Effectiveness of NA External Fixator with T-clamp in treating Open proximal and Distal Fractures of Tibia

Objective: To compare the outcomes of the open proximal and distal fractures of tibia treated by Nasser Awais External Fixator with T-clamp. Methodology: This cross sectional study was carried out in the department of orthopaedics Nishtar hospital, Multan in one year duration from July 2016 to July 2017. Study was started after ethical approval from hospital ethical board. Collected data of all patients was entered in SPSS software version 23 and analyzed. Mean and SD was calculated for quantitative data like age, frequency and percentages were calculated for qualitative data gender. Chi square was applied to see association of outcome variables with other variables and confounder. P value ≤ 0.05 was considered as significant. Results: Overall, there were 100% (n=180) patients; 50% (n=90) in each of the two groups. Clinical results were excellent in 88.9% (n=80) patients, good in 7.8% (n=7) patients and fair in 3.3% (n=3) patients in group A. While, in group B, the clinical results were excellent in 83.3% (n=75) patients, good in 10% (n=9) patients and fair in 6.7% (n=6) patients. No association was found between clinical results and the groups (χ2= 1.411 DF = 2, P value=0.494). Conclusion: Nasser Awais External Fixator with T-Clamp is a safe and effective technique that enhances the union rate with a low complication rate with less union time in distal tibial fracture compared to proximal fracture. Keywords: NAEF, Tibia, Open proximal, T Clamp, External Fixator.

Study of rare mesonic decays involving di-neutrinos in their final state

We have carried out phenomenological implication of R-parity violating (\NEG% {R}_{p}) Minimal Supersymmetric Model (MSSM) via analyses of pure leptonic($$) and semileptonic decays of pseudo-scalar mesons(% $M\rightarrow X\nu \bar{\nu}$). These analyses involve prediction of branching fraction of pure leptonic decays by using experimental limits/bounds derived from the study of semileptonic decays on \NEG{R}_{p} parameters. We have found, in general that \NEG{R}_{p} contribution dominates over the SM contribution i.e., by a factor of $10^{2}$ for the semleptonic decays of $K^{0}$, $10$ for the pure leptonic decays of $K_{L,S}$ , while $10^{2}~$\& $10^{4}$ in case of $B_{s}$ and $B_{d}$ respectively. This demonstrates the role of \NEG{R}_{p} as a viable model for the study of NP contribution in rare decays

Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations

Outcomes of obstructed abdominal wall hernia: results from the UK national small bowel obstruction audit

Background: Abdominal wall hernia is a common surgical condition. Patients may present in an emergency with bowel obstruction, incarceration or strangulation. Small bowel obstruction (SBO) is a serious surgical condition associated with significant morbidity. The aim of this study was to describe current management and outcomes of patients with obstructed hernia in the UK as identified in the National Audit of Small Bowel Obstruction (NASBO). Methods: NASBO collated data on adults treated for SBO at 131 UK hospitals between January and March 2017. Those with obstruction due to abdominal wall hernia were included in this study. Demographics, co-morbidity, imaging, operative treatment, and in-hospital outcomes were recorded. Modelling for factors associated with mortality and complications was undertaken using Cox proportional hazards and multivariable regression modelling. Results: NASBO included 2341 patients, of whom 415 (17·7 per cent) had SBO due to hernia. Surgery was performed in 312 (75·2 per cent) of the 415 patients; small bowel resection was required in 198 (63·5 per cent) of these operations. Non-operative management was reported in 35 (54 per cent) of 65 patients with a parastomal hernia and in 34 (32·1 per cent) of 106 patients with an incisional hernia. The in-hospital mortality rate was 9·4 per cent (39 of 415), and was highest in patients with a groin hernia (11·1 per cent, 17 of 153). Complications were common, including lower respiratory tract infection in 16·3 per cent of patients with a groin hernia. Increased age was associated with an increased risk of death (hazard ratio 1·05, 95 per cent c.i. 1·01 to 1·10; P = 0·009) and complications (odds ratio 1·05, 95 per cent c.i. 1·02 to 1·09; P = 0·001). Conclusion: NASBO has highlighted poor outcomes for patients with SBO due to hernia, highlighting the need for quality improvement initiatives in this group

Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries: an analysis from the Global Burden of Disease Study 2016

The UN’s Sustainable Development Goals (SDGs) are grounded in the global ambition of “leaving no one behind”. Understanding today’s gains and gaps for the health-related SDGs is essential for decision makers as they aim to improve the health of populations. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016), we measured 37 of the 50 health-related SDG indicators over the period 1990–2016 for 188 countries, and then on the basis of these past trends, we projected indicators to 2030