Closed diaphyseal fractures of femur in children treated by hip spica: early result of a clinical study

Background: Diaphyseal fracture of femur is a common injury in children with bimodal age distribution. The treatment modality of these fractures depend on several factors such as age of the patient, characteristics of the fracture– degree of displacement, location of fracture in femur, comminution, and open or closed injury. With the invention of titanium elastic nails, the recent trend in treating these fractures is by closed reduction and TENS, but the surgical management is not without complications hence we share our experience to reemphasize the role of hip spica cast immobilisation in treating these injuries.Methods: This is a prospective study of 30 cases of diaphyseal fractures of femur in children between the ages of 6 month to 6 years. History and mode of injury were recorded and complete physical examination was done. Plain anteroposterior and lateral radiographs confirmed diagnosis. Hip spica cast was applied under sedation or short general anesthesia. One and half spica was applied over thick padding with hip flexed 45 degrees abducted 30 degrees and external rotation of 10 degree. No attempt was made to obtain an end to end reduction. Patients were allowed to go home the same day after giving instructions regarding spica care. Follow up was done and radiographs were taken at 1, 2, 4 and 12 weeks. Any malunion– LLD, angulation or rotation were recorded.Results: The mean age of patients was 3.5 years (range 0.5 to 6 years). Of these 12 (40%) were male and 18 (60%) were female. The commonest mode of injury was fall while play in 73.33% (n=22) of patients. Mid shaft fractures are more common 53.33% (n=16) followed by upper third 40% (n=12). Average time for fracture union was 6 weeks (range 4-10 weeks). At one year all fractures healed in a satisfactory position without any LLD. Two patients had minor skin problems which were easily treated and cast continued. No stiffness of hip, knee or ankle was noted. Conclusions: Hip spica casting is an effective and reliable method for treating femoral shaft fractures in children with a union rate of 100%. The advantages of conservative treatment such as the avoidance of general anaesthesia on two occasions and the avoidance of surgery make a compelling argument in favour of this form of treatment

Comparative study between transforaminal epidural selective nerve root block versus interlaminar epidural in the treatment of lumbar radicular leg pain

Background: Sciatic neuralgia is a result of nerve root oedema because of the inflammatory, immunological and mechanical factors. Steroid injections play an important role in the management of sciatic radiculopathy. Steroids act by reducing the oedema around the nerve roots and decreasing pain. Locally administered steroids have the advantage of reduced dosage and targeted delivery around the nerve roots. This forms the basis of epidural steroid injections. This can be given around the nerve root in the transforaminal space or in the interlaminar space. There is a paucity of literature comparing the two techniques of epidural steroid injections. We have done a randomized comparative trial, to compare the effectiveness of the two modalities of injection in the management of a single level unilateral foraminal disc herniation.Methods: Patients were randomized in two groups Group A: Transforaminal epidural (SNRB) and Group B: interlaminar epidural. Same dose of steroid was used in each group.Results: Immediate post injection, 2 week and 1 month transforaminal epidural (SNRB) was better compare to interlaminar epidural however at the end of 3 months the difference was not significant (p=0.08).Conclusions: Both transforaminal and interlaminar epidural injection are effective form of treatment in mild to moderate grade of disc disease. Both the technique provide short lasting relief in the symptoms associated with disc pathology, however pain management is better in transforaminal group compared to interlaminar group. Thus these techniques can be considered for delaying surgery and providing intermitant relief.

Autologous blood injection technique in the treatment of refractory lateral elbow tendinopathy

Background: Lateral elbow tendinopathy is a very common clinical condition whose management by the consultant often shifts from one to another modality. This study was conducted to know the efficacy of a minimally invasive technique of autologous blood injection in patients who were resistant to more conservative methods.Methods: This is a randomized prospective study of forty-eight patients (median age, 37 to 40 years), presenting with lateral elbow symptoms for a duration of more than six weeks and failed to respond to other methods of conservative treatment. Patients were consecutively grouped into treatment with autologous blood injections (Group I, n = 24) and control group with injection of normal saline (Group II, n = 24). 1 ml of autologous blood was drawn from dorsal venous arch and injected into the site of maximum tenderness over lateral aspect of the elbow under all aseptic precautions for all patients in group I. Similarly 1 ml of normal saline was injected at the site of maximum tenderness for patients in group II.  Results were evaluated based on severity of the elbow complaints, tenderness and Cozen’s test at the end of follow-up of twenty weeks.Results: The incidence of this condition was more in the third decade 39.6% (n=19), with female preponderance 58.3% (n=28) and the dominant arm being more commonly involved 58.3% (n=28). Excellent results were found in group I in n=15 (62.5%) whereas poor results were more in group II in n=14 (58.3%). Group I had poor result only in n=03 (12.5%) of patients who later were given another dose of autologous blood or were treated surgically. Conclusions: Injection of autologous blood is a very efficacious minimally invasive procedure with satisfactory results in patients of lateral elbow tendinopathy who do not respond to other conservative methods of treatment

Design and Simulation of Solar Car

This work, focused on an idea about solar car technology which solves the major problem of fuel and pollution in present days. Determine how feasible widespread change to solar car’s would be in future with all information taken into account, concluded that solar cars have several advantages as energy efficient, low pollution. In the present work a complete drawing and drafting of solar car have been prepared using Solid works software. After complete analysis of this drawing by using ANSYS 13.0 it is find out bear capability of load, stress, an d strain of front & rear collision of car frame. A completed data are analyzed to examine the technical aspects of the solar car technology. Overall, solar technology has a lot of potential in the distant future, but as for right now they are not a signif icant applied over today’s internal combustion engine

Photodynamic Therapy Combined with CO2 Laser Vaporization on Disseminated Superficial Actinic Porokeratosis: A Report of 2 Cases on the Face

Disseminated superficial actinic porokeratosis (DSAP) is a skin condition that usually shows a poor response to different modalities of treatment. Herein we describe 2 patients with DSAP on the face, each treated with 3 to 4 sessions of photodynamic therapy combined with laser vaporization

Peripartum Cardiomyopathy: Facts and Figures

Peripartum cardiomyopathy (PPCM) is a rare clinical entity during pregnancy. PPCM is a diagnosis of exclusion. These patients do not have prior history of heart disease, and there are no other known possible causes of heart failure. It is more common in African countries, may be related to the consumption of kanwa, in the postpartum period. The multiparity, African descent and pregnancy-induced hypertension are a few risk factors for PPCM. The exact etiology of PPCM is not known; possible theories range from myocarditis to the maladaptation to the changes of pregnancy. The clinical manifestation varies from shortness of breath to thromboembolic phenomenon. Echocardiography is essential for diagnosis as well as differential diagnosis of PPCM. These patients preferably are managed in tertiary healthcare facilities. Anticoagulation and antiarrhythmic medications are pillars for the management of PPCM patients. If required, mechanical devices should be used temporarily. PPCM patients may need heart transplant. The beneficial role of bromocriptine and immunosuppression is not clear in PPCM patients. Subsequent pregnancies should be avoided to prevent the PPCM occurrence

High-Pitch, Low-Voltage and Low-Iodine-Concentration CT Angiography of Aorta: Assessment of Image Quality and Radiation Dose with Iterative Reconstruction

Objective: To assess the image quality of aorta obtained by dual-source computed tomography angiography (DSCTA), performed with high pitch, low tube voltage, and low iodine concentration contrast medium (CM) with images reconstructed using iterative reconstruction (IR). Methods: One hundred patients randomly allocated to receive one of two types of CM underwent DSCTA with the electrocardiogram-triggered Flash protocol. In the low-iodine group, 50 patients received CM containing 270 mg I/mL and were scanned at low tube voltage (100 kVp). In the high-iodine CM group, 50 patients received CM containing 370 mg I/mL and were scanned at the tube voltage (120 kVp). The filtered back projection (FBP) algorithm was used for reconstruction in both groups. In addition, the IR algorithm was used in the low-iodine group. Image quality of the aorta was analyzed subjectively by a 3-point grading scale and objectively by measuring the CT attenuation in terms of the signal- and contrast-to-noise ratios (SNR and CNR, respectively). Radiation and CM doses were compared.Results: The CT attenuation, subjective image quality assessment, SNR, and CNR of various aortic regions of interest did not differ significantly between two groups. In the low-iodine group, images reconstructed by FBP and IR demonstrated significant differences in image noise, SNR, and CNR (p<0.05). The low-iodine group resulted in 34.3% less radiation (4.4 ± 0.5 mSv) than the high-iodine group (6.7 ± 0.6 mSv), and 27.3% less iodine weight (20.36 ± 2.65 g) than the high-iodine group (28 ± 1.98 g). Observers exhibited excellent agreement on the aortic image quality scores (κ = 0.904). Conclusions: CT images of aorta could be obtained within 2 s by using a DSCT Flash protocol with low tube voltage, IR, and low-iodine-concentration CM. Appropriate contrast enhancement was achieved while maintaining good image quality and decreasing the radiation and iodine doses

EVALUATION OF MATERIAL SELECTION FOR POLYMERIC COMPOSITE AUTOMOTIVE BUMPER BEAM USING THE WEIGHTED SUM METHOD (WSM)

&lt;p&gt;A bumper beam is the curved bar across the front of an automobile that protects it from getting dented or scratched during minor accidents Polymeric composite automobile bumper beam material choices. The composites used in vehicle bumper beams need to be selected with care since they have a major job in the distribution and absorption of impact forces during collisions. In recent years, bumper beam applications have seen a rise in the usage of polymeric composites because of their rare connection of mechanical properties, low weight&amp; design flexibility. This introductions goal is to provide a broad overview of the selection process for elements for polymeric composite automobile bumper beams. Research on bumper of an automobile is very important because a vehicles bumper is designed to absorb as much impact as possible, protecting the more important parts of the vehicle. Inthisstudy,theweightedsummethod(WSM)isusedtofindsuitablecompositepolymermaterialsforautomotivebumperbeams.&nbsp;Six different materials are tested in order to choose It is the absolute material for polymer composite bumper beams in transport. The final rank of this paper the Glass fibre reinforced epoxy (M−1) in 1strank, the Carbon fibre reinforced epoxy (M−2) is in 2nd rank, the Carbon fibre reinforced polypropylene (10%) (M−3) is in 6th rank, the Glass fibre reinforced polypropylene (40%) (M−4) is in 3rd rank, the Glass fibre reinforced polyester (30%) (M−5) in 5th rank, the Glass fibre vinyl ester SMC (60%) (M−6) in 4th rank. The final result is done by using the WSM method. For the material selection of automotive bumper beam,the final rank of this paper the Glass fibre reinforced epoxy (M−1) in 1strank,the Carbon fibre reinforced epoxy (M−2) is in 2nd rank, the Carbon fibre reinforced polypropylene (10%) (M−3) is in 6th rank, the Glass fibre reinforced polypropylene (40%) (M−4) is in 3rd rank, the Glass fibre reinforced polyester (30%) (M−5) in 5th rank, the Glass fibre vinyl ester SMC (60%) (M−6) in 4th rank. The final result is done by using the WSM method.&lt;/p&gt;&lt;p&gt;&nbsp;&lt;/p&gt