Morscher’s osteotomy in posttraumatic sequale of hip in adolescent using dynamic hip screw: case report

Premature closure of proximal femoral epiphyseal plate can be a complication of hip dysplasia, Perthe’s disease, trauma or septic arthritis of hip. It may eventually result in Coxavara and shortening of femoral neck and upward migration of greater trochanter. Morscher’s osteotomy is an intertrochanteric osteotomy that can create valgusization with lengthening of femoral neck, correction of high riding greater trochanter and compensates for short limb length as a single stage procedure. The purpose of this case report is to evaluate early results of Morscher’s osteotomy fixed using paediatric dynamic hip screw in adolescence

Supply-Side Equilibria in Recommender Systems

Algorithmic recommender systems such as Spotify and Netflix affect not only consumer behavior but also producer incentives. Producers seek to create content that will be shown by the recommendation algorithm, which can impact both the diversity and quality of their content. In this work, we investigate the resulting supply-side equilibria in personalized content recommender systems. We model users and content as $D$-dimensional vectors, the recommendation algorithm as showing each user the content with highest dot product, and producers as maximizing the number of users who are recommended their content minus the cost of production. Two key features of our model are that the producer decision space is multi-dimensional and the user base is heterogeneous, which contrasts with classical low-dimensional models. Multi-dimensionality and heterogeneity create the potential for specialization, where different producers create different types of content at equilibrium. Using a duality argument, we derive necessary and sufficient conditions for whether specialization occurs: these conditions depend on the extent to which users are heterogeneous and to which producers can perform well on all dimensions at once without incurring a high cost. Then, we characterize the distribution of content at equilibrium in concrete settings with two populations of users. Lastly, we show that specialization can enable producers to achieve positive profit at equilibrium, which means that specialization can reduce the competitiveness of the marketplace. At a conceptual level, our analysis of supply-side competition takes a step towards elucidating how personalized recommendations shape the marketplace of digital goods, and towards understanding what new phenomena arise in multi-dimensional competitive settings.Comment: Updated version with revised and expanded conten

Early postnatal caloric restriction protects adult male intrauterine growth-restricted offspring from obesity.

Postnatal ad libitum caloric intake superimposed on intrauterine growth restriction (IUGR) is associated with adult-onset obesity, insulin resistance, and type 2 diabetes mellitus (T2DM). We hypothesized that this paradigm of prenatal nutrient deprivation-induced programming can be reversed with the introduction of early postnatal calorie restriction. Ten-month-old male rats exposed to either prenatal nutrient restriction with ad libitum postnatal intake (IUGR), pre- and postnatal nutrient restriction (IPGR), or postnatal nutrient restriction limited to the suckling phase (50% from postnatal [PN]1 to PN21) (PNGR) were compared with age-matched controls (CON). Visceral adiposity, metabolic profile, and insulin sensitivity by hyperinsulinemic-euglycemic clamps were examined. The 10-month-old male IUGR group had a 1.5- to 2.0-fold increase in subcutaneous and visceral fat (P < 0.0002) while remaining euglycemic, insulin sensitive, inactive, and exhibiting metabolic inflexibility (Vo(2)) versus CON. The IPGR group remained lean, euglycemic, insulin sensitive, and active while maintaining metabolic flexibility. The PNGR group was insulin sensitive, similar to IPGR, but less active while maintaining metabolic flexibility. We conclude that IUGR resulted in obesity without insulin resistance and energy metabolic perturbations prior to development of glucose intolerance and T2DM. Postnatal nutrient restriction superimposed on IUGR was protective, restoring metabolic normalcy to a lean and active phenotype

Association of sociodemographic characteristics with KAP regarding menstrual hygiene among women in an urban area in Delhi

Introduction: Menstruation despite being a natural process is linked with several misconceptions and false practices, which sometimes results in adverse health outcomes. The aim of this study was to assess knowledge, attitude, and practices regarding menstrual hygiene and their association with sociodemographic determinants among women in an urban area of Delhi.Materials and Methods: A community‑based cross‑sectional survey was conducted for a period of 1 year among 350 women age 18–45 years residing in an urban resettlement colony in Delhi. Semi‑structured questionnaire containing questions regarding subject’s demographic profile, their knowledge, attitude, and practices pertaining to menstrual hygiene was used. It had seven questions regarding knowledge and eight questions each about attitude and practices regarding menstrual hygiene, respectively. A 5‑point Likert scale was used to assess women’s responses to attitude questions. Practices satisfactory or unsatisfactory were based on UNICEF guidelines. Data were analyzed using SPSS software version 17.Results: The mean age of women was 26.53 ± 0.295 years. More than three‑fourths (88.3%) women had good knowledge, whereas only 32.3% of women had a positive attitude regarding menstrual hygiene. More than two‑thirds of the women were using sanitary pads as menstrual absorbent. Significant association was seen between knowledge and subject’s marital status (P = 0.034) and subject’s occupation (P = 0.046). A significant association was observed between attitude and socioeconomic status of the participant (P = 0.001).Conclusion: These findings indicate the need for education about healthy menstrual practices. Health education is an essential requirement to fill the knowledge gap to promote accessibility, availability, and sanitary facilities and products.Keywords: Attitude; knowledge; menstrual hygiene; practice

Demographics and follow up of post partum intra-uterine copper device in tertiary hospital in Delhi, India

Background: Increasing unintended pregnancies in post partum females in our country warrants urgent attention towards prevalence and efficacy of contraceptives used. This study was done to determine the prevalence of PPIUCD and its follow up in patients attending tertiary hospital in New Delhi, India.Methods: Prospective study was carried in Department of Obstetrics and Gynecology, Dr. RML Hospital, New Delhi, India over a period of 1 year from July 2017 to July 2018. The awareness and prevalence of PPIUCD was assessed. At 6 week follow-up visit, women with PPIUCD were asked for symptoms of unusual vaginal discharge, irregular or heavy bleeding per vagina, and any expulsions if noticed. All the data was recorded and assessed.Results: Out of 1478 deliveries, 1372 were eligible for PPIUCD. 335 patients got PPIUCD inserted. 295 patients were followed as 40 patients were lost to follow up. 79.3% women did not have any complaints. 11.8%, 1% and 7.4% women had only heavy menstrual bleeding, only lower abdominal pain and both symptoms respectively. Spontaneous expulsion rate was noted in one patient (0.3%) at 6 weeks. IUCD removal was done in 4 patients who had complaints of pain and heavy menstrual bleeding not conservatively managed.Conclusions: PPIUCD insertion is a safe, convenient and effective method of contraception. The benefits of contraception immediately after delivery outweigh disadvantage of complications. Antenatal counseling and follow up in hospitals need to be strengthened to increase awareness and acceptability of PPIUCD

Histone deacetylase inhibitors: pharmacotherapeutic implications as epigenetic modifier

Epigenetic modifications such as acetylation and deacetylation of histone proteins play a decisive role in transcriptional alteration and expression of genes. Acetylation is catalysed by the histone acetyl transferases enzymes and activates expression of genes by converting chromatin into a less compact, transcriptionally active state. Histone deacetylases enzymes catalyze deacetylation that condenses chromatin into a closed structure .Consequently transcriptional factors are unable to access DNA and gene expression is suppressed. Balanced activity of HATs and HDACS is essential for normal gene expression. Increased HDAC activity can lead to imbalance in protein acetylation resulting in hypoacetylation, tight chromatin structure and suppression of various genes. This aberrant suppression of genes is the hallmark of several malignant and other diseases including neurodegenerative disorders. Histone Deacetylase Inhibitors (HDACIs) have potential to restore the balance of histone acetylation that reverses the silencing of pathological genes. Thus HDACIs modify expression of genes without affecting sequence of DNA and act as epigenetic modifiers. Vorinostat and romidepsin are FDA approved HDACIs. Valproic acid, belinostat and many others are in different phases of clinical trials. This review article explores the target based epigenetic mechanisms as well as existing and potential therapeutic role of HDACIs in various malignant and non-malignant diseases. Data sources were articles published in medical journals and bibliographic database Medline

Abnormal semen parameters among males in infertile couples: a cross sectional study from a tertiary care centre

Background: In India, the prevalence of primary infertility ranges from 3.9% to 16.8%. Male factor contributes 40-50% of this. Male factor infertility is indicated by decreased sperm concentration, reduced motility, vitality or abnormal sperm morphology. Semen analysis is the single most important investigation to detect male factor infertility. The aim of this study was to analyse the prevalence of abnormal semen parameters among males in infertile couples and their association with contributing factors.Methods: This cross-sectional hospital-based study was carried out in the Department of Pathology at Lady Hardinge Medical College and Smt. Sucheta Kriplani Hospital. A total of 400 cases were analyzed during a period of 6 months. Detailed history of the couple was taken. Semen analysis was done using automated semen analyzer (SQA-vision) after 3 days of abstinence according to the WHO 5th edition 2010 guidelines. The results were analysed using excel sheet and SPSS software.Results: In the present study, 122 cases (30.5%) out of 400 cases had abnormal semen parameters. Most common abnormality detected was asthenozoospermia (14.3%) followed by oligozoospermia (13.8%), azoospermia (10.5%) and teratozoospermia (10.5%). There was significant association of alcohol intake, obesity and trauma with abnormal semen parameters.Conclusions: Asthenozoospermia was the most common abnormality noted in this study. Lifestyle modifications along with timely medical attention in male partners of infertile couples can improve the semen quality

Role of ferric carboxymaltose in battle with anemia among north Indian pregnant women

Background: Anemia among pregnant women is a serious global health concern. Anemia is a major hematological, nutritional deficiency but still a manageable health problem among the pregnant women and very common in developing countries like India in under privileged population. Increased morbidity and mortality is seen in pregnant women and their foetuses suffering from anemia. Aim of this study was to study safety and efficacy of injection ferric carboxymaltose in pregnant women with iron deficiency anemia. Methods: This is a Prospective interventional comparative randomized study carried among antenatal women in the Department of Obstetrics and Gynaecology, S. N. Medical College, Agra from (May 2021-October 2022), comprised of 200 pregnant women divided into two groups. Group A-100 antenatal women were transfused with iron sucrose (IS), Group B-100 antenatal women were transfused with ferric carboxymaltose (FCM). Results: In FCM group after 3 weeks of post transfusion hemoglobin level was 10.5±0.44 and in iron sucrose group it was 9.9±0.59 (p=0.0001). 6 week post transfusion hemoglobin level in FCM group was 11.37±0.62 and in iron sucrose group it was 10.45±0.59 (p=0.0001). Average rise in hemoglobin in FCM group after 3 week post transfusion was 2.9±0.02 and after 6 week it was 3.77±0.16. In iron sucrose group at 3 week it was 2.1±0.06 and at 6 week it was 2.65±0.04. The average rise in hemoglobin level was greater among patients of FCM compared to Iron sucrose group. Conclusions: Ferric carboxymaltose was safe and more effective in treatment of iron deficiency anaemia in pregnant women as compared to iron sucrose with lesser side effect and better patient compliance

ANAGEMENT OF PROXIMAL HUMERUS FRACTURE IN ADULTS WITH PHILOS PLATE FIXATION IN NEER TYPE 2 AND TYPE 3

Objective: One of the most frequent bone fractures is a fracture of the proximal humerus. They make up between 4% and 5% of all fracture. With less invasive soft-tissue injury and a lower risk of iatrogenic avascular necrosis, closed reduction and percutaneous fixation have become more popular in recent years as opposed to open reduction (OR) and extensive internal fixation (IF) (by plates and screws). The aim of this study was to compare the functional results of proximal humerous locking osteosynthesis (PHILOS) fixation against OR and IF of proximal humerus fractures (2 and 3 Neer’s classification).  Methodology: This study involved 40 patients, with a mean age of 53 and a range of ages from 18 to 55, with 2 and 3 part fractures according to Neer’s classification. Patients were randomized to either group, with Group I type 2 fractures receiving OR and IF for 22 patients, and Group II (type 3 fractures) with 18 patients receiving PHILOS plate fixation, with function assessed using the CMS score.  Results: At 1 month, 3 months, and 6 months of follow-up, Group I’s mean Visual analog scale (VAS) score decreased to 2.52, 2.10, and 1.22 and in Group II, 3.86, 2.64, and 2.41. The VAS score was reduced and function CMS score were significantly increased in Group I (80% VAS score, 65% CMS score) as compared to Group II (64% VAS score, and 58%CMS score). At 1, 3, and 6 months, there was a statistically significant difference between the two groups. Conclusion: Both groups saw satisfactory results, with each method having benefits and drawbacks. We discovered that plate fixation provided stable fixation with few implant problems and early range-of-motion exercise to achieve acceptable functional results

Atypical presentation of intra-articular osteochondroma of knee in adolescent- case report

Osteochondroma is most common benign bone tumor around knee joint. They occur during the period of growth, grows away from joint line and rarely responsible for mechanical symptoms. This paper reports a rare presentation of intra-articular osteochondroma in knee with mechanical instability symptoms, mild to moderate pain and swelling of knee joint. Patient was 20 years old male and misdiagnosed as chronic nonspecific synovitis, tubercular arthritis and anterior cruciate ligament tear of knee. We assessed him clinically and radiologically and diagnosis was established based on MRI and arthroscopy. He was treated by open excision of tumor, and patients recover uneventfully. Instability of knee joint in this case can be attributed due to rough surface of osteochondroma just beneath lower attachment of patellar tendon