Surgical management of avascular necrosis of femoral head in young adults treated with uncemented total hip replacement

Background: Normal hip joint is subjected to many stresses during daily activities performed by an individual. Since it is one of the major weight bearing joints of the body, its normal function is necessary for daily activities. Avascular necrosis (AVN) of the femoral head is one of the common causes of painful hip in a young adult. Core decompression, fibular sturt graft can be considered in early stages, total hip arthroplasty in later stages of AVN of femoral head.Methods: This is a retrospective study of 30 patients following uncemented total hip replacement, who were operated between August 2017 and March 2020 at MNR medical college and hospital, Sangareddy. They were followed up for a minimum period of 1 year and evaluated using Harris hip scoring system. Harris hip score is designed specifically for measuring functional outcomes in hip arthroplasty.Results: There was a significant improvement in function as measured with the Harris hip score. The overall preoperative Harris hip score was 43, which remarkably improved to 89 postoperatively. The results observed, showed that all patients had good to excellent results, (Harris hip score ≥0) thus showing a good degree of pain relief, improvement in function and range of motion.Conclusions: Although the use of total hip arthroplasty in young patients will more likely necessitate future revision surgery, the consistent relief of pain and good functional results have made this procedure an attractive treatment choice for the debilitating arthritis resulting from osteonecrosis of the femoral head.

A study on functional outcome of posterior cruciate ligament substituted total knee arthroplasty

Background: Total knee replacement surgery is considered as a treatment of choice in patients with advanced arthritis, especially in patients where conservative treatment has been failed. Total knee replacement gives good pain relief, functional improvement of knee and correction of deformity.Methods: This is study of 39 patients following total knee arthroplasty, who were operated between August 2017 and March 2020 at MNR Medical College and Hospital, Sangareddy. They were followed up for a minimum period of 1 year and evaluated using oxford knee scoring system. Oxford knee score is designed specifically for measuring outcomes in knee arthroplasty. There were 14 right knees, 10 left knees, 15 bilateral knees.Results: There was a significant functional improvement of knee in patients and we had achieved excellent results, out of 39 patients and 4 patients had post op suprapatellar fullness, which was relieved with medications for 3 weeks and 2 patients (2 knees) without no signs of immediate post-operative period, developed infection after 6 months followed which underwent staged revision total knee replacement. The outcome categories based on oxford knee scoring system: excellent (40-48), good (30-39), fair (20-29) and poor (0-19).Conclusions: It is difficult to balance the knee with retention of posterior cruciate ligament, whereas posterior cruciate ligament substituting total knee replacement gives reproducible and good results, hence it is the preferred mode of management

The Power of Two Choices in Distributed Voting

Distributed voting is a fundamental topic in distributed computing. In pull voting, in each step every vertex chooses a neighbour uniformly at random, and adopts its opinion. The voting is completed when all vertices hold the same opinion. On many graph classes including regular graphs, pull voting requires $\Theta(n)$ expected steps to complete, even if initially there are only two distinct opinions. In this paper we consider a related process which we call two-sample voting: every vertex chooses two random neighbours in each step. If the opinions of these neighbours coincide, then the vertex revises its opinion according to the chosen sample. Otherwise, it keeps its own opinion. We consider the performance of this process in the case where two different opinions reside on vertices of some (arbitrary) sets $A$ and $B$, respectively. Here, $|A| + |B| = n$ is the number of vertices of the graph. We show that there is a constant $K$ such that if the initial imbalance between the two opinions is ?$\nu_0 = (|A| - |B|)/n \geq K \sqrt{(1/d) + (d/n)}$, then with high probability two sample voting completes in a random $d$ regular graph in $O(\log n)$ steps and the initial majority opinion wins. We also show the same performance for any regular graph, if $\nu_0 \geq K \lambda_2$ where $\lambda_2$ is the second largest eigenvalue of the transition matrix. In the graphs we consider, standard pull voting requires $\Omega(n)$ steps, and the minority can still win with probability $|B|/n$.Comment: 22 page

A study on the effect of silver nitrate and 8-hydroxyquinoline citrate pulsing solutions on Lilium cut flowers

Lilium is one of the most important cut flowers in commercial markets, giving customers ornamental value. Fresh flowers, a highly perishable item, need more care and proper treatment for their longer post-harvest life and due to this, the end users face the post-harvest losses of cut flowers. Such losses can be minimized by using preservative chemical, which plays an important role in increasing the vase life of flowers. To increase the post-harvest life of lilium cut flowers cv. ‘Pavia’, the present investigation was aimed to study the effect of different combinations and concentrations of silver nitrate at 50, 75 and 100 ppm and 8-hydroquinoline citrate at 100, 150 and 200 ppm pulsing solutions with 20 % sucrose. Three replications were completely randomised with 16 treatments and one control. Silver nitrate showed better results in flower bud opening, flower bud opening to complete flowering, flower size, bloom life, dry weight and dry matter percentage. Among the treatment concentrations, AgNO3 at 50 ppm with 20% sucrose showed the most effective result on enhancing the selected parameters and improved flower quality during post-harvest life. Among the treatment combinations, 8-HQC at 100 ppm + AgNO3 at 75 ppm with 20 % sucrose showed better results. These findings will be useful to researchers, farmers, and end users to retain the ornamental value of lilium cut flowers for longer than usual

Surgical management of middle and distal third fractures of scaphoid fixed with Herbert screw by volar approach

Surgical treatment of scaphoid fractures has evolved over the years to include variety of procedures and techniques. However scaphoid middle and distal third fractures fixation with Herbert screw by means of volar approach is a safe and effective method with good functional outcome and union rates. Our study concluded that management of middle and distal third scaphoid fractures with Herbert screw by volar approach gives excellent results in terms of union and recovery to daily activities. The wrist function improvement is more satisfactory, and the incidence of complications is low with this modality of treatment

Surgical management of giant cell tumor in adolescent by excision or curettage followed by fibular strut graft

Giant cell tumour (GCT) in adolescent is a rare tumour. It commonly occurs in skeletally mature patients aged between 20-40 years. In adults it is seen in epiphyseal region. In patients with intact physis, it arises from the metaphysis. Giant cells are more common in females. It is more common in the ends of long bones of distal end of femur, proximal tibia, and distal radius. 14 cases of surgical management of GCT by excision or curettage in adolescent followed by fibular strut graft. 1 year follow up of all cases of GCT in adolescent treated with excision or curettage followed by fibular strut graft was done. Out of 14 patients, 12 patients did not develop any recurrence of GCT. 2 patient developed recurrence after 6 months. All the patients were able to attain good range of movements 2 months after surgery. GCT in adolescent surgically treated with excision or curettage followed by fibular graft had excellent results in terms of recovery of daily activities, wound healing. Chances of recurrence more in patients treated with curettage and bone grafting.

Eco-psychiatry and Environmental Conservation: Study from Sundarban Delta, India

Aims This study attempts to examine the extent and impact of human-animal conflicts visa-vis psychosocial stressors and mental health of affected people in two villages adjacent to Sundarban Reserve Forest (SRF) in the Gosaba Block, West Bengal, India. Methods Door to door household survey for incidents of human-animal conflicts, Focus Group Discussions, In-depth Interviews, Case studies, Community Mental health clinics and participatory observation. Results A total of 3084 households covering a population of 16,999 were surveyed. 32.8% people live on forest-based occupation. During the last 15 years 111 persons (male 83, female 28) became victims of animal attacks, viz, Tiger (82%), Crocodile (10.8%) and Shark (7.2%) of which 73.9% died. In 94.5% cases the conflict took place in and around the SRF during livelihood activities. Tracking of 66 widows, resulted from these conflicts, showed that majority of them (51.%) are either disabled or in a very poor health condition, 40.9% are in extreme economic stress and only 10.6% remarried. 1 widow committed suicide and 3 attempted suicide. A total of 178 persons (male 82, female 96) attended the community mental health clinics. Maximum cases were Major Depressive Disorder (14.6%), followed by Somatoform Pain Disorder (14.0%), Post Traumatic Stress Disorder-animal attack related (9.6%) and Adjustment Disorder (9%). 11.2% cases had history of deliberate self-harm attempt, of which 55% used pesticides. Conclusions Improvement of quality of life of this deltaic population by appropriate income generation and proper bio-forest management are the key factors to save their life as well as the mangrove environment of the Sundarban region

Response of preservative chemicals on the shelf life of cut lilium (Lilium spp.) flower cv. ‘Pavia’

Lilium cut flowers have commercial importance and extending their vase life is vital. An increase in the vase life quality and quantity can directly increase the viability and price realization of commercially important flowers like lilium. Shelf life of cut lilium flower is influenced by using different preservative chemicals and sucrose added in vase solution. Such an extension of vase life can be achieved via chemical treatment. The trial was carried out to examine the effect of various concentration of two chemicals, AgNO3 (silver nitrate) and 8-HQC (8-Hydroxyquinoline citrate) along with sucrose on the shelf life of lilium cut flower cv. ‘Pavia’ (cross between Asiatic and Longiflorum lilies). In the experiment, sucrose (20%), 8-HQC at 3 concentrations (100, 150, 200 ppm) and AgNO3 at 3 concentrations (50, 75, 100 ppm) and water (distilled) as control were tested alone and with combinations. Cut flowers of lilium were treated at one bud opening stage. The trial was carried out in a completely randomized design (CRD) having 16 treatments and one control in three (3) replications. The fresh weight and relative fresh weight of the cut flower spike, opening of all flowers on a spike, vase solution uptake on a day, total vase solution uptake and vase life of lilium cut flower spike showed the best outcome with AgNO3 (50 ppm) and 20% sucrose treatment combination. Out of the two chemicals, silver nitrate showed better results than 8-HQC as a preservative in enhancing the shelf life of cut Lilium flower cv. ‘Pavia’. Analysis of this new and exciting method will be useful to research institutes, commercial producers, wholesalers, retailers, consumers or anyone to choose right chemical and concentration of holding solution to maximize the post-harvest life of lilium cut flowers