Correction of neglected post-burn severe calcaneo-valgus deformity of foot with Joshi’s external stabilization system: a one stage surgical procedure

Post burn calcaneovalgus is a complex foot deformity and management becomes increasingly difficult especially if deformity is neglected in growing young child resulting in secondary bony deformity. A simple technique of single stage surgical correction with Joshi’s external stabilization system (JESS) is described using principle of distraction osteogenesis or histogenesis without need of extensive plastic surgical procedure. A functional plantigrade foot is achieved after completion of the procedure without need of any bony procedure and least chances of any neurovascular compromise. JESS is a versatile external fixation device for correction of neglected postburn complex calcaneovalgus deformity

Comparison of Composition and Degradation Characteristics of Early Bloom Alfalfa with Fenugreek (Trigonella Foenum-Graecum) Forages Harvested at Different Stages of Maturity

The objective of this study was to compare the composition and degradation characteristics of early bloom alfalfa and fenugreek harvested after 9, 15 and 17 wk of growth. Crude protein (CP) content of fenugreek cut at 9, 15 and 17 wk was lower (P\u3c0.05) than that of alfalfa. Neutral detergent fibre (NDF) and lignin content of fenugreek harvested after 15 and 17 wk were higher (P\u3c0.05) than that of alfalfa. Ash content was lower (P\u3c0.05) in fenugreek than for alfalfa. In vitro dry matter disappearance (IVDMD) of fenugreek cut at 15 and 17 wk was similar to that of alfalfa. Total in vitro gas production of fenugreek cut at the three stages of growth was not significantly different from those observed for alfalfa. Results indicate that chemical composition and IVDMD of fenugreek at all stages of maturity were comparable to that of early bloom alfalfa

Confronting the opioid crisis: Practical pain management and strategies: AOA 2018 critical issues symposium

The United States is in the midst of an opioid crisis. Clinicians have been part of the problem because of overprescribing of narcotics for perioperative pain management. Clinicians need to understand the pathophysiology and science of addiction to improve perioperative management of pain for their patients. Multiple modalities for pain management exist that decrease the use of narcotics. Physical strategies, cognitive strategies, and multimodal medication can all provide improved pain relief and decrease the use of narcotics. National medical societies are developing clinical practice guidelines for pain management that incorporate multimodal strategies and multimodal medication. Changes to policy that improve provider education, access to naloxone, and treatment for addiction can decrease narcotic misuse and the risk of addiction

Hyperparathyroidism in Survivors of Childhood Malignancy after Total Body Irradiation

Objective: The risk of developing hyperparathyroidism (HPT) in adults after radiation exposure is higher than that of the general population. Extensive follow up guidelines of United Kingdom Children’s Cancer Study group (UKCCSG) or Scottish intercollegiate guidelines network (SIGN) do not recommend monitoring serum calcium or parathyroid hormone in patients treated for childhood malignancies. The aim of this study was to examine the occurrence of HPT in a cohort of survivors of childhood malignancy attending a late effects clinic after their treatment for haematological and non-haematological malignancies that included previous irradiation Design and methods: Study was performed in 105 patients attending a late effects clinic. These patients had received different modalities f treatment including surgery, chemotherapy, radiotherapy and bone marrow transplant for haematological and non-haematological malignancies in their childhood with. All patients had evaluation for thyroid and parathyroid disease with a clinical examination and biochemical investigations. Patients with hyperparathyroidism were treated with parathyroidectomy in the absence of thyroid disease and positive localization on imaging. This resulted in normalization of serum calcium. Conclusion: This data suggests that there is a significant risk of hyperparathyroidism in young females with haematological malignancies who received total body irradiation as a single fraction for bone marrow transplant

M-Theory on Deformed Superspace

In this paper we will analyse a noncommutative deformation of the ABJM theory in N=1 superspace formalism. We will then analyse the BRST and the anti-BRST symmetries for this deformed ABJM theory, in linear as well as non-linear gauges. We will show that the sum of gauge fixing term and the ghost term for this deformed ABJM theory can be expressed as a combination of the total BRST and the total anti-BRST variation, in Landau and non-linear gauges. We will show that in Landau and Curci-Ferrari gauges this deformed ABJM theory is invariant under a additional set of symmetry transformations. We will also discuss the effect that the addition of a bare mass term has on this theory.Comment: 16 pages, 0 figures, accepted for publication in Phys Rev