Open reduction and internal fixation in a case with transscaphoid perilunate dislocation 8 months after the injury: a patient with a 5-year follow-up

The management of perilunate dislocations diagnosed later than three months continue to elicit debate with literature being scarce. We report a 22-year-old male with transscaphoid perilunate dislocation who reported to our hospital 8 months after sustaining the injury. Open reduction was done along with bone grafting. Five years after the surgery the patient is symptom-free with an excellent range of motion

The reciprocal ledge closing wedge osteotomy for post traumatic coxa vara

To report a proximal femoral osteotomy with retention of bone ledges in a reciprocal position to increase bone contact and stability. The method was applied to 5 patients over a 3-year period. All patients had coxa vara. The average length gained was 1.5 cm, and the average neck shaft angle improvement was 30°. The Harris hip score improved from an average of 63 to 82. The reciprocal ledge osteotomy is technically less demanding and also allows conversion of normal shear forces around the upper femur to stabilizing forces. This method allows easier use of the DHS implant as potential rotation about the axis of the screw is negated by the ledges and the dynamic forces

A REVIEW ON THE IMPACT OF THE COVID-19 PANDEMIC ON THE HEALTH CARE SECTOR

The global crisis of the present era, the COVID-19 pandemic, has changed given new normal ways in many of the sectors. The present review highlights the impact, problems, and challenges faced by major areas of the health care sector due to pandemics and also addresses some of the aspects of upcoming approaches. The healthcare sector is the one sector that is on-demand since this COVID-19 pandemic raised. During the initial period, there was disruption of various services provided by the health care sector due to supply chain management issues and reduction in demand by consumers, quarantine, and lockdown period. The healthcare workers also confronted a huge challenge due to the increased number of cases and shortage of amenities and safety measures. This significantly affected even COVID-19 patients and the general public suffering from other diseases. To fight this issue, research and development (RandD) in pharmaceutical industries with great efforts to explore molecules and save many lives. Gradually innovative ways to strengthen and combat pandemics started emerging. Numeral ways and rules were adopted to prevent, diagnose and cure the disease. Artificial intelligence technology has emerged as one of the boons to address many of the unresolved or time-consuming mysteries. All the divisions of health care sectors have started working more efficiently with adopted new strategies to face future challenges

Interleukin-18 induces angiogenic factors in rheumatoid arthritis synovial tissue fibroblasts via distinct signaling pathways

Objective Interleukin-18 (IL-18) is a proinflammatory cytokine implicated in the pathogenesis of rheumatoid arthritis (RA). This study was undertaken to examine the role of IL-18 in up-regulating secretion of the angiogenic factors stromal cell–derived factor 1Α (SDF-1Α)/CXCL12, monocyte chemoattractant protein 1 (MCP-1)/CCL2, and vascular endothelial growth factor (VEGF) in RA synovial tissue (ST) fibroblasts, and the underlying signaling mechanisms involved. Methods We used enzyme-linked immunosorbent assays, Western blotting, and chemical inhibitors/antisense oligodeoxynucleotides to signaling intermediates to assess the role of IL-18. Results IL-18 significantly enhanced the production of SDF-1Α/CXCL12, MCP-1/CCL2, and VEGF in RA ST fibroblasts, in a time- and concentration-dependent manner. IL-18–induced SDF-1Α/CXCL12 up-regulation was dependent on JNK, p38 MAPK, phosphatidylinositol 3-kinase (PI3K), and NFΚB. While IL-18–induced production of SDF-1Α/CXCL12 was also dependent on protein kinase CΔ (PKCΔ), production of MCP-1/CCL2 was dependent on PKCΑ, not PKCΔ. Additionally, RA ST fibroblast IL-18–induced MCP-1/CCL2 production was mediated by JNK, PI3K, and NFΚB. In contrast, IL-18 did not induce secretion of RA ST fibroblast MCP-1/CCL2 or VEGF via p38 MAPK. IL-18–induced RA ST fibroblast production of VEGF was mediated mainly by JNK-2, PKCΑ, and NFΚB. IL-18 induced phosphorylation of JNK, PKCΔ, p38 MAPK, and activating transcription factor 2 (ATF-2) in RA ST fibroblasts in a time-dependent manner, with JNK-2 being upstream of PKCΔ, ATF-2, and NFΚB. Conclusion These data support the notion that IL-18 has a unique role in inducing the secretion of angiogenic SDF-1Α/CXCL12, MCP-1/CCL2, and VEGF in RA ST fibroblasts, via distinct signaling intermediates.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/56041/1/22705_ftp.pd

Molecular epidemiology of clinical and carrier strains of methicillin resistant Staphylococcus aureus (MRSA) in the hospital settings of north India

BACKGROUND: The study was conducted between 2000 and 2003 on 750 human subjects, yielding 850 strains of staphylococci from clinical specimens (575), nasal cultures of hospitalized patients (100) and eye & nasal sources of hospital workers (50 & 125 respectively) in order to determine their epidemiology, acquisition and dissemination of resistance genes. METHODS: Organisms from clinical samples were isolated, cultured and identified as per the standard routine procedures. Susceptibility was measured by the agar diffusion method, as recommended by the Nat ional Committee for Clinical Laboratory Standards (NCCLS). The modified method of Birnboin and Takahashi was used for isolation of plasmids from staphylococci. Pulsed-field gel electrophoresis (PFGE) typing of clinical and carrier Methicillin resistant Staphylococcus aureus (MRSA) strains isolated during our study was performed as described previously. RESULTS: It was shown that 35.1% of Staphylococcus aureus and 22.5% of coagulase-negative staphylococcal isolates were resistant to methicillin. Highest percentage of MRSA (35.5%) was found in pus specimens (n = 151). The multiple drug resistance of all MRSA (n = 180) and Methicillin resistant Coagulase-negative Staphylococcus aureus (MRCNS) (n = 76) isolates was detected. In case of both methicillin-resistant as well as methicillin-sensitive Saphylococcal isolates zero resistance was found to vancomycin where as highest resistance was found to penicillin G followed by ampicillin. It was shown that the major reservoir of methicillin resistant staphylococci in hospitals are colonized/infected inpatients and colonized hospital workers, with carriers at risk for developing endogenous infection or transmitting infection to health care workers and patients. The results were confirmed by molecular typing using PFGE by SmaI-digestion. It was shown that the resistant markers G and T got transferred from clinical S. aureus (JS-105) to carrier S. aureus (JN-49) and the ciprofloxacin (Cf) and erythromycin (E) resistance seemed to be chromosomal mediated. In one of the experiments, plasmid pJMR1O from Staphylococcus aureus coding for ampicillin (A), gentamicin (G) and amikacin (Ak) resistance was transformed into Escherichia coli. The minimal inhibitory concentrations (MICs) for A and G were lower in E. coli than in S. aureus. However, the MIC for Ak was higher in E. coli transformants than in S. aureus. CONCLUSION: There is a progressive increase in MRSA prevalence and multi-drug resistance in staphylococci. Vancomycin is still the drug of choice for MRSA infections. The major reservoir of methicillin resistant staphylococci in hospitals is colonized/infected inpatients and colonized hospital workers. Resistance transfer from staphylococci to E. coli as well as from clinical to carrier staphylococci due to antibiotic stress seemed to be an alarming threat to antimicrobial chemotherapy

Structural characteristics of camel-bone gelatin by demineralization and extraction

Camel bone was demineralized through HCl acidulation process at different concentrations (0.0%, 1.5%, 3.0%, and 6.0%) over 1–5 days. The level of demineralization was acid concentration and soaking time dependent. Highest demineralization (62.0%) was recorded in bone sample treated with 6.0% dilute acid for 5 days. Energy dispersive X-ray spectroscopy (EDX) elemental analysis revealed reduction in Ca and increase in N and H, while O remains unaffected. Particulate characteristics by scanning electron microscope showed an increased surface roughness of bone after demineralization. Fourier transform infrared (FT-IR) analysis of ossein depicted the presence of functional group similar to that of bone protein (collagen). Statistical optimization by central composite design (CCD) revealed a significant quadratic model for optimum values of extraction temperature, pH, and extraction time. The highest gelatin yield from camel bone was 23.66% at optimum extraction condition (71.87°C, pH 5.26, and 2.58 h) and the bloom was 205.74 g. Camel bone is suitable for production of gelatin with good potentials in food and nonfood applications. © 2017 Taylor & Francis Group, LLC

Reprofiling of Octogenarian Antiviral Agent: A New Avenue Venture to Discover Viral Infection

Identification of a new drug molecule to a new target, specifically viral, bacterial, and fungal infection, is the prime focus of time immortal. The tridiagonal practice of drug discovery for emerging viral infection turned out to be a new venture to combat the morbidly and mortality of recent pandemics due to viral, bacterial, fungal, infection and infestation, the emerging number of viral infections day by day, the targeted therapy with the gap in assessment lead to reprofiling or repositioning available FDA-approved formulation give promising drug candidate for various infection specifically the current scenario of antiviral drug-reprofiling through drug designing approach, the emergence of resistance to existing antiviral drugs and re-emerging viral infections are the greatest challenges in antiviral drug discovery. The reprofiling approach is a worthy strategy to get the potent antiviral in brief span of time to overcome the challenges in antiviral therapy. The present chapter will be another representing the most promising results of reprofiling (Repositioning or repurposing) approach in the treatment of various infectious diseases

Dietary knowledge, attitude and practice among type 2 diabetes mellitus patients in Sudan: a hospital-based cross-sectional study

Background: In Sudan, the prevalence of diabetes in adults was estimated at 19.1% in 2015. This study assessed dietary knowledge, attitude, and practices (KAP) of type 2 diabetes mellitus (T2DM) patients in Sudan. Methods: We randomly selected 238 T2DM patients from a list of 2460 patients from the Jabber Abulizz Hospital. We interviewed them face-to-face using a structured questionnaire. Multivariate logistic regression analyses were performed to investigate the determinants of KAP regarding the recommended diets for T2DM patients. Results: Majority of the patients demonstrated good knowledge (54.6%), positive attitude (79%); and good practice (58%). The result revealed that patients with formal education had 3.0 (95% CI: 1.6-5.7) times higher odds of having good diabetic dietary knowledge than those with informal education. While patients who had good knowledge and a positive attitude were respectively 4.7 (95% CI: 2.4-8.9) and 3.2 (95% CI: 1.5-6.7) times more likely to follow dietary recommendations than the patients with poor knowledge and negative attitudes. Conclusion: Irrespective of the socio-demographic position, the good knowledge and the positive attitude towards the recommended diet, all the T2DM patients complied with the dietary recommendations. These findings highlight the need for improving knowledge and promoting positive attitudes towards the recommended diet among T2DM patients