A prospective study on surgical fixation of complex supracondylar femur fracture with distal femoral locking compression plate: our experiences at a tertiary care centre

Background: The optimal treatment of complex supracondylar femur fractures remains always challenging and controversial. the purpose of this prospective study was to evaluate the efficacy of distal femoral locking compression plate (DF-LCP) in terms of functional outcome and union rate for highly unstable complex supracondylar femur fractures and to determine the influencing factors of an unfavourable outcome.Methods: After obtaining approval from institutional ethics committee, 45 patients with complex supracondylar femur fractures were managed by open reduction and internal fixation with DF-LCP through lateral approach and as per standard protocol. The follow-up results were analysed clinically and radiologically, using the “Schatzker and Lambert criteria” at once in a month for first three months, once in three months up to one year and once in six months thereafter up to 2 years post-operatively.Results: In the present study, average duration of radiological union was 16 (range 12-22) weeks. The average range of motion of knee joint was 105 degrees. Out of 45 patients, clinical results were excellent in 48.9%, good in 17.8%, fair in 22.2% and poor in 11.1% patients according to Schatzker and Lambert criteria. Knee stiffness (7 cases), secondary arthritis (5 cases), and non-union (4 cases) were the main complications observed in this study, which were treated accordingly.Conclusions: DF-LCP holds the metaphyseal bone strongly and prevents metaphyseal collapse and mal-rotation in complex or highly unstable supracondylar femur fractures and simultaneously, it provides stable fixation to promote fracture union and allows early rehabilitation with acceptable complications

Extensive humeral hydatid cyst with extraosseous involvement: a case report

Hydatid cysts caused by Echinococcus species mainly involve visceral organs. Rarely skeletal involvement occurs. The spine and pelvis account for half of the cases of osseous hydatidosis, making humeral hydatid cysts one of the rarest conditions. We report a case of humeral hydatidosis in a 42-year male who presented to us with pain and swelling over the left upper arm, radiological investigations suggestive of osseous cystic lesions were inconclusive and diagnosis of hydatidosis was confirmed with a biopsy subsequently. Surgical excision and curettage of bone and surrounding soft tissue were done, and the void was filled using PMMA cement followed by antihelminthic chemotherapy. No complication or recurrence has been found postoperatively at the end of 6 months of follow-up, with preservation of limb function. To keep orthopedic surgeons aware of this morbid condition, due to its low prevalence, and advanced presentation which is likely misdiagnosed, and even after the early intervention, there is a high recurrence rate which makes this one of the rare cases of humeral hydatidosis notifiable

Management of lateral epicondylitis (tennis elbow) by local infiltration of platelet rich plasma an outcome study

Background: Platelet-rich plasma (PRP) has been recently the emerging biological therapy in which a large pool of signals released from platelets producing a biological microenvironment for local and migrating cells for tissue regeneration. A prospective randomized observational study was done to assess the efficacy of autologous PRP injection in lateral epicondylitis of elbow.Methods: A total 100 patients of lateral epicondylitis were selected and treated from December 2015 to November 2017. VAS (visual analogue scale) and PRTEE (patient rated tennis elbow evaluation) scoring were used for clinical and functional assessment at pre-injection, 2nd week, 4th week, 3rd month and 6th month.Results: At the end of 6 months follow-up 61% patients were completely relieved of pain. 34% patients had mild pain that was significantly decreased (p value <0.0001) from mean VAS (75) and mean PRTEE (78.62) to mean VAS (6.05) and mean PRTEE (5.63). 5 patients were lost their 6 months follow-up. There was a significant increase in post intervention pain for few days in 70% patients. Recurrence rate of 0% was noted at the end of 6 months follow-up.Conclusions: An injection of PRP improves pain and function in patients suffering from lateral epicondylitis

Rapid Identification of Fatty Acids from Leptadenia reticulata Areal Parts by GC-MS

709-711The investigation was carried out to identify the various fatty acids present in the areal parts of Leptadenia reticulata, one of the important medicinal plants of India. Non-polar (Petroleum Ether) extract of areal parts was used for this study. Saponification was carried out using dried extract to obtain fatty acids. Further esterification of saponifiable fraction was performed to obtain fatty acid methyl ester. Extracted fatty acid methyl esters were analyzed by gas chromatography and mass spectrometry (GC-MS) technique using NIST library. From GC-MS analysis, 14 components were identified in areal parts of Leptadenia reticulata. This study reveals that L. reticulata is a good source of fatty acids with medicinal properties. This methodology has the advantage of excellent identification of Non polar moiety of medicinal plant

Rapid Identification of Fatty Acids from Leptadenia reticulata Areal Parts by GC-MS

The investigation was carried out to identify the various fatty acids present in the areal parts of Leptadenia reticulata, one of the important medicinal plants of India. Non-polar (Petroleum Ether) extract of areal parts was used for this study. Saponification was carried out using dried extract to obtain fatty acids. Further esterification of saponifiable fraction was performed to obtain fatty acid methyl ester. Extracted fatty acid methyl esters were analyzed by gas chromatography and mass spectrometry (GC-MS) technique using NIST library. From GC-MS analysis, 14 components were identified in areal parts of Leptadenia reticulata. This study reveals that L. reticulata is a good source of fatty acids with medicinal properties. This methodology has the advantage of excellent identification of Non polar moiety of medicinal plant

Global, regional, and national burden of neurological disorders during 1990-2015 : a systematic analysis for the Global Burden of Disease Study 2015

Background Comparable data on the global and country-specific burden of neurological disorders and their trends are crucial for health-care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study provides such information but does not routinely aggregate results that are of interest to clinicians specialising in neurological conditions. In this systematic analysis, we quantified the global disease burden due to neurological disorders in 2015 and its relationship with country development level. Methods We estimated global and country-specific prevalence, mortality, disability-adjusted life-years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) for various neurological disorders that in the GBD classification have been previously spread across multiple disease groupings. The more inclusive grouping of neurological disorders included stroke, meningitis, encephalitis, tetanus, Alzheimer's disease and other dementias, Parkinson's disease, epilepsy, multiple sclerosis, motor neuron disease, migraine, tension-type headache, medication overuse headache, brain and nervous system cancers, and a residual category of other neurological disorders. We also analysed results based on the Socio-demographic Index (SDI), a compound measure of income per capita, education, and fertility, to identify patterns associated with development and how countries fare against expected outcomes relative to their level of development. Findings Neurological disorders ranked as the leading cause group of DALYs in 2015 (250.7 [95% uncertainty interval (UI) 229.1 to 274.7] million, comprising 10.2% of global DALYs) and the second-leading cause group of deaths (9.4 [9.1 to 9.7] million], comprising 16.8% of global deaths). The most prevalent neurological disorders were tensiontype headache (1505 9 [UI 1337.3 to 1681.6 million cases]), migraine (958.8 [872.1 to 1055.6] million), medication overuse headache (58.5 [50.8 to 67.4 million]), and Alzheimer's disease and other dementias (46.0 [40.2 to 52.7 million]). Between 1990 and 2015, the number of deaths from neurological disorders increased by 36.7%, and the number of DALYs by 7.4%. These increases occurred despite decreases in age-standardised rates of death and DALYs of 26.1% and 29.7%, respectively; stroke and communicable neurological disorders were responsible for most of these decreases. Communicable neurological disorders were the largest cause of DALYs in countries with low SDI. Stroke rates were highest at middle levels of SDI and lowest at the highest SDI. Most of the changes in DALY rates of neurological disorders with development were driven by changes in YLLs. Interpretation Neurological disorders are an important cause of disability and death worldwide. Globally, the burden of neurological disorders has increased substantially over the past 25 years because of expanding population numbers and ageing, despite substantial decreases in mortality rates from stroke and communicable neurological disorders. The number of patients who will need care by clinicians with expertise in neurological conditions will continue to grow in coming decades. Policy makers and health-care providers should be aware of these trends to provide adequate services.Peer reviewe

Evaluating the Effects of SARS-CoV-2 Spike Mutation D614G on Transmissibility and Pathogenicity.

Global dispersal and increasing frequency of the SARS-CoV-2 spike protein variant D614G are suggestive of a selective advantage but may also be due to a random founder effect. We investigate the hypothesis for positive selection of spike D614G in the United Kingdom using more than 25,000 whole genome SARS-CoV-2 sequences. Despite the availability of a large dataset, well represented by both spike 614 variants, not all approaches showed a conclusive signal of positive selection. Population genetic analysis indicates that 614G increases in frequency relative to 614D in a manner consistent with a selective advantage. We do not find any indication that patients infected with the spike 614G variant have higher COVID-19 mortality or clinical severity, but 614G is associated with higher viral load and younger age of patients. Significant differences in growth and size of 614G phylogenetic clusters indicate a need for continued study of this variant

Azimuthal anisotropy of charged jet production in root s(NN)=2.76 TeV Pb-Pb collisions

We present measurements of the azimuthal dependence of charged jet production in central and semi-central root s(NN) = 2.76 TeV Pb-Pb collisions with respect to the second harmonic event plane, quantified as nu(ch)(2) (jet). Jet finding is performed employing the anti-k(T) algorithm with a resolution parameter R = 0.2 using charged tracks from the ALICE tracking system. The contribution of the azimuthal anisotropy of the underlying event is taken into account event-by-event. The remaining (statistical) region-to-region fluctuations are removed on an ensemble basis by unfolding the jet spectra for different event plane orientations independently. Significant non-zero nu(ch)(2) (jet) is observed in semi-central collisions (30-50% centrality) for 20 <p(T)(ch) (jet) <90 GeV/c. The azimuthal dependence of the charged jet production is similar to the dependence observed for jets comprising both charged and neutral fragments, and compatible with measurements of the nu(2) of single charged particles at high p(T). Good agreement between the data and predictions from JEWEL, an event generator simulating parton shower evolution in the presence of a dense QCD medium, is found in semi-central collisions. (C) 2015 CERN for the benefit of the ALICE Collaboration. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).Peer reviewe