Clinical Outcomes of the Ilizarov Method After an Infected Tibial Non Union

Background: The Ilizarov technique has been used in the UK for the last 20 years in the management of infected non-union of long bones. This method uses fine wires inserted percutaneously which are attached and tensioned to provide a strong frame construct. The majority of tibial and femoral non unions can be treated successfully by internal fixation. However, an infected non-union of the tibia can prove a difficult problem. The Ilizarov method can prove useful for treating these complex injuries. Objectives: To assess whether a new limb reconstruction centre in the UK has comparable results. Patients and Methods: Twelve patients (10 M: 2 F; Avg age 43.3 years) who had an infected tibial non-union between March 2009 and August 2010 treated with the Ilizarov technique. Intervention method was Ilizarov technique and main outcome measures include functional and radiological outcomes assessed using the Association for the Study and Application of Methods of Ilizarov (ASAMI) criteria, American Orthopaedic Foot and Ankle Score (AOFAS) and Visual Analogue Pain scores. Results: All twelve patients united. None required amputation. Mean time to union was 46 weeks (range 24 - 70/median 50). The average follow up time was 62 weeks (39 - 164/ median 59). According to the ASAMI score bone/radiological results ten were classed as excellent with the remainder being good. Functionally six were graded as excellent, four as good and two as poor. The average AOFAS score was 83/100 (70 - 90) and pain visual analogue scale (VAS) was two. Conclusions: Our results in terms of ASAMI scores are comparable with the published literature. Furthermore, our return to work is better than most European studies (63%). All our patients said they would have the procedure again. We attribute this success partly to the multidisciplinary approach. We recommend early referral to a dedicated unit if there is any evidence of a non-union

Transcranial direct current stimulation and stroke recovery: opportunities and challenges

Transcranial direct current stimulation (tDCS) is one type of neuromodulation, which is an emerging technology that holds promise for the future studies on therapeutic and diagnosis applications in treatment of neurological and psychiatric diseases. However, there is a serious question among developing countries with limited financial and human resources, about the potential returns of an investment in this field and regarding the best time to transfer this technology from controlled experimental settings to health systems in the public and private sectors. This article reviews the tDCS as tools of neuromodulation for stroke and discusses the opportunities and challenges available for clinicians and researchers interested in advancing neuromodulation therapy. The aim of this review is to highlight the usefulness of tDCS and to generate an interest that will lead to appropriate studies that assess the true clinical value of tDCS for brain diseases in developing countries. Methods: Literature review was done on PubMed from 2016 on neuromodulation in under-developed countries (UDCs) by non-invasive brain stimulation methods, using the key words “stroke”, “rehabilitation”, and “tDCS”. Results: We first identified articles and websites, of which were further selected for extensive analysis mainly based on clinical relevance, study quality and reliability, and date of publication. Conclusion: Despite the promising results obtained with tDCS in basic and clinical neuroscience, further progress has been impeded by a lack of clarity to use in mostly UDCs

Plain film diagnosis in meconium plug syndrome, meconium ileus and neonatal Hirschsprung's disease - A scoring system

Abdominal plain films of 133 neonates, with 82 cases of meconium plug syndrome (MPS), 27 cases of meconium ileus (MI) and 24 cases of neonatal Hirschsprung's disease (HD), were reviewed to assess the value of such radiographs for diagnosis. The radiographs were examined according to a list of 11 parameters. By using multivariate discriminant analysis, it appeared that 4 parameters i.e. dilatation of bowel loops, varying loop calibre, fluid levels and colonic gas were most important in discriminating among the three disorders. For each parameter the weight (in points) was derived. To classify patients, three group-scores had to be calculated: the group-score with the largest value indicated the most likely disorder. So in 99%, 88% and 63% of MPS, HD and MI, respectively, an accurate diagnosis could be predicted. The overall diagnostic accuracy was 89%. Such a diagnosis can be a sound basis for further investigation

3-(4-Bromo­phenyl­sulfon­yl)-8-methyl-1,3-diaza­spiro­[4.5]decane-2,4-dione

The crystal structure of the title compound, C15H17BrN2O4S, is stabilized by inter­molecular N—H⋯O hydrogen bonds which link the mol­ecules into centrosymmetric dimers. The dihedral angle subtended by the 4-bromo­phenyl group with the mean plane passing through the hydantoin unit is 83.29 (5)°. The cyclo­hexyl group adopts an ideal chair conformation with the methyl group in an equatorial position

3-(4-Chloro­phenyl­sulfon­yl)-8-methyl-1,3-diaza­spiro­[4.5]decane-2,4-dione

In the title compound, C15H17ClN2O4S, the atoms in the hydantoin ring are coplanar (r.m.s. deviation = 0.006 Å). The crystal structure is stabilized by inter­molecular N—H⋯O hydrogen bonds which link the mol­ecules into centrosymmetric dimers. The dihedral angle subtended by the 4-chloro­phenyl group with the plane passing through the hydantoin unit is 82.98 (4)°. The cyclo­hexyl ring adopts an ideal chair conformation

Impact of zinc uptake on morphology, physiology and yield attributes of wheat in Pakistan

A pot experiment was conducted in the Old Botanical Garden, University of Agriculture Faisalabad, to assess the effect of zinc uptake on morphological, physiological and yield attributes of wheat (Triticum aestivum L.). Two varieties of wheat, i.e. W-141 and W-142, procured from Ayub Agricultural Research Institute (AARI), Faisalabad, Pakistan, were used during this study. The soil used during experiment was field soil from university fields having sandy loam texture. The experiment was laid out in a completely randomized design (CRD) with five treatments and four replicates. Different treatments of zinc were applied on different intervals. After 25 and 35 days of germination, the plants were subjected to three levels of ZnSO4 (0, 400 mgL-1, 600 mgL-1). During the experiment, the harvests were taken after 10 days of intervals for morphological and physiological analysis. After the maturity of plants, final harvest was taken and yield attributes were recorded. Data of various morphological, physiological and yield attributes were statistically analyzed. The results showed that zinc toxicity had adverse effects on the wheat varieties. The variety W-141 was a little bit tolerant to zinc toxicity, as per shown by the results, as compared to W-142, which suffered by the toxicity of zinc. It was also revealed by the results that zinc affects the morphological, physiological and yield attributes of wheat when applied in toxic concentration

Qualitative and quantitative response of three cultivars of lentil (Lens culinaris Medic) to phosphorous application

ABSTRACT Investigations to see the yield and cooking quality response of three varieties of lentils to phosphorus application were carried out at the University of Agriculture, Faisalabad. Varieties used were local, Masoor-85 and Masoor-93. The phosphorus levels were 0, 25, 50 and 75 kg P 2 O 5 ha -1 . Masoor-93 yielded higher than to other varieties when treated with 50-75-50 kg N, P 2 O 5 , K 2 O ha -1 and the increase in grain yield was attributed to increase in the number of seeds per pod, total seed weight per plant and weight per 1000 grains. Cooking quality was significantly improved with phosphorus application over the control but the varieties were at par with one another in their cooking scores