Percutaneous trigger thumb release: a safe push-pull technique

Background: Stenosing tenosynovitis of the thumb is an inflammation of flexor tendon sheath of A1 pulley. Percutaneous release has recently gained popularity. Successful percutaneous release depends upon proper prediction of the location of the A1 pulley and circumventing injury to the neurovascular bundles. The aim of this study was to determine the safety of percutaneous release of trigger thumb.Methods: Twenty eight patients were included in the study between 2015 and 2018. All the patients were percutaneously released using push-pull technique. Steroid injection was given following the release. Quinnell grading, patient questionnaire and visual analogue scale score was used to assess the patients at 2 weeks, 6 weeks and 6 months and 1 year.Results: Satisfactory results were found in 93% of patients. Two patients complained of pain and swelling till third week. No digital nerve injury occurred in any patients.Conclusions: Percutaneous trigger thumb release using this push-pull technique is a simple and a safe technique with very minimal complications.

Pre-operative hypoalbuminemia: overlooked prior knee arthroplasty?

Background: Role of preoperative serum albumin on primary total knee arthroplasty.Methods: A total of 1022 patients who underwent primary knee arthroplasty were collected. All patients were divided into the control group (preoperative serum albumin ≥3.5 g/dl) and case group (preoperative serum albumin <3.5 g/dl). The risk factors of preoperative hypoalbuminemia and the postoperative complications were analyzed.Results: Compared to controls, hypoalbuminemia patients were older (p<0.05 ), had higher risk for any complication such as delayed wound healing, pleural effusion, and pneumonia, lower BMI and longer hospital stay (p<0.001).Conclusions: Preoperative hypoalbuminemia is more frequent in patients who are older, have poor nutritional condition, and have more than two concurrent disorders. Hypoalbuminemia before surgery is linked to a higher risk of postoperative problems

Unusual medial tibial plateau fracture fixation using dual plating

Background: Medial tibial plateau fractures is a subtype of proximal tibial fractures that involve the articular surface and can present in several distinct patterns. Purpose of this study was to assess the clinical outcome of stabilizing these biplanar medial tibial plateau fractures using dual plating technique through a single incision.Methods: Between 2017 to 2019, 12 men and 8 women with closed medial tibial plateau fracture who underwent reconstruction using two plates through a posteromedial approach were included in the study group. The fractures were classified using the three column concept of Lou.Results: One patient had an articular step off that was unacceptable and two patients had an acceptable articular step off. Functional assessment was done using the objective scoring of Oxford knee score criteria and radiological assessment was done using the Rasmussen modified score.Conclusions: Biplanar reconstruction using dual plates is a reliable and safe technique to reconstruct complex medial tibial plateau fractures

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

International nosocomial infection control consortium (INICC) report, data summary of 36 countries, for 2004-2009

The results of a surveillance study conducted by the International Nosocomial Infection Control Consortium (INICC) from January 2004 through December 2009 in 422 intensive care units (ICUs) of 36 countries in Latin America, Asia, Africa, and Europe are reported. During the 6-year study period, using Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN; formerly the National Nosocomial Infection Surveillance system [NNIS]) definitions for device-associated health care-associated infections, we gathered prospective data from 313,008 patients hospitalized in the consortium's ICUs for an aggregate of 2,194,897 ICU bed-days. Despite the fact that the use of devices in the developing countries' ICUs was remarkably similar to that reported in US ICUs in the CDC's NHSN, rates of device-associated nosocomial infection were significantly higher in the ICUs of the INICC hospitals; the pooled rate of central line-associated bloodstream infection in the INICC ICUs of 6.8 per 1,000 central line-days was more than 3-fold higher than the 2.0 per 1,000 central line-days reported in comparable US ICUs. The overall rate of ventilator-associated pneumonia also was far higher (15.8 vs 3.3 per 1,000 ventilator-days), as was the rate of catheter-associated urinary tract infection (6.3 vs. 3.3 per 1,000 catheter-days). Notably, the frequencies of resistance of Pseudomonas aeruginosa isolates to imipenem (47.2% vs 23.0%), Klebsiella pneumoniae isolates to ceftazidime (76.3% vs 27.1%), Escherichia coli isolates to ceftazidime (66.7% vs 8.1%), Staphylococcus aureus isolates to methicillin (84.4% vs 56.8%), were also higher in the consortium's ICUs, and the crude unadjusted excess mortalities of device-related infections ranged from 7.3% (for catheter-associated urinary tract infection) to 15.2% (for ventilator-associated pneumonia). Copyright © 2012 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved

Cost effective preparation and characterization of nanocrystalline nickel ferrites (NiFe2O4) in low temperature regime

Nanocrystalline forms of nickel ferrite (NiFe2O4) have been synthesized with the aid of single step chemical combustion method using citric acid as fuel in the 1:1 ratio. The single phase formation of nickel ferrite was confirmed through powder X-ray diffraction (XRD). The presence of various functional groups was confirmed through Fourier transform infrared spectroscopic (FTIR) analysis and the compositional analysis was performed through Energy dispersive X-ray studies (EDX). The micro structural features of nanocrystallites were examined by scanning electron microscope (SEM). Surface morphology of the nanocrystalline form of NiFe2O4 was also investigated through transmission electron microscopic (TEM) analysis. Magnetic measurements have showed the ferrimagnetic properties with Curie temperature @ 500 °C. The obtained results are in good agreement with the reported values. The other results have been discussed in detail