Effectiveness of messaging apps in emergency room-online survey study

Background: Medical professionals communicate effectively and conveniently using mobile communication applications (Apps). With clinical details being transmitted quickly among multidisciplinary teams, the potential improvements in patient care and education are significant. However, there are also moral and legal concerns with sharing patient data in this manner.  This study aimed to quantify and categorize how often medical staff members used communication apps in clinical settings, their role in patient care, their knowledge of and attitudes toward safety, and the main advantages, potential drawbacks, and policy implications. Methods: A 16-question survey with an anonymous response was distributed to our 1500 bedded hospital's medical staff. The study gathered information on the demographics of the respondents, how they used communication apps in clinical settings, how they felt about such apps, how safe they thought their data was, and why they chose one app over another. The study period was January to March 2023. Results: From students to consultants, communication apps are widely utilized with WhatsApp being the most popular one. Although all respondents thought these apps were useful for swiftly exchanging information in a clinical context, they were all concerned about the privacy consequences. Overall, 62.5% use WhatsApp in the ER, and 70.8% found that it has helped reduce the communication gap between junior and senior orthopaedic surgeons. Conclusions: Messaging apps help medical professionals communicate more effectively, but their use poses compliance difficulties, particularly with privacy laws. Hence, a user-friendly design and privacy-compliant must be given top priority when creating apps

Twelfth rib syndrome: role of intercostal blocks: case series of 10 patients

Twelfth rib syndrome (TRS) is a rare condition that causes severe pain in the loin. It is often misdiagnosed, leading to unnecessary investigations and treatments. Intercostal blocks in the 11th and 12th rib often resolve the pain for these patients. In this research paper, we aim to explore the role of intercostal block in the management of TRS based on our experience with 10 patients. Data of patients who were diagnosed with TRS were studied retrospectively from our hospital records who have been given intercostal block injection from the period of Jan 2022 to August 2023 as an audit.  Four patients underwent intercostal blocks. VAS scores were measured in follow-up for 1 and 3 months. 4 patients were lost to follow up and hence not considered in this study. The male to female ratio was 7:3. There was a statistically significant reduction in VAS score at 1 month and 3 months compared to pre-injection times. Patients who have failed conservative management for TRS can be effectively managed with intercostal block injections

INVESTIGATION OF CHEMICAL COMPOSITION FROM DRYOPTERIS CHOCHLEATA (D.DON) C. CHR. (DRYOPTERIDACEAE)

ABSTRACTObjective: The present study was for the determination of bioactive volatile compounds from chloroform and ethanolic extract.Methods: For present investigation of the samples were carried out by using Shimadzu Make QP-2010 with nonpolar 60 M RTX 5MS Column.Interpretation on Mass-Spectrum GC-MS was conducted using the database of National Institute Slandered and Technology (NIST) having more62,000 patterns.Results: In Ethanolic extract seven compounds and chloroform extract fourteen compounds were identified. The common compounds in these twoextracts are Germacrene D; 1, 3-cyclohexanedione, 2-methyl-2 (3-Oxobutyl); Neoisolongifolene, 8, 9-dehydro.Coclusion: Present investigation emphasizes the efficacy of traditional remedies and that it inspires the people to realize the importance of naturalresources for its potent pharmaceutical use.Keywords: Medicinal pteridophyte, Gas chromatography-mass spectroscopy analysis, Ethanol extract, Chloroform extract, Bioactive compounds

PRedItOR: Text Guided Image Editing with Diffusion Prior

Diffusion models have shown remarkable capabilities in generating high quality and creative images conditioned on text. An interesting application of such models is structure preserving text guided image editing. Existing approaches rely on text conditioned diffusion models such as Stable Diffusion or Imagen and require compute intensive optimization of text embeddings or fine-tuning the model weights for text guided image editing. We explore text guided image editing with a Hybrid Diffusion Model (HDM) architecture similar to DALLE-2. Our architecture consists of a diffusion prior model that generates CLIP image embedding conditioned on a text prompt and a custom Latent Diffusion Model trained to generate images conditioned on CLIP image embedding. We discover that the diffusion prior model can be used to perform text guided conceptual edits on the CLIP image embedding space without any finetuning or optimization. We combine this with structure preserving edits on the image decoder using existing approaches such as reverse DDIM to perform text guided image editing. Our approach, PRedItOR does not require additional inputs, fine-tuning, optimization or objectives and shows on par or better results than baselines qualitatively and quantitatively. We provide further analysis and understanding of the diffusion prior model and believe this opens up new possibilities in diffusion models research

Cost benefit analysis of intralesional injections in keloids using Luer lock and non-locking syringes

Background: For keloid scarring, intralesional corticosteroid injections continue to be the most often utilised first therapeutic option. This is a common procedure done on an outpatient basis by surgeons and orthopaedists. Luer lock syringes which lock the needle with syringe prevent any leakage or spillage of drug while pushing it near the keloid compared to normal syringes. Methods: We intend to do a cost benefit analysis based on the retrospective data of intralesional steroid injections done by the authors (AP and SK) in their private practice. Results: The time between 2021 to 2022, 200 injection data was retrieved, 100 each using non locking syringes and Luer lock syringes. The spillage rate with non-Luer lock syringes was 14%. Conclusions: We found that luer lock syringes prove to be cost effective after giving more than 200 injections in keloids than non-locking syringes.

Relationship of incidence of anterior cruciate ligament injuries and body-built Index somatotype in Indian population

Background: Incidence of ACL injuries and physical parameters like age, sex, height, weight and BMI has been studied intensely as a risk factor. Each of them poses as a different risk factor for occurrence of ACL injuries. But body-built index-somatotype considers relative proportions of fatness, muscle mass and skeletal architecture in terms of endomorphy, mesomorphy and ectomorphy in a single individual which neutralises variables like age, sex, BMI. Methods: 100 patients were included in the study, excluding those with multiligament injuries, associated fractures around knee, mucoid degeneration of ACL and road traffic accident cases. Parameters such as skin fold thickness, circumference and epicondylar, condylar width was taken into consideration. Body built index was calculated in terms of endomorphy, mesomorphy and ectomorphy using the heath-carter anthropometric somatotype manual. Results: We found that amongst all those have ACL injury, endomorphy was higher grade (5.49), followed by mesomorphy (4.75). Lesser grades of ectomorphs i.e., slender people were having ACL injuries. Though there was low margin of grading between the two, endomorphy was higher in ACL injured people followed by mesomorphy. Conclusions: Endomorphs and mesomorphs have higher tendancy of ACL injury. Ectomorphs have lesser incidence of ACL injury

Treatment of proximal tibia fractures with locking compression plate: a prospective study

Background: With the rise in the incidence of proximal tibia fractures in India due to road traffic accidents, this prospective study was intended to assess the operative procedure in the management of such fractures using the locking compression plate (LCP).Methods: 30 subjects attending the study site scheduled to undergo the defined surgery were enrolled as per the study selection criteria.Results: A total of 30 patients with proximal tibia fractures were enrolled. Majority of cases were due to RTAs, with a higher incidence of types IV, V and VI. Average time for union of fracture ranged from around 16-24 weeks. 23 patients were treated with ORIF and 7 patients were treated with MIPO technique. Three different principles of fixation were done using the LCP, viz. compression, bridging and combined. Functional outcome was evaluated, which revealed excellent results in 53.33% patients, good results in 30% patients, fair results in 13.33% results, while 3.33% had poor outcomes.Conclusions: Based on the findings of the present study we can conclude that overall Locking Compression plate (LCP) for fractures of the proximal tibia is a useful adjunct in the management of trauma patients. The locking compression plate system with its various type of fixation act as a good biological fixation including difficult fracture situations

Management of comminuted fractures of the shaft of femur by interlocking nailing at a tertiary level hospital in India

Background: Fracture shaft of femur is one of the most common fractures encountered in orthopaedic practice. Fracture shaft of femur is major cause of morbidity and mortality in patients who sustain high energy trauma. This study looks at the epidemiology of patients presenting with femur fracture at a tertiary level hospital in Navi Mumbai.Methods: This prospective study was performed at a tertiary level hospital in Navi Mumbai from January 1, 2014 till July 31, 2015. All patients aged 18 years or above, who presented with comminuted femur fracture and were treated with interlocking nailing was included in the study. Various clinical and radiological parameters were collected during the course of treatment.Results: 50 patients were included in the study; 84% males. 88% aged 50 years or less. Road traffic accident was the most common mode of injury and 54% of patients had fracture in the middle one-third femur. 76% of the patients presented within 24 hours of injury. 52% of the patient’s demonstrated clinical union of the fracture in 12 to 14 weeks and majority showed radiological union in 16 to 18 weeks. Partial weight bearing was started in 36% patients in 10 weeks and full weight bearing in 42% patients in 16 weeks. Majority of the patients stayed in hospital for 10 to 14 days and the functional outcome as measured by Klemm and Borner criteria was excellent in 66% patients. Complications were seen only in 6 patients.Conclusions: In our experience, interlocking nailing had very low complication rate and excellent functional outcome in two thirds patients of comminuted femur fracture

Current state of awareness and safety practices for ionising radiation risks in orthopaedic doctors in Navi Mumbai: an online survey

Background: Radiographic imaging in orthopaedic surgical centers is becoming more common, posing additional risks to the orthopaedic doctors, who become more exposed to ionising irradiation. As a result, orthopaedic surgeons must have a good understanding of radiation hazards. Despite these issues, many orthopaedic specialists do not get basic radiation safety training. A review of orthopaedic specialists' understanding, awareness, and routine radiation safety practices at an academic hospital in Navi Mumbai. Methods: After institutional ethical approval, a panel of experts created an online survey comprising multiple-choice questions, which was utilized to perform a descriptive research. The questionnaire contained several aspects, each of which assessed orthopaedic understanding, awareness, and practices. The research cohort comprised orthopaedic doctors working through our tertiary medical center and medical college. Results: According to our findings, only 82% of respondents were aware of the radiation dangers associated with fluoroscopy. The use of lead aprons, thyroid shields, goggles, and protective caps is 99%, 42%, 25%, and 25%, respectively. Despite the fact that 60% of respondents were aware of TLD badges. Only 23% of those who operate with inosing radiation use TLD badges. Approximately 61% of respondents were ignorant of intermittent fluoroscopy, and 85% utilized the C-arm tube while the device was active. Conclusions: The vast majority of orthopaedic doctors utilise fluoroscopic imagery in the operating room on a daily basis, but they lack in-depth information and awareness about the radiation security hazards connected with this imaging modality. It is consequently advised that a radiation safety training curriculum be implemented

Comparative study of vacuum-assisted closure therapy versus vacuum-assisted closure therapy supplemented with vitamin C in compound wound healing

Background: It is imperative for early and precise management of the compound wound for preventing further complication and delaying definitive management. As we all know superiority of vacuum assisted closure (VAC) therapy in wound management over any other method, but adding vitamin C has been shown to accelerate wound healing, reducing hospital stay, and cost of management and prevention of delaying definitive management of wound due to some conspicuous property of vitamin C that serve as superior adjuvant in wound healing. Methods: A case series of 40 patients who have been inflicted with compound wounds with most following road traffic accidents. We then categorised patients and tried to observe any difference in rate of satisfactorily healing of wound with 20 patients put on VAC therapy alone and other 20 patients put on VAC therapy supplemented with vit C. Results: Patients who were undergoing VAC dressing and supplemented with vitamin C, not only portrayed a better result of wound healing but also reduced the amount of vacuum dressing sittings. Conclusions: It was observed that, in general, patients who were undergoing VAC dressing and supplemented with vitamin C, not only portrayed a better result of wound healing but also reduced amount of vacuum dressing sittings, improved rate of granulation tissue, reduced hospital stay, early definitive fixation of associated fracture and skin grafting and showed superior outcomes in terms of better tissue recovery