A study of clinical and functional outcome of primary total knee arthroplasty using posterior cruciate substitute design

Background: To study the clinical and functional outcome in a consecutive series of Total Knee Arthroplasty using Posterior cruciate substituting (PS) design using the Knee Society Score(KSS). The objectives of the study was 1) To assess the improvement in pain relief post-operatively, stability, mobility of the joint and to assess the correction of deformities. 2) To compare the knee clinical score (KCS) pre-operatively and post-operatively. 3) To compare the knee functional score (KFS) pre-operatively and post-operatively. 4) To assess the radiological outcome of total knee arthroplasty. 5) To study the association between the KCS and the KFS.Methods: The study was conducted on patients who have undergone Primary total knee replacement, in Department of Orthopaedics, KIMS hospital from June 2014 to February 2017. The patient was assessed clinically, functionally using the Knee Society Score and a radiographic evaluation was done. These evaluations were performed at 6weeks, 12 weeks, 24 weeks and 1year follow up visits.Results: At 1 year follow up of 60 knees, the average pre-op knee clinical score and functional score of 24.7 and 41.2 improved to an average post-op score of 89.9 and 87.8 respectively. Knee clinical and functional score grade of excellent to good was seen in 96.7% (58 knees of 60). Significant association was seen between KCS and KFS. 5 patients had delayed wound healing and one patient had deep infection. Alignment of prosthesis was found satisfactory in all patients. Flexion deformity, valgus and varus correction achieved in all the patients. Conclusions: Total knee arthroplasty using posterior cruciate substituting designs resulted in excellent relief of pain, range of motion, restoration of function, low prevalence of patellofemoral complications and continues to function well during the follow-up period. Improvement in clinical score correlated significantly with improvement in functional score. Knee society scoring system effective in evaluating clinical, functional and radiological outcomes.

Wet High Intensity Magnetic Seperation of some Uranium Ores of India

Wet High Intensity Magnetic Separation (WHIMS) or magnetic filtration is relatively a new process used in the mineral industry and it is generally being used for the removal of magnetic impurities, ( from kaolin clay, desulfurisation of coal and separation of weakly magnetic pafficles of fine sized material ). Run of mine material can be directly treated in the case of clays and coal or a preconcentrate, preferably, in the case of minerals

Effect of dietary supplementation of marigold oleoresin on growth, survival and total muscle carotenoid of Koi carp, Cyprinus carpio L.

The experiment was conducted to evaluate the effect of dietary supplementation of carotenoid (marigold oleoresin) on growth, survival and total body carotenoid of Koi carp (Cyprinus carpio). The experiment was carried out in 12 fiber aquarium tanks of size 12"×6"×6"(20l capacity). Each tank was stocked with15 fishes of uniform size. The marigold oleoresin were as dietary supplement at levels 60, 120, 180, 240, 300 ppm/kg of the feed and designated as treatment T1, T2, T3, T4 and T5 respectively and diet without marigold oleoresin supplementationserved as a control (T0). The result of the experiment showed that there was significant difference found in absolute growth rate and specific growth rate of the fish (P >0.05). However, 180ppm marigold oleoresin fed fishes showed higher mean weight gain of 3.98±0.22g and lower feed conversion ratio (FCR) of 2.81±0.04 than the other treatment groups. The body coloration and total carotenoid concentration of muscle tissue (30.16±0.60?g/g) was significantly higher in fish fed with 180 ppm marigold oleoresin diet. The study showed that incorporation of 180ppm of marigold oleoresin in diet was found better to enhance the growth and coloration in C. carpio

Healthy Sexuality

Sexuality is one of the basic instincts which determine the behavior of an individual. Though it is one of the basic drives, it is under researched. Sexuality has biological, psychological and social dimensions. Sexuality is a developmental phenomenon; from childhood to old age it has several implications. Exercise, sleep, nutrition, marriage, divorce and diseases have their own impact on sexuality. Sexuality is one of the key components in determining the quality of life. In this article, we have tried to explore various dimensions of sexuality

Current Practice of Neonatal Resuscitation Documentation in North America: A Multi-Center Retrospective Chart Review

Background To determine the comprehensiveness of neonatal resuscitation documentation and to determine the association of various patient, provider and institutional factors with completeness of neonatal documentation. Methods Multi-center retrospective chart review of a sequential sample of very low birth weight infants born in 2013. The description of resuscitation in each infant’s record was evaluated for the presence of 29 Resuscitation Data Items and assigned a Number of items documented per record. Covariates associated with this Assessment were identified. Results Charts of 263 infants were reviewed. The mean gestational age was 28.4 weeks, and the mean birth weight 1050 g. Of the infants, 69 % were singletons, and 74 % were delivered by Cesarean section. A mean of 13.2 (SD 3.5) of the 29 Resuscitation Data Items were registered for each birth. Items most frequently present were; review of obstetric history (98 %), Apgar scores (96 %), oxygen use (77 %), suctioning (71 %), and stimulation (62 %). In our model adjusted for measured covariates, the institution was significantly associated with documentation. Conclusions Neonatal resuscitation documentation is not standardized and has significant variation. Variation in documentation was mostly dependent on institutional factors, not infant or provider characteristics. Understanding this variation may lead to efforts to standardize documentation of neonatal resuscitation

Evaluation of wound healing activity of Allamanda cathartica. L. and Laurus nobilis. L. extracts on rats

BACKGROUND: Allamanda cathartica. L. is a perennial shrub used in traditional medicine for treating malaria and jaundice. Laurus nobilis. L. is a tree and has been used for its astringent, healing and diuretic properties. The objective of this study was to investigate the aqueous extracts of Allamanda and Laurus nobilis to evaluate their wound healing activity in rats. METHODS: Excision and incision wound models were used to evaluate the wound healing activity of both the extracts on Sprague Dawley rats. In each model, animals were divided into four groups of 10 animals each. In both the model, group 1 served as control and group 2 as reference standard. In an excision wound model, group 3 animals were treated with Allamanda (150 mg kg(-1 )day(-1)) and group 4 animals were treated with Laurus nobilis (200 mg kg(-1 )b.w day(-1)) for 14 days respectively. In the case of incision wound model, group 3 and 4 animals were treated with the extracts of Allamanda and Laurus respectively for 10 days. The effects of vehicles on the rate of wound healing were assessed by the rate of wound closure, period of epithelialisation, tensile strength, weights of the granulation tissue, hydroxyproline content and histopathology of the granulation tissue. RESULTS: The aqueous extract of Allamanda promoted wound healing activity significantly in both the wound models studied. High rate of wound contraction (P < .001), decrease in the period of epithelialisation (10.2 ± 0.13), high skin breaking strength (440.0 ± 4.53), significant increase in the weight of the granulation tissue (P < .001) and hydroxyproline (P < .001) content were observed in animals treated with the aqueous extract of Allamanda. Histological studies of the granulation tissue from the Allamanda treated group showed the presence of a lesser number of inflammatory cells, and increased collagen formation than the control. In Laurus nobilis treated animals, the rate of wound contraction, weight of the granulation tissue and hydroxyproline content were moderately high (P < .05). The histological study of the granulation tissue of the Laurus nobilis treated animals showed larger number of inflammatory cells, and lesser collagen when compared with the Allamanda treated group of animals. However, it was better than the control group of animals. CONCLUSION: The data of this study indicated that the leaf extract of Allamanda possesses better wound healing activity than the Laurus nobilis and it can be used to treat different types of wounds in human beings too

Carbohydrate Intake in the Etiology of Crohn's Disease and Ulcerative Colitis

Background: Diet may have a role in the etiology of inflammatory bowel disease. In previous studies, the associations between increased intakes of carbohydrates, sugar, starch, and inflammatory bowel disease are inconsistent. However, few prospective studies have investigated the associations between these macronutrients and incident Crohn's disease (CD) or ulcerative colitis (UC). Methods: A total of 401,326 men and women were recruited between 1991 and 1998. At recruitment, dietary intakes of carbohydrate, sugar, and starch were measured using validated food frequency questionnaires. The cohort was monitored identifying participants who developed incident CD or UC. Cases were matched with 4 controls, and odds ratios were calculated for quintiles of total carbohydrate, sugar, and starch intakes adjusted for total energy intake, body mass index, and smoking. Results: One hundred ten participants developed CD, and 244 participants developed UC during follow-up. The adjusted odds ratio for the highest versus the lowest quintiles of total carbohydrate intake for CD was 0.87, 95% CI = 0.24 to 3.12 and for UC 1.46, 95% CI = 0.62 to 3.46, with no significant trends across quintiles for either (CD, Ptrend = 0.70; UC, Ptrend = 0.41). Similarly, no associations were observed with intakes of total sugar (CD, Ptrend = 0.50; UC, Ptrend = 0.71) or starch (CD, Ptrend = 0.69; UC, Ptrend = 0.17). Conclusions: The lack of associations with these nutrients is in agreement with many case–control studies that have not identified associations with CD or UC. As there is biological plausibility for how specific carbohydrates could have an etiological role in inflammatory bowel disease, future epidemiological work should assess individual carbohydrates, although there does not seem to be a macronutrient effect

Outcomes and care practices for preterm infants born at less than 33 weeks’ gestation: A quality-improvement study

BACKGROUND: Preterm birth is the leading cause of morbidity and mortality in children younger than 5 years. We report the changes in neonatal outcomes and care practices among very preterm infants in Canada over 14 years within a national, collaborative, continuous quality-improvement program. METHODS: We retrospectively studied infants born at 23–32 weeks’ gestation who were admitted to tertiary neonatal intensive care units that participated in the Evidence-based Practice for Improving Quality program in the Canadian Neonatal Network from 2004 to 2017. The primary outcome was survival without major morbidity during the initial hospital admission. We quantified changes using process-control charts in 6-month intervals to identify special-cause variations, adjusted regression models for yearly changes, and interrupted time series analyses. RESULTS: The final study population included 50 831 infants. As a result of practice changes, survival without major morbidity increased significantly (56.6% [669/1183] to 70.9% [1424/2009]; adjusted odds ratio [OR] 1.08, 95% confidence interval [CI] 1.06–1.10, per year) across all gestational ages. Survival of infants born at 23–25 weeks’ gestation increased (70.8% [97/137] to 74.5% [219/294]; adjusted OR 1.03, 95% CI 1.02–1.05, per year). Changes in care practices included increased use of antenatal steroids (83.6% [904/1081] to 88.1% [1747/1983]), increased rates of normothermia at admission (44.8% [520/1160] to 67.5% [1316/1951]) and reduced use of pulmonary surfactant (52.8% [625/1183] to 42.7% [857/2009]). INTERPRETATION: Network-wide quality-improvement activities that include better implementation of optimal care practices can yield sustained improvement in survival without morbidity in very preterm infants

Outcomes and resource usage of infants born at ≤ 25 weeks gestation in Canada

Objectives: To determine the outcomes and resource usage of infants born at ≤ 25 weeks gestational age (GA). Methods: Retrospective study of infants born between April 2009 and September 2011 at ≤ 25 weeks\u27 GA in all neonatal intensive care units in Canada with follow-up in the neonatal follow-up clinics. Short-term morbidities, neurodevelopmental impairment, significant neurodevelopmental impairment, and resource utilization of infants born at ≤ 24 weeks were compared with neonates born at 25 weeks. Results: Of 803 neonates discharged alive, 636 (80.4%) infants born at ≤ 25 weeks\u27 GA were assessed at 18 to 24 months. Caesarean delivery, lower birth weight, and less antenatal steroid exposure were more common in infants born ≤ 24 weeks as compared with 25 weeks. They had significantly higher incidences of ductus arteriosus ligation, severe intracranial hemorrhage, retinopathy of prematurity as well as longer length of stay, central line days, days on respiratory support, days on total parenteral nutrition, days on antibiotics, and need for postnatal steroids. Neurodevelopmental impairment rates were 68.9, 64.5, and 55.6% (P=0.01) and significant neurodevelopmental impairment rates were 39.3, 29.6, and 20.9% (P\u3c0.01) for infants ≤ 23, 24, and 25 weeks GA, respectively. Postdischarge service referrals were higher for those ≤ 23 weeks. Nonsurviving infants born at 25 weeks GA had higher resource utilization during admission than infants born less than 25 weeks. Conclusions: Adverse outcomes and resource usage were significantly higher among infants born ≤ 24 weeks GA as compared with 25 weeks GA