Quality of life and thigh girth following anterior cruciate ligament reconstruction using hamstring autograft

Background: Arthroscopic anterior cruciate ligament reconstruction is commonly performed with intent to return earlier to normal activities, so graft selection becomes more important. The use of hamstring tendon autograft is supposed to have less postoperative morbidities. In this prospective study we assess the early post-operative complications.Methods: 25 patients were operated in Shadan Institute of Medical Sciences and Research Centre, Hyderabad, India, by the same surgeon and were assessed preoperatively, and 3 and 6 months after surgery. The hamstring and quadriceps strength were measured with PRIMUS RS machine. The patients were also assessed for their subjective complaints using International Knee Documentation Committee (IKDC) knee scoring system.Results: The peak power of flexion and extension of the knee joint significantly improved following the surgery which is essential for any athletic activities. Quadriceps and hamstring strengths were restored to 90%, which suggests that the grafting has been successful in restoring isometric strength. This is necessary to return to sporting activities. Power of hamstrings and quadriceps significantly improved following surgery. Quadriceps and hamstring endurance recovered and improved at the end of 6 months following surgery. Using IKDC scoring, nearly normal were 14, normal were 10 and abnormal 1. 3 patients (12%) presented with anterior knee pain. Sensory loss was noted in 6 patients (24%) at the end of 6 months following surgery. Swelling was noted in 5 patients (25%).Conclusions: Most morbidities are temporary in nature and do not significantly affect the patient’s activities

Laplace Transform of Products of Bessel Functions: A Visitation of Earlier Formulas

This note deals with the Laplace transforms of integrands of the form ${x^\lambda }{J_\alpha }\left( {ax} \right){J_\beta }\left( {bx} \right)$, which are found in numerous fields of application. Specifically, we provide herein both a correction and a supplement to the list of integrals given in 1997 by Hanson and Puja, who in turn extended the formulas of Eason, Noble and Sneddon of 1956. The paper concludes with an extensive tabulation for particular cases and range of parameters

Outcome of radial head and neck fractures with radial head replacement

Radial head and neck fractures are a significant concern in elbow injuries, often stemming from incidents like falls or accidents, which can severely affect elbow stability and function. This study, conducted at Shadan Institute of Medical Sciences in Hyderabad, India, focused on 15 patients with severe radial head fractures classified as Mason type III and IV. The research aimed to evaluate the effectiveness of radial head replacement utilizing implants from leading manufacturers such as DePuy Synthes® and Zimmer Biomet®. The surgical procedures were carried out successfully without any notable intraoperative complications, with an average surgery duration of 60 minutes. Postoperative complications, though relatively rare, included issues such as elbow stiffness and peri-prosthetic osteolysis, which were manageable. However, the majority of patients exhibited improved functional outcomes, as indicated by excellent Mayo elbow performance scores during the 6-month follow-up. This intervention not only enhances elbow stability but also facilitates soft tissue healing and promotes better range of motion. Consequently, radial head replacement emerges as a highly effective approach for managing severe radial head fractures, leading to considerable improvements in patient outcomes and quality of life.

Study of the prescription pattern of anti-depressants in a tertiary care hospital: a prospective observational study

Background: One of the most important public health priorities are psychiatric disorders. Prescribing medications play a crucial role in providing good health care. Therefore, there is a need to understand prescription patterns at regular intervals. Methods: This was a prospective, cross-sectional, observational study conducted at the psychiatry department OPD of Government Medical College, Aurangabad (Maharashtra, India) from January 2021 to June 2022. Records of prescriptions were collected from the hospital management information system. Results: N=417 prescriptions were analysed. The male: female ratio was 1.25. Among total prescriptions analysed, selective serotonin reuptake inhibitors (SSRIs) were the most prescribed drug class (32.18%) followed by benzodiazepines (25.19%) and atypical antipsychotics (19.97%). Drugs prescribed as fixed dose combinations (FDC) were 2.10%. Most of the patients received polytherapy in which most patients constituted of two drug therapy (46.28%) and 34.53% of patients received monotherapy. In the patients managed by monotherapy, SSRIs were the most prescribed (29.16%), followed by atypical anti-psychotics (26.38%) and benzodiazepines (24.30%). Prescriptions with generic names were 93.12%. The average number of drugs per encounter was 1.88. Drugs prescribed from the essential drugs list (India) were 41.66%. Drugs prescribed from the essential medicines list (WHO) were 47%. The total number of prescriptions with injections 0.23%. Conclusions: Prescribing patterns were according to the WHO-DUS parameters. Most patients were prescribed generic medicines. SSRIs, benzodiazepines and tricyclic antidepressants were the most prescribed drug class

Making rainfed agriculture sustainable through environmental friendly technologies in Pakistan: A review

Abstract:Pakistan is an agricultural country spreading over an area of about 79. 6 million hectares (Mha) with an arid and semi arid climate. Of 79. 6 Mha, about 23 Mha is suitable for crop production and nearly 25 percent of the total cultivated area is designated for rainfed agriculture. Unfortunately, rain-fed agriculture is constrained with multifarious problems such as moisture stress, soil erosion and crusting, nutrient deficiency, depletion and poor nutrient use efficiency, and weed infestation limiting the yield potential of these lands. In addition, deforestation and poor crop husbandry techniques are commonly noticed features. To meet the food requirements, farmers bring all the available pieces of lands under plough including steep slopes. Farming on steep slopes if not managed on scientific lines, results in severe erosion. The problems faced by the farmers are due to the unsustainable practices they adopt to practice dryland agriculture, limiting the productive potential of these important ecosystems. However, their potential can be improved by adopting suitable rainwater harvesting techniques; employing scientific soil and water conservation methods and using sustainable agricultural practices. This paper highlights some important issues associated with the rainfed agriculture of Pakistan. Working strategies for realizing optimum and sustainable yields have been outlined while conserving both land and water resources

Neuroactive steroids and their role in epilepsy

Neuroactive steroids are the certain steroids that alter neuronal excitability via the cell surface through interaction with certain neurotransmitter receptors. Neuroactive steroids regulate physiological functions of the central nervous system and have possible therapeutic potential in neurological diseases. They have been shown to affect neuronal excitability via their interaction with the ligand-gated ion channel family, such as the GABAA receptor by acting genomically as well as nongenomically. Positive modulators of GABAA receptor have anticonvulsant action as they enhance GABAergic transmission thereby increasing the seizure threshold. By virtue of these properties, neurosteroids appear to be relevant to pathophysiology and pharmacological treatment of many neurological diseases including catamenial epilepsy, stress induced epilepsy, temporal lobe epilepsy, alcohol withdrawal seizures, infantile spasm and status epilepticus. So far, only synthetic neurosteroid, ganaxolone has been tried in treatment of epilepsy and has shown good efficacy and tolerability. But, human data of trials are limited and hence, large double-blinded, placebo-controlled, randomized clinical trials are required before their use. The paper reviews the biosynthesis and GABAA receptor modulation of neurosteroids and their potential role in epilepsy

Analysis of neuro-theatre utilisation and reasons for cancellation to improve efficiency and productivity

Aim: In neurosurgery, much emphasis has recently been placed on theatre cancellation and time utilization as a key hospital management performance indicator. We sought to evaluate our unit’s theatre throughput efficiency, and identify the causes of elective surgery cancellations. Methods: We retrospectively audited all scheduled elective neurosurgical procedures over a period of 9 months. Results: Mean theatre utilization time was 47.0%. The common causes of cancellations were lack of theatre time (32%), non-availability of beds in recovery room (18.6%), and insufficient preoperative patient preparation (5.5%). Discussion: Inefficiencies were noted in turnover of patients and inaccurate prediction of operative time. Our theatre utilization time is consistent with available literature, however cancellations of elective surgery waste valuable operative time and resources. Conclusions: A multi- dimensional approach must be taken to improve theatre utilization and reduce cancellation rates. A pre-assessment clinic has been introduced in order to reduce cancellation rates

Review: Inelastic Constitutive Modeling: Polycrystalline Materials

This article provides a literature review that details the development of inelastic constitutive modeling as it relates to polycrystalline materials. This review distinguishes between inelastic constitutive models that account for nonlinear behavior at the microstructural level, time-independent classic plasticity models, and time-dependent unified models. Particular emphasis is placed on understanding the underlying theoretical framework for unified viscoplasticity models where creep and classical plasticity behavior are considered the result of applied boundary conditions instead of separable rates representing distinct physical mechanisms. This article establishes a clear understanding of the advantages of the unified approach to improve material modeling. This review also discusses recent topics in constitutive modeling that offer new techniques that bridge the gap between the microstructure and the continuum

VARIABLES IMPACTING GFR ESTIMATION METHOD FOR DRUG DOSING IN CKD: ARTIFICIAL NEURAL NETWORK PREDICTION MODEL

Objective: This study aimed to measure concordance between different renal function estimates in terms of drug doses and determine the potential significant clinical differences. Methods: Around one hundred and eighty patients (≥ 18 y) with chronic kidney disease (CKD) were eligible for inclusion in this study. A paired-proportion cohort design was utilized using an artificial intelligence model. CKD patients refined into those who have drugs adjusted for renal function. For superiority of Cockcroft-Gault (CG) vs. modified diet in renal disease (MDRD) guided with references for concordance or discordance of the two equations and determined the dosing tiers of each drug. Validated artificial neural networks (ANN) was one outcome of interest. Variable impacts and performed reassignments were compared to evaluate the factors that affect the accuracy in estimating the kidney function for a better drug dosing. Results: The best ANN model classified most cases to CG as the best dosing method (79 vs. 72). The probability was 85% and the top performance was slightly above 93%. Creatinine levels and CKD staging were the most important factors in determining the best dosing method of CG versus MDRD. Ideal and actual body weights were second (24%). Whereas drug class or the specific drug was an important third factor (14%). Conclusion: Among many variables that affect the optimal dosing method, the top three are probably CKD staging, weight, and the drug. The contrasting CKD stages from the different methods can be used to recognize patterns, identify and predict the best dosing tactics in CKD patients

Prevalence of Muscle Dysmorphia and Associated Health Activities in Male Medical Students in Karachi, Pakistan

Background: Muscle Dysmorphia (MD) is a subtype of body dysmorphic disorder (BDD) and is currently classified under anxiety disorders (subheading: Obsessive-compulsive disorder) in DSM 5. MD is hypothesized to affect the self-esteem and social outlook of the younger generation. MD shows a higher rate in males and may influence their self-confidence rendering them more prone towards using steroids, supplementary proteins and other drugs to alter their physical outlooks as shown in previous studies. This problem has been on the rise lately due to revolutionary advancement in the media and film industry and the abrupt changes about the standards of physical good looks and body shapes. With the lack of studies done in our population, our study will be helpful to consider the prevalence of the disease in our setting and increase awareness in the general public and clinicians. We hope to help clinicians/ therapists find better options in managing the disease. Materials: We performed a cross-sectional study with a sample size of 246 medical school students in Karachi to collect data through self-administered questionnaires. We used the DSM 5 criteria for the diagnosis of BDD and additional questions on the presence of MD. Nutritional habits, exercise routines, use of supplements and drugs were also obtained for exploratory analysis. Results: Our study predicted the prevalence of MD to be 25%. Other main findings included statistical significant associations between MD and the thoughts and practice of steroid use for muscularity. Conclusion: MD is an underdiagnosed and often unrecognized disease that we believe has significant consequences for the young male population. Further work is needed on this in our part of the world. Our research, we believe, can be a stepping stone for further studies that would incorporate wider populations