Functional Outcomes of Close Reduction With K-wires Vs Open Reduction and Internal Fixation in Distal Radius Fractures

Background: Radius and/or ulna fractures are frequent which encounter higher emergency room visits. Despite high incidence, proper management between closed reduction and internal fixation (CRIF) with K-wires and open reduction and internal fixation (ORIF) with anatomical Volar locking plate, remains debatable. This study aimed to compare the functional outcomes between the two management protocols. Methods: A total of 118 patients with distal radius fractures were treated operatively, at Dr. Ziauddin University Hospital Karachi, from January 2017 to October 2020. Out of these, 29 patients (24.6%) were treated with CRIF and 89 patients (75.4%) with ORIF. The functional outcomes of both groups were assessed through disabilities of arm, shoulder and hand (DASH) scores at 3 and 6 months. functional outcomes were assessed through a t-test, p-value <0.05 was considered significant. Results: The male to female ratio was 2.5:1, with an average age of 40.9 years. The Arbeitsgemeinschaft für Osteosynthesefragen (AO) 23-B type injury was observed in 29 (24.6%) patients. The mean DASH score among the ORIF group and CRIF group at 3 months was 43.03 and 46.19 (p <0.007) respectively. Whereas the DASH score of the ORIF and CRIF group at 6 months was 41.35 and 44.70 (p <0.007) respectively. Both groups at 6 months of management reported 33 (28%) patients with complete satisfaction, however, the return to work in the ORIF group was found highly significant (p=0.00). Conclusion: Open reduction and internal fixation with the distal radius locking compression plate produce functionally improved outcomes compared to K-wires for displaced distal radius fractures. Keywords: Radius, Bone Wires; Open Fracture Reduction; Fracture Fixation

Parmotrema cooperi中的新型抗醣化物质和酶抑制剂(英文)

通讯作者, E-mail: [email protected]地衣是被广泛用于传统药物中的独特个体.本文对一类地衣,Parmotrema cooperi,进行了生物测定引导的植物化学研究和生物活性评价.对该类地衣的首次生物测定引导的化学研究分离出了化合物ethyl heamatomate(1),atraric acid(2),ethyl orsellinate(3),orsellinic acid(4),lecanoric acid(5),gyrophoric acid(6)以及licanorin(7).化合物1～7的结构主要通过一维、二维核磁共振谱和质谱等谱学方法判定.对这些化合物还进行了抗醣化活性以及尿素酶、α-胰凝乳蛋白酶、β-葡萄糖醛酸苷酶抑制活性的评价.这些苯酚化合物没有显示特别好的活性,但其中大部分对蛋白质醣化和尿素酶活性具有较好的抑制作用

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Information Security in Business: A Bibliometric Analysis of the 100 Top Cited Articles

This study aims a bibliometric analysis of the 100 top-cited articles extracted from the Web of Science database on the topic of information security in the business context. A retrospective method was applied to the dataset extracted from the Web of Science Database. A total of 500 most cited items were downloaded and the authors selected the articles related to information security and business for further analysis. It was found that the top-cited papers were published between the years 1990 and 2018 and had received 3,375 citations. While most of the articles followed the three-author pattern, the single author pattern articles had received the maximum citation impact. Cybersecurity policies were recognized as the most researched topic and the majority of articles had been published in Quartile-1 journals. Furthermore, the majority (67%) of the articles were published in journals having impact factors ranging from 2.3 to 6.95. The Journal of Management Information System was found to top the list of most prolific journals with 13 articles. This study identifies the trends and patterns of research publications on information security in the business. This evaluation is likely to develop awareness in understanding the scope and coverage of information security from a business perspective. The findings of this study have highlighted the various parameters of highly cited articles on information security published during the last three decades. The results might support new researchers’ interest in information security in the context of businesses

Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019

10.1016/s0140-6736(21)01169-7The Lancet397102922337-236