patient demographics, injury mechanism, clinical presentation, management, and time to healing was collected. A fracture was defined as clinically healed when the patient had returned to their baseline ambulatory status without pain and there was an absence of tenderness to palpation on physical examination. Radiographic healing was defined as the presence of complete osseous consolidation. A total of 2,466 patients presented with 5th metatarsal fractures during the study period. Results: Among all 5th metatarsal fractures, 170 patients (6.9%) were classified as “true Jones” fractures. The mean age of patients presenting with Jones fractures was 46.1 +/- 18.6 years, and 65.8% were female. 19.9% were treated operatively (92.9% with screw fixation and 7.1% with ORIF), and 80.1% were treated nonoperatively. 95.9% of patients with Jones fractures went on to heal with no difference in time to radiographic healing (p = 0.296) or clinical healing between both groups (p = 0.228). Furthermore, there was no difference between groups with respect to the proportion of patients who developed delayed radiographic union with incomplete osseous healing at 6 months post-injury (9.3% in the nonoperative group versus 10.7% in the operative group, p = 0.098). Conclusion: Contrary to popular opinion, operative treatment of true Jones fractures was not associated with faster or more reliable radiographic union or time to clinical healing compared to patients treated nonoperatively. The overall rate of nonunion in true Jones fractures was found to be lower than previously described, and there was no evidence of any difference in nonunion rate with operative treatment compared to nonoperative management

The Proximal 5th Metatarsal Fracture: A Spectrum of Misunderstood Fractures

Category: Midfoot/Forefoot; Trauma Introduction/Purpose: Several different types of 5th metatarsal fractures exist and are treated with various methods of immobilization, weight bearing restrictions, and occasionally operative procedures. The purpose of this study was to evaluate the differences in clinical and radiographic outcomes between pseudo-Jones fractures (Zones 1 and 2 of the 5th MT base), True Jones fractures (Zone 3), and 5th MT shaft fractures. Methods: This was a retrospective cohort study of patients presenting to a single large, urban, academic medical center with any 5th MT fracture between 2012 and 2022. Inclusion criteria for this analysis included patient follow up until there was evidence of radiographic healing, clinical healing, or duration greater than one year following injury. Radiographs obtained at the initial presentation were reviewed and fracture patterns were categorized as either Zone 1, Zone 2, Zone 3, or Shaft. Linear regression models were used to evaluate the effect of fracture type on the duration of healing when controlling for age, sex, BMI, smoking status, and history of diabetes. 1,279 patients with 5th metatarsal fracture met the inclusion criteria and were included in the analysis (mean age 49.2 +/- 17.9 years). Overall, 5.2% were treated in a splint or cast, 67.5% in a CAM boot, 20.3% in a hard sole shoe, and 7.0% without immobilization. Results: 31.2% of patients were non-weight bearing, 8.1% partial weight bearing, and 60.7% weight bearing as tolerated. There was no difference in time to radiographic union (p=0.946) or time to clinical healing (p=0.520) between any of the fracture types. Similarly, there was no difference in the proportion of patients with incomplete radiographic healing at 6 months (p=0.310) and at 1 year after injury (p=0.552) based on the fracture type. Likewise, there was no difference in any clinical or radiographic healing parameter based on fracture type for patients treated operatively. Based on linear regression model, there was no difference in the time to clinical or radiographic healing when controlling for confounding factors. Conclusion: All commonly occurring 5th metatarsal fractures, including those of both the metatarsal base and the shaft, demonstrate similar times to clinical and radiographic healing