Special Section on Electrical Contacts

Welcome to the Special Topics Section dedicated to the 2015 Holm Conference on Electrical Contacts. This Special Section contains six high-quality papers that comprehensively describe the state of the art and potential future directions for topics of great interest to our readers. The Editor-in-Chief (EIC), in consultation with the other EICs, Associate Editors (AEs), and domain experts, selects the topics for the Special Sections, and a Guest Editor or AE (GE/AE) who is a leading expert in the technical area then directs the solicitation and peer review of the papers. In cases where the GE/AE is also an author, the EIC is responsible for the peer review to avoid any real or perceived conflicts of interest

A First Order Analysis of Lighting, Shading, and Shadows

The shading in a scene depends on a combination of many factors---how the lighting varies spatially across a surface, how it varies along different directions, the geometric curvature and reflectance properties of objects, and the locations of soft shadows. In this paper, we conduct a complete first order or gradient analysis of lighting, shading and shadows, showing how each factor separately contributes to scene appearance, and when it is important. Gradients are well suited for analyzing the intricate combination of appearance effects, since each gradient term corresponds directly to variation in a specific factor. First, we show how the spatial {\em and} directional gradients of the light field change, as light interacts with curved objects. This extends the recent frequency analysis of Durand et al.\ to gradients, and has many advantages for operations, like bump-mapping, that are difficult to analyze in the Fourier domain. Second, we consider the individual terms responsible for shading gradients, such as lighting variation, convolution with the surface BRDF, and the object's curvature. This analysis indicates the relative importance of various terms, and shows precisely how they combine in shading. As one practical application, our theoretical framework can be used to adaptively sample images in high-gradient regions for efficient rendering. Third, we understand the effects of soft shadows, computing accurate visibility gradients. We generalize previous work to arbitrary curved occluders, and develop a local framework that is easy to integrate with conventional ray-tracing methods. Our visibility gradients can be directly used in practical gradient interpolation methods for efficient rendering

Radiographic evaluation of knee joint space width using fixed flexion view in knees of Indian adults

Background: The objective of this study is to evaluate the tibiofemoral joint space width in the medial and lateral compartments of the knee using digital radiograph. The measurement of knee joint space width (JSW), in between the femur and the tibia is a way of evaluating the tibio-femoral cartilage thickness. This study is aimed at establishing normal references of joint space width for use in diagnosis and follows up of knee cartilage diseases.Methods: This study is prospective and carried on 50 subjects at SAMC & PGI, Indore, M.P. One patient refused to sign the consent and was excluded. All subjects were healthy adults with sedentary lifestyle. All subjects underwent x-ray of bilateral knee joints. The joint space width of both medial and lateral compartments of each knee was measured using the scale in the computerized software.Results: The average age in the study group was 44.59 years with male preponderance.The mean left medial and lateral joint space width was 5.34 mm±1.26 mm and 5.21 mm±1.04 mm and on right side was 5.26±1.11 mm and 5.57±1.57 mm, respectively. No statistically significant difference was found between right and left knee joint space width compartments.Conclusions: The values obtained after observing the radiographic references showed no significant gender variation in knee joint space width. But, it is seen that there is a decrease in joint space width with increasing age, which progresses towards osteoarthritis of knee

A survey of hysterectomies in young patients in Eastern Uttar Pradesh: are the wombs being removed unnecessarily?

Background: There are reports of unnecessary hysterectomies in young patients in some parts of Eastern Uttar Pradesh and adjoining regions. This study was conducted to know the indications of hysterectomies done at less than 35 years of age. Methods: This study was conducted in the outpatient Department of Gynaecology and Obstetrics, Sir Sundar Hospital, Institute of Medical Sciences, Banaras Hindu University Varanasi over a period of one year. Hysterectomised patients with age less than 35 years were included in the study. After getting an informed consent, a detailed history was taken, patient’s past medical record was reviewed and their socio-demographic profiles, indication for hysterectomy and any surgical complications were recorded. Statistical analysis of data was done using SPSS and results were recorded as mean and percentage.  Results: One hundred patients were included in the study over a period of one year. Mean age of the study population was 28 years.  The 32% patient were below 25 years of age, 44% were between 25 to 30 years of age whereas 24% were in the age group of 30 to 35 years. Unevaluated Vaginal discharge (28%) and pain in pelvic region (25%) were the main indication for hysterectomy. Menstrual abnormalities (13%), asymptomatic uterine fibroid (12%), small functional ovarian cyst (10%) and abnormal colposcopic images (12%) were other indications.Conclusions: There is a high prevalence of unnecessary hysterectomies in eastern part of Uttar Pradesh, India. Such practice must be discouraged and stopped. Public awareness, adherence to medical ethics and strict action against those involved in medical malpractice would be helpful in decreasing the number of unnecessary hysterectomies in the young women

Evaluation of mobilization in operated case of fracture tibia

Background: In spite of all the advances optimal method of treatment, fractures of the tibia still pose a challenge to the orthopaedic surgeons and thus the management of the fractured tibia requires the widest experience, the greatest wisdom, and the nicest of the clinical judgement in order to choose the most appropriate treatment for particular pattern of injury. Therefore, in this study we evaluated the role of mobilization efficacy and results of nailing and plating compression in management of tibial fractures and its VAS scoring.Methods: This is a prospective study of fractures tibia in 150 cases aged from 18-60 years, out of which 109 (72.6%) were males. The left side was involved in 85(56.6%) patients and RTA was the major cause of the tibial fractures 98 (65.3%). Among the patients full weight bearing time was early (<3 weeks) with 90 (60%) and 60 (40%) patients within delay (>3 weeks) of surgery.Results: VAS score was significant better in early (<3 weeks) mobilization and in nailing treatment of tibial fractures in first month (7.8±074 and 7.6±0.81) and (2.1±0.8 and 1.8±0.65) at the final follow-up. Vas score correlation was significant with process and mobilization.Conclusions: We here conclude from our study that interlocking nailing appears to be promising method of treatment of unstable tibia fractures in adults without any external splintage after adequate stabilization and early weight bearing leading to excellent functional results in most of cases

Combined free flap and ilizarov bone reconstruction in complex lower limb trauma: our experience

Background: Reconstruction of complex lower limb trauma is a major concern for both plastic and Orthopedic surgeons. The use of free flap with Ilizarov method for soft tissue coverage and bone reconstruction not only gives the patient near normal shape and function but also allows early mobilization of the patient, even during the process of distraction with Ilizarov method.Methods: In this study patients with bone and soft tissue defects of the lower leg were included in the study. Our protocol was immediate wound debridement along with application of external fixator and early free flap coverage within 48-72 hours. After 3-4 weeks of the free flap transfer definitive bone reconstruction is done with Ilizarov method.Results: 122 flaps survived fully and distal flap necrosis occurred in 4 patients. Necrosis of flap occurred before the start of bone reconstruction with Ilizarov and was managed conservatively or with skin graft. Pin tract infection occurred in 45 (35.71%) patients and was treated by pin care and antibiotics. Other complications in treated patients included pain due to distraction (33.33%). delayed union at docking site (11.90%), discrepancy of limb size (9.52%) and union with deformity (6.35%). The functional outcome was satisfactory in majority of the cases.Conclusions: Combined use of free flap and Ilizarov provides a more reliable soft tissue coverage and bone reconstruction with almost near normal shape and function. It has advantages like regenerating same quality bone and allowing the early mobilization of the patient with acceptable rate of complications

Outcome analysis of vacuum assisted closure therapy in patients with open wounds

Background: Vacuum assisted Closure (VAC) of wound is a recent trend and proven method of fast and better healing of wounds. The basic concept is the removal of blood and serous collection from the wound site with negative pressure and promoting the healing process rapidly by altering the local microcellular environment.The objective of the study was to show the efficacy of healing process in open wounds treated by VAC method of dressing.Methods: In this prospective study, total of 50 patients with upper and lower limbs non-healing open wounds were recruited. Before the application of VAC, surgical debridement was performed to remove all the devitalized necrotic tissues and the wound was packed with povodine iodine. Prior to and at the end of VAC dressing, wound dimensions were noted.Results: Patients mean age was 46.72±7.63 years and out of which 42 patients (84%) were males and 8 patients (16%) were females. All patients had suffered an acute trauma. VAC therapy was applied through continuous or intermittent suction on wounds and dressing were changed every second or third day. After application of VAC therapy all wounds showed improvement, which were indicated by presence of healthy granulation tissue, absence of necrotic tissue and subsequent wound closure. Conclusions: VAC dressing in an open wound is an efficient and safe adjunct to treat severe infections and may be a good alternative to treat the open wounds in selected patients. Short time intervals between VAC changes and short course of therapy result in good patient acceptance. This method is recommended for all the types of non-healing wounds management

Primary tendon repair in a case of acute traumatic tibialis anterior with extensor hallucis longus tendon rupture in a young male-a case report

Tibialis anterior tendon rupture is a rare entity which can be either traumatic and non-traumatic. It often presents late due to mild clinical symptoms and signs. Acute ruptures are traumatic occurring in young individuals while chronic ruptures are due to degenerative processes occurring in elderly individuals, commonly after 45 years of age. Tibia anterior along with extensor hallucis tendon is an even rarer entity, operative management of which becomes mandatory, more so in a young active individual for better outcome. We have a 31-year-old male patient, who presented to us with an acute post traumatic tibialis anterior tendon rupture of 3 days duration which was diagnosed following an initial clinical examination, an unremarkable X-ray picture, and Ultrasonography confirming the diagnosis. The patient was managed with primary repair of the tibialis anterior tendon along with Extensor hallucis tendon (which was found intra-operatively) with 2-0 ethibond sutures using a cross-linked Bunnell technique. The patient regained full ankle range of motion at 8 weeks post operative period with ankle dorsiflexion and great toe extension back to pre-injury state.As we have seen with this case, early primary repair in a case of acute rupture at tibialis anterior and extensor hallucis longus rupture with non-absorbable suture has significant improved post operative outcome in terms of return of the affected range of motion and can be practice safely in new hands with limited resources as material of suture and technique has not significant effect in post operative outcome. Acute tibialis anterior and extensor hallucis tendon rupture, non absorbable suture, ethibond, cross linked Bunnell technique.

Surgical management of septic knee arthritis with open arthrotomy and debridement-a case report

Septic arthritis is an inflammatory destruction of the native joint following inoculation of pathogen. Most common organisms causing septic arthritis are Staphylococcus and Streptococcus. Large joints are commonly involved with hip and knee joint accounting for approximately 60% of the total cases. Diagnosis is usually straightforward with the patient presenting with obvious local signs and symptoms along with toxic constitutional symptoms owing to the aggressive nature of the disease. Medical management in form of intra-venous antibiotics forms the mainstay of treatment but it is often required for a prompt surgical intervention in order to provide acute relief from symptom and also to decrease the disease load so as to save the joint from irreversible damage. We have a 63-year-old male patient came presented to us with a right knee swelling and tenderness of 3 weeks duration with restricted ROM with severe toxic constitutional symptoms of 1 week duration. Patient was planned for open arthrotomy and debridement and drainage of the pus and was started on an empirical therapy of injection piperacillin and tazobactam combination for 3 weeks. Immediate relief from symptoms following arthrotomy with good range of motion at 4 weeks post-surgery. As is clear from our case, an early diagnosis of septic arthritis and starting of appropriate antibiotics along with appropriately aggressive surgical interventions in the form of open debridement is the key for treatment of septic arthritis in order to save the joint from irreversible inflammatory damage. Surgical intervention not only gives immediate symptomatic relief but also decreases the load over antibiotics and increases local blood supply subsequently helping in better healing.