Tibial plateau fractures: A new classification scheme

Fractures of the tibial plateaus are common injuries. Various classification schemes have been used to describe these injuries. Although each system has its own purpose, the simpler systems do not allow comparison with more complex divisions. The problem is compounded by the variable use of adjectives that describe these fractures. A comprehensive classification of tibial plateau fractures should group fractures that are similar in topography, morphology, and pathogenesis, requiring similar treatment, and having a similar prognosis. Fracture dislocations and standard tibial plateau fractures should be incorporated into a single classification to avoid the use of two complementary classifications. Any such classification should not be difficult to remember or to use. Keeping in mind these requirements, the authors devised a simple yet comprehensive classification. The authors studied 80 cases of tibial plateau fractures from January 1988 to September 1997, and used contemporary classifications of tibial plateau fractures as a database to formulate the new classification. A new fracture, subcondylar bicondylar with coronal split, has been classified for the first time. An alphanumeric system has been developed that has made nomenclature easy to remember and use. An effort has been made to address the profoundly confusing issue of variable adjectives that describe these injuries. A review of the literature shows that fractures in the authors\u27 classification have been grouped according to similar pathomechanics, treatment, and functional results

COVID-19 PANDEMIC AND IMPENDING GLOBAL MENTAL HEALTH IMPLICATIONS

The increase in organisms transference and infectious pandemics across the globe have been accelerated by an increase in travel, international exchange and global changes in earth’s climate. COVID-19, a virus caused by the novel coronavirus that was initially identified on December 2019, in Wuhan city of China is currently affecting 146 territories, states and countries raising distress, panic and increasing anxiety in individuals exposed to the (actual or supposed) peril of the virus across the globe. Fundamentally, these concerns ascend with all infections, including those of flu and other agents, and the same worldwide safeguards are compulsory and suggested for protection and the prevention of further diffusion. However, media has underlined COVID-19 as rather an exclusive threat, which has added to panic and stress in masses which can lead to several mental health issues like anxiety, obsessive compulsive disorder and post-traumatic stress disorder which should be contained immediately in its initial phases

Tracheal inujry due to blunt chest trauma: a rare surgical emergency

Tracheal injury is a rare complication of blunt chest trauma. The patients usually present with signs of respiratory distress. Primary repair is the treatment of choice in case of large defects, while small tears can be managed conservatively. Immediate operation is recommended to improve deteriorating pulmonary function. The decrease in mortality and long-term morbidity depends on early diagnosis. We report a case of tracheal injury due to non-penetrating thoracic trauma which was successfully managed with surgery

Efficient blockchain-based group key distribution for secure authentication in VANETs

This paper proposes a group key distribution scheme using smart contract-based blockchain technology. The smart contract’s functions allow for securely distributing the group session key, following the initial legitimacy detection using public key infrastructure-based authentication. For message authentication, we propose a lightweight symmetric key cryptography-based group signature method, supporting the security and privacy requirements of vehicular ad hoc networks (VANETs). Our discussion examined the scheme’s robustness against typical adversarial attacks. To evaluate the gas costs associated with smart contract’s functions, we implemented it on the Ethereum main network. Finally, comprehensive analyses of computation and communication costs demonstrate the scheme’s effectiveness

Blockchain-based secret key extraction for efficient and secure authentication in VANETs

Intelligent transportation systems are an emerging technology that facilitates real-time vehicle-to-everything communication. Hence, securing and authenticating data packets for intra- and inter-vehicle communication are fundamental security services in vehicular ad-hoc networks (VANETs). However, public-key cryptography (PKC) is commonly used in signature-based authentication, which consumes significant computation resources and communication bandwidth for signatures generation and verification, and key distribution. Therefore, physical layer-based secret key extraction has emerged as an effective candidate for key agreement, exploiting the randomness and reciprocity features of wireless channels. However, the imperfect channel reciprocity generates discrepancies in the extracted key, and existing reconciliation algorithms suffer from significant communication costs and security issues. In this paper, PKC-based authentication is used for initial legitimacy detection and exchanging authenticated probing packets. Accordingly, we propose a blockchain-based reconciliation technique that allows the trusted third party (TTP) to publish the correction sequence of the mismatched bits through a transaction using a smart contract. The smart contract functions enable the TTP to map the transaction address to vehicle-related information and allow vehicles to obtain the transaction contents securely. The obtained shared key is then used for symmetric key cryptography (SKC)-based authentication for subsequent transmissions, saving significant computation and communication costs. The correctness and security robustness of the scheme are proved using Burrows–Abadi–Needham (BAN)-logic and Automated Validation of Internet Security Protocols and Applications (AVISPA) simulator. We also discussed the scheme’s resistance to typical attacks. The scheme’s performance in terms of packet delay and loss ratio is evaluated using the network simulator (OMNeT++). Finally, the computation analysis shows that the scheme saves ~99% of the time required to verify 1000 messages compared to existing PKC-based schemes

To Determine Mean Change In Weight Of Patients Undergoing Maxillomandibular Fixation

Abstract Objective: Optimum management of patient needs is the most important step for the restoration of form and function. Maxillomandibular fixation is one of the treatment modalities used very frequently in maxillofacial surgery. This study aims to determine the mean change in weight in patients undergoing Maxillomandibular Fixation. Methods: This observational cross-sectional study was conducted at the Department of Oral and Maxillofacial Surgery Foundation University Medical College from 27th April 2018 to 22nd January 2019. This study included patients male and female, who presented with maxillofacial trauma, orthognathic surgery and procedures in which MMF ( Maxillomandibular fixation ) was indicated were included in this study. Pre-operative weight was measured in kilograms with an analogue weight machine and designated as W1. Patients were advised to a liquid diet and kept on follow-up. After four weeks of MMF again weight of the patient was measured and designated as W2. Follow-up was done through the patient's contact number. Results: In this study, the mean weight of patients preoperatively was 59.46±12.23 Kg. The postoperative mean weight of patients was 57.81±11.58 Kg. A decrease of 1.65 Kg was seen in the patient’s weight postoperatively.  No significant difference was seen for weight change in patients postoperatively with age, gender, educational status, occupational status, socioeconomic status and an indication of MMF. Conclusion: Results of this study showed weight loss in patients who underwent maxillomandibular fixation. This factor should be considered during the perioperative period to prevent postoperative complications, postoperative weight loss, and malnutrition of patients undergoing maxillomandibular surgery and reflect the need for guidance on diet postoperatively, mainly directed to frequency of feeding and high protein liquid diet and nutritional supplements.