Functional results of shoulders Neer’s prosthesis for four part fracture dislocation of shoulder

Background: Objective was to study the clinical and functional outcome of shoulder hemi-arthroplasty using Neer’s prosthesis in four part fracture dislocation of shoulder.Methods: The study was conducted on patients who underwent shoulder hemi-arthroplasty using Neer’s prosthesis for four part fracture dislocation of shoulder in Department of Orthopaedics, GMCH Aurangabad from January 2020 to January 2021. The patients were assessed clinically and functionally using Shoulder range of motion, Visual Analog Scale (VAS), American Society of shoulder and elbow (ASES) score and Constant-Murley score and radiological assessment at 3, 6 and 12 months.Results: At one year follow up of 30 patients, no loosening or dislocation of prosthesis was detected, and mean forward elevation of 129.33o (90o - 150o), mean external rotation of 26.7o (18o – 34o), mean internal rotation of 47.86o (33o-58o), the mean ASES score of 79.46 (range 68-88), the mean VAS score of 1.5 (range 1-3) and mean Constant-Murley score of 82.9 (range 72-94) were achieved. 1 patient developed axillary nerve injury which recovered 6 weeks after surgery and 1 diabetic patient developed superficial infection which healed with antibiotics.Conclusions: Hemiarthroplasty with Neer’s prosthesis can be utilized in four part fracture dislocations of humerus with poor bone stock risking avascular necrosis of head and screw cut out with satisfactory outcome

Clinical evaluation of low cost Indian knee prosthesis in government medical colleges

Background: The clinical and functional outcome of total knee arthroplasty was studied using low cost Indian knee prosthesis called Destiknee by Maxx Company in government medical hospital. The objectives was to do assessment of pain relief, joint mobility and deformity correction post-operatively, pre-operative and post-operative Knee society score comparison.Methods: Patients included were those who underwent primary total knee arthroplasty in Department of Orthopaedics, GMCH Aurangabad from January 2020 to January 2021. Clinical and functional assessment was done using the Knee society score and x-rays at 3, 6 and 12 months intervals.Results: At 1 year follow up of 28 knees, there was an improvement in the average pre-op Knee society score of 53.92 to average post-op score of 86.25 and in the range of motion from 80.42 degree to 127.32 degrees and knee flexion deformity improved from 15.25 degrees to 2.17 degrees, all of which had a p value<0.05 are significant statistically. One diabetic patient with poor glycemic control had superficial infection and one developed minor pulmonary embolism which recovered with medical management. Patients had good satisfaction both in unilateral and bilateral TKA.Conclusions: TKA resulted in significant reduction in knee pain and improvement in the functional ability of patients. The results of this low cost Indian prosthesis in a government rural setup with no laminar airflow with good efficacy and minimal complications are excellent. It was a boon for the rural population suffering from knee pain

Spectrum of Mutations in NDP Resulting in Ocular Disease; a Systematic Review

Aims and Rationale: The inner retina is supplied by three intraretinal capillary plexi whereas the outer retina is supplied by the choroidal circulation: NDP is essential for normal intraretinal vascularisation. Pathogenic variants in NDP (Xp11.3) may result in either a severe retinal phenotype associated with hearing loss (Norrie Disease) or a moderate retinal phenotype (Familial Exudative Vitreoretinopathy, FEVR). However, little is known about whether the nature or location of the NDP variant is predictive of severity. In this systematic review we summarise all reported NDP variants and draw conclusions about whether the nature of the NDP variant is predictive of the severity of the resulting ocular pathology and associated hearing loss and intellectual disability. Findings: 201 different variants in the NDP gene have been reported as disease-causing. The pathological phenotype that may result from a disease-causing NDP variant is quite diverse but generally comprises a consistent cluster of features (retinal hypovascularisation, exudation, persistent foetal vasculature, tractional/exudative retinal detachment, intellectual disability and hearing loss) that vary predictably with severity. Previous reviews have found no clear pattern in the nature of NDP mutations that cause either FEVR or Norrie disease, with the exception that mutations affecting cysteine residues have been associated with Norrie Disease and that visual loss amongst patients with Norrie disease tends to be more severe if the NDP mutation results in an early termination of translation as opposed to a missense related amino acid change. A key limitation of previous reviews has been variability in the case definition of Norrie disease and FEVR amongst authors. We thus reclassified patients into two groups based only on the severity of their retinal disease. Of the reported pathogenic variants that have been described in more than one patient, we found that any given variant caused an equivalent severity of retinopathy each time it was reported with very few exceptions. We therefore conclude that specific NDP mutations generally result in a consistent retinal phenotype each time they arise. Reports by different authors of the same variant causing either FEVR or Norrie disease conflict primarily due to variability in the authors' respective case definitions rather than true differences in disease severity

Bortezomib in Kidney Transplantation

Although current therapies for pretransplant desensitization and treatment of antibody-mediated rejection (AMR) have had some success, they do not specifically deplete plasma cells that produce antihuman leukocyte antigen (HLA) antibodies. Bortezomib, a proteasome inhibitor approved for the treatment of multiple myeloma (a plasma cell neoplasm), induces plasma cell apoptosis. In this paper we review the current body of literature regarding the use of this biological agent in the field of transplantation. Although limited experience with bortezomib may seem to show promise in the realm of transplant recipients desensitization and treatment of AMR, there is also experience that may suggest otherwise. Bortezomib's role in desensitization protocols and treatment of AMR will be defined better as more clinical data and trials become available

Review on machining of additively manufactured nickel and titanium alloys

The machining of nickel and titanium-based superalloy components is very expensive and involves unusually high lead times compared with other engineering metals such as steels and aluminum. This has led to the development of most suitable additive manufacturing (AM) processes to fabricate these difficult-to-machine metals into near-net shape parts, thereby reducing the lead time and material waste, and significantly increasing productivity. Nonetheless, finish machining is still required on the AMed metal components to meet the dimensional and surface requirements of the application. Several research studies have investigated the machinability of AMed nickel and titanium alloy workpieces and have compared the results with the machining responses of wrought counterparts, which is detailed in this review. The categorization of the literature is based on the machining operations including turning, milling, drilling, and non-conventional machining, and the observations are discussed in accordance with various input parameters such as workpiece characteristics (hardness, microstructures) and anisotropy in mechanical properties due to build orientations during the AM process. Moreover, the influence of these parameters on cutting forces and temperatures, chip formation, and tool wear is analyzed and reported. From this review, it is found that the machinability of AMed nickel and titanium workpieces is quite different to the machining responses of their wrought counterparts. Further thorough experimentation is required to develop optimized machining parameters for AMed metal parts, while an exploration of different cutting tool geometries, coolant, and lubrication strategies for enhanced tool performance for machining AMed workpieces is essential. Finally, this study reviews the state of contemporary research, and offers suggestions for future research

3D printed pellets (miniprintlets): A novel, multi-drug, controlled release platform technology

[ENG]Selective laser sintering (SLS) is a single-step three-dimensional printing (3DP) process that can be leveraged to engineer a wide array of drug delivery systems. The aim of this work was to utilise SLS 3DP, for the first time, to produce small oral dosage forms with modified release properties. As such, paracetamol-loaded 3D printed multiparticulates, termed miniprintlets, were fabricated in 1 mm and 2 mm diameters. Despite their large surface area compared with a conventional monolithic tablet, the ethyl cellulose-based miniprintlets exhibited prolonged drug release patterns. The possibility of producing miniprintlets combining two drugs, namely paracetamol and ibuprofen, was also investigated. By varying the polymer, the dual miniprintlets were programmed to achieve customised drug release patterns, whereby one drug was released immediately from a Kollicoat Instant Release matrix, whilst the effect of the second drug was sustained over an extended time span using ethyl cellulose. Herein, this work has highlighted the versatility of SLS 3DP to fabricate small and intricate formulations containing multiple active pharmaceutical ingredients with distinct release propertiesS

Effect of age, sex and physiological stages on hematological indices of Banni buffalo (Bubalus bubalis)

Aim: To determine the physiological baseline values for hematological indices of Banni buffalo Bubalus bubalis) as well as to assess their alteration due to age, sex and physiological stages. Materials and Methods: A total of 42 clinically healthy Banni buffaloes were categorized into seven groups (n=6): Group I (male calves ≤1 year), Group II (bulls >1 year), Group III (female calves ≤1 year), Group IV (pregnant lactating buffaloes), Group V (non-pregnant lactating buffaloes), Group VI (pregnant dry buffaloes), and Group VII (non-pregnant dry buffaloes). Blood samples collected aseptically from all the experimental groups were analyzed employing automated hematology analyzer. The data obtained were statistically analyzed; the mean and standard deviations were calculated and set as the reference values. Results: The erythrocytic indices viz. total erythrocytes count (TEC), hemoglobin, and packed cell volume (PCV) were significantly higher in bulls as compared to that of male calves unlike mean corpuscular volume, mean corpuscular hemoglobin (MCH), and MCH concentration. The female calves had higher TEC and PCV than the adult buffaloes irrespective of sex. The total leukocyte count (TLC) and neutrophil counts in male calves were significantly lower than the bulls unlike the eosinophil, while monocyte and basophil remained unchanged with age. The TLC, differential leukocyte count and platelet count varied non-significantly among the adult female groups at different physiological stages. However, neutrophils were found to be apparently higher in lactating buffaloes. Conclusion: The present study would be helpful for physiological characterization of this unique buffalo breed of Gujarat. Further, data generated may be a tool for monitoring the health and prognosis as well as diagnosis of diseases