Salvage total hip arthroplasty (THA) for failed internal fixations of proximal hip fractures

Background: Failed proximal femoral fractures like operated transcervical neck fractures, intertrochanteric fractures and subtrochanteric fractures poses a great challenge to surgeon with limited options. Revision of failed internal fixation with hip arthroplasty, also known as Salvage THA (Total Hip Arthroplasty) is a promising surgical option in elderly patients providing early mobility and preventing age related complications.Methods: 45 patients with failed proximal hip fractures were treated over a period of 2 year with THA with modular cemented prosthesis by southern approach.Results: Fourty five patients were followed up for atleast 16 months with no radiological evidence of loosening and heterotrophic ossification and analyzed for pain, difficulty in walking, muscle power, range of motion of joint and functional status. The overall results were expressed in terms of Salvati-Wilson hip grading system.Conclusions: Revision of failed internal fixation with hip arthroplasty, also known as Salvage THA (Total Hip Arthroplasty) is a promising surgical option in elderly patients providing early mobility and preventing age related complications

Influence of interventions on prescription writing practices in a tertiary care teaching hospital

Background: Prescription practices should be good so that they are correctly interpreted and medications are used or administered accordingly. Studies are found usually focusing on WHO prescribing indicators in various healthcare set-ups. This prescription audit study was conducted to analyse the prescription practices in a tertiary care hospital and see the influence of various interventions on these practices.Methods: It was a quality initiative undertaken to retrospectively assess and evaluate the change in the prescription writing practices in the in-patient department of a tertiary care teaching hospital from March 2017 to April 2018. Number of interventions were conducted to meet the compliance of prescription parameters during the study period and prescription parameters was analysed again thereafter for one-year to see the change.Results: An overall increase in compliance of prescription parameters was found from 67.3% in March 2017 to 94.8% in June 2017. Thereafter this was consistently maintained upto 91% during the study period. Most of the prescription parameters were seen to be improved like allergy history taking from 52.2-95.6%; mention of prescriber’s name, sign, registration number from 53.5-86%; consideration to food-drug interaction from 28.7-99.5%.Conclusions: Prescription writing practices were quite poor initially which improved after various interventions were carried out in the study area

Novel Protocol for Synthesis of O,O-Dialkyl Monothiophospharic Acid Sodium Salt

Preparation of O,O-dialkyl monothiophospharic acid sodium salt (DMP-SNa) by addition of sulphur selectively on phosphorous using organic base to form a salt of O,O-dialkyl monothiophospharic acid trialkyl amine salt which is soluble in the non-polar organic solvent and treated with alkali to form O,O-dialkyl monothiophospharic acid sodium salt (DAP-SNa). Trialkylamine becomes free and remains in the nonpolar solvents can be recycled. This synthesis method is effluent free. DOI: http://dx.doi.org/10.17807/orbital.v13i5.159

Roof and Wall Vents Study under Simulated Hurricane Winds

Ventilation might seem like a minor consideration, but when properly installed, it can extend the life of the attic and roof structure of residential buildings saving huge dollar amounts in repair costs. The objectives of this study were to measure the wind effect on different kind of vents as the problem is vents are subjected to high wind loads during hurricane events and often fail causing water penetration and damage of interior contents. Wind-induced failure of rooftop vents during a hurricane may result in large openings in the roof that will allow water to penetrate into the building, a puncturing of the roof membrane, again allowing water infiltration, and detached rooftop vents can pose considerable threats as windborne debris. The study found that water infiltration through a vent system is dependent upon the differential pressure as well as the vent mechanism. For vents experiencing higher differential pressures, vent covers can be used during storms to reduce water infiltration. Active controls can also be designed to close the vents automatically as differential pressure increases based on the wind speed and wind angle of attack

Calcaneal fractures: a management dilemma-minimally invasive approach for intra and extra articular calcaneal fractures

Background: Calcaneal fractures which constitutes 2% of total fractures are frequent and very debilitating if not treated properly. Calcaneal fractures generally affect younger population leading to significant man-days loss(around 2-5 years3) and in-turn leading significant economic burden on the society. The goal of treatment for calcaneal fractures is elimination of pain and restoration of normal foot shape, biomechanics, and walking ability. Wound related complications are common with open surgeries. After open reduction internal fixation with perimeter plates for displaced calcaneal fractures, wound edge necrosis is commonly observed with the extended lateral approach. Because of such high incidence of wound complications in open reduction of calcaneum fractures, minimally invasive approach takes priority over open reduction of these fractures.Methods: The study aimed to evaluate the results of minimally invasive approach for calcaneal fractures. To reduce the operative complications, 30 patients were treated with minimally invasive methods in both extra articular and intra-articular calcaneal fractures and the results were evaluated. All patients were evaluated clinically , functionally and radiologically 3D- CT reconstruction images.Results: All cases were followed up for 2 years at specified intervals. The outcome measures were evaluated by AOFAS scores10 with excellent result in 13 cases and good to fair results in the rest. Operated patients had no wound infection, no skin necrosis, 5 patients had mild subtalar arthrosis and 3 patients complained slight difficulty in wearing shoes. None of them have any gait abnormalities.Conclusions: Our study suggests that the minimally invasive methods will reduce the operative complication rates. The minimally invasive surgical intervention in an expert hand can yield better results with less complication rates

The Effect of a Portable Electrical Muscle Stimulation Device at Home on Muscle Strength and Activation Patterns in Locomotive Syndrome Patients: A Randomized Control Trial

The aim of the present study was to quantify the effect of electrical muscle stimulation (EMS) intervention using a portable device on muscle strength and activation patterns in locomotive syndrome. Nineteen women were randomly assigned to the intervention group (n = 10; age = 71–82 years) and control group (n = 9; age = 70–84 years). Participants in the intervention group used a portable EMS device to stimulate the bilateral quadriceps muscles for 8 weeks (23 min/5 days/week). To understand the effects of EMS, the following measurements were made at baseline, 8 weeks, and 12 weeks: locomotive syndrome assessment score, knee extensor strength, vastus lateralis muscle activation patterns during a maximal isometric knee extension contraction using multi-channel surface electromyography, and muscle thickness. The locomotive syndrome assessment, muscle strength, muscle thickness, and muscle activity patterns in the intervention group were significantly different to control after 8 weeks (p \u3c 0.05). However, these results were not sustained at 12 weeks. EMS increased locomotor assessment scores, which were accompanied by enhanced muscle strength, increased muscle thickness, and changes in muscle activation patterns in locomotive syndrome patients. These results suggest that EMS is potentially useful for improving muscle neural activation and force output in locomotive syndrome

The performance of the LHCf detector for hadronic showers

The Large Hadron Collider forward (LHCf) experiment has been designed to use the LHC to benchmark the hadronic interaction models used in cosmic-ray physics. The LHCf experiment measures neutral particles emitted in the very forward region of LHC collisions. In this paper, the performances of the LHCf detectors for hadronic showers was studied with MC simulations and beam tests. The detection efficiency for neutrons is from 60% to 70% above 500 GeV. The energy resolutions are about 40% and the position resolution is 0.1 to 1.3mm depend on the incident energy for neutrons. The energy scale determined by the MC simulations and the validity of the MC simulations were examined using 350 GeV proton beams at the CERN-SPS.Comment: 15pages, 19 figure