Analysis of results of huge segmental bone loss of tibia treated with Ilizarov external fixator: our experience in Indian population

Background: Orthopaedic surgeons face challenges in treating complex tibial fractures with bone loss due to complications like infection, repeat surgeries, and patient psychological burden. The Ilizarov external fixator approach offers better clinical and radiological results, addressing these issues. The purpose of this study was to examine the outcome of tibial segmental loss treated with the Iliazrov external fixator. Methods: The study was done between January 2015 to December 2021. It’s a prospective as well as retro-prospective study. The age group of 18-65 years was considered. Patients were monitored monthly, up to nine months post-surgery, or until bone union. Functional and bone outcomes of the patients were evaluated using ASAMI criteria, knee society score, and St. Pierre ankle scoring system. Results: The study included 20 patients, all of them were male and had a mean age of 34.1±10.1. Bone union was achieved in all cases. After ilizarov application, the average bone defect was 82.6±42.9 mm. The final regeneration attained was 75.1±47.5 mm. The average limb length difference was 20.41±6.55 mm after achieving union. Out of 20 patients, 13 and 4 had good and fair ASAMI score, 1, 4, and 13 had fair, good, and excellent knee society score, and17 had fair St. Pierre score and 3 patients were lost to follow-up. Conclusions: Ilizarov technique is an excellent way for treating complicated tibial fractures. The difficulties, challenges, and complications associated with Ilizarov external fixation are negligible compared to the significant difficulties associated with open techniques

4-Chloro-N′-[(Z)-4-(dimethyl­amino)benzyl­idene]benzohydrazide mono­hydrate

In the title compound, C16H16ClN3O·H2O, the dihedral angle between the two aromatic rings is 44.58 (11)°. The N atom of the dimethyl­amino group adopts a pyramidal configuration. In the crystal structure, mol­ecules are linked into a two-dimensional network parallel to the (001) plane by inter­molecular N—H⋯O, O—H⋯N and O—H⋯O hydrogen bonds involving the water mol­ecule and C—H⋯Cl hydrogen bonds. In addition, C—H⋯π inter­actions are observed

N′-[(E)-1-Phenyl­ethyl­idene]benzo­hydrazide

The title compound, C15H14N2O, crystallized with two independent mol­ecules in the asymmetric unit. Both mol­ecules are non-planar and have an E configuration with respect to the C=N bond. The dihedral angles between the two benzene rings are 11.1 (2)° in one mol­ecule and 12.40 (19)° in the other. In the crystal structure, the mol­ecules are linked by N—H⋯O hydrogen bonds and weak C—H⋯O inter­actions into infinite one-dimensional chains along [1 0 0]. The crystal structure is further stabilized by N—H⋯O hydrogen bonds, weak C—H⋯O and very weak C—H⋯π inter­actions

4-Amino-3-{1-[4-(2-methyl­prop­yl)phen­yl]eth­yl}-1H-1,2,4-triazole-5(4H)-thione

In the title triazole compound, C14H20N4S, the dihedral angle between the triazole and benzene rings is 83.29 (11)°. The methine H atom and two methyl groups of the isobutyl group are disordered over two sites with occupancies of 0.684 (9) and 0.316 (9). In the crystal structure, N—H⋯S hydrogen bonds link the mol­ecules into chains running along the b axis. These chains are cross-linked into a two-dimensional network parallel to the ab plane by C—H⋯S hydrogen bonds

4-(4-Bromo­benzyl­ideneamino)-1-(diphenyl­amino­meth­yl)-3-[1-(4-isobutyl­phen­yl)eth­yl]-1H-1,2,4-triazole-5(4H)-thione

In the title compound, C34H34BrN5S, the two phenyl rings of the diphenyl­amino­methyl group are inclined at an angle of 73.86 (8)° and they form dihedral angles of 74.04 (8) and 48.74 (8)° with the triazole ring. Intra­molecular C—H⋯S hydrogen bonds generate S(6) and S(5) ring motifs. The crystal structure is stabilized by weak C—H⋯π inter­actions

3-[1-(4-Isobutyl­phen­yl)eth­yl]-6-(4-methyl­phen­yl)-1,2,4-triazolo[3,4-b][1,3,4]thia­diazole

In the title compound, C22H24N4S, the methylphenyl and isobutylphenyl rings are inclined at an angle of 79.98 (1)° and they form dihedral angles of 4.59 (1) and 75.47 (1)°, respectively, with the triazolothia­diazole unit. An intra­molecular C—H⋯S hydrogen bond generates an S(5) ring motif. The crystal structure is stabilized by inter­molecular C—H⋯N hydrogen bonds and weak C—H⋯π and π–π inter­actions [centroid–centroid distances between the thia­diazole ring and a symmetry-related phenyl ring and between the triazole ring and the phenyl ring range from 3.5680 (8) to 3.7313 (8) Å]

4-[(E)-2,6-Dichloro­benzyl­ideneamino]-3-{1-[4-(2-methyl­prop­yl)phen­yl]eth­yl}-1H-1,2,4-triazole-5(4H)-thione

In the title Schiff base compound, C21H22Cl2N4S, the triazole ring makes dihedral angles of 2.15 (11) and 87.48 (11)° with the 2,6-dichloro­phenyl and methyl­propyl­phenyl rings, respectively. Weak intra­molecular C—H⋯S and C—H⋯Cl inter­actions generate S(6) and S(5) ring motifs, respectively. In the crystal structure, centrosymmetrically related mol­ecules are linked into dimers by N—H⋯S hydrogen bonds. These dimers are arranged into sheets parallel to the ab plane and are stacked along the c axis. C—H⋯π inter­actions involving the methyl­propyl­phenyl ring and π–π inter­actions involving the dichloro­phenyl ring [centroid–centroid distance = 3.5865 (3) Å] are also observed

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

N&#8242;-[(Z)-4-(Dimethylamino)benzylidene]-4-nitrobenzohydrazide monohydrate

In the asymmetric unit of the title compound, C16H16N4O3&#183;H2O, there are two symmetry-independent hydrazide molecules with almost identical geometries, and two independent water molecules. The dihedral angles between the two benzene rings in the two hydrazide molecules are 0.11&#8197;(5) and 0.77&#8197;(5)&#176;. In one molecule, an intramolecular C&#8212;H...O hydrogen bond generates a ring of graph-set motif S(5). Intermolecular N&#8212;H...O, O&#8212;H...O, O&#8212;H...N and C&#8212;H...O hydrogen bonds and &#960;&#8211;&#960; stacking interactions between the benzene rings [centroid&#8211;centroid distances in the range 3.5021&#8197;(6)&#8211;3.6403&#8197;(6)&#8197;&#197;] are observed, together with O...O [2.7226&#8197;(11)&#8197;&#197;], O...N [2.7072&#8197;(10)&#8197;&#197;] and N...O [2.7072&#8197;(10)&#8211;2.8582&#8197;(12)&#8197;&#197;] short contacts. The hydrazine molecules are stacked along the b axis and adjacent molecules are linked by water molecules

4-[(E)-2-Furylmethyleneamino]-3-phenyl-1H-1,2,4-triazole-5(4H)-thione

In the title molecule, C13H10N4OS, the triazole ring makes dihedral angles of 16.14&#8197;(9) and 58.51&#8197;(11)&#176;, respectively, with the phenyl and furan rings. Intramolecular C&#8212;H...N hydrogen bonds generate S(5) and S(6) ring motifs. In the crystal structure, centrosymmetrically related molecules are linked via N&#8212;H...S hydrogen bonds to form dimeric pairs, which are interlinked via C&#8212;H...O and C&#8212;H...&#960; interactions