Closed reduction and percutaneous k-wire fixation for distal end radius fractures

Background: To evaluate radiological and functional outcome in fractures of the distal radius treated by K-wire fixation.Methods: Forty patients (16 males, 24 females) with different types of fractures of distal radius were treated. K-wire fixation was performed under axillary bolock or general anaesthesia. Anatomical  restoration was evaluated by postero-anterior and lateral radiographs obtained preoperatively and at 09 months of follow up to evaluate Radial Height (RH), Radial Inclination (RI) and Volar Tilt (VT). Functional outcome was evaluated using Mayo scoring system.Results: According to Mayo score 72.5% (n=29) of our patients had excellent to good outcome while as 17.5% (n=7) had fair outcome and 10% (n=4) patients had poor outcome.Conclusions: Kirschner wire fixation is an inexpensive procedure that  provides anatomic  reduction,  fracture  fixation,  and maintenance  of  reduction  with  an  adequate method of  immobilization

Early fixation versus delayed fixation in cervical spine trauma patient with absent cough reflex in view of intensive care unit stay and cost effectiveness

Background: This study was conducted in GMC Jammu to evaluate ICU stay and cost effectiveness in patients with cervical spine trauma undergoing early fixation (within 24-72 hours after trauma) versus late fixation (delayed fixation after applying traction and waiting for return of cough reflex).Methods: Retrospective and prospective study was done by collecting data from admission register and patient follow-up during 2016-2019. 50 patients were admitted as cervical spine trauma, out of which 38 were operated upon and ten managed conservatively. 15 patients were operated within 72 hours of admission with absent cough reflex and 23 were put on cervical traction and operated upon after return of cough reflex.Results: Average ICU stay for 15 patients (4 females 11 males) immediately operated ranged from 10 to 15 days along with prolonged mechanical ventilation. Average ICU stay for 23 patients (16 males and 7 females) operated after returning of cough reflex ranged from 3-4 days with considerably decreased requirement of mechanical ventilation.Conclusions: Delayed fixation of cervical spine after returning of cough reflex shortens post-operative ICU stay and is considerably more cost effective than early fixation

Clinical and biochemical profile of liver abscess patients

Background: Liver comprises 48% of all the visceral abscesses. It is common in India with 2nd highest incidence due to poor sanitation, overcrowding and inadequate nutrition. Worldwide, approximately 40-50 million people are infected annually with amoebic abscesses. This study aims to observe the clinical and biochemical profile of liver abscess patients so that a prompt diagnosis can be made and early treatment can be given.Methods: The study was conducted over a period of 1 year on 50 patients of liver abscess. History and physical examination was done. All patients were subjected to complete hemogram, liver function test, coagulation profile (PT/INR) and USG abdomen. Serology for Entamoeba histolytica and HIV was done.Results: The mean age of the patients was 41.8 years with male preponderance. Amoebic liver abscess (86%) was predominant over pyogenic liver abscess (14%). Alcoholism (52%) and diabetes mellitus (20%) are main predisposing factors in case of liver abscess. Hepatomegaly was found in 80% cases. Elevated ALP, low albumin, increased PT INR points to the diagnosis of liver abscess. The abscesses were predominantly in right lobe (76%) and solitary (66%). Complications seen were ascites (12%) and pleural effusion (6%).Conclusions: Liver abscess should be suspected in patients presenting with prolonged fever and pain upper abdomen specially if patient is alcoholic or has diabetes mellitus. Ultrasonography is an easy and cost effective investigation to diagnose liver abscess. Early and aggressive treatment is the mainstay to prevent complications, morbidity and mortality

The impact of peripheral arterial disease on patients with mechanical circulatory support.

Background: Left ventricular assist devices (LVAD) are indicated as bridging or destination therapy for patients with advanced (Stage D) heart failure and reduced ejection fraction (HFrEF). Due to the clustering of the mutual risk factors, HFrEF patients have a high prevalence of peripheral arterial disease (PAD). This, along with the fact that continuous flow LVAD influence shear stress on the vasculature, can further deteriorate the PAD. Methods: We queried the National Inpatient Sample (NIS) database (2002-2014) to identify the burden of pre-existing PAD cases, its association with LVAD, in-hospital mortality, and other complications of LVAD. The adjusted odds ratio (aOR) and 95% confidence interval (CI) were calculated using the Cochran-Mantel-Haenszel test. Results: A total of 20,817 LVAD patients, comprising of 1,625 (7.8%) PAD and 19,192 (91.2%) non-PAD patients were included in the study. The odds of in-hospital mortality in PAD patients were significantly higher compared to non-PAD group (OR 1.29, CI, 1.07-1.55, P = 0.007). The PAD group had significantly higher adjusted odds as compared to non-PAD group for acute myocardial infarction (aOR 1.29; 95% CI, 1.07-1.55, P = 0.007), major bleeding requiring transfusion (aOR, 1.286; 95% CI, 1.136-1.456, P \u3c 0.001), vascular complications (aOR, 2.360; 95% CI, 1.781-3.126, P \u3c 0.001), surgical wound infections (aOR, 1.50; 95% CI, 1.17-1.94, P = 0.002), thromboembolic complications (aOR, 1.69; 95% CI, 1.36-2.10, P \u3c 0.001), implant-related complications (aOR, 1.47; 95% CI, 1.19-1.80, P \u3c 0.001), and acute renal failure (aOR, 1.26; 95% CI, 1.12-1.43, P \u3c 0.001). Conclusion: PAD patients can have high LVAD associated mortality as compared to non-PAD

Comparative Biochemical Evaluation of Schizothorax niger and Cyprinus carpio from River Jhelum of Kashmir Valley

ABSTRACT The present study was conducted to evaluate the comparative biochemical profile of Schizothorax niger (endemic fish) and Cyprinus carpio (exotic fish) from the River Jhelum seasonally for a period of two years. .98 mg/dl). In both the fish hosts the higher biochemical values were recorded in the summer season and the lower values in the winter season during the study period. The seasonal differences in the biochemical parameters of the fish can be attributed to the water pollution of River Jhelum by various contaminants including metals and the comparative higher values in Schizothorax niger can be speculated to be due to the higher sensitivity of the host. From the present study it may be inferred that the change in biochemical parameters of the native fish would be one of the reasons for its decline from fresh water resources of the Kashmir Valley

Studies of the silkworm enzyme activity and their correlations with economic variables

The experiment was conducted to analyse the larval performance and economic traits of bivoltine silkworm breeds of silkworm (SK-1, SK-6, SK-22, SK-28, SK-33, CSR4, CSR2, NB4D2, DUN6 and APS4) during spring season. The haemolymph total protein, succinate and gultamate dehydrogenase activities were estimated and their correlation with economic traits were also worked out. The results of the study confirmed that among ten bivoltine silkworm breeds, highest haemolymph SDH activity of 3.47 µmoles/ml/mgprotein/min was recorded in the silkworm breed SK1 and least SDH activity of 1.58 µmoles/ml/mg protein/min was recorded in the breed APS4. The highest peak of succinate dehydrogenase activity of 2.65 µmoles/ml/mg protein/min was observed on 7th day of the 5th instar and lowest peak of succinate dehydrogenase activity of 2.39 µmoles/ml/mg protein/min was observed on 4th day of the 5th instar. GDH activity of 0.46 µmoles/ml/mg protein/min was recorded highest in the silkworm breed SK1 and lowest of 0.15 µmoles/ml/mg protein/min was recorded in silkworm breed APS4. The highest peak of haemolymph GDH of 0.36 µmoles/ml/mg protein/min was recorded on 7th day of 5th instar and lowest peak of 0.26 µmoles/ml/mg protein/min was recorded on 4th day of 5th instar. The correlational studies revealed that haemolymph total protein, SDH and GDH were found to be positively corelated with yield by weight and number (cocoon), weight of mature larvae, shell weight ,cocoon weight, shell ratio percent, silk productivity, rate of pupation, fecundity, raw silk percentage  and length of filament. Thus, the study revealed that silkworm breeds like SK1, SK6, SK22 and SK28 as productive breeds and hence may be used for future breeding programmes for evolution of new robust silkworm breed

Housekeeping and other metabolic functions of the Plasmodium plastid

The malaria parasite carries a plastid called the apicoplast that has been the subject of intense study in the last 15 years. Having originated from red-algal plastids, the apicoplast has lost its ability to photosynthesize, but carries out other essential functions such as type-II fatty acid synthesis, biosynthesis of haem and isoprenoid synthesis; the DOXP pathway for isoprenoid synthesis has recently been demonstrated to be the only pathway critical for parasite survival in the erythrocytic stage. The apicoplast also has a functional Suf system for assembly of (Fe–S) complexes on target proteins. The organelle has a 35 kb, double-stranded DNA genome that encodes a set of RNAs and proteins, the latter being translated from organellar mRNA by an active translation machinery, a major component of which is encoded by the nucleus. This article reviews current knowledge of housekeeping functions of the Plasmodium apicoplast and its (Fe–S) assembly system and discusses these components as sites for drug intervention against malaria

Effect of process parameters on the laser microdrilling performance of stainless steel, aluminium and copper

Micromachining techniques are being used regularly in various engineering and production sectors such as Micro Electromechanical Systems, Aerospace, Automotive, Electronics and Biomedical industries. For Laser Beam Micromachining, highly energized laser beam is focused on a small region of the workpiece surface. As a result, it is heated up rapidly to sufficiently high temperatures, then the material starts to melt and/or vaporize from the surface. This phenomenon of material removal is called laser ablation. The holes that are produced by one-dimensional laser beam drilling (LBD) can come with defects like taper, heat affected zone (HAZ) and Recast Layer. On the other hand, LBD process offers high control, high efficiency, precision, and production rate, particularly for drilling microscopic holes in a variety of materials. LBD performance is measured on different parameters such as taper and recast layer of the machined holes. Previous studies report many observations regarding the performance parameters and the process input parameters. But a thorough study of the performance parameters with respect to different material properties has not been reported yet. The research work for this paper focuses on the experimental investigation for different materials such as stainless steel (type SS304), Aluminum and Copper to observe the effects of Laser input parameters (namely laser power, scanning speed, and pulse repetition rate) on the performance of the LBD. The study also considers different thermophysical as well as optical properties such as thermal conductivity, specific heat, melting point, absorptivity and how it affects the outcome of LBD in a combined manner. Characterization of different output parameters such as Entry area, Exit Area and Recast Area is done by SEM (Scanning Electron Microscope) machine. For 75 Loop count, 90% Laser Power, 950 mm/s Scanning Speed and 10kHz pulse repetition rate, the highest amount of Recast Area is observed in SS, valued at 0.053 mm2. The largest amount of taperness is found in Cu at 44.404º. Scanning Speed and Laser Power has been identified as the most significant process factors for LBD performance

Reconstruction of soft tissue defects in Fournier’s gangrene at a tertiary care centre

Background: Fournier’s gangrene is an acute and potentially lethal multi-bacterial necrotizing infection that primarily involves the scrotum but may extend beyond its confines to perineum and abdominal wall. The disease may result in sepsis and death if treatment is delayed. Management consists of timely diagnosis, aggressive debridement, broad-spectrum antibiotics followed by reconstruction which still remains a surgical challenge.Methods: It is a prospective study conducted from Jan 2006 to Dec 2015 on 29 patients of Fournier’s gangrene who were referred to the department of Plastic and Reconstructive Surgery, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, for reconstruction after initial debridement by general surgeon/urologist. The patient’s age, predisposing factors, site and the size of the defects, reconstructive options used and outcome were evaluated. Assessment of testicular function was done at 6 months by sperm count and morphology.Results: A total of 29 patients of Fournier’s gangrene consisting of 28 males and one female were included in the study. The mean age was 37 years and the most common comorbidity was diabetes mellitus in 18 patients (62%). Wounds were allowed to heal by secondary intension in 8 patients. Scrotal advancement flap was done in seven patients. Split thickness skin grafting (STSG) of extensive wounds was done in 11 patients and testes were placed in medial thigh subcutaneous pocket in one patient. Two elderly diabetic patients succumbed to sepsis and multi organ failure. Overall complication rate was 18.5%.Conclusions: Thorough debridement and early wound cover are essential in the management of Fournier’s gangrene for successful rehabilitation. Various reconstructive options are available with no conclusive evidence to support flap rather than skin graft and most of the procedures result in preservation of testicular function in the long term