Risk factors for septic arthritis of hip in neonates and infants

Background: Suppurative arthritis of hip is pyogenic inflammation of synovial membrane of the hip, usually due to bacterial infection. The main aim of early diagnosis and treatment of septic arthritis of hip is to prevent damage to articular cartilage and growth plate, give stable and painless hip and to resume normal development and prevent sequelae.Methods: Prospective interventional study consisted of 34 patients with 36 Hips septic arthritis of hip less than one year of age carried out at Department of Orthopedics of a tertiary care centre during August 2011 to December 2013. Risk factors and related laboratory investigations were carried out. Data entry and analysis was done by MS Excel 3.0.Results: In our study more than 70% patients presented after one week. Left sided hip involvement (59%) was more common followed by right hip (35%). Sex ratio of the study population was   M: F-4:6.  NICU admission was present in 94% cases.  In many of our patients there were more than one risk factors like septicemia, low birth weight, jaundice and ventilator support. Conclusions: All NICU neonates should be handled with strict aseptic precaution

Stateful metadata for big data

Large volumes of data, characterized by large variety and high update velocities, pose challenges in terms of storage, application of concurrently occurring frequent updates, and serving processes that require the most accurate version of the data simultaneously. In most current schemes, it is not possible to guarantee all of these characteristics and a relaxing one or more requirements is necessary. The present disclosure describes a scalable, easy-to-maintain metadata mechanism that is fast and efficient to update, and can provide all the above guarantees on data. The metadata maintains lightweight validity markers, and simple algebra is performed thereof to surface the most up to date and accurate data while enabling constant updates to the data in a non-blocking fashion

Competing Visions: Domestic Forests, Politics and Forest Policy in the Central Western Ghats of South India

International audienceRural people in developing countries including India continue to access a number of types of 'forests' to meet specific needs such as fuelwood, fodder, food, non-timber forest produce and timber for both subsistence and income generation. While a plethora of terms exist to describe the types of forests that rural people use—such as farm forests, social forests, community forests and small-scale for-ests—the expression domestic forest has recently been proposed. Domestic forest is a term aimed at capturing the diversity of forests transformed and managed by rural communities and a way to introduce a new scientific domain that recognises that production and conservation can be reconciled and that local communities can be effective managers. This paper argues in the context of the central Western Ghats of south India that while the domestic forest concept is a useful umbrella term to capture the diversity of forests used by rural people, these domestic forests are often not autonomous local forests but sites of contestation between local actors and the state forest bureaucracy. Hence, a paradigm shift within the forest bureaucracy will only occur if the scientific forestry community questions its own normative views on forest management and sees forest policy as a means to recognise local claims and support existing practices of forest dependent communities

Migration of superior vena cava stent

There has been a recent increase in the use of endovascular prostheses resulting in complex surgical and interventional complications not previously recognised. We report a case of Superior vena cava stenosis treated with a wallstent which migrated to the right atrium, necessitating a combined radiological and surgical approach to retrieve it

International criteria for acute kidney injury: advantages and remaining challenges

• Acute Kidney Injury (AKI) is defined using widely accepted international criteria that are based on changes in serum creatinine concentration and degree of oliguria. • AKI, when defined in this way, has a strong association with poor patient outcomes, including high mortality rates and longer hospital admissions with increased resource utilisation and subsequent chronic kidney disease. • The detection of AKI using current criteria can assist with AKI diagnosis and stratification of individual patient risk. • The diagnosis of AKI requires clinical judgement to integrate the definition of AKI with the clinical situation, to determine underlying cause of AKI, and to take account of factors that may affect performance of current definitions

Exploring the relationship between plural values of nature, human well-being, and conservation and development intervention: Why it matters and how to do it?

1. Globally, land and seascapes across the bioculturally diverse tropics are in transition. Impacted by the demands of distant consumers, the processes of global environmental change and numerous interventions seeking climate, conservation and development goals, these transitions have the potential to impact the relationships and plurality of values held between people and place. 2. This paper is a Synthesis of seven empirical studies within the Special Feature (SF): ‘What is lost in transition? Capturing the impacts of conservation and development interventions on relational values and human wellbeing in the tropics’. Through two Open Forum workshops, and critical review, contributing authors explored emergent properties across the papers of the SF. Six core themes were identified and are subsumed within broad categories of: (i) the problem of reconciling scale and complexity, (ii) key challenges to be overcome for more plural understanding of social dimensions of landscape change and (iii) ways forward: the potential of an environmental justice framework, and a practical overview of methods available to do so. 3. The Synthesis interprets disparate fields and complex academic work on relational values, human well-being and de-colonial approaches in impact appraisal. It offers a practical and actionable catalogue of methods for plural valuation in the field, and reflects on their combinations, strengths and weaknesses. 4. The research contribution is policy relevant because it builds the case for why a more plural approach in intervention design and evaluation is essential for achieving more just and sustainable futures, and highlights some of the key actions points deemed necessary to achieve such a transition to conventional practice

Plantar fasciitis: A review

Plantar fasciitis, though a common condition seen by pain specialists, occasionally presents diagnostic dilemmas and very often the management of this condition suffers from lack of awareness of the varied treatment modalities and progressive escalation of treatment options. For this purpose, we searched through all articles with key words of plantar fasciitis or heel pain in the last ten years for which full text was available and compiled a narrative review to guide clinical decision making. An appreciation of pathomechanics of involved structures, possible differential diagnoses and a review of all treatment modalities presented in this article may perhaps help in simplifying matters. Treatment options consist of non-invasive physical therapy modalities, footwear modification, exercise program and newer modalities like shock-wave therapy, minimally invasive treatments like steroid or platelet-rich plasma injections and surgery in recalcitrant cases. Resorting to combining treatment modalities, step-wise escalation of treatment depending on duration of the condition and using our suggested step-ladder approach maybe an appropriate way of treating this condition

Ambulation following spinal cord injury and its correlates

Objectives: To assess walking ability of spinal cord injury (SCI) patients and observe its correlation with functional and neurological outcomes. Patients and Methods: The present prospective, observational study was conducted in a tertiary research hospital in India with 66 patients (46 males) between January 2012 and December 2013. Mean age was 32.62 ± 11.85 years (range 16-65 years), mean duration of injury was 85.3 ± 97.6 days (range 14-365 days) and mean length of stay in the rehabilitation unit was 38.08 ± 21.66 days (range 14-97 days) in the study. Walking Index for spinal cord injury (WISCI II) was used to assess ambulation of the SCI patients. Functional recovery was assessed using Barthel Index (BI) and Spinal Cord Independence Measures (SCIM). Neurological recovery was assessed using ASIA impairment scale (AIS). We tried to correlate ambulatory ability of the patients with functional and neurological recovery. Results: Ambulatory ability of the patients improved significantly using WISCI II (P < 0.001) when admission and discharge scores were compared (1.4 ± 3.5 vs 7.6 ± 6.03). Similarly, functional (BI: 31.7 ± 20.5 vs 58.4 ± 23.7 and SCIM: 29.9 ± 15.1 vs 56.2 ± 20.6) and neurological recovery were found to be very significant (P < 0.001) when admission vs discharge scores were compared. Improvement in WISCI II scores was significantly correlated with improvement in neurological (using AIS scores) and functional status (using BI and SCIM scores) (P < 0.001). Conclusions: Significant improvement was seen in WISCI II, BI, and SCIM scores after in-patient rehabilitation. Improvement in WISCI II scores also significantly correlated with functional and neurological recovery

Prevalence of depression, fatigue, and sleep disturbances in patients with myelopathy: Their relation with functional and neurological recovery

exterior, 200